Bill Summary – FastDemocracy

       Florida Senate - 2024                                    SB 1254
       
       
        
       By Senator Collins
       
       
       
       
       
       14-01028B-24                                          20241254__
                      A bill to be entitled                      
       An act relating to dental therapy; amending s.
       409.906, F.S.; authorizing Medicaid to reimburse for
       dental services provided in a mobile dental unit that
       is owned by, operated by, or contracted with a health
       access setting or another similar setting or program;
       amending s. 466.001, F.S.; revising legislative
       purpose and intent; amending s. 466.002, F.S.;
       providing applicability; reordering and amending s.
       466.003, F.S.; defining the terms “dental therapist”
       and “dental therapy”; making technical changes;
       amending s. 466.004, F.S.; requiring the chair of the
       Board of Dentistry to appoint a Council on Dental
       Therapy, effective after a specified timeframe;
       providing for membership, meetings, and the purpose of
       the council; amending s. 466.006, F.S.; revising the
       definitions of the terms “full-time practice” and
       “full-time practice of dentistry within the geographic
       boundaries of this state within 1 year” to include
       full-time faculty members of certain dental therapy
       schools; amending s. 466.009, F.S.; requiring the
       Department of Health to allow any person who fails the
       dental therapy examination to retake the examination;
       providing that a person who fails a practical or
       clinical examination to practice dental therapy and
       who has failed one part or procedure of the
       examination may be required to retake only that part
       or procedure to pass the examination; amending s.
       466.011, F.S.; requiring the board to certify an
       applicant for licensure as a dental therapist;
       creating s. 466.0136, F.S.; requiring the board to
       require each licensed dental therapist to complete a
       specified number of hours of continuing education;
       requiring the board to adopt rules and guidelines;
       authorizing the board to excuse licensees from
       continuing education requirements in certain
       circumstances; amending s. 466.016, F.S.; requiring a
       practitioner of dental therapy to post and display her
       or his license in each office where she or he
       practices; amending s. 466.017, F.S.; requiring the
       board to adopt certain rules relating to dental
       therapists; authorizing a dental therapist under the
       general supervision of a dentist to administer local
       anesthesia and operate an X-ray machine, expose dental
       X-ray films, and interpret or read such films if
       specified requirements are met; correcting the
       spelling of a term; amending s. 466.018, F.S.;
       providing that a dentist of record remains primarily
       responsible for the dental treatment of a patient
       regardless of whether the treatment is provided by a
       dental therapist; requiring that the initials of a
       dental therapist who renders treatment to a patient be
       placed in the record of the patient; creating s.
       466.0225, F.S.; providing application requirements and
       examination and licensure qualifications for dental
       therapists; creating s. 466.0227, F.S.; authorizing a
       dental therapist to perform specified services under
       the general supervision of a dentist under certain
       conditions; specifying state-specific dental therapy
       services; requiring that a collaborative management
       agreement be signed by a supervising dentist and a
       dental therapist and to include certain information;
       requiring the supervising dentist to determine the
       number of hours of practice that a dental therapist
       must complete before performing certain authorized
       services; authorizing a supervising dentist to
       restrict or limit the dental therapist’s practice in a
       collaborative management agreement; providing that a
       supervising dentist may authorize a dental therapist
       to provide dental therapy services to a patient before
       the dentist examines or diagnoses the patient under
       certain conditions; requiring a supervising dentist to
       be licensed and practicing in this state; specifying
       that the supervising dentist is responsible for
       certain services; amending s. 466.026, F.S.; providing
       criminal penalties for practicing dental therapy
       without an active license, selling or offering to sell
       a diploma from a dental therapy school or college,
       falsely using a specified name or initials, or holding
       oneself out as an actively licensed dental therapist;
       amending s. 466.028, F.S.; revising grounds for denial
       of a license or disciplinary action to include the
       practice of dental therapy; amending s. 466.0285,
       F.S.; prohibiting persons other than licensed dentists
       from employing a dental therapist in the operation of
       a dental office and from controlling the use of any
       dental equipment or material in certain circumstances;
       requiring the department, in consultation with the
       board and the Agency for Health Care Administration,
       to provide reports to the Legislature by specified
       dates; requiring that certain information and
       recommendations be included in the reports; providing
       an effective date.
        
Be It Enacted by the Legislature of the State of Florida:

       Section 1. Paragraph (c) of subsection (1) of section
409.906, Florida Statutes, is amended, and paragraph (e) is
added to subsection (6) of that section, to read:
       409.906 Optional Medicaid services.—Subject to specific
appropriations, the agency may make payments for services which
are optional to the state under Title XIX of the Social Security
Act and are furnished by Medicaid providers to recipients who
are determined to be eligible on the dates on which the services
were provided. Any optional service that is provided shall be
provided only when medically necessary and in accordance with
state and federal law. Optional services rendered by providers
in mobile units to Medicaid recipients may be restricted or
prohibited by the agency. Nothing in this section shall be
construed to prevent or limit the agency from adjusting fees,
reimbursement rates, lengths of stay, number of visits, or
number of services, or making any other adjustments necessary to
comply with the availability of moneys and any limitations or
directions provided for in the General Appropriations Act or
chapter 216. If necessary to safeguard the state’s systems of
providing services to elderly and disabled persons and subject
to the notice and review provisions of s. 216.177, the Governor
may direct the Agency for Health Care Administration to amend
the Medicaid state plan to delete the optional Medicaid service
known as “Intermediate Care Facilities for the Developmentally
Disabled.” Optional services may include:
       (1) ADULT DENTAL SERVICES.—
       (c) However, Medicaid will not provide reimbursement for
dental services provided in a mobile dental unit, except for a
mobile dental unit:
       1. Owned by, operated by, or having a contractual agreement
with the Department of Health and complying with Medicaid’s
county health department clinic services program specifications
as a county health department clinic services provider.
       2. Owned by, operated by, or having a contractual
arrangement with a federally qualified health center and
complying with Medicaid’s federally qualified health center
specifications as a federally qualified health center provider.
       3. Rendering dental services to Medicaid recipients, 21
years of age and older, at nursing facilities.
       4. Owned by, operated by, or having a contractual agreement
with a state-approved dental educational institution.
       5. Owned by, operated by, or having a contractual agreement
with a health access setting as defined in s. 466.003 or a
similar setting or program.
       (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for
diagnostic, preventive, or corrective procedures, including
orthodontia in severe cases, provided to a recipient under age
21, by or under the supervision of a licensed dentist. The
agency may also reimburse a health access setting as defined in
s. 466.003 for the remediable tasks that a licensed dental
hygienist is authorized to perform under s. 466.024(2). Services
provided under this program include treatment of the teeth and
associated structures of the oral cavity, as well as treatment
of disease, injury, or impairment that may affect the oral or
general health of the individual. However, Medicaid will not
provide reimbursement for dental services provided in a mobile
dental unit, except for a mobile dental unit:
       (e) Owned by, operated by, or having a contractual
agreement with a health access setting as defined in s. 466.003
or a similar setting or program.
       Section 2. Section 466.001, Florida Statutes, is amended to
read:
       466.001 Legislative purpose and intent.—The legislative
purpose for enacting this chapter is to ensure that every
dentist, dental therapist, or dental hygienist practicing in
this state meets minimum requirements for safe practice without
undue clinical interference by persons not licensed under this
chapter. It is the legislative intent that dental services be
provided only in accordance with the provisions of this chapter
and not be delegated to unauthorized individuals. It is the
further legislative intent that dentists, dental therapists, and
dental hygienists who fall below minimum competency or who
otherwise present a danger to the public shall be prohibited
from practicing in this state. All provisions of this chapter
relating to the practice of dentistry, dental therapy, and
dental hygiene shall be liberally construed to carry out such
purpose and intent.
       Section 3. Subsections (5) and (6) of section 466.002,
Florida Statutes, are amended to read:
       466.002 Persons exempt from operation of chapter.—Nothing
in this chapter shall apply to the following practices, acts,
and operations:
       (5) Students in Florida schools of dentistry, dental
therapy, and dental hygiene or dental assistant educational
programs, while performing regularly assigned work under the
curriculum of such schools or programs.
       (6) Instructors in Florida schools of dentistry,
instructors in dental programs that prepare persons holding
D.D.S. or D.M.D. degrees for certification by a specialty board
and that are accredited in the United States by January 1, 2005,
in the same manner as the board recognizes accreditation for
Florida schools of dentistry that are not otherwise affiliated
with a Florida school of dentistry, or instructors in Florida
schools of dental hygiene or dental therapy or dental assistant
educational programs, while performing regularly assigned
instructional duties under the curriculum of such schools or
programs. A full-time dental instructor at a dental school or
dental program approved by the board may be allowed to practice
dentistry at the teaching facilities of such school or program,
upon receiving a teaching permit issued by the board, in strict
compliance with such rules as are adopted by the board
pertaining to the teaching permit and with the established rules
and procedures of the dental school or program as recognized in
this section.
       Section 4. Section 466.003, Florida Statutes, is reordered
and amended to read:
       466.003 Definitions.—As used in this chapter, the term:
       (1) “Board” means the Board of Dentistry.
       (7)(2) “Dentist” means a person licensed to practice
dentistry pursuant to this chapter.
       (8)(3) “Dentistry” means the healing art which is concerned
with the examination, diagnosis, treatment planning, and care of
conditions within the human oral cavity and its adjacent tissues
and structures. It includes the performance or attempted
performance of any dental operation, or oral or oral
maxillofacial surgery and any procedures adjunct thereto,
including physical evaluation directly related to such operation
or surgery pursuant to hospital rules and regulations. It also
includes dental service of any kind gratuitously or for any
remuneration paid, or to be paid, directly or indirectly, to any
person or agency. The term “dentistry” shall also includes
include the following:
       (a) The Taking of an impression of the human tooth, teeth,
or jaws directly or indirectly and by any means or method.
       (b) Supplying artificial substitutes for the natural teeth
or furnishing, supplying, constructing, reproducing, or
repairing any prosthetic denture, bridge, appliance, or any
other structure designed to be worn in the human mouth except on
the written work order of a duly licensed dentist.
       (c) The Placing of an appliance or structure in the human
mouth or the adjusting or attempting to adjust the same.
       (d) Delivering the same to any person other than the
dentist upon whose work order the work was performed.
       (e) Professing to the public by any method to furnish,
supply, construct, reproduce, or repair any prosthetic denture,
bridge, appliance, or other structure designed to be worn in the
human mouth.
       (f) Diagnosing, prescribing, or treating or professing to
diagnose, prescribe, or treat disease, pain, deformity,
deficiency, injury, or physical condition of the human teeth or
jaws or oral-maxillofacial region.
       (g) Extracting or attempting to extract human teeth.
       (h) Correcting or attempting to correct malformations of
teeth or of jaws.
       (i) Repairing or attempting to repair cavities in the human
teeth.
       (3)(4) “Dental hygiene” means the rendering of educational,
preventive, and therapeutic dental services pursuant to ss.
466.023 and 466.024 and any related extra-oral procedure
required in the performance of such services.
       (4)(5) “Dental hygienist” means a person licensed to
practice dental hygiene pursuant to this chapter.
       (2)(6) “Dental assistant” means a person, other than a
dental hygienist, who, under the supervision and authorization
of a dentist, provides dental care services directly to a
patient. This term does shall not include a certified registered
nurse anesthetist licensed under part I of chapter 464.
       (5) “Dental therapist” means a person licensed to practice
dental therapy pursuant to s. 466.0225.
       (6) “Dental therapy” means the rendering of services
pursuant to s. 466.0227 and any related extraoral services or
procedures required in the performance of such services.
       (9)(7) “Department” means the Department of Health.
       (10)(8) “Direct supervision” means supervision whereby a
dentist diagnoses the condition to be treated, a dentist
authorizes the procedure to be performed, a dentist remains on
the premises while the procedures are performed, and a dentist
approves the work performed before dismissal of the patient.
       (13)(9) “Indirect supervision” means supervision whereby a
dentist authorizes the procedure and a dentist is on the
premises while the procedures are performed.
       (11)(10) “General supervision” means supervision whereby a
dentist authorizes the procedures which are being carried out
but need not be present when the authorized procedures are being
performed. The authorized procedures may also be performed at a
place other than the dentist’s usual place of practice. The
issuance of a written work authorization to a commercial dental
laboratory by a dentist does not constitute general supervision.
       (14)(11) “Irremediable tasks” are those intraoral treatment
tasks which, when performed, are irreversible and create
unalterable changes within the oral cavity or the contiguous
structures or which cause an increased risk to the patient. The
administration of anesthetics other than topical anesthesia is
considered to be an “irremediable task” fo