STATE BOARD OF DENTISTRY
[49 PA. CODE CH. 33]
Continuing Dental Education and Biennial Renewals
[28 Pa.B. 3293]
The State Board of Dentistry (Board) proposes to amend §§ 33.1, 33.105 and 33.106 and add §§ 33.401--33.404 to read as set forth in Annex A relating to biennial renewals and continuing education requirements.
A. Effective Date
The proposed amendments would be effective upon publication of final-form regulations in the Pennsylvania Bulletin. The continuing education requirement will apply to the 1999-2001 renewal period.
B. Statutory Authority
The proposed amendments for continuing education, certification in cardiopulmonary resuscitation (CPR) and restoration are governed by sections 3(j.1) and (j.2) and 3.1 of the Dental Law (act) (63 P. S. §§ 122(j.1) and (j.2) and 122.1).
C. Background and Purpose
Section 3 of the act was amended in 1996, to require two conditions of biennial license or certification renewal for dentists, dental hygienists and expanded function dental assistants:
1. Licensees and certificate holders must obtain current certification in CPR from a bona fide charitable organization.
2. Dentists must complete 30 hours of continuing education credit, dental hygienists must complete 20 hours of continuing education credit and expanded function dental assistants must complete 10 hours of continuing education credit.
The amendments also added section 3.1 to the act setting forth additional requirements for restoration of licenses and certificates. The CPR and continuing education requirements for the lapsed period must be satisfied before a license or certificate may be restored. Also, licensees and certificate holders who fail to renew their licenses/certificates for more than 5 years, may be required to take the licensure examination.
The proposed amendments implement these provisions.
D. Description of Amendments
Section 33.1 (relating to definitions) would be amended to add definitions of ''certificate of completion,'' ''credit hour,'' ''individual study'' and ''program sponsor.''
New § 33.105(b) (relating to biennial renewal of licenses and certificates) would implement section 3(j) of the act (63 P. S. § 122(j)), setting forth two additional conditions for biennial renewal: maintain current certification in CPR from the American Heart Association or the American Red Cross, and effective with the 1999-2001 renewal period, satisfy the continuing education requirements specified in §§ 33.401--33.404.
New § 33.106 would implement section 3.1 of the act relating to reactivation. In addition to the existing requirements for reactivation, proposed subsection (a) requires that dentists, dental hygienists and expanded function dental assistants maintain current CPR certification. Effective with the 1999-2001 renewal period, licensees and certificate holders would also be required to complete all of the continuing education required for the renewal periods during which the license or certificate was not renewed. Proposed subsection (b) specifies that applicants who have failed to renew for more than 5 years may be subject to reexamination.
Proposed § 33.401 (relating to credit-hour requirements) establishes the parameters of the continuing education requirement. Subsection (a) delineates the number of credit hours which must be completed in the preceding biennium. Because the Board believes that the credit hour requirement is not onerous, licensees/certificate holders would be precluded from a carry forward of excess credit hours in subsequent biennial periods. Subsection (b) specifies that the credit hours must be completed in the subject areas permitted under § 33.402 (relating to continuing education subject areas) from the program sponsors listed in § 33.403 (relating to program sponsors).
Proposed subsections (c) and (d) identify four sources of continuing education credit: lecture or clinical presentations, individual study, serving as an instructor and authoring a book, article or continuing education program. The Board believes that interacting with an instructor and other participants is beneficial to the learning process. Therefore, the Board believes that at least 50% of the required credit hours should be taken in lecture or clinical presentations.
The proposed amendments would allow instructors to account for the time preparing their presentations as satisfying the continuing education requirement. In the Board's judgment, instructors routinely spend 2 hours of preparation to every 1 hour of class instruction. Proposed paragraph (1) would permit instructors to claim an additional 2 credit hours as preparation time for each credit hour of instruction.
Proposed paragraph (2) sets out the credit calculation for authorship of professional works. Like the credit awarded to instructors, authors of books, continuing education programs and professional articles would be permitted to claim up to one-half of the required hours. The Board proposes to cap these awards at 50% because it believes that the legislative intent of the new amendments was to require licensees and certificate holders to learn from others.
Proposed subsection (f) sets forth the exceptions to the credit hour requirement. Licensees and certificate holders would be exempt from the credit hour requirement for the biennial period during which the applicant passed the licensure/certification examination. In addition, licensees and certificate holders who cannot meet the continuing education requirement due to illness, emergency or hardship would be able to seek a waiver from the Board. Licensees or certificate holders whose licenses or certificates are suspended would not be exempt from the continuing education requirement.
Section 33.402 requires licensees and certificate holders to complete their credit hours in subjects which contribute directly to the maintenance of clinical competence.
In accordance with section 3(j.2)(1) of the act, credit will not be awarded for billing, office management and practice building. Also, credit will not be awarded for money management, business matters, insurance reimbursement, finance, communication, memory training, speed reading or computer training. The Board acknowledges that these subjects may be personally beneficial to dentists, dental hygienists and expanded function dental assistants, however, the Board believes because they do not enhance clinical competency, they fall within the gamut of the topic areas prohibited by section 3(j.2)(1) of the act.
Section 3(j.2)(1) of the act requires the Board to approve program sponsors by regulation. Section 33.403(a) identifies the 11 preapproved sponsors. The Board has selected these sponsors because of the quality of their programs, the comprehensive review process which their programs undergo, and the availability of their programs. In addition, people who develop programs routinely use these entities as sponsors. This rulemaking will allow new programs to obtain sponsorship. Included within these 11 selected are the state, district, local and constituent professional societies.
Proposed subsection (b) delineates program sponsor responsibilities. In addition to assuring quality programs, presenters, facilities and materials, program sponsors would be required to provide participants with a certificate of completion after assuring satisfactory completion and attendance of the programs. A program sponsor's approval could be withdrawn under proposed subsection (c), in accordance with 2 Pa.C.S. §§ 501--508 (relating to practice and procedure of Commonwealth agencies).
Section 33.404 (relating to reporting continuing education credit hours) describes the reporting requirements. Licensees and certificate holders would be required to certify that they have met the continuing education requirements on their application for biennial renewal. In addition, they would be required to list the title of the course, the program sponsor, the dates attended and the credit hours claimed. Documentation, listed in § 33.404(c), which would evidence completion of the continuing education requirement, would only have to be provided to the Board upon request. Failure to provide documentation when requested or falsification of the requested information would constitute a violation of the act and could result in disciplinary action.
E. Compliance with Executive Order 1996-1.
In accordance with the requirements of Executive Order 1996-1 (February 6, 1996), in drafting the proposed amendments the Board solicited input and suggestions from the regulated community by providing drafts to organizations and entities which represent the professions, educational institutions and interested individuals.
F. Fiscal Impact and Paperwork Requirements
1. Commonwealth--The proposed amendments will require the Board to assure compliance with the continuing education requirement before renewing a license or certificate. The costs associated with implementing these amendments, including an audit, will be borne by the general licensee/certificate holder population through biennial renewal fees which generate revenue for all Board activities. Additional paperwork will be incurred by the Board to amend renewal application forms.
2. Political subdivisions--There will be no adverse fiscal impact or paperwork requirements imposed.
3. Private sector--There will be no adverse fiscal impact or paperwork requirements imposed.
G. Sunset Date
The Board continuously monitors its regulations. Therefore, no sunset date has been assigned.
H. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on July 1, 1998, the Board submitted a copy of these proposed amendments to the Independent Regulatory Review Commission (IRRC) and the Chairpersons of the House Professional Licensure Committee and the Senate Consumer Protection and Professional Licensure Committee. In addition to submitting the proposed amendments, the Board has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Board in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
Under section 5(g) of the Regulatory Review Act, if IRRC has objections to any portion of the proposed amendments, it will notify the Department within 10 days of the close of the Committees' review period. The notification shall specify the regulatory review criteria that have not been met by the portion of the proposed amendments to which an objection is made. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the amendments, by the Department, the General Assembly and the Governor of objections raised.
I. Public Comment
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed amendments to Judith Pachter Schulder, Counsel, State Board of Dentistry, 116 Pine Street, Post Office Box 2649, Harrisburg, PA 17105-2649, within 30 days of publication of this proposed rulemaking. Please reference No. 16A-464 (Continuing Education), when submitting comments.
EDWIN F. WEAVER, III, D.D.S.,
Fiscal Note: 16A-464. No fiscal impact; (8) recommends adoption.
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 33. STATE BOARD OF DENTISTRY
Subchapter A. GENERAL PROVISIONS
§ 33.1. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
* * * * *
Continuing education certificate--A document prepared by the program sponsor which contains the title of the course, the dates attended or completed and the hours of education completed.
Credit hour--A minimum unit of continuing education consisting of 60 minutes of instruction. Programs longer than 60 minutes will be credited in 30 minute increments.
* * * * *
Individual study--A course of continuing education which permits the participant to learn without interacting with an instructor or interactive learning methodologies and which requires a passing grade on a written examination or workbook.
* * * * *
Program sponsor--The party responsible for the development and presentation of the continuing dental education program approved by the Board.
* * * * *
Subchapter B. LICENSURE OF DENTISTS AND DENTAL HYGIENTS.
§ 33.105. Biennial renewal of licenses and certificates.
(a) Licenses and certificates are renewable for a 2-year period beginning April 1 of each odd-numbered year. The fee for the biennial renewal is set by the Board. See § 33.3 (relating to fees). Upon [renewing their licenses] renewal, licensees and certificate holders receive new biennial renewal licenses or certificates, as appropriate, and wallet-size [license] cards [that show the next] which include the expiration date [of the license. These documents are the only evidence of valid, current licensure].
(b) As a condition of biennial renewal, licensees and certificate holders shall maintain current certification in cardiopulmonary resuscitation from the American Heart Association continuing education requirements specified in Subchapter F (relating to continuing dental education).
(c) Dentists and dental hygienists who fail to renew their licenses and expanded function dental assistants who fail to renew their certificates are prohibited from practicing their profession in this Commonwealth.
§ 33.106. Reactivation of licenses and certificates.
(a) Dentists and dental hygienists who have failed to renew their licenses and expanded function dental assistants who have failed to renew their certificates may apply for reactivation [of licensure] on forms prescribed by the Board. The applicant for reactivation [of licensure] shall pay the current biennial renewal fee, maintain current certification in cardiopulmonary resuscitation from the American Heart Association or the American Red Cross, and shall submit a notarized affidavit identifying the period of time in which the applicant did not practice in this Commonwealth. Effective with the 1999-2001 renewal period, licensees and certificate holders shall also complete the continuing education requirements for the renewal periods during which the license or certificate was not renewed.
(b) [An] In addition to the requirements in subsection (a), an applicant for reactivation who has failed to renew for more than 5 years may be subject to reexamination under section 3 of the act (63 P. S. § 122).
(c) An applicant for reactivation [of licensure] who practiced in this Commonwealth without a current license or certificate shall pay a late renewal fee of $5 for each month or part of a month during which the unauthorized practice occurred, as provided in section 225 of the Bureau of Professional and Occupational Affairs Fee Act (63 P. S. § 1401-225). In addition, the applicant shall pay the biennial renewal fee for each biennium during which unauthorized practice occurred. The payment of late fees and biennial renewal fees does not preclude the Board from taking disciplinary action against a dentist or dental hygienist who practiced without a current license or an expanded function dental assistant who practiced without a current certificate.
(Editor's Note: The following subchapter is new. It has been printed in regular type to enhance readability.)
Subchapter F. CONTINUING DENTAL EDUCATION
33.401. Credit-hour requirements. 33.402. Continuing education subject areas. 33.403. Program sponsors. 33.404. Reporting continuing education credit hours.
§ 33.401. Credit-hour requirements.
(a) An applicant shall complete the following continuing education credit hours during the preceding biennial period:
(1) Dentists--30 hours.
(2) Dental hygienists--20 hours.
(3) Expanded function dental assistants--10 hours.
(b) The required hours shall be taken in the subject areas listed in § 33.402 (relating to continuing education subject areas) from a program sponsor listed in § 33.403 (relating to program sponsors).
(c) At least 50% of the required credit hours shall be taken in lecture or clinical presentations.
(d) A maximum of 50% of the required credit hours may be taken through individual study, serving as an instructor or author of a book, article or continuing education program.
(1) Instructors will be awarded two additional credit hours as preparation time for each credit hour of instruction up to 50% of the required hours.
(2) Authors will be awarded up to 25% of the required hours on a self-declaration basis. Additional credit, up to 50% of the required hours, may be awarded based on the complexity of the subject matter or work.
(e) Credit will not be awarded for repeating a program in the same renewal period unless the subject matter has substantially changed during that period.
(f) A licensee or certificate holder suspended for disciplinary reasons is not exempt from the continuing education requirements in subsection (a).
(g) Exceptions are as follows:
(1) An applicant is exempt from the continuing education requirement in subsection (a) for only the biennial period during which the applicant passed the licensure or certification examination.
(2) An applicant who cannot meet the continuing education requirement due to illness, emergency or hardship may apply to the Board in writing for a waiver. The request shall explain why compliance is impossible. Waiver requests will be evaluated by the Board on a case-by-case basis.
§ 33.402. Continuing education subject areas.
(a) The required credit hours shall be completed in subjects which contribute directly to the maintenance of clinical competence of a dentist, dental hygienist or expanded function dental assistant. Examples of acceptable subjects include:
(1) Diagnosis and treatment of oral pathosis.
(2) Clinical and technological subjects.
(3) Emergency procedures.
(4) Infection control.
(5) Abuse and neglect.
(6) Medical and scientific subjects.
(7) Laws and regulations pertaining to dentists, dental hygienists and expanded function dental assistants.
(b) Credit hours will not be awarded in nonclinical subjects, including:
(2) Office management.
(3) Practice building.
(4) Insurance reimbursement.
(5) Communication skills.
§ 33.403. Program sponsors.
(a) The Board has approved the following as program sponsors:
(1) An accredited dental, dental hygiene or expanded function dental assisting school or program.
(2) Medical or osteopathic medical school or college accredited by an accrediting body recognized by the State Board of Medicine or the State Board of Osteopathic Medicine.
(3) The American Dental Association Continuing Education Review Program, the American Dental Asociation's speciality associations, the American Dental Hygienists Association and the American Dental Assistants Association.
(4) The National Dental Association and its speciality societies and the National Dental Hygienists Association.
(5) The American Medical Association and the American Osteopathic Medical Association.
(6) The Pennsylvania Academy of Dental Hygiene Studies.
(7) The Academy of General Dentistry National Sponsor Approval Program.
(8) The Veterans' Administration.
(9) The United States military services.
(10) The National Institutes of Health.
(11) The United States Public Health Services.
(b) Program sponsors shall:
(1) Disclose in advance to prospective participants the objectives, prerequisites, experience level, content, required advanced preparation, teaching method and number of continuing education credits involved in the program.
(2) Conduct programs in subjects which contribute directly to the maintenance of clinical competence of a dentist, dental hygienist or expanded function dental assistant.
(3) Provide program materials which are accurate and consistent with currently accepted standards relating to the program's subject matter. Prior to developing errata sheets, the instructor is responsible for informing participants of changes.
(4) Provide sufficient physical facilities for the number of participants and the teaching methods to be utilized.
(5) Evaluate the program, through questionnaires of the participants and instructors, to determine its effectiveness.
(6) Retain accurate attendance records and written outlines for a 5-year period.
(7) Provide participants with a continuing education certificate after assuring satisfactory completion and attendance of the program.
(c) The Board may, following notice and hearing under 2 Pa.C.S. §§ 501--508 (relating to practice and procedure of Commonwealth agencies), withdraw the approval of a program sponsor for cause.
§ 33.404. Reporting continuing education credit hours.
(a) The applicant shall provide the requested information concerning the required hours on an application for biennial renewal.
(b) The applicant shall provide a copy of the documentation supporting the completion of the required hours when requested to do so by the Board.
(c) Acceptable documentation consists of the following:
(1) A continuing education certificate or sponsor-generated printouts.
(2) A certified transcript of courses taken for credit in an accredited university or college. For noncredit courses taken, a statement of hours of attendance, signed by the instructor.
(3) Evidence of publication for published articles, books or continuing education programs.
(4) Evidence obtained from the program sponsor of having been an instructor, including an agenda.
(d) The responsibility for documenting the continuing education requirements rests with the applicant. The documentation shall be maintained for 4 years after the completion of the program.
(e) Falsification of information required under subsection (a) constitutes a violation of § 33.212(1) (relating to misleading, deceptive, untrue or fraudulent representations).
(f) Failure to comply with subsection (b) may result in disciplinary or corrective action.
[Pa.B. Doc. No. 98-1098. Filed for public inspection July 10, 1998, 9:00 a.m.]
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