Florida Senate - 2016 SENATOR AMENDMENT
Bill No. CS for HB 977
Senate . House
Floor: 1/AE/2R . Floor: SENAT/C
03/09/2016 07:24 PM . 03/10/2016 05:16 PM
Senator Grimsley moved the following:
1 Senate Amendment (with title amendment)
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Section 394.453, Florida Statutes, is amended to
7 394.453 Legislative intent.—It is the intent of the
8 Legislature to authorize and direct the Department of Children
9 and Families to evaluate, research, plan, and recommend to the
10 Governor and the Legislature programs designed to reduce the
11 occurrence, severity, duration, and disabling aspects of mental,
12 emotional, and behavioral disorders. It is the intent of the
13 Legislature that treatment programs for such disorders shall
14 include, but not be limited to, comprehensive health, social,
15 educational, and rehabilitative services to persons requiring
16 intensive short-term and continued treatment in order to
17 encourage them to assume responsibility for their treatment and
18 recovery. It is intended that such persons be provided with
19 emergency service and temporary detention for evaluation when
20 required; that they be admitted to treatment facilities on a
21 voluntary basis when extended or continuing care is needed and
22 unavailable in the community; that involuntary placement be
23 provided only when expert evaluation determines that it is
24 necessary; that any involuntary treatment or examination be
25 accomplished in a setting which is clinically appropriate and
26 most likely to facilitate the person’s return to the community
27 as soon as possible; and that individual dignity and human
28 rights be guaranteed to all persons who are admitted to mental
29 health facilities or who are being held under s. 394.463. It is
30 the further intent of the Legislature that the least restrictive
31 means of intervention be employed based on the individual needs
32 of each person, within the scope of available services. It is
33 the policy of this state that the use of restraint and seclusion
34 on clients is justified only as an emergency safety measure to
35 be used in response to imminent danger to the client or others.
36 It is, therefore, the intent of the Legislature to achieve an
37 ongoing reduction in the use of restraint and seclusion in
38 programs and facilities serving persons with mental illness. The
39 Legislature further finds the need for additional psychiatrists
40 to be of critical state concern and recommends the establishment
41 of an additional psychiatry program to be offered by one of
42 Florida’s schools of medicine currently not offering psychiatry.
43 The program shall seek to integrate primary care and psychiatry
44 and other evolving models of care for persons with mental health
45 and substance use disorders. Additionally, the Legislature finds
46 that the use of telemedicine for patient evaluation, case
47 management, and ongoing care will improve management of patient
48 care and reduce costs of transportation.
49 Section 2. Subsection (2) of section 394.467, Florida
50 Statutes, is amended to read:
51 394.467 Involuntary inpatient placement.—
52 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
53 retained by a receiving facility or involuntarily placed in a
54 treatment facility upon the recommendation of the administrator
55 of the receiving facility where the patient has been examined
56 and after adherence to the notice and hearing procedures
57 provided in s. 394.4599. The recommendation must be supported by
58 the opinion of a psychiatrist and the second opinion of a
59 clinical psychologist or another psychiatrist, both of whom have
60 personally examined the patient within the preceding 72 hours,
61 that the criteria for involuntary inpatient placement are met.
in a county that has a population of fewer than 50,000,
63 if the administrator certifies that a psychiatrist or clinical
64 psychologist is not available to provide the second opinion, the
65 second opinion may be provided by a licensed physician who has
66 postgraduate training and experience in diagnosis and treatment
67 of mental and nervous disorders or by a psychiatric nurse. Any
68 second opinion authorized in this subsection may be conducted
69 through a face-to-face examination, in person or by electronic
70 means. Such recommendation shall be entered on an involuntary
71 inpatient placement certificate that authorizes the receiving
72 facility to retain the patient pending transfer to a treatment
73 facility or completion of a hearing.
74 Section 3. Paragraphs (e) and (f) of subsection (1) and
75 paragraph (b) of subsection (4) of section 397.451, Florida
76 Statutes, are amended to read:
77 397.451 Background checks of service provider personnel.—
78 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND
80 (e) Personnel employed directly or under contract with the
81 Department of Corrections in an inmate substance abuse program
82 who have direct contact with unmarried inmates under the age of
83 18 or with inmates who are developmentally disabled are exempt
84 from the fingerprinting and background check requirements of
85 this section unless they have direct contact with unmarried
86 inmates under the age of 18 or with inmates who are
87 developmentally disabled.
88 (f) Service provider personnel who request an exemption
89 from disqualification must submit the request within 30 days
90 after being notified of the disqualification. If 5 years or more
91 have elapsed since the most recent disqualifying offense,
92 service provider personnel may work with adults with substance
93 use disorders under the supervision of a qualified professional
94 licensed under chapter 490 or chapter 491 or a master’s level
95 certified addiction professional until the agency makes a final
96 determination regarding the request for an exemption from
97 disqualification Upon notification of the disqualification, the
98 service provider shall comply with requirements regarding
99 exclusion from employment in s. 435.06.
100 (4) EXEMPTIONS FROM DISQUALIFICATION.—
101 (b) Since rehabilitated substance abuse impaired persons
102 are effective in the successful treatment and rehabilitation of
103 individuals with substance use disorders substance abuse
104 impaired adolescents, for service providers which treat
105 adolescents 13 years of age and older, service provider
106 personnel whose background checks indicate crimes under s.
107 817.563, s. 893.13, or s. 893.147 may be exempted from
108 disqualification from employment pursuant to this paragraph.
109 Section 4. Paragraph (g) is added to subsection (1) of
110 section 456.44, Florida Statutes, and subsections (2) and (3) of
111 that section are amended, to read:
112 456.44 Controlled substance prescribing.—
113 (1) DEFINITIONS.—As used in this section, the term:
114 (g) “Registrant” means a physician who meets the
115 requirements of subsection (2).
116 (2) REGISTRATION.— Effective January 1, 2012, A physician
117 licensed under chapter 458, chapter 459, chapter 461, or chapter
118 466 who prescribes any controlled substance, listed in Schedule
119 II, Schedule III, or Schedule IV as defined in s. 893.03, for
120 the treatment of chronic nonmalignant pain, must:
121 (a) Designate himself or herself as a controlled substance
122 prescribing practitioner on his or her the physician’s
123 practitioner profile.
124 (b) Comply with the requirements of this section and
125 applicable board rules.
126 (3) STANDARDS OF PRACTICE.—The standards of practice in
127 this section do not supersede the level of care, skill, and
128 treatment recognized in general law related to health care
130 (a) A complete medical history and a physical examination
131 must be conducted before beginning any treatment and must be
132 documented in the medical record. The exact components of the
133 physical examination shall be left to the judgment of the
134 registrant clinician who is expected to perform a physical
135 examination proportionate to the diagnosis that justifies a
136 treatment. The medical record must, at a minimum, document the
137 nature and intensity of the pain, current and past treatments
138 for pain, underlying or coexisting diseases or conditions, the
139 effect of the pain on physical and psychological function, a
140 review of previous medical records, previous diagnostic studies,
141 and history of alcohol and substance abuse. The medical record
142 shall also document the presence of one or more recognized
143 medical indications for the use of a controlled substance. Each
144 registrant must develop a written plan for assessing each
145 patient’s risk of aberrant drug-related behavior, which may
146 include patient drug testing. Registrants must assess each
147 patient’s risk for aberrant drug-related behavior and monitor
148 that risk on an ongoing basis in accordance with the plan.
149 (b) Each registrant must develop a written individualized
150 treatment plan for each patient. The treatment plan shall state
151 objectives that will be used to determine treatment success,
152 such as pain relief and improved physical and psychosocial
153 function, and shall indicate if any further diagnostic
154 evaluations or other treatments are planned. After treatment
155 begins, the registrant physician shall adjust drug therapy to
156 the individual medical needs of each patient. Other treatment
157 modalities, including a rehabilitation program, shall be
158 considered depending on the etiology of the pain and the extent
159 to which the pain is associated with physical and psychosocial
160 impairment. The interdisciplinary nature of the treatment plan
161 shall be documented.
162 (c) The registrant physician shall discuss the risks and
163 benefits of the use of controlled substances, including the
164 risks of abuse and addiction, as well as physical dependence and
165 its consequences, with the patient, persons designated by the
166 patient, or the patient’s surrogate or guardian if the patient
167 is incompetent. The registrant physician shall use a written
168 controlled substance agreement between the registrant physician
169 and the patient outlining the patient’s responsibilities,
170 including, but not limited to:
171 1. Number and frequency of controlled substance
172 prescriptions and refills.
173 2. Patient compliance and reasons for which drug therapy
174 may be discontinued, such as a violation of the agreement.
175 3. An agreement that controlled substances for the
176 treatment of chronic nonmalignant pain shall be prescribed by a
177 single treating registrant physician unless otherwise authorized
178 by the treating registrant physician and documented in the
179 medical record.
180 (d) The patient shall be seen by the registrant physician
181 at regular intervals, not to exceed 3 months, to assess the
182 efficacy of treatment, ensure that controlled substance therapy
183 remains indicated, evaluate the patient’s progress toward
184 treatment objectives, consider adverse drug effects, and review
185 the etiology of the pain. Continuation or modification of
186 therapy shall depend on the registrant’s physician’s evaluation
187 of the patient’s progress. If treatment goals are not being
188 achieved, despite medication adjustments, the registrant
189 physician shall reevaluate the appropriateness of continued
190 treatment. The registrant physician shall monitor patient
191 compliance in medication usage, related treatment plans,
192 controlled substance agreements, and indications of substance
193 abuse or diversion at a minimum of 3-month intervals.
194 (e) The registrant physician shall refer the patient as
195 necessary for additional evaluation and treatment in order to
196 achieve treatment objectives. Special attention shall be given
197 to those patients who are at risk for misusing their medications
198 and those whose living arrangements pose a risk for medication
199 misuse or diversion. The management of pain in patients with a
200 history of substance abuse or with a comorbid psychiatric
201 disorder requires extra care, monitoring, and documentation and
202 requires consultation with or referral to an addiction medicine
203 specialist or a psychiatrist.
204 (f) A registrant physician registered under this section
205 must maintain accurate, current, and complete records that are
206 accessible and readily available for review and comply with the
207 requirements of this section, the applicable practice act, and
208 applicable board rules. The medical records must include, but
209 are not limited to:
210 1. The complete medical history and a physical examination,
211 including history of drug abuse or dependence.
212 2. Diagnostic, therapeutic, and laboratory results.
213 3. Evaluations and consultations.
214 4. Treatment objectives.
215 5. Discussion of risks and benefits.
216 6. Treatments.
217 7. Medications, including date, type, dosage, and quantity
219 8. Instructions and agreements.
220 9. Periodic reviews.
221 10. Results of any drug testing.
222 11. A photocopy of the patient’s government-issued photo
224 12. If a written prescription for a controlled substance is
225 given to the patient, a duplicate of the prescription.
226 13. The registrant’s physician’s full name presented in a
227 legible manner.
228 (g) A registrant shall immediately refer patients with
229 signs or symptoms of substance abuse shall be immediately
230 referred to a board-certified pain management physician, an
231 addiction medicine specialist, or a mental health addiction
232 facility as it pertains to drug abuse or addiction unless the
233 registrant is a physician who is board-certified or board-
234 eligible in pain management. Throughout the period of time
235 before receiving the consultant’s report, a prescribing
236 registrant physician shall clearly and completely document
237 medical justification for continued treatment with controlled
238 substances and those steps taken to ensure medically appropriate
239 use of controlled substances by the patient. Upon receipt of the
240 consultant’s written report, the prescribing registrant
241 physician shall incorporate the consultant’s recommendations for
242 continuing, modifying, or discontinuing controlled substance
243 therapy. The resulting changes in treatment shall be
244 specifically documented in the patient’s medical record.
245 Evidence or behavioral indications of diversion shall be
246 followed by discontinuation of controlled substance therapy, and
247 the patient shall be discharged, and all results of testing and
248 actions taken by the registrant physician shall be documented in
249 the patient’s medical record.
251 This subsection does not apply to a board-eligible or board
252 certified anesthesiologist, physiatrist, rheumatologist, or
253 neurologist, or to a board-certified physician who has surgical
254 privileges at a hospital or ambulatory surgery center and
255 primarily provides surgical services. This subsection does not
256 apply to a board-eligible or board-certified medical specialist
257 who has also completed a fellowship in pain medicine approved by
258 the Accreditation Council for Graduate Medical Education or the
259 American Osteopathic Association, or who is board eligible or
260 board certified in pain medicine by the American Board of Pain
261 Medicine, the American Board of Interventional Pain Physicians,
262 the American Association of Physician Specialists, or a board
263 approved by the American Board of Medical Specialties or the
264 American Osteopathic Association and performs interventional
265 pain procedures of the type routinely billed using surgical
266 codes. This subsection does not apply to a registrant physician
267 who prescribes medically necessary controlled substances for a
268 patient during an inpatient stay in a hospital licensed under
269 chapter 395.
270 Section 5. Paragraph (b) of subsection (2) of section
271 458.3265, Florida Statutes, is amended to read:
272 458.3265 Pain-management clinics.—
273 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities
274 apply to any physician who provides professional services in a
275 pain-management clinic that is required to be registered in
276 subsection (1).
277 (b) Only a person may not dispense any medication on the
278 premises of a registered pain-management clinic unless he or she
279 is a physician licensed under this chapter or chapter 459 may
280 dispense medication or prescribe a controlled substance
281 regulated under chapter 893 on the premises of a registered
282 pain-management clinic.
283 Section 6. Paragraph (b) of subsection (2) of section
284 459.0137, Florida Statutes, is amended to read:
285 459.0137 Pain-management clinics.—
286 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities
287 apply to any osteopathic physician who provides professional
288 services in a pain-management clinic that is required to be
289 registered in subsection (1).
290 (b) Only a person may not dispense any medication on the
291 premises of a registered pain-management clinic unless he or she
292 is a physician licensed under this chapter or chapter 458 may
293 dispense medication or prescribe a controlled substance
294 regulated under chapter 893 on the premises of a registered
295 pain-management clinic.
296 Section 7. Section 464.012, Florida Statutes, is amended to
298 464.012 Certification of advanced registered nurse
299 practitioners; fees.—
300 (1) Any nurse desiring to be certified as an advanced
301 registered nurse practitioner shall apply to the department and
302 submit proof that he or she holds a current license to practice
303 professional nursing and that he or she meets one or more of the
304 following requirements as determined by the board:
305 (a) Satisfactory completion of a formal postbasic
306 educational program of at least one academic year, the primary
307 purpose of which is to prepare nurses for advanced or
308 specialized practice.
309 (b) Certification by an appropriate specialty board. Such
310 certification shall be required for initial state certification
311 and any recertification as a registered nurse anesthetist,
312 psychiatric nurse, or nurse midwife. The board may by rule
313 provide for provisional state certification of graduate nurse
314 anesthetists, psychiatric nurses, and nurse midwives for a
315 period of time determined to be appropriate for preparing for
316 and passing the national certification examination.
317 (c) Graduation from a program leading to a master’s degree
318 in a nursing clinical specialty area with preparation in
319 specialized practitioner skills. For applicants graduating on or
320 after October 1, 1998, graduation from a master’s degree program
321 shall be required for initial certification as a nurse
322 practitioner under paragraph (4)(c). For applicants graduating
323 on or after October 1, 2001, graduation from a master’s degree
324 program shall be required for initial certification as a
325 registered nurse anesthetist under paragraph (4)(a).
326 (2) The board shall provide by rule the appropriate
327 requirements for advanced registered nurse practitioners in the
328 categories of certified registered nurse anesthetist, certified
329 nurse midwife, and nurse practitioner.
330 (3) An advanced registered nurse practitioner shall perform
331 those functions authorized in this section within the framework
332 of an established protocol that is filed with the board upon
333 biennial license renewal and within 30 days after entering into
334 a supervisory relationship with a physician or changes to the
335 protocol. The board shall review the protocol to ensure
336 compliance with applicable regulatory standards for protocols.
337 The board shall refer to the department licensees submitting
338 protocols that are not compliant with the regulatory standards
339 for protocols. A practitioner currently licensed under chapter
340 458, chapter 459, or chapter 466 shall maintain supervision for
341 directing the specific course of medical treatment. Within the
342 established framework, an advanced registered nurse practitioner
344 (a) Monitor and alter drug therapies.
345 (b) Initiate appropriate therapies for certain conditions.
346 (c) Perform additional functions as may be determined by
347 rule in accordance with s. 464.003(2).
348 (d) Order diagnostic tests and physical and occupational
350 (4) In addition to the general functions specified in
351 subsection (3), an advanced registered nurse practitioner may
352 perform the following acts within his or her specialty:
353 (a) The certified registered nurse anesthetist may, to the
354 extent authorized by established protocol approved by the
355 medical staff of the facility in which the anesthetic service is
356 performed, perform any or all of the following:
357 1. Determine the health status of the patient as it relates
358 to the risk factors and to the anesthetic management of the
359 patient through the performance of the general functions.
360 2. Based on history, physical assessment, and supplemental
361 laboratory results, determine, with the consent of the
362 responsible physician, the appropriate type of anesthesia within
363 the framework of the protocol.
364 3. Order under the protocol preanesthetic medication.
365 4. Perform under the protocol procedures commonly used to
366 render the patient insensible to pain during the performance of
367 surgical, obstetrical, therapeutic, or diagnostic clinical
368 procedures. These procedures include ordering and administering
369 regional, spinal, and general anesthesia; inhalation agents and
370 techniques; intravenous agents and techniques; and techniques of
372 5. Order or perform monitoring procedures indicated as
373 pertinent to the anesthetic health care management of the
375 6. Support life functions during anesthesia health care,
376 including induction and intubation procedures, the use of
377 appropriate mechanical supportive devices, and the management of
378 fluid, electrolyte, and blood component balances.
379 7. Recognize and take appropriate corrective action for
380 abnormal patient responses to anesthesia, adjunctive medication,
381 or other forms of therapy.
382 8. Recognize and treat a cardiac arrhythmia while the
383 patient is under anesthetic care.
384 9. Participate in management of the patient while in the
385 postanesthesia recovery area, including ordering the
386 administration of fluids and drugs.
387 10. Place special peripheral and central venous and
388 arterial lines for blood sampling and monitoring as appropriate.
389 (b) The certified nurse midwife may, to the extent
390 authorized by an established protocol which has been approved by
391 the medical staff of the health care facility in which the
392 midwifery services are performed, or approved by the nurse
393 midwife’s physician backup when the delivery is performed in a
394 patient’s home, perform any or all of the following:
395 1. Perform superficial minor surgical procedures.
396 2. Manage the patient during labor and delivery to include
397 amniotomy, episiotomy, and repair.
398 3. Order, initiate, and perform appropriate anesthetic
400 4. Perform postpartum examination.
401 5. Order appropriate medications.
402 6. Provide family-planning services and well-woman care.
403 7. Manage the medical care of the normal obstetrical
404 patient and the initial care of a newborn patient.
405 (c) The nurse practitioner may perform any or all of the
406 following acts within the framework of established protocol:
407 1. Manage selected medical problems.
408 2. Order physical and occupational therapy.
409 3. Initiate, monitor, or alter therapies for certain
410 uncomplicated acute illnesses.
411 4. Monitor and manage patients with stable chronic
413 5. Establish behavioral problems and diagnosis and make
414 treatment recommendations.
415 (5) A psychiatric nurse, as defined in s. 394.455, within
416 the framework of an established protocol with a psychiatrist,
417 may prescribe psychotropic controlled substances for the
418 treatment of mental disorders.
419 (6) The board shall certify, and the department shall issue
420 a certificate to, any nurse meeting the qualifications in this
421 section. The board shall establish an application fee not to
422 exceed $100 and a biennial renewal fee not to exceed $50. The
423 board is authorized to adopt such other rules as are necessary
424 to implement the provisions of this section.
425 Section 8. Paragraph (p) is added to subsection (1) of
426 section 464.018, Florida Statutes, and subsection (2) of that
427 section is republished, to read:
428 464.018 Disciplinary actions.—
429 (1) The following acts constitute grounds for denial of a
430 license or disciplinary action, as specified in s. 456.072(2):
431 (p) For a psychiatric nurse:
432 1. Presigning blank prescription forms.
433 2. Prescribing for office use any medicinal drug appearing
434 in Schedule II of s. 893.03.
435 3. Prescribing, ordering, dispensing, administering,
436 supplying, selling, or giving a drug that is an amphetamine, a
437 sympathomimetic amine drug, or a compound designated in s.
438 893.03(2) as a Schedule II controlled substance, to or for any
439 person except for:
440 a. The treatment of narcolepsy; hyperkinesis; behavioral
441 syndrome in children characterized by the developmentally
442 inappropriate symptoms of moderate to severe distractibility,
443 short attention span, hyperactivity, emotional lability, and
444 impulsivity; or drug-induced brain dysfunction.
445 b. The differential diagnostic psychiatric evaluation of
446 depression or the treatment of depression shown to be refractory
447 to other therapeutic modalities.
448 c. The clinical investigation of the effects of such drugs
449 or compounds when an investigative protocol is submitted to,
450 reviewed by, and approved by the department before such
451 investigation is begun.
452 4. Prescribing, ordering, dispensing, administering,
453 supplying, selling, or giving growth hormones, testosterone or
454 its analogs, human chorionic gonadotropin (HCG), or other
455 hormones for the purpose of muscle building or to enhance
456 athletic performance. As used in this subparagraph, the term
457 “muscle building” does not include the treatment of injured
458 muscle. A prescription written for the drug products identified
459 in this subparagraph may be dispensed by a pharmacist with the
460 presumption that the prescription is for legitimate medical use.
461 5. Promoting or advertising on any prescription form a
462 community pharmacy unless the form also states: “This
463 prescription may be filled at any pharmacy of your choice.”
464 6. Prescribing, dispensing, administering, mixing, or
465 otherwise preparing a legend drug, including a controlled
466 substance, other than in the course of his or her professional
467 practice. For the purposes of this subparagraph, it is legally
468 presumed that prescribing, dispensing, administering, mixing, or
469 otherwise preparing legend drugs, including all controlled
470 substances, inappropriately or in excessive or inappropriate
471 quantities is not in the best interest of the patient and is not
472 in the course of the advanced registered nurse practitioner’s
473 professional practice, without regard to his or her intent.
474 7. Prescribing, dispensing, or administering a medicinal
475 drug appearing on any schedule set forth in chapter 893 to
476 himself or herself, except a drug prescribed, dispensed, or
477 administered to the psychiatric nurse by another practitioner
478 authorized to prescribe, dispense, or administer medicinal
480 8. Prescribing, ordering, dispensing, administering,
481 supplying, selling, or giving amygdalin (laetrile) to any
483 9. Dispensing a substance designated in s. 893.03(2) or (3)
484 as a substance controlled in Schedule II or Schedule III,
485 respectively, in violation of s. 465.0276.
486 10. Promoting or advertising through any communication
487 medium the use, sale, or dispensing of a substance designated in
488 s. 893.03 as a controlled substance.
489 (2) The board may enter an order denying licensure or
490 imposing any of the penalties in s. 456.072(2) against any
491 applicant for licensure or licensee who is found guilty of
492 violating any provision of subsection (1) of this section or who
493 is found guilty of violating any provision of s. 456.072(1).
494 Section 9. Subsection (21) of section 893.02, Florida
495 Statutes, is amended to read:
496 893.02 Definitions.—The following words and phrases as used
497 in this chapter shall have the following meanings, unless the
498 context otherwise requires:
499 (21) “Practitioner” means a physician licensed pursuant to
500 chapter 458, a dentist licensed pursuant to chapter 466, a
501 veterinarian licensed pursuant to chapter 474, an osteopathic
502 physician licensed pursuant to chapter 459, a naturopath
503 licensed pursuant to chapter 462, a certified optometrist
504 licensed pursuant to chapter 463, a psychiatric nurse as defined
505 in s. 394.455, or a podiatric physician licensed pursuant to
506 chapter 461, provided such practitioner holds a valid federal
507 controlled substance registry number.
508 Section 10. This act shall take effect upon becoming a law.
509 ================= T I T L E A M E N D M E N T ================
510 And the title is amended as follows:
511 Delete everything before the enacting clause
512 and insert:
513 A bill to be entitled
514 An act relating to behavioral health workforce;
515 amending s. 394.453, F.S.; revising legislative
516 intent; amending s. 394.467, F.S.; authorizing a
517 second opinion for admission to a treatment facility
518 to be provided by certain licensed physicians in all
519 counties, rather than counties with a specified
520 population size; revising procedures for recommending
521 admission of a patient to a treatment facility;
522 amending s. 397.451, F.S.; revising provisions
523 relating to personnel background checks and exemptions
524 from disqualification for certain service provider
525 personnel; amending s. 456.44, F.S.; defining the term
526 “registrant”; requiring psychiatric nurses to make
527 certain designations and comply with certain
528 requirements under specified circumstances; amending
529 s. 458.3265, F.S.; restricting to physicians the
530 authorization to dispense certain medications or
531 prescribe certain controlled substances on the
532 premises of a registered pain-management clinic;
533 amending s. 459.0137, F.S.; restricting to osteopathic
534 physicians the authorization to dispense certain
535 medications or prescribe certain controlled substances
536 on the premises of a registered pain-management
537 clinic; amending s. 464.012, F.S.; providing
538 certification criteria for psychiatric nurses;
539 authorizing psychiatric nurses to prescribe certain
540 psychotropic controlled substances under certain
541 circumstances; amending s. 464.018, F.S.; providing
542 that certain acts by a psychiatric nurse constitute
543 grounds for denial of a license or disciplinary
544 action; amending s. 893.02, F.S.; revising the
545 definition of the term “practitioner”; providing an
546 effective date.