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HOUSE: | Bills Introduced | Resolutions Introduced | Abstract | Topical Index | Committee Schedule | Calendar | Local Calendar | Special Calendar | Journal | Menu |

House Journal


Day 00 (01-9-02013)
Day 01 (02-13-2013)
Day 02 (02-14-2013)
Day 03 (02-15-2013)
Day 06 (02-18-2013)
Day 07 (02-19-2013)
Day 08 (02-20-2013)
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Day 10 (02-22-2013)
Day 13 (02-25-2013)
Day 14 (02-26-2013)
Day 15 (02-27-2013)
Day 16 (02-28-2013)
Day 17 (03-01-2013)
Day 20 (03-04-2013)
Day 21 (03-05-2013)
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Day 23 (03-07-2013)
Day 24 (03-08-2013)
Day 27 (03-11-2013)
Day 28 (03-12-2013)
Day 29 (03-13-2013)
Day 30 (03-14-2013)
Day 34 (03-18-2013)
Day 35 (03-19-2013)
Day 36 (03-20-2013)
Day 37 (03-21-2013)
Day 38 (03-22-2013)
Day 41 (03-25-2013)
Day 42 (03-26-2013)
Day 43 (03-27-2013)
Day 44 (03-28-2013)
Day 45 (03-29-2013)
Day 48 (04-01-2013)
Day 49 (04-02-2013)
Day 50 (04-03-2013)
Day 51 (04-04-2013)
Day 52 (04-05-2013)
Day 55 (04-08-2013)
Day 56 (04-09-2013)
Day 57 (04-10-2013)
Day 58 (04-11-2013)
Day 59 (04-12-2013)

Eighty-first Legislature

First Regular Session

Held at Charleston

Published by the Clerk of the House

 

West Virginia Legislature

JOURNAL

of the

House of Delegates

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__________*__________



 

Tuesday, April 9, 2013

FIFTY-SIXTH DAY

[Mr. Speaker, Mr. Thompson, in the Chair]

 

 

            The House of Delegates met at 11:00 a.m., and was called to order by the Honorable Rick Thompson, Speaker.

            Prayer was offered and the House was led in recitation of the Pledge of Allegiance.

            The Clerk proceeded to read the Journal of Monday, April 8, 2013, being the first order of business, when the further reading thereof was dispensed with and the same approved.

Committee Reports

            Mr. Speaker, Mr. Thompson, from the Committee on Rules, submitted the following report, which was received:

            Your Committee on Rules has had under consideration:

            H. C. R. 112, The “Army Command Sergeant Major Wade Damron Memorial Bridge”,

            H. C. R. 125, The “Army Sergeant Richard Bowry Memorial Bridge”,

            H. C. R. 126, The “John Jacob Fry II Memorial Highway”,

            H. C. R. 133, The “James T. and Paul T. Billups Bridge”,

            And,

            H. C. R. 135, Proclaiming West Virginia as a Purple Heart State,

            And reports the same back with the recommendation that they each be adopted.

            Mr. Speaker, Mr. Thompson, from the Committee on Rules, submitted the following report, which was received:

            Your Committee on Rules has had under consideration:

            H. C. R. 56, The “John Edgar Saville Memorial Bridge”,

            And reports back a committee substitute therefore, with a new title, as follows:

            Com. Sub. for H. C. R. 56 – “Requesting that bridge number 2-6-0.96 being constructed on County Route 6, Dry Run Road, crossing Back Creek near Hedgesville, Berkeley County, West Virginia, be named the ‘John Edgar Saville Memorial Bridge’,”

            H. C. R. 120, The “1st Sergeant Walter Criss Street, United States Army”,

            And reports back a committee substitute therefore, with a new title, as follows:

            Com. Sub. for H. C. R. 120 – “Requesting the Division of Highways to name bridge number 44-905-0.61 on Market Street near the junction with Front Street in the City of Spencer, Roane County, West Virginia, the ‘1st Sergeant Walter Criss Bridge, United States Army’,”

            And,

            H. C. R. 121, The “LSC (SS) Andrew Scott Mollohan Memorial Bridge”,

            And reports back a committee substitute therefore, with a new title, as follows:

            Com. Sub. for H. C. R. 121 – “Requesting that bridge number 54-68-23.53 on Routes 2 and 68, known as the I-77 overpass in Wood County, West Virginia, be named the ‘U.S. Navy LSC (SS) Andrew Scott Mollohan Memorial Bridge’,”

            With the recommendation that the committee substitutes each be adopted.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            Com. Sub. for S. B. 202, Creating WV Spay Neuter Assistance Program and Fund,

            Com. Sub. for S. B. 401, Relating to Board of Registration for Professional Engineers,

            S. B. 441, Relating to withdrawal of erroneous state tax liens,

            Com. Sub. for S. B. 454, Relating to taxation of alternative motor fuels,

            S. B. 523, Making supplementary appropriation of unappropriated moneys to various accounts,

            S. B. 525, Making supplementary appropriation of federal funds to various accounts,

            S. B. 664, Decreasing appropriations of public moneys in State Fund, General Revenue,

            And reports the same back, with amendments, with the recommendation that they each do pass, as amended.

            Delegate Poling, Chair of the Committee on Education, submitted the following report, which was received:

            Your Committee on Education has had under consideration:

            S. B. 663, Creating WV Feed to Achieve Act, 

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

            Com. Sub. for S. B. 250, Authorizing Department of Commerce promulgate legislative rules,

             Com. Sub. for S. B. 265, Authorizing DHHR promulgate legislative rules,

             Com. Sub. for S. B. 270, Authorizing Department of Revenue promulgate legislative rules,

             Com. Sub. for S. B. 426, Relating to filings under Uniform Commercial Code as to secured transactions,

             S. B. 515, Relating to use of television receivers and other devices in vehicles,

             Com. Sub. for S. B. 538, Eliminating requirement law enforcement maintain files of domestic violence orders,

            And reports the same back, with amendment, with the recommendation that they each do pass, as amended.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

             Com. Sub. for S. B. 281, Authorizing Department of Transportation promulgate legislative rules,

             Com. Sub. for S. B. 477, Relating to electronic registration of voters,

            And,

             Com. Sub. for S. B. 604, Expanding definition of “electioneering communication”,

            And reports the same back with the recommendation that they each do pass.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

            S. B. 407, Requiring cellular and phone companies provide certain information to Bureau for Child Support Enforcement,

            And reports the same back, with a title amendment, with the recommendation that it do pass, as amended.

            Delegate Poling, Chair of the Committee on Education, submitted the following report, which was received:

            Your Committee on Education has had under consideration:

            S. B. 394, Relating to scholarships for dependent children of state troopers who die in performance of duty,

            And,

            Com. Sub. for S. B. 444, Relating to higher education generally,

            And reports the same back, with amendments, with the recommendation that they each do pass, as amended, but that they first be referred to the Committee on Finance.

            In accordance with the former direction of the Speaker, the bills (S. B. 394 and Com. Sub. for S. B. 444) were each referred to the Committee on Finance.

            Delegate Poling, Chair of the Committee on Education, submitted the following report, which was received:

            Your Committee on Education has had under consideration:

            S. B. 623, Relating to funding for probation officers to address truancy,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            H. B. 2014, Budget Bill, making appropriations of public money out of the treasury in accordance with section fifty-one, article six of the Constitution,

            And reports back a committee substitute therefor, with the same title, as follows:

            Com. Sub. for H. B. 2014 - “A Bill making appropriations of public money out of the Treasury in accordance with section fifty-one, article VI of the Constitution,”

            With the recommendation that the committee substitute do pass.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

            Com. Sub. for S. B. 371, Relating to prison overcrowding,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended, but that it first be referred to the Committee on Finance.

            In accordance with the former direction of the Speaker, the bill (Com. Sub. for S. B. 371) was referred to the Committee on Finance.

 

Resolutions Introduced

            Delegates Williams, Boggs, Pethtel, Perdue, Anderson, Iaquinta, Guthrie, Miller, Walker, Manypenny, White, Ashley, Barill, Caputo, Craig, Eldridge, A. Evans, Ferro, Fleischauer, Hartman, Hunt, Ireland, Lawrence, Lynch, Manchin, Marcum, Miley, Moore, Morgan, Pasdon, Perry, R. Phillips, Pino, M. Poling, Reynolds, Skaff, P. Smith, Staggers and Stowers offered the following resolution, which was read by its title and referred to the Committee on Rules:

            H. C. R. 139 - “Requesting the Joint Committee on Government and Finance to create a select working group to study the potential for creating new jobs and improving our economy by increasing agribusiness in the state through the development of a sustainable regional-based food system that supports the production, processing, aggregation, distribution and consumption of West Virginia foods.”

            Whereas, A strong, regionally-based food system can provide a wellspring of economic growth for rural communities and cities. While other areas in the United States have realized some gain from developing agricultural and food-based resources, West Virginia’s potential remains largely underutilized. Total farm sales in the state increased by 19 percent to $591 million from 2002 to 2007, but these amounts pale in comparison to other states and West Virginia ranked 43rd in the nation for total farm product sales in 2007; and

            Whereas, Despite West Virginia’s mountainous terrain, many farms and much agricultural land exist in the state. Currently, most farms have cattle or calf inventory, but there is significant room for vegetable and fruit production to expand to fill the local shortage, or the difference between consumption and production; and

            Whereas, A significant market exists for vegetables and fruits, and in particular, there is a high demand for fresh vegetables. This fact, combined with the trend of low current vegetable production, highlights a market opportunity for increased vegetable production in West Virginia; and

            Whereas, Significantly expanding vegetable and fruit production in West Virginia would have an important economic impact on the state. For example, if West Virginia farmers grew enough vegetables and fruits to meet 75 percent of the fresh seasonal produce needs of all West Virginians it would create an estimated 1,330 jobs (519 jobs in farming and 398 jobs in food and beverage retail), and the resulting increase in production would create an estimated $93.9 million in additional sales. If West Virginia farmers grew enough vegetables and fruits to meet 100 percent of the fresh seasonal produce needs of all West Virginians it would create an estimated 1,723 jobs (690 jobs in farming and 510 jobs in food and beverage retail), and the resulting increase in production would create an estimated $120.8 million in additional sales; and

            Whereas, There are also opportunities to grow jobs and stimulate the West Virginia economy by increasing the production and processing of livestock and poultry that we consume in this state. According to the U.S. Food Market Estimator developed by Iowa State University, almost 72 million pounds of beef are consumed annually in West Virginia, and much of that is currently imported from outside the state and the country. A recent West Virginia University Extension Service study estimated the potential economic benefit of raising and processing all the beef and pork we consume in this state to be a total of 14,295 additional jobs when factoring the direct, indirect and induced effect of the production; and

            Whereas, There are many positive economic impacts of a vibrant local food system, but the primary economic benefits take the form of increased income and employment, which are driven by substitution (buying local food instead of food from far away) and localization (bringing processing activities into the region instead of processing food far away). This results in more jobs and more recirculated dollars, as an enhanced local food system can even stimulate neighboring businesses and increase the sharing of local skill sets; and

            Whereas, In addition to the foregoing direct economic benefits, local food systems also have secondary socioeconomic benefits such as improving the health of residents. Local food is usually fresher and less processed, and the availability of readily accessible local food may lead to healthier diet choices, like eating more vegetables, fruits and leaner meats. Additionally, local food may also improve school children’s diets, and school-based healthy food programming can help increase fruit, vegetable and leaner meat intake; and

            Whereas, A coordinated, strategic and collaborative effort is needed to successfully implement policy changes that will help establish a sustainable regional-based food system in West Virginia to grow our economy; therefore, be it

            Resolved by the Legislature of West Virginia:

            That the Joint Committee on Government and Finance is hereby requested to create a select working group to study the potential for creating new jobs and improving our economy by increasing agribusiness in the state through the development of a sustainable regional-based food system that supports the production, processing, aggregation, distribution and consumption of West Virginia foods; and, be it

            Further Resolved, That the Joint Committee on Government and Finance report to the regular session of the Legislature, 2014, on its findings, conclusions and recommendations, together with drafts of any legislation necessary to effectuate its recommendations; and, be it

            Further Resolved, That the expenses necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.

Petitions

            Delegate A. Evans presented a petition on behalf of his constituents concerned about the current freeze on the Aged and Disabled Medicaid Waiver Program; which was referred to the Committee on Health and Human Resources.

Special Calendar

Unfinished Business

            The following resolutions, coming up in regular order, as unfinished business, were reported by the Clerk and adopted:

            H. C. R. 98, Requesting a study on the feasibility of obtaining a waiver of the federal requirement relating to state/federal matching highway funds based on a proposed funding model,

            Com. Sub. for H. C. R. 102, The “Michael A. Oliverio, Sr. Interchange”,

            H. C. R. 105, Requesting a study on the necessity of hiring additional fraud investigators for the Department of Health and Human Resources and the Medicaid Fraud Control Unit,

            Com. Sub. for H. C. R. 106, The “O. Winston Link Trail”,

            And,

            H. C. R. 118, The “U.S. Marine Corps PFC Daniel L. Edwards Memorial Bridge”.

            Ordered, That the Clerk of the House communicate to the Senate the action of the House of Delegates and request concurrence therein.

Third ReadingCom. Sub. for S. B. 80, Including substitute teaching in job duties of certain professional educators employed by county boards; on third reading, coming up in regular order, was read a third time.

            The question being on the passage of the bill, the yeas and nays were taken (Roll No. 222), and there were--yeas 78, nays 20, absent and not voting 2, with the nays and absent and not voting being as follows:

            Nays: Andes, Armstead, Arvon, Butler, Cadle, Cowles, Ellem, Espinosa, Faircloth, Hamrick, Householder, Howell, Kump, E. Nelson, O’Neal, Overington, Raines, Shott, R. Smith and Sumner.

            Absent and Not Voting: Marshall and J. Nelson.

            So, a majority of the members present and voting having voted in the affirmative, the Speaker declared the bill (Com. Sub. for S. B. 80) passed.

            Delegate Boggs moved that the bill take effect July 1, 2013.

            On this question, the yeas and nays were taken (Roll No. 223), and there were--yeas 81, nays 17, absent and not voting 2, with the nays and absent and not voting being as follows:

            Nays: Andes, Arvon, Cadle, Cowles, Espinosa, Faircloth, Gearheart, Hamrick, Householder, Howell, Kump, E. Nelson, O’Neal, Overington, Raines, R. Smith and Sumner.

            Absent and Not Voting: Marshall and J. Nelson.

            So, two thirds of the members elected to the House of Delegates having voted in the affirmative, the Speaker declared the bill (Com. Sub. for S. B. 80) takes effect July 1, 2013.

            Ordered, That the Clerk of the House communicate to the Senate the action of the House of Delegates.

            S. B. 183, Updating terms in Corporation Net Income Tax Act; on third reading, coming up in regular order, was read a third time.

            The question being on the passage of the bill, the yeas and nays were taken (Roll No. 224), and there were--yeas 98, nays none, absent and not voting 2, with the absent and not voting being as follows:

            Absent and Not Voting: Marshall and J. Nelson.

            So, a majority of the members present and voting having voted in the affirmative, the Speaker declared the bill (S. B. 183) passed.

            Delegate Boggs moved that the bill take effect from its passage.

            On this question, the yeas and nays were taken (Roll No. 225), and there were--yeas 98, nays none, absent and not voting 2, with the absent and not voting being as follows:

            Absent and Not Voting: Marshall and J. Nelson.

            So, two thirds of the members elected to the House of Delegates having voted in the affirmative, the Speaker declared the bill (S. B. 183) takes effect from its passage.

            Ordered, That the Clerk of the House communicate to the Senate the action of the House of Delegates.

Second ReadingCom. Sub. for S. B. 60, Relating to name-change notice publication requirements; on second reading, coming up in regular order, was read a second time.

            At the request of Delegate Boggs, and by unanimous consent, the bill was advanced to third reading with an amendment pending, and the rule was suspended to permit the consideration of the amendment on that reading.

            S. B. 108, Creating Unintentional Pharmaceutical Drug Overdose Fatality Review Team; on second reading, coming up in regular order, was read a second time.

            An amendment, recommended by the Committee on Health and Human Resources, was reported by the Clerk on page one, by striking out everything after the enacting clause and inserting in lieu thereof the following:

            “That §48-25A-1, §48-25A-2, and §48-25A-3 of the Code of West Virginia, 1931, as amended, be repealed; that §48-27A-1, §48-27A-2, and §48-27A-3 of said code be repealed; that §49-5D-5 of said code be repealed; that said code be amended by adding thereto a new article, designated §61-12A-1, §61-12A-2, §61-12A-3, §61-12A-4 and §61-12A-5, all to read as follows:

ARTICLE 12A. FATALITY REVIEW TEAM.

§61-12A-1. Fatality Review Team.

            (a) A fatality review team is created under the Office of the Chief Medical Examiner. The fatality review team combines the Maternal Mortality Review Team, the Domestic Violence Fatality Review Team and the Child Fatality Review Team. The fatality review team is a multidisciplinary team created to examine, review and analyze the deaths of all persons in West Virginia who die as a result of unintentional prescription or pharmaceutical drug overdoses; the deaths of children under the age of eighteen years; the deaths resulting from suspected domestic violence; and the deaths of all infants and of all women who die during pregnancy, at the time of birth or within one year of the birth of a child.

            (b) The fatality review team shall consist of the following:

            (1) The Chief Medical Examiner in the Bureau for Public Health or his or her designee, who is to serve as the chairperson and who is responsible for calling and coordinating all meetings;

            (2) The Commissioner of the Bureau for Public Health or his or her designee;

            (3) The Superintendent of the West Virginia State Police or his or her designee; and

            (4) A prosecuting attorney or his or her designee, as appointed by the Governor.

            (c) Each member serve for a term of three years, unless otherwise reappointed to a second or subsequent term. Members shall continue to serve until their respective terms expire or until their successors have been appointed.

            (d) Each member shall serve without additional compensation and may not be reimbursed for any expenses incurred in the discharge of his or her duties under the provisions of this article.

§61-12A-2. Responsibilities of the Fatality Review Team.

            (a) The Fatality Review Team shall:

            (1) Review and analyze all deaths as required by this article;

            (2) Ascertain and document the trends, patterns and risk factors;

            (3) Provide statistical information and analysis regarding the causes of certain fatalities.

            (b) During the review process, the team may include any additional persons with expertise or knowledge in a particular field that it determines is needed in the review and consideration of a particular case as a result of a death in subsection (a) of section one.

            (c) The fatality review team, in the exercise of its duties as defined in this section, may not:

            (1) Call witnesses or take testimony from individuals involved in the investigation of a fatality;

            (2) Contact a family member of the deceased;

            (3) Enforce any public health standard or criminal law or otherwise participate in any legal proceeding; or

            (4) Otherwise take any action which, in the determination of a prosecuting attorney or his or her assistants, impairs the ability of the prosecuting attorney, his or her assistants or any law-enforcement officer to perform his or her statutory duties.

            (d) The fatality review team shall submit an annual report to the Governor and to the Legislative Oversight Commission on Health and Human Resources Accountability concerning its activities within the state. The report is due annually on December 1. The report is to include statistical information concerning cases reviewed during the year, trends and patterns concerning these cases and the team’s recommendations to reduce the number of unintentional pharmaceutical drug overdose fatalities in the state.

§61-12A-3. Access to information; other agencies of government required to cooperate.

            (a) Notwithstanding any other provision of this code to the contrary, the fatality review team may request information and records as necessary to carry out its responsibilities. Records and information that may be requested under this section include:

            (1) Medical, dental and mental health records;

            (2) Substance abuse records to the extent allowed by federal law; and

            (3) Information and records maintained by any state, county and local government agency, except as provided in subsection (c), section two of this article.

            (b) State, county and local government agencies shall provide the fatality review team with any information requested in writing by the team.

§61-12A-4. Confidentiality.

            (a) Proceedings, records and opinions of the fatality review team are confidential and are not subject to discovery, subpoena or introduction into evidence in any civil or criminal proceeding. This section does not limit or restrict the right to discover or use in any civil or criminal proceeding anything that is available from another source and entirely independent of the proceedings of the fatality review team.

            (b) Members of the fatality review team may not be questioned in any civil or criminal proceeding regarding information presented in or opinions formed as a result of a meeting of the team. This subsection does not prevent a member of the fatality review team from testifying to information obtained independently of the team or which is public information.

            (c) Proceedings, records and opinions of the fatality review team are exempt from disclosure under the Freedom of Information Act, as provided in chapter twenty-nine-b of this code.

§61-12A-5. Rules.

            The Office of the Chief Medical Examiner, in consultation with the fatality review team, shall propose rules for legislative approval in accordance with article three, chapter twenty-nine-a of this code. Those rules shall include, at a minimum:

            (1) The standard procedures for the conduct of the fatality review team;

            (2) The processes and protocols for the review and analysis of fatalities of those who were not suffering from mortal diseases shortly before death;

            (3) The processes and protocols to ensure confidentiality of records obtained by the fatality review team; and

            (4) Other rules as may be deemed necessary to effectuate the purposes of this article.

            On motion of Delegate Perdue, the amendment was amended on page three line twenty, after the word “overdose”, by striking out the remainder of the sentence and inserting “deaths; deaths of children under the age of eighteen years; deaths from suspected domestic violence; and the deaths of all infants and women who die during pregnancy, at the time of birth to one year in the state.”

            The Health and Human Resources amendment as amended was then adopted.

            The bill was then ordered to third reading.

            Com. Sub. for S. B. 158, Creating Complete Streets Act; on second reading, coming up in regular order, was read a second time and ordered to third reading.

            Com. Sub. for S. B. 580, Updating requirements for dental intern, resident and teaching permits; on second reading, coming up in regular order, was read a second time.

            An amendment, recommended by the Committee on Health and Human Resources, was reported by the Clerk and adopted, amending the bill on page one, following the enacting clause, by inserting the following:

            “That §30-4-8a, §30-4-10a, §30-4-25, §30-4-26, §30-4-27, §30-4-28 and §30-4-29 of the Code of West Virginia, 1931, as amended, be repealed; that §30-4A-6a, §30-4A-6b, §30-4A-6c, §30-4A-6d and §30-4A-18 of said code be repealed; that §30-4B-5, §30-4B-6, §30-4B-7 and §30-4B-8 of said code be repealed; that §30-4-1, §30-4-2, §30-4-3, §30-4-4, §30-4-5, §30-4-6, §30-4-7, §30-4-8, §30-4-9, §30-4-10, §30-4-11, §30-4-12, §30-4-13, §30-4-14, §30-4-15, §30-4-16, §30-4-17, §30-4-18, §30-4-19, §30-4-20, §30-4-21, §30-4-22, §30-4-23 and §30-4-24 of said code be amended and reenacted; that §30-4A-1, §30-4A-2, §30-4A-3, §30-4A-4, §30-4A-5, §30-4A-6, §30-4A-7, §30-4A-8, §30-4A-9, §30-4A-10, §30-4A-11, §30-4A-12, §30-4A-13, §30-4A-14, §30-4A-15, §30-4A-16 and §30-4A-17 of said code be amended and reenacted; and that §30-4B-1, §30-4B-2, §30-4B-3 and §30-4B-4 of said code be amended and reenacted; all to read as follows:

ARTICLE 4. WEST VIRGINIA DENTAL PRACTICE ACT.

§30-4-1. Unlawful acts.

            (a) It is unlawful for any person to practice or offer to practice dentistry or dental hygiene this state without a license, issued under the provisions of this article, or advertise or use any title or description tending to convey or give the impression that they are a dentist or dental hygienist, unless the person is licensed under the provisions of this article.

            (b) A business entity may not render any service or engage in any activity which, if rendered or engaged in by an individual, would constitute the practice of dentistry, except through a licensee.

§30-4-2. Applicable law.

            The practices authorized under the provisions of this article and the Board of Dentistry are subject to article one of this chapter, the provisions of this article, and any rules promulgated hereunder.

§30-4-3. Definitions.

            As used in article four, four-a and four-b, the following words and terms have the following meanings:

            (1) ‘AAOMS’ means the American Association of Oral and Maxillofacial Surgeons;

            (2) ‘AAPD’ means the American Academy of Pediatric Dentistry;

            (3) ‘ACLS’ means Advanced Cardiac Life Support;

            (4) ‘ADA’ means the American Dental Association;

            (5) ‘AMA’ means the American Medical Association;

            (6) ‘ASA’ means American Society of Anesthesiologists;

            (7)’Anxiolysis(anxiety-free)/minimal sedation’ or premedication for anxiety - means removing, eliminating or decreasing anxiety by the use of a single anxiety or analgesia medication that is administered in an amount consistent with the manufacturer's current recommended dosage for the unsupervised treatment of anxiety, insomnia or pain, in conjunction with nitrous oxide and oxygen. This does not include multiple dosing or exceeding current normal dosage limits set by the manufacturer for unsupervised use by the patient (at home), for the treatment of anxiety;

            (8) ‘Approved dental hygiene program’ means a program that is approved by the board and is accredited or its educational standards are deemed by the board to be substantially equivalent to those required by the Commission on Dental Accreditation of the American Dental Association;

            (9) ‘Approved dental school, college or dental department of a university’ means a dental school, college or dental department of a university that is approved by the board and is accredited or its educational standards are deemed by the board to be substantially equivalent to those required by the Commission on Dental Accreditation of the American Dental Association;

            (10) ‘Authorize’ means that the dentist is giving permission or approval to dental auxiliary personnel to perform delegated procedures in accordance with the dentist’s diagnosis and treatment plan;

            (11) ‘BLS’ means Basic Life Support;

            (12) ‘Board’ means the West Virginia Board of Dentistry;

            (13) ‘Business entity’ means any firm, partnership, association, company, corporation, limited partnership, limited liability company or other entity;

            (14) ‘Central Nervous System Anesthesia’ means an induced controlled state of unconsciousness or depressed consciousness produced by a pharmacologic method;

            (15) ‘Certificate of qualification’ means a certificate authorizing a dentist to practice a specialty;

            (16) ‘CPR’ means Cardiopulmonary Resuscitation;

            (17) ‘Conscious sedation/Moderate sedation’ means an induced controlled state of depressed consciousness, produced through the administration of nitrous oxide and oxygen and/or the administration of other agents whether enteral or parenteral, in which the patient retains the ability to independently and continuously maintain an airway and to respond purposefully to physical stimulation and to verbal command;

            (18) ‘CRNA’ means Certified Registered Nurse Anesthetist;

            (19) ‘Delegated procedures’ means those procedures specified by law or by rule of the board and performed by dental auxiliary personnel under the supervision of a licensed dentist;

            (20) ‘Dentist Anesthesiologist’ means a dentist who is trained in the practice of anesthesiology and has completed an additional approved anesthesia education course;

            (21) ‘Dental assistant’ means a person qualified by education, training or experience who aids or assists a dentist in the delivery of patient care in accordance with delegated procedures as specified by the board by rule or who may perform nonclinical duties in the dental office;

            (22) ‘Dental auxiliary personnel’ or ‘auxiliary’ means dental hygienists and dental assistants who assist the dentist in the practice of dentistry;

            (23) ‘Dental Hygiene’ means the performance of educational, preventive or therapeutic dental services and as further provided in section nine and legislative rule;

            (24) ‘Dental hygienist’ means a person licensed by the board to practice provides dental hygiene and other services as specified by the board by rule to patients in the dental office and in a public health setting;

            (25) ‘Dental laboratory’ means a business performing dental laboratory services;

            (26) ‘Dental laboratory services’ means the fabricating, repairing or altering of a dental prosthesis;

            (27) ‘Dental laboratory technician’ means a person qualified by education, training or experience who has completed a dental laboratory technology education program and who fabricates, repairs or alters a dental prosthesis in accordance with a dentist’s work authorization;

            (28) ‘Dental office’ means the place where the licensed dentist and dental auxiliary personnel are practicing dentistry;

            (29) ‘Dental prosthesis’ means an artificial appliance fabricated to replace one or more teeth or other oral or peri-oral structure in order to restore or alter function or aesthetics;

            (30) ‘Dentist’ means an individual licensed by the board to practice dentistry;

            (31) ‘Dentistry’ means the evaluation, diagnosis, prevention and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures provided by a dentist;

            (32) ‘Direct supervision’ means supervision of dental auxiliary personnel provided by a licensed dentist who is physically present in the dental office or treatment facility when procedures are being performed;

            (33) ‘Facility Permit’ means a permit for a facility where sedation procedures are used that correspond with the level of anesthesia provided;

            (34) ‘General anesthesia’ means an induced controlled state of unconsciousness in which the patient experiences complete loss of protective reflexes, as evidenced by the inability to independently maintain an airway, the inability to respond purposefully to physical stimulation, or the inability to respond purposefully to verbal command. ‘Deep conscious sedation/general anesthesia’ includes partial loss of protective reflexes and the patient retains the ability to independently and continuously maintain an airway;

            (35) ‘General supervision’ means a dentist is not required to be in the office or treatment facility when procedures are being performed by the auxiliary dental personnel, but has personally diagnosed the condition to be treated, has personally authorized the procedures and will evaluate the treatment provided by the dental auxiliary personnel;

            (36) ‘Good moral character’ means a lack of history of dishonesty;

            (37) ‘Health Care Provider BLS/CPR’ means Health Care Provider Basic Life Support/Cardiopulmonary Resuscitation;

            (38) ‘License’ means a license to practice dentistry or dental hygiene;

            (39) ‘Licensee’ means a person holding a license;

            (40) ‘Mobile Dental Facility’ any self-contained facility in which dentistry or dental hygiene will be practiced which may be moved, towed, or transported from one location to another;

            (41) ‘Other dental practitioner’ means those persons excluded from the definition of the practice of dentistry under the provisions of subsections (3), (4) and (5), section twenty-nine, of and also those persons who hold teaching permits which have been issued to them under the provisions of section fourteen, article four of this chapter;

            (42) ‘PALS’ means Pediatric Advanced Life Support;

            (43) ‘Pediatric Patient’ means infants and children;

            (44) ‘Physician Anesthesiologist’ means a physician, MD or DO, who is specialized in the practice of anesthesiology;

            (45) ‘Portable Dental Unit’ any non-facility in which dental equipment, utilized in the practice of dentistry, is transported to and utilized on a temporary basis an out-of-office location, including, but not limited to, patient’s homes, schools, nursing homes, or other institutions;

            (46) ‘Public health practice’ means treatment or procedures in a public health setting which shall be designated by a rule promulgated by the board to require direct, general or no supervision of a dental hygienist by a dentist;

            (47)’Public health setting’ means hospitals, schools, correctional facilities, jails, community clinics, long-term care facilities, nursing homes, home health agencies, group homes, state institutions under the West Virginia Department of Health and Human Resources, public health facilities, homebound settings, accredited dental hygiene education programs and any other place designated by the board by rule;

            (48) ‘Qualified Monitor’ means an individual who by virtue of credentialing and/or training checks closely and documents the status of a patient undergoing anesthesia and observes utilized equipment;

            (49) ‘Relative analgesia/minimal sedation’ means an induced controlled state of minimally depressed consciousness, produced solely by the inhalation of a combination of nitrous oxide and oxygen, or single oral premedication without the addition of nitrous oxide and oxygen in which the patient retains the ability to independently and continuously maintain an airway and to respond purposefully to physical stimulation and to verbal command. Dosage of oral premedication is not to exceed the recommended dosage limits set by the manufacturer for the treatment of anxiety, insomnia or pain;

            (50) ‘Specialty’ means the practice of a certain branch of dentistry;

            (51) ‘Subcommittee’ means West Virginia Board of Dentistry Subcommittee on Anesthesia;

            (52) ‘Work authorization’ means a written order for dental laboratory services which has been issued by a licensed dentist or other dental practitioner.

§30-4-4. Board of dental examiners.

            (a) The ‘West Virginia Board of Dental Examiners’ is continued and on July 1, 2013, the board shall be renamed the ‘West Virginia Board of Dentistry’. The members of the board in office on the date this section takes effect shall, unless sooner removed, continue to serve until their respective terms expire and until their successors have been appointed and qualified.

            (b) The Governor, by and with the advice and consent of the Senate, shall appoint:

            (1) Six licensed dentists;

            (2) One licensed dental hygienist;

            (3) One nationally certified dental assistant or currently practicing dental assistant with a minimum of ten years experience and;

            (4) One citizen member who is not licensed under the provisions of this article and does not perform any services related to the practice of dentistry.

            (c) The West Virginia Dental Association may submit recommendations to the Governor for the appointment of the licensed dentists board members, the West Virginia Association of Dental Hygienists may submit recommendations to the Governor for the appointment of an Dental Hygienist board member, and the West Virginia Dental Assistant Association may submit recommendations to the Governor for the appointment of an Dental Assistant board member.

            (d) A person connected with a commercial entity that may derive financial gain from the profession of dentistry and a person employed as full-time faculty with a dental college, school or dental department of a university are not eligible for appointment to the board.

            (e) After the initial appointment term, the appointment term is five years. A member may not serve more than two consecutive terms. A member who has served two consecutive full terms may not be reappointed for at least one year after completion of his or her second full term. A member may continue to serve until his or her successor has been appointed and qualified.

            (f) Each licensed member of the board, at the time of his or her appointment, shall have held a license in this state for a period of not less than five years immediately preceding the appointment.

            (g) Each member of the board shall be a resident of this state during the appointment term.

            (h) A vacancy on the board shall be filled by appointment by the Governor for the unexpired term of the member whose office is vacant.

            (i) The Governor may remove any member from the board for neglect of duty, incompetency or official misconduct.

            (j) A licensed member of the board immediately and automatically forfeits membership to the board if his or her license to practice is suspended or revoked in any jurisdiction.

            (k) A member of the board immediately and automatically forfeits membership to the board if he or she is convicted of a felony under the laws of any jurisdiction or becomes a nonresident of this state.

            (l) The board shall elect annually one of its members as president and one member as secretary who shall serve at the will and pleasure of the board.

            (m) Each member of the board is entitled to receive compensation and expense reimbursement in accordance with article one of this chapter.

            (n) A simple majority of the membership serving on the board at a given time is a quorum for the transaction of business.

            (o) The board shall hold at least two meetings annually. Other meetings shall be held at the call of the president or upon the written request of four members, at the time and place as designated in the call or request.

            (p) Prior to commencing his or her duties as a member of the board, each member shall take and subscribe to the oath required by section five, article four of the Constitution of this state.

            (q) The members of the board when acting in good faith and without malice shall enjoy immunity from individual civil liability while acting within the scope of their duties as board members.

§30-4-5. Powers of the board.

            The board has all the powers and duties set forth in this article, by rule, in article one of this chapter and elsewhere in law, including:

            (1) Hold meetings;

            (2) Establish procedures for submitting, approving and rejecting applications for a license, certificate and permit;

            (3) Determine the qualifications of any applicant for a license, certificate and permit;

            (4) Establish the fees charged under the provisions of this article;

            (5) Issue, renew, deny, suspend, revoke or reinstate a license, certificate and permit;

            (6) Prepare, conduct, administer and grade written, oral or written and oral examinations for a license;

            (7) Contract with third parties to administer the examinations required under the provisions of this article;

            (8) Maintain records of the examinations the board or a third party administers, including the number of persons taking the examination and the pass and fail rate;

            (9) Maintain an office, and hire, discharge, establish the job requirements and fix the compensation of employees and contract with persons necessary to enforce the provisions of this article.

            (10) Employ investigators, attorneys, hearing examiners, consultants and other employees as may be necessary, who are exempt from the classified service and who serve at the will and pleasure of the board.

            (11) Investigate alleged violations of the provisions of this article, article four-a and article four-b of this chapter, legislative rule, orders and final decisions of the board;

            (12) Conduct disciplinary hearings of persons regulated by the board;

            (13) Determine disciplinary action and issue orders;

            (14) Institute appropriate legal action for the enforcement of the provisions of this article;

            (15) Maintain an accurate registry of names and addresses of all persons regulated by the board;

            (16) Keep accurate and complete records of its proceedings, and certify the same as may be necessary and appropriate;

            (17) Propose rules in accordance with the provisions of article three, chapter twenty-nine-a of this code to implement the provisions of this article;

            (18) Sue and be sued in its official name as an agency of this state; and

            (19) Confer with the Attorney General or his or her assistant in connection with legal matters and questions.

§30-4-6. Rule-making authority.

            (a) The board shall propose rules for legislative approval, in accordance with the provisions of article three, chapter twenty-nine-a of this code, to implement the provisions of this article, and articles four-a and four-b of this chapter including:

            (1) Standards and requirements for licenses, certifications and permits;

            (2) Requirements for third parties to prepare and/or administer examinations and reexaminations;

            (3) Educational and experience requirements;

            (4) Continuing education requirements and approval of continuing education courses;

            (5) Procedures for the issuance and renewal of licenses, certifications and permits;

            (6) Establish a fee schedule;

            (7) Regulate dental specialities;

            (8) Delegate procedures to be performed by a dental hygienist;

            (9) Delegate procedures to be performed by a dental assistant;

            (10) Designate the services and procedures performed under direct supervision, general supervision in public health practice;

            (11) Designate additional public health settings;

            (12) Regulate the use of firm or trade names;

            (13) Regulate dental corporations;

            (14) Regulate professional limited liability companies;

            (15) Establish professional conduct requirements;

            (16) Establish the procedures for denying, suspending, revoking, reinstating or limiting the practice of licensees, certifications and permitees;

            (17) Establish requirements for inactive or revoked licenses, certifications and permits;

            (18) Regulate dental anesthesia, including:

            (A) Fees;

            (B) Evaluations;

            (C) Equipment;

            (D) Emergency Drugs;

            (E) Definitions;

            (F) Qualified Monitor Requirements; and

            (G) Education;

            (19) Any other rules necessary to implement this article.

            (b) All of the board's rules in effect and not in conflict with these provisions, shall remain in effect until they are amended or rescinded.

§30-4-7. Fees; special revenue account; administrative fines.

            (a) All fees and other moneys, except administrative fines, received by the board shall be deposited in a separate special revenue fund in the State Treasury designated the ‘Board of Dentists and Dental Hygienist Special Fund’, which is continued and shall be known as the ‘Board of Dentistry Special Fund’. The fund is used by the board for the administration of this article. Except as may be provided in article one of this chapter, the board retains the amount in the special revenue account from year to year. No compensation or expense incurred under this article is a charge against the General Revenue Fund.

            (b) Any amounts received as administrative fines imposed pursuant to this article shall be deposited into the general revenue fund of the State Treasury.

§30-4-8. License to practice dentistry.

            (a) The board shall issue a license to practice dentistry to an applicant who meets the following requirements:

            (1) Is at least eighteen years of age;

            (2) Is of good moral character;

            (3) Is a graduate of and has a diploma from a Commission on Dental Accreditation or equivalent approved dental college, school or dental department of a university;

            (4) Has passed the National Board examination as given by the Joint Commission on National Dental Examinations and a clinical board as specified by the board by rule;

            (5) Has not been found guilty of cheating, deception or fraud in the examination or any part of the application;

            (6) Has paid the application fee specified by rule; and

            (7) Not be an alcohol or drug abuser, as these terms are defined in section eleven, article one-a, chapter twenty-seven of this code: Provided, That an applicant in an active recovery process, which may, in the discretion of the board, be evidenced by participation in a twelve-step program or other similar group or process, may be considered.

            (b) A dentist may not represent to the public that he or she is a specialist in any branch of dentistry or limit his or her practice to any branch of dentistry unless first issued a certificate of qualification in that branch of dentistry by the board.

            (c) A license to practice dentistry issued by the board shall for all purposes be considered a license issued under this section: Provided, That a person holding a license shall renew the license.

§30-4-9. Scope of practice of a dentist.
            The practice of dentistry includes the following:

            (1) Coordinate dental services to meet the oral health needs of the patient;

            (2) Examine, evaluate and diagnose diseases, disorders and conditions of the oral cavity, maxillofacial area and adjacent and associated structures;

            (3) Treat diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures;

            (4) Provide services to prevent diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures;

            (5) Fabricate, repair or alter a dental prosthesis;

            (6) Administer anesthesia in accordance with the provisions of article four-a of this chapter;

            (7) Prescribe drugs necessary for the practice of dentistry;

            (8) Execute and sign a death certificate when it is required in the practice of dentistry;

            (9) Employ and supervise dental auxiliary personnel;

            (10) Authorize delegated procedures to be performed by dental auxiliary personnel; and

            (11) Perform any other work included in the curriculum of an approved dental school, college or dental department of a university.

§30-4-10. License to practice dental hygiene.

            (a) The board shall issue a dental hygienist license to an applicant who meets the following requirements:

            (1) Is at least eighteen years of age;

            (2) Is of good moral character;

            (3) Is a graduate with a degree in dental hygiene from an approved dental hygiene program of a college, school or dental department of a university;

            (4) Has passed the national board dental hygiene examination, a regional or state clinical examination and a state law examination that tests the applicant's knowledge of subjects specified by the board by rule;

            (5) Has not been found guilty of cheating, deception or fraud in the examination or any part of the application;

            (6) Has paid the application fee specified by rule; and,

            (7) Not be an alcohol or drug abuser, as these terms are defined in section eleven, article one-a, chapter twenty-seven of this code: Provided, That an applicant in an active recovery process, which may, in the discretion of the board, be evidenced by participation in a twelve-step program or other similar group or process, may be considered.

            (b) A dental hygienist license issued by the board shall for all purposes be considered a dental hygienist license issued under this section: Provided, That a person holding a dental hygienist license shall renew the license.

§30-4-11. Scope of practice for a dental hygienist.
            The practice of dental hygiene includes the following:

            (1) Perform a complete prophylaxis, including the removal of any deposit, accretion or stain from supra and subgingival, the surface of a tooth or a restoration;

            (2) Apply a medicinal agent to a tooth for a prophylactic purpose;

            (3) Take a radiograph for interpretation by a dentist;

            (4) Instruct a patient on proper oral hygiene practice;

            (5) Place sealants on a patient’s teeth without a prior examination by a licensed dentist: Provided, That for this subdivision, the dental hygienist has a public health practice permit issued by the board, and subject to a collaborative agreement with a supervising dentist and the patient is referred for a dental examination within six months of sealant application;

            (6) Perform all delegated procedures of a dental hygienist specified by rule by the board; and

            (7) Performing all delegated procedures of a dental assistant specified by rule by the board.

§30-4-12. License renewal.

            (a) All persons regulated by this article shall annually or biannually, renew his or her board authorization by completing a form prescribed by the board and submitting any other information required by the board.

            (b) The board shall charge a fee for each renewal of a board authorization and shall charge a late fee for any renewal not paid by the due date. 

            (c) The board shall require as a condition of renewal that each licensee, certificate holder or permittee complete continuing education.

            (d) The board may deny an application for renewal for any reason which would justify the denial of an original application.

§30-4-13. Board authorizations shall be displayed.

            (a) The board shall prescribe the form for a board authorization, and may issue a duplicate upon payment of a fee.

            (b) Any person regulated by the article shall conspicuously display his or her board authorization at his or her principal business location.

§30-4-14. Dental intern, resident, or teaching permit.

            (a) The board may issue a dental intern or dental resident permit to an applicant who has been accepted as a dental intern or dental resident by a licensed hospital or dental school in this state which maintains an established dental department under the supervision of a licensed dentist and meets the following qualifications:

            (1) Has graduated from a Commission on Dental Accreditation or equivalent approved dental college, school or dental department of a university with a degree in dentistry;

            (2) Has paid the application fee specified by rule; and

            (3) Meets the other qualifications specified by rule.

            (b) The dental intern or dental resident permit may be renewed and expires on the earlier of:

            (1) The date the permit holder ceases to be a dental intern or dental resident; or

            (2) One year after the date of issue.

            (c) The board may issue a teaching permit to an applicant who is not otherwise licensed to practice dentistry in this state and who meets the following conditions:

            (1) Shall have authorization or has been eligible for a authorization to practice dentistry in another jurisdiction;

            (2) Has met or been approved under the credentialing standards of a dental school or an academic medical center with which the person is to be affiliated; the dental school or academic medical center shall be accredited by the Commission on Dental Accreditation or Joint Commission on Accreditation of Health Care Organizations;

            (3) The permittee may teach and practice dentistry in or on behalf of a dental school or college offering a doctoral degree in dentistry operated and conducted in this state, in connection with an academic medical center or at any teaching hospital adjacent to a dental school or an academic medical center;

            (4) May be renewed annually with a written recommendation from the dental school dean;

            (5) Shall successfully complete the West Virginia Dental Law Examination;

            (6) Shall pay annual renewal fees to the board;

            (7) Shall comply with continuing education requirements;

            (8) Has had no disciplinary actions taken or pending against him or her by any other jurisdiction; and

            (9) Shall be responsible for the permit as would a regular dental license.

            (d) While in effect, a permittee is subject to the restrictions and requirements imposed by this article. In addition, a permittee may not receive any fee for service other than a salary paid by the hospital or dental school

§30-4-15. Special volunteer dentist or dental hygienist license; civil immunity for voluntary services rendered to indigents.

            (a) There is continued a special volunteer dentist and dental hygienist license for dentist and dental hygienists retired or retiring from the active practice of dentistry and dental hygiene who wish to donate their expertise for the care and treatment of indigent and needy patients in the clinic setting of clinics organized, in whole or in part, for the delivery of health care services without charge. The special volunteer dentist or dental hygienist license shall be issued by the board to dentist or dental hygienists licensed or otherwise eligible for licensure under this article and the legislative rules promulgated hereunder without the payment of an application fee, license fee or renewal fee, shall be issued for the remainder of the licensing period, and renewed consistent with the boards other licensing requirements. The board shall develop application forms for the special license provided in this subsection which shall contain the dental hygienist’s acknowledgment that:

            (1) The dentist or dental hygienist’s practice under the special volunteer dentist or dental hygienist license will be exclusively devoted to providing dentistry or dental hygiene care to needy and indigent persons in West Virginia;

            (2) The dentist or dental hygienist will not receive any payment or compensation, either direct or indirect, or have the expectation of any payment or compensation, for any dentistry or dental hygiene services rendered under the special volunteer dentist or dental hygienist license;

            (3) The dentist or dental hygienist will supply any supporting documentation that the board may reasonably require; and

            (4) The dentist or dental hygienist agrees to continue to participate in continuing professional education as required by the board for the special volunteer dentist or dental hygienist.

            (b) Any dentist or dental hygienist who renders any dentistry or dental hygiene service to indigent and needy patients of a clinic organized, in whole or in part, for the delivery of health care services without charge under a special volunteer dentist or dental hygienist license authorized under subsection (a) of this section without payment or compensation or the expectation or promise of payment or compensation is immune from liability for any civil action arising out of any act or omission resulting from the rendering of the dental hygiene service at the clinic unless the act or omission was the result of the dentist’s or dental hygienist’s gross negligence or willful misconduct. In order for the immunity under this subsection to apply, there shall be a written agreement between the dentist or dental hygienist and the clinic pursuant to which the dentist or dental hygienist will provide voluntary uncompensated dental hygiene services under the control of the clinic to patients of the clinic before the rendering of any services by the dentist or dental hygienist at the clinic: Provided, That any clinic entering into such written agreement is required to maintain liability coverage of not less than one million dollars per occurrence.

            (c) Notwithstanding the provisions of subsection (b) of this section, a clinic organized, in whole or in part, for the delivery of health care services without charge is not relieved from imputed liability for the negligent acts of a dentist or dental hygienist rendering voluntary dental hygiene services at or for the clinic under a special volunteer dentist or dental hygienist license authorized under subsection (a) of this section.

            (d) For purposes of this section, ‘otherwise eligible for licensure’ means the satisfaction of all the requirements for licensure as listed in section ten of this article and in the legislative rules promulgated thereunder, except the fee requirements of subdivision six of that section and of the legislative rules promulgated by the board relating to fees.

            (e) Nothing in this section may be construed as requiring the board to issue a special volunteer dentist or dental hygienist license to any dental hygienist whose license is or has been subject to any disciplinary action or to any dentist or dental hygienist who has surrendered a license or caused such license to lapse, expire and become invalid in lieu of having a complaint initiated or other action taken against his or her dentist or dental hygienist license, or who has elected to place a dentist or dental hygienist license in inactive status in lieu of having a complaint initiated or other action taken against his or her license, or who has been denied a dentist or dental hygienist license.

            (f) Any policy or contract of liability insurance providing coverage for liability sold, issued or delivered in this state to any dentist or dental hygienist covered under the provisions of this article shall be read so as to contain a provision or endorsement whereby the company issuing such policy waives or agrees not to assert as a defense on behalf of the policyholder or any beneficiary thereof, to any claim covered by the terms of such policy within the policy limits, the immunity from liability of the insured by reason of the care and treatment of needy and indigent patients by a dentist or dental hygienist who holds a special volunteer dentist or dental hygienist license.

§30-4-16. Dental corporations.

            (a) Dental corporations are continued.

            (b) One or more dentists may organize and become a shareholder or shareholders of a dental corporation domiciled within this state under the terms and conditions and subject to the limitations and restrictions specified by rule.

            (c) No corporation may practice dentistry, or any of its branches, or hold itself out as being capable of doing so without a certificate of authorization from the board.

            (d) When the Secretary of State receives a certificate of authorization to act as a dental corporation from the board, he or she shall attach the authorization to the corporation application and, upon compliance with the applicable provisions of chapter thirty-one of this code, the Secretary of State shall issue to the incorporators a certificate of incorporation for the dental corporation.

            (e) A corporation holding a certificate of authorization shall renew annually, on or before June 30, on a form prescribed by the board and pay an annual fee in an amount specified by rule.

            (f) A dental corporation may practice dentistry only through an individual dentist or dentists licensed to practice dentistry in this state, but the dentist or dentists may be employees rather than shareholders of the corporation.

            (g) A dental corporation holding a certificate of authorization shall cease to engage in the practice of dentistry upon being notified by the board that any of its shareholders is no longer a licensed dentist or when any shares of the corporation have been sold or disposed of to a person who is not a licensed dentist: Provided, That the personal representative of a deceased shareholder has a period, not to exceed twenty-four months from the date of the shareholder’s death, to dispose of the shares; but nothing contained herein may be construed as affecting the existence of the corporation or its right to continue to operate for all lawful purposes other than the practice of dentistry.

§30-4-17. Reinstatement.

            (a) A licensee against whom disciplinary action has been taken under the provisions of this article shall be afforded an opportunity to demonstrate the qualifications to resume practice. The application for reinstatement shall be in writing and subject to the procedures specified by the board by rule.

            (b) A licensee who does not complete annual renewal, as specified by the board by rule, and whose licensed has lapsed for one year or longer, shall make application for reinstatement as specified by the board by rule.

            (c) The board, at its discretion and for cause, may require an applicant for reinstatement to undergo a physical and/or mental evaluation to determine a licensee is competent to practice or if the licensee is impaired by drugs or alcohol.

§30-5-18. Actions to enjoin violations.

            (a) If the board obtains information that any person has engaged in, is engaging in or is about to engage in any act which constitutes or will constitute a violation of the provisions of this article, the rules promulgated pursuant to this article, or a final order or decision of the board, it may issue a notice to the person to cease and desist in engaging in the act and/or apply to the circuit court in the county of the alleged violation for an order enjoining the act.

            (b) The circuit court may issue a temporary injunction pending a decision on the merits, and may issue a permanent injunction based on its findings in the case.

            (c) The judgment of the circuit court on an application permitted by the provisions of this section is final unless reversed, vacated or modified on appeal to the West Virginia Supreme Court of Appeals.

§30-5-19. Complaints; investigations; due process procedure;   grounds for disciplinary action.

            (a) The board may initiate a complaint upon receipt of credible information, and shall upon the receipt of a written complaint of any person, cause an investigation to be made to determine whether grounds exist for disciplinary action under this article or the legislative rules promulgated pursuant to this article.

            (b) After reviewing any information obtained through an investigation, the board shall determine if probable cause exists that the licensee, certificate holder or permittee has violated subsection (g) of this section or rules promulgated pursuant to this article.

            (c) Upon a finding of probable cause to go forward with a complaint, the board shall provide a copy of the complaint to the licensee, certificate holder or permittee.

            (d) Upon a finding that probable cause exists that the licensee, certificate holder or permittee has violated subsection (g) of this section or rules promulgated pursuant to this article, the board may enter into a consent decree or hold a hearing for disciplinary action against the licensee, certificate holder or permittee. Any hearing shall be held in accordance with the provisions of this article, and shall require a violation to be proven by a preponderance of the evidence.

            (e) A member of the complaint committee or the executive director of the board may issue subpoenas and subpoenas duces tecum to obtain testimony and documents to aid in the investigation of allegations against any person regulated by the article.

            (f) Any member of the board or its executive director may sign a consent decree or other legal document on behalf of the board.

            (g) The board may, after notice and opportunity for hearing, deny or refuse to renew, suspend, restrict or revoke the license, certificate or permit of, or impose probationary conditions upon or take disciplinary action against, any licensee, certificate holder or permittee for any of the following reasons:

            (1) Obtaining a board authorization by fraud, misrepresentation or concealment of material facts;

            (2) Being convicted of a felony or other crime involving drugs, violent crime, or moral turpitude;

            (3) Being guilty of unprofessional conduct which placed the public at risk, as defined by legislative rule of the board;

            (4) Intentional violation of a lawful order or legislative rule of the board;

            (5) Having had a board authorization revoked or suspended, other disciplinary action taken, or an application for a board authorization denied by the proper authorities of another jurisdiction;

            (6) Aiding or abetting unlicensed practice;

            (7) Engaging in an act while acting in a professional capacity which has endangered or is likely to endanger the health, welfare or safety of the public;

            (8) Incapacity that prevents a licensee from engaging in the practice of dentistry or dental hygiene, with reasonable skill, competence, and safety to the public;

            (9) Committing fraud in connection with the practice of dentistry or dental hygiene;

            (10) Failure to report to the board one's surrender of a license or authorization to practice dentistry or dental hygiene in another jurisdiction while under disciplinary investigation by any of those authorities or bodies for conduct that would constitute grounds for action as defined in this section;

            (11) Failure to report to the board any adverse judgment, settlement, or award arising from a malpractice claim arising related to conduct that would constitute grounds for action as defined in this section;

            (12) Being guilty of unprofessional conduct as contained in the American Dental Association principles of ethics and code of professional conduct. The following acts are conclusively presumed to be unprofessional conduct:

            (A) Being guilty of any fraud or deception;

            (B) Committing a criminal operation or being convicted of a crime involving moral turpitude;

            (C) Abusing alcohol or drugs;

            (D) Violating any professional confidence or disclosing any professional secret;

            (E) Being grossly immoral;

            (F) Harassing, abusing, intimidating, insulting, degrading or humiliating a patient physically, verbally or through another form of communication;

            (G) Obtaining any fee by fraud or misrepresentation;

            (H) Employing directly or indirectly, or directing or permitting any suspended or unlicensed person so employed, to perform operations of any kind or to treat lesions of the human teeth or jaws or correct malimposed formations thereof;

            (I) Practicing, or offering, or undertaking to practice dentistry under any firm name or trade name not approved by the board;

            (J) Having a professional connection or association with, or lending his or her name to another, for the illegal practice of dentistry, or professional connection or association with any person, firm or corporation holding himself or herself, themselves or itself out in any manner contrary to this article;

            (K) Making use of any advertising relating to the use of any drug or medicine of unknown formula;

            (L) Advertising to practice dentistry or perform any operation thereunder without causing pain;

            (M) Advertising professional superiority or the performance of professional services in a superior manner;

(N) Advertising to guarantee any dental service;

            (O) Advertising in any manner that is false or misleading in any material respect;

            (P) Soliciting subscriptions from individuals within or without the state for, or advertising or offering to individuals within or without the state, a course or instruction or course materials in any phase, part or branch of dentistry or dental hygiene in any journal, newspaper, magazine or dental publication, or by means of radio, television or United States mail, or in or by any other means of contacting individuals: Provided, That the provisions of this paragraph may not be construed so as to prohibit:

                        (i) An individual dentist or dental hygienist from presenting articles pertaining to procedures or technique to state or national journals or accepted dental publications; or

                        (ii) educational institutions approved by the board from offering courses or instruction or course materials to individual dentists and dental hygienists from within or without the state; or

            (Q) Engaging in any action or conduct which would have warranted the denial of the license.

            (13) Knowing or suspecting that a licensee is incapable of engaging in the practice of dentistry or dental hygiene, with reasonable skill, competence, and safety to the public, and failing to report any relevant information to the board;

            (14) Illegal use or disclosure of protected health information;

            (15) Engaging in any conduct that subverts or attempts to subvert any licensing examination or the administration of any licensing examination;

            (16) Failure to furnish to the board or its representatives any information legally requested by the board, or failure to cooperate with or engaging in any conduct which obstructs an investigation being conducted by the board;

            (17) Announcing or otherwise holding himself or herself out to the public as a specialist or as being specially qualified in any particular branch of dentistry or as giving special attention to any branch of dentistry or as limiting his or her practice to any branch of dentistry without first complying with the requirements established by the board for the specialty and having been issued a certificate of qualification in the specialty by the board;

            (18) Failing to report to the board within 72 hours of becoming aware thereof any life threatening occurrence, serious injury or death of a patient resulting from dental treatment or complications following a dental procedure;

            (19) Failing to report to the board any Driving Under the Influence and/or Driving While Intoxicated offense; or

            (20) Violation of any of the terms or conditions of any order entered in any disciplinary action. 

            (h) For the purposes of subsection (g) of this section, effective July 1, 2013, disciplinary action may include:

            (1) Reprimand;

            (2) Probation;

            (3) Restrictions;

            (4) Suspension;

            (5) Revocation;

            (6) Administrative fine, not to exceed $1,000 per day per violation;

            (7) Mandatory attendance at continuing education seminars or other training;

            (8) Practicing under supervision or other restriction; or

            (9) Requiring the licensee or permittee to report to the board for periodic interviews for a specified period of time.

            (i) In addition to any other sanction imposed, the board may require a licensee or permittee to pay the costs of the proceeding.

            (j) Nothing shall be construed as barring criminal prosecutions for violations of this article.

            (k) A person authorized to practice under this article, who reports or otherwise provides evidence of the negligence, impairment or incompetence of another member of this profession to the board or to any peer review organization, is not liable to any person for making the report if the report is made without actual malice and in the reasonable belief that the report is warranted by the facts known to him or her at the time.

§30-5-20. Procedures for hearing; right of appeal.

            (a) Hearings are governed by the provisions of section eight, article one of this chapter.

            (b) The board may conduct the hearing or elect to have an administrative law judge conduct the hearing.

            (c) If the hearing is conducted by an administrative law judge, at the conclusion of a hearing he or she shall prepare a proposed written order containing findings of fact and conclusions of law. The proposed order may contain proposed disciplinary actions if the board so directs. The board may accept, reject or modify the decision of the administrative law judge.

            (d) Any member or the executive director of the board has the authority to administer oaths, examine any person under oath.

            (e) If, after a hearing, the board determines the licensee or permittee has violated provisions of this article or the board's rules, a formal written decision shall be prepared which contains findings of fact, conclusions of law and a specific description of the disciplinary actions imposed.

§30-5-21. Judicial review.

            A person adversely affected by a decision of the board denying an application or entered after a hearing may obtain judicial review of the decision in accordance with section four, article five, chapter twenty-nine-a of this code, and may appeal any ruling resulting from judicial review in accordance with article six, chapter twenty-nine-a of this code.

§30-4-22. Criminal proceedings; penalties.
            (a) When, as a result of an investigation under this article or otherwise, the board has reason to believe that a person authorized under this article has committed a criminal offense under this article, the board may bring its information to the attention of an appropriate law-enforcement official.

            (b) Any person who intentionally practices, or holds himself or herself out as qualified to practice dentistry or dental hygiene, or uses any title, word or abbreviation to indicate to or induce others to believe he or she is licensed to practice as a dentist or dental hygienist without obtaining an active, valid West Virginia license to practice that profession or with a license that is:

            (1) Expired, suspended or lapsed; or

            (2) Inactive, revoked, suspended as a result of disciplinary action, or surrendered, is guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than $10,000.

§30-4-23. Single act evidence of practice.
            In any action brought under this article, article four-a or article four-b any proceeding initiated under this article, evidence of the commission of a single act prohibited by this article is sufficient to justify a penalty, injunction, restraining order or conviction without evidence of a general course of conduct.

§30-4-24. Inapplicability of article.

            The provisions of this article do not apply to:

            (1) A licensed physician or surgeon in the practice of his or her profession when rendering dental relief in emergency cases, unless he or she undertakes to reproduce or reproduces lost parts of the human teeth or to restore or replace lost or missing teeth in the human mouth;

            (2) A dental laboratory in the performance of dental laboratory services, while the dental laboratory, in the performance of the work, conforms in all respects to the requirements of article four-b and further does not apply to persons performing dental laboratory services under the direct supervision of a licensed dentist or under the direct supervision of a person authorized under this article to perform any of the acts in this article defined to constitute the practice of dentistry while the work is performed in connection with, and as a part of, the dental practice of the licensed dentist or other authorized person and for his or her dental patients;

            (3) A student enrolled in and regularly attending any dental college recognized by the board, provided their acts are done in the dental college and under the direct and personal supervision of their instructor;

            (4) A student enrolled in and regularly attending any dental college recognized by the board may practice dentistry in a public health setting, provided their acts are done under the direct supervision of their instructor, adjunct instructor or a dentist;

            (5) An authorized dentist of another state temporarily operating a clinic under the auspices of a organized and reputable dental college or reputable dental society, or to one lecturing before a reputable society composed exclusively of dentists; or

            (6) A dentists whose practice is confined exclusively to the service of the United States Army, the United States Navy, the United States Air Force, The United States Coast Guard, the United States Public Health Service, the United States Veteran’s Bureau or any other authorized United States government agency or bureau.

ARTICLE 4A. ADMINISTRATION OF ANESTHESIA BY DENTISTS.

§30-4A-1. Requirement for anesthesia permit.

            (a) No dentist may induce central nervous system anesthesia without first having obtained an anesthesia permit for the level of anesthesia being induced.

            (b) The applicant for an anesthesia permit shall pay the appropriate permit fees and renewal fees, submit a completed board-approved application and consent to an office evaluation.

            (c) Permits shall be issued to coincide with the annual renewal dates.

            (d) Permit holders shall report the names and qualifications of each qualified monitor. Qualified monitors shall apply for certification and pay the appropriate application fees and renewal fees. Qualified monitors are required to renew annually by the 30th day of June. Qualified monitor requirements for each level of sedation are as specified by rule.

            (e) A dentist shall hold a class permit equivalent to or exceeding the anesthesia level being provided, unless the provider of anesthesia is a physician anesthesiologist or licensed dentist who holds a current anesthesia permit issued by the board.

§30-4A-2. Presumption of Degree of Central Nervous System Depression.

            (a) In any hearing where a question exists as to the degree of central nervous system depression a licensee has induced (i.e., local anesthesia, relative analgesia, anxiolysis, conscious sedation, general anesthesia/deep conscious sedation) the board may base its findings on, among other things, the types, dosages and routes of administration of drugs administered to the patient and what result can reasonably be expected from those drugs in those dosages and routes administered in a patient of that physical and psychological status.

            (b) No permit holder may have more than one person under conscious sedation/moderate sedation and/or general anesthesia/deep conscious sedation at the same time, exclusive of recovery.

§30-4A-3. Classes of anesthesia permits.

            (a) The board shall issue the following permits:

            (1) Class 2 Permit: A Class 2 Permit authorizes a dentist to induce anxiolysis/minimal sedation.

            (2) Class 3 Permit: A Class 3 Permit authorizes a dentist to induce conscious sedation/moderate sedation as limited enteral (3a) and/or comprehensive parenteral (3b), and anxiolysis/minimal sedation.

            (3) Class 4 Permit: A Class 4 Permit authorizes a dentist to induce general anesthesia/deep conscious sedation, conscious sedation/moderate sedation, and anxiolysis/minimal sedation.

            (b) When anesthesia services are provided in dental facilities by a MD or DO physician anesthesiologist, dentist anesthesiologist, or CRNA, the dental facility shall be inspected and approved for a Class 4 permit, and the dentist shall have a minimum of a Class 2 permit. If anesthesia services are provided by a CRNA, the dental facility shall be inspected and approved for a Class 4 permit. and the supervising dentist shall have the same level of permit for the level of anesthesia provided by the CRNA.

§30-4A-4. Qualifications, standards, and continuing education requirements for relative             analgesia/minimal sedation use.

            (a) The board shall allow administration of relative analgesia if the practitioner:

            (1) Is a licensed dentist in the state;

            (2) Holds valid and current documentation showing successful completion of a Health Care Provider BLS/CPR course; and

            (3) Has completed a training course of instruction in dental school, continuing education or as a postgraduate in the administration of relative analgesia.

            (b) A practitioner who administers relative analgesia shall have the following facilities, equipment and drugs available during the procedure and during recovery:

            (1) An operating room large enough to adequately accommodate the patient on an operating table or in an operating chair and to allow delivery of age appropriate care in an emergency situation;

            (2) An operating table or chair which permits the patient to be positioned so that the patient's airway can be maintained, quickly alter the patient's position in an emergency, and provide a firm platform for the administration of basic life support;

            (3) A lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure;

            (4) Suction equipment which permits aspiration of the oral and pharyngeal cavities;

            (5) An oxygen delivery system with adequate age appropriate full face masks and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system;

            (6) A nitrous oxide delivery system with a fail-safe mechanism that will insure appropriate continuous oxygen delivery and a scavenger system; and

            (7) A defibrillator device: Provided, That this requirement is only for Class 2, 3, and 4 permittees.

            (c) All equipment used shall be appropriate for the height and weight and age of the patient.

            (d) Before inducing relative analgesia/minimal sedation by means of nitrous oxide or a single pre-med agent, a practitioner shall:

            (1) Evaluate the patient;

            (2) Give instruction to the patient or, when appropriate due to age or psychological status of the patient, the patient's guardian; and

            (3) Certify that the patient is an appropriate candidate for relative analgesia/minimal sedation.

            (e) A practitioner who administers relative analgesia/minimal sedation shall see that the patient’s condition is visually monitored. At all times, the patient shall be observed by a qualified monitor until discharge criteria have been met.

            (f) A qualified monitor’s record shall include documentation of all medications administered with dosages, time intervals and route of administration including local anesthesia.

            (g) A discharge entry shall be made in the patient's record indicating the patient's condition upon discharge.

            (h) A qualified monitor shall hold valid and current documentation:

            (1) Showing successful completion of a Health Care Provider BLS/CPR course; and

            (2) Have received training and be competent in the recognition and treatment of medical emergencies, monitoring vital signs, the operation of nitrous oxide delivery systems and the use of the sphygmomanometer and stethoscope.

            (i) The practitioner shall assess the patient's responsiveness using preoperative values as normal guidelines and discharge the patient only when the following criteria are met:

            (1) The patient is alert and oriented to person, place and time as appropriate to age and preoperative neurological status;

            (2) The patient can talk and respond coherently to verbal questioning or to preoperative neurological status;

            (3) The patient can sit up unaided or without assistance or to preoperative neurological status;

            (4) The patient can ambulate with minimal assistance or to preoperative neurological status; and

            (5) The patient does not have uncontrollable nausea, vomiting or dizziness.

§30-4A-5. Qualifications, standards, and continuing education requirements for a Class 2 Permit.

            (a) The board shall issue a Class 2 Permit to an applicant who:

            (1) Is a licensed dentist in West Virginia;

            (2) Holds valid and current documentation showing successful completion of a Health Care Provider BLS/CPR; and

            (3) Has completed a board approved course of at least six hours didactic and clinical of either predoctoral dental school or postgraduate instruction.

            (b) A dentist who induces relative analgesia/minimal sedation and anxiolysis/minimal sedation shall have the following facilities, properly maintained equipment and appropriate drugs available during the procedures and during recovery:

            (1) An operating room large enough to adequately accommodate the patient on an operating table or in an operating chair and to allow an operating team of at least two individuals to freely move about the patient;

            (2) An operating table or chair which permits the patient to be positioned so the operating team can maintain the patient's airway, quickly alter the patient's position in an emergency, and provide a firm platform for the administration of basic life support;

            (3) A lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure;

            (4) Suction equipment which permits aspiration of the oral and pharyngeal cavities;

            (5) An oxygen delivery system with adequate age appropriate full face mask and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system;

            (6) A nitrous oxide delivery system with a fail-safe mechanism that will insure appropriate continuous oxygen delivery and a scavenger system;

            (7) A recovery area that has available oxygen, adequate lighting, suction and electrical outlets. The recovery area can be the operating room;

            (8) Sphygmomanometer, stethoscope, and pulse oximeter;

            (9) Emergency drugs as specified by rule;

            (10) A defibrillator device; and

            (11) All equipment and medication dosages shall be in accordance with the height and weight and age of the patient being treated.

            (c) Before inducing anxiolysis, a dentist shall:

            (1) Evaluate the patient and certify by using the ASA Patient Physical Status Classification of the ASA that the patient is an appropriate candidate for anxiolysis sedation; and

            (2) Obtain written informed consent from the patient or patient's guardian for the anesthesia. The obtaining of the informed consent shall be documented in the patient's record.

            (d) The dentist shall monitor and record the patient's condition or shall use a qualified monitor to monitor and record the patient's condition. The documented requirements of a qualified monitor monitoring anxiolysis sedation cases are as specified by rule. A Class 2 Permit holder may have no more than one person under anxiolysis at the same time.

            (e) The patient shall be monitored as follows:

            (1) Patients shall have continuous monitoring using pulse oximetry. The patient's blood pressure, heart rate and respiration shall be recorded at least once before, during and after the procedure, and these recordings shall be documented in the patient record. At all times, the patient shall be observed by a qualified monitor until discharge criteria have been met. If the dentist is unable to obtain this information, the reasons shall be documented in the patient's record. The record shall also include documentation of all medications administered with dosages, time intervals and route of administration including local anesthesia.

            (2) A discharge entry shall be made by the dentist in the patient's record indicating the patient's condition upon discharge.

            (f) A permit holder who uses anxiolysis shall see that the patient’s condition is visually monitored. The patient shall be monitored as to response to verbal stimulation, oral mucosal color and preoperative and postoperative vital signs.

            (g) The dentist shall assess the patient's responsiveness using preoperative values as normal guidelines and discharge the patient only when the following criteria are met:

            (1) Vital signs including blood pressure, pulse rate and respiratory rate are stable;

            (2) The patient is alert and oriented to person, place and time as appropriate to age and preoperative neurological status;

            (3) The patient can talk and respond coherently to verbal questioning, or to preoperative neurological status;

            (4) The patient can sit up unaided, or to preoperative neurological status;

            (5) The patient can ambulate with minimal assistance, or to preoperative neurological status; and

            (6) The patient does not have uncontrollable nausea or vomiting and has minimal dizziness.

            (h) A dentist may not release a patient who has undergone anxiolysis/minimal sedation except to the care of a responsible adult third party.

§30-4A-6. Qualifications, standards, and continuing education requirements for Class 3 Anesthesia Permit.

            (a) The board shall issue or renew a Class 3 Permit to an applicant who:

            (1) Is a licensed dentist in West Virginia;

            (2) Holds valid and current documentation showing successful completion of a Health Care Provider BLS/CPR course, ACLS and/or a PALS course if treating pediatric patients; and

            (3) Satisfies one of the following criteria:

            (A) Certificate of completion of a comprehensive training program in conscious sedation that satisfies the requirements described in the ADA Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students and the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists at the time training was commenced.

            (B) Certificate of completion of an ADA accredited postdoctoral training program which affords comprehensive and appropriate training necessary to administer and manage conscious sedation, commensurate with these guidelines.

            (C) In lieu of these requirements, the board may accept documented evidence of equivalent training or experience in conscious sedation anesthesia for Limited Enteral Permit as Class 3a or comprehensive Parenteral Permit as Class 3b as specified by rule.

            (b) A dentist who induces conscious sedation shall have the following facilities, properly maintained age appropriate equipment and age appropriate medications available during the procedures and during recovery:

            (1) An operating room large enough to adequately accommodate the patient on an operating table or in an operating chair and to allow an operating team of at least two individuals to freely move about the patient;

            (2) An operating table or chair which permits the patient to be positioned so the operating team can maintain the patient's airway, quickly alter the patient's position in an emergency, and provide a firm platform for the administration of basic life support;

            (3) A lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure;

            (4) Suction equipment which permits aspiration of the oral and pharyngeal cavities and a backup suction device which will function in the event of a general power failure;

            (5) An oxygen delivery system with adequate age appropriate full face mask and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system;

            (6) A nitrous oxide delivery system with a fail-safe mechanism that will insure appropriate continuous oxygen delivery and a scavenger system;

            (7) A recovery area that has available oxygen, adequate lighting, suction and electrical outlets. The recovery area can be the operating room;

            (8) Sphygmomanometer, pulse oximeter, oral and nasopharyngeal airways, intravenous fluid administration equipment and/or equipment required for the standard of care or as specified by rule;

            (9) Emergency drugs as specified by rule; and

            (10) A defibrillator device.

            (c) Before inducing conscious sedation, a dentist shall:

            (1) Evaluate the patient and document, using the ASA Patient Physical Status Classifications, that the patient is an appropriate candidate for conscious sedation;

            (2) Give written preoperative and postoperative instructions to the patient or, when appropriate due to age or neurological status of the patient, the patient's guardian; and

            (3) Obtain written informed consent from the patient or patient's guardian for the anesthesia.

            (d) The dentist shall ensure that the patient's condition is monitored and recorded on a contemporaneous record. The dentist shall use a Qualified Monitor to monitor and record the patient's condition in addition to the chair side dental assistant. A Qualified Monitor shall be present to monitor the patient at all times.

            (e) The patient shall be monitored as follows:

            (1) Patients shall have continuous monitoring using pulse oximetry and/or equipment required for the standard of care or as specified by rule by a Qualified Monitor until discharge criteria have been met. The documented requirements of a Qualified Monitor monitoring limited enteral or comprehensive parenteral sedations cases are as specified by rule. The patient's blood pressure, heart rate, and respiration shall be recorded every five minutes, and these recordings shall be documented in the patient record. The record shall also include documentation of preoperative and postoperative vital signs, all medications administered with dosages, time intervals and route of administration including local anesthesia. If the dentist is unable to obtain this information, the reasons shall be documented in the patient's record.

            (2) During the recovery phase, the patient shall be monitored by a qualified monitor.

            (3) A discharge entry shall be made by the dentist in the patient's record indicating the patient's condition upon discharge and the name of the responsible party to whom the patient was discharged.

            (f) A dentist may not release a patient who has undergone conscious sedation/moderate sedation except to the care of a responsible adult third party.

            (g) When discharging a pediatric patient the dentist shall follow the current edition of AAPD Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures.

            (h) The dentist shall assess the patient's responsiveness using preoperative values as normal guidelines and discharge the patient only when the following criteria are met:

            (1) Vital signs including blood pressure, pulse rate and respiratory rate are stable;

            (2) The patient is alert and oriented to person, place and time as appropriate to age and preoperative neurological status;

            (3) The patient can talk and respond coherently to verbal questioning, or to preoperative neurological status;

            (4) The patient can sit up unaided, or to preoperative neurological status;

            (5) The patient can ambulate with minimal assistance, or to preoperative neurological status; and

            (6) The patient does not have uncontrollable nausea or vomiting and has minimal dizziness.

            (i) A dentist who induces conscious sedation shall employ the services of a Qualified Monitor and a chair side dental assistant at all times who each shall hold a valid BLS/CPR certification and maintains certification as specified by rule.

§30-4A-7. Qualifications, standards, and continuing education requirements for Class 4                         Anesthesia Permit.

            (a) A Class 4 Permit permits the use of general anesthesia/deep conscious sedation, conscious sedation/moderate sedation, and anxiolysis/minimal sedation.

            (b) The board shall issue or renew a Class 4 Permit to an applicant who:

            (1) Is a licensed dentist in West Virginia;

            (2) Holds a valid and current documentation showing successful completion of a Healthcare Provider BLS/CPR course, Advanced Cardiac Life Support (ACLS) and/or Pediatric Advanced Life Support (PALS) course if treating pediatric patients;

            (3) Satisfies one of the following criteria:

            (A) Completion of an advanced training program in anesthesia and related subjects beyond the undergraduate dental curriculum that satisfies the requirements described in the ADA Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students and the ADA Guidelines for the Use of Sedation and General Anesthesia by Dentists at the time training was commenced;

            (B) Completion of an ADA or AMA accredited postdoctoral training program which affords comprehensive and appropriate training necessary to administer and manage general anesthesia, commensurate with these guidelines;

            (C) In lieu of these requirements, the board may accept documented evidence of equivalent training or experience in general anesthesia/deep conscious sedation.

            (c) A dentist who induces general anesthesia/deep conscious sedation shall have the following facilities, properly maintained age appropriate equipment and age appropriate drugs available during the procedure and during recovery:

            (1) An operating room large enough to adequately accommodate the patient on an operating table or in an operating chair and to allow an operating team of at least three individuals to freely move about the patient;

            (2) An operating table or chair which permits the patient to be positioned so the operating team can maintain the patient's airway, quickly alter the patient's position in an emergency, and provide a firm platform for the administration of basic life support;

            (3) A lighting system which permits evaluation of the patient's skin and mucosal color and a backup lighting system of sufficient intensity to permit completion of any operation underway in the event of a general power failure;

            (4) Suction equipment which permits aspiration of the oral and pharyngeal cavities and a backup suction device which will function in the event of a general power failure;

            (5) An oxygen delivery system with adequate age appropriate full face mask and appropriate connectors that is capable of delivering high flow oxygen to the patient under positive pressure, together with an adequate backup system;

            (6) A nitrous oxide delivery system with a fail-safe mechanism that will insure appropriate continuous oxygen delivery and a scavenger system;

            (7) A recovery area that has available oxygen, adequate lighting, suction and electrical outlets. The recovery area can be the operating room;

            (8) Equipment as specified by rule;

            (9) Emergency drugs as specified by rule

            (10) A defibrillator device.

            (d) Before inducing general anesthesia/deep conscious sedation the dentist shall:

            (1) Evaluate the patient and document, using the ASA Patient Physical Status Classifications, that the patient is an appropriate candidate for general anesthesia or deep conscious sedation;

            (2) Shall give written preoperative and postoperative instructions to the patient or, when appropriate due to age or neurological status of the patient, the patient's guardian; and

            (3) Shall obtain written informed consent from the patient or patient's guardian for the anesthesia.

            (e) A dentist who induces general anesthesia/deep conscious sedation shall ensure that the patient’s condition is monitored and recorded on a contemporaneous record. The dentist shall use a Qualified Monitor to monitor and record the patient’s condition on a contemporaneous record and a chair side dental assistant. The documented requirements of a Qualified Monitor monitoring general anesthesia/deep conscious sedation cases are as specified by rule. No permit holder may have more than one patient under general anesthesia at the same time.

            (f) The patient shall be monitored as follows:

            (1) Patients shall have continuous monitoring using pulse oximetry and/or equipment required for the standard of care or as specified by rule by a Qualified Monitor until discharge criteria have been met. The patient's blood pressure, heart rate and oxygen saturation shall be assessed every five minutes, and shall be contemporaneously documented in the patient record. The record shall also include documentation of preoperative and postoperative vital signs, all medications administered with dosages, time intervals and route of administration including local anesthesia. The person administering the anesthesia may not leave the patient while the patient is under general anesthesia;

            (2) During the recovery phase, the patient shall be monitored, including the use of pulse oximetry, by a Qualified Monitor; and

            (3) A dentist may not release a patient who has undergone general anesthesia/deep conscious sedation except to the care of a responsible adult third party.

            (4) When discharging a pediatric patient the dentist shall follow the current edition of AAPD Guidelines for the Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures.

            (g) The dentist shall assess the patient's responsiveness using preoperative values as normal guidelines and discharge the patient only when the following criteria are met:

            (1) Vital signs including blood pressure, pulse rate and respiratory rate are stable;

            (2) The patient is alert and oriented to person, place and time as appropriate to age and preoperative neurological status;

            (3) The patient can talk and respond coherently to verbal questioning, or to preoperative neurological status;

            (4) The patient can sit up unaided, or to preoperative neurological status;

            (5) The patient can ambulate with minimal assistance, or to preoperative neurological status; and

            (6) The patient does not have uncontrollable nausea or vomiting and has minimal dizziness.

            (7) A discharge entry shall be made in the patient's record by the dentist indicating the patient's condition upon discharge and the name of the responsible party to whom the patient was discharged.

            (h) A dentist who induces general anesthesia shall employ the services of a Qualified Monitor and a chair side dental assistant at all times, who each shall hold a valid BLS/CPR certification and maintains certification as specified by rule.

§30-4A-8. Board to review, inspect and reinspect dentists for issuance of permits.

            (a) By making application to the board for an anesthesia permit, a dentist consents and authorizes the board to review his or her credentials, inspect or reinspect his or her facilities, and investigate any alleged anesthesia mortalities, misadventure, or other adverse occurrences. The board shall conduct an in-office review or on-site inspection of any dentist applying for or holding a permit to administer anesthesia.

            Prior to issuing a permit, the board shall conduct an on-site inspection of facility, equipment, and auxiliary personnel of the applicant to determine if, in fact, all the requirements for the permit have been met. This inspection or evaluation, if required, shall be carried out by at least two members of the subcommittee. This evaluation is to be carried out in a manner following the principles, but not necessarily the procedures, set forth by the current edition of the AAOMS Office Anesthesia Evaluation Manual. On-site inspections are required and shall be performed for all Class 3a, 3b and 4 permitees. The board may reinspect annually, at its discretion, but shall perform an on-site inspection for all permit holders at least once every five years except Class 2 permit holders. The board reserves the right to conduct an on-site inspection whenever it deems necessary for all permit holders. All on-site inspections shall be held during regular business hours.

            (b) Cancellation or failure to appear or be present for a scheduled evaluation by a permit holder, for an unexplained or unexcusable reason, shall be assessed a penalty fee two times the permit holders normal annual renewal fee. The penalty fee shall be separate from the annual renewal fees.

§30-4A-9. Office evaluations.

            (a) The in-office evaluation shall include:

            (1) Observation of one or more cases of anesthesia to determine the appropriateness of technique and adequacy of patient evaluation and care;

            (2) Inspection of facilities, which shall include but not be limited to, the inspection of equipment, drugs and patient records and qualified monitor’s certifications and documentation; and

            (3) The evaluation shall be performed by a team appointed by the board and shall include a member of the Subcommittee who holds a current anesthesia permit in the same class or in a higher class than that held by the permit holder being evaluated.

            (4) Class 2 permit holders may be audited periodically as determined by the committee; and

            (5) Class 3 and 4 permit holders shall be evaluated once every five years.

            (b) A dentist utilizing a licensed dentist who holds a current anesthesia permit issued by the board shall have his or her office inspected to the level of a class 4 permit as specified by section 10 of this article. The office is only approved at that level when the anesthesia permit holder is present and shall have the number of qualified monitors present as required by this article.

            (c) In addition to the requirements of this article a treating dentist who applies for a certificate to allow a CRNA to administer anesthesia and sedation to a patient, shall maintain a permit as follows:

            (1) A treating dentist, who allows a CRNA to administer limited enteral sedation to a patient, shall maintain a Class 3a permit for themselves and the administration site shall be inspected to a Class 4 permit level;

            (2) A treating dentist, who allows a CRNA to administer comprehensive parenteral sedation to a patient, shall maintain a Class 3b permit for themselves and the administration site shall be inspected to a Class 4 permit level; and

            (3) A treating dentist, who allows a CRNA to administer general anesthesia/deep conscious sedation to a patient, shall maintain a Class 4 permit for themselves and the administration site shall be inspected to a Class 4 permit level.

§30-4A-10. Reporting of Death, Serious Complications or Injury.

            If a death, any serious complication or any injury occurs which may have resulted from the administration of general anesthesia/deep conscious sedation, conscious sedation/moderate sedation, anxiolysis/minimal sedation, or relative analgesia/minimal sedation, the licensee performing the dental procedure shall submit a written detailed report to the board within 72 hours of the incident along with copies of the patient's original complete dental records. If the anesthetic agent was administered by a person other than the person performing the dental procedure, that person shall also submit a detailed written report. The detailed report(s) shall include:

            (1) Name, age and address of patient;

            (2) Name of the licensee and other persons present during the incident along with their names and addresses;

            (3) Address where the incident took place;

            (4) Type of anesthesia and dosages of drugs administered to the patient including local anesthesia;

            (5) A narrative description of the incident including approximate times and evolution of symptoms; and

            (6) The anesthesia record and the signed informed consent form for the anesthesia.

§30-4A-11. Immunity from liability.

            (a) Notwithstanding any other provision of law, no person providing information to the board or to the subcommittee may be held, by reason of having provided the information, to be civilly liable under any law unless the information was false and the person providing information knew or had reason to believe the such information was false.

            (b) No member or employee of the board or the subcommittee may be held by reason of the performance by him or her of any duty, function or activity authorized or required of the board or the subcommittee to be civilly liable. The foregoing provisions of this subsection do not apply with respect to any action taken by any individual if the individual, in taking the action, was motivated by malice toward any person affected by the action.

§30-4A-12. Facility Inspections.

            (a) The board shall perform an onsite evaluation of Class 3 and 4 applicants dental facilities, equipment, techniques, and personnel prior to issuing a permit. The board may conduct further on-site evaluations.

            (b) The board may inspect Class 2 applicants facilities.

§30-4A-13. Issuance of regular annual permits.

            Upon the recommendation of the subcommittee, the board shall issue permits to applicable dentists. An anesthesia permit shall be renewed annually.

§30-4A-14. Waiting period for reapplication or reinspection of facilities.

            A dentist whose application has been denied for failure to satisfy the requirements in the application procedure or the on-site evaluation shall wait thirty days from the date of the denial prior to reapplying and shall submit to another on-site evaluation prior to receiving a permit. The board and the subcommittee shall promptly reinspect the applicant dentist's facilities, techniques, equipment, and personnel within ninety days after the applicant has made reapplication.

§30-4A-15. Application and annual renewal of regular permits; fees.

            The board shall require an initial application fee and an annual renewal fee for Class 2, Class 3 and 4 Permits. Permits expire annually. The board shall renew permits for the use of anesthesia after the permittee satisfies the application for renewal.

§30-4A-16. Violations of article; penalties for practicing anesthesia without a permit.

            Violations of any of the provisions of this article, whether intentional or unintentional, may result in the revocation or suspension of the dentist's permit to administer anesthesia; multiple or repeated violations or gross infractions, such as practicing anesthesia without a valid permit may result in suspension of the dentist's license to practice dentistry for up to one year as well as other disciplinary measures as deemed appropriate by the board.

§30-4A-17. Appointment of Subcommittee; credentials review; and on-site inspections.

            (a) The board shall appoint a subcommittee to carry out the review and on-site inspection of any dentist applying for or renewing a permit under this article.

            (b) The subcommittee shall make a recommendation for issuing or revoking a permit under this article.

            (c) This subcommittee shall be known as the ‘West Virginia Board of Dentistry Subcommittee on Anesthesia,’ The subcommittee shall, at a minimum, consist of one member of the board who shall act as chairman of the subcommittee, and two members holding a Class 4 permit and two members holding a Class 3 permit.

            (d) The subcommittee shall adopt policies and procedures related to the regulation of general anesthesia/deep conscious sedation, conscious sedation/moderate sedation, anxiolysis/minimal sedation, and relative analgesia/minimal sedation with the same being approved by the board. The subcommittee members shall be paid and reimbursed expenses pursuant to article one of this chapter.

ARTICLE 4B. DENTAL LABORATORY SERVICES.

§30-4B-1. Unlawful acts.

            (a) It is unlawful for any person, other than a dentist or other dental practitioner, to sell, offer for sale or furnish any dental prosthesis or other dental laboratory service to any person who is not a dentist or other dental practitioner.

            (b) It is unlawful for any person to perform dental laboratory services without a work authorization: Provided, That this subsection does not apply to a dentist or other dental practitioner, or to their employees working under their direct supervision, performing dental laboratory services as a part of their own dental practice and for their own dental patients.

            (c) It is unlawful for any dental laboratory to perform any dental laboratory service without the issuance of a work authorization by a dentist or other dental practitioner.

            (d) It is unlawful for any dental laboratory or dentist who fabricates a full upper or full lower set of prosthetic dentures not to affix upon the dentures, in a nonremovable manner, the name of the patient, the initials of the dentist’s state of practice and license identification.

            (e) It is unlawful for any dental laboratory either directly or indirectly:

            (1) To advertise that it is engaged in the business of performing dental laboratory services;

            (2) To advertise it performs dental laboratory services for members of the public;

            (3) To advertise a price for the performance of dental laboratory services; or

            (4) To advertise techniques used or materials employed by it in the performance of dental laboratory services: Provided, That this subsection does not prevent dental laboratories from advertising in dental journals or in other professional dental publications or from communicating directly to a dentist and other dental practitioner or from listing the dental laboratory in business and telephone directories if the business and telephone directory announcements are limited to name, address and telephone number and do not occupy more than the number of lines necessary to disclose the information, or from displaying the trade name and address of the dental laboratory on the door of its place of business or on name plates or door plates exhibited on the interior or exterior of the place of business. 

§30-4B-2. Work authorization required; contents; retention.

            (a) No dental laboratory technician may perform any dental laboratory service without the issuance of a work authorization by a dentist or other dental practitioner.

            (b) Each work authorization shall contain:

            (1) The name and address of the dental laboratory to which it is directed;

            (2) The case identification;

            (3) A specification of the materials to be used;

            (4) A description of the work to be done and, if necessary, diagrams thereof;

            (5) The date of issue; and

            (6) The signature and address of the dentist or other dental practitioner issuing the work authorization.  

            (c)A separate work authorization shall be issued for each patient of the dentist or other dental practitioner for whom a dental laboratory service is to be performed.

            (d) Every work authorization shall be made in duplicate with the original being delivered to the dental laboratory to which it is directed and the copy being retained in the office of the issuing dentist or other dental practitioner. A work authorization shall be saved for a period of two years from its date of issue.

§30-4B-3. Denture identification.

             A dental laboratory and a dentist who engages in dental laboratory services and who fabricates any full upper or full lower set of prosthetic dentures shall affix upon the dentures, in a nonremovable manner, the name of the patient for whom the dentures are made and the initials of the dentist’s state of practice and license identification number.

§30-4B-4. Review of dental laboratory services.

            The board may review the dental laboratory services of a dental laboratory on a random and general basis without any requirement of a formal complaint or suspicion of impropriety.

            The bill was then ordered to third reading.

            Com. Sub. for H. B. 2538, Expiring, supplementing, amending, increasing, and adding items of appropriation in various accounts; on second reading, coming up in regular order, was read a second time and ordered to engrossment and third reading.

            H. B. 2541, Making a supplementary appropriation from the State Fund, State Excess Lottery Revenue Fund, to the Department of Health and Human Resources, Division of Human Services; on second reading, coming up in regular order, was read a second time and ordered to engrossment and third reading.

First ReadingThe following bills on first reading, coming up in regular order, were each read a first time and ordered to second reading:

            S. B. 208, Making supplementary appropriation from State Fund, General Revenue, to Department of Commerce, Division of Labor, and DHHR, Division of Human Services,

            S. B. 214, Eliminating interview requirement for certain medical licensee applicants,

            Com. Sub. for S. B. 358, Relating to municipal policemen and firemen pensions,

            S. B. 387, Relating to family court judge supervision of criminal background investigations,

            Com. Sub. for S. B. 440, Relating to disclosure of specified tax information for enforcement of Tobacco Master Settlement Agreement,

            Com. Sub. for S. B. 445, Allowing Tax Commissioner divert lottery prizes to offset tax liabilities of lottery winners,

            S. B. 446, Conforming motor fuel taxes with International Fuel Tax Agreement,

            S. B. 462, Extending time for informal conferences on surface mining permit applications

            Com. Sub. for S. B. 478, Redefining “video lottery games”; permitting wagering by historic resort hotel employees,

            S. B. 491, Relating to rental car license cost recovery fee,

            S. B. 504, Relating to cooperative associations,

            S. B. 524, Supplementing, amending, decreasing and increasing appropriations from State Road Fund to DOT,

            S. B. 526, Making supplementary appropriation of federal funds to DHHR, Division of Human Services-Temporary Assistance for Needy Families,

            Com. Sub. for S. B. 534, Correcting internal code reference regarding insurance information disclosure,

            Com. Sub. for S. B. 542, Relating to restricted races at pari-mutuel thoroughbred horse race tracks,

            Com. Sub. for S. B. 544, Scheduling departmental performance reviews,

            Com. Sub. for S. B. 553, Relating to Highway Design-Build Program,

            Com. Sub. for S. B. 557, Continuing Preventive Care Pilot Program,

            S. B. 561, Establishing Tucker County Cultural District Authority,

            And,

            S. B. 658, Extending time for Madison City Council to meet as levying body.

            At 12:47 p.m., on motion of Delegate Boggs, the House of Delegates recessed until 5:00 p.m., and reconvened at that time.

* * * * * * *

Afternoon Session

* * * * * * *

            At the request of Delegate Boggs, and by unanimous consent, the House of Delegates returned to the Third Order of Business for the purpose of receiving committee reports.

Committee Reports

            Delegate Morgan, Chair of the Committee on Government Organization, submitted the following report, which was received:

            Your Committee on Government Organization has had under consideration:

            S. B. 82, Requiring rate-paying residential customer on public service board,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate Poling, Chair of the Committee on Education, submitted the following report, which was received:

            Your Committee on Education has had under consideration:

            Com. Sub. for S. B. 586, Transferring authority to license cosmetology, barber and massage schools to Council for Community and Technical College Education,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            Com. Sub. for S. B. 371, Relating to prison overcrowding,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            Com. Sub. for S. B. 469, Clarifying service credit for certain PERS members,

            And,

            S. B. 596, Determining grant awards for Chesapeake Bay and Greenbrier River watershed compliance projects,

            And reports the same back, with title amendments, with the recommendation that they each do pass, as amended.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            S. B. 65, Exempting PERS retirement income of DNR police officers from state income tax,

            Com. Sub. for S. B. 195, Removing tax rate expiration date on eligible acute care hospitals,

            And,

            S. B. 331, Permitting Courthouse Facilities Improvement Authority to issue bonds,

            And reports the same back with the recommendation that they each do pass.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

            Com. Sub. for S. B. 437, Regulating commercial dog-breeding operations,

            And,

            Com. Sub. for S. B. 481, Relating to juvenile mental health treatment,

            And reports the same back with the recommendation that it do pass.

            Delegate Miley, Chair of the Committee on the Judiciary, submitted the following report, which was received:

            Your Committee on the Judiciary has had under consideration:

             Com. Sub. for S. B. 200, Relating to Eyewitness Identification Act,

             Com. Sub. for S. B. 243, Authorizing DEP promulgate legislative rules,

             Com. Sub. for S. B. 355, Relating to final wage payment to discharged employees,

             Com. Sub. for S. B. 369, Relating to concealed handgun license reciprocity,

             Com. Sub. for S. B. 386, Relating to personal safety orders,

             Com. Sub. for S. B. 464, Regulating tanning facilities,

            And reports the same back, with amendment, with the recommendation that it do pass, as amended.

            Delegate White, Chair of the Committee on Finance, submitted the following report, which was received:

            Your Committee on Finance has had under consideration:

            S. B. 194, Repealing code relating to Medicaid program contract procedure,

            Com. Sub. for S. B. 482, Relating to sale of voter registration lists,

            And,

            Com. Sub. for S. B. 535, Relating to process for maintaining voter registration lists,

            And reports the same back, with amendments, with the recommendation that they each do pass, as amended.

Leaves of Absence

            At the request of Delegate Boggs, and by unanimous consent, leave of absence for the day was granted Delegate J. Nelson.

            At 6:01 p.m., the House of Delegates adjourned until 11:00 a.m., Wednesday, April 10, 2013.

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