Florida Senate - 2019                                     SB 684
       
       
        
       By Senator Brandes
       
       
       
       
       
       24-00394-19                                            2019684__
    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; amending s. 466.003, F.S.;
   10         defining the terms “dental therapist” and “dental
   11         therapy”; revising the definition of the term “health
   12         access setting” to include certain dental therapy
   13         programs; amending s. 466.004, F.S.; requiring the
   14         chair of the Board of Dentistry to appoint a Council
   15         on Dental Therapy effective after a specified
   16         timeframe; providing for membership, meetings, and the
   17         purpose of the council; amending s. 466.006, F.S.;
   18         revising the definition of the terms “full-time
   19         practice” and “full-time practice of dentistry within
   20         the geographic boundaries of this state within 1 year”
   21         to include full-time faculty members of certain dental
   22         therapy schools; amending s. 466.0075, F.S.;
   23         authorizing the board to require any person who
   24         applies to take the examination to practice dental
   25         therapy in this state to maintain medical malpractice
   26         insurance in a certain amount; amending s. 466.009,
   27         F.S.; requiring the Department of Health to allow any
   28         person who fails the dental therapy examination to
   29         retake the examination; providing that a person who
   30         fails a practical or clinical examination to practice
   31         dental therapy and who has failed one part or
   32         procedure of the examination may be required to retake
   33         only that part or procedure to pass the examination;
   34         amending s. 466.011, F.S.; requiring the board to
   35         certify applicants for licensure as a dental
   36         therapist; creating s. 466.0136, F.S.; requiring the
   37         board to require each licensed dental therapist to
   38         complete a specified number of hours of continuing
   39         professional education; requiring the board to adopt
   40         rules and guidelines; authorizing the board to excuse
   41         licensees from continuing education requirements in
   42         certain circumstances; amending s. 466.016, F.S.;
   43         requiring a practitioner of dental therapy to post and
   44         display her or his license in each office where she or
   45         he practices; amending s. 466.017, F.S.; requiring the
   46         board to adopt certain rules relating to dental
   47         therapists; authorizing a dental therapist under the
   48         general supervision of a dentist to administer local
   49         anesthesia and utilize an X-ray machine, expose dental
   50         X-ray films, and interpret or read such films if
   51         specified requirements are met; correcting a term;
   52         amending s. 466.018, F.S.; providing that a dentist
   53         remains primarily responsible for the dental treatment
   54         of a patient regardless of whether the treatment is
   55         provided by a dental therapist; requiring the initials
   56         of a dental therapist who renders treatment to a
   57         patient to be placed in the record of the patient;
   58         creating s. 466.0225, F.S.; providing application
   59         requirements and examination and licensure
   60         qualifications for dental therapists; creating s.
   61         466.0227, F.S.; providing legislative findings and
   62         intent; limiting the practice of dental therapy to
   63         specified settings; authorizing a dental therapist to
   64         perform specified services under the general
   65         supervision of a dentist under certain conditions;
   66         specifying state-specific dental therapy services;
   67         requiring a collaborative management agreement to be
   68         signed by a supervising dentist and a dental therapist
   69         and to include certain information; requiring the
   70         supervising dentist to determine the number of hours
   71         of practice that a dental therapist must complete
   72         before performing certain authorized services;
   73         authorizing a supervising dentist to restrict or limit
   74         the dental therapist’s practice in a collaborative
   75         management agreement; providing that a supervising
   76         dentist may authorize a dental therapist to provide
   77         dental therapy services to a patient before the
   78         dentist examines or diagnoses the patient under
   79         certain conditions; requiring a supervising dentist to
   80         be licensed and practicing in this state; specifying
   81         that the supervising dentist is responsible for
   82         certain services; amending s. 466.026, F.S.; providing
   83         criminal penalties for practicing dental therapy
   84         without an active license, selling or offering to sell
   85         a diploma from a dental therapy school or college,
   86         falsely using a specified name or initials or holding
   87         herself or himself out as an actively licensed dental
   88         therapist; amending s. 466.028, F.S.; revising grounds
   89         for denial of a license or disciplinary action to
   90         include the practice of dental therapy; amending s.
   91         466.0285, F.S.; prohibiting persons other than
   92         licensed dentists from employing a dental therapist in
   93         the operation of a dental office and from controlling
   94         the use of any dental equipment or material in certain
   95         circumstances; amending s. 466.051, F.S.; revising a
   96         public records exemption to include personal
   97         identifying information contained in a record provided
   98         by a dental therapist in response to a dental
   99         workforce survey and held by the department; requiring
  100         the department, in consultation with the board and the
  101         Agency for Health Care Administration, to provide
  102         reports to the Legislature by specified dates;
  103         requiring that certain information and recommendations
  104         be included in the reports; providing an effective
  105         date.
  106          
  107  Be It Enacted by the Legislature of the State of Florida:
  108  
  109         Section 1. Paragraph (c) of subsection (1) of section
  110  409.906, Florida Statutes, is amended, and paragraph (e) is
  111  added to subsection (6) of that section, to read:
  112         409.906 Optional Medicaid services.—Subject to specific
  113  appropriations, the agency may make payments for services which
  114  are optional to the state under Title XIX of the Social Security
  115  Act and are furnished by Medicaid providers to recipients who
  116  are determined to be eligible on the dates on which the services
  117  were provided. Any optional service that is provided shall be
  118  provided only when medically necessary and in accordance with
  119  state and federal law. Optional services rendered by providers
  120  in mobile units to Medicaid recipients may be restricted or
  121  prohibited by the agency. Nothing in this section shall be
  122  construed to prevent or limit the agency from adjusting fees,
  123  reimbursement rates, lengths of stay, number of visits, or
  124  number of services, or making any other adjustments necessary to
  125  comply with the availability of moneys and any limitations or
  126  directions provided for in the General Appropriations Act or
  127  chapter 216. If necessary to safeguard the state’s systems of
  128  providing services to elderly and disabled persons and subject
  129  to the notice and review provisions of s. 216.177, the Governor
  130  may direct the Agency for Health Care Administration to amend
  131  the Medicaid state plan to delete the optional Medicaid service
  132  known as “Intermediate Care Facilities for the Developmentally
  133  Disabled.” Optional services may include:
  134         (1) ADULT DENTAL SERVICES.—
  135         (c) However, Medicaid will not provide reimbursement for
  136  dental services provided in a mobile dental unit, except for a
  137  mobile dental unit:
  138         1. Owned by, operated by, or having a contractual agreement
  139  with the Department of Health and complying with Medicaid’s
  140  county health department clinic services program specifications
  141  as a county health department clinic services provider.
  142         2. Owned by, operated by, or having a contractual
  143  arrangement with a federally qualified health center and
  144  complying with Medicaid’s federally qualified health center
  145  specifications as a federally qualified health center provider.
  146         3. Rendering dental services to Medicaid recipients, 21
  147  years of age and older, at nursing facilities.
  148         4. Owned by, operated by, or having a contractual agreement
  149  with a state-approved dental educational institution.
  150         5.Owned by, operated by, or having a contractual
  151  relationship with a health access setting, as defined in s.
  152  466.003(16), or a similar setting or program that serves
  153  underserved or vulnerable populations that face serious barriers
  154  to accessing dental services, which may include, but is not
  155  limited to, Early Head Start programs, homeless shelters,
  156  schools, and the Special Supplemental Nutrition Program for
  157  Women, Infants, and Children.
  158         (6) CHILDREN’S DENTAL SERVICES.—The agency may pay for
  159  diagnostic, preventive, or corrective procedures, including
  160  orthodontia in severe cases, provided to a recipient under age
  161  21, by or under the supervision of a licensed dentist. The
  162  agency may also reimburse a health access setting as defined in
  163  s. 466.003(16) s. 466.003 for the remediable tasks that a
  164  licensed dental hygienist is authorized to perform under s.
  165  466.024(2). Services provided under this program include
  166  treatment of the teeth and associated structures of the oral
  167  cavity, as well as treatment of disease, injury, or impairment
  168  that may affect the oral or general health of the individual.
  169  However, Medicaid will not provide reimbursement for dental
  170  services provided in a mobile dental unit, except for a mobile
  171  dental unit:
  172         (e)Owned by, operated by, or having a contractual
  173  relationship with a health access setting, as defined in s.
  174  466.003(16), or a similar setting or program that serves
  175  underserved or vulnerable populations that face serious barriers
  176  to accessing dental services, which may include, but is not
  177  limited to, Early Head Start programs, homeless shelters,
  178  schools, and the Special Supplemental Nutrition Program for
  179  Women, Infants, and Children.
  180         Section 2. Section 466.001, Florida Statutes, is amended to
  181  read:
  182         466.001 Legislative purpose and intent.—The legislative
  183  purpose for enacting this chapter is to ensure that every
  184  dentist, dental therapist, or dental hygienist practicing in
  185  this state meets minimum requirements for safe practice without
  186  undue clinical interference by persons not licensed under this
  187  chapter. It is the legislative intent that dental services be
  188  provided only in accordance with the provisions of this chapter
  189  and not be delegated to unauthorized individuals. It is the
  190  further legislative intent that dentists, dental therapists, and
  191  dental hygienists who fall below minimum competency or who
  192  otherwise present a danger to the public shall be prohibited
  193  from practicing in this state. All provisions of this chapter
  194  relating to the practice of dentistry, dental therapy, and
  195  dental hygiene shall be liberally construed to carry out such
  196  purpose and intent.
  197         Section 3. Subsections (5) and (6) of section 466.002,
  198  Florida Statutes, are amended to read:
  199         466.002 Persons exempt from operation of chapter.—Nothing
  200  in this chapter shall apply to the following practices, acts,
  201  and operations:
  202         (5) Students in Florida schools of dentistry, dental
  203  therapy, and dental hygiene or dental assistant educational
  204  programs, while performing regularly assigned work under the
  205  curriculum of such schools.
  206         (6) Instructors in Florida schools of dentistry,
  207  instructors in dental programs that prepare persons holding
  208  D.D.S. or D.M.D. degrees for certification by a specialty board
  209  and that are accredited in the United States by January 1, 2005,
  210  in the same manner as the board recognizes accreditation for
  211  Florida schools of dentistry that are not otherwise affiliated
  212  with a Florida school of dentistry, or instructors in Florida
  213  schools of dental hygiene or dental therapy or dental assistant
  214  educational programs, while performing regularly assigned
  215  instructional duties under the curriculum of such schools or
  216  programs. A full-time dental instructor at a dental school or
  217  dental program approved by the board may be allowed to practice
  218  dentistry at the teaching facilities of such school or program,
  219  upon receiving a teaching permit issued by the board, in strict
  220  compliance with such rules as are adopted by the board
  221  pertaining to the teaching permit and with the established rules
  222  and procedures of the dental school or program as recognized in
  223  this section.
  224         Section 4. Subsections (7) through (15) of section 466.003,
  225  Florida Statutes, are renumbered as subsections (9) through
  226  (17), respectively, present subsections (14) and (15) are
  227  amended, and new subsections (7) and (8) are added to that
  228  section, to read:
  229         466.003 Definitions.—As used in this chapter:
  230         (7)“Dental therapist” means a person licensed to practice
  231  dental therapy pursuant to s. 466.0225.
  232         (8)“Dental therapy” means the rendering of services
  233  pursuant to s. 466.0227 and any related extraoral services or
  234  procedures required in the performance of such services.
  235         (16)(14) “Health access setting” means a program or an
  236  institution of the Department of Children and Families, the
  237  Department of Health, the Department of Juvenile Justice, a
  238  nonprofit community health center, a Head Start center, a
  239  federally qualified health center or look-alike as defined by
  240  federal law, a school-based prevention program, a clinic
  241  operated by an accredited college of dentistry, or an accredited
  242  dental hygiene or dental therapy program in this state if such
  243  community service program or institution immediately reports to
  244  the Board of Dentistry all violations of s. 466.027, s. 466.028,
  245  or other practice act or standard of care violations related to
  246  the actions or inactions of a dentist, dental hygienist, dental
  247  therapist, or dental assistant engaged in the delivery of dental
  248  care in such setting.
  249         (17)(15) “School-based prevention program” means preventive
  250  oral health services offered at a school by one of the entities
  251  defined in subsection (16) (14) or by a nonprofit organization
  252  that is exempt from federal income taxation under s. 501(a) of
  253  the Internal Revenue Code, and described in s. 501(c)(3) of the
  254  Internal Revenue Code.
  255         Section 5. Subsection (2) of section 466.004, Florida
  256  Statutes, is amended to read:
  257         466.004 Board of Dentistry.—
  258         (2) To advise the board, it is the intent of the
  259  Legislature that councils be appointed as specified in
  260  paragraphs (a)-(d) (a), (b), and (c). The department shall
  261  provide administrative support to the councils and shall provide
  262  public notice of meetings and agenda of the councils. Councils
  263  shall include at least one board member who shall chair the
  264  council and shall include nonboard members. All council members
  265  shall be appointed by the board chair. Council members shall be
  266  appointed for 4-year terms, and all members shall be eligible
  267  for reimbursement of expenses in the manner of board members.
  268         (a) A Council on Dental Hygiene shall be appointed by the
  269  board chair and shall include one dental hygienist member of the
  270  board, who shall chair the council, one dental member of the
  271  board, and three dental hygienists who are actively engaged in
  272  the practice of dental hygiene in this state. In making the
  273  appointments, the chair shall consider recommendations from the
  274  Florida Dental Hygiene Association. The council shall meet at
  275  the request of the board chair, a majority of the members of the
  276  board, or the council chair; however, the council must meet at
  277  least three times a year. The council is charged with the
  278  responsibility of and shall meet for the purpose of developing
  279  rules and policies for recommendation to the board, which the
  280  board shall consider, on matters pertaining to that part of
  281  dentistry consisting of educational, preventive, or therapeutic
  282  dental hygiene services; dental hygiene licensure, discipline,
  283  or regulation; and dental hygiene education. Rule and policy
  284  recommendations of the council shall be considered by the board
  285  at its next regularly scheduled meeting in the same manner in
  286  which it considers rule and policy recommendations from
  287  designated subcommittees of the board. Any rule or policy
  288  proposed by the board pertaining to the specified part of
  289  dentistry defined by this subsection shall be referred to the
  290  council for a recommendation before final action by the board.
  291  The board may take final action on rules pertaining to the
  292  specified part of dentistry defined by this subsection without a
  293  council recommendation if the council fails to submit a
  294  recommendation in a timely fashion as prescribed by the board.
  295         (b) A Council on Dental Assisting shall be appointed by the
  296  board chair and shall include one board member who shall chair
  297  the council and three dental assistants who are actively engaged
  298  in dental assisting in this state. The council shall meet at the
  299  request of the board chair or a majority of the members of the
  300  board. The council shall meet for the purpose of developing
  301  recommendations to the board on matters pertaining to that part
  302  of dentistry related to dental assisting.
  303         (c)Effective 28 months after the first dental therapy
  304  license is granted by the board, a Council on Dental Therapy
  305  shall be appointed by the board chair and shall include one
  306  board member who shall chair the council and three dental
  307  therapists who are actively engaged in the practice of dental
  308  therapy in this state. The council shall meet at the request of
  309  the board chair, a majority of the members of the board, or the
  310  council chair; however, the council must meet at least three
  311  times per year. The council is charged with the responsibility
  312  of, and shall meet for the purpose of, developing rules and
  313  policies for recommendation to the board on matters pertaining
  314  to that part of dentistry consisting of educational,
  315  preventative, or therapeutic dental therapy services; dental
  316  therapy licensure, discipline, or regulation; and dental therapy
  317  education. Rule and policy recommendations of the council must
  318  be considered by the board at its next regularly scheduled
  319  meeting in the same manner in which it considers rule and policy
  320  recommendations from designated subcommittees of the board. Any
  321  rule or policy proposed by the board pertaining to the specified
  322  part of dentistry defined by this subsection must be referred to
  323  the council for a recommendation before final action by the
  324  board. The board may take final action on rules pertaining to
  325  the specified part of dentistry defined by this subsection
  326  without a council recommendation if the council fails to submit
  327  a recommendation in a timely fashion as prescribed by the board.
  328         (d)(c) With the concurrence of the State Surgeon General,
  329  the board chair may create and abolish other advisory councils
  330  relating to dental subjects, including, but not limited to:
  331  examinations, access to dental care, indigent care, nursing home
  332  and institutional care, public health, disciplinary guidelines,
  333  and other subjects as appropriate. Such councils shall be
  334  appointed by the board chair and shall include at least one
  335  board member who shall serve as chair.
  336         Section 6. Subsection (4) and paragraph (b) of subsection
  337  (6) of section 466.006, Florida Statutes, are amended to read:
  338         466.006 Examination of dentists.—
  339         (4) Notwithstanding any other provision of law in chapter
  340  456 pertaining to the clinical dental licensure examination or
  341  national examinations, to be licensed as a dentist in this
  342  state, an applicant must successfully complete the following:
  343         (a) A written examination on the laws and rules of the
  344  state regulating the practice of dentistry;
  345         (b)1. A practical or clinical examination, which shall be
  346  the American Dental Licensing Examination produced by the
  347  American Board of Dental Examiners, Inc., or its successor
  348  entity, if any, that is administered in this state and graded by
  349  dentists licensed in this state and employed by the department
  350  for just such purpose, provided that the board has attained, and
  351  continues to maintain thereafter, representation on the board of
  352  directors of the American Board of Dental Examiners, the
  353  examination development committee of the American Board of
  354  Dental Examiners, and such other committees of the American
  355  Board of Dental Examiners as the board deems appropriate by rule
  356  to assure that the standards established herein are maintained
  357  organizationally. A passing score on the American Dental
  358  Licensing Examination administered in this state and graded by
  359  dentists who are licensed in this state is valid for 365 days
  360  after the date the official examination results are published.
  361         2.a. As an alternative to the requirements of subparagraph
  362  1., an applicant may submit scores from an American Dental
  363  Licensing Examination previously administered in a jurisdiction
  364  other than this state after October 1, 2011, and such
  365  examination results shall be recognized as valid for the purpose
  366  of licensure in this state. A passing score on the American
  367  Dental Licensing Examination administered out-of-state shall be
  368  the same as the passing score for the American Dental Licensing
  369  Examination administered in this state and graded by dentists
  370  who are licensed in this state. The examination results are
  371  valid for 365 days after the date the official examination
  372  results are published. The applicant must have completed the
  373  examination after October 1, 2011.
  374         b. This subparagraph may not be given retroactive
  375  application.
  376         3. If the date of an applicant’s passing American Dental
  377  Licensing Examination scores from an examination previously
  378  administered in a jurisdiction other than this state under
  379  subparagraph 2. is older than 365 days, then such scores shall
  380  nevertheless be recognized as valid for the purpose of licensure
  381  in this state, but only if the applicant demonstrates that all
  382  of the following additional standards have been met:
  383         a.(I) The applicant completed the American Dental Licensing
  384  Examination after October 1, 2011.
  385         (II) This sub-subparagraph may not be given retroactive
  386  application;
  387         b. The applicant graduated from a dental school accredited
  388  by the American Dental Association Commission on Dental
  389  Accreditation or its successor entity, if any, or any other
  390  dental accrediting organization recognized by the United States
  391  Department of Education. Provided, however, if the applicant did
  392  not graduate from such a dental school, the applicant may submit
  393  proof of having successfully completed a full-time supplemental
  394  general dentistry program accredited by the American Dental
  395  Association Commission on Dental Accreditation of at least 2
  396  consecutive academic years at such accredited sponsoring
  397  institution. Such program must provide didactic and clinical
  398  education at the level of a D.D.S. or D.M.D. program accredited
  399  by the American Dental Association Commission on Dental
  400  Accreditation;
  401         c. The applicant currently possesses a valid and active
  402  dental license in good standing, with no restriction, which has
  403  never been revoked, suspended, restricted, or otherwise
  404  disciplined, from another state or territory of the United
  405  States, the District of Columbia, or the Commonwealth of Puerto
  406  Rico;
  407         d. The applicant submits proof that he or she has never
  408  been reported to the National Practitioner Data Bank, the
  409  Healthcare Integrity and Protection Data Bank, or the American
  410  Association of Dental Boards Clearinghouse. This sub
  411  subparagraph does not apply if the applicant successfully
  412  appealed to have his or her name removed from the data banks of
  413  these agencies;
  414         e.(I) In the 5 years immediately preceding the date of
  415  application for licensure in this state, the applicant must
  416  submit proof of having been consecutively engaged in the full
  417  time practice of dentistry in another state or territory of the
  418  United States, the District of Columbia, or the Commonwealth of
  419  Puerto Rico, or, if the applicant has been licensed in another
  420  state or territory of the United States, the District of
  421  Columbia, or the Commonwealth of Puerto Rico for less than 5
  422  years, the applicant must submit proof of having been engaged in
  423  the full-time practice of dentistry since the date of his or her
  424  initial licensure.
  425         (II) As used in this section, “full-time practice” is
  426  defined as a minimum of 1,200 hours per year for each and every
  427  year in the consecutive 5-year period or, where applicable, the
  428  period since initial licensure, and must include any combination
  429  of the following:
  430         (A) Active clinical practice of dentistry providing direct
  431  patient care.
  432         (B) Full-time practice as a faculty member employed by a
  433  dental, dental therapy, or dental hygiene school approved by the
  434  board or accredited by the American Dental Association
  435  Commission on Dental Accreditation.
  436         (C) Full-time practice as a student at a postgraduate
  437  dental education program approved by the board or accredited by
  438  the American Dental Association Commission on Dental
  439  Accreditation.
  440         (III) The board shall develop rules to determine what type
  441  of proof of full-time practice is required and to recoup the
  442  cost to the board of verifying full-time practice under this
  443  section. Such proof must, at a minimum, be:
  444         (A) Admissible as evidence in an administrative proceeding;
  445         (B) Submitted in writing;
  446         (C) Submitted by the applicant under oath with penalties of
  447  perjury attached;
  448         (D) Further documented by an affidavit of someone unrelated
  449  to the applicant who is familiar with the applicant’s practice
  450  and testifies with particularity that the applicant has been
  451  engaged in full-time practice; and
  452         (E) Specifically found by the board to be both credible and
  453  admissible.
  454         (IV) An affidavit of only the applicant is not acceptable
  455  proof of full-time practice unless it is further attested to by
  456  someone unrelated to the applicant who has personal knowledge of
  457  the applicant’s practice. If the board deems it necessary to
  458  assess credibility or accuracy, the board may require the
  459  applicant or the applicant’s witnesses to appear before the
  460  board and give oral testimony under oath;
  461         f. The applicant must submit documentation that he or she
  462  has completed, or will complete, prior to licensure in this
  463  state, continuing education equivalent to this state’s
  464  requirements for the last full reporting biennium;
  465         g. The applicant must prove that he or she has never been
  466  convicted of, or pled nolo contendere to, regardless of
  467  adjudication, any felony or misdemeanor related to the practice
  468  of a health care profession in any jurisdiction;
  469         h. The applicant must successfully pass a written
  470  examination on the laws and rules of this state regulating the
  471  practice of dentistry and must successfully pass the computer
  472  based diagnostic skills examination; and
  473         i. The applicant must submit documentation that he or she
  474  has successfully completed the National Board of Dental
  475  Examiners dental examination.
  476         (6)
  477         (b)1. As used in this section, “full-time practice of
  478  dentistry within the geographic boundaries of this state within
  479  1 year” is defined as a minimum of 1,200 hours in the initial
  480  year of licensure, which must include any combination of the
  481  following:
  482         a. Active clinical practice of dentistry providing direct
  483  patient care within the geographic boundaries of this state.
  484         b. Full-time practice as a faculty member employed by a
  485  dental, dental therapy, or dental hygiene school approved by the
  486  board or accredited by the American Dental Association
  487  Commission on Dental Accreditation and located within the
  488  geographic boundaries of this state.
  489         c. Full-time practice as a student at a postgraduate dental
  490  education program approved by the board or accredited by the
  491  American Dental Association Commission on Dental Accreditation
  492  and located within the geographic boundaries of this state.
  493         2. The board shall develop rules to determine what type of
  494  proof of full-time practice of dentistry within the geographic
  495  boundaries of this state for 1 year is required in order to
  496  maintain active licensure and shall develop rules to recoup the
  497  cost to the board of verifying maintenance of such full-time
  498  practice under this section. Such proof must, at a minimum:
  499         a. Be admissible as evidence in an administrative
  500  proceeding;
  501         b. Be submitted in writing;
  502         c. Be submitted by the applicant under oath with penalties
  503  of perjury attached;
  504         d. Be further documented by an affidavit of someone
  505  unrelated to the applicant who is familiar with the applicant’s
  506  practice and testifies with particularity that the applicant has
  507  been engaged in full-time practice of dentistry within the
  508  geographic boundaries of this state within the last 365 days;
  509  and
  510         e. Include such additional proof as specifically found by
  511  the board to be both credible and admissible.
  512         3. An affidavit of only the applicant is not acceptable
  513  proof of full-time practice of dentistry within the geographic
  514  boundaries of this state within 1 year, unless it is further
  515  attested to by someone unrelated to the applicant who has
  516  personal knowledge of the applicant’s practice within the last
  517  365 days. If the board deems it necessary to assess credibility
  518  or accuracy, the board may require the applicant or the
  519  applicant’s witnesses to appear before the board and give oral
  520  testimony under oath.
  521         Section 7. Section 466.0075, Florida Statutes, is amended
  522  to read:
  523         466.0075 Applicants for examination; medical malpractice
  524  insurance.—The board may require any person applying to take the
  525  examination to practice dentistry in this state, the examination
  526  to practice dental therapy in this state, or the examination to
  527  practice dental hygiene in this state to maintain medical
  528  malpractice insurance in amounts sufficient to cover any
  529  incident of harm to a patient during the clinical examination.
  530         Section 8. Subsection (1) of section 466.009, Florida
  531  Statutes, is amended, and subsection (4) is added to that
  532  section, to read:
  533         466.009 Reexamination.—
  534         (1) The department shall allow permit any person who fails
  535  an examination that which is required under s. 466.006, or s.
  536  466.007, or s. 466.0225 to retake the examination. If the
  537  examination to be retaken is a practical or clinical
  538  examination, the applicant shall pay a reexamination fee set by
  539  rule of the board in an amount not to exceed the original
  540  examination fee.
  541         (4)If an applicant for a license to practice dental
  542  therapy fails the practical or clinical examination and has
  543  failed one part or procedure of such examination, she or he may
  544  be required to retake only that part or procedure to pass such
  545  examination. However, if any such applicant fails more than one
  546  part or procedure of any such examination, she or he shall be
  547  required to retake the entire examination.
  548         Section 9. Section 466.011, Florida Statutes, is amended to
  549  read:
  550         466.011 Licensure.—The board shall certify for licensure by
  551  the department any applicant who satisfies the requirements of
  552  s. 466.006, s. 466.0067, or s. 466.007, or s. 466.0225. The
  553  board may refuse to certify an applicant who has violated any of
  554  the provisions of s. 466.026 or s. 466.028.
  555         Section 10. Section 466.0136, Florida Statutes, is created
  556  to read:
  557         466.0136Continuing education; dental therapists.—In
  558  addition to any other requirements for relicensure for dental
  559  therapists specified in this chapter, the board shall require
  560  each licensed dental therapist to complete at least 24 hours,
  561  but not more than 36 hours, biennially of continuing
  562  professional education in dental subjects in programs approved
  563  by the board or in equivalent programs of continuing education.
  564  Programs of continuing education approved by the board must be
  565  programs of learning that, in the opinion of the board,
  566  contribute directly to the dental education of the dental
  567  therapist. An individual who is licensed as both a dental
  568  therapist and a dental hygienist may use 1 hour of continuing
  569  professional education that is approved for both dental therapy
  570  and dental hygiene education to satisfy both dental therapy and
  571  dental hygiene continuing education requirements. The board
  572  shall adopt rules and guidelines to administer and enforce this
  573  section. The dental therapist shall retain in her or his records
  574  any receipts, vouchers, or certificates necessary to document
  575  completion of the continuing education. Compliance with the
  576  continuing education requirements is mandatory for issuance of
  577  the renewal certificate. The board may excuse licensees, as a
  578  group or as individuals, from all or part of the continuing
  579  education requirements if an unusual circumstance, emergency, or
  580  hardship prevented compliance with this section.
  581         Section 11. Section 466.016, Florida Statutes, is amended
  582  to read:
  583         466.016 License to be displayed.—Every practitioner of
  584  dentistry, dental therapy, or dental hygiene within the meaning
  585  of this chapter shall post and keep conspicuously displayed her
  586  or his license in the office where wherein she or he practices,
  587  in plain sight of the practitioner’s patients. Any dentist,
  588  dental therapist, or dental hygienist who practices at more than
  589  one location shall be required to display a copy of her or his
  590  license in each office where she or he practices.
  591         Section 12. Present subsections (7) and (8) of section
  592  466.017, Florida Statutes, are renumbered as subsections (8) and
  593  (9), respectively, paragraphs (d) and (e) of subsection (3),
  594  subsection (4), and present subsections (7) and (8) are amended,
  595  and a new subsection (7) is added to that section, to read:
  596         466.017 Prescription of drugs; anesthesia.—
  597         (3) The board shall adopt rules which:
  598         (d) Establish further requirements relating to the use of
  599  general anesthesia or sedation, including, but not limited to,
  600  office equipment and the training of dental assistants, dental
  601  therapists, or dental hygienists who work with dentists using
  602  general anesthesia or sedation.
  603         (e) Establish an administrative mechanism enabling the
  604  board to verify compliance with training, education, experience,
  605  equipment, or certification requirements of dentists, dental
  606  therapists, dental hygienists, and dental assistants adopted
  607  pursuant to this subsection. The board may charge a fee to
  608  defray the cost of verifying compliance with requirements
  609  adopted pursuant to this paragraph.
  610         (4) A dentist, dental therapist, or dental hygienist who
  611  administers or employs the use of any form of anesthesia must
  612  possess a certification in either basic cardiopulmonary
  613  resuscitation for health professionals or advanced cardiac life
  614  support approved by the American Heart Association or the
  615  American Red Cross or an equivalent agency-sponsored course with
  616  recertification every 2 years. Each dental office which uses any
  617  form of anesthesia must have immediately available and in good
  618  working order such resuscitative equipment, oxygen, and other
  619  resuscitative drugs as are specified by rule of the board in
  620  order to manage possible adverse reactions.
  621         (7)A dental therapist under the general supervision of a
  622  dentist may administer local anesthesia, including intraoral
  623  block anesthesia or soft tissue infiltration anesthesia, or
  624  both, if she or he has completed the course described in
  625  subsection (5) and presents evidence of current certification in
  626  basic or advanced cardiac life support.
  627         (8)(7) A licensed dentist, or a dental therapist who is
  628  authorized by her or his supervising dentist, may utilize an X
  629  ray machine, expose dental X-ray films, and interpret or read
  630  such films. Notwithstanding The provisions of part IV of chapter
  631  468 to the contrary notwithstanding, a licensed dentist, or a
  632  dental therapist who is authorized by her or his supervising
  633  dentist, may authorize or direct a dental assistant to operate
  634  such equipment and expose such films under her or his direction
  635  and supervision, pursuant to rules adopted by the board in
  636  accordance with s. 466.024 which ensure that said assistant is
  637  competent by reason of training and experience to operate said
  638  equipment in a safe and efficient manner. The board may charge a
  639  fee not to exceed $35 to defray the cost of verifying compliance
  640  with requirements adopted pursuant to this section.
  641         (9)(8)Notwithstanding The provisions of s. 465.0276
  642  notwithstanding, a dentist need not register with the board or
  643  comply with the continuing education requirements of that
  644  section if the dentist confines her or his dispensing activity
  645  to the dispensing of fluorides and chlorhexidine chlorohexidine
  646  rinse solutions; provided that the dentist complies with and is
  647  subject to all laws and rules applicable to pharmacists and
  648  pharmacies, including, but not limited to, chapters 465, 499,
  649  and 893, and all applicable federal laws and regulations, when
  650  dispensing such products.
  651         Section 13. Subsection (1) of section 466.018, Florida
  652  Statutes, is amended to read:
  653         466.018 Dentist of record; patient records.—
  654         (1) Each patient shall have a dentist of record. The
  655  dentist of record shall remain primarily responsible for all
  656  dental treatment on such patient regardless of whether the
  657  treatment is rendered by the dentist or by another dentist,
  658  dental therapist, dental hygienist, or dental assistant
  659  rendering such treatment in conjunction with, at the direction
  660  or request of, or under the supervision of such dentist of
  661  record. The dentist of record shall be identified in the record
  662  of the patient. If treatment is rendered by a dentist other than
  663  the dentist of record or by a dental hygienist, dental
  664  therapist, or dental assistant, the name or initials of such
  665  person shall be placed in the record of the patient. In any
  666  disciplinary proceeding brought pursuant to this chapter or
  667  chapter 456, it shall be presumed as a matter of law that
  668  treatment was rendered by the dentist of record unless otherwise
  669  noted on the patient record pursuant to this section. The
  670  dentist of record and any other treating dentist are subject to
  671  discipline pursuant to this chapter or chapter 456 for treatment
  672  rendered to the patient and performed in violation of such
  673  chapter. One of the purposes of this section is to ensure that
  674  the responsibility for each patient is assigned to one dentist
  675  in a multidentist practice of any nature and to assign primary
  676  responsibility to the dentist for treatment rendered by a dental
  677  hygienist, dental therapist, or dental assistant under her or
  678  his supervision. This section shall not be construed to assign
  679  any responsibility to a dentist of record for treatment rendered
  680  pursuant to a proper referral to another dentist who does not in
  681  practice with the dentist of record or to prohibit a patient
  682  from voluntarily selecting a new dentist without permission of
  683  the dentist of record.
  684         Section 14. Section 466.0225, Florida Statutes, is created
  685  to read:
  686         466.0225Examination of dental therapists; licensing.—
  687         (1)Any person desiring to be licensed as a dental
  688  therapist shall apply to the department to take the licensure
  689  examinations and shall verify the information required on the
  690  application by oath. The application must include two recent
  691  photographs of the applicant.
  692         (2)An applicant is entitled to take the examinations
  693  required in this section and receive licensure to practice
  694  dental therapy in this state if the applicant:
  695         (a)Is 18 years of age or older;
  696         (b)Is a graduate of a dental therapy college or school
  697  accredited by the American Dental Association Commission on
  698  Dental Accreditation or its successor entity, if any, or any
  699  other dental therapy accrediting entity recognized by the United
  700  States Department of Education. For applicants applying for a
  701  dental therapy license before January 1, 2024, the board shall
  702  approve the applicant’s dental therapy education program if the
  703  program was administered by a college or school that operates an
  704  accredited dental or dental hygiene program and the college or
  705  school certifies to the board that the applicant’s education
  706  substantially conformed to the education standards established
  707  by the American Dental Association Commission on Dental
  708  Accreditation;
  709         (c)Has successfully completed a dental therapy practical
  710  or clinical examination produced by the American Board of Dental
  711  Examiners, Inc., (ADEX) or its successor entity, if any, if the
  712  board finds that the successor entity’s examination meets or
  713  exceeds the provisions of this section. If an applicant fails to
  714  pass the ADEX Dental Therapy Examination after three attempts,
  715  the applicant is not eligible to retake the examination unless
  716  the applicant completes additional education requirements as
  717  specified by the board. If a dental therapy examination has not
  718  been established by the ADEX, the board shall administer or
  719  approve an alternative examination;
  720         (d)Has not been disciplined by a board, except for
  721  citation offenses or minor violations;
  722         (e)Has not been convicted of or pled nolo contendere to,
  723  regardless of adjudication, any felony or misdemeanor related to
  724  the practice of a health care profession; and
  725         (f)Has successfully completed a written examination on the
  726  laws and rules of this state regulating the practice of dental
  727  therapy.
  728         (3)An applicant who meets the requirements of this
  729  section, and who has successfully completed the examinations
  730  identified in paragraph (2)(c) in a jurisdiction other than this
  731  state, or who has successfully completed comparable examinations
  732  administered or approved by the licensing authority in a
  733  jurisdiction other than this state shall be licensed to practice
  734  dental therapy in this state if the board determines that the
  735  other jurisdiction’s examinations and scope of practice are
  736  substantially similar to those identified in paragraph (2)(c).
  737         Section 15. Section 466.0227, Florida Statutes, is created
  738  to read:
  739         466.0227Dental therapists; scope and area of practice.—
  740         (1)The Legislature finds that authorizing licensed dental
  741  therapists to perform the services specified in subsection (3)
  742  would improve access to high-quality affordable oral health
  743  services for all residents in this state. The Legislature
  744  intends to rapidly improve such access for low-income,
  745  uninsured, and underserved patients and communities. To further
  746  this intent, a dental therapist licensed under this chapter is
  747  limited to practicing dental therapy in the following settings:
  748         (a)A health access setting, as defined in s. 466.003(16).
  749         (b)A community health center, including an off-site care
  750  setting.
  751         (c)A nursing facility.
  752         (d)A military or veterans’ hospital or clinic, including
  753  an off-site care setting.
  754         (e)A governmental or public health clinic, including an
  755  off-site care setting.
  756         (f)A school, Head Start program, or school-based
  757  prevention program, as defined in s. 466.003(17).
  758         (g)An oral health education institution, including an off
  759  site care setting.
  760         (h)A hospital.
  761         (i)A geographic area designated as a dental health
  762  professional shortage area by the state or the Federal
  763  Government which is not located within a federally designated
  764  metropolitan statistical area.
  765         (j)Any other clinic or practice setting if at least 50
  766  percent of the patients served by the dental therapist in such
  767  clinic or practice setting:
  768         1.Are enrolled in Medicaid or another state or local
  769  governmental health care program for low-income or uninsured
  770  patients; or
  771         2.Do not have dental insurance and report a gross annual
  772  income that is less than 200 percent of the applicable federal
  773  poverty guidelines.
  774         (2)Except as otherwise provided in this chapter, a dental
  775  therapist may perform the dental therapy services specified in
  776  subsection (3) under the general supervision of a dentist to the
  777  extent authorized by the supervising dentist and provided within
  778  the terms of a written collaborative management agreement signed
  779  by the dental therapist and the supervising dentist which meets
  780  the requirements of subsection (4).
  781         (3)Dental therapy services include all of the following:
  782         (a)All services, treatments, and competencies identified
  783  by the American Dental Association Commission on Dental
  784  Accreditation in its Dental Therapy Education Accreditation
  785  Standards.
  786         (b)The following state-specific services, if the dental
  787  therapist’s education included curriculum content satisfying the
  788  American Dental Association Commission on Dental Accreditation
  789  criteria for state-specific dental therapy services:
  790         1.Evaluating radiographs.
  791         2.Placement of space maintainers.
  792         3.Pulpotomies on primary teeth.
  793         4.Dispensing and administering nonopioid analgesics
  794  including nitrous oxide, anti-inflammatories, and antibiotics as
  795  authorized by the supervising dentist and within the parameters
  796  of the collaborative management agreement.
  797         5.Oral evaluation and assessment of dental disease and
  798  formulation of an individualized treatment plan if authorized by
  799  a supervising dentist and subject to any conditions,
  800  limitations, and protocols specified by the supervising dentist
  801  in the collaborative management agreement.
  802         (4)Before performing any of the services authorized in
  803  subsection (3), a dental therapist must enter into a written
  804  collaborative management agreement with a supervising dentist.
  805  The agreement must be signed by the dental therapist and the
  806  supervising dentist and must include:
  807         (a)Practice settings where services may be provided by the
  808  dental therapist and the populations to be served by the dental
  809  therapist.
  810         (b)Any limitations on the services that may be provided by
  811  the dental therapist, including the level of supervision
  812  required by the supervising dentist.
  813         (c)Age- and procedure-specific practice protocols for the
  814  dental therapist, including case selection criteria, assessment
  815  guidelines, and imaging frequency.
  816         (d)A procedure for creating and maintaining dental records
  817  for the patients who are treated by the dental therapist.
  818         (e)A plan to manage medical emergencies in each practice
  819  setting where the dental therapist provides care.
  820         (f)A quality assurance plan for monitoring care provided
  821  by the dental therapist, including patient care review, referral
  822  followup, and a quality assurance chart review.
  823         (g)Protocols for the dental therapist to administer and
  824  dispense medications, including the specific conditions and
  825  circumstances under which the medications are to be dispensed
  826  and administered.
  827         (h)Criteria relating to the provision of care by the
  828  dental therapist to patients with specific medical conditions or
  829  complex medication histories, including requirements for
  830  consultation before the initiation of care.
  831         (i)Supervision criteria of dental therapists.
  832         (j)A plan for the provision of clinical resources and
  833  referrals in situations that are beyond the capabilities of the
  834  dental therapist.
  835         (5)A supervising dentist shall determine the number of
  836  hours of practice that a dental therapist must complete under
  837  direct or indirect supervision of the supervising dentist before
  838  the dental therapist may perform any of the services authorized
  839  in subsection (3) under general supervision.
  840         (6)A supervising dentist may restrict or limit the dental
  841  therapist’s practice in a collaborative management agreement to
  842  be less than the full scope of practice for dental therapists
  843  which is authorized in subsection (3).
  844         (7)A supervising dentist may authorize a dental therapist
  845  to provide dental therapy services to a patient before the
  846  dentist examines or diagnoses the patient if the authority,
  847  conditions, and protocols are established in a written
  848  collaborative management agreement and if the patient is
  849  subsequently referred to a dentist for any needed additional
  850  services that exceed the dental therapist’s scope of practice or
  851  authorization under the collaborative management agreement.
  852         (8)A supervising dentist must be licensed and practicing
  853  in this state. The supervising dentist is responsible for all
  854  services authorized and performed by the dental therapist
  855  pursuant to the collaborative management agreement and for
  856  providing or arranging followup services to be provided by a
  857  dentist for those services that are beyond the dental
  858  therapist’s scope of practice and authorization under the
  859  collaborative management agreement.
  860         Section 16. Section 466.026, Florida Statutes, is amended
  861  to read:
  862         466.026 Prohibitions; penalties.—
  863         (1) Each of the following acts constitutes a felony of the
  864  third degree, punishable as provided in s. 775.082, s. 775.083,
  865  or s. 775.084:
  866         (a) Practicing dentistry, dental therapy, or dental hygiene
  867  unless the person has an appropriate, active license issued by
  868  the department pursuant to this chapter.
  869         (b) Using or attempting to use a license issued pursuant to
  870  this chapter which license has been suspended or revoked.
  871         (c) Knowingly employing any person to perform duties
  872  outside the scope allowed such person under this chapter or the
  873  rules of the board.
  874         (d) Giving false or forged evidence to the department or
  875  board for the purpose of obtaining a license.
  876         (e) Selling or offering to sell a diploma conferring a
  877  degree from a dental college, or dental hygiene school or
  878  college, or dental therapy school or college, or a license
  879  issued pursuant to this chapter, or procuring such diploma or
  880  license with intent that it shall be used as evidence of that
  881  which the document stands for, by a person other than the one
  882  upon whom it was conferred or to whom it was granted.
  883         (2) Each of the following acts constitutes a misdemeanor of
  884  the first degree, punishable as provided in s. 775.082 or s.
  885  775.083:
  886         (a) Using the name or title “dentist,” the letters “D.D.S.”
  887  or “D.M.D.”, or any other words, letters, title, or descriptive
  888  matter which in any way represents a person as being able to
  889  diagnose, treat, prescribe, or operate for any disease, pain,
  890  deformity, deficiency, injury, or physical condition of the
  891  teeth or jaws or oral-maxillofacial region unless the person has
  892  an active dentist’s license issued by the department pursuant to
  893  this chapter.
  894         (b) Using the name “dental hygienist” or the initials
  895  “R.D.H.” or otherwise holding herself or himself out as an
  896  actively licensed dental hygienist or implying to any patient or
  897  consumer that she or he is an actively licensed dental hygienist
  898  unless that person has an active dental hygienist’s license
  899  issued by the department pursuant to this chapter.
  900         (c)Using the name “dental therapist” or the initials
  901  “D.T.” or otherwise holding herself or himself out as an
  902  actively licensed dental therapist or implying to any patient or
  903  consumer that she or he is an actively licensed dental therapist
  904  unless that person has an active dental therapist’s license
  905  issued by the department pursuant to this chapter.
  906         (d)(c) Presenting as her or his own the license of another.
  907         (e)(d) Knowingly concealing information relative to
  908  violations of this chapter.
  909         (f)(e) Performing any services as a dental assistant as
  910  defined herein, except in the office of a licensed dentist,
  911  unless authorized by this chapter or by rule of the board.
  912         Section 17. Paragraphs (b), (c), (g), (s), and (t) of
  913  subsection (1) of section 466.028, Florida Statutes, are amended
  914  to read:
  915         466.028 Grounds for disciplinary action; action by the
  916  board.—
  917         (1) The following acts constitute grounds for denial of a
  918  license or disciplinary action, as specified in s. 456.072(2):
  919         (b) Having a license to practice dentistry, dental therapy,
  920  or dental hygiene revoked, suspended, or otherwise acted
  921  against, including the denial of licensure, by the licensing
  922  authority of another state, territory, or country.
  923         (c) Being convicted or found guilty of or entering a plea
  924  of nolo contendere to, regardless of adjudication, a crime in
  925  any jurisdiction which relates to the practice of dentistry,
  926  dental therapy, or dental hygiene. A plea of nolo contendere
  927  shall create a rebuttable presumption of guilt to the underlying
  928  criminal charges.
  929         (g) Aiding, assisting, procuring, or advising any
  930  unlicensed person to practice dentistry, dental therapy, or
  931  dental hygiene contrary to this chapter or to a rule of the
  932  department or the board.
  933         (s) Being unable to practice her or his profession with
  934  reasonable skill and safety to patients by reason of illness or
  935  use of alcohol, drugs, narcotics, chemicals, or any other type
  936  of material or as a result of any mental or physical condition.
  937  In enforcing this paragraph, the department shall have, upon a
  938  finding of the State Surgeon General or her or his designee that
  939  probable cause exists to believe that the licensee is unable to
  940  practice dentistry, dental therapy, or dental hygiene because of
  941  the reasons stated in this paragraph, the authority to issue an
  942  order to compel a licensee to submit to a mental or physical
  943  examination by physicians designated by the department. If the
  944  licensee refuses to comply with such order, the department’s
  945  order directing such examination may be enforced by filing a
  946  petition for enforcement in the circuit court where the licensee
  947  resides or does business. The licensee against whom the petition
  948  is filed shall not be named or identified by initials in any
  949  public court records or documents, and the proceedings shall be
  950  closed to the public. The department shall be entitled to the
  951  summary procedure provided in s. 51.011. A licensee affected
  952  under this paragraph shall at reasonable intervals be afforded
  953  an opportunity to demonstrate that she or he can resume the
  954  competent practice of her or his profession with reasonable
  955  skill and safety to patients.
  956         (t) Fraud, deceit, or misconduct in the practice of
  957  dentistry, dental therapy, or dental hygiene.
  958         Section 18. Paragraphs (a) and (b) of subsection (1) of
  959  section 466.0285, Florida Statutes, are amended to read:
  960         466.0285 Proprietorship by nondentists.—
  961         (1) No person other than a dentist licensed pursuant to
  962  this chapter, nor any entity other than a professional
  963  corporation or limited liability company composed of dentists,
  964  may:
  965         (a) Employ a dentist, a dental therapist, or a dental
  966  hygienist in the operation of a dental office.
  967         (b) Control the use of any dental equipment or material
  968  while such equipment or material is being used for the provision
  969  of dental services, whether those services are provided by a
  970  dentist, a dental therapist, a dental hygienist, or a dental
  971  assistant.
  972  
  973  Any lease agreement, rental agreement, or other arrangement
  974  between a nondentist and a dentist whereby the nondentist
  975  provides the dentist with dental equipment or dental materials
  976  shall contain a provision whereby the dentist expressly
  977  maintains complete care, custody, and control of the equipment
  978  or practice.
  979         Section 19. Subsection (1) of section 466.051, Florida
  980  Statutes, is amended to read:
  981         466.051 Confidentiality of certain information contained in
  982  dental workforce surveys.—
  983         (1) Personal identifying information that is contained in a
  984  record provided by a dentist, dental therapist, or dental
  985  hygienist licensed under this chapter in response to a dental
  986  workforce survey and held by the Department of Health is
  987  confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
  988  of the State Constitution. Personal identifying information in
  989  such a record:
  990         (a) Shall be disclosed with the express written consent of
  991  the individual to whom the information pertains or the
  992  individual’s legally authorized representative.
  993         (b) Shall be disclosed by court order upon a showing of
  994  good cause.
  995         (c) May be disclosed to a research entity, if the entity
  996  seeks the records or data pursuant to a research protocol
  997  approved by the Department of Health, maintains the records or
  998  data in accordance with the approved protocol, and enters into a
  999  purchase and data-use agreement with the department, the fee
 1000  provisions of which are consistent with s. 119.07(4). The
 1001  department may deny a request for records or data if the
 1002  protocol provides for intrusive follow-back contacts, does not
 1003  plan for the destruction of the confidential records after the
 1004  research is concluded, is administratively burdensome, or does
 1005  not have scientific merit. The agreement must prohibit the
 1006  release of information by the research entity which would
 1007  identify individuals, limit the use of records or data to the
 1008  approved research protocol, and prohibit any other use of the
 1009  records or data. Copies of records or data issued pursuant to
 1010  this paragraph remain the property of the department.
 1011         Section 20. The Department of Health, in consultation with
 1012  the Board of Dentistry and the Agency for Health Care
 1013  Administration, shall submit a progress report to the President
 1014  of the Senate and the Speaker of the House of Representatives by
 1015  July 1, 2022, and a final report 3 years after the first dental
 1016  therapy license is issued. The reports must include all of the
 1017  following components:
 1018         (1)The progress that has been made in this state to
 1019  implement dental therapy training programs, licensing, and
 1020  Medicaid reimbursement.
 1021         (2)Data demonstrating the effects of dental therapy in
 1022  this state on:
 1023         (a)Access to dental services;
 1024         (b)The use of primary and preventive dental services in
 1025  underserved regions and populations, including the Medicaid
 1026  population;
 1027         (c)Costs to dental providers, patients, dental insurance
 1028  carriers, and the state; and
 1029         (d)The quality and safety of dental services.
 1030         (3)Specific recommendations for any necessary legislative,
 1031  administrative, or regulatory reform relating to the practice of
 1032  dental therapy.
 1033         (4)Any other information deemed appropriate by the
 1034  department.
 1035         Section 21. This act shall take effect July 1, 2019.