Florida Senate - 2023                              CS for SB 652
       
       
        
       By the Committee on Health Policy; and Senator Yarborough
       
       
       
       
       
       588-02788-23                                           2023652c1
    1                        A bill to be entitled                      
    2         An act relating to dentistry; amending s. 466.006,
    3         F.S.; deleting the role of the Board of Dentistry in
    4         the administration of the licensure examination for
    5         dentists; deleting the requirement for the board to
    6         establish an examination fee; revising requirements
    7         for licensure as a dentist; deleting a time-limitation
    8         on the validity of certain licensure examination
    9         results; conforming provisions to changes made by the
   10         act; deleting a requirement that certain applicants
   11         for licensure engage in the full-time practice of
   12         dentistry inside the geographic boundaries of this
   13         state for 1 year after licensure; deleting provisions
   14         related to compliance with and enforcement of such
   15         requirement; amending s. 466.009, F.S.; conforming a
   16         provision to changes made by the act; deleting a
   17         board-imposed reexamination fee; amending s. 466.0135,
   18         F.S.; revising continuing education requirements for
   19         dentists; repealing s. 466.0282, F.S., relating to
   20         specialties; providing an effective date.
   21          
   22  Be It Enacted by the Legislature of the State of Florida:
   23  
   24         Section 1. Paragraph (b) of subsection (1), subsection (2),
   25  paragraph (b) of subsection (4), subsection (5), and subsection
   26  (6) of section 466.006, Florida Statutes, are amended to read:
   27         466.006 Examination of dentists.—
   28         (1)
   29         (b) Any person desiring to be licensed as a dentist shall
   30  apply to the department to take the licensure examinations and
   31  shall verify the information required on the application by
   32  oath. The application shall include two recent photographs.
   33  There is shall be an application fee set by the board which may
   34  not to exceed $100 and is which shall be nonrefundable. There
   35  shall also be an examination fee set by the board, which shall
   36  not exceed $425 plus the actual per applicant cost to the
   37  department for purchase of some or all of the examination from
   38  the American Board of Dental Examiners or its successor entity,
   39  if any, provided the board finds the successor entity’s clinical
   40  examination complies with the provisions of this section. The
   41  examination fee may be refundable if the applicant is found
   42  ineligible to take the examinations.
   43         (2) The department shall license an applicant whom the
   44  board certifies meets all of the following criteria shall be
   45  entitled to take the examinations required in this section to
   46  practice dentistry in this state if the applicant:
   47         (a) Is 18 years of age or older.
   48         (b)1. Is a graduate of a dental school accredited by the
   49  American Dental Association Commission on Dental Accreditation
   50  or its successor entity, if any, or any other dental accrediting
   51  entity recognized by the United States Department of Education;
   52  or
   53         2. Is a dental student in the final year of a program at
   54  such an accredited dental school who has completed all the
   55  coursework necessary to prepare the student to perform the
   56  clinical and diagnostic procedures required to pass the
   57  examinations. With respect to a dental student in the final year
   58  of a program at a dental school, a passing score on the
   59  examinations is valid for 365 days after the date the
   60  examinations were completed. A dental school student who takes
   61  the licensure examinations during the student’s final year of an
   62  approved dental school must graduate have graduated before being
   63  certified for licensure pursuant to s. 466.011.
   64         (c)1. Has successfully completed the examination
   65  administered by the Joint Commission on National Dental
   66  Examinations or its successor organization National Board of
   67  Dental Examiners dental examination; or
   68         2. Has an active health access dental license in this
   69  state; and
   70         a. The applicant has at least 5,000 hours within 4
   71  consecutive years of clinical practice experience providing
   72  direct patient care in a health access setting as defined in s.
   73  466.003; the applicant is a retired veteran dentist of any
   74  branch of the United States Armed Services who has practiced
   75  dentistry while on active duty and has at least 3,000 hours
   76  within 3 consecutive years of clinical practice experience
   77  providing direct patient care in a health access setting as
   78  defined in s. 466.003; or the applicant has provided a portion
   79  of his or her salaried time teaching health profession students
   80  in any public education setting, including, but not limited to,
   81  a community college, college, or university, and has at least
   82  3,000 hours within 3 consecutive years of clinical practice
   83  experience providing direct patient care in a health access
   84  setting as defined in s. 466.003;
   85         b. The applicant has not been disciplined by the board,
   86  except for citation offenses or minor violations;
   87         c. The applicant has not filed a report pursuant to s.
   88  456.049; and
   89         d. The applicant has not been convicted of or pled nolo
   90  contendere to, regardless of adjudication, any felony or
   91  misdemeanor related to the practice of a health care profession.
   92         (4) Notwithstanding any other provision of law in chapter
   93  456 pertaining to the clinical dental licensure examination or
   94  national examinations, to be licensed as a dentist in this
   95  state, an applicant must successfully complete both of the
   96  following:
   97         (b) A practical or clinical examination, which must be the
   98  American Dental Licensing Examination produced by the American
   99  Board of Dental Examiners, Inc., or its successor entity, if
  100  any, that is administered in this state, provided that the board
  101  has attained, and continues to maintain thereafter,
  102  representation on the board of directors of the American Board
  103  of Dental Examiners, the examination development committee of
  104  the American Board of Dental Examiners, and such other
  105  committees of the American Board of Dental Examiners as the
  106  board deems appropriate by rule to assure that the standards
  107  established herein are maintained organizationally. A passing
  108  score on the American Dental Licensing Examination administered
  109  in this state is valid for 365 days after the date the official
  110  examination results are published.
  111         1. As an alternative to such practical or clinical
  112  examination, an applicant may submit scores from an American
  113  Dental Licensing Examination previously administered in a
  114  jurisdiction other than this state after October 1, 2011, and
  115  such examination results are shall be recognized as valid for
  116  the purpose of licensure in this state. A passing score on the
  117  American Dental Licensing Examination administered out of state
  118  is shall be the same as the passing score for the American
  119  Dental Licensing Examination administered in this state. The
  120  examination results are valid for 365 days after the date the
  121  official examination results are published. The applicant must
  122  have completed the examination after October 1, 2011. This
  123  subparagraph may not be given retroactive application.
  124         2. If the date of an applicant’s passing American Dental
  125  Licensing Examination scores from an examination previously
  126  administered in a jurisdiction other than this state under
  127  subparagraph 1. is older than 365 days, such scores are
  128  nevertheless valid for the purpose of licensure in this state,
  129  but only if the applicant demonstrates that all of the following
  130  additional standards have been met:
  131         a. The applicant completed the American Dental Licensing
  132  Examination after October 1, 2011. This sub-subparagraph may not
  133  be given retroactive application;
  134         b. The applicant graduated from a dental school accredited
  135  by the American Dental Association Commission on Dental
  136  Accreditation or its successor entity, if any, or any other
  137  dental accrediting organization recognized by the United States
  138  Department of Education. Provided, however, if the applicant did
  139  not graduate from such a dental school, the applicant may submit
  140  proof of having successfully completed a full-time supplemental
  141  general dentistry program accredited by the American Dental
  142  Association Commission on Dental Accreditation of at least 2
  143  consecutive academic years at such accredited sponsoring
  144  institution. Such program must provide didactic and clinical
  145  education at the level of a D.D.S. or D.M.D. program accredited
  146  by the American Dental Association Commission on Dental
  147  Accreditation. For purposes of this sub-subparagraph, a
  148  supplemental general dentistry program does not include an
  149  advanced education program in a dental specialty;
  150         c. The applicant currently possesses a valid and active
  151  dental license in good standing, with no restriction, which has
  152  never been revoked, suspended, restricted, or otherwise
  153  disciplined, from another state or territory of the United
  154  States, the District of Columbia, or the Commonwealth of Puerto
  155  Rico;
  156         d. The applicant submits proof that he or she has never
  157  been reported to the National Practitioner Data Bank, the
  158  Healthcare Integrity and Protection Data Bank, or the American
  159  Association of Dental Boards Clearinghouse. This sub
  160  subparagraph does not apply if the applicant successfully
  161  appealed to have his or her name removed from the clearinghouse
  162  data banks of these agencies;
  163         e.(I)(A) The applicant submits proof of having been
  164  consecutively engaged in the full-time practice of dentistry in
  165  another state or territory of the United States, the District of
  166  Columbia, or the Commonwealth of Puerto Rico in the 5 years
  167  immediately preceding the date of application for licensure in
  168  this state; or
  169         (B) If the applicant has been licensed in another state or
  170  territory of the United States, the District of Columbia, or the
  171  Commonwealth of Puerto Rico for less than 5 years, the applicant
  172  submits proof of having been engaged in the full-time practice
  173  of dentistry since the date of his or her initial licensure.
  174         (II) As used in this section, “full-time practice” is
  175  defined as a minimum of 1,200 hours per year for each and every
  176  year in the consecutive 5-year period or, when applicable, the
  177  period since initial licensure, and must include any combination
  178  of the following:
  179         (A) Active clinical practice of dentistry providing direct
  180  patient care.
  181         (B) Full-time practice as a faculty member employed by a
  182  dental or dental hygiene school approved by the board or
  183  accredited by the American Dental Association Commission on
  184  Dental Accreditation.
  185         (C) Full-time practice as a student at a postgraduate
  186  dental education program approved by the board or accredited by
  187  the American Dental Association Commission on Dental
  188  Accreditation.
  189         (III) The board shall develop rules to determine what type
  190  of proof of full-time practice is required and to recoup the
  191  cost to the board of verifying full-time practice under this
  192  section. Such proof must, at a minimum, be:
  193         (A) Admissible as evidence in an administrative proceeding;
  194         (B) Submitted in writing;
  195         (C) Submitted by the applicant under oath with penalties of
  196  perjury attached;
  197         (D) Further documented by an applicant’s annual income tax
  198  return filed with the Internal Revenue Service for each year in
  199  the preceding 5-year period or, if the applicant has been
  200  practicing for less than 5 years, the period since initial
  201  licensure affidavit of someone unrelated to the applicant who is
  202  familiar with the applicant’s practice and testifies with
  203  particularity that the applicant has been engaged in full-time
  204  practice; and
  205         (D)(E) Specifically found by the board to be both credible
  206  and admissible.
  207         (IV) The board may excuse applicants from the 1,200-hour
  208  requirement of this sub-subparagraph in the event of an unusual
  209  circumstance, emergency, or special hardship An affidavit of
  210  only the applicant is not acceptable proof of full-time practice
  211  unless it is further attested to by someone unrelated to the
  212  applicant who has personal knowledge of the applicant’s
  213  practice. If the board deems it necessary to assess credibility
  214  or accuracy, the board may require the applicant or the
  215  applicant’s witnesses to appear before the board and give oral
  216  testimony under oath;
  217         f. The applicant submits documentation that he or she has
  218  completed, or will complete before he or she is licensed in this
  219  state, continuing education equivalent to this state’s
  220  requirements for the last full reporting biennium;
  221         g. The applicant proves that he or she has never been
  222  convicted of, or pled nolo contendere to, regardless of
  223  adjudication, any felony or misdemeanor related to the practice
  224  of a health care profession in any jurisdiction;
  225         h. The applicant has successfully passed a written
  226  examination on the laws and rules of this state regulating the
  227  practice of dentistry and the computer-based diagnostic skills
  228  examination; and
  229         i. The applicant submits documentation that he or she has
  230  successfully completed the applicable examination administered
  231  by the Joint Commission on National Dental Examinations or its
  232  successor organization.
  233         (5)(a) The practical examination required under subsection
  234  (4) is the American Dental Licensing Examination developed by
  235  the American Board of Dental Examiners, Inc., or its successor
  236  entity, if any, provided the board finds that the successor
  237  entity’s clinical examination complies with the provisions of
  238  this section, and must include, at a minimum, all of the
  239  following:
  240         1. A comprehensive diagnostic skills examination covering
  241  the full scope of dentistry and an examination on applied
  242  clinical diagnosis and treatment planning in dentistry for
  243  dental candidates.;
  244         2. Two restorations on a manikin that has typodont teeth
  245  with simulated caries as approved by the Commission on Dental
  246  Competency Assessments. The board by rule shall determine the
  247  class of such restorations.;
  248         3. A demonstration of periodontal skills on a manikin that
  249  has typodont teeth with simulated calculus as approved by the
  250  Commission on Dental Competency Assessments.;
  251         4. A demonstration of prosthetics and restorative skills in
  252  complete and partial dentures and crowns and bridges and the
  253  utilization of practical methods of evaluation, specifically
  254  including the evaluation by the candidate of completed
  255  laboratory products such as, but not limited to, crowns and
  256  inlays filled to prepared model teeth.;
  257         5. A demonstration of restorative skills on a manikin which
  258  requires the candidate to complete procedures performed in
  259  preparation for a cast restoration.;
  260         6. A demonstration of endodontic skills.; and
  261         7. A diagnostic skills examination demonstrating ability to
  262  diagnose conditions within the human oral cavity and its
  263  adjacent tissues and structures from photographs, slides,
  264  radiographs, or models pursuant to rules of the board. If an
  265  applicant fails to pass the diagnostic skills examination in
  266  three attempts, the applicant is not eligible for reexamination
  267  unless she or he completes additional educational requirements
  268  established by the board.
  269         (b) The department shall consult with the board in planning
  270  the times, places, physical facilities, training of personnel,
  271  and other arrangements concerning the administration of the
  272  examination. The board or a duly designated committee thereof
  273  shall approve the final plans for the administration of the
  274  examination;
  275         (c) If the applicant fails to pass the clinical examination
  276  in three attempts, the applicant is shall not be eligible for
  277  reexamination unless she or he completes additional educational
  278  requirements established by the board.; and
  279         (c)(d) The board may by rule provide for additional
  280  procedures that which are to be tested, provided such procedures
  281  are shall be common to the practice of general dentistry. The
  282  board by rule shall determine the passing grade for each
  283  procedure and the acceptable variation for examiners. No Such
  284  rules may not rule shall apply retroactively.
  285  
  286  The department shall require a mandatory standardization
  287  exercise for all examiners prior to each practical or clinical
  288  examination and shall retain for employment only those dentists
  289  who have substantially adhered to the standard of grading
  290  established at such exercise.
  291         (6)(a) It is the finding of the Legislature that absent a
  292  threat to the health, safety, and welfare of the public, the
  293  relocation of applicants to practice dentistry within the
  294  geographic boundaries of this state, who are lawfully and
  295  currently practicing dentistry in another state or territory of
  296  the United States, the District of Columbia, or the Commonwealth
  297  of Puerto Rico, based on their scores from the American Dental
  298  Licensing Examination administered in a state other than this
  299  state, is substantially related to achieving the important state
  300  interest of improving access to dental care for underserved
  301  citizens of this state and furthering the economic development
  302  goals of the state. Therefore, in order to maintain valid active
  303  licensure in this state, all applicants for licensure who are
  304  relocating to this state based on scores from the American
  305  Dental Licensing Examination administered in a state other than
  306  this state must actually engage in the full-time practice of
  307  dentistry inside the geographic boundaries of this state within
  308  1 year of receiving such licensure in this state. The
  309  Legislature finds that, if such applicants do not actually
  310  engage in the full-time practice of dentistry within the
  311  geographic boundaries of this state within 1 year of receiving
  312  such a license in this state, access to dental care for the
  313  public will not significantly increase, patients’ continuity of
  314  care will not be attained, and the economic development goals of
  315  the state will not be significantly met.
  316         (b)1. As used in this section, “full-time practice of
  317  dentistry within the geographic boundaries of this state within
  318  1 year” is defined as a minimum of 1,200 hours in the initial
  319  year of licensure, which must include any combination of the
  320  following:
  321         a. Active clinical practice of dentistry providing direct
  322  patient care within the geographic boundaries of this state.
  323         b. Full-time practice as a faculty member employed by a
  324  dental or dental hygiene school approved by the board or
  325  accredited by the American Dental Association Commission on
  326  Dental Accreditation and located within the geographic
  327  boundaries of this state.
  328         c. Full-time practice as a student at a postgraduate dental
  329  education program approved by the board or accredited by the
  330  American Dental Association Commission on Dental Accreditation
  331  and located within the geographic boundaries of this state.
  332         2. The board shall develop rules to determine what type of
  333  proof of full-time practice of dentistry within the geographic
  334  boundaries of this state for 1 year is required in order to
  335  maintain active licensure and shall develop rules to recoup the
  336  cost to the board of verifying maintenance of such full-time
  337  practice under this section. Such proof must, at a minimum:
  338         a. Be admissible as evidence in an administrative
  339  proceeding;
  340         b. Be submitted in writing;
  341         c. Be submitted by the applicant under oath with penalties
  342  of perjury attached;
  343         d. Be further documented by an affidavit of someone
  344  unrelated to the applicant who is familiar with the applicant’s
  345  practice and testifies with particularity that the applicant has
  346  been engaged in full-time practice of dentistry within the
  347  geographic boundaries of this state within the last 365 days;
  348  and
  349         e. Include such additional proof as specifically found by
  350  the board to be both credible and admissible.
  351         3. An affidavit of only the applicant is not acceptable
  352  proof of full-time practice of dentistry within the geographic
  353  boundaries of this state within 1 year, unless it is further
  354  attested to by someone unrelated to the applicant who has
  355  personal knowledge of the applicant’s practice within the last
  356  365 days. If the board deems it necessary to assess credibility
  357  or accuracy, the board may require the applicant or the
  358  applicant’s witnesses to appear before the board and give oral
  359  testimony under oath.
  360         (c) It is the further intent of the Legislature that a
  361  license issued pursuant to paragraph (a) shall expire in the
  362  event the board finds that it did not receive acceptable proof
  363  of full-time practice within the geographic boundaries of this
  364  state within 1 year after the initial issuance of the license.
  365  The board shall make reasonable attempts within 30 days prior to
  366  the expiration of such a license to notify the licensee in
  367  writing at his or her last known address of the need for proof
  368  of full-time practice in order to continue licensure. If the
  369  board has not received a satisfactory response from the licensee
  370  within the 30-day period, the licensee must be served with
  371  actual or constructive notice of the pending expiration of
  372  licensure and be given 20 days in which to submit proof required
  373  in order to continue licensure. If the 20-day period expires and
  374  the board finds it has not received acceptable proof of full
  375  time practice within the geographic boundaries of this state
  376  within 1 year after the initial issuance of the license, then
  377  the board must issue an administrative order finding that the
  378  license has expired. Such an order may be appealed by the former
  379  licensee in accordance with the provisions of chapter 120. In
  380  the event of expiration, the licensee shall immediately cease
  381  and desist from practicing dentistry and shall immediately
  382  surrender to the board the wallet-size identification card and
  383  wall card. A person who uses or attempts to use a license issued
  384  pursuant to this section which has expired commits unlicensed
  385  practice of dentistry, a felony of the third degree pursuant to
  386  s. 466.026(1)(b), punishable as provided in s. 775.082, s.
  387  775.083, or s. 775.084.
  388         Section 2. Subsection (1) of section 466.009, Florida
  389  Statutes, is amended to read:
  390         466.009 Reexamination.—
  391         (1) The department shall permit Any person who fails an
  392  examination which is required under s. 466.006 or s. 466.007 may
  393  to retake the examination. If the examination to be retaken is a
  394  practical or clinical examination, the applicant shall pay a
  395  reexamination fee set by rule of the board in an amount not to
  396  exceed the original examination fee.
  397         Section 3. Paragraph (c) of subsection (1) of section
  398  466.0135, Florida Statutes, is amended to read:
  399         466.0135 Continuing education; dentists.—
  400         (1) In addition to the other requirements for renewal set
  401  out in this chapter, each licensed dentist shall be required to
  402  complete biennially not less than 30 hours of continuing
  403  professional education in dental subjects, with a minimum of 2
  404  hours of continuing education on the safe and effective
  405  prescribing of controlled substances. Programs of continuing
  406  education shall be programs of learning that contribute directly
  407  to the dental education of the dentist and may include, but
  408  shall not be limited to, attendance at lectures, study clubs,
  409  college postgraduate courses, or scientific sessions of
  410  conventions; and research, graduate study, teaching, or service
  411  as a clinician. Programs of continuing education shall be
  412  acceptable when adhering to the following general guidelines:
  413         (c) The board may also authorize up to 3 hours of credit
  414  biennially for a practice management course that includes
  415  instruction on principles of ethical practice management,
  416  provides substance abuse, effective communication with patients,
  417  time management, or and burnout prevention instruction.
  418         Section 4. Section 466.0282, Florida Statutes, is repealed.
  419         Section 5. This act shall take effect July 1, 2023.