Florida Senate - 2016                                     SB 234
       By Senator Gaetz
       1-00273-16                                             2016234__
    1                        A bill to be entitled                      
    2         An act relating to dental care; creating s. 381.4019,
    3         F.S.; establishing a joint local and state dental care
    4         access account initiative, subject to the availability
    5         of funding; authorizing the creation of dental care
    6         access accounts; specifying the purpose of the
    7         initiative; defining terms; providing criteria for the
    8         selection of dentists for participation in the
    9         initiative; providing for the establishment of
   10         accounts; requiring the Department of Health to
   11         implement an electronic benefit transfer system;
   12         providing for the use of funds deposited in the
   13         accounts; requiring the department to distribute state
   14         funds to accounts, subject to legislative
   15         appropriations; authorizing the department to accept
   16         contributions from a local source for deposit in a
   17         designated account; limiting the number of years that
   18         an account may remain open; providing for the
   19         immediate closing of accounts under certain
   20         circumstances; authorizing the department to transfer
   21         state funds remaining in a closed account at a
   22         specified time and to return unspent funds from local
   23         sources; requiring a dentist to repay funds in certain
   24         circumstances; authorizing the department to pursue
   25         disciplinary enforcement actions and to use other
   26         legal means to recover funds; requiring the department
   27         to establish by rule application procedures and a
   28         process to verify the use of funds withdrawn from a
   29         dental care access account; requiring the department
   30         to give priority to applications from dentists
   31         practicing in certain areas; requiring the Department
   32         of Economic Opportunity to rank dental health
   33         professional shortage areas and medically underserved
   34         areas; requiring the Department of Health to develop a
   35         marketing plan in cooperation with certain dental
   36         colleges and the Florida Dental Association; requiring
   37         the Department of Health to annually submit a report
   38         with certain information to the Governor and the
   39         Legislature; providing rulemaking authority to require
   40         the submission of information for such reporting;
   41         providing an effective date.
   43  Be It Enacted by the Legislature of the State of Florida:
   45         Section 1. Section 381.4019, Florida Statutes, is created
   46  to read:
   47         381.4019 Dental care access accounts.—Subject to the
   48  availability of funds, the Legislature establishes a joint local
   49  and state dental care access account initiative and authorizes
   50  the creation of dental care access accounts to promote economic
   51  development by supporting qualified dentists who practice in
   52  dental health professional shortage areas or medically
   53  underserved areas or who treat a medically underserved
   54  population. The Legislature recognizes that maintaining good
   55  oral health is integral to overall health status and that the
   56  good health of residents of this state is an important
   57  contributing factor in economic development. Better health,
   58  including better oral health, enables workers to be more
   59  productive, reduces the burden of health care costs, and enables
   60  children to improve in cognitive development.
   61         (1) As used in this section, the term:
   62         (a) “Dental health professional shortage area” means a
   63  geographic area so designated by the Health Resources and
   64  Services Administration of the United States Department of
   65  Health and Human Services.
   66         (b) “Department” means the Department of Health.
   67         (c) “Medically underserved area” means a geographic area so
   68  designated by the Health Resources and Services Administration
   69  of the United States Department of Health and Human Services.
   70         (d) “Public health program” means a county health
   71  department, the Children’s Medical Services Network, a federally
   72  qualified community health center, a federally funded migrant
   73  health center, or other publicly funded or nonprofit health care
   74  program as designated by the department.
   75         (2The department shall develop and implement a dental
   76  care access account initiative to benefit dentists licensed to
   77  practice in this state who demonstrate, as required by the
   78  department by rule:
   79         (a)Active employment by a public health program located in
   80  a dental health professional shortage area or a medically
   81  underserved area; or
   82         (b)A commitment to opening a private practice in a dental
   83  health professional shortage area or a medically underserved
   84  area, as demonstrated by the dentist residing in the designated
   85  area, maintaining an active Medicaid provider agreement,
   86  enrolling in one or more Medicaid managed care plans, expending
   87  sufficient capital to make substantial progress in opening a
   88  dental practice that is capable of serving at least 1,200
   89  patients, and obtaining financial support from the local
   90  community in which the dentist is practicing or intending to
   91  open a practice.
   92         (3) The department shall establish dental care access
   93  accounts as individual benefit accounts for each dentist who
   94  satisfies the requirements of subsection (2) and is selected by
   95  the department for participation. The department shall implement
   96  an electronic benefit transfer system that enables each dentist
   97  to spend funds from his or her account for the purposes
   98  described in subsection (4).
   99         (4Funds contributed from state and local sources to a
  100  dental care access account may be used for one or more of the
  101  following purposes:
  102         (a) Repayment of dental school student loans.
  103         (b) Investment in property, facilities, or equipment
  104  necessary to establish and operate a dental office consisting of
  105  no fewer than two operatories.
  106         (c) Payment of transitional expenses related to the
  107  relocation or opening of a dental practice which are
  108  specifically approved by the department.
  109         (5Subject to legislative appropriation, the department
  110  shall distribute state funds as an award to each dental care
  111  access account. An individual award must be in an amount not
  112  more than $100,000 and not less than $10,000, except that a
  113  state award may not exceed 3 times the amount contributed to an
  114  account in the same year from local sources. If a dentist
  115  qualifies for a dental care access account under paragraph
  116  (2)(a), the dentist’s salary and associated employer
  117  expenditures constitute a local match and qualify the account
  118  for a state award if the salary and associated expenditures do
  119  not come from state funds. State funds may not be included in a
  120  determination of the amount contributed to an account from local
  121  sources.
  122         (6) The department may accept contributions of funds from a
  123  local source for deposit in the account of a dentist designated
  124  by the donor.
  125         (7) The department shall close an account no later than 5
  126  years after the first deposit of state or local funds into that
  127  account or immediately upon the occurrence of any of the
  128  following:
  129         (a) Termination of the dentist’s employment with a public
  130  health program, unless, within 30 days of such termination, the
  131  dentist opens a private practice in a dental health professional
  132  shortage area or medically underserved area.
  133         (b) Termination of the dentist’s practice in a designated
  134  dental health professional shortage area or medically
  135  underserved area.
  136         (c) Termination of the dentist’s participation in the
  137  Florida Medicaid program.
  138         (d) Participation by the dentist in any fraudulent
  139  activity.
  140         (8) Any state funds remaining in a closed account may be
  141  awarded and transferred to another account concurrent with the
  142  distribution of funds under the next legislative appropriation
  143  for the initiative. The department shall return to the donor on
  144  a pro rata basis unspent funds from local sources which remain
  145  in a closed account.
  146         (9) If the department determines that a dentist has
  147  withdrawn account funds after the occurrence of an event
  148  specified in subsection (7), has used funds for purposes not
  149  authorized in subsection (4), or has not remained eligible for a
  150  dental care access account for a minimum of 2 years, the dentist
  151  shall repay the funds to his or her account. The department may
  152  recover the withdrawn funds through disciplinary enforcement
  153  actions and other methods authorized by law.
  154         (10) The department shall establish by rule:
  155         (a) Application procedures for dentists who wish to apply
  156  for a dental care access account. An applicant may demonstrate
  157  that he or she has expended sufficient capital to make
  158  substantial progress in opening a dental practice that is
  159  capable of serving at least 1,200 patients by documenting
  160  contracts for the purchase or lease of a practice location and
  161  providing executed obligations for the purchase or other
  162  acquisition of at least 30 percent of the value of equipment or
  163  supplies necessary to operate a dental practice. The department
  164  may limit the number of applicants selected and shall give
  165  priority to those applicants practicing in the areas receiving
  166  higher rankings pursuant to subsection (11). The department may
  167  establish additional criteria for selection which recognize an
  168  applicant’s active engagement with and commitment to the
  169  community providing a local match.
  170         (b)A process to verify that funds withdrawn from a dental
  171  care access account have been used solely for the purposes
  172  described in subsection (4).
  173         (11) The Department of Economic Opportunity shall rank the
  174  dental health professional shortage areas and medically
  175  underserved areas of the state based on the extent to which
  176  limited access to dental care is impeding the areas’ economic
  177  development, with a higher ranking indicating a greater
  178  impediment to development.
  179         (12) The department shall develop a marketing plan for the
  180  dental care access account initiative in cooperation with the
  181  University of Florida College of Dentistry, the Nova
  182  Southeastern University College of Dental Medicine, the Lake
  183  Erie College of Osteopathic Medicine School of Dental Medicine,
  184  and the Florida Dental Association.
  185         (13)(a) By January 1 of each year, beginning in 2018, the
  186  department shall issue a report to the Governor, the President
  187  of the Senate, and the Speaker of the House of Representatives
  188  which must include:
  189         1. The number of patients served by dentists receiving
  190  funding under this section.
  191         2. The number of Medicaid recipients served by dentists
  192  receiving funding under this section.
  193         3. The average number of hours worked and patients served
  194  in a week by dentists receiving funding under this section.
  195         4. The number of dentists in each dental health
  196  professional shortage area or medically underserved area
  197  receiving funding under this section.
  198         5. The amount and source of local matching funds received
  199  by the department.
  200         6. The amount of state funds awarded to dentists under this
  201  section.
  202         7. A complete accounting of the use of funds by categories
  203  identified by the department, including, but not limited to,
  204  loans, supplies, equipment, rental property payments, real
  205  property purchases, and salary and wages.
  206         (b) The department shall adopt rules to require dentists to
  207  report information to the department which is necessary for the
  208  department to fulfill its reporting requirement under this
  209  subsection.
  210         Section 2. This act shall take effect July 1, 2016.