(a) A dentist may delegate to a Texas licensed dental hygienist authorization to perform a service, task or procedure for patients whom the dentist has not seen within the past twelve months when conditions are met as follows:
  (1) The dentist provides express authorization in writing which must include:
    (A) the dentist's name;
    (B) the dental hygienist's name;
    (C) the patient's name;
    (D) the name and address of the location where service is to be provided;
    (E) the date of the authorization; and
    (F) those procedures the dentist specifically authorizes the hygienist to perform, including those procedures necessary to allow subsequent clinical evaluation by a dentist;
  (2) The dentist has verified that the dental hygienist has at least two years experience as a dental hygienist; and
  (3) The service, task or procedure must be performed in either:
    (A) a nursing facility as defined in the Health and Safety Code, §242.301;
    (B) a school-based health center established under Chapter 38, Subchapter B, Texas Education Code; or
    (C) a community health center as defined by §136.002, Human Resources Code.
(b) The dental hygienist must refer patients treated under the provisions of this rule to a dentist by notification in writing of the dentist's name and address. Such notification must be provided to the patient or a person legally responsible for the patient, the authorizing dentist, the referral dentist, and copies to the patient's medical record. This notification must include a statement of services, tasks, and procedures performed.
(c) A dental hygienist, after having performed the services, tasks or procedures under this rule, may only perform delegated services, tasks or procedures with respect to the patient for six months unless the patient has been seen by either the dentist who delegated to the hygienist the authority or by a dentist to whom the patient was referred.
(d) The facility defined in subsection (a) of this section must agree to include information provided pursuant to subsection (b) of this section in the patient's medical records.

Source Note: The provisions of this §115.5 adopted to be effective December 30, 2001, 26 TexReg 10573; amended to be effective February 2, 2010, 35 TexReg 641