2021 - 2022 LEGISLATURE
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2021 SENATE BILL 181
March 9, 2021 - Introduced by Senators FELZKOWSKI, BERNIER, DARLING, KOOYENGA,
PFAFF, RINGHAND, STAFSHOLT, STROEBEL and L. TAYLOR, cosponsored by
Representatives PLUMER, ARMSTRONG, BALDEH, BROOKS, CALLAHAN, DITTRICH,
DUCHOW, GUNDRUM, KRUG, MAGNAFICI, MOSES, MURSAU, L. MYERS, NEYLON,
RAMTHUN, J. RODRIGUEZ, ROZAR, SCHRAA, SKOWRONSKI, SNYDER, SPIROS,
TAUCHEN and ZIMMERMAN. Referred to Committee on Insurance, Licensing and
Forestry.
1 AN ACT to amend 15.405 (6) (b), 36.61 (1) (b), 36.61 (3) (a), 36.61 (5) (b) 1., 36.61
2 (8) (c) 3., 146.81 (1) (c), 146.89 (1) (r) 1., 146.89 (1) (r) 5., 146.89 (3) (b) 8., 146.89
3 (3m) (intro.), 146.997 (1) (d) 3., 155.01 (7), 252.14 (1) (ar) 3., 257.01 (5) (a), 257.01
4 (5) (b), 447.02 (1) (a), 447.02 (1) (b), 447.02 (2) (a), 447.02 (3) (a) (intro.), 447.02
5 (3) (a) 2., 447.02 (3) (b), 447.02 (5), 447.03 (3) (c), 447.05, 447.06 (1), 447.06 (2)
6 (a) 3., 447.06 (2) (b), 447.06 (2) (c) (intro.), 447.06 (2) (c) 2. (intro.), 447.063,
7 447.065, 447.07 (1), 447.07 (3) (intro.), 447.07 (3) (e) to (h), 447.40 (intro.),
8 447.40 (6), 448.03 (2) (a), 448.21 (1) (a), 450.03 (1) (e), 450.10 (3) (a) 4., 462.02
9 (2) (d), 462.04, 463.10 (5), 463.12 (5), 632.87 (4), 895.48 (1m) (a) (intro.), 895.48
10 (1m) (a) 2. and 941.315 (5); and to create 36.61 (1) (ak), 440.03 (13) (b) 20m.,
11 440.08 (2) (a) 25m., 447.01 (6g), 447.01 (6r), 447.02 (1) (g), 447.02 (3) (a) 3.,
12 447.02 (6), 447.03 (1m), 447.03 (3) (am), 447.04 (1m), 447.057, 447.06 (1m) and
13 447.06 (3) of the statutes; relating to: licensure of dental therapists; extending
14 the time limit for emergency rule procedures; providing an exemption from
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SENATE BILL 181
1 emergency rule procedures; providing an exemption from rule-making
2 procedures; and granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill provides for the licensure of dental therapists, who are health care
practitioners who may engage in the limited practice of dentistry.
Under current law, dentists and dental hygienists are licensed by the Dentistry
Examining Board to practice dentistry and dental hygiene, respectively. This bill
provides for the licensure of a third type of dental practitioner, dental therapists.
Under the bill, the board must grant a dental therapist license to an individual who
satisfies certain criteria, including completion of an approved dental therapy
program and passage of required examinations.
Dental therapists may provide dental therapy services only under the
supervision of a dentist with whom the dental therapist has a collaborative
management agreement that addresses various aspects of the dental therapist's
practice. Dental therapists are, subject to the terms of a collaborative management
agreement and what was covered in their dental therapy education program, limited
to providing services, treatments, and procedures that are specified in the bill, as
well as additional services, treatments, or procedures specified by the board by rule.
Dental therapists may initially provide dental therapy services only under the direct
or indirect supervision of a qualifying dentist. Once a dental therapist licensed has
provided dental therapy services for at least 2,000 hours, the dental therapist may
provide services under the general supervision of a qualifying dentist. However, the
level of supervision for a dental therapist may be further limited under the terms of
a collaborative management agreement. Dental therapists must also, under the bill,
either 1) limit their practice to federally defined dental shortage areas or 2) practice
in settings where at least 50 percent of their patient base consists of certain specified
populations. Dental therapists must complete 12 hours of continuing education each
biennium.
The bill subjects dental therapists to, or covers dental therapists under, various
other laws, including the health care records law, the volunteer health care provider
program, the health care worker protection law, and the emergency volunteer health
care practitioner law. The bill also provides for loan forgiveness for dental therapists
under the health care provider loan assistance program.
Finally, the bill requires, effective when 50 individuals become licensed as a
dental therapist in this state or five years after the bill is enacted, that, to the extent
possible, one of the dental hygienist members on the board also be licensed as a
dental therapist.
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SENATE BILL 181
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
1 SECTION 1. 15.405 (6) (b) of the statutes is amended to read:
2 15.405 (6) (b) Three dental hygienists who are licensed under ch. 447. The
3 governor shall, to the extent possible, appoint members under this paragraph so that
4 at least one of the members under this paragraph is an individual who is also a dental
5 therapist licensed under ch. 447. Notwithstanding s. 15.08 (1m) (a), the dental
6 hygienist members under this paragraph may participate in the preparation and
7 grading of licensing examinations for dental hygienists.
8 SECTION 2. 36.61 (1) (ak) of the statutes is created to read:
9 36.61 (1) (ak) “Dental therapist” means an individual licensed under s. 447.04
10 (1m).
11 SECTION 3. 36.61 (1) (b) of the statutes is amended to read:
12 36.61 (1) (b) “Health care provider" means a dental therapist, dental hygienist,
13 physician assistant, nurse-midwife, or nurse practitioner.
14 SECTION 4. 36.61 (3) (a) of the statutes is amended to read:
15 36.61 (3) (a) The board shall enter into a written agreement with the health
16 care provider. In the agreement, the health care provider shall agree to practice at
17 least 32 clinic hours per week for 3 years in one or more eligible practice areas in this
18 state or in a rural area, except that a health care provider in the expanded loan
19 assistance program under sub. (8) who is not a dental therapist or dental hygienist
20 may only agree to practice at a public or private nonprofit entity in a health
21 professional shortage area.
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SENATE BILL 181 SECTION 5
1 SECTION 5. 36.61 (5) (b) 1. of the statutes is amended to read:
2 36.61 (5) (b) 1. The degree to which there is an extremely high need for medical
3 care in the eligible practice area, health professional shortage area, or rural area in
4 which an eligible applicant who is not a dental therapist or dental hygienist desires
5 to practice and the degree to which there is an extremely high need for dental care
6 in the dental health shortage area or rural area in which an eligible applicant who
7 is a dental therapist or dental hygienist desires to practice.
8 SECTION 6. 36.61 (8) (c) 3. of the statutes is amended to read:
9 36.61 (8) (c) 3. Practice at a public or private nonprofit entity in a health
10 professional shortage area, if the health care provider is not a dental therapist or
11 dental hygienist, or in a dental health shortage area, if the health care provider is
12 a dental therapist or dental hygienist.
13 SECTION 7. 146.81 (1) (c) of the statutes is amended to read:
14 146.81 (1) (c) A dentist or dental therapist licensed under ch. 447.
15 SECTION 8. 146.89 (1) (r) 1. of the statutes is amended to read:
16 146.89 (1) (r) 1. Licensed as a physician under ch. 448, a dentist, dental
17 therapist, or dental hygienist under ch. 447, a registered nurse, practical nurse, or
18 nurse-midwife under ch. 441, an optometrist under ch. 449, a physician assistant
19 under ch. 448, a pharmacist under ch. 450, a chiropractor under ch. 446, a podiatrist
20 under subch. IV of ch. 448, or a physical therapist under subch. III of ch. 448.
21 SECTION 9. 146.89 (1) (r) 5. of the statutes is amended to read:
22 146.89 (1) (r) 5. An individual who holds a valid, unexpired license,
23 certification, or registration issued by another state or territory that authorizes or
24 qualifies the individual to perform acts that are substantially the same as those acts
25 that an individual who is described in subds. 1. to 4., except a dentist, dental
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SENATE BILL 181 SECTION 9
1 therapist, or dental hygienist, is licensed or certified to perform and who performs
2 acts that are within the scope of that license, certification, or registration.
3 SECTION 10. 146.89 (3) (b) 8. of the statutes is amended to read:
4 146.89 (3) (b) 8. Dental services, including tooth extractions and other
5 procedures done under local anesthesia only and any necessary suturing related to
6 the extractions, performed by a dentist or dental therapist who is a volunteer health
7 provider; and dental hygiene services, performed by a dental hygienist who is a
8 volunteer health provider.
9 SECTION 11. 146.89 (3m) (intro.) of the statutes is amended to read:
10 146.89 (3m) (intro.) A volunteer health care provider who is a dentist or dental
11 therapist may provide dental services or a volunteer health care provider who is a
12 dental hygienist may provide dental hygiene services, to persons who are recipients
13 of Medical Assistance, if all of the following apply:
14 SECTION 12. 146.997 (1) (d) 3. of the statutes is amended to read:
15 146.997 (1) (d) 3. A dentist or dental therapist licensed under ch. 447.
16 SECTION 13. 155.01 (7) of the statutes is amended to read:
17 155.01 (7) “Health care provider" means a nurse licensed or permitted under
18 ch. 441, a chiropractor licensed under ch. 446, a dentist or dental therapist licensed
19 under ch. 447, a physician, physician assistant, perfusionist, podiatrist, physical
20 therapist, physical therapist assistant, occupational therapist, or occupational
21 therapy assistant licensed under ch. 448, a person practicing Christian Science
22 treatment, an optometrist licensed under ch. 449, a psychologist licensed under ch.
23 455, a physical therapist or physical therapist assistant who holds a compact
24 privilege under subch. IX of ch. 448, a partnership thereof, a corporation or limited
25 liability company thereof that provides health care services, a cooperative health
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SENATE BILL 181 SECTION 13
1 care association organized under s. 185.981 that directly provides services through
2 salaried employees in its own facility, or a home health agency, as defined in s. 50.49
3 (1) (a).
4 SECTION 14. 252.14 (1) (ar) 3. of the statutes is amended to read:
5 252.14 (1) (ar) 3. A dentist or dental therapist licensed under ch. 447.
6 SECTION 15. 257.01 (5) (a) of the statutes is amended to read:
7 257.01 (5) (a) An individual who is licensed as a physician, a physician
8 assistant, or a podiatrist under ch. 448, licensed as a registered nurse, licensed
9 practical nurse, or nurse-midwife under ch. 441, licensed as a dentist or dental
10 therapist under ch. 447, licensed as a pharmacist under ch. 450, licensed as a
11 veterinarian or certified as a veterinary technician under ch. 89, or certified as a
12 respiratory care practitioner under ch. 448.
13 SECTION 16. 257.01 (5) (b) of the statutes is amended to read:
14 257.01 (5) (b) An individual who was at any time within the previous 10 years,
15 but is not currently, licensed as a physician, a physician assistant, or a podiatrist
16 under ch. 448, licensed as a registered nurse, licensed practical nurse or
17 nurse-midwife, under ch. 441, licensed as a dentist or dental therapist under ch. 447,
18 licensed as a pharmacist under ch. 450, licensed as a veterinarian or certified as a
19 veterinary technician under ch. 89, or certified as a respiratory care practitioner
20 under ch. 448, if the individual's license or certification was never revoked, limited,
21 suspended, or denied renewal.
22 SECTION 17. 440.03 (13) (b) 20m. of the statutes is created to read:
23 440.03 (13) (b) 20m. Dental therapist.
24 SECTION 18. 440.08 (2) (a) 25m. of the statutes is created to read:
25 440.08 (2) (a) 25m. Dental therapist: October 1 of each odd-numbered year.
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SENATE BILL 181 SECTION 19
1 SECTION 19. 447.01 (6g) of the statutes is created to read:
2 447.01 (6g) “Dental therapist” means an individual who practices dental
3 therapy.
4 SECTION 20. 447.01 (6r) of the statutes is created to read:
5 447.01 (6r) “Dental therapy” means the limited practice of dentistry, consisting
6 of the services, treatments, and procedures specified in s. 447.06 (3) (b).
7 SECTION 21. 447.02 (1) (a) of the statutes is amended to read:
8 447.02 (1) (a) Governing the reexamination of an applicant who fails an
9 examination specified in s. 447.04 (1) (a) 5., (1m) (e), or (2) (a) 5. The rules may specify
10 additional educational requirements for those applicants and may specify the
11 number of times an applicant may be examined.
12 SECTION 22. 447.02 (1) (b) of the statutes is amended to read:
13 447.02 (1) (b) Governing the standards and conditions for the use of radiation
14 and ionizing equipment in the practice of dentistry or dental therapy.
15 SECTION 23. 447.02 (1) (g) of the statutes is created to read:
16 447.02 (1) (g) Specifying services, treatments, or procedures, in addition to
17 those specified under s. 447.06 (3) (b) 1. to 27., that are included within the practice
18 of dental therapy.
19 SECTION 24. 447.02 (2) (a) of the statutes is amended to read:
20 447.02 (2) (a) The conditions for supervision and the degree of supervision
21 required under ss. 447.03 (3) (a), (am), (b) and (d) 2. and 447.065.
22 SECTION 25. 447.02 (3) (a) (intro.) of the statutes is amended to read:
23 447.02 (3) (a) (intro.) The examining board may issue a permit authorizing the
24 practice in this state, without compensation, of dentistry, dental therapy, or dental
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SENATE BILL 181 SECTION 25
1 hygiene to an applicant who is licensed to practice dentistry, dental therapy, or dental
2 hygiene in another state, if all of the following apply:
3 SECTION 26. 447.02 (3) (a) 2. of the statutes is amended to read:
4 447.02 (3) (a) 2. The examining board determines that the applicant is qualified
5 and satisfies the criteria specified under s. 447.04 (1) (b) 1. to 3., except that the
6 examining board may not require the applicant to pass an examination of state
7 statutes and rules relating to dentistry, dental therapy, or dental hygiene.
8 SECTION 27. 447.02 (3) (a) 3. of the statutes is created to read:
9 447.02 (3) (a) 3. If the applicant is applying for a permit to practice dental
10 therapy, the applicant graduated from a dental therapy education program approved
11 under s. 447.04 (1m) (c) 1. to 3.
12 SECTION 28. 447.02 (3) (b) of the statutes is amended to read:
13 447.02 (3) (b) A permit under this subsection shall authorize the practice of
14 dentistry, dental therapy, or dental hygiene in a specified area of the state for a period
15 of time not more than 10 days in a year and may be renewed by the examining board.
16 The examining board may not require an applicant to pay a fee for the issuance or
17 renewal of a permit under this subsection.
18 SECTION 29. 447.02 (5) of the statutes is amended to read:
19 447.02 (5) Except as provided in ss. 447.058 and 447.063, nothing in this
20 chapter may be construed as authorizing the examining board to regulate business
21 or administrative support functions or services, that do not constitute the practice
22 of dentistry, dental therapy, or dental hygiene, provided to a business that provides
23 dental or dental hygiene services.
24 SECTION 30. 447.02 (6) of the statutes is created to read:
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