Florida Senate - 2012                          SENATOR AMENDMENT
       Bill No. SB 1040
       
       
       
       
       
       
                                Barcode 719830                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 1/AD/2R         .                                
             03/01/2012 11:38 AM       .                                
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       Senator Bogdanoff moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (3) of section 466.006, Florida
    6  Statutes, is amended to read:
    7         466.006 Examination of dentists.—
    8         (3) If an applicant is a graduate of a dental college or
    9  school not accredited in accordance with paragraph (2)(b) or of
   10  a dental college or school not approved by the board, the
   11  applicant is shall not be entitled to take the examinations
   12  required in this section to practice dentistry until she or he
   13  satisfies one of the following:
   14         (a) Completes a program of study, as defined by the board
   15  by rule, at an accredited American dental school and
   16  demonstrates receipt of a D.D.S. or D.M.D. from said school; or
   17         (b) Submits proof of having successfully completed at least
   18  2 consecutive academic years at a full-time supplemental general
   19  dentistry program accredited by the American Dental Association
   20  Commission on Dental Accreditation. This program must provide
   21  didactic and clinical education at the level of a D.D.S. or
   22  D.M.D. program accredited by the American Dental Association
   23  Commission on Dental Accreditation Completes a 2-year
   24  supplemental dental education program at an accredited dental
   25  school and receives a dental diploma, degree, or certificate as
   26  evidence of program completion.
   27         Section 2. Subsections (2) and (4) of section 466.007,
   28  Florida Statutes, are amended, and subsections (5) and (6) are
   29  added to that section, to read:
   30         466.007 Examination of dental hygienists.—
   31         (2) An applicant is shall be entitled to take the
   32  examinations required in this section to practice dental hygiene
   33  in this state if the applicant:
   34         (a) Is 18 years of age or older.
   35         (b)1. Is a graduate of a dental hygiene college or school
   36  approved by the board or accredited by the Commission on
   37  Accreditation of the American Dental Association or its
   38  successor entity, if any, or any other dental hygiene program
   39  accrediting entity recognized by the United States Department of
   40  Education agency; or
   41         2. Is a graduate of a dental college or school accredited
   42  in accordance with s. 466.006(2)(b), or a graduate of an
   43  unaccredited dental college or school, and has met the
   44  requirements of subsection (3).
   45         (c)1. In the case of a graduate of a dental hygiene college
   46  or school under subparagraph (2)(b)1.:
   47         a. Has successfully completed the National Board of Dental
   48  Hygiene examination at any time before the date of application
   49  within 10 years of the date of application;
   50         b. Has been certified by the American Dental Association
   51  Joint Commission on National Dental Examinations at any time
   52  before the date of application within 10 years of the date of
   53  application; and
   54         c. Effective January 1, 1997, has completed coursework that
   55  which is comparable to an associate in science degree;.
   56         d. Has not been disciplined by a board, except for citation
   57  offenses or minor violations; and
   58         e. Has not been convicted of or pled nolo contendere to,
   59  regardless of adjudication, any felony or misdemeanor related to
   60  the practice of a health care profession.
   61         2. In the case of a graduate of a dental college or school
   62  under subparagraph (2)(b)2., has successfully completed either
   63  the National Board of Dental Hygiene Examination or the National
   64  Board of Dental Examiners dental Examination, within 10 years of
   65  the date of application.
   66         (4) Effective July 1, 2012, to be licensed as a dental
   67  hygienist in this state, an applicant must successfully complete
   68  the following:
   69         (a) A written examination on the laws and rules of this
   70  state regulating the practice of dental hygiene.
   71         (b) A practical or clinical examination approved by the
   72  board. Effective July 1, 2012, and thereafter, the examination
   73  shall be the Dental Hygiene Examination produced by the American
   74  Board of Dental Examiners, Inc. (ADEX) or its successor entity,
   75  if any, if the board finds that the successor entity’s clinical
   76  examination meets or exceeds the provisions of this section. The
   77  board shall approve the ADEX Dental Hygiene Examination if the
   78  board has attained and continues to maintain representation on
   79  the ADEX House of Representatives, the ADEX Dental Hygiene
   80  Examination Development Committee, and such other ADEX Dental
   81  Hygiene committees as the board deems appropriate through
   82  rulemaking to ensure that the standards established in this
   83  section are maintained organizationally. The ADEX Dental Hygiene
   84  Examination or the examination produced by its successor entity
   85  is a comprehensive examination in which an applicant must
   86  demonstrate skills within the dental hygiene scope of practice
   87  on a live patient and any other components that the board deems
   88  necessary for the applicant to successfully demonstrate
   89  competency for purpose of licensure. The ADEX Dental Hygiene
   90  Examination or the examination by the successor entity
   91  administered in this state shall be graded by dentists and
   92  dental hygienists licensed in this state who are employed by the
   93  department for this purpose.
   94         (5) Effective July 1, 2012, an applicant who has completed
   95  the ADEX Dental Hygiene Examination in a jurisdiction other than
   96  this state and who has obtained a passing score may practice
   97  dental hygiene in this state if the applicant:
   98         (a) Has successfully completed the National Board Dental
   99  Hygiene Examination at any time before the date of application;
  100  and
  101         (b) Has been certified by the American Dental Association
  102  Joint Commission on National Dental Examinations at any time
  103  before the date of application, as specified by state law.
  104         (6)(a) A passing score on the ADEX Dental Hygiene
  105  Examination administered out of state shall be considered the
  106  same as a passing score for the ADEX Dental Hygiene Examination
  107  administered in this state and graded by licensed dentists and
  108  dental hygienists.
  109         (b) If an applicant fails to pass the ADEX Dental Hygiene
  110  Examination in three attempts, the applicant is not eligible to
  111  retake the examination unless the applicant completes additional
  112  education requirements as specified by the board. The practical
  113  or clinical examination shall test competency in areas to be
  114  established by rule of the board which shall include testing the
  115  ability to adequately perform a prophylaxis. On or after October
  116  1, 1986, every applicant who is otherwise qualified shall be
  117  eligible to take the examination a total of three times,
  118  notwithstanding the number of times the applicant has previously
  119  failed. If an applicant fails the examination three times, the
  120  applicant shall no longer be eligible to take the examination
  121  unless he or she obtains additional educational requirements
  122  established by the board. The department shall require a
  123  mandatory standardization exercise pursuant to s. 456.017(1)(b)
  124  for all examiners prior to each practical or clinical
  125  examination and shall retain for employment only those dentists
  126  and dental hygienists who have substantially adhered to the
  127  standard of grading established at such exercise. It is the
  128  intent of the Legislature that the examinations relate to those
  129  procedures which are actually performed by a dental hygienist in
  130  general practice.
  131         Section 3. Present subsection (4) of section 466.017,
  132  Florida Statutes, is amended, subsections (5) and (6) are
  133  renumbered as subsections (7) and (8), respectively, and new
  134  subsections (5) and (6) are added to that section, to read:
  135         466.017 Prescription of drugs; anesthesia.—
  136         (4) A dentist or dental hygienist who administers or
  137  employs the use of any form of anesthesia must possess a
  138  certification in either basic cardiopulmonary resuscitation for
  139  health professionals or advanced cardiac life support approved
  140  by the American Heart Association or the American Red Cross or
  141  an equivalent agency-sponsored course with recertification every
  142  2 years. Each dental office which uses any form of anesthesia
  143  must have immediately available and in good working order such
  144  resuscitative equipment, oxygen, and other resuscitative drugs
  145  as are specified by rule of the board in order to manage
  146  possible adverse reactions.
  147         (5) A dental hygienist under the direct supervision of a
  148  dentist may administer local anesthesia, including intraoral
  149  block anesthesia, soft tissue infiltration anesthesia, or both,
  150  to a nonsedated patient who is 18 years of age or older, if the
  151  following criteria are met:
  152         (a) The dental hygienist has successfully completed a
  153  course in the administration of local anesthesia which is
  154  offered by a dental or dental hygiene program accredited by the
  155  Commission on Dental Accreditation of the American Dental
  156  Association or approved by the board. The course must include a
  157  minimum of 30 hours of didactic instruction and 30 hours of
  158  clinical experience, and instruction in:
  159         1. Theory of pain control.
  160         2. Selection-of-pain-control modalities.
  161         3. Anatomy.
  162         4. Neurophysiology.
  163         5. Pharmacology of local anesthetics.
  164         6. Pharmacology of vasoconstrictors.
  165         7. Psychological aspects of pain control.
  166         8. Systematic complications.
  167         9. Techniques of maxillary anesthesia.
  168         10. Techniques of mandibular anesthesia.
  169         11. Infection control.
  170         12. Medical emergencies involving local anesthesia.
  171         (b) The dental hygienist presents evidence of current
  172  certification in basic or advanced cardiac life support.
  173         (c) The dental hygienist possesses a valid certificate
  174  issued under subsection (6).
  175         (6) Any dental hygienist seeking a certificate to
  176  administer local anesthesia must apply to the department, remit
  177  an application fee, and submit proof of successful completion of
  178  a course in the administration of local anesthesia pursuant to
  179  subsection (5). The board shall certify, and the department
  180  shall issue a certificate to, any dental hygienist who fulfills
  181  the qualifications of subsection (5). The board shall establish
  182  a one-time application fee not to exceed $35. The certificate is
  183  not subject to renewal but is part of the dental hygienist’s
  184  permanent record and must be prominently displayed at the
  185  location where the dental hygienist is authorized to administer
  186  local anesthesia. The board shall adopt rules necessary to
  187  administer subsection (5) and this subsection.
  188         Section 4. Subsection (7) is added to section 466.023,
  189  Florida Statutes, to read:
  190         466.023 Dental hygienists; scope and area of practice.—
  191         (7) A dental hygienist may administer local anesthesia as
  192  provided in ss. 466.017 and 466.024.
  193         Section 5. Subsection (1) of section 466.024, Florida
  194  Statutes, is amended to read:
  195         466.024 Delegation of duties; expanded functions.—
  196         (1) A dentist may not delegate irremediable tasks to a
  197  dental hygienist or dental assistant, except as provided by law.
  198  A dentist may delegate remediable tasks to a dental hygienist or
  199  dental assistant when such tasks pose no risk to the patient. A
  200  dentist may only delegate remediable tasks so defined by law or
  201  rule of the board. The board by rule shall designate which tasks
  202  are remediable and delegable, except that the following are by
  203  law found to be remediable and delegable:
  204         (a) Taking impressions for study casts but not for the
  205  purpose of fabricating any intraoral restorations or orthodontic
  206  appliance.
  207         (b) Placing periodontal dressings.
  208         (c) Removing periodontal or surgical dressings.
  209         (d) Removing sutures.
  210         (e) Placing or removing rubber dams.
  211         (f) Placing or removing matrices.
  212         (g) Placing or removing temporary restorations.
  213         (h) Applying cavity liners, varnishes, or bases.
  214         (i) Polishing amalgam restorations.
  215         (j) Polishing clinical crowns of the teeth for the purpose
  216  of removing stains but not changing the existing contour of the
  217  tooth.
  218         (k) Obtaining bacteriological cytological specimens not
  219  involving cutting of the tissue.
  220         (l) Administering local anesthesia pursuant to s.
  221  466.017(5).
  222  
  223  This subsection does not limit delegable tasks to those
  224  specified herein.
  225         Section 6. This act shall take effect upon becoming a law.
  226  
  227  ================= T I T L E  A M E N D M E N T ================
  228         And the title is amended as follows:
  229         Delete everything before the enacting clause
  230  and insert:
  231                        A bill to be entitled                      
  232         An act relating to the practice of dentistry; amending
  233         s. 466.006, F.S.; revising the eligibility
  234         requirements for taking the examinations required to
  235         practice dentistry if the applicant is a graduate of a
  236         certain dental college or school; amending s. 466.007,
  237         F.S.; revising the eligibility requirements for taking
  238         the examinations required to practice dental hygiene;
  239         revising the licensing requirements to practice as a
  240         dental hygienist; amending s. 466.017, F.S.;
  241         authorizing dental hygienists to administer certain
  242         local anesthesia under the direct supervision of a
  243         licensed dentist if certain educational requirements
  244         are met; requiring dental hygienists to maintain
  245         current certification in basic or advanced
  246         cardiopulmonary resuscitation or advanced cardiac life
  247         support with recertification every 2 years; amending
  248         s. 466.023, F.S.; revising the scope and area of
  249         practice for dental hygienists, to conform to changes
  250         made by this act; amending s. 466.024, F.S.; revising
  251         the delegated duties that are found to be remediable
  252         and delegable, to conform to changes made by this act;
  253         providing an effective date.