Florida Senate - 2011                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1228
       
       
       
       
       
       
                                Barcode 317436                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AD/2R         .                                
             05/03/2011 03:56 PM       .                                
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       Senator Altman moved the following:
       
    1         Senate Amendment (with title amendment)
    2         Delete lines 102 - 111
    3  and insert:
    4         Section 3. Present subsections (1) through (4) of section
    5  459.0076, Florida Statutes, are renumbered as subsections (2)
    6  through (5), respectively, and a new subsection (1) is added to
    7  that section, to read:
    8         459.0076 Temporary certificate for practice in areas of
    9  critical need.—
   10         (1) A certificate issued pursuant to this section may be
   11  cited as the Rear Admiral LeRoy Collins, Jr., Temporary
   12  Certificate for Practice in Areas of Critical Need.
   13         Section 4. Subsection (14) of section 466.003, Florida
   14  Statutes, is amended, and subsection (15) is added to that
   15  section, to read:
   16         466.003 Definitions.—As used in this chapter:
   17         (14) “Health access setting settings” means a program or an
   18  institution programs and institutions of the Department of
   19  Children and Family Services, the Department of Health, the
   20  Department of Juvenile Justice, a nonprofit community health
   21  center centers, a Head Start center centers, a federally
   22  qualified health center or look-alike centers (FQHCs), FQHC
   23  look-alikes as defined by federal law, a school-based prevention
   24  program, a clinic and clinics operated by an accredited college
   25  colleges of dentistry, or an accredited dental hygiene program
   26  in this state if such community service program or institution
   27  programs and institutions immediately reports report to the
   28  Board of Dentistry all violations of s. 466.027, s. 466.028, or
   29  other practice act or standard of care violations related to the
   30  actions or inactions of a dentist, dental hygienist, or dental
   31  assistant engaged in the delivery of dental care in such setting
   32  settings.
   33         (15) “School-based prevention program” means preventive
   34  oral health services offered at a school by one of the entities
   35  defined in subsection (14) or by a nonprofit organization that
   36  is exempt from federal income taxation under s. 501(a) of the
   37  Internal Revenue Code, and described in s. 501(c)(3) of the
   38  Internal Revenue Code.
   39         Section 5. Subsections (2) and (3) of section 466.023,
   40  Florida Statutes, are amended to read:
   41         466.023 Dental hygienists; scope and area of practice.—
   42         (2) Dental hygienists may perform their duties:
   43         (a) In the office of a licensed dentist;
   44         (b) In public health programs and institutions of the
   45  Department of Children and Family Services, Department of
   46  Health, and Department of Juvenile Justice under the general
   47  supervision of a licensed dentist; or
   48         (c) In a health access setting as defined in s. 466.003; or
   49         (d)(c) Upon a patient of record of a dentist who has issued
   50  a prescription for the services of a dental hygienist, which
   51  prescription shall be valid for 2 years unless a shorter length
   52  of time is designated by the dentist, in:
   53         1. Licensed public and private health facilities;
   54         2. Other public institutions of the state and federal
   55  government;
   56         3. Public and private educational institutions;
   57         4. The home of a nonambulatory patient; and
   58         5. Other places in accordance with the rules of the board.
   59  
   60  However, the dentist issuing such prescription shall remain
   61  responsible for the care of such patient. As used in this
   62  subsection, “patient of record” means a patient upon whom a
   63  dentist has taken a complete medical history, completed a
   64  clinical examination, recorded any pathological conditions, and
   65  prepared a treatment plan.
   66         (3) Dental hygienists may, without supervision, provide
   67  educational programs, faculty or staff training programs, and
   68  authorized fluoride rinse programs; apply fluorides; instruct a
   69  patient in oral hygiene care; supervise the oral hygiene care of
   70  a patient;, and perform other services that which do not involve
   71  diagnosis or treatment of dental conditions and that which
   72  services are approved by rule of the board.
   73         Section 6. Subsection (2) of section 466.0235, Florida
   74  Statutes, is amended to read:
   75         466.0235 Dental charting.—
   76         (2) A dental hygienist may, without supervision and within
   77  the lawful scope of his or her duties as authorized by law,
   78  perform dental charting of hard and soft tissues in public and
   79  private educational institutions of the state and Federal
   80  Government, nursing homes, assisted living and long-term care
   81  facilities, community health centers, county health departments,
   82  mobile dental or health units, health access settings as defined
   83  in s. 466.003, and epidemiological surveys for public health. A
   84  dental hygienist may also perform dental charting on a volunteer
   85  basis at health fairs.
   86         Section 7. Section 466.024, Florida Statutes, is amended to
   87  read:
   88         466.024 Delegation of duties; expanded functions.—
   89         (1) A dentist may not delegate irremediable tasks to a
   90  dental hygienist or dental assistant, except as provided by law.
   91  A dentist may delegate remediable tasks to a dental hygienist or
   92  dental assistant when such tasks pose no risk to the patient. A
   93  dentist may only delegate remediable tasks so defined by law or
   94  rule of the board. The board by rule shall designate which tasks
   95  are remediable and delegable, except that the following are by
   96  law found to be remediable and delegable:
   97         (a) Taking impressions for study casts but not for the
   98  purpose of fabricating any intraoral restorations or orthodontic
   99  appliance.
  100         (b) Placing periodontal dressings.
  101         (c) Removing periodontal or surgical dressings.
  102         (d) Removing sutures.
  103         (e) Placing or removing rubber dams.
  104         (f) Placing or removing matrices.
  105         (g) Placing or removing temporary restorations.
  106         (h) Applying cavity liners, varnishes, or bases.
  107         (i) Polishing amalgam restorations.
  108         (j) Polishing clinical crowns of the teeth for the purpose
  109  of removing stains but not changing the existing contour of the
  110  tooth.
  111         (k) Obtaining bacteriological cytological specimens not
  112  involving cutting of the tissue.
  113  
  114  Nothing in This subsection does not shall be construed to limit
  115  delegable tasks to those specified herein.
  116         (2) A dental hygienist licensed in this state may perform
  117  the following remediable tasks in a health access setting as
  118  defined in s. 466.003 without the physical presence, prior
  119  examination, or authorization of a dentist:
  120         (a) Perform dental charting as defined in s. 466.0235 and
  121  as provided by rule.
  122         (b) Measure and record a patient’s blood pressure rate,
  123  pulse rate, respiration rate, and oral temperature.
  124         (c) Record a patient’s case history.
  125         (d) Apply topical fluorides, including fluoride varnishes,
  126  which are approved by the American Dental Association or the
  127  Food and Drug Administration.
  128         (e) Apply dental sealants.
  129         (f) Remove calculus deposits, accretions, and stains from
  130  exposed surfaces of the teeth and from tooth surfaces within the
  131  gingival sulcus.
  132         1. A dentist licensed under this chapter or a physician
  133  licensed under chapter 458 or chapter 459 must give medical
  134  clearance before a dental hygienist removes calculus deposits,
  135  accretions, and stains from exposed surfaces of the teeth or
  136  from tooth surfaces within the gingival sulcus.
  137         2. A dentist shall conduct a dental examination on a
  138  patient within 13 months after a dental hygienist removes the
  139  patient’s calculus deposits, accretions, and stains from exposed
  140  surfaces of the teeth or from tooth surfaces within the gingival
  141  sulcus. Additional oral hygiene services may not be performed
  142  under this paragraph without a clinical examination by a dentist
  143  who is licensed under this chapter.
  144  
  145  This subsection does not authorize a dental hygienist to perform
  146  root planing or gingival curettage without supervision by a
  147  dentist.
  148         (3) For all remediable tasks listed in subsection (2), the
  149  following disclaimer must be provided to the patient in writing
  150  before any procedure is performed:
  151         (a) The services being offered are not a substitute for a
  152  comprehensive dental exam by a dentist.
  153         (b) The diagnosis of caries, soft tissue disease, oral
  154  cancer, temporomandibular joint disease (TMJ), and dentofacial
  155  malocclusions will be completed only by a dentist in the context
  156  of delivering a comprehensive dental exam.
  157         (4) This section does not prevent a program operated by one
  158  of the health access settings as defined in s. 466.003 or a
  159  nonprofit organization that is exempt from federal income
  160  taxation under s. 501(a) of the Internal Revenue Code and
  161  described in s. 501(c)(3) of the Internal Revenue Code from
  162  billing and obtaining reimbursement for the services described
  163  in this section which are provided by a dental hygienist or from
  164  making or maintaining any records pursuant to s. 456.057
  165  necessary to obtain reimbursement.
  166         (5) A dental hygienist who performs, without supervision,
  167  the remediable tasks listed in subsection (2) shall:
  168         (a) Provide a dental referral in strict compliance with
  169  federal and state patient referral, anti-kickback, and patient
  170  brokering laws.
  171         (b) Encourage the establishment of a dental home.
  172         (c) Maintain professional malpractice insurance coverage
  173  that has minimum limits of $100,000 per occurrence and $300,000
  174  in the aggregate through the employing health access setting or
  175  individual policy.
  176         (6)(2) Notwithstanding subsection (1) or subsection (2), a
  177  dentist may delegate the tasks of gingival curettage and root
  178  planing to a dental hygienist but not to a dental assistant.
  179         (7)(3) All other remediable tasks shall be performed under
  180  the direct, indirect, or general supervision of a dentist, as
  181  determined by rule of the board, and after such formal or on
  182  the-job training by the dental hygienist or dental assistant as
  183  the board by rule may require. The board by rule may establish a
  184  certification process for expanded-duty dental assistants,
  185  establishing such training or experience criteria or
  186  examinations as it deems necessary and specifying which tasks
  187  may be delegable only to such assistants. If the board does
  188  establish such a certification process, the department shall
  189  implement the application process for such certification and
  190  administer any examinations required.
  191         (8)(4) Notwithstanding subsection (1) or subsection (2), a
  192  dentist may not delegate to anyone other than another licensed
  193  dentist:
  194         (a) Any prescription of drugs or medications requiring the
  195  written order or prescription of a licensed dentist or
  196  physician.
  197         (b) Any diagnosis for treatment or treatment planning.
  198         (9)(5) Notwithstanding any other provision of law, a
  199  dentist is primarily responsible for all procedures delegated by
  200  her or him.
  201         (10)(6)A No dental assistant may not shall perform an
  202  intraoral procedure except after such formal or on-the-job
  203  training as the board by rule shall prescribe.
  204         Section 8. For the purpose of incorporating the amendment
  205  made by this act to section 466.003, Florida Statutes, in a
  206  reference thereto, subsection (2) of section 466.00672, Florida
  207  Statutes, is reenacted to read:
  208         466.00672 Revocation of health access dental license.—
  209         (2) Failure of an individual licensed pursuant to s.
  210  466.0067 to limit the practice of dentistry to health access
  211  settings as defined in s. 466.003 constitutes the unlicensed
  212  practice of dentistry.
  213         Section 9. Effective October 1, 2011, section 466.006,
  214  Florida Statutes, is amended to read:
  215         466.006 Examination of dentists.—
  216         (1)(a) It is the intent of the Legislature to reduce the
  217  costs associated with an independent state-developed practical
  218  or clinical examination to measure an applicant’s ability to
  219  practice the profession of dentistry and to use the American
  220  Dental Licensing Examination developed by the American Board of
  221  Dental Examiners, Inc., in lieu of an independent state
  222  developed practical or clinical examination. The Legislature
  223  finds that the American Dental Licensing Examination, in both
  224  its structure and function, consistently meets generally
  225  accepted testing standards and has been found, as it is
  226  currently organized and operating, to adequately and reliably
  227  measure an applicant’s ability to practice the profession of
  228  dentistry.
  229         (b) Any person desiring to be licensed as a dentist shall
  230  apply to the department to take the licensure examinations and
  231  shall verify the information required on the application by
  232  oath. The application shall include two recent photographs.
  233  There shall be an application fee set by the board not to exceed
  234  $100 which shall be nonrefundable. There shall also be an
  235  examination fee set by the board, which shall not exceed $425
  236  plus the actual per applicant cost to the department for
  237  purchase of some or all portions of the examination from the
  238  American Board of Dental Examiners or its successor entity, if
  239  any, provided the board finds the successor entity’s clinical
  240  examination complies with the provisions of this section. The
  241  examination fee Northeast Regional Board of Dental Examiners or
  242  a similar national organization, which may be refundable if the
  243  applicant is found ineligible to take the examinations.
  244         (2) An applicant shall be entitled to take the examinations
  245  required in this section to practice dentistry in this state if
  246  the applicant:
  247         (a) Is 18 years of age or older.
  248         (b)1. Is a graduate of a dental school accredited by the
  249  American Dental Association Commission on Dental Accreditation
  250  Commission on Accreditation of the American Dental Association
  251  or its successor entity agency, if any, or any other dental
  252  nationally recognized accrediting entity recognized by the
  253  United States Department of Education agency; or
  254         2. Is a dental student in the final year of a program at
  255  such an accredited dental school who has completed all the
  256  coursework necessary to prepare the student to perform the
  257  clinical and diagnostic procedures required to pass the
  258  examinations. With respect to a dental student in the final year
  259  of a program at a dental school, a passing score on the
  260  examinations is valid for 365 180 days after the date the
  261  examinations were completed. A dental school student who takes
  262  the licensure examinations during the student’s final year of an
  263  approved dental school must have graduated before being
  264  certified for licensure pursuant to s. 466.011.
  265         (c)1. Has successfully completed the National Board of
  266  Dental Examiners dental examination within 10 years of the date
  267  of application; or
  268         2. Has an active health access dental license in this
  269  state; and
  270         a. The applicant has at least 5,000 hours within 4
  271  consecutive years of clinical practice experience providing
  272  direct patient care in a health access setting as defined in s.
  273  466.003 s. 466.003(14); the applicant is a retired veteran
  274  dentist of any branch of the United States Armed Services who
  275  has practiced dentistry while on active duty and has at least
  276  3,000 hours within 3 consecutive years of clinical practice
  277  experience providing direct patient care in a health access
  278  setting as defined in s. 466.003 s. 466.003(14); or the
  279  applicant has provided a portion of his or her salaried time
  280  teaching health profession students in any public education
  281  setting, including, but not limited to, a community college,
  282  college, or university, and has at least 3,000 hours within 3
  283  consecutive years of clinical practice experience providing
  284  direct patient care in a health access setting as defined in s.
  285  466.003 s. 466.003(14);
  286         b. The applicant has not been disciplined by the board,
  287  except for citation offenses or minor violations;
  288         c. The applicant has not filed a report pursuant to s.
  289  456.049; and
  290         d. The applicant has not been convicted of or pled nolo
  291  contendere to, regardless of adjudication, any felony or
  292  misdemeanor related to the practice of a health care profession.
  293         (3) If an applicant is a graduate of a dental college or
  294  school not accredited in accordance with paragraph (2)(b) or of
  295  a dental college or school not approved by the board, the
  296  applicant shall not be entitled to take the examinations
  297  required in this section to practice dentistry until she or he
  298  satisfies one of the following:
  299         (a) Completes a program of study, as defined by the board
  300  by rule, at an accredited American dental school and
  301  demonstrates receipt of a D.D.S. or D.M.D. from said school; or
  302         (b) Completes a 2-year supplemental dental education
  303  program at an accredited dental school and receives a dental
  304  diploma, degree, or certificate as evidence of program
  305  completion.
  306         (4) Notwithstanding any other provision of law in chapter
  307  456 pertaining to the clinical dental licensure examination or
  308  national examinations s. 456.017(1)(c), to be licensed as a
  309  dentist in this state, an applicant must successfully complete
  310  the following:
  311         (a) A written examination on the laws and rules of the
  312  state regulating the practice of dentistry;
  313         (b)1. A practical or clinical examination, which shall be
  314  the American Dental Licensing Examination produced by the
  315  American Board of Dental Examiners, Inc., or its successor
  316  entity, if any, which is administered in this state and graded
  317  by dentists licensed in this state and employed by the
  318  department for just such purpose, provided that the board has
  319  attained, and continues to maintain thereafter, representation
  320  on the board of directors of the American Board of Dental
  321  Examiners, the examination development committee of the American
  322  Board of Dental Examiners, and such other committees of the
  323  American Board of Dental Examiners as the board deems
  324  appropriate by rule to ensure that the standards established
  325  herein are maintained organizationally. A passing score on the
  326  American Dental Licensing Examination administered in this state
  327  and graded by dentists who are licensed in this state is valid
  328  for 365 days after the date the official examination results are
  329  published.
  330         2.a. As an alternative to the requirements of subparagraph
  331  1., an applicant may submit scores from an American Dental
  332  Licensing Examination previously administered in a jurisdiction
  333  other than this state after October 1, 2011, and such
  334  examination results shall be recognized as valid for the purpose
  335  of licensure in this state. A passing score on the American
  336  Dental Licensing Examination administered out of state shall be
  337  the same as the passing score for the American Dental Licensing
  338  Examination administered in this state and graded by dentists
  339  who are licensed in this state. The examination results are
  340  valid for 365 days after the date the official examination
  341  results are published. The applicant must have completed the
  342  examination after October 1, 2011.
  343         b. This subparagraph may not be given retroactive
  344  application.
  345         3. If the date of an applicant’s passing American Dental
  346  Licensing Examination scores from an examination previously
  347  administered in a jurisdiction other than this state under
  348  subparagraph 2. is older than 365 days, such scores shall
  349  nevertheless be recognized as valid for the purpose of licensure
  350  in this state, but only if the applicant demonstrates that all
  351  of the following additional standards have been met:
  352         a.(I) The applicant completed the American Dental Licensing
  353  Examination after October 1, 2011;
  354         (II) This sub-subparagraph may not be given retroactive
  355  application;
  356         b. The applicant graduated from a dental school accredited
  357  by the American Dental Association Commission on Dental
  358  Accreditation or its successor entity, if any, or any other
  359  dental accrediting organization recognized by the United States
  360  Department of Education. Provided however, if the applicant did
  361  not graduate from such a dental school, the applicant may submit
  362  proof of having successfully completed a full-time supplemental
  363  general dentistry program accredited by the American Dental
  364  Association Commission on Dental Accreditation of at least 2
  365  consecutive academic years at such accredited sponsoring
  366  institution. Such program must provide didactic and clinical
  367  education at the level of a D.D.S. or D.M.D. program accredited
  368  by the American Dental Association Commission on Dental
  369  Accreditation;
  370         c. The applicant currently possesses a valid and active
  371  dental license in good standing, with no restriction, which has
  372  never been revoked, suspended, restricted, or otherwise
  373  disciplined, from another state or territory of the United
  374  States, the District of Columbia, or the Commonwealth of Puerto
  375  Rico;
  376         d. The applicant submits proof that he or she has never
  377  been reported to the National Practitioner Data Bank, the
  378  Healthcare Integrity and Protection Data Bank, or the American
  379  Association of Dental Boards Clearinghouse. This sub
  380  subparagraph does not apply if the applicant successfully
  381  appealed to have his or her name removed from the data banks of
  382  these agencies;
  383         e.(I) In the 5 years immediately preceding the date of
  384  application for licensure in this state, the applicant submits
  385  proof of having been consecutively engaged in the full-time
  386  practice of dentistry in another state or territory of the
  387  United States, the District of Columbia, or the Commonwealth of
  388  Puerto Rico, or, if the applicant has been licensed in another
  389  state or territory of the United States, the District of
  390  Columbia, or the Commonwealth of Puerto Rico for less than 5
  391  years, the applicant submits proof of having been engaged in the
  392  full-time practice of dentistry since the date of his or her
  393  initial licensure.
  394         (II) As used in this section, “full-time practice” is
  395  defined as a minimum of 1,200 hours per year for each and every
  396  year in the consecutive 5-year period or, where applicable, the
  397  period since initial licensure, and must include any combination
  398  of the following:
  399         (A) Active clinical practice of dentistry providing direct
  400  patient care.
  401         (B) Full-time practice as a faculty member employed by a
  402  dental or dental hygiene school approved by the board or
  403  accredited by the American Dental Association Commission on
  404  Dental Accreditation.
  405         (C) Full-time practice as a student at a postgraduate
  406  dental education program approved by the board or accredited by
  407  the American Dental Association Commission on Dental
  408  Accreditation.
  409         (III) The board shall develop rules to determine what type
  410  of proof of full-time practice is required and to recoup the
  411  cost to the board of verifying full-time practice under this
  412  section. Such proof must, at a minimum, be:
  413         (A) Admissible as evidence in an administrative proceeding;
  414         (B) Submitted in writing;
  415         (C) Submitted by the applicant under oath with penalties of
  416  perjury attached;
  417         (D) Further documented by an affidavit of someone unrelated
  418  to the applicant who is familiar with the applicant’s practice
  419  and testifies with particularity that the applicant has been
  420  engaged in full-time practice; and
  421         (E) Specifically found by the board to be both credible and
  422  admissible.
  423         (IV) An affidavit of only the applicant is not acceptable
  424  proof of full-time practice unless it is further attested to by
  425  someone unrelated to the applicant who has personal knowledge of
  426  the applicant’s practice. If the board deems it necessary to
  427  assess credibility or accuracy, the board may require the
  428  applicant or the applicant’s witnesses to appear before the
  429  board and give oral testimony under oath;
  430         f. The applicant submits documentation that he or she has
  431  completed, or will complete, prior to licensure in this state,
  432  continuing education equivalent to this state’s requirements for
  433  the last full reporting biennium;
  434         g. The applicant submits proof that he or she has never
  435  been convicted of, or pled nolo contendere to, regardless of
  436  adjudication, any felony or misdemeanor related to the practice
  437  of a health care profession in any jurisdiction;
  438         h. The applicant has successfully passed a written
  439  examination on the laws and rules of this state regulating the
  440  practice of dentistry and has successfully passed the computer
  441  based diagnostic skills examination; and
  442         i. The applicant submits documentation that he or she has
  443  successfully completed the National Board of Dental Examiners
  444  dental examination.
  445         (5)(a) The practical examination required under subsection
  446  (4) shall be the American Dental Licensing Examination developed
  447  by the American Board of Dental Examiners, Inc., or its
  448  successor entity, if any, provided the board finds that the
  449  successor entity’s clinical examination complies with the
  450  provisions of this section, and shall include, at a minimum:
  451         1. A comprehensive diagnostic skills examination covering
  452  the full scope of dentistry and an examination on applied
  453  clinical diagnosis and treatment planning in dentistry for
  454  dental candidates.
  455         2.a. Two restorations on a live patient or patients., and
  456  The board by rule shall determine the class of such restorations
  457  and whether they shall be performed on mannequins, live
  458  patients, or both. At least one restoration shall be on a live
  459  patient;
  460         3.b. A demonstration of periodontal skills on a live
  461  patient;
  462         4.c. A demonstration of prosthetics and restorative skills
  463  in complete and partial dentures and crowns and bridges and the
  464  utilization of practical methods of evaluation, specifically
  465  including the evaluation by the candidate of completed
  466  laboratory products such as, but not limited to, crowns and
  467  inlays filled to prepared model teeth;
  468         5.d. A demonstration of restorative skills on a mannequin
  469  which requires the candidate to complete procedures performed in
  470  preparation for a cast restoration; and
  471         6.e. A demonstration of endodontic skills; and.
  472         7. A diagnostic skills examination demonstrating ability to
  473  diagnose conditions within the human oral cavity and its
  474  adjacent tissues and structures from photographs, slides,
  475  radiographs, or models pursuant to rules of the board. If an
  476  applicant fails to pass the diagnostic skills examination in
  477  three attempts, the applicant is not eligible for reexamination
  478  unless she or he completes additional educational requirements
  479  established by the board.
  480         (b)2. The department shall consult with the board in
  481  planning the times, places, physical facilities, training of
  482  personnel, and other arrangements concerning the administration
  483  of the examination. The board or a duly designated committee
  484  thereof shall approve the final plans for the administration of
  485  the examination.
  486         (c)3. If the applicant fails to pass the clinical
  487  examination in three attempts, the applicant shall not be
  488  eligible for reexamination unless she or he completes additional
  489  educational requirements established by the board.; and
  490         (c) A diagnostic skills examination demonstrating ability
  491  to diagnose conditions within the human oral cavity and its
  492  adjacent tissues and structures from photographs, slides,
  493  radiographs, or models pursuant to rules of the board. If an
  494  applicant fails to pass the diagnostic skills examination in
  495  three attempts, the applicant shall not be eligible for
  496  reexamination unless she or he completes additional educational
  497  requirements established by the board.
  498         (d) The board may by rule provide for additional procedures
  499  which are to be tested, provided such procedures shall be common
  500  to the practice of general dentistry. The board by rule shall
  501  determine the passing grade for each procedure and the
  502  acceptable variation for examiners. No such rule shall apply
  503  retroactively.
  504  
  505  The department shall require a mandatory standardization
  506  exercise for all examiners prior to each practical or clinical
  507  examination and shall retain for employment only those dentists
  508  who have substantially adhered to the standard of grading
  509  established at such exercise.
  510         (6)(a) It is the finding of the Legislature that absent a
  511  threat to the health, safety, and welfare of the public, the
  512  relocation of applicants to practice dentistry within the
  513  geographic boundaries of this state who are lawfully and
  514  currently practicing dentistry in another state or territory of
  515  the United States, the District of Columbia, or the Commonwealth
  516  of Puerto Rico, based on their scores from the American Dental
  517  Licensing Examination administered in a state other than this
  518  state, is substantially related to achieving the important state
  519  interest of improving access to dental care for underserved
  520  citizens of this state and furthering the economic development
  521  goals of the state. Therefore, in order to maintain valid active
  522  licensure in this state, all applicants for licensure who are
  523  relocating to this state based on scores from the American
  524  Dental Licensing Examination administered in a state other than
  525  this state must actually engage in the full-time practice of
  526  dentistry inside the geographic boundaries of this state within
  527  1 year after receiving such licensure in this state. The
  528  Legislature finds that, if such applicants do not actually
  529  engage in the full-time practice of dentistry within the
  530  geographic boundaries of this state within 1 year after
  531  receiving such a license in this state, access to dental care
  532  for the public will not significantly increase, patients’
  533  continuity of care will not be attained, and the economic
  534  development goals of the state will not be significantly met.
  535         (b)1. As used in this section, the term “full-time practice
  536  of dentistry within the geographic boundaries of this state
  537  within 1 year” is defined as a minimum of 1,200 hours in the
  538  initial year of licensure, which must include any combination of
  539  the following:
  540         a. Active clinical practice of dentistry providing direct
  541  patient care within the geographic boundaries of this state.
  542         b. Full-time practice as a faculty member employed by a
  543  dental or dental hygiene school approved by the board or
  544  accredited by the American Dental Association Commission on
  545  Dental Accreditation and located within the geographic
  546  boundaries of this state.
  547         c. Full-time practice as a student at a postgraduate dental
  548  education program approved by the board or accredited by the
  549  American Dental Association Commission on Dental Accreditation
  550  and located within the geographic boundaries of this state.
  551         2. The board shall develop rules to determine what type of
  552  proof of full-time practice of dentistry within the geographic
  553  boundaries of this state for 1 year is required in order to
  554  maintain active licensure and shall develop rules to recoup the
  555  cost to the board of verifying maintenance of such full-time
  556  practice under this section. Such proof must, at a minimum:
  557         a. Be admissible as evidence in an administrative
  558  proceeding;
  559         b. Be submitted in writing;
  560         c. Be submitted by the applicant under oath with penalties
  561  of perjury attached;
  562         d. Be further documented by an affidavit of someone
  563  unrelated to the applicant who is familiar with the applicant’s
  564  practice and testifies with particularity that the applicant has
  565  been engaged in full-time practice of dentistry within the
  566  geographic boundaries of this state within the last 365 days;
  567  and
  568         e. Include such additional proof as specifically found by
  569  the board to be both credible and admissible.
  570         3. An affidavit of only the applicant is not acceptable
  571  proof of full-time practice of dentistry within the geographic
  572  boundaries of this state within 1 year, unless it is further
  573  attested to by someone unrelated to the applicant who has
  574  personal knowledge of the applicant’s practice within the last
  575  365 days. If the board deems it necessary to assess credibility
  576  or accuracy, the board may require the applicant or the
  577  applicant’s witnesses to appear before the board and give oral
  578  testimony under oath.
  579         (c) It is the further intent of the Legislature that a
  580  license issued pursuant to paragraph (a) shall expire in the
  581  event the board finds that it did not receive acceptable proof
  582  of full-time practice within the geographic boundaries of this
  583  state within 1 year after the initial issuance of the license.
  584  The board shall make reasonable attempts within 30 days prior to
  585  the expiration of such a license to notify the licensee in
  586  writing at his or her last known address of the need for proof
  587  of full-time practice in order to continue licensure. If the
  588  board has not received a satisfactory response from the licensee
  589  within the 30-day period, the licensee must be served with
  590  actual or constructive notice of the pending expiration of
  591  licensure and be given 20 days in which to submit proof required
  592  in order to continue licensure. If the 20-day period expires and
  593  the board finds it has not received acceptable proof of full
  594  time practice within the geographic boundaries of this state
  595  within 1 year after the initial issuance of the license, the
  596  board must issue an administrative order finding that the
  597  license has expired. Such an order may be appealed by the former
  598  licensee in accordance with the provisions of chapter 120. In
  599  the event of expiration, the licensee shall immediately cease
  600  and desist from practicing dentistry and shall immediately
  601  surrender to the board the wallet-size identification card and
  602  wall card. A person who uses or attempts to use a license issued
  603  pursuant to this section which has expired commits unlicensed
  604  practice of dentistry, a felony of the third degree pursuant to
  605  s. 466.026(1)(b), punishable as provided in s. 775.082, s.
  606  775.083, or s. 775.084.
  607         Section 10. Effective October 1, 2011, section 466.0067,
  608  Florida Statutes, is amended, and, for the purpose of
  609  incorporating the amendment made by this act to section 466.006,
  610  Florida Statutes, in references thereto, subsections (2), (5),
  611  (9), and (12) of that section are reenacted, to read:
  612         466.0067 Application for health access dental license.—The
  613  Legislature finds that there is an important state interest in
  614  attracting dentists to practice in underserved health access
  615  settings in this state and further, that allowing out-of-state
  616  dentists who meet certain criteria to practice in health access
  617  settings without the supervision of a dentist licensed in this
  618  state is substantially related to achieving this important state
  619  interest. Therefore, notwithstanding the requirements of s.
  620  466.006, the board shall grant a health access dental license to
  621  practice dentistry in this state in health access settings as
  622  defined in s. 466.003 s. 466.003(14) to an applicant that:
  623         (1) Files an appropriate application approved by the board;
  624         (2) Pays an application license fee for a health access
  625  dental license, laws-and-rule exam fee, and an initial licensure
  626  fee. The fees specified in this subsection may not differ from
  627  an applicant seeking licensure pursuant to s. 466.006;
  628         (3) Has not been convicted of or pled nolo contendere to,
  629  regardless of adjudication, any felony or misdemeanor related to
  630  the practice of a health care profession;
  631         (4) Submits proof of graduation from a dental school
  632  accredited by the Commission on Dental Accreditation of the
  633  American Dental Association or its successor agency;
  634         (5) Submits documentation that she or he has completed, or
  635  will obtain prior to licensure, continuing education equivalent
  636  to this state’s requirement for dentists licensed under s.
  637  466.006 for the last full reporting biennium before applying for
  638  a health access dental license;
  639         (6) Submits proof of her or his successful completion of
  640  parts I and II of the dental examination by the National Board
  641  of Dental Examiners and a state or regional clinical dental
  642  licensing examination that the board has determined effectively
  643  measures the applicant’s ability to practice safely;
  644         (7) Currently holds a valid, active, dental license in good
  645  standing which has not been revoked, suspended, restricted, or
  646  otherwise disciplined from another of the United States, the
  647  District of Columbia, or a United States territory;
  648         (8) Has never had a license revoked from another of the
  649  United States, the District of Columbia, or a United States
  650  territory;
  651         (9) Has never failed the examination specified in s.
  652  466.006, unless the applicant was reexamined pursuant to s.
  653  466.006 and received a license to practice dentistry in this
  654  state;
  655         (10) Has not been reported to the National Practitioner
  656  Data Bank, unless the applicant successfully appealed to have
  657  his or her name removed from the data bank;
  658         (11) Submits proof that he or she has been engaged in the
  659  active, clinical practice of dentistry providing direct patient
  660  care for 5 years immediately preceding the date of application,
  661  or in instances when the applicant has graduated from an
  662  accredited dental school within the preceding 5 years, submits
  663  proof of continuous clinical practice providing direct patient
  664  care since graduation; and
  665         (12) Has passed an examination covering the laws and rules
  666  of the practice of dentistry in this state as described in s.
  667  466.006(4)(a).
  668         Section 11. Effective October 1, 2011, for the purpose of
  669  incorporating the amendment made by this act to section 466.006,
  670  Florida Statutes, in a reference thereto, subsection (1) of
  671  section 466.0065, Florida Statutes, is reenacted to read:
  672         466.0065 Regional licensure examinations.—
  673         (1) It is the intent of the Legislature that schools of
  674  dentistry be allowed to offer regional licensure examinations to
  675  dental students who are in the final year of a program at an
  676  approved dental school for the sole purpose of facilitating the
  677  student’s licensing in other jurisdictions. This section does
  678  not allow a person to be licensed as a dentist in this state
  679  without taking the examinations as set forth in s. 466.006, nor
  680  does this section mean that regional examinations administered
  681  under this section may be substituted for complying with testing
  682  requirements under s. 466.006.
  683         Section 12. Effective October 1, 2011, for the purpose of
  684  incorporating the amendment made by this act to section 466.006,
  685  Florida Statutes, in a reference thereto, paragraph (d) of
  686  subsection (1) of section 466.00671, Florida Statutes, is
  687  reenacted to read:
  688         466.00671 Renewal of the health access dental license.—
  689         (1) A health access dental licensee shall apply for renewal
  690  each biennium. At the time of renewal, the licensee shall sign a
  691  statement that she or he has complied with all continuing
  692  education requirements of an active dentist licensee. The board
  693  shall renew a health access dental license for an applicant
  694  that:
  695         (d) Has not failed the examination specified in s. 466.006
  696  since initially receiving a health access dental license or
  697  since the last renewal; and
  698         Section 13. Effective October 1, 2011, for the purpose of
  699  incorporating the amendment made by this act to section 466.006,
  700  Florida Statutes, in references thereto, paragraph (b) of
  701  subsection (2) and subsection (3) of section 466.007, Florida
  702  Statutes, are reenacted to read:
  703         466.007 Examination of dental hygienists.—
  704         (2) An applicant shall be entitled to take the examinations
  705  required in this section to practice dental hygiene in this
  706  state if the applicant:
  707         (b)1. Is a graduate of a dental hygiene college or school
  708  approved by the board or accredited by the Commission on
  709  Accreditation of the American Dental Association or its
  710  successor agency; or
  711         2. Is a graduate of a dental college or school accredited
  712  in accordance with s. 466.006(2)(b), or a graduate of an
  713  unaccredited dental college or school, and has met the
  714  requirements of subsection (3).
  715         (3) A graduate of a dental college or school shall be
  716  entitled to take the examinations required in this section to
  717  practice dental hygiene in this state if, in addition to the
  718  requirements specified in subsection (2), the graduate meets the
  719  following requirements:
  720         (a) Submits the following credentials for review by the
  721  board:
  722         1. Transcripts totaling 4 academic years of postsecondary
  723  dental education; and
  724         2. A dental school diploma which is comparable to a D.D.S.
  725  or D.M.D.
  726  
  727  Such credentials shall be submitted in a manner provided by rule
  728  of the board. The board shall approve those credentials which
  729  comply with this paragraph and with rules of the board adopted
  730  pursuant to this paragraph. The provisions of this paragraph
  731  notwithstanding, an applicant of a foreign dental college or
  732  school not accredited in accordance with s. 466.006(2)(b) who
  733  cannot produce the credentials required by this paragraph, as a
  734  result of political or other conditions in the country in which
  735  the applicant received his or her education, may seek the
  736  board’s approval of his or her educational background by
  737  submitting, in lieu of the credentials required in this
  738  paragraph, such other reasonable and reliable evidence as may be
  739  set forth by board rule. The board shall not accept such other
  740  evidence until it has made a reasonable attempt to obtain the
  741  credentials required by this paragraph from the educational
  742  institutions the applicant is alleged to have attended, unless
  743  the board is otherwise satisfied that such credentials cannot be
  744  obtained.
  745         (b) Successfully completes one or more courses, of a scope
  746  and duration approved and defined by board rule, that meet the
  747  requirements of law for instructing health care providers on the
  748  human immunodeficiency virus and acquired immune deficiency
  749  syndrome. In addition, the board may require an applicant who
  750  graduated from a nonaccredited dental college or school to
  751  successfully complete additional coursework, only after failing
  752  the initial examination, as defined by board rule, at an
  753  educational institution approved by the board or accredited as
  754  provided in subparagraph (2)(b)1. A graduate of a foreign dental
  755  college or school not accredited in accordance with s.
  756  466.006(2)(b) may not take the coursework set forth in this
  757  paragraph until the board has approved the credentials required
  758  by paragraph (a).
  759         Section 14. Effective October 1, 2011, for the purpose of
  760  incorporating the amendment made by this act to section 466.006,
  761  Florida Statutes, in a reference thereto, subsection (1) of
  762  section 466.009, Florida Statutes, is reenacted to read:
  763         466.009 Reexamination.—
  764         (1) The department shall permit any person who fails an
  765  examination which is required under s. 466.006 or s. 466.007 to
  766  retake the examination. If the examination to be retaken is a
  767  practical or clinical examination, the applicant shall pay a
  768  reexamination fee set by rule of the board in an amount not to
  769  exceed the original examination fee.
  770         Section 15. Effective October 1, 2011, for the purpose of
  771  incorporating the amendment made by this act to section 466.006,
  772  Florida Statutes, in a reference thereto, section 466.011,
  773  Florida Statutes, is reenacted to read:
  774         466.011 Licensure.—The board shall certify for licensure by
  775  the department any applicant who satisfies the requirements of
  776  s. 466.006, s. 466.0067, or s. 466.007. The board may refuse to
  777  certify an applicant who has violated any of the provisions of
  778  s. 466.026 or s. 466.028.
  779         Section 16. Subsections (7), (8), and (9) of section
  780  468.701, Florida Statutes, are renumbered as subsections (8),
  781  (9), and (10), respectively, and a new subsection (7) is added
  782  to that section, to read:
  783         468.701 Definitions.—As used in this part, the term:
  784         (7) “Board of Certification” means the nationally
  785  accredited certifying body for athletic trainers or its
  786  successor agency.
  787         Section 17. Subsection (2) of section 468.703, Florida
  788  Statutes, is amended to read:
  789         468.703 Board of Athletic Training.—
  790         (2) Five members of the board must be licensed athletic
  791  trainers, certified by the Board of Certification. One member of
  792  the board must be a physician licensed under chapter 458 or
  793  chapter 459. One member of the board must be a physician
  794  licensed under chapter 460. Two members of the board shall be
  795  consumer members, each of whom must be a resident of this state
  796  who has never worked as an athletic trainer, who has no
  797  financial interest in the practice of athletic training, and who
  798  has never been a licensed health care practitioner as defined in
  799  s. 456.001(4).
  800         Section 18. Section 468.707, Florida Statutes, is amended
  801  to read:
  802         468.707 Licensure by examination; requirements.—
  803         (1) Any person desiring to be licensed as an athletic
  804  trainer shall apply to the department on a form approved by the
  805  department. The department shall license each applicant who:
  806         (1)(a) Has completed the application form and remitted the
  807  required fees.
  808         (2)(b) Is at least 21 years of age.
  809         (3)(c) Has obtained a baccalaureate degree from a college
  810  or university accredited by an accrediting agency recognized and
  811  approved by the United States Department of Education or the
  812  Commission on Recognition of Postsecondary Accreditation, or
  813  approved by the board, or recognized by the Board of
  814  Certification.
  815         (4)(d)If graduated after 2004, has completed an approved
  816  athletic training curriculum from a college or university
  817  accredited by a program recognized by the Board of Certification
  818  an accrediting agency recognized and approved by the United
  819  States Department of Education or the Commission on Recognition
  820  of Postsecondary Accreditation, or approved by the board.
  821         (5)(e) Has current certification in cardiovascular
  822  pulmonary resuscitation with an automated external defibrillator
  823  from the American Red Cross or, the American Heart Association,
  824  or an equivalent certification as determined by the board.
  825         (6)(f) Has passed the an examination and is certified by
  826  the Board of Certification administered or approved by the
  827  board.
  828         (2) Pursuant to the requirements of s. 456.034, each
  829  applicant shall complete a continuing education course on human
  830  immunodeficiency virus and acquired immune deficiency syndrome
  831  as part of initial licensure.
  832         Section 19. Section 468.711, Florida Statutes, is amended
  833  to read:
  834         468.711 Renewal of license; continuing education.—
  835         (1) The department shall renew a license upon receipt of
  836  the renewal application and fee, provided the applicant is in
  837  compliance with the provisions of this section, chapter 456, and
  838  rules promulgated pursuant thereto.
  839         (2) The board may, by rule, prescribe continuing education
  840  requirements, not to exceed 24 hours biennially. The criteria
  841  for continuing education shall be approved by the board and must
  842  shall include a current certificate in cardiovascular pulmonary
  843  resuscitation with an automated external defibrillator from the
  844  American Red Cross or the American Heart Association or an
  845  equivalent training as determined by the board.
  846         (3) If initially licensed after January 1, 1998, the
  847  licensee must be currently certified by the Board of
  848  Certification or its successor agency Pursuant to the
  849  requirements of s. 456.034, each licensee shall complete a
  850  continuing education course on human immunodeficiency virus and
  851  acquired immune deficiency syndrome as part of biennial
  852  relicensure.
  853         Section 20. If any provision of this act or its application
  854  to any person or circumstance is held invalid by a court of
  855  competent jurisdiction, the invalidity does not affect other
  856  provisions or applications of the act which can be given effect
  857  without the invalid provision or application, and to this end
  858  the provisions of this act are severable.
  859         Section 21. Except as otherwise expressly provided in this
  860  act, this act shall take effect upon becoming a law, and shall
  861  not apply retroactively.
  862  
  863  ================= T I T L E  A M E N D M E N T ================
  864         And the title is amended as follows:
  865         Delete line 19
  866  and insert:
  867         Collins, Jr.; amending s. 466.003, F.S.; revising the
  868         definition of the term “health access setting” and
  869         defining the term “school-based prevention program”
  870         for purposes of provisions regulating the practice of
  871         dentistry; amending s. 466.023, F.S.; revising the
  872         scope and area of practice for dental hygienists;
  873         amending s. 466.0235, F.S.; revising the locations at
  874         which dental hygienists may perform dental charting;
  875         amending s. 466.024, F.S.; authorizing dental
  876         hygienists to perform certain duties without
  877         supervision or authorization by a dentist; providing
  878         exceptions; requiring that dental hygienists in a
  879         health access setting provide a certain disclaimer to
  880         patients before a procedure is performed; providing
  881         that a health access setting may bill for certain
  882         services; requiring that dental hygienists provide a
  883         referral, encourage the establishment of a dental
  884         home, and maintain insurance coverage in specified
  885         circumstances; reenacting s. 466.00672(2), F.S.,
  886         relating to the revocation of health access dental
  887         licenses, to incorporate the amendment made by the act
  888         to s. 466.003, F.S., in a reference thereto; amending
  889         s. 466.006, F.S.; providing legislative intent with
  890         respect to the use of the American Dental Licensing
  891         Examination developed by the American Board of Dental
  892         Examiners, Inc., in lieu of an independent state
  893         developed practical or clinical exam, to measure an
  894         applicant’s ability to practice the profession of
  895         dentistry; providing for examination fees and use
  896         thereof; revising criteria for applicants for
  897         licensure with respect to accreditation of dental
  898         schools and period of validity of examination scores;
  899         adopting the American Dental Licensure Exam as the
  900         clinical or practical licensure examination used for
  901         licensure as a dentist in this state if specified
  902         conditions are maintained; providing for the period of
  903         validity of examination scores; authorizing applicants
  904         to submit American Dental Licensing Examination scores
  905         from a jurisdiction outside the state; specifying the
  906         period of validity of such examination scores;
  907         providing that authority to submit such examination
  908         scores does not apply retroactively; providing that
  909         such examination scores outside the period of validity
  910         be recognized as valid upon demonstration that the
  911         applicant has met specified additional standards;
  912         designating the practical examination and specifying
  913         minimum standards therefor; requiring applicants for
  914         licensure using American Dental Licensing Examination
  915         scores from a state other than this state to engage in
  916         the full-time practice of dentistry inside the
  917         geographic boundaries of this state within 1 year
  918         after receiving such licensure in this state;
  919         providing legislative findings with respect thereto;
  920         providing a definition; providing legislative intent
  921         with respect to expiration of such licenses upon a
  922         finding that acceptable proof of full-time practice
  923         within the geographic boundaries of this state within
  924         1 year after the initial issuance of the license was
  925         not received by the board; providing procedures and
  926         requirements with respect to determination of
  927         compliance; providing procedures, requirements, and
  928         prohibitions in the event of expiration; providing a
  929         penalty for using or attempting to use a license that
  930         has expired; amending s. 466.0067, F.S.; correcting a
  931         cross-reference; reenacting ss. 466.0065(1),
  932         466.0067(2), (5), (9), and (12), 466.00671(1)(d),
  933         466.007(2)(b) and (3), 466.009(1), and 466.011, F.S.,
  934         relating to regional licensure examinations,
  935         application for health access dental license, renewal
  936         of the health access dental license, examination of
  937         dental hygienists, reexamination, and licensure,
  938         respectively, to incorporate the amendments made to s.
  939         466.006, F.S., in references thereto; amending s.
  940         468.701, F.S.; defining “Board of Certification”;
  941         amending s. 468.703, F.S.; revising qualifications for
  942         certain members of the Board of Athletic
  943         Training;amending s. 468.707, F.S.; revising
  944         requirements for licensure by the Department of Health
  945         as an athletic trainer; reorganizing provisions;
  946         amending s. 468.711, F.S.; revising provisions
  947         relating to renewal of license and continuing
  948         education requirements for athletic trainers;
  949         providing for severability; providing that the act
  950         does not apply retroactively; providing effective
  951         dates.