Bill Text: FL S1254 | 2024 | Regular Session | Introduced
Bill Title: Dental Therapy
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2024-03-08 - Died in Health Policy [S1254 Detail]
Download: Florida-2024-S1254-Introduced.html
Florida Senate - 2024 SB 1254
By Senator Collins
14-01028B-24 20241254__
1 A bill to be entitled
2 An act relating to dental therapy; amending s.
3 409.906, F.S.; authorizing Medicaid to reimburse for
4 dental services provided in a mobile dental unit that
5 is owned by, operated by, or contracted with a health
6 access setting or another similar setting or program;
7 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”; making technical changes;
12 amending s. 466.004, F.S.; requiring the chair of the
13 Board of Dentistry to appoint a Council on Dental
14 Therapy, effective after a specified timeframe;
15 providing for membership, meetings, and the purpose of
16 the council; amending s. 466.006, F.S.; revising the
17 definitions of the terms “full-time practice” and
18 “full-time practice of dentistry within the geographic
19 boundaries of this state within 1 year” to include
20 full-time faculty members of certain dental therapy
21 schools; amending s. 466.009, F.S.; requiring the
22 Department of Health to allow any person who fails the
23 dental therapy examination to retake the examination;
24 providing that a person who fails a practical or
25 clinical examination to practice dental therapy and
26 who has failed one part or procedure of the
27 examination may be required to retake only that part
28 or procedure to pass the examination; amending s.
29 466.011, F.S.; requiring the board to certify an
30 applicant for licensure as a dental therapist;
31 creating s. 466.0136, F.S.; requiring the board to
32 require each licensed dental therapist to complete a
33 specified number of hours of continuing education;
34 requiring the board to adopt rules and guidelines;
35 authorizing the board to excuse licensees from
36 continuing education requirements in certain
37 circumstances; amending s. 466.016, F.S.; requiring a
38 practitioner of dental therapy to post and display her
39 or his license in each office where she or he
40 practices; amending s. 466.017, F.S.; requiring the
41 board to adopt certain rules relating to dental
42 therapists; authorizing a dental therapist under the
43 general supervision of a dentist to administer local
44 anesthesia and operate an X-ray machine, expose dental
45 X-ray films, and interpret or read such films if
46 specified requirements are met; correcting the
47 spelling of a term; amending s. 466.018, F.S.;
48 providing that a dentist of record remains primarily
49 responsible for the dental treatment of a patient
50 regardless of whether the treatment is provided by a
51 dental therapist; requiring that the initials of a
52 dental therapist who renders treatment to a patient be
53 placed in the record of the patient; creating s.
54 466.0225, F.S.; providing application requirements and
55 examination and licensure qualifications for dental
56 therapists; creating s. 466.0227, F.S.; authorizing a
57 dental therapist to perform specified services under
58 the general supervision of a dentist under certain
59 conditions; specifying state-specific dental therapy
60 services; requiring that a collaborative management
61 agreement be signed by a supervising dentist and a
62 dental therapist and to include certain information;
63 requiring the supervising dentist to determine the
64 number of hours of practice that a dental therapist
65 must complete before performing certain authorized
66 services; authorizing a supervising dentist to
67 restrict or limit the dental therapist’s practice in a
68 collaborative management agreement; providing that a
69 supervising dentist may authorize a dental therapist
70 to provide dental therapy services to a patient before
71 the dentist examines or diagnoses the patient under
72 certain conditions; requiring a supervising dentist to
73 be licensed and practicing in this state; specifying
74 that the supervising dentist is responsible for
75 certain services; amending s. 466.026, F.S.; providing
76 criminal penalties for practicing dental therapy
77 without an active license, selling or offering to sell
78 a diploma from a dental therapy school or college,
79 falsely using a specified name or initials, or holding
80 oneself out as an actively licensed dental therapist;
81 amending s. 466.028, F.S.; revising grounds for denial
82 of a license or disciplinary action to include the
83 practice of dental therapy; amending s. 466.0285,
84 F.S.; prohibiting persons other than licensed dentists
85 from employing a dental therapist in the operation of
86 a dental office and from controlling the use of any
87 dental equipment or material in certain circumstances;
88 requiring the department, in consultation with the
89 board and the Agency for Health Care Administration,
90 to provide reports to the Legislature by specified
91 dates; requiring that certain information and
92 recommendations be included in the reports; providing
93 an effective date.
94
95 Be It Enacted by the Legislature of the State of Florida:
96
97 Section 1. Paragraph (c) of subsection (1) of section
98 409.906, Florida Statutes, is amended, and paragraph (e) is
99 added to subsection (6) of that section, to read:
100 409.906 Optional Medicaid services.—Subject to specific
101 appropriations, the agency may make payments for services which
102 are optional to the state under Title XIX of the Social Security
103 Act and are furnished by Medicaid providers to recipients who
104 are determined to be eligible on the dates on which the services
105 were provided. Any optional service that is provided shall be
106 provided only when medically necessary and in accordance with
107 state and federal law. Optional services rendered by providers
108 in mobile units to Medicaid recipients may be restricted or
109 prohibited by the agency. Nothing in this section shall be
110 construed to prevent or limit the agency from adjusting fees,
111 reimbursement rates, lengths of stay, number of visits, or
112 number of services, or making any other adjustments necessary to
113 comply with the availability of moneys and any limitations or
114 directions provided for in the General Appropriations Act or
115 chapter 216. If necessary to safeguard the state’s systems of
116 providing services to elderly and disabled persons and subject
117 to the notice and review provisions of s. 216.177, the Governor
118 may direct the Agency for Health Care Administration to amend
119 the Medicaid state plan to delete the optional Medicaid service
120 known as “Intermediate Care Facilities for the Developmentally
121 Disabled.” Optional services may include:
122 (1) ADULT DENTAL SERVICES.—
123 (c) However, Medicaid will not provide reimbursement for
124 dental services provided in a mobile dental unit, except for a
125 mobile dental unit:
126 1. Owned by, operated by, or having a contractual agreement
127 with the Department of Health and complying with Medicaid’s
128 county health department clinic services program specifications
129 as a county health department clinic services provider.
130 2. Owned by, operated by, or having a contractual
131 arrangement with a federally qualified health center and
132 complying with Medicaid’s federally qualified health center
133 specifications as a federally qualified health center provider.
134 3. Rendering dental services to Medicaid recipients, 21
135 years of age and older, at nursing facilities.
136 4. Owned by, operated by, or having a contractual agreement
137 with a state-approved dental educational institution.
138 5. Owned by, operated by, or having a contractual agreement
139 with a health access setting as defined in s. 466.003 or a
140 similar setting or program.
141 (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for
142 diagnostic, preventive, or corrective procedures, including
143 orthodontia in severe cases, provided to a recipient under age
144 21, by or under the supervision of a licensed dentist. The
145 agency may also reimburse a health access setting as defined in
146 s. 466.003 for the remediable tasks that a licensed dental
147 hygienist is authorized to perform under s. 466.024(2). Services
148 provided under this program include treatment of the teeth and
149 associated structures of the oral cavity, as well as treatment
150 of disease, injury, or impairment that may affect the oral or
151 general health of the individual. However, Medicaid will not
152 provide reimbursement for dental services provided in a mobile
153 dental unit, except for a mobile dental unit:
154 (e) Owned by, operated by, or having a contractual
155 agreement with a health access setting as defined in s. 466.003
156 or a similar setting or program.
157 Section 2. Section 466.001, Florida Statutes, is amended to
158 read:
159 466.001 Legislative purpose and intent.—The legislative
160 purpose for enacting this chapter is to ensure that every
161 dentist, dental therapist, or dental hygienist practicing in
162 this state meets minimum requirements for safe practice without
163 undue clinical interference by persons not licensed under this
164 chapter. It is the legislative intent that dental services be
165 provided only in accordance with the provisions of this chapter
166 and not be delegated to unauthorized individuals. It is the
167 further legislative intent that dentists, dental therapists, and
168 dental hygienists who fall below minimum competency or who
169 otherwise present a danger to the public shall be prohibited
170 from practicing in this state. All provisions of this chapter
171 relating to the practice of dentistry, dental therapy, and
172 dental hygiene shall be liberally construed to carry out such
173 purpose and intent.
174 Section 3. Subsections (5) and (6) of section 466.002,
175 Florida Statutes, are amended to read:
176 466.002 Persons exempt from operation of chapter.—Nothing
177 in this chapter shall apply to the following practices, acts,
178 and operations:
179 (5) Students in Florida schools of dentistry, dental
180 therapy, and dental hygiene or dental assistant educational
181 programs, while performing regularly assigned work under the
182 curriculum of such schools or programs.
183 (6) Instructors in Florida schools of dentistry,
184 instructors in dental programs that prepare persons holding
185 D.D.S. or D.M.D. degrees for certification by a specialty board
186 and that are accredited in the United States by January 1, 2005,
187 in the same manner as the board recognizes accreditation for
188 Florida schools of dentistry that are not otherwise affiliated
189 with a Florida school of dentistry, or instructors in Florida
190 schools of dental hygiene or dental therapy or dental assistant
191 educational programs, while performing regularly assigned
192 instructional duties under the curriculum of such schools or
193 programs. A full-time dental instructor at a dental school or
194 dental program approved by the board may be allowed to practice
195 dentistry at the teaching facilities of such school or program,
196 upon receiving a teaching permit issued by the board, in strict
197 compliance with such rules as are adopted by the board
198 pertaining to the teaching permit and with the established rules
199 and procedures of the dental school or program as recognized in
200 this section.
201 Section 4. Section 466.003, Florida Statutes, is reordered
202 and amended to read:
203 466.003 Definitions.—As used in this chapter, the term:
204 (1) “Board” means the Board of Dentistry.
205 (7)(2) “Dentist” means a person licensed to practice
206 dentistry pursuant to this chapter.
207 (8)(3) “Dentistry” means the healing art which is concerned
208 with the examination, diagnosis, treatment planning, and care of
209 conditions within the human oral cavity and its adjacent tissues
210 and structures. It includes the performance or attempted
211 performance of any dental operation, or oral or oral
212 maxillofacial surgery and any procedures adjunct thereto,
213 including physical evaluation directly related to such operation
214 or surgery pursuant to hospital rules and regulations. It also
215 includes dental service of any kind gratuitously or for any
216 remuneration paid, or to be paid, directly or indirectly, to any
217 person or agency. The term “dentistry” shall also includes
218 include the following:
219 (a) The Taking of an impression of the human tooth, teeth,
220 or jaws directly or indirectly and by any means or method.
221 (b) Supplying artificial substitutes for the natural teeth
222 or furnishing, supplying, constructing, reproducing, or
223 repairing any prosthetic denture, bridge, appliance, or any
224 other structure designed to be worn in the human mouth except on
225 the written work order of a duly licensed dentist.
226 (c) The Placing of an appliance or structure in the human
227 mouth or the adjusting or attempting to adjust the same.
228 (d) Delivering the same to any person other than the
229 dentist upon whose work order the work was performed.
230 (e) Professing to the public by any method to furnish,
231 supply, construct, reproduce, or repair any prosthetic denture,
232 bridge, appliance, or other structure designed to be worn in the
233 human mouth.
234 (f) Diagnosing, prescribing, or treating or professing to
235 diagnose, prescribe, or treat disease, pain, deformity,
236 deficiency, injury, or physical condition of the human teeth or
237 jaws or oral-maxillofacial region.
238 (g) Extracting or attempting to extract human teeth.
239 (h) Correcting or attempting to correct malformations of
240 teeth or of jaws.
241 (i) Repairing or attempting to repair cavities in the human
242 teeth.
243 (3)(4) “Dental hygiene” means the rendering of educational,
244 preventive, and therapeutic dental services pursuant to ss.
245 466.023 and 466.024 and any related extra-oral procedure
246 required in the performance of such services.
247 (4)(5) “Dental hygienist” means a person licensed to
248 practice dental hygiene pursuant to this chapter.
249 (2)(6) “Dental assistant” means a person, other than a
250 dental hygienist, who, under the supervision and authorization
251 of a dentist, provides dental care services directly to a
252 patient. This term does shall not include a certified registered
253 nurse anesthetist licensed under part I of chapter 464.
254 (5) “Dental therapist” means a person licensed to practice
255 dental therapy pursuant to s. 466.0225.
256 (6) “Dental therapy” means the rendering of services
257 pursuant to s. 466.0227 and any related extraoral services or
258 procedures required in the performance of such services.
259 (9)(7) “Department” means the Department of Health.
260 (10)(8) “Direct supervision” means supervision whereby a
261 dentist diagnoses the condition to be treated, a dentist
262 authorizes the procedure to be performed, a dentist remains on
263 the premises while the procedures are performed, and a dentist
264 approves the work performed before dismissal of the patient.
265 (13)(9) “Indirect supervision” means supervision whereby a
266 dentist authorizes the procedure and a dentist is on the
267 premises while the procedures are performed.
268 (11)(10) “General supervision” means supervision whereby a
269 dentist authorizes the procedures which are being carried out
270 but need not be present when the authorized procedures are being
271 performed. The authorized procedures may also be performed at a
272 place other than the dentist’s usual place of practice. The
273 issuance of a written work authorization to a commercial dental
274 laboratory by a dentist does not constitute general supervision.
275 (14)(11) “Irremediable tasks” are those intraoral treatment
276 tasks which, when performed, are irreversible and create
277 unalterable changes within the oral cavity or the contiguous
278 structures or which cause an increased risk to the patient. The
279 administration of anesthetics other than topical anesthesia is
280 considered to be an “irremediable task” for purposes of this
281 chapter.
282 (16)(12) “Remediable tasks” are those intraoral treatment
283 tasks which are reversible and do not create unalterable changes
284 within the oral cavity or the contiguous structures and which do
285 not cause an increased risk to the patient.
286 (15)(13) “Oral and maxillofacial surgery” means the
287 specialty of dentistry involving diagnosis, surgery, and
288 adjunctive treatment of diseases, injuries, and defects
289 involving the functional and esthetic aspects of the hard and
290 soft tissues of the oral and maxillofacial regions. This term
291 may not be construed to apply to any individual exempt under s.
292 466.002(1).
293 (12)(14) “Health access setting” means a program or an
294 institution of the Department of Children and Families, the
295 Department of Health, the Department of Juvenile Justice, a
296 nonprofit community health center, a Head Start center, a
297 federally qualified health center or look-alike as defined by
298 federal law, a school-based prevention program, a clinic
299 operated by an accredited college of dentistry, or an accredited
300 dental hygiene program in this state if such community service
301 program or institution immediately reports to the Board of
302 Dentistry all violations of s. 466.027, s. 466.028, or other
303 practice act or standard of care violations related to the
304 actions or inactions of a dentist, dental hygienist, or dental
305 assistant engaged in the delivery of dental care in such
306 setting.
307 (17)(15) “School-based prevention program” means preventive
308 oral health services offered at a school by one of the entities
309 described defined in subsection (12) (14) or by a nonprofit
310 organization that is exempt from federal income taxation under
311 s. 501(a) of the Internal Revenue Code, and described in s.
312 501(c)(3) of the Internal Revenue Code.
313 Section 5. Subsection (2) of section 466.004, Florida
314 Statutes, is amended to read:
315 466.004 Board of Dentistry.—
316 (2) To advise the board, it is the intent of the
317 Legislature that councils be appointed as specified in
318 paragraphs (a)-(d) (a), (b), and (c). The department shall
319 provide administrative support to the councils and shall provide
320 public notice of meetings and agendas agenda of the councils.
321 Councils must shall include at least one board member, who shall
322 serve as chair, the council and must shall include nonboard
323 members. All council members shall be appointed by the board
324 chair. Council members shall be appointed for 4-year terms, and
325 all members are shall be eligible for reimbursement of expenses
326 in the manner of board members.
327 (a) A Council on Dental Hygiene shall be appointed by the
328 board chair and shall include one dental hygienist member of the
329 board, who shall chair the council, one dental member of the
330 board, and three dental hygienists who are actively engaged in
331 the practice of dental hygiene in this state. In making the
332 appointments, the chair shall consider recommendations from the
333 Florida Dental Hygiene Association. The council shall meet at
334 the request of the board chair, a majority of the members of the
335 board, or the council chair; however, the council must meet at
336 least three times a year. The council is charged with the
337 responsibility of and shall meet for the purpose of developing
338 rules and policies for recommendation to the board, which the
339 board shall consider, on matters pertaining to that part of
340 dentistry consisting of educational, preventive, or therapeutic
341 dental hygiene services; dental hygiene licensure, discipline,
342 or regulation; and dental hygiene education. Rule and policy
343 recommendations of the council must shall be considered by the
344 board at its next regularly scheduled meeting in the same manner
345 in which it considers rule and policy recommendations from
346 designated subcommittees of the board. Any rule or policy
347 proposed by the board pertaining to the specified part of
348 dentistry identified defined by this subsection must shall be
349 referred to the council for a recommendation before final action
350 by the board. The board may take final action on rules
351 pertaining to the specified part of dentistry identified defined
352 by this subsection without a council recommendation if the
353 council fails to submit a recommendation in a timely fashion as
354 prescribed by the board.
355 (b) A Council on Dental Assisting shall be appointed by the
356 board chair and shall include one board member who shall chair
357 the council and three dental assistants who are actively engaged
358 in dental assisting in this state. The council shall meet at the
359 request of the board chair or a majority of the members of the
360 board. The council shall meet for the purpose of developing
361 recommendations to the board on matters pertaining to that part
362 of dentistry related to dental assisting.
363 (c) Effective 28 months after the first dental therapy
364 license is granted by the board, the board chair shall appoint a
365 Council on Dental Therapy, which must include one board member
366 who shall chair the council and three dental therapists who are
367 actively engaged in the practice of dental therapy in this
368 state. The council shall meet at the request of the board chair,
369 a majority of the members of the board, or the council chair;
370 however, the council shall meet at least three times per year.
371 The council is charged with the responsibility of, and shall
372 meet for the purpose of, developing rules and policies for
373 recommendation to the board on matters pertaining to that part
374 of dentistry consisting of educational, preventive, or
375 therapeutic dental therapy services; dental therapy licensure,
376 discipline, or regulation; and dental therapy education. Rule
377 and policy recommendations of the council must be considered by
378 the board at its next regularly scheduled meeting in the same
379 manner in which it considers rule and policy recommendations
380 from designated subcommittees of the board. Any rule or policy
381 proposed by the board pertaining to the specified part of
382 dentistry identified by this subsection must be referred to the
383 council for a recommendation before final action by the board.
384 The board may take final action on rules pertaining to the
385 specified part of dentistry identified by this subsection
386 without a council recommendation if the council fails to submit
387 a recommendation in a timely fashion as prescribed by the board.
388 (d) With the concurrence of the State Surgeon General, the
389 board chair may create and abolish other advisory councils
390 relating to dental subjects, including, but not limited to:
391 examinations, access to dental care, indigent care, nursing home
392 and institutional care, public health, disciplinary guidelines,
393 and other subjects as appropriate. Such councils shall be
394 appointed by the board chair and shall include at least one
395 board member who shall serve as chair.
396 Section 6. Paragraph (b) of subsection (4) and paragraph
397 (b) of subsection (6) of section 466.006, Florida Statutes, are
398 amended to read:
399 466.006 Examination of dentists.—
400 (4) Notwithstanding any other provision of law in chapter
401 456 pertaining to the clinical dental licensure examination or
402 national examinations, to be licensed as a dentist in this
403 state, an applicant must successfully complete both of the
404 following:
405 (b) A practical or clinical examination, which must be the
406 American Dental Licensing Examination produced by the American
407 Board of Dental Examiners, Inc., or its successor entity, if
408 any, that is administered in this state, provided that the board
409 has attained, and continues to maintain thereafter,
410 representation on the board of directors of the American Board
411 of Dental Examiners, the examination development committee of
412 the American Board of Dental Examiners, and such other
413 committees of the American Board of Dental Examiners as the
414 board deems appropriate by rule to assure that the standards
415 established herein are maintained organizationally. A passing
416 score on the American Dental Licensing Examination administered
417 in this state is valid for 365 days after the date the official
418 examination results are published.
419 1. As an alternative to such practical or clinical
420 examination, an applicant may submit scores from an American
421 Dental Licensing Examination previously administered in a
422 jurisdiction other than this state after October 1, 2011, and
423 such examination results must shall be recognized as valid for
424 the purpose of licensure in this state. A passing score on the
425 American Dental Licensing Examination administered out of state
426 is shall be the same as the passing score for the American
427 Dental Licensing Examination administered in this state. The
428 examination results are valid for 365 days after the date the
429 official examination results are published. The applicant must
430 have completed the examination after October 1, 2011. This
431 subparagraph may not be given retroactive application.
432 2. If the date of an applicant’s passing American Dental
433 Licensing Examination scores from an examination previously
434 administered in a jurisdiction other than this state under
435 subparagraph 1. is older than 365 days, such scores are
436 nevertheless valid for the purpose of licensure in this state,
437 but only if the applicant demonstrates that all of the following
438 additional standards have been met:
439 a. The applicant completed the American Dental Licensing
440 Examination after October 1, 2011. This sub-subparagraph may not
441 be given retroactive application;
442 b. The applicant graduated from a dental school accredited
443 by the American Dental Association Commission on Dental
444 Accreditation or its successor entity, if any, or any other
445 dental accrediting organization recognized by the United States
446 Department of Education. Provided, however, if the applicant did
447 not graduate from such a dental school, the applicant may submit
448 proof of having successfully completed a full-time supplemental
449 general dentistry program accredited by the American Dental
450 Association Commission on Dental Accreditation of at least 2
451 consecutive academic years at such accredited sponsoring
452 institution. Such program must provide didactic and clinical
453 education at the level of a D.D.S. or D.M.D. program accredited
454 by the American Dental Association Commission on Dental
455 Accreditation. For purposes of this sub-subparagraph, a
456 supplemental general dentistry program does not include an
457 advanced education program in a dental specialty;
458 c. The applicant currently possesses a valid and active
459 dental license in good standing, with no restriction, which has
460 never been revoked, suspended, restricted, or otherwise
461 disciplined, from another state or territory of the United
462 States, the District of Columbia, or the Commonwealth of Puerto
463 Rico;
464 d. The applicant submits proof that he or she has never
465 been reported to the National Practitioner Data Bank, the
466 Healthcare Integrity and Protection Data Bank, or the American
467 Association of Dental Boards Clearinghouse. This sub
468 subparagraph does not apply if the applicant successfully
469 appealed to have his or her name removed from the data banks of
470 these agencies;
471 e.(I)(A) The applicant submits proof of having been
472 consecutively engaged in the full-time practice of dentistry in
473 another state or territory of the United States, the District of
474 Columbia, or the Commonwealth of Puerto Rico in the 5 years
475 immediately preceding the date of application for licensure in
476 this state; or
477 (B) If the applicant has been licensed in another state or
478 territory of the United States, the District of Columbia, or the
479 Commonwealth of Puerto Rico for less than 5 years, the applicant
480 submits proof of having been engaged in the full-time practice
481 of dentistry since the date of his or her initial licensure.
482 (II) As used in this section, “full-time practice” is
483 defined as a minimum of 1,200 hours per year for each and every
484 year in the consecutive 5-year period or, when applicable, the
485 period since initial licensure, and must include any combination
486 of the following:
487 (A) Active clinical practice of dentistry providing direct
488 patient care.
489 (B) Full-time practice as a faculty member employed by a
490 dental, dental therapy, or dental hygiene school approved by the
491 board or accredited by the American Dental Association
492 Commission on Dental Accreditation.
493 (C) Full-time practice as a student at a postgraduate
494 dental education program approved by the board or accredited by
495 the American Dental Association Commission on Dental
496 Accreditation.
497 (III) The board shall develop rules to determine what type
498 of proof of full-time practice is required and to recoup the
499 cost to the board of verifying full-time practice under this
500 section. Such proof must, at a minimum, be:
501 (A) Admissible as evidence in an administrative proceeding;
502 (B) Submitted in writing;
503 (C) Submitted by the applicant under oath with penalties of
504 perjury attached;
505 (D) Further documented by an affidavit of someone unrelated
506 to the applicant who is familiar with the applicant’s practice
507 and testifies with particularity that the applicant has been
508 engaged in full-time practice; and
509 (E) Specifically found by the board to be both credible and
510 admissible.
511 (IV) An affidavit of only the applicant is not acceptable
512 proof of full-time practice unless it is further attested to by
513 someone unrelated to the applicant who has personal knowledge of
514 the applicant’s practice. If the board deems it necessary to
515 assess credibility or accuracy, the board may require the
516 applicant or the applicant’s witnesses to appear before the
517 board and give oral testimony under oath;
518 f. The applicant submits documentation that he or she has
519 completed, or will complete before he or she is licensed in this
520 state, continuing education equivalent to this state’s
521 requirements for the last full reporting biennium;
522 g. The applicant proves that he or she has never been
523 convicted of, or pled nolo contendere to, regardless of
524 adjudication, any felony or misdemeanor related to the practice
525 of a health care profession in any jurisdiction;
526 h. The applicant has successfully passed a written
527 examination on the laws and rules of this state regulating the
528 practice of dentistry and the computer-based diagnostic skills
529 examination; and
530 i. The applicant submits documentation that he or she has
531 successfully completed the applicable examination administered
532 by the Joint Commission on National Dental Examinations or its
533 successor organization.
534 (6)
535 (b)1. As used in this section, “full-time practice of
536 dentistry within the geographic boundaries of this state within
537 1 year” is defined as a minimum of 1,200 hours in the initial
538 year of licensure, which must include any combination of the
539 following:
540 a. Active clinical practice of dentistry providing direct
541 patient care within the geographic boundaries of this state.
542 b. Full-time practice as a faculty member employed by a
543 dental, dental therapy, or dental hygiene school approved by the
544 board or accredited by the American Dental Association
545 Commission on Dental Accreditation and located within the
546 geographic boundaries of this state.
547 c. Full-time practice as a student at a postgraduate dental
548 education program approved by the board or accredited by the
549 American Dental Association Commission on Dental Accreditation
550 and located within the geographic boundaries of this state.
551 2. The board shall develop rules to determine what type of
552 proof of full-time practice of dentistry within the geographic
553 boundaries of this state for 1 year is required in order to
554 maintain active licensure and shall develop rules to recoup the
555 cost to the board of verifying maintenance of such full-time
556 practice under this section. Such proof must, at a minimum:
557 a. Be admissible as evidence in an administrative
558 proceeding;
559 b. Be submitted in writing;
560 c. Be submitted by the applicant under oath with penalties
561 of perjury attached;
562 d. Be further documented by an affidavit of someone
563 unrelated to the applicant who is familiar with the applicant’s
564 practice and testifies with particularity that the applicant has
565 been engaged in full-time practice of dentistry within the
566 geographic boundaries of this state within the last 365 days;
567 and
568 e. Include such additional proof as specifically found by
569 the board to be both credible and admissible.
570 3. An affidavit of only the applicant is not acceptable
571 proof of full-time practice of dentistry within the geographic
572 boundaries of this state within 1 year, unless it is further
573 attested to by someone unrelated to the applicant who has
574 personal knowledge of the applicant’s practice within the last
575 365 days. If the board deems it necessary to assess credibility
576 or accuracy, the board may require the applicant or the
577 applicant’s witnesses to appear before the board and give oral
578 testimony under oath.
579 Section 7. Subsection (1) of section 466.009, Florida
580 Statutes, is amended, and subsection (4) is added to that
581 section, to read:
582 466.009 Reexamination.—
583 (1) The department shall allow permit any person who fails
584 an examination that which is required under s. 466.006, or s.
585 466.007, or s. 466.0225 to retake the examination. If the
586 examination to be retaken is a practical or clinical
587 examination, the applicant must shall pay a reexamination fee
588 set by rule of the board in an amount not to exceed the original
589 examination fee.
590 (4) If an applicant for a license to practice dental
591 therapy fails the practical or clinical examination and she or
592 he has failed only one part or procedure of such examination,
593 she or he may be required to retake only that part or procedure
594 to pass such examination. However, if any such applicant fails
595 more than one part or procedure of any such examination, she or
596 he must be required to retake the entire examination.
597 Section 8. Section 466.011, Florida Statutes, is amended to
598 read:
599 466.011 Licensure.—The board shall certify for licensure by
600 the department any applicant who satisfies the requirements of
601 s. 466.006, s. 466.0067, or s. 466.007, or s. 466.0225. The
602 board may refuse to certify an applicant who has violated any of
603 the provisions of s. 466.026 or s. 466.028.
604 Section 9. Section 466.0136, Florida Statutes, is created
605 to read:
606 466.0136 Continuing education; dental therapists.—In
607 addition to any other requirements for relicensure for dental
608 therapists specified in this chapter, the board shall require
609 each licensed dental therapist to complete at least 24 hours,
610 but not more than 36 hours, biennially of continuing education
611 in dental subjects in programs approved by the board or in
612 equivalent programs of continuing education. Programs of
613 continuing education approved by the board must be programs of
614 learning which, in the opinion of the board, contribute directly
615 to the dental education of the dental therapist. An individual
616 who is licensed as both a dental therapist and a dental
617 hygienist may use 2 hours of continuing education that is
618 approved for both dental therapy and dental hygiene education to
619 satisfy both dental therapy and dental hygiene continuing
620 education requirements. The board shall adopt rules and
621 guidelines to administer and enforce this section. The dental
622 therapist shall retain in her or his records any receipts,
623 vouchers, or certificates necessary to document completion of
624 the continuing education. Compliance with the continuing
625 education requirements is mandatory for issuance of the renewal
626 certificate. The board may excuse licensees, as a group or as
627 individuals, from all or part of the continuing education
628 requirements if an unusual circumstance, emergency, or hardship
629 prevented compliance with this section.
630 Section 10. Section 466.016, Florida Statutes, is amended
631 to read:
632 466.016 License to be displayed.—Every practitioner of
633 dentistry, dental therapy, or dental hygiene within the meaning
634 of this chapter shall post and keep conspicuously displayed her
635 or his license in the office where wherein she or he practices,
636 in plain sight of the practitioner’s patients. Any dentist,
637 dental therapist, or dental hygienist who practices at more than
638 one location shall be required to display a copy of her or his
639 license in each office where she or he practices.
640 Section 11. Present subsections (7) through (15) of section
641 466.017, Florida Statutes, are redesignated as subsections (8)
642 through (16), respectively, a new subsection (7) is added to
643 that section, and paragraphs (d) and (e) of subsection (3),
644 subsection (4), and present subsections (7), (8), and (14) of
645 that section are amended, to read:
646 466.017 Prescription of drugs; anesthesia.—
647 (3) The board shall adopt rules which:
648 (d) Establish further requirements relating to the use of
649 general anesthesia or sedation, including, but not limited to,
650 office equipment and the training of dental assistants, dental
651 therapists, or dental hygienists who work with dentists using
652 general anesthesia or sedation.
653 (e) Establish an administrative mechanism enabling the
654 board to verify compliance with training, education, experience,
655 equipment, or certification requirements of dentists, dental
656 therapists, dental hygienists, and dental assistants adopted
657 pursuant to this subsection. The board may charge a fee to
658 defray the cost of verifying compliance with requirements
659 adopted pursuant to this paragraph.
660 (4) A dentist, dental therapist, or dental hygienist who
661 administers or employs the use of any form of anesthesia must
662 possess a certification in either basic cardiopulmonary
663 resuscitation for health professionals or advanced cardiac life
664 support approved by the American Heart Association or the
665 American Red Cross or an equivalent agency-sponsored course with
666 recertification every 2 years. Each dental office that which
667 uses any form of anesthesia must have immediately available and
668 in good working order such resuscitative equipment, oxygen, and
669 other resuscitative drugs as are specified by rule of the board
670 in order to manage possible adverse reactions.
671 (7) A dental therapist, under the general supervision of a
672 dentist, may administer local anesthesia, including intraoral
673 block anesthesia or soft tissue infiltration anesthesia if she
674 or he has completed the course described in subsection (5) and
675 presents evidence of current certification in basic or advanced
676 cardiac life support.
677 (8)(7) A licensed dentist, or a dental therapist who is
678 authorized by her or his supervising dentist, may operate
679 utilize an X-ray machine, expose dental X-ray films, and
680 interpret or read such films. Notwithstanding The provisions of
681 part IV of chapter 468 to the contrary notwithstanding, a
682 licensed dentist, or a dental therapist who is authorized by her
683 or his supervising dentist, may authorize or direct a dental
684 assistant to operate such equipment and expose such films under
685 her or his direction and supervision, pursuant to rules adopted
686 by the board in accordance with s. 466.024 which ensure that the
687 said assistant is competent by reason of training and experience
688 to operate the X-ray said equipment in a safe and efficient
689 manner. The board may charge a fee not to exceed $35 to defray
690 the cost of verifying compliance with requirements adopted
691 pursuant to this section.
692 (9)(8) Notwithstanding The provisions of s. 465.0276
693 notwithstanding, a dentist need not register with the board or
694 comply with the continuing education requirements of that
695 section if the dentist confines her or his dispensing activity
696 to the dispensing of fluorides and chlorhexidine chlorohexidine
697 rinse solutions; provided that the dentist complies with and is
698 subject to all laws and rules applicable to pharmacists and
699 pharmacies, including, but not limited to, chapters 465, 499,
700 and 893, and all applicable federal laws and regulations, when
701 dispensing such products.
702 (15)(14) As used in subsections (10)-(14) (9)-(13), the
703 term “adverse incident” means any mortality that occurs during
704 or as the result of a dental procedure, or an incident that
705 results in a temporary or permanent physical or mental injury
706 that requires hospitalization or emergency room treatment of a
707 dental patient which occurs during or as a direct result of the
708 use of general anesthesia, deep sedation, moderate sedation,
709 pediatric moderate sedation, oral sedation, minimal sedation
710 (anxiolysis), nitrous oxide, or local anesthesia.
711 Section 12. Subsection (1) of section 466.018, Florida
712 Statutes, is amended to read:
713 466.018 Dentist of record; patient records.—
714 (1) Each patient must shall have a dentist of record. The
715 dentist of record shall remain primarily responsible for all
716 dental treatment on such patient regardless of whether the
717 treatment is rendered by that the dentist or by another dentist,
718 a dental therapist, a dental hygienist, or a dental assistant
719 rendering such treatment in conjunction with, at the direction
720 or request of, or under the supervision of such dentist of
721 record. The dentist of record must shall be identified in the
722 record of the patient. If treatment is rendered by a dentist
723 other than the dentist of record or by a dental hygienist,
724 dental therapist, or dental assistant, the name or initials of
725 such person must shall be placed in the record of the patient.
726 In any disciplinary proceeding brought pursuant to this chapter
727 or chapter 456, it must shall be presumed as a matter of law
728 that treatment was rendered by the dentist of record unless
729 otherwise noted on the patient record pursuant to this section.
730 The dentist of record and any other treating dentist are subject
731 to discipline pursuant to this chapter or chapter 456 for
732 treatment rendered to the patient and performed in violation of
733 such chapter. One of the purposes of this section is to ensure
734 that the responsibility for each patient is assigned to one
735 dentist in a multidentist practice of any nature and to assign
736 primary responsibility to the dentist for treatment rendered by
737 a dental hygienist, dental therapist, or dental assistant under
738 her or his supervision. This section may shall not be construed
739 to assign any responsibility to a dentist of record for
740 treatment rendered pursuant to a proper referral to another
741 dentist who does not in practice with the dentist of record or
742 to prohibit a patient from voluntarily selecting a new dentist
743 without permission of the dentist of record.
744 Section 13. Section 466.0225, Florida Statutes, is created
745 to read:
746 466.0225 Examination of dental therapists; licensing.—
747 (1) Any person desiring to be licensed as a dental
748 therapist must apply to the department to take the licensure
749 examinations and shall verify the information required on the
750 application by oath. The application must include two recent
751 photographs of the applicant.
752 (2) An applicant is entitled to take the examinations
753 required under this section and receive licensure to practice
754 dental therapy in this state if the applicant meets all of the
755 following criteria:
756 (a) Is 18 years of age or older.
757 (b) Is a graduate of a dental therapy college or school
758 accredited by the American Dental Association Commission on
759 Dental Accreditation or its successor entity, if any, or any
760 other dental therapy accrediting entity recognized by the United
761 States Department of Education. For applicants applying for a
762 dental therapy license before January 1, 2029, the board must
763 approve the applicant’s dental therapy education program if the
764 program was administered by a college or school that operates an
765 accredited dental or dental hygiene program and the college or
766 school certifies to the board that the applicant’s education
767 substantially conformed to the education standards established
768 by the American Dental Association Commission on Dental
769 Accreditation or its successor entity.
770 (c) Has successfully completed a dental therapy practical
771 or clinical examination produced by the American Board of Dental
772 Examiners, Inc., (ADEX) or its successor entity, if any, if the
773 board finds that the successor entity’s examination meets or
774 exceeds the requirements of this section. If an applicant fails
775 to pass such an examination after three attempts, the applicant
776 is not eligible to retake the examination unless the applicant
777 completes additional education requirements as specified by the
778 board. If a dental therapy examination has not been established
779 by ADEX, the board must administer or approve an alternative
780 examination.
781 (d) Has not been disciplined by a board, except for
782 citation offenses or minor violations.
783 (e) Has not been convicted of or pled nolo contendere to,
784 regardless of adjudication, any felony or misdemeanor related to
785 the practice of a health care profession.
786 (f) Has successfully completed a written examination on the
787 laws and rules of this state regulating the practice of dental
788 therapy.
789 (3) An applicant who meets the requirements of this section
790 and who has successfully completed an examination identified in
791 paragraph (2)(c) in a jurisdiction other than this state, or who
792 has successfully completed a comparable examination administered
793 or approved by the licensing authority in a jurisdiction other
794 than this state, must be licensed to practice dental therapy in
795 this state if the board determines that the other jurisdiction’s
796 examination is substantially similar to those identified in
797 paragraph (2)(c).
798 Section 14. Section 466.0227, Florida Statutes, is created
799 to read:
800 466.0227 Dental therapists; scope and area of practice.—
801 (1) Except as otherwise provided in this chapter, a dental
802 therapist may perform the dental therapy services specified in
803 subsection (2) under the general supervision of a dentist to the
804 extent authorized by the supervising dentist and provided within
805 the terms of a written collaborative management agreement signed
806 by the dental therapist and the supervising dentist which meets
807 the requirements of subsection (3).
808 (2) Dental therapy services include all of the following:
809 (a) All services, treatments, and competencies identified
810 by the American Dental Association Commission on Dental
811 Accreditation in the commission’s Accreditation Standards for
812 Dental Therapy Education Programs.
813 (b) The following state-specific services, if the dental
814 therapist’s education included curriculum content satisfying the
815 American Dental Association Commission on Dental Accreditation
816 criteria for state-specific dental therapy services:
817 1. Evaluating radiographs.
818 2. Placement of space maintainers.
819 3. Pulpotomies on primary teeth.
820 4. Dispensing and administering nonopioid analgesics,
821 including nitrous oxide, anti-inflammatories, and antibiotics,
822 as authorized by the supervising dentist and within the
823 parameters of the collaborative management agreement.
824 5. Oral evaluation and assessment of dental disease and
825 formulation of an individualized treatment plan if authorized by
826 the supervising dentist and subject to any conditions,
827 limitations, and protocols specified by the supervising dentist
828 in the collaborative management agreement.
829 (3) Before performing any of the services authorized in
830 subsection (2), a dental therapist must enter into a written
831 collaborative management agreement with a supervising dentist.
832 The agreement must be signed by the dental therapist and the
833 supervising dentist and must include all of the following
834 information:
835 (a) Practice settings where services may be provided by the
836 dental therapist and the populations to be served by the dental
837 therapist.
838 (b) Any limitations on the services that may be provided by
839 the dental therapist, including the level of supervision
840 required by the supervising dentist. This may include
841 telehealth.
842 (c) Age-specific and procedure-specific practice protocols
843 for the dental therapist, including case selection criteria,
844 assessment guidelines, and imaging frequency.
845 (d) A procedure for creating and maintaining dental records
846 for the patients who are treated by the dental therapist.
847 (e) A plan to manage medical emergencies in each practice
848 setting where the dental therapist provides care.
849 (f) A quality assurance plan for monitoring care provided
850 by the dental therapist, including patient care review, referral
851 follow-up, and a quality assurance chart review.
852 (g) Protocols for the dental therapist to administer and
853 dispense medications, including the specific conditions and
854 circumstances under which the medications are to be dispensed
855 and administered.
856 (h) Criteria relating to the provision of care by the
857 dental therapist to patients with specific medical conditions or
858 complex medication histories, including requirements for
859 consultation before the initiation of care.
860 (i) Supervision criteria of dental therapists.
861 (j) A plan for the provision of clinical resources and
862 referrals in situations that are beyond the capabilities of the
863 dental therapist.
864 (4) A supervising dentist shall determine the number of
865 hours of practice that a dental therapist must complete under
866 direct or indirect supervision of the supervising dentist before
867 the dental therapist may perform any of the services authorized
868 in subsection (2) under general supervision.
869 (5) A supervising dentist may restrict or limit the dental
870 therapist’s practice in the written collaborative management
871 agreement to be less than the full scope of practice for dental
872 therapists which is authorized in subsection (2).
873 (6) A supervising dentist may authorize a dental therapist
874 to provide dental therapy services to a patient before the
875 supervising dentist examines or diagnoses the patient if the
876 authority, conditions, and protocols are established in a
877 written collaborative management agreement and if the patient is
878 subsequently referred to a dentist for any needed additional
879 services that exceed the dental therapist’s scope of practice or
880 authorization under the collaborative management agreement.
881 (7) A supervising dentist must be licensed and practicing
882 in this state. The supervising dentist is responsible for all
883 services authorized and performed by the dental therapist
884 pursuant to the collaborative management agreement and for
885 providing or arranging follow-up services to be provided by a
886 dentist for any additional services that exceed the dental
887 therapist’s scope of practice or authorization under the
888 collaborative management agreement.
889 Section 15. Section 466.026, Florida Statutes, is amended
890 to read:
891 466.026 Prohibitions; penalties.—
892 (1) Each of the following acts constitutes a felony of the
893 third degree, punishable as provided in s. 775.082, s. 775.083,
894 or s. 775.084:
895 (a) Practicing dentistry, dental therapy, or dental hygiene
896 unless the person has an appropriate, active license issued by
897 the department pursuant to this chapter.
898 (b) Using or attempting to use a license issued pursuant to
899 this chapter which license has been suspended or revoked.
900 (c) Knowingly employing any person to perform duties
901 outside the scope allowed such person under this chapter or the
902 rules of the board.
903 (d) Giving false or forged evidence to the department or
904 board for the purpose of obtaining a license.
905 (e) Selling or offering to sell a diploma conferring a
906 degree from a dental college, or dental hygiene school or
907 college, or dental therapy school or college, or a license
908 issued pursuant to this chapter, or procuring such diploma or
909 license with intent that it will shall be used as evidence of
910 that which the document stands for, by a person other than the
911 one upon whom it was conferred or to whom it was granted.
912 (2) Each of the following acts constitutes a misdemeanor of
913 the first degree, punishable as provided in s. 775.082 or s.
914 775.083:
915 (a) Using the name or title “dentist,” the letters “D.D.S.”
916 or “D.M.D.”, or any other words, letters, title, or descriptive
917 matter which in any way represents a person as being able to
918 diagnose, treat, prescribe, or operate for any disease, pain,
919 deformity, deficiency, injury, or physical condition of the
920 teeth or jaws or oral-maxillofacial region unless the person has
921 an active dentist’s license issued by the department pursuant to
922 this chapter.
923 (b) Using the name “dental hygienist” or the initials
924 “R.D.H.” or otherwise holding herself or himself out as an
925 actively licensed dental hygienist or implying to any patient or
926 consumer that she or he is an actively licensed dental hygienist
927 unless that person has an active dental hygienist’s license
928 issued by the department pursuant to this chapter.
929 (c) Using the name “dental therapist” or the initials
930 “D.T.” or otherwise holding herself or himself out as an
931 actively licensed dental therapist or implying to any patient or
932 consumer that she or he is an actively licensed dental therapist
933 unless that person has an active dental therapist’s license
934 issued by the department pursuant to this chapter.
935 (d) Presenting as her or his own the license of another.
936 (e)(d) Knowingly concealing information relative to
937 violations of this chapter.
938 (f)(e) Performing any services as a dental assistant as
939 defined herein, except in the office of a licensed dentist,
940 unless authorized by this chapter or by rule of the board.
941 Section 16. Paragraphs (b), (c), (g), (s), and (t) of
942 subsection (1) of section 466.028, Florida Statutes, are amended
943 to read:
944 466.028 Grounds for disciplinary action; action by the
945 board.—
946 (1) The following acts constitute grounds for denial of a
947 license or disciplinary action, as specified in s. 456.072(2):
948 (b) Having a license to practice dentistry, dental therapy,
949 or dental hygiene revoked, suspended, or otherwise acted
950 against, including the denial of licensure, by the licensing
951 authority of another state, territory, or country.
952 (c) Being convicted or found guilty of or entering a plea
953 of nolo contendere to, regardless of adjudication, a crime in
954 any jurisdiction which relates to the practice of dentistry,
955 dental therapy, or dental hygiene. A plea of nolo contendere
956 creates shall create a rebuttable presumption of guilt to the
957 underlying criminal charges.
958 (g) Aiding, assisting, procuring, or advising any
959 unlicensed person to practice dentistry, dental therapy, or
960 dental hygiene contrary to this chapter or to a rule of the
961 department or the board.
962 (s) Being unable to practice her or his profession with
963 reasonable skill and safety to patients by reason of illness or
964 use of alcohol, drugs, narcotics, chemicals, or any other type
965 of material or as a result of any mental or physical condition.
966 In enforcing this paragraph, the department shall have, upon a
967 finding of the State Surgeon General or her or his designee that
968 probable cause exists to believe that the licensee is unable to
969 practice dentistry, dental therapy, or dental hygiene because of
970 the reasons stated in this paragraph, has the authority to issue
971 an order to compel a licensee to submit to a mental or physical
972 examination by physicians designated by the department. If the
973 licensee refuses to comply with such order, the department’s
974 order directing such examination may be enforced by filing a
975 petition for enforcement in the circuit court where the licensee
976 resides or does business. The licensee against whom the petition
977 is filed may shall not be named or identified by initials in any
978 public court records or documents, and the proceedings must
979 shall be closed to the public. The department is shall be
980 entitled to the summary procedure provided in s. 51.011. A
981 licensee affected under this paragraph must shall at reasonable
982 intervals be afforded an opportunity to demonstrate that she or
983 he can resume the competent practice of her or his profession
984 with reasonable skill and safety to patients.
985 (t) Fraud, deceit, or misconduct in the practice of
986 dentistry, dental therapy, or dental hygiene.
987 Section 17. Paragraphs (a) and (b) of subsection (1) of
988 section 466.0285, Florida Statutes, are amended to read:
989 466.0285 Proprietorship by nondentists.—
990 (1) No person other than a dentist licensed pursuant to
991 this chapter, nor any entity other than a professional
992 corporation or limited liability company composed of dentists,
993 may:
994 (a) Employ a dentist, a dental therapist, or a dental
995 hygienist in the operation of a dental office.
996 (b) Control the use of any dental equipment or material
997 while such equipment or material is being used for the provision
998 of dental services, whether those services are provided by a
999 dentist, a dental therapist, a dental hygienist, or a dental
1000 assistant.
1001
1002 Any lease agreement, rental agreement, or other arrangement
1003 between a nondentist and a dentist whereby the nondentist
1004 provides the dentist with dental equipment or dental materials
1005 shall contain a provision whereby the dentist expressly
1006 maintains complete care, custody, and control of the equipment
1007 or practice.
1008 Section 18. The Department of Health, in consultation with
1009 the Board of Dentistry and the Agency for Health Care
1010 Administration, shall submit a progress report to the President
1011 of the Senate and the Speaker of the House of Representatives by
1012 July 1, 2027, and a final report 4 years after the first dental
1013 therapy license is issued. The reports must include all of the
1014 following information and recommendations:
1015 (1) The progress that has been made in this state to
1016 implement dental therapy training programs, licensing, and
1017 Medicaid reimbursement.
1018 (2) Data demonstrating the effects of dental therapy in
1019 this state on all of the following:
1020 (a) Patient access to dental services.
1021 (b) Costs to dental providers, patients, dental insurance
1022 carriers, and the state.
1023 (c) The quality and safety of dental services.
1024 (3) Specific recommendations for any necessary legislative,
1025 administrative, or regulatory reform relating to the practice of
1026 dental therapy.
1027 (4) Any other information the department deems appropriate.
1028 Section 19. This act shall take effect July 1, 2024.
