Rule Proposal

51 N.J.R. 1648(a)

VOLUME 51, ISSUE 22, NOVEMBER 18, 2019

RULE PROPOSALS

Reporter

51 N.J.R. 1648(a)

NJ - New Jersey Register  >  2019  >  NOVEMBER  >  NOVEMBER 18, 2019   >  RULE PROPOSALS  >  LAW AND PUBLIC SAFETY -- DIVISION OF CONSUMER AFFAIRS

Interested Persons Statement

INTERESTED PERSONS

Interested persons may submit comments, information or arguments concerning any of the rule proposals in this issue until the date indicated in the proposal. Submissions and any inquiries about submissions should be addressed to the agency officer specified for a particular proposal.

The required minimum period for comment concerning a proposal is 30 days. A proposing agency may extend the 30-day comment period to accommodate public hearings or to elicit greater public response to a proposed new rule or amendment. Most notices of proposal include a 60-day comment period, in order to qualify the notice for an exception to the rulemaking calendar requirements of N.J.S.A. 52:14B-3 . An extended comment deadline will be noted in the heading of a proposal or appear in a subsequent notice in the Register.

At the close of the period for comments, the proposing agency may thereafter adopt a proposal, without change, or with changes not in violation of the rulemaking procedures at N.J.A.C. 1:30-6.3 . The adoption becomes effective upon publication in the Register of a notice of adoption, unless otherwise indicated in the adoption notice. Promulgation in the New Jersey Register establishes a new or amended rule as an official part of the New Jersey Administrative Code.

Agency

LAW AND PUBLIC SAFETY > DIVISION OF CONSUMER AFFAIRS > STATE BOARD OF DENTISTRY

Administrative Code Citation

 Proposed Amendments: N.J.A.C. 13:30-1.2, 1.5, 1A.2, 1A.4, 1A.5, 1A.7, 2.2, 2.3, 2.7, 2.8, 3, 5, 6.2, 8.1, 8.2, 8.3, 8.4, 8.7, 8.8, 8.9, 8.10, and 8.26

 Proposed Repeal and New Rule: N.J.A.C. 13:30-8.6

 Proposed New Rules: N.J.A.C. 13:30-8.5A, 8.6A, 8.6B, and 8.12A

 Board of Dentistry Rules

Authorized By: State Board of Dentistry, Jonathan Eisenmenger, Executive Director.

Authority: N.J.S.A. 45:1-15 and 45:6-19.4; and P.L, 2007, c. 235, P.L. 2009, c. 221, P.L. 2013, c. 182, and P.L. 2017, c. 28.

Calendar Reference: See Summary below for explanation of exception to calendar requirement.

Proposal Number: PRN 2019-138.

Submit comments by January 17, 2020, to:

Jonathan Eisenmenger, Executive Director

State Board of Dentistry

124 Halsey Street

PO Box 45005

Newark, New Jersey 07101

 or electronically at: http://www.njconsumeraffairs.gov/Proposals/Pages/default.aspx.

The agency proposal follows:

 Summary

 The State Board of Dentistry (Board) is proposing amendments, repeals, and new rules to: 1) implement new laws; 2) update rules, terminology, citations, website addresses, and the names of the licensure examinations; and 3) clarify and codify current standards of practice and licensure and registration requirements. The rulemaking reflects updates related to statutory changes, additions to enhance the safety of patients receiving dental services and those working in the profession, and identifies continuing education courses that must be completed in each renewal period. In response to adverse incident reports and news articles from across the country, the Board is proposing amendments to the sedation rules to enhance the safety of patients receiving dental services. Because the Board is seeing incidents of trained individuals achieving a deeper level of sedation than intended, the Board wants to provide more guidance to the regulated community as to what is expected so as to enhance patient safety.

 The Board proposes to amend N.J.A.C. 13:30-1.2 to update the reference to the North East Regional Board examination to the ADEX dental examination, including the Periodontal Examination, administered by the Commission on Dental Competency Assessments. In addition, at subparagraphs (b)5, (d)4, and (e)6, the Board proposes to replace the requirement to take the New Jersey Jurisprudence examination with an online orientation that must be taken within six months of the date of application. The Board will develop the orientation, which will contain information about the statutes and rules governing the practice of dentistry in New Jersey, and it will be available on the Board's website. The Board also proposes to amend subsection (d) to remove the five-year limitation on recognizing the results of, and requirements to retake, the ADEX examination. Instead, the Board proposes that applicants who previously passed the ADEX dental examination but who have not practiced for a period of five or more years prior to the date of application, shall be required to retake the examination or a Board-approved refresher course with a post-course examination. The Board will use the results of the clinical or post-course examination to assess the candidate's competency and practice proficiencies and to determine whether any additional education, training, or conditions on licensure are necessary to assure that the applicant practices with reasonable skill and safety. Finally, the Board proposes new subparagraph (g) to codify its existing practice to consider and evaluate, as part of its review of an application for licensure as a dentist, any prior or pending disciplinary action against, or investigation of, an applicant; reports from the National Practitioner Data Bank (NPDB); the applicant's employment history; or actions (for example, by a hospital or Medicaid) affecting the applicant's privileges to practice dentistry or any other profession.

 The Board proposes to update the cross-reference at N.J.A.C. 13:30-1.5.

 The Board proposes to update, throughout N.J.A.C. 13:30-1A, the names of the examinations required for licensure. Specifically, at N.J.A.C. 13:30-1A.2 and 1A.7, the Board proposes to change the National Dental Hygiene Board examination to the National Board Dental Hygiene Examination (NBDHE) administered by the Joint Commission on National Dental Examinations (JCNDE). The Board also proposes to change at N.J.A.C. 13:30-1A.2 and 1A.7 references to the North East Regional Board examination to the ADEX dental hygiene examination administered by the Commission on Dental Competency Assessments (CDCA). In addition, the Board proposes to replace the requirement to take the New Jersey Jurisprudence examination with an online orientation that must be taken within six months of the date of application.

 In addition, the Board proposes to amend N.J.A.C. 13:30-1A.2(d)3 consistent with subsection (e) to specify that the Board will recognize the examination results of the ADEX dental hygiene examination for up to five years and, thereafter, the Board will determine on an individual basis whether to recognize an applicant's examination results. The Board proposes to amend N.J.A.C. 13:30-1A.5(d)2 to change the administrator of the written examination in the administration of anesthesia to CDCA. The Board also proposes to amend N.J.A.C. 13:30-1A.5(e) to clarify that the existing requirement for continuing education in the administration of local anesthesia is four hours every four years.

 Currently, licensed dental hygienists practicing under general supervision may make radiographic exposures in a dental office or dental clinic, or in an institution. Due to technology limitations, dental hygienists were not able make radiographic exposures in a school setting. Because there is new portable technology enabling the machines to be brought into school settings, the Board proposes to add new N.J.A.C. 13:30-1A.4(c)5 to allow licensed dental hygienists practicing under general supervision in a school setting to make radiographic exposures as permitted by the Department of Environmental Protection. Consistent with the existing conditions for hygienists practicing under general supervision in a school setting, the radiographic exposures may be made solely for the school's students and written parental or guardian consent is required.

 The Board proposes to amend the references to the Registered Dental Assistant Certification Examination to Certified Dental Assistant Examination at N.J.A.C. 13:30-2.2 and 2.7. In addition, the Board proposes to amend N.J.A.C. 13:30-2.2, 2.3, 2.7, and 2.8 to replace the requirement to take the New Jersey Jurisprudence examination with an online orientation that must be taken within six months of the date of application.

 The Board proposes to update Subchapter 3, concerning applicants for a limited teaching certificate in a dental school, to reflect statutory amendments to N.J.S.A. 45:6-16.1 and 16.2. Consistent with the statutory amendments, the Board proposes to amend N.J.A.C. 13:30-3.1(b) to change the qualifications standard for applicants. The Board proposes to remove knowledge "similar to that required in this State for a license to practice dentistry without limitation" and to replace it with "the competency to teach the science of dentistry as predicated upon the applicant's" general and technical knowledge. The Board also proposes to amend N.J.A.C. 13:30-3.1(c) to remove the requirement that the dental school, college, or department of a university must be approved by the Board or by the Commission on Dental Accreditation.

 The Board proposes to amend N.J.A.C. 13:30-3.2(a) to add a requirement that the applicant provide employment history and professional history from the time the dental degree was conferred, and to delete the requirement that the dental school be accredited. The Board also proposes to add new subsection (b) to set forth the certification and supporting information requirements for the dean of the dental school in which the applicant seeks employment.

 [page=1649] The Board proposes to amend N.J.A.C. 13:30-3.3 to specify that the limited teaching certificate shall not be deemed to authorize the licensee to engage in the practice of dentistry outside of the premises of the dental school or its clinical facilities, and that the certificate automatically expires upon the termination of the certificate holder's employment by a dental school in this State.

 In accordance with N.J.S.A. 45:6-16.2(b), the Board proposes to amend N.J.A.C. 13:30-3.4(c) to limit to 15, the number of persons with a limited teaching certificate who graduated from a dental school not approved by the Board that may be employed at any one time by a dental school. The Board will approve a dental school located in the United States, Canada, or a territory or possession of the United States.

 The Board is proposing amendments to Subchapter 5, concerning continuing education requirements for licensed dentists, licensed dental hygienists, registered dental assistants, and limited registered dental assistants in orthodontics. The Board proposes to require continuing education in cardiopulmonary resuscitation, which must be taken in a live and in-person format, infection control, professional ethics and New Jersey law, and opioid drugs. In addition, the Board is proposing to clarify that webinars shall not be considered electronic media distance learning courses if they are live, meaning not previously recorded, and synchronous, meaning the instructor and licensee interact with each other in real time.

 The Board is proposing to amend N.J.A.C. 13:30-5.1 to mandate 10 hours of specific continuing education that must be taken of the 40 hours required every biennial period. These 10 hours shall consist of three hours of cardiopulmonary resuscitation (CPR), which meets the American Heart Association certification standards for health care providers and shall include the use of an automatic external defibrillator (AED), unconscious and conscious choking, and rescue breathing. As noted above, the Board proposes to specify that webinars and electronic media distance learning courses will not satisfy this requirement. In addition, the Board proposes to require three hours of continuing education on pharmacology and internal medicine and the use of the New Jersey Prescription Monitoring Program (NJPMP). The Board also proposes to require two hours of continuing education in preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings. The Board proposes to require one hour of continuing education in professional ethics and New Jersey law concerning the practice of dentistry and to specify that the online jurisprudence orientation that is required for initial licensure may not be used to satisfy this continuing education requirement. In addition, as required by P.L. 2017, c. 28, the Board is mandating one hour of continuing education in educational programs or topics concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion. The Board, however, consistent with the law, may waive this requirement on an individual basis. The Board also proposes to specify that this one credit is not eligible for carry-over as described in subsection (k). In addition, notwithstanding the exemption from the completion of continuing education credits as set forth in paragraph (a)2, licensed dentists, within 24 months of becoming licensed, must satisfy this one credit requirement related to prescription opioid drugs.

 In addition, the Board proposes to relocate the final sentence of existing N.J.A.C. 13:30-5.1(e) as new paragraph (e)4, stating that the Board shall not accept for continuing education credit subjects in estate planning, financial or investment/tax planning, or personal health. As noted above, the Board also proposes to amend subsection (i) to specify that webinars are not considered electronic media distance learning courses provided they are live and synchronous.

 To implement P.L. 2009, c. 221, the Board is proposing new N.J.A.C. 13:30-5.1(n) to waive up to one-half of the biennial dental continuing education hours for volunteer dental services rendered to eligible persons. The Board proposes to include definitions for "eligible person" and "volunteer dental service" consistent with those set forth at N.J.S.A. 45:6-10.4. The Board will waive one half-hour of one continuing dental education credit hour for each hour of volunteer dental service. Notwithstanding the provisions of this rule, a licensee may not waive the 10 mandatory continuing education hours proposed in subsection (e), as discussed above. To seek the waiver, as part of the biennial renewal of licensure, the licensee must complete the Board's form, available on its website, documenting evidence of the total number of credits that are eligible for waiver.

 Similar to the proposed continuing education requirements for licensed dentists, the Board proposes to amend the continuing education requirements for licensed dental hygienists at N.J.A.C. 13:30-5.2 by mandating six continuing education credits every biennial period. The Board proposes to require three hours of CPR, one hour in preventing and controlling infectious diseases, one hour of continuing education in professional ethics and New Jersey law concerning the practice of dental hygiene, and one hour of continuing education in educational programs or topics concerning prescription opioid drugs. The Board also proposes to waive up to one-half of the required biennial continuing dental hygiene education for a licensee who renders volunteer clinician services, defined consistent with the statutory definition of "volunteer dental service," to eligible persons as defined in proposed N.J.A.C. 13:30-5.1(n). The licensee, however, may not waive the required six hours of mandatory continuing education.

 The Board also proposes to amend the continuing education requirements for registered dental assistants and limited registered dental assistants in orthodontics at N.J.A.C. 13:30-5.3 by mandating six continuing education credits every biennial period. The Board proposes to require three hours of CPR, one hour in preventing and controlling infectious diseases, one hour of continuing education in professional ethics and New Jersey law concerning the practice of dental assisting, and one hour of continuing education in educational programs or topics concerning prescription opioid drugs. The Board also proposes to waive up to two of the required biennial continuing education credits for a registrant who renders volunteer clinician services to eligible persons as defined in proposed N.J.A.C. 13:30-5.1(n). The registrant, however, may not waive the six mandatory continuing education hours.

 Although the statute does not require the Board to waive any portion of the continuing education requirements for volunteer services by licensed dental hygienists, registered dental assistants, or limited registered dental assistants in orthodontics for volunteer services, the Board believes that waiving a portion of the continuing education requirements is a way to encourage licensees and registrants to provide volunteer services, which benefits the public. As with licensed dentists, N.J.A.C. 13:30-5.2(a) and 5.3(f) specify that the online jurisprudence orientation that is required for initial licensure may not be used to satisfy the professional ethics and New Jersey law continuing education requirement.

 For ease of reference, the Board proposes to include in its advertising regulation as new N.J.A.C. 13:30-6.2(s), the existing requirement set forth at N.J.A.C. 13:30-8.1A that a dentist advertising sedation services who uses the terms "sleep," "sleep dentistry," "sleeplike-state," or any similar words or combinations in connection with the provision of dental services are considered to be inducing deep sedation and must comply with the requirements of N.J.A.C. 13:30-8.3. The Board believes that it is important, regardless of the section of rules being reviewed, that a licensee is aware of these requirements. The Board also notes that, as part of an anticipated future rulemaking, it is continuing to review its advertising rules at Subchapter 6.

 The Board proposes to amend the fee schedule at N.J.A.C. 13:30-8.1 to remove the $ 35.00 fee for supervisors of the three-month internship program for training of registered dental assistants because this program no longer exists. In addition, the Board proposes to remove the inactive license and registration renewal fees for dentists, dental hygienists, registered dental assistants, and limited registered dental assistants in orthodontics because, as discussed below, there is no longer any distinction between the inactive paid and inactive unpaid status. In addition, the Board proposes to reduce the application fee for licensure of dentists by credentials from $ 250.00 to $ 125.00, which is consistent with the application fee assessed to dentists for initial licensure.

 To protect the public health and safety, the Board proposes several changes to the parenteral conscious sedation (PCS) (also known as moderate sedation), the use of general anesthesia, and the enteral sedation rules set forth respectively at N.J.A.C. 13:30-8.2, 8.3, and 8.4. The Board is proposing to standardize the inspection periods for mobile equipment, [page=1650] drugs, and supplies, and office inspections for both PCS and general anesthesia. The Board also proposes to require both basic life support and advanced cardiac life support for both the licensed dentists and the personnel who are present and trained to assist in the monitoring of a patient whenever PCS, enteral sedation, or general anesthesia is employed. In addition, to ensure patient safety, the Board proposes to update the list of equipment and supplies that is required for each facility providing PCS, general anesthesia, or enteral sedation, and to specify the pharmacological agents that are required in an emergency drug kit. The Board also proposes to specify that the requirement for reviewing medical history, is that of an up-to-date history, including any changes and any medications, including both natural and homeopathic medications. In addition, the Board proposes to specify that dentists engaging in the use of PCS, general anesthesia, or enteral sedation, must maintain contemporaneous anesthetic records.

 The Board proposes to amend the heading of N.J.A.C. 13:30-8.2 to reflect that PCS is also known as moderate sedation. To better ensure that those obtaining a permit to administer PCS have received adequate training, the Board proposes to amend the required formal training set forth at N.J.A.C. 13:30-8.2(d) from a combined 80 hours to 40 hours in didactic instruction and 40 hours of supervised clinical training in the administration of PCS. In addition, the Board proposes to amend paragraph (d)5 to specify that the required understanding of clinical pharmacology pertains to the drugs used for PCS and the interaction of these drugs. The Board also proposes to include at paragraph (a)7 that the certifying training institute must certify that the applicant is competent in the use of capnography. The Board proposes to delete paragraph (a)8, which requires that the certifying training institute certify that the applicant is competent to recognize and manage anesthetic and medical emergencies arising from the use of PCS, and to include the competencies required of dentists using PCS as set forth at proposed new subsection (f), discussed below.

 Proposed new N.J.A.C. 13:30-8.2(e) requires all offices in which PCS is conducted to be inspected and approved once every six years by the Board or its designee, to meet the Board's specified standards, described below, and to have, at a minimum, the equipment and supplies required by the Board at subsection (i) and N.J.A.C. 13:30-8.26, which must be readily accessible and maintained in good operating condition. The proposed standards provide that offices conducting PCS must have an operating room with a large enough space to provide adequate accommodation of the patient on a table or in an operating chair, and to allow an operating team consisting of at least three individuals to move about the patient without restriction or limitation; a recovery area, which can be an operating theatre, that has available oxygen and monitoring equipment, adequate lighting, suction, and electrical outlets; and a lighting system adequate to permit visual evaluation of the patient's skin and mucosal color.

 Proposed new N.J.A.C. 13:30-8.2(f) sets forth competencies for a licensed dentist who is administering PCS. Specifically, the licensee must be able to recognize and manage complications and medical emergencies from drug administrations; understand the clinical pharmacology of the drugs used for PCS and the interactions of these drugs; maintain patient airways and support ventilation; monitor patients during the administration of PCS using clinical evaluations and mechanical means, including the use of an EKG monitor, pulse oximeter, and capnogram, and the interpretation of such readings; manage patients during the post-operative period and assess patients' suitability for discharge; and maintain accurate anesthetic records including drugs, dosages, vital signs, and patient responses.

 The Board proposes to amend recodified subsections (g) and (h) to require an applicant for a PCS permit and at least two of the dentist's employees to complete and maintain current certification in the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, in addition to the required Advanced Cardiac Life Support course. The Board also proposes to amend recodified subsection (i) to update the list of equipment and supplies that a PCS permit holder's facility must contain. Because of the potential for a patient to fall into a deeper level of sedation than intended, with the exception of a thermometer, the Board believes that a PCS permit holder facility must have the same equipment and drugs that are required for a general anesthesia permit holder's facility. The Board also believes that to ensure patient safety, it is necessary to specify the drugs that an emergency drug kit must contain. Accordingly, the Board is amending recodified subsection (i) to include the specific list of required drugs, battery-powered clocks or watches, mouth props of assorted adult and pediatric sizes, an emergency suction device, respiration monitoring equipment (for example, visible reservoir bag); intravenous solutions "ACLS compatible," IV administration sets and tubing; syringes, needles, IV catheters, and tape scissors; laryngoscopes, assorted size blades, and spare batteries; endotracheal tubes (adult and pediatric sizes); magil forceps; yankauer type suction tips and catheter suction; and a capnometer. The Board is also proposing to amend the requirement for suction to specify suction equipment capable of aspirating gastric contents from the mouth and pharynx. In addition, the Board is proposing to remove from the existing list of required equipment those items that are required in all dental offices as part of the emergency protocol as set forth at N.J.A.C. 13:30-8.26. The Board, therefore, proposes to remove positive pressure oxygen and battery-operated equipment consisting of, at a minimum, lighting, and a pulse oximeter.

 The Board proposes to amend recodified subsection (k) to require that when an M.D. or D.O. is providing the anesthesia services, the M.D. or D.O. remains present through patient discharge. The Board also proposes to amend recodified subsection (l) to change the cross-references due to the proposed recodifications of subsections, and to include "drugs" in the term "mobile equipment, drugs, and supplies." The Board proposes to amend recodified subsection (m) to delete that the administration of PCS agent is for controlling pain, to specify that the permit holder shall review the patient's up-to-date medical history, which must include any changes and any medications, including natural and homeopathic medications, and to include "contemporaneous" before "records." The Board also proposes to update this subsection to add a cross-reference to the Board's patient recordkeeping rule at N.J.A.C. 13:30-8.7.

 The Board proposes to amend N.J.A.C. 13:30-8.3(c) to codify the Board's practice in regards to branch locations by specifying that a separate general anesthesia permit is required for each practice location at which it is administered, and that each permit must be renewed biennially. The Board proposes to amend paragraph (d)3 to update the names of the American Society of Oral Surgeons and the New Jersey Society of Oral Surgeons to include "Maxillofacial" before "Surgeons." The Board's current application for a general anesthesia permit contains a list of required equipment and pharmacological agents that must be available in each office that practices general anesthesia. The Board proposes to amend subsection (f) to remove reference to the Board's list of required equipment and supplies and to codify the requirements. The Board is proposing to remove from the existing list of required equipment those items that are required in all dental offices as part of the emergency protocol as set forth at N.J.A.C. 13:30-8.26, and to update the terminology for purposes of consistency with the PCS and enteral sedation rules. The Board, therefore, proposes to remove positive pressure oxygen, portable oxygen supply, defibrillator, electrodes, and supplies or AED, and battery-operated equipment consisting of, at a minimum, lighting, and a pulse oximeter. The Board also proposes to replace "suction tips and tubing" with "suction equipment capable of aspirating gastric contents from the mouth and pharynx"; "blood pressure equipment" with "blood pressure monitoring device"; "oxygen saturation (pulse oximeter, continuous use)" with "pulse oximeter or its equivalent"; "temperature" with "thermometer"; "oral and nasal airways" with "nasopharyngeal tubes"; and "oropharyngeal tubes" and "capnography" with "capnometer."

 The Board proposes to amend subsection (g) to include a cross-reference to proposed new subsection (j), discussed below. The Board proposes to amend subsection (i) to include reference to "drugs" and to change the period of inspection for mobile equipment, drugs, and supplies to every three, rather than six, years. As noted previously, the Board is standardizing the inspection periods for both office inspections and mobile equipment, drugs, and supplies inspections for PCS and general anesthesia.

 Proposed new N.J.A.C. 13:30-8.3(j) sets forth the facility standards for offices in which general anesthesia is administered. The proposed standards are the same as those proposed for offices conducting PCS, as described above. In addition, the offices must have the equipment and [page=1651] supplies required by the Board at subsection (f) and at N.J.A.C. 13:30-8.26, which must be readily accessible and maintained in good operating condition.

 The Board proposes to amend recodified subsection (m) to delete that the purpose for the administration of an anesthetic agent is for controlling pain, to specify that the permit holder shall review the patient's up-to-date medical history, which must include any changes and any medications, including natural and homeopathic medications, and to include "contemporaneous" before "records." The Board also proposes to update this subsection to cross-reference to the Board's patient recordkeeping rule at N.J.A.C. 13:30-8.7. The Board proposes to amend recodified subsection (n) to require that when an M.D. or D.O. is providing the anesthesia services, the M.D. or D.O. remains present through patient discharge.

 Proposed new N.J.A.C. 13:30-8.3(o) sets forth competencies for a licensed dentist who is administering general anesthesia. Specifically, the licensee must be able to recognize and manage complications and medical emergencies from general anesthetic drug administrations; understand the clinical pharmacology of the drugs used for general anesthesia and the interactions of these drugs; maintain patient airways and support ventilation; monitor patients during the administration of general anesthesia using clinical evaluations and mechanical means including the use of an EKG monitor, pulse oximeter, and capnogram, and the interpretation of such readings; manage patients during the post-operative period and assess patients' suitability for discharge; and maintain accurate anesthetic records including drugs, dosages, vital signs, and patient responses. The Board proposes to amend recodified subsection (p) to require an applicant for a permit to use general anesthesia and all persons who assist with monitoring a patient under general anesthesia to complete and maintain current certification in both the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, and the Advanced Cardiac Life Support course.

 The Board proposes amending N.J.A.C. 13:30-8.4(h) and (j) to require an applicant for an enteral sedation permit and at least one of the dentist's employees to complete and maintain current certification in the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, in addition to the required Advanced Cardiac Life Support course. In addition, the Board proposes to amend subsection (i) to properly describe that the dentist prescribes enteral sedation medications for the purpose of dental treatment and its management. The Board also proposes to amend paragraph (i)2 to specify that the dentist must be prepared to manage any reasonable foreseeable complications from the administration of drugs producing effects along the sedation spectrum, including from a level other than anxiolysis (minimal sedation), which has produced sedation.

 The Board proposes to amend N.J.A.C. 13:30-8.4(k) to specify that the required equipment and supplies must be readily accessible and maintained in good operating condition, cross-reference the equipment and supplies required in all offices as set forth at N.J.A.C. 13:30-8.26, and to update the list of required equipment and supplies that the Board believes is necessary to ensure patient safety when enteral sedation is administered. The Board believes that to ensure patient safety, it must specify the drugs that an emergency drug kit must contain. Accordingly, the Board is amending subsection (k) to include: an emergency suction device, mouth props of assorted adult and pediatric sizes, the specific list of required drugs, battery-powered clocks or watches, and yankauer type suction tips and catheter suction. In addition, the Board is proposing to remove from the existing list of required equipment those items that are required in all dental offices as part of the emergency protocol as set forth at N.J.A.C. 13:30-8.26, and to update some of the terminology for purposes of consistency with the PCS and general anesthesia rules. The Board, therefore, proposes to remove a portable oxygen delivery system including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivering positive pressure and oxygen-enriched patient ventilation, and battery-operated equipment consisting of, at a minimum, lighting, and a pulse oximeter. The Board also proposes to replace "a blood pressure cuff (sphygmomanometer) of appropriate size and a stethoscope or equivalent monitoring devices" with "blood pressure monitoring device."

 The Board also proposes to amend subsection (l) to specify that the permit holder shall review the patient's up-to-date medical history, which must include any changes and any medications, including natural and homeopathic medications, and to include "contemporaneous" before "notations." The Board also proposes to update this subsection to cross-reference the Board's patient recordkeeping rule at N.J.A.C. 13:30-8.7.

 The Board proposes to amend subsection (o) to require that when an M.D. or D.O. is providing the anesthesia services, the M.D. or D.O. must remain present through patient discharge. The Board also proposes to amend subsection (p) to include "drugs" in the term "mobile equipment, drugs, and supplies."

 Proposed new N.J.A.C. 13:30-8.5A requires all licensed dentists, at least once a biennial period, to provide or make available infection prevention education and training to all personnel involved in patient-related sterilization, patient care, and/or maintaining equipment. Such education and training shall include at a minimum the continuing education topics set forth at N.J.A.C. 13:30-5.1(e)1iii. The Board believes that this requirement, in addition to the proposed mandatory continuing education for licensees and registrants discussed above, will ensure that all personnel involved in patient-related sterilization, patient care, and/or maintaining equipment are properly educated and trained on a regular basis, which will protect the health and welfare of patients and dental personnel.

 To implement P.L. 2013, c. 182, which modifies the renewal, reinstatement, and reactivation requirements for professional or occupational licensees, the Board proposes to repeal existing N.J.A.C. 13:30-8.6, which sets forth requirements for biennial license and registration renewal, establishes requirements for reinstatement from a license suspension, and the election of inactive licensure status, and replace it with new N.J.A.C. 13:30-8.6 (renewal), 8.6A (reactivation), and 8.6B (reinstatement).

 Proposed new N.J.A.C. 13:30-8.6 relates to license and registration renewal. Proposed subsection (a) details the Board's responsibility for providing licensees and registrants with renewal notices. Proposed subsection (b) requires licensees and registrants to renew their licenses or registrations prior to license expiration. Proposed subsection (c) permits licensees and registrants to place their license or registration, as applicable, on inactive status. The Board proposes to eliminate the distinction between inactive paid and inactive unpaid status as set forth at existing N.J.A.C. 13:30-8.6(g) because there is no longer any distinction between the inactive paid and inactive unpaid status. The Board sends notice of renewal to all active and inactive licensees, regardless if they are paid or unpaid, and the Board no longer disseminates information by mail that would require an inactive licensee to pay for the privilege to receive such information. Proposed new subsection (d) establishes a 30-day grace period after the license or registration has expired, during which time a licensee or registrant, as applicable, may still renew the license or registration and continue to practice. Proposed subsection (e) mandates that any license or registration not renewed by the end of the grace period will be administratively suspended. Proposed subsection (f) sets forth the consequences for continued practice after an individual's license or registration has been administratively suspended.

 Proposed new N.J.A.C. 13:30-8.6A relates to reactivation of an inactive license or registration. Consistent with P.L. 2013, c. 182, the Board proposes to pro-rate the biennial renewal fee based upon the year of the biennial renewal period in which the renewal application is submitted. Also, consistent with P.L. 2013, c. 182, the proposed new rule eliminates the differing standards for reactivating an inactive license or registration based upon the period the license or registration was inactive. Instead, the Board will assess each application for reactivation on a case-by-case basis. With respect to the continuing education required to reactivate an inactive license or registration, if the applicant holds a valid, current license or registration, as applicable, in good standing issued by another state to engage in the practice of dentistry, dental hygiene, or dental assisting, as applicable, the Board will accept proof of the applicant having satisfied that state's continuing education requirements. Otherwise, instead of requiring continuing education credits for each biennial period up to a maximum of two, the applicant must satisfy the Board's continuing education requirements for the biennial period immediately prior to the renewal period for which reactivation is sought. [page=1652] In addition, for any courses that are specifically required in New Jersey, the Board will allow an applicant to take the courses within 12 months following reactivation.

 Proposed N.J.A.C. 13:30-8.6A(a) also lists the documentation that a licensee or registrant who has placed his or her license or registration on inactive status must provide to the Board when applying for reactivation of his or her license or registration. Proposed subsection (b) sets forth the criteria that the Board must consider when reviewing an application to determine practice deficiencies and grants the Board discretion to require any applicant found to have practice deficiencies to successfully complete an examination, additional education, training, supervision, or other requirements as a condition of reactivation.

 Proposed new N.J.A.C. 13:30-8.6B relates to reinstatement of a license or registration that has been administratively suspended. Consistent with P.L. 2013, c. 182, the proposed new rule eliminates the differing standards for reinstating an administratively suspended license or registration based upon the period the license or registration was suspended. Instead, the Board will assess each application for reinstatement on a case-by-case basis. In addition, applicants seeking reinstatement will be required to pay the renewal fees for the current and one prior renewal period, instead of all past delinquent renewal fees. With respect to the continuing education required to reinstate an administratively suspended license or registration, if the applicant holds a valid, current license or registration in good standing issued by another state to engage in the practice of dentistry, dental hygiene, or dental assisting, as applicable, the Board will accept proof of the applicant having satisfied that state's continuing education requirements. Otherwise, instead of satisfying the continuing education requirements for all past biennial periods, the applicant must satisfy the Board's continuing education requirements for the biennial period immediately prior to the renewal period for which reinstatement is sought. In addition, for any courses that are specifically required in New Jersey, the Board will allow an applicant to take the courses within 12 months following reinstatement. Proposed subsection (a) also lists the documentation that a licensee whose license has been administratively suspended must provide to the Board in order to apply for reinstatement of his or her license. Proposed subsection (b) sets forth the criteria that the Board must consider when reviewing an application to determine whether there are practice deficiencies and grants the Board discretion to require any applicant found to have practice deficiencies to successfully complete an examination, additional education, training, supervision, or other requirements as a condition of reinstatement.

 The Board proposes to amend N.J.A.C. 13:30-8.7(a)4 to require the treatment plan to be signed by the patient. In addition, the patient must sign a revised treatment plan if there are any significant changes to the treatment plan. Proposed new N.J.A.C. 13:30-8.7(c)7 requires electronic records to comply with the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Federal health privacy rule. The Board proposes to delete "working models may be maintained" from N.J.A.C. 13:30-8.7(d) because it has led to confusion as to whether there is a difference between working and study models.

 The Board proposes to amend N.J.A.C. 13:30-8.8 to update the Board's website address. The Board also proposes to amend N.J.A.C. 13:30-8.9(a) to require the names of the individuals who are "the owners of the facility" instead of the licensees who are "responsible for the administration of the facility" to be displayed on all exterior signs. The Board proposes to amend the heading of N.J.A.C. 13:30-8.10 from "dental insurance forms" to "third-party payor records" because it is more inclusive of the different types of reimbursement options and more descriptive of the rule content. Similarly, the Board proposes to amend subsection (e) to change "insurance" records to those of "third-party payor." The Board also proposes to amend subsection (e) to require that the records be readily retrievable if they are not maintained pursuant to N.J.A.C. 13:30-8.7. In addition, the Board proposes to amend paragraph (b)3 to add "and/or beneficial" for a basis for justification of the service or procedure.

 Proposed new N.J.A.C. 13:30-8.12A requires licensees and registrants to notify the Board in writing within 30 days upon conviction of any crime or arrest, summons, indictment, admission into pre-trial intervention, or plea of guilty to any violation of law, ordinance, felony, misdemeanor, or disorderly persons offense in New Jersey, any other state, the District of Columbia, or in any other jurisdiction. As part of the biennial renewal process, the Board requires licensees and registrants to disclose this information. The Board believes, however, that the licensee or registrant should promptly notify the Board within 30 days instead of waiting up to two years to inform the Board of such information. Having this information will allow the Board to determine whether any action is necessary to protect the welfare and safety of the public.

 The Board proposes to amend N.J.A.C. 13:30-8.26(a)2 to specify that the existing requirement for equipment to maintain adult and pediatric airways includes a portable oxygen delivery system including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivery positive pressure and oxygen-enriched patient ventilation (instead of an ambu-bag (bag-valve-mask rescuscitator) and positive-pressure oxygen. The Board also proposes to require that each dental office, facility, dental clinic, or institution at which there is patient contact to have an AED and contain back-up, battery-operated equipment consisting of at least lighting, suction, and a pulse oximeter, which must be readily accessible and properly operating. The Board believes that requiring the AED and the positive pressure oxygen are part of the standard of practice for basic life support, which is necessary for patient health and safety.

 The Board has provided a 60-day comment period for this notice of proposal. Therefore, this notice is excepted from the rulemaking calendar requirement pursuant to N.J.A.C. 1:30-3.3(a)5.

 Social Impact

 The Board believes that the proposed amendments and new rules will have a positive social impact upon the regulated community and the public by setting forth clear practice standards that will ensure the public's health, welfare, and safety.

 The Board believes that the proposed amendments to N.J.A.C. 13:30-1.2 removing the limit to the number of years for which the Board recognizes the results of the ADEX dental examination and instead focusing on the individual applicant's practice history will make it easier for applicants to become licensed as a dentist without negatively impacting the welfare of the public. The Board also believes that changing the New Jersey Jurisprudence examination to an online orientation will facilitate completion of the application process.

 The proposed amendment to N.J.A.C. 13:30-1A.4 will have a positive social impact by facilitating a dentist's ability to diagnose with x-rays taken by a hygienist in a school setting.

 In addition, the Board believes that the proposed amendments to the continuing education requirements at Subchapter 5 will have a positive social impact. The ongoing education concerning the recognition of opioid addiction is an essential component to preventing drug diversion and prescription drug abuse. In addition, ongoing education in CPR, including the use of an AED, choking and rescue breathing, and preventing and controlling infectious diseases are critical for the public's health, safety, and welfare. Similarly, requiring licensed dentists to have ongoing education concerning pharmacology and internal medicine will benefit patient safety. The Board also believes that requiring continuing education in professional ethics and law will have a positive social impact on the regulated community by ensuring that they stay abreast of ethical and legal developments. In addition, the Board believes that clarifying that a webinar is not considered an electronic media distance learning course if it is live and synchronous will provide licensees and registrants with more freedom to choose the source of, and more options for taking, their continuing education credits.

 The Board also believes that the proposed amendments to Subchapter 5 to waive a portion of the required continuing education in exchange for performing qualifying volunteer dental services or clinician services, as applicable, benefits society by encouraging licensees and registrants to provide dental care to those who otherwise may not be able to have access to it.

 The Board also believes that the amendments at N.J.A.C. 13:30-8.2, 8.3, and 8.4, concerning, respectively, parenteral conscious sedation, the use of general anesthesia, and enteral sedation, will have a positive social impact by ensuring that the regulated community is aware of the minimum standards and competencies required for engaging in these forms of sedation, as well as by protecting public health, safety, and welfare.

 [page=1653] Specifically, the Board believes that the amendments at N.J.A.C. 13:30-8.2(d), to require 40 hours in didactic instruction and 40 hours of supervised clinical training in the administration of PCS, and proposed new N.J.A.C. 13:30-8.2(f) and 8.3(o), will establish training and minimum competencies that will benefit patient health, safety, and welfare.

 The Board also believes that the proposed amendments at N.J.A.C. 13:30-8.2 and 8.3 to establish consistent inspection periods for mobile equipment, drugs, and supplies, and offices will provide clarity to the regulated community as to when inspections will occur. The Board also believes that the proposed minimum standards for the offices in which PCS is conducted and general anesthesia is used will benefit patient health and safety.

 In addition, the Board believes that the proposed amendments at N.J.A.C. 13:30-8.2, 8.3, and 8.4 requiring both basic life support and advanced cardiac life support training for all applicants engaging in sedation and the personnel who are present and trained to assist in the monitoring of patients, will ensure that personnel are properly trained to handle emergencies that may arise, which will help to protect patient health and safety. Similarly, requiring that the M.D. or D.O who is providing anesthesia services remain present through patient discharge, will help to protect patient health and safety. In addition, by specifying that the required review of the patient's medical history is of an up-to-date history and includes both natural and homeopathic medications will help ensure that the dentists are inquiring about, and the patients are prompted to inform the dentist of, information that may impact patient treatment decisions. The Board also believes that specifying that the basic equipment and supplies to deal with emergency situations must be maintained in good operating condition and readily accessible will protect patient health and safety.

 Proposed new N.J.A.C. 13:30-8.5A requiring that dentists provide or make available infection prevention education to all staff who are involved in patient-related sterilization, patient care, and/or maintaining equipment will protect patient and staff health, safety, and welfare.

 The Board believes that the proposed new rules at N.J.A.C. 13:30-8.6, 8.6A, and 8.6B implementing P.L. 2013, c. 182, will make it easier for licensees and registrants to resume, after a period of inactivation or administrative suspension, engaging in the practice of dentistry, dental hygiene, or dental assisting, as applicable. The proposed new rules allow licensees and registrants to submit proof of compliance with another state's continuing education requirements. In addition, proposed new N.J.A.C. 13:30-8.6B no longer mandates retaking the licensing examination if the period of administrative suspension is for more than five years, but provides the Board the flexibility to determine if remediation is necessary to continue to ensure the safety and welfare of the public.

 The proposed amendments at N.J.A.C. 13:30-8.7 to require the patient to sign the treatment plan and, if there are significant changes, a revised treatment plan enhances transparency and communication between the dentist and patient, and will help to minimize situations in which a patient is not clearly advised or does not fully understand the treatment to be provided, and the associated costs of the treatment.

 The Board believes that proposed new N.J.A.C. 13:30-8.12A will have a positive impact on the public by promptly notifying the Board of a licensee's convictions, arrests, and/or other information, enabling the Board to determine whether it should take any action to ensure the safety and welfare of the public.

 In addition, the Board believes that the proposed amendments to the emergency protocol at N.J.A.C. 13:30-8.26 to require a portable oxygen delivery system, including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivering positive pressure and oxygen-enriched patient ventilation, positive pressure oxygen, an AED, and back-up, battery-operated equipment, which is readily accessible and properly operating are important for the public's health, safety, and welfare.

 Economic Impact

 The Board believes that the proposed amendments at N.J.A.C. 13:30-1.2, 1A.2, and 1A.7 will have a positive economic impact on applicants for licensure as dentists and dental hygienists because the cost of licensure has been reduced by the replacement of the New Jersey Jurisprudence examination by a free online orientation. The proposed requirement will not have any economic impact on applicants for registration as dental assistants and limited registered dental assistants in orthodontics. The proposed amendments at N.J.A.C. 13:30-1.2(d) may have an economic impact on applicants for licensure as a dentist who have not practiced since the time of successfully completing the ADEX dental examination, to the extent the Board determines they need to complete additional education or training as a condition of licensure.

 The Board believes that the proposed amendments at N.J.A.C. 13:30-3, which are necessary to be consistent with the statutory amendments to N.J.S.A. 45:6-16.1 and 16.2, may have an economic impact on dental schools to the extent there are administrative costs associated with the certification requirements.

 The Board believes that the proposed amendments to Subchapter 5 to specify that a webinar shall not be considered electronic media distance learning courses may have a positive economic impact on licensees and registrants to the extent that satisfying continuing education through live, synchronous webinars may be less expensive. The Board further believes that these proposed amendments may have a small impact on continuing education providers. Continuing education providers that develop live, synchronous webinar programs may be able to offset a loss, if any, of revenues from decreased attendance at live events. Although the tuition for webinars may be lower than for live events, webinars may attract more students than live events because of their convenience.

 In addition, the Board believes that the proposed amendments to waive a portion of the continuing education credits for a licensee or registrant who renders qualifying volunteer dental or clinician services, as applicable, will have a positive economic impact for licensees, registrants, and to eligible persons. Licensees and registrants will be able to reduce the costs of continuing education and eligible persons will receive free dental care.

 The proposed amendments at N.J.A.C. 13:30-8.1 will have a positive economic impact on dentists applying for licensure by credentials because of the reduced costs of the application fee from $ 250.00 to $ 125.00.

 The Board believes that the proposed amendments at N.J.A.C. 13:30-8.2, 8.3, and 8.4 will have an economic impact to the extent that dental offices do not already have the equipment and supplies or meet the standards required by the Board. To the extent that they do not already maintain both certifications, licensees, registrants, and other personnel who assist with the monitoring of patients will incur additional costs associated with obtaining and maintaining certification in both the basic and advanced cardiac life support courses. To the extent there are additional costs associated with an M.D. or D.O. remaining present through patient discharge after the administration of PCS or general anesthesia, there will be an economic impact on PCS permit holders and general anesthesia permit holders who use the services of an M.D. or D.O.

 Proposed new N.J.A.C. 13:30-8.5A will have an economic impact on dentists to the extent there are costs associated with providing or making available infection prevention education and training to all personnel involved in patient-related sterilization, patient care, and/or maintaining equipment.

 Proposed new N.J.A.C. 13:30-8.6, 8.6A, and 8.6B will continue to have an economic impact on applicants for renewal, reactivation, and reinstatement. Under proposed new N.J.A.C. 13:30-8.6, 8.6A, and 8.6B, licensees and registrants will continue to bear the costs associated with license and registration renewal, reactivation, and reinstatement. However, the dollar amount for each of the existing fees for renewal, reactivation, and reinstatement remain unchanged. In addition, proposed N.J.A.C. 13:30-8.6, concerning licensure and registration renewal, may have an economic impact upon licensees to the extent that licensees and registrants who submit their renewal applications within 30 days of the expiration date must submit a late fee, in addition to the standard renewal fee charged by the Board.

 The Board believes that proposed new N.J.A.C. 13:30-8.6A may have a positive economic impact upon licensees and registrants to the extent they seek to reactivate their license or registration, as applicable, in the second year of the biennial renewal period because the fee is prorated. In addition, the Board believes that proposed new N.J.A.C. 13:30-8.6A and 8.6B may have a positive economic impact upon licensees and registrants [page=1654] seeking to reactivate or reinstate their license or registration. Accepting continuing education requirements of another state may save licensees and registrants the costs associated with completing the Board's continuing education requirements. In addition, applicants for reinstatement will no longer need to complete the continuing education requirements for up to two biennial periods.

 Proposed new N.J.A.C. 13:30-8.6A and 8.6B will continue to have an economic impact upon licensees and registrants seeking reactivation or reinstatement of their license to the extent the Board deems them in need of remediation and they are required to pass an examination or complete additional education or training.

 The proposed amendments at N.J.A.C. 13:30-8.26 will have an economic impact on dentists and dental facilities to the extent that they do not already have, and need to add, an AED, a portable oxygen delivery system, including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivering positive pressure and oxygen-enriched patient ventilation, positive pressure oxygen, and back-up, battery-operated equipment, including, but not limited to, lighting, blood pressure monitoring device, and a pulse oximeter.

 The Board believes that any costs that may be borne by members of the regulated community as a result of the proposed new rules and amendments are outweighed by the benefit to patient health, safety, and welfare in ensuring that dental care and services are provided by qualified professionals in dental offices consistent with the professional practice and facility standards delineated in the rules.

 Federal Standards Statement

 A Federal standards analysis is not required because the proposed amendments, new rules, and repeal are governed by N.J.S.A. 45:6, and are not subject to any Federal requirements or standards. Although the proposed amendments and new rules are not subject to any Federal requirements or standards, proposed new N.J.A.C. 13:30-8.7(c)7 references compliance with HIPAA and Federal health privacy rule.

 Jobs Impact

 The Board does not believe that the proposed amendments, new rules, and repeal will result in the creation or loss of jobs in the State.

 Agriculture Industry Impact

 The proposed amendments, new rules, and repeal will have no impact on the agriculture industry in the State.

 Regulatory Flexibility Analysis

 Currently, the Board licenses approximately 9,080 dentists and 6,090 dental hygienists, and registers approximately 3,590 dental assistants and three limited registered dental assistants in orthodontics. Dental hygienists, dental assistants, and limited registered dental assistants in orthodontics cannot be considered "small businesses" because they may not engage in independent practice. If dentists licensed by the Board are considered "small businesses" within the meaning of the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq., then the following analysis applies.

 The proposed amendments and new rules impose reporting, recordkeeping, and compliance requirements on licensed dentists. These requirements are discussed in the Summary above. No professional services will be needed to comply with the proposed amendments and new rules. The costs of compliance with the proposed amendments and new rules are discussed in the Economic Impact statement above. The Board believes that the proposed amendments and new rules should be uniformly applied to all licensed dentists in order to ensure the health, safety, and welfare of the general public in the provision of dental and dental hygiene services. Therefore, no differing compliance requirements for licensed dentists are provided based upon the size of the business.

 Housing Affordability Impact Analysis

 The proposed amendments, new rules, and repeal will have an insignificant impact on the affordability of housing in New Jersey and there is an extreme unlikelihood that the proposed amendments, new rules, and repeal would evoke a change in the average costs associated with housing, because the proposed amendments, new rules, and repeal concern the practice of dentistry, dental hygiene, dental assisting, and dental assisting in orthodontics.

 Smart Growth Development Impact Analysis

 The proposed amendments, new rules, and repeal will have an insignificant impact on smart growth and there is an extreme unlikelihood that the proposed amendments, new rules and repeal would evoke a change in housing production in Planning Areas 1 or 2, or within designated centers, under the State Development and Redevelopment Plan because the proposed amendments, new rules, and repeal concern the practice of dentistry, dental hygiene, dental assisting, and dental assisting in orthodontics.

 Racial and Ethnic Community Criminal Justice and Public Safety Impact

 The Board has evaluated this rulemaking and determined that it will not have an impact on pretrial detention, sentencing, probation, or parole policies concerning adults and juveniles in the State. Accordingly, no further analysis is required.

 Full text of the rule proposed for repeal may be found in the New Jersey Administrative Code at N.J.A.C. 13:30-8.6.

 Full text of the proposed amendments and new rules follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):

 SUBCHAPTER 1. LICENSURE TO PRACTICE DENTISTRY

 13:30-1.2 Application for licensure to practice dentistry

 (a) (No change.)

 (b) To qualify as a candidate for dental licensure, an applicant shall submit a completed application to the Board, which shall contain the following information and materials:

 1.-2. (No change.)

 3. Results from the successful completion of the [North East Regional Board] ADEX dental examination, including the Periodontal Examination, administered by the Commission on Dental Competency Assessments. If an applicant fails any portion of the [North East Regional Board] ADEX dental examination three consecutive times, the Board may require the applicant to sit for, and pass, a remedial course in the subject area at a dental school, college, or department of a university approved by the Commission on Dental Accreditation[.]; [The Board shall recognize successful completion of the North East Regional Board examination for up to five years;]

 4. (No change.)

 5. [Results from the successful] A certificate of completion of the online New Jersey Jurisprudence [examination] orientation taken within [one year] six months of the date of application;

 6.-9. (No change.)

 (c) (No change.)

 (d) A candidate for dental licensure who has successfully completed the [North East Regional Board examination five years or more prior to the date of application] ADEX dental examination and who has not practiced as a licensed dentist for a period of five years of more prior to the date of application shall re-take the ADEX examination or a Board-approved refresher course with a post-course examination. The Board shall use the results of the clinical or post-course examination to assess competency and practice proficiencies. If the examination identifies deficiencies or educational needs, the Board may require the applicant as a condition of licensure to take and successfully complete any education or training or to submit to any supervision, monitoring, or limitations as the Board determines is necessary to assure that the applicant practices with reasonable skill and safety. A candidate for dental licensure shall submit a completed application to the Board, which shall contain the following information and materials:

 1.-3. (No change.)

 4. [Results from the successful] A certificate of completion of the online  New Jersey Jurisprudence [examination] orientation taken within [two years] six months of the date of application;

 5.-8. (No change.)

 (e) A candidate for dental licensure by credentials, who is licensed to practice dentistry in another state or jurisdiction, shall submit a completed application to the Board, which shall contain the following information and materials:

 [page=1655] 1.-5. (No change.)

 6. [Results from the successful] A certification of completion of the online New Jersey Jurisprudence [examination] orientation taken within [two years] six months of the date of application;

 7.-10. (No change.)

 (f) (No change.)

 (g) As part of its review of applicants for licensure as a dentist, the Board shall consider and evaluate any prior record of disciplinary action or pending disciplinary action against the applicant, investigation of the applicant in any other state or jurisdiction, reports from the National Practitioner Data Bank (NPDB), and the applicant's complete professional employment history, or actions affecting the applicant's privileges taken by any institution, organization, or employer related to the practice of dentistry or other professional or occupational practice in New Jersey, any other state, the District of Columbia, or in any other jurisdiction.

 13:30-1.5 Retired licensure

 A licensee who has practiced dentistry for at least 25 years may, upon application to the Board, be licensed as a retired dentist. A retired licensee shall not engage in the practice of dentistry for the entire biennial period in which he or she has been granted retired status. A retired licensee may resume the practice of dentistry upon fulfilling the requirements of N.J.A.C. 13:30-[8.6(h) or (i), whichever is appropriate] 8.6A.

 SUBCHAPTER 1A. DENTAL HYGIENISTS

 13:30-1A.2 Application for licensure as dental hygienist

 (a) (No change.)

 (b) An applicant for licensure as a dental hygienist shall submit a completed application to the Board, which shall contain the following information and materials:

 1.-2. (No change.)

 3. The results of the successful completion of the [National Dental Hygiene Board examination] National Board Dental Hygiene Examination (NBDHE) administered by the Joint Commission on National Dental Examinations (JCNDE);

 4. The results of the successful completion of the [North East Regional Board examination] ADEX dental hygiene examination administered by the Commission on Dental Competency Assessments, except as provided in (d) and (e) below;

 5. [The results of the successful] A certificate of completion of the online New Jersey Jurisprudence [examination] orientation taken within [one year] six months of the date of application;

 6.-8. (No change.)

 (c) (No change.)

 (d) Upon a written request from an applicant, the Board may grant a waiver of [North East Regional Board performance testing] the ADEX dental hygiene examination. The candidate requesting such a waiver shall submit, at a minimum, the following:

 1.-2. (No change.)

 3. Test results of any state or regional clinical examination other than the [North East Regional Board] ADEX dental hygiene examination. The Board shall recognize successful completion of the examination results for up to five years. After five years, the Board shall review each request for recognition on a case-by-case basis.

 (e) The Board shall recognize successful completion of the [North East Regional Board] ADEX dental hygiene examination for up to five years. After five years, the Board shall review each request for recognition of the [North East Regional Board] ADEX dental hygiene examination on a [case by case] case-by-case basis and may recognize successful completion of the examination provided the candidate submits, at a minimum, a certification by the board of dentistry in every state or jurisdiction in which the applicant holds a license to practice dental hygiene verifying that the applicant's license in that state or jurisdiction is in good standing.

 (f) (No change.)

 13:30-1A.4 Scope of practice of licensed dental hygienist under general supervision

 (a)-(b) (No change.)

 (c) School setting. A licensed dental hygienist practicing under the general supervision of a licensed dentist in a school setting [may]:

 1. [Administer] May administer to that school's students, with written parental or guardian consent, preventive measures such as the application of fluorides, pit and fissure sealants, as well as other recognized topical agents, including topical anesthetics, for the prevention of oral disease or associated discomfort and the detection of caries, and may use a curing light for the application of sealants, provided that:

 i. (No change.)

 ii. When applying sealants, the licensed dental hygienist conforms to the assessment guidelines set forth by the supervising dentist and adheres to acceptable treatment protocol standards, including maintaining a dry field[.] ;

 2. Shall make radiographic exposures as permitted by the Department of Environmental Protection pursuant to N.J.S.A. 26:2D-24 et seq., provided that the exposures are made for the school's students and written parental or guardian consent is obtained; and

 [2.] 3. [The licensed dental hygienist must] Shall comply with the notification requirements of [(e)3] (f)3 below and provide written notice of the administered treatment to the supervising dentist, school, and parent/guardian.

 i.-ii. (No change.)

 [3.] (d) The supervising dentist of a licensed dental hygienist practicing under the general supervision in a school setting shall [maintain]:

 1. Maintain for at least seven years:

 i. (No change.)

 ii. The written record of treatment by the licensed dental hygienist[.] ; and

 [4.] 2. [The supervising dentist shall review] Review, within 30 days of treatment by the licensed dental hygienist, the written record of treatment to ensure compliance with the assessment guidelines, treatment protocol standards, and notification requirements set forth in (c)[1 and 2] above.

 i. (No change.)

 Recodify existing (d)-(e) as (e)-(f) (No change in text.)

 13:30-1A.5 Administration of local anesthesia by licensed dental hygienists

 (a)-(c) (No change.)

 (d) A licensed dental hygienist applying for a Board permit to administer local anesthesia shall satisfy the following requirements:

 1. (No change.)

 2. Passage of the written examination in the administration of local anesthesia administered by the [Northeast Regional Board of Dental Examiners (NERB)] Commission on Dental Competency Assessments (CDCA).

 (e) A licensed dental hygienist who holds a permit to administer local anesthesia under the direct supervision of a licensed dentist shall complete four hours of continuing education in the administration of local anesthesia in every other biennial renewal period (that is, four hours every four years), consistent with the requirements of N.J.A.C. 13:30-5.2.

 (f)-(h) (No change.)

 13:30-1A.7 Credit towards licensure as a dental hygienist for education, training, and experience received while serving as a member of the Armed Forces

 (a) (No change.)

 (b) The Board shall issue a license as a dental hygienist to the applicant if the applicant presents evidence to the Board that:

 1.-2. (No change.)

 3. The applicant complies with all other requirements for licensure as a dental hygienist, including successful completion of the [National Dental Hygiene Board examination] National Board Dental Hygiene Examination (NBDHE) administered by the Joint Commission on National Dental Examinations (JCNDE), the [North East Regional Board] ADEX dental hygiene examination, and the online New Jersey Jurisprudence [examination] orientation within six months of the date of application, as set forth in N.J.A.C. 13:30-[1A.1] 1A.2.

 [page=1656] (c)-(e) (No change.)

 SUBCHAPTER 2. DENTAL ASSISTANTS

 13:30-2.2 Application for registration as dental assistant

 (a) An applicant desiring to secure registration as a dental assistant shall have a certificate of completion of the online New Jersey Jurisprudence orientation taken within six months of the date of application and:

 1. Satisfactorily completed and graduated, within the past 10 years, from an educational program for dental assistants approved by the Board and the Commission on Dental Accreditation and shall have taken the [Registered Dental Assistant Certification] Certified Dental Assistant Examination administered by the Dental Assisting National Board (DANB) within 10 years prior to the date of application; or

 2. Successfully completed high school (or its equivalent) and shall have:

 i. Obtained at least two years of work experience as a dental assistant during the five-year period prior to making application for registration, passed the [Registered Dental Assistant Certification] Certified Dental Assistant Examination administered by DANB within 10 years prior to the date of application, successfully completed a Board-approved program in expanded functions, and passed the New Jersey Expanded Functions Examination administered by DANB; or

 ii. Obtained at least two years of work experience as a dental assistant during the five-year period prior to making application for registration, passed the [Registered Dental Assistant Certification] Certified Dental Assistant Examination administered by DANB within 10 years prior to application, and passed the New Jersey Expanded Functions Examination administered by DANB.

 (b) An applicant for registration as a dental assistant shall submit a completed application to the Board [which] that contains the following information and materials:

 1. (No change.)

 2. Proof of the following, if applicable pursuant to (a) above:

 i.-ii. (No change.)

 iii. A certificate of successful completion of an approved program in expanded functions in dental assisting. The Board shall recognize the following as providers of approved programs in expanded functions:

 (1)-(2) (No change.)

 (3) In-service training programs conducted at the graduate level by agencies of the Federal, State, or local government[, which] that are substantially similar to programs described in (b)2iii(1) and (2) above; [and]

 iv. A certificate of successful completion of the Registered Dental Assistant Certification Examination administered by DANB; and

 v. A certificate of completion of the online New Jersey Jurisprudence orientation within six months of the date of application;

 3.-4. (No change.)

 13:30-2.3 Application for registration as limited registered dental assistant in orthodontics

 (a) An applicant desiring to secure registration as a limited registered dental assistant in orthodontics shall have a certificate of completion of the online New Jersey Jurisprudence orientation taken within six months of the date of application and:

 1.-2. (No change.)

 (b) An applicant for registration as a limited registered dental assistant in orthodontics shall submit a completed application to the Board[, which] that contains the following information and materials:

 1.-2. (No change.)

 3. A certificate of successful completion of the Certified Orthodontic Assistant (COA) Examination, or successor examination, administered by DANB, the Topical Fluoride Examination, or successor examination, administered by DANB, [and] the Coronal Polish Examination, or successor examination, administered by DANB, and a certificate of completion of the online New Jersey Jurisprudence orientation within six months of the date of application;

 4.-5. (No change.)

 13:30-2.7 Credit towards registration as a dental assistant for education, training, and experience received while serving as a member of the Armed Forces

 (a) (No change.)

 (b) The Board shall issue a registration as a dental assistant to the applicant if the applicant presents evidence to the Board that:

 1.-2. (No change.)

 3. The applicant complies with all other requirements for registration, including successful completion of the [Registered Dental Assistant Certification] Certified Dental Assistant Examination administered by the Dental Assisting National Board (DANB) [and], the New Jersey Expanded Functions Examination administered by DANB, as applicable, as set forth [in] at N.J.A.C. 13:30-2.2, and completion of the online New Jersey Jurisprudence orientation within six months of the date of application.

 (c)-(e) (No change.)

 13:30-2.8 Credit towards registration as a limited registered dental assistant in orthodontics for education, training, and experience received while serving as a member of the Armed Forces

 (a) (No change.)

 (b) The Board shall issue a registration as a limited registered dental assistant in orthodontics to the applicant if the applicant presents evidence to the Board that:

 1.-2. (No change.)

 3. The applicant complies with all other requirements for registration, including successful completion of the examination requirements as set forth [in] at N.J.A.C. 13:30-2.3, and completion of the online New Jersey Jurisprudence orientation within six months of the date of application.

 (c)-(e) (No change.)

 SUBCHAPTER 3. APPLICANTS FOR LIMITED TEACHING CERTIFICATE IN A DENTAL SCHOOL

 13:30-3.1 Qualifications of applicants

 (a) (No change.)

 (b) An applicant for such limited license must have the competency to teach the science of dentistry as predicated upon the applicant's general and technical knowledge [similar to that required in this State for a license to practice dentistry without limitation].

 (c) An applicant for a limited teaching certificate shall submit a certified transcript from the secretary or dean of a dental school, college, or department of a university [approved by the Board or by the Commission on Dental Accreditation], verifying that the applicant has obtained a dental degree from such institution.

 13:30-3.2 Application procedure

 (a) The applicant for a limited teaching certificate shall:

 1. Submit a completed and notarized application, which shall include a certified transcript of graduation from [an accredited] a dental school by an authorized official of the dental school; [and]

 2. Provide employment history and professional history from the time the dental degree was conferred; and

 [2.] 3. (No change in text.)

 (b) In addition to the requirements of (a) above, the dean of the dental school in which the applicant seeks employment shall submit to the Board:

 1. A certification that the applicant is properly qualified to teach, demonstrate, and practice dentistry at the dental school; and

 2. Supporting information from which the Board can determine that the applicant's general and technical level of knowledge and moral character suitably qualifies the applicant to teach, demonstrate, and practice dentistry at a dental school in this State.

 13:30-3.3 Limitations on certificate

 (a) (No change.)

 (b) No limited teaching certificate shall be deemed to authorize the licensee to engage in the private practice of dentistry [either within or [page=1657] without] outside of the premises [designated in the certificate] of the dental school or its clinical facilities.

 (c) A limited teaching certificate shall automatically expire upon the termination of the certificate holder's employment by a dental school in this State.

 13:30-3.4 Educational institutions

 (a)-(b) (No change.)

 (c) No dental school in this State shall employ, at any one time, more than 15 persons with limited teaching certificates who have graduated from dental schools not approved by the Board. For the purposes of this subsection, if the dental school from which the applicant graduated is located in the United States, Canada, or a territory or possession of the United States, the dental school shall be approved by the Board.

 SUBCHAPTER 5. CONTINUING EDUCATION

 13:30-5.1 Continuing dental education requirements for dentists

 (a) Continuing education shall be a mandatory requirement for license renewal, except that the Board shall not require completion of continuing dental education credits for initial registration of dentists. All licensed dentists holding active licenses shall submit a certification verifying completion of 40 hours of continuing dental education every two years at the time of registration renewal, including the 10 mandatory hours of continuing dental education specified in (e) below, except for the following:

 1.-2. (No change.)

 (b)-(d) (No change.)

 (e) All continuing education activities to be accepted for credit shall have significant intellectual or practical content, which deals primarily with matters directly related to the practice of dentistry or with the professional responsibilities or ethical obligations of licensees. [Subjects such as estate planning, financial or investment/tax planning, and personal health shall not be acceptable for continuing education credit.]

 1. The following 10 hours of continuing education shall be completed by each licensee during each biennial renewal period as required in (a) above:

 i. Three hours of continuing education with practical hands-on certification for cardiopulmonary resuscitation (CPR), which meets the American Heart Association certification standards for healthcare providers. The training shall include the use of an automatic external defibrillator (AED), unconscious and conscious choking, and rescue breathing. Webinars and electronic media distance learning courses shall not satisfy this requirement;

 ii. Three hours of continuing education of pharmacology and internal medicine, which includes the appropriate use of analgesics, antibiotics, local anesthesia and agents to control anxiety, drug (medication) knowledge and interactions, prescription writing, abuse of prescriptions by patients, taking complete medical histories, and the use of the New Jersey Prescription Monitoring Program (NJPMP);

 iii. Two hours of continuing education in preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings. Examples of such education include: modes of disease transmission and the chain of infection; strategies that can prevent occupational exposures to blood and bodily fluids; methods to ensure that patient-care items and environmental surfaces are safe for use; selection and use of safe dental devices and dental water quality assurance and practice monitoring; and evaluation of dental infection control programs;

 iv. One hour of continuing education in professional ethics and New Jersey law concerning the practice of dentistry. Examples of such education include: dental ethics, professionalism, New Jersey jurisprudence, ethical issues concerning the abuse of prescriptions by patients, child abuse, competence and judgment, and patient confidentiality. The online New Jersey Jurisprudence orientation shall not satisfy this continuing education requirement; and

 v. Pursuant to P.L. 2017, c. 28, one hour of continuing education in educational programs or topics concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion. This one credit shall not be eligible for carry-over as described in (k) below.

 2. In accordance with P.L. 2017, c. 28, if the Board deems it appropriate, on an individual basis, the Board may waive the specific one credit continuing education requirement concerning prescription opioid drugs. Any such waiver request shall be filed pursuant to (m) below.

 3. Notwithstanding the exemption from the completion of continuing education credits as set forth in (a)2 above, the applicant, once licensed by the Board, shall complete, within 24 months of becoming licensed, one credit in educational programs or topics concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion.

 4. The Board shall not accept the following topics for continuing education credit:

 i. Estate planning;

 ii. Financial or investment/tax planning; or

 iii. Personal health.

 (f)-(h) (No change.)

 (i) A licensee may obtain continuing education credits from any of the areas of study listed below. A licensee shall not receive credit for more than the maximum number of hours permitted in each area of study for each biennial period, as set forth in (i)1 through 4 below.

 1. Educational and scientific courses related to the practice of dentistry;

 i. (No change.)

 ii. The following shall satisfy the requirement of 40 hours of continuing education, including the 10 mandatory hours required in (e) above, for a biennial registration period:

 (1) (No change.)

 (2) Attendance at, or completion of, an approved advanced education program leading to [specialty] certification in endodontics, oral and maxillofacial surgery, oral and maxillofacial pathology, orthodontics, pediatric dentistry, periodontics, prosthodontics, public health, or oral and maxillofacial radiology.

 iii. (No change.)

 iv. A maximum of 20 hours of continuing education credit shall be given for any form of written or electronic media distance learning courses. A written or electronic media distance learning course shall include a written post-test, and such test shall be retained by the licensee as an additional record of completion of the course. Webinars shall not be considered electronic media distance learning courses if they are live (not previously recorded) and synchronous (the instructor and licensee interact with each other in real time).

 v. (No change.)

 2.-4. (No change.)

 (j)-(m) (No change.)

 (n) Pursuant to N.J.S.A. 45:6-10.4, consistent with the provisions of this subsection, the Board shall waive up to one-half of the required biennial continuing dental education hours set forth in (a) above for a licensee who renders volunteer dental services to eligible persons.

 1. For purposes of this subsection, the following words and terms shall have the following meanings, unless the context clearly indicates otherwise:

 "Eligible person" means:

 (1) Any person under the age of 19 whose parent or guardian attests that he or she meets the eligibility requirements for, and is enrolled in, the NJ FamilyCare Program established pursuant to P.L. 2005, c. 156 (N.J.S.A. 30:4J-8 et seq.);

 (2) A child who is in the custody of the Division of Child Protection and Permanency in the Department of Children and Families; or

 (3) Any person who attests that he or she meets the eligibility requirements for, and is enrolled in, the Medicaid program established pursuant to P.L. 1968, c. 413 (N.J.S.A. 30:4D-1 et seq.), the Pharmaceutical Assistance to the Aged and Disabled program established pursuant to P.L. 1975, c. 194 (N.J.S.A. 30:4D-20 et seq.), [page=1658] or the Senior Gold Prescription Discount Program established pursuant to P.L. 2001, c. 96 (N.J.S.A. 30:4D-43 et seq.).

 "Volunteer dental service" means dental care provided, without charge, to an eligible person, or to a minor in a primary school, secondary school, or other school setting, or to a patient through a dental clinic as defined by section 1 of P.L. 1951, c. 199 (N.J.S.A. 45:6-15.1), consistent with the requirements of this subsection.

 2. One half-hour of one continuing dental education credit hour shall be waived for each hour of volunteer dental service.

 3. The 10 mandatory continuing education hours set forth in (e) above shall not be eligible for waiver.

 4. As part of biennial renewal, a licensee shall submit to the Board, on a form supplied by the Board and available on the Board's website at http://www.njconsumeraffairs.gov/den, documentation evidencing the total number of credits that are eligible for the waiver in accordance with this subsection.

 13:30-5.2 Continuing education requirements for dental hygienists

 (a) All licensed dental hygienists shall submit a certification verifying the completion of 20 hours of continuing education every two years at the time of license renewal, except as provided in (b) and (d) below, including the six mandatory continuing education credits specified in this subsection. No more than one-half of the required continuing education hours in the two-year period may be obtained through written or electronic media distance learning courses. Webinars shall not be considered electronic media distance learning courses if they are live (not previously recorded) and synchronous (the instructor and licensee interact with each other in real time).

 1. The following six hours of continuing education shall be completed by each licensee during each biennial renewal period:

 i. Three hours of continuing education with practical hands-on certification for cardiopulmonary resuscitation (CPR) that meets the American Heart Association certification standards for healthcare providers. The training shall include the use of an automatic external defibrillator (AED), unconscious and conscious choking, and rescue breathing. Webinars and electronic media distance learning courses shall not satisfy this requirement;

 ii. One hour of continuing education in preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings. Examples of such education include: modes of disease transmission and the chain of infection; strategies that can prevent occupational exposures to blood and bodily fluids; methods to ensure that patient-care items and environmental surfaces are safe for use; selection and use of safe dental devices and dental water quality assurance and practice monitoring; and evaluation of dental infection control programs;

 iii. One hour of continuing education in professional ethics and New Jersey law concerning the practice of dental hygiene. Examples of such education include: dental ethics, professionalism, New Jersey jurisprudence, ethical issues concerning the abuse of prescriptions by patients, child abuse, competence and judgment, and patient confidentiality. The online New Jersey Jurisprudence orientation shall not satisfy this continuing education requirement; and

 iv. One hour of continuing education in educational programs or topics concerning prescription opioid drugs, including the risks and signs of opioid abuse, addiction, and diversion.

 (b)-(f) (No change.)

 (g) Consistent with the provisions of this subsection, the Board shall waive up to one-half of the required biennial continuing dental hygiene education hours set forth in (a) above for a licensee who renders volunteer services as a clinician to eligible persons as defined at N.J.A.C. 13:30-5.1(n).

 1. One half-hour of one continuing dental hygiene education credit hour shall be waived for each hour of volunteer clinician service. "Volunteer clinician service" means clinician services provided, without charge, to an eligible person, as defined at N.J.A.C. 13:30-5.1(n), or to a minor in a primary school, secondary school, or other school setting, or to a patient through a dental clinic as defined by section 1 of P.L. 1951, c. 199 (N.J.S.A. 45:6-15.1), consistent with the requirements of this subsection.

 2. The six mandatory continuing education hours set forth in (a)1 above shall not be eligible for waiver.

 3. As part of the biennial renewal, a licensee shall submit to the Board, on a form supplied by the Board and available on the Board's website at http://www.njconsumeraffairs.gov/den, documentation evidencing the total number of credits that are eligible for the waiver in accordance with this subsection.

 13:30-5.3 Continuing education requirements for registered dental assistants and limited registered dental assistants in orthodontics

 (a) All registered dental assistants and limited registered dental assistants in orthodontics shall submit a certification verifying the completion of 10 hours of continuing education every two years at the time of registration renewal, including the six mandatory continuing education hours set forth in (f) below. No more than one-half of the required continuing education hours in the two-year period may be obtained through written or electronic media distance learning courses. Webinars shall not be considered electronic media distance learning courses if they are live (not previously recorded) and synchronous (the instructor and registrant interact with each other in real time).

 (b)-(e) (No change.)

 (f) The following six hours of continuing education shall be completed by each registrant during each biennial renewal period:

 1. Three hours of continuing education with practical hands-on certification for cardiopulmonary resuscitation (CPR), which meets the American Heart Association certification standards for healthcare providers. The training shall include the use of an automatic external defibrillator (AED), unconscious and conscious choking, and rescue breathing. Webinars and electronic media distance learning courses shall not satisfy this requirement;

 2. One hour of continuing education in preventing and controlling infectious diseases and managing personnel health and safety concerns related to infection control in dental settings. Examples of such education include: modes of disease transmission and the chain of infection; strategies that can prevent occupational exposures to blood and bodily fluids; methods to ensure that patient-care items and environmental surfaces are safe for use; selection and use of safe dental devices and dental water quality assurance and practice monitoring; and evaluation of dental infection control programs;

 3. One hour of continuing education in professional ethics and New Jersey law concerning the practice of dental assisting. Examples of such education include: dental ethics, professionalism, New Jersey jurisprudence, ethical issues concerning the abuse of prescriptions by patients, child abuse, competence and judgment, and patient confidentiality. The online New Jersey Jurisprudence orientation shall not satisfy this continuing education requirement; and

 4. One hour of continuing education in educational programs or topics concerning prescription opioid drugs, including the risks and signs of opioid abuse, addiction, and diversion.

 (g) Consistent with the provisions of this subsection, the Board shall waive up to two of the required biennial continuing dental assistant education hours set forth in (a) above for a registrant who renders volunteer services as a clinician to eligible persons as defined at N.J.A.C. 13:30-5.1(n).

 1. One half-hour of one continuing dental assisting education credit hour shall be waived for each hour of volunteer clinician service. "Volunteer clinician service" means clinician services provided, without charge, to an eligible person, as defined at N.J.A.C. 13:30-5.1(n), or to a minor in a primary school, secondary school, or other school setting, or to a patient through a dental clinic as defined by section 1 of P.L. 1951, c. 199 (N.J.S.A. 45:6-15.1), consistent with the requirements of this subsection.

 2. The six mandatory continuing education hours set forth in (f) above shall not be eligible for waiver.

 3. As part of the biennial renewal, a registrant shall submit to the Board, on a form supplied by the Board and available on the Board's website at http://www.njconsumeraffairs.gov/den, documentation evidencing the total number of credits that are eligible for the waiver in accordance with this subsection.

 [page=1659] SUBCHAPTER 6. ADVERTISING

 13:30-6.2 Professional advertising

 (a)-(o) (No change.)

 (p) A licensee shall be presumed to have approved and shall be personally responsible for the form and contents of an advertisement [which] that contains the licensee's name, office address, or telephone number or which is published or caused to be published by an entity to which the licensee has paid a fee or when the licensee has agreed to have his or her name listed as a participant pursuant to (q) below. A licensee who employs or allows another to employ for his or her benefit an intermediary source or other agent in the course of advertising shall be personally responsible for the form and contents of [said] the advertisement.

 (q)-(r) (No change.)

 (s) A dentist advertising sedation services who uses the terms "sleep," "sleep dentistry," "sleeplike-state," or any similar words or combinations thereof in connection with the provision of dental services shall be considered to be inducing deep sedation as defined at N.J.A.C. 13:30-8.1A(a) and shall comply with the requirements of N.J.A.C. 13:30-8.3.

 SUBCHAPTER 8. GENERAL PROVISIONS

 13:30-8.1 Fee schedules

 (a) The application fees charged by the New Jersey State Board of Dentistry shall be the following:

 1.-3. (No change.)

 [4. Supervisor of three-month internship program for training of registered dental assistants $ 35.00]

 (b) The biennial license and registration fees charged by the New Jersey State Board of Dentistry shall be the following:

 1. Dentists:

 i.-ii. (No change.)

 [iii. Inactive license renewal....................................................... $ 140.00]

 iii. (Reserved)

 iv.-v. (No change.)

 2. Dental Hygienists

 i.-ii. (No change.)

 [iii. Inactive license renewal........................................................ $ 50.00]

 3. Registered Dental Assistants, Limited Registered Dental Assistants and Limited Registered Orthodontic Assistants:

 i.-ii. (No change.)

 [iii. Inactive registration renewal................................................. $ 50.00]

 (c)-(d) (No change.)

 (e) Other fees:

 1.-2. (No change.)

 3. Licensure of dentists by credentials--application fee............................................$[250.00] 125.00

 4.-8. (No change.)

 (f) (No change.)

 13:30-8.2 Parenteral conscious sedation

 (a)-(b) (No change.)

 (c) No dentist shall use PCS for dental patients unless such dentist possesses a PCS permit issued by the State Board of Dentistry for a specified practice location, which shall be renewed biennially. A dentist shall obtain a separate PCS permit for each practice location at which PCS is administered, except as set forth in [(j)] (l) below.

 (d) A dentist applying for a Board permit to administer PCS shall complete an application as provided by the Board. The dentist shall submit as part of a completed application a certification from an accredited university, teaching hospital, or other training institution or facility approved pursuant to N.J.S.A. 45:6-2, establishing that the applicant has completed formal training in the administration of PCS. Such formal training shall consist of, at a minimum, [a combined 80] 40 hours in didactic instruction and 40 hours of supervised clinical training in the administration of PCS. Such formal training shall have been completed within three years preceding the date of application. Supervised clinical training shall consist of, at a minimum, delivering intravenous, intramuscular, subcutaneous, submucosal and inhalation medications, monitoring patient activity, and managing patient care for 20 PCS patients. As part of the dentist's PCS permit application, the institution shall certify the applicant is competent to:

 1.-4. (No change.)

 5. Understand the clinical pharmacology of the drugs used for PCS and the interactions of [the] these drugs [used for PCS];

 6. (No change.)

 7. Monitor patients during the administration of PCS using clinical evaluations and mechanical means, including the use of an EKG monitor and a pulse oximeter, capnography, and the interpretation of such readings;

 [8. Recognize and manage anesthetic and medical emergencies arising from the use of PCS;]

 Recodify existing 9.-10. as 8.- 9. (No change in text.)

 (e) All offices in which parenteral conscious sedation is conducted shall be inspected and approved once every six years by the State Board of Dentistry, or its designee, and shall, at a minimum, have the equipment and supplies set forth at (i) below and at N.J.A.C. 13:30-8.26, which shall be readily accessible and maintained in good operating condition and shall meet the following standards:

 1. The operating room shall have space large enough to provide adequate accommodation of the patient on a table or in an operating chair, and allow an operating team consisting of at least three individuals to move about the patient without restriction or limitation;

 2. A recovery area that has available oxygen and monitoring equipment, adequate lighting, suction, and electrical outlets. The recovery area can be the operating theatre; and

 3. A lighting system adequate to permit visual evaluation of the patient's skin and mucosal color.

 (f) A licensee who administers parenteral conscious sedation shall:

 1. Be able to recognize and manage complications and medical emergencies from drug administrations;

 2. Understand the clinical pharmacology of the drugs used for parenteral conscious sedation and the interactions of these drugs;

 3. Maintain patient airways and support ventilation;

 4. Monitor patients during the administration of parenteral conscious sedation using clinical evaluations and mechanical means, including the use of an EKG monitor, pulse oximeter, and capnogram, and the interpretation of such readings;

 5. Manage patients during the post-operative period and assess patients' suitability for discharge; and

 6. Maintain accurate and contemporaneous anesthetic records including drugs, dosages, vital signs, and patient responses.

 [(e)] (g) An applicant for a PCS permit shall obtain emergency training by completing ["Basic Life Support: Course C" of] the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, [or] and a course in Advanced Cardiac Life Support, or its equivalent, and shall maintain current certification in such course s. The applicant shall furnish proof of this training and certification to the Board upon application for a PCS permit and proof of recertification upon biennial renewal of the permit.

 [(f)] (h) An applicant for a PCS permit shall certify to the Board upon application for a permit and upon biennial renewal of the permit that the dentist employs no fewer than two persons who will be present in the office, at least one of whom shall assist in monitoring the patient whenever PCS is employed. The applicant shall further certify that these persons are trained in, and capable of, monitoring vital signs and of assisting in emergency procedures and that they maintain current certification in ["Basic Life Support: Course C"] American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, [or] and in Advanced Cardiac Life Support, or its equivalent.

 [(g)] (i) An applicant for a PCS permit shall certify as part of the application for a permit and upon biennial renewal of the permit that he or she possesses basic equipment and supplies to deal with emergency situations. The permit holder's facility shall contain the following readily accessible and properly operating equipment: [emergency]

 1. Emergency drug kit, consisting of, at a minimum, the following [; positive pressure oxygen; stethoscope; suction; nasopharyngeal] :

 i. Analgesics;

 [page=1660] ii. Local anesthetics;

 iii. Vasopressors;

 iv. Vasodilators (coronary);

 v. Anti-bradicardic agents;

 vi. Bronchodilators;

 vii. Muscle relaxant for treatment of laryngospasm;

 viii. Antihistamine;

 ix. Narcotic antagonist;

 x. Anticonvulsant;

 xi. Steroids;

 xii. Tranquilizers;

 xiii. Anti-hypertensive;

 xiv. Benzodiazepines;

 xv. Benzodiazepine antagonist;

 xvi. Anti-arrhythmic (for example, lidocaine or amiodarone);

 xvii. Aspirin;

 xviii. Nitroglycerine (tablets, paste, or spray);

 xix. Antiemetic; and

 xx. Dantrolene;

 2. Battery-powered clocks or watches;

 3. Stethoscope;

 4. Mouth props (assorted adult and pediatric sizes);

 5. Suction equipment capable of aspirating gastric contents from the mouth and pharynx;

 6. Emergency suction device;

 7. Nasopharyngeal tubes; [oropharyngeal]

 8. Oropharyngeal tubes; [a]

 9. A blood pressure monitoring device; [an]

 10. An EKG monitor; [and a]

 11. A pulse oximeter or its equivalent[. The permit holder's facility shall also contain back-up, battery-operated equipment consisting of, at a minimum, lighting, suction and a pulse oximeter, which shall be readily accessible and properly operating.];

 12. Respiration monitoring equipment (for example, visible reservoir bag);

 13. Intravenous solutions ("ACLS compatible" IV administration sets and tubing);

 14. Syringes, needles, IV catheters, and tape scissors;

 15. Laryngoscopes, assorted size blades, and spare batteries;

 16. Endotracheal tubes (adult and pediatric sizes);

 17. Magil forceps;

 18. Yankauer type suction tips and catheter suction; and

 19. A capnometer.

 [(h)] (j) (No change in text.)

 [(i)] (k) A dentist who utilizes the services of a PCS permit holder or an M.D. or D.O. who is a member of the anesthesiology staff of an accredited hospital or who is authorized to perform anesthesia services by the Board of Medical Examiners pursuant to N.J.A.C. 13:35-4A shall not be deemed to be administering PCS, provided that the PCS permit holder or M.D. or D.O. remains present during the administration of PCS through patient discharge, and bears full responsibility during the entire procedure until the patient has recovered fully and has been discharged.

 [(j)] (l) A PCS permit holder invited by a dentist to provide PCS services at a specific location shall bear full responsibility for compliance with all provisions of this section including the minimum requirements for assisting staff and equipment set forth in [(f) and (g)] (e), (h), and (i) above. When a PCS permit holder utilizes mobile equipment and supplies to administer PCS pursuant to this section, the mobile equipment, drugs, and supplies of the permit holder shall be inspected by the Board or its designee not less than once every three years. "Mobile equipment, drugs, and supplies," for purposes of this subsection, means any equipment, drugs, and/or supplies [which] that are transported and used by a permit holder to administer PCS in one or more locations. When more than one permit holder utilizes the mobile equipment and supplies, it shall be the responsibility of the permit holder using the equipment and supplies to ensure that the mobile equipment, drugs, and supplies satisfy the requirements of this section as set forth in [(g)] (i) above prior to the administration of PCS.

 [(k)] (m) Prior to the administration of a PCS agent [for the purpose of controlling pain], the permit holder shall conduct a physical evaluation of the patient [shall be made by the permit holder and a complete medical history shall be obtained], review the patient's up-to-date medical history, which shall include [previous] any changes and any medications, including natural and homeopathic medications, allergies, and sensitivities. The patient history shall be maintained in the files of each dentist for a period of not less than seven years. Specific contemporaneous records on the use of PCS shall be kept as part of every patient chart and shall include the [type of] agent s utilized, the dosage, and the duration of sedation. The patient record, including medical history, shall be maintained in accordance with N.J.A.C. 13:30-8.7.

 Recodify existing (l)-(m) as (n) - (o) (No change in text.)

 13:30-8.3 Use of general anesthesia

 (a)-(b) (No change.)

 (c) No dentist shall employ or use general anesthesia on an outpatient basis for dental patients unless such dentist possesses a permit or authorization issued by the State Board of Dentistry for a specified practice location, which shall be renewed biennially. [The dentist holding such permit shall be subject to review, and such permit shall be renewed biennially.] A dentist shall obtain a separate general anesthesia permit for each practice location at which general anesthesia is administered, except as set forth in (i) below.

 (d) In order to receive such a permit, the dentist shall apply on an official application form and submit certified or verifiable proof [that he or she] of the following:

 [i.] 1. [Has completed] Completion of a minimum of three years of post-doctoral training in oral surgery, or a minimum one-year training course in anesthesiology; or

 [ii.] 2.[Is] Being a diplomate in oral surgery or is Board-eligible in oral surgery; or

 [iii.] 3. [Is] Being a fellow of the American Dental Society of Anesthesiology, or is a member of the American Society of Oral and Maxillofacial Surgeons and/or is a member of the New Jersey Society of Oral and Maxillofacial Surgeons.

 (e) (No change.)

 (f) Every applicant for a general anesthesia permit must certify that he or she possesses basic equipment and supplies to deal with emergency situations, [which equipment and supplies] as required by the Board, which shall be readily accessible and maintained in good [order] operating condition. [This shall consist of no less than the list that shall be supplied by the Board.] The permit holder's facility shall contain the following readily accessible and properly operating equipment:

 1. Emergency drug kit, consisting of, at a minimum, the following:

 i. Analgesics;

 ii. Local anesthetics;

 iii. Vasopressors;

 iv. Vasodilators (coronary);

 v. Anti-bradicardic agents;

 vi. Bronchodilators;

 vii. Muscle relaxant for treatment of laryngospasm;

 viii. Antihistamine;

 ix. Narcotic antagonist;

 x. Anticonvulsant;

 xi. Steroids;

 xii. Tranquilizers;

 xiii. Anti-hypertensive;

 xiv. Benzodiazepines;

 xv. Benzodiazepine antagonist;

 xvi. Anti-arrhythmic (for example, lidocaine or amiodarone);

 xvii. Aspirin;

 xviii. Nitroglycerine (tablets, paste, or spray);

 xix. Antiemetic; and

 xx. Dantrolene;

 2. Battery-powered clocks or watches;

 3. Stethoscope;

 4. Mouth props (assorted adult and pediatric sizes);

 5. Suction equipment capable of aspirating gastric contents from the mouth and pharynx;

 6. Emergency suction device;

 7. Nasopharyngeal tubes;

 [page=1661] 8. Oropharyngeal tubes;

 9. A blood pressure monitoring device;

 10. An EKG monitor;

 11. A pulse oximeter or its equivalent;

 12. Respiration monitoring equipment (for example, visible reservoir bag);

 13. Intravenous solutions ("ACLS compatible" IV administration sets and tubing);

 14. Syringes, needles, IV catheters, and tape scissors;

 15. Laryngoscopes, assorted size blades, and spare batteries;

 16. Endotracheal tubes (adult and pediatric sizes);

 17. Magil forceps;

 18. Yankauer type suction tips and catheter suction; and

 19. A capnometer.

 (g) Any permit holder invited by a dentist to provide general anesthesia services shall be responsible for compliance with all terms and conditions of this section, including the minimum requirements for assisting staff, as set forth in (e) above, [and] equipment, as set forth in (f) above, and facility standards as set forth in (j) below.

 (h) (No change.)

 (i) In a dental facility where a permit holder administers general anesthesia pursuant to this section, the mobile equipment, drugs, and supplies of the permit holder shall be inspected and approved by the State Board of Dentistry or its designee once every [six] three years. "Mobile equipment, drugs, and supplies," for purposes of this subsection, means any equipment, drugs, and/or supplies [which] that are transported and used by a permit holder to administer anesthesia in one or more dental facilities.

 (j) All offices in which general anesthesia is administered shall, at a minimum, have the equipment and supplies as set forth at (f) above and N.J.A.C. 13:30-8.6, which shall be readily accessible and maintained in good operating condition and shall meet the following standards:

 1. An operating room with space large enough to provide adequate accommodation of the patient on a table or in an operating chair, and allow an operating team consisting of at least three individuals to move about the patient without restriction or limitation;

 2. A recovery area that has available oxygen and monitoring equipment, adequate lighting, suction, and electrical outlets. The recovery area can be the operating theatre; and

 3. A lighting system adequate to permit visual evaluation of the patient's skin and mucosal color.

 Recodify existing (j)-(k) as (k)-(l) (No change in text.)

 [(l)] (m) Prior to the administration of an anesthetic agent [for the purpose of controlling pain], the permit holder shall conduct a physical evaluation [shall be made by the permit holder and a complete] of the patient, review the patient's up-to-date medical history, which shall include [previous] any changes and any medications, including natural and homeopathic medications, allergies, and sensitivities [shall be obtained]. [Said] The patient history shall be maintained in the files of each dentist for a period of not less than seven years succeeding the taking of the same. Specific contemporaneous records on use of general anesthesia shall be kept and shall include [type of] the agent s utilized, dosage, and duration. The patient record, including medical history, shall be maintained in accordance with N.J.A.C. 13:30-8.7.

 [(m)] (n) Any dentist who utilizes the services of a general anesthesia permit holder or an M.D. or D.O. who is a member of the anesthesiology staff of an accredited hospital or who is authorized to perform anesthesia services by the Board of Medical Examiners pursuant to N.J.A.C. 13:35-4A shall not be deemed to be practicing general anesthesia provided that the general anesthesia permit holder or M.D. or D.O. remains present through patient discharge and bears full responsibility during the entire procedure and until any patient regains consciousness. Any general anesthesia permit holder invited by a dentist to provide general anesthesia services shall bear full responsibility for compliance with all terms and conditions of this rule including, but not limited to, the minimum requirements for equipment and assisting staff.

 (o) A licensee who administers general anesthesia shall:

 1. Be able to recognize and manage complications and medical emergencies from general anesthetic drug administrations;

 2. Understand the clinical pharmacology of the drugs used for general anesthesia and the interactions of these drugs;

 3. Maintain patient airways and support ventilation;

 4. Monitor patients during the administration of general anesthesia using clinical evaluations and mechanical means, including the use of an EKG monitor, pulse oximeter, and capnogram, and the interpretation of such readings;

 5. Manage patients during the post-operative period and assess patients' suitability for discharge; and

 6. Maintain accurate anesthetic contemporaneous records including drugs, dosages, vital signs, and patient responses.

 [(n)] (p) Every applicant for a permit to use general anesthesia must obtain emergency training by completing [the "Basic Life Support: Course C" of] the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, and a course in Advanced Cardiac Life Support, or its equivalent, and must maintain current certification in [said] these courses. [This training also shall be required of all persons who assist in monitoring a patient under general anesthesia.] All persons who assist in monitoring a patient under general anesthesia must have emergency training by completing the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, and a course in Advanced Cardiac Life Support, or its equivalent. The permit applicant must furnish proof of [said] the training and certification to the Board.

 Recodify existing (o)-(p) as (q)- (r) (No change in text.)

 13:30-8.4 Enteral sedation with single or multiple pharmacological agents

 (a)-(g) (No change.)

 (h) An applicant for an enteral sedation permit shall obtain emergency training by completing ["Basic Life Support: Course C" of] the American Heart Association Basic Life Support for Healthcare Professionals, or its equivalent, [or] and a course in Advanced Cardiac Life Support, or its equivalent, and shall maintain current certification in such course. The applicant shall furnish proof of this training and certification to the Board upon application for an enteral sedation permit and proof of recertification upon biennial renewal of the permit.

 (i) A dentist may administer, dispense, or prescribe enteral sedation [only] medications for purposes of dental treatment and its management in a dental treatment setting and shall:

 1. (No change.)

 2. Be prepared to manage any reasonably foreseeable complications, including, but not limited to, [the capability] being capable of rescuing the patient from a deeper level of sedation than intended and from a level other than anxiolysis that has produced sedation; and

 3. (No change.)

 (j) An applicant for an enteral sedation permit shall certify to the Board upon application for a permit and upon biennial renewal of the permit that the dentist employs a licensed health care professional who will be present in the office, trained to assist in the monitoring of the patient whenever enteral sedation is employed. The applicant shall further certify such health care professional is trained in, and capable of, monitoring vital signs and assisting in emergency procedures and that the health care professional maintains current certification in ["Basic Life Support: Course C"] the American Heart Association course in Basic Life Support for Healthcare Professionals, or its equivalent, [or] and in Advanced Cardiac Life Support, or its equivalent.

 (k) An applicant for an enteral sedation permit shall certify as part of the application for a permit and upon biennial renewal of the permit that he or she possesses basic equipment and supplies to deal with emergency situations, as required by the Board, which shall be readily accessible and maintained in good operating condition. [The] In addition to the equipment and supplies set forth at N.J.A.C. 13:30-8.26, the permit holder's facility shall contain the following readily accessible and properly operating equipment:

 1. (No change.)

 [page=1662] [2. A portable oxygen delivery system including full face masks and a bag valve-mask combination with appropriate connectors capable of delivering positive pressure and oxygen-enriched patient ventilation;

 3. A blood pressure cuff (sphygmomanometer) of appropriate size and a stethoscope or equivalent monitoring devices;

 4. A pulse oximeter or equivalent device;

 5. An emergency drug kit; and

 6. Emergency backup lighting, suction and a pulse oximeter or equivalent device.]

 2. Emergency suction device;

 3. Mouth props (assorted adult and pediatric sizes);

 4. Blood pressure monitoring device;

 5. A pulse oximeter or its equivalent;

 6. An emergency drug kit consisting of, at a minimum, the following:

 i. Analgesics;

 ii. Local anesthetics;

 iii. Vasopressors;

 iv. Vasodilators (coronary);

 v. Anti-bradicardic agents;

 vi. Bronchodilators;

 vii. A muscle relaxant for treatment of laryngospasm;

 viii. Antihistamine;

 ix. A narcotic antagonist;

 x. An anticonvulsant;

 xi. Steroids;

 xii. Tranquilizers;

 xiii. Anti-hypertensive;

 xiv. Benzodiazepines;

 xv. Benzodiazepine antagonist;

 xvi. Anti-arrhythmic (for example, lidocaine, amiodarone);

 xvii. Aspirin;

 xviii. Nitroglycerine (tablets, paste, or spray);

 xix. An antiemetic; and

 xx. Dantrolene;

 7. Battery-powered clocks or watches; and

 8. Yankauer type suction tips and catheter suction.

 (l) Prior to the administration, dispensing, or prescribing of enteral sedation, the permit holder shall conduct a physical evaluation of the patient [shall be conducted by the permit holder and a complete], review the patient's up-to-date medical history [shall be obtained], which shall include [the patient's previous] any changes and any medications, including natural and homeopathic medications, allergies, and sensitivities. The patient history shall be maintained in the patient's record for a period of not less than seven years. Specific contemporaneous notations on the use of enteral sedation shall be kept as part of every patient record and shall include the [type of] agent s utilized, the dosage, the duration of sedation, the patient's vital signs during administration and recovery, and any untoward reaction. The patient record, including medical history, shall be maintained in accordance with N.J.A.C. 13:30-8.7.

 (m)-(n) (No change.)

 (o) A dentist who utilizes the services of an enteral sedation permit holder or an M.D. or D.O. who is a member of the anesthesiology staff of an accredited hospital or who is authorized to perform anesthesia services by the Board of Medical Examiners pursuant to N.J.A.C. 13:35-4A shall not be deemed to be administering enteral sedation, provided that the enteral sedation permit holder, M.D. or D.O. remains present during the administration of the enteral sedation through patient discharge, and bears full responsibility during the entire procedure until the patient has recovered fully and has been discharged.

 (p) An enteral sedation permit holder invited by a dentist to provide enteral sedation services at a specific location shall bear full responsibility for compliance with all provisions of this section including the minimum requirements for assisting staff and equipment set forth in (j) and (k) above. When an enteral sedation permit holder utilizes mobile equipment and supplies to administer enteral sedation pursuant to this section, the mobile equipment, drugs, and supplies of the permit holder shall be inspected by the Board or its designee not less than once every three years. "Mobile equipment, drugs, and supplies," for purposes of this subsection, means any equipment, drugs, and/or supplies which are transported and used by a permit holder to administer enteral sedation in one or more locations. When more than one permit holder utilizes the mobile equipment, drugs, and supplies, it shall be the responsibility of the permit holder using the equipment, drugs, and supplies to ensure that the mobile equipment and supplies satisfy the requirements of this section as set forth in (k) above prior to the administration of enteral sedation.

 13:30-8.5A Infection control education

 At least once every biennial renewal period, all licensed dentists shall provide or make available infection prevention education and training to all personnel involved in patient-related sterilization, patient care, and/or maintaining equipment. Such education and training shall include, at a minimum, the topics covered at N.J.A.C. 13:30-5.1(e)1iii.

 13:30-8.6 Biennial license and registration renewal

 (a) The Board shall send a notice of renewal to each licensee or registrant, at least 60 days prior to the expiration of the license or registration. The notice of renewal shall explain inactive renewal and advise the licensee or registrant of the option to renew as inactive. If the notice to renew is not sent 60 days prior to the expiration date, no monetary penalties or fines shall apply to the holder for failure to renew provided that the license or registration is renewed within 60 days from the date the notice is sent or within 30 days following the date of license or registration expiration, whichever is later.

 (b) A licensee or registrant shall renew his or her license or registration for a period of two years from the last expiration date. The licensee or registrant shall submit a renewal application to the Board, along with the renewal fee set forth at N.J.A.C. 13:30-8.1, prior to the date of license or registration expiration.

 (c) A licensee or registrant may renew his or her license or registration by choosing inactive status. A licensee or registrant electing to renew his or her license or registration as inactive shall not engage, as applicable, in the practice of dentistry, dental hygiene, or dental assisting, or hold himself or herself out as eligible to engage, as applicable, in the practice of dentistry, dental hygiene, or dental assisting in New Jersey until such time as the license or registration, as applicable, is returned to active status.

 (d) If a licensee or registrant does not renew the license or registration prior to its expiration date, the licensee or registrant may renew the license or registration within 30 days of its expiration by submitting a renewal application, a renewal fee, and a late fee as set forth at N.J.A.C. 13:30-8.1. During this 30-day period, the license or registration shall be valid and the licensee or registrant shall not be deemed practicing without a license or registration, as applicable.

 (e) A licensee or registrant who fails to submit a renewal application within 30 days of license or registration expiration shall have his or her license or registration, as applicable, suspended without a hearing.

 (f) A licensee or registrant who continues to engage in the practice of dentistry, dental hygiene, or dental assisting, as applicable, with a suspended license or registration shall be deemed to be engaging in the unauthorized practice of dentistry, dental hygiene, or dental assisting, as applicable, and shall be subject to action consistent with N.J.S.A. 45:1-14 et seq., even if no notice of suspension has been provided to the individual.

 13:30-8.6A License and registration reactivation

 (a) A licensee or registrant who holds an inactive license or registration, pursuant to N.J.A.C. 13:30-8.6(c), or a retired license pursuant to N.J.A.C. 13:30-1.5, may apply to the Board for reactivation of the inactive or retired license or inactive registration. A licensee or registrant seeking reactivation of an inactive or retired license or inactive registration shall submit:

 1. A renewal application;

 2. A certification of employment listing each job held during the period the license or registration was inactive, which includes the name, address, and telephone number of each employer;

 3. The renewal fee for the biennial period for which reactivation is sought as set forth at N.J.A.C. 13:30-8.1.

 [page=1663] i. If the renewal application is sent during the first year of the biennial period, the applicant shall submit the renewal fee as set forth at N.J.A.C. 13:30-8.1.

 ii. If the renewal application is sent during the second year of the biennial period, the applicant shall submit one-half of the renewal fee as set forth at N.J.A.C. 13:30-8.1; and

 4. Evidence of having completed all continuing education credits that were required to be completed during the biennial period immediately prior to the renewal period for which reactivation is sought, consistent with the requirements set forth at N.J.A.C. 13:30-5.1, 5.2, and 5.3, as applicable.

 i. An applicant who holds a valid, current license or registration in good standing issued by another state to engage in the practice of dentistry, dental hygiene, dental assisting, or dental assisting in orthodontics, as applicable, and submits proof of having satisfied that state's continuing education requirements for that license or registration, shall be deemed to have satisfied the requirements of this paragraph. If the other state does not have any continuing education requirements, the requirements of this paragraph shall apply.

 ii. To the extent that specific courses are required to satisfy the continuing education requirement for, or are required to have been satisfied prior to, the biennial period for which reactivation is sought, the Board will allow applicants to take the courses within 12 months following reactivation.

 (b) If a Board review of an application establishes a basis for concluding that there may be practice deficiencies in need of remediation prior to reactivation, the Board may require the applicant to submit to, and successfully pass, an examination or an assessment of skills, a refresher course, or other requirements as determined by the Board prior to reactivation of the license or registration. If that examination or assessment identifies deficiencies or educational needs, the Board may require the applicant, as a condition of reactivation of licensure or registration, to take, and successfully complete, any education or training or to submit to any supervision, monitoring, or limitations as the Board determines is necessary to ensure that the applicant practices with reasonable skill and safety. The Board, in its discretion, may restore the license or registration subject to the applicant's completion of the training within a period of time prescribed by the Board following the restoration of the license or registration. In making its determination whether there are practice deficiencies requiring remediation, the Board shall consider the following non-exhaustive factors:

 1. Length of time license or registration was inactive;

 2. Employment history;

 3. Professional history;

 4. Disciplinary history and any action taken against the applicant's license or registration by any licensing board;

 5. Actions affecting the applicant's privileges taken by any institution, organization, or employer related to the practice of dentistry, dental hygiene, dental assisting, or dental assisting in orthodontics, as applicable, or other professional or occupational practice in New Jersey, any other state, the District of Columbia, or in any other jurisdiction;

 6. Pending proceedings against a professional or occupational license or registration issued to the licensee or registrant by a professional board in New Jersey, any other state, the District of Columbia, or in any other jurisdiction; and

 7. Civil litigation related to the practice of dentistry, dental hygiene, or dental assisting, as applicable, or other professional or occupational practice in New Jersey, any other state, the District of Columbia, or in any other jurisdiction.

 13:30-8.6B License and registration reinstatement

 (a) A licensee or registrant who has had his or her license or registration suspended pursuant to N.J.A.C. 13:30-8.6(e) may apply to the Board for reinstatement. A licensee or registrant applying for reinstatement shall submit:

 1. A reinstatement application;

 2. A certification of employment listing each job held during the period of suspended license or registration, which includes the name, address, and telephone number of each employer;

 3. The renewal fee for the biennial period for which reinstatement is sought;

 4. The past due renewal fee for the biennial period immediately preceding the renewal period for which reinstatement is sought;

 5. The reinstatement fee set forth at N.J.A.C. 13:30-8.1; and

 6. Evidence of having completed all continuing education credits that were required to be completed during the biennial period immediately prior to the renewal period for which reinstatement is sought, consistent with the requirements set forth at N.J.A.C. 13:30-5.1, 5.2, and 5.3, as applicable.

 i. An applicant who holds a valid, current license or registration in good standing issued by another state to engage in the practice of dentistry, dental hygiene, dental assisting, or dental assisting in orthodontics, as applicable, and submits proof of having satisfied that state's continuing education requirements for that license or registration, shall be deemed to have satisfied the requirements of this paragraph. If the other state does not have any continuing education requirements, the requirements of this paragraph shall apply.

 ii. To the extent that specific courses are required to satisfy the continuing education requirement for, or are required to have been satisfied prior to, the biennial period for which reinstatement is sought, the Board will allow applicants to take the courses within 12 months following reinstatement.

 (b) If a Board review of an application establishes a basis for concluding that there may be practice deficiencies in need of remediation prior to reinstatement, the Board may require the applicant to submit to, and successfully pass, an examination or an assessment of skills, a refresher course, or other requirements as determined by the Board prior to reinstatement of the license or registration. If that examination or assessment identifies deficiencies or educational needs, the Board may require the applicant, as a condition of reinstatement of licensure, to take, and successfully complete, any education or training or to submit to any supervision, monitoring, or limitations as the Board determines is necessary to assure that the applicant practices with reasonable skill and safety. The Board, in its discretion, may restore the license or registration subject to the applicant's completion of the training within a period of time prescribed by the Board following the restoration of the license or registration. In making its determination whether there are practice deficiencies requiring remediation, the Board shall consider the following non-exhaustive factors:

 1. Length of time license or registration was suspended;

 2. Employment history;

 3. Professional history;

 4. Disciplinary history and any action taken against the applicant's license by any licensing board;

 5. Actions affecting the applicant's privileges taken by any institution, organization, or employer related to the practice of dentistry, dental hygiene, dental assisting, or dental assisting in orthodontics, as applicable, or other professional or occupational practice in New Jersey, any other state, the District of Columbia, or in any other jurisdiction;

 6. Pending proceedings against a professional or occupational license or registration issued to the licensee or registrant by a professional board in New Jersey, any other state, the District of Columbia, or in any other jurisdiction; and

 7. Civil litigation related to the practice of dentistry, dental hygiene, dental assisting, or dental assisting in orthodontics, as applicable, or other professional or occupational practice in New Jersey, any other state, the District of Columbia, or in any other jurisdiction.

 13:30-8.7 Patient records

 (a) A contemporaneous, permanent patient record shall be prepared and maintained by a licensee for each person seeking or receiving dental services, regardless of whether any treatment is actually rendered or whether any fee is charged. Licensees [also] shall also maintain records relating to charges made to patients and third-party carriers for professional services. All treatment records, bills, and claim forms shall [page=1664] accurately reflect the treatment or services rendered. Such records shall include, at a minimum:

 1.-3. (No change.)

 4. A diagnosis and a treatment plan signed by the patient, which shall also include the material treatment risks and clinically acceptable alternatives, and costs relative to the treatment that is recommended and/or rendered. Any significant changes to the treatment plan requires the patient to sign the revised treatment plan;

 5.-14. (No change.)

 (b) (No change.)

 (c) A patient record may be prepared and maintained on a personal or other computer provided that the licensee complies with all of the following requirements:

 1.-4. (No change.)

 5. The licensee shall prepare a back-up of all computerized patient records at least quarterly, except that if a licensee changes computer systems or software programs, the licensee shall prepare a back-up as of the last date when the system to be replaced shall be used.

 i.-iii. (No change.)

 iv. The licensee shall maintain and store the fourth quarter (annual) back-up offsite; [and]

 6. The licensee shall provide to the Board upon request any back-up data maintained off premises, together with the following information:

 i.-iii. (No change.)

 iv. The name of a contact person at the practice management company, if any, that provides technical support for the licensee's computer system[.]; and

 7. Electronic records shall comply with the Federal Health Insurance Portability and Accountability Act of 1996 and the Federal health privacy rule set forth at 45 CFR Parts 160 and 164.

 (d) Patient records, including all radiographs, shall be maintained for at least seven years from the date of the last entry, except that diagnostic and study models used for definitive treatment shall be maintained for at least three years from the date the model is made. [Working models may be maintained.]

 (e)-(i) (No change.)

 13:30-8.8 Reporting of incidents or deaths

 (a) All licensees shall report to the State Board of Dentistry within seven days, in writing, on a form supplied by the Board and available on the Board's website at [http://www.njconsumeraffairs.gov/dentistry/]  www.njconsumeraffairs.gov/den, any incident occurring in a dental office, clinic, or any other dental facility after dental treatment has been initiated [, which] that requires the removal of a patient to a hospital for observation or treatment.

 (b) All licensees shall report to the Board within seven days, in writing, on a form supplied by the Board and available on the Board's website at [http://www.njconsumeraffairs.gov/dentistry/] www.njconsumeraffairs.gov/den, any death, which may be related to dental treatment, whether or not the death occurred in a dental office, clinic, or other dental facility.

 13:30-8.9 Display of names; identifying badges

 (a) Every facility offering dental care to the public shall legibly display on all exterior signs or other means of exterior display, the names of the licensees who are [responsible for the administration] the owners of the facility. A dental facility may display on exterior signs or other means of exterior display, the names of licensees associated with the facility.

 (b)-(c) (No change.)

 13:30-8.10 [Dental insurance forms] Third-party payor records

 (a) (No change.)

 (b) No licensee shall submit to a third-party payor any claim, bill, or governmental assistance claim [, which] that contains any of the following:

 1.-2. (No change.)

 3. Any service or procedure, which cannot be justified by the licensee as necessary [and], proper, and/or beneficial;

 4.-5. (No change.)

 (c) (No change.)

 (d) The accuracy of all information contained in written or electronic submissions to a [third party] third-party payor including predeterminations, claims, bills, or governmental assistance claims, shall be the personal responsibility of the licensee whose name, license number, or signature appears on the signature line of the claim. In the case of electronic claims, the licensee identified as the provider shall be held responsible for the accuracy of the information whether or not [said] the licensee actually completed the claim. The Board shall presume that the licensee identified on the claim reviewed its contents and approved its submission.

 1.-2. (No change.)

 (e) All [insurance] third-party payor records shall be maintained pursuant to the provisions of N.J.A.C. 13:30-8.7 or be readily retrievable.

 13:30-8.12A Notification of conviction, arrest, or actions affecting privileges

 A licensee or registrant shall notify the Board in writing within 30 days of receiving a summons; being arrested or taken into custody; being indicted, tried, charged with, or admitted into pre-trial intervention (P.T.I.); plead guilty to any violation of law, ordinance, felony, misdemeanor, or disorderedly persons offense in this State or any other state; being disciplined or denied a dental license or any other professional license; or having a professional license or certificate of any type suspended, revoked, or surrendered. Parking or speeding violations need not be disclosed, but motor vehicle violations, such as driving while impaired or intoxicated, shall be disclosed.

 13:30-8.26 Emergency protocol

 (a) Each dental office, facility, dental clinic, or institution at which there is patient contact, at a minimum, shall:

 1. (No change.)

 2. Have equipment to maintain adult and pediatric airways[;

 3. Have an ambu bag (bag-valve-mask resuscitator); and], including:

 i. A portable oxygen delivery system, including full face masks and a bag-valve-mask combination with appropriate connectors capable of delivering positive pressure and oxygen-enriched patient ventilation; and

 ii. Positive pressure oxygen;

 3. Have an automatic external defibrillator (AED);

 4. Contain back-up, battery-operated equipment consisting of, at a minimum, lighting, a blood pressure monitoring device, and a pulse oximeter, which shall be readily accessible and properly operating; and

 [4.] 5. (No change in text.)