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Our focus this
issue is to convey to everyone the multiple benefits of membership in
the AGD. An informed organization is a nimble one, and keeping our
members updated on all significant matters related to new laws or
regulations that impact business practices and the provision of dental
care is a high priority for our FLAGD Legislative and Governmental
Affairs Council.
By early this
year, the Florida Legislature will have completed four special
sessions. Two of those sessions focused primarily on property tax
reform.
During the first
extra session, Personal Injury Protection (PIP) was fully reinstated
after being allowed to lapse on October 1, 2007. There are positive
dental implications in this bill, which now treats licensed dentists
providing services in emergency rooms, trauma centers and hospitals
equally with medical counterparts. If PIP had not been restored,
Florida would return to a tort system which requires the establishment
of who is at-fault and liable for an injured party’s medical expenses
after an accident.
The Florida
Board of Dentistry (BOD) recently published its amended rule on one
time fee assessments to address budgetary deficits (FAC 64B5-15.030).
Currently, Florida law requires that all professions completely fund
their own regulation through revenues collected by each recognized
profession. The law does specify a fee cap (presently $305) and
dentists have been paying that capped renewal fee since 2001. The BOD
is empowered within the rule to assess dental professionals a one-time
fee in order to eliminate a budget deficit. The Board is projected to
have a $2 million shortfall by 2010-2011. Failure to pay the
assessment will result in a loss of license renewal privileges and a
$1000 fine.
Rule 64B5-12.016
now allows a dentist to earn up to three hours of continuing education
renewal credit per biennium by completing an approved course in dental
practice management. The course must meet certain criteria set forth
in Section 466.0135(1)(c), F.S. For those using CE Broker, courses
previously listed in the General subject area can now be moved into
the new subject area (Practice Management).
Many items of
interest came up during the September 2007 Florida Board of Dentistry
meeting held in Gainesville. Disciplinary proceedings included
fourteen dental professionals with costs and fines assessments ranging
from $1600 to $10,000, with several license suspensions and
revocations imposed. A standard of care issue related to
hand-over-mouth patient management resulted in the largest fine
imposed.
A declarative
statement request was denied by the BOD regarding temporary
certificate holders working in N. Florida prison systems. A placement
agency (Smallwood Prison Dental Services) contends that they are
unable to place adequate dental coverage in many prisons at this time.
Eight petitions
for variance or waiver were reviewed. These were primarily requests
by foreign trained dentists requesting the privilege to challenge the
dental board after completing various types of supplemental education
programs. The BOD approved certain waivers, appearing to favor
supplemental education programs conducted within the state of Florida.
The licensure
application reviews for dental and dental hygiene examination
candidates totaled eight. These were applications to take the dental
hygiene examination by foreign trained dentists, and all applications
presented were denied due to incomplete documentation. During
application reviews, a dentist having held a Florida dental license
for 61 years was denied a temporary certificate to practice dental
hygiene in a county health office.
An attorney
with the Florida Department of Health petitioned the BOD for a
position statement regarding dental bleaching outside of dental
offices. A request was made that certain practices be considered a
violation of the dental practice act. Violations of the DPA are
considered third degree felony cases. The BOD concurred that certain
bleaching activities should be considered as the unlicensed practice
of dentistry.
The BOD also
established a special committee to review the FDA position regarding
delegable duties and use of injectable neurotoxins and dermal fillers.
The president of
the Florida Dental Hygiene Association requested that the BOD obtain
additional opinions regarding the FDA/CDEL proposed new language on
anesthesia guidelines. The BOD placed this matter in committee.
A proposal was
introduced to change the current rule 64B5-17.005 to provide mandatory
identification of all removable dental prostheses instead of
patient-elective identification. BOD legal council agreed that the
proposal was valid and useful, but indicated that this type of rules
change might exceed the BOD’s authority. The proposal was moved to
the Rules Committee and Chairman Ackley indicated that the FDA might
consider pursuing this process through statutory change in the
legislature.
The new ADA
Sedation policy statement and guidelines (October 2007) will be opened
for public comment and a report is expected from the Rules Committee
on proposed changes to the expanded function dental assisting
regulations.
The annual 2008
FDA Dentist’s Day on the Hill will be held April 1st and 2nd in
Tallahassee. FLAGD continues to support DDOH by scheduling one of our
annual Board meetings at the FDA headquarters. Top FDA leaders brief
our directors on their current affairs, and once the meeting is
complete, many of our Board members go over to the Capital to advocate
side-by-side with the FDA in support of dentally significant issues.
The FDA has
asked for assistance from dentists in an effort to gather information
about dental supply houses selling whitening/bleaching equipment and
supplies to non-dentists. As mentioned earlier, the BOD ruled that
tooth whitening constitutes the practice of dentistry such that anyone
offering to perform or actually performing the service must be a
dentist. The Board had become aware of dental supply house sales and
has taken the position that this will be viewed as aiding and abetting
the unlicensed practice of dentistry which becomes a criminal matter.
There were
significant developments in Federal legislation this past fall.
Education Secretary Spelling had agreed to increase the aggregate
combined Stafford loan limit for health professions students to
$233,793. Many students are and have been incurring educational debts
in excess of the new aggregate limit.
Fiscal year 2008
appropriations sessions are underway in
Washington,
and a new Labor-HHS bill was introduced during the week of October 15,
2007. This $150 billion bill includes over $48 million for Title VII
Health Professions Program funding for dentistry. This includes an $8
million increase over the previous fiscal year, a 23.6% boost.
Passage is expected and a presidential veto is likely. Even though
the $8 million is well short of what AGD and others in the dental
community lobbied for, it does represent an increase from current
levels.
The SCHIP
Reauthorization Bill (H.R. 976), which passed House and Senate votes,
was vetoed by President Bush on October 3, 2007. Funding for the
bill would have come from a 61-cent-per-pack cigarette tax increase.
A veto override vote was attempted but failed to achieve the necessary
two-thirds vote in each congressional chamber. Because there are tax
provisions, the override bill had to originate in the House; this
chamber could not muster a veto-proof majority vote during initial
passage.
Alternate SCHIP
legislation is being worked on by Florida senator Mel Martinez and
others. The new bill would reauthorize the current program and would
include an enhanced outreach program for those eligible but not signed
up. Additionally, a child health care tax credit would be given to
families living between 200 and 300% of federal poverty levels in an
effort to stimulate parents to purchase child health insurance in the
private market. This would cover the population of children
originally targeted in H.R. 976 while simultaneously avoiding an
expansion of federally-mandated healthcare programs objected to by the
President. Progress on SCHIP reauthorization will continue to be
tracked by this committee.
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