SB 1040                                   Second Engrossed (ntc)
       
       
       
       
       
       
       
       
       20121040e2
       
    1                        A bill to be entitled                      
    2         An act relating to the practice of dentistry; amending
    3         s. 466.006, F.S.; revising the eligibility
    4         requirements for taking the examinations required to
    5         practice dentistry if the applicant is a graduate of a
    6         certain dental college or school; amending s. 466.007,
    7         F.S.; revising the eligibility requirements for taking
    8         the examinations required to practice dental hygiene;
    9         revising the licensing requirements to practice as a
   10         dental hygienist; amending s. 466.017, F.S.;
   11         authorizing dental hygienists to administer certain
   12         local anesthesia under the direct supervision of a
   13         licensed dentist if certain educational requirements
   14         are met; requiring dental hygienists to maintain
   15         current certification in basic or advanced
   16         cardiopulmonary resuscitation or advanced cardiac life
   17         support with recertification every 2 years; amending
   18         s. 466.023, F.S.; revising the scope and area of
   19         practice for dental hygienists, to conform to changes
   20         made by this act; amending s. 466.024, F.S.; revising
   21         the delegated duties that are found to be remediable
   22         and delegable, to conform to changes made by this act;
   23         providing an effective date.
   24  
   25  Be It Enacted by the Legislature of the State of Florida:
   26  
   27         Section 1. Subsection (3) of section 466.006, Florida
   28  Statutes, is amended to read:
   29         466.006 Examination of dentists.—
   30         (3) If an applicant is a graduate of a dental college or
   31  school not accredited in accordance with paragraph (2)(b) or of
   32  a dental college or school not approved by the board, the
   33  applicant is shall not be entitled to take the examinations
   34  required in this section to practice dentistry until she or he
   35  satisfies one of the following:
   36         (a) Completes a program of study, as defined by the board
   37  by rule, at an accredited American dental school and
   38  demonstrates receipt of a D.D.S. or D.M.D. from said school; or
   39         (b) Submits proof of having successfully completed at least
   40  2 consecutive academic years at a full-time supplemental general
   41  dentistry program accredited by the American Dental Association
   42  Commission on Dental Accreditation. This program must provide
   43  didactic and clinical education at the level of a D.D.S. or
   44  D.M.D. program accredited by the American Dental Association
   45  Commission on Dental Accreditation Completes a 2-year
   46  supplemental dental education program at an accredited dental
   47  school and receives a dental diploma, degree, or certificate as
   48  evidence of program completion.
   49         Section 2. Subsections (2) and (4) of section 466.007,
   50  Florida Statutes, are amended, and subsections (5) and (6) are
   51  added to that section, to read:
   52         466.007 Examination of dental hygienists.—
   53         (2) An applicant is shall be entitled to take the
   54  examinations required in this section to practice dental hygiene
   55  in this state if the applicant:
   56         (a) Is 18 years of age or older.
   57         (b)1. Is a graduate of a dental hygiene college or school
   58  approved by the board or accredited by the Commission on
   59  Accreditation of the American Dental Association or its
   60  successor entity, if any, or any other dental hygiene program
   61  accrediting entity recognized by the United States Department of
   62  Education agency; or
   63         2. Is a graduate of a dental college or school accredited
   64  in accordance with s. 466.006(2)(b), or a graduate of an
   65  unaccredited dental college or school, and has met the
   66  requirements of subsection (3).
   67         (c)1. In the case of a graduate of a dental hygiene college
   68  or school under subparagraph (2)(b)1.:
   69         a. Has successfully completed the National Board of Dental
   70  Hygiene examination at any time before the date of application
   71  within 10 years of the date of application;
   72         b. Has been certified by the American Dental Association
   73  Joint Commission on National Dental Examinations at any time
   74  before the date of application within 10 years of the date of
   75  application; and
   76         c. Effective January 1, 1997, has completed coursework that
   77  which is comparable to an associate in science degree;.
   78         d. Has not been disciplined by a board, except for citation
   79  offenses or minor violations; and
   80         e. Has not been convicted of or pled nolo contendere to,
   81  regardless of adjudication, any felony or misdemeanor related to
   82  the practice of a health care profession.
   83         2. In the case of a graduate of a dental college or school
   84  under subparagraph (2)(b)2.:, has
   85         a. Successfully completed either the National Board of
   86  Dental Hygiene Examination or the National Board of Dental
   87  Examiners dental Examination;, within 10 years of the date of
   88  application.
   89         b. Has not been disciplined by a board, except for citation
   90  offenses or minor violations; and
   91         c. Has not been convicted of or pled nolo contendere to,
   92  regardless of adjudication, any felony or misdemeanor related to
   93  the practice of a health care profession.
   94         (4) Effective July 1, 2012, to be licensed as a dental
   95  hygienist in this state, an applicant must successfully complete
   96  the following:
   97         (a) A written examination on the laws and rules of this
   98  state regulating the practice of dental hygiene.
   99         (b) A practical or clinical examination approved by the
  100  board. The examination shall be the Dental Hygiene Examination
  101  produced by the American Board of Dental Examiners, Inc. (ADEX)
  102  or its successor entity, if any, if the board finds that the
  103  successor entity’s clinical examination meets or exceeds the
  104  provisions of this section. The board shall approve the ADEX
  105  Dental Hygiene Examination if the board has attained and
  106  continues to maintain representation on the ADEX House of
  107  Representatives, the ADEX Dental Hygiene Examination Development
  108  Committee, and such other ADEX Dental Hygiene committees as the
  109  board deems appropriate through rulemaking to ensure that the
  110  standards established in this section are maintained
  111  organizationally. The ADEX Dental Hygiene Examination or the
  112  examination produced by its successor entity is a comprehensive
  113  examination in which an applicant must demonstrate skills within
  114  the dental hygiene scope of practice on a live patient and any
  115  other components that the board deems necessary for the
  116  applicant to successfully demonstrate competency for the purpose
  117  of licensure. The ADEX Dental Hygiene Examination or the
  118  examination by the successor entity administered in this state
  119  shall be graded by dentists and dental hygienists licensed in
  120  this state who are employed by the department for this purpose.
  121         (5) Effective July 1, 2012, an applicant who has completed
  122  the ADEX Dental Hygiene Examination in a jurisdiction other than
  123  this state and who has obtained a passing score may practice
  124  dental hygiene in this state if the applicant:
  125         (a) Has successfully completed the National Board Dental
  126  Hygiene Examination at any time before the date of application;
  127         (b) Has been certified by the American Dental Association
  128  Joint Commission on National Dental Examinations at any time
  129  before the date of application, as specified by state law;
  130         (c) Has successfully completed a written examination on the
  131  laws and rules of this state regulating the practice of dental
  132  hygiene;
  133         (d) Has not been disciplined by a board, except for
  134  citation offenses or minor violations; and
  135         (e) Has not been convicted of or pled nolo contendere to,
  136  regardless of adjudication, any felony or misdemeanor related to
  137  the practice of a health care profession.
  138         (6)(a) A passing score on the ADEX Dental Hygiene
  139  Examination administered out of state shall be considered the
  140  same as a passing score for the ADEX Dental Hygiene Examination
  141  administered in this state and graded by licensed dentists and
  142  dental hygienists.
  143         (b) If an applicant fails to pass the ADEX Dental Hygiene
  144  Examination in three attempts, the applicant is not eligible to
  145  retake the examination unless the applicant completes additional
  146  education requirements as specified by the board. The practical
  147  or clinical examination shall test competency in areas to be
  148  established by rule of the board which shall include testing the
  149  ability to adequately perform a prophylaxis. On or after October
  150  1, 1986, every applicant who is otherwise qualified shall be
  151  eligible to take the examination a total of three times,
  152  notwithstanding the number of times the applicant has previously
  153  failed. If an applicant fails the examination three times, the
  154  applicant shall no longer be eligible to take the examination
  155  unless he or she obtains additional educational requirements
  156  established by the board. The department shall require a
  157  mandatory standardization exercise pursuant to s. 456.017(1)(b)
  158  for all examiners prior to each practical or clinical
  159  examination and shall retain for employment only those dentists
  160  and dental hygienists who have substantially adhered to the
  161  standard of grading established at such exercise. It is the
  162  intent of the Legislature that the examinations relate to those
  163  procedures which are actually performed by a dental hygienist in
  164  general practice.
  165         Section 3. Present subsection (4) of section 466.017,
  166  Florida Statutes, is amended, subsections (5) and (6) are
  167  renumbered as subsections (7) and (8), respectively, and new
  168  subsections (5) and (6) are added to that section, to read:
  169         466.017 Prescription of drugs; anesthesia.—
  170         (4) A dentist or dental hygienist who administers or
  171  employs the use of any form of anesthesia must possess a
  172  certification in either basic cardiopulmonary resuscitation for
  173  health professionals or advanced cardiac life support approved
  174  by the American Heart Association or the American Red Cross or
  175  an equivalent agency-sponsored course with recertification every
  176  2 years. Each dental office which uses any form of anesthesia
  177  must have immediately available and in good working order such
  178  resuscitative equipment, oxygen, and other resuscitative drugs
  179  as are specified by rule of the board in order to manage
  180  possible adverse reactions.
  181         (5) A dental hygienist under the direct supervision of a
  182  dentist may administer local anesthesia, including intraoral
  183  block anesthesia, soft tissue infiltration anesthesia, or both,
  184  to a nonsedated patient who is 18 years of age or older, if the
  185  following criteria are met:
  186         (a) The dental hygienist has successfully completed a
  187  course in the administration of local anesthesia which is
  188  offered by a dental or dental hygiene program accredited by the
  189  Commission on Dental Accreditation of the American Dental
  190  Association or approved by the board. The course must include a
  191  minimum of 30 hours of didactic instruction and 30 hours of
  192  clinical experience, and instruction in:
  193         1. Theory of pain control.
  194         2. Selection-of-pain-control modalities.
  195         3. Anatomy.
  196         4. Neurophysiology.
  197         5. Pharmacology of local anesthetics.
  198         6. Pharmacology of vasoconstrictors.
  199         7. Psychological aspects of pain control.
  200         8. Systematic complications.
  201         9. Techniques of maxillary anesthesia.
  202         10. Techniques of mandibular anesthesia.
  203         11. Infection control.
  204         12. Medical emergencies involving local anesthesia.
  205         (b) The dental hygienist presents evidence of current
  206  certification in basic or advanced cardiac life support.
  207         (c) The dental hygienist possesses a valid certificate
  208  issued under subsection (6).
  209         (6) Any dental hygienist seeking a certificate to
  210  administer local anesthesia must apply to the department, remit
  211  an application fee, and submit proof of successful completion of
  212  a course in the administration of local anesthesia pursuant to
  213  subsection (5). The board shall certify, and the department
  214  shall issue a certificate to, any dental hygienist who fulfills
  215  the qualifications of subsection (5). The board shall establish
  216  a one-time application fee not to exceed $35. The certificate is
  217  not subject to renewal but is part of the dental hygienist’s
  218  permanent record and must be prominently displayed at the
  219  location where the dental hygienist is authorized to administer
  220  local anesthesia. The board shall adopt rules necessary to
  221  administer subsection (5) and this subsection.
  222         Section 4. Subsection (7) is added to section 466.023,
  223  Florida Statutes, to read:
  224         466.023 Dental hygienists; scope and area of practice.—
  225         (7) A dental hygienist may administer local anesthesia as
  226  provided in ss. 466.017 and 466.024.
  227         Section 5. Subsection (1) of section 466.024, Florida
  228  Statutes, is amended to read:
  229         466.024 Delegation of duties; expanded functions.—
  230         (1) A dentist may not delegate irremediable tasks to a
  231  dental hygienist or dental assistant, except as provided by law.
  232  A dentist may delegate remediable tasks to a dental hygienist or
  233  dental assistant when such tasks pose no risk to the patient. A
  234  dentist may only delegate remediable tasks so defined by law or
  235  rule of the board. The board by rule shall designate which tasks
  236  are remediable and delegable, except that the following are by
  237  law found to be remediable and delegable:
  238         (a) Taking impressions for study casts but not for the
  239  purpose of fabricating any intraoral restorations or orthodontic
  240  appliance.
  241         (b) Placing periodontal dressings.
  242         (c) Removing periodontal or surgical dressings.
  243         (d) Removing sutures.
  244         (e) Placing or removing rubber dams.
  245         (f) Placing or removing matrices.
  246         (g) Placing or removing temporary restorations.
  247         (h) Applying cavity liners, varnishes, or bases.
  248         (i) Polishing amalgam restorations.
  249         (j) Polishing clinical crowns of the teeth for the purpose
  250  of removing stains but not changing the existing contour of the
  251  tooth.
  252         (k) Obtaining bacteriological cytological specimens not
  253  involving cutting of the tissue.
  254         (l) Administering local anesthesia pursuant to s.
  255  466.017(5).
  256  
  257  This subsection does not limit delegable tasks to those
  258  specified herein.
  259         Section 6. This act shall take effect upon becoming a law.