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ARIZONA HOUSE OF REPRESENTATIVESFifty-seventh Legislature First Regular Session |
House: HHS DP 7-5-0-0 |
HB 2190: dentists; dental hygienists; compact
Sponsor: Representative Bliss, LD 1
House Engrossed
Overview
Adopts the Dentists and Dental Hygienists Compact (Compact) which enables dentists and dental hygienists living in a participating state to obtain Compact privilege that authorizes them to practice in another participating state in which they are not licensed.
History
Arizona State Board of Dental Examiners (Board) regulates and licenses dental professionals, including dentists, dental hygienists, dental consultants, dental therapists and denturists. Additionally, the Board reviews complaints against licensees and business entities, conducts investigations and is authorized to take disciplinary action for violations of state laws relating to the profession (Title 32, Chapter 11).
Dentistry or dentist means the general practice of dentistry and all specialties or restricted practices of dentistry. A dental hygienist is any person who is licensed and engaged in the general practice of dental hygiene and all related and associated duties, including educational, clinical and therapeutic dental hygiene procedures (A.R.S. § 32-1201).
The Council of State Governments is partnering with the Department of Defense, the American Dental Association and the American Dental Hygienists’ Association to support the mobility of licensed dentists and dental hygienists through the development of a new interstate compact. There are currently 10 states that have adopted the Compact, including Washington, Colorado, Kansas, Minnesota, Iowa, Wisconsin, Ohio, Tennessee, Virginia and Maine (Compact Map).
Provisions
Compact Purpose
1. Declares the purpose of the Compact is to facilitate the interstate practice of dentistry and dental hygiene and improve public access to dentistry and dental hygiene services by providing dentists and dental hygienists who are licensed in a participating state with the ability to practice in other participating states in which they are not licensed. (Sec. 1)
2. States that the Compact does this by establishing a pathway for dentists and dental hygienists living in a participating state to obtain Compact privilege that authorizes them to practice in another participating state in which they are not licensed. (Sec. 1)
3. States this Compact enables participating states to protect the public, health and safety, with respect to the practice of such dentists and dental hygienists, through the state's authority to regulate the practice of dentistry and dental hygiene in Arizona. (Sec. 1)
4. Lists Compact objectives and defines terms. (Sec. 1)
State Participation in the Compact
5. Requires a participating state to do all the following:
a) enact a Compact that is not materially different from the model Compact as determined in accordance with Commission rules;
b) participate fully in the Commission's data system;
c) have a mechanism in place for receiving and investigating complaints about its licensees and license applicants;
d) notify the Commission, in compliance with Compact terms and Commission rules, of any adverse action or the availability of significant investigative information regarding a licensee or license applicant;
e) fully implement a criminal background check requirement, within a timeframe established by Commission rule, by receiving the results of a qualifying criminal background check;
f) comply with the Commission rules applicable to a participating state;
g) accept the national board examinations of the Joint Commission on National Dental Examinations or another examination accepted by Commission rule as a licensure examination;
h) require for licensure that applicants successfully complete a clinical assessment;
i) have continuing professional development requirements as a condition for license renewal;
j) pay a participation fee to the Commission as established by rule;
k) accept for licensure that applicants for a dentist license graduate from a predoctoral dental education program accredited by the Commission on Dental Accreditation, or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs, leading to a Doctor of Dental Surgery or a Doctor of Dental Medicine degree; and
l) accept for licensure that applicants for a dental hygienist license graduate from a dental hygiene education program accredited by the Commission on Dental Accreditation or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs. (Sec. 1)
6. Specifies that providing alternative pathways for an individual to obtain an unrestricted license does not disqualify a state from participating in the Compact. (Sec. 1)
7. Requires the state licensing authority, when conducting a criminal background check, to:
a) consider that information in making a licensure decision;
b) maintain documentation of completion of the criminal background check and background check information to the extent allowed by state and federal law; and
c) report to the Commission whether the state licensing authority has completed the criminal background check and whether the individual was granted or denied a license. (Sec. 1)
8. Grants Compact privilege to a licensee of a participating state who has a qualifying license in that state and does not hold an encumbered license in a remote state in accordance with the terms of this Compact and Commission rules. (Sec. 1)
9. Stipulates that if a remote state has a jurisprudence requirement, a Compact privilege will not be issued to the licensee unless the licensee has satisfied the requirement. (Sec. 1)
Compact Privilege
10. Outlines the terms for a licensee to obtain Compact privilege as follows:
a) have a qualifying license as a dentist or dental hygienists in a participating state;
b) be eligible for a Compact privilege in any remote state in accordance with the Compact requirements;
c) submit to an application process whenever the licensee is seeking a Compact privilege;
d) pay any applicable Commission and remote state fees for a Compact privilege;
e) meet any jurisprudence requirement established by a remote state in which the licensee is seeking a Compact privilege;
f) have passed a national board examination of the Joint Commission on National Dental Examinations or another examination accepted by Commission rule;
g) for a dentists, have graduated from a predoctoral dental education program accredited by the Commission on Dental Accreditation, or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs, leading to a Doctor of Dental Surgery or Doctor of Dental Medicine degree;
h) for a dental hygienist, have graduated from a dental hygiene education program accredited by the Commission on Dental Accreditation or another accrediting agency recognized by the United States Department of Education for the accreditation of dentistry and dental hygiene education programs;
i) have successfully completed a clinical assessment for licensure;
j) report to the Commission any adverse action taken by a nonparticipating state when applying for a Compact privilege and otherwise within 30 days after the date the adverse action is taken;
k) report to the Commission when applying for a Compact privilege the address of the licensee's primary residence and thereafter immediately report to the Commission any address change; and
l) consent to accept service of process by mail at the licensee's primary residence on record with the Commission with respect to any action brought against the licensee by the Commission or a participating state and consent to accept service of a subpoena by mail at the licensee's primary residence on record with the Commission with respect to any action brought or investigation conducted by the Commission or participating state. (Sec. 1)
11. Requires a licensee to comply with all Compact privilege requirements to maintain the privilege in the remote state. (Sec. 1)
12. Specifies that the Compact privilege will continue as long as the licensee maintains a qualifying license through which the licensee applied for the Compact privilege and pays any applicable renewal fees and meets all requirements. (Sec. 1)
13. Asserts that a licensee who provides dentistry or dental hygiene services in a remote state under the Compact privilege must function within the scope of practice authorized by the remote state. (Sec. 1)
14. Subjects a licensee who provides dentistry or dental hygiene services pursuant to a Compact privilege in a remote state to the state's regulatory authority. (Sec. 1)
15. Allows a remote state, in accordance with due process and that state's laws, by adverse action to revoke or remove a licensee's Compact privilege in the remote state for a specific period of time, impose fines or take any other necessary action to protect the health and safety of its citizens. (Sec. 1)
16. Specifies that if a remote state imposes an adverse action against a Compact privilege that limits the Compact privilege that adverse action applies to all Compact privileges in all remote states. (Sec. 1)
17. Makes a licensee whose Compact privilege in a remote state is removed for a specified period ineligible for a Compact privilege in any other remote state until the specific time for removal of the Compact privilege has passed and all encumbrance requirements are satisfied. (Sec. 1)
18. Specifies that if a licensee in a participating state is an encumbered license, the licensee must lose the Compact privilege in a remote state and is ineligible for a Compact privilege in any remote state until the license is no longer encumbered. (Sec. 1)
19. Requires a licensee to meet the Compact privilege requirements to obtain the privilege in a remote state once an encumbered license in a participating state is restored to good standing. (Sec. 1)
20. States that if a licensee's Compact privilege in a remote state is removed by the remote state, the individual will loose or be ineligible for the Compact privilege in any remote state until both of the following occur:
a) the specific period for which the Compact privilege was removed has ended; and
b) all conditions for removal of the Compact privilege have been satisfied. (Sec. 1)
21. Prohibits an active military member and their spouse from being required to pay a fee to the Commission for Compact privilege. (Sec. 1)
22. States that if a remote state chooses to charge a fee for Compact privilege, it may choose to charge a reduced fee or no fee to an active military member and their spouse. (Sec. 1)
Adverse Actions
23. Declares a participating state in which a licensee is licensed to have exclusive authority to impose adverse action against the qualifying license issued by that participating state. (Sec. 1)
24. Allows a participating state to take adverse action based on the significant investigative information of a remote state so long as the participating state follows its own procedures for imposing adverse action. (Sec. 1)
25. States this Compact does not override a participating state's decision that participation in an alternative program may be used in lieu of adverse action and that such participation must remain nonpublic if required by the participating state's laws. (Sec. 1)
26. Directs participating states to require licensees who enter any alternative program in lieu of discipline to agree not to practice pursuant to Compact privilege in any other participating state during the term of the alternative program without prior authorization from such other participating state. (Sec. 1)
27. Allows any participating state in which a licensee is applying to practice or is practicing pursuant to Compact privilege to investigate actual or alleged violation of the statutes and rules authorizing the practice of dentistry or dental hygiene in any other participating state in which the dentist or dental hygienists hold a license or Compact privilege. (Sec. 1)
28. Outlines the authority a remote state can take regarding adverse actions and joint investigations for dentists and dental hygienists practicing under a Compact privilege. (Sec. 1)
29. Requires subpoenas issued by a state licensing authority in a participating state for the attendance and testimony of witness or the production of evidence from another participating state to be enforced in the latter state by any court of competent jurisdiction according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. (Sec. 1)
30. Requires the issuing authority to pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state where the witness or evidence is located. (Sec. 1)
31. Permits a remote state, after a licensee's Compact Privilege is terminated, to continue an investigation of a licensee that began when the licensee had a Compact privilege in that remote state. (Sec. 1)
32. States that if an investigation yields what would be significant investigative information had the licensee continued to have a Compact privilege in that remote state, the remote state must report the presence of such information to the Data system as if it were significant investigative information. (Sec. 1)
Establishment and Operation of the Commission
33. Creates and establishes a joint government agency whose membership consists of all participating states that have enacted the Compact. (Sec. 1)
34. States that the Commission is an instrumentality of the participating states acting jointly and not an instrumentality of any one state. (Sec. 1)
35. Requires the Commission to come into existence on or after the effective date of this Compact. (Sec. 1)
36. Establishes the powers and duties of the Commission. (Sec. 1)
37. Outlines participating, voting and meeting procedures for the Commission. (Sec. 1)
38. Requires all meetings of the Commission that are not closed to be open to the public. (Sec. 1)
39. Requires notice of public meeting to be posted on the Commission's website at least 30 days before the public meeting. (Sec. 1)
40. Allows the Commission to convene an emergency public meeting by providing at least 24-hour prior notice on its website and by any other means provided in Commission rules. (Sec. 1)
41. Lists the type of information that the Commission can receive legal advice on or discuss in a closed and nonpublic meeting. (Sec. 1)
42. Requires the presiding officer to state that the meeting will be closed and reference each relevant exemption, including in the minutes, if a meeting or portion of a meeting is closed. (Sec. 1)
43. Requires the Commission to keep minutes that fully and clearly describe all matters discussed in a meeting and provide a full and accurate summary of actions taken and the reasons therefore, including a description of the views expressed. (Sec. 1)
44. Subjects all minutes and documents of a closed meeting under seal and release only by a majority vote of the Commission or order of a court of competent jurisdiction. (Sec. 1)
45. Outlines financing of the Commission as follows:
a) the Commission must pay or provide for the payment of the reasonable expenses of its establishment, organization and ongoing activities;
b) the Commission may accept any appropriate source of revenue, donation and grant of monies, equipment, supplies, materials and services;
c) the Commission may levy on and collect an annual assessment from each participating state and impose fees on licenses of participating states when a Compact privilege is granted to cover the costs of the operations, activities of the Commission and its staff;
d) the Commission is prohibited from incurring obligations of any kind before securing the monies adequate to meet the obligations and pledging the credit of any participating state except by and with the authority of the participating state; and
e) the Commission must keep accurate accounts of all of its receipts disbursements, which are subject to the financial review and accounting procedures established under its bylaws. (Sec. 1)
46. Requires the Executive Board to have the power to act on behalf of the Commission according to the terms of the Compact, which include:
a) overseeing the day-to-day activities of administering this Compact, including Compact compliance, Commission rules and bylaws;
b) recommending to the Commission changes to the rules or bylaws;
c) ensuring that Compact administration services are appropriately provided;
d) preparing and recommending the budget;
e) maintain financial records on behalf of the Commission;
f) monitoring Compact compliance of participating states and providing compliance reports to the Commission;
g) establishing additional committees as necessary;
h) exercising the powers and duties of the Commission during the interim between Commission meetings; and
i) performing any other duty as provided in the Commission's rules or bylaws. (Sec. 1)
47. Requires the Executive Board to be composed of seven members as follows:
a) the chairperson, vice chairperson, secretary and treasurer of the Commission and any other voting members of the Executive Board; and
b) other than the chairperson, vice chairperson, secretary and treasurer, the Commission may elect up to three voting members from the current membership of the Commission. (Sec. 1)
48. Allows the Commission to remove any member of the Executive Board as provided in the Commission's bylaws. (Sec. 1)
49. Establishes procedures and notice requirements for annual Executive Board meetings. (Sec. 1)
50. Allows the Executive Board to hold an emergency meeting when acting for the Commission to do any of the following:
a) meet an imminent threat to public health, safety or welfare;
b) prevent a loss of Commission or participating state monies; or
c) protect public health and safety. (Sec. 1)
51. Outlines immunity, defense and indemnification requirements and procedures. (Sec. 1)
Data System
52. Requires the Commission to provide for the development, maintenance, operation and utilization of a coordinated database and reporting system containing licensure, adverse action and the presence of significant investigative information on all licensees and applicants for a license in participating states. (Sec. 1)
53. Requires a participating state to submit a uniform data set to the data system on all applicable individuals as required by Commission rules, including all the following:
a) identifying information;
b) licensure data;
c) adverse actions against licensees, applicants or Compact privilege holders;
d) nonconfidential information related to alternative program participation;
e) any denial of an application for licensure and the reasons for such denial;
f) the presence of significant investigative information; and
g) other information that may facilitate the administration of this Compact or the protection of the public as determined by Commission rules. (Sec. 1)
54. Requires the records and information provided to a participating state pursuant to this Compact or through the data system, when certified by the Commission or an agent thereof to constitute the authenticated business records of the Commission and be entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceeding in a participating state. (Sec. 1)
55. Requires significant investigate information pertaining to a licensee in any participating state to be available only to other participating states. (Sec. 1)
56. Makes it the responsibility of the participating states to monitor the database to determine whether adverse action has been taken against a licensee or license applicant. (Sec. 1)
57. Requires adverse action information pertaining to a licensee or license applicant in any participating state to be available only to other participating states. (Sec. 1)
58. Enables participating states contributing information to the data system to designate information that may not be shared with the public without the express permission of the contributing state. (Sec. 1)
59. Requires any information submitted to the data system that is subsequently expunged pursuant to federal law or the laws of the participating state contributing the information to be removed from the data system. (Sec. 1)
Rulemaking
60. Requires the Commission to adopt reasonable rules to implement and administer the purposes and provisions of this Compact effectively and efficiently. (Sec. 1)
61. Requires a Commission rule to be invalid and have no force or effect only if a court of competent jurisdiction holds that the rule is invalid because the Commission exercised its rulemaking authority in a manner that is beyond the scope and purposes of this Compact, or the powers granted hereunder or based on another applicable standard of review. (Sec. 1)
62. Requires the rules of the Commission to have the force of law in each participating state, provided however that where the rules of the Commission conflict with the laws of that participating state that establish the participating state's scope of practice as held by a court of competent jurisdiction, the rules will be ineffective in that state to the extent of the conflict. (Sec. 1)
63. Requires the Commission to exercise its rulemaking powers pursuant to the criteria set forth by this Compact and rules adopted by the Commission. (Sec. 1)
64. States that rules become binding as of the date specified by the Commission for each rule. (Sec. 1)
65. States that if a majority of legislatures of participating state's reject a Commission rule or portion of a Commission rule by enacting a statute or resolution in the same manner used to adopt this Compact, within four years after the date of adoption of the rule, the rule must have no further force and effect in any participating state or to any state applying to participate in this Compact. (Sec. 1)
66. Requires rules to be adopted at a regular or special meeting of the Commission. (Sec. 1)
67. Requires the Commission, before adopting a proposed rule, to hold a public hearing and allow persons to provide oral and written comments, data, facts, opinions and arguments. (Sec. 1)
68. Requires the Commission, before adopting a proposed rule and at least 30 days before meeting, to provide a notice of proposed rulemaking:
a) on the website of the Commission or other publicly accessible platform;
b) to persons who have requested notice of the Commission's notices of proposed rulemaking; and
c) in any other way the Commission may by rule specify. (Sec. 1)
69. Outlines what the notice of proposed rulemaking must include. (Sec. 1)
70. Requires all hearings to be recorded and a copy of the recording, all written comments and documents received by the Commission in response to a proposed rule to be made available to the public. (Sec. 1)
71. Requires the Commission, by majority vote of all commissioners, to take final action on a proposed rule based on the rulemaking record as follows:
a) the Commission may adopt changes to the proposed rule if the changes do not enlarge the original purpose of the proposed rule;
b) the Commission must provide an explanation of the reasons for substantive changes made to the proposed rule as well as reasons for substantive changes made to the proposed rule not made that were recommended by commenters; and
c) the Commission must determine a reasonable effective date for the rule. (Sec. 1)
72. Establishes criteria, processes and procedures for the Commission when considering and adopting an emergency rule. (Sec. 1)
73. States that a participating state's rulemaking requirements do not apply to the Compact. (Sec. 1)
Oversight, Dispute Resolution and Enforcement
74. Requires the executive and judicial branches of state government in each participating state to enforce this Compact and take all actions necessary and appropriate to implement the Compact. (Sec. 1)
75. Requires the venue to be proper and judicial proceedings by or against the Commission be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. (Sec. 1)
76. Allows the Commission to waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings. (Sec. 1)
77. Clarifies that this does not affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice, misconduct or any such similar matter. (Sec. 1)
78. Requires the Commission to be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the Compact or Commission rule and have standing to intervene in such a proceeding for all purposes. (Sec. 1)
79. Deems failure to provide the Commission service of process must render a judgement or order void as to the Commission, this Compact or adopted rules. (Sec. 1)
80. Prescribes requirements for default, technical assistance and termination procedures. (Sec. 1)
81. Makes a state that has been terminated responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination. (Sec. 1)
82. Requires a terminated state to immediately provide notice to all licensees of the state, including licensees of other participating states that were issued Compact privilege to practice within that state. (Sec. 1)
83. Requires the terminated state to continue to recognize all Compact privileges for a minimum of 180 days after the date of the notice of termination. (Sec. 1)
84. Prohibits the Commission from bearing any costs related to a state that is found in default or that has been terminated from the Compact, unless agreed on in writing between the Commission and defaulting state. (Sec. 1)
85. Allows a defaulting state to appeal the action of the Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices. (Sec. 1)
86. Requires the prevailing party to be awarded all costs of such litigation, including reasonable attorney fees. (Sec. 1)
87. Describes dispute resolution and enforcement procedures. (Sec. 1)
Effective Date, Withdrawal and Amendment
88. Declares the Compact effective on the date on which the Compact statute is enacted into law by the seventh member state. (Sec. 1)
89. Requires the Commission to convene and review the enactment of each of the states that enacted this Compact before the Commission convening to determine whether the statute enacted by each such charter participating state is materially different than the model Compact as outlined. (Sec. 1)
90. Makes participating states enacting the Compact subsequent to the charter participating states subject to the process set forth in the Compact to determine whether their enactments are materially different from the model Compact and whether they qualify for participation. (Sec. 1)
91. Declares all actions taken for the benefit of the Commission or in furtherance of the purposes of the administration of this Compact before the effective date of this Compact or the Commission coming into existence to be considered to be actions of the Commission unless specifically repudiated by the Commission. (Sec. 1)
92. Subjects any state that joins this Compact subsequent to the Commission's initial adoption of the rules and bylaws to the Commission's rules and bylaws as they exist on the date on which this Compact becomes law in that state. (Sec. 1)
93. Declares any rule that has been previously adopted by the Commission to have the full force and effect of law on the day this Compact becomes law in that state. (Sec. 1)
94. Allows any participating state to withdraw from the Compact by enacting a statute repealing that state's enactment as follows:
a) a participating state's withdrawal is prohibited from taking effect until 180 days after enactment of the repealing statute; and
b) withdrawals are prohibited from affecting the continuing requirement of the withdrawing state's licensing authority or authorities to comply with the investigative and adverse action reporting requirements of this Compact before the effective date of withdrawal. (Sec. 1)
95. Requires a state, on the enactment of a statute withdrawing from the Compact, to immediately provide notice of such withdrawal to all licensees within that state. (Sec. 1)
96. Stipulates that this Compact does not invalidate or prevent any licensure agreement or other cooperative arrangement between a participating state and a nonparticipating state that does not conflict with the provisions of this Compact. (Sec. 1)
97. Allows the Compact to be amended by the participating states and the Compact amendment does not become effective and binding on any participating state until the amendment is enacted into the laws of all participating states. (Sec. 1)
Construction and Severability
98. Requires the Compact and the Commission's rulemaking authority to be liberally construed to effectuate the Compact's purposes, implementation and administration. (Sec. 1)
99. Requires the provisions of the Compact to be severable. (Sec. 1)
100. Asserts that, if any phrase, clause, sentence or provision of the Compact is declared to be contrary to the constitution of a member state, a state seeking Compact membership or the United States, the validity of the remainder of the Compact and the applicability to any government, agency, person or circumstance is not affected. (Sec. 1)
101. Allows the Commission to deny a state's participation in the Compact or terminate a member state's participation if it determines that a state constitutional requirement is a material departure from the Compact. (Sec. 1)
102. Specifies that, if the Compact is held to be contrary to the constitution of a member state, the Compact remains in full force and effect in:
a) the remaining member states; and
b) the affected member state as to all severable matters. (Sec. 1)
Consistent Effect and Conflict with Other State Laws
103. Clarifies that the Compact does not prevent or inhibit the enforcement of any other law of a member state that is not inconsistent with the Compact. (Sec. 1)
104. States that any laws, statutes, regulations or other legal requirements of a member state that are in conflict with the Compact are superseded to the extent of the conflict. (Sec. 1)
105. Specifies that all agreements between the Commission and member states are binding in accordance with their terms. (Sec. 1)
106. Cites this act as the Dental and Dental Hygienists Compact. (Sec. 1)
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