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requiring the department 27 to establish by rule application procedures and a 28 process to verify the use of funds withdrawn from a 29 dental care access account; requiring the department 30 to give priority to applications from dentists 31 practicing in certain areas; requiring the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. 42 43 Be It Enacted by the Legislature of the State of Florida: 44 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 (2) The 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 (4) Funds 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 (5) Subject 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.