Criminal Backgrounds of Health Providers: Florida’s Licensing System Is All Cavities

After three years in a federal pen, dentist David Goldston is back in practice in Polk City.

He’ll have to fix a lot of teeth to pay off $2 million in tax-fraud penalties, but at least he doesn’t have to worry about losing his state dental license. He didn’t get even a slap on the wrist from the Department of Health or Board of Dentistry.

In fact, there is no indication that they are even aware of Goldston’s federal conviction.

That’s not uncommon, a Health News Florida investigation found. Criminal convictions of health professionals often fly under the state’s radar.

Dennis Brager, a California tax attorney who recently studied and wrote about the Goldston case, was surprised to hear that the dentist is back in active practice.

“I know in California if you’re convicted, they lift your license,” Brager said.

But this is Florida. The rules are different here.

A law with holes

The Department of Health and the boards that it supports are supposed to protect the public from dishonest and incompetent practitioners. It has a website where consumers can look up licensees and check their backgrounds.

But that website doesn’t mention arrests, except in rare cases when an emergency suspension order is issued. As a result, the arrest can go unlisted for years, if a case drags on that long.

Even after a case ends with a conviction, DOH doesn’t always find out. Licenses can be listed as “clear/active” even as their owners serve prison time or felony probation.

DOH says it is not at fault, that it is carrying out the law as the Legislature wrote it. In the late 1990s, lawmakers authorized the agency to do criminal background checks on several types of health professionals, but not most.

Long-time legislators and their staffs — even some who retired — said they couldn’t recall passage of the law and why it was done that way.

Do they read the news?

Even when a crime and court case makes headlines, DOH sometimes remains oblivious. The Goldston case, for example, made news in at least two state newspapers.

Health News Florida decided to pick two types of professionals that aren’t covered under the background-check law and see what could be found at no charge, just using state search sites and Google. A check of dentists and allied mental-health fields turned up nine cases in which licensees’ criminal convictions were not mentioned on their license records.

They include three therapists addicted to cocaine or prescription drugs; two men accused of sex crimes with minors; two tax evaders, and two thieves. Four served time in jail; two are still there.

On the DOH website, none of those convictions is mentioned. In fact, most of the offenders’ licenses are marked “Clear/Active” with no past discipline and no pending complaints.

When a reporter brought this to the attention of DOH Secretary and Surgeon General Frank Farmer, he said he was concerned. “I’ll check into it and see what the story is,” he said.

Who’s checked, who’s not

Attorneys familiar with Florida laws governing the health professions say DOH is authorized to do criminal background checks only on nurses, medical and osteopathic physicians, chiropractors and podiatrists.

Not mentioned are dentists and 29 others, including pharmacists, optometrists, acupuncturists, midwives and psychologists.

(See the list here).

If there was logic at work in the Legislature’s choice of professions to scrutinize, it’s not obvious. For example, a pharmacy owner requires a background check, but not a pharmacist. A prosthetic fitter gets checked, but not a hearing-aid specialist.

Advanced registered nurse practitioners must undergo background checks, while physician assistants don’t.

Expanding the background checks to cover the missing professions would not require a state expense. Licensees have to pay for the screening every two years; for most, it costs $43.25.

But this is not a time when Florida officials seem eager to ramp up oversight of the private sector. Both Gov. Rick Scott and legislative leaders are currently rolling back rules and regulations.

DOH relies on self-reports

For its part, DOH has not aggressively sought the authority to cross-check licensees against the Florida Department of Law Enforcement’s database. The agency depends on licensees to report themselves.

All those who apply for a Florida health professional license are asked to disclose criminal convictions on the form. If they’re already licensed when the arrest occurs, they are supposed to notify DOH within 30 days of a conviction (or plea of no contest).

But that doesn’t necessarily happen.

For example, William Earl Hayes, a now-retired mental-health counselor in Miami, kept his license pristine for more than a decade even as his name and picture circulated on the Florida Department of Law Enforcement’s sex-offender registry.

Nobody ever told DOH, which is fine with him. He said, “I don’t want to open a can of worms. I don’t need the aggravation.”

–Carol Gentry, Health News Florida