| 1 | The Health Care Regulation Committee recommends the following: |
| 2 |
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| 3 | Council/Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to dental charting; amending s. 466.023, |
| 7 | F.S.; expanding the scope and area of practice of dental |
| 8 | hygienists to include dental charting; creating s. |
| 9 | 466.0235, F.S.; providing for regulation of dental |
| 10 | charting; providing a definition; authorizing dental |
| 11 | hygienists to perform dental charting under certain |
| 12 | conditions; regulating the use and content of disclosure |
| 13 | and charting forms; requiring the Board of Dentistry to |
| 14 | approve disclosure and charting forms; limiting the |
| 15 | applicability of dental charting; providing restrictions |
| 16 | on periodontal probe use in dental charting; providing |
| 17 | restrictions on dental charting reimbursement, referrals |
| 18 | made in conjunction with the provision of dental charting |
| 19 | services, and the provision of dental charting by a dental |
| 20 | hygienist without supervision; providing an effective |
| 21 | date. |
| 22 |
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| 23 | Be It Enacted by the Legislature of the State of Florida: |
| 24 |
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| 25 | Section 1. Subsection (5) of section 466.023, Florida |
| 26 | Statutes, is renumbered as subsection (6) and a new subsection |
| 27 | (5) is added to that section to read: |
| 28 | 466.023 Dental hygienists; scope and area of practice.-- |
| 29 | (5) Dental hygienists may, without supervision, perform |
| 30 | dental charting as provided in s. 466.0235. |
| 31 | Section 2. Section 466.0235, Florida Statutes, is created |
| 32 | to read: |
| 33 | 466.0235 Dental charting.-- |
| 34 | (1) For purposes of this section, the term "dental |
| 35 | charting" means a recording of visual observations of clinical |
| 36 | conditions of the oral cavity without the use of X rays, |
| 37 | laboratory tests, or other diagnostic methods or equipment, |
| 38 | except the instruments necessary to record visual restorations, |
| 39 | missing teeth, suspicious areas, and periodontal pockets. |
| 40 | (2) A dental hygienist may, without supervision and within |
| 41 | the lawful scope of his or her duties as authorized by law, |
| 42 | perform dental charting of hard and soft tissues in public and |
| 43 | private educational institutions of the state and Federal |
| 44 | Government, nursing homes, assisted living and long-term care |
| 45 | facilities, community health centers, county health departments, |
| 46 | mobile dental or health units, and epidemiological surveys for |
| 47 | public health. A dental hygienist may also perform dental |
| 48 | charting on a volunteer basis at health fairs. |
| 49 | (3) Each person who receives a dental charting pursuant to |
| 50 | this section, or the parent or legal guardian of the person, |
| 51 | shall receive and acknowledge a written disclosure form before |
| 52 | receiving the dental charting procedure that states that the |
| 53 | purpose of the dental charting is to collect data for use by a |
| 54 | dentist at a prompt subsequent examination. The disclosure form |
| 55 | shall also emphasize that diagnosis of caries, soft tissue |
| 56 | disease, oral cancer, temporomandibular joint disease (TMJ), and |
| 57 | dentofacial malocclusions can only be completed by a dentist in |
| 58 | the context of delivering a comprehensive dental examination. |
| 59 | (4) The board shall approve the content of charting and |
| 60 | disclosure forms to be used under this section. Both forms shall |
| 61 | emphasize the inherent limitations of dental charting and |
| 62 | encourage complete examination by a dentist in rendering a |
| 63 | professional diagnosis of the patient's overall oral health |
| 64 | needs. |
| 65 | (5) Dental charting performed under this section is not a |
| 66 | substitute for a comprehensive dental examination. |
| 67 | (6) Medical clearance by a physician or dentist is |
| 68 | required before a periodontal probe may be used on a person who |
| 69 | receives a dental charting. |
| 70 | (7) Nothing in this section shall be construed to permit |
| 71 | direct reimbursement for dental charting performed under this |
| 72 | section by Medicaid, health insurers, health maintenance |
| 73 | organizations, prepaid dental plans, or other third-party payors |
| 74 | beyond what is otherwise allowable by law. |
| 75 | (8) All referrals made in conjunction with the provision |
| 76 | of dental charting services under this section shall be in |
| 77 | strict conformance with federal and state patient referral, |
| 78 | anti-kickback, and patient brokering laws. |
| 79 | (9) A dental hygienist performing dental charting without |
| 80 | supervision shall not be deemed to have created either a patient |
| 81 | of record or a medical record. |
| 82 | Section 3. This act shall take effect July 1, 2006. |