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A bill to be entitled

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

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

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revising the requirements for entitlement to take the

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necessary examinations to practice dentistry in this

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

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for application for a health access dental license in this

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

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

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

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of Dentistry of the Department of Health may revoke a

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health access dental license; providing that the failure

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

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practice of dentistry to health access settings is the

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unlicensed practice of dentistry; creating s. 466.00673,

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

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regarding health access dental licensure; creating s.

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

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

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

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revising requirements relating to retention of dental

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laboratories by dentists; changing terminology to reflect

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employment of dental laboratories and to change references

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to work orders to prescriptions; requiring a dental

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laboratory to keep the original or an electronic copy of

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

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dental hygienists to do certain tasks with and without

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

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specified continuing education for renewal of registration

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of a dental laboratory by a time certain; providing a

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listing of agencies or organizations that are authorized

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to develop and offer continuing education; requiring a

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dental laboratory owner to submit a sworn statement

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attesting to compliance with continuing education

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requirements and providing specified information;

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authorizing the Department of Health to request

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documentation of continuing education; authorizing the

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department to request such documentation at random without

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cause; providing exemptions from continuing education

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requirements; providing for voluntary compliance by

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certain dental laboratories; providing an effective date.

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Be It Enacted by the Legislature of the State of Florida:

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

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Florida Statutes, to read:

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     466.003  Definitions.--As used in this chapter:

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     (14) "Health access settings" means programs and

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institutions of the Department of Children and Family Services,

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the Department of Health, the Department of Juvenile Justice,

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nonprofit community health centers, Head Start centers, federally

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

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federal law, and clinics operated by accredited colleges of

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dentistry in this state if such community service programs and

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institutions immediately report to the Board of Dentistry all

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

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standard of care violations related to the actions or inactions

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

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the delivery of dental care in such settings.

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

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466.006, Florida Statutes, is amended to read:

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     466.006  Examination of dentists.--

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

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required in this section to practice dentistry in this state if

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the applicant:

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

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Dental Examiners dental examination within 10 years of the date

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of application; or.

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     2. Has an active health access dental license in this

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state; and

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

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consecutive years of clinical practice experience providing

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

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

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branch of the United States Armed Services who has practiced

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

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within 3 consecutive years of clinical practice experience

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providing direct patient care in a health access setting as

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

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portion of his or her salaried time teaching health profession

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students in any public education setting, including, but not

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

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

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practice experience providing direct patient care in a health

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

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

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except for citation offenses or minor violations;

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

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456.049; and

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

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contendere to, regardless of adjudication, any felony or

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misdemeanor related to the practice of a health care profession.

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     Section 3.  Section 466.0067, Florida Statutes, is created

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to read:

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     466.0067 Application for health access dental license.--The

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Legislature finds that there is an important state interest in

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attracting dentists to practice in underserved health access

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

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dentists who meet certain criteria to practice in health access

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settings without the supervision of a dentist licensed in this

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state is substantially related to achieving this important state

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interest. Therefore, notwithstanding the requirements of s.

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

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practice dentistry in this state in health access settings as

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

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

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

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

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

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applicant seeking licensure pursuant to s. 466.006;

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     (3) Has not been convicted of or pled nolo contendere to,

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regardless of adjudication, any felony or misdemeanor related to

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the practice of a health care profession;

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     (4) Submits proof of graduation from a dental school

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accredited by the Commission on Dental Accreditation of the

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American Dental Association or its successor agency;

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

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will obtain prior to licensure, continuing education equivalent

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

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466.006 for the last full reporting biennium before applying for

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a health access dental license;

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

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

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Dental Examiners and a state or regional clinical dental

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licensing examination that the board has determined effectively

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measures the applicant's ability to practice safely;

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

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

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otherwise disciplined from another of these United States, the

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District of Columbia, or a United States territory;

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

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

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territory;

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

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466.006, unless the applicant was reexamined pursuant to s.

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466.006 and received a license to practice dentistry in this

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state;

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     (10) Has not been reported to the National Practitioner

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Data Bank, unless the applicant successfully appealed to have his

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or her name removed from the data bank;

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

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active, clinical practice of dentistry providing direct patient

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care for 5 years immediately preceding the date of application,

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or in instances when the applicant has graduated from an

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accredited dental school within the preceding 5 years, submits

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proof of continuous clinical practice providing direct patient

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care since graduation; and

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

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

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466.006(4)(a).

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     Section 4.  Section 466.00671, Florida Statutes, is created

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to read:

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     466.00671 Renewal of the health access dental license.--

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

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

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statement that she or he has complied with all continuing

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education requirements of an active dentist licensee. The board

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

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

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the employer in the health access setting that the licensee has

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at all times pertinent remained an employee;

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     (b) Has not been convicted of or pled nolo contendere to,

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regardless of adjudication, any felony or misdemeanor related to

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the practice of a health care profession;

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

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specified herein may not differ from the renewal fee adopted by

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

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

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other department funds;

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

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since initially receiving a health access dental license or since

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the last renewal; and

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

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Bank, unless the applicant successfully appealed to have his or

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her name removed from the data bank.

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     (2) The board may undertake measures to independently

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verify the health access dental licensee's ongoing employment

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status in the health access setting.

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     Section 5.  Section 466.00672, Florida Statutes, is created

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to read:

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     466.00672 Revocation of health access dental license.--

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

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upon:

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

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qualifying health access setting;

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     (b) Final agency action determining that the licensee has

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

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infractions constituting citation offenses or minor violations;

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or

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     (c) Failure of the Florida dental licensure examination.

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

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466.0067 to limit the practice of dentistry to health access

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settings as defined in s. 466.003 constitutes the unlicensed

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practice of dentistry.

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     Section 6.  Section 466.00673, Florida Statutes, is created

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to read:

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     466.00673 Repeal of a health access dental

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

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repealed unless reenacted by the Legislature. Any health access

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

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

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     Section 7.  Section 466.00775, Florida Statutes, is created

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to read:

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     466.00775 Rulemaking.--The board shall adopt rules pursuant

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

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

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

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read:

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     466.011  Licensure.--The board shall certify for licensure

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by the department any applicant who satisfies the requirements of

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

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

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466.026 or s. 466.028.

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

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read:

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     466.021 Retention Employment of dental laboratories

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

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dentist who uses the services of any dental laboratory unlicensed

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

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

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splint, or orthodontic or other prosthetic appliance, or other

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suitable form of artificial oral restorative device shall be

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required to furnish the dental laboratory such unlicensed person

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with a written prescription work order in a such form as

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

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dated and signed by the such dentist and shall include the

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

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sufficient descriptive information to clearly identify the case

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

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the dental laboratory, and a specification of materials to be

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

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work order shall be retained in a file in the prescribing

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

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prescription was issued, and the original prescription work order

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

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

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business. A registered dental laboratory shall disclose in

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

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prescribing dentist the materials and all certificates of

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authenticity that constitute each product manufactured and the

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point of origin of manufacture of each restoration, including the

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address and contact information of the dental laboratory. The

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

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dentist and the dental laboratory or by such unlicensed person

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shall be open to inspection at any reasonable time by the

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department or its duly constituted agent. Failure of the dentist

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to keep records of each prescription such work orders shall

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subject the dentist to suspension or revocation of her or his

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

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laboratory that has accepted a prescription to have the original

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or electronic copy of each prescription and to ensure the

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

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delivered to the prescribing dentist such unlicensed person to

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

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section is shall be admissible evidence of a violation of this

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chapter and constitutes shall constitute a misdemeanor of the

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

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775.083. This section does not preclude a registered dental

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laboratory from working for another registered dental laboratory

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if, provided that such work is performed pursuant to written

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

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which evidences that the originating laboratory has obtained a

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

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performed and the resulting material certifications to be

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provided. A dental laboratory accepting prescriptions from

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dentists is liable for damages caused by inaccuracies in the

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material disclosure, certificates of authenticity, or point of

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origin provided by the dental laboratory to the prescribing

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dentist. This section does not preclude a registered laboratory

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from providing its services to dentists licensed and practicing

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

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otherwise authorized in written form that which clearly

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identifies the name and address of the requesting dentist and

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which sets forth the work to be performed and otherwise complies

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with all applicable laws and treaties.

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

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section 466.023, Florida Statutes, to read:

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

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

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without supervision and without prior authorization of a dentist,

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

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

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

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     (c) Applying fluoride treatments, including the use of

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fluoride varnishes;

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

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

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restorations, or orthodontic appliances and which are conveyed to

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

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

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for review and development of a treatment plan.

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     (8) Patients receiving services listed in paragraphs

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

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prior authorization must be examined by a dentist before the

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hygienist performs any additional services without supervision or

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prior authorization.

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     (9) A dental hygienist may perform the following tasks

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under general supervision:

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     (a) Applying dental sealants.

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     (b) Placing subgingival resorbable chlorhexidine,

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doxycycline hyclate, or minocycline hydrochloride.

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

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Florida Statutes, to read:

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     466.032  Registration.--

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

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any dental laboratory renewing registration on or after July 1,

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2010, shall complete 18 hours of continuing education biennially.

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Programs of continuing education shall be programs of learning

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that contribute directly to the education of the dental

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

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

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conventions and research.

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     (a) The aim of continuing education for dental technicians

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

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is impacted through the design, manufacture, and use of

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artificial human oral prosthetics and related restorative

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appliances.

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     (b) Continuing education courses shall address one or more

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of the following areas of professional development, including,

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but not limited to:

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     1. Laboratory and technological subjects, including, but

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not limited to, laboratory techniques and procedures, materials,

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and equipment; and

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     2. Subjects pertinent to oral health, infection control,

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and safety.

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     (c) Programs meeting the general requirements of continuing

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education may be developed and offered to dental technicians by

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the Florida Dental Laboratory Association and the Florida Dental

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Association. Other organizations, schools, or agencies may also

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be approved to develop and offer continuing education in

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accordance with specific criteria established by the department.

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     (d) Any dental laboratory renewing a registration on or

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

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approved by the department, attesting that either the dental

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laboratory owner or one dental technician employed by the

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registered dental laboratory has completed the continuing

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education required in this subsection in accordance with the

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guidelines and provisions of this subsection and listing the

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

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continuing education courses. The dental laboratory shall retain

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

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necessary to document completion of the continuing education

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courses listed in accordance with this subsection. With cause,

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the department may request that the documentation be provided by

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the applicant. The department may also request the documentation

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from applicants selected at random without cause.

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

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that is physically located within a dental practice operated by a

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dentist licensed under this chapter.

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     2. A dental laboratory in another state or country which

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provides service to a dentist licensed under this chapter is not

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required to register with the state and may continue to provide

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services to such dentist with a proper prescription. A dental

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laboratory in another state or country, however, may voluntarily

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comply with this subsection.

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