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HB 4913

DENTAL HYGIENIST-ANESTHESIA

104th Regular Session Introduced by Mike Crawford and 2 co-sponsors

HB 4913 lets trained public health dental hygienists in community health centers administer local anesthesia under strict supervision and on-site presence, expanding their scope.

Rule 19(a) / Re-referred to Rules Committee
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Bill Summary · HB 4913

Summary of HB 4913 (Illinois, 104th General Assembly)

intent and overview
- Purpose: Amend the Illinois Dental Practice Act to expand the scope of practice for dental hygienists in certain settings, specifically allowing public health dental hygienists in community health centers to administer local anesthetics after training, under defined supervision and institutional policies.
- Context: The bill defines and clarifies “community health center” and updates supervision rules related to dental hygiene activities, including local anesthesia administration, in designated settings.

Key provisions and changes
- Definitions updated:
- Community health center: Includes migrant health centers, community health centers, care programs for the homeless or public housing residents under the federal Public Health Service Act, and FQHCs (including Look-Alikes) with at least one federally designated primary care site in Illinois.
- Physician: Defined as a licensed physician under the Medical Practice Act of 1987 (excludes chiropractic physicians).

  • Public health dental hygienist and local anesthesia:

    • Public health dental hygienist may administer local anesthetics only under the amendatory provisions (new authority).
    • In a community health center, local anesthetic administration by a dental hygienist is allowed if:
    • The hygienist completes a Department-approved training program.
    • The administration is under the general supervision of a dentist.
    • The community health center has written policies/procedures requiring supervision by a dentist or physician at the time of administration.
    • A dentist or physician is physically present in the clinic when the local anesthetics are administered.

  • Other notable definitions and terms (definitions section):

    • Expanded scope and supervision concepts for dental hygienists (general supervision vs. supervision).
    • Public health setting and public health supervision details for hygienists operating in approved facilities or programs serving Medicaid, uninsured, or low-income populations.
    • Teledentistry and mobile/portable dental units are defined, along with related procedural and supervisory standards.

  • Section 18 changes (acts constituting the practice of dental hygiene; limitations):

    • Explicitly includes administration of local anesthetics as a permissible act for dental hygienists under training and supervision conditions (within the public health context and community health centers).
    • Maintains other hygiene functions under general or specific supervision, including nitrous oxide administration only under approved training (and not necessarily in all settings).

  • Practice and employment restrictions (highlights):

    • Dental hygienists may be employed by dentists, public or private institutions, schools, or public clinics under the defined supervision framework.
    • In school-based settings, certain procedures (e.g., sealants, fluoride treatments) can be provided by hygienists under general supervision, with various timing requirements for implementation.
    • The number of hygienists in a dental office cannot exceed four times the number of dentists in that office at any given time.

  • Public health hygienist qualifications:

    • A public health dental hygienist must have two years of full-time clinical experience (or 4,000 hours) plus at least 42 hours of specialized advanced coursework in public health dentistry.

  • Patient care protections and consent:

    • In settings where hygienists provide services without direct dentist presence, patient consent and referrals to a dentist are required (where applicable), and updated medical/dental histories must be obtained as needed.

Affected parties and impact
- Dental hygienists: Expanded to administer local anesthetics in community health centers after specific training and under supervision.
- Community health centers (and related entities): Authorized to employ and supervise hygienists who administer local anesthesia, with written policies and on-site dentist/physician presence requirements.
- Dentists and physicians: Maintain supervision duties; must be physically present in the clinic when local anesthesia is administered by hygienists in these settings.
- Medicaid and uninsured patients: Provisions for public health supervision target care for patients eligible for Medicaid or with income not exceeding 300% of the federal poverty level in certain settings.

Procedural and timeline aspects
- Status: As introduced and amended in committee, with actions occurring in 2026 (House Health Care Licenses Committee and Rules Committee, then floor actions).
- Effective dates: Many definitions align with existing act changes; some references note prior PA amendments with effective dates (e.g., 1-1-24 and subsequent dates). The bill text indicates that the act portions being amended (Sections 4 and 18) would implement the new public health dental hygiene authorities when enacted.
- Next steps in process: Following committee amendments and floor votes, the bill would proceed to the Senate (if passed by the House) for consideration.

Notes
- The bill explicitly integrates the concept of a “community health center” for the purposes of expanded hygienist authority, aligning with federally designated primary care delivery sites.
- The change requires adoption of written supervision policies by centers and ensures on-site dentist or physician presence during local anesthetic administration.

Overall, HB 4913 would broaden the ability of public health dental hygienists operating in community health centers to administer local anesthesia, subject to approved training and stringent supervision and facility requirements, while preserving existing supervision standards for other hygienic procedures.

Compiled from official sources — confirm details with the bill’s official record.

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