Bill Text: FL S0184 | 2022 | Regular Session | Introduced


Bill Title: Dental Therapy

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2022-03-14 - Died in Health Policy [S0184 Detail]

Download: Florida-2022-S0184-Introduced.html
       Florida Senate - 2022                                     SB 184
       
       
        
       By Senator Brandes
       
       
       
       
       
       24-00062-22                                            2022184__
    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 a similar setting or program;
    7         amending s. 466.001, F.S.; revising legislative
    8         purpose and intent; amending s. 466.002, F.S.;
    9         providing applicability; reordering and amending s.
   10         466.003, F.S.; defining the terms “dental therapist”
   11         and “dental therapy”; revising the definition of the
   12         term “health access setting” to include certain dental
   13         therapy programs; amending s. 466.004, F.S.; requiring
   14         the chair of the Board of Dentistry to appoint a
   15         Council on Dental Therapy within a specified
   16         timeframe; providing for membership, meetings, and the
   17         purpose of the council; providing a process for
   18         rulemaking; making technical changes; amending s.
   19         466.006, F.S.; revising the definitions of the terms
   20         “full-time practice” and “full-time practice of
   21         dentistry within the geographic boundaries of this
   22         state within 1 year” to include full-time faculty
   23         members of certain dental therapy schools; amending s.
   24         466.0075, F.S.; authorizing the board to require any
   25         person who applies to take the examination to practice
   26         dental therapy in this state to maintain medical
   27         malpractice insurance in a certain amount; amending s.
   28         466.009, F.S.; requiring the Department of Health to
   29         allow an applicant who fails the dental therapy
   30         examination to retake the examination; providing that
   31         an applicant who fails a practical or clinical
   32         examination to practice dental therapy because of a
   33         failing grade on just one part or procedure tested is
   34         required to retake and receive a passing score on only
   35         the failed part or procedure to be eligible for
   36         licensure; requiring an applicant who fails more than
   37         one part or procedure tested to retake the entire
   38         examination; making technical changes; amending s.
   39         466.011, F.S.; requiring the board to certify certain
   40         applicants for licensure as a dental therapist;
   41         creating s. 466.0136, F.S.; providing that the board
   42         must require each licensed dental therapist to
   43         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         resulting from the administration of local anesthesia;
   63         requiring a complete written report of such incidents
   64         to be filed with the board within a specified
   65         timeframe; providing for disciplinary action; amending
   66         s. 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 or programs; authorizing a dental
   78         therapist to perform specified services, including
   79         specified state-specific dental therapy services,
   80         under the general supervision of a dentist under
   81         certain conditions; requiring a collaborative
   82         management agreement to be signed by a supervising
   83         dentist and a dental therapist and to include certain
   84         information; requiring a supervising dentist to
   85         determine the number of hours of practice which a
   86         dental therapist must complete under direct or
   87         indirect supervision before performing certain
   88         authorized services under general supervision;
   89         authorizing a supervising dentist to restrict or limit
   90         a dental therapist’s practice in a collaborative
   91         management agreement; authorizing a dental therapist
   92         to provide dental therapy services to a patient before
   93         the supervising dentist examines or diagnoses the
   94         patient under certain conditions; requiring a
   95         supervising dentist to be licensed or registered and
   96         practicing in this state; specifying that the
   97         supervising dentist is responsible for certain
   98         services and for providing and arranging certain
   99         followup services; amending s. 466.026, F.S.;
  100         providing criminal penalties; amending s. 466.028,
  101         F.S.; revising grounds for denial of a license or
  102         disciplinary action to include the practice of dental
  103         therapy; amending s. 921.0022, F.S.; conforming the
  104         criminal offense severity chart to changes made by the
  105         act; requiring the Department of Health, in
  106         consultation with the Board of Dentistry and the
  107         Agency for Health Care Administration, to submit
  108         certain reports to the Legislature by specified dates;
  109         providing requirements for such reports; providing an
  110         effective date.
  111          
  112  Be It Enacted by the Legislature of the State of Florida:
  113  
  114         Section 1. Paragraph (c) of subsection (1) and subsection
  115  (6) of section 409.906, Florida Statutes, are amended to read:
  116         409.906 Optional Medicaid services.—Subject to specific
  117  appropriations, the agency may make payments for services which
  118  are optional to the state under Title XIX of the Social Security
  119  Act and are furnished by Medicaid providers to recipients who
  120  are determined to be eligible on the dates on which the services
  121  were provided. Any optional service that is provided shall be
  122  provided only when medically necessary and in accordance with
  123  state and federal law. Optional services rendered by providers
  124  in mobile units to Medicaid recipients may be restricted or
  125  prohibited by the agency. Nothing in this section shall be
  126  construed to prevent or limit the agency from adjusting fees,
  127  reimbursement rates, lengths of stay, number of visits, or
  128  number of services, or making any other adjustments necessary to
  129  comply with the availability of moneys and any limitations or
  130  directions provided for in the General Appropriations Act or
  131  chapter 216. If necessary to safeguard the state’s systems of
  132  providing services to elderly and disabled persons and subject
  133  to the notice and review provisions of s. 216.177, the Governor
  134  may direct the Agency for Health Care Administration to amend
  135  the Medicaid state plan to delete the optional Medicaid service
  136  known as “Intermediate Care Facilities for the Developmentally
  137  Disabled.” Optional services may include:
  138         (1) ADULT DENTAL SERVICES.—
  139         (c) However, Medicaid will not provide reimbursement for
  140  dental services provided in a mobile dental unit, except for a
  141  mobile dental unit:
  142         1. Owned by, operated by, or having a contractual agreement
  143  with the Department of Health and complying with Medicaid’s
  144  county health department clinic services program specifications
  145  as a county health department clinic services provider.
  146         2. Owned by, operated by, or having a contractual
  147  arrangement with a federally qualified health center and
  148  complying with Medicaid’s federally qualified health center
  149  specifications as a federally qualified health center provider.
  150         3. Rendering dental services to Medicaid recipients, 21
  151  years of age and older, at nursing facilities.
  152         4. Owned by, operated by, or having a contractual agreement
  153  with a state-approved dental educational institution.
  154         5.Owned by, operated by, or having a contractual agreement
  155  with a health access setting, as defined in s. 466.003, or a
  156  similar setting or program that serves underserved or vulnerable
  157  populations that face serious barriers to accessing dental
  158  services. Such settings or programs include, but are not limited
  159  to, homeless shelters, schools, Early Head Start programs, or
  160  the Special Supplemental Nutrition Program for Women, Infants,
  161  and Children.
  162         (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for
  163  diagnostic, preventive, or corrective procedures, including
  164  orthodontia in severe cases, provided to a recipient under age
  165  21, by or under the supervision of a licensed dentist. The
  166  agency may also reimburse a health access setting as defined in
  167  s. 466.003 for the remediable tasks that a licensed dental
  168  hygienist is authorized to perform under s. 466.024(2). Services
  169  provided under this program include treatment of the teeth and
  170  associated structures of the oral cavity, as well as treatment
  171  of disease, injury, or impairment that may affect the oral or
  172  general health of the individual. However, Medicaid will not
  173  provide reimbursement for dental services provided in a mobile
  174  dental unit, except for a mobile dental unit:
  175         (a) Owned by, operated by, or having a contractual
  176  agreement with the Department of Health and complying with
  177  Medicaid’s county health department clinic services program
  178  specifications as a county health department clinic services
  179  provider.
  180         (b) Owned by, operated by, or having a contractual
  181  arrangement with a federally qualified health center and
  182  complying with Medicaid’s federally qualified health center
  183  specifications as a federally qualified health center provider.
  184         (c) Rendering dental services to Medicaid recipients, 21
  185  years of age and older, at nursing facilities.
  186         (d) Owned by, operated by, or having a contractual
  187  agreement with a state-approved dental educational institution.
  188         (e)Owned by, operated by, or having a contractual
  189  agreement with a health access setting, as defined in s.
  190  466.003, or a similar setting or program that serves underserved
  191  or vulnerable populations that face serious barriers to
  192  accessing dental services. Such settings or programs include,
  193  but are not limited to, homeless shelters, schools, Early Head
  194  Start programs, or the Special Supplemental Nutrition Program
  195  for Women, Infants, and Children.
  196         Section 2. Section 466.001, Florida Statutes, is amended to
  197  read:
  198         466.001 Legislative purpose and intent.—The legislative
  199  purpose for enacting this chapter is to ensure that every
  200  dentist, dental therapist, and or dental hygienist practicing in
  201  this state meets minimum requirements for safe practice without
  202  undue clinical interference by persons not licensed under this
  203  chapter. It is the legislative intent that dental services be
  204  provided only in accordance with the provisions of this chapter
  205  and not be delegated to unauthorized individuals. It is the
  206  further legislative intent that dentists, dental therapists, and
  207  dental hygienists who fall below minimum competency or who
  208  otherwise present a danger to the public shall be prohibited
  209  from practicing in this state. All provisions of this chapter
  210  relating to the practice of dentistry, dental therapy, and
  211  dental hygiene must shall be liberally construed to carry out
  212  such purpose and intent.
  213         Section 3. Subsections (5) and (6) of section 466.002,
  214  Florida Statutes, are amended to read:
  215         466.002 Persons exempt from operation of chapter.—Nothing
  216  in this chapter shall apply to the following practices, acts,
  217  and operations:
  218         (5) Students in Florida schools of dentistry, dental
  219  therapy, and dental hygiene or dental assistant educational
  220  programs, while performing regularly assigned work under the
  221  curriculum of such schools.
  222         (6) Instructors in Florida schools of dentistry,
  223  instructors in dental programs that prepare persons holding
  224  D.D.S. or D.M.D. degrees for certification by a specialty board
  225  and that are accredited in the United States by January 1, 2005,
  226  in the same manner as the board recognizes accreditation for
  227  Florida schools of dentistry that are not otherwise affiliated
  228  with a Florida school of dentistry, or instructors in Florida
  229  schools of dental therapy or dental hygiene or dental assistant
  230  educational programs, while performing regularly assigned
  231  instructional duties under the curriculum of such schools or
  232  programs. A full-time dental instructor at a dental school or
  233  dental program approved by the board may be allowed to practice
  234  dentistry at the teaching facilities of such school or program,
  235  upon receiving a teaching permit issued by the board, in strict
  236  compliance with such rules as are adopted by the board
  237  pertaining to the teaching permit and with the established rules
  238  and procedures of the dental school or program as recognized in
  239  this section.
  240         Section 4. Section 466.003, Florida Statutes, is reordered
  241  and amended to read:
  242         466.003 Definitions.—As used in this chapter, the term:
  243         (1) “Board” means the Board of Dentistry.
  244         (7)(2) “Dentist” means a person licensed to practice
  245  dentistry pursuant to this chapter.
  246         (8)(3) “Dentistry” means the healing art which is concerned
  247  with the examination, diagnosis, treatment planning, and care of
  248  conditions within the human oral cavity and its adjacent tissues
  249  and structures. It includes the performance or attempted
  250  performance of any dental operation, or oral or oral
  251  maxillofacial surgery and any procedures adjunct thereto,
  252  including physical evaluation directly related to such operation
  253  or surgery pursuant to hospital rules and regulations. It also
  254  includes dental service of any kind gratuitously or for any
  255  remuneration paid, or to be paid, directly or indirectly, to any
  256  person or agency. The term “dentistry” shall also include the
  257  following:
  258         (a) The taking of an impression of the human tooth, teeth,
  259  or jaws directly or indirectly and by any means or method.
  260         (b) Supplying artificial substitutes for the natural teeth
  261  or furnishing, supplying, constructing, reproducing, or
  262  repairing any prosthetic denture, bridge, appliance, or any
  263  other structure designed to be worn in the human mouth except on
  264  the written work order of a duly licensed dentist.
  265         (c) The placing of an appliance or structure in the human
  266  mouth or the adjusting or attempting to adjust the same.
  267         (d) Delivering the same to any person other than the
  268  dentist upon whose work order the work was performed.
  269         (e) Professing to the public by any method to furnish,
  270  supply, construct, reproduce, or repair any prosthetic denture,
  271  bridge, appliance, or other structure designed to be worn in the
  272  human mouth.
  273         (f) Diagnosing, prescribing, or treating or professing to
  274  diagnose, prescribe, or treat disease, pain, deformity,
  275  deficiency, injury, or physical condition of the human teeth or
  276  jaws or oral-maxillofacial region.
  277         (g) Extracting or attempting to extract human teeth.
  278         (h) Correcting or attempting to correct malformations of
  279  teeth or of jaws.
  280         (i) Repairing or attempting to repair cavities in the human
  281  teeth.
  282         (3)(4) “Dental hygiene” means the rendering of educational,
  283  preventive, and therapeutic dental services pursuant to ss.
  284  466.023 and 466.024 and any related extra-oral procedure
  285  required in the performance of such services.
  286         (4)(5) “Dental hygienist” means a person licensed to
  287  practice dental hygiene pursuant to this chapter.
  288         (5)Dental therapist” means a person licensed to practice
  289  dental therapy pursuant to s. 466.0225.
  290         (6)Dental therapy” means the rendering of services
  291  pursuant to s. 466.0227 and any related extraoral services or
  292  procedures required in the performance of such services.
  293         (2)(6) “Dental assistant” means a person, other than a
  294  dental hygienist, who, under the supervision and authorization
  295  of a dentist, provides dental care services directly to a
  296  patient. This term shall not include a certified registered
  297  nurse anesthetist licensed under part I of chapter 464.
  298         (9)(7) “Department” means the Department of Health.
  299         (10)(8) “Direct supervision” means supervision whereby a
  300  dentist diagnoses the condition to be treated, a dentist
  301  authorizes the procedure to be performed, a dentist remains on
  302  the premises while the procedures are performed, and a dentist
  303  approves the work performed before dismissal of the patient.
  304         (13)(9) “Indirect supervision” means supervision whereby a
  305  dentist authorizes the procedure and a dentist is on the
  306  premises while the procedures are performed.
  307         (11)(10) “General supervision” means supervision whereby a
  308  dentist authorizes the procedures which are being carried out
  309  but need not be present when the authorized procedures are being
  310  performed. The authorized procedures may also be performed at a
  311  place other than the dentist’s usual place of practice. The
  312  issuance of a written work authorization to a commercial dental
  313  laboratory by a dentist does not constitute general supervision.
  314         (14)(11) “Irremediable tasks” are those intraoral treatment
  315  tasks which, when performed, are irreversible and create
  316  unalterable changes within the oral cavity or the contiguous
  317  structures or which cause an increased risk to the patient. The
  318  administration of anesthetics other than topical anesthesia is
  319  considered to be an “irremediable task” for purposes of this
  320  chapter.
  321         (16)(12) “Remediable tasks” are those intraoral treatment
  322  tasks which are reversible and do not create unalterable changes
  323  within the oral cavity or the contiguous structures and which do
  324  not cause an increased risk to the patient.
  325         (15)(13) “Oral and maxillofacial surgery” means the
  326  specialty of dentistry involving diagnosis, surgery, and
  327  adjunctive treatment of diseases, injuries, and defects
  328  involving the functional and esthetic aspects of the hard and
  329  soft tissues of the oral and maxillofacial regions. This term
  330  may not be construed to apply to any individual exempt under s.
  331  466.002(1).
  332         (12)(14) “Health access setting” means a program or an
  333  institution of the Department of Children and Families, the
  334  Department of Health, the Department of Juvenile Justice, a
  335  nonprofit community health center, a Head Start center, a
  336  federally qualified health center or look-alike as defined by
  337  federal law, a school-based prevention program, a clinic
  338  operated by an accredited college of dentistry, or an accredited
  339  dental therapy or dental hygiene program in this state if such
  340  community service program or institution immediately reports to
  341  the Board of Dentistry all violations of s. 466.027, s. 466.028,
  342  or other practice act or standard of care violations related to
  343  the actions or inactions of a dentist, dental therapist, dental
  344  hygienist, or dental assistant engaged in the delivery of dental
  345  care in such setting.
  346         (17)(15) “School-based prevention program” means preventive
  347  oral health services offered at a school by one of the entities
  348  defined in subsection (12) (14) or by a nonprofit organization
  349  that is exempt from federal income taxation under s. 501(a) of
  350  the Internal Revenue Code, and described in s. 501(c)(3) of the
  351  Internal Revenue Code.
  352         Section 5. Subsection (2) of section 466.004, Florida
  353  Statutes, is amended to read:
  354         466.004 Board of Dentistry.—
  355         (2) To advise the board, It is the intent of the
  356  Legislature that councils be appointed as specified in this
  357  subsection to advise the board paragraphs (a), (b), and (c). The
  358  department shall provide administrative support to the councils
  359  and shall provide public notice of meetings and agendas agenda
  360  of the councils. Councils must shall include at least one board
  361  member, who shall chair the council, and shall include nonboard
  362  members. All council members shall be appointed by the board
  363  chair. Council members shall be appointed for 4-year terms, and
  364  all members are shall be eligible for reimbursement of expenses
  365  in the manner of board members.
  366         (a) A Council on Dental Hygiene shall be appointed by the
  367  board chair and shall include one dental hygienist member of the
  368  board, who shall chair the council, one dental member of the
  369  board, and three dental hygienists who are actively engaged in
  370  the practice of dental hygiene in this state. In making the
  371  appointments, the chair shall consider recommendations from the
  372  Florida Dental Hygienists’ Hygiene Association. The council
  373  shall meet at the request of the board chair, a majority of the
  374  members of the board, or the council chair; however, the council
  375  must meet at least three times a year. The council is charged
  376  with the responsibility of and shall recommend proposed meet for
  377  the purpose of developing rules and policies for recommendation
  378  to the board, which the board shall consider, on matters
  379  pertaining to the areas that part of dentistry consisting of
  380  educational, preventive, or therapeutic dental hygiene services;
  381  dental hygiene licensure, discipline, or regulation; and dental
  382  hygiene education. The board shall consider these rules and
  383  policies Rule and policy recommendations of the council shall be
  384  considered by the board at its next regularly scheduled meeting
  385  in the same manner in which it considers rule and policy
  386  recommendations from designated subcommittees of the board. Any
  387  rule or policy proposed by the board pertaining to these areas
  388  must the specified part of dentistry defined by this subsection
  389  shall be referred to the council for its a recommendation before
  390  final action by the board. The board may take final action on
  391  rules pertaining to these areas the specified part of dentistry
  392  defined by this subsection without a council recommendation if
  393  the council fails to submit a recommendation in a timely
  394  fashion, as prescribed by the board.
  395         (b) A Council on Dental Assisting shall be appointed by the
  396  board chair and shall include one board member, who shall chair
  397  the council, and three dental assistants who are actively
  398  engaged in dental assisting in this state. The council shall
  399  meet at the request of the board chair or a majority of the
  400  members of the board. The council shall meet for the purpose of
  401  developing recommendations to the board on matters pertaining to
  402  that part of dentistry related to dental assisting.
  403         (c) Effective 28 months after the first dental therapy
  404  license is granted by the board, the board chair shall appoint a
  405  Council on Dental Therapy, which must include one board member,
  406  who shall chair the council, and three dental therapists who are
  407  actively engaged in the practice of dental therapy in this
  408  state. The council shall meet at the request of the board chair,
  409  a majority of the members of the board, or the council chair;
  410  however, the council must meet at least three times per year.
  411  The council shall recommend proposed rules and policies to the
  412  board on matters pertaining to the areas of educational,
  413  preventive, or therapeutic dental therapy services; dental
  414  therapy licensure, discipline, or regulation; and dental therapy
  415  education. The board shall consider the council’s rule and
  416  policy recommendations at its next regularly scheduled meeting
  417  in the same manner in which it considers rule and policy
  418  recommendations from designated subcommittees of the board. Any
  419  rule or policy proposed by the board pertaining to these areas
  420  must be referred to the council for its recommendation before
  421  final action by the board. The board may take final action on
  422  rules pertaining to these areas without a council recommendation
  423  if the council fails to submit a recommendation in a timely
  424  fashion, as prescribed by the board.
  425         (d) With the concurrence of the State Surgeon General, the
  426  board chair may create and abolish other advisory councils
  427  relating to dental subjects, including, but not limited to,:
  428  examinations, access to dental care, indigent care, nursing home
  429  and institutional care, public health, disciplinary guidelines,
  430  and other subjects, as appropriate. Such councils must shall be
  431  appointed by the board chair and must shall include at least one
  432  board member, who shall serve as chair.
  433         Section 6. Subsection (4) and paragraph (b) of subsection
  434  (6) of section 466.006, Florida Statutes, are amended to read:
  435         466.006 Examination of dentists.—
  436         (4) Notwithstanding any other provision of law in chapter
  437  456 pertaining to the clinical dental licensure examination or
  438  national examinations, to be licensed as a dentist in this
  439  state, an applicant must successfully complete both of the
  440  following:
  441         (a) A written examination on the laws and rules of the
  442  state regulating the practice of dentistry.
  443         (b) A practical or clinical examination, which must be the
  444  American Dental Licensing Examination produced by the American
  445  Board of Dental Examiners, Inc., or its successor entity, if
  446  any, that is administered in this state, provided that the board
  447  has attained, and continues to maintain thereafter,
  448  representation on the board of directors of the American Board
  449  of Dental Examiners, the examination development committee of
  450  the American Board of Dental Examiners, and such other
  451  committees of the American Board of Dental Examiners as the
  452  board deems appropriate by rule to assure that the standards
  453  established herein are maintained organizationally. A passing
  454  score on the American Dental Licensing Examination administered
  455  in this state is valid for 365 days after the date the official
  456  examination results are published.
  457         1. As an alternative to such practical or clinical
  458  examination, an applicant may submit scores from an American
  459  Dental Licensing Examination previously administered in a
  460  jurisdiction other than this state after October 1, 2011, and
  461  such examination results shall be recognized as valid for the
  462  purpose of licensure in this state. A passing score on the
  463  American Dental Licensing Examination administered out of state
  464  shall be the same as the passing score for the American Dental
  465  Licensing Examination administered in this state. The
  466  examination results are valid for 365 days after the date the
  467  official examination results are published. The applicant must
  468  have completed the examination after October 1, 2011. This
  469  subparagraph may not be given retroactive application.
  470         2. If the date of an applicant’s passing American Dental
  471  Licensing Examination scores from an examination previously
  472  administered in a jurisdiction other than this state under
  473  subparagraph 1. is older than 365 days, such scores are
  474  nevertheless valid for the purpose of licensure in this state,
  475  but only if the applicant demonstrates that all of the following
  476  additional standards have been met:
  477         a. The applicant completed the American Dental Licensing
  478  Examination after October 1, 2011. This sub-subparagraph may not
  479  be given retroactive application;
  480         b. The applicant graduated from a dental school accredited
  481  by the American Dental Association Commission on Dental
  482  Accreditation or its successor entity, if any, or any other
  483  dental accrediting organization recognized by the United States
  484  Department of Education. Provided, however, if the applicant did
  485  not graduate from such a dental school, the applicant may submit
  486  proof of having successfully completed a full-time supplemental
  487  general dentistry program accredited by the American Dental
  488  Association Commission on Dental Accreditation of at least 2
  489  consecutive academic years at such accredited sponsoring
  490  institution. Such program must provide didactic and clinical
  491  education at the level of a D.D.S. or D.M.D. program accredited
  492  by the American Dental Association Commission on Dental
  493  Accreditation. For purposes of this sub-subparagraph, a
  494  supplemental general dentistry program does not include an
  495  advanced education program in a dental specialty;
  496         c. The applicant currently possesses a valid and active
  497  dental license in good standing, with no restriction, which has
  498  never been revoked, suspended, restricted, or otherwise
  499  disciplined, from another state or territory of the United
  500  States, the District of Columbia, or the Commonwealth of Puerto
  501  Rico;
  502         d. The applicant submits proof that he or she has never
  503  been reported to the National Practitioner Data Bank, the
  504  Healthcare Integrity and Protection Data Bank, or the American
  505  Association of Dental Boards Clearinghouse. This sub
  506  subparagraph does not apply if the applicant successfully
  507  appealed to have his or her name removed from the data banks of
  508  these agencies;
  509         e.(I)(A) The applicant submits proof of having been
  510  consecutively engaged in the full-time practice of dentistry in
  511  another state or territory of the United States, the District of
  512  Columbia, or the Commonwealth of Puerto Rico in the 5 years
  513  immediately preceding the date of application for licensure in
  514  this state; or
  515         (B) If the applicant has been licensed in another state or
  516  territory of the United States, the District of Columbia, or the
  517  Commonwealth of Puerto Rico for less than 5 years, the applicant
  518  submits proof of having been engaged in the full-time practice
  519  of dentistry since the date of his or her initial licensure.
  520         (II) As used in this section, “full-time practice” is
  521  defined as a minimum of 1,200 hours per year for each and every
  522  year in the consecutive 5-year period or, when applicable, the
  523  period since initial licensure, and must include any combination
  524  of the following:
  525         (A) Active clinical practice of dentistry providing direct
  526  patient care.
  527         (B) Full-time practice as a faculty member employed by a
  528  dental, dental therapy, or dental hygiene school approved by the
  529  board or accredited by the American Dental Association
  530  Commission on Dental Accreditation.
  531         (C) Full-time practice as a student at a postgraduate
  532  dental education program approved by the board or accredited by
  533  the American Dental Association Commission on Dental
  534  Accreditation.
  535         (III) The board shall develop rules to determine what type
  536  of proof of full-time practice is required and to recoup the
  537  cost to the board of verifying full-time practice under this
  538  section. Such proof must, at a minimum, be:
  539         (A) Admissible as evidence in an administrative proceeding;
  540         (B) Submitted in writing;
  541         (C) Submitted by the applicant under oath with penalties of
  542  perjury attached;
  543         (D) Further documented by an affidavit of someone unrelated
  544  to the applicant who is familiar with the applicant’s practice
  545  and testifies with particularity that the applicant has been
  546  engaged in full-time practice; and
  547         (E) Specifically found by the board to be both credible and
  548  admissible.
  549         (IV) An affidavit of only the applicant is not acceptable
  550  proof of full-time practice unless it is further attested to by
  551  someone unrelated to the applicant who has personal knowledge of
  552  the applicant’s practice. If the board deems it necessary to
  553  assess credibility or accuracy, the board may require the
  554  applicant or the applicant’s witnesses to appear before the
  555  board and give oral testimony under oath;
  556         f. The applicant submits documentation that he or she has
  557  completed, or will complete before he or she is licensed in this
  558  state, continuing education equivalent to this state’s
  559  requirements for the last full reporting biennium;
  560         g. The applicant proves that he or she has never been
  561  convicted of, or pled nolo contendere to, regardless of
  562  adjudication, any felony or misdemeanor related to the practice
  563  of a health care profession in any jurisdiction;
  564         h. The applicant has successfully passed a written
  565  examination on the laws and rules of this state regulating the
  566  practice of dentistry and the computer-based diagnostic skills
  567  examination; and
  568         i. The applicant submits documentation that he or she has
  569  successfully completed the applicable examination administered
  570  by the Joint Commission on National Dental Examinations or its
  571  successor organization.
  572         (6)
  573         (b)1. As used in this section, “full-time practice of
  574  dentistry within the geographic boundaries of this state within
  575  1 year” is defined as a minimum of 1,200 hours in the initial
  576  year of licensure, which must include any combination of the
  577  following:
  578         a. Active clinical practice of dentistry providing direct
  579  patient care within the geographic boundaries of this state.
  580         b. Full-time practice as a faculty member employed by a
  581  dental, dental therapy, or dental hygiene school approved by the
  582  board or accredited by the American Dental Association
  583  Commission on Dental Accreditation and located within the
  584  geographic boundaries of this state.
  585         c. Full-time practice as a student at a postgraduate dental
  586  education program approved by the board or accredited by the
  587  American Dental Association Commission on Dental Accreditation
  588  and located within the geographic boundaries of this state.
  589         2. The board shall develop rules to determine what type of
  590  proof of full-time practice of dentistry within the geographic
  591  boundaries of this state for 1 year is required in order to
  592  maintain active licensure and shall develop rules to recoup the
  593  cost to the board of verifying maintenance of such full-time
  594  practice under this section. Such proof must, at a minimum:
  595         a. Be admissible as evidence in an administrative
  596  proceeding;
  597         b. Be submitted in writing;
  598         c. Be submitted by the applicant under oath with penalties
  599  of perjury attached;
  600         d. Be further documented by an affidavit of someone
  601  unrelated to the applicant who is familiar with the applicant’s
  602  practice and testifies with particularity that the applicant has
  603  been engaged in full-time practice of dentistry within the
  604  geographic boundaries of this state within the last 365 days;
  605  and
  606         e. Include such additional proof as specifically found by
  607  the board to be both credible and admissible.
  608         3. An affidavit of only the applicant is not acceptable
  609  proof of full-time practice of dentistry within the geographic
  610  boundaries of this state within 1 year, unless it is further
  611  attested to by someone unrelated to the applicant who has
  612  personal knowledge of the applicant’s practice within the last
  613  365 days. If the board deems it necessary to assess credibility
  614  or accuracy, the board may require the applicant or the
  615  applicant’s witnesses to appear before the board and give oral
  616  testimony under oath.
  617         Section 7. Section 466.0075, Florida Statutes, is amended
  618  to read:
  619         466.0075 Applicants for examination; medical malpractice
  620  insurance.—The board may require any person applying to take the
  621  examination to practice dentistry in this state, the examination
  622  to practice dental therapy in this state, or the examination to
  623  practice dental hygiene in this state to maintain medical
  624  malpractice insurance in amounts sufficient to cover any
  625  incident of harm to a patient during the clinical examination.
  626         Section 8. Section 466.009, Florida Statutes, is amended to
  627  read:
  628         466.009 Reexamination.—
  629         (1) The department shall allow permit any person who fails
  630  an examination that which is required under s. 466.006, or s.
  631  466.007, or s. 466.0225 to retake the examination. If the
  632  examination to be retaken is a practical or clinical
  633  examination, the applicant must shall pay a reexamination fee
  634  set by rule of the board in an amount not to exceed the original
  635  examination fee.
  636         (2) If an applicant for a license to practice dentistry
  637  fails the practical or clinical examination because of a failing
  638  grade on just one part or procedure tested, she or he must shall
  639  be required to retake and receive a passing score on only the
  640  failed that part or procedure to be eligible for licensure.
  641  However, if any such applicant fails more than one part or
  642  procedure of any such examination, she or he must shall be
  643  required to retake the entire examination.
  644         (3) If an applicant for a license to practice dental
  645  hygiene fails one portion of the practical or clinical
  646  examination because of a failing grade on just one part or
  647  procedure tested, such applicant must shall be required to
  648  retake and receive a passing score on only the failed part or
  649  procedure to be eligible for licensure that portion if she or he
  650  reapplies within 12 months. If, however, the applicant fails the
  651  prophylaxis, she or he must shall be required to retake the
  652  entire examination.
  653         (4)If an applicant for a license to practice dental
  654  therapy fails the practical or clinical examination because of a
  655  failing grade on just one part or procedure tested, she or he
  656  must retake and receive a passing score on only the failed part
  657  or procedure to be eligible for licensure. However, if such
  658  applicant fails more than one part or procedure of any such
  659  examination, she or he must retake the entire examination.
  660         Section 9. Section 466.011, Florida Statutes, is amended to
  661  read:
  662         466.011 Licensure.—The board shall certify for licensure by
  663  the department any applicant who satisfies the requirements of
  664  s. 466.006, s. 466.0067, or s. 466.007, or s. 466.0225. The
  665  board may refuse to certify an applicant who has violated any of
  666  the provisions of s. 466.026 or s. 466.028.
  667         Section 10. Section 466.0136, Florida Statutes, is created
  668  to read:
  669         466.0136Continuing education; dental therapists.—In
  670  addition to any other requirements specified in this chapter for
  671  relicensure of dental therapists, the board shall require each
  672  licensed dental therapist to complete at least 24 hours, but not
  673  more than 36 hours, biennially of continuing education in dental
  674  subjects in programs approved by the board or in equivalent
  675  programs of continuing education. Programs of continuing
  676  education approved by the board must be programs of learning
  677  which, in the opinion of the board, contribute directly to the
  678  dental education of the dental therapist. An individual who is
  679  licensed as both a dental therapist and a dental hygienist may
  680  use continuing education that is approved for both dental
  681  therapy and dental hygiene education to satisfy both dental
  682  therapy and dental hygiene continuing education requirements.
  683  The board shall adopt rules and guidelines to administer and
  684  enforce this section. A dental therapist shall retain in her or
  685  his records any receipts, vouchers, or certificates necessary to
  686  document completion of the required continuing education.
  687  Compliance with the continuing education requirements is
  688  mandatory for issuance of the renewal certificate. The board may
  689  excuse licensees, as a group or as individuals, from all or part
  690  of the continuing education requirements if an unusual
  691  circumstance, emergency, or hardship prevents compliance with
  692  this section.
  693         Section 11. Section 466.016, Florida Statutes, is amended
  694  to read:
  695         466.016 License to be displayed.—Every practitioner of
  696  dentistry, dental therapy, or dental hygiene within the meaning
  697  of this chapter shall post and keep conspicuously displayed her
  698  or his license in the office where wherein she or he practices,
  699  in plain sight of the practitioner’s patients. Any dentist,
  700  dental therapist, or dental hygienist who practices at more than
  701  one location shall be required to display a copy of her or his
  702  license in each office where she or he practices.
  703         Section 12. Present subsections (7) through (10) and (11)
  704  through (15) of section 466.017, Florida Statutes, are
  705  redesignated as subsections (8) through (11) and (13) through
  706  (17), respectively, new subsections (7) and (12) are added to
  707  that section, and paragraphs (d) and (e) of subsection (3),
  708  subsection (4), and present subsections (7), (8), (12), and (14)
  709  of that section are amended, to read:
  710         466.017 Prescription of drugs; anesthesia.—
  711         (3) The board shall adopt rules which:
  712         (d) Establish further requirements relating to the use of
  713  general anesthesia or sedation, including, but not limited to,
  714  office equipment and the training of dental assistants, dental
  715  therapists, or dental hygienists who work with dentists using
  716  general anesthesia or sedation.
  717         (e) Establish an administrative mechanism enabling the
  718  board to verify compliance with training, education, experience,
  719  equipment, or certification requirements of dentists, dental
  720  therapists, dental hygienists, and dental assistants adopted
  721  pursuant to this subsection. The board may charge a fee to
  722  defray the cost of verifying compliance with requirements
  723  adopted pursuant to this paragraph.
  724         (4) A dentist, dental therapist, or dental hygienist who
  725  administers or employs the use of any form of anesthesia must
  726  possess a certification in either basic cardiopulmonary
  727  resuscitation for health professionals or advanced cardiac life
  728  support approved by the American Heart Association or the
  729  American Red Cross or an equivalent agency-sponsored course with
  730  recertification every 2 years. Each dental office that which
  731  uses any form of anesthesia must have immediately available and
  732  in good working order such resuscitative equipment, oxygen, and
  733  other resuscitative drugs as are specified by rule of the board
  734  in order to manage possible adverse reactions.
  735         (7)A dental therapist under the general supervision of a
  736  dentist may administer local anesthesia, including intraoral
  737  block anesthesia or soft tissue infiltration anesthesia, or
  738  both, if she or he has completed the course described in
  739  paragraph (5)(a) and presents evidence of current certification
  740  in basic or advanced cardiac life support.
  741         (8)(7) A licensed dentist, or a dental therapist who is
  742  authorized by her or his supervising dentist, may operate
  743  utilize an X-ray machine, expose dental X-ray films, and
  744  interpret or read such films. Notwithstanding The provisions of
  745  part IV of chapter 468 to the contrary notwithstanding, a
  746  licensed dentist, or a dental therapist who is authorized by her
  747  or his supervising dentist, may authorize or direct a dental
  748  assistant to operate such equipment and expose such films under
  749  her or his direction and supervision, pursuant to rules adopted
  750  by the board in accordance with s. 466.024 which ensure that the
  751  said assistant is competent by reason of training and experience
  752  to operate the X-ray said equipment in a safe and efficient
  753  manner. The board may charge a fee not to exceed $35 to defray
  754  the cost of verifying compliance with requirements adopted
  755  pursuant to this section.
  756         (9)(8)Notwithstanding The provisions of s. 465.0276
  757  notwithstanding, a dentist need not register with the board or
  758  comply with the continuing education requirements of that
  759  section if the dentist confines her or his dispensing activity
  760  to the dispensing of fluorides and chlorhexidine chlorohexidine
  761  rinse solutions,; provided that the dentist, when dispensing
  762  such products, complies with and is subject to all laws and
  763  rules applicable to pharmacists and pharmacies, including, but
  764  not limited to, chapters 465, 499, and 893, and all applicable
  765  federal laws and regulations, when dispensing such products.
  766         (12) A licensed dental therapist administering local
  767  anesthesia shall notify the board in writing by registered mail
  768  within 48 hours after any adverse incident related to or
  769  resulting from the administration of local anesthesia. A
  770  complete written report must be filed with the board within 30
  771  days after the mortality or other adverse incident.
  772         (14)(12) A failure by the dentist, dental therapist, or
  773  dental hygienist to timely and completely comply with all the
  774  reporting requirements in this section is the basis for
  775  disciplinary action by the board pursuant to s. 466.028(1).
  776         (16)(14) As used in subsections (10)-(15) (9)-(13), the
  777  term “adverse incident” means any mortality that occurs during
  778  or as the result of a dental procedure, or an incident that
  779  results in a temporary or permanent physical or mental injury
  780  that requires hospitalization or emergency room treatment of a
  781  dental patient which occurs during or as a direct result of the
  782  use of general anesthesia, deep sedation, moderate sedation,
  783  pediatric moderate sedation, oral sedation, minimal sedation
  784  (anxiolysis), nitrous oxide, or local anesthesia.
  785         Section 13. Subsection (1) of section 466.018, Florida
  786  Statutes, is amended to read:
  787         466.018 Dentist of record; patient records.—
  788         (1) Each patient shall have a dentist of record. The
  789  dentist of record shall remain primarily responsible for all
  790  dental treatment on such patient regardless of whether the
  791  treatment is rendered by the dentist or by another dentist,
  792  dental therapist, dental hygienist, or dental assistant
  793  rendering such treatment in conjunction with, at the direction
  794  or request of, or under the supervision of such dentist of
  795  record. The dentist of record shall be identified in the record
  796  of the patient. If treatment is rendered by a dentist other than
  797  the dentist of record or by a dental therapist, dental
  798  hygienist, or dental assistant, the name or initials of such
  799  person must shall be placed in the record of the patient. In any
  800  disciplinary proceeding brought pursuant to this chapter or
  801  chapter 456, it is shall be presumed as a matter of law that
  802  treatment was rendered by the dentist of record unless otherwise
  803  noted on the patient record pursuant to this section. The
  804  dentist of record and any other treating dentist are subject to
  805  discipline pursuant to this chapter or chapter 456 for treatment
  806  rendered to the patient and performed in violation of such
  807  chapter. One of the purposes of this section is to ensure that
  808  the responsibility for each patient is assigned to one dentist
  809  in a multidentist practice of any nature and to assign primary
  810  responsibility to the dentist for treatment rendered by a dental
  811  therapist, dental hygienist, or dental assistant under her or
  812  his supervision. This section may shall not be construed to
  813  assign any responsibility to a dentist of record for treatment
  814  rendered pursuant to a proper referral to another dentist who
  815  does not in practice with the dentist of record or to prohibit a
  816  patient from voluntarily selecting a new dentist without
  817  permission of the dentist of record.
  818         Section 14. Section 466.0225, Florida Statutes, is created
  819  to read:
  820         466.0225Examination of dental therapists; licensing.—
  821         (1)Any person desiring to be licensed as a dental
  822  therapist must apply to the department to take the licensure
  823  examinations and must verify the information required on the
  824  application by oath. The application must be accompanied by two
  825  recent photographs of the applicant.
  826         (2)An applicant is entitled to take the examinations
  827  required under this section and receive licensure to practice
  828  dental therapy in this state if the applicant meets all of the
  829  following requirements:
  830         (a)Is 18 years of age or older.
  831         (b)Is a graduate of a dental therapy college or school
  832  accredited by the American Dental Association Commission on
  833  Dental Accreditation or its successor entity, if any, or any
  834  other dental therapy accrediting entity recognized by the United
  835  States Department of Education. For applicants applying for a
  836  dental therapy license before January 1, 2026, the board shall
  837  approve the applicant’s dental therapy education program if the
  838  program was administered by a college or school that operates an
  839  accredited dental or dental hygiene education program and the
  840  college or school certifies to the board that the applicant’s
  841  education substantially conformed to the education standards
  842  established by the American Dental Association Commission on
  843  Dental Accreditation.
  844         (c)Has successfully completed a dental therapy practical
  845  or clinical examination produced by the American Board of Dental
  846  Examiners, Inc., (ADEX) or its successor entity, if any, if the
  847  board finds that the successor entity’s examination meets or
  848  exceeds the requirements of this section. If an applicant fails
  849  to pass such an examination after three attempts, the applicant
  850  may not retake the examination unless the applicant completes
  851  additional education requirements as specified by the board. If
  852  a dental therapy examination has not been established by ADEX,
  853  the board shall administer or approve an alternative
  854  examination.
  855         (d)Has not been disciplined by a board, except for
  856  citation offenses or minor violations, as determined by the
  857  board.
  858         (e)Has not been convicted of or pled nolo contendere to,
  859  regardless of adjudication, any felony or misdemeanor related to
  860  the practice of a health care profession.
  861         (f)Has successfully completed a written examination on the
  862  laws and rules of this state regulating the practice of dental
  863  therapy.
  864         (3)An applicant who meets the requirements of this section
  865  and who has successfully completed an examination identified in
  866  paragraph (2)(c) in a jurisdiction other than this state, or who
  867  has successfully completed a comparable examination administered
  868  or approved by the licensing authority in a jurisdiction other
  869  than this state, must be licensed to practice dental therapy in
  870  this state if the board determines that the other jurisdiction’s
  871  examination and scope of practice are substantially similar to
  872  those identified in paragraph (2)(c).
  873         Section 15. Section 466.0227, Florida Statutes, is created
  874  to read:
  875         466.0227Dental therapists; scope and area of practice.—
  876         (1)The Legislature finds that authorizing licensed dental
  877  therapists to perform the services specified in subsection (3)
  878  would improve access to high-quality, affordable oral health
  879  services for all residents of this state. The Legislature
  880  intends to rapidly improve such access for low-income,
  881  uninsured, and underserved patients and communities. To further
  882  this intent, a dental therapist licensed under this chapter is
  883  limited to practicing dental therapy in the following settings
  884  or programs:
  885         (a)A health access setting, as defined in s. 466.003.
  886         (b)A community health center, including an off-site care
  887  setting.
  888         (c)A nursing facility.
  889         (d)A military or veterans’ hospital or clinic, including
  890  an off-site care setting.
  891         (e)A governmental or public health clinic, including an
  892  off-site care setting.
  893         (f)A school, an Early Head Start program, or a school
  894  based prevention program as defined in s. 466.003.
  895         (g)An oral health education institution, including an off
  896  site care setting.
  897         (h)A hospital.
  898         (i)A correctional facility clinic setting.
  899         (j)A geographic area designated as a dental health
  900  professional shortage area by the state or the Federal
  901  Government.
  902         (k)A health facility operated by the Indian Health Service
  903  or by a tribal organization.
  904         (l)Any other clinic or practice setting if at least 50
  905  percent of the patients served by the dental therapist in such
  906  clinic or practice setting:
  907         1.Are enrolled in Medicaid or another state or local
  908  governmental health care program for low-income or uninsured
  909  patients; or
  910         2.Do not have dental insurance and report a gross annual
  911  income that is less than 200 percent of the applicable federal
  912  poverty guidelines.
  913         (2)Except as otherwise provided in this chapter, a dental
  914  therapist may perform the dental therapy services specified in
  915  subsection (3) under the general supervision of a dentist to the
  916  extent authorized by the supervising dentist and provided within
  917  the terms of a written collaborative management agreement signed
  918  by the dental therapist and the supervising dentist which meets
  919  the requirements of subsection (4).
  920         (3)Dental therapy services include all of the following:
  921         (a)All services, treatments, and competencies identified
  922  by the American Dental Association Commission on Dental
  923  Accreditation in its Dental Therapy Education Accreditation
  924  Standards.
  925         (b)All of the following state-specific services, if the
  926  dental therapist’s education included curriculum content
  927  satisfying the American Dental Association Commission on Dental
  928  Accreditation criteria for state-specific dental therapy
  929  services:
  930         1.Evaluation of radiographs.
  931         2.Placement of space maintainers.
  932         3.Pulpotomies on primary teeth.
  933         4.Tooth reimplantation and stabilization.
  934         5.Recementation of permanent dental crowns.
  935         6.Direct pulp capping of primary teeth.
  936         7.Fabrication of soft occlusal guards.
  937         8.Dispensing and administering nonopioid analgesics,
  938  including nitrous oxide, anti-inflammatories, and antibiotics,
  939  as authorized by the supervising dentist and within the
  940  parameters of the collaborative management agreement.
  941         9.Oral evaluation and assessment of dental disease and
  942  formulation of an individualized treatment plan if authorized by
  943  a supervising dentist and subject to any conditions,
  944  limitations, or protocols specified by the supervising dentist
  945  in the collaborative management agreement.
  946         (c)Any other task deemed appropriate by the board.
  947         (4)Before performing any of the services specified in
  948  subsection (3), a dental therapist must enter into a written
  949  collaborative management agreement with a supervising dentist.
  950  The agreement must be signed by the dental therapist and the
  951  supervising dentist and must include all of the following:
  952         (a)Any limitation on the practice settings, services, and
  953  populations that may be served. If the agreement is silent as to
  954  any such limitation, the full scope of practice is permitted
  955  under the agreement.
  956         (b)A procedure for creating and maintaining dental records
  957  for the patients who are treated by the dental therapist.
  958         (c)A plan to manage medical emergencies in each practice
  959  setting where the dental therapist provides care.
  960         (d)A quality assurance plan for monitoring care provided
  961  by the dental therapist, including patient care review, referral
  962  followup, and a quality assurance chart review.
  963         (e)Protocols for the dental therapist to administer and
  964  dispense medications, including the specific conditions and
  965  circumstances under which the medications are to be administered
  966  and dispensed.
  967         (f)Criteria relating to the provision of care by the
  968  dental therapist to patients with specific medical conditions or
  969  complex medication histories, including requirements for
  970  consultation before the initiation of care.
  971         (g)Supervision criteria for dental therapists.
  972         (h)A plan for the provision of clinical resources and
  973  referrals in situations that are beyond the capabilities of the
  974  dental therapist.
  975         (5)A supervising dentist shall determine the number of
  976  hours of practice a dental therapist must complete under direct
  977  or indirect supervision of the supervising dentist before the
  978  dental therapist may perform any of the services specified in
  979  subsection (3) under general supervision.
  980         (6)A supervising dentist may restrict or limit the dental
  981  therapist’s practice in a collaborative management agreement to
  982  be less than the full scope of practice for dental therapists
  983  authorized in subsection (3).
  984         (7)A dental therapist may provide dental therapy services
  985  to a patient before the supervising dentist examines or
  986  diagnoses the patient if the applicable authority, conditions,
  987  and protocols are established in a written collaborative
  988  management agreement and the patient is subsequently referred to
  989  a dentist for any additional necessary services that exceed the
  990  dental therapist’s scope of practice or authorization under the
  991  collaborative management agreement.
  992         (8)A supervising dentist must be licensed under chapter
  993  466 or registered under s. 456.47 and practicing in this state.
  994  The supervising dentist is responsible for all services
  995  authorized and performed by the dental therapist pursuant to the
  996  collaborative management agreement and for providing or
  997  arranging followup services to be provided by a dentist for
  998  those services that are beyond the dental therapist’s scope of
  999  practice and authorization under the collaborative management
 1000  agreement.
 1001         Section 16. Section 466.026, Florida Statutes, is amended
 1002  to read:
 1003         466.026 Prohibitions; penalties.—
 1004         (1) Each of the following acts constitutes a felony of the
 1005  third degree, punishable as provided in s. 775.082, s. 775.083,
 1006  or s. 775.084:
 1007         (a) Practicing dentistry, dental therapy, or dental hygiene
 1008  unless the person has an appropriate, active license issued by
 1009  the department pursuant to this chapter.
 1010         (b) Using or attempting to use a license issued pursuant to
 1011  this chapter which license has been suspended or revoked.
 1012         (c) Knowingly employing any person to perform duties
 1013  outside the scope allowed such person under this chapter or the
 1014  rules of the board.
 1015         (d) Giving false or forged evidence to the department or
 1016  board for the purpose of obtaining a license.
 1017         (e) Selling or offering to sell a diploma conferring a
 1018  degree from a dental college or a dental therapy or dental
 1019  hygiene school or college, or a license issued pursuant to this
 1020  chapter, or procuring such diploma or license with intent that
 1021  it shall be used as evidence of that which the document stands
 1022  for, by a person other than the one upon whom it was conferred
 1023  or to whom it was granted.
 1024         (2) Each of the following acts constitutes a misdemeanor of
 1025  the first degree, punishable as provided in s. 775.082 or s.
 1026  775.083:
 1027         (a) Using the name or title “dentist,” the initials letters
 1028  “D.D.S.” or “D.M.D.”, or any other words, letters, title, or
 1029  descriptive matter which in any way represents a person as being
 1030  able to diagnose, treat, prescribe, or operate for any disease,
 1031  pain, deformity, deficiency, injury, or physical condition of
 1032  the teeth or jaws or oral-maxillofacial region unless the person
 1033  has an active dentist’s license issued by the department
 1034  pursuant to this chapter.
 1035         (b) Using the name or title “dental therapist” or the
 1036  initials “D.T.” or otherwise holding herself or himself out as
 1037  an actively licensed dental therapist or implying to any patient
 1038  or consumer that she or he is an actively licensed dental
 1039  therapist unless that person has an active dental therapist’s
 1040  license issued by the department pursuant to this chapter.
 1041         (c) Using the name or title “dental hygienist” or the
 1042  initials “R.D.H.” or otherwise holding herself or himself out as
 1043  an actively licensed dental hygienist or implying to any patient
 1044  or consumer that she or he is an actively licensed dental
 1045  hygienist unless that person has an active dental hygienist’s
 1046  license issued by the department pursuant to this chapter.
 1047         (d)(c) Presenting as her or his own the license of another.
 1048         (e)(d) Knowingly concealing information relative to
 1049  violations of this chapter.
 1050         (f)(e) Performing any services as a dental assistant as
 1051  defined herein, except in the office of a licensed dentist,
 1052  unless authorized by this chapter or by rule of the board.
 1053         Section 17. Paragraphs (b), (c), (g), (s), and (t) of
 1054  subsection (1) of section 466.028, Florida Statutes, are amended
 1055  to read:
 1056         466.028 Grounds for disciplinary action; action by the
 1057  board.—
 1058         (1) The following acts constitute grounds for denial of a
 1059  license or disciplinary action, as specified in s. 456.072(2):
 1060         (b) Having a license to practice dentistry, dental therapy,
 1061  or dental hygiene revoked, suspended, or otherwise acted
 1062  against, including the denial of licensure, by the licensing
 1063  authority of another state, territory, or country.
 1064         (c) Being convicted or found guilty of or entering a plea
 1065  of nolo contendere to, regardless of adjudication, a crime in
 1066  any jurisdiction which relates to the practice of dentistry,
 1067  dental therapy, or dental hygiene. A plea of nolo contendere
 1068  shall create a rebuttable presumption of guilt to the underlying
 1069  criminal charges.
 1070         (g) Aiding, assisting, procuring, or advising any
 1071  unlicensed person to practice dentistry, dental therapy, or
 1072  dental hygiene contrary to this chapter or to a rule of the
 1073  department or the board.
 1074         (s) Being unable to practice her or his profession with
 1075  reasonable skill and safety to patients by reason of illness or
 1076  use of alcohol, drugs, narcotics, chemicals, or any other type
 1077  of material or as a result of any mental or physical condition.
 1078  In enforcing this paragraph, the department shall have, upon a
 1079  finding of the State Surgeon General or her or his designee that
 1080  probable cause exists to believe that the licensee is unable to
 1081  practice dentistry, dental therapy, or dental hygiene because of
 1082  the reasons stated in this paragraph, the authority to issue an
 1083  order to compel a licensee to submit to a mental or physical
 1084  examination by physicians designated by the department. If the
 1085  licensee refuses to comply with such order, the department’s
 1086  order directing such examination may be enforced by filing a
 1087  petition for enforcement in the circuit court where the licensee
 1088  resides or does business. The licensee against whom the petition
 1089  is filed shall not be named or identified by initials in any
 1090  public court records or documents, and the proceedings shall be
 1091  closed to the public. The department shall be entitled to the
 1092  summary procedure provided in s. 51.011. A licensee affected
 1093  under this paragraph shall at reasonable intervals be afforded
 1094  an opportunity to demonstrate that she or he can resume the
 1095  competent practice of her or his profession with reasonable
 1096  skill and safety to patients.
 1097         (t) Fraud, deceit, or misconduct in the practice of
 1098  dentistry, dental therapy, or dental hygiene.
 1099         Section 18. Paragraph (g) of subsection (3) of section
 1100  921.0022, Florida Statutes, is amended to read:
 1101         921.0022 Criminal Punishment Code; offense severity ranking
 1102  chart.—
 1103         (3) OFFENSE SEVERITY RANKING CHART
 1104         (g) LEVEL 7
 1105  
 1106  FloridaStatute           FelonyDegree         Description         
 1107  316.027(2)(c)                 1st     Accident involving death, failure to stop; leaving scene.
 1108  316.193(3)(c)2.               3rd     DUI resulting in serious bodily injury.
 1109  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.
 1110  327.35(3)(c)2.                3rd     Vessel BUI resulting in serious bodily injury.
 1111  402.319(2)                    2nd     Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
 1112  409.920 (2)(b)1.a.            3rd     Medicaid provider fraud; $10,000 or less.
 1113  409.920 (2)(b)1.b.            2nd     Medicaid provider fraud; more than $10,000, but less than $50,000.
 1114  456.065(2)                    3rd     Practicing a health care profession without a license.
 1115  456.065(2)                    2nd     Practicing a health care profession without a license which results in serious bodily injury.
 1116  458.327(1)                    3rd     Practicing medicine without a license.
 1117  459.013(1)                    3rd     Practicing osteopathic medicine without a license.
 1118  460.411(1)                    3rd     Practicing chiropractic medicine without a license.
 1119  461.012(1)                    3rd     Practicing podiatric medicine without a license.
 1120  462.17                        3rd     Practicing naturopathy without a license.
 1121  463.015(1)                    3rd     Practicing optometry without a license.
 1122  464.016(1)                    3rd     Practicing nursing without a license.
 1123  465.015(2)                    3rd     Practicing pharmacy without a license.
 1124  466.026(1)                    3rd     Practicing dentistry, dental therapy, or dental hygiene without a license.
 1125  467.201                       3rd     Practicing midwifery without a license.
 1126  468.366                       3rd     Delivering respiratory care services without a license.
 1127  483.828(1)                    3rd     Practicing as clinical laboratory personnel without a license.
 1128  483.901(7)                    3rd     Practicing medical physics without a license.
 1129  484.013(1)(c)                 3rd     Preparing or dispensing optical devices without a prescription.
 1130  484.053                       3rd     Dispensing hearing aids without a license.
 1131  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.
 1132  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.
 1133  560.125(5)(a)                 3rd     Money services business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
 1134  655.50(10)(b)1.               3rd     Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
 1135  775.21(10)(a)                 3rd     Sexual predator; failure to register; failure to renew driver license or identification card; other registration violations.
 1136  775.21(10)(b)                 3rd     Sexual predator working where children regularly congregate.
 1137  775.21(10)(g)                 3rd     Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
 1138  782.051(3)                    2nd     Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
 1139  782.07(1)                     2nd     Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
 1140  782.071                       2nd     Killing of a human being or unborn child by the operation of a motor vehicle in a reckless manner (vehicular homicide).
 1141  782.072                       2nd     Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
 1142  784.045(1)(a)1.               2nd     Aggravated battery; intentionally causing great bodily harm or disfigurement.
 1143  784.045(1)(a)2.               2nd     Aggravated battery; using deadly weapon.
 1144  784.045(1)(b)                 2nd     Aggravated battery; perpetrator aware victim pregnant.
 1145  784.048(4)                    3rd     Aggravated stalking; violation of injunction or court order.
 1146  784.048(7)                    3rd     Aggravated stalking; violation of court order.
 1147  784.07(2)(d)                  1st     Aggravated battery on law enforcement officer.
 1148  784.074(1)(a)                 1st     Aggravated battery on sexually violent predators facility staff.
 1149  784.08(2)(a)                  1st     Aggravated battery on a person 65 years of age or older.
 1150  784.081(1)                    1st     Aggravated battery on specified official or employee.
 1151  784.082(1)                    1st     Aggravated battery by detained person on visitor or other detainee.
 1152  784.083(1)                    1st     Aggravated battery on code inspector.
 1153  787.06(3)(a)2.                1st     Human trafficking using coercion for labor and services of an adult.
 1154  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.
 1155  790.07(4)                     1st     Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
 1156  790.16(1)                     1st     Discharge of a machine gun under specified circumstances.
 1157  790.165(2)                    2nd     Manufacture, sell, possess, or deliver hoax bomb.
 1158  790.165(3)                    2nd     Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
 1159  790.166(3)                    2nd     Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
 1160  790.166(4)                    2nd     Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
 1161  790.23                      1st,PBL   Possession of a firearm by a person who qualifies for the penalty enhancements provided for in s. 874.04.
 1162  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.
 1163  796.05(1)                     1st     Live on earnings of a prostitute; 2nd offense.
 1164  796.05(1)                     1st     Live on earnings of a prostitute; 3rd and subsequent offense.
 1165  800.04(5)(c)1.                2nd     Lewd or lascivious molestation; victim younger than 12 years of age; offender younger than 18 years of age.
 1166  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.
 1167  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.
 1168  806.01(2)                     2nd     Maliciously damage structure by fire or explosive.
 1169  810.02(3)(a)                  2nd     Burglary of occupied dwelling; unarmed; no assault or battery.
 1170  810.02(3)(b)                  2nd     Burglary of unoccupied dwelling; unarmed; no assault or battery.
 1171  810.02(3)(d)                  2nd     Burglary of occupied conveyance; unarmed; no assault or battery.
 1172  810.02(3)(e)                  2nd     Burglary of authorized emergency vehicle.
 1173  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.
 1174  812.014(2)(b)2.               2nd     Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
 1175  812.014(2)(b)3.               2nd     Property stolen, emergency medical equipment; 2nd degree grand theft.
 1176  812.014(2)(b)4.               2nd     Property stolen, law enforcement equipment from authorized emergency vehicle.
 1177  812.0145(2)(a)                1st     Theft from person 65 years of age or older; $50,000 or more.
 1178  812.019(2)                    1st     Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
 1179  812.131(2)(a)                 2nd     Robbery by sudden snatching.
 1180  812.133(2)(b)                 1st     Carjacking; no firearm, deadly weapon, or other weapon.
 1181  817.034(4)(a)1.               1st     Communications fraud, value greater than $50,000.
 1182  817.234(8)(a)                 2nd     Solicitation of motor vehicle accident victims with intent to defraud.
 1183  817.234(9)                    2nd     Organizing, planning, or participating in an intentional motor vehicle collision.
 1184  817.234(11)(c)                1st     Insurance fraud; property value $100,000 or more.
 1185  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.
 1186  817.418(2)(a)                 3rd     Offering for sale or advertising personal protective equipment with intent to defraud.
 1187  817.504(1)(a)                 3rd     Offering or advertising a vaccine with intent to defraud.
 1188  817.535(2)(a)                 3rd     Filing false lien or other unauthorized document.
 1189  817.611(2)(b)                 2nd     Traffic in or possess 15 to 49 counterfeit credit cards or related documents.
 1190  825.102(3)(b)                 2nd     Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
 1191  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.
 1192  827.03(2)(b)                  2nd     Neglect of a child causing great bodily harm, disability, or disfigurement.
 1193  827.04(3)                     3rd     Impregnation of a child under 16 years of age by person 21 years of age or older.
 1194  837.05(2)                     3rd     Giving false information about alleged capital felony to a law enforcement officer.
 1195  838.015                       2nd     Bribery.                    
 1196  838.016                       2nd     Unlawful compensation or reward for official behavior.
 1197  838.021(3)(a)                 2nd     Unlawful harm to a public servant.
 1198  838.22                        2nd     Bid tampering.              
 1199  843.0855(2)                   3rd     Impersonation of a public officer or employee.
 1200  843.0855(3)                   3rd     Unlawful simulation of legal process.
 1201  843.0855(4)                   3rd     Intimidation of a public officer or employee.
 1202  847.0135(3)                   3rd     Solicitation of a child, via a computer service, to commit an unlawful sex act.
 1203  847.0135(4)                   2nd     Traveling to meet a minor to commit an unlawful sex act.
 1204  872.06                        2nd     Abuse of a dead human body. 
 1205  874.05(2)(b)                  1st     Encouraging or recruiting person under 13 to join a criminal gang; second or subsequent offense.
 1206  874.10                      1st,PBL   Knowingly initiates, organizes, plans, finances, directs, manages, or supervises criminal gang-related activity.
 1207  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.
 1208  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.
 1209  893.13(4)(a)                  1st     Use or hire of minor; deliver to minor other controlled substance.
 1210  893.135(1)(a)1.               1st     Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
 1211  893.135 (1)(b)1.a.            1st     Trafficking in cocaine, more than 28 grams, less than 200 grams.
 1212  893.135 (1)(c)1.a.            1st     Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
 1213  893.135 (1)(c)2.a.            1st     Trafficking in hydrocodone, 28 grams or more, less than 50 grams.
 1214  893.135 (1)(c)2.b.            1st     Trafficking in hydrocodone, 50 grams or more, less than 100 grams.
 1215  893.135 (1)(c)3.a.            1st     Trafficking in oxycodone, 7 grams or more, less than 14 grams.
 1216  893.135 (1)(c)3.b.            1st     Trafficking in oxycodone, 14 grams or more, less than 25 grams.
 1217  893.135 (1)(c)4.b.(I)         1st     Trafficking in fentanyl, 4 grams or more, less than 14 grams.
 1218  893.135 (1)(d)1.a.            1st     Trafficking in phencyclidine, 28 grams or more, less than 200 grams.
 1219  893.135(1)(e)1.               1st     Trafficking in methaqualone, 200 grams or more, less than 5 kilograms.
 1220  893.135(1)(f)1.               1st     Trafficking in amphetamine, 14 grams or more, less than 28 grams.
 1221  893.135 (1)(g)1.a.            1st     Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
 1222  893.135 (1)(h)1.a.            1st     Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
 1223  893.135 (1)(j)1.a.            1st     Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
 1224  893.135 (1)(k)2.a.            1st     Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
 1225  893.135 (1)(m)2.a.            1st     Trafficking in synthetic cannabinoids, 280 grams or more, less than 500 grams.
 1226  893.135 (1)(m)2.b.            1st     Trafficking in synthetic cannabinoids, 500 grams or more, less than 1,000 grams.
 1227  893.135 (1)(n)2.a.            1st     Trafficking in n-benzyl phenethylamines, 14 grams or more, less than 100 grams.
 1228  893.1351(2)                   2nd     Possession of place for trafficking in or manufacturing of controlled substance.
 1229  896.101(5)(a)                 3rd     Money laundering, financial transactions exceeding $300 but less than $20,000.
 1230  896.104(4)(a)1.               3rd     Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
 1231  943.0435(4)(c)                2nd     Sexual offender vacating permanent residence; failure to comply with reporting requirements.
 1232  943.0435(8)                   2nd     Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
 1233  943.0435(9)(a)                3rd     Sexual offender; failure to comply with reporting requirements.
 1234  943.0435(13)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1235  943.0435(14)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1236  944.607(9)                    3rd     Sexual offender; failure to comply with reporting requirements.
 1237  944.607(10)(a)                3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1238  944.607(12)                   3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1239  944.607(13)                   3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1240  985.4815(10)                  3rd     Sexual offender; failure to submit to the taking of a digitized photograph.
 1241  985.4815(12)                  3rd     Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
 1242  985.4815(13)                  3rd     Sexual offender; failure to report and reregister; failure to respond to address verification; providing false registration information.
 1243  
 1244         Section 19. The Department of Health, in consultation with
 1245  the Board of Dentistry and the Agency for Health Care
 1246  Administration, shall submit a progress report to the President
 1247  of the Senate and the Speaker of the House of Representatives by
 1248  July 1, 2025, and shall submit a final report 3 years after the
 1249  first dental therapy license is issued. The reports must include
 1250  all of the following components:
 1251         (1)The progress that has been made in this state to
 1252  implement training programs, licensing, and Medicaid
 1253  reimbursement for dental therapists.
 1254         (2)Data demonstrating the effects of authorizing the
 1255  practice of dental therapy in this state on each of the
 1256  following:
 1257         (a)Patient access to dental services.
 1258         (b)The use of primary and preventive dental services in
 1259  underserved regions and populations, including the Medicaid
 1260  population.
 1261         (c)Costs to dental providers, patients, dental insurance
 1262  carriers, and the state.
 1263         (d)The quality and safety of dental services.
 1264         (3)Specific recommendations for any necessary legislative,
 1265  administrative, or regulatory reforms relating to the practice
 1266  of dental therapy.
 1267         (4)Any other information the department deems appropriate.
 1268         Section 20. This act shall take effect July 1, 2022.

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