Florida Senate - 2021                                     SB 604
       
       
        
       By Senator Brandes
       
       
       
       
       
       24-00348C-21                                           2021604__
    1                        A bill to be entitled                      
    2         An act relating to dental therapy; amending s.
    3         409.906, F.S.; authorizing Medicaid to reimburse for
    4         dental services provided in a mobile dental unit that
    5         is owned by, operated by, or contracted with a health
    6         access setting or another similar setting or program;
    7         conforming a cross-reference; amending s. 466.001,
    8         F.S.; revising legislative purpose and intent;
    9         amending s. 466.002, F.S.; providing applicability;
   10         amending s. 466.003, F.S.; defining the terms “dental
   11         therapist” and “dental therapy”; revising the
   12         definition of the term “health access setting” to
   13         include certain dental therapy programs; amending s.
   14         466.004, F.S.; requiring the chair of the Board of
   15         Dentistry to appoint a Council on Dental Therapy
   16         within a specified timeframe; providing for
   17         membership, meetings, and the purpose of the council;
   18         providing a process for rulemaking; making technical
   19         changes; amending s. 466.006, F.S.; revising the
   20         definition of the terms “full-time practice” and
   21         “full-time practice of dentistry within the geographic
   22         boundaries of this state within 1 year” to include
   23         full-time faculty members of certain dental therapy
   24         schools; amending s. 466.0075, F.S.; authorizing the
   25         board to require any person who applies to take the
   26         examination to practice dental therapy in this state
   27         to maintain medical malpractice insurance in a certain
   28         amount; amending s. 466.009, F.S.; requiring the
   29         Department of Health to allow an applicant who fails
   30         the dental therapy examination to retake the
   31         examination; providing that an applicant who fails a
   32         practical or clinical examination to practice dental
   33         therapy because of a failing grade on just one part or
   34         procedure tested is required to retake and receive a
   35         passing score on only the failed part or procedure to
   36         be eligible for licensure; requiring an applicant who
   37         fails more than one part or procedure tested to retake
   38         the entire examination; making technical changes;
   39         amending s. 466.011, F.S.; requiring the board to
   40         certify certain applicants for licensure as a dental
   41         therapist; creating s. 466.0136, F.S.; providing that
   42         the board must require each licensed dental therapist
   43         to complete a specified number of hours of continuing
   44         education; providing requirements for the content of
   45         such continuing education; requiring the board to
   46         adopt rules and guidelines; authorizing the board to
   47         excuse licensees from continuing education
   48         requirements in certain circumstances; amending s.
   49         466.016, F.S.; requiring a practitioner of dental
   50         therapy to post and display her or his license in each
   51         office where she or he practices; amending s. 466.017,
   52         F.S.; requiring the board to adopt certain rules
   53         relating to dental therapists; requiring certain
   54         dental therapists to possess a specified
   55         certification; authorizing a dental therapist under
   56         the general supervision of a dentist to administer
   57         local anesthesia and operate an X-ray machine, expose
   58         dental X-ray films, and interpret or read such films
   59         if specified requirements are met; requiring certain
   60         dental therapists to report to the board within a
   61         specified timeframe adverse incidents related to or
   62         the result of the administration of local anesthesia;
   63         requiring a complete written report to be filed with
   64         the board within a specified timeframe; providing for
   65         discipline; making a technical change; amending s.
   66         466.018, F.S.; providing that a dentist of record
   67         remains primarily responsible for the dental treatment
   68         of a patient regardless of whether the treatment is
   69         provided by a dental therapist; requiring the name or
   70         initials of a dental therapist who renders treatment
   71         to a patient to be placed in the record of the
   72         patient; creating s. 466.0225, F.S.; providing
   73         application requirements and examination and licensure
   74         qualifications for dental therapists; creating s.
   75         466.0227, F.S.; providing legislative findings and
   76         intent; limiting the practice of dental therapy to
   77         specified settings; authorizing a dental therapist to
   78         perform specified services, including specified state
   79         specific dental therapy services, under the general
   80         supervision of a dentist under certain conditions;
   81         requiring a collaborative management agreement to be
   82         signed by a supervising dentist and a dental therapist
   83         and to include certain information; requiring a
   84         supervising dentist to determine the number of hours
   85         of practice which a dental therapist must complete
   86         under direct or indirect supervision before performing
   87         certain authorized services under general supervision;
   88         authorizing a supervising dentist to restrict or limit
   89         a dental therapist’s practice in a collaborative
   90         management agreement; authorizing a dental therapist
   91         to provide dental therapy services to a patient before
   92         the supervising dentist examines or diagnoses the
   93         patient under certain conditions; requiring a
   94         supervising dentist to be licensed or registered and
   95         practicing in this state; specifying that the
   96         supervising dentist is responsible for certain
   97         services and for providing and arranging certain
   98         followup services; amending s. 466.026, F.S.;
   99         providing criminal penalties; amending s. 466.028,
  100         F.S.; revising grounds for denial of a license or
  101         disciplinary action to include the practice of dental
  102         therapy; amending s. 921.0022, F.S.; conforming the
  103         criminal offense severity chart to changes made by the
  104         act; requiring the Department of Health, in
  105         consultation with the Board of Dentistry and the
  106         Agency for Health Care Administration, to submit
  107         certain reports to the Legislature by specified dates;
  108         providing requirements for such reports; providing an
  109         effective date.
  110          
  111  Be It Enacted by the Legislature of the State of Florida:
  112  
  113         Section 1. Paragraph (c) of subsection (1) and subsection
  114  (6) of section 409.906, Florida Statutes, are amended to read:
  115         409.906 Optional Medicaid services.—Subject to specific
  116  appropriations, the agency may make payments for services which
  117  are optional to the state under Title XIX of the Social Security
  118  Act and are furnished by Medicaid providers to recipients who
  119  are determined to be eligible on the dates on which the services
  120  were provided. Any optional service that is provided shall be
  121  provided only when medically necessary and in accordance with
  122  state and federal law. Optional services rendered by providers
  123  in mobile units to Medicaid recipients may be restricted or
  124  prohibited by the agency. Nothing in this section shall be
  125  construed to prevent or limit the agency from adjusting fees,
  126  reimbursement rates, lengths of stay, number of visits, or
  127  number of services, or making any other adjustments necessary to
  128  comply with the availability of moneys and any limitations or
  129  directions provided for in the General Appropriations Act or
  130  chapter 216. If necessary to safeguard the state’s systems of
  131  providing services to elderly and disabled persons and subject
  132  to the notice and review provisions of s. 216.177, the Governor
  133  may direct the Agency for Health Care Administration to amend
  134  the Medicaid state plan to delete the optional Medicaid service
  135  known as “Intermediate Care Facilities for the Developmentally
  136  Disabled.” Optional services may include:
  137         (1) ADULT DENTAL SERVICES.—
  138         (c) However, Medicaid will not provide reimbursement for
  139  dental services provided in a mobile dental unit, except for a
  140  mobile dental unit:
  141         1. Owned by, operated by, or having a contractual agreement
  142  with the Department of Health and complying with Medicaid’s
  143  county health department clinic services program specifications
  144  as a county health department clinic services provider.
  145         2. Owned by, operated by, or having a contractual
  146  arrangement with a federally qualified health center and
  147  complying with Medicaid’s federally qualified health center
  148  specifications as a federally qualified health center provider.
  149         3. Rendering dental services to Medicaid recipients, 21
  150  years of age and older, at nursing facilities.
  151         4. Owned by, operated by, or having a contractual agreement
  152  with a state-approved dental educational institution.
  153         5.Owned by, operated by, or having a contractual agreement
  154  with a health access setting, as defined in s. 466.003(16), or a
  155  similar setting or program that serves underserved or vulnerable
  156  populations that face serious barriers to accessing dental
  157  services and which may include, but is not limited to, homeless
  158  shelters, schools, Early Head Start programs, and the Special
  159  Supplemental Nutrition Program for Women, Infants, and Children.
  160         (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for
  161  diagnostic, preventive, or corrective procedures, including
  162  orthodontia in severe cases, provided to a recipient under age
  163  21, by or under the supervision of a licensed dentist. The
  164  agency may also reimburse a health access setting as defined in
  165  s. 466.003(16) s. 466.003 for the remediable tasks that a
  166  licensed dental hygienist is authorized to perform under s.
  167  466.024(2). Services provided under this program include
  168  treatment of the teeth and associated structures of the oral
  169  cavity, as well as treatment of disease, injury, or impairment
  170  that may affect the oral or general health of the individual.
  171  However, Medicaid will not provide reimbursement for dental
  172  services provided in a mobile dental unit, except for a mobile
  173  dental unit:
  174         (a) Owned by, operated by, or having a contractual
  175  agreement with the Department of Health and complying with
  176  Medicaid’s county health department clinic services program
  177  specifications as a county health department clinic services
  178  provider.
  179         (b) Owned by, operated by, or having a contractual
  180  arrangement with a federally qualified health center and
  181  complying with Medicaid’s federally qualified health center
  182  specifications as a federally qualified health center provider.
  183         (c) Rendering dental services to Medicaid recipients, 21
  184  years of age and older, at nursing facilities.
  185         (d) Owned by, operated by, or having a contractual
  186  agreement with a state-approved dental educational institution.
  187         (e)Owned by, operated by, or having a contractual
  188  agreement with a health access setting, as defined in s.
  189  466.003(16), or a similar setting or program that serves
  190  underserved or vulnerable populations that face serious barriers
  191  to accessing dental services and which may include, but is not
  192  limited to, homeless shelters, schools, Early Head Start
  193  programs, and the Special Supplemental Nutrition Program for
  194  Women, Infants, and Children.
  195         Section 2. Section 466.001, Florida Statutes, is amended to
  196  read:
  197         466.001 Legislative purpose and intent.—The legislative
  198  purpose for enacting this chapter is to ensure that every
  199  dentist, dental therapist, and or dental hygienist practicing in
  200  this state meets minimum requirements for safe practice without
  201  undue clinical interference by persons not licensed under this
  202  chapter. It is the legislative intent that dental services be
  203  provided only in accordance with the provisions of this chapter
  204  and not be delegated to unauthorized individuals. It is the
  205  further legislative intent that dentists, dental therapists, and
  206  dental hygienists who fall below minimum competency or who
  207  otherwise present a danger to the public are shall be prohibited
  208  from practicing in this state. All provisions of this chapter
  209  relating to the practice of dentistry, dental therapy, and
  210  dental hygiene must shall be liberally construed to carry out
  211  such purpose and intent.
  212         Section 3. Subsections (5) and (6) of section 466.002,
  213  Florida Statutes, are amended to read:
  214         466.002 Persons exempt from operation of chapter.—Nothing
  215  in this chapter shall apply to the following practices, acts,
  216  and operations:
  217         (5) Students in Florida schools of dentistry, dental
  218  therapy, and dental hygiene or dental assistant educational
  219  programs, while performing regularly assigned work under the
  220  curriculum of such schools.
  221         (6) Instructors in Florida schools of dentistry,
  222  instructors in dental programs that prepare persons holding
  223  D.D.S. or D.M.D. degrees for certification by a specialty board
  224  and that are accredited in the United States by January 1, 2005,
  225  in the same manner as the board recognizes accreditation for
  226  Florida schools of dentistry that are not otherwise affiliated
  227  with a Florida school of dentistry, or instructors in Florida
  228  schools of dental therapy or dental hygiene or dental assistant
  229  educational programs, while performing regularly assigned
  230  instructional duties under the curriculum of such schools or
  231  programs. A full-time dental instructor at a dental school or
  232  dental program approved by the board may be allowed to practice
  233  dentistry at the teaching facilities of such school or program,
  234  upon receiving a teaching permit issued by the board, in strict
  235  compliance with such rules as are adopted by the board
  236  pertaining to the teaching permit and with the established rules
  237  and procedures of the dental school or program as recognized in
  238  this section.
  239         Section 4. Present subsections (7) through (15) of section
  240  466.003, Florida Statutes, are redesignated as subsections (9)
  241  through (17), respectively, new subsections (7) and (8) are
  242  added to that section, and present subsections (14) and (15) of
  243  that section are amended, to read:
  244         466.003 Definitions.—As used in this chapter:
  245         (7)Dental therapist” means a person licensed to practice
  246  dental therapy pursuant to s. 466.0225.
  247         (8)Dental therapy” means the rendering of services
  248  pursuant to s. 466.0227 and any related extraoral services or
  249  procedures required in the performance of such services.
  250         (16)(14) “Health access setting” means a program or an
  251  institution of the Department of Children and Families, the
  252  Department of Health, the Department of Juvenile Justice, a
  253  nonprofit community health center, a Head Start center, a
  254  federally qualified health center or look-alike as defined by
  255  federal law, a school-based prevention program, a clinic
  256  operated by an accredited college of dentistry, or an accredited
  257  dental therapy or dental hygiene program in this state if such
  258  community service program or institution immediately reports to
  259  the Board of Dentistry all violations of s. 466.027, s. 466.028,
  260  or other practice act or standard of care violations related to
  261  the actions or inactions of a dentist, dental therapist, dental
  262  hygienist, or dental assistant engaged in the delivery of dental
  263  care in such setting.
  264         (17)(15) “School-based prevention program” means preventive
  265  oral health services offered at a school by one of the entities
  266  defined in subsection (16) (14) or by a nonprofit organization
  267  that is exempt from federal income taxation under s. 501(a) of
  268  the Internal Revenue Code, and described in s. 501(c)(3) of the
  269  Internal Revenue Code.
  270         Section 5. Subsection (2) of section 466.004, Florida
  271  Statutes, is amended to read:
  272         466.004 Board of Dentistry.—
  273         (2) To advise the board, It is the intent of the
  274  Legislature that councils be appointed as specified in this
  275  subsection to advise the board paragraphs (a), (b), and (c). The
  276  department shall provide administrative support to the councils
  277  and shall provide public notice of meetings and agendas agenda
  278  of the councils. Councils must shall include at least one board
  279  member, who shall chair the council, and shall include nonboard
  280  members. All council members shall be appointed by the board
  281  chair. Council members shall be appointed for 4-year terms, and
  282  all members are shall be eligible for reimbursement of expenses
  283  in the manner of board members.
  284         (a) A Council on Dental Hygiene shall be appointed by the
  285  board chair and shall include one dental hygienist member of the
  286  board, who shall chair the council, one dental member of the
  287  board, and three dental hygienists who are actively engaged in
  288  the practice of dental hygiene in this state. In making the
  289  appointments, the chair shall consider recommendations from the
  290  Florida Dental Hygienists’ Hygiene Association. The council
  291  shall meet at the request of the board chair, a majority of the
  292  members of the board, or the council chair; however, the council
  293  must meet at least three times a year. The council is charged
  294  with the responsibility of and shall recommend proposed meet for
  295  the purpose of developing rules and policies for recommendation
  296  to the board, which the board shall consider, on matters
  297  pertaining to the areas that part of dentistry consisting of
  298  educational, preventive, or therapeutic dental hygiene services;
  299  dental hygiene licensure, discipline, or regulation; and dental
  300  hygiene education. The board shall consider these rules and
  301  policies Rule and policy recommendations of the council shall be
  302  considered by the board at its next regularly scheduled meeting
  303  in the same manner in which it considers rule and policy
  304  recommendations from designated subcommittees of the board. Any
  305  rule or policy proposed by the board pertaining to these areas
  306  must the specified part of dentistry defined by this subsection
  307  shall be referred to the council for its a recommendation before
  308  final action by the board. The board may take final action on
  309  rules pertaining to these areas the specified part of dentistry
  310  defined by this subsection without a council recommendation if
  311  the council fails to submit a recommendation in a timely
  312  fashion, as prescribed by the board.
  313         (b) A Council on Dental Assisting shall be appointed by the
  314  board chair and shall include one board member, who shall chair
  315  the council, and three dental assistants who are actively
  316  engaged in dental assisting in this state. The council shall
  317  meet at the request of the board chair or a majority of the
  318  members of the board. The council shall meet for the purpose of
  319  developing recommendations to the board on matters pertaining to
  320  that part of dentistry related to dental assisting.
  321         (c)Effective 28 months after the first dental therapy
  322  license is granted by the board, the board chair shall appoint a
  323  Council on Dental Therapy, which must include one board member,
  324  who shall chair the council, and three dental therapists who are
  325  actively engaged in the practice of dental therapy in this
  326  state. The council shall meet at the request of the board chair,
  327  a majority of the members of the board, or the council chair;
  328  however, the council must meet at least three times per year.
  329  The council shall recommend proposed rules and policies to the
  330  board on matters pertaining to the areas of educational,
  331  preventive, or therapeutic dental therapy services; dental
  332  therapy licensure, discipline, or regulation; and dental therapy
  333  education. The council’s rule and policy recommendations must be
  334  considered by the board at its next regularly scheduled meeting
  335  in the same manner in which it considers rule and policy
  336  recommendations from designated subcommittees of the board. Any
  337  rule or policy proposed by the board pertaining to these areas
  338  must be referred to the council for its recommendation before
  339  final action by the board. The board may take final action on
  340  rules pertaining to these areas without a council recommendation
  341  if the council fails to submit a recommendation in a timely
  342  fashion, as prescribed by the board.
  343         (d)(c) With the concurrence of the State Surgeon General,
  344  the board chair may create and abolish other advisory councils
  345  relating to dental subjects, including, but not limited to,:
  346  examinations, access to dental care, indigent care, nursing home
  347  and institutional care, public health, disciplinary guidelines,
  348  and other subjects, as appropriate. Such councils must shall be
  349  appointed by the board chair and must shall include at least one
  350  board member, who shall serve as chair.
  351         Section 6. Subsection (4) and paragraph (b) of subsection
  352  (6) of section 466.006, Florida Statutes, are amended to read:
  353         466.006 Examination of dentists.—
  354         (4) Notwithstanding any other provision of law in chapter
  355  456 pertaining to the clinical dental licensure examination or
  356  national examinations, to be licensed as a dentist in this
  357  state, an applicant must successfully complete both of the
  358  following:
  359         (a) A written examination on the laws and rules of the
  360  state regulating the practice of dentistry.
  361         (b) A practical or clinical examination, which must be the
  362  American Dental Licensing Examination produced by the American
  363  Board of Dental Examiners, Inc., or its successor entity, if
  364  any, that is administered in this state, provided that the board
  365  has attained, and continues to maintain thereafter,
  366  representation on the board of directors of the American Board
  367  of Dental Examiners, the examination development committee of
  368  the American Board of Dental Examiners, and such other
  369  committees of the American Board of Dental Examiners as the
  370  board deems appropriate by rule to assure that the standards
  371  established herein are maintained organizationally. A passing
  372  score on the American Dental Licensing Examination administered
  373  in this state is valid for 365 days after the date the official
  374  examination results are published.
  375         1. As an alternative to such practical or clinical
  376  examination, an applicant may submit scores from an American
  377  Dental Licensing Examination previously administered in a
  378  jurisdiction other than this state after October 1, 2011, and
  379  such examination results shall be recognized as valid for the
  380  purpose of licensure in this state. A passing score on the
  381  American Dental Licensing Examination administered out of state
  382  shall be the same as the passing score for the American Dental
  383  Licensing Examination administered in this state. The
  384  examination results are valid for 365 days after the date the
  385  official examination results are published. The applicant must
  386  have completed the examination after October 1, 2011. This
  387  subparagraph may not be given retroactive application.
  388         2. If the date of an applicant’s passing American Dental
  389  Licensing Examination scores from an examination previously
  390  administered in a jurisdiction other than this state under
  391  subparagraph 1. is older than 365 days, such scores are
  392  nevertheless valid for the purpose of licensure in this state,
  393  but only if the applicant demonstrates that all of the following
  394  additional standards have been met:
  395         a. The applicant completed the American Dental Licensing
  396  Examination after October 1, 2011. This sub-subparagraph may not
  397  be given retroactive application;
  398         b. The applicant graduated from a dental school accredited
  399  by the American Dental Association Commission on Dental
  400  Accreditation or its successor entity, if any, or any other
  401  dental accrediting organization recognized by the United States
  402  Department of Education. Provided, however, if the applicant did
  403  not graduate from such a dental school, the applicant may submit
  404  proof of having successfully completed a full-time supplemental
  405  general dentistry program accredited by the American Dental
  406  Association Commission on Dental Accreditation of at least 2
  407  consecutive academic years at such accredited sponsoring
  408  institution. Such program must provide didactic and clinical
  409  education at the level of a D.D.S. or D.M.D. program accredited
  410  by the American Dental Association Commission on Dental
  411  Accreditation. For purposes of this sub-subparagraph, a
  412  supplemental general dentistry program does not include an
  413  advanced education program in a dental specialty;
  414         c. The applicant currently possesses a valid and active
  415  dental license in good standing, with no restriction, which has
  416  never been revoked, suspended, restricted, or otherwise
  417  disciplined, from another state or territory of the United
  418  States, the District of Columbia, or the Commonwealth of Puerto
  419  Rico;
  420         d. The applicant submits proof that he or she has never
  421  been reported to the National Practitioner Data Bank, the
  422  Healthcare Integrity and Protection Data Bank, or the American
  423  Association of Dental Boards Clearinghouse. This sub
  424  subparagraph does not apply if the applicant successfully
  425  appealed to have his or her name removed from the data banks of
  426  these agencies;
  427         e.(I)(A) The applicant submits proof of having been
  428  consecutively engaged in the full-time practice of dentistry in
  429  another state or territory of the United States, the District of
  430  Columbia, or the Commonwealth of Puerto Rico in the 5 years
  431  immediately preceding the date of application for licensure in
  432  this state; or
  433         (B) If the applicant has been licensed in another state or
  434  territory of the United States, the District of Columbia, or the
  435  Commonwealth of Puerto Rico for less than 5 years, the applicant
  436  submits proof of having been engaged in the full-time practice
  437  of dentistry since the date of his or her initial licensure.
  438         (II) As used in this section, “full-time practice” is
  439  defined as a minimum of 1,200 hours per year for each and every
  440  year in the consecutive 5-year period or, when applicable, the
  441  period since initial licensure, and must include any combination
  442  of the following:
  443         (A) Active clinical practice of dentistry providing direct
  444  patient care.
  445         (B) Full-time practice as a faculty member employed by a
  446  dental, dental therapy, or dental hygiene school approved by the
  447  board or accredited by the American Dental Association
  448  Commission on Dental Accreditation.
  449         (C) Full-time practice as a student at a postgraduate
  450  dental education program approved by the board or accredited by
  451  the American Dental Association Commission on Dental
  452  Accreditation.
  453         (III) The board shall develop rules to determine what type
  454  of proof of full-time practice is required and to recoup the
  455  cost to the board of verifying full-time practice under this
  456  section. Such proof must, at a minimum, be:
  457         (A) Admissible as evidence in an administrative proceeding;
  458         (B) Submitted in writing;
  459         (C) Submitted by the applicant under oath with penalties of
  460  perjury attached;
  461         (D) Further documented by an affidavit of someone unrelated
  462  to the applicant who is familiar with the applicant’s practice
  463  and testifies with particularity that the applicant has been
  464  engaged in full-time practice; and
  465         (E) Specifically found by the board to be both credible and
  466  admissible.
  467         (IV) An affidavit of only the applicant is not acceptable
  468  proof of full-time practice unless it is further attested to by
  469  someone unrelated to the applicant who has personal knowledge of
  470  the applicant’s practice. If the board deems it necessary to
  471  assess credibility or accuracy, the board may require the
  472  applicant or the applicant’s witnesses to appear before the
  473  board and give oral testimony under oath;
  474         f. The applicant submits documentation that he or she has
  475  completed, or will complete before he or she is licensed in this
  476  state, continuing education equivalent to this state’s
  477  requirements for the last full reporting biennium;
  478         g. The applicant proves that he or she has never been
  479  convicted of, or pled nolo contendere to, regardless of
  480  adjudication, any felony or misdemeanor related to the practice
  481  of a health care profession in any jurisdiction;
  482         h. The applicant has successfully passed a written
  483  examination on the laws and rules of this state regulating the
  484  practice of dentistry and the computer-based diagnostic skills
  485  examination; and
  486         i. The applicant submits documentation that he or she has
  487  successfully completed the applicable examination administered
  488  by the Joint Commission on National Dental Examinations or its
  489  successor organization.
  490         (6)
  491         (b)1. As used in this section, “full-time practice of
  492  dentistry within the geographic boundaries of this state within
  493  1 year” is defined as a minimum of 1,200 hours in the initial
  494  year of licensure, which must include any combination of the
  495  following:
  496         a. Active clinical practice of dentistry providing direct
  497  patient care within the geographic boundaries of this state.
  498         b. Full-time practice as a faculty member employed by a
  499  dental, dental therapy, or dental hygiene school approved by the
  500  board or accredited by the American Dental Association
  501  Commission on Dental Accreditation and located within the
  502  geographic boundaries of this state.
  503         c. Full-time practice as a student at a postgraduate dental
  504  education program approved by the board or accredited by the
  505  American Dental Association Commission on Dental Accreditation
  506  and located within the geographic boundaries of this state.
  507         2. The board shall develop rules to determine what type of
  508  proof of full-time practice of dentistry within the geographic
  509  boundaries of this state for 1 year is required in order to
  510  maintain active licensure and shall develop rules to recoup the
  511  cost to the board of verifying maintenance of such full-time
  512  practice under this section. Such proof must, at a minimum:
  513         a. Be admissible as evidence in an administrative
  514  proceeding;
  515         b. Be submitted in writing;
  516         c. Be submitted by the applicant under oath with penalties
  517  of perjury attached;
  518         d. Be further documented by an affidavit of someone
  519  unrelated to the applicant who is familiar with the applicant’s
  520  practice and testifies with particularity that the applicant has
  521  been engaged in full-time practice of dentistry within the
  522  geographic boundaries of this state within the last 365 days;
  523  and
  524         e. Include such additional proof as specifically found by
  525  the board to be both credible and admissible.
  526         3. An affidavit of only the applicant is not acceptable
  527  proof of full-time practice of dentistry within the geographic
  528  boundaries of this state within 1 year, unless it is further
  529  attested to by someone unrelated to the applicant who has
  530  personal knowledge of the applicant’s practice within the last
  531  365 days. If the board deems it necessary to assess credibility
  532  or accuracy, the board may require the applicant or the
  533  applicant’s witnesses to appear before the board and give oral
  534  testimony under oath.
  535         Section 7. Section 466.0075, Florida Statutes, is amended
  536  to read:
  537         466.0075 Applicants for examination; medical malpractice
  538  insurance.—The board may require any person applying to take the
  539  examination to practice dentistry in this state, the examination
  540  to practice dental therapy in this state, or the examination to
  541  practice dental hygiene in this state to maintain medical
  542  malpractice insurance in amounts sufficient to cover any
  543  incident of harm to a patient during the clinical examination.
  544         Section 8. Section 466.009, Florida Statutes, is amended to
  545  read:
  546         466.009 Reexamination.—
  547         (1) The department shall allow permit any person who fails
  548  an examination that which is required under s. 466.006, or s.
  549  466.007, or s. 466.0225 to retake the examination. If the
  550  examination to be retaken is a practical or clinical
  551  examination, the applicant must shall pay a reexamination fee
  552  set by rule of the board in an amount not to exceed the original
  553  examination fee.
  554         (2) If an applicant for a license to practice dentistry
  555  fails the practical or clinical examination because of a failing
  556  grade on just one part or procedure tested, she or he must shall
  557  be required to retake and receive a passing score on only the
  558  failed that part or procedure to be eligible for licensure.
  559  However, if any such applicant fails more than one part or
  560  procedure of any such examination, she or he must shall be
  561  required to retake the entire examination.
  562         (3) If an applicant for a license to practice dental
  563  hygiene fails one portion of the practical or clinical
  564  examination because of a failing grade on just one part or
  565  procedure tested, such applicant must shall be required to
  566  retake and receive a passing score on only the failed part or
  567  procedure to be eligible for licensure that portion if she or he
  568  reapplies within 12 months. If, however, the applicant fails the
  569  prophylaxis, she or he must shall be required to retake the
  570  entire examination.
  571         (4)If an applicant for a license to practice dental
  572  therapy fails the practical or clinical examination because of a
  573  failing grade on just one part or procedure tested, she or he
  574  must retake and receive a passing score on only the failed part
  575  or procedure to be eligible for licensure. However, if such
  576  applicant fails more than one part or procedure of any such
  577  examination, she or he must retake the entire examination.
  578         Section 9. Section 466.011, Florida Statutes, is amended to
  579  read:
  580         466.011 Licensure.—The board shall certify for licensure by
  581  the department any applicant who satisfies the requirements of
  582  s. 466.006, s. 466.0067, or s. 466.007, or s. 466.0225. The
  583  board may refuse to certify an applicant who has violated any of
  584  the provisions of s. 466.026 or s. 466.028.
  585         Section 10. Section 466.0136, Florida Statutes, is created
  586  to read:
  587         466.0136Continuing education; dental therapists.—In
  588  addition to any other requirements specified in this chapter for
  589  relicensure of dental therapists, the board shall require each
  590  licensed dental therapist to complete at least 24 hours, but not
  591  more than 36 hours, biennially of continuing education in dental
  592  subjects in programs approved by the board or in equivalent
  593  programs of continuing education. Programs of continuing
  594  education approved by the board must be programs of learning
  595  which, in the opinion of the board, contribute directly to the
  596  dental education of the dental therapist. An individual who is
  597  licensed as both a dental therapist and a dental hygienist may
  598  use continuing education that is approved for both dental
  599  therapy and dental hygiene education to satisfy both dental
  600  therapy and dental hygiene continuing education requirements.
  601  The board shall adopt rules and guidelines to administer and
  602  enforce this section. A dental therapist shall retain in her or
  603  his records any receipts, vouchers, or certificates necessary to
  604  document completion of the required continuing education.
  605  Compliance with the continuing education requirements is
  606  mandatory for issuance of the renewal certificate. The board may
  607  excuse licensees, as a group or as individuals, from all or part
  608  of the continuing education requirements if an unusual
  609  circumstance, emergency, or hardship prevents compliance with
  610  this section.
  611         Section 11. Section 466.016, Florida Statutes, is amended
  612  to read:
  613         466.016 License to be displayed.—Every practitioner of
  614  dentistry, dental therapy, or dental hygiene within the meaning
  615  of this chapter shall post and keep conspicuously displayed her
  616  or his license in the office where wherein she or he practices,
  617  in plain sight of the practitioner’s patients. Any dentist,
  618  dental therapist, or dental hygienist who practices at more than
  619  one location shall be required to display a copy of her or his
  620  license in each office where she or he practices.
  621         Section 12. Present subsections (7) through (10) and (11)
  622  through (15) of section 466.017, Florida Statutes, are
  623  redesignated as subsections (8) through (11) and (13) through
  624  (17), respectively, new subsections (7) and (12) are added to
  625  that section, and paragraphs (d) and (e) of subsection (3),
  626  subsection (4), and present subsections (7), (8), (12), and (14)
  627  of that section are amended, to read:
  628         466.017 Prescription of drugs; anesthesia.—
  629         (3) The board shall adopt rules which:
  630         (d) Establish further requirements relating to the use of
  631  general anesthesia or sedation, including, but not limited to,
  632  office equipment and the training of dental assistants, dental
  633  therapists, or dental hygienists who work with dentists using
  634  general anesthesia or sedation.
  635         (e) Establish an administrative mechanism enabling the
  636  board to verify compliance with training, education, experience,
  637  equipment, or certification requirements of dentists, dental
  638  therapists, dental hygienists, and dental assistants adopted
  639  pursuant to this subsection. The board may charge a fee to
  640  defray the cost of verifying compliance with requirements
  641  adopted pursuant to this paragraph.
  642         (4) A dentist, dental therapist, or dental hygienist who
  643  administers or employs the use of any form of anesthesia must
  644  possess a certification in either basic cardiopulmonary
  645  resuscitation for health professionals or advanced cardiac life
  646  support approved by the American Heart Association or the
  647  American Red Cross or an equivalent agency-sponsored course with
  648  recertification every 2 years. Each dental office that which
  649  uses any form of anesthesia must have immediately available and
  650  in good working order such resuscitative equipment, oxygen, and
  651  other resuscitative drugs as are specified by rule of the board
  652  in order to manage possible adverse reactions.
  653         (7)A dental therapist under the general supervision of a
  654  dentist may administer local anesthesia, including intraoral
  655  block anesthesia or soft tissue infiltration anesthesia, or
  656  both, if she or he has completed the course described in
  657  paragraph (5)(a) and presents evidence of current certification
  658  in basic or advanced cardiac life support.
  659         (8)(7) A licensed dentist, or a dental therapist who is
  660  authorized by her or his supervising dentist, may operate
  661  utilize an X-ray machine, expose dental X-ray films, and
  662  interpret or read such films. Notwithstanding The provisions of
  663  part IV of chapter 468 to the contrary notwithstanding, a
  664  licensed dentist, or a dental therapist who is authorized by her
  665  or his supervising dentist, may authorize or direct a dental
  666  assistant to operate such equipment and expose such films under
  667  her or his direction and supervision, pursuant to rules adopted
  668  by the board in accordance with s. 466.024 which ensure that the
  669  said assistant is competent by reason of training and experience
  670  to operate the X-ray said equipment in a safe and efficient
  671  manner. The board may charge a fee not to exceed $35 to defray
  672  the cost of verifying compliance with requirements adopted
  673  pursuant to this section.
  674         (9)(8)Notwithstanding The provisions of s. 465.0276
  675  notwithstanding, a dentist need not register with the board or
  676  comply with the continuing education requirements of that
  677  section if the dentist confines her or his dispensing activity
  678  to the dispensing of fluorides and chlorhexidine chlorohexidine
  679  rinse solutions,; provided that the dentist complies with and is
  680  subject to all laws and rules applicable to pharmacists and
  681  pharmacies, including, but not limited to, chapters 465, 499,
  682  and 893, and all applicable federal laws and regulations, when
  683  dispensing such products.
  684         (12) A licensed dental therapist administering local
  685  anesthesia must notify the board in writing by registered mail
  686  within 48 hours after any adverse incident that was related to
  687  or the result of the administration of local anesthesia. A
  688  complete written report must be filed with the board within 30
  689  days after the mortality or other adverse incident.
  690         (14)(12) A failure by the dentist, dental therapist, or
  691  dental hygienist to timely and completely comply with all the
  692  reporting requirements in this section is the basis for
  693  disciplinary action by the board pursuant to s. 466.028(1).
  694         (16)(14) As used in subsections (10)-(15) (9)-(13), the
  695  term “adverse incident” means any mortality that occurs during
  696  or as the result of a dental procedure, or an incident that
  697  results in a temporary or permanent physical or mental injury
  698  that requires hospitalization or emergency room treatment of a
  699  dental patient which occurs during or as a direct result of the
  700  use of general anesthesia, deep sedation, moderate sedation,
  701  pediatric moderate sedation, oral sedation, minimal sedation
  702  (anxiolysis), nitrous oxide, or local anesthesia.
  703         Section 13. Subsection (1) of section 466.018, Florida
  704  Statutes, is amended to read:
  705         466.018 Dentist of record; patient records.—
  706         (1) Each patient shall have a dentist of record. The
  707  dentist of record shall remain primarily responsible for all
  708  dental treatment on such patient regardless of whether the
  709  treatment is rendered by the dentist or by another dentist,
  710  dental therapist, dental hygienist, or dental assistant
  711  rendering such treatment in conjunction with, at the direction
  712  or request of, or under the supervision of such dentist of
  713  record. The dentist of record shall be identified in the record
  714  of the patient. If treatment is rendered by a dentist other than
  715  the dentist of record or by a dental therapist, dental
  716  hygienist, or dental assistant, the name or initials of such
  717  person must shall be placed in the record of the patient. In any
  718  disciplinary proceeding brought pursuant to this chapter or
  719  chapter 456, it is shall be presumed as a matter of law that
  720  treatment was rendered by the dentist of record unless otherwise
  721  noted on the patient record pursuant to this section. The
  722  dentist of record and any other treating dentist are subject to
  723  discipline pursuant to this chapter or chapter 456 for treatment
  724  rendered to the patient and performed in violation of such
  725  chapter. One of the purposes of this section is to ensure that
  726  the responsibility for each patient is assigned to one dentist
  727  in a multidentist practice of any nature and to assign primary
  728  responsibility to the dentist for treatment rendered by a dental
  729  therapist, dental hygienist, or dental assistant under her or
  730  his supervision. This section shall not be construed to assign
  731  any responsibility to a dentist of record for treatment rendered
  732  pursuant to a proper referral to another dentist who does not in
  733  practice with the dentist of record or to prohibit a patient
  734  from voluntarily selecting a new dentist without permission of
  735  the dentist of record.
  736         Section 14. Section 466.0225, Florida Statutes, is created
  737  to read:
  738         466.0225Examination of dental therapists; licensing.—
  739         (1)Any person desiring to be licensed as a dental
  740  therapist shall apply to the department to take the licensure
  741  examinations and shall verify the information required on the
  742  application by oath. The application must be accompanied by two
  743  recent photographs of the applicant.
  744         (2)An applicant is entitled to take the examinations
  745  required under this section and receive licensure to practice
  746  dental therapy in this state if the applicant:
  747         (a)Is 18 years of age or older;
  748         (b)Is a graduate of a dental therapy college or school
  749  accredited by the American Dental Association Commission on
  750  Dental Accreditation or its successor entity, if any, or any
  751  other dental therapy accrediting entity recognized by the United
  752  States Department of Education. For applicants applying for a
  753  dental therapy license before January 1, 2025, the board shall
  754  approve the applicant’s dental therapy education program if the
  755  program was administered by a college or school that operates an
  756  accredited dental or dental hygiene education program and the
  757  college or school certifies to the board that the applicant’s
  758  education substantially conformed to the education standards
  759  established by the American Dental Association Commission on
  760  Dental Accreditation;
  761         (c)Has successfully completed a dental therapy practical
  762  or clinical examination produced by the American Board of Dental
  763  Examiners, Inc., (ADEX) or its successor entity, if any, if the
  764  board finds that the successor entity’s examination meets or
  765  exceeds the provisions of this section. If an applicant fails to
  766  pass such an examination after three attempts, the applicant is
  767  not eligible to retake the examination unless the applicant
  768  completes additional education requirements as specified by the
  769  board. If a dental therapy examination has not been established
  770  by the ADEX, the board shall administer or approve an
  771  alternative examination;
  772         (d)Has not been disciplined by a board, except for
  773  citation offenses or minor violations;
  774         (e)Has not been convicted of or pled nolo contendere to,
  775  regardless of adjudication, any felony or misdemeanor related to
  776  the practice of a health care profession; and
  777         (f)Has successfully completed a written examination on the
  778  laws and rules of this state regulating the practice of dental
  779  therapy.
  780         (3)An applicant who meets the requirements of this section
  781  and who has successfully completed the examinations identified
  782  in paragraph (2)(c) in a jurisdiction other than this state, or
  783  who has successfully completed comparable examinations
  784  administered or approved by the licensing authority in a
  785  jurisdiction other than this state, shall be licensed to
  786  practice dental therapy in this state if the board determines
  787  that the other jurisdiction’s examinations and scope of practice
  788  are substantially similar to those identified in paragraph
  789  (2)(c).
  790         Section 15. Section 466.0227, Florida Statutes, is created
  791  to read:
  792         466.0227Dental therapists; scope and area of practice.—
  793         (1)The Legislature finds that authorizing licensed dental
  794  therapists to perform the services specified in subsection (3)
  795  would improve access to high-quality, affordable oral health
  796  services for all residents in this state. The Legislature
  797  intends to rapidly improve such access for low-income,
  798  uninsured, and underserved patients and communities. To further
  799  this intent, a dental therapist licensed under this chapter is
  800  limited to practicing dental therapy in the following settings
  801  or programs:
  802         (a)A health access setting, as defined in s. 466.003(16).
  803         (b)A community health center, including an off-site care
  804  setting.
  805         (c)A nursing facility.
  806         (d)A military or veterans’ hospital or clinic, including
  807  an off-site care setting.
  808         (e)A governmental or public health clinic, including an
  809  off-site care setting.
  810         (f)A school, a Head Start program, or a school-based
  811  prevention program as defined in s. 466.003(17).
  812         (g)An oral health education institution, including an off
  813  site care setting.
  814         (h)A hospital.
  815         (i)A correctional facility clinic setting.
  816         (j)A geographic area designated as a dental health
  817  professional shortage area by the state or the Federal
  818  Government.
  819         (k)A health facility operated by the Indian Health Service
  820  or by a tribal organization.
  821         (l)Any other clinic or practice setting if at least 50
  822  percent of the patients served by the dental therapist in such
  823  clinic or practice setting:
  824         1.Are enrolled in Medicaid or another state or local
  825  governmental health care program for low-income or uninsured
  826  patients; or
  827         2.Do not have dental insurance and report a gross annual
  828  income that is less than 200 percent of the applicable federal
  829  poverty guidelines.
  830         (2)Except as otherwise provided in this chapter, a dental
  831  therapist may perform the dental therapy services specified in
  832  subsection (3) under the general supervision of a dentist to the
  833  extent authorized by the supervising dentist and provided within
  834  the terms of a written collaborative management agreement signed
  835  by the dental therapist and the supervising dentist which meets
  836  the requirements of subsection (4).
  837         (3)Dental therapy services include all of the following:
  838         (a)All services, treatments, and competencies identified
  839  by the American Dental Association Commission on Dental
  840  Accreditation in its Dental Therapy Education Accreditation
  841  Standards.
  842         (b)All of the following state-specific services, if the
  843  dental therapist’s education included curriculum content
  844  satisfying the American Dental Association Commission on Dental
  845  Accreditation criteria for state-specific dental therapy
  846  services:
  847         1.Evaluation of radiographs.
  848         2.Placement of space maintainers.
  849         3.Pulpotomies on primary teeth.
  850         4.Tooth reimplantation and stabilization.
  851         5.Recementation of permanent dental crowns.
  852         6.Direct pulp capping of primary teeth.
  853         7.Fabrication of soft occlusal guards.
  854         8.Dispensing and administering nonopioid analgesics,
  855  including nitrous oxide, anti-inflammatories, and antibiotics,
  856  as authorized by the supervising dentist and within the
  857  parameters of the collaborative management agreement.
  858         9.Oral evaluation and assessment of dental disease and
  859  formulation of an individualized treatment plan if authorized by
  860  a supervising dentist and subject to any conditions,
  861  limitations, and protocols specified by the supervising dentist
  862  in the collaborative management agreement.
  863         (c)Any other task deemed appropriate by the board.
  864         (4)Before performing any of the services authorized in
  865  subsection (3), a dental therapist must enter into a written
  866  collaborative management agreement with a supervising dentist.
  867  The agreement must be signed by the dental therapist and the
  868  supervising dentist and must include all of the following:
  869         (a)Any limitation on the practice settings, services, and
  870  populations which may be provided. If the agreement is silent as
  871  to any such limitation, the full scope of practice is permitted
  872  under the agreement.
  873         (b)A procedure for creating and maintaining dental records
  874  for the patients who are treated by the dental therapist.
  875         (c)A plan to manage medical emergencies in each practice
  876  setting where the dental therapist provides care.
  877         (d)A quality assurance plan for monitoring care provided
  878  by the dental therapist, including patient care review, referral
  879  followup, and a quality assurance chart review.
  880         (e)Protocols for the dental therapist to administer and
  881  dispense medications, including the specific conditions and
  882  circumstances under which the medications are to be dispensed
  883  and administered.
  884         (f)Criteria relating to the provision of care by the
  885  dental therapist to patients with specific medical conditions or
  886  complex medication histories, including requirements for
  887  consultation before the initiation of care.
  888         (g)Supervision criteria for dental therapists.
  889         (h)A plan for the provision of clinical resources and
  890  referrals in situations that are beyond the capabilities of the
  891  dental therapist.
  892         (5)A supervising dentist shall determine the number of
  893  hours of practice a dental therapist must complete under direct
  894  or indirect supervision of the supervising dentist before the
  895  dental therapist may perform any of the services authorized in
  896  subsection (3) under general supervision.
  897         (6)A supervising dentist may restrict or limit the dental
  898  therapist’s practice in a collaborative management agreement to
  899  be less than the full scope of practice for dental therapists
  900  which is authorized in subsection (3).
  901         (7)A dental therapist may provide dental therapy services
  902  to a patient before the supervising dentist examines or
  903  diagnoses the patient if the applicable authority, conditions,
  904  and protocols are established in a written collaborative
  905  management agreement and the patient is subsequently referred to
  906  a dentist for any needed additional services that exceed the
  907  dental therapist’s scope of practice or authorization under the
  908  collaborative management agreement.
  909         (8)A supervising dentist must be licensed under chapter
  910  466 or registered under s. 456.47 and practicing in this state.
  911  The supervising dentist is responsible for all services
  912  authorized and performed by the dental therapist pursuant to the
  913  collaborative management agreement and for providing or
  914  arranging followup services to be provided by a dentist for
  915  those services that are beyond the dental therapist’s scope of
  916  practice and authorization under the collaborative management
  917  agreement.
  918         Section 16. Section 466.026, Florida Statutes, is amended
  919  to read:
  920         466.026 Prohibitions; penalties.—
  921         (1) Each of the following acts constitutes a felony of the
  922  third degree, punishable as provided in s. 775.082, s. 775.083,
  923  or s. 775.084:
  924         (a) Practicing dentistry, dental therapy, or dental hygiene
  925  unless the person has an appropriate, active license issued by
  926  the department pursuant to this chapter.
  927         (b) Using or attempting to use a license issued pursuant to
  928  this chapter which license has been suspended or revoked.
  929         (c) Knowingly employing any person to perform duties
  930  outside the scope allowed such person under this chapter or the
  931  rules of the board.
  932         (d) Giving false or forged evidence to the department or
  933  board for the purpose of obtaining a license.
  934         (e) Selling or offering to sell a diploma conferring a
  935  degree from a dental college or a dental therapy or dental
  936  hygiene school or college, or a license issued pursuant to this
  937  chapter, or procuring such diploma or license with intent that
  938  it shall be used as evidence of that which the document stands
  939  for, by a person other than the one upon whom it was conferred
  940  or to whom it was granted.
  941         (2) Each of the following acts constitutes a misdemeanor of
  942  the first degree, punishable as provided in s. 775.082 or s.
  943  775.083:
  944         (a) Using the name or title “dentist,” the initials letters
  945  “D.D.S.” or “D.M.D.”, or any other words, letters, title, or
  946  descriptive matter which in any way represents a person as being
  947  able to diagnose, treat, prescribe, or operate for any disease,
  948  pain, deformity, deficiency, injury, or physical condition of
  949  the teeth or jaws or oral-maxillofacial region unless the person
  950  has an active dentist’s license issued by the department
  951  pursuant to this chapter.
  952         (b) Using the name or title “dental therapist” or the
  953  initials “D.T.” or otherwise holding herself or himself out as
  954  an actively licensed dental therapist or implying to any patient
  955  or consumer that she or he is an actively licensed dental
  956  therapist unless that person has an active dental therapist’s
  957  license issued by the department pursuant to this chapter.
  958         (c) Using the name or title “dental hygienist” or the
  959  initials “R.D.H.” or otherwise holding herself or himself out as
  960  an actively licensed dental hygienist or implying to any patient
  961  or consumer that she or he is an actively licensed dental
  962  hygienist unless that person has an active dental hygienist’s
  963  license issued by the department pursuant to this chapter.
  964         (d)(c) Presenting as her or his own the license of another.
  965         (e)(d) Knowingly concealing information relative to
  966  violations of this chapter.
  967         (f)(e) Performing any services as a dental assistant as
  968  defined herein, except in the office of a licensed dentist,
  969  unless authorized by this chapter or by rule of the board.
  970         Section 17. Paragraphs (b), (c), (g), (s), and (t) of
  971  subsection (1) of section 466.028, Florida Statutes, are amended
  972  to read:
  973         466.028 Grounds for disciplinary action; action by the
  974  board.—
  975         (1) The following acts constitute grounds for denial of a
  976  license or disciplinary action, as specified in s. 456.072(2):
  977         (b) Having a license to practice dentistry, dental therapy,
  978  or dental hygiene revoked, suspended, or otherwise acted
  979  against, including the denial of licensure, by the licensing
  980  authority of another state, territory, or country.
  981         (c) Being convicted or found guilty of or entering a plea
  982  of nolo contendere to, regardless of adjudication, a crime in
  983  any jurisdiction which relates to the practice of dentistry,
  984  dental therapy, or dental hygiene. A plea of nolo contendere
  985  shall create a rebuttable presumption of guilt to the underlying
  986  criminal charges.
  987         (g) Aiding, assisting, procuring, or advising any
  988  unlicensed person to practice dentistry, dental therapy, or
  989  dental hygiene contrary to this chapter or to a rule of the
  990  department or the board.
  991         (s) Being unable to practice her or his profession with
  992  reasonable skill and safety to patients by reason of illness or
  993  use of alcohol, drugs, narcotics, chemicals, or any other type
  994  of material or as a result of any mental or physical condition.
  995  In enforcing this paragraph, the department shall have, upon a
  996  finding of the State Surgeon General or her or his designee that
  997  probable cause exists to believe that the licensee is unable to
  998  practice dentistry, dental therapy, or dental hygiene because of
  999  the reasons stated in this paragraph, the authority to issue an
 1000  order to compel a licensee to submit to a mental or physical
 1001  examination by physicians designated by the department. If the
 1002  licensee refuses to comply with such order, the department’s
 1003  order directing such examination may be enforced by filing a
 1004  petition for enforcement in the circuit court where the licensee
 1005  resides or does business. The licensee against whom the petition
 1006  is filed shall not be named or identified by initials in any
 1007  public court records or documents, and the proceedings shall be
 1008  closed to the public. The department shall be entitled to the
 1009  summary procedure provided in s. 51.011. A licensee affected
 1010  under this paragraph shall at reasonable intervals be afforded
 1011  an opportunity to demonstrate that she or he can resume the
 1012  competent practice of her or his profession with reasonable
 1013  skill and safety to patients.
 1014         (t) Fraud, deceit, or misconduct in the practice of
 1015  dentistry, dental therapy, or dental hygiene.
 1016         Section 18. Paragraph (g) of subsection (3) of section
 1017  921.0022, Florida Statutes, is amended to read:
 1018         921.0022 Criminal Punishment Code; offense severity ranking
 1019  chart.—
 1020         (3) OFFENSE SEVERITY RANKING CHART
 1021         (g) LEVEL 7
 1022  
 1023  FloridaStatute           FelonyDegree         Description         
 1024  316.027(2)(c)                 1st     Accident involving death, failure to stop; leaving scene.
 1025  316.193(3)(c)2.               3rd     DUI resulting in serious bodily injury.
 1026  316.1935(3)(b)                1st     Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated.
 1027  327.35(3)(c)2.                3rd     Vessel BUI resulting in serious bodily injury.
 1028  402.319(2)                    2nd     Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
 1029  409.920(2)(b)1.a.             3rd     Medicaid provider fraud; $10,000 or less.
 1030  409.920(2)(b)1.b.             2nd     Medicaid provider fraud; more than $10,000, but less than $50,000.
 1031  456.065(2)                    3rd     Practicing a health care profession without a license.
 1032  456.065(2)                    2nd     Practicing a health care profession without a license which results in serious bodily injury.
 1033  458.327(1)                    3rd     Practicing medicine without a license.
 1034  459.013(1)                    3rd     Practicing osteopathic medicine without a license.
 1035  460.411(1)                    3rd     Practicing chiropractic medicine without a license.
 1036  461.012(1)                    3rd     Practicing podiatric medicine without a license.
 1037  462.17                        3rd     Practicing naturopathy without a license.
 1038  463.015(1)                    3rd     Practicing optometry without a license.
 1039  464.016(1)                    3rd     Practicing nursing without a license.
 1040  465.015(2)                    3rd     Practicing pharmacy without a license.
 1041  466.026(1)                    3rd     Practicing dentistry, dental therapy, or dental hygiene without a license.
 1042  467.201                       3rd     Practicing midwifery without a license.
 1043  468.366                       3rd     Delivering respiratory care services without a license.
 1044  483.828(1)                    3rd     Practicing as clinical laboratory personnel without a license.
 1045  483.901(7)                    3rd     Practicing medical physics without a license.
 1046  484.013(1)(c)                 3rd     Preparing or dispensing optical devices without a prescription.
 1047  484.053                       3rd     Dispensing hearing aids without a license.
 1048  494.0018(2)                   1st     Conviction of any violation of chapter 494 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
 1049  560.123(8)(b)1.               3rd     Failure to report currency or payment instruments exceeding $300 but less than $20,000 by a money services business.
 1050  560.125(5)(a)                 3rd     Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
 1051  655.50(10)(b)1.               3rd     Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
 1052  775.21(10)(a)                 3rd     Sexual predator; failure to register; failure to renew driver license or identification card; other registration violations.
 1053  775.21(10)(b)                 3rd     Sexual predator working where children regularly congregate.
 1054  775.21(10)(g)                 3rd     Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
 1055  782.051(3)                    2nd     Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
 1056  782.07(1)                     2nd     Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
 1057  782.071                       2nd     Killing of a human being or unborn child by the operation of a motor vehicle in a reckless manner (vehicular homicide).
 1058  782.072                       2nd     Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
 1059  784.045(1)(a)1.               2nd     Aggravated battery; intentionally causing great bodily harm or disfigurement.
 1060  784.045(1)(a)2.               2nd     Aggravated battery; using deadly weapon.
 1061  784.045(1)(b)                 2nd     Aggravated battery; perpetrator aware victim pregnant.
 1062  784.048(4)                    3rd     Aggravated stalking; violation of injunction or court order.
 1063  784.048(7)                    3rd     Aggravated stalking; violation of court order.
 1064  784.07(2)(d)                  1st     Aggravated battery on law enforcement officer.
 1065  784.074(1)(a)                 1st     Aggravated battery on sexually violent predators facility staff.
 1066  784.08(2)(a)                  1st     Aggravated battery on a person 65 years of age or older.
 1067  784.081(1)                    1st     Aggravated battery on specified official or employee.
 1068  784.082(1)                    1st     Aggravated battery by detained person on visitor or other detainee.
 1069  784.083(1)                    1st     Aggravated battery on code inspector.
 1070  787.06(3)(a)2.                1st     Human trafficking using coercion for labor and services of an adult.
 1071  787.06(3)(e)2.                1st     Human trafficking using coercion for labor and services by the transfer or transport of an adult from outside Florida to within the state.
 1072  790.07(4)                     1st     Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
 1073  790.16(1)                     1st     Discharge of a machine gun under specified circumstances.
 1074  790.165(2)                    2nd     Manufacture, sell, possess, or deliver hoax bomb.
 1075  790.165(3)                    2nd     Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
 1076  790.166(3)                    2nd     Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
 1077  790.166(4)                    2nd     Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
 1078  790.23                      1st,PBL   Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04.
 1079  794.08(4)                     3rd     Female genital mutilation; consent by a parent, guardian, or a person in custodial authority to a victim younger than 18 years of age.
 1080  796.05(1)                     1st     Live on earnings of a prostitute; 2nd offense.
 1081  796.05(1)                     1st     Live on earnings of a prostitute; 3rd and subsequent offense.
 1082  800.04(5)(c)1.                2nd     Lewd or lascivious molestation; victim younger than 12 years of age; offender younger than 18 years of age.
 1083  800.04(5)(c)2.                2nd     Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years of age; offender 18 years of age or older.
 1084  800.04(5)(e)                  1st     Lewd or lascivious molestation; victim 12 years of age or older but younger than 16 years; offender 18 years or older; prior conviction for specified sex offense.
 1085  806.01(2)                     2nd     Maliciously damage structure by fire or explosive.
 1086  810.02(3)(a)                  2nd     Burglary of occupied dwelling; unarmed; no assault or battery.
 1087  810.02(3)(b)                  2nd     Burglary of unoccupied dwelling; unarmed; no assault or battery.
 1088  810.02(3)(d)                  2nd     Burglary of occupied conveyance; unarmed; no assault or battery.
 1089  810.02(3)(e)                  2nd     Burglary of authorized emergency vehicle.
 1090  812.014(2)(a)1.               1st     Property stolen, valued at $100,000 or more or a semitrailer deployed by a law enforcement officer; property stolen while causing other property damage; 1st degree grand theft.
 1091  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1092  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1093  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1094  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1095  812.019(2)                    1st     Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
 1096  812.131(2)(a)                 2nd     Robbery by sudden snatching.
 1097  812.133(2)(b)                 1st     Carjacking; no firearm, deadly weapon, or other weapon.
 1098  817.034(4)(a)1.               1st     Communications fraud, value greater than $50,000.
 1099  817.234(8)(a)                 2nd     Solicitation of motor vehicle accident victims with intent to defraud.
 1100  817.234(9)                    2nd     Organizing, planning, or participating in an intentional motor vehicle collision.
 1101  817.234(11)(c)                1st     Insurance fraud; property value $100,000 or more.
 1102  817.2341(2)(b) & (3)(b)       1st     Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity.
 1103  817.535(2)(a)                 3rd     Filing false lien or other unauthorized document.
 1104  817.611(2)(b)                 2nd     Traffic in or possess 15 to 49 counterfeit credit cards or related documents.
 1105  825.102(3)(b)                 2nd     Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
 1106  825.103(3)(b)                 2nd     Exploiting an elderly person or disabled adult and property is valued at $10,000 or more, but less than $50,000.
 1107  827.03(2)(b)                  2nd     Neglect of a child causing great bodily harm, disability, or disfigurement.
 1108  827.04(3)                     3rd     Impregnation of a child under 16 years of age by person 21 years of age or older.
 1109  837.05(2)                     3rd     Giving false information about alleged capital felony to a law enforcement officer.
 1110  838.015                       2nd     Bribery.                    
 1111  838.016                       2nd     Unlawful compensation or reward for official behavior.
 1112  838.021(3)(a)                 2nd     Unlawful harm to a public servant.
 1113  838.22                        2nd     Bid tampering.              
 1114  843.0855(2)                   3rd     Impersonation of a public officer or employee.
 1115  843.0855(3)                   3rd     Unlawful simulation of legal process.
 1116  843.0855(4)                   3rd     Intimidation of a public officer or employee.
 1117  847.0135(3)                   3rd     Solicitation of a child, via a computer service, to commit an unlawful sex act.
 1118  847.0135(4)                   2nd     Traveling to meet a minor to commit an unlawful sex act.
 1119  872.06                        2nd     Abuse of a dead human body. 
 1120  874.05(2)(b)                  1st     Encouraging or recruiting person under 13 to join a criminal gang; second or subsequent offense.
 1121  874.10                      1st,PBL   Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity.
 1122  893.13(1)(c)1.                1st     Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center.
 1123  893.13(1)(e)1.                1st     Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)5., within 1,000 feet of property used for religious services or a specified business site.
 1124  893.13(4)(a)                  1st     Use or hire of minor; deliver to minor other controlled substance.
 1125  893.135(1)(a)1.               1st     Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
 1126  893.135(1)(b)1.a.             1st     Trafficking in cocaine, more than 28 grams, less than 200 grams.
 1127  893.135(1)(c)1.a.             1st     Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
 1128  893.135(1)(c)2.a.             1st     Trafficking in hydrocodone, 28 grams or more, less than 50 grams.
 1129  893.135(1)(c)2.b.             1st     Trafficking in hydrocodone, 50 grams or more, less than 100 grams.
 1130  893.135(1)(c)3.a.             1st     Trafficking in oxycodone, 7 grams or more, less than 14 grams.
 1131  893.135(1)(c)3.b.             1st     Trafficking in oxycodone, 14 grams or more, less than 25 grams.
 1132  893.135(1)(c)4.b.(I)          1st     Trafficking in fentanyl, 4 grams or more, less than 14 grams.
 1133  893.135(1)(d)1.a.             1st     Trafficking in phencyclidine, 28 grams or more, less than 200 grams.
 1134  893.135(1)(e)1.               1st     Trafficking in methaqualone, 200 grams or more, less than 5 kilograms.
 1135  893.135(1)(f)1.               1st     Trafficking in amphetamine, 14 grams or more, less than 28 grams.
 1136  893.135(1)(g)1.a.             1st     Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
 1137  893.135(1)(h)1.a.             1st     Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
 1138  893.135(1)(j)1.a.             1st     Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
 1139  893.135(1)(k)2.a.             1st     Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
 1140  893.135(1)(m)2.a.             1st     Trafficking in synthetic cannabinoids, 280 grams or more, less than 500 grams.
 1141  893.135(1)(m)2.b.             1st     Trafficking in synthetic cannabinoids, 500 grams or more, less than 1,000 grams.
 1142  893.135(1)(n)2.a.             1st     Trafficking in n-benzyl phenethylamines, 14 grams or more, less than 100 grams.
 1143  893.1351(2)                   2nd     Possession of place for trafficking in or manufacturing of controlled substance.
 1144  896.101(5)(a)                 3rd     Money laundering, financial transactions exceeding $300 but less than $20,000.
 1145  896.104(4)(a)1.               3rd     Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
 1146  943.0435(4)(c)                2nd     Sexual offender vacating permanent residence; failure to comply with reporting requirements.
 1147  943.0435(8)                   2nd     Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
 1148  943.0435(9)(a)                3rd     Sexual offender; failure to comply with reporting requirements.
 1149  943.0435(13)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1150  943.0435(14)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1151  944.607(9)                    3rd     Sexual offender; failure to comply with reporting requirements.
 1152  944.607(10)(a)                3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1153  944.607(12)                   3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1154  944.607(13)                   3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1155  985.4815(10)                  3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1156  985.4815(12)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1157  985.4815(13)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1158  
 1159         Section 19. The Department of Health, in consultation with
 1160  the Board of Dentistry and the Agency for Health Care
 1161  Administration, shall submit a progress report to the President
 1162  of the Senate and the Speaker of the House of Representatives by
 1163  July 1, 2024, and shall submit a final report 3 years after the
 1164  first dental therapy license is issued. The reports must include
 1165  all of the following components:
 1166         (1)The progress that has been made in this state to
 1167  implement training programs, licensing, and Medicaid
 1168  reimbursement for dental therapists.
 1169         (2)Data demonstrating the effects of authorizing the
 1170  practice of dental therapy in this state on:
 1171         (a)Patient access to dental services;
 1172         (b)The use of primary and preventive dental services in
 1173  underserved regions and populations, including the Medicaid
 1174  population;
 1175         (c)Costs to dental providers, patients, dental insurance
 1176  carriers, and the state; and
 1177         (d)The quality and safety of dental services.
 1178         (3)Specific recommendations for any necessary legislative,
 1179  administrative, or regulatory reforms relating to the practice
 1180  of dental therapy.
 1181         (4)Any other information the department deems appropriate.
 1182         Section 20. This act shall take effect July 1, 2021.