Florida Senate - 2015              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 606
       
       
       
       
       
                               Ì161922ÊÎ161922                          
       
       576-02551-15                                                    
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to dental care; creating s. 381.4019,
    3         F.S.; establishing a joint local and state dental care
    4         access account initiative, subject to the availability
    5         of funding; authorizing the creation of dental care
    6         access accounts; specifying the purpose of the
    7         initiative; defining terms; providing criteria for the
    8         selection of dentists for participation in the
    9         initiative; providing for the establishment of
   10         accounts; requiring the Department of Health to
   11         implement an electronic benefit transfer system;
   12         providing for the use of funds deposited in the
   13         accounts; authorizing the department to distribute
   14         state funds to accounts subject to legislative
   15         appropriations; authorizing the department to accept
   16         contributions from local sources for deposit in
   17         designated accounts; limiting the number of years that
   18         an account may remain open; providing for the
   19         immediate closure of accounts under certain
   20         circumstances; authorizing the department to transfer
   21         state funds remaining in a closed account at a
   22         specified time and to return unspent funds from local
   23         sources; requiring a dentist to repay funds in certain
   24         circumstances; authorizing the department to pursue
   25         disciplinary enforcement actions and to use other
   26         legal means to recover funds; requiring the department
   27         to establish by rule application procedures and a
   28         process to verify the use of funds withdrawn from a
   29         dental care access account; requiring the department
   30         to give priority to applications from dentists
   31         practicing in certain areas; requiring the Department
   32         of Economic Opportunity to rank shortage areas and
   33         medically underserved areas; requiring the Department
   34         of Health to develop a marketing plan in cooperation
   35         with certain dental colleges and the Florida Dental
   36         Association; providing an effective date.
   37          
   38  Be It Enacted by the Legislature of the State of Florida:
   39  
   40         Section 1. Section 381.4019, Florida Statutes, is created
   41  to read:
   42         381.4019 Dental care access accounts.—Subject to the
   43  availability of funds, the Legislature establishes a joint local
   44  and state dental care access account initiative and authorizes
   45  the creation of dental care access accounts to promote economic
   46  development by supporting qualified dentists who practice in
   47  dental health professional shortage areas or medically
   48  underserved areas or who treat a medically underserved
   49  population. The Legislature recognizes that maintaining good
   50  oral health is integral to overall health status and that the
   51  good health of residents of this state is an important
   52  contributing factor in economic development. Better health,
   53  including better oral health, enables workers to be more
   54  productive, reduces the burden of health care costs, and enables
   55  children to improve in cognitive development.
   56         (1) As used in this section, the term:
   57         (a) “Dental health professional shortage area” means a
   58  geographic area so designated by the Health Resources and
   59  Services Administration of the United States Department of
   60  Health and Human Services.
   61         (b) “Department” means the Department of Health.
   62         (c) “Medically underserved area” means a geographic area so
   63  designated by the Health Resources and Services Administration
   64  of the United States Department of Health and Human Services.
   65         (d) “Public health program” means a county health
   66  department, the Children’s Medical Services program, a federally
   67  qualified community health center, a federally funded migrant
   68  health center, or other publicly funded or nonprofit health care
   69  program as designated by the department.
   70         (2The department shall develop and implement a dental
   71  care access account initiative to benefit dentists licensed to
   72  practice in this state who demonstrate, as required by the
   73  department by rule:
   74         (a)Active employment by a public health program located in
   75  a dental health professional shortage area or a medically
   76  underserved area; or
   77         (b)A commitment to opening a private practice in a dental
   78  health professional shortage area or a medically underserved
   79  area evidenced by residing in the designated area, maintaining
   80  an active Medicaid provider agreement, enrolling in one or more
   81  Medicaid managed care plans, expending sufficient capital to
   82  make substantial progress in opening a dental practice that is
   83  capable of serving at least 1,200 patients, and obtaining
   84  financial support from the local community in which the dentist
   85  is practicing or intending to open a practice.
   86         (3) The department shall establish dental care access
   87  accounts as individual benefit accounts for each dentist who
   88  satisfies the requirements of subsection (2) and is selected by
   89  the department for participation. The department shall implement
   90  an electronic benefit transfer system that enables each dentist
   91  to spend funds from his or her account for the purposes
   92  described in subsection (4).
   93         (4Funds contributed from state and local sources to a
   94  dental care access account may be used for one or more of the
   95  following purposes:
   96         (a) Repayment of dental school student loans.
   97         (b) Investment in property, facilities, or equipment
   98  necessary to establish and operate a dental office consisting of
   99  no fewer than two operatories.
  100         (c) Payment of transitional expenses related to the
  101  relocation or opening of a dental practice which are
  102  specifically approved by the department.
  103         (5Subject to legislative appropriation, the department
  104  shall distribute state funds as an award to each dental care
  105  access account. Such awards must be in an amount not more than
  106  $100,000 and not less than $10,000, except that a state award
  107  may not exceed 3 times the amount contributed to an account in
  108  the same year from local sources. If a dentist qualifies for a
  109  dental care access account under paragraph (2)(a), the dentist’s
  110  salary and associated employer expenditures constitute a local
  111  match and qualify the account for a state award if the salary
  112  and associated expenditures do not come from state funds. State
  113  funds may not be included in a determination of the amount
  114  contributed to an account from local sources.
  115         (6) The department may accept contributions of funds from
  116  local sources for deposit in the account of a dentist designated
  117  by the donor.
  118         (7) The department shall close an account no later than 5
  119  years after the first deposit of state or local funds into that
  120  account or immediately upon the occurrence of any of the
  121  following:
  122         (a) Termination of the dentist’s employment with a public
  123  health program, unless, within 30 days of such termination, the
  124  dentist opens a private practice in a dental health professional
  125  shortage area or medically underserved area.
  126         (b) Termination of the dentist’s practice in a designated
  127  dental health professional shortage area or medically
  128  underserved area.
  129         (c) Termination of the dentist’s participation in the
  130  Florida Medicaid program.
  131         (d) Participation by the dentist in any fraudulent
  132  activity.
  133         (8) Any state funds remaining in a closed account may be
  134  awarded and transferred to another account concurrent with the
  135  distribution of funds under the next legislative appropriation
  136  for the initiative. The department shall return to the donor on
  137  a pro rata basis unspent funds from local sources which remain
  138  in a closed account.
  139         (9) If the department determines that a dentist has
  140  withdrawn account funds after the occurrence of an event
  141  specified in subsection (7), has used funds for purposes not
  142  authorized in subsection (4), or has not remained eligible for a
  143  dental care access account for a minimum of 2 years, the dentist
  144  shall repay the funds to his or her account. The department may
  145  recover the withdrawn funds through disciplinary enforcement
  146  actions and other methods authorized by law.
  147         (10) The department shall establish by rule:
  148         (a) Application procedures for dentists who wish to apply
  149  for a dental care access account. An applicant may demonstrate
  150  that he or she has expended sufficient capital to make
  151  substantial progress in opening a dental practice that is
  152  capable of serving at least 1,200 patients by documenting
  153  contracts for the purchase or lease of a practice location and
  154  providing executed obligations for the purchase or other
  155  acquisition of at least 30 percent of the value of equipment or
  156  supplies necessary to operate a dental practice. The department
  157  may limit the number of applicants selected and shall give
  158  priority to those applicants practicing in the areas receiving
  159  higher rankings pursuant to subsection (11). The department may
  160  establish additional criteria for selection which recognize an
  161  applicant’s active engagement with and commitment to the
  162  community providing a local match.
  163         (b)A process to verify that funds withdrawn from a dental
  164  care access account have been used solely for the purposes
  165  described in subsection (4).
  166         (11) The Department of Economic Opportunity shall rank the
  167  dental health professional shortage areas and medically
  168  underserved areas of the state based on the extent to which
  169  limited access to dental care is impeding the area’s economic
  170  development, with a higher ranking indicating a greater
  171  impediment to development.
  172         (12) The department shall develop a marketing plan for the
  173  dental care access account initiative in cooperation with the
  174  University of Florida College of Dentistry, the Nova
  175  Southeastern University College of Dental Medicine, the Lake
  176  Erie College of Osteopathic Medicine School of Dental Medicine,
  177  and the Florida Dental Association.
  178         Section 2. This act shall take effect July 1, 2015.