HP0829, LD 1211, item 1, An Act To Provide Rule-making Powers and Increased Authority over Dental Hygienists to the Subcommittee on Dental Hygienists

An Act To Provide Rule-making Powers and Increased Authority over Dental Hygienists to the Subcommittee on Dental Hygienists

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 32 MRSA §1073, sub-§2, as amended by PL 1997, c. 107, §4, is further amended to read:

2. Rules. Adopt rules in accordance with the Maine Administrative Procedure Act that are necessary for the implementation of this chapter , except for rules relating to the operation of the Subcommittee on Dental Hygienists and the licensure and practice in this State of dental hygienists, independent practice dental hygienists, dental hygiene therapists, registered dental hygienists and dental hygienists with public health supervision status. The rules may include, but need not be limited to, requirements for licensure, interviews for licensing and renewal, continuing education, inactive licensure status, use of general anesthesia and fees for providing a list of addresses of licensed professionals upon request;

Sec. 2. 32 MRSA §1077-A is enacted to read:

§ 1077-A. Disciplinary actions involving dental hygienists

Notwithstanding section 1077, the Subcommittee on Dental Hygienists, referred to in this section as "the subcommittee," has exclusive jurisdiction over all disciplinary actions or other actions regarding noncompliance with or violation of this chapter, or rules adopted pursuant to this chapter, by a licensed dental hygienist, independent practice dental hygienist, dental hygiene therapist, registered dental hygienist or dental hygienist with public health supervision status, referred to in this section as "the licensee."

1. Disciplinary proceedings and sanctions. The subcommittee shall investigate a complaint on its own motion or upon receipt of a written complaint filed with the board or the subcommittee.

The subcommittee shall notify the licensee of the content of a complaint filed against the licensee as soon as possible, but no later than 60 days from receipt of this information. The licensee shall respond within 30 days. If the licensee's response to the complaint satisfies the subcommittee that the complaint does not merit further investigation or action, the matter may be dismissed, with notice of the dismissal to the complainant, if any.

If, in the opinion of the subcommittee, the factual basis of the complaint is or may be true, and the complaint is of sufficient gravity to warrant further action, the subcommittee may request an informal conference with the licensee. The subcommittee shall provide the licensee with adequate notice of the conference and of the issues to be discussed. The conference must be conducted in executive session of the subcommittee, pursuant to Title 1, section 405, unless otherwise requested by the licensee. Statements made at the conference may not be introduced at a subsequent formal hearing unless all parties consent.

If the subcommittee finds that the factual basis of the complaint is true and is of sufficient gravity to warrant further action, it may take any of the following actions it considers appropriate:

A. With the consent of the licensee, enter into a consent agreement that takes any action authorized by Title 10, section 8003, subsection 5 or Title 10, section 8003-D. A consent agreement may be used to terminate a complaint investigation if entered into by the subcommittee, the licensee and the Attorney General's office;

B. In consideration for acceptance of a voluntary surrender of the license, if a consent agreement is signed by the subcommittee, the licensee and the Attorney General's office, negotiate stipulations, including terms and conditions for reinstatement, that ensure protection of the public health and safety and that serve to rehabilitate or educate the licensee; or

C. If the subcommittee concludes that suspension or revocation of the license is in order, the subcommittee may file a complaint in the District Court in accordance with Title 4, chapter 5.

Notwithstanding Title 10, section 8003, subsection 5, any nonconsensual revocation of a license by a dental adjudicatory panel pursuant to Title 10, section 8003 may be imposed only after a hearing conforming to the requirements of Title 5, chapter 375, subchapter 4 and is subject to judicial review exclusively in the Superior Court in accordance with Title 5, chapter 375, subchapter 7. The subcommittee retains the authority to take any other action pursuant to this section and Title 10, section 8003 regarding the disposition of any complaint that does not involve an adjudicatory hearing.

2. Grounds for discipline. The subcommittee may suspend or revoke a license pursuant to Title 5, section 10004. The following are grounds for an action to suspend or revoke or refuse to issue, modify or renew the license of a licensee:

A. The practice of fraud or deceit in obtaining a license under this chapter or in connection with service rendered within the scope of the license issued;

B. Misuse of alcohol, drugs or other substances that has resulted or may result in the licensee performing services in a manner that endangers the health or safety of patients;

C. A professional diagnosis of a mental or physical condition that has resulted or may result in the licensee performing services in a manner that endangers the health or safety of patients;

D. Aiding or abetting the practice of a dental profession by an individual who is not licensed under this chapter and who claims to be legally licensed;

E. Incompetence in the practice for which the licensee is licensed. A licensee is considered incompetent in the practice if the licensee has:

(1) Engaged in conduct that evidences a lack of ability or fitness to perform the duties owed by the licensee to a client or patient or the general public; or

(2) Engaged in conduct that evidences a lack of knowledge or inability to apply principles or skills to carry out the practice for which the licensee is licensed;

F. Unprofessional conduct. A licensee is considered to have engaged in unprofessional conduct if the licensee violates a standard of professional behavior that has been established in the practice for which the licensee is licensed;

G. Subject to the limitations of Title 5, chapter 341, conviction of a crime that involves dishonesty or false statement or that relates directly to the practice for which the licensee is licensed, or conviction of a crime for which incarceration for one year or more may be imposed;

H. A violation of this chapter or a rule adopted by the subcommittee; or

I. Engaging in false, misleading or deceptive advertising.

Sec. 3. 32 MRSA §1079, sub-§1, as amended by PL 2007, c. 620, Pt. A, §2, is further amended to read:

1. Membership. The subcommittee consists of 5 members:

A. A dental hygienist who is a member of the board;

B. Two dental hygienists, appointed by the Governor, who are qualified pursuant to subchapter 6 4, are legal residents of the State and have practiced in the State for at least 6 years immediately preceding appointment; and

C. Two dentists One dentist who are members is a member of the board, appointed by the president of the board . ; and

D. One dental hygienist, appointed by the Governor, who is involved in the education and training of dental hygienists at an accredited school of dental hygiene.

The subcommittee shall annually elect a chair and a secretary.

Sec. 4. 32 MRSA §1079, sub-§3, as amended by PL 2007, c. 620, Pt. A, §2, is further amended to read:

3. Duties. The subcommittee shall:

A. Perform an initial a review of and take appropriate action on all complaints initiated pursuant to section 1077 1077-A involving dental hygienists . Upon completion of its review of a complaint, the secretary of the subcommittee shall report to the board the subcommittee's recommended disposition of the complaint in accordance with those dispositions authorized by section 1077. Notwithstanding the provisions of section 1077, the board shall adopt the subcommittee's recommended disposition of a complaint unless no fewer than 2/3 of the board members who are present and voting vote to reject that recommended disposition; and

B. Perform an initial a review of all applications for licensure as a dental hygienist pursuant to section 1097, all submissions relating to continuing education of dental hygienists pursuant to sections 1098-B and 1099 and all submissions relating to public health supervision status of dental hygienists as defined by board rule. Upon completion of its review of an application or submission, the secretary of the subcommittee shall report to the board the subcommittee's recommended disposition of take appropriate action on the application or submission, including issuance, renewal, denial or nonrenewal of a dental hygienist license . Notwithstanding the provisions of section 1098, the board shall adopt the subcommittee's recommended disposition of an application or submission unless no fewer than 2/3 of the board members who are present and voting vote to reject that recommended disposition. ; and

C. Adopt routine technical rules, as defined in Title 5, chapter 375, subchapter 2-A, relating to the operation of the subcommittee and the licensure and practice of dental hygienists in this State.

Sec. 5. 32 MRSA §1094-I, as enacted by PL 2007, c. 620, Pt. B, §1, is amended to read:

§ 1094-I. Independent practice

An independent practice dental hygienist licensed by the board Subcommittee on Dental Hygienists pursuant to this subchapter may practice without supervision by a dentist to the extent permitted by this subchapter. Any licensee of the board subcommittee may be the proprietor of a place where independent practice dental hygiene is performed and may purchase, own or lease equipment necessary for the performance of independent practice dental hygiene.

A person practicing independent practice dental hygiene as an employee of another shall cause that person's name to be conspicuously displayed at the entrance of the place where the practice is conducted.

Sec. 6. 32 MRSA §1094-J, sub-§2, as enacted by PL 2007, c. 620, Pt. B, §1, is amended to read:

2. Licensure as dental hygienist. Possess a valid license to practice dental hygiene issued by the board Subcommittee on Dental Hygienists pursuant to subchapter 4 or qualify for licensure as an independent practice dental hygienist by endorsement pursuant to section 1094-L; and

Sec. 7. 32 MRSA §1094-Q, sub-§2, as enacted by PL 2007, c. 620, Pt. B, §1, is amended to read:

2. Practice under supervision. An independent practice dental hygienist licensed under this subchapter may perform duties under the supervision of a dentist as set forth in the rules of the board Subcommittee on Dental Hygienists pursuant to section 1095.

Sec. 8. 32 MRSA §1094-S, as enacted by PL 2007, c. 620, Pt. B, §1, is amended to read:

§ 1094-S. Mental or physical examination

For the purposes of this section, by application for and acceptance of a license to practice under this subchapter, an independent practice dental hygienist is considered to have given consent to a mental or physical examination when directed by the board Subcommittee on Dental Hygienists. The board subcommittee may direct an independent practice dental hygienist to submit to an examination whenever the board subcommittee determines the independent practice dental hygienist may be suffering from a mental illness that may be interfering with the competent independent practice of dental hygiene or from the use of intoxicants or drugs to an extent that they are preventing the independent practice dental hygienist from practicing dental hygiene competently and with safety to patients. An independent practice dental hygienist examined pursuant to an order of the board subcommittee may not prevent the testimony of the examining individual or prevent the acceptance into evidence of the report of an examining individual. Failure to comply with an order of the board subcommittee to submit to a mental or physical examination results in the immediate suspension of the license to practice independent dental hygiene by order of the District Court until the independent practice dental hygienist submits to the examination.

Sec. 9. 32 MRSA §1094-AA, first ¶, as enacted by PL 2013, c. 575, §7, is amended to read:

A dental hygienist or independent practice dental hygienist licensed by the board Subcommittee on Dental Hygienists pursuant to this chapter may practice as a licensed dental hygiene therapist to the extent permitted by this subchapter. To qualify for licensure under this subchapter as a dental hygiene therapist, a person shall apply to the board subcommittee on forms provided by the board subcommittee, pay the application fee under section 1094-DD and demonstrate to the board subcommittee that the applicant:

Sec. 10. 32 MRSA §1094-AA, sub-§2, ¶¶C and D, as enacted by PL 2013, c. 575, §7, are amended to read:

C. Is consistent with the model curriculum for educating dental hygiene therapists adopted by the American Association of Public Health Dentistry, or a successor organization, is consistent with existing dental hygiene therapy programs in other states and is approved by the board Subcommittee on Dental Hygienists; and

D. Meets the requirements for dental hygiene therapy education programs adopted by the board Subcommittee on Dental Hygienists;

Sec. 11. 32 MRSA §1094-AA, sub-§§4 and 5, as enacted by PL 2013, c. 575, §7, are amended to read:

4. Examination. Has passed a comprehensive, competency-based clinical examination approved by the board Subcommittee on Dental Hygienists and administered independently of an institution providing dental hygiene therapy education and has passed an examination of the applicant's knowledge of Maine laws and rules relating to the practice of dentistry. An applicant who fails the clinical examination twice may not take the clinical examination again until further education and training, as specified by the board subcommittee, are obtained; and

5. Supervised clinical practice. Has completed 2,000 hours of supervised clinical practice under the supervision of a dentist licensed under this chapter and in conformity with rules adopted by the board Subcommittee on Dental Hygienists, during which supervised clinical practice the applicant holds a provisional dental hygiene therapy license pursuant to section 1094-BB. For purposes of meeting the requirements of this subsection, an applicant's hours of supervised clinical experience while enrolled in the 4-semester dental training therapy program may be included.

Sec. 12. 32 MRSA §1094-BB, as enacted by PL 2013, c. 575, §7, is amended to read:

§ 1094-BB. Provisional dental hygiene therapy license

The board Subcommittee on Dental Hygienists shall issue a provisional dental hygiene therapy license to an applicant for licensure under this subchapter who has met the requirements of section 1094-AA, subsections 1 to 4 and rules adopted by the board subcommittee and who has paid a fee established by the board subcommittee of not more than $175. During the period of provisional licensure, which may not exceed 3 years, the applicant shall maintain in good standing the applicant's license to practice as a dental hygienist or an independent practice dental hygienist. During the period of provisional licensure the applicant may be compensated for services performed as a dental hygiene therapist.

Sec. 13. 32 MRSA §1094-DD, as enacted by PL 2013, c. 575, §7, is amended to read:

§ 1094-DD. License; fees; discontinuation of license

The board Subcommittee on Dental Hygienists shall issue a license to practice as a dental hygiene therapist to an applicant for licensure under this subchapter who has met the requirements of this subchapter and rules adopted pursuant to the subchapter for licensure and has paid the application fee of not more than $175. A dental hygiene therapist shall publicly exhibit the license at the therapist's place of business or employment. The initial date of expiration of the license must be the original expiration date of the dental hygiene therapist's dental hygienist license issued by the board subcommittee pursuant to subchapter 4 or, for an independent practice dental hygienist licensed by endorsement, January 1st of the first odd-numbered year following initial licensure. On or before January 1st of each odd-numbered year, a dental hygiene therapist shall pay to the board subcommittee a license renewal fee. The board subcommittee may renew the license of a dental hygiene therapist who meets the requirements for continued licensure and pays a renewal fee and a late fee by February 1st in the year in which renewal is due. The board subcommittee shall suspend the license of a dental hygiene therapist who does not renew a license by February 1st in the year that renewal is due. The board subcommittee may renew the license of a dental hygiene therapist who pays a renewal fee and a reinstatement fee as required by the board subcommittee. The subcommittee shall forward any fee received pursuant to this section to the board.

Sec. 14. 32 MRSA §1094-EE, as enacted by PL 2013, c. 575, §7, is amended to read:

§ 1094-EE. Continuing education

As a condition of renewal of a license to practice under this subchapter, a dental hygiene therapist shall submit evidence of successful completion of 35 hours of continuing education in the 2 years prior to renewal. Continuing education under this section must be in conformity with the provisions of section 1084-A and must include board-approved courses approved by the Subcommittee on Dental Hygienists, including but not limited to a course in cardiopulmonary resuscitation. The board subcommittee may refuse renewal to an applicant who has not satisfied the requirements of this section or may renew a license on terms and conditions set by the board subcommittee.

Sec. 15. 32 MRSA §1094-GG, sub-§4, as enacted by PL 2013, c. 575, §7, is amended to read:

4. Requirements. A supervising dentist and a dental hygiene therapist who sign a written practice agreement shall each file a copy of the agreement with the board and the Subcommittee on Dental Hygienists, keep a copy for the dentist's or dental hygiene therapist's own records and make a copy available to patients of the dental hygiene therapist upon request. The copy of the written practice agreement in the records of the board and the subcommittee must be made available to the public upon request.

Sec. 16. 32 MRSA §1094-HH, first ¶, as enacted by PL 2013, c. 575, §7, is amended to read:

A dental hygiene therapist may provide the care and services listed in this section and may provide them only under the direct supervision of a dentist licensed in this State. A dental hygiene therapist practicing under general supervision of a dentist may perform all duties of a dental hygiene therapist listed in rules adopted by the board Subcommittee on Dental Hygienists. A dental hygiene therapist who is licensed as a dental hygienist may perform all of the duties of a dental hygienist under this chapter. A dental hygiene therapist who is licensed as an independent practice dental hygienist may perform all of the duties of an independent practice dental hygienist. A dental hygiene therapist may:

Sec. 17. 32 MRSA §1094-KK, as enacted by PL 2013, c. 575, §7, is amended to read:

§ 1094-KK. Rulemaking

The board Subcommittee on Dental Hygienists shall adopt rules to implement this subchapter. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

Sec. 18. 32 MRSA §1095, as amended by PL 1993, c. 600, Pt. A, §79, is further amended to read:

§ 1095. Definition

The dental hygienist who practices under the supervision of a dentist of record may perform duties as defined and set forth in the rules of the Board of Dental Examiners Subcommittee on Dental Hygienists, except that nothing in this subchapter may be construed to affect the practice of medicine or dentistry or to prevent students of a dental college, university or school of dental hygiene from practicing dental hygiene under the supervision of their instructors.

Sec. 19. 32 MRSA §1096, as amended by PL 1993, c. 600, Pt. A, §80, is further amended to read:

§ 1096. Qualifications

A person 18 years old or over who has successfully completed 2 years' training in a school of dental hygiene approved by the board Subcommittee on Dental Hygienists, or who is a full-time dental student who has satisfactorily completed at least half of the prescribed course of study in an accredited dental college, but who has not graduated from a dental college, is eligible to apply for examination.

Sec. 20. 32 MRSA §1097, as amended by PL 2003, c. 669, §7, is further amended to read:

§ 1097. Application; fee

An eligible person desiring to practice dental hygiene must make written application to the Board of Dental Examiners Subcommittee on Dental Hygienists to take the examination. The application must be accompanied by a fee to be determined by the board subcommittee not to exceed $175. Applicants for licensure must pay a fee set by the board subcommittee for the examination. The board subcommittee may recognize a nationally or regionally administered examination for applicants to practice dental hygiene in the State. The subcommittee shall forward any fee received pursuant to this section to the board.

Sec. 21. 32 MRSA §1098, as amended by PL 2005, c. 45, §4, is further amended to read:

§ 1098. License; biennial fee

The board Subcommittee on Dental Hygienists shall issue a license to practice as a dental hygienist in this State to an individual who has met the licensure requirements. The license must be exhibited publicly at the person's place of employment. The license authorizes practice as a dental hygienist in this State for the year in which it is issued until the expiration date that appears on the license. On or before January 1st of each odd-numbered year, the dental hygienist must pay to the board subcommittee a license renewal fee of not more than $175 to be determined by the board subcommittee. Dental hygienists who have not paid the renewal fee on or before January 1st must be reinstated upon payment of a late fee of not more than $50 to be determined by the board subcommittee if paid before February 1st of the year in which license renewal is due. Failure to be properly licensed by February 1st results in automatic suspension of a license to practice dental hygiene. Reinstatement may be made, if approved by the board subcommittee, by payment to the secretary-treasurer of the board subcommittee of a fee determined by the board subcommittee of not more than $175. A new applicant who has paid the application fee shall pay the biennial licensure fee if the applicant applies in an odd-numbered year or half the biennial licensure fee if the applicant applies in an even-numbered year. The subcommittee shall forward any fee received pursuant to this section to the board.

The board subcommittee may issue temporary licenses to dental hygienists who present credentials satisfactory to the board. The board subcommittee may charge a fee of up to $25 for a temporary license.

Sec. 22. 32 MRSA §1098-C, as enacted by PL 2003, c. 669, §10, is amended to read:

§ 1098-C. Mental or physical examination

For the purposes of this section, by application for and acceptance of a license to practice, a licensed dental hygienist is considered to have given consent to a mental or physical examination when directed by the board Subcommittee on Dental Hygienists. The board subcommittee may direct a dental hygienist to submit to an examination whenever the board subcommittee determines the dental hygienist may be suffering from a mental illness that may be interfering with the competent practice of dental hygiene or from the use of intoxicants or drugs to an extent that they are preventing the dental hygienist from practicing dental hygiene competently and with safety to patients. A dental hygienist examined pursuant to an order of the board subcommittee may not prevent the testimony of the examining individual or prevent the acceptance into evidence of the report of an examining individual. Failure to comply with an order of the board subcommittee to submit to a mental or physical examination results in the immediate suspension of the license of the dental hygienist by order of the District Court until the dental hygienist submits to the examination.

Sec. 23. 32 MRSA §1098-D, sub-§1, ¶E, as enacted by PL 2003, c. 669, §10, is amended to read:

E. For any applicant who has completed the Northeast Regional Board Dental Hygiene Examination or the successor to that examination more than one year prior to application for licensure in the State, have successfully completed a personal interview before the board Subcommittee on Dental Hygienists; or

Sec. 24. 32 MRSA §1098-D, sub-§2, as amended by PL 2005, c. 289, §2, is further amended to read:

2. Licensure by endorsement. For licensure by endorsement, the applicant must:

A. Have graduated from an accredited dental hygiene program;

B. If the candidate graduated subsequent to 1964, have completed with a passing grade the National Board Dental Hygiene Examination, or the successor to that examination, if such examination was required;

C. Have furnished proof, satisfactory to the board Subcommittee on Dental Hygienists, that the candidate has been duly licensed to practice dental hygiene in another state after full compliance with its laws;

D. If the candidate graduated subsequent to 1970, have completed with a passing grade the Northeast Regional Board Dental Hygiene Examination, or the successor to that examination, if such examination was required, except that the board Subcommittee on Dental Hygienists may at its discretion waive the Northeast Regional Board Dental Hygiene Examination, or the successor to that examination, if all other requirements of this subsection have been met;

E. Have engaged in active clinical practice for a minimum of 3 years prior to application;

F. Have completed with a passing grade the jurisprudence examination given by the board Subcommittee on Dental Hygienists; and

G. Have successfully completed a personal interview before the board Subcommittee on Dental Hygienists.

The board Subcommittee on Dental Hygienists may at its discretion waive the Northeast Regional Board Dental Hygiene Examination, or the successor to that examination, if all other requirements have been met.

Sec. 25. 32 MRSA §1098-E, as enacted by PL 2005, c. 198, §1, is amended to read:

§ 1098-E. Temporary filling procedures

A dental hygienist with public health supervision status, as defined by rules adopted by the Board of Dental Examiners Subcommittee on Dental Hygienists, may perform temporary filling procedures without a dentist present under protocols developed by the Board of Dental Examiners subcommittee. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

Sec. 26. 32 MRSA §1099, as amended by PL 2007, c. 620, Pt. A, §3, is further amended to read:

§ 1099. Endorsement

The board Subcommittee on Dental Hygienists may at its discretion, without examination, issue a license to an applicant to practice dental hygiene who furnishes proof satisfactory to the board subcommittee that the dental hygienist has been duly licensed for at least 3 years to practice in another state or a Canadian province after full compliance with the requirements of its dental laws, except that the professional education may not be less than is required in this State. The board subcommittee may require letters of reference as to ability. Applicants for licensure by endorsement who meet the requirements of this section must be interviewed in person by the Subcommittee on Dental Hygienists, as established in section 1079 subcommittee prior to being issued a license. Every license so given must state upon its face that it was granted on the basis of endorsement. The fee for that license must be determined by the board subcommittee, but may not be more than $175.

Sec. 27. 32 MRSA §1100-A, as amended by PL 2007, c. 620, Pt. C, §10, is further amended to read:

§ 1100-A. Definition

Duties of dental auxiliaries other than dental hygienists and expanded function dental assistants must be defined and governed by the rules of the Board of Dental Examiners , except that duties of independent practice dental hygienists set forth in section 1094-Q, subsection 1 may not be restricted or expanded by the board. Dental auxiliaries include, but are not limited to , dental hygienists, independent practice dental hygienists, dental assistants, expanded function dental assistants, dental laboratory technicians and denturists.

Sec. 28. Transition. Until the Board of Dental Examiners, Subcommittee on Dental Hygienists adopts rules relating to the operation of the subcommittee and the licensure and practice of dental hygienists, independent practice dental hygienists, dental hygiene therapists, registered dental hygienists and dental hygienists with public health supervision status, as authorized by the Maine Revised Statutes, Title 32, section 1073, subsection 2 and Title 32, sections 1094-KK and 1098-E, the rules adopted by the board and in effect on the effective date of this Act remain in effect.

SUMMARY

Under current law, the Board of Dental Examiners, Subcommittee on Dental Hygienists performs an initial review of complaints regarding dental hygienists and applications and continuing education requirements for dental hygienists. Following its review, the subcommittee makes a recommendation to the board and the board acts on the subcommittee's recommendation.

This bill provides the subcommittee with exclusive jurisdiction over licensing, continuing education and disciplinary matters regarding dental hygienists, independent practice dental hygienists, dental hygiene therapists, registered dental hygienists and dental hygienists with public health supervision status and provides the subcommittee with rule-making authority regarding these matters.

The bill also changes the composition of the subcommittee by replacing one of the dentists with a dental hygienist who is involved in the training and education of dental hygienists at an accredited school of dental hygiene and removing the requirement that the existing 2 dental hygienists are qualified denturists.

HP0829 LD 1211	Session - 127th Maine Legislature		LR 655 Item 1
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