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House Bill 1919

Florida House of Representatives - 1997 HB 1919 By Representative Cosgrove 1 A bill to be entitled 2 An act relating to psychological services; 3 amending s. 490.003, F.S.; revising the 4 definition of "practice of psychology" to 5 include authority to prescribe and administer 6 psychotropic drugs and to provide requirements 7 with respect thereto; requiring testing 8 laboratories to provide certain test results 9 requested by prescribing psychologists; 10 amending ss. 464.003, 464.012, and 893.02, 11 F.S., relating to the definitions of "practice 12 of practical nursing" and "advanced or 13 specialized nursing practice," to duties of 14 advanced registered nurse practitioners, and to 15 the definition of "practitioner" as it applies 16 to the Florida Comprehensive Drug Abuse 17 Prevention and Control Act, to incorporate 18 reference to such prescribing psychologists 19 therein; providing an effective date. 20 21 Be It Enacted by the Legislature of the State of Florida: 22 23 Section 1. Subsection (4) of section 490.003, Florida 24 Statutes, is amended to read: 25 490.003 Definitions.-- 26 (4)(a) "Practice of psychology" means the 27 observations, description, evaluation, interpretation, and 28 modification of human behavior, by the use of scientific and 29 applied psychological principles, methods, and procedures, for 30 the purpose of describing, preventing, alleviating, or 31 eliminating symptomatic, maladaptive, or undesired behavior 1 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 and of enhancing interpersonal behavioral health and mental or 2 psychological health. The ethical practice of psychology 3 includes, but is not limited to, psychological testing and the 4 evaluation or assessment of personal characteristics such as 5 intelligence, personality, abilities, interests, aptitudes, 6 and neuropsychological functioning, including evaluation of 7 mental competency to manage one's affairs and to participate 8 in legal proceedings; counseling, psychoanalysis, all forms of 9 psychotherapy, sex therapy, hypnosis, biofeedback, and 10 behavioral analysis and therapy; psychoeducational evaluation, 11 therapy, remediation, and consultation; and use of 12 psychological methods to diagnose and treat mental, nervous, 13 psychological, marital, or emotional disorders, illness, or 14 disability, alcoholism and substance abuse, and disorders of 15 habit or conduct, as well as the psychological aspects of 16 physical illness, accident, injury, or disability, including 17 neuropsychological evaluation, diagnosis, prognosis, etiology, 18 and treatment. 19 1.(a) Psychological services may be rendered to 20 individuals, couples, families, groups, and the public without 21 regard to place of service. 22 2.(b) The use of specific modalities within the 23 practice of psychology is restricted to psychologists 24 appropriately trained in the use of such modalities. 25 3.(c) The practice of psychology shall be construed 26 within the meaning of this definition without regard to 27 whether payment is requested or received for services 28 rendered. 29 (b) "Practice of psychology" also includes the 30 prescription and administration of psychotropic drugs within 31 the recognized scope of practice of the profession. Such a 2 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 prescribing psychologist must meet the profession's 2 established standards of training according to the board's 3 professional guidelines or be a nationally recognized Fellow 4 of the Prescribing Psychologists' Register. The board shall 5 include training in, but not limited to, the following 6 professional didactic subject areas and require the following 7 preceptorship-supervision: 8 1. Pharmacology/psychopharmacology, clinical (child, 9 adult, and geriatric): 10 a. Pharmacokinetics and pharmacodynamics, drug 11 interactions, side effects, and substance abuse. 12 b. Serology, laboratory, and maintenance of 13 therapeutic drug levels. 14 2. Related sciences: 15 a. Neuroanatomy, neurophysiology, and neurochemistry. 16 b. Pathophysiology, organ and anatomy systems of 17 functioning and nonfunctioning systems, and 18 metabolism/biotransformation. 19 3. Treatment applications: 20 a. Consultation with other professionals. 21 b. Ethics and professional issues. 22 c. Computer-enhanced record and history 23 accountability. 24 4. Preceptorship-supervision of 1 year minimum with 25 100 patients. 26 27 Testing laboratories licensed by the state shall provide 28 prescribing psychologists, upon request, test results for 29 their patients receiving psychotropic drugs. 30 Section 2. Subsection (3) of section 464.003, Florida 31 Statutes, 1996 Supplement, is amended to read: 3 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 464.003 Definitions.--As used in this chapter: 2 (3)(a) "Practice of professional nursing" means the 3 performance of those acts requiring substantial specialized 4 knowledge, judgment, and nursing skill based upon applied 5 principles of psychological, biological, physical, and social 6 sciences which shall include, but not be limited to: 7 1. The observation, assessment, nursing diagnosis, 8 planning, intervention, and evaluation of care; health 9 teaching and counseling of the ill, injured, or infirm; and 10 the promotion of wellness, maintenance of health, and 11 prevention of illness of others. 12 2. The administration of medications and treatments as 13 prescribed or authorized by a duly licensed practitioner 14 authorized by the laws of this state to prescribe such 15 medications and treatments. 16 3. The supervision and teaching of other personnel in 17 the theory and performance of any of the above acts. 18 19 The professional nurse shall be responsible and accountable 20 for making decisions that are based upon the individual's 21 educational preparation and experience in nursing. 22 (b) "Practice of practical nursing" means the 23 performance of selected acts, including the administration of 24 treatments and medications, in the care of the ill, injured, 25 or infirm and the promotion of wellness, maintenance of 26 health, and prevention of illness of others under the 27 direction of a registered nurse, a licensed physician, a 28 licensed osteopathic physician, a licensed podiatrist, or a 29 licensed dentist, or a licensed prescribing psychologist. The 30 professional nurse and the practical nurse shall be 31 responsible and accountable for making decisions that are 4 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 based upon the individual's educational preparation and 2 experience in nursing. 3 (c) "Advanced or specialized nursing practice" means, 4 in addition to the practice of professional nursing, the 5 performance of advanced-level nursing acts approved by the 6 board which, by virtue of postbasic specialized education, 7 training, and experience, are proper to be performed by an 8 advanced registered nurse practitioner. Within the context of 9 advanced or specialized nursing practice, the advanced 10 registered nurse practitioner may perform acts of nursing 11 diagnosis and nursing treatment of alterations of the health 12 status. The advanced registered nurse practitioner may also 13 perform acts of medical diagnosis and treatment, prescription, 14 and operation which are identified and approved by a joint 15 committee composed of three members appointed by the Board of 16 Nursing, two of whom shall be advanced registered nurse 17 practitioners; three members appointed by the Board of 18 Medicine, two of whom shall have had work experience with 19 advanced registered nurse practitioners; and the director of 20 the agency or the director's designee. Each committee member 21 appointed by a board shall be appointed to a term of 4 years 22 unless a shorter term is required to establish or maintain 23 staggered terms. The Board of Nursing shall adopt rules 24 authorizing the performance of any such acts approved by the 25 joint committee. Unless otherwise specified by the joint 26 committee, such acts shall be performed under the general 27 supervision of a practitioner licensed under chapter 458, 28 chapter 459, or chapter 466, or chapter 490 within the 29 framework of standing protocols which identify the medical 30 acts or acts of a prescribing psychologist to be performed and 31 the conditions for their performance. The agency may, by rule, 5 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 require that a copy of the protocol be filed with the agency 2 along with the notice required by s. 458.348. 3 (d) "Nursing diagnosis" means the observation and 4 evaluation of physical or mental conditions, behaviors, signs 5 and symptoms of illness, and reactions to treatment and the 6 determination as to whether such conditions, signs, symptoms, 7 and reactions represent a deviation from normal. 8 (e) "Nursing treatment" means the establishment and 9 implementation of a nursing regimen for the care and comfort 10 of individuals, the prevention of illness, and the education, 11 restoration, and maintenance of health. 12 Section 3. Subsection (3) of section 464.012, Florida 13 Statutes, 1996 Supplement, is amended to read: 14 464.012 Certification of advanced registered nurse 15 practitioners; fees.-- 16 (3) An advanced registered nurse practitioner shall 17 perform those functions authorized in this section within the 18 framework of an established protocol. A practitioner currently 19 licensed under chapter 458, chapter 459, or chapter 466, or 20 chapter 490 shall maintain supervision for directing the 21 specific course of medical treatment or treatment prescribed 22 by a prescribing psychologist. Within the established 23 framework, an advanced registered nurse practitioner may: 24 (a) Monitor and alter drug therapies. 25 (b) Initiate appropriate therapies for certain 26 conditions. 27 (c) Perform additional functions as may be determined 28 by rule in accordance with s. 464.003(3)(c). 29 (d) Order diagnostic tests and physical and 30 occupational therapy. 31 6 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1919 141-432-97 1 Section 4. Subsection (18) of section 893.02, Florida 2 Statutes, is amended to read: 3 893.02 Definitions.--The following words and phrases 4 as used in this chapter shall have the following meanings, 5 unless the context otherwise requires: 6 (18) "Practitioner" means a physician licensed 7 pursuant to chapter 458, a dentist licensed pursuant to 8 chapter 466, a veterinarian licensed pursuant to chapter 474, 9 an osteopathic physician licensed pursuant to chapter 459, a 10 naturopath licensed pursuant to chapter 462, or a podiatrist 11 licensed pursuant to chapter 461, or a prescribing 12 psychologist licensed pursuant to chapter 490, provided such 13 practitioner holds a valid federal controlled substance 14 registry number. 15 Section 5. This act shall take effect October 1, 1997. 16 17 ***************************************** 18 HOUSE SUMMARY 19 Authorizes psychologists to prescribe and administer 20 psychotropic drugs and provides the training and preceptor-supervision requirements therefor. Requires 21 testing laboratories licensed by the state to provide test results requested by prescribing psychologists for 22 patients receiving such drugs. Revises other provisions of law relating to supervision of nurses and regulation 23 of controlled substances to incorporate reference to such prescribing psychologists therein. See bill for details. 24 25 26 27 28 29 30 31 7