Florida Senate - 2015                       CS for CS for SB 606
       
       
        
       By the Committees on Appropriations; and Health Policy; and
       Senators Gaetz, Montford, Sobel, Hays, Soto, and Grimsley
       
       
       
       
       576-03811-15                                           2015606c2
    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   28         process to verify the use of funds withdrawn from a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; requiring the Department of Health to
   37         annually submit a report with certain information to
   38         the Governor and the Legislature; providing rulemaking
   39         authority to require the submission of information for
   40         such reporting; providing an effective date.
   41          
   42  Be It Enacted by the Legislature of the State of Florida:
   43  
   44         Section 1. Section 381.4019, Florida Statutes, is created
   45  to read:
   46         381.4019 Dental care access accounts.—Subject to the
   47  availability of funds, the Legislature establishes a joint local
   48  and state dental care access account initiative and authorizes
   49  the creation of dental care access accounts to promote economic
   50  development by supporting qualified dentists who practice in
   51  dental health professional shortage areas or medically
   52  underserved areas or who treat a medically underserved
   53  population. The Legislature recognizes that maintaining good
   54  oral health is integral to overall health status and that the
   55  good health of residents of this state is an important
   56  contributing factor in economic development. Better health,
   57  including better oral health, enables workers to be more
   58  productive, reduces the burden of health care costs, and enables
   59  children to improve in cognitive development.
   60         (1) As used in this section, the term:
   61         (a) “Dental health professional shortage area” means a
   62  geographic area so designated by the Health Resources and
   63  Services Administration of the United States Department of
   64  Health and Human Services.
   65         (b) “Department” means the Department of Health.
   66         (c) “Medically underserved area” means a geographic area so
   67  designated by the Health Resources and Services Administration
   68  of the United States Department of Health and Human Services.
   69         (d) “Public health program” means a county health
   70  department, the Children’s Medical Services program, a federally
   71  qualified community health center, a federally funded migrant
   72  health center, or other publicly funded or nonprofit health care
   73  program as designated by the department.
   74         (2The department shall develop and implement a dental
   75  care access account initiative to benefit dentists licensed to
   76  practice in this state who demonstrate, as required by the
   77  department by rule:
   78         (a)Active employment by a public health program located in
   79  a dental health professional shortage area or a medically
   80  underserved area; or
   81         (b)A commitment to opening a private practice in a dental
   82  health professional shortage area or a medically underserved
   83  area evidenced by residing in the designated area, maintaining
   84  an active Medicaid provider agreement, enrolling in one or more
   85  Medicaid managed care plans, expending sufficient capital to
   86  make substantial progress in opening a dental practice that is
   87  capable of serving at least 1,200 patients, and obtaining
   88  financial support from the local community in which the dentist
   89  is practicing or intending to open a practice.
   90         (3) The department shall establish dental care access
   91  accounts as individual benefit accounts for each dentist who
   92  satisfies the requirements of subsection (2) and is selected by
   93  the department for participation. The department shall implement
   94  an electronic benefit transfer system that enables each dentist
   95  to spend funds from his or her account for the purposes
   96  described in subsection (4).
   97         (4Funds contributed from state and local sources to a
   98  dental care access account may be used for one or more of the
   99  following purposes:
  100         (a) Repayment of dental school student loans.
  101         (b) Investment in property, facilities, or equipment
  102  necessary to establish and operate a dental office consisting of
  103  no fewer than two operatories.
  104         (c) Payment of transitional expenses related to the
  105  relocation or opening of a dental practice which are
  106  specifically approved by the department.
  107         (5Subject to legislative appropriation, the department
  108  shall distribute state funds as an award to each dental care
  109  access account. Such awards must be in an amount not more than
  110  $100,000 and not less than $10,000, except that a state award
  111  may not exceed 3 times the amount contributed to an account in
  112  the same year from local sources. If a dentist qualifies for a
  113  dental care access account under paragraph (2)(a), the dentist’s
  114  salary and associated employer expenditures constitute a local
  115  match and qualify the account for a state award if the salary
  116  and associated expenditures do not come from state funds. State
  117  funds may not be included in a determination of the amount
  118  contributed to an account from local sources.
  119         (6) The department may accept contributions of funds from
  120  local sources for deposit in the account of a dentist designated
  121  by the donor.
  122         (7) The department shall close an account no later than 5
  123  years after the first deposit of state or local funds into that
  124  account or immediately upon the occurrence of any of the
  125  following:
  126         (a) Termination of the dentist’s employment with a public
  127  health program, unless, within 30 days of such termination, the
  128  dentist opens a private practice in a dental health professional
  129  shortage area or medically underserved area.
  130         (b) Termination of the dentist’s practice in a designated
  131  dental health professional shortage area or medically
  132  underserved area.
  133         (c) Termination of the dentist’s participation in the
  134  Florida Medicaid program.
  135         (d) Participation by the dentist in any fraudulent
  136  activity.
  137         (8) Any state funds remaining in a closed account may be
  138  awarded and transferred to another account concurrent with the
  139  distribution of funds under the next legislative appropriation
  140  for the initiative. The department shall return to the donor on
  141  a pro rata basis unspent funds from local sources which remain
  142  in a closed account.
  143         (9) If the department determines that a dentist has
  144  withdrawn account funds after the occurrence of an event
  145  specified in subsection (7), has used funds for purposes not
  146  authorized in subsection (4), or has not remained eligible for a
  147  dental care access account for a minimum of 2 years, the dentist
  148  shall repay the funds to his or her account. The department may
  149  recover the withdrawn funds through disciplinary enforcement
  150  actions and other methods authorized by law.
  151         (10) The department shall establish by rule:
  152         (a) Application procedures for dentists who wish to apply
  153  for a dental care access account. An applicant may demonstrate
  154  that he or she has expended sufficient capital to make
  155  substantial progress in opening a dental practice that is
  156  capable of serving at least 1,200 patients by documenting
  157  contracts for the purchase or lease of a practice location and
  158  providing executed obligations for the purchase or other
  159  acquisition of at least 30 percent of the value of equipment or
  160  supplies necessary to operate a dental practice. The department
  161  may limit the number of applicants selected and shall give
  162  priority to those applicants practicing in the areas receiving
  163  higher rankings pursuant to subsection (11). The department may
  164  establish additional criteria for selection which recognize an
  165  applicant’s active engagement with and commitment to the
  166  community providing a local match.
  167         (b)A process to verify that funds withdrawn from a dental
  168  care access account have been used solely for the purposes
  169  described in subsection (4).
  170         (11) The Department of Economic Opportunity shall rank the
  171  dental health professional shortage areas and medically
  172  underserved areas of the state based on the extent to which
  173  limited access to dental care is impeding the area’s economic
  174  development, with a higher ranking indicating a greater
  175  impediment to development.
  176         (12) The department shall develop a marketing plan for the
  177  dental care access account initiative in cooperation with the
  178  University of Florida College of Dentistry, the Nova
  179  Southeastern University College of Dental Medicine, the Lake
  180  Erie College of Osteopathic Medicine School of Dental Medicine,
  181  and the Florida Dental Association.
  182         (13)(a) By January 1 of each year, beginning in 2017, the
  183  department shall issue a report to the Governor, the President
  184  of the Senate, and the Speaker of the House of Representatives,
  185  which must include:
  186         1. The number of patients served by dentists receiving
  187  funding under this section.
  188         2. The number of Medicaid recipients served by dentists
  189  receiving funding under this section.
  190         3. The average number of hours worked and patients served
  191  in a week by dentists receiving funding under this section.
  192         4. The number of dentists in each dental health
  193  professional shortage area or medically underserved area
  194  receiving funding under this section.
  195         5. The amount and source of local matching funds received
  196  by the department.
  197         6. The amount of state funds awarded to dentists under this
  198  section.
  199         7. A complete accounting of the use of funds, by categories
  200  identified by the department, including, but not limited to,
  201  loans, supplies, equipment, rental property payments, real
  202  property purchases, and salary and wages.
  203         (b) The department shall adopt rules to require dentists to
  204  report information to the department which is necessary for the
  205  department to fulfill its reporting requirement under this
  206  subsection.
  207         Section 2. This act shall take effect July 1, 2015.