Florida Senate - 2018                        COMMITTEE AMENDMENT
       Bill No. SB 1862
       
       
       
       
       
       
                                Ì1760385Î176038                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: WD            .                                
                  03/01/2018           .                                
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       The Committee on Rules (Brandes) recommended the following:
       
    1         Senate Amendment to Amendment (204760) (with title
    2  amendment)
    3  
    4         Delete line 91
    5  and insert:
    6         Section 2. Effective October 1, 2018, subsections (3), (6),
    7  and (7) of section 464.003, Florida Statutes, are amended, to
    8  read:
    9         464.003 Definitions.—As used in this part, the term:
   10         (3) “Advanced practice registered nurse” “Advanced
   11  registered nurse practitioner” means any person licensed in this
   12  state to practice professional nursing and who is licensed
   13  certified in an advanced or specialized nursing practice,
   14  including certified nurse midwives, certified nurse
   15  practitioners, certified registered nurse anesthetists, clinical
   16  nurse specialists certified nurse midwives, and psychiatric
   17  nurses nurse practitioners.
   18         (6)“Clinical nurse specialist” means any person licensed
   19  in this state to practice professional nursing and certified in
   20  clinical nurse specialist practice.
   21         (7)“Clinical nurse specialist practice” means the delivery
   22  and management of advanced practice nursing care to individuals
   23  or groups, including the ability to:
   24         (a)Assess the health status of individuals and families
   25  using methods appropriate to the population and area of
   26  practice.
   27         (b)Diagnose human responses to actual or potential health
   28  problems.
   29         (c)Plan for health promotion, disease prevention, and
   30  therapeutic intervention in collaboration with the patient or
   31  client.
   32         (d)Implement therapeutic interventions based on the nurse
   33  specialist’s area of expertise and within the scope of advanced
   34  nursing practice, including, but not limited to, direct nursing
   35  care, counseling, teaching, and collaboration with other
   36  licensed health care providers.
   37         (e)Coordinate health care as necessary and appropriate and
   38  evaluate with the patient or client the effectiveness of care.
   39         Section 3. Effective October 1, 2018, section 464.0115,
   40  Florida Statutes, is repealed.
   41         Section 4. Effective October 1, 2018, section 464.012,
   42  Florida Statutes, as amended by section 3 of chapter 2017-134,
   43  section 8 of chapter 2016-139, and section 7 of chapter 2016
   44  231, Laws of Florida, is amended to read:
   45         464.012 Licensure Certification of advanced practice
   46  registered nurses advanced registered nurse practitioners; fees;
   47  controlled substance prescribing.—
   48         (1) Any nurse desiring to be licensed certified as an
   49  advanced practice registered nurse must advanced registered
   50  nurse practitioner shall apply to the department and submit
   51  proof that he or she holds a current license to practice
   52  professional nursing or holds an active multistate license to
   53  practice professional nursing pursuant to s. 464.0095 and that
   54  he or she meets one or more of the following requirements as
   55  determined by the board:
   56         (a) Certification by an appropriate specialty board. Such
   57  certification is shall be required for initial state licensure
   58  certification and any licensure renewal recertification as a
   59  certified nurse midwife, certified nurse practitioner, certified
   60  registered nurse anesthetist, clinical nurse specialist, or
   61  psychiatric nurse, or nurse midwife. The board may by rule
   62  provide for provisional state licensure certification of
   63  graduate certified registered nurse anesthetists, clinical nurse
   64  specialists, certified nurse practitioners, psychiatric nurses,
   65  and certified nurse midwives for a period of time determined to
   66  be appropriate for preparing for and passing the national
   67  certification examination.
   68         (b) Graduation from a program leading to a master’s degree
   69  in a nursing clinical specialty area with preparation in
   70  specialized practitioner skills. For applicants graduating on or
   71  after October 1, 1998, graduation from a master’s degree program
   72  is shall be required for initial licensure certification as a
   73  certified nurse practitioner under paragraph (4)(a) (4)(c).
   74         1. For applicants graduating on or after October 1, 2001,
   75  graduation from a master’s degree program is shall be required
   76  for initial licensure certification as a certified registered
   77  nurse anesthetist who may perform the acts listed in under
   78  paragraph (4)(b) (4)(a).
   79         2.For applicants graduating on or after October 1, 1998,
   80  graduation from a master’s degree program is required for
   81  initial licensure as a certified nurse midwife who may perform
   82  the acts listed in paragraph (4)(c).
   83         3.For applicants graduating on or after July 1, 2007,
   84  graduation from a master’s degree program is required for
   85  initial licensure as a clinical nurse specialist who may perform
   86  the acts listed in paragraph (4)(d).
   87         (2)(a) The board shall provide by rule the appropriate
   88  requirements for advanced practice registered nurses for
   89  advanced registered nurse practitioners in the advanced nursing
   90  practices categories of certified nurse midwives, certified
   91  nurse practitioners, certified registered nurse anesthetists
   92  anesthetist, clinical certified nurse specialists midwife, and
   93  psychiatric nurses nurse practitioner.
   94         (3) An advanced practice registered nurse advanced
   95  registered nurse practitioner shall perform those functions
   96  authorized in this section within the framework of an
   97  established protocol that which must be maintained on site at
   98  the location or locations at which an advanced practice
   99  registered nurse advanced registered nurse practitioner
  100  practices. In the case of multiple supervising physicians in the
  101  same group, an advanced practice registered nurse advanced
  102  registered nurse practitioner must enter into a supervisory
  103  protocol with at least one physician within the physician group
  104  practice. A practitioner currently licensed under chapter 458,
  105  chapter 459, or chapter 466 shall maintain supervision for
  106  directing the specific course of medical treatment. Within the
  107  established framework, an advanced practice registered nurse
  108  advanced registered nurse practitioner may:
  109         (a) Prescribe, dispense, administer, or order any drug;
  110  however, an advanced practice registered nurse advanced
  111  registered nurse practitioner may prescribe or dispense a
  112  controlled substance as defined in s. 893.03 only if the
  113  advanced practice registered nurse advanced registered nurse
  114  practitioner has graduated from a program leading to a master’s
  115  or doctoral degree in a clinical nursing specialty area with
  116  training in specialized practitioner skills.
  117         (b) Initiate appropriate therapies for certain conditions.
  118         (c) Perform additional functions as may be determined by
  119  rule in accordance with s. 464.003(2).
  120         (d) Order diagnostic tests and physical and occupational
  121  therapy.
  122         (e) Order any medication for administration to a patient in
  123  a facility licensed under chapter 395 or part II of chapter 400,
  124  notwithstanding any provisions in chapter 465 or chapter 893.
  125         (4) In addition to the general functions specified in
  126  subsection (3), an advanced practice registered nurse advanced
  127  registered nurse practitioner may perform the following acts
  128  within his or her specialty:
  129         (a)The certified nurse practitioner may perform any or all
  130  of the following acts within the framework of established
  131  protocol:
  132         1.Manage selected medical problems.
  133         2.Order physical and occupational therapy.
  134         3.Initiate, monitor, or alter therapies for certain
  135  uncomplicated acute illnesses.
  136         4.Monitor and manage patients with stable chronic
  137  diseases.
  138         5.Establish behavioral problems and diagnosis and make
  139  treatment recommendations.
  140         (b)(a) The certified registered nurse anesthetist may, to
  141  the extent authorized by established protocol approved by the
  142  medical staff of the facility in which the anesthetic service is
  143  performed, perform any or all of the following:
  144         1. Determine the health status of the patient as it relates
  145  to the risk factors and to the anesthetic management of the
  146  patient through the performance of the general functions.
  147         2. Based on history, physical assessment, and supplemental
  148  laboratory results, determine, with the consent of the
  149  responsible physician, the appropriate type of anesthesia within
  150  the framework of the protocol.
  151         3. Order under the protocol preanesthetic medication.
  152         4. Perform under the protocol procedures commonly used to
  153  render the patient insensible to pain during the performance of
  154  surgical, obstetrical, therapeutic, or diagnostic clinical
  155  procedures. These procedures include ordering and administering
  156  regional, spinal, and general anesthesia; inhalation agents and
  157  techniques; intravenous agents and techniques; and techniques of
  158  hypnosis.
  159         5. Order or perform monitoring procedures indicated as
  160  pertinent to the anesthetic health care management of the
  161  patient.
  162         6. Support life functions during anesthesia health care,
  163  including induction and intubation procedures, the use of
  164  appropriate mechanical supportive devices, and the management of
  165  fluid, electrolyte, and blood component balances.
  166         7. Recognize and take appropriate corrective action for
  167  abnormal patient responses to anesthesia, adjunctive medication,
  168  or other forms of therapy.
  169         8. Recognize and treat a cardiac arrhythmia while the
  170  patient is under anesthetic care.
  171         9. Participate in management of the patient while in the
  172  postanesthesia recovery area, including ordering the
  173  administration of fluids and drugs.
  174         10. Place special peripheral and central venous and
  175  arterial lines for blood sampling and monitoring as appropriate.
  176         (c)(b) The certified nurse midwife may, to the extent
  177  authorized by an established protocol which has been approved by
  178  the medical staff of the health care facility in which the
  179  midwifery services are performed, or approved by the nurse
  180  midwife’s physician backup when the delivery is performed in a
  181  patient’s home, perform any or all of the following:
  182         1. Perform superficial minor surgical procedures.
  183         2. Manage the patient during labor and delivery to include
  184  amniotomy, episiotomy, and repair.
  185         3. Order, initiate, and perform appropriate anesthetic
  186  procedures.
  187         4. Perform postpartum examination.
  188         5. Order appropriate medications.
  189         6. Provide family-planning services and well-woman care.
  190         7. Manage the medical care of the normal obstetrical
  191  patient and the initial care of a newborn patient.
  192         (d)The clinical nurse specialist may perform any or all of
  193  the following acts within the framework of established protocol:
  194         1.Assess the health status of individuals and families
  195  using methods appropriate to the population and area of
  196  practice.
  197         2.Diagnose human responses to actual or potential health
  198  problems.
  199         3.Plan for health promotion, disease prevention, and
  200  therapeutic intervention in collaboration with the patient or
  201  client.
  202         4.Implement therapeutic interventions based on the nurse
  203  specialist’s area of expertise and within the scope of advanced
  204  nursing practice, including, but not limited to, direct nursing
  205  care, counseling, teaching, and collaboration with other
  206  licensed health care providers.
  207         5.Coordinate health care as necessary and appropriate and
  208  evaluate with the patient or client the effectiveness of care.
  209         (c)The nurse practitioner may perform any or all of the
  210  following acts within the framework of established protocol:
  211         1.Manage selected medical problems.
  212         2.Order physical and occupational therapy.
  213         3.Initiate, monitor, or alter therapies for certain
  214  uncomplicated acute illnesses.
  215         4.Monitor and manage patients with stable chronic
  216  diseases.
  217         5.Establish behavioral problems and diagnosis and make
  218  treatment recommendations.
  219         (e)(5) A psychiatric nurse, who meets the requirements in
  220  s. 394.455(35) as defined in s. 394.455, within the framework of
  221  an established protocol with a psychiatrist, may prescribe
  222  psychotropic controlled substances for the treatment of mental
  223  disorders.
  224         (5)(6) The board shall approve for licensure certify, and
  225  the department shall issue a license certificate to, any nurse
  226  meeting the qualifications in this section. The board shall
  227  establish an application fee not to exceed $100 and a biennial
  228  renewal fee not to exceed $50. The board is authorized to adopt
  229  such other rules as are necessary to implement the provisions of
  230  this section.
  231         (6)(7)(a) The board shall establish a committee to
  232  recommend a formulary of controlled substances that an advanced
  233  practice registered nurse advanced registered nurse practitioner
  234  may not prescribe or may prescribe only for specific uses or in
  235  limited quantities. The committee must consist of three advanced
  236  practice registered nurses advanced registered nurse
  237  practitioners licensed under this section, recommended by the
  238  board; three physicians licensed under chapter 458 or chapter
  239  459 who have work experience with advanced practice registered
  240  nurses advanced registered nurse practitioners, recommended by
  241  the Board of Medicine; and a pharmacist licensed under chapter
  242  465 who is a doctor of pharmacy, recommended by the Board of
  243  Pharmacy. The committee may recommend an evidence-based
  244  formulary applicable to all advanced practice registered nurses
  245  advanced registered nurse practitioners which is limited by
  246  specialty certification, is limited to approved uses of
  247  controlled substances, or is subject to other similar
  248  restrictions the committee finds are necessary to protect the
  249  health, safety, and welfare of the public. The formulary must
  250  restrict the prescribing of psychiatric mental health controlled
  251  substances for children younger than 18 years of age to advanced
  252  practice registered nurses advanced registered nurse
  253  practitioners who also are psychiatric nurses as defined in s.
  254  394.455. The formulary must also limit the prescribing of
  255  Schedule II controlled substances as listed in s. 893.03 to a 7
  256  day supply, except that such restriction does not apply to
  257  controlled substances that are psychiatric medications
  258  prescribed by psychiatric nurses as defined in s. 394.455.
  259         (b) The board shall adopt by rule the recommended formulary
  260  and any revision to the formulary which it finds is supported by
  261  evidence-based clinical findings presented by the Board of
  262  Medicine, the Board of Osteopathic Medicine, or the Board of
  263  Dentistry.
  264         (c) The formulary required under this subsection does not
  265  apply to a controlled substance that is dispensed for
  266  administration pursuant to an order, including an order for
  267  medication authorized by subparagraph (4)(b)3., subparagraph
  268  (4)(b)4., or subparagraph (4)(b)9 subparagraph (4)(a)3.,
  269  subparagraph (4)(a)4., or subparagraph (4)(a)9.
  270         (d) The board shall adopt the committee’s initial
  271  recommendation no later than October 31, 2016.
  272         (7)(8) This section shall be known as “The Barbara Lumpkin
  273  Prescribing Act.”
  274         (8)The department and board shall establish a transition
  275  timeline and process for practitioners certified as of September
  276  30, 2018, as advanced registered nurse practitioners or clinical
  277  nurse specialists, to convert a certificate in good standing to
  278  a license that becomes effective on October 1, 2018, to practice
  279  as an advanced practice registered nurse. An advanced registered
  280  nurse practitioner or a clinical nurse specialist holding a
  281  certificate to practice in good standing on September 30, 2018,
  282  may continue to practice with all rights, authorizations, and
  283  responsibilities under this section for licensure as an advanced
  284  practice registered nurse and may use the applicable title under
  285  s. 464.015 after the effective date of this act while the
  286  department and board complete the transition from certification
  287  to licensure, as established under this act. This subsection may
  288  not be construed to limit or restrict the department’s or
  289  board’s disciplinary authority or enforcement responsibilities
  290  for safe nursing practice. This subsection expires on October 1,
  291  2020.
  292         Section 5. Effective October 1, 2018, subsection (2) of
  293  section 960.28, Florida Statutes, is amended to read:
  294         960.28 Payment for victims’ initial forensic physical
  295  examinations.—
  296         (2) The Crime Victims’ Services Office of the department
  297  shall pay for medical expenses connected with an initial
  298  forensic physical examination of a victim of sexual battery as
  299  defined in chapter 794 or a lewd or lascivious offense as
  300  defined in chapter 800. Such payment shall be made regardless of
  301  whether the victim is covered by health or disability insurance
  302  and whether the victim participates in the criminal justice
  303  system or cooperates with law enforcement. The payment shall be
  304  made only out of moneys allocated to the Crime Victims’ Services
  305  Office for the purposes of this section, and the payment may not
  306  exceed $500 with respect to any violation. The department shall
  307  develop and maintain separate protocols for the initial forensic
  308  physical examination of adults and children. Payment under this
  309  section is limited to medical expenses connected with the
  310  initial forensic physical examination, and payment may be made
  311  to a medical provider using an examiner qualified under part I
  312  of chapter 464, excluding s. 464.003(14) s. 464.003(16); chapter
  313  458; or chapter 459. Payment made to the medical provider by the
  314  department shall be considered by the provider as payment in
  315  full for the initial forensic physical examination associated
  316  with the collection of evidence. The victim may not be required
  317  to pay, directly or indirectly, the cost of an initial forensic
  318  physical examination performed in accordance with this section.
  319         Section 6. Effective October 1, 2018, paragraph (c) of
  320  subsection (5) and paragraph (a) of subsection (6) of section
  321  39.303, Florida Statutes, are amended to read:
  322         39.303 Child protection teams and sexual abuse treatment
  323  programs; services; eligible cases.—
  324         (5) All abuse and neglect cases transmitted for
  325  investigation to a circuit by the hotline must be simultaneously
  326  transmitted to the child protection team for review. For the
  327  purpose of determining whether a face-to-face medical evaluation
  328  by a child protection team is necessary, all cases transmitted
  329  to the child protection team which meet the criteria in
  330  subsection (4) must be timely reviewed by:
  331         (c) An advanced practice registered nurse advanced
  332  registered nurse practitioner licensed under chapter 464 who has
  333  a specialty in pediatrics or family medicine and is a member of
  334  a child protection team;
  335         (6) A face-to-face medical evaluation by a child protection
  336  team is not necessary when:
  337         (a) The child was examined for the alleged abuse or neglect
  338  by a physician who is not a member of the child protection team,
  339  and a consultation between the child protection team medical
  340  director or a child protection team board-certified
  341  pediatrician, advanced practice registered nurse advanced
  342  registered nurse practitioner, physician assistant working under
  343  the supervision of a child protection team medical director or a
  344  child protection team board-certified pediatrician, or
  345  registered nurse working under the direct supervision of a child
  346  protection team medical director or a child protection team
  347  board-certified pediatrician, and the examining physician
  348  concludes that a further medical evaluation is unnecessary;
  349  
  350  Notwithstanding paragraphs (a), (b), and (c), a child protection
  351  team medical director or a child protection team pediatrician,
  352  as authorized in subsection (5), may determine that a face-to
  353  face medical evaluation is necessary.
  354         Section 7. Effective October 1, 2018, paragraph (b) of
  355  subsection (1) of section 39.304, Florida Statutes, is amended
  356  to read:
  357         39.304 Photographs, medical examinations, X rays, and
  358  medical treatment of abused, abandoned, or neglected child.—
  359         (1)
  360         (b) If the areas of trauma visible on a child indicate a
  361  need for a medical examination, or if the child verbally
  362  complains or otherwise exhibits distress as a result of injury
  363  through suspected child abuse, abandonment, or neglect, or is
  364  alleged to have been sexually abused, the person required to
  365  investigate may cause the child to be referred for diagnosis to
  366  a licensed physician or an emergency department in a hospital
  367  without the consent of the child’s parents or legal custodian.
  368  Such examination may be performed by any licensed physician or
  369  an advanced practice registered nurse advanced registered nurse
  370  practitioner licensed pursuant to part I of chapter 464. Any
  371  licensed physician, or advanced practice registered nurse
  372  advanced registered nurse practitioner licensed pursuant to part
  373  I of chapter 464, who has reasonable cause to suspect that an
  374  injury was the result of child abuse, abandonment, or neglect
  375  may authorize a radiological examination to be performed on the
  376  child without the consent of the child’s parent or legal
  377  custodian.
  378         Section 8. Effective October 1, 2018, paragraph (a) of
  379  subsection (1) of section 90.503, Florida Statutes, is amended
  380  to read:
  381         90.503 Psychotherapist-patient privilege.—
  382         (1) For purposes of this section:
  383         (a) A “psychotherapist” is:
  384         1. A person authorized to practice medicine in any state or
  385  nation, or reasonably believed by the patient so to be, who is
  386  engaged in the diagnosis or treatment of a mental or emotional
  387  condition, including alcoholism and other drug addiction;
  388         2. A person licensed or certified as a psychologist under
  389  the laws of any state or nation, who is engaged primarily in the
  390  diagnosis or treatment of a mental or emotional condition,
  391  including alcoholism and other drug addiction;
  392         3. A person licensed or certified as a clinical social
  393  worker, marriage and family therapist, or mental health
  394  counselor under the laws of this state, who is engaged primarily
  395  in the diagnosis or treatment of a mental or emotional
  396  condition, including alcoholism and other drug addiction;
  397         4. Treatment personnel of facilities licensed by the state
  398  pursuant to chapter 394, chapter 395, or chapter 397, of
  399  facilities designated by the Department of Children and Families
  400  pursuant to chapter 394 as treatment facilities, or of
  401  facilities defined as community mental health centers pursuant
  402  to s. 394.907(1), who are engaged primarily in the diagnosis or
  403  treatment of a mental or emotional condition, including
  404  alcoholism and other drug addiction; or
  405         5. An advanced practice registered nurse licensed advanced
  406  registered nurse practitioner certified under s. 464.012, whose
  407  primary scope of practice is the diagnosis or treatment of
  408  mental or emotional conditions, including chemical abuse, and
  409  limited only to actions performed in accordance with part I of
  410  chapter 464.
  411         Section 9. Effective October 1, 2018, paragraph (d) of
  412  subsection (2) of section 110.12315, Florida Statutes, is
  413  amended to read:
  414         110.12315 Prescription drug program.—The state employees’
  415  prescription drug program is established. This program shall be
  416  administered by the Department of Management Services, according
  417  to the terms and conditions of the plan as established by the
  418  relevant provisions of the annual General Appropriations Act and
  419  implementing legislation, subject to the following conditions:
  420         (2) In providing for reimbursement of pharmacies for
  421  prescription drugs and supplies dispensed to members of the
  422  state group health insurance plan and their dependents under the
  423  state employees’ prescription drug program:
  424         (d) The department shall establish the reimbursement
  425  schedule for prescription drugs and supplies dispensed under the
  426  program. Reimbursement rates for a prescription drug or supply
  427  must be based on the cost of the generic equivalent drug or
  428  supply if a generic equivalent exists, unless the physician,
  429  advanced practice registered nurse advanced registered nurse
  430  practitioner, or physician assistant prescribing the drug or
  431  supply clearly states on the prescription that the brand name
  432  drug or supply is medically necessary or that the drug or supply
  433  is included on the formulary of drugs and supplies that may not
  434  be interchanged as provided in chapter 465, in which case
  435  reimbursement must be based on the cost of the brand name drug
  436  or supply as specified in the reimbursement schedule adopted by
  437  the department.
  438         Section 10. Effective October 1, 2018, paragraph (f) of
  439  subsection (3) of section 121.0515, Florida Statutes, is amended
  440  to read:
  441         121.0515 Special Risk Class.—
  442         (3) CRITERIA.—A member, to be designated as a special risk
  443  member, must meet the following criteria:
  444         (f) Effective January 1, 2001, the member must be employed
  445  in one of the following classes and must spend at least 75
  446  percent of his or her time performing duties which involve
  447  contact with patients or inmates in a correctional or forensic
  448  facility or institution:
  449         1. Dietitian (class codes 5203 and 5204);
  450         2. Public health nutrition consultant (class code 5224);
  451         3. Psychological specialist (class codes 5230 and 5231);
  452         4. Psychologist (class code 5234);
  453         5. Senior psychologist (class codes 5237 and 5238);
  454         6. Regional mental health consultant (class code 5240);
  455         7. Psychological Services Director—DCF (class code 5242);
  456         8. Pharmacist (class codes 5245 and 5246);
  457         9. Senior pharmacist (class codes 5248 and 5249);
  458         10. Dentist (class code 5266);
  459         11. Senior dentist (class code 5269);
  460         12. Registered nurse (class codes 5290 and 5291);
  461         13. Senior registered nurse (class codes 5292 and 5293);
  462         14. Registered nurse specialist (class codes 5294 and
  463  5295);
  464         15. Clinical associate (class codes 5298 and 5299);
  465         16. Advanced practice registered nurse Advanced registered
  466  nurse practitioner (class codes 5297 and 5300);
  467         17. Advanced practice registered nurse Advanced registered
  468  nurse practitioner specialist (class codes 5304 and 5305);
  469         18. Registered nurse supervisor (class codes 5306 and
  470  5307);
  471         19. Senior registered nurse supervisor (class codes 5308
  472  and 5309);
  473         20. Registered nursing consultant (class codes 5312 and
  474  5313);
  475         21. Quality management program supervisor (class code
  476  5314);
  477         22. Executive nursing director (class codes 5320 and 5321);
  478         23. Speech and hearing therapist (class code 5406); or
  479         24. Pharmacy manager (class code 5251);
  480         Section 11. Effective October 1, 2018, paragraph (a) of
  481  subsection (3) of section 252.515, Florida Statutes, is amended
  482  to read:
  483         252.515 Postdisaster Relief Assistance Act; immunity from
  484  civil liability.—
  485         (3) As used in this section, the term:
  486         (a) “Emergency first responder” means:
  487         1. A physician licensed under chapter 458.
  488         2. An osteopathic physician licensed under chapter 459.
  489         3. A chiropractic physician licensed under chapter 460.
  490         4. A podiatric physician licensed under chapter 461.
  491         5. A dentist licensed under chapter 466.
  492         6. An advanced practice registered nurse licensed advanced
  493  registered nurse practitioner certified under s. 464.012.
  494         7. A physician assistant licensed under s. 458.347 or s.
  495  459.022.
  496         8. A worker employed by a public or private hospital in the
  497  state.
  498         9. A paramedic as defined in s. 401.23(17).
  499         10. An emergency medical technician as defined in s.
  500  401.23(11).
  501         11. A firefighter as defined in s. 633.102.
  502         12. A law enforcement officer as defined in s. 943.10.
  503         13. A member of the Florida National Guard.
  504         14. Any other personnel designated as emergency personnel
  505  by the Governor pursuant to a declared emergency.
  506         Section 12. Effective October 1, 2018, paragraph (c) of
  507  subsection (1) of section 310.071, Florida Statutes, is amended
  508  to read:
  509         310.071 Deputy pilot certification.—
  510         (1) In addition to meeting other requirements specified in
  511  this chapter, each applicant for certification as a deputy pilot
  512  must:
  513         (c) Be in good physical and mental health, as evidenced by
  514  documentary proof of having satisfactorily passed a complete
  515  physical examination administered by a licensed physician within
  516  the preceding 6 months. The board shall adopt rules to establish
  517  requirements for passing the physical examination, which rules
  518  shall establish minimum standards for the physical or mental
  519  capabilities necessary to carry out the professional duties of a
  520  certificated deputy pilot. Such standards shall include zero
  521  tolerance for any controlled substance regulated under chapter
  522  893 unless that individual is under the care of a physician, an
  523  advanced practice registered nurse advanced registered nurse
  524  practitioner, or a physician assistant and that controlled
  525  substance was prescribed by that physician, advanced practice
  526  registered nurse advanced registered nurse practitioner, or
  527  physician assistant. To maintain eligibility as a certificated
  528  deputy pilot, each certificated deputy pilot must annually
  529  provide documentary proof of having satisfactorily passed a
  530  complete physical examination administered by a licensed
  531  physician. The physician must know the minimum standards and
  532  certify that the certificateholder satisfactorily meets the
  533  standards. The standards for certificateholders shall include a
  534  drug test.
  535         Section 13. Effective October 1, 2018, subsection (3) of
  536  section 310.073, Florida Statutes, is amended to read:
  537         310.073 State pilot licensing.—In addition to meeting other
  538  requirements specified in this chapter, each applicant for
  539  license as a state pilot must:
  540         (3) Be in good physical and mental health, as evidenced by
  541  documentary proof of having satisfactorily passed a complete
  542  physical examination administered by a licensed physician within
  543  the preceding 6 months. The board shall adopt rules to establish
  544  requirements for passing the physical examination, which rules
  545  shall establish minimum standards for the physical or mental
  546  capabilities necessary to carry out the professional duties of a
  547  licensed state pilot. Such standards shall include zero
  548  tolerance for any controlled substance regulated under chapter
  549  893 unless that individual is under the care of a physician, an
  550  advanced practice registered nurse advanced registered nurse
  551  practitioner, or a physician assistant and that controlled
  552  substance was prescribed by that physician, advanced practice
  553  registered nurse advanced registered nurse practitioner, or
  554  physician assistant. To maintain eligibility as a licensed state
  555  pilot, each licensed state pilot must annually provide
  556  documentary proof of having satisfactorily passed a complete
  557  physical examination administered by a licensed physician. The
  558  physician must know the minimum standards and certify that the
  559  licensee satisfactorily meets the standards. The standards for
  560  licensees shall include a drug test.
  561         Section 14. Effective October 1, 2018, paragraph (b) of
  562  subsection (3) of section 310.081, Florida Statutes, is amended
  563  to read:
  564         310.081 Department to examine and license state pilots and
  565  certificate deputy pilots; vacancies.—
  566         (3) Pilots shall hold their licenses or certificates
  567  pursuant to the requirements of this chapter so long as they:
  568         (b) Are in good physical and mental health as evidenced by
  569  documentary proof of having satisfactorily passed a physical
  570  examination administered by a licensed physician or physician
  571  assistant within each calendar year. The board shall adopt rules
  572  to establish requirements for passing the physical examination,
  573  which rules shall establish minimum standards for the physical
  574  or mental capabilities necessary to carry out the professional
  575  duties of a licensed state pilot or a certificated deputy pilot.
  576  Such standards shall include zero tolerance for any controlled
  577  substance regulated under chapter 893 unless that individual is
  578  under the care of a physician, an advanced practice registered
  579  nurse advanced registered nurse practitioner, or a physician
  580  assistant and that controlled substance was prescribed by that
  581  physician, advanced practice registered nurse advanced
  582  registered nurse practitioner, or physician assistant. To
  583  maintain eligibility as a certificated deputy pilot or licensed
  584  state pilot, each certificated deputy pilot or licensed state
  585  pilot must annually provide documentary proof of having
  586  satisfactorily passed a complete physical examination
  587  administered by a licensed physician. The physician must know
  588  the minimum standards and certify that the certificateholder or
  589  licensee satisfactorily meets the standards. The standards for
  590  certificateholders and for licensees shall include a drug test.
  591  
  592  Upon resignation or in the case of disability permanently
  593  affecting a pilot’s ability to serve, the state license or
  594  certificate issued under this chapter shall be revoked by the
  595  department.
  596         Section 15. Effective October 1, 2018, paragraph (b) of
  597  subsection (1) of section 320.0848, Florida Statutes, is amended
  598  to read:
  599         320.0848 Persons who have disabilities; issuance of
  600  disabled parking permits; temporary permits; permits for certain
  601  providers of transportation services to persons who have
  602  disabilities.—
  603         (1)
  604         (b)1. The person must be currently certified as being
  605  legally blind or as having any of the following disabilities
  606  that render him or her unable to walk 200 feet without stopping
  607  to rest:
  608         a. Inability to walk without the use of or assistance from
  609  a brace, cane, crutch, prosthetic device, or other assistive
  610  device, or without the assistance of another person. If the
  611  assistive device significantly restores the person’s ability to
  612  walk to the extent that the person can walk without severe
  613  limitation, the person is not eligible for the exemption parking
  614  permit.
  615         b. The need to permanently use a wheelchair.
  616         c. Restriction by lung disease to the extent that the
  617  person’s forced (respiratory) expiratory volume for 1 second,
  618  when measured by spirometry, is less than 1 liter, or the
  619  person’s arterial oxygen is less than 60 mm/hg on room air at
  620  rest.
  621         d. Use of portable oxygen.
  622         e. Restriction by cardiac condition to the extent that the
  623  person’s functional limitations are classified in severity as
  624  Class III or Class IV according to standards set by the American
  625  Heart Association.
  626         f. Severe limitation in the person’s ability to walk due to
  627  an arthritic, neurological, or orthopedic condition.
  628         2. The certification of disability which is required under
  629  subparagraph 1. must be provided by a physician licensed under
  630  chapter 458, chapter 459, or chapter 460, by a podiatric
  631  physician licensed under chapter 461, by an optometrist licensed
  632  under chapter 463, by an advanced practice registered nurse
  633  advanced registered nurse practitioner licensed under chapter
  634  464 under the protocol of a licensed physician as stated in this
  635  subparagraph, by a physician assistant licensed under chapter
  636  458 or chapter 459, or by a similarly licensed physician from
  637  another state if the application is accompanied by documentation
  638  of the physician’s licensure in the other state and a form
  639  signed by the out-of-state physician verifying his or her
  640  knowledge of this state’s eligibility guidelines.
  641         Section 16. Effective October 1, 2018, paragraph (c) of
  642  subsection (1) of section 381.00315, Florida Statutes, is
  643  amended to read:
  644         381.00315 Public health advisories; public health
  645  emergencies; isolation and quarantines.—The State Health Officer
  646  is responsible for declaring public health emergencies, issuing
  647  public health advisories, and ordering isolation or quarantines.
  648         (1) As used in this section, the term:
  649         (c) “Public health emergency” means any occurrence, or
  650  threat thereof, whether natural or manmade, which results or may
  651  result in substantial injury or harm to the public health from
  652  infectious disease, chemical agents, nuclear agents, biological
  653  toxins, or situations involving mass casualties or natural
  654  disasters. Before declaring a public health emergency, the State
  655  Health Officer shall, to the extent possible, consult with the
  656  Governor and shall notify the Chief of Domestic Security. The
  657  declaration of a public health emergency shall continue until
  658  the State Health Officer finds that the threat or danger has
  659  been dealt with to the extent that the emergency conditions no
  660  longer exist and he or she terminates the declaration. However,
  661  a declaration of a public health emergency may not continue for
  662  longer than 60 days unless the Governor concurs in the renewal
  663  of the declaration. The State Health Officer, upon declaration
  664  of a public health emergency, may take actions that are
  665  necessary to protect the public health. Such actions include,
  666  but are not limited to:
  667         1. Directing manufacturers of prescription drugs or over
  668  the-counter drugs who are permitted under chapter 499 and
  669  wholesalers of prescription drugs located in this state who are
  670  permitted under chapter 499 to give priority to the shipping of
  671  specified drugs to pharmacies and health care providers within
  672  geographic areas that have been identified by the State Health
  673  Officer. The State Health Officer must identify the drugs to be
  674  shipped. Manufacturers and wholesalers located in the state must
  675  respond to the State Health Officer’s priority shipping
  676  directive before shipping the specified drugs.
  677         2. Notwithstanding chapters 465 and 499 and rules adopted
  678  thereunder, directing pharmacists employed by the department to
  679  compound bulk prescription drugs and provide these bulk
  680  prescription drugs to physicians and nurses of county health
  681  departments or any qualified person authorized by the State
  682  Health Officer for administration to persons as part of a
  683  prophylactic or treatment regimen.
  684         3. Notwithstanding s. 456.036, temporarily reactivating the
  685  inactive license of the following health care practitioners,
  686  when such practitioners are needed to respond to the public
  687  health emergency: physicians licensed under chapter 458 or
  688  chapter 459; physician assistants licensed under chapter 458 or
  689  chapter 459; licensed practical nurses, registered nurses, and
  690  advanced practice registered nurses advanced registered nurse
  691  practitioners licensed under part I of chapter 464; respiratory
  692  therapists licensed under part V of chapter 468; and emergency
  693  medical technicians and paramedics certified under part III of
  694  chapter 401. Only those health care practitioners specified in
  695  this paragraph who possess an unencumbered inactive license and
  696  who request that such license be reactivated are eligible for
  697  reactivation. An inactive license that is reactivated under this
  698  paragraph shall return to inactive status when the public health
  699  emergency ends or before the end of the public health emergency
  700  if the State Health Officer determines that the health care
  701  practitioner is no longer needed to provide services during the
  702  public health emergency. Such licenses may only be reactivated
  703  for a period not to exceed 90 days without meeting the
  704  requirements of s. 456.036 or chapter 401, as applicable.
  705         4. Ordering an individual to be examined, tested,
  706  vaccinated, treated, isolated, or quarantined for communicable
  707  diseases that have significant morbidity or mortality and
  708  present a severe danger to public health. Individuals who are
  709  unable or unwilling to be examined, tested, vaccinated, or
  710  treated for reasons of health, religion, or conscience may be
  711  subjected to isolation or quarantine.
  712         a. Examination, testing, vaccination, or treatment may be
  713  performed by any qualified person authorized by the State Health
  714  Officer.
  715         b. If the individual poses a danger to the public health,
  716  the State Health Officer may subject the individual to isolation
  717  or quarantine. If there is no practical method to isolate or
  718  quarantine the individual, the State Health Officer may use any
  719  means necessary to vaccinate or treat the individual.
  720  
  721  Any order of the State Health Officer given to effectuate this
  722  paragraph shall be immediately enforceable by a law enforcement
  723  officer under s. 381.0012.
  724         Section 17. Effective October 1, 2018, subsection (3) of
  725  section 381.00593, Florida Statutes, is amended to read:
  726         381.00593 Public school volunteer health care practitioner
  727  program.—
  728         (3) For purposes of this section, the term “health care
  729  practitioner” means a physician licensed under chapter 458; an
  730  osteopathic physician licensed under chapter 459; a chiropractic
  731  physician licensed under chapter 460; a podiatric physician
  732  licensed under chapter 461; an optometrist licensed under
  733  chapter 463; an advanced practice registered nurse advanced
  734  registered nurse practitioner, registered nurse, or licensed
  735  practical nurse licensed under part I of chapter 464; a
  736  pharmacist licensed under chapter 465; a dentist or dental
  737  hygienist licensed under chapter 466; a midwife licensed under
  738  chapter 467; a speech-language pathologist or audiologist
  739  licensed under part I of chapter 468; a dietitian/nutritionist
  740  licensed under part X of chapter 468; or a physical therapist
  741  licensed under chapter 486.
  742         Section 18. Effective October 1, 2018, paragraph (c) of
  743  subsection (1) of section 383.14, Florida Statutes, is amended
  744  to read:
  745         383.14 Screening for metabolic disorders, other hereditary
  746  and congenital disorders, and environmental risk factors.—
  747         (1) SCREENING REQUIREMENTS.—To help ensure access to the
  748  maternal and child health care system, the Department of Health
  749  shall promote the screening of all newborns born in Florida for
  750  metabolic, hereditary, and congenital disorders known to result
  751  in significant impairment of health or intellect, as screening
  752  programs accepted by current medical practice become available
  753  and practical in the judgment of the department. The department
  754  shall also promote the identification and screening of all
  755  newborns in this state and their families for environmental risk
  756  factors such as low income, poor education, maternal and family
  757  stress, emotional instability, substance abuse, and other high
  758  risk conditions associated with increased risk of infant
  759  mortality and morbidity to provide early intervention,
  760  remediation, and prevention services, including, but not limited
  761  to, parent support and training programs, home visitation, and
  762  case management. Identification, perinatal screening, and
  763  intervention efforts shall begin prior to and immediately
  764  following the birth of the child by the attending health care
  765  provider. Such efforts shall be conducted in hospitals,
  766  perinatal centers, county health departments, school health
  767  programs that provide prenatal care, and birthing centers, and
  768  reported to the Office of Vital Statistics.
  769         (c) Release of screening results.—Notwithstanding any law
  770  to the contrary, the State Public Health Laboratory may release,
  771  directly or through the Children’s Medical Services program, the
  772  results of a newborn’s hearing and metabolic tests or screenings
  773  to the newborn’s health care practitioner, the newborn’s parent
  774  or legal guardian, the newborn’s personal representative, or a
  775  person designated by the newborn’s parent or legal guardian. As
  776  used in this paragraph, the term “health care practitioner”
  777  means a physician or physician assistant licensed under chapter
  778  458; an osteopathic physician or physician assistant licensed
  779  under chapter 459; an advanced practice registered nurse
  780  advanced registered nurse practitioner, registered nurse, or
  781  licensed practical nurse licensed under part I of chapter 464; a
  782  midwife licensed under chapter 467; a speech-language
  783  pathologist or audiologist licensed under part I of chapter 468;
  784  or a dietician or nutritionist licensed under part X of chapter
  785  468.
  786         Section 19. Effective October 1, 2018, paragraph (c) of
  787  subsection (1) of section 383.141, Florida Statutes, is amended
  788  to read:
  789         383.141 Prenatally diagnosed conditions; patient to be
  790  provided information; definitions; information clearinghouse;
  791  advisory council.—
  792         (1) As used in this section, the term:
  793         (c) “Health care provider” means a practitioner licensed or
  794  registered under chapter 458 or chapter 459 or an advanced
  795  practice registered nurse licensed advanced registered nurse
  796  practitioner certified under chapter 464.
  797         Section 20. Effective October 1, 2018, paragraph (a) of
  798  subsection (7) of section 384.27, Florida Statutes, is amended
  799  to read:
  800         384.27 Physical examination and treatment.—
  801         (7)(a) A health care practitioner licensed under chapter
  802  458, or chapter 459, or certified under s. 464.012 may provide
  803  expedited partner therapy if the following requirements are met:
  804         1. The patient has a laboratory-confirmed or suspected
  805  clinical diagnosis of a sexually transmissible disease.
  806         2. The patient indicates that he or she has a partner with
  807  whom he or she engaged in sexual activity before the diagnosis
  808  of the sexually transmissible disease.
  809         3. The patient indicates that his or her partner is unable
  810  or unlikely to seek clinical services in a timely manner.
  811         Section 21. Effective October 1, 2018, paragraph (a) of
  812  subsection (3) of section 390.0111, Florida Statutes, is amended
  813  to read:
  814         390.0111 Termination of pregnancies.—
  815         (3) CONSENTS REQUIRED.—A termination of pregnancy may not
  816  be performed or induced except with the voluntary and informed
  817  written consent of the pregnant woman or, in the case of a
  818  mental incompetent, the voluntary and informed written consent
  819  of her court-appointed guardian.
  820         (a) Except in the case of a medical emergency, consent to a
  821  termination of pregnancy is voluntary and informed only if:
  822         1. The physician who is to perform the procedure, or the
  823  referring physician, has, at a minimum, orally, while physically
  824  present in the same room, and at least 24 hours before the
  825  procedure, informed the woman of:
  826         a. The nature and risks of undergoing or not undergoing the
  827  proposed procedure that a reasonable patient would consider
  828  material to making a knowing and willful decision of whether to
  829  terminate a pregnancy.
  830         b. The probable gestational age of the fetus, verified by
  831  an ultrasound, at the time the termination of pregnancy is to be
  832  performed.
  833         (I) The ultrasound must be performed by the physician who
  834  is to perform the abortion or by a person having documented
  835  evidence that he or she has completed a course in the operation
  836  of ultrasound equipment as prescribed by rule and who is working
  837  in conjunction with the physician.
  838         (II) The person performing the ultrasound must offer the
  839  woman the opportunity to view the live ultrasound images and
  840  hear an explanation of them. If the woman accepts the
  841  opportunity to view the images and hear the explanation, a
  842  physician or a registered nurse, licensed practical nurse,
  843  advanced practice registered nurse advanced registered nurse
  844  practitioner, or physician assistant working in conjunction with
  845  the physician must contemporaneously review and explain the
  846  images to the woman before the woman gives informed consent to
  847  having an abortion procedure performed.
  848         (III) The woman has a right to decline to view and hear the
  849  explanation of the live ultrasound images after she is informed
  850  of her right and offered an opportunity to view the images and
  851  hear the explanation. If the woman declines, the woman shall
  852  complete a form acknowledging that she was offered an
  853  opportunity to view and hear the explanation of the images but
  854  that she declined that opportunity. The form must also indicate
  855  that the woman’s decision was not based on any undue influence
  856  from any person to discourage her from viewing the images or
  857  hearing the explanation and that she declined of her own free
  858  will.
  859         (IV) Unless requested by the woman, the person performing
  860  the ultrasound may not offer the opportunity to view the images
  861  and hear the explanation and the explanation may not be given
  862  if, at the time the woman schedules or arrives for her
  863  appointment to obtain an abortion, a copy of a restraining
  864  order, police report, medical record, or other court order or
  865  documentation is presented which provides evidence that the
  866  woman is obtaining the abortion because the woman is a victim of
  867  rape, incest, domestic violence, or human trafficking or that
  868  the woman has been diagnosed as having a condition that, on the
  869  basis of a physician’s good faith clinical judgment, would
  870  create a serious risk of substantial and irreversible impairment
  871  of a major bodily function if the woman delayed terminating her
  872  pregnancy.
  873         c. The medical risks to the woman and fetus of carrying the
  874  pregnancy to term.
  875  
  876  The physician may provide the information required in this
  877  subparagraph within 24 hours before the procedure if requested
  878  by the woman at the time she schedules or arrives for her
  879  appointment to obtain an abortion and if she presents to the
  880  physician a copy of a restraining order, police report, medical
  881  record, or other court order or documentation evidencing that
  882  she is obtaining the abortion because she is a victim of rape,
  883  incest, domestic violence, or human trafficking.
  884         2. Printed materials prepared and provided by the
  885  department have been provided to the pregnant woman, if she
  886  chooses to view these materials, including:
  887         a. A description of the fetus, including a description of
  888  the various stages of development.
  889         b. A list of entities that offer alternatives to
  890  terminating the pregnancy.
  891         c. Detailed information on the availability of medical
  892  assistance benefits for prenatal care, childbirth, and neonatal
  893  care.
  894         3. The woman acknowledges in writing, before the
  895  termination of pregnancy, that the information required to be
  896  provided under this subsection has been provided.
  897  
  898  Nothing in this paragraph is intended to prohibit a physician
  899  from providing any additional information which the physician
  900  deems material to the woman’s informed decision to terminate her
  901  pregnancy.
  902         Section 22. Effective October 1, 2018, paragraphs (c), (e),
  903  and (f) of subsection (3) of section 390.012, Florida Statutes,
  904  are amended to read:
  905         390.012 Powers of agency; rules; disposal of fetal
  906  remains.—
  907         (3) For clinics that perform or claim to perform abortions
  908  after the first trimester of pregnancy, the agency shall adopt
  909  rules pursuant to ss. 120.536(1) and 120.54 to implement the
  910  provisions of this chapter, including the following:
  911         (c) Rules relating to abortion clinic personnel. At a
  912  minimum, these rules shall require that:
  913         1. The abortion clinic designate a medical director who is
  914  licensed to practice medicine in this state, and all physicians
  915  who perform abortions in the clinic have admitting privileges at
  916  a hospital within reasonable proximity to the clinic, unless the
  917  clinic has a written patient transfer agreement with a hospital
  918  within reasonable proximity to the clinic which includes the
  919  transfer of the patient’s medical records held by both the
  920  clinic and the treating physician.
  921         2. If a physician is not present after an abortion is
  922  performed, a registered nurse, licensed practical nurse,
  923  advanced practice registered nurse advanced registered nurse
  924  practitioner, or physician assistant be present and remain at
  925  the clinic to provide postoperative monitoring and care until
  926  the patient is discharged.
  927         3. Surgical assistants receive training in counseling,
  928  patient advocacy, and the specific responsibilities associated
  929  with the services the surgical assistants provide.
  930         4. Volunteers receive training in the specific
  931  responsibilities associated with the services the volunteers
  932  provide, including counseling and patient advocacy as provided
  933  in the rules adopted by the director for different types of
  934  volunteers based on their responsibilities.
  935         (e) Rules relating to the abortion procedure. At a minimum,
  936  these rules shall require:
  937         1. That a physician, registered nurse, licensed practical
  938  nurse, advanced practice registered nurse advanced registered
  939  nurse practitioner, or physician assistant is available to all
  940  patients throughout the abortion procedure.
  941         2. Standards for the safe conduct of abortion procedures
  942  that conform to obstetric standards in keeping with established
  943  standards of care regarding the estimation of fetal age as
  944  defined in rule.
  945         3. Appropriate use of general and local anesthesia,
  946  analgesia, and sedation if ordered by the physician.
  947         4. Appropriate precautions, such as the establishment of
  948  intravenous access at least for patients undergoing post-first
  949  trimester abortions.
  950         5. Appropriate monitoring of the vital signs and other
  951  defined signs and markers of the patient’s status throughout the
  952  abortion procedure and during the recovery period until the
  953  patient’s condition is deemed to be stable in the recovery room.
  954         (f) Rules that prescribe minimum recovery room standards.
  955  At a minimum, these rules must require that:
  956         1. Postprocedure recovery rooms be supervised and staffed
  957  to meet the patients’ needs.
  958         2. Immediate postprocedure care consist of observation in a
  959  supervised recovery room for as long as the patient’s condition
  960  warrants.
  961         3. A registered nurse, licensed practical nurse, advanced
  962  practice registered nurse advanced registered nurse
  963  practitioner, or physician assistant who is trained in the
  964  management of the recovery area and is capable of providing
  965  basic cardiopulmonary resuscitation and related emergency
  966  procedures remain on the premises of the abortion clinic until
  967  all patients are discharged.
  968         4. A physician sign the discharge order and be readily
  969  accessible and available until the last patient is discharged to
  970  facilitate the transfer of emergency cases if hospitalization of
  971  the patient or viable fetus is necessary.
  972         5. A physician discuss Rho(D) immune globulin with each
  973  patient for whom it is indicated and ensure that it is offered
  974  to the patient in the immediate postoperative period or will be
  975  available to her within 72 hours after completion of the
  976  abortion procedure. If the patient refuses the Rho(D) immune
  977  globulin, she and a witness must sign a refusal form approved by
  978  the agency which must be included in the medical record.
  979         6. Written instructions with regard to postabortion coitus,
  980  signs of possible problems, and general aftercare which are
  981  specific to the patient be given to each patient. The
  982  instructions must include information regarding access to
  983  medical care for complications, including a telephone number for
  984  use in the event of a medical emergency.
  985         7. A minimum length of time be specified, by type of
  986  abortion procedure and duration of gestation, during which a
  987  patient must remain in the recovery room.
  988         8. The physician ensure that, with the patient’s consent, a
  989  registered nurse, licensed practical nurse, advanced practice
  990  registered nurse advanced registered nurse practitioner, or
  991  physician assistant from the abortion clinic makes a good faith
  992  effort to contact the patient by telephone within 24 hours after
  993  surgery to assess the patient’s recovery.
  994         9. Equipment and services be readily accessible to provide
  995  appropriate emergency resuscitative and life support procedures
  996  pending the transfer of the patient or viable fetus to the
  997  hospital.
  998         Section 23. Effective October 1, 2018, subsections (35) and
  999  (44) of section 394.455, Florida Statutes, are amended to read:
 1000         394.455 Definitions.—As used in this part, the term:
 1001         (35) “Psychiatric nurse” means an advanced practice
 1002  registered nurse licensed advanced registered nurse practitioner
 1003  certified under s. 464.012 who has a master’s or doctoral degree
 1004  in psychiatric nursing, holds a national advanced practice
 1005  certification as a psychiatric mental health advanced practice
 1006  nurse, and has 2 years of post-master’s clinical experience
 1007  under the supervision of a physician.
 1008         (44) “Service provider” means a receiving facility, a
 1009  facility licensed under chapter 397, a treatment facility, an
 1010  entity under contract with the department to provide mental
 1011  health or substance abuse services, a community mental health
 1012  center or clinic, a psychologist, a clinical social worker, a
 1013  marriage and family therapist, a mental health counselor, a
 1014  physician, a psychiatrist, an advanced practice registered nurse
 1015  advanced registered nurse practitioner, a psychiatric nurse, or
 1016  a qualified professional as defined in s. 39.01.
 1017         Section 24. Effective October 1, 2018, paragraphs (a) and
 1018  (b) of subsection (2) and subsection (4) of section 395.0191,
 1019  Florida Statutes, are amended to read:
 1020         395.0191 Staff membership and clinical privileges.—
 1021         (2)(a) Each licensed facility shall establish rules and
 1022  procedures for consideration of an application for clinical
 1023  privileges submitted by an advanced practice registered nurse
 1024  advanced registered nurse practitioner licensed and certified
 1025  under part I of chapter 464, in accordance with the provisions
 1026  of this section. No licensed facility shall deny such
 1027  application solely because the applicant is licensed under part
 1028  I of chapter 464 or because the applicant is not a participant
 1029  in the Florida Birth-Related Neurological Injury Compensation
 1030  Plan.
 1031         (b) An advanced practice registered nurse advanced
 1032  registered nurse practitioner who is certified as a registered
 1033  nurse anesthetist licensed under part I of chapter 464 shall
 1034  administer anesthesia under the onsite medical direction of a
 1035  professional licensed under chapter 458, chapter 459, or chapter
 1036  466, and in accordance with an established protocol approved by
 1037  the medical staff. The medical direction shall specifically
 1038  address the needs of the individual patient.
 1039         (4) Nothing herein shall restrict in any way the authority
 1040  of the medical staff of a licensed facility to review for
 1041  approval or disapproval all applications for appointment and
 1042  reappointment to all categories of staff and to make
 1043  recommendations on each applicant to the governing board,
 1044  including the delineation of privileges to be granted in each
 1045  case. In making such recommendations and in the delineation of
 1046  privileges, each applicant shall be considered individually
 1047  pursuant to criteria for a doctor licensed under chapter 458,
 1048  chapter 459, chapter 461, or chapter 466, or for an advanced
 1049  practice registered nurse advanced registered nurse practitioner
 1050  licensed and certified under part I of chapter 464, or for a
 1051  psychologist licensed under chapter 490, as applicable. The
 1052  applicant’s eligibility for staff membership or clinical
 1053  privileges shall be determined by the applicant’s background,
 1054  experience, health, training, and demonstrated competency; the
 1055  applicant’s adherence to applicable professional ethics; the
 1056  applicant’s reputation; and the applicant’s ability to work with
 1057  others and by such other elements as determined by the governing
 1058  board, consistent with this part.
 1059         Section 25. Effective October 1, 2018, subsection (34) of
 1060  section 397.311, Florida Statutes, is amended to read:
 1061         397.311 Definitions.—As used in this chapter, except part
 1062  VIII, the term:
 1063         (34) “Qualified professional” means a physician or a
 1064  physician assistant licensed under chapter 458 or chapter 459; a
 1065  professional licensed under chapter 490 or chapter 491; an
 1066  advanced practice registered nurse advanced registered nurse
 1067  practitioner licensed under part I of chapter 464; or a person
 1068  who is certified through a department-recognized certification
 1069  process for substance abuse treatment services and who holds, at
 1070  a minimum, a bachelor’s degree. A person who is certified in
 1071  substance abuse treatment services by a state-recognized
 1072  certification process in another state at the time of employment
 1073  with a licensed substance abuse provider in this state may
 1074  perform the functions of a qualified professional as defined in
 1075  this chapter but must meet certification requirements contained
 1076  in this subsection no later than 1 year after his or her date of
 1077  employment.
 1078         Section 26. Effective October 1, 2018, section 397.4012,
 1079  Florida Statutes, is amended to read:
 1080         397.4012 Exemptions from licensure.—The following are
 1081  exempt from the licensing provisions of this chapter:
 1082         (1) A hospital or hospital-based component licensed under
 1083  chapter 395.
 1084         (2) A nursing home facility as defined in s. 400.021.
 1085         (3) A substance abuse education program established
 1086  pursuant to s. 1003.42.
 1087         (4) A facility or institution operated by the Federal
 1088  Government.
 1089         (5) A physician or physician assistant licensed under
 1090  chapter 458 or chapter 459.
 1091         (6) A psychologist licensed under chapter 490.
 1092         (7) A social worker, marriage and family therapist, or
 1093  mental health counselor licensed under chapter 491.
 1094         (8) A legally cognizable church or nonprofit religious
 1095  organization or denomination providing substance abuse services,
 1096  including prevention services, which are solely religious,
 1097  spiritual, or ecclesiastical in nature. A church or nonprofit
 1098  religious organization or denomination providing any of the
 1099  licensed service components itemized under s. 397.311(26) is not
 1100  exempt from substance abuse licensure but retains its exemption
 1101  with respect to all services which are solely religious,
 1102  spiritual, or ecclesiastical in nature.
 1103         (9) Facilities licensed under chapter 393 which, in
 1104  addition to providing services to persons with developmental
 1105  disabilities, also provide services to persons developmentally
 1106  at risk as a consequence of exposure to alcohol or other legal
 1107  or illegal drugs while in utero.
 1108         (10) DUI education and screening services provided pursuant
 1109  to ss. 316.192, 316.193, 322.095, 322.271, and 322.291. Persons
 1110  or entities providing treatment services must be licensed under
 1111  this chapter unless exempted from licensing as provided in this
 1112  section.
 1113         (11) A facility licensed under s. 394.875 as a crisis
 1114  stabilization unit.
 1115  
 1116  The exemptions from licensure in this section do not apply to
 1117  any service provider that receives an appropriation, grant, or
 1118  contract from the state to operate as a service provider as
 1119  defined in this chapter or to any substance abuse program
 1120  regulated pursuant to s. 397.4014. Furthermore, this chapter may
 1121  not be construed to limit the practice of a physician or
 1122  physician assistant licensed under chapter 458 or chapter 459, a
 1123  psychologist licensed under chapter 490, a psychotherapist
 1124  licensed under chapter 491, or an advanced practice registered
 1125  nurse advanced registered nurse practitioner licensed under part
 1126  I of chapter 464, who provides substance abuse treatment, so
 1127  long as the physician, physician assistant, psychologist,
 1128  psychotherapist, or advanced practice registered nurse advanced
 1129  registered nurse practitioner does not represent to the public
 1130  that he or she is a licensed service provider and does not
 1131  provide services to individuals pursuant to part V of this
 1132  chapter. Failure to comply with any requirement necessary to
 1133  maintain an exempt status under this section is a misdemeanor of
 1134  the first degree, punishable as provided in s. 775.082 or s.
 1135  775.083.
 1136         Section 27. Effective October 1, 2018, subsections (4),
 1137  (7), and (8) of section 397.427, Florida Statutes, are amended
 1138  to read:
 1139         397.427 Medication-assisted treatment service providers;
 1140  rehabilitation program; needs assessment and provision of
 1141  services; persons authorized to issue takeout medication;
 1142  unlawful operation; penalty.—
 1143         (4) Notwithstanding s. 465.019(2), a physician assistant, a
 1144  registered nurse, an advanced practice registered nurse advanced
 1145  registered nurse practitioner, or a licensed practical nurse
 1146  working for a licensed service provider may deliver takeout
 1147  medication for opiate treatment to persons enrolled in a
 1148  maintenance treatment program for medication-assisted treatment
 1149  for opiate addiction if:
 1150         (a) The medication-assisted treatment program for opiate
 1151  addiction has an appropriate valid permit issued pursuant to
 1152  rules adopted by the Board of Pharmacy;
 1153         (b) The medication for treatment of opiate addiction has
 1154  been delivered pursuant to a valid prescription written by the
 1155  program’s physician licensed pursuant to chapter 458 or chapter
 1156  459;
 1157         (c) The medication for treatment of opiate addiction which
 1158  is ordered appears on a formulary and is prepackaged and
 1159  prelabeled with dosage instructions and distributed from a
 1160  source authorized under chapter 499;
 1161         (d) Each licensed provider adopts written protocols which
 1162  provide for supervision of the physician assistant, registered
 1163  nurse, advanced practice registered nurse advanced registered
 1164  nurse practitioner, or licensed practical nurse by a physician
 1165  licensed pursuant to chapter 458 or chapter 459 and for the
 1166  procedures by which patients’ medications may be delivered by
 1167  the physician assistant, registered nurse, advanced practice
 1168  registered nurse advanced registered nurse practitioner, or
 1169  licensed practical nurse. Such protocols shall be signed by the
 1170  supervising physician and either the administering registered
 1171  nurse, the advanced practice registered nurse advanced
 1172  registered nurse practitioner, or the licensed practical nurse.
 1173         (e) Each licensed service provider maintains and has
 1174  available for inspection by representatives of the Board of
 1175  Pharmacy all medical records and patient care protocols,
 1176  including records of medications delivered to patients, in
 1177  accordance with the board.
 1178         (7) A physician assistant, a registered nurse, an advanced
 1179  practice registered nurse advanced registered nurse
 1180  practitioner, or a licensed practical nurse working for a
 1181  licensed service provider may deliver medication as prescribed
 1182  by rule if:
 1183         (a) The service provider is authorized to provide
 1184  medication-assisted treatment;
 1185         (b) The medication has been administered pursuant to a
 1186  valid prescription written by the program’s physician who is
 1187  licensed under chapter 458 or chapter 459; and
 1188         (c) The medication ordered appears on a formulary or meets
 1189  federal requirements for medication-assisted treatment.
 1190         (8) Each licensed service provider that provides
 1191  medication-assisted treatment must adopt written protocols as
 1192  specified by the department and in accordance with federally
 1193  required rules, regulations, or procedures. The protocol shall
 1194  provide for the supervision of the physician assistant,
 1195  registered nurse, advanced practice registered nurse advanced
 1196  registered nurse practitioner, or licensed practical nurse
 1197  working under the supervision of a physician who is licensed
 1198  under chapter 458 or chapter 459. The protocol must specify how
 1199  the medication will be used in conjunction with counseling or
 1200  psychosocial treatment and that the services provided will be
 1201  included on the treatment plan. The protocol must specify the
 1202  procedures by which medication-assisted treatment may be
 1203  administered by the physician assistant, registered nurse,
 1204  advanced practice registered nurse advanced registered nurse
 1205  practitioner, or licensed practical nurse. These protocols shall
 1206  be signed by the supervising physician and the administering
 1207  physician assistant, registered nurse, advanced practice
 1208  registered nurse advanced registered nurse practitioner, or
 1209  licensed practical nurse.
 1210         Section 28. Effective October 1, 2018, section 397.679,
 1211  Florida Statutes, is amended to read:
 1212         397.679 Emergency admission; circumstances justifying.—A
 1213  person who meets the criteria for involuntary admission in s.
 1214  397.675 may be admitted to a hospital or to a licensed
 1215  detoxification facility or addictions receiving facility for
 1216  emergency assessment and stabilization, or to a less intensive
 1217  component of a licensed service provider for assessment only,
 1218  upon receipt by the facility of a certificate by a physician, an
 1219  advanced practice registered nurse advanced registered nurse
 1220  practitioner, a psychiatric nurse, a clinical psychologist, a
 1221  clinical social worker, a marriage and family therapist, a
 1222  mental health counselor, a physician assistant working under the
 1223  scope of practice of the supervising physician, or a master’s
 1224  level-certified addictions professional for substance abuse
 1225  services, if the certificate is specific to substance abuse
 1226  impairment, and the completion of an application for emergency
 1227  admission.
 1228         Section 29. Effective October 1, 2018, subsection (1) of
 1229  section 397.6793, Florida Statutes, is amended to read:
 1230         397.6793 Professional’s certificate for emergency
 1231  admission.—
 1232         (1) A physician, a clinical psychologist, a physician
 1233  assistant working under the scope of practice of the supervising
 1234  physician, a psychiatric nurse, an advanced practice registered
 1235  nurse advanced registered nurse practitioner, a mental health
 1236  counselor, a marriage and family therapist, a master’s-level
 1237  certified addictions professional for substance abuse services,
 1238  or a clinical social worker may execute a professional’s
 1239  certificate for emergency admission. The professional’s
 1240  certificate must include the name of the person to be admitted,
 1241  the relationship between the person and the professional
 1242  executing the certificate, the relationship between the
 1243  applicant and the professional, any relationship between the
 1244  professional and the licensed service provider, a statement that
 1245  the person has been examined and assessed within the preceding 5
 1246  days after the application date, and factual allegations with
 1247  respect to the need for emergency admission, including:
 1248         (a) The reason for the belief that the person is substance
 1249  abuse impaired;
 1250         (b) The reason for the belief that because of such
 1251  impairment the person has lost the power of self-control with
 1252  respect to substance abuse; and
 1253         (c)1. The reason for the belief that, without care or
 1254  treatment, the person is likely to suffer from neglect or refuse
 1255  to care for himself or herself; that such neglect or refusal
 1256  poses a real and present threat of substantial harm to his or
 1257  her well-being; and that it is not apparent that such harm may
 1258  be avoided through the help of willing family members or friends
 1259  or the provision of other services, or there is substantial
 1260  likelihood that the person has inflicted or, unless admitted, is
 1261  likely to inflict, physical harm on himself, herself, or
 1262  another; or
 1263         2. The reason for the belief that the person’s refusal to
 1264  voluntarily receive care is based on judgment so impaired by
 1265  reason of substance abuse that the person is incapable of
 1266  appreciating his or her need for care and of making a rational
 1267  decision regarding his or her need for care.
 1268         Section 30. Effective October 1, 2018, subsection (8) of
 1269  section 400.021, Florida Statutes, is amended to read:
 1270         400.021 Definitions.—When used in this part, unless the
 1271  context otherwise requires, the term:
 1272         (8) “Geriatric outpatient clinic” means a site for
 1273  providing outpatient health care to persons 60 years of age or
 1274  older, which is staffed by a registered nurse, a physician
 1275  assistant, or a licensed practical nurse under the direct
 1276  supervision of a registered nurse, advanced practice registered
 1277  nurse advanced registered nurse practitioner, physician
 1278  assistant, or physician.
 1279         Section 31. Effective October 1, 2018, subsection (3) of
 1280  section 400.462, Florida Statutes, is amended to read:
 1281         400.462 Definitions.—As used in this part, the term:
 1282         (3) “Advanced practice registered nurse” “Advanced
 1283  registered nurse practitioner” means a person licensed in this
 1284  state to practice professional nursing and certified in advanced
 1285  or specialized nursing practice, as defined in s. 464.003.
 1286         Section 32. Effective October 1, 2018, section 400.487,
 1287  Florida Statutes, is amended to read:
 1288         400.487 Home health service agreements; physician’s,
 1289  physician assistant’s, and advanced practice registered nurse’s
 1290  advanced registered nurse practitioner’s treatment orders;
 1291  patient assessment; establishment and review of plan of care;
 1292  provision of services; orders not to resuscitate.—
 1293         (1) Services provided by a home health agency must be
 1294  covered by an agreement between the home health agency and the
 1295  patient or the patient’s legal representative specifying the
 1296  home health services to be provided, the rates or charges for
 1297  services paid with private funds, and the sources of payment,
 1298  which may include Medicare, Medicaid, private insurance,
 1299  personal funds, or a combination thereof. A home health agency
 1300  providing skilled care must make an assessment of the patient’s
 1301  needs within 48 hours after the start of services.
 1302         (2) When required by the provisions of chapter 464; part I,
 1303  part III, or part V of chapter 468; or chapter 486, the
 1304  attending physician, physician assistant, or advanced practice
 1305  registered nurse advanced registered nurse practitioner, acting
 1306  within his or her respective scope of practice, shall establish
 1307  treatment orders for a patient who is to receive skilled care.
 1308  The treatment orders must be signed by the physician, physician
 1309  assistant, or advanced practice registered nurse advanced
 1310  registered nurse practitioner before a claim for payment for the
 1311  skilled services is submitted by the home health agency. If the
 1312  claim is submitted to a managed care organization, the treatment
 1313  orders must be signed within the time allowed under the provider
 1314  agreement. The treatment orders shall be reviewed, as frequently
 1315  as the patient’s illness requires, by the physician, physician
 1316  assistant, or advanced practice registered nurse advanced
 1317  registered nurse practitioner in consultation with the home
 1318  health agency.
 1319         (3) A home health agency shall arrange for supervisory
 1320  visits by a registered nurse to the home of a patient receiving
 1321  home health aide services in accordance with the patient’s
 1322  direction, approval, and agreement to pay the charge for the
 1323  visits.
 1324         (4) Each patient has the right to be informed of and to
 1325  participate in the planning of his or her care. Each patient
 1326  must be provided, upon request, a copy of the plan of care
 1327  established and maintained for that patient by the home health
 1328  agency.
 1329         (5) When nursing services are ordered, the home health
 1330  agency to which a patient has been admitted for care must
 1331  provide the initial admission visit, all service evaluation
 1332  visits, and the discharge visit by a direct employee. Services
 1333  provided by others under contractual arrangements to a home
 1334  health agency must be monitored and managed by the admitting
 1335  home health agency. The admitting home health agency is fully
 1336  responsible for ensuring that all care provided through its
 1337  employees or contract staff is delivered in accordance with this
 1338  part and applicable rules.
 1339         (6) The skilled care services provided by a home health
 1340  agency, directly or under contract, must be supervised and
 1341  coordinated in accordance with the plan of care.
 1342         (7) Home health agency personnel may withhold or withdraw
 1343  cardiopulmonary resuscitation if presented with an order not to
 1344  resuscitate executed pursuant to s. 401.45. The agency shall
 1345  adopt rules providing for the implementation of such orders.
 1346  Home health personnel and agencies shall not be subject to
 1347  criminal prosecution or civil liability, nor be considered to
 1348  have engaged in negligent or unprofessional conduct, for
 1349  withholding or withdrawing cardiopulmonary resuscitation
 1350  pursuant to such an order and rules adopted by the agency.
 1351         Section 33. Effective October 1, 2018, paragraph (a) of
 1352  subsection (13) of section 400.506, Florida Statutes, is amended
 1353  to read:
 1354         400.506 Licensure of nurse registries; requirements;
 1355  penalties.—
 1356         (13) All persons referred for contract in private
 1357  residences by a nurse registry must comply with the following
 1358  requirements for a plan of treatment:
 1359         (a) When, in accordance with the privileges and
 1360  restrictions imposed upon a nurse under part I of chapter 464,
 1361  the delivery of care to a patient is under the direction or
 1362  supervision of a physician or when a physician is responsible
 1363  for the medical care of the patient, a medical plan of treatment
 1364  must be established for each patient receiving care or treatment
 1365  provided by a licensed nurse in the home. The original medical
 1366  plan of treatment must be timely signed by the physician,
 1367  physician assistant, or advanced practice registered nurse
 1368  advanced registered nurse practitioner, acting within his or her
 1369  respective scope of practice, and reviewed in consultation with
 1370  the licensed nurse at least every 2 months. Any additional order
 1371  or change in orders must be obtained from the physician,
 1372  physician assistant, or advanced practice registered nurse
 1373  advanced registered nurse practitioner and reduced to writing
 1374  and timely signed by the physician, physician assistant, or
 1375  advanced practice registered nurse advanced registered nurse
 1376  practitioner. The delivery of care under a medical plan of
 1377  treatment must be substantiated by the appropriate nursing notes
 1378  or documentation made by the nurse in compliance with nursing
 1379  practices established under part I of chapter 464.
 1380         Section 34. Effective October 1, 2018, subsections (5) and
 1381  (7) of section 400.9973, Florida Statutes, are amended to read:
 1382         400.9973 Client admission, transfer, and discharge.—
 1383         (5) A client admitted to a transitional living facility
 1384  must be admitted upon prescription by a licensed physician,
 1385  physician assistant, or advanced practice registered nurse
 1386  advanced registered nurse practitioner and must remain under the
 1387  care of a licensed physician, physician assistant, or advanced
 1388  practice registered nurse advanced registered nurse practitioner
 1389  for the duration of the client’s stay in the facility.
 1390         (7) A person may not be admitted to a transitional living
 1391  facility if the person:
 1392         (a) Presents significant risk of infection to other clients
 1393  or personnel. A health care practitioner must provide
 1394  documentation that the person is free of apparent signs and
 1395  symptoms of communicable disease;
 1396         (b) Is a danger to himself or herself or others as
 1397  determined by a physician, physician assistant, advanced
 1398  practice registered nurse, or advanced registered nurse
 1399  practitioner or a mental health practitioner licensed under
 1400  chapter 490 or chapter 491, unless the facility provides
 1401  adequate staffing and support to ensure patient safety;
 1402         (c) Is bedridden; or
 1403         (d) Requires 24-hour nursing supervision.
 1404         Section 35. Effective October 1, 2018, subsection (1) and
 1405  paragraphs (a) and (b) of subsection (2) of section 400.9974,
 1406  Florida Statutes, are amended to read:
 1407         400.9974 Client comprehensive treatment plans; client
 1408  services.—
 1409         (1) A transitional living facility shall develop a
 1410  comprehensive treatment plan for each client as soon as
 1411  practicable but no later than 30 days after the initial
 1412  comprehensive treatment plan is developed. The comprehensive
 1413  treatment plan must be developed by an interdisciplinary team
 1414  consisting of the case manager, the program director, the
 1415  advanced practice registered nurse advanced registered nurse
 1416  practitioner, and appropriate therapists. The client or, if
 1417  appropriate, the client’s representative must be included in
 1418  developing the comprehensive treatment plan. The comprehensive
 1419  treatment plan must be reviewed and updated if the client fails
 1420  to meet projected improvements outlined in the plan or if a
 1421  significant change in the client’s condition occurs. The
 1422  comprehensive treatment plan must be reviewed and updated at
 1423  least once monthly.
 1424         (2) The comprehensive treatment plan must include:
 1425         (a) Orders obtained from the physician, physician
 1426  assistant, or advanced practice registered nurse advanced
 1427  registered nurse practitioner and the client’s diagnosis,
 1428  medical history, physical examination, and rehabilitative or
 1429  restorative needs.
 1430         (b) A preliminary nursing evaluation, including orders for
 1431  immediate care provided by the physician, physician assistant,
 1432  or advanced practice registered nurse advanced registered nurse
 1433  practitioner, which shall be completed when the client is
 1434  admitted.
 1435         Section 36. Effective October 1, 2018, section 400.9976,
 1436  Florida Statutes, is amended to read:
 1437         400.9976 Administration of medication.—
 1438         (1) An individual medication administration record must be
 1439  maintained for each client. A dose of medication, including a
 1440  self-administered dose, shall be properly recorded in the
 1441  client’s record. A client who self-administers medication shall
 1442  be given a pill organizer. Medication must be placed in the pill
 1443  organizer by a nurse. A nurse shall document the date and time
 1444  that medication is placed into each client’s pill organizer. All
 1445  medications must be administered in compliance with orders of a
 1446  physician, physician assistant, or advanced practice registered
 1447  nurse advanced registered nurse practitioner.
 1448         (2) If an interdisciplinary team determines that self
 1449  administration of medication is an appropriate objective, and if
 1450  the physician, physician assistant, or advanced practice
 1451  registered nurse advanced registered nurse practitioner does not
 1452  specify otherwise, the client must be instructed by the
 1453  physician, physician assistant, or advanced practice registered
 1454  nurse advanced registered nurse practitioner to self-administer
 1455  his or her medication without the assistance of a staff person.
 1456  All forms of self-administration of medication, including
 1457  administration orally, by injection, and by suppository, shall
 1458  be included in the training. The client’s physician, physician
 1459  assistant, or advanced practice registered nurse advanced
 1460  registered nurse practitioner must be informed of the
 1461  interdisciplinary team’s decision that self-administration of
 1462  medication is an objective for the client. A client may not
 1463  self-administer medication until he or she demonstrates the
 1464  competency to take the correct medication in the correct dosage
 1465  at the correct time, to respond to missed doses, and to contact
 1466  the appropriate person with questions.
 1467         (3) Medication administration discrepancies and adverse
 1468  drug reactions must be recorded and reported immediately to a
 1469  physician, physician assistant, or advanced practice registered
 1470  nurse advanced registered nurse practitioner.
 1471         Section 37. Effective October 1, 2018, subsections (2)
 1472  through (5) of section 400.9979, Florida Statutes, are amended
 1473  to read:
 1474         400.9979 Restraint and seclusion; client safety.—
 1475         (2) The use of physical restraints must be ordered and
 1476  documented by a physician, physician assistant, or advanced
 1477  practice registered nurse advanced registered nurse practitioner
 1478  and must be consistent with the policies and procedures adopted
 1479  by the facility. The client or, if applicable, the client’s
 1480  representative shall be informed of the facility’s physical
 1481  restraint policies and procedures when the client is admitted.
 1482         (3) The use of chemical restraints shall be limited to
 1483  prescribed dosages of medications as ordered by a physician,
 1484  physician assistant, or advanced practice registered nurse
 1485  advanced registered nurse practitioner and must be consistent
 1486  with the client’s diagnosis and the policies and procedures
 1487  adopted by the facility. The client and, if applicable, the
 1488  client’s representative shall be informed of the facility’s
 1489  chemical restraint policies and procedures when the client is
 1490  admitted.
 1491         (4) Based on the assessment by a physician, physician
 1492  assistant, or advanced practice registered nurse advanced
 1493  registered nurse practitioner, if a client exhibits symptoms
 1494  that present an immediate risk of injury or death to himself or
 1495  herself or others, a physician, physician assistant, or advanced
 1496  practice registered nurse advanced registered nurse practitioner
 1497  may issue an emergency treatment order to immediately administer
 1498  rapid-response psychotropic medications or other chemical
 1499  restraints. Each emergency treatment order must be documented
 1500  and maintained in the client’s record.
 1501         (a) An emergency treatment order is not effective for more
 1502  than 24 hours.
 1503         (b) Whenever a client is medicated under this subsection,
 1504  the client’s representative or a responsible party and the
 1505  client’s physician, physician assistant, or advanced practice
 1506  registered nurse advanced registered nurse practitioner shall be
 1507  notified as soon as practicable.
 1508         (5) A client who is prescribed and receives a medication
 1509  that can serve as a chemical restraint for a purpose other than
 1510  an emergency treatment order must be evaluated by his or her
 1511  physician, physician assistant, or advanced practice registered
 1512  nurse advanced registered nurse practitioner at least monthly to
 1513  assess:
 1514         (a) The continued need for the medication.
 1515         (b) The level of the medication in the client’s blood.
 1516         (c) The need for adjustments to the prescription.
 1517         Section 38. Effective October 1, 2018, subsections (1) and
 1518  (2) of section 401.445, Florida Statutes, are amended to read:
 1519         401.445 Emergency examination and treatment of
 1520  incapacitated persons.—
 1521         (1) No recovery shall be allowed in any court in this state
 1522  against any emergency medical technician, paramedic, or
 1523  physician as defined in this chapter, any advanced practice
 1524  registered nurse licensed advanced registered nurse practitioner
 1525  certified under s. 464.012, or any physician assistant licensed
 1526  under s. 458.347 or s. 459.022, or any person acting under the
 1527  direct medical supervision of a physician, in an action brought
 1528  for examining or treating a patient without his or her informed
 1529  consent if:
 1530         (a) The patient at the time of examination or treatment is
 1531  intoxicated, under the influence of drugs, or otherwise
 1532  incapable of providing informed consent as provided in s.
 1533  766.103;
 1534         (b) The patient at the time of examination or treatment is
 1535  experiencing an emergency medical condition; and
 1536         (c) The patient would reasonably, under all the surrounding
 1537  circumstances, undergo such examination, treatment, or procedure
 1538  if he or she were advised by the emergency medical technician,
 1539  paramedic, physician, advanced practice registered nurse
 1540  advanced registered nurse practitioner, or physician assistant
 1541  in accordance with s. 766.103(3).
 1542  
 1543  Examination and treatment provided under this subsection shall
 1544  be limited to reasonable examination of the patient to determine
 1545  the medical condition of the patient and treatment reasonably
 1546  necessary to alleviate the emergency medical condition or to
 1547  stabilize the patient.
 1548         (2) In examining and treating a person who is apparently
 1549  intoxicated, under the influence of drugs, or otherwise
 1550  incapable of providing informed consent, the emergency medical
 1551  technician, paramedic, physician, advanced practice registered
 1552  nurse advanced registered nurse practitioner, or physician
 1553  assistant, or any person acting under the direct medical
 1554  supervision of a physician, shall proceed wherever possible with
 1555  the consent of the person. If the person reasonably appears to
 1556  be incapacitated and refuses his or her consent, the person may
 1557  be examined, treated, or taken to a hospital or other
 1558  appropriate treatment resource if he or she is in need of
 1559  emergency attention, without his or her consent, but
 1560  unreasonable force shall not be used.
 1561         Section 39. Effective October 1, 2018, subsection (1) of
 1562  section 409.905, Florida Statutes, is amended to read:
 1563         409.905 Mandatory Medicaid services.—The agency may make
 1564  payments for the following services, which are required of the
 1565  state by Title XIX of the Social Security Act, furnished by
 1566  Medicaid providers to recipients who are determined to be
 1567  eligible on the dates on which the services were provided. Any
 1568  service under this section shall be provided only when medically
 1569  necessary and in accordance with state and federal law.
 1570  Mandatory services rendered by providers in mobile units to
 1571  Medicaid recipients may be restricted by the agency. Nothing in
 1572  this section shall be construed to prevent or limit the agency
 1573  from adjusting fees, reimbursement rates, lengths of stay,
 1574  number of visits, number of services, or any other adjustments
 1575  necessary to comply with the availability of moneys and any
 1576  limitations or directions provided for in the General
 1577  Appropriations Act or chapter 216.
 1578         (1) ADVANCED PRACTICE REGISTERED NURSE ADVANCED REGISTERED
 1579  NURSE PRACTITIONER SERVICES.—The agency shall pay for services
 1580  provided to a recipient by a licensed advanced practice
 1581  registered nurse advanced registered nurse practitioner who has
 1582  a valid collaboration agreement with a licensed physician on
 1583  file with the Department of Health or who provides anesthesia
 1584  services in accordance with established protocol required by
 1585  state law and approved by the medical staff of the facility in
 1586  which the anesthetic service is performed. Reimbursement for
 1587  such services must be provided in an amount that equals not less
 1588  than 80 percent of the reimbursement to a physician who provides
 1589  the same services, unless otherwise provided for in the General
 1590  Appropriations Act.
 1591         Section 40. Effective October 1, 2018, paragraph (a) of
 1592  subsection (3) and subsection (7) of section 409.908, Florida
 1593  Statutes, are amended to read:
 1594         409.908 Reimbursement of Medicaid providers.—Subject to
 1595  specific appropriations, the agency shall reimburse Medicaid
 1596  providers, in accordance with state and federal law, according
 1597  to methodologies set forth in the rules of the agency and in
 1598  policy manuals and handbooks incorporated by reference therein.
 1599  These methodologies may include fee schedules, reimbursement
 1600  methods based on cost reporting, negotiated fees, competitive
 1601  bidding pursuant to s. 287.057, and other mechanisms the agency
 1602  considers efficient and effective for purchasing services or
 1603  goods on behalf of recipients. If a provider is reimbursed based
 1604  on cost reporting and submits a cost report late and that cost
 1605  report would have been used to set a lower reimbursement rate
 1606  for a rate semester, then the provider’s rate for that semester
 1607  shall be retroactively calculated using the new cost report, and
 1608  full payment at the recalculated rate shall be effected
 1609  retroactively. Medicare-granted extensions for filing cost
 1610  reports, if applicable, shall also apply to Medicaid cost
 1611  reports. Payment for Medicaid compensable services made on
 1612  behalf of Medicaid eligible persons is subject to the
 1613  availability of moneys and any limitations or directions
 1614  provided for in the General Appropriations Act or chapter 216.
 1615  Further, nothing in this section shall be construed to prevent
 1616  or limit the agency from adjusting fees, reimbursement rates,
 1617  lengths of stay, number of visits, or number of services, or
 1618  making any other adjustments necessary to comply with the
 1619  availability of moneys and any limitations or directions
 1620  provided for in the General Appropriations Act, provided the
 1621  adjustment is consistent with legislative intent.
 1622         (3) Subject to any limitations or directions provided for
 1623  in the General Appropriations Act, the following Medicaid
 1624  services and goods may be reimbursed on a fee-for-service basis.
 1625  For each allowable service or goods furnished in accordance with
 1626  Medicaid rules, policy manuals, handbooks, and state and federal
 1627  law, the payment shall be the amount billed by the provider, the
 1628  provider’s usual and customary charge, or the maximum allowable
 1629  fee established by the agency, whichever amount is less, with
 1630  the exception of those services or goods for which the agency
 1631  makes payment using a methodology based on capitation rates,
 1632  average costs, or negotiated fees.
 1633         (a) Advanced practice registered nurse Advanced registered
 1634  nurse practitioner services.
 1635         (7) A provider of family planning services shall be
 1636  reimbursed the lesser of the amount billed by the provider or an
 1637  all-inclusive amount per type of visit for physicians and
 1638  advanced practice registered nurses advanced registered nurse
 1639  practitioners, as established by the agency in a fee schedule.
 1640         Section 41. Effective October 1, 2018, paragraph (a) of
 1641  subsection (1) of section 409.973, Florida Statutes, is amended
 1642  to read:
 1643         409.973 Benefits.—
 1644         (1) MINIMUM BENEFITS.—Managed care plans shall cover, at a
 1645  minimum, the following services:
 1646         (a) Advanced practice registered nurse Advanced registered
 1647  nurse practitioner services.
 1648         Section 42. Effective March 1, 2019, subsection (1) of
 1649  section 409.973, Florida Statutes, as amended by section 1 of
 1650  chapter 2016-109, Laws of Florida, is amended to read:
 1651         409.973 Benefits.—
 1652         (1) MINIMUM BENEFITS.—Managed care plans shall cover, at a
 1653  minimum, the following services:
 1654         (a) Advanced practice registered nurse Advanced registered
 1655  nurse practitioner services.
 1656         (b) Ambulatory surgical treatment center services.
 1657         (c) Birthing center services.
 1658         (d) Chiropractic services.
 1659         (e) Early periodic screening diagnosis and treatment
 1660  services for recipients under age 21.
 1661         (f) Emergency services.
 1662         (g) Family planning services and supplies. Pursuant to 42
 1663  C.F.R. s. 438.102, plans may elect to not provide these services
 1664  due to an objection on moral or religious grounds, and must
 1665  notify the agency of that election when submitting a reply to an
 1666  invitation to negotiate.
 1667         (h) Healthy start services, except as provided in s.
 1668  409.975(4).
 1669         (i) Hearing services.
 1670         (j) Home health agency services.
 1671         (k) Hospice services.
 1672         (l) Hospital inpatient services.
 1673         (m) Hospital outpatient services.
 1674         (n) Laboratory and imaging services.
 1675         (o) Medical supplies, equipment, prostheses, and orthoses.
 1676         (p) Mental health services.
 1677         (q) Nursing care.
 1678         (r) Optical services and supplies.
 1679         (s) Optometrist services.
 1680         (t) Physical, occupational, respiratory, and speech therapy
 1681  services.
 1682         (u) Physician services, including physician assistant
 1683  services.
 1684         (v) Podiatric services.
 1685         (w) Prescription drugs.
 1686         (x) Renal dialysis services.
 1687         (y) Respiratory equipment and supplies.
 1688         (z) Rural health clinic services.
 1689         (aa) Substance abuse treatment services.
 1690         (bb) Transportation to access covered services.
 1691         Section 43. Effective October 1, 2018, paragraph (a) of
 1692  subsection (2) and paragraph (a) of subsection (7) of section
 1693  429.918, Florida Statutes, are amended to read:
 1694         429.918 Licensure designation as a specialized Alzheimer’s
 1695  services adult day care center.—
 1696         (2) As used in this section, the term:
 1697         (a) “ADRD participant” means a participant who has a
 1698  documented diagnosis of Alzheimer’s disease or a dementia
 1699  related disorder (ADRD) from a licensed physician, licensed
 1700  physician assistant, or a licensed advanced practice registered
 1701  nurse advanced registered nurse practitioner.
 1702         (7)(a) An ADRD participant admitted to an adult day care
 1703  center having a license designated under this section, or the
 1704  caregiver when applicable, must:
 1705         1. Require ongoing supervision to maintain the highest
 1706  level of medical or custodial functioning and have a
 1707  demonstrated need for a responsible party to oversee his or her
 1708  care.
 1709         2. Not actively demonstrate aggressive behavior that places
 1710  himself, herself, or others at risk of harm.
 1711         3. Provide the following medical documentation signed by a
 1712  licensed physician, licensed physician assistant, or a licensed
 1713  advanced practice registered nurse advanced registered nurse
 1714  practitioner:
 1715         a. Any physical, health, or emotional conditions that
 1716  require medical care.
 1717         b. A listing of the ADRD participant’s current prescribed
 1718  and over-the-counter medications and dosages, diet restrictions,
 1719  mobility restrictions, and other physical limitations.
 1720         4. Provide documentation signed by a health care provider
 1721  licensed in this state which indicates that the ADRD participant
 1722  is free of the communicable form of tuberculosis and free of
 1723  signs and symptoms of other communicable diseases.
 1724         Section 44. Effective October 1, 2018, section 456.0391,
 1725  Florida Statutes, is amended to read:
 1726         456.0391 Advanced practice registered nurses Advanced
 1727  registered nurse practitioners; information required for
 1728  licensure certification.—
 1729         (1)(a) Each person who applies for initial licensure
 1730  certification under s. 464.012 must, at the time of application,
 1731  and each person licensed certified under s. 464.012 who applies
 1732  for licensure certification renewal must, in conjunction with
 1733  the renewal of such licensure certification and under procedures
 1734  adopted by the Department of Health, and in addition to any
 1735  other information that may be required from the applicant,
 1736  furnish the following information to the Department of Health:
 1737         1. The name of each school or training program that the
 1738  applicant has attended, with the months and years of attendance
 1739  and the month and year of graduation, and a description of all
 1740  graduate professional education completed by the applicant,
 1741  excluding any coursework taken to satisfy continuing education
 1742  requirements.
 1743         2. The name of each location at which the applicant
 1744  practices.
 1745         3. The address at which the applicant will primarily
 1746  conduct his or her practice.
 1747         4. Any certification or designation that the applicant has
 1748  received from a specialty or certification board that is
 1749  recognized or approved by the regulatory board or department to
 1750  which the applicant is applying.
 1751         5. The year that the applicant received initial
 1752  certification or licensure and began practicing the profession
 1753  in any jurisdiction and the year that the applicant received
 1754  initial certification or licensure in this state.
 1755         6. Any appointment which the applicant currently holds to
 1756  the faculty of a school related to the profession and an
 1757  indication as to whether the applicant has had the
 1758  responsibility for graduate education within the most recent 10
 1759  years.
 1760         7. A description of any criminal offense of which the
 1761  applicant has been found guilty, regardless of whether
 1762  adjudication of guilt was withheld, or to which the applicant
 1763  has pled guilty or nolo contendere. A criminal offense committed
 1764  in another jurisdiction which would have been a felony or
 1765  misdemeanor if committed in this state must be reported. If the
 1766  applicant indicates that a criminal offense is under appeal and
 1767  submits a copy of the notice for appeal of that criminal
 1768  offense, the department must state that the criminal offense is
 1769  under appeal if the criminal offense is reported in the
 1770  applicant’s profile. If the applicant indicates to the
 1771  department that a criminal offense is under appeal, the
 1772  applicant must, within 15 days after the disposition of the
 1773  appeal, submit to the department a copy of the final written
 1774  order of disposition.
 1775         8. A description of any final disciplinary action taken
 1776  within the previous 10 years against the applicant by a
 1777  licensing or regulatory body in any jurisdiction, by a specialty
 1778  board that is recognized by the board or department, or by a
 1779  licensed hospital, health maintenance organization, prepaid
 1780  health clinic, ambulatory surgical center, or nursing home.
 1781  Disciplinary action includes resignation from or nonrenewal of
 1782  staff membership or the restriction of privileges at a licensed
 1783  hospital, health maintenance organization, prepaid health
 1784  clinic, ambulatory surgical center, or nursing home taken in
 1785  lieu of or in settlement of a pending disciplinary case related
 1786  to competence or character. If the applicant indicates that the
 1787  disciplinary action is under appeal and submits a copy of the
 1788  document initiating an appeal of the disciplinary action, the
 1789  department must state that the disciplinary action is under
 1790  appeal if the disciplinary action is reported in the applicant’s
 1791  profile.
 1792         (b) In addition to the information required under paragraph
 1793  (a), each applicant for initial licensure certification or
 1794  licensure certification renewal must provide the information
 1795  required of licensees pursuant to s. 456.049.
 1796         (2) The Department of Health shall send a notice to each
 1797  person licensed certified under s. 464.012 at the licensee’s
 1798  certificateholder’s last known address of record regarding the
 1799  requirements for information to be submitted by advanced
 1800  practice registered nurses advanced registered nurse
 1801  practitioners pursuant to this section in conjunction with the
 1802  renewal of such license certificate.
 1803         (3) Each person licensed certified under s. 464.012 who has
 1804  submitted information pursuant to subsection (1) must update
 1805  that information in writing by notifying the Department of
 1806  Health within 45 days after the occurrence of an event or the
 1807  attainment of a status that is required to be reported by
 1808  subsection (1). Failure to comply with the requirements of this
 1809  subsection to update and submit information constitutes a ground
 1810  for disciplinary action under chapter 464 and s. 456.072(1)(k).
 1811  For failure to comply with the requirements of this subsection
 1812  to update and submit information, the department or board, as
 1813  appropriate, may:
 1814         (a) Refuse to issue a license certificate to any person
 1815  applying for initial licensure certification who fails to submit
 1816  and update the required information.
 1817         (b) Issue a citation to any certificateholder or licensee
 1818  who fails to submit and update the required information and may
 1819  fine the certificateholder or licensee up to $50 for each day
 1820  that the certificateholder or licensee is not in compliance with
 1821  this subsection. The citation must clearly state that the
 1822  certificateholder or licensee may choose, in lieu of accepting
 1823  the citation, to follow the procedure under s. 456.073. If the
 1824  certificateholder or licensee disputes the matter in the
 1825  citation, the procedures set forth in s. 456.073 must be
 1826  followed. However, if the certificateholder or licensee does not
 1827  dispute the matter in the citation with the department within 30
 1828  days after the citation is served, the citation becomes a final
 1829  order and constitutes discipline. Service of a citation may be
 1830  made by personal service or certified mail, restricted delivery,
 1831  to the subject at the certificateholder’s or licensee’s last
 1832  known address.
 1833         (4)(a) An applicant for initial licensure certification
 1834  under s. 464.012 must submit a set of fingerprints to the
 1835  Department of Health on a form and under procedures specified by
 1836  the department, along with payment in an amount equal to the
 1837  costs incurred by the Department of Health for a national
 1838  criminal history check of the applicant.
 1839         (b) An applicant for renewed licensure certification who
 1840  has not previously submitted a set of fingerprints to the
 1841  Department of Health for purposes of certification must submit a
 1842  set of fingerprints to the department as a condition of the
 1843  initial renewal of his or her certificate after the effective
 1844  date of this section. The applicant must submit the fingerprints
 1845  on a form and under procedures specified by the department,
 1846  along with payment in an amount equal to the costs incurred by
 1847  the Department of Health for a national criminal history check.
 1848  For subsequent renewals, the applicant for renewed licensure
 1849  certification must only submit information necessary to conduct
 1850  a statewide criminal history check, along with payment in an
 1851  amount equal to the costs incurred by the Department of Health
 1852  for a statewide criminal history check.
 1853         (c)1. The Department of Health shall submit the
 1854  fingerprints provided by an applicant for initial licensure
 1855  certification to the Florida Department of Law Enforcement for a
 1856  statewide criminal history check, and the Florida Department of
 1857  Law Enforcement shall forward the fingerprints to the Federal
 1858  Bureau of Investigation for a national criminal history check of
 1859  the applicant.
 1860         2. The department shall submit the fingerprints provided by
 1861  an applicant for the initial renewal of licensure certification
 1862  to the Florida Department of Law Enforcement for a statewide
 1863  criminal history check, and the Florida Department of Law
 1864  Enforcement shall forward the fingerprints to the Federal Bureau
 1865  of Investigation for a national criminal history check for the
 1866  initial renewal of the applicant’s certificate after the
 1867  effective date of this section.
 1868         3. For any subsequent renewal of the applicant’s
 1869  certificate, the department shall submit the required
 1870  information for a statewide criminal history check of the
 1871  applicant to the Florida Department of Law Enforcement.
 1872         (d) Any applicant for initial licensure certification or
 1873  renewal of licensure certification as an advanced practice
 1874  registered nurse advanced registered nurse practitioner who
 1875  submits to the Department of Health a set of fingerprints and
 1876  information required for the criminal history check required
 1877  under this section shall not be required to provide a subsequent
 1878  set of fingerprints or other duplicate information required for
 1879  a criminal history check to the Agency for Health Care
 1880  Administration, the Department of Juvenile Justice, or the
 1881  Department of Children and Families for employment or licensure
 1882  with such agency or department, if the applicant has undergone a
 1883  criminal history check as a condition of initial licensure
 1884  certification or renewal of licensure certification as an
 1885  advanced practice registered nurse advanced registered nurse
 1886  practitioner with the Department of Health, notwithstanding any
 1887  other provision of law to the contrary. In lieu of such
 1888  duplicate submission, the Agency for Health Care Administration,
 1889  the Department of Juvenile Justice, and the Department of
 1890  Children and Families shall obtain criminal history information
 1891  for employment or licensure of persons licensed certified under
 1892  s. 464.012 by such agency or department from the Department of
 1893  Health’s health care practitioner credentialing system.
 1894         (5) Each person who is required to submit information
 1895  pursuant to this section may submit additional information to
 1896  the Department of Health. Such information may include, but is
 1897  not limited to:
 1898         (a) Information regarding publications in peer-reviewed
 1899  professional literature within the previous 10 years.
 1900         (b) Information regarding professional or community service
 1901  activities or awards.
 1902         (c) Languages, other than English, used by the applicant to
 1903  communicate with patients or clients and identification of any
 1904  translating service that may be available at the place where the
 1905  applicant primarily conducts his or her practice.
 1906         (d) An indication of whether the person participates in the
 1907  Medicaid program.
 1908         Section 45. Effective October 1, 2018, subsection (2) of
 1909  section 456.0392, Florida Statutes, is amended to read:
 1910         456.0392 Prescription labeling.—
 1911         (2) A prescription for a drug that is not listed as a
 1912  controlled substance in chapter 893 which is written by an
 1913  advanced practice registered nurse licensed advanced registered
 1914  nurse practitioner certified under s. 464.012 is presumed,
 1915  subject to rebuttal, to be valid and within the parameters of
 1916  the prescriptive authority delegated by a practitioner licensed
 1917  under chapter 458, chapter 459, or chapter 466.
 1918         Section 46. Effective October 1, 2018, paragraph (a) of
 1919  subsection (1) and subsection (6) of section 456.041, Florida
 1920  Statutes, are amended to read:
 1921         456.041 Practitioner profile; creation.—
 1922         (1)(a) The Department of Health shall compile the
 1923  information submitted pursuant to s. 456.039 into a practitioner
 1924  profile of the applicant submitting the information, except that
 1925  the Department of Health shall develop a format to compile
 1926  uniformly any information submitted under s. 456.039(4)(b).
 1927  Beginning July 1, 2001, the Department of Health may compile the
 1928  information submitted pursuant to s. 456.0391 into a
 1929  practitioner profile of the applicant submitting the
 1930  information. The protocol submitted pursuant to s. 464.012(3)
 1931  must be included in the practitioner profile of the advanced
 1932  practice registered nurse advanced registered nurse
 1933  practitioner.
 1934         (6) The Department of Health shall provide in each
 1935  practitioner profile for every physician or advanced practice
 1936  registered nurse advanced registered nurse practitioner
 1937  terminated for cause from participating in the Medicaid program,
 1938  pursuant to s. 409.913, or sanctioned by the Medicaid program a
 1939  statement that the practitioner has been terminated from
 1940  participating in the Florida Medicaid program or sanctioned by
 1941  the Medicaid program.
 1942         Section 47. Effective October 1, 2018, subsection (1) of
 1943  section 456.048, Florida Statutes, is amended to read:
 1944         456.048 Financial responsibility requirements for certain
 1945  health care practitioners.—
 1946         (1) As a prerequisite for licensure or license renewal, the
 1947  Board of Acupuncture, the Board of Chiropractic Medicine, the
 1948  Board of Podiatric Medicine, and the Board of Dentistry shall,
 1949  by rule, require that all health care practitioners licensed
 1950  under the respective board, and the Board of Medicine and the
 1951  Board of Osteopathic Medicine shall, by rule, require that all
 1952  anesthesiologist assistants licensed pursuant to s. 458.3475 or
 1953  s. 459.023, and the Board of Nursing shall, by rule, require
 1954  that advanced practice registered nurses licensed advanced
 1955  registered nurse practitioners certified under s. 464.012, and
 1956  the department shall, by rule, require that midwives maintain
 1957  medical malpractice insurance or provide proof of financial
 1958  responsibility in an amount and in a manner determined by the
 1959  board or department to be sufficient to cover claims arising out
 1960  of the rendering of or failure to render professional care and
 1961  services in this state.
 1962         Section 48. Effective October 1, 2018, subsection (7) of
 1963  section 456.072, Florida Statutes, is amended to read:
 1964         456.072 Grounds for discipline; penalties; enforcement.—
 1965         (7) Notwithstanding subsection (2), upon a finding that a
 1966  physician has prescribed or dispensed a controlled substance, or
 1967  caused a controlled substance to be prescribed or dispensed, in
 1968  a manner that violates the standard of practice set forth in s.
 1969  458.331(1)(q) or (t), s. 459.015(1)(t) or (x), s. 461.013(1)(o)
 1970  or (s), or s. 466.028(1)(p) or (x), or that an advanced practice
 1971  registered nurse advanced registered nurse practitioner has
 1972  prescribed or dispensed a controlled substance, or caused a
 1973  controlled substance to be prescribed or dispensed, in a manner
 1974  that violates the standard of practice set forth in s.
 1975  464.018(1)(n) or (p)6., the physician or advanced practice
 1976  registered nurse advanced registered nurse practitioner shall be
 1977  suspended for a period of not less than 6 months and pay a fine
 1978  of not less than $10,000 per count. Repeated violations shall
 1979  result in increased penalties.
 1980         Section 49. Effective October 1, 2018, paragraph (g) of
 1981  subsection (1) and subsection (2) of section 456.44, Florida
 1982  Statutes, are amended to read:
 1983         456.44 Controlled substance prescribing.—
 1984         (1) DEFINITIONS.—As used in this section, the term:
 1985         (g) “Registrant” means a physician, a physician assistant,
 1986  or an advanced practice registered nurse advanced registered
 1987  nurse practitioner who meets the requirements of subsection (2).
 1988         (2) REGISTRATION.—A physician licensed under chapter 458,
 1989  chapter 459, chapter 461, or chapter 466, a physician assistant
 1990  licensed under chapter 458 or chapter 459, or an advanced
 1991  practice registered nurse licensed advanced registered nurse
 1992  practitioner certified under part I of chapter 464 who
 1993  prescribes any controlled substance, listed in Schedule II,
 1994  Schedule III, or Schedule IV as defined in s. 893.03, for the
 1995  treatment of chronic nonmalignant pain, must:
 1996         (a) Designate himself or herself as a controlled substance
 1997  prescribing practitioner on his or her practitioner profile.
 1998         (b) Comply with the requirements of this section and
 1999  applicable board rules.
 2000         Section 50. Effective October 1, 2018, paragraph (c) of
 2001  subsection (2) of section 458.3265, Florida Statutes, is amended
 2002  to read:
 2003         458.3265 Pain-management clinics.—
 2004         (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities
 2005  apply to any physician who provides professional services in a
 2006  pain-management clinic that is required to be registered in
 2007  subsection (1).
 2008         (c) A physician, a physician assistant, or an advanced
 2009  practice registered nurse advanced registered nurse practitioner
 2010  must perform a physical examination of a patient on the same day
 2011  that the physician prescribes a controlled substance to a
 2012  patient at a pain-management clinic. If the physician prescribes
 2013  more than a 72-hour dose of controlled substances for the
 2014  treatment of chronic nonmalignant pain, the physician must
 2015  document in the patient’s record the reason for prescribing that
 2016  quantity.
 2017         Section 51. Effective October 1, 2018, paragraph (dd) of
 2018  subsection (1) of section 458.331, Florida Statutes, is amended
 2019  to read:
 2020         458.331 Grounds for disciplinary action; action by the
 2021  board and department.—
 2022         (1) The following acts constitute grounds for denial of a
 2023  license or disciplinary action, as specified in s. 456.072(2):
 2024         (dd) Failing to supervise adequately the activities of
 2025  those physician assistants, paramedics, emergency medical
 2026  technicians, advanced practice registered nurses advanced
 2027  registered nurse practitioners, or anesthesiologist assistants
 2028  acting under the supervision of the physician.
 2029         Section 52. Effective October 1, 2018, paragraph (a) of
 2030  subsection (1) and subsection (3) of section 458.348, Florida
 2031  Statutes, are amended to read:
 2032         458.348 Formal supervisory relationships, standing orders,
 2033  and established protocols; notice; standards.—
 2034         (1) NOTICE.—
 2035         (a) When a physician enters into a formal supervisory
 2036  relationship or standing orders with an emergency medical
 2037  technician or paramedic licensed pursuant to s. 401.27, which
 2038  relationship or orders contemplate the performance of medical
 2039  acts, or when a physician enters into an established protocol
 2040  with an advanced practice registered nurse advanced registered
 2041  nurse practitioner, which protocol contemplates the performance
 2042  of medical acts set forth in s. 464.012(3) and (4), the
 2043  physician shall submit notice to the board. The notice shall
 2044  contain a statement in substantially the following form:
 2045  
 2046         I, ...(name and professional license number of
 2047  physician)..., of ...(address of physician)... have hereby
 2048  entered into a formal supervisory relationship, standing orders,
 2049  or an established protocol with ...(number of persons)...
 2050  emergency medical technician(s), ...(number of persons)...
 2051  paramedic(s), or ...(number of persons)... advanced practice
 2052  registered nurse(s) advanced registered nurse practitioner(s).
 2053  
 2054         (3) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.—A
 2055  physician who supervises an advanced practice registered nurse
 2056  advanced registered nurse practitioner or physician assistant at
 2057  a medical office other than the physician’s primary practice
 2058  location, where the advanced practice registered nurse advanced
 2059  registered nurse practitioner or physician assistant is not
 2060  under the onsite supervision of a supervising physician, must
 2061  comply with the standards set forth in this subsection. For the
 2062  purpose of this subsection, a physician’s “primary practice
 2063  location” means the address reflected on the physician’s profile
 2064  published pursuant to s. 456.041.
 2065         (a) A physician who is engaged in providing primary health
 2066  care services may not supervise more than four offices in
 2067  addition to the physician’s primary practice location. For the
 2068  purpose of this subsection, “primary health care” means health
 2069  care services that are commonly provided to patients without
 2070  referral from another practitioner, including obstetrical and
 2071  gynecological services, and excludes practices providing
 2072  primarily dermatologic and skin care services, which include
 2073  aesthetic skin care services.
 2074         (b) A physician who is engaged in providing specialty
 2075  health care services may not supervise more than two offices in
 2076  addition to the physician’s primary practice location. For the
 2077  purpose of this subsection, “specialty health care” means health
 2078  care services that are commonly provided to patients with a
 2079  referral from another practitioner and excludes practices
 2080  providing primarily dermatologic and skin care services, which
 2081  include aesthetic skin care services.
 2082         (c) A physician who supervises an advanced practice
 2083  registered nurse advanced registered nurse practitioner or
 2084  physician assistant at a medical office other than the
 2085  physician’s primary practice location, where the advanced
 2086  practice registered nurse advanced registered nurse practitioner
 2087  or physician assistant is not under the onsite supervision of a
 2088  supervising physician and the services offered at the office are
 2089  primarily dermatologic or skin care services, which include
 2090  aesthetic skin care services other than plastic surgery, must
 2091  comply with the standards listed in subparagraphs 1.-4.
 2092  Notwithstanding s. 458.347(4)(e)6., a physician supervising a
 2093  physician assistant pursuant to this paragraph may not be
 2094  required to review and cosign charts or medical records prepared
 2095  by such physician assistant.
 2096         1. The physician shall submit to the board the addresses of
 2097  all offices where he or she is supervising an advanced practice
 2098  registered nurse advanced registered nurse practitioner or a
 2099  physician’s assistant which are not the physician’s primary
 2100  practice location.
 2101         2. The physician must be board certified or board eligible
 2102  in dermatology or plastic surgery as recognized by the board
 2103  pursuant to s. 458.3312.
 2104         3. All such offices that are not the physician’s primary
 2105  place of practice must be within 25 miles of the physician’s
 2106  primary place of practice or in a county that is contiguous to
 2107  the county of the physician’s primary place of practice.
 2108  However, the distance between any of the offices may not exceed
 2109  75 miles.
 2110         4. The physician may supervise only one office other than
 2111  the physician’s primary place of practice except that until July
 2112  1, 2011, the physician may supervise up to two medical offices
 2113  other than the physician’s primary place of practice if the
 2114  addresses of the offices are submitted to the board before July
 2115  1, 2006. Effective July 1, 2011, the physician may supervise
 2116  only one office other than the physician’s primary place of
 2117  practice, regardless of when the addresses of the offices were
 2118  submitted to the board.
 2119         (d) A physician who supervises an office in addition to the
 2120  physician’s primary practice location must conspicuously post in
 2121  each of the physician’s offices a current schedule of the
 2122  regular hours when the physician is present in that office and
 2123  the hours when the office is open while the physician is not
 2124  present.
 2125         (e) This subsection does not apply to health care services
 2126  provided in facilities licensed under chapter 395 or in
 2127  conjunction with a college of medicine, a college of nursing, an
 2128  accredited graduate medical program, or a nursing education
 2129  program; not-for-profit, family-planning clinics that are not
 2130  licensed pursuant to chapter 390; rural and federally qualified
 2131  health centers; health care services provided in a nursing home
 2132  licensed under part II of chapter 400, an assisted living
 2133  facility licensed under part I of chapter 429, a continuing care
 2134  facility licensed under chapter 651, or a retirement community
 2135  consisting of independent living units and a licensed nursing
 2136  home or assisted living facility; anesthesia services provided
 2137  in accordance with law; health care services provided in a
 2138  designated rural health clinic; health care services provided to
 2139  persons enrolled in a program designed to maintain elderly
 2140  persons and persons with disabilities in a home or community
 2141  based setting; university primary care student health centers;
 2142  school health clinics; or health care services provided in
 2143  federal, state, or local government facilities. Subsection (2)
 2144  and this subsection do not apply to offices at which the
 2145  exclusive service being performed is laser hair removal by an
 2146  advanced practice registered nurse advanced registered nurse
 2147  practitioner or physician assistant.
 2148         Section 53. Effective October 1, 2018, paragraph (c) of
 2149  subsection (2) of section 459.0137, Florida Statutes, is amended
 2150  to read:
 2151         459.0137 Pain-management clinics.—
 2152         (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities
 2153  apply to any osteopathic physician who provides professional
 2154  services in a pain-management clinic that is required to be
 2155  registered in subsection (1).
 2156         (c) An osteopathic physician, a physician assistant, or an
 2157  advanced practice registered nurse advanced registered nurse
 2158  practitioner must perform a physical examination of a patient on
 2159  the same day that the physician prescribes a controlled
 2160  substance to a patient at a pain-management clinic. If the
 2161  osteopathic physician prescribes more than a 72-hour dose of
 2162  controlled substances for the treatment of chronic nonmalignant
 2163  pain, the osteopathic physician must document in the patient’s
 2164  record the reason for prescribing that quantity.
 2165         Section 54. Effective October 1, 2018, paragraph (hh) of
 2166  subsection (1) of section 459.015, Florida Statutes, is amended
 2167  to read:
 2168         459.015 Grounds for disciplinary action; action by the
 2169  board and department.—
 2170         (1) The following acts constitute grounds for denial of a
 2171  license or disciplinary action, as specified in s. 456.072(2):
 2172         (hh) Failing to supervise adequately the activities of
 2173  those physician assistants, paramedics, emergency medical
 2174  technicians, advanced practice registered nurses advanced
 2175  registered nurse practitioners, anesthesiologist assistants, or
 2176  other persons acting under the supervision of the osteopathic
 2177  physician.
 2178         Section 55. Effective October 1, 2018, paragraph (a) of
 2179  subsection (1) and subsection (3) of section 459.025, Florida
 2180  Statutes, are amended to read:
 2181         459.025 Formal supervisory relationships, standing orders,
 2182  and established protocols; notice; standards.—
 2183         (1) NOTICE.—
 2184         (a) When an osteopathic physician enters into a formal
 2185  supervisory relationship or standing orders with an emergency
 2186  medical technician or paramedic licensed pursuant to s. 401.27,
 2187  which relationship or orders contemplate the performance of
 2188  medical acts, or when an osteopathic physician enters into an
 2189  established protocol with an advanced practice registered nurse
 2190  advanced registered nurse practitioner, which protocol
 2191  contemplates the performance of medical acts or acts set forth
 2192  in s. 464.012(3) and (4), the osteopathic physician shall submit
 2193  notice to the board. The notice must contain a statement in
 2194  substantially the following form:
 2195  
 2196         I, ...(name and professional license number of osteopathic
 2197  physician)..., of ...(address of osteopathic physician)... have
 2198  hereby entered into a formal supervisory relationship, standing
 2199  orders, or an established protocol with ...(number of
 2200  persons)... emergency medical technician(s), ...(number of
 2201  persons)... paramedic(s), or ...(number of persons)... advanced
 2202  practice registered nurse(s) advanced registered nurse
 2203  practitioner(s).
 2204         (3) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.
 2205  An osteopathic physician who supervises an advanced practice
 2206  registered nurse advanced registered nurse practitioner or
 2207  physician assistant at a medical office other than the
 2208  osteopathic physician’s primary practice location, where the
 2209  advanced practice registered nurse advanced registered nurse
 2210  practitioner or physician assistant is not under the onsite
 2211  supervision of a supervising osteopathic physician, must comply
 2212  with the standards set forth in this subsection. For the purpose
 2213  of this subsection, an osteopathic physician’s “primary practice
 2214  location” means the address reflected on the physician’s profile
 2215  published pursuant to s. 456.041.
 2216         (a) An osteopathic physician who is engaged in providing
 2217  primary health care services may not supervise more than four
 2218  offices in addition to the osteopathic physician’s primary
 2219  practice location. For the purpose of this subsection, “primary
 2220  health care” means health care services that are commonly
 2221  provided to patients without referral from another practitioner,
 2222  including obstetrical and gynecological services, and excludes
 2223  practices providing primarily dermatologic and skin care
 2224  services, which include aesthetic skin care services.
 2225         (b) An osteopathic physician who is engaged in providing
 2226  specialty health care services may not supervise more than two
 2227  offices in addition to the osteopathic physician’s primary
 2228  practice location. For the purpose of this subsection,
 2229  “specialty health care” means health care services that are
 2230  commonly provided to patients with a referral from another
 2231  practitioner and excludes practices providing primarily
 2232  dermatologic and skin care services, which include aesthetic
 2233  skin care services.
 2234         (c) An osteopathic physician who supervises an advanced
 2235  practice registered nurse advanced registered nurse practitioner
 2236  or physician assistant at a medical office other than the
 2237  osteopathic physician’s primary practice location, where the
 2238  advanced practice registered nurse advanced registered nurse
 2239  practitioner or physician assistant is not under the onsite
 2240  supervision of a supervising osteopathic physician and the
 2241  services offered at the office are primarily dermatologic or
 2242  skin care services, which include aesthetic skin care services
 2243  other than plastic surgery, must comply with the standards
 2244  listed in subparagraphs 1.-4. Notwithstanding s.
 2245  459.022(4)(e)6., an osteopathic physician supervising a
 2246  physician assistant pursuant to this paragraph may not be
 2247  required to review and cosign charts or medical records prepared
 2248  by such physician assistant.
 2249         1. The osteopathic physician shall submit to the Board of
 2250  Osteopathic Medicine the addresses of all offices where he or
 2251  she is supervising or has a protocol with an advanced practice
 2252  registered nurse advanced registered nurse practitioner or a
 2253  physician physician’s assistant which are not the osteopathic
 2254  physician’s primary practice location.
 2255         2. The osteopathic physician must be board certified or
 2256  board eligible in dermatology or plastic surgery as recognized
 2257  by the Board of Osteopathic Medicine pursuant to s. 459.0152.
 2258         3. All such offices that are not the osteopathic
 2259  physician’s primary place of practice must be within 25 miles of
 2260  the osteopathic physician’s primary place of practice or in a
 2261  county that is contiguous to the county of the osteopathic
 2262  physician’s primary place of practice. However, the distance
 2263  between any of the offices may not exceed 75 miles.
 2264         4. The osteopathic physician may supervise only one office
 2265  other than the osteopathic physician’s primary place of practice
 2266  except that until July 1, 2011, the osteopathic physician may
 2267  supervise up to two medical offices other than the osteopathic
 2268  physician’s primary place of practice if the addresses of the
 2269  offices are submitted to the Board of Osteopathic Medicine
 2270  before July 1, 2006. Effective July 1, 2011, the osteopathic
 2271  physician may supervise only one office other than the
 2272  osteopathic physician’s primary place of practice, regardless of
 2273  when the addresses of the offices were submitted to the Board of
 2274  Osteopathic Medicine.
 2275         (d) An osteopathic physician who supervises an office in
 2276  addition to the osteopathic physician’s primary practice
 2277  location must conspicuously post in each of the osteopathic
 2278  physician’s offices a current schedule of the regular hours when
 2279  the osteopathic physician is present in that office and the
 2280  hours when the office is open while the osteopathic physician is
 2281  not present.
 2282         (e) This subsection does not apply to health care services
 2283  provided in facilities licensed under chapter 395 or in
 2284  conjunction with a college of medicine or college of nursing or
 2285  an accredited graduate medical or nursing education program;
 2286  offices where the only service being performed is hair removal
 2287  by an advanced practice registered nurse advanced registered
 2288  nurse practitioner or physician assistant; not-for-profit,
 2289  family-planning clinics that are not licensed pursuant to
 2290  chapter 390; rural and federally qualified health centers;
 2291  health care services provided in a nursing home licensed under
 2292  part II of chapter 400, an assisted living facility licensed
 2293  under part I of chapter 429, a continuing care facility licensed
 2294  under chapter 651, or a retirement community consisting of
 2295  independent living units and either a licensed nursing home or
 2296  assisted living facility; anesthesia services provided in
 2297  accordance with law; health care services provided in a
 2298  designated rural health clinic; health care services provided to
 2299  persons enrolled in a program designed to maintain elderly
 2300  persons and persons with disabilities in a home or community
 2301  based setting; university primary care student health centers;
 2302  school health clinics; or health care services provided in
 2303  federal, state, or local government facilities.
 2304         Section 56. Effective October 1, 2018, subsection (2) of
 2305  section 464.003, Florida Statutes, is amended to read:
 2306         464.003 Definitions.—As used in this part, the term:
 2307         (2) “Advanced or specialized nursing practice” means, in
 2308  addition to the practice of professional nursing, the
 2309  performance of advanced-level nursing acts approved by the board
 2310  which, by virtue of postbasic specialized education, training,
 2311  and experience, are appropriately performed by an advanced
 2312  practice registered nurse advanced registered nurse
 2313  practitioner. Within the context of advanced or specialized
 2314  nursing practice, the advanced practice registered nurse
 2315  advanced registered nurse practitioner may perform acts of
 2316  nursing diagnosis and nursing treatment of alterations of the
 2317  health status. The advanced practice registered nurse advanced
 2318  registered nurse practitioner may also perform acts of medical
 2319  diagnosis and treatment, prescription, and operation as
 2320  authorized within the framework of an established supervisory
 2321  protocol. The department may, by rule, require that a copy of
 2322  the protocol be filed with the department along with the notice
 2323  required by s. 458.348.
 2324         Section 57. Effective October 1, 2018, subsection (2) of
 2325  section 464.004, Florida Statutes, is amended to read:
 2326         464.004 Board of Nursing; membership; appointment; terms.—
 2327         (2) Seven members of the board must be registered nurses
 2328  who are residents of this state and who have been engaged in the
 2329  practice of professional nursing for at least 4 years, including
 2330  at least one advanced practice registered nurse advanced
 2331  registered nurse practitioner, one nurse educator member of an
 2332  approved program, and one nurse executive. These seven board
 2333  members should be representative of the diverse areas of
 2334  practice within the nursing profession. In addition, three
 2335  members of the board must be licensed practical nurses who are
 2336  residents of this state and who have been actively engaged in
 2337  the practice of practical nursing for at least 4 years prior to
 2338  their appointment. The remaining three members must be residents
 2339  of the state who have never been licensed as nurses and who are
 2340  in no way connected with the practice of nursing. No person may
 2341  be appointed as a lay member who is in any way connected with,
 2342  or has any financial interest in, any health care facility,
 2343  agency, or insurer. At least one member of the board must be 60
 2344  years of age or older.
 2345         Section 58. Effective October 1, 2018, paragraph (b) of
 2346  subsection (3) of section 464.013, Florida Statutes, is amended
 2347  to read:
 2348         464.013 Renewal of license or certificate.—
 2349         (3) The board shall by rule prescribe up to 30 hours of
 2350  continuing education biennially as a condition for renewal of a
 2351  license or certificate.
 2352         (b) Notwithstanding the exemption in paragraph (a), as part
 2353  of the maximum 30 hours of continuing education hours required
 2354  under this subsection, advanced practice registered nurses
 2355  licensed advanced registered nurse practitioners certified under
 2356  s. 464.012 must complete at least 3 hours of continuing
 2357  education on the safe and effective prescription of controlled
 2358  substances. Such continuing education courses must be offered by
 2359  a statewide professional association of physicians in this state
 2360  accredited to provide educational activities designated for the
 2361  American Medical Association Physician’s Recognition Award
 2362  Category 1 credit, the American Nurses Credentialing Center, the
 2363  American Association of Nurse Anesthetists, or the American
 2364  Association of Nurse Practitioners and may be offered in a
 2365  distance learning format.
 2366         Section 59. Effective October 1, 2018, subsections (5) and
 2367  (8), of section 464.015, Florida Statutes, are amended to read:
 2368         464.015 Titles and abbreviations; restrictions; penalty.—
 2369         (5) Only persons who hold valid licenses certificates to
 2370  practice as clinical nurse specialists in this state may use the
 2371  title “Clinical Nurse Specialist” and the abbreviation “C.N.S.”
 2372         (8) Only persons who hold valid licenses certificates to
 2373  practice as advanced practice registered nurses advanced
 2374  registered nurse practitioners in this state may use the title
 2375  “Advanced Practice Registered Nurse” “Advanced Registered Nurse
 2376  Practitioner” and the abbreviation “A.P.R.N.” “A.R.N.P.”
 2377         Section 60. Effective October 1, 2018, subsection (9) of
 2378  section 464.015, Florida Statutes, as amended by section 9 of
 2379  chapter 2016-139, Laws of Florida, is amended to read:
 2380         464.015 Titles and abbreviations; restrictions; penalty.—
 2381         (9) A person may not practice or advertise as, or assume
 2382  the title of, registered nurse, licensed practical nurse,
 2383  clinical nurse specialist, certified registered nurse
 2384  anesthetist, certified nurse midwife, certified nurse
 2385  practitioner, or advanced practice registered nurse advanced
 2386  registered nurse practitioner or use the abbreviation “R.N.,”
 2387  “L.P.N.,” “C.N.S.,” “C.R.N.A.,” “C.N.M.,” “C.N.P.,” or
 2388  “A.P.R.N.,” “A.R.N.P.” or take any other action that would lead
 2389  the public to believe that person was authorized by law to
 2390  practice as such or is performing nursing services pursuant to
 2391  the exception set forth in s. 464.022(8), unless that person is
 2392  licensed, certified, or authorized pursuant to s. 464.0095 to
 2393  practice as such.
 2394         Section 61. Effective October 1, 2018, paragraph (a) of
 2395  subsection (2) of section 464.016, Florida Statutes, is amended
 2396  to read:
 2397         464.016 Violations and penalties.—
 2398         (2) Each of the following acts constitutes a misdemeanor of
 2399  the first degree, punishable as provided in s. 775.082 or s.
 2400  775.083:
 2401         (a) Using the name or title “Nurse,” “Registered Nurse,”
 2402  “Licensed Practical Nurse,” “Clinical Nurse Specialist,”
 2403  “Certified Registered Nurse Anesthetist,” “Certified Nurse
 2404  Practitioner,” “Certified Nurse Midwife,” “Advanced Practice
 2405  Registered Nurse,” “Advanced Registered Nurse Practitioner,” or
 2406  any other name or title which implies that a person was licensed
 2407  or certified as same, unless such person is duly licensed or
 2408  certified.
 2409         Section 62. Effective October 1, 2018, paragraphs (p) and
 2410  (q) of subsection (1) of section 464.018, Florida Statutes, are
 2411  amended to read:
 2412         464.018 Disciplinary actions.—
 2413         (1) The following acts constitute grounds for denial of a
 2414  license or disciplinary action, as specified in s. 456.072(2):
 2415         (p) For an advanced practice registered nurse advanced
 2416  registered nurse practitioner:
 2417         1. Presigning blank prescription forms.
 2418         2. Prescribing for office use any medicinal drug appearing
 2419  on Schedule II in chapter 893.
 2420         3. Prescribing, ordering, dispensing, administering,
 2421  supplying, selling, or giving a drug that is an amphetamine, a
 2422  sympathomimetic amine drug, or a compound designated in s.
 2423  893.03(2) as a Schedule II controlled substance, to or for any
 2424  person except for:
 2425         a. The treatment of narcolepsy; hyperkinesis; behavioral
 2426  syndrome in children characterized by the developmentally
 2427  inappropriate symptoms of moderate to severe distractibility,
 2428  short attention span, hyperactivity, emotional lability, and
 2429  impulsivity; or drug-induced brain dysfunction.
 2430         b. The differential diagnostic psychiatric evaluation of
 2431  depression or the treatment of depression shown to be refractory
 2432  to other therapeutic modalities.
 2433         c. The clinical investigation of the effects of such drugs
 2434  or compounds when an investigative protocol is submitted to,
 2435  reviewed by, and approved by the department before such
 2436  investigation is begun.
 2437         4. Prescribing, ordering, dispensing, administering,
 2438  supplying, selling, or giving growth hormones, testosterone or
 2439  its analogs, human chorionic gonadotropin (HCG), or other
 2440  hormones for the purpose of muscle building or to enhance
 2441  athletic performance. As used in this subparagraph, the term
 2442  “muscle building” does not include the treatment of injured
 2443  muscle. A prescription written for the drug products identified
 2444  in this subparagraph may be dispensed by a pharmacist with the
 2445  presumption that the prescription is for legitimate medical use.
 2446         5. Promoting or advertising on any prescription form a
 2447  community pharmacy unless the form also states: “This
 2448  prescription may be filled at any pharmacy of your choice.”
 2449         6. Prescribing, dispensing, administering, mixing, or
 2450  otherwise preparing a legend drug, including a controlled
 2451  substance, other than in the course of his or her professional
 2452  practice. For the purposes of this subparagraph, it is legally
 2453  presumed that prescribing, dispensing, administering, mixing, or
 2454  otherwise preparing legend drugs, including all controlled
 2455  substances, inappropriately or in excessive or inappropriate
 2456  quantities is not in the best interest of the patient and is not
 2457  in the course of the advanced practice registered nurse’s
 2458  advanced registered nurse practitioner’s professional practice,
 2459  without regard to his or her intent.
 2460         7. Prescribing, dispensing, or administering a medicinal
 2461  drug appearing on any schedule set forth in chapter 893 to
 2462  himself or herself, except a drug prescribed, dispensed, or
 2463  administered to the advanced practice registered nurse advanced
 2464  registered nurse practitioner by another practitioner authorized
 2465  to prescribe, dispense, or administer medicinal drugs.
 2466         8. Prescribing, ordering, dispensing, administering,
 2467  supplying, selling, or giving amygdalin (laetrile) to any
 2468  person.
 2469         9. Dispensing a substance designated in s. 893.03(2) or (3)
 2470  as a substance controlled in Schedule II or Schedule III,
 2471  respectively, in violation of s. 465.0276.
 2472         10. Promoting or advertising through any communication
 2473  medium the use, sale, or dispensing of a substance designated in
 2474  s. 893.03 as a controlled substance.
 2475         (q) For a psychiatric nurse:
 2476         1. Presigning blank prescription forms.
 2477         2. Prescribing for office use any medicinal drug appearing
 2478  in Schedule II of s. 893.03.
 2479         3. Prescribing, ordering, dispensing, administering,
 2480  supplying, selling, or giving a drug that is an amphetamine, a
 2481  sympathomimetic amine drug, or a compound designated in s.
 2482  893.03(2) as a Schedule II controlled substance, to or for any
 2483  person except for:
 2484         a. The treatment of narcolepsy; hyperkinesis; behavioral
 2485  syndrome in children characterized by the developmentally
 2486  inappropriate symptoms of moderate to severe distractibility,
 2487  short attention span, hyperactivity, emotional lability, and
 2488  impulsivity; or drug-induced brain dysfunction.
 2489         b. The differential diagnostic psychiatric evaluation of
 2490  depression or the treatment of depression shown to be refractory
 2491  to other therapeutic modalities.
 2492         c. The clinical investigation of the effects of such drugs
 2493  or compounds when an investigative protocol is submitted to,
 2494  reviewed by, and approved by the department before such
 2495  investigation is begun.
 2496         4. Prescribing, ordering, dispensing, administering,
 2497  supplying, selling, or giving growth hormones, testosterone or
 2498  its analogs, human chorionic gonadotropin (HCG), or other
 2499  hormones for the purpose of muscle building or to enhance
 2500  athletic performance. As used in this subparagraph, the term
 2501  “muscle building” does not include the treatment of injured
 2502  muscle. A prescription written for the drug products identified
 2503  in this subparagraph may be dispensed by a pharmacist with the
 2504  presumption that the prescription is for legitimate medical use.
 2505         5. Promoting or advertising on any prescription form a
 2506  community pharmacy unless the form also states: “This
 2507  prescription may be filled at any pharmacy of your choice.”
 2508         6. Prescribing, dispensing, administering, mixing, or
 2509  otherwise preparing a legend drug, including a controlled
 2510  substance, other than in the course of his or her professional
 2511  practice. For the purposes of this subparagraph, it is legally
 2512  presumed that prescribing, dispensing, administering, mixing, or
 2513  otherwise preparing legend drugs, including all controlled
 2514  substances, inappropriately or in excessive or inappropriate
 2515  quantities is not in the best interest of the patient and is not
 2516  in the course of the advanced practice registered nurse’s
 2517  advanced registered nurse practitioner’s professional practice,
 2518  without regard to his or her intent.
 2519         7. Prescribing, dispensing, or administering a medicinal
 2520  drug appearing on any schedule set forth in chapter 893 to
 2521  himself or herself, except a drug prescribed, dispensed, or
 2522  administered to the psychiatric nurse by another practitioner
 2523  authorized to prescribe, dispense, or administer medicinal
 2524  drugs.
 2525         8. Prescribing, ordering, dispensing, administering,
 2526  supplying, selling, or giving amygdalin (laetrile) to any
 2527  person.
 2528         9. Dispensing a substance designated in s. 893.03(2) or (3)
 2529  as a substance controlled in Schedule II or Schedule III,
 2530  respectively, in violation of s. 465.0276.
 2531         10. Promoting or advertising through any communication
 2532  medium the use, sale, or dispensing of a substance designated in
 2533  s. 893.03 as a controlled substance.
 2534         Section 63. Effective October 1, 2018, paragraph (a) of
 2535  subsection (4) of section 464.0205, Florida Statutes, is amended
 2536  to read:
 2537         464.0205 Retired volunteer nurse certificate.—
 2538         (4) A retired volunteer nurse receiving certification from
 2539  the board shall:
 2540         (a) Work under the direct supervision of the director of a
 2541  county health department, a physician working under a limited
 2542  license issued pursuant to s. 458.317 or s. 459.0075, a
 2543  physician licensed under chapter 458 or chapter 459, an advanced
 2544  practice registered nurse licensed advanced registered nurse
 2545  practitioner certified under s. 464.012, or a registered nurse
 2546  licensed under s. 464.008 or s. 464.009.
 2547         Section 64. Effective October 1, 2018, subsection (2) of
 2548  section 467.003, Florida Statutes, is amended to read:
 2549         467.003 Definitions.—As used in this chapter, unless the
 2550  context otherwise requires:
 2551         (2) “Certified nurse midwife” means a person who is
 2552  licensed as an advanced practice registered nurse advanced
 2553  registered nurse practitioner under part I of chapter 464 and
 2554  who is certified to practice midwifery by the American College
 2555  of Nurse Midwives.
 2556         Section 65. Effective October 1, 2018, subsection (1) of
 2557  section 480.0475, Florida Statutes, is amended to read:
 2558         480.0475 Massage establishments; prohibited practices.—
 2559         (1) A person may not operate a massage establishment
 2560  between the hours of midnight and 5 a.m. This subsection does
 2561  not apply to a massage establishment:
 2562         (a) Located on the premises of a health care facility as
 2563  defined in s. 408.07; a health care clinic as defined in s.
 2564  400.9905(4); a hotel, motel, or bed and breakfast inn, as those
 2565  terms are defined in s. 509.242; a timeshare property as defined
 2566  in s. 721.05; a public airport as defined in s. 330.27; or a
 2567  pari-mutuel facility as defined in s. 550.002;
 2568         (b) In which every massage performed between the hours of
 2569  midnight and 5 a.m. is performed by a massage therapist acting
 2570  under the prescription of a physician or physician assistant
 2571  licensed under chapter 458, an osteopathic physician or
 2572  physician assistant licensed under chapter 459, a chiropractic
 2573  physician licensed under chapter 460, a podiatric physician
 2574  licensed under chapter 461, an advanced practice registered
 2575  nurse advanced registered nurse practitioner licensed under part
 2576  I of chapter 464, or a dentist licensed under chapter 466; or
 2577         (c) Operating during a special event if the county or
 2578  municipality in which the establishment operates has approved
 2579  such operation during the special event.
 2580         Section 66. Effective October 1, 2018, subsection (7) of
 2581  section 483.041, Florida Statutes, is amended to read:
 2582         483.041 Definitions.—As used in this part, the term:
 2583         (7) “Licensed practitioner” means a physician licensed
 2584  under chapter 458, chapter 459, chapter 460, or chapter 461; a
 2585  certified optometrist licensed under chapter 463; a dentist
 2586  licensed under chapter 466; a person licensed under chapter 462;
 2587  a consultant pharmacist or doctor of pharmacy licensed under
 2588  chapter 465; or an advanced practice registered nurse advanced
 2589  registered nurse practitioner licensed under part I of chapter
 2590  464; or a duly licensed practitioner from another state licensed
 2591  under similar statutes who orders examinations on materials or
 2592  specimens for nonresidents of the State of Florida, but who
 2593  reside in the same state as the requesting licensed
 2594  practitioner.
 2595         Section 67. Effective October 1, 2018, subsection (5) of
 2596  section 483.801, Florida Statutes, is amended to read:
 2597         483.801 Exemptions.—This part applies to all clinical
 2598  laboratories and clinical laboratory personnel within this
 2599  state, except:
 2600         (5) Advanced practice registered nurses advanced registered
 2601  nurse practitioners licensed under part I of chapter 464 who
 2602  perform provider-performed microscopy procedures (PPMP) in an
 2603  exclusive-use laboratory setting.
 2604         Section 68. Effective October 1, 2018, paragraph (a) of
 2605  subsection (11) of section 486.021, Florida Statutes, is amended
 2606  to read:
 2607         486.021 Definitions.—In this chapter, unless the context
 2608  otherwise requires, the term:
 2609         (11) “Practice of physical therapy” means the performance
 2610  of physical therapy assessments and the treatment of any
 2611  disability, injury, disease, or other health condition of human
 2612  beings, or the prevention of such disability, injury, disease,
 2613  or other condition of health, and rehabilitation as related
 2614  thereto by the use of the physical, chemical, and other
 2615  properties of air; electricity; exercise; massage; the
 2616  performance of acupuncture only upon compliance with the
 2617  criteria set forth by the Board of Medicine, when no penetration
 2618  of the skin occurs; the use of radiant energy, including
 2619  ultraviolet, visible, and infrared rays; ultrasound; water; the
 2620  use of apparatus and equipment in the application of the
 2621  foregoing or related thereto; the performance of tests of
 2622  neuromuscular functions as an aid to the diagnosis or treatment
 2623  of any human condition; or the performance of electromyography
 2624  as an aid to the diagnosis of any human condition only upon
 2625  compliance with the criteria set forth by the Board of Medicine.
 2626         (a) A physical therapist may implement a plan of treatment
 2627  developed by the physical therapist for a patient or provided
 2628  for a patient by a practitioner of record or by an advanced
 2629  practice registered nurse advanced registered nurse practitioner
 2630  licensed under s. 464.012. The physical therapist shall refer
 2631  the patient to or consult with a practitioner of record if the
 2632  patient’s condition is found to be outside the scope of physical
 2633  therapy. If physical therapy treatment for a patient is required
 2634  beyond 30 days for a condition not previously assessed by a
 2635  practitioner of record, the physical therapist shall have a
 2636  practitioner of record review and sign the plan. The requirement
 2637  that a physical therapist have a practitioner of record review
 2638  and sign a plan of treatment does not apply when a patient has
 2639  been physically examined by a physician licensed in another
 2640  state, the patient has been diagnosed by the physician as having
 2641  a condition for which physical therapy is required, and the
 2642  physical therapist is treating the condition. For purposes of
 2643  this paragraph, a health care practitioner licensed under
 2644  chapter 458, chapter 459, chapter 460, chapter 461, or chapter
 2645  466 and engaged in active practice is eligible to serve as a
 2646  practitioner of record.
 2647         Section 69. Effective October 1, 2018, paragraph (d) of
 2648  subsection (1) of section 490.012, Florida Statutes, is amended
 2649  to read:
 2650         490.012 Violations; penalties; injunction.—
 2651         (1)
 2652         (d) A person may not No person shall hold herself or
 2653  himself out by any title or description incorporating the word,
 2654  or a permutation of the word, “psychotherapy” unless such person
 2655  holds a valid, active license under chapter 458, chapter 459,
 2656  chapter 490, or chapter 491, or such person is licensed
 2657  certified as an advanced practice registered nurse under
 2658  advanced registered nurse practitioner, pursuant to s. 464.012,
 2659  who has been determined by the Board of Nursing as a specialist
 2660  in psychiatric mental health.
 2661         Section 70. Effective October 1, 2018, subsection (1) of
 2662  section 491.0057, Florida Statutes, is amended to read:
 2663         491.0057 Dual licensure as a marriage and family
 2664  therapist.—The department shall license as a marriage and family
 2665  therapist any person who demonstrates to the board that he or
 2666  she:
 2667         (1) Holds a valid, active license as a psychologist under
 2668  chapter 490 or as a clinical social worker or mental health
 2669  counselor under this chapter, or is licensed certified under s.
 2670  464.012 as an advanced practice registered nurse advanced
 2671  registered nurse practitioner who has been determined by the
 2672  Board of Nursing as a specialist in psychiatric mental health.
 2673         Section 71. Effective October 1, 2018, paragraph (d) of
 2674  subsection (1) and subsection (2) of section 491.012, Florida
 2675  Statutes, are amended to read:
 2676         491.012 Violations; penalty; injunction.—
 2677         (1) It is unlawful and a violation of this chapter for any
 2678  person to:
 2679         (d) Use the terms psychotherapist, sex therapist, or
 2680  juvenile sexual offender therapist unless such person is
 2681  licensed pursuant to this chapter or chapter 490, or is licensed
 2682  certified under s. 464.012 as an advanced practice registered
 2683  nurse advanced registered nurse practitioner who has been
 2684  determined by the Board of Nursing as a specialist in
 2685  psychiatric mental health and the use of such terms is within
 2686  the scope of her or his practice based on education, training,
 2687  and licensure.
 2688         (2) It is unlawful and a violation of this chapter for any
 2689  person to describe her or his services using the following terms
 2690  or any derivative thereof, unless such person holds a valid,
 2691  active license under this chapter or chapter 490, or is licensed
 2692  certified under s. 464.012 as an advanced practice registered
 2693  nurse advanced registered nurse practitioner who has been
 2694  determined by the Board of Nursing as a specialist in
 2695  psychiatric mental health and the use of such terms is within
 2696  the scope of her or his practice based on education, training,
 2697  and licensure:
 2698         (a) “Psychotherapy.”
 2699         (b) “Sex therapy.”
 2700         (c) “Sex counseling.”
 2701         (d) “Clinical social work.”
 2702         (e) “Psychiatric social work.”
 2703         (f) “Marriage and family therapy.”
 2704         (g) “Marriage and family counseling.”
 2705         (h) “Marriage counseling.”
 2706         (i) “Family counseling.”
 2707         (j) “Mental health counseling.”
 2708         Section 72. Effective October 1, 2018, subsection (2) of
 2709  section 493.6108, Florida Statutes, is amended to read:
 2710         493.6108 Investigation of applicants by Department of
 2711  Agriculture and Consumer Services.—
 2712         (2) In addition to subsection (1), the department shall
 2713  make an investigation of the general physical fitness of the
 2714  Class “G” applicant to bear a weapon or firearm. Determination
 2715  of physical fitness shall be certified by a physician or
 2716  physician assistant currently licensed pursuant to chapter 458,
 2717  chapter 459, or any similar law of another state or authorized
 2718  to act as a licensed physician by a federal agency or department
 2719  or by an advanced practice registered nurse advanced registered
 2720  nurse practitioner currently licensed pursuant to chapter 464.
 2721  Such certification shall be submitted on a form provided by the
 2722  department.
 2723         Section 73. Effective October 1, 2018, paragraph (b) of
 2724  subsection (1) of section 627.357, Florida Statutes, is amended
 2725  to read:
 2726         627.357 Medical malpractice self-insurance.—
 2727         (1) DEFINITIONS.—As used in this section, the term:
 2728         (b) “Health care provider” means any:
 2729         1. Hospital licensed under chapter 395.
 2730         2. Physician licensed, or physician assistant licensed,
 2731  under chapter 458.
 2732         3. Osteopathic physician or physician assistant licensed
 2733  under chapter 459.
 2734         4. Podiatric physician licensed under chapter 461.
 2735         5. Health maintenance organization certificated under part
 2736  I of chapter 641.
 2737         6. Ambulatory surgical center licensed under chapter 395.
 2738         7. Chiropractic physician licensed under chapter 460.
 2739         8. Psychologist licensed under chapter 490.
 2740         9. Optometrist licensed under chapter 463.
 2741         10. Dentist licensed under chapter 466.
 2742         11. Pharmacist licensed under chapter 465.
 2743         12. Registered nurse, licensed practical nurse, or advanced
 2744  practice registered nurse advanced registered nurse practitioner
 2745  licensed or registered under part I of chapter 464.
 2746         13. Other medical facility.
 2747         14. Professional association, partnership, corporation,
 2748  joint venture, or other association established by the
 2749  individuals set forth in subparagraphs 2., 3., 4., 7., 8., 9.,
 2750  10., 11., and 12. for professional activity.
 2751         Section 74. Effective October 1, 2018, subsection (6) of
 2752  section 627.6471, Florida Statutes, is amended to read:
 2753         627.6471 Contracts for reduced rates of payment;
 2754  limitations; coinsurance and deductibles.—
 2755         (6) If psychotherapeutic services are covered by a policy
 2756  issued by the insurer, the insurer shall provide eligibility
 2757  criteria for each group of health care providers licensed under
 2758  chapter 458, chapter 459, chapter 490, or chapter 491, which
 2759  include psychotherapy within the scope of their practice as
 2760  provided by law, or for any person who is licensed certified as
 2761  an advanced practice registered nurse advanced registered nurse
 2762  practitioner in psychiatric mental health under s. 464.012. When
 2763  psychotherapeutic services are covered, eligibility criteria
 2764  shall be established by the insurer to be included in the
 2765  insurer’s criteria for selection of network providers. The
 2766  insurer may not discriminate against a health care provider by
 2767  excluding such practitioner from its provider network solely on
 2768  the basis of the practitioner’s license.
 2769         Section 75. Effective October 1, 2018, subsections (15) and
 2770  (17) of section 627.6472, Florida Statutes, are amended to read:
 2771         627.6472 Exclusive provider organizations.—
 2772         (15) If psychotherapeutic services are covered by a policy
 2773  issued by the insurer, the insurer shall provide eligibility
 2774  criteria for all groups of health care providers licensed under
 2775  chapter 458, chapter 459, chapter 490, or chapter 491, which
 2776  include psychotherapy within the scope of their practice as
 2777  provided by law, or for any person who is licensed certified as
 2778  an advanced practice registered nurse advanced registered nurse
 2779  practitioner in psychiatric mental health under s. 464.012. When
 2780  psychotherapeutic services are covered, eligibility criteria
 2781  shall be established by the insurer to be included in the
 2782  insurer’s criteria for selection of network providers. The
 2783  insurer may not discriminate against a health care provider by
 2784  excluding such practitioner from its provider network solely on
 2785  the basis of the practitioner’s license.
 2786         (17) An exclusive provider organization shall not
 2787  discriminate with respect to participation as to any advanced
 2788  practice registered nurse advanced registered nurse practitioner
 2789  licensed and certified pursuant to s. 464.012, who is acting
 2790  within the scope of such license and certification, solely on
 2791  the basis of such license or certification. This subsection
 2792  shall not be construed to prohibit a plan from including
 2793  providers only to the extent necessary to meet the needs of the
 2794  plan’s enrollees or from establishing any measure designed to
 2795  maintain quality and control costs consistent with the
 2796  responsibilities of the plan.
 2797         Section 76. Effective October 1, 2018, paragraph (a) of
 2798  subsection (1) of section 627.736, Florida Statutes, is amended
 2799  to read:
 2800         627.736 Required personal injury protection benefits;
 2801  exclusions; priority; claims.—
 2802         (1) REQUIRED BENEFITS.—An insurance policy complying with
 2803  the security requirements of s. 627.733 must provide personal
 2804  injury protection to the named insured, relatives residing in
 2805  the same household, persons operating the insured motor vehicle,
 2806  passengers in the motor vehicle, and other persons struck by the
 2807  motor vehicle and suffering bodily injury while not an occupant
 2808  of a self-propelled vehicle, subject to subsection (2) and
 2809  paragraph (4)(e), to a limit of $10,000 in medical and
 2810  disability benefits and $5,000 in death benefits resulting from
 2811  bodily injury, sickness, disease, or death arising out of the
 2812  ownership, maintenance, or use of a motor vehicle as follows:
 2813         (a) Medical benefits.—Eighty percent of all reasonable
 2814  expenses for medically necessary medical, surgical, X-ray,
 2815  dental, and rehabilitative services, including prosthetic
 2816  devices and medically necessary ambulance, hospital, and nursing
 2817  services if the individual receives initial services and care
 2818  pursuant to subparagraph 1. within 14 days after the motor
 2819  vehicle accident. The medical benefits provide reimbursement
 2820  only for:
 2821         1. Initial services and care that are lawfully provided,
 2822  supervised, ordered, or prescribed by a physician licensed under
 2823  chapter 458 or chapter 459, a dentist licensed under chapter
 2824  466, or a chiropractic physician licensed under chapter 460 or
 2825  that are provided in a hospital or in a facility that owns, or
 2826  is wholly owned by, a hospital. Initial services and care may
 2827  also be provided by a person or entity licensed under part III
 2828  of chapter 401 which provides emergency transportation and
 2829  treatment.
 2830         2. Upon referral by a provider described in subparagraph
 2831  1., followup services and care consistent with the underlying
 2832  medical diagnosis rendered pursuant to subparagraph 1. which may
 2833  be provided, supervised, ordered, or prescribed only by a
 2834  physician licensed under chapter 458 or chapter 459, a
 2835  chiropractic physician licensed under chapter 460, a dentist
 2836  licensed under chapter 466, or, to the extent permitted by
 2837  applicable law and under the supervision of such physician,
 2838  osteopathic physician, chiropractic physician, or dentist, by a
 2839  physician assistant licensed under chapter 458 or chapter 459 or
 2840  an advanced practice registered nurse advanced registered nurse
 2841  practitioner licensed under chapter 464. Followup services and
 2842  care may also be provided by the following persons or entities:
 2843         a. A hospital or ambulatory surgical center licensed under
 2844  chapter 395.
 2845         b. An entity wholly owned by one or more physicians
 2846  licensed under chapter 458 or chapter 459, chiropractic
 2847  physicians licensed under chapter 460, or dentists licensed
 2848  under chapter 466 or by such practitioners and the spouse,
 2849  parent, child, or sibling of such practitioners.
 2850         c. An entity that owns or is wholly owned, directly or
 2851  indirectly, by a hospital or hospitals.
 2852         d. A physical therapist licensed under chapter 486, based
 2853  upon a referral by a provider described in this subparagraph.
 2854         e. A health care clinic licensed under part X of chapter
 2855  400 which is accredited by an accrediting organization whose
 2856  standards incorporate comparable regulations required by this
 2857  state, or
 2858         (I) Has a medical director licensed under chapter 458,
 2859  chapter 459, or chapter 460;
 2860         (II) Has been continuously licensed for more than 3 years
 2861  or is a publicly traded corporation that issues securities
 2862  traded on an exchange registered with the United States
 2863  Securities and Exchange Commission as a national securities
 2864  exchange; and
 2865         (III) Provides at least four of the following medical
 2866  specialties:
 2867         (A) General medicine.
 2868         (B) Radiography.
 2869         (C) Orthopedic medicine.
 2870         (D) Physical medicine.
 2871         (E) Physical therapy.
 2872         (F) Physical rehabilitation.
 2873         (G) Prescribing or dispensing outpatient prescription
 2874  medication.
 2875         (H) Laboratory services.
 2876         3. Reimbursement for services and care provided in
 2877  subparagraph 1. or subparagraph 2. up to $10,000 if a physician
 2878  licensed under chapter 458 or chapter 459, a dentist licensed
 2879  under chapter 466, a physician assistant licensed under chapter
 2880  458 or chapter 459, or an advanced practice registered nurse
 2881  advanced registered nurse practitioner licensed under chapter
 2882  464 has determined that the injured person had an emergency
 2883  medical condition.
 2884         4. Reimbursement for services and care provided in
 2885  subparagraph 1. or subparagraph 2. is limited to $2,500 if a
 2886  provider listed in subparagraph 1. or subparagraph 2. determines
 2887  that the injured person did not have an emergency medical
 2888  condition.
 2889         5. Medical benefits do not include massage as defined in s.
 2890  480.033 or acupuncture as defined in s. 457.102, regardless of
 2891  the person, entity, or licensee providing massage or
 2892  acupuncture, and a licensed massage therapist or licensed
 2893  acupuncturist may not be reimbursed for medical benefits under
 2894  this section.
 2895         6. The Financial Services Commission shall adopt by rule
 2896  the form that must be used by an insurer and a health care
 2897  provider specified in sub-subparagraph 2.b., sub-subparagraph
 2898  2.c., or sub-subparagraph 2.e. to document that the health care
 2899  provider meets the criteria of this paragraph. Such rule must
 2900  include a requirement for a sworn statement or affidavit.
 2901  
 2902  Only insurers writing motor vehicle liability insurance in this
 2903  state may provide the required benefits of this section, and
 2904  such insurer may not require the purchase of any other motor
 2905  vehicle coverage other than the purchase of property damage
 2906  liability coverage as required by s. 627.7275 as a condition for
 2907  providing such benefits. Insurers may not require that property
 2908  damage liability insurance in an amount greater than $10,000 be
 2909  purchased in conjunction with personal injury protection. Such
 2910  insurers shall make benefits and required property damage
 2911  liability insurance coverage available through normal marketing
 2912  channels. An insurer writing motor vehicle liability insurance
 2913  in this state who fails to comply with such availability
 2914  requirement as a general business practice violates part IX of
 2915  chapter 626, and such violation constitutes an unfair method of
 2916  competition or an unfair or deceptive act or practice involving
 2917  the business of insurance. An insurer committing such violation
 2918  is subject to the penalties provided under that part, as well as
 2919  those provided elsewhere in the insurance code.
 2920         Section 77. Effective October 1, 2018, subsection (5) of
 2921  section 633.412, Florida Statutes, is amended to read:
 2922         633.412 Firefighters; qualifications for certification.—A
 2923  person applying for certification as a firefighter must:
 2924         (5) Be in good physical condition as determined by a
 2925  medical examination given by a physician, surgeon, or physician
 2926  assistant licensed to practice in the state pursuant to chapter
 2927  458; an osteopathic physician, surgeon, or physician assistant
 2928  licensed to practice in the state pursuant to chapter 459; or an
 2929  advanced practice registered nurse advanced registered nurse
 2930  practitioner licensed to practice in the state pursuant to
 2931  chapter 464. Such examination may include, but need not be
 2932  limited to, the National Fire Protection Association Standard
 2933  1582. A medical examination evidencing good physical condition
 2934  shall be submitted to the division, on a form as provided by
 2935  rule, before an individual is eligible for admission into a
 2936  course under s. 633.408.
 2937         Section 78. Effective October 1, 2018, section 641.3923,
 2938  Florida Statutes, is amended to read:
 2939         641.3923 Discrimination against providers prohibited.—A
 2940  health maintenance organization may shall not discriminate with
 2941  respect to participation as to any advanced practice registered
 2942  nurse advanced registered nurse practitioner licensed and
 2943  certified pursuant to s. 464.012, who is acting within the scope
 2944  of such license and certification, solely on the basis of such
 2945  license or certification. This section may shall not be
 2946  construed to prohibit a plan from including providers only to
 2947  the extent necessary to meet the needs of the plan’s enrollees
 2948  or from establishing any measure designed to maintain quality
 2949  and control costs consistent with the responsibilities of the
 2950  plan.
 2951         Section 79. Effective October 1, 2018, subsection (3) of
 2952  section 766.103, Florida Statutes, is amended to read:
 2953         766.103 Florida Medical Consent Law.—
 2954         (3) No recovery shall be allowed in any court in this state
 2955  against any physician licensed under chapter 458, osteopathic
 2956  physician licensed under chapter 459, chiropractic physician
 2957  licensed under chapter 460, podiatric physician licensed under
 2958  chapter 461, dentist licensed under chapter 466, advanced
 2959  practice registered nurse licensed advanced registered nurse
 2960  practitioner certified under s. 464.012, or physician assistant
 2961  licensed under s. 458.347 or s. 459.022 in an action brought for
 2962  treating, examining, or operating on a patient without his or
 2963  her informed consent when:
 2964         (a)1. The action of the physician, osteopathic physician,
 2965  chiropractic physician, podiatric physician, dentist, advanced
 2966  practice registered nurse advanced registered nurse
 2967  practitioner, or physician assistant in obtaining the consent of
 2968  the patient or another person authorized to give consent for the
 2969  patient was in accordance with an accepted standard of medical
 2970  practice among members of the medical profession with similar
 2971  training and experience in the same or similar medical community
 2972  as that of the person treating, examining, or operating on the
 2973  patient for whom the consent is obtained; and
 2974         2. A reasonable individual, from the information provided
 2975  by the physician, osteopathic physician, chiropractic physician,
 2976  podiatric physician, dentist, advanced practice registered nurse
 2977  advanced registered nurse practitioner, or physician assistant,
 2978  under the circumstances, would have a general understanding of
 2979  the procedure, the medically acceptable alternative procedures
 2980  or treatments, and the substantial risks and hazards inherent in
 2981  the proposed treatment or procedures, which are recognized among
 2982  other physicians, osteopathic physicians, chiropractic
 2983  physicians, podiatric physicians, or dentists in the same or
 2984  similar community who perform similar treatments or procedures;
 2985  or
 2986         (b) The patient would reasonably, under all the surrounding
 2987  circumstances, have undergone such treatment or procedure had he
 2988  or she been advised by the physician, osteopathic physician,
 2989  chiropractic physician, podiatric physician, dentist, advanced
 2990  practice registered nurse advanced registered nurse
 2991  practitioner, or physician assistant in accordance with the
 2992  provisions of paragraph (a).
 2993         Section 80. Effective October 1, 2018, paragraph (d) of
 2994  subsection (3) of section 766.1115, Florida Statutes, is amended
 2995  to read:
 2996         766.1115 Health care providers; creation of agency
 2997  relationship with governmental contractors.—
 2998         (3) DEFINITIONS.—As used in this section, the term:
 2999         (d) “Health care provider” or “provider” means:
 3000         1. A birth center licensed under chapter 383.
 3001         2. An ambulatory surgical center licensed under chapter
 3002  395.
 3003         3. A hospital licensed under chapter 395.
 3004         4. A physician or physician assistant licensed under
 3005  chapter 458.
 3006         5. An osteopathic physician or osteopathic physician
 3007  assistant licensed under chapter 459.
 3008         6. A chiropractic physician licensed under chapter 460.
 3009         7. A podiatric physician licensed under chapter 461.
 3010         8. A registered nurse, nurse midwife, licensed practical
 3011  nurse, or advanced practice registered nurse advanced registered
 3012  nurse practitioner licensed or registered under part I of
 3013  chapter 464 or any facility which employs nurses licensed or
 3014  registered under part I of chapter 464 to supply all or part of
 3015  the care delivered under this section.
 3016         9. A midwife licensed under chapter 467.
 3017         10. A health maintenance organization certificated under
 3018  part I of chapter 641.
 3019         11. A health care professional association and its
 3020  employees or a corporate medical group and its employees.
 3021         12. Any other medical facility the primary purpose of which
 3022  is to deliver human medical diagnostic services or which
 3023  delivers nonsurgical human medical treatment, and which includes
 3024  an office maintained by a provider.
 3025         13. A dentist or dental hygienist licensed under chapter
 3026  466.
 3027         14. A free clinic that delivers only medical diagnostic
 3028  services or nonsurgical medical treatment free of charge to all
 3029  low-income recipients.
 3030         15. Any other health care professional, practitioner,
 3031  provider, or facility under contract with a governmental
 3032  contractor, including a student enrolled in an accredited
 3033  program that prepares the student for licensure as any one of
 3034  the professionals listed in subparagraphs 4.-9.
 3035  
 3036  The term includes any nonprofit corporation qualified as exempt
 3037  from federal income taxation under s. 501(a) of the Internal
 3038  Revenue Code, and described in s. 501(c) of the Internal Revenue
 3039  Code, which delivers health care services provided by licensed
 3040  professionals listed in this paragraph, any federally funded
 3041  community health center, and any volunteer corporation or
 3042  volunteer health care provider that delivers health care
 3043  services.
 3044         Section 81. Effective October 1, 2018, subsection (1) of
 3045  section 766.1116, Florida Statutes, is amended to read:
 3046         766.1116 Health care practitioner; waiver of license
 3047  renewal fees and continuing education requirements.—
 3048         (1) As used in this section, the term “health care
 3049  practitioner” means a physician or physician assistant licensed
 3050  under chapter 458; an osteopathic physician or physician
 3051  assistant licensed under chapter 459; a chiropractic physician
 3052  licensed under chapter 460; a podiatric physician licensed under
 3053  chapter 461; an advanced practice registered nurse advanced
 3054  registered nurse practitioner, registered nurse, or licensed
 3055  practical nurse licensed under part I of chapter 464; a dentist
 3056  or dental hygienist licensed under chapter 466; or a midwife
 3057  licensed under chapter 467, who participates as a health care
 3058  provider under s. 766.1115.
 3059         Section 82. Effective October 1, 2018, paragraph (c) of
 3060  subsection (1) of section 766.118, Florida Statutes, is amended
 3061  to read:
 3062         766.118 Determination of noneconomic damages.—
 3063         (1) DEFINITIONS.—As used in this section, the term:
 3064         (c) “Practitioner” means any person licensed under chapter
 3065  458, chapter 459, chapter 460, chapter 461, chapter 462, chapter
 3066  463, chapter 466, chapter 467, or chapter 486 or certified under
 3067  s. 464.012. “Practitioner” also means any association,
 3068  corporation, firm, partnership, or other business entity under
 3069  which such practitioner practices or any employee of such
 3070  practitioner or entity acting in the scope of his or her
 3071  employment. For the purpose of determining the limitations on
 3072  noneconomic damages set forth in this section, the term
 3073  “practitioner” includes any person or entity for whom a
 3074  practitioner is vicariously liable and any person or entity
 3075  whose liability is based solely on such person or entity being
 3076  vicariously liable for the actions of a practitioner.
 3077         Section 83. Effective October 1, 2018, subsection (5) of
 3078  section 794.08, Florida Statutes, is amended to read:
 3079         794.08 Female genital mutilation.—
 3080         (5) This section does not apply to procedures performed by
 3081  or under the direction of a physician licensed under chapter
 3082  458, an osteopathic physician licensed under chapter 459, a
 3083  registered nurse licensed under part I of chapter 464, a
 3084  practical nurse licensed under part I of chapter 464, an
 3085  advanced practice registered nurse advanced registered nurse
 3086  practitioner licensed under part I of chapter 464, a midwife
 3087  licensed under chapter 467, or a physician assistant licensed
 3088  under chapter 458 or chapter 459 when necessary to preserve the
 3089  physical health of a female person. This section also does not
 3090  apply to any autopsy or limited dissection conducted pursuant to
 3091  chapter 406.
 3092         Section 84. Effective October 1, 2018, subsection (23) of
 3093  section 893.02, Florida Statutes, is amended to read:
 3094         893.02 Definitions.—The following words and phrases as used
 3095  in this chapter shall have the following meanings, unless the
 3096  context otherwise requires:
 3097         (23) “Practitioner” means a physician licensed under
 3098  chapter 458, a dentist licensed under chapter 466, a
 3099  veterinarian licensed under chapter 474, an osteopathic
 3100  physician licensed under chapter 459, an advanced practice
 3101  registered nurse licensed advanced registered nurse practitioner
 3102  certified under chapter 464, a naturopath licensed under chapter
 3103  462, a certified optometrist licensed under chapter 463, a
 3104  psychiatric nurse as defined in s. 394.455, a podiatric
 3105  physician licensed under chapter 461, or a physician assistant
 3106  licensed under chapter 458 or chapter 459, provided such
 3107  practitioner holds a valid federal controlled substance registry
 3108  number.
 3109         Section 85. Effective October 1, 2018, paragraph (b) of
 3110  subsection (1) of section 893.05, Florida Statutes, is amended
 3111  to read:
 3112         893.05 Practitioners and persons administering controlled
 3113  substances in their absence.—
 3114         (1)
 3115         (b) Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
 3116  464.012(3), as applicable, a practitioner who supervises a
 3117  licensed physician assistant or advanced practice registered
 3118  nurse advanced registered nurse practitioner may authorize the
 3119  licensed physician assistant or advanced practice registered
 3120  nurse advanced registered nurse practitioner to order controlled
 3121  substances for administration to a patient in a facility
 3122  licensed under chapter 395 or part II of chapter 400.
 3123         Section 86. Effective October 1, 2018, subsection (6) of
 3124  section 943.13, Florida Statutes, is amended to read:
 3125         943.13 Officers’ minimum qualifications for employment or
 3126  appointment.—On or after October 1, 1984, any person employed or
 3127  appointed as a full-time, part-time, or auxiliary law
 3128  enforcement officer or correctional officer; on or after October
 3129  1, 1986, any person employed as a full-time, part-time, or
 3130  auxiliary correctional probation officer; and on or after
 3131  October 1, 1986, any person employed as a full-time, part-time,
 3132  or auxiliary correctional officer by a private entity under
 3133  contract to the Department of Corrections, to a county
 3134  commission, or to the Department of Management Services shall:
 3135         (6) Have passed a physical examination by a licensed
 3136  physician, physician assistant, or licensed advanced practice
 3137  registered nurse certified advanced registered nurse
 3138  practitioner, based on specifications established by the
 3139  commission. In order to be eligible for the presumption set
 3140  forth in s. 112.18 while employed with an employing agency, a
 3141  law enforcement officer, correctional officer, or correctional
 3142  probation officer must have successfully passed the physical
 3143  examination required by this subsection upon entering into
 3144  service as a law enforcement officer, correctional officer, or
 3145  correctional probation officer with the employing agency, which
 3146  examination must have failed to reveal any evidence of
 3147  tuberculosis, heart disease, or hypertension. A law enforcement
 3148  officer, correctional officer, or correctional probation officer
 3149  may not use a physical examination from a former employing
 3150  agency for purposes of claiming the presumption set forth in s.
 3151  112.18 against the current employing agency.
 3152         Section 87. Effective October 1, 2018, paragraph (n) of
 3153  subsection (1) of section 948.03, Florida Statutes, is amended
 3154  to read:
 3155         948.03 Terms and conditions of probation.—
 3156         (1) The court shall determine the terms and conditions of
 3157  probation. Conditions specified in this section do not require
 3158  oral pronouncement at the time of sentencing and may be
 3159  considered standard conditions of probation. These conditions
 3160  may include among them the following, that the probationer or
 3161  offender in community control shall:
 3162         (n) Be prohibited from using intoxicants to excess or
 3163  possessing any drugs or narcotics unless prescribed by a
 3164  physician, an advanced practice registered nurse advanced
 3165  registered nurse practitioner, or a physician assistant. The
 3166  probationer or community controllee may not knowingly visit
 3167  places where intoxicants, drugs, or other dangerous substances
 3168  are unlawfully sold, dispensed, or used.
 3169         Section 88. Effective October 1, 2018, paragraph (i) of
 3170  subsection (3) of section 1002.20, Florida Statutes, is amended
 3171  to read:
 3172         1002.20 K-12 student and parent rights.—Parents of public
 3173  school students must receive accurate and timely information
 3174  regarding their child’s academic progress and must be informed
 3175  of ways they can help their child to succeed in school. K-12
 3176  students and their parents are afforded numerous statutory
 3177  rights including, but not limited to, the following:
 3178         (3) HEALTH ISSUES.—
 3179         (i) Epinephrine use and supply.—
 3180         1. A student who has experienced or is at risk for life
 3181  threatening allergic reactions may carry an epinephrine auto
 3182  injector and self-administer epinephrine by auto-injector while
 3183  in school, participating in school-sponsored activities, or in
 3184  transit to or from school or school-sponsored activities if the
 3185  school has been provided with parental and physician
 3186  authorization. The State Board of Education, in cooperation with
 3187  the Department of Health, shall adopt rules for such use of
 3188  epinephrine auto-injectors that shall include provisions to
 3189  protect the safety of all students from the misuse or abuse of
 3190  auto-injectors. A school district, county health department,
 3191  public-private partner, and their employees and volunteers shall
 3192  be indemnified by the parent of a student authorized to carry an
 3193  epinephrine auto-injector for any and all liability with respect
 3194  to the student’s use of an epinephrine auto-injector pursuant to
 3195  this paragraph.
 3196         2. A public school may purchase a supply of epinephrine
 3197  auto-injectors from a wholesale distributor as defined in s.
 3198  499.003 or may enter into an arrangement with a wholesale
 3199  distributor or manufacturer as defined in s. 499.003 for the
 3200  epinephrine auto-injectors at fair-market, free, or reduced
 3201  prices for use in the event a student has an anaphylactic
 3202  reaction. The epinephrine auto-injectors must be maintained in a
 3203  secure location on the public school’s premises. The
 3204  participating school district shall adopt a protocol developed
 3205  by a licensed physician for the administration by school
 3206  personnel who are trained to recognize an anaphylactic reaction
 3207  and to administer an epinephrine auto-injection. The supply of
 3208  epinephrine auto-injectors may be provided to and used by a
 3209  student authorized to self-administer epinephrine by auto
 3210  injector under subparagraph 1. or trained school personnel.
 3211         3. The school district and its employees, agents, and the
 3212  physician who provides the standing protocol for school
 3213  epinephrine auto-injectors are not liable for any injury arising
 3214  from the use of an epinephrine auto-injector administered by
 3215  trained school personnel who follow the adopted protocol and
 3216  whose professional opinion is that the student is having an
 3217  anaphylactic reaction:
 3218         a. Unless the trained school personnel’s action is willful
 3219  and wanton;
 3220         b. Notwithstanding that the parents or guardians of the
 3221  student to whom the epinephrine is administered have not been
 3222  provided notice or have not signed a statement acknowledging
 3223  that the school district is not liable; and
 3224         c. Regardless of whether authorization has been given by
 3225  the student’s parents or guardians or by the student’s
 3226  physician, physician’s assistant, or advanced practice
 3227  registered nurse advanced registered nurse practitioner.
 3228         Section 89. Effective October 1, 2018, paragraph (b) of
 3229  subsection (17) of section 1002.42, Florida Statutes, is amended
 3230  to read:
 3231         1002.42 Private schools.—
 3232         (17) EPINEPHRINE SUPPLY.—
 3233         (b) The private school and its employees, agents, and the
 3234  physician who provides the standing protocol for school
 3235  epinephrine auto-injectors are not liable for any injury arising
 3236  from the use of an epinephrine auto-injector administered by
 3237  trained school personnel who follow the adopted protocol and
 3238  whose professional opinion is that the student is having an
 3239  anaphylactic reaction:
 3240         1. Unless the trained school personnel’s action is willful
 3241  and wanton;
 3242         2. Notwithstanding that the parents or guardians of the
 3243  student to whom the epinephrine is administered have not been
 3244  provided notice or have not signed a statement acknowledging
 3245  that the school district is not liable; and
 3246         3. Regardless of whether authorization has been given by
 3247  the student’s parents or guardians or by the student’s
 3248  physician, physician’s assistant, or advanced practice
 3249  registered nurse advanced registered nurse practitioner.
 3250         Section 90. Effective October 1, 2018, subsections (4) and
 3251  (5) of section 1006.062, Florida Statutes, are amended to read:
 3252         1006.062 Administration of medication and provision of
 3253  medical services by district school board personnel.—
 3254         (4) Nonmedical assistive personnel shall be allowed to
 3255  perform health-related services upon successful completion of
 3256  child-specific training by a registered nurse or advanced
 3257  practice registered nurse advanced registered nurse practitioner
 3258  licensed under chapter 464, a physician licensed pursuant to
 3259  chapter 458 or chapter 459, or a physician assistant licensed
 3260  pursuant to chapter 458 or chapter 459. All procedures shall be
 3261  monitored periodically by a nurse, advanced practice registered
 3262  nurse advanced registered nurse practitioner, physician
 3263  assistant, or physician, including, but not limited to:
 3264         (a) Intermittent clean catheterization.
 3265         (b) Gastrostomy tube feeding.
 3266         (c) Monitoring blood glucose.
 3267         (d) Administering emergency injectable medication.
 3268         (5) For all other invasive medical services not listed in
 3269  this subsection, a registered nurse or advanced practice
 3270  registered nurse advanced registered nurse practitioner licensed
 3271  under chapter 464, a physician licensed pursuant to chapter 458
 3272  or chapter 459, or a physician assistant licensed pursuant to
 3273  chapter 458 or chapter 459 shall determine if nonmedical
 3274  district school board personnel shall be allowed to perform such
 3275  service.
 3276         Section 91. Effective October 1, 2018, subsection (1) and
 3277  paragraph (a) of subsection (2) of section 1009.65, Florida
 3278  Statutes, are amended to read:
 3279         1009.65 Medical Education Reimbursement and Loan Repayment
 3280  Program.—
 3281         (1) To encourage qualified medical professionals to
 3282  practice in underserved locations where there are shortages of
 3283  such personnel, there is established the Medical Education
 3284  Reimbursement and Loan Repayment Program. The function of the
 3285  program is to make payments that offset loans and educational
 3286  expenses incurred by students for studies leading to a medical
 3287  or nursing degree, medical or nursing licensure, or advanced
 3288  practice registered nurse licensure advanced registered nurse
 3289  practitioner certification or physician assistant licensure. The
 3290  following licensed or certified health care professionals are
 3291  eligible to participate in this program: medical doctors with
 3292  primary care specialties, doctors of osteopathic medicine with
 3293  primary care specialties, physician’s assistants, licensed
 3294  practical nurses and registered nurses, and advanced practice
 3295  registered nurses advanced registered nurse practitioners with
 3296  primary care specialties such as certified nurse midwives.
 3297  Primary care medical specialties for physicians include
 3298  obstetrics, gynecology, general and family practice, internal
 3299  medicine, pediatrics, and other specialties which may be
 3300  identified by the Department of Health.
 3301         (2) From the funds available, the Department of Health
 3302  shall make payments to selected medical professionals as
 3303  follows:
 3304         (a) Up to $4,000 per year for licensed practical nurses and
 3305  registered nurses, up to $10,000 per year for advanced practice
 3306  registered nurses advanced registered nurse practitioners and
 3307  physician’s assistants, and up to $20,000 per year for
 3308  physicians. Penalties for noncompliance shall be the same as
 3309  those in the National Health Services Corps Loan Repayment
 3310  Program. Educational expenses include costs for tuition,
 3311  matriculation, registration, books, laboratory and other fees,
 3312  other educational costs, and reasonable living expenses as
 3313  determined by the Department of Health.
 3314         Section 92. Effective October 1, 2018, subsection (2) of
 3315  section 1009.66, Florida Statutes, is amended to read:
 3316         1009.66 Nursing Student Loan Forgiveness Program.—
 3317         (2) To be eligible, a candidate must have graduated from an
 3318  accredited or approved nursing program and have received a
 3319  Florida license as a licensed practical nurse or a registered
 3320  nurse or a Florida license certificate as an advanced practice
 3321  registered nurse advanced registered nurse practitioner.
 3322         Section 93. Effective October 1, 2018, subsection (3) of
 3323  section 1009.67, Florida Statutes, is amended to read:
 3324         1009.67 Nursing scholarship program.—
 3325         (3) A scholarship may be awarded for no more than 2 years,
 3326  in an amount not to exceed $8,000 per year. However, registered
 3327  nurses pursuing a graduate degree for a faculty position or to
 3328  practice as an advanced practice registered nurse advanced
 3329  registered nurse practitioner may receive up to $12,000 per
 3330  year. These amounts shall be adjusted by the amount of increase
 3331  or decrease in the Consumer Price Index for All Urban Consumers
 3332  published by the United States Department of Commerce.
 3333         Section 94. Except as otherwise expressly provided in this
 3334  act, this act shall take effect upon becoming a law.
 3335  
 3336  ================= T I T L E  A M E N D M E N T ================
 3337  And the title is amended as follows:
 3338         Delete lines 98 - 105
 3339  and insert:
 3340         An act relating to licensed health care professionals;
 3341         creating s. 456.0541, F.S.; establishing the Physician
 3342         Fee Sharing Task Force within the Department of
 3343         Health; providing for duties, membership, and meetings
 3344         of the task force; requiring a report to the Governor
 3345         and Legislature by a specified date; providing for
 3346         expiration of the task force; amending s. 464.003,
 3347         F.S.; defining the term “advanced practice registered
 3348         nurse”; deleting the terms “advanced registered nurse
 3349         practitioner,” “clinical nurse specialist,” and
 3350         “clinical nurse specialist practice,” to conform to
 3351         changes made by the act; repealing s. 464.0115, F.S.,
 3352         relating to the certification of clinical nurse
 3353         specialists; amending s. 464.012, F.S.; requiring any
 3354         nurse desiring to be licensed as an advanced practice
 3355         registered nurse to apply to the Department of Health,
 3356         submit proof that he or she holds a current license to
 3357         practice professional nursing, and meet one or more
 3358         specified requirements as determined by the Board of
 3359         Nursing; authorizing the board to adopt rules to
 3360         provide for provisional state licensure of certified
 3361         nurse midwives, certified nurse practitioners,
 3362         certified registered nurse anesthetists, clinical
 3363         nurse specialists, and psychiatric nurses for a
 3364         specified period of time; requiring the department and
 3365         the board to establish a transition process for
 3366         converting certain certified practitioners to licensed
 3367         practitioners; authorizing certain certified
 3368         practitioners to continue practicing advanced nursing
 3369         during a specified period of time; providing
 3370         construction; providing an expiration date for
 3371         provisions relating to the transition from
 3372         certification to licensure; conforming provisions to
 3373         changes made by the act; amending s. 960.28, F.S.;
 3374         conforming a cross-reference; amending ss. 39.303,
 3375         39.304, 90.503, 110.12315, 121.0515, 252.515, 310.071,
 3376         310.073, 310.081, 320.0848, 381.00315, 381.00593,
 3377         383.14, 383.141, 384.27, 390.0111, 390.012, 394.455,
 3378         395.0191, 397.311, 397.4012, 397.427, 397.679,
 3379         397.6793, 400.021, 400.462, 400.487, 400.506,
 3380         400.9973, 400.9974, 400.9976, 400.9979, 401.445,
 3381         409.905, 409.908, 409.973, 429.918, 456.0391,
 3382         456.0392, 456.041, 456.048, 456.072, 456.44, 458.3265,
 3383         458.331, 458.348, 459.0137, 459.015, 459.025, 464.003,
 3384         464.004, 464.013, 464.015, 464.016, 464.018, 464.0205,
 3385         467.003, 480.0475, 483.041, 483.801, 486.021, 490.012,
 3386         491.0057, 491.012, 493.6108, 627.357, 627.6471,
 3387         627.6472, 627.736, 633.412, 641.3923, 766.103,
 3388         766.1115, 766.1116, 766.118, 794.08, 893.02, 893.05,
 3389         943.13, 948.03, 1002.20, 1002.42, 1006.062, 1009.65,
 3390         1009.66, and 1009.67, F.S.; conforming provisions to
 3391         changes made by the act; providing effective dates.