The 2011 Legislative Session was one of thrills and chills as the Florida Dental Association (FDA)'s priority issues were both smoking hot and icy cold, depending on which side of the capitol the bills were being heard, debated and voted on by legislators. After the final hankies were dropped and "sine die" was called, several bills of interest to dentistry made it to the governor's desk.
CS/CS/HB 1319, submitted by Representative Gayle Harrell, R-Port St. Lucie, was originally written to create a 12-month, non-renewable temporary license for military spouses seeking Florida licensure in a health care field. The bill then became a vehicle for amendments that Representative Harrell graciously allowed the FDA to add. One amendment addresses the licensure exam process by looking at the American Dental Licensing Examination (ADLEX). Because ADLEX is I dentical to the current Florida clinical licensure exam, the amendment states that ADLEX should be the clinical licensure exam given in Florida. It also states that after October 1, 2011, out-of-state dentists who successfully pass ADLEX in any of the 27 states where it is given will be allowed to apply for Florida licensure within 365 days of their passage.
Amendments to this bill also include joint FDA/FDHA language from HB 225 by Representative Fred Costello to change supervision levels for hygienists. This portion allows the placement of sealants and fluoride in health access settings like county health departments, community health centers and schools, without supervision of a dentist. It also allows for dental cleanings, but only after medical clearance by a dentist or physician. In this case, in order for an additional cleaning to take place, a comprehensive dental evaluation must be performed within 13 months. The FDA and FDHA have worked together for several years to establish language that addresses the access issue in a manner that will be effective and efficient while maintaining patient safety. HB 1319 was signed by Governor Scott on May 31, and will go into effect on October 1.
Another bill that made it through the process was CS/CS/CS/CS/HB 479, introduced by Representative Mike Horner, R-Kissimmee. This bill requires that non-Florida licensed expert witnesses hold an active and valid license in another state or Canada. It also requires that these individuals receive a certificate from the Florida licensing board prior to testifying. This certificate does not allow the expert witness to practice, but it does allow discipline by licensing boards in the instance of fraudulent testimony. Efforts have been made to get this legislation out of both chambers for more than ten years, so this is a great victory for health care providers (over trial lawyers).
Filed by Representative Robert Schenck, R-Spring Hill, CS/HB 7107 and 7109 was passed on the last day of session. This bill addresses Medicaid reform in the form of managed care for all of Florida's Medicaid enrollees. The federal government, however, must approve a waiver in order for this to occur. If allowed, full implementation of Medicaid reform, without any carve outs for dental care, will occur October 1, 2014.
CS/CS/HB 7095, also introduced by Representative Schenck, affects the 200 Florida dentists that are considered dispensing practitioners. According to this bill, these dentists can no longer dispense Schedule II or III controlled substances unless in conjunction with the performance of a surgical procedure that requires anesthesia. Patients are further limited to a 14-day supply after the procedure is performed. These dentists will be credentialed by drug wholesalers if they purchase Schedule II or III controlled substances, and must report to the database within seven days of dispensing a controlled substance. As outlined by this bill, dentists must use counterfeitproof prescription pads for controlled substance prescriptions. Additionally, dentists who treat chronic, non-malignant pain are required to designate themselves as a controlled substance prescribing practitioner on a forthcoming internet profile. All dentists will be subject to strict discipline for improper prescribing.
Passage of non-covered services legislation has been a main priority of the FDA for the last two legislative sessions. This year, Senate bill CS/SB 546, submitted by Representative Alan Hays, R-Umatilla, made it out of three of the four senate committees it was assigned to. HB 367 by Rep. Ed Hooper, R-Clearwater, made it out of one house committee, but was unable to make it on the agenda of the House of Representatives' Insurance and Banking Subcommittee. This was despite significant contact by FDA dentists at Dentists' Day on the Hill to Representative Bryan Nelson, chair of that committee, and a meeting with Speaker of the House Representative Dean Cannon, R- Orlando, by over one dozen FDA leaders. This will continue to be a focus in next year's legislative agenda. Nationwide, 22 states have passed similar legislation that prohibits insurance companies from setting fees for services they do not cover.
Many budget items passed the House and Senate that included dentistry, primarily one involving a $56 million increase in children's dental services to dental providers, the first major increase in over twenty years. FAMU Crestview Center was allocated $1.5 million for operational staff, but there was no specific mention of dentistry in this item. Also approved was: $150,000 for the state's fluoridation project; $250,000 for Gadsden County's mobile health unit (which may include dentistry); $500,000 for Duval County's mobile dental unit; $1.2 million for an MQA unlicensed activity unit; and $1.9 million for Nova Southeastern University's assignment of medical, pharmacy and dental students to rotations in rural and underserved clinics. The governor has final authority to approve or veto any portion of the budget; whether these allocations will remain in the final budget remains to be seen.
2011 Legislators of the Year are Senator Alan Hays, R-Umatilla, and Representative Gayle Harrell, R- Port St. Lucie. Both were outstanding in their support of dentistry and deserve special gratitude for their efforts. Recipients of the Dr. Lew Earle Legislative Awards are Senator Thad Altman, R-Melbourne, Representative Ed Hooper, R-Clearwater, Representative Paige Kreegel, R-Punta Gorda and Representative Ari Porth, D-Coral Springs. Freshman Legislator of the Year award goes to Representative Fred Costello, R-Ormond Beach. Finally, the FDA's Champion for Dentistry award winner is Senator Joe Negron, R- Palm City, for his extended efforts in including a children's dental Medicaid budget increase in a year of Medicaid reform and budget cuts.
The 2012 Session will be much earlier than usual due to redistricting. Dentists' Day on the Hill 2012 has a proposed date of February 1, 2012, so keep an eye on the FDA master calendar so you can plan to be there to make a difference for the FDA's legislative agenda