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, andordental 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 withthe provisions ofthis 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 publicshallbe 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 mustshallbe 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 boardparagraphs(a), (b), and (c). The 358 department shall provide administrative support to the councils 359 and shall provide public notice of meetings and agendasagenda360 of the councils. Councils mustshallinclude at least one board 361 member, who shall chair the council, andshall includenonboard 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 areshall beeligible 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’HygieneAssociation. 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 councilis charged376with the responsibility of andshall recommend proposedmeet for377the purpose of developingrules and policiesfor recommendation378to the board, which the board shall consider, on matters379 pertaining to the areasthat part of dentistry consistingof 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 policiesRule and policy recommendations of the council shall be384considered by the boardat 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 mustthe specified part of dentistry defined by this subsection389shallbe referred to the council for itsarecommendation before 390 final action by the board. The board may take final action on 391 rules pertaining to these areasthe specified part of dentistry392defined by this subsectionwithout 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 meetfor the purpose of 401 developing recommendations to the board on matters pertaining to 402that part of dentistry related todental 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 mustshallbe 431 appointed by the board chair and mustshallinclude 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 allowpermitany person who fails 630 an examination thatwhichis required under s. 466.006,ors. 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 mustshallpay 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 mustshall639be required toretake and receive a passing score on only the 640 failedthatpart or procedure to be eligible for licensure. 641 However, ifanysuch applicant fails more than one part or 642 procedure of any such examination, she or he mustshall be643required toretake the entire examination. 644 (3) If an applicant for a license to practice dental 645 hygiene failsone portion ofthe practical or clinical 646 examination because of a failing grade on just one part or 647 procedure tested, such applicant mustshall be required to648 retake and receive a passing score on only the failed part or 649 procedure to be eligible for licensurethat portionif she or he 650 reapplies within 12 months. If, however, the applicant fails the 651 prophylaxis, she or he mustshall be required toretake 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,ors. 466.007, or s. 466.0225. The 665 board may refuse to certify an applicant who has violatedany of666the provisions ofs. 466.026 or s. 466.028. 667 Section 10. Section 466.0136, Florida Statutes, is created 668 to read: 669 466.0136 Continuing 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 wherewhereinshe 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 shallbe required todisplay 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 thatwhich731 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 743utilizean X-ray machine, expose dental X-ray films, and 744 interpret or read such films. NotwithstandingThe provisions of745 part IV of chapter 468to 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 751saidassistant is competent by reason of training and experience 752 to operate the X-raysaidequipment 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)NotwithstandingThe provisions ofs. 465.0276 757notwithstanding, 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 chlorhexidinechlorohexidine761 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 mustshallbe placed in the record of the patient. In any 800 disciplinary proceeding brought pursuant to this chapter or 801 chapter 456, it isshall bepresumed 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 mayshallnot 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 notinpractice 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: 820 466.0225 Examination 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: 875 466.0227 Dental 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 initialsletters1028 “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.