1

The Committee on Health and Human Services Appropriations

2

(Peaden) recommended the following amendment:

3

4

     Senate Amendment (with title amendment)

5

     Delete everything after the enacting clause

6

and insert:

7

     Section 1.  Subsection (14) is added to section 466.003,

8

Florida Statutes, to read:

9

     466.003  Definitions.--As used in this chapter:

10

     (14) "Health access settings" means programs and

11

institutions of the Department of Children and Family Services,

12

the Department of Health, the Department of Juvenile Justice,

13

nonprofit community health centers, Head Start centers, federally

14

qualified health centers (FQHCs), FQHC look-alikes as defined by

15

federal law, and clinics operated by accredited colleges of

16

dentistry in this state if such community service programs and

17

institutions immediately report to the Board of Dentistry all

18

violations of s. 466.027, s. 466.028, and other practice act or

19

standard of care violations related to the actions or inactions

20

of a dentist, dental hygienist, or dental assistant engaged in

21

the delivery of dental care in such settings.

22

     Section 2.  Paragraph (c) of subsection (2) of section

23

466.006, Florida Statutes, is amended to read:

24

     466.006  Examination of dentists.--

25

     (2)  An applicant shall be entitled to take the examinations

26

required in this section to practice dentistry in this state if

27

the applicant:

28

     (c)1. Has successfully completed the National Board of

29

Dental Examiners dental examination within 10 years of the date

30

of application; or.

31

     2. Has an active health access dental license in this

32

state; and

33

     a. The applicant has at least 5,000 hours within 4

34

consecutive years of clinical practice experience providing

35

direct patient care in a health access setting as defined in s.

36

466.003(14); the applicant is a retired veteran dentist of any

37

branch of the United States Armed Services who has practiced

38

dentistry while on active duty and has at least 3,000 hours

39

within 3 consecutive years of clinical practice experience

40

providing direct patient care in a health access setting as

41

defined in s. 466.003(14); or the applicant has provided a

42

portion of his or her salaried time teaching health profession

43

students in any public education setting, including, but not

44

limited to, a community college, college, or university, and has

45

at least 3,000 hours within 3 consecutive years of clinical

46

practice experience providing direct patient care in a health

47

access setting as defined in s. 466.003(14);

48

     b. The applicant has not been disciplined by the board,

49

except for citation offenses or minor violations;

50

     c. The applicant has not filed a report pursuant to s.

51

456.049; and

52

     d. The applicant has not been convicted of or pled nolo

53

contendere to, regardless of adjudication, any felony or

54

misdemeanor related to the practice of a health care profession.

55

     Section 3.  Section 466.0067, Florida Statutes, is created

56

to read:

57

     466.0067 Application for health access dental license.--The

58

Legislature finds that there is an important state interest in

59

attracting dentists to practice in underserved health access

60

settings in this state and further, that allowing out-of-state

61

dentists who meet certain criteria to practice in health access

62

settings without the supervision of a dentist licensed in this

63

state is substantially related to achieving this important state

64

interest. Therefore, notwithstanding the requirements of s.

65

466.006, the board shall grant a health access dental license to

66

practice dentistry in this state in health access settings as

67

defined in s. 466.003(14) to an applicant that:

68

     (1) Files an appropriate application approved by the board;

69

     (2) Pays an application license fee for a health access

70

dental license, laws-and-rule exam fee, and an initial licensure

71

fee. The fees specified in this subsection may not differ from an

72

applicant seeking licensure pursuant to s. 466.006;

73

     (3) Has not been convicted or pled guilty or nolo

74

contendere to, regardless of adjudication, a crime in any

75

jurisdiction;

76

     (4) Submits proof of graduation from a dental school

77

accredited by the Commission on Dental Accreditation of the

78

American Dental Association or its successor agency;

79

     (5) Submits documentation that she or he has completed, or

80

will obtain prior to licensure, continuing education equivalent

81

to this state's requirement for dentists licensed under s.

82

466.006 for the last full reporting biennium before applying for

83

a health access dental license;

84

     (6) Submits proof of her or his successful completion of

85

parts I and II of the dental examination by the National Board of

86

Dental Examiners and a state or regional clinical dental

87

licensing examination that the board has determined effectively

88

measures the applicant's ability to practice safely;

89

     (7) Currently holds a valid, active, dental license in good

90

standing which has not been revoked, suspended, restricted, or

91

otherwise disciplined from another of these United States, the

92

District of Columbia, or a United States territory;

93

     (8) Has never had a license revoked from another of these

94

United States, the District of Columbia, or a United States

95

territory;

96

     (9) Has never failed the examination specified in s.

97

466.006, unless the applicant was reexamined pursuant to s.

98

466.006 and received a license to practice dentistry in this

99

state;

100

     (10) Has not been reported to the National Practitioner

101

Data Bank, unless the applicant successfully appealed to have his

102

or her name removed from the data bank;

103

     (11) Submits proof that he or she has been engaged in the

104

active, clinical practice of dentistry providing direct patient

105

care for 5 years immediately preceding the date of application,

106

or in instances when the applicant has graduated from an

107

accredited dental school within the preceding 5 years, submits

108

proof of continuous clinical practice providing direct patient

109

care since graduation; and

110

     (12) Has passed an examination covering the laws and rules

111

of the practice of dentistry in this state as described in s.

112

466.006(4)(a).

113

     Section 4.  Section 466.00671, Florida Statutes, is created

114

to read:

115

     466.00671 Renewal of the health access dental license.--

116

     (1) A health access dental licensee shall apply for renewal

117

each biennium. At the time of renewal, the licensee shall sign a

118

statement that she or he has complied with all continuing

119

education requirements of an active dentist licensee. The board

120

shall renew a health access dental license for an applicant that:

121

     (a) Submits documentation, as approved by the board, from

122

the employer in the health access setting that the licensee has

123

at all times pertinent remained an employee;

124

     (b) Has not been convicted or pled guilty or nolo

125

contendere to, regardless of adjudication, a crime in any

126

jurisdiction;

127

     (c) Has paid a renewal fee set by the board. The fee

128

specified herein may not differ from the renewal fee adopted by

129

the board pursuant to s. 466.013. The department may provide

130

payment for these fees through the dentist's salary, benefits, or

131

other department funds;

132

     (d) Has not failed the examination specified in s. 466.006

133

since initially receiving a health access dental license or since

134

the last renewal; and

135

     (e) Has not been reported to the National Practitioner Data

136

Bank, unless the applicant successfully appealed to have his or

137

her name removed from the data bank.

138

     (2) The board may undertake measures to independently

139

verify the health access dental licensee's ongoing employment

140

status in the health access setting.

141

     Section 5.  Section 466.00672, Florida Statutes, is created

142

to read:

143

     466.00672 Revocation of health access dental license.--

144

     (1) The board shall revoke a health access dental license

145

upon:

146

     (a) The licensee's termination from employment from a

147

qualifying health access setting;

148

     (b) Final agency action determining that the licensee has

149

violated any provision of s. 466.027 or s. 466.028, other than

150

infractions constituting citation offenses or minor violations;

151

or

152

     (c) Failure of the Florida dental licensure examination.

153

     (2) Failure of an individual licensed pursuant to s.

154

466.0067 to limit the practice of dentistry to health access

155

settings as defined in s. 466.003 constitutes the unlicensed

156

practice of dentistry.

157

     Section 6.  Section 466.00673, Florida Statutes, is created

158

to read:

159

     466.00673 Repeal of a health access dental

160

license.--Effective January 1, 2015, ss. 466.0067-466.00673 are

161

repealed unless reenacted by the Legislature. Any health access

162

dental license issued before January 1, 2015, shall remain valid

163

according to ss. 466.0067-466.00673, without effect from repeal.     

164

     Section 7.  Section 466.00775, Florida Statutes, is created

165

to read:

166

     466.00775 Rulemaking.--The board shall adopt rules pursuant

167

to ss. 120.536(1) and 120.54 to administer ss. 466.003(14),

168

466.0067, 466.00671, 466.00672, 466.00673, 466.021, and 466.032.

169

     Section 8.  Section 466.011, Florida Statutes, is amended to

170

read:

171

     466.011  Licensure.--The board shall certify for licensure

172

by the department any applicant who satisfies the requirements of

173

s. 466.006, s. 466.0067, or s. 466.007. The board may refuse to

174

certify an applicant who has violated any of the provisions of s.

175

466.026 or s. 466.028.

176

     Section 9.  Section 466.021, Florida Statutes, is amended to

177

read:

178

     466.021 Retention Employment of dental laboratories

179

unlicensed persons by dentist; penalty.--Each Every duly licensed

180

dentist who uses the services of any dental laboratory unlicensed

181

person for the purpose of constructing, altering, repairing, or

182

duplicating any denture, implant, veneer, partial denture, bridge

183

splint, or orthodontic or other prosthetic appliance, or other

184

suitable form of artificial oral restorative device shall be

185

required to furnish the dental laboratory such unlicensed person

186

with a written prescription work order in a such form as

187

prescribed by rule of the board. This prescription form shall be

188

dated and signed by the such dentist and shall include the

189

license number of the dentist, the patient's name or number with

190

sufficient descriptive information to clearly identify the case

191

for each separate and individual piece of work to be performed by

192

the dental laboratory, and a specification of materials to be

193

contained in each work product. A copy of the prescription such

194

work order shall be retained in a file in the prescribing

195

dentist's office for a period of 4 years following the date the

196

prescription was issued, and the original prescription work order

197

shall be retained in a file by the dental laboratory for a period

198

of 4 years by such unlicensed person in her or his place of

199

business. A registered dental laboratory shall disclose in

200

writing at the time of delivery of the final restoration to the

201

prescribing dentist the materials and all certificates of

202

authenticity that constitute each product manufactured and the

203

point of origin of manufacture of each restoration, including the

204

address and contact information of the dental laboratory. The

205

Such file of prescriptions work orders to be kept by the such

206

dentist and the dental laboratory or by such unlicensed person

207

shall be open to inspection at any reasonable time by the

208

department or its duly constituted agent. Failure of the dentist

209

to keep records of each prescription such work orders shall

210

subject the dentist to suspension or revocation of her or his

211

license to practice dentistry in this state. Failure of a dental

212

laboratory that has accepted a prescription to have the original

213

or electronic copy of each prescription and to ensure the

214

accuracy of each product's material disclosure at the time it is

215

delivered to the prescribing dentist such unlicensed person to

216

have in her or his possession a work order as required by this

217

section is shall be admissible evidence of a violation of this

218

chapter and constitutes shall constitute a misdemeanor of the

219

second degree, punishable as provided in s. 775.082 or s.

220

775.083. This section does not preclude a registered dental

221

laboratory from working for another registered dental laboratory

222

if, provided that such work is performed pursuant to written

223

authorization, in a form to be prescribed by rule of the board,

224

which evidences that the originating laboratory has obtained a

225

valid prescription work order and which sets forth the work to be

226

performed and the resulting material certifications to be

227

provided. A dental laboratory accepting prescriptions from

228

dentists is liable for damages caused by inaccuracies in the

229

material disclosure, certificates of authenticity, or point of

230

origin provided by the dental laboratory to the prescribing

231

dentist. This section does not preclude a registered laboratory

232

from providing its services to dentists licensed and practicing

233

in another state if, provided that such work is requested or

234

otherwise authorized in written form that which clearly

235

identifies the name and address of the requesting dentist and

236

which sets forth the work to be performed and otherwise complies

237

with all applicable laws and treaties.

238

     Section 10.  Subsections (7), (8), and (9) are added to

239

section 466.023, Florida Statutes, to read:

240

     466.023  Dental hygienists; scope and area of practice.--

241

     (7) A dental hygienist may perform the following tasks,

242

without supervision and without prior authorization of a dentist,

243

in a health access setting, as defined in s. 466.003(14):

244

     (a) Conducting services listed in s. 466.023(3);

245

     (b) Doing dental charting listed in s. 466.0235;

246

     (c) Applying fluoride treatments, including the use of

247

fluoride varnishes;

248

     (d) Doing impressions for study casts that are not being

249

made for the purpose of fabricating any intra-oral appliances,

250

restorations, or orthodontic appliances and which are conveyed to

251

a dentist for review and development of a treatment plan; and

252

     (e) Taking medical and dental history conveyed to a dentist

253

for review and development of a treatment plan.

254

     (8) Patients receiving services listed in paragraphs

255

(7)(c), (d), and (e) from a hygienist without supervision or

256

prior authorization must be examined by a dentist before the

257

hygienist performs any additional services without supervision or

258

prior authorization.

259

     (9) A dental hygienist may perform the following tasks

260

under general supervision:

261

     (a) Applying dental sealants.

262

     (b) Placing subgingival resorbable chlorhexidine,

263

doxycycline hyclate, or minocycline hydrochloride.

264

     Section 11.  Subsection (5) is added to section 466.032,

265

Florida Statutes, to read:

266

     466.032  Registration.--

267

     (5) The dental laboratory owner or at least one employee of

268

any dental laboratory renewing registration on or after July 1,

269

2010, shall complete 18 hours of continuing education biennially.

270

Programs of continuing education shall be programs of learning

271

that contribute directly to the education of the dental

272

technician and may include, but are not limited to, attendance at

273

lectures, study clubs, college courses, or scientific sessions of

274

conventions; and research.

275

     (a) The aim of continuing education for dental technicians

276

is to improve dental health care delivery to the public as such

277

is impacted through the design, manufacture, and use of

278

artificial human oral prosthetics and related restorative

279

appliances.

280

     (b) Continuing education courses shall address one or more

281

of the following areas of professional development, including,

282

but not limited to:

283

     1. Laboratory and technological subjects, including, but

284

not limited to, laboratory techniques and procedures, materials,

285

and equipment; and

286

     2. Subjects pertinent to oral health, infection control,

287

and safety.

288

     (c) Programs meeting the general requirements of continuing

289

education may be developed and offered to dental technicians by

290

the Florida Dental Laboratory Association and the Florida Dental

291

Association. Other organizations, schools, or agencies may also

292

be approved to develop and offer continuing education in

293

accordance with specific criteria established by the department.

294

     (d) Any dental laboratory renewing a registration on or

295

after July 1, 2010, shall submit a sworn affidavit, on a form

296

approved by the department, attesting that either the dental

297

laboratory owner or one dental technician employed by the

298

registered dental laboratory has completed the continuing

299

education required in this subsection in accordance with the

300

guidelines and provisions of this subsection and listing the

301

date, location, sponsor, subject matter, and hours of completed

302

continuing education courses. The dental laboratory shall retain

303

in its records such receipts, vouchers, or certificates as may be

304

necessary to document completion of the continuing education

305

courses listed in accordance with this subsection. With cause,

306

the department may request that the documentation be provided by

307

the applicant. The department may also request the documentation

308

from applicants selected at random without cause.

309

     (e)1. This subsection does not apply to a dental laboratory

310

that is physically located within a dental practice operated by a

311

dentist licensed under this chapter.

312

     2. A dental laboratory in another state or country which

313

provides service to a dentist licensed under this chapter is not

314

required to register with the state and may continue to provide

315

services to such dentist with a proper prescription. A dental

316

laboratory in another state or country, however, may voluntarily

317

comply with this subsection.

318

     Section 12.  This act shall take effect January 1, 2009.

319

320

321

================ T I T L E  A M E N D M E N T ================

322

And the title is amended as follows:

323

     Delete everything before the enacting clause

324

and insert:

325

A bill to be entitled

326

An act relating to dentistry; amending s. 466.003, F.S.;

327

providing a definition; amending s. 466.006, F.S.;

328

revising the requirements for entitlement to take the

329

necessary examinations to practice dentistry in this

330

state; creating s. 466.0067, F.S.; providing requirements

331

for application for a health access dental license in this

332

state; creating s. 466.00671, F.S.; providing requirements

333

for renewal of a health access dental license; creating s.

334

466.00672, F.S.; providing conditions in which the Board

335

of Dentistry of the Department of Health may revoke a

336

health access dental license; providing that the failure

337

of a holder of a health access dental license to limit the

338

practice of dentistry to health access settings is the

339

unlicensed practice of dentistry; creating s. 466.00673,

340

F.S.; providing for the repeal of statutory language

341

regarding health access dental licensure; creating s.

342

466.00775, F.S.; requiring the board to adopt rules;

343

amending s. 466.011, F.S.; conforming provisions to

344

changes made in this act; amending s. 466.021, F.S.;

345

revising requirements relating to retention of dental

346

laboratories by dentists; changing terminology to reflect

347

employment of dental laboratories and to change references

348

to work orders to prescriptions; requiring a dental

349

laboratory to keep the original or an electronic copy of

350

prescriptions; amending s. 466.023, F.S.; authorizing

351

dental hygienists to do certain tasks with and without

352

general supervision; amending s. 466.032, F.S.; requiring

353

specified continuing education for renewal of registration

354

of a dental laboratory by a time certain; providing a

355

listing of agencies or organizations that are authorized

356

to develop and offer continuing education; requiring a

357

dental laboratory owner to submit a sworn statement

358

attesting to compliance with continuing education

359

requirements and providing specified information;

360

authorizing the Department of Health to request

361

documentation of continuing education; authorizing the

362

department to request such documentation at random without

363

cause; providing exemptions from continuing education

364

requirements; providing for voluntary compliance by

365

certain dental laboratories; providing an effective date.

4/1/2008  8:19:00 AM     2-06249-08