Section 64W-6.003 - Documentation Requirements(1) FRAMEdental applicants must complete and submit the following forms in the FRAMEworks portal:(b) The Florida Reimbursement Assistance for Medical Education - Dental (FRAMEdental) Employment Verification Form (PDF only). One form is required for each employer. Signatures must be in ink. The FRAMEdental Employment Verification Form, DH8018-PHSPM-07/2023, is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-16374.(c) The Florida Reimbursement Assistance for Medical Education - Dental (FRAMEdental) Loan Certification Form for each educational loan (PDF only). Signatures must be in ink or utilize a legally binding eSignature. The FRAMEdental Loan Certification Form, DH8019-PHSPM-07/2023, is incorporated by reference and available at https://www.flrules.org/Gateway/reference.asp?No=Ref-16375.(2) The following document(s) must be uploaded to the FRAMEworks portal, as applicable: (a) For all practice locations that are in an FQHC, upload documentation of dental shortage designation status. A PDF copy of the HRSA "Find Shortage Areas State/County" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/hpsa-find) is considered acceptable documentation.(b) For all practice locations that are not in an FQHC, but are designated by HRSA as having a shortage of dental health professionals based on geographic location, special population, or facility, upload a PDF copy of the query result for each practice site location from HRSA "Find Shortage Areas by Address" query result for each practice site location (https://data.hrsa.gov/tools/shortage-area/by-address).(3) If requested by the Department, an applicant must provide documentation of status as a United States citizen (U.S. born or naturalized) or United States national, as defined by 8 U.S.C. 1401 - 1440, shall be provided by the applicant within 5 business days.(4) The FRAMEdental Employment Verification Form and the FRAMEdental Loan Certification Form will be made available on the Department's website at https://www.fdohframe.com/s/forms.(5) This rule will be reviewed and repealed, modified, or renewed through the rulemaking process 5 years from the effective date.Fla. Admin. Code Ann. R. 64W-6.003
Rulemaking Authority 381.4019 FS. Law Implemented 381.4019 FS.
Adopted by Florida Register Volume 50, Number 020, January 30, 2024 effective 2/15/2024.