Existing law requires the State Dental Health Officer to be licensed to practice dentistry in this State. (NRS 439.272) Section 1 of this bill provides that the State Dental Health Officer is not required to be so licensed if he or she: (1) holds an advanced degree in public health or a related field; and (2) has graduated from a dental college or an accredited residency program. (NRS 439.272) Existing law requires the State Public Health Dental Hygienist to be licensed to practice dental hygiene in this State and have an endorsement to practice public health dental hygiene. (NRS 439.279) Section 1.3 of this bill removes a prohibition on the State Public Health Dental Hygienist pursuing an outside business or vocation and instead authorizes the State Public Health Dental Hygienist to pursue an outside business or vocation with the approval of the Division of Public and Behavioral Health of the Department of Health and Human Services. Section 27.5 of this bill authorizes the Board of Dental Examiners of Nevada to issue a limited license as a dentist or dental hygienist, as applicable, to a person who is under contract to serve as the State Dental Health Officer or the State Public Health Dental Hygienist. Section 27.5 prohibits the holder of a limited license from practicing dentistry or dental hygiene, as applicable, outside the scope of his or her service as the State Dental Health Officer or State Public Health Dental Hygienist. Section 39.5 of this bill requires such a limited license to be renewed annually. Sections 39.5, 40.5 and 41.5 of this bill make conforming changes to provide exceptions for a limited license to certain general requirements. Existing law authorizes the Governor to proclaim a state of emergency, declare a disaster or issue an executive order proclaiming a public health emergency or other health event in certain circumstances. (NRS 414.070, 439.970) Sections 10-12 of this bill define certain terms. Section 13 of this bill authorizes the Division of Public and Behavioral Health of the Department of Health and Human Services to issue a permit as a dental responder to a dentist, dental hygienist or dental therapist who has received certain training in emergency response. Section 13 authorizes a dental responder to provide emergency medical care, immunizations, medical care in mobile clinics and humanitarian care during a state of emergency, declaration of disaster, public health emergency or other health event. Section 14 of this bill creates the Committee on Dental Emergency Management within the Division. Section 15 of this bill prescribes certain requirements concerning the operations of the Committee. Sections 15 and 18 of this bill exempt meetings of the Committee held during a state of emergency, declaration of disaster, public health emergency or other health event from requirements that meetings of a public body must be open and public. Section 16 of this bill prescribes the duties of the Committee, which relate to emergency management and the practice of professions that provide dental care. Existing law creates the Committee on Emergency Medical Services, which advises the Division on certain matters relating to emergency management and encourages the training and education of emergency medical service personnel. (NRS 450B.151, 450B.153) Section 17 of this bill requires the State Board of Health to appoint one dental responder to the Committee. Existing law defines the term “provider of health care” as a person who practices any of certain professions related to the provision of health care. (NRS 629.031) Existing law imposes certain requirements upon providers of health care, including requirements for billing, standards for advertisements and criminal penalties for acquiring certain debts. (NRS 629.071, 629.076, 629.078) Section 22 of this bill includes dental hygienists and dental therapists in the definition of “provider of health care,” thereby subjecting dental hygienists and dental therapists to those requirements. Existing law defines the term “telehealth” to mean the delivery of services from a provider of health care to a patient at a different location through the use of information and audio-visual communication technology, not including standard telephone, facsimile or electronic mail. (NRS 629.515) Section 26 of this bill defines the term “teledentistry” to mean the use of telehealth by a dentist, dental hygienist or dental therapist to facilitate the diagnosis, treatment, education, care management and self-management of or consultation with a patient. Sections 24, 25 and 27 of this bill define certain other terms related to teledentistry. Section 36 of this bill makes a conforming change to indicate the placement of sections 24-27 in the Nevada Revised Statutes. Section 28 of this bill requires a person who provides services through teledentistry to a patient located in this State to be licensed in this State as a dentist, dental hygienist or dental therapist. Section 28 also requires a dentist, dental hygienist or dental therapist providing services through teledentistry to adhere to the applicable laws, regulations and standards of care to the same extent as when providing services in person. Section 29 of this bill requires a dentist, dental hygienist or dental therapist who provides services through teledentistry to be insured against liabilities arising from services provided through teledentistry. Section 30 of this bill authorizes the use of teledentistry for certain purposes relating to the provision of a diagnosis or treatment. Section 31 of this bill requires a dentist, dental hygienist or dental therapist to establish a bona fide practitioner-patient relationship, confirm certain facts about a patient and obtain informed consent before providing services through teledentistry. Section 32 of this bill requires a dentist, dental hygienist or dental therapist to: (1) use communications technology that complies with certain federal requirements concerning the privacy of information relating to patients when providing services through teledentistry; and (2) create a complete record of each encounter with a patient through teledentistry. Section 33 of this bill imposes certain requirements to ensure that adequate, in-person care is available to a patient who receives services through teledentistry if needed. Section 34 of this bill requires the Board of Dental Examiners of Nevada to adopt regulations governing teledentistry. Sections 37, 39 and 47 of this bill require an applicant for a license to practice dentistry or dental therapy or a special endorsement to practice public health dental hygiene or the holder of such a license or endorsement to complete certain training concerning teledentistry. Section 38 of this bill makes a conforming change. Section 40 of this bill requires the Board to adopt regulations prescribing specific criteria for the accreditation of a course in teledentistry. Section 35 of this bill prescribes certain requirements concerning the secure electronic storage of information concerning patients. Section 41 of this bill provides that it is unprofessional conduct for a dentist, dental hygienist or dental therapist to: (1) fail to actively involve a patient in decisions concerning his or her treatment; or (2) require a patient to enter into an agreement that restricts the ability of the patient to submit a complaint to the Board. Sections 1.7, 42 and 45 of this bill require hospitals and issuers of Medicaid, including managed care plans, to take certain measures to improve the access of recipients of Medicaid to teledentistry. Sections 42 and 45 of this bill require a health maintenance organization or a managed care organization that provides dental services to recipients of Medicaid to allow providers of teledental services to include on claim forms codes for both real-time interactions and asynchronous transmissions. Sections 2-8 of this bill make conforming changes to indicate the proper placement of section 1.7 in the Nevada Revised Statutes and provide for the enforcement of the requirements of section 1.7. Sections 19-21 of this bill require a public school, private school or child care facility that requires a dental examination, screening or assessment of a child as a condition of admission to accept a dental examination, screening or assessment provided through teledentistry that meets certain criteria for that purpose.

Statutes affected:
As Introduced: 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 450B.151, 241.016, 629.031, 631.005, 631.220, 631.260, 631.287, 631.342, 631.3475, 695C.1708, 695D.240, 695D.270, 695G.162
Reprint 1: 439.272, 439.279, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 450B.151, 241.016, 629.031, 631.005, 631.220, 631.260, 631.287, 631.330, 631.342, 631.345, 631.3475, 631.350, 695C.1708, 695G.162
Reprint 2: 439.272, 439.279, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 450B.151, 241.016, 629.031, 631.005, 631.220, 631.260, 631.287, 631.330, 631.342, 631.345, 631.3475, 631.350, 695C.1708, 695G.162
As Enrolled: 439.272, 439.279, 449.029, 449.0301, 449.089, 449.160, 449.163, 449.220, 449.240, 450B.151, 241.016, 629.031, 631.005, 631.220, 631.260, 631.287, 631.330, 631.342, 631.345, 631.3475, 631.350, 695C.1708, 695G.162