CODING: Words stricken are deletions; words underlined are additions.

House Bill 2013e1

HB 2013, First Engrossed 1 A bill to be entitled 2 An act relating to regulation of health care 3 professions; amending s. 402.48, F.S., relating 4 to health care services pools; increasing the 5 period of registration; updating a definition 6 and a provision relating to meeting financial 7 responsibility requirements; amending s. 8 457.102, F.S.; revising definitions applicable 9 to the regulation of acupuncture; amending s. 10 457.105, F.S.; revising qualifications for 11 licensure to practice acupuncture; revising 12 fees; conforming terminology; amending s. 13 457.107, F.S.; revising licensure renewal fees; 14 conforming terminology; amending s. 457.1085, 15 F.S.; revising requirements on the adoption of 16 rules relating to infection control and on the 17 use of acupuncture needles; amending ss. 18 457.103, 457.108, 457.109, and 457.116, F.S., 19 to conform; amending s. 458.303, F.S.; 20 eliminating references to physician's trained 21 assistants; amending s. 458.305, F.S.; updating 22 the definition of "department"; amending s. 23 458.307, F.S.; revising provisions relating to 24 probable cause panels of the Board of Medicine; 25 amending s. 455.206, F.S.; correcting a cross 26 reference, to conform; amending s. 458.311, 27 F.S.; revising requirements for licensure of 28 physicians by examination; revising an 29 educational and postgraduate training 30 requirement; allowing certain applicants to 31 complete a specified fellowship to partially 1 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 satisfy the licensing requirements; providing 2 for additional remedial education or training 3 upon failure to pass the licensing examination 4 after a certain number of attempts; authorizing 5 persons in certain training programs to take 6 the examination under certain circumstances; 7 amending s. 458.313, F.S.; revising 8 requirements for licensure of physicians by 9 endorsement; eliminating a provision 10 authorizing oral examinations; providing for 11 additional remedial education or training upon 12 failure to pass the licensing examination after 13 a certain number of attempts; authorizing 14 additional requirements prior to certification 15 of eligibility for licensure; correcting a 16 cross reference; eliminating a provision 17 authorizing licensure under a period of 18 supervision; providing conditions for 19 reactivation of certain licenses issued by 20 endorsement; amending s. 458.317, F.S., 21 relating to limited licenses; eliminating the 22 requirement that applicants for a limited 23 license be retired from the practice of 24 medicine; restricting certain limited licensees 25 to noncompensated practice; requiring the 26 payment of fees if a person receives 27 compensation for the practice of medicine; 28 amending s. 458.319, F.S.; clarifying 29 requirements for renewal of license to practice 30 medicine; revising recent-practice 31 requirements; amending s. 458.320, F.S.; 2 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 correcting a cross reference; requiring 2 physicians not carrying medical malpractice 3 insurance to post notice and provide a written 4 statement thereof; providing for acknowledgment 5 that the patient has been so informed; amending 6 s. 458.331, F.S.; revising and providing 7 grounds for disciplinary action; providing 8 penalties; creating s. 458.3312, F.S.; 9 prohibiting physicians from falsely 10 representing that they are board-certified 11 specialists; amending s. 458.345, F.S., 12 relating to registration of resident 13 physicians, interns, and fellows; providing for 14 designation of a person responsible at each 15 hospital using such residents for the 16 hospital's semiannual reports to the 17 department; requiring certain notice to the 18 executive director of the board; providing that 19 registrants are subject to specified 20 disciplinary provisions; providing requirements 21 for the prescribing of medicinal drugs and 22 controlled substances; amending s. 458.346, 23 F.S.; providing for meetings of the Public 24 Sector Physician Advisory Committee; amending 25 ss. 458.347 and 459.022, F.S.; revising 26 requirements for certification as a physician 27 assistant; updating terminology; amending s. 28 458.3485, F.S.; requiring medical assistants to 29 be under the direct supervision of a licensed 30 physician; creating ss. 458.351 and 459.025, 31 F.S.; requiring serious incident reports; 3 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 providing for rules; amending s. 459.003, F.S.; 2 updating the definition of "department"; 3 providing that certain terms are equivalent; 4 amending s. 459.021, F.S.; revising terminology 5 relating to osteopathic medicine; revising 6 provisions relating to registration of resident 7 physicians, interns, and fellows; providing for 8 designation of a person responsible at each 9 hospital using such residents for the 10 hospital's semiannual reports to the 11 department; requiring certain notice to the 12 executive director of the board; providing that 13 registrants are subject to specified 14 disciplinary provisions; amending s. 459.0075, 15 F.S., relating to limited licenses; eliminating 16 the requirement that applicants for a limited 17 license be retired from the practice of 18 osteopathic medicine; restricting certain 19 limited licensees to noncompensated practice; 20 requiring the payment of fees if a person 21 receives compensation for the practice of 22 osteopathic medicine; amending s. 459.0085, 23 F.S.; correcting a cross reference; requiring 24 osteopathic physicians not carrying medical 25 malpractice insurance to post notice and 26 provide a written statement thereof; providing 27 for acknowledgment that the patient has been so 28 informed; amending s. 459.015, F.S.; revising 29 and providing grounds for disciplinary action; 30 providing penalties; creating s. 459.0152, 31 F.S.; prohibiting osteopathic physicians from 4 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 falsely representing that they are 2 board-certified specialists; amending ss. 3 240.4067, 390.011, 395.0191, 408.035, 409.905, 4 415.102, 415.1034, 415.504, 440.106, 440.13, 5 440.134, 440.15, 456.31, 459.006, 462.01, 6 468.301, 468.302, 476.044, 477.0135, 483.291, 7 621.03, 627.351, 627.357, 627.6482, 725.01, 8 766.101, 766.103, 766.105, 766.110, 817.234, 9 and 945.047, F.S.; conforming and correcting 10 terminology relating to osteopathic medicine; 11 amending s. 460.403, F.S.; updating the 12 definition of "department"; amending s. 13 460.413, F.S.; revising grounds for 14 disciplinary action; providing penalties; 15 providing criteria for determining the 16 applicable penalty; providing certain 17 evidentiary standards; providing authority and 18 procedure to enjoin a chiropractor from 19 providing medical services under certain 20 circumstances; reenacting ss. 320.0848(9), 21 455.236(4)(g), and 766.111(2), F.S., relating 22 to parking permits for disabled persons, 23 prohibited referrals to home health agencies, 24 and unnecessary diagnostic testing, to 25 incorporate the amendment to s. 460.413, F.S., 26 in references thereto; amending s. 460.4165, 27 F.S.; revising a provision relating to the fee 28 accompanying applications to supervise 29 chiropractic physician's assistants; amending 30 s. 461.003, F.S.; updating the definition of 31 "department"; amending s. 461.013, F.S.; 5 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 revising a ground for disciplinary action; 2 providing penalties; amending s. 461.018, F.S.; 3 clarifying a provision relating to the limited 4 practice of podiatry in designated areas of 5 need; amending s. 464.003, F.S.; revising a 6 definition to update authority over regulation 7 of nursing; amending ss. 464.004, 464.008, 8 464.009, 464.012, 464.013, and 464.014, F.S., 9 to conform; amending s. 464.018, F.S.; revising 10 grounds for disciplinary action; providing 11 penalties; conforming terminology; amending s. 12 464.019, F.S., relating to approval of nursing 13 programs; providing for a program review fee; 14 conforming terminology; creating s. 464.0205, 15 F.S.; providing for certification of retired 16 volunteer nurses; providing requirements, 17 qualifications, fees, and restrictions; 18 amending s. 464.022, F.S.; providing an 19 exemption from regulation relating to certain 20 nurses accompanying and caring for patients 21 temporarily residing in this state; amending s. 22 465.003, F.S.; updating the definition of 23 "department"; amending s. 465.004, F.S.; 24 increasing the membership of the Board of 25 Pharmacy; revising membership qualifications; 26 amending s. 465.014, F.S.; increasing the 27 number of pharmacy technicians who may be 28 supervised by a licensed pharmacist; amending 29 s. 465.0156, F.S.; revising information 30 required for registration of nonresident 31 pharmacies; amending s. 465.016, F.S.; revising 6 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 a ground for disciplinary action; providing 2 penalties; amending s. 465.035, F.S.; allowing 3 the dispensing of controlled substances based 4 on electronic facsimiles of the original 5 prescriptions; amending s. 466.003, F.S.; 6 updating the definition of "department"; 7 amending s. 466.006, F.S., relating to the 8 examination of dentists; revising prerequisites 9 for certain applicants to take the examination; 10 amending s. 466.017, F.S.; eliminating obsolete 11 provisions relating to the utilization of 12 general anesthesia and parenteral conscious 13 sedation by licensed dentists; amending s. 14 466.028, F.S.; revising grounds for 15 disciplinary action; providing penalties; 16 amending s. 468.1115, F.S.; revising and 17 providing exemptions from regulation as a 18 speech-language pathologist or audiologist; 19 amending s. 468.1125, F.S.; updating the 20 definition of "department"; amending s. 21 468.1155, F.S.; revising provisional licensure 22 requirements; providing requirements for 23 cross-discipline licensure; amending s. 24 468.1185, F.S.; revising licensure 25 requirements; conforming a reference; amending 26 s. 468.1195, F.S.; revising continuing 27 education requirements; providing for adoption 28 of standards of approval of continuing 29 education providers; creating s. 468.1201, 30 F.S.; requiring instruction on human 31 immunodeficiency virus and acquired immune 7 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 deficiency syndrome as a condition of being 2 granted a license or certificate to practice 3 speech-language pathology or audiology; 4 amending s. 468.1215, F.S.; revising 5 requirements for certification as a 6 speech-language pathology or audiology 7 assistant; conforming a reference; amending s. 8 468.1245, F.S.; revising language relating to 9 certain complaints concerning hearing aids; 10 amending s. 468.1295, F.S.; revising and 11 providing grounds for disciplinary action; 12 revising and providing penalties; creating s. 13 468.1296, F.S.; prohibiting sexual misconduct 14 in the practice of speech-language pathology 15 and audiology, for which there are penalties; 16 amending s. 468.1655, F.S.; updating the 17 definition of "department"; amending s. 18 468.1695, F.S.; reducing the number of times a 19 year the examination for licensure as a nursing 20 home administrator must be given; amending s. 21 468.203, F.S.; revising definitions applicable 22 to regulation of occupational therapy; amending 23 s. 468.205, F.S.; replacing the Occupational 24 Therapy Council with a Board of Occupational 25 Therapy Practice; providing for qualifications, 26 appointments, and terms of board members; 27 providing for the filling of vacancies on the 28 board; amending s. 468.209, F.S.; revising 29 educational requirements for licensure as an 30 occupational therapist or occupational therapy 31 assistant; providing for licensure of certain 8 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 applicants without meeting such educational 2 requirements; providing for certain temporary 3 permits; requiring documentation of continuing 4 education for certain applicants; amending s. 5 468.211, F.S.; providing a restriction on the 6 number of times an applicant may fail the 7 examination and requiring remediation after a 8 certain number; amending s. 468.213, F.S.; 9 revising requirements for licensure by 10 endorsement; amending s. 468.225, F.S.; 11 providing exemptions from regulation of 12 occupational therapy; amending ss. 468.351, 13 468.352, 468.354, 468.355, 468.356, 468.357, 14 468.358, 468.359, 468.36, 468.361, 468.363, 15 468.364, 468.365, 468.366, and 468.368, F.S., 16 and transferring and amending s. 468.362, F.S.; 17 providing for licensure of respiratory care 18 practitioners and respiratory therapists; 19 eliminating references to certification and 20 registration; updating the definition of 21 "department"; revising terminology; revising 22 approval of educational programs; eliminating 23 annual continuing education requirements for 24 certain persons; providing penalties; amending 25 s. 478.42, F.S.; updating the definition of 26 "department"; amending s. 478.45, F.S.; 27 revising requirements for licensure as an 28 electrologist; amending s. 478.46, F.S.; 29 revising requirements relating to issuance of 30 temporary permits; correcting a cross reference 31 and terminology; amending s. 478.47, F.S.; 9 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 revising requirements for licensure by 2 endorsement; amending s. 478.52, F.S.; 3 prohibiting the operation of unlicensed 4 electrolysis facilities; providing penalties; 5 amending s. 480.033, F.S.; revising the 6 definition of "board"; updating the definition 7 of "department"; amending s. 480.034, F.S.; 8 eliminating an exemption from regulation 9 applicable to certain skin treatments and 10 weight-loss programs; amending s. 480.035, 11 F.S.; renaming the Board of Massage as the 12 Board of Massage Therapy; amending s. 480.041, 13 F.S.; eliminating provisional licensure to 14 practice massage therapy; amending s. 480.0415, 15 F.S.; authorizing an increase in the number of 16 classroom hours of continuing education that 17 may be required for renewal of a license to 18 practice massage therapy; amending s. 480.042, 19 F.S.; revising what examinations must measure; 20 repealing s. 480.0425, F.S., relating to 21 inactive status; amending s. 480.043, F.S.; 22 revising provisions relating to the transfer of 23 licenses; amending s. 480.044, F.S.; revising 24 provisions relating to fees; amending s. 25 480.047, F.S.; prohibiting the practice of 26 massage therapy without a license unless 27 exempted from licensure; creating s. 480.0485, 28 F.S.; prohibiting sexual misconduct in the 29 practice of massage therapy, for which there 30 are disciplinary actions; amending s. 20.43, 31 F.S., relating to the Department of Health; 10 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 conforming terminology; updating a reference; 2 amending s. 381.81, F.S., to conform; amending 3 s. 483.800, F.S.; revising policy and purpose 4 relating to regulation of clinical laboratory 5 personnel; amending s. 483.801, F.S.; providing 6 a regulatory exemption relating to advanced 7 registered nurse practitioners; amending s. 8 483.803, F.S.; updating the definition of 9 "department"; providing definitions; amending 10 s. 483.809, F.S.; revising licensing 11 provisions; authorizing an alternative 12 examination for public health laboratory 13 scientists; creating s. 483.812, F.S.; 14 providing for licensure of public health 15 laboratory scientists; amending s. 483.813, 16 F.S.; extending the period of a temporary 17 license for clinical laboratory personnel; 18 providing a period for a conditional license; 19 amending s. 483.823, F.S.; revising provisions 20 relating to qualifications of clinical 21 laboratory personnel; amending s. 483.825, 22 F.S.; revising and providing grounds for 23 disciplinary action; providing penalties; 24 creating s. 483.828, F.S.; providing penalties 25 for specified violations; amending s. 483.901, 26 F.S., the "Florida Medical Physicists Act"; 27 providing that the Advisory Council of Medical 28 Physicists is an advisory rather than a 29 regulatory body; increasing the number and 30 terms of council members; clarifying initial 31 and other appointment provisions; revising 11 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 provisions relating to council meetings; 2 revising licensure requirements; clarifying 3 that the required continuing education hours 4 are to be satisfied biennially and that the 5 organizations providing such education must be 6 approved by the Department of Health; revising 7 and providing grounds for disciplinary action; 8 revising and providing criminal acts; providing 9 an administrative fine; providing penalties; 10 eliminating a provision authorizing a licensure 11 exception; amending s. 484.041, F.S.; updating 12 the definition of "department"; amending s. 13 484.042, F.S.; updating a reference, to 14 conform; amending s. 484.051, F.S.; updating a 15 reference, to conform; amending s. 486.021, 16 F.S.; updating the definition of "department"; 17 amending s. 486.023, F.S.; increasing the 18 membership of the Board of Physical Therapy 19 Practice; amending ss. 486.031 and 486.081, 20 F.S.; providing an alternative licensure 21 examination; revising accreditation provisions 22 relating to licensure as a physical therapist; 23 amending s. 486.041, F.S.; revising provisions 24 relating to applying for a license as a 25 physical therapist and to the fee therefor; 26 amending s. 486.051, F.S.; revising provisions 27 relating to examination of applicants for 28 licensure as a physical therapist; amending s. 29 486.102, F.S.; revising accreditation 30 provisions relating to licensure as a physical 31 therapist assistant; amending s. 486.103, F.S.; 12 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 revising provisions relating to applying for a 2 license as a physical therapist assistant and 3 to the fee therefor; amending s. 486.104, F.S.; 4 revising provisions relating to examination of 5 applicants for licensure as a physical 6 therapist assistant; creating s. 486.123, F.S.; 7 prohibiting sexual misconduct in the practice 8 of physical therapy, for which there are 9 disciplinary actions; amending s. 486.125, 10 F.S.; providing for recovery of the actual 11 costs of investigation and prosecution; 12 amending s. 641.495, F.S.; requiring a health 13 maintenance organization to designate as 14 medical director a state-licensed physician or 15 osteopathic physician; amending s. 499.012, 16 F.S.; clarifying and providing for additional 17 wholesale distribution exceptions; providing an 18 effective date. 19 20 Be It Enacted by the Legislature of the State of Florida: 21 22 Section 1. Paragraph (a) of subsection (1), subsection 23 (4), and paragraph (g) of subsection (8) of section 402.48, 24 Florida Statutes, 1996 Supplement, are amended to read: 25 402.48 Health care services pools.-- 26 (1) As used in this section, the term: 27 (a) "Department" means the Department of Health 28 Business and Professional Regulation. 29 (4) Each registration shall be for a period of 2 years 30 1 year. A new registration is required upon the sale of a 31 controlling interest in a health care services pool. 13 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (8) 2 (g) Meeting the financial responsibility requirements 3 of this section must be established at the time of issuance or 4 renewal of a certificate of registration on or after January 5 1, 1991. 6 Section 2. Section 457.102, Florida Statutes, is 7 amended to read: 8 457.102 Definitions.--As used in this chapter: 9 (1) "Acupuncture" means a form of primary health care, 10 based on traditional Chinese medical concepts, that employs 11 acupuncture diagnosis and treatment, as well as adjunctive 12 therapies and diagnostic techniques, for the promotion, 13 maintenance, and restoration of health and the prevention of 14 disease. Acupuncture shall include, but not be limited to, the 15 insertion of acupuncture needles and the application of 16 moxibustion to specific areas of the human body. 17 (2) "Acupuncturist" means any person licensed 18 certified as provided in this chapter to practice acupuncture 19 as a primary health care provider. 20 (3) "Board" means the Board of Acupuncture. 21 (4) "License Certificate" means the document of 22 authorization issued by the department for a person to engage 23 in the practice of acupuncture. 24 (5) "Department" means the Department of Health 25 Business and Professional Regulation. 26 Section 3. Subsection (1) of section 457.103, Florida 27 Statutes, is amended to read: 28 457.103 Board of Acupuncture; membership; appointment 29 and terms.-- 30 (1) The Board of Acupuncture is created within the 31 department and shall consist of five members, to be appointed 14 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 by the Governor and confirmed by the Senate. Three members of 2 the board must be licensed certified Florida acupuncturists. 3 Two members must be laypersons who are not and who have never 4 been acupuncturists or members of any closely related 5 profession. Members shall be appointed for 4-year terms or for 6 the remainder of the unexpired term of a vacancy. 7 Section 4. Section 457.105, Florida Statutes, is 8 amended to read: 9 457.105 Licensure Certification qualifications and 10 fees.-- 11 (1) It is unlawful for any person to practice 12 acupuncture in this state unless such person has been licensed 13 certified by the board, is in a board-approved tutorial 14 program or course of study, or is otherwise exempted by this 15 chapter. 16 (2) A person may become licensed certified to practice 17 acupuncture if the person applies to the department and 18 applicant: 19 (a) Is 18 years of age or older and meets one of the 20 following criteria: 21 1. He is a citizen of the United States; 22 2. He is a permanent resident of the United States; or 23 3. He is a legal alien who has resided in the United 24 States for 6 months immediately prior to qualifying for 25 examination; 26 (b) Has completed 60 college credits from an 27 accredited postsecondary institution as a prerequisite to 28 enrollment in an authorized 3-year course of study in 29 acupuncture, and has completed a 3-year course of study in 30 acupuncture, and effective July 31, 2001, a 4-year course of 31 study in acupuncture, which meets standards established by the 15 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 board by rule, which standards include successful completion 2 of academic courses in western anatomy, western physiology, 3 western pathology, and western biomedical terminology. 4 However, any person who enrolled in an authorized course of 5 study in acupuncture before August 1, 1997, must have 6 completed only the following: 7 1. a 2-year course of study which meets standards 8 established by the board by rule, which standards must shall 9 include, but are not limited to, successful completion of 10 academic courses in western anatomy, western physiology, and 11 western pathology; 12 2. A 2-year tutorial program which meets standards 13 established by the board by rule, which standards shall 14 include, but are not limited to, successful completion of 15 academic courses in western anatomy, western physiology, and 16 western pathology. Prior to entrance in a tutorial program, an 17 individual shall have been approved by the board, registered 18 with the department, and paid a registration fee not to exceed 19 $200 as set by rule of the board. Such tutorial program shall 20 be of a continuous nature for not less than 2 years under the 21 supervision of an acupuncturist certified under this chapter 22 and shall have commenced after October 1, 1986. A person 23 enrolled in a tutorial program approved by the board prior to 24 October 1, 1986, may complete that program to meet the 25 requirement for such training; or 26 3. At least 5 years of experience as an acupuncturist 27 pursuant to standards and criteria established by board rule; 28 (c) Has successfully completed a board-approved 29 national certification process, is actively licensed in a 30 state that which has examination requirements that are 31 substantially equivalent to or more stringent than those of 16 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 this state, or passes an examination administered by the 2 department, which examination tests the applicant's competency 3 and knowledge of the practice of acupuncture. At the request 4 of any applicant, oriental nomenclature for the points shall 5 be used in the examination. The examination shall include a 6 practical examination of the knowledge and skills required to 7 practice acupuncture, covering diagnostic and treatment 8 techniques and procedures; and 9 (d) Pays the required fees set by the board by rule 10 not to exceed the following amounts: 11 1. Examination fee: $500 $1,000 plus the actual per 12 applicant cost to the department for purchase of the written 13 and practical portions of the examination from the National 14 Commission for the Certification of Acupuncturists or a 15 similar national organization approved by the board. 16 2. Application fee: $300 $750. 17 3. Reexamination fee: $500 $1,000 plus the actual per 18 applicant cost to the department for purchase of the written 19 and practical portions of the examination from the National 20 Commission for the Certification of Acupuncturists or a 21 similar national organization approved by the board. 22 4. Initial biennial licensure certification fee: 23 $400, if licensed in the first half of the biennium, and $200, 24 if licensed in the second half of the biennium $2,000. 25 Section 5. Section 457.107, Florida Statutes, is 26 amended to read: 27 457.107 Renewal of licenses certificates; continuing 28 education.-- 29 (1) The department shall renew a license certificate 30 upon receipt of the renewal application and the fee set by the 31 board by rule, not to exceed $700 $1,000. 17 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) The department shall adopt rules establishing a 2 procedure for the biennial renewal of licenses certificates. 3 (3) The board shall by rule prescribe continuing 4 education requirements, not to exceed 30 hours biennially, as 5 a condition for renewal of a license certificate. The criteria 6 for such programs or courses shall be approved by the board. 7 In order to meet continuing education requirements, prior 8 approval by the board of such programs or courses is required. 9 All education programs that contribute to the advancement, 10 extension, or enhancement of professional skills and knowledge 11 related to the practice of acupuncture, whether conducted by a 12 nonprofit or profitmaking entity, are eligible for approval. 13 The board shall have the authority to set a fee, not to exceed 14 $100, for each continuing education provider or program 15 submitted for approval. 16 Section 6. Section 457.108, Florida Statutes, is 17 amended to read: 18 457.108 Inactive status; expiration; reactivation of 19 licenses certificates.-- 20 (1) A license certificate that has become inactive may 21 be reactivated under this section upon application to the 22 department. The board shall prescribe by rule continuing 23 education requirements as a condition of reactivating a 24 license certificate. The continuing education requirements for 25 reactivating a license certificate must not exceed 10 26 classroom hours for each year the license certificate was 27 inactive, in addition to completion of the number of hours 28 required for renewal on the date the license certificate 29 became inactive. 30 (2) The board shall adopt rules relating to 31 application procedures for inactive status, renewal of 18 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 inactive licenses certificates, and reactivation of licenses 2 certificates. The board shall prescribe by rule an application 3 fee for inactive status, a renewal fee for inactive status, a 4 delinquency fee, and a fee for the reactivation of a license 5 certificate. None of these fees may exceed the biennial 6 renewal fee established by the board for an active license 7 certificate. 8 (3) The department shall not reactivate a license 9 certificate unless the inactive or delinquent licensee 10 certificateholder has paid any applicable biennial renewal or 11 delinquency fee, or both, and a reactivation fee. 12 Section 7. Section 457.1085, Florida Statutes, is 13 amended to read: 14 457.1085 Infection control.--Prior to November 1, 15 1986, the board shall adopt rules relating to the prevention 16 of infection, the sterilization of needles and other equipment 17 or materials capable of transmitting possible infection, the 18 safe disposal of any potentially infectious materials, and 19 other requirements to protect the health, safety, and welfare 20 of the public. Beginning October 1, 1997, all acupuncture 21 needles that are to be used on a patient must be sterile and 22 disposable, and each needle may be used only once. Acupuncture 23 needles shall be thoroughly cleansed with an antiseptic 24 solution and hot water prior to sterilization by autoclave. 25 Presterilized, prewrapped, disposable needles may be used. 26 Section 8. Section 457.109, Florida Statutes, is 27 amended to read: 28 457.109 Disciplinary actions; grounds; action by the 29 board.-- 30 31 19 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) The following acts shall constitute grounds for 2 which the disciplinary actions specified in subsection (2) may 3 be taken: 4 (a) Attempting to obtain, obtaining, or renewing a 5 license certificate to practice acupuncture by bribery, by 6 fraudulent misrepresentations, or through an error of the 7 department. 8 (b) Having a license certificate to practice 9 acupuncture revoked, suspended, or otherwise acted against, 10 including the denial of licensure certification, by the 11 licensing authority of another state, territory, or country. 12 (c) Being convicted or found guilty, regardless of 13 adjudication, in any jurisdiction of a crime which directly 14 relates to the practice of acupuncture or to the ability to 15 practice acupuncture. Any plea of nolo contendere shall be 16 considered a conviction for purposes of this chapter. 17 (d) False, deceptive, or misleading advertising or 18 advertising which claims that acupuncture is useful in curing 19 any disease. 20 (e) Advertising, practicing, or attempting to practice 21 under a name other than one's own. 22 (f) Failing to report to the department any person who 23 the licensee certificateholder knows is in violation of this 24 chapter or of the rules of the department. 25 (g) Aiding, assisting, procuring, employing, or 26 advising any unlicensed uncertified person to practice 27 acupuncture contrary to this chapter or to a rule of the 28 department. 29 (h) Failing to perform any statutory or legal 30 obligation placed upon a licensed certified acupuncturist. 31 20 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (i) Making or filing a report which the licensee 2 certificateholder knows to be false, intentionally or 3 negligently failing to file a report or record required by 4 state or federal law, willfully impeding or obstructing such 5 filing or inducing another person to do so. Such reports or 6 records shall include only those which are signed in the 7 capacity as a licensed certified acupuncturist. 8 (j) Exercising influence within a 9 patient-acupuncturist relationship for purposes of engaging a 10 patient in sexual activity. A patient shall be presumed to be 11 incapable of giving free, full, and informed consent to sexual 12 activity with his acupuncturist. 13 (k) Making deceptive, untrue, or fraudulent 14 representations in the practice of acupuncture or employing a 15 trick or scheme in the practice of acupuncture when such 16 scheme or trick fails to conform to the generally prevailing 17 standards of treatment in the community. 18 (l) Soliciting patients, either personally or through 19 an agent, through the use of fraud, intimidation, undue 20 influence, or a form of overreaching or vexatious conduct. A 21 solicitation is any communication which directly or implicitly 22 requests an immediate oral response from the recipient. 23 (m) Failing to keep written medical records justifying 24 the course of treatment of the patient. 25 (n) Exercising influence on the patient to exploit the 26 patient for the financial gain of the licensee 27 certificateholder or of a third party. 28 (o) Being unable to practice acupuncture with 29 reasonable skill and safety to patients by reason of illness 30 or use of alcohol, drugs, narcotics, chemicals, or any other 31 type of material or as a result of any mental or physical 21 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 condition. In enforcing this paragraph, upon a finding of the 2 secretary or his designee that probable cause exists to 3 believe that the licensee certificateholder is unable to serve 4 as an acupuncturist due to the reasons stated in this 5 paragraph, the department shall have the authority to issue an 6 order to compel the licensee certificateholder to submit to a 7 mental or physical examination by a physician designated by 8 the department. If the licensee certificateholder refuses to 9 comply with such order, the department's order directing such 10 examination may be enforced by filing a petition for 11 enforcement in the circuit court where the licensee 12 certificateholder resides or serves as an acupuncturist. The 13 licensee certificateholder against whom the petition is filed 14 shall not be named or identified by initials in any public 15 court record or document, and the proceedings shall be closed 16 to the public. The department shall be entitled to the summary 17 procedure provided in s. 51.011. An acupuncturist affected 18 under this paragraph shall at reasonable intervals be afforded 19 an opportunity to demonstrate that he can resume the competent 20 practice of acupuncture with reasonable skill and safety to 21 patients. In any proceeding under this paragraph, neither the 22 record of proceedings nor the orders entered by the department 23 shall be used against an acupuncturist in any other 24 proceeding. 25 (p) Gross or repeated malpractice or the failure to 26 practice acupuncture with that level of care, skill, and 27 treatment which is recognized by a reasonably prudent similar 28 acupuncturist as being acceptable under similar conditions and 29 circumstances. 30 (q) Practicing or offering to practice beyond the 31 scope permitted by law or accepting and performing 22 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 professional responsibilities which the licensee 2 certificateholder knows or has reason to know that he is not 3 competent to perform. 4 (r) Delegating professional responsibilities to a 5 person when the licensee certificateholder delegating such 6 responsibilities knows or has reason to know that such person 7 is not qualified by training, experience, or licensure 8 certification to perform them. 9 (s) Violating any provision of this chapter, a rule of 10 the department, or a lawful order of the department previously 11 entered in a disciplinary hearing or failing to comply with a 12 lawfully issued subpoena of the department. 13 (t) Conspiring with another to commit an act, or 14 committing an act, which would tend to coerce, intimidate, or 15 preclude another licensee certificateholder from lawfully 16 advertising his services. 17 (u) Fraud or deceit or gross negligence, incompetence, 18 or misconduct in the operation of a tutorial program or a 19 course of study. 20 (v) Failing to comply with state, county, or municipal 21 regulations or reporting requirements relating to public 22 health and the control of contagious and infectious diseases. 23 (w) Failing to comply with any rule of the board 24 relating to health and safety, including, but not limited to, 25 the sterilization of needles and equipment and the disposal of 26 potentially infectious materials. 27 (2) When the board finds any person guilty of any of 28 the acts set forth in subsection (1), it may enter an order 29 imposing one or more of the following penalties: 30 (a) Refusal to certify to the department an 31 application for licensure. 23 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) Revocation or suspension of a license certificate. 2 (c) Restriction of practice. 3 (d) Imposition of an administrative fine not to exceed 4 $1,000 for each count or separate offense. 5 (e) Issuance of a reprimand. 6 (f) Placement of the acupuncturist on probation for a 7 period of time and subject to such conditions as the board may 8 specify. 9 (3) The department shall not reinstate the license 10 certificate of an acupuncturist, or cause a license 11 certificate to be issued to a person it has deemed to be 12 unqualified, until such time as the board is satisfied that he 13 has complied with all the terms and conditions set forth in 14 the final order and that he is capable of safely engaging in 15 the practice of acupuncture. 16 Section 9. Section 457.116, Florida Statutes, is 17 amended to read: 18 457.116 Prohibited acts; penalty.-- 19 (1) It is unlawful for any person to: 20 (a) Hold himself out as a certified or licensed 21 acupuncturist unless licensed under this chapter certified as 22 provided herein. 23 (b) Practice acupuncture or attempt to practice 24 acupuncture without an active license certificate or as 25 otherwise permitted by board rule established under the 26 authority of s. 457.105(2)(b) or as otherwise provided by this 27 chapter. 28 (c) Obtain or attempt to obtain or obtain a license 29 certificate to practice acupuncture by fraudulent 30 misrepresentation. 31 24 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (d) Permit an employed person to engage in the 2 practice of acupuncture unless such person holds an active 3 license certificate as an acupuncturist, except as otherwise 4 provided by this chapter. 5 (2) Any person who violates any provision of this 6 section commits is guilty of a misdemeanor of the second 7 degree, punishable as provided in s. 775.082 or s. 775.083. 8 Section 10. Subsection (2) of section 458.303, Florida 9 Statutes, is amended to read: 10 458.303 Provisions not applicable to other 11 practitioners; exceptions, etc.-- 12 (2) Nothing in s. 458.301, s. 458.303, s. 458.305, s. 13 458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s. 14 458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s. 15 458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347 16 shall be construed to prohibit any service rendered by a 17 physician's trained assistant, a registered nurse, or a 18 licensed practical nurse, if such service is rendered under 19 the direct supervision and control of a licensed physician who 20 provides specific direction for any service to be performed 21 and gives final approval to all services performed. Further, 22 nothing in this or any other chapter shall be construed to 23 prohibit any service rendered by a medical assistant 24 physician's trained assistant in accordance with the 25 provisions of s. 458.3485 this subsection. 26 Section 11. Subsection (2) of section 458.305, Florida 27 Statutes, is amended to read: 28 458.305 Definitions.--As used in this chapter: 29 (2) "Department" means the Department of Health 30 Business and Professional Regulation. 31 25 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 12. Subsections (2) and (5) of section 2 458.307, Florida Statutes, are amended to read: 3 458.307 Board of Medicine.-- 4 (2)(a) Twelve members of the board must be licensed 5 physicians in good standing in this state who are residents of 6 the state and who have been engaged in the active practice or 7 teaching of medicine for at least 4 years immediately 8 preceding their appointment. One of the physicians must be on 9 the full-time faculty of a medical school in this state, and 10 one of the physicians must be in private practice and on the 11 full-time staff of a statutory teaching hospital in this state 12 as defined in s. 408.07. At least one of the physicians must 13 be a graduate of a foreign medical school. The remaining 14 three members must be residents of the state who are not, and 15 never have been, licensed health care practitioners. One 16 member must be a hospital risk manager certified under part IX 17 of chapter 626. At least one member of the board must be 60 18 years of age or older. 19 (b) The board shall establish at least one, but not 20 more than two, probable cause panels to meet the 21 responsibilities set out in s. 455.225(4). Each probable cause 22 panel shall be composed of three members, one of whom shall be 23 a lay member. One physician member may, if provided for in 24 administrative rule, be a past board member who is not 25 currently appointed to the board. 26 (5) During the time members are appointed to a 27 probable cause panel, they shall attempt to complete their 28 work on every case presented to them. In the event that 29 consideration of a case is begun but not completed during the 30 term of those members on the panel, they may reconvene as a 31 probable cause panel, in addition to the panels established 26 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 under paragraph (2)(b), for the purpose of completing their 2 deliberations on that case. 3 Section 13. Section 455.206, Florida Statutes, is 4 amended to read: 5 455.206 Board members.--Notwithstanding any provision 6 of law to the contrary, any person who otherwise meets the 7 requirements of law for board membership and who is connected 8 in any way with any medical college, dental college, or 9 community college may be appointed to any board so long as 10 that connection does not result in a relationship wherein such 11 college represents the person's principal source of income. 12 However, this section shall not apply to the physicians 13 required by s. 458.307(2)(a) to be on the faculty of a medical 14 school in this state or on the full-time staff of a teaching 15 hospital in this state. 16 Section 14. Paragraph (f) of subsection (1) and 17 subsection (2) of section 458.311, Florida Statutes, 1996 18 Supplement, are amended, and subsection (10) is added to said 19 section, to read: 20 458.311 Licensure by examination; requirements; 21 fees.-- 22 (1) Any person desiring to be licensed as a physician 23 shall apply to the department to take the licensure 24 examination. The department shall examine each applicant whom 25 the board certifies: 26 (f) Meets one of the following medical education and 27 postgraduate training requirements: 28 1.a. Is a graduate of an allopathic medical school or 29 allopathic college recognized and approved by an accrediting 30 agency recognized by the United States Office of Education or 31 is a graduate of an allopathic medical school or allopathic 27 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 college within a territorial jurisdiction of the United States 2 recognized by the accrediting agency of the governmental body 3 of that jurisdiction; 4 b. If the language of instruction of the medical 5 school is other than English, has demonstrated competency in 6 English through presentation of a satisfactory grade on the 7 Test of Spoken English of the Educational Testing Service or a 8 similar test approved by rule of the board; and 9 c. Has completed an approved residency of at least 1 10 year. 11 2.a. Is a graduate of a foreign medical school 12 registered with the World Health Organization and certified 13 pursuant to s. 458.314 as having met the standards required to 14 accredit medical schools in the United States or reasonably 15 comparable standards; 16 b. If the language of instruction of the foreign 17 medical school is other than English, has demonstrated 18 competency in English through presentation of the Educational 19 Commission for on Foreign Medical Graduates English 20 proficiency certificate or by a satisfactory grade on the Test 21 of Spoken English of the Educational Testing Service or a 22 similar test approved by rule of the board; and 23 c. Has completed an approved residency of at least 1 24 year. 25 3.a. Is a graduate of a foreign medical school which 26 has not been certified pursuant to s. 458.314; 27 b. Has had his medical credentials evaluated by the 28 Educational Education Commission for on Foreign Medical 29 Graduates, holds an active, valid certificate issued by that 30 commission, and has passed the examination utilized by that 31 commission; and 28 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 c. Has completed an approved residency of at least 1 2 year; however, after October 1, 1992, the applicant shall have 3 completed an approved residency or fellowship of at least 2 3 4 years in one specialty area. However, to be acceptable, the 5 fellowship experience and training must be counted toward 6 regular or subspecialty certification by a board recognized 7 and certified by the American Board of Medical Specialties. 8 (2) As prescribed by board rule, the board may require 9 an applicant who does not pass the licensing examination after 10 five attempts to complete additional remedial education or 11 training. The board shall prescribe the additional 12 requirements in a manner that permits the applicant to 13 complete the requirements and be reexamined within 2 years 14 after the date the applicant petitions the board to retake the 15 examination a sixth or subsequent time. Every applicant who 16 is otherwise qualified may take the licensing examination five 17 times after October 1, 1986, notwithstanding the number of 18 times the examination has been previously failed. If an 19 applicant fails the examination taken after October 1, 1986, 20 five times, he shall no longer be eligible for licensure. 21 (10) Notwithstanding any other provision of this 22 section, the department shall examine any person who meets the 23 criteria set forth in sub-subparagraph (1)(f)1.a., 24 sub-subparagraphs (1)(f)3.a. and b., or subsection (3), if the 25 person: 26 (a) Submits proof of successful completion of Steps I 27 and II of the United States Medical Licensing Examination or 28 the equivalent, as defined by rule of the board; 29 (b) Is participating in an allocated slot in an 30 allopathic training program in this state on a full-time basis 31 at the time of examination; 29 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (c) Makes a written request to the department that he 2 or she be administered the examination without applying for a 3 license as a physician in this state; and 4 (d) Remits a nonrefundable administration fee not to 5 exceed $50 and an examination fee not to exceed $300 plus the 6 actual cost per person to the department for the purchase of 7 the examination from the Federation of State Medical Boards of 8 the United States or a similar national organization. The 9 examination fee is refundable if the person is found to be 10 ineligible to take the examination. 11 Section 15. Section 458.313, Florida Statutes, 1996 12 Supplement, is amended to read: 13 458.313 Licensure by endorsement; requirements; 14 fees.-- 15 (1) The department shall issue a license by 16 endorsement to any applicant who, upon applying to the 17 department and remitting a fee not to exceed $500 set by the 18 board, demonstrates to the board certifies that he: 19 (a) Has met the qualifications for licensure in s. 20 458.311(1)(b)-(f); 21 (b) Has obtained a passing score, as established by 22 rule of the board, on the licensure examination of the 23 Federation of State Medical Boards of the United States, Inc. 24 (FLEX), or of the United States Medical Licensing Examination 25 (USMLE), or the examination of the National Board of Medical 26 Examiners, or on a combination thereof, provided the board 27 certifies as eligible for licensure by endorsement any 28 applicant who took the required examinations more than 10 29 years prior to application that said examination or 30 combination of examinations required shall have been so taken 31 30 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 within the 10 years immediately preceding the filing of his 2 application for licensure under this section; and 3 (c) Has submitted Shows evidence of the active 4 licensed practice of medicine in another jurisdiction, for at 5 least 2 of the immediately preceding 4 years, or evidence of 6 successful completion of either board-approved postgraduate 7 training, or a board-approved clinical competency examination, 8 within the year preceding the filing of an application for 9 licensure. For purposes of this paragraph, "active licensed 10 practice of medicine" means that practice of medicine by 11 physicians, including those employed by any governmental 12 entity in community or public health, as defined by this 13 chapter, medical directors under s. 641.495(11) who are 14 practicing medicine, and those on the active teaching faculty 15 of an accredited medical school. 16 (2)(a) As prescribed by board rule, the board may 17 require an applicant who does not pass the licensing 18 examination after five attempts to complete additional 19 remedial education or training. The board shall prescribe the 20 additional requirements in a manner that permits the applicant 21 to complete the requirements and be reexamined within 2 years 22 after the date the applicant petitions the board to retake the 23 examination a sixth or subsequent time. The board may require 24 oral examinations of any applicant under the provisions of 25 this section. However, the applicant must be given adequate 26 notice of the examination, both as to the time, place, nature, 27 and scope thereof, as well as a statement of the reasons 28 requiring such examination. Failure to successfully complete 29 an oral examination, if required by the board, shall result in 30 revocation of the license. 31 31 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) The board may require an applicant for licensure 2 by endorsement to take and pass the appropriate licensure 3 examination prior to certifying the applicant as eligible for 4 licensure. 5 (3) The department and the board shall ensure assure 6 that applicants for licensure by endorsement meet applicable 7 criteria in this chapter through an investigative process. 8 When the investigative process is not completed within the 9 time set out in s. 120.60(1) and the department or board has 10 reason to believe that the applicant does not meet the 11 criteria, the secretary or his designee may issue a 90-day 12 licensure delay which shall be in writing and sufficient to 13 notify the applicant of the reason for the delay. The 14 provisions of this subsection shall control over any 15 conflicting provisions of s. 120.60(1). 16 (4) If the applicant has not actively practiced 17 medicine or been on the active teaching faculty of an 18 accredited medical school within the previous 4 years, the 19 board shall certify the applicant to the department for 20 licensure by endorsement subject to the condition that the 21 applicant work under the supervision of another physician for 22 a period, not to exceed 1 year, as determined by the board 23 based on its determination of the licensee's ability to 24 practice medicine. The supervising physician shall have had 25 no probable cause findings against him within the previous 3 26 years. 27 (4)(5) The board may promulgate rules and regulations, 28 to be applied on a uniform and consistent basis, which may be 29 necessary to carry out the provisions of this section. 30 (5)(6) Upon certification by the board, the department 31 shall impose conditions, limitations, or restrictions on a 32 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 license by endorsement if the applicant is on probation in 2 another jurisdiction for an act which would constitute a 3 violation of this chapter. 4 (6)(7) The department shall not issue a license by 5 endorsement to any applicant who is under investigation in any 6 jurisdiction for an act or offense which would constitute a 7 violation of this chapter until such time as the investigation 8 is complete, at which time the provisions of s. 458.331 shall 9 apply. Furthermore, the department may not issue an 10 unrestricted license to any individual who has committed any 11 act or offense in any jurisdiction which would constitute the 12 basis for disciplining a physician pursuant to s. 458.331. 13 When the board finds that an individual has committed an act 14 or offense in any jurisdiction which would constitute the 15 basis for disciplining a physician pursuant to s. 458.331, 16 then the board may enter an order imposing one or more of the 17 terms set forth in subsection (7) (8). 18 (7)(8) When the board determines that any applicant 19 for licensure by endorsement has failed to meet, to the 20 board's satisfaction, each of the appropriate requirements set 21 forth in this section, it may enter an order requiring one or 22 more of the following terms: 23 (a) Refusal to certify to the department an 24 application for licensure, certification, or registration; 25 (b) Certification to the department of an application 26 for licensure, certification, or registration with 27 restrictions on the scope of practice of the licensee; or 28 (c) Certification to the department of an application 29 for licensure, certification, or registration with placement 30 of the physician on probation for a period of time and subject 31 to such conditions as the board may specify, including, but 33 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 not limited to, requiring the physician to submit to 2 treatment, attend continuing education courses, submit to 3 reexamination, or work under the supervision of another 4 physician. 5 (8) The department shall reactivate the license of any 6 physician whose license has become void by failure to practice 7 in Florida for a period of 1 year within 3 years after 8 issuance of the license by endorsement, if the physician was 9 issued a license by endorsement prior to 1989, has actively 10 practiced medicine in another state for the last 4 years, 11 applies for licensure before October 1, 1998, pays the 12 applicable fees, and otherwise meets any continuing education 13 requirements for reactivation of the license as determined by 14 the board. 15 Section 16. Paragraphs (a) and (b) of subsection (1) 16 of section 458.317, Florida Statutes, are amended to read: 17 458.317 Limited licenses.-- 18 (1)(a) Any person desiring to obtain a limited license 19 shall: 20 1. Submit to the board, with an application and fee 21 not to exceed $300, an affidavit stating that he has been 22 licensed to practice medicine in any jurisdiction in the 23 United States for at least 10 years and has retired or intends 24 to retire from the practice of medicine and intends to 25 practice only pursuant to the restrictions of a limited 26 license granted pursuant to this section. However, a 27 physician who is not fully retired in all jurisdictions, may 28 use a limited license only for noncompensated practice. If 29 the person applying for a limited license submits a notarized 30 statement from the employing agency or institution stating 31 that he will not receive monetary compensation for any service 34 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 involving the practice of medicine, the application fee and 2 all licensure fees shall be waived. However, any person who 3 receives a waiver of fees for a limited license shall pay such 4 fees if the person receives compensation for the practice of 5 medicine. 6 2. Meet the requirements in s. 458.311(1)(b)-(f) and 7 (5). If the applicant graduated from medical school prior to 8 1946, the board or its appropriate committee may accept 9 military medical training or medical experience as a 10 substitute for the approved 1-year residency requirement in s. 11 458.311(1)(f). 12 (b) After approval of an application under this 13 section, no license shall be issued until the applicant 14 provides to the board an affidavit that the applicant has in 15 fact retired from the practice of medicine in this or any 16 other jurisdiction in which the applicant holds a license and 17 that there have been no substantial changes in status since 18 initial application. 19 20 Nothing herein limits in any way any policy by the board, 21 otherwise authorized by law, to grant licenses to physicians 22 duly licensed in other states under conditions less 23 restrictive than the requirements of this section. 24 Notwithstanding the other provisions of this section, the 25 board may refuse to authorize a physician otherwise qualified 26 to practice in the employ of any agency or institution 27 otherwise qualified if the agency or institution has caused or 28 permitted violations of the provisions of this chapter which 29 it knew or should have known were occurring. 30 Section 17. Subsection (1) of section 458.319, Florida 31 Statutes, is amended to read: 35 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 458.319 Renewal of license.-- 2 (1) The department shall renew a license upon receipt 3 of the renewal application, evidence that the applicant has 4 actively practiced medicine or has been on the active teaching 5 faculty of an accredited medical school for at least 2 years 6 of the immediately preceding within the previous 4 years, and 7 a fee not to exceed $500; provided, however, that if the 8 licensee is either a resident physician, assistant resident 9 physician, fellow, house physician, or intern in an approved 10 postgraduate training program, as defined by the board by 11 rule, the fee shall not exceed $100 per annum. If the 12 licensee has not actively practiced medicine for at least 2 13 years of the immediately preceding within the previous 4 14 years, the board shall require that the licensee successfully 15 complete a board-approved clinical competency examination 16 prior to renewal of the license. "Actively practiced medicine" 17 means that practice of medicine by physicians, including those 18 employed by any governmental entity in community or public 19 health, as defined by this chapter, including physicians 20 practicing administrative medicine. 21 Section 18. Paragraphs (a) and (g) of subsection (5) 22 of section 458.320, Florida Statutes, 1996 Supplement, are 23 amended to read: 24 458.320 Financial responsibility.-- 25 (5) The requirements of subsections (1), (2), and (3) 26 shall not apply to: 27 (a) Any person licensed under this chapter who 28 practices medicine exclusively as an officer, employee, or 29 agent of the Federal Government or of the state or its 30 agencies or its subdivisions. For the purposes of this 31 subsection, an agent of the state, its agencies, or its 36 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 subdivisions is a person who is eligible for coverage under 2 any self-insurance or insurance program authorized by the 3 provisions of s. 768.28(15)(14). 4 (g) Any person holding an active license under this 5 chapter who agrees to meet all of the following criteria: 6 1. Upon the entry of an adverse final judgment arising 7 from a medical malpractice arbitration award, from a claim of 8 medical malpractice either in contract or tort, or from 9 noncompliance with the terms of a settlement agreement arising 10 from a claim of medical malpractice either in contract or 11 tort, the licensee shall pay the judgment creditor the lesser 12 of the entire amount of the judgment with all accrued interest 13 or either $100,000, if the physician is licensed pursuant to 14 this chapter but does not maintain hospital staff privileges, 15 or $250,000, if the physician is licensed pursuant to this 16 chapter and maintains hospital staff privileges, within 60 17 days after the date such judgment became final and subject to 18 execution, unless otherwise mutually agreed to in writing by 19 the parties. Such adverse final judgment shall include any 20 cross-claim, counterclaim, or claim for indemnity or 21 contribution arising from the claim of medical malpractice. 22 Upon notification of the existence of an unsatisfied judgment 23 or payment pursuant to this subparagraph, the department shall 24 notify the licensee by certified mail that he shall be subject 25 to disciplinary action unless, within 30 days from the date of 26 mailing, he either: 27 a. Shows proof that the unsatisfied judgment has been 28 paid in the amount specified in this subparagraph; or 29 b. Furnishes the department with a copy of a timely 30 filed notice of appeal and either: 31 37 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (I) A copy of a supersedeas bond properly posted in 2 the amount required by law; or 3 (II) An order from a court of competent jurisdiction 4 staying execution on the final judgment pending disposition of 5 the appeal. 6 2. Upon the next meeting of the probable cause panel 7 of the board following 30 days after the date of mailing the 8 notice of disciplinary action to the licensee, the panel shall 9 make a determination of whether probable cause exists to take 10 disciplinary action against the licensee pursuant to 11 subparagraph 1. 12 3. If the board determines that the factual 13 requirements of subparagraph 1. are met, it shall take 14 disciplinary action as it deems appropriate against the 15 licensee. Such disciplinary action shall include, at a 16 minimum, probation of the license with the restriction that 17 the licensee must make payments to the judgment creditor on a 18 schedule determined by the board to be reasonable and within 19 the financial capability of the physician. Notwithstanding any 20 other disciplinary penalty imposed, the disciplinary penalty 21 may include suspension of the license for a period not to 22 exceed 5 years. In the event that an agreement to satisfy a 23 judgment has been met, the board shall remove any restriction 24 on the license. 25 4. The licensee has completed a form supplying 26 necessary information as required by the department. 27 28 A licensee who meets the requirements of this paragraph shall 29 be required to either post notice in the form of a sign 30 prominently displayed in the reception area and clearly 31 noticeable by all patients and or provide a written statement 38 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 to any person to whom medical services are being provided. A 2 copy of the written statement shall be given to each patient 3 to sign, acknowledging receipt thereof, and the signed copy 4 shall be maintained in the patient's file. If the patient 5 refuses to sign or is unable to sign the written statement, 6 the licensee shall so note it on the form. Such sign and or 7 statement shall state that: "Under Florida law, physicians 8 are generally required to carry medical malpractice insurance 9 or otherwise demonstrate financial responsibility to cover 10 potential claims for medical malpractice. YOUR DOCTOR HAS 11 DECIDED NOT TO CARRY MEDICAL MALPRACTICE INSURANCE. This is 12 permitted under Florida law subject to certain conditions. 13 Florida law imposes penalties against noninsured physicians 14 who fail to satisfy adverse judgments arising from claims of 15 medical malpractice. This notice is provided pursuant to 16 Florida law." 17 Section 19. Paragraphs (m), (cc), and (ii) of 18 subsection (1) of section 458.331, Florida Statutes, 1996 19 Supplement, are amended, and paragraph (ll) is added to said 20 subsection, to read: 21 458.331 Grounds for disciplinary action; action by the 22 board and department.-- 23 (1) The following acts shall constitute grounds for 24 which the disciplinary actions specified in subsection (2) may 25 be taken: 26 (m) Failing to keep legible, as defined by department 27 rule in consultation with the board, written medical records 28 that identify the licensed physician or the physician extender 29 and supervising physician by name and professional title who 30 is or are responsible for rendering, ordering, supervising, or 31 billing for each diagnostic or treatment procedure and that 39 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 justify justifying the course of treatment of the patient, 2 including, but not limited to, patient histories; examination 3 results; test results; records of drugs prescribed, dispensed, 4 or administered; and reports of consultations and 5 hospitalizations. 6 (cc) Prescribing, ordering, dispensing, administering, 7 supplying, selling, or giving any drug which is a Schedule II 8 amphetamine or a Schedule II sympathomimetic amine drug or any 9 compound thereof, pursuant to chapter 893, to or for any 10 person except for: 11 1. The treatment of narcolepsy; hyperkinesis; 12 behavioral syndrome in children characterized by the 13 developmentally inappropriate symptoms of moderate to severe 14 distractability, short attention span, hyperactivity, 15 emotional lability, and impulsivity; or drug-induced brain 16 dysfunction; 17 2. The differential diagnostic psychiatric evaluation 18 of depression or the treatment of depression shown to be 19 refractory to other therapeutic modalities; or 20 3. The clinical investigation of the effects of such 21 drugs or compounds when an investigative protocol therefor is 22 submitted to, reviewed, and approved by the board before such 23 investigation is begun. 24 (ii) Failing to report to the department Division of 25 Medical Quality Assurance any licensee physician licensed 26 under this chapter or osteopathic physician licensed under 27 chapter 459 who the physician or physician assistant knows has 28 violated the grounds for disciplinary action set out in the 29 law under which that person physician or osteopathic physician 30 is licensed and who provides health care services in a 31 facility licensed under chapter 395, or a health maintenance 40 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 organization certificated under part I of chapter 641, in 2 which the physician or physician assistant also provides 3 services. 4 (ll) Advertising or holding oneself out as a 5 board-certified specialist, if not qualified under s. 6 458.3312, in violation of this chapter. 7 Section 20. Section 458.3312, Florida Statutes, is 8 created to read: 9 458.3312 Specialties.--A physician licensed under this 10 chapter may not hold himself or herself out as a 11 board-certified specialist unless the physician has received 12 formal recognition as a specialist from a specialty board of 13 the American Board of Medical Specialties or other recognizing 14 agency approved by the board. However, a physician may 15 indicate the services offered and may state that his or her 16 practice is limited to one or more types of services when this 17 accurately reflects the scope of practice of the physician. 18 Section 21. Section 458.345, Florida Statutes, is 19 amended to read: 20 458.345 Registration of resident physicians, interns, 21 and fellows; list of hospital employees; prescribing of 22 medicinal drugs and controlled substances; penalty.-- 23 (1) Any person desiring to practice as a resident 24 physician, assistant resident physician, house physician, 25 intern, or fellow in fellowship training which leads to 26 subspecialty board certification in this state who does not 27 hold a valid, active license issued under this chapter shall 28 apply to the department to be registered and shall remit a fee 29 not to exceed $300 as set by the board. The department shall 30 register any applicant the board certifies has met the 31 following requirements: 41 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Is at least 21 years of age. 2 (b) Has not committed any act or offense within or 3 without the state which would constitute the basis for refusal 4 to certify an application for licensure pursuant to s. 5 458.331. 6 (c) Is a graduate of a medical school or college as 7 specified in s. 458.311(1)(f). 8 (2) The board shall not certify to the department for 9 registration any applicant who is under investigation in any 10 state or jurisdiction for an act which would constitute the 11 basis for imposing a disciplinary penalty specified in s. 12 458.331(2)(b) until such time as the investigation is 13 completed, at which time the provisions of s. 458.331 shall 14 apply. 15 (3) Every hospital employing or utilizing the services 16 of a resident physician, assistant resident physician, house 17 physician, intern, or fellow in fellowship training which 18 leads to subspecialty board certification shall designate a 19 person who shall, on January 1 and July 1 of each year, 20 furnish the department with a list of the hospital's its 21 employees and such other information as the board may direct. 22 The chief executive officer of each such hospital shall 23 provide the executive director of the board with the name, 24 title, and address of the person responsible for furnishing 25 such reports. 26 (4) Registration under this section shall 27 automatically expire after 2 years without further action by 28 the board or the department unless an application for renewal 29 is approved by the board. No person registered under this 30 section may be employed or utilized as a house physician or 31 act as a resident physician, an assistant resident physician, 42 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 an intern, or a fellow in fellowship training which leads to a 2 subspecialty board certification in a hospital of this state 3 for more than 2 years without a valid, active license or 4 renewal of registration under this section. Requirements for 5 renewal of registration shall be established by rule of the 6 board. An application fee not to exceed $300 as set by the 7 board shall accompany the application for renewal, except that 8 resident physicians, assistant resident physicians, interns, 9 and fellows in fellowship training which leads to subspecialty 10 board certification shall be exempt from payment of any 11 renewal fees. 12 (5) Notwithstanding any provision of this section or 13 s. 120.52 to the contrary, any person who is registered under 14 this section is subject to the provisions of s. 458.331. 15 (6) A resident physician, assistant resident 16 physician, house physician, intern, or fellow may prescribe 17 medicinal drugs and controlled substances under the following 18 circumstances: 19 (a) Such person is employed in a hospital and the 20 hospital specifically grants such person controlled substance 21 prescriptive authority; 22 (b) Such person is engaged in an accredited training 23 program; 24 (c) Such person prescribes only in the normal course 25 of his or her employment; 26 (d) Such person is the holder of a prescriber number 27 issued by the hospital and the prescription involved has that 28 number printed thereon; 29 (e) Internal control code numbers are issued to each 30 such person who is granted prescriptive authority under this 31 subsection; and 43 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (f) Third-party payment procedures can accommodate the 2 required numbering system which includes control codes. 3 (7)(5) Any person willfully violating this section 4 commits a misdemeanor of the first degree, punishable as 5 provided in s. 775.082 or s. 775.083. 6 Section 22. Subsection (2) of section 458.346, Florida 7 Statutes, is amended to read: 8 458.346 Public Sector Physician Advisory Committee.-- 9 (2) PUBLIC SECTOR PHYSICIAN ADVISORY COMMITTEE.--There 10 is hereby created a Public Sector Physician Advisory Committee 11 which shall be comprised of three physicians. One physician 12 shall be appointed by the chair chairman of the Board of 13 Medicine. The two remaining physicians shall be appointed by 14 the secretary of the department from recommendations of the 15 appropriate organization, if any, representing such physicians 16 for the purpose of collective bargaining. The chair chairman 17 of the committee shall be one of the two public sector 18 physicians who shall be elected by majority vote of the 19 committee members. Members of the committee shall serve 20 3-year terms and shall meet at least once each year or upon 21 the call of the committee chair on a quarterly basis. The 22 initial term for one public sector physician shall be for 2 23 years, and the other for 3 years. Members of the committee 24 are subject to reappointment. Committee members shall receive 25 reimbursement for per diem and travel expenses. 26 Section 23. Section 458.347, Florida Statutes, 1996 27 Supplement, is amended to read: 28 458.347 Physician assistants.-- 29 (1) LEGISLATIVE INTENT.-- 30 (a) The purpose of this section is to encourage more 31 effective utilization of the skills of physicians or groups of 44 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 physicians by enabling them to delegate health care tasks to 2 qualified assistants when such delegation is consistent with 3 the patient's health and welfare. 4 (b) In order that maximum skills may be obtained 5 within a minimum time period of education, a physician 6 assistant shall be specialized to the extent that he can 7 operate efficiently and effectively in the specialty areas in 8 which he has been trained or is experienced. 9 (c) The purpose of this section is to encourage the 10 utilization of physician assistants by physicians and to allow 11 for innovative development of programs for the education of 12 physician assistants. 13 (2) DEFINITIONS.--As used in this section: 14 (a) "Agency" means the Agency for Health Care 15 Administration. 16 (a)(b) "Approved program" means a program, formally 17 approved by the boards, for the education of physician 18 assistants. 19 (b)(c) "Boards" means the Board of Medicine and the 20 Board of Osteopathic Medicine. 21 (c)(d) "Council" means the Council on Physician 22 Assistants. 23 (d)(e) "Trainee" means a person who is currently 24 enrolled in an approved program. 25 (e)(f) "Physician assistant" means a person who is a 26 graduate of an approved program or its equivalent or meets 27 standards approved by the boards and is certified to perform 28 medical services delegated by the supervising physician. 29 (f)(g) "Supervision" means responsible supervision and 30 control. Except in cases of emergency, supervision requires 31 the easy availability or physical presence of the licensed 45 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 physician for consultation and direction of the actions of the 2 physician assistant. For the purposes of this definition, the 3 term "easy availability" includes the ability to communicate 4 by way of telecommunication. The boards shall establish rules 5 as to what constitutes responsible supervision of the 6 physician assistant. 7 (g)(h) "Proficiency examination" means an entry-level 8 examination approved by the boards, including, but not limited 9 to, those examinations administered by the National Commission 10 on Certification of Physician Assistants. 11 (h)(i) "Continuing medical education" means courses 12 recognized and approved by the boards, the American Academy of 13 Physician Assistants, the American Medical Association, the 14 American Osteopathic Association, or the Accreditation Council 15 on Continuing Medical Education. 16 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.--Each 17 physician or group of physicians supervising a certified 18 physician assistant must be qualified in the medical areas in 19 which the physician assistant is to perform and shall be 20 individually or collectively responsible and liable for the 21 performance and the acts and omissions of the physician 22 assistant. A physician may not supervise more than four 23 currently certified physician assistants at any one time. 24 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.-- 25 (a) The boards shall adopt, by rule, the general 26 principles that supervising physicians must use in developing 27 the scope of practice of a physician assistant under direct 28 supervision and under indirect supervision. These principles 29 shall recognize the diversity of both specialty and practice 30 settings in which physician assistants are used. 31 46 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) This chapter does not prevent third-party payors 2 from reimbursing employers of physician assistants for covered 3 services rendered by certified physician assistants. 4 (c) Certified physician assistants may not be denied 5 clinical hospital privileges, except for cause, so long as the 6 supervising physician is a staff member in good standing. 7 (d) A supervisory physician may delegate to a 8 certified physician assistant, pursuant to a written protocol, 9 the authority to act according to s. 154.04(1)(c)(d). Such 10 delegated authority is limited to the supervising physician's 11 practice in connection with a county public health department 12 unit as defined and established pursuant to chapter 154. The 13 boards shall adopt rules governing the supervision of 14 physician assistants by physicians in county public health 15 departments units. 16 (e) A supervisory physician may delegate to a fully 17 certified physician assistant the authority to prescribe any 18 medication used in the supervisory physician's practice if 19 such medication is listed on the formulary created pursuant to 20 paragraph (f). A fully certified physician assistant may only 21 prescribe such medication under the following circumstances: 22 1. A physician assistant must clearly identify to the 23 patient that he is a physician assistant. Furthermore, the 24 physician assistant must inform the patient that the patient 25 has the right to see the physician prior to any prescription 26 being prescribed by the physician assistant. 27 2. The supervisory physician must notify the 28 department agency of his intent to delegate, on a 29 department-approved an agency-approved form, before delegating 30 such authority and with each certification renewal application 31 filed by the physician assistant. 47 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 3. The physician assistant must file with the 2 department agency, before commencing to prescribe, evidence 3 that he has completed a continuing medical education course of 4 at least 3 classroom hours in prescriptive practice, conducted 5 by an accredited program approved by the boards, which course 6 covers the limitations, responsibilities, and privileges 7 involved in prescribing medicinal drugs, or evidence that he 8 has received education comparable to the continuing education 9 course as part of an accredited physician assistant training 10 program. 11 4. The physician assistant must file with the 12 department agency, before commencing to prescribe, evidence 13 that the physician assistant has a minimum of 3 months of 14 clinical experience in the specialty area of the supervising 15 physician. 16 5. The physician assistant must file with the 17 department agency a signed affidavit that he has completed a 18 minimum of 10 continuing medical education hours in the 19 specialty practice in which the physician assistant has 20 prescriptive privileges with each certification renewal 21 application. 22 6. The department agency shall issue certification and 23 a prescriber number to the physician assistant granting 24 authority for the prescribing of medicinal drugs authorized 25 within this paragraph upon completion of the foregoing 26 requirements. 27 7. The prescription must be written in a form that 28 complies with chapter 499 and must contain, in addition to the 29 supervisory physician's name, address, and telephone number, 30 the physician assistant's prescriber number. The prescription 31 must be filled in a pharmacy permitted under chapter 465 and 48 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 must be dispensed in that pharmacy by a pharmacist licensed 2 under chapter 465. The appearance of the prescriber number 3 creates a presumption that the physician assistant is 4 authorized to prescribe the medicinal drug and the 5 prescription is valid. 6 8. The physician assistant must note the prescription 7 in the appropriate medical record, and the supervisory 8 physician must review and sign each notation. For dispensing 9 purposes only, the failure of the supervisory physician to 10 comply with these requirements does not affect the validity of 11 the prescription. 12 9. This paragraph does not prohibit a supervisory 13 physician from delegating to a physician assistant the 14 authority to order medication for a hospitalized patient of 15 the supervisory physician. 16 17 This paragraph does not apply to facilities licensed pursuant 18 to chapter 395. 19 (f)1. There is created a five-member committee 20 appointed by the Director of Health Care Administration. The 21 committee must be composed of one fully certified physician 22 assistant certified pursuant to this section or s. 459.022 23 458.022, two physicians licensed pursuant to this chapter, one 24 of whom supervises a fully licensed physician assistant, one 25 osteopathic physician licensed pursuant to chapter 459, and 26 one pharmacist licensed pursuant to chapter 465 who is not 27 licensed pursuant to this chapter or chapter 459. The 28 committee shall establish a formulary of medicinal drugs for 29 which a fully certified physician assistant may prescribe. 30 The formulary may not include controlled substances as defined 31 in chapter 893, antineoplastics, antipsychotics, 49 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 radiopharmaceuticals, general anesthetics or radiographic 2 contrast materials, or any parenteral preparations except 3 insulin and epinephrine. 4 2. Only the committee shall add to, delete from, or 5 modify the formulary. Any person who requests an addition, 6 deletion, or modification of a medicinal drug listed on such 7 formulary has the burden of proof to show cause why such 8 addition, deletion, or modification should be made. 9 3. The boards shall adopt the formulary required by 10 this paragraph, and each addition, deletion, or modification 11 to the formulary, by rule. Notwithstanding any provision of 12 chapter 120 to the contrary, the formulary rule shall be 13 effective 60 days after the date it is filed with the 14 Secretary of State. Upon adoption of the formulary, the 15 department agency shall mail a copy of such formulary to each 16 fully certified physician assistant and to each pharmacy 17 licensed by the state. The boards shall establish, by rule, a 18 fee not to exceed $200 to fund the provisions of this 19 paragraph and paragraph (e). 20 (5) PERFORMANCE BY TRAINEES.--Notwithstanding any 21 other law, a trainee may perform medical services when such 22 services are rendered within the scope of an approved program. 23 (6) PROGRAM APPROVAL.-- 24 (a) The boards shall approve programs, based on 25 recommendations by the council, for the education and training 26 of physician assistants which meet standards established by 27 rule of the boards. The council may recommend only those 28 physician assistant programs that hold full accreditation or 29 provisional accreditation from the Commission on Accreditation 30 of Allied Health Programs or its successor organization. Any 31 educational institution offering a physician assistant program 50 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 approved by the boards pursuant to this paragraph may also 2 offer the physician assistant program authorized in paragraph 3 (c) for unlicensed physicians. 4 (b) The boards shall adopt and publish standards to 5 ensure that such programs operate in a manner that does not 6 endanger the health or welfare of the patients who receive 7 services within the scope of the programs. The boards shall 8 review the quality of the curricula, faculties, and facilities 9 of such programs and take whatever other action is necessary 10 to determine that the purposes of this section are being met. 11 (c) Any community college with the approval of the 12 State Board of Community Colleges may conduct a physician 13 assistant program which shall apply for national accreditation 14 through the American Medical Association's Committee on Allied 15 Health, Education, and Accreditation, or its successor 16 organization, and which may admit unlicensed physicians, as 17 authorized in subsection (7), who are graduates of foreign 18 medical schools listed with the World Health Organization. 19 The unlicensed physician must have been a resident of this 20 state for a minimum of 12 months immediately prior to 21 admission to the program. An evaluation of knowledge base by 22 examination shall be required to grant advanced academic 23 credit and to fulfill the necessary requirements to graduate. 24 A minimum of one 16-week semester of supervised clinical and 25 didactic education, which may be completed simultaneously, 26 shall be required before graduation from the program. All 27 other provisions of this section shall remain in effect. 28 (7) PHYSICIAN ASSISTANT CERTIFICATION.-- 29 (a) Any person desiring to be certified as a physician 30 assistant must apply to the department agency. The department 31 51 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 agency shall issue a certificate to any person certified by 2 the council as having met the following requirements: 3 1. Is at least 18 years of age. 4 2. Has satisfactorily passed a proficiency examination 5 by an acceptable score established by the National Commission 6 on Certification of Physician Assistants. If an applicant 7 does not hold a current certificate issued by the National 8 Commission on Certification of Physician Assistants and has 9 not actively practiced as a physician assistant within the 10 immediately preceding 4 years, the applicant must retake and 11 successfully complete the entry-level examination of the 12 National Commission on Certification of Physician Assistants 13 to be eligible for certification. 14 3. Has completed the application form and remitted an 15 application fee not to exceed $300 as set by the boards. An 16 application for certification made by a physician assistant 17 must include: 18 a. A certificate of completion of a physician 19 assistant training program specified in subsection (6). 20 b. A sworn statement of any prior felony convictions. 21 c. A sworn statement of any previous revocation or 22 denial of licensure or certification in any state. 23 d. Two letters of recommendation. 24 (b)1. Notwithstanding subparagraph (a)2. and 25 sub-subparagraph (a)3.a., the department agency shall examine 26 each applicant who the Board of Medicine certifies: 27 a. Has completed the application form and remitted a 28 nonrefundable application fee not to exceed $500 and an 29 examination fee not to exceed $300, plus the actual cost to 30 the department agency to provide the examination. The 31 examination fee is refundable if the applicant is found to be 52 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 ineligible to take the examination. The department agency 2 shall translate the examination into the native language of 3 any applicant who requests and agrees to pay all costs of such 4 translation, provided the applicant demonstrates to the 5 department agency the ability to communicate orally in basic 6 English. 7 b. Is an unlicensed physician who graduated from a 8 foreign medical school listed with the World Health 9 Organization who has not previously taken and failed the 10 examination of the National Commission on Certification of 11 Physician Assistants and who has been certified by the Board 12 of Medicine as having met the requirements for licensure as a 13 medical doctor by examination as set forth in s. 458.311(1), 14 (3), (4), and (5), with the exception that the applicant is 15 not required to have completed an approved residency of at 16 least 1 year and the applicant is not required to have passed 17 the licensing examination specified under s. 458.311 or hold a 18 valid, active certificate issued by the Educational Commission 19 for Foreign Medical Graduates. 20 c. Was eligible and made initial application for 21 certification as a physician assistant in this state between 22 July 1, 1990, and June 30, 1991. 23 d. Was a resident of this state on July 1, 1990, or 24 was licensed or certified in any state in the United States as 25 a physician assistant on July 1, 1990. 26 2. The department agency may grant temporary 27 certification to an applicant who meets the requirements of 28 subparagraph 1. Between meetings of the council, the 29 department agency may grant temporary certification to 30 practice based on the completion of all temporary 31 certification requirements. All such administratively issued 53 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 certifications shall be reviewed and acted on at the next 2 regular meeting of the council. A temporary certificate 3 expires upon receipt and notice of scores to the 4 certificateholder from the first available examination 5 specified in subparagraph 1. following certification by the 6 department agency. An applicant who fails the proficiency 7 examination is no longer temporarily certified, but may apply 8 for a one-time extension of temporary certification after 9 reapplying for the next available examination. Extended 10 certification shall expire upon failure of the 11 certificateholder to sit for the next available examination or 12 upon receipt and notice of scores to the certificateholder 13 from such examination. 14 3. Notwithstanding any other provision of law, the 15 examination specified pursuant to subparagraph 1. shall be 16 administered by the department agency only five times. 17 Applicants certified by the board for examination shall 18 receive at least 6 months' notice of eligibility prior to the 19 administration of the initial examination. Subsequent 20 examinations shall be administered at intervals determined by 21 the department agency after the reporting of the scores of the 22 first examination. For the purposes of this paragraph, the 23 department agency may develop, contract for the development 24 of, purchase, or approve an examination, including a practical 25 component, that adequately measures an applicant's ability to 26 practice with reasonable skill and safety. The minimum 27 passing score on the examination shall be established by the 28 department agency, with the advice of the board. Those 29 applicants failing to pass that examination or any subsequent 30 examination shall receive notice of the administration of the 31 next examination with the notice of scores following such 54 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 examination. Any applicant who passes the examination and 2 meets the requirements of this section shall be certified as a 3 physician assistant with all rights defined thereby. 4 (c) The certification must be renewed biennially. 5 Each renewal must include: 6 1. A renewal fee not to exceed $500 as set by the 7 boards. 8 2. A sworn statement of no felony convictions in the 9 previous 2 years. 10 (d) Each certified physician assistant shall 11 biennially complete 100 hours of continuing medical education 12 or shall hold a current certificate issued by the National 13 Commission on Certification of Physician Assistants. 14 (e) Upon employment as a physician assistant, a 15 certified physician assistant must notify the department 16 agency in writing within 30 days after such employment or 17 after any subsequent changes in the supervising physician. The 18 notification must include the full name, Florida medical 19 license number, specialty, and address of the supervising 20 physician. 21 (f) Notwithstanding subparagraph (a)2., the department 22 agency may grant to a recent graduate of an approved program, 23 as specified in subsection (6), temporary certification to 24 expire upon receipt of scores of the proficiency examination 25 administered by the National Commission on Certification of 26 Physician Assistants. Between meetings of the council, the 27 department agency may grant temporary certification to 28 practice based on the completion of all temporary 29 certification requirements. All such administratively issued 30 certifications shall be reviewed and acted on at the next 31 regular meeting of the council. The recent graduate may be 55 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 certified prior to employment, but must comply with paragraph 2 (e). An applicant who has passed the proficiency examination 3 may be granted permanent certification. An applicant failing 4 the proficiency examination is no longer temporarily 5 certified, but may reapply for a 1-year extension of temporary 6 certification. An applicant may not be granted more than two 7 temporary certificates and may not be certified as a physician 8 assistant until he passes the examination administered by the 9 National Commission on Certification of Physician Assistants. 10 As prescribed by board rule, the council may require an 11 applicant who does not pass the licensing examination after 12 five or more attempts to complete additional remedial 13 education or training. The council shall prescribe the 14 additional requirements in a manner that permits the applicant 15 to complete the requirements and be reexamined within 2 years 16 after the date the applicant petitions the council to retake 17 the examination a sixth or subsequent time. 18 (g) The Board of Medicine may impose any of the 19 penalties specified in ss. 455.227 and 458.331(2) upon a 20 physician assistant if the physician assistant or the 21 supervising physician has been found guilty of or is being 22 investigated for any act that constitutes a violation of this 23 chapter or chapter 455. 24 (8) DELEGATION OF POWERS AND DUTIES.--The boards may 25 delegate such powers and duties to the council as they may 26 deem proper. 27 (9) COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on 28 Physician Assistants is created within the department Agency 29 for Health Care Administration. 30 (a) The council shall consist of five members 31 appointed as follows: 56 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 1. The chairperson of the Board of Medicine shall 2 appoint three members who are physicians and members of the 3 Board of Medicine. One of the physicians must supervise a 4 physician assistant in the physician's practice. 5 2. The chairperson of the Board of Osteopathic 6 Medicine shall appoint one member who is a physician, 7 supervises a physician assistant in the physician's practice, 8 and is a member of the Board of Osteopathic Medicine. 9 3. The secretary of the department head of the agency 10 or his designee shall appoint a fully certified physician 11 assistant licensed under this chapter or chapter 459. 12 (b) Two of the members appointed to the council must 13 be physicians who supervise physician assistants in their 14 practice. Members shall be appointed to terms of 4 years, 15 except that of the initial appointments, two members shall be 16 appointed to terms of 2 years, two members shall be appointed 17 to terms of 3 years, and one member shall be appointed to a 18 term of 4 years, as established by rule of the boards. 19 Council members may not serve more than two consecutive terms. 20 The council shall annually elect a chairperson from among its 21 members. 22 (c) The council shall: 23 1. Recommend to the department agency the 24 certification of physician assistants. 25 2. Develop all rules regulating the use of physician 26 assistants by physicians under this chapter and chapter 459, 27 except for rules relating to the formulary developed under 28 paragraph (4)(f). The council shall also develop rules to 29 ensure that the continuity of supervision is maintained in 30 each practice setting. The boards shall consider adopting a 31 proposed rule developed by the council at the regularly 57 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 scheduled meeting immediately following the submission of the 2 proposed rule by the council. A proposed rule submitted by 3 the council may not be adopted by either board unless both 4 boards have accepted and approved the identical language 5 contained in the proposed rule. The language of all proposed 6 rules submitted by the council must be approved by both boards 7 pursuant to each respective board's guidelines and standards 8 regarding the adoption of proposed rules. If either board 9 rejects the council's proposed rule, that board must specify 10 its objection to the council with particularity and include 11 any recommendations it may have for the modification of the 12 proposed rule. 13 3. Make recommendations to the boards regarding all 14 matters relating to physician assistants. 15 4. Address concerns and problems of practicing 16 physician assistants in order to improve safety in the 17 clinical practices of certified physician assistants. 18 (10) INACTIVE AND DELINQUENT STATUS.--A certificate on 19 inactive or delinquent status may be reactivated only as 20 provided in s. 455.271. 21 (11) PENALTY.--Any person who has not been certified 22 by the council and approved by the department agency and who 23 holds himself out as a physician assistant or who uses any 24 other term in indicating or implying that he is a physician 25 assistant commits a felony of the third degree, punishable as 26 provided in s. 775.082 or s. 775.084 or by a fine not 27 exceeding $5,000. 28 (12) DENIAL, SUSPENSION, OR REVOCATION OF 29 CERTIFICATION.--The boards may deny, suspend, or revoke a 30 physician assistant certification if a board determines that 31 the physician assistant has violated this chapter. 58 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (13) RULES.--The boards shall adopt rules to implement 2 this section, including rules detailing the contents of the 3 application for certification and notification pursuant to 4 subsection (7) and rules to ensure both the continued 5 competency of physician assistants and the proper utilization 6 of them by physicians or groups of physicians. 7 (14) EXISTING PROGRAMS.--This section does not 8 eliminate or supersede existing laws relating to other 9 paramedical professions or services and is supplemental to all 10 such existing laws relating to the certification and practice 11 of paramedical professions. 12 (15) LIABILITY.--Each supervising physician using a 13 physician assistant is liable for any acts or omissions of the 14 physician assistant acting under the physician's supervision 15 and control. 16 (16) LEGAL SERVICES.--The Department of Legal Affairs 17 shall provide legal services to the council as authorized in 18 s. 455.221(1). 19 (17) FEES.--The department agency shall allocate the 20 fees collected under this section to the council. 21 Section 24. Subsections (1) and (2) of section 22 458.3485, Florida Statutes, are amended to read: 23 458.3485 Medical assistant.-- 24 (1) DEFINITION.--As used in this section, "medical 25 assistant" means a professional multiskilled person dedicated 26 to assisting in all aspects of medical practice under the 27 direct supervision and responsibility of a physician. This 28 practitioner assists with patient care management, executes 29 administrative and clinical procedures, and often performs 30 managerial and supervisory functions. Competence in the field 31 also requires that a medical assistant adhere to ethical and 59 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 legal standards of professional practice, recognize and 2 respond to emergencies, and demonstrate professional 3 characteristics. 4 (2) DUTIES.--Under the direct supervision and 5 responsibility of a licensed physician, the duties of a 6 medical assistant may undertake the following duties are to: 7 (a) Performing Perform clinical procedures, to 8 include: 9 1. Performing aseptic procedures. 10 2. Taking vital signs. 11 3. Preparing patients for the physician's care. 12 4. Performing venipunctures and nonintravenous 13 injections. 14 5. Observing and reporting patients' signs or 15 symptoms. 16 (b) Administering basic first aid. 17 (c) Assisting with patient examinations or treatments. 18 (d) Operating office medical equipment. 19 (e) Collecting routine laboratory specimens as 20 directed by the physician. 21 (f) Administering medication as directed by the 22 physician. 23 (g) Performing basic laboratory procedures. 24 (h) Performing office procedures including all general 25 administrative duties required by the physician. 26 (i) Performing Perform dialysis procedures, including 27 home dialysis. 28 Section 25. Section 458.351, Florida Statutes, is 29 created to read: 30 458.351 Incident reports.-- 31 60 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) Effective January 1, 1998, any physician 2 practicing in this state must notify the board in writing, by 3 certified mail, of any serious incident which occurs in the 4 physician's office. In the case of a group practice, the 5 chief administrative officer must notify the board in writing, 6 by certified mail, of any serious incident which occurs in any 7 of the offices of the physicians of that practice. The 8 required notification must be postmarked within 30 days after 9 the physician becomes aware of the incident. Incidents which 10 must be reported include: the death of a patient; severe 11 brain or spinal damage to a patient; a surgical procedure 12 being performed on the wrong patient; or a surgical procedure 13 unrelated to the patient's diagnosis or medical needs being 14 performed on any patient. 15 (2) The board may adopt rules necessary to carry out 16 the provisions of this section. 17 Section 26. Subsection (2) of section 459.003, Florida 18 Statutes, is amended, and subsection (5) is added to said 19 section, to read: 20 459.003 Definitions.--As used in this chapter: 21 (2) "Department" means the Department of Health 22 Business and Professional Regulation. 23 (5) "Doctor of Osteopathy" and "Doctor of Osteopathic 24 Medicine," when referring to degrees, shall be construed to be 25 equivalent and equal degrees. 26 Section 27. Subsections (1) and (3) and paragraph (b) 27 of subsection (5) of section 459.021, Florida Statutes, are 28 amended, and subsection (8) is added to said section, to read: 29 459.021 Registration of resident physicians, interns, 30 and fellows; list of hospital employees; penalty.-- 31 61 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) Any person who holds a degree of Doctor of 2 Osteopathic Medicine Osteopathy from a college of osteopathic 3 medicine recognized and approved by the American Osteopathic 4 Association who desires to practice as a resident physician, 5 assistant resident physician, house physician, intern, or 6 fellow in fellowship training which leads to subspecialty 7 board certification in this state who does not hold an active 8 license issued under this chapter shall apply to the 9 department to be registered, on an application provided by the 10 department, within 30 days of commencing such a training 11 program and shall remit a fee not to exceed $300 as set by the 12 board. 13 (3) Every hospital having employed or contracted with 14 or utilized the services of a person who holds a degree of 15 Doctor of Osteopathic Medicine Osteopathy from a college of 16 osteopathic medicine recognized and approved by the American 17 Osteopathic Association as a resident physician, assistant 18 resident physician, house physician, intern, or fellow in 19 fellowship training which leads to subspecialty board 20 certification shall designate a person who shall furnish, in 21 January and July of each year, to the department a list of all 22 such persons who have served in the hospital during the 23 preceding 6-month period. The chief executive officer of each 24 such hospital shall provide the executive director of the 25 board with the name, title, and address of the person 26 responsible for furnishing such reports. 27 (5) It is a misdemeanor of the second degree, 28 punishable as provided in s. 775.082 or s. 775.083 for any 29 hospital, and also for the superintendent, administrator, and 30 other person or persons having administrative authority in a 31 hospital: 62 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) To fail to furnish to the department the list and 2 information required by subsection (3). 3 (8) Notwithstanding any provision of this section or 4 s. 120.52 to the contrary, any person who is registered under 5 this section is subject to the provisions of s. 459.015. 6 (9) A person registered as a resident physician under 7 this section may in the normal course of his or her employment 8 prescribe medicinal drugs described in schedules set out in 9 chapter 893 when: 10 (a) The person prescribes such medicinal drugs through 11 use of a Drug Enforcement Administration number issued to the 12 hospital by which the person is employed or at which the 13 person's services are used; 14 (b) The person is identified by a discrete suffix to 15 the identification number issued to the hospital; and 16 (c) The use of the institutional identification number 17 and individual suffixes conforms to the requirements of the 18 federal Drug Enforcement Administration. 19 Section 28. Subsection (1) of section 459.0075, 20 Florida Statutes, is amended to read: 21 459.0075 Limited licenses.-- 22 (1) Any person desiring to obtain a limited license 23 shall: 24 (a) Submit to the board a licensure application and 25 fee required by this chapter. However, an osteopathic 26 physician who is not fully retired in all jurisdictions, may 27 use a limited license only for noncompensated practice. 28 However, If the person applying for a limited license submits 29 a notarized statement from the employing agency or institution 30 stating that he will not receive monetary compensation for any 31 service involving the practice of osteopathic medicine, the 63 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 application fee and all licensure fees shall be waived. 2 However, any person who receives a waiver of fees for a 3 limited license shall pay such fees if the person receives 4 compensation for the practice of osteopathic medicine. 5 (b) Submit an affidavit that such osteopathic 6 physician has been licensed to practice osteopathic medicine 7 in any jurisdiction in the United States in good standing and 8 pursuant to law for at least 10 years and has now retired and 9 that he was in good standing at the time of his retirement. 10 (c) Complete an amount of continuing education 11 established by the board. 12 Section 29. Paragraphs (a) and (g) of subsection (5) 13 of section 459.0085, Florida Statutes, 1996 Supplement, are 14 amended to read: 15 459.0085 Financial responsibility.-- 16 (5) The requirements of subsections (1), (2), and (3) 17 shall not apply to: 18 (a) Any person licensed under this chapter who 19 practices medicine exclusively as an officer, employee, or 20 agent of the Federal Government or of the state or its 21 agencies or its subdivisions. For the purposes of this 22 subsection, an agent of the state, its agencies, or its and 23 subdivisions is a person who is eligible for coverage under 24 any self-insurance or insurance program authorized by the 25 provisions of s. 768.28(15)(14). 26 (g) Any person holding an active license under this 27 chapter who agrees to meet all of the following criteria: 28 1. Upon the entry of an adverse final judgment arising 29 from a medical malpractice arbitration award, from a claim of 30 medical malpractice either in contract or tort, or from 31 noncompliance with the terms of a settlement agreement arising 64 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 from a claim of medical malpractice either in contract or 2 tort, the licensee shall pay the judgment creditor the lesser 3 of the entire amount of the judgment with all accrued interest 4 or either $100,000, if the osteopathic physician is licensed 5 pursuant to this chapter but does not maintain hospital staff 6 privileges, or $250,000, if the osteopathic physician is 7 licensed pursuant to this chapter and maintains hospital staff 8 privileges, within 60 days after the date such judgment became 9 final and subject to execution, unless otherwise mutually 10 agreed to in writing by the parties. Such adverse final 11 judgment shall include any cross-claim, counterclaim, or claim 12 for indemnity or contribution arising from the claim of 13 medical malpractice. Upon notification of the existence of an 14 unsatisfied judgment or payment pursuant to this subparagraph, 15 the department shall notify the licensee by certified mail 16 that he shall be subject to disciplinary action unless, within 17 30 days from the date of mailing, he either: 18 a. Shows proof that the unsatisfied judgment has been 19 paid in the amount specified in this subparagraph; or 20 b. Furnishes the department with a copy of a timely 21 filed notice of appeal and either: 22 (I) A copy of a supersedeas bond properly posted in 23 the amount required by law; or 24 (II) An order from a court of competent jurisdiction 25 staying execution on the final judgment, pending disposition 26 of the appeal. 27 2. Upon the next meeting of the probable cause panel 28 of the board following 30 days after the date of mailing the 29 notice of disciplinary action to the licensee, the panel shall 30 make a determination of whether probable cause exists to take 31 65 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 disciplinary action against the licensee pursuant to 2 subparagraph 1. 3 3. If the board determines that the factual 4 requirements of subparagraph 1. are met, it shall take 5 disciplinary action as it deems appropriate against the 6 licensee. Such disciplinary action shall include, at a 7 minimum, probation of the license with the restriction that 8 the licensee must make payments to the judgment creditor on a 9 schedule determined by the board to be reasonable and within 10 the financial capability of the osteopathic physician. 11 Notwithstanding any other disciplinary penalty imposed, the 12 disciplinary penalty may include suspension of the license for 13 a period not to exceed 5 years. In the event that an 14 agreement to satisfy a judgment has been met, the board shall 15 remove any restriction on the license. 16 4. The licensee has completed a form supplying 17 necessary information as required by the department. 18 19 A licensee who meets the requirements of this paragraph shall 20 be required to either post notice in the form of a sign 21 prominently displayed in the reception area and clearly 22 noticeable by all patients and or provide a written statement 23 to any person to whom medical services are being provided. A 24 copy of the written statement shall be given to each patient 25 to sign, acknowledging receipt thereof, and the signed copy 26 shall be maintained in the patient's file. If the patient 27 refuses to sign or is unable to sign the written statement, 28 the licensee shall so note it on the form. Such sign and or 29 statement shall state that: "Under Florida law, osteopathic 30 physicians are generally required to carry medical malpractice 31 insurance or otherwise demonstrate financial responsibility to 66 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 cover potential claims for medical malpractice. YOUR 2 OSTEOPATHIC PHYSICIAN HAS DECIDED NOT TO CARRY MEDICAL 3 MALPRACTICE INSURANCE. This is permitted under Florida law 4 subject to certain conditions. Florida law imposes strict 5 penalties against noninsured osteopathic physicians who fail 6 to satisfy adverse judgments arising from claims of medical 7 malpractice. This notice is provided pursuant to Florida 8 law." 9 Section 30. Paragraphs (o), (gg), and (ll) of 10 subsection (1) of section 459.015, Florida Statutes, 1996 11 Supplement, are amended, and paragraph (nn) is added to said 12 subsection, to read: 13 459.015 Grounds for disciplinary action by the 14 board.-- 15 (1) The following acts shall constitute grounds for 16 which the disciplinary actions specified in subsection (2) may 17 be taken: 18 (o) Failing to keep legible, as defined by department 19 rule in consultation with the board, written medical records 20 that identify the licensed osteopathic physician or the 21 osteopathic physician extender and supervising osteopathic 22 physician by name and professional title who is or are 23 responsible for rendering, ordering, supervising, or billing 24 for each diagnostic or treatment procedure and that justify 25 justifying the course of treatment of the patient, including, 26 but not limited to, patient histories; examination results; 27 test results; records of drugs prescribed, dispensed, or 28 administered; and reports of consultations and 29 hospitalizations. 30 (gg) Prescribing, ordering, dispensing, administering, 31 supplying, selling, or giving any drug which is a Schedule II 67 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 amphetamine or Schedule II sympathomimetic amine drug or any 2 compound thereof, pursuant to chapter 893, to or for any 3 person except for: 4 1. The treatment of narcolepsy; hyperkinesis; 5 behavioral syndrome in children characterized by the 6 developmentally inappropriate symptoms of moderate to severe 7 distractability, short attention span, hyperactivity, 8 emotional lability, and impulsivity; or drug-induced brain 9 dysfunction; 10 2. The differential diagnostic psychiatric evaluation 11 of depression or the treatment of depression shown to be 12 refractory to other therapeutic modalities; or 13 3. The clinical investigation of the effects of such 14 drugs or compounds when an investigative protocol therefor is 15 submitted to, reviewed, and approved by the board before such 16 investigation is begun. 17 (ll) Failing to report to the department Division of 18 Medical Quality Assurance any licensee physician licensed 19 under chapter 458 or osteopathic physician licensed under this 20 chapter who the osteopathic physician or physician assistant 21 knows has violated the grounds for disciplinary action set out 22 in the law under which that person physician or osteopathic 23 physician is licensed and who provides health care services in 24 a facility licensed under chapter 395, or a health maintenance 25 organization certificated under part I of chapter 641, in 26 which the osteopathic physician or physician assistant also 27 provides services. 28 (nn) Advertising or holding oneself out as a 29 board-certified specialist in violation of this chapter. 30 Section 31. Section 459.0152, Florida Statutes, is 31 created to read: 68 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 459.0152 Specialties.--An osteopathic physician 2 licensed under this chapter may not hold himself or herself 3 out as a board-certified specialist unless the osteopathic 4 physician has successfully completed the requirements for 5 certification by the American Osteopathic Association or the 6 Accreditation Council on Graduate Medical Education and is 7 certified as a specialist by a certifying agency approved by 8 the board. However, an osteopathic physician may indicate the 9 services offered and may state that his or her practice is 10 limited to one or more types of services when this accurately 11 reflects the scope of practice of the osteopathic physician. 12 Section 32. Section 459.022, Florida Statutes, 1996 13 Supplement, is amended to read: 14 459.022 Physician assistants.-- 15 (1) LEGISLATIVE INTENT.-- 16 (a) The purpose of this section is to encourage more 17 effective utilization of the skills of osteopathic physicians 18 or groups of osteopathic physicians by enabling them to 19 delegate health care tasks to qualified assistants when such 20 delegation is consistent with the patient's health and 21 welfare. 22 (b) In order that maximum skills may be obtained 23 within a minimum time period of education, a physician 24 assistant shall be specialized to the extent that he can 25 operate efficiently and effectively in the specialty areas in 26 which he has been trained or is experienced. 27 (c) The purpose of this section is to encourage the 28 utilization of physician assistants by osteopathic physicians 29 and to allow for innovative development of programs for the 30 education of physician assistants. 31 (2) DEFINITIONS.--As used in this section: 69 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) "Agency" means the Agency for Health Care 2 Administration. 3 (a)(b) "Approved program" means a program, formally 4 approved by the boards, for the education of physician 5 assistants. 6 (b)(c) "Boards" means the Board of Medicine and the 7 Board of Osteopathic Medicine. 8 (c)(d) "Council" means the Council on Physician 9 Assistants. 10 (d)(e) "Trainee" means a person who is currently 11 enrolled in an approved program. 12 (e)(f) "Physician assistant" means a person who is a 13 graduate of an approved program or its equivalent or meets 14 standards approved by the boards and is certified to perform 15 medical services delegated by the supervising physician. 16 (f)(g) "Supervision" means responsible supervision and 17 control. Except in cases of emergency, supervision requires 18 the easy availability or physical presence of the licensed 19 physician for consultation and direction of the actions of the 20 physician assistant. For the purposes of this definition, the 21 term "easy availability" includes the ability to communicate 22 by way of telecommunication. The boards shall establish rules 23 as to what constitutes responsible supervision of the 24 physician assistant. 25 (g)(h) "Proficiency examination" means an entry-level 26 examination approved by the boards, including, but not limited 27 to, those examinations administered by the National Commission 28 on Certification of Physician Assistants. 29 (h)(i) "Continuing medical education" means courses 30 recognized and approved by the boards, the American Academy of 31 Physician Assistants, the American Medical Association, the 70 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 American Osteopathic Association, or the Accreditation Council 2 on Continuing Medical Education. 3 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.--Each 4 physician or group of physicians supervising a certified 5 physician assistant must be qualified in the medical areas in 6 which the physician assistant is to perform and shall be 7 individually or collectively responsible and liable for the 8 performance and the acts and omissions of the physician 9 assistant. A physician may not supervise more than four 10 currently certified physician assistants at any one time. 11 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.-- 12 (a) The boards shall adopt, by rule, the general 13 principles that supervising physicians must use in developing 14 the scope of practice of a physician assistant under direct 15 supervision and under indirect supervision. These principles 16 shall recognize the diversity of both specialty and practice 17 settings in which physician assistants are used. 18 (b) This chapter does not prevent third-party payors 19 from reimbursing employers of physician assistants for covered 20 services rendered by certified physician assistants. 21 (c) Certified physician assistants may not be denied 22 clinical hospital privileges, except for cause, so long as the 23 supervising physician is a staff member in good standing. 24 (d) A supervisory physician may delegate to a 25 certified physician assistant, pursuant to a written protocol, 26 the authority to act according to s. 154.04(1)(c)(d). Such 27 delegated authority is limited to the supervising physician's 28 practice in connection with a county public health department 29 unit as defined and established pursuant to chapter 154. The 30 boards shall adopt rules governing the supervision of 31 71 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 physician assistants by physicians in county public health 2 departments units. 3 (e) A supervisory physician may delegate to a fully 4 certified physician assistant the authority to prescribe any 5 medication used in the supervisory physician's practice if 6 such medication is listed on the formulary created pursuant to 7 s. 458.347. A fully certified physician assistant may only 8 prescribe such medication under the following circumstances: 9 1. A physician assistant must clearly identify to the 10 patient that he is a physician assistant. Furthermore, the 11 physician assistant must inform the patient that the patient 12 has the right to see the physician prior to any prescription 13 being prescribed by the physician assistant. 14 2. The supervisory physician must notify the 15 department agency of his intent to delegate, on a 16 department-approved an agency-approved form, before delegating 17 such authority and with each certification renewal application 18 filed by the physician assistant. 19 3. The physician assistant must file with the 20 department agency, before commencing to prescribe, evidence 21 that he has completed a continuing medical education course of 22 at least 3 classroom hours in prescriptive practice, conducted 23 by an accredited program approved by the boards, which course 24 covers the limitations, responsibilities, and privileges 25 involved in prescribing medicinal drugs, or evidence that he 26 has received education comparable to the continuing education 27 course as part of an accredited physician assistant training 28 program. 29 4. The physician assistant must file with the 30 department agency, before commencing to prescribe, evidence 31 that the physician assistant has a minimum of 3 months of 72 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 clinical experience in the specialty area of the supervising 2 physician. 3 5. The physician assistant must file with the 4 department agency a signed affidavit that he has completed a 5 minimum of 10 continuing medical education hours in the 6 specialty practice in which the physician assistant has 7 prescriptive privileges with each certification renewal 8 application. 9 6. The department agency shall issue certification and 10 a prescriber number to the physician assistant granting 11 authority for the prescribing of medicinal drugs authorized 12 within this paragraph upon completion of the foregoing 13 requirements. 14 7. The prescription must be written in a form that 15 complies with chapter 499 and must contain, in addition to the 16 supervisory physician's name, address, and telephone number, 17 the physician assistant's prescriber number. The prescription 18 must be filled in a pharmacy permitted under chapter 465, and 19 must be dispensed in that pharmacy by a pharmacist licensed 20 under chapter 465. The appearance of the prescriber number 21 creates a presumption that the physician assistant is 22 authorized to prescribe the medicinal drug and the 23 prescription is valid. 24 8. The physician assistant must note the prescription 25 in the appropriate medical record, and the supervisory 26 physician must review and sign each notation. For dispensing 27 purposes only, the failure of the supervisory physician to 28 comply with these requirements does not affect the validity of 29 the prescription. 30 9. This paragraph does not prohibit a supervisory 31 physician from delegating to a physician assistant the 73 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 authority to order medication for a hospitalized patient of 2 the supervisory physician. 3 4 This paragraph does not apply to facilities licensed pursuant 5 to chapter 395. 6 (f)1. There is created a five-member committee 7 appointed by the Director of Health Care Administration. The 8 committee must be composed of one fully certified physician 9 assistant certified pursuant to this section or s. 458.347, 10 two physicians licensed pursuant to chapter 458, one of whom 11 supervises a fully licensed physician assistant, one 12 osteopathic physician licensed pursuant to this chapter, and 13 one pharmacist licensed pursuant to chapter 465 who is not 14 licensed pursuant to this chapter or chapter 458. The 15 committee shall establish a formulary of medicinal drugs for 16 which a fully certified physician assistant may prescribe. 17 The formulary may not include controlled substances as defined 18 in chapter 893, antineoplastics, antipsychotics, 19 radiopharmaceuticals, general anesthetics or radiographic 20 contrast materials, or any parenteral preparations except 21 insulin and epinephrine. 22 2. Only the committee shall add to, delete from, or 23 modify the formulary. Any person who requests an addition, 24 deletion, or modification of a medicinal drug listed on such 25 formulary has the burden of proof to show cause why such 26 addition, deletion, or modification should be made. 27 3. The boards shall adopt the formulary required by 28 this paragraph, and each addition, deletion, or modification 29 to the formulary, by rule. Notwithstanding any provision of 30 chapter 120 to the contrary, the formulary rule shall be 31 effective 60 days after the date it is filed with the 74 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Secretary of State. Upon adoption of the formulary, the 2 department agency shall mail a copy of such formulary to each 3 fully certified physician assistant and to each pharmacy 4 licensed by the state. The boards shall establish, by rule, a 5 fee not to exceed $200 to fund the provisions of this 6 paragraph and paragraph (e). 7 (5) PERFORMANCE BY TRAINEES.--Notwithstanding any 8 other law, a trainee may perform medical services when such 9 services are rendered within the scope of an approved program. 10 (6) PROGRAM APPROVAL.-- 11 (a) The boards shall approve programs, based on 12 recommendations by the council, for the education and training 13 of physician assistants which meet standards established by 14 rule of the boards. The council may recommend only those 15 physician assistant programs that hold full accreditation or 16 provisional accreditation from the Commission on Accreditation 17 of Allied Health Programs or its successor organization. 18 (b) The boards shall adopt and publish standards to 19 ensure that such programs operate in a manner that does not 20 endanger the health or welfare of the patients who receive 21 services within the scope of the programs. The boards shall 22 review the quality of the curricula, faculties, and facilities 23 of such programs and take whatever other action is necessary 24 to determine that the purposes of this section are being met. 25 (7) PHYSICIAN ASSISTANT CERTIFICATION.-- 26 (a) Any person desiring to be certified as a physician 27 assistant must apply to the department agency. The department 28 agency shall issue a certificate to any person certified by 29 the council as having met the following requirements: 30 1. Is at least 18 years of age. 31 75 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 2. Has satisfactorily passed a proficiency examination 2 by an acceptable score established by the National Commission 3 on Certification of Physician Assistants. If an applicant 4 does not hold a current certificate issued by the National 5 Commission on Certification of Physician Assistants and has 6 not actively practiced as a physician assistant within the 7 immediately preceding 4 years, the applicant must retake and 8 successfully complete the entry-level examination of the 9 National Commission on Certification of Physician Assistants 10 to be eligible for certification. 11 3. Has completed the application form and remitted an 12 application fee not to exceed $300 as set by the boards. An 13 application for certification made by a physician assistant 14 must include: 15 a. A certificate of completion of a physician 16 assistant training program specified in subsection (6). 17 b. A sworn statement of any prior felony convictions. 18 c. A sworn statement of any previous revocation or 19 denial of licensure or certification in any state. 20 d. Two letters of recommendation. 21 (b) The certification must be renewed biennially. 22 Each renewal must include: 23 1. A renewal fee not to exceed $500 as set by the 24 boards. 25 2. A sworn statement of no felony convictions in the 26 previous 2 years. 27 (c) Each certified physician assistant shall 28 biennially complete 100 hours of continuing medical education 29 or shall hold a current certificate issued by the National 30 Commission on Certification of Physician Assistants. 31 76 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (d) Upon employment as a physician assistant, a 2 certified physician assistant must notify the department 3 agency in writing within 30 days after such employment or 4 after any subsequent changes in the supervising physician. 5 The notification must include the full name, Florida medical 6 license number, specialty, and address of the supervising 7 physician. 8 (e) Notwithstanding subparagraph (a)2., the department 9 agency may grant to a recent graduate of an approved program, 10 as specified in subsection (6), temporary certification to 11 expire upon receipt of scores of the proficiency examination 12 administered by the National Commission on Certification of 13 Physician Assistants. Between meetings of the council, the 14 department agency may grant temporary certification to 15 practice to physician assistant applicants based on the 16 completion of all temporary certification requirements. All 17 such administratively issued certifications shall be reviewed 18 and acted on at the next regular meeting of the council. The 19 recent graduate may be certified prior to employment, but must 20 comply with paragraph (d). An applicant who has passed the 21 proficiency examination may be granted permanent 22 certification. An applicant failing the proficiency 23 examination is no longer temporarily certified, but may 24 reapply for a 1-year extension of temporary certification. An 25 applicant may not be granted more than two temporary 26 certificates and may not be certified as a physician assistant 27 until he passes the examination administered by the National 28 Commission on Certification of Physician Assistants. As 29 prescribed by board rule, the council may require an applicant 30 who does not pass the licensing examination after five or more 31 attempts to complete additional remedial education or 77 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 training. The council shall prescribe the additional 2 requirements in a manner that permits the applicant to 3 complete the requirements and be reexamined within 2 years 4 after the date the applicant petitions the council to retake 5 the examination a sixth or subsequent time. 6 (f) The Board of Osteopathic Medicine may impose any 7 of the penalties specified in ss. 455.227 and 459.015(2) upon 8 a physician assistant if the physician assistant or the 9 supervising physician has been found guilty of or is being 10 investigated for any act that constitutes a violation of this 11 chapter or chapter 455. 12 (8) DELEGATION OF POWERS AND DUTIES.--The boards may 13 delegate such powers and duties to the council as they may 14 deem proper. 15 (9) COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on 16 Physician Assistants is created within the department Agency 17 for Health Care Administration. 18 (a) The council shall consist of five members 19 appointed as follows: 20 1. The chairperson of the Board of Medicine shall 21 appoint three members who are physicians and members of the 22 Board of Medicine. One of the physicians must supervise a 23 physician assistant in the physician's practice. 24 2. The chairperson of the Board of Osteopathic 25 Medicine shall appoint one member who is a physician, 26 supervises a physician assistant in the physician's practice, 27 and is a member of the Board of Osteopathic Medicine. 28 3. The secretary of the department head of the agency 29 or his designee shall appoint a fully certified physician 30 assistant licensed under chapter 458 or this chapter. 31 78 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) Two of the members appointed to the council must 2 be physicians who supervise physician assistants in their 3 practice. Members shall be appointed to terms of 4 years, 4 except that of the initial appointments, two members shall be 5 appointed to terms of 2 years, two members shall be appointed 6 to terms of 3 years, and one member shall be appointed to a 7 term of 4 years, as established by rule of the boards. 8 Council members may not serve more than two consecutive terms. 9 The council shall annually elect a chairperson from among its 10 members. 11 (c) The council shall: 12 1. Recommend to the department agency the 13 certification of physician assistants. 14 2. Develop all rules regulating the use of physician 15 assistants by physicians under chapter 458 and this chapter, 16 except for rules relating to the formulary developed under s. 17 458.347(4)(f). The council shall also develop rules to ensure 18 that the continuity of supervision is maintained in each 19 practice setting. The boards shall consider adopting a 20 proposed rule developed by the council at the regularly 21 scheduled meeting immediately following the submission of the 22 proposed rule by the council. A proposed rule submitted by 23 the council may not be adopted by either board unless both 24 boards have accepted and approved the identical language 25 contained in the proposed rule. The language of all proposed 26 rules submitted by the council must be approved by both boards 27 pursuant to each respective board's guidelines and standards 28 regarding the adoption of proposed rules. If either board 29 rejects the council's proposed rule, that board must specify 30 its objection to the council with particularity and include 31 79 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 any recommendations it may have for the modification of the 2 proposed rule. 3 3. Make recommendations to the boards regarding all 4 matters relating to physician assistants. 5 4. Address concerns and problems of practicing 6 physician assistants in order to improve safety in the 7 clinical practices of certified physician assistants. 8 (10) INACTIVE AND DELINQUENT STATUS.--A certificate on 9 inactive or delinquent status may be reactivated only as 10 provided in s. 455.271. 11 (11) PENALTY.--Any person who has not been certified 12 by the council and approved by the department agency and who 13 holds himself out as a physician assistant or who uses any 14 other term in indicating or implying that he is a physician 15 assistant commits a felony of the third degree, punishable as 16 provided in s. 775.082 or s. 775.084 or by a fine not 17 exceeding $5,000. 18 (12) DENIAL, SUSPENSION, OR REVOCATION OF 19 CERTIFICATION.--The boards may deny, suspend, or revoke a 20 physician assistant certification if a board determines that 21 the physician assistant has violated this chapter. 22 (13) RULES.--The boards shall adopt rules to implement 23 this section, including rules detailing the contents of the 24 application for certification and notification pursuant to 25 subsection (7) and rules to ensure both the continued 26 competency of physician assistants and the proper utilization 27 of them by physicians or groups of physicians. 28 (14) EXISTING PROGRAMS.--This section does not 29 eliminate or supersede existing laws relating to other 30 paramedical professions or services and is supplemental to all 31 80 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 such existing laws relating to the certification and practice 2 of paramedical professions. 3 (15) LIABILITY.--Each supervising physician using a 4 physician assistant is liable for any acts or omissions of the 5 physician assistant acting under the physician's supervision 6 and control. 7 (16) LEGAL SERVICES.--The Department of Legal Affairs 8 shall provide legal services to the council as authorized in 9 s. 455.221(1). 10 (17) FEES.--The department agency shall allocate the 11 fees collected under this section to the council. 12 Section 33. Section 459.025, Florida Statutes, is 13 created to read: 14 459.025 Incident reports.-- 15 (1) Effective January 1, 1998, any physician 16 practicing in this state must notify the board in writing, by 17 certified mail, of any serious incident which occurs in the 18 physician's office. In the case of a group practice, the 19 chief administrative officer must notify the board in writing, 20 by certified mail, of any serious incident which occurs in any 21 of the offices of the physicians of that practice. The 22 required notification must be postmarked within 30 days after 23 the physician becomes aware of the incident. Incidents which 24 must be reported include: the death of a patient; severe 25 brain or spinal damage to a patient; a surgical procedure 26 being performed on the wrong patient; or a surgical procedure 27 unrelated to the patient's diagnosis or medical needs being 28 performed on any patient. 29 (2) The board may adopt rules necessary to carry out 30 the provisions of this section. 31 81 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 34. Subsection (1) of section 240.4067, 2 Florida Statutes, is amended to read: 3 240.4067 Medical Education Reimbursement and Loan 4 Repayment Program.-- 5 (1) To encourage qualified medical professionals to 6 practice in underserved locations where there are shortages of 7 such personnel, there is established the Medical Education 8 Reimbursement and Loan Repayment Program. The function of the 9 program is to make payments that offset loans and educational 10 expenses incurred by students for studies leading to a medical 11 or nursing degree, medical or nursing licensure, or advanced 12 registered nurse practitioner or physician's assistant 13 certification. The following licensed or certified health 14 care professionals are eligible to participate in this 15 program: medical doctors with primary care specialties, 16 doctors of osteopathic medicine osteopathy with primary care 17 specialties, physician's assistants, licensed practical nurses 18 and registered nurses, and advanced registered nurse 19 practitioners with primary care specialties such as certified 20 nurse midwives. Primary care medical specialties for 21 physicians include obstetrics, gynecology, general and family 22 practice, internal medicine, pediatrics, and other specialties 23 which may be identified by the Department of Health and 24 Rehabilitative Services. 25 Section 35. Subsection (5) of section 390.011, Florida 26 Statutes, is amended to read: 27 390.011 Definitions.--As used in this act: 28 (5) "Physician" means a physician licensed under 29 chapter 458 or chapter 459 or a physician practicing medicine 30 or osteopathic medicine osteopathy in the employment of the 31 United States or this state. 82 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 36. Subsection (1) of section 395.0191, 2 Florida Statutes, is amended to read: 3 395.0191 Staff membership and clinical privileges.-- 4 (1) No licensed facility, in considering and acting 5 upon an application for staff membership or clinical 6 privileges, shall deny the application of a qualified doctor 7 of medicine licensed under chapter 458, a doctor of 8 osteopathic medicine osteopathy licensed under chapter 459, a 9 doctor of dentistry licensed under chapter 466, a doctor of 10 podiatry licensed under chapter 461, or a psychologist 11 licensed under chapter 490 for such staff membership or 12 clinical privileges within the scope of his or her respective 13 licensure solely because the applicant is licensed under any 14 of such chapters. 15 Section 37. Paragraph (g) of subsection (1) of section 16 408.035, Florida Statutes, is amended to read: 17 408.035 Review criteria.-- 18 (1) The agency shall determine the reviewability of 19 applications and shall review applications for 20 certificate-of-need determinations for health care facilities 21 and services, hospices, and health maintenance organizations 22 in context with the following criteria: 23 (g) The need for research and educational facilities, 24 including, but not limited to, institutional training programs 25 and community training programs for health care practitioners 26 and for doctors of osteopathic medicine osteopathy and 27 medicine at the student, internship, and residency training 28 levels. 29 Section 38. Subsection (9) of section 409.905, Florida 30 Statutes, 1996 Supplement, is amended to read: 31 83 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 409.905 Mandatory Medicaid services.--The agency may 2 make payments for the following services, which are required 3 of the state by Title XIX of the Social Security Act, 4 furnished by Medicaid providers to recipients who are 5 determined to be eligible on the dates on which the services 6 were provided. Any service under this section shall be 7 provided only when medically necessary and in accordance with 8 state and federal law. Nothing in this section shall be 9 construed to prevent or limit the agency from adjusting fees, 10 reimbursement rates, lengths of stay, number of visits, number 11 of services, or any other adjustments necessary to comply with 12 the availability of moneys and any limitations or directions 13 provided for in the General Appropriations Act or chapter 216. 14 (9) PHYSICIAN SERVICES.--The agency shall pay for 15 covered services and procedures rendered to a recipient by, or 16 under the personal supervision of, a person licensed under 17 state law to practice medicine or osteopathic medicine 18 osteopathy. These services may be furnished in the 19 physician's office, the Medicaid recipient's home, a hospital, 20 a nursing facility, or elsewhere, but shall be medically 21 necessary for the treatment of an injury, illness, or disease 22 within the scope of the practice of medicine or osteopathic 23 medicine osteopathy as defined by state law. The agency shall 24 not pay for services that are clinically unproven, 25 experimental, or for purely cosmetic purposes. 26 Section 39. Subsection (33) of section 415.102, 27 Florida Statutes, is amended to read: 28 415.102 Definitions of terms used in ss. 29 415.101-415.113.--As used in ss. 415.101-415.113, the term: 30 (33) "Specified medical personnel" means licensed or 31 certified physicians, osteopathic physicians osteopaths, 84 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 nurses, paramedics, advanced registered nurse practitioners, 2 psychologists, psychiatrists, mental health professionals, or 3 any other licensed or certified medical personnel. 4 Section 40. Paragraph (a) of subsection (1) of section 5 415.1034, Florida Statutes, is amended to read: 6 415.1034 Mandatory reporting of abuse, neglect, or 7 exploitation of disabled adults or elderly persons; mandatory 8 reports of death.-- 9 (1) MANDATORY REPORTING.-- 10 (a) Any person, including, but not limited to, any: 11 1. Physician, osteopathic physician osteopath, medical 12 examiner, chiropractor, nurse, or hospital personnel engaged 13 in the admission, examination, care, or treatment of disabled 14 adults or elderly persons; 15 2. Health professional or mental health professional 16 other than one listed in subparagraph 1.; 17 3. Practitioner who relies solely on spiritual means 18 for healing; 19 4. Nursing home staff; assisted living facility staff; 20 adult day care center staff; adult family-care home staff; 21 social worker; or other professional adult care, residential, 22 or institutional staff; 23 5. State, county, or municipal criminal justice 24 employee or law enforcement officer; 25 6. Human rights advocacy committee or long-term care 26 ombudsman council member; or 27 7. Bank, savings and loan, or credit union officer, 28 trustee, or employee, 29 30 who knows, or has reasonable cause to suspect, that a disabled 31 adult or an elderly person has been or is being abused, 85 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 neglected, or exploited shall immediately report such 2 knowledge or suspicion to the central abuse registry and 3 tracking system on the single statewide toll-free telephone 4 number. 5 Section 41. Paragraph (a) of subsection (1) of section 6 415.504, Florida Statutes, 1996 Supplement, is amended to 7 read: 8 415.504 Mandatory reports of child abuse or neglect; 9 mandatory reports of death; central abuse hotline.-- 10 (1) Any person, including, but not limited to, any: 11 (a) Physician, osteopathic physician osteopath, 12 medical examiner, chiropractor, nurse, or hospital personnel 13 engaged in the admission, examination, care, or treatment of 14 persons; 15 16 who knows, or has reasonable cause to suspect, that a child is 17 an abused, abandoned, or neglected child shall report such 18 knowledge or suspicion to the department in the manner 19 prescribed in subsection (2). 20 Section 42. Subsection (2) of section 440.106, Florida 21 Statutes, is amended to read: 22 440.106 Civil remedies; administrative penalties.-- 23 (2) Whenever a physician, osteopathic physician 24 osteopath, chiropractor, podiatrist, or other practitioner is 25 determined to have violated s. 440.105, the Board of Medicine 26 Medical Examiners as set forth in chapter 458, the Board of 27 Osteopathic Medicine Medical Examiners as set forth in chapter 28 459, the Board of Chiropractic as set forth in chapter 460, 29 the Board of Podiatric Medicine as set forth in chapter 461, 30 or other appropriate licensing authority, shall hold an 31 administrative hearing to consider the imposition of 86 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 administrative sanctions as provided by law against said 2 physician, osteopathic physician osteopath, chiropractor, or 3 other practitioner. 4 Section 43. Paragraph (r) of subsection (1) of section 5 440.13, Florida Statutes, 1996 Supplement, is amended to read: 6 440.13 Medical services and supplies; penalty for 7 violations; limitations.-- 8 (1) DEFINITIONS.--As used in this section, the term: 9 (r) "Physician" or "doctor" means a medical doctor or 10 doctor of osteopathy licensed under chapter 458, a physician 11 licensed under chapter 458, an osteopathic physician osteopath 12 licensed under chapter 459, a chiropractor licensed under 13 chapter 460, a podiatrist licensed under chapter 461, an 14 optometrist licensed under chapter 463, or a dentist licensed 15 under chapter 466, each of whom must be certified by the 16 division as a health care provider. 17 Section 44. Paragraphs (i) and (k) of subsection (1) 18 of section 440.134, Florida Statutes, are amended to read: 19 440.134 Workers' compensation managed care 20 arrangement.-- 21 (1) As used in this section, the term: 22 (i) "Medical care coordinator" means a primary care 23 provider within a provider network who is responsible for 24 managing the medical care of an injured worker including 25 determining other health care providers and health care 26 facilities to which the injured employee will be referred for 27 evaluation or treatment. A medical care coordinator shall be a 28 physician licensed under chapter 458 or an osteopathic 29 physician osteopath licensed under chapter 459. 30 (k) "Primary care provider" means, except in the case 31 of emergency treatment, the initial treating physician and, 87 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 when appropriate, continuing treating physician, who may be a 2 family practitioner, general practitioner, or internist 3 physician licensed under chapter 458; a family practitioner, 4 general practitioner, or internist osteopathic physician 5 osteopath licensed under chapter 459; a chiropractor licensed 6 under chapter 460; a podiatrist licensed under chapter 461; an 7 optometrist licensed under chapter 463; or a dentist licensed 8 under chapter 466. 9 Section 45. Paragraph (a) of subsection (3) of section 10 440.15, Florida Statutes, 1996 Supplement, is amended to read: 11 440.15 Compensation for disability.--Compensation for 12 disability shall be paid to the employee, subject to the 13 limits provided in s. 440.12(2), as follows: 14 (3) PERMANENT IMPAIRMENT AND WAGE-LOSS BENEFITS.-- 15 (a) Impairment benefits.-- 16 1. Once the employee has reached the date of maximum 17 medical improvement, impairment benefits are due and payable 18 within 20 days after the carrier has knowledge of the 19 impairment. 20 2. The three-member panel, in cooperation with the 21 division, shall establish and use a uniform permanent 22 impairment rating schedule. This schedule must be based on 23 medically or scientifically demonstrable findings as well as 24 the systems and criteria set forth in the American Medical 25 Association's Guides to the Evaluation of Permanent 26 Impairment; the Snellen Charts, published by American Medical 27 Association Committee for Eye Injuries; and the Minnesota 28 Department of Labor and Industry Disability Schedules. The 29 schedule should be based upon objective findings. The schedule 30 shall be more comprehensive than the AMA Guides to the 31 Evaluation of Permanent Impairment and shall expand the areas 88 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 already addressed and address additional areas not currently 2 contained in the guides. On August 1, 1979, and pending the 3 adoption, by rule, of a permanent schedule, Guides to the 4 Evaluation of Permanent Impairment, copyright 1977, 1971, 5 1988, by the American Medical Association, shall be the 6 temporary schedule and shall be used for the purposes hereof. 7 For injuries after July 1, 1990, pending the adoption by 8 division rule of a uniform disability rating schedule, the 9 Minnesota Department of Labor and Industry Disability Schedule 10 shall be used unless that schedule does not address an injury. 11 In such case, the Guides to the Evaluation of Permanent 12 Impairment by the American Medical Association shall be used. 13 Determination of permanent impairment under this schedule must 14 be made by a physician licensed under chapter 458, a doctor of 15 osteopathic medicine osteopathy licensed under chapters 458 16 and 459, a chiropractor licensed under chapter 460, a 17 podiatrist licensed under chapter 461, an optometrist licensed 18 under chapter 463, or a dentist licensed under chapter 466, as 19 appropriate considering the nature of the injury. No other 20 persons are authorized to render opinions regarding the 21 existence of or the extent of permanent impairment. 22 3. All impairment income benefits shall be based on an 23 impairment rating using the impairment schedule referred to in 24 subparagraph 2. Impairment income benefits are paid weekly at 25 the rate of 50 percent of the employee's average weekly 26 temporary total disability benefit not to exceed the maximum 27 weekly benefit under s. 440.12. An employee's entitlement to 28 impairment income benefits begins the day after the employee 29 reaches maximum medical improvement or the expiration of 30 temporary benefits, whichever occurs earlier, and continues 31 until the earlier of: 89 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 a. The expiration of a period computed at the rate of 2 3 weeks for each percentage point of impairment; or 3 b. The death of the employee. 4 4. After the employee has been certified by a doctor 5 as having reached maximum medical improvement or 6 weeks 6 before the expiration of temporary benefits, whichever occurs 7 earlier, the certifying doctor shall evaluate the condition of 8 the employee and assign an impairment rating, using the 9 impairment schedule referred to in subparagraph 2. 10 Compensation is not payable for the mental, psychological, or 11 emotional injury arising out of depression from being out of 12 work. If the certification and evaluation are performed by a 13 doctor other than the employee's treating doctor, the 14 certification and evaluation must be submitted to the treating 15 doctor, and the treating doctor must indicate agreement or 16 disagreement with the certification and evaluation. The 17 certifying doctor shall issue a written report to the 18 division, the employee, and the carrier certifying that 19 maximum medical improvement has been reached, stating the 20 impairment rating, and providing any other information 21 required by the division. If the employee has not been 22 certified as having reached maximum medical improvement before 23 the expiration of 102 weeks after the date temporary total 24 disability benefits begin to accrue, the carrier shall notify 25 the treating doctor of the requirements of this section. 26 5. The carrier shall pay the employee impairment 27 income benefits for a period based on the impairment rating. 28 Section 46. Subsection (2) of section 456.31, Florida 29 Statutes, is amended to read: 30 456.31 Legislative intent.-- 31 90 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) It is the intent of the Legislature to provide for 2 certain practitioners of the healing arts, such as a trained 3 and qualified dentist, to use hypnosis for hypnoanesthesia or 4 for the allaying of anxiety in relation to dental work; 5 however, under no circumstances shall it be legal or proper 6 for the dentist or the individual to whom the dentist may 7 refer the patient, to use hypnosis for the treatment of the 8 neurotic difficulties of a patient. The same applies to the 9 optometrist, podiatrist, chiropractor, osteopathic physician 10 osteopath, or physician of medicine. 11 Section 47. Subsection (1) of section 459.006, Florida 12 Statutes, is amended to read: 13 459.006 Licensure by examination.--Any person desiring 14 to be licensed by examination shall: 15 (1) Have successfully completed a resident internship 16 of not less than 12 months in a hospital approved for this 17 purpose by the Board of Trustees of the American Osteopathic 18 Association or any other internship program approved by the 19 board upon a showing of good cause by the applicant. This 20 requirement may be waived for applicants who matriculated in a 21 college of osteopathic medicine osteopathy during or before 22 1948. 23 Section 48. Subsection (1) of section 462.01, Florida 24 Statutes, is amended to read: 25 462.01 Definitions.--As used in this chapter: 26 (1) "Natureopathy" and "Naturopathy" shall be 27 construed as synonymous terms and mean the use and practice of 28 psychological, mechanical, and material health sciences to aid 29 in purifying, cleansing, and normalizing human tissues for the 30 preservation or restoration of health, according to the 31 fundamental principles of anatomy, physiology, and applied 91 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 psychology, as may be required. Naturopathic practice 2 employs, among other agencies, phytotherapy, dietetics, 3 psychotherapy, suggestotherapy, hydrotherapy, zone therapy, 4 biochemistry, external applications, electrotherapy, 5 mechanotherapy, mechanical and electrical appliances, hygiene, 6 first aid, sanitation, and heliotherapy; provided, however, 7 that nothing in this chapter shall be held or construed to 8 authorize any naturopathic physician licensed hereunder to 9 practice materia medica or surgery or chiropractic, nor shall 10 the provisions of this law in any manner apply to or affect 11 the practice of osteopathic medicine osteopathy, chiropractic, 12 Christian Science, or any other treatment authorized and 13 provided for by law for the cure or prevention of disease and 14 ailments. 15 Section 49. Subsection (10) of section 468.301, 16 Florida Statutes, is amended to read: 17 468.301 Definitions.--As used in this part, the term: 18 (10) "Licensed practitioner" means a person who is 19 licensed or otherwise authorized by law to practice medicine, 20 podiatry, chiropody, osteopathic medicine osteopathy, 21 naturopathy, or chiropractic in this state. 22 Section 50. Paragraph (a) of subsection (6) of section 23 468.302, Florida Statutes, 1996 Supplement, is amended to 24 read: 25 468.302 Use of radiation; identification of certified 26 persons; limitations; exceptions.-- 27 (6) Requirement for certification does not apply to: 28 (a) A hospital resident who is not a licensed 29 practitioner in this state or a student enrolled in and 30 attending a school or college of medicine, osteopathic 31 medicine osteopathy, chiropody, podiatry, or chiropractic or a 92 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 radiologic technology educational program and who applies 2 radiation to a human being while under the direct supervision 3 of a licensed practitioner. 4 Section 51. Subsection (1) of section 476.044, Florida 5 Statutes, is amended to read: 6 476.044 Exemptions.--This chapter does not apply to 7 the following persons when practicing pursuant to their 8 professional responsibilities and duties: 9 (1) Persons authorized under the laws of this state to 10 practice medicine, surgery, osteopathic medicine osteopathy, 11 chiropractic, naturopathy, or podiatry; 12 Section 52. Paragraph (a) of subsection (1) of section 13 477.0135, Florida Statutes, is amended to read: 14 477.0135 Exemptions.-- 15 (1) This chapter does not apply to the following 16 persons when practicing pursuant to their professional or 17 occupational responsibilities and duties: 18 (a) Persons authorized under the laws of this state to 19 practice medicine, surgery, osteopathic medicine osteopathy, 20 chiropractic, massage, naturopathy, or podiatry. 21 Section 53. Paragraph (a) of subsection (8) of section 22 483.291, Florida Statutes, is amended to read: 23 483.291 Powers and duties of the agency; rules.--The 24 agency shall adopt rules to implement this part, which rules 25 must include the following: 26 (8) PERSONNEL.--The agency shall prescribe minimum 27 qualifications for center personnel. A center may employ as a 28 medical assistant a person who has at least one of the 29 following qualifications: 30 (a) Prior experience of not less than 6 months as a 31 medical assistant in the office of a licensed medical doctor 93 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 or osteopathic physician osteopath or in a hospital, an 2 ambulatory surgical center, a home health agency, or a health 3 maintenance organization. 4 Section 54. Subsection (1) of section 621.03, Florida 5 Statutes, is amended to read: 6 621.03 Definitions.--As used in this act the following 7 words shall have the meaning indicated: 8 (1) The term "professional service" means any type of 9 personal service to the public which requires as a condition 10 precedent to the rendering of such service the obtaining of a 11 license or other legal authorization. By way of example and 12 without limiting the generality thereof, the personal services 13 which come within the provisions of this act are the personal 14 services rendered by certified public accountants, public 15 accountants, chiropractors, dentists, osteopathic physicians 16 osteopaths, physicians and surgeons, doctors of medicine, 17 doctors of dentistry, podiatrists, chiropodists, architects, 18 veterinarians, attorneys at law, and life insurance agents. 19 Section 55. Paragraph (h) of subsection (4) of section 20 627.351, Florida Statutes, 1996 Supplement, is amended to 21 read: 22 627.351 Insurance risk apportionment plans.-- 23 (4) MEDICAL MALPRACTICE RISK APPORTIONMENT.-- 24 (h) As used in this subsection: 25 1. "Health care provider" means hospitals licensed 26 under chapter 395; physicians licensed under chapter 458; 27 osteopathic physicians osteopaths licensed under chapter 459; 28 podiatrists licensed under chapter 461; dentists licensed 29 under chapter 466; chiropractors licensed under chapter 460; 30 naturopaths licensed under chapter 462; nurses licensed under 31 chapter 464; midwives licensed under chapter 467; clinical 94 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 laboratories registered under chapter 483; physician 2 assistants certified under chapter 458; physical therapists 3 and physical therapist assistants licensed under chapter 486; 4 health maintenance organizations certificated under part I of 5 chapter 641; ambulatory surgical centers licensed under 6 chapter 395; other medical facilities as defined in 7 subparagraph 2.; blood banks, plasma centers, industrial 8 clinics, and renal dialysis facilities; or professional 9 associations, partnerships, corporations, joint ventures, or 10 other associations for professional activity by health care 11 providers. 12 2. "Other medical facility" means a facility the 13 primary purpose of which is to provide human medical 14 diagnostic services or a facility providing nonsurgical human 15 medical treatment, to which facility the patient is admitted 16 and from which facility the patient is discharged within the 17 same working day, and which facility is not part of a 18 hospital. However, a facility existing for the primary 19 purpose of performing terminations of pregnancy or an office 20 maintained by a physician or dentist for the practice of 21 medicine shall not be construed to be an "other medical 22 facility." 23 3. "Health care facility" means any hospital licensed 24 under chapter 395, health maintenance organization 25 certificated under part I of chapter 641, ambulatory surgical 26 center licensed under chapter 395, or other medical facility 27 as defined in subparagraph 2. 28 Section 56. Paragraph (b) of subsection (1) of section 29 627.357, Florida Statutes, is amended to read: 30 627.357 Medical malpractice self-insurance.-- 31 (1) DEFINITIONS.--As used in this section, the term: 95 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) "Health care provider" means any: 2 1. Hospital licensed under chapter 395. 3 2. Physician licensed, or physician assistant 4 certified, under chapter 458. 5 3. Osteopathic physician Osteopath licensed under 6 chapter 459. 7 4. Podiatrist licensed under chapter 461. 8 5. Health maintenance organization certificated under 9 part I of chapter 641. 10 6. Ambulatory surgical center licensed under chapter 11 395. 12 7. Chiropractor licensed under chapter 460. 13 8. Psychologist licensed under chapter 490. 14 9. Optometrist licensed under chapter 463. 15 10. Dentist licensed under chapter 466. 16 11. Pharmacist licensed under chapter 465. 17 12. Registered nurse, licensed practical nurse, or 18 advanced registered nurse practitioner licensed or registered 19 under chapter 464. 20 13. Other medical facility. 21 14. Professional association, partnership, 22 corporation, joint venture, or other association established 23 by the individuals set forth in subparagraphs 2., 3., 4., 7., 24 8., 9., 10., 11., and 12. for professional activity. 25 Section 57. Subsection (10) of section 627.6482, 26 Florida Statutes, is amended to read: 27 627.6482 Definitions.--As used in ss. 28 627.648-627.6498, the term: 29 (10) "Physician" means a physician licensed under 30 chapter 458; an osteopathic physician osteopath licensed under 31 chapter 459; a chiropractor licensed under chapter 460; a 96 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 podiatrist licensed under chapter 461; or, for purposes of 2 oral surgery only, a dental surgeon licensed under chapter 3 466. 4 Section 58. Section 725.01, Florida Statutes, is 5 amended to read: 6 725.01 Promise to pay another's debt, etc.--No action 7 shall be brought whereby to charge any executor or 8 administrator upon any special promise to answer or pay any 9 debt or damages out of his own estate, or whereby to charge 10 the defendant upon any special promise to answer for the debt, 11 default or miscarriage of another person or to charge any 12 person upon any agreement made upon consideration of marriage, 13 or upon any contract for the sale of lands, tenements or 14 hereditaments, or of any uncertain interest in or concerning 15 them, or for any lease thereof for a period longer than 1 16 year, or upon any agreement that is not to be performed within 17 the space of 1 year from the making thereof, or whereby to 18 charge any health care provider upon any guarantee, warranty, 19 or assurance as to the results of any medical, surgical, or 20 diagnostic procedure performed by any physician licensed under 21 chapter 458, osteopathic physician osteopath licensed under 22 chapter 459, chiropractor licensed under chapter 460, 23 podiatrist licensed under chapter 461, or dentist licensed 24 under chapter 466, unless the agreement or promise upon which 25 such action shall be brought, or some note or memorandum 26 thereof shall be in writing and signed by the party to be 27 charged therewith or by some other person by him thereunto 28 lawfully authorized. 29 Section 59. Paragraph (b) of subsection (1) of section 30 766.101, Florida Statutes, 1996 Supplement, is amended to 31 read: 97 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 766.101 Medical review committee, immunity from 2 liability.-- 3 (1) As used in this section: 4 (b) The term "health care providers" means physicians 5 licensed under chapter 458, osteopathic physicians osteopaths 6 licensed under chapter 459, podiatrists licensed under chapter 7 461, optometrists licensed under chapter 463, dentists 8 licensed under chapter 466, chiropractors licensed under 9 chapter 460, pharmacists licensed under chapter 465, or 10 hospitals or ambulatory surgical centers licensed under 11 chapter 395. 12 Section 60. Subsection (3) of section 766.103, Florida 13 Statutes, is amended to read: 14 766.103 Florida Medical Consent Law.-- 15 (3) No recovery shall be allowed in any court in this 16 state against any physician licensed under chapter 458, 17 osteopathic physician osteopath licensed under chapter 459, 18 chiropractor licensed under chapter 460, podiatrist licensed 19 under chapter 461, or dentist licensed under chapter 466 in an 20 action brought for treating, examining, or operating on a 21 patient without his informed consent when: 22 (a)1. The action of the physician, osteopathic 23 physician osteopath, chiropractor, podiatrist, or dentist in 24 obtaining the consent of the patient or another person 25 authorized to give consent for the patient was in accordance 26 with an accepted standard of medical practice among members of 27 the medical profession with similar training and experience in 28 the same or similar medical community; and 29 2. A reasonable individual, from the information 30 provided by the physician, osteopathic physician osteopath, 31 chiropractor, podiatrist, or dentist, under the circumstances, 98 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 would have a general understanding of the procedure, the 2 medically acceptable alternative procedures or treatments, and 3 the substantial risks and hazards inherent in the proposed 4 treatment or procedures, which are recognized among other 5 physicians, osteopathic physicians osteopaths, chiropractors, 6 podiatrists, or dentists in the same or similar community who 7 perform similar treatments or procedures; or 8 (b) The patient would reasonably, under all the 9 surrounding circumstances, have undergone such treatment or 10 procedure had he been advised by the physician, osteopathic 11 physician osteopath, chiropractor, podiatrist, or dentist in 12 accordance with the provisions of paragraph (a). 13 Section 61. Paragraphs (b) and (i) of subsection (1) 14 and paragraph (e) of subsection (2) of section 766.105, 15 Florida Statutes, 1996 Supplement, are amended to read: 16 766.105 Florida Patient's Compensation Fund.-- 17 (1) DEFINITIONS.--The following definitions apply in 18 the interpretation and enforcement of this section: 19 (b) The term "health care provider" means any: 20 1. Hospital licensed under chapter 395. 21 2. Physician licensed, or physician assistant 22 certified, under chapter 458. 23 3. Osteopathic physician Osteopath licensed under 24 chapter 459. 25 4. Podiatrist licensed under chapter 461. 26 5. Health maintenance organization certificated under 27 part I of chapter 641. 28 6. Ambulatory surgical center licensed under chapter 29 395. 30 7. "Other medical facility" as defined in paragraph 31 (c). 99 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 8. Professional association, partnership, corporation, 2 joint venture, or other association by the individuals set 3 forth in subparagraphs 2., 3., and 4. for professional 4 activity. 5 (i) The term "house physician" means any physician, 6 osteopathic physician osteopath, podiatrist, or dentist 7 except: a physician, osteopathic physician osteopath, 8 podiatrist, or dentist with staff privileges at a hospital; a 9 physician, osteopathic physician osteopath, podiatrist, or 10 dentist providing emergency room services; an 11 anesthesiologist, pathologist, or radiologist; or a physician, 12 osteopathic physician osteopath, podiatrist, or dentist who 13 performs a service for a fee. 14 (2) COVERAGE.-- 15 (e) The coverage afforded by the fund for a 16 participating hospital or ambulatory surgical center shall 17 apply to the officers, trustees, volunteer workers, trainees, 18 committee members (including physicians, osteopathic 19 physicians osteopaths, podiatrists, and dentists), and 20 employees of the hospital or ambulatory surgical center, other 21 than employed physicians licensed under chapter 458, physician 22 assistants licensed under chapter 458, osteopathic physicians 23 osteopaths licensed under chapter 459, dentists licensed under 24 chapter 466, and podiatrists licensed under chapter 461. 25 However, the coverage afforded by the fund for a participating 26 hospital shall apply to house physicians, interns, employed 27 physician residents in a resident training program, or 28 physicians performing purely administrative duties for the 29 participating hospitals other than the treatment of patients. 30 This coverage shall apply to the hospital or ambulatory 31 100 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 surgical center and those included in this subsection as one 2 health care provider. 3 Section 62. Subsection (2) of section 766.110, Florida 4 Statutes, is amended to read: 5 766.110 Liability of health care facilities.-- 6 (2) Every hospital licensed under chapter 395 may 7 carry liability insurance or adequately insure itself in an 8 amount of not less than $1.5 million per claim, $5 million 9 annual aggregate to cover all medical injuries to patients 10 resulting from negligent acts or omissions on the part of 11 those members of its medical staff who are covered thereby in 12 furtherance of the requirements of ss. 458.320 and 459.0085. 13 Self-insurance coverage extended hereunder to a member of a 14 hospital's medical staff meets the financial responsibility 15 requirements of ss. 458.320 and 459.0085 if the physician's 16 coverage limits are not less than the minimum limits 17 established in ss. 458.320 and 459.0085 and the hospital is a 18 verified trauma center as of July 1, 1990, that has extended 19 self-insurance coverage continuously to members of its medical 20 staff for activities both inside and outside of the hospital 21 since January 1, 1987. Any insurer authorized to write 22 casualty insurance may make available, but shall not be 23 required to write, such coverage. The hospital may assess on 24 an equitable and pro rata basis the following professional 25 health care providers for a portion of the total hospital 26 insurance cost for this coverage: physicians licensed under 27 chapter 458, osteopathic physicians osteopaths licensed under 28 chapter 459, podiatrists licensed under chapter 461, dentists 29 licensed under chapter 466, and nurses licensed under chapter 30 464. The hospital may provide for a deductible amount to be 31 applied against any individual health care provider found 101 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 liable in a law suit in tort or for breach of contract. The 2 legislative intent in providing for the deductible to be 3 applied to individual health care providers found negligent or 4 in breach of contract is to instill in each individual health 5 care provider the incentive to avoid the risk of injury to the 6 fullest extent and ensure that the citizens of this state 7 receive the highest quality health care obtainable. 8 Section 63. Subsection (2) of section 817.234, Florida 9 Statutes, is amended to read: 10 817.234 False and fraudulent insurance claims.-- 11 (2) Any physician licensed under chapter 458, 12 osteopathic physician osteopath licensed under chapter 459, 13 chiropractor licensed under chapter 460, or other practitioner 14 licensed under the laws of this state who knowingly and 15 willfully assists, conspires with, or urges any insured party 16 to fraudulently violate any of the provisions of this section 17 or part XI of chapter 627, or any person who, due to such 18 assistance, conspiracy, or urging by said physician, 19 osteopathic physician osteopath, chiropractor, or 20 practitioner, knowingly and willfully benefits from the 21 proceeds derived from the use of such fraud, is guilty of a 22 felony of the third degree, punishable as provided in s. 23 775.082, s. 775.083, or s. 775.084. In the event that a 24 physician, osteopathic physician osteopath, chiropractor, or 25 practitioner is adjudicated guilty of a violation of this 26 section, the Board of Medicine as set forth in chapter 458, 27 the Board of Osteopathic Medicine as set forth in chapter 459, 28 the Board of Chiropractic as set forth in chapter 460, or 29 other appropriate licensing authority shall hold an 30 administrative hearing to consider the imposition of 31 administrative sanctions as provided by law against said 102 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 physician, osteopathic physician osteopath, chiropractor, or 2 practitioner. 3 Section 64. Subsection (1) of section 945.047, Florida 4 Statutes, is amended to read: 5 945.047 Licensing requirements for physicians, 6 osteopathic physicians, and chiropractors employed by the 7 department.-- 8 (1) The Department of Corrections shall employ only 9 physicians, osteopathic physicians, or chiropractic physicians 10 holding licenses in good standing to practice medicine in this 11 state, except that, by October 1, 1980, no more than 10 12 percent of the total number of such physicians employed by the 13 department may be exempted from the provisions of this 14 subsection. Each such exempted physician shall hold a valid 15 license to practice medicine, osteopathic medicine osteopathy, 16 or chiropractic in another state and shall have been certified 17 by the appropriate board as eligible for admission for 18 examination in this state under chapter 458, chapter 459, or 19 chapter 460, as applicable. The appropriate board shall not 20 certify as eligible for admission for examination any person 21 who has been adjudged unqualified or guilty of any of the acts 22 enumerated in the disciplinary provisions contained in chapter 23 458, chapter 459, or chapter 460, as applicable. 24 Section 65. Subsection (1) of section 460.403, Florida 25 Statutes, 1996 Supplement, is amended to read: 26 460.403 Definitions.--As used in this chapter, the 27 term: 28 (1) "Department" means the Department of Health 29 Business and Professional Regulation. 30 Section 66. Paragraphs (q) and (gg) of subsection (1) 31 and subsection (2) of section 460.413, Florida Statutes, 1996 103 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Supplement, are amended, and subsections (6) and (7) are added 2 to said section, to read: 3 460.413 Grounds for disciplinary action; action by the 4 board.-- 5 (1) The following acts shall constitute grounds for 6 which the disciplinary actions specified in subsection (2) may 7 be taken: 8 (q) Being unable to practice chiropractic with 9 reasonable skill and safety to patients by reason of illness 10 or use of alcohol, drugs, narcotics, chemicals, or any other 11 type of material or as a result of any mental or physical 12 condition. In enforcing this paragraph, upon a finding by the 13 secretary of the department, or his or her designee, or the 14 probable cause panel of the board that probable cause exists 15 to believe that the licensee is unable to practice the 16 profession because of reasons stated in this paragraph, the 17 department shall have the authority to compel a licensee to 18 submit to a mental or physical examination by a physician 19 designated by the department. If the licensee refuses to 20 comply with the department's order, the department may file a 21 petition for enforcement in the circuit court of the circuit 22 in which the licensee resides or does business. The licensee 23 shall not be named or identified by initials in any other 24 public court records or documents and the enforcement 25 proceedings shall be closed to the public. The department 26 shall be entitled to the summary procedure provided in s. 27 51.011. The record of proceedings to obtain a compelled 28 mental or physical examination shall not be used against a 29 licensee in any other proceedings. A chiropractic physician 30 affected under this paragraph shall at reasonable intervals be 31 afforded an opportunity to demonstrate that he can resume the 104 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 competent practice of chiropractic with reasonable skill and 2 safety to patients. 3 (gg) Failing to report to the department Division of 4 Medical Quality Assurance any licensee physician licensed 5 under chapter 458 or osteopathic physician licensed under 6 chapter 459 who the chiropractic physician or chiropractic 7 physician's assistant knows has violated the grounds for 8 disciplinary action set out in the law under which that person 9 physician or osteopathic physician is licensed and who 10 provides health care services in a facility licensed under 11 chapter 395, or a health maintenance organization certificated 12 under part I of chapter 641, in which the chiropractic 13 physician or chiropractic physician's assistant also provides 14 services. 15 (2) When the board finds any person guilty of any of 16 the grounds set forth in subsection (1), it may enter an order 17 imposing one or more of the following penalties: 18 (a) Refusal to certify to the department an 19 application for licensure. 20 (b) Revocation or suspension of a license. 21 (c) Restriction of practice. 22 (d) Imposition of an administrative fine not to exceed 23 $2,000 for each count or separate offense. 24 (e) Issuance of a reprimand. 25 (f) Placement of the chiropractic physician on 26 probation for a period of time and subject to such conditions 27 as the board may specify, including requiring the chiropractic 28 physician to submit to treatment, to attend continuing 29 education courses, to submit to reexamination, or to work 30 under the supervision of another chiropractic physician. 31 105 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (g) Imposition of costs of the investigation and 2 prosecution. 3 (h) Requirement that the chiropractic physician 4 undergo remedial education. 5 (i) Issuance of a letter of concern. 6 (j) Corrective action. 7 (k) Refund of fees billed to and collected from the 8 patient or a third party. 9 10 In determining what action is appropriate, the board must 11 first consider what sanctions are necessary to protect the 12 public or to compensate the patient. Only after those 13 sanctions have been imposed may the disciplining authority 14 consider and include in the order requirements designed to 15 rehabilitate the chiropractic physician. All costs associated 16 with compliance with orders issued under this subsection are 17 the obligation of the chiropractic physician. 18 (6) In any administrative action against a 19 chiropractic physician which does not involve revocation or 20 suspension of license, the department shall have the burden, 21 by the greater weight of the evidence, to establish the 22 existence of grounds for disciplinary action. The department 23 shall establish grounds for revocation or suspension of 24 license by clear and convincing evidence. 25 (7) If any chiropractic physician is guilty of such 26 unprofessional conduct, negligence, or mental or physical 27 incapacity or impairment that the department determines that 28 the chiropractic physician is unable to practice with 29 reasonable skill and safety and presents a danger to patients, 30 the department shall be authorized to maintain an action in 31 circuit court enjoining such chiropractic physician from 106 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 providing medical services to the public until the 2 chiropractic physician demonstrates the ability to practice 3 with reasonable skill and safety and without danger to 4 patients. 5 Section 67. For the purpose of incorporating the 6 amendment to section 460.413, Florida Statutes, 1996 7 Supplement, in references thereto, the sections or 8 subdivisions of Florida Statutes set forth below are reenacted 9 to read: 10 320.0848 Persons who have disabilities; issuance of 11 disabled parking permits; temporary permits; permits for 12 certain providers of transportation services to persons who 13 have disabilities.-- 14 (9) A violation of this section is grounds for 15 disciplinary action under s. 458.331, s. 459.015, s. 460.413, 16 or s. 461.013, as applicable. 17 455.236 Financial arrangements between referring 18 health care providers and providers of health care services.-- 19 (4) PROHIBITED REFERRALS AND CLAIMS FOR 20 PAYMENT.--Except as provided in this section: 21 (g) A violation of this section by a health care 22 provider shall constitute grounds for disciplinary action to 23 be taken by the applicable board pursuant to s. 458.331(2), s. 24 459.015(2), s. 460.413(2), s. 461.013(2), s. 463.016(2), or s. 25 466.028(2). Any hospital licensed under chapter 395 found in 26 violation of this section shall be subject to the rules 27 adopted by the Department of Health and Rehabilitative 28 Services pursuant to s. 395.0185(2). 29 766.111 Engaging in unnecessary diagnostic testing; 30 penalties.-- 31 107 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) A violation of this section shall be grounds for 2 disciplinary action pursuant to s. 458.331, s. 459.015, s. 3 460.413, s. 461.013, or s. 466.028, as applicable. 4 Section 68. Paragraph (a) of subsection (8) of section 5 460.4165, Florida Statutes, is amended to read: 6 460.4165 Chiropractic physician's assistants.-- 7 (8) FEES.-- 8 (a) A fee not to exceed $100 set by the board shall 9 accompany the annual application by a chiropractic physician 10 or group of chiropractic physicians for authorization to 11 supervise a certified chiropractic physician's assistant. 12 Section 69. Subsection (1) of section 461.003, Florida 13 Statutes, is amended to read: 14 461.003 Definitions.--As used in this chapter: 15 (1) "Department" means the Department of Health 16 Business and Professional Regulation. 17 Section 70. Paragraph (aa) of subsection (1) of 18 section 461.013, Florida Statutes, is amended to read: 19 461.013 Grounds for disciplinary action; action by the 20 board; investigations by department.-- 21 (1) The following acts shall constitute grounds for 22 which the disciplinary actions specified in subsection (2) may 23 be taken: 24 (aa) Failing to report to the department Division of 25 Medical Quality Assurance any licensee physician licensed 26 under chapter 458 or osteopathic physician licensed under 27 chapter 459 who the podiatrist knows has violated the grounds 28 for disciplinary action set out in the law under which that 29 person physician or osteopathic physician is licensed and who 30 provides health care services in a facility licensed under 31 chapter 395, or a health maintenance organization certificated 108 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 under part I of chapter 641, in which the podiatrist also 2 provides services. 3 Section 71. Section 461.018, Florida Statutes, 1996 4 Supplement, is amended to read: 5 461.018 Limited scope of practice; area of 6 need.--Those persons holding valid certificates on October 1, 7 1991, who were certified pursuant to chapters 88-205 and 8 88-392, Laws of Florida, and who have been practicing under a 9 board-approved protocol for at least 2 years are eligible to 10 receive a podiatry license to practice without supervision 11 under their present limited scope of practice of the 12 nonsurgical treatment of corns, calluses, and ingrown toenails 13 in a specially designated area of need as provided by rule of 14 the board. 15 Section 72. Subsection (1) and paragraph (c) of 16 subsection (3) of section 464.003, Florida Statutes, 1996 17 Supplement, are amended to read: 18 464.003 Definitions.--As used in this chapter: 19 (1) "Department Agency" means the Department of Agency 20 for Health Care Administration. 21 (3) 22 (c) "Advanced or specialized nursing practice" means, 23 in addition to the practice of professional nursing, the 24 performance of advanced-level nursing acts approved by the 25 board which, by virtue of postbasic specialized education, 26 training, and experience, are proper to be performed by an 27 advanced registered nurse practitioner. Within the context of 28 advanced or specialized nursing practice, the advanced 29 registered nurse practitioner may perform acts of nursing 30 diagnosis and nursing treatment of alterations of the health 31 status. The advanced registered nurse practitioner may also 109 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 perform acts of medical diagnosis and treatment, prescription, 2 and operation which are identified and approved by a joint 3 committee composed of three members appointed by the Board of 4 Nursing, two of whom shall be advanced registered nurse 5 practitioners; three members appointed by the Board of 6 Medicine, two of whom shall have had work experience with 7 advanced registered nurse practitioners; and the secretary 8 director of the department agency or the secretary's 9 director's designee. Each committee member appointed by a 10 board shall be appointed to a term of 4 years unless a shorter 11 term is required to establish or maintain staggered terms. The 12 Board of Nursing shall adopt rules authorizing the performance 13 of any such acts approved by the joint committee. Unless 14 otherwise specified by the joint committee, such acts shall be 15 performed under the general supervision of a practitioner 16 licensed under chapter 458, chapter 459, or chapter 466 within 17 the framework of standing protocols which identify the medical 18 acts to be performed and the conditions for their performance. 19 The department agency may, by rule, require that a copy of the 20 protocol be filed with the department agency along with the 21 notice required by s. 458.348. 22 Section 73. Subsection (1) of section 464.004, Florida 23 Statutes, 1996 Supplement, is amended to read: 24 464.004 Board of Nursing; membership; appointment; 25 terms.-- 26 (1) The Board of Nursing is created within the 27 department agency and shall consist of 13 members to be 28 appointed by the Governor and confirmed by the Senate. 29 Section 74. Subsection (1) of section 464.008, Florida 30 Statutes, 1996 Supplement, is amended to read: 31 464.008 Licensure by examination.-- 110 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) Any person desiring to be licensed as a registered 2 nurse or licensed practical nurse shall apply to the 3 department agency to take the licensure examination. The 4 department agency shall examine each applicant who: 5 (a) Has completed the application form and remitted a 6 fee set by the board not to exceed $150 and has remitted an 7 examination fee set by the board not to exceed $75 plus the 8 actual per applicant cost to the department agency for 9 purchase of the examination from the National Council of State 10 Boards of Nursing or a similar national organization. 11 (b) Has provided sufficient information on or after 12 October 1, 1989, which must be submitted by the department 13 agency for a statewide criminal records correspondence check 14 through the Department of Law Enforcement. 15 (c) Is in good mental and physical health, is a 16 recipient of a high school diploma or the equivalent, and has 17 completed the requirements for graduation from an approved 18 program for the preparation of registered nurses or licensed 19 practical nurses, whichever is applicable. Courses 20 successfully completed in a professional nursing program which 21 are at least equivalent to a practical nursing program may be 22 used to satisfy the education requirements for licensure as a 23 licensed practical nurse. 24 (d) Has the ability to communicate in the English 25 language, which may be determined by an examination given by 26 the department agency. 27 Section 75. Subsections (1) and (3) of section 28 464.009, Florida Statutes, 1996 Supplement, are amended to 29 read: 30 464.009 Licensure by endorsement.-- 31 111 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) The department agency shall issue the appropriate 2 license by endorsement to practice professional or practical 3 nursing to an applicant who, upon applying to the department 4 agency and remitting a fee set by the board not to exceed 5 $100, demonstrates to the board that he: 6 (a) Holds a valid license to practice professional or 7 practical nursing in another state of the United States, 8 provided that, when the applicant secured his original 9 license, the requirements for licensure were substantially 10 equivalent to or more stringent than those existing in Florida 11 at that time; or 12 (b) Meets the qualifications for licensure in s. 13 464.008 and has successfully completed a state, regional, or 14 national examination which is substantially equivalent to or 15 more stringent than the examination given by the department 16 agency. 17 (3) The department agency shall not issue a license by 18 endorsement to any applicant who is under investigation in 19 another state for an act which would constitute a violation of 20 this chapter until such time as the investigation is complete, 21 at which time the provisions of s. 464.018 shall apply. 22 Section 76. Subsections (1) and (5) of section 23 464.012, Florida Statutes, 1996 Supplement, are amended to 24 read: 25 464.012 Certification of advanced registered nurse 26 practitioners; fees.-- 27 (1) Any nurse desiring to be certified as an advanced 28 registered nurse practitioner shall apply to the department 29 agency and submit proof that he holds a current license to 30 practice professional nursing and that he meets one or more of 31 the following requirements as determined by the board: 112 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Satisfactory completion of a formal postbasic 2 educational program of at least one academic year, the primary 3 purpose of which is to prepare nurses for advanced or 4 specialized practice. 5 (b) Certification by an appropriate specialty board. 6 Such certification shall be required for initial state 7 certification and any recertification as a registered nurse 8 anesthetist or nurse midwife. The board may by rule provide 9 for provisional state certification of graduate nurse 10 anesthetists and nurse midwives for a period of time 11 determined to be appropriate for preparing for and passing the 12 national certification examination. 13 (c) Graduation from a program leading to a master's 14 degree in a nursing clinical specialty area with preparation 15 in specialized practitioner skills. For applicants graduating 16 on or after October 1, 1998, graduation from a master's degree 17 program shall be required for initial certification as a nurse 18 practitioner under paragraph (4)(c). For applicants 19 graduating on or after October 1, 2001, graduation from a 20 master's degree program shall be required for initial 21 certification as a registered nurse anesthetist under 22 paragraph (4)(a). 23 (5) The board shall certify, and the department agency 24 shall issue a certificate to, any nurse meeting the 25 qualifications in this section. The board shall establish an 26 application fee not to exceed $100 and a biennial renewal fee 27 not to exceed $50. The board is authorized to adopt such 28 other rules as are necessary to implement the provisions of 29 this section. 30 31 113 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 77. Subsections (1) and (2) of section 2 464.013, Florida Statutes, 1996 Supplement, are amended to 3 read: 4 464.013 Renewal of license or certificate.-- 5 (1) The department agency shall renew a license upon 6 receipt of the renewal application and fee. 7 (2) The department agency shall adopt rules 8 establishing a procedure for the biennial renewal of licenses. 9 Section 78. Subsection (2) of section 464.014, Florida 10 Statutes, 1996 Supplement, is amended to read: 11 464.014 Inactive status.-- 12 (2) The department agency may not reactivate a license 13 unless the inactive or delinquent licensee has paid any 14 applicable biennial renewal or delinquency fee, or both, and a 15 reactivation fee. 16 Section 79. Paragraphs (a), (c), (j), (k), (l), and 17 (m) of subsection (1) and paragraph (a) of subsection (2) of 18 section 464.018, Florida Statutes, 1996 Supplement, are 19 amended to read: 20 464.018 Disciplinary actions.-- 21 (1) The following acts shall be grounds for 22 disciplinary action set forth in this section: 23 (a) Procuring, attempting to procure, or renewing a 24 license to practice nursing by bribery, by knowing 25 misrepresentations, or through an error of the department 26 agency or the board. 27 (c) Being convicted or found guilty of, or entering a 28 plea of nolo contendere to, regardless of adjudication, of a 29 crime in any jurisdiction which directly relates to the 30 practice of nursing or to the ability to practice nursing. 31 114 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (j) Being unable to practice nursing with reasonable 2 skill and safety to patients by reason of illness or use of 3 alcohol, drugs, narcotics, or chemicals or any other type of 4 material or as a result of any mental or physical condition. 5 In enforcing this paragraph, the department agency shall have, 6 upon a finding of the secretary director or the secretary's 7 his designee that probable cause exists to believe that the 8 licensee is unable to practice nursing because of the reasons 9 stated in this paragraph, the authority to issue an order to 10 compel a licensee to submit to a mental or physical 11 examination by physicians designated by the department agency. 12 If the licensee refuses to comply with such order, the 13 department's agency's order directing such examination may be 14 enforced by filing a petition for enforcement in the circuit 15 court where the licensee resides or does business. The 16 licensee against whom the petition is filed shall not be named 17 or identified by initials in any public court records or 18 documents, and the proceedings shall be closed to the public. 19 The department agency shall be entitled to the summary 20 procedure provided in s. 51.011. A nurse affected by the 21 provisions of this paragraph shall at reasonable intervals be 22 afforded an opportunity to demonstrate that he can resume the 23 competent practice of nursing with reasonable skill and safety 24 to patients. 25 (k) Failing to report to the department agency any 26 person who the licensee knows is in violation of this chapter 27 or of the rules of the department agency or the board; 28 however, if the licensee verifies that such person is actively 29 participating in a board-approved program for the treatment of 30 a physical or mental condition, the licensee is required to 31 115 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 report such person only to an impaired professionals 2 consultant. 3 (l) Knowingly violating any provision of this chapter, 4 a rule of the board or the department agency, or a lawful 5 order of the board or department agency previously entered in 6 a disciplinary proceeding or failing to comply with a lawfully 7 issued subpoena of the department agency. 8 (m) Failing to report to the department Division of 9 Health Quality Assurance any licensee physician licensed under 10 chapter 458 or osteopathic physician licensed under chapter 11 459 who the nurse knows has violated the grounds for 12 disciplinary action set out in the law under which that person 13 physician or osteopathic physician is licensed and who 14 provides health care services in a facility licensed under 15 chapter 395, or a health maintenance organization certificated 16 under part I of chapter 641, in which the nurse also provides 17 services. 18 (2) When the board finds any person guilty of any of 19 the grounds set forth in subsection (1), it may enter an order 20 imposing one or more of the following penalties: 21 (a) Refusal to certify to the department agency an 22 application for licensure. 23 Section 80. Subsections (1), (3), and (4) of section 24 464.019, Florida Statutes, 1996 Supplement, are amended to 25 read: 26 464.019 Approval of nursing programs.-- 27 (1) An institution desiring to conduct an approved 28 program for the education of professional or practical nurses 29 shall apply to the department agency and submit such evidence 30 as may be required to show that it complies with the 31 provisions of this chapter and with the rules of the board. 116 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 The application shall include a program review fee, as set by 2 the board, not to exceed $1,000. 3 (3) The department agency shall survey each 4 institution applying for approval and submit its findings to 5 the board. If the board is satisfied that the program meets 6 the requirements of this chapter and rules pursuant thereto, 7 it shall certify the program for approval and the department 8 agency shall approve the program. 9 (4) If the board, through an investigation by the 10 department agency, finds that an approved program no longer 11 meets the required standards, it may place the program on 12 probationary status until such time as the standards are 13 restored. If a program fails to correct these conditions 14 within a specified period of time, the board may rescind the 15 approval. Any program having its approval rescinded shall 16 have the right to reapply. 17 Section 81. Section 464.0205, Florida Statutes, is 18 created to read: 19 464.0205 Retired volunteer nurse certificate.-- 20 (1) Any retired practical or registered nurse desiring 21 to serve indigent, underserved, or critical need populations 22 in this state may apply to the department for a retired 23 volunteer nurse certificate by providing: 24 (a) A complete application. 25 (b) An application and processing fee of $25. 26 (c) Verification that the applicant had been licensed 27 to practice nursing in any jurisdiction in the United States 28 for at least 10 years, had retired or plans to retire, intends 29 to practice nursing only pursuant to the limitations provided 30 by the retired volunteer nurse certificate, and has not 31 117 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 committed any act that would constitute a violation under s. 2 464.018(1). 3 (d) Proof that the applicant meets the requirements 4 for licensure under s. 464.008 or s. 464.009. 5 (2) All related administrative costs shall be borne by 6 the applicant. 7 (3) The board may deny a retired volunteer nurse 8 certificate to any applicant who has committed, or who is 9 under investigation or prosecution for, any act that would 10 constitute a ground for disciplinary action under s. 464.018. 11 (4) A retired volunteer nurse receiving certification 12 from the board shall: 13 (a) Work under the direct supervision of the director 14 of a county health department, a physician working under a 15 limited license issued pursuant to s. 458.317 or s. 459.0075, 16 a physician licensed under chapter 458 or chapter 459, an 17 advanced registered nurse practitioner certified under s. 18 464.012, or a registered nurse licensed under s. 464.008 or s. 19 464.009. 20 (b) Comply with the minimum standards of practice for 21 nurses and be subject to disciplinary action for violations of 22 s. 464.018, except that the scope of practice for certified 23 volunteers shall be limited to primary and preventive health 24 care, or as further defined by board rule. 25 (c) Work only in a setting for which there are 26 provisions for professional liability coverage for acts or 27 omissions of the retired volunteer nurse. 28 (d) Provide services under the certificate only in 29 settings whose sponsors have been approved by the board. 30 (5) A retired volunteer nurse receiving certification 31 from the board shall not: 118 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Administer controlled substances. 2 (b) Supervise other nurses. 3 (c) Receive monetary compensation. 4 (6) A retired volunteer nurse certified under this 5 section may practice only in board-approved settings in public 6 agencies or institutions or in nonprofit agencies or 7 institutions meeting the requirements of s. 501(c)(3) of the 8 Internal Revenue Code, which agencies or institutions are 9 located in areas of critical nursing need as determined by the 10 board. Determination of underserved areas shall be made by 11 the board after consultation with the Department of Health, 12 the Department of Children and Family Services, the Agency for 13 Health Care Administration, and the Department of Elderly 14 Affairs; however, such determination shall include, but not be 15 limited to, health manpower shortage areas designated by the 16 United States Department of Health and Human Services. The 17 sponsoring agencies desiring to use certified retired 18 volunteer nurses shall submit to the board verification of 19 their status under s. 501(c)(3) of the Internal Revenue Code, 20 the sites at which such volunteer nurses would work, the 21 duties and scope of practice intended for such volunteer 22 nurses, and the training or skills validation for such 23 volunteer nurses. 24 (7) The retired volunteer nurse certificate shall be 25 valid for 2 years, and a certificateholder may reapply for a 26 certificate so long as the certificateholder continues to meet 27 the eligibility requirements of this section. Any 28 legislatively mandated continuing education on specific topics 29 must be completed by the certificateholder prior to renewal; 30 otherwise, the provisions of s. 464.013 do not apply. 31 119 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 82. Subsection (12) is added to section 2 464.022, Florida Statutes, to read: 3 464.022 Exceptions.--No provision of this chapter 4 shall be construed to prohibit: 5 (12) The practice of nursing by any legally qualified 6 nurse of another state whose employment requires the nurse to 7 accompany and care for a patient temporarily residing in this 8 state for not more than 30 consecutive days, provided the 9 patient is not in an inpatient setting, the board is notified 10 prior to arrival of the patient and nurse, the nurse has the 11 standing physician orders and current medical status of the 12 patient available, and prearrangements with the appropriate 13 licensed health care providers in this state have been made in 14 case the patient needs placement in an inpatient setting. 15 Section 83. Subsection (4) of section 465.003, Florida 16 Statutes, is amended to read: 17 465.003 Definitions.--As used in this chapter, the 18 term: 19 (4) "Department" means the Department of Health 20 Business and Professional Regulation. 21 Section 84. Subsections (1) and (2) of section 22 465.004, Florida Statutes, are amended to read: 23 465.004 Board of Pharmacy.-- 24 (1) The Board of Pharmacy is created within the 25 department and shall consist of nine seven members to be 26 appointed by the Governor and confirmed by the Senate. 27 (2) Seven Five members of the board must be licensed 28 pharmacists who are residents of this state and who have been 29 engaged in the practice of the profession of pharmacy in this 30 state for at least 4 years and, to the extent practicable, 31 represent the various pharmacy practice settings. Of the 120 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 pharmacist members, one must be on the full-time faculty of a 2 pharmacy school in this state, one must be currently engaged 3 in the practice of pharmacy in a community pharmacy, one must 4 be currently engaged in the practice of pharmacy in a Class II 5 institutional pharmacy or a Modified Class II institutional 6 pharmacy, and four shall be pharmacists licensed in this state 7 irrespective of practice setting. The remaining two members 8 must be residents of the state who have never been licensed as 9 pharmacists and who are in no way connected with the practice 10 of the profession of pharmacy. No person may be appointed as 11 a consumer lay member who is in any way connected with a drug 12 manufacturer or wholesaler. At least one member of the board 13 must be 60 years of age or older. 14 Section 85. Section 465.014, Florida Statutes, is 15 amended to read: 16 465.014 Pharmacy technician.--No person other than a 17 licensed pharmacist or pharmacy intern may engage in the 18 practice of the profession of pharmacy, except that a licensed 19 pharmacist may delegate to nonlicensed pharmacy technicians 20 those duties, tasks, and functions which do not fall within 21 the purview of s. 465.003(12). All such delegated acts shall 22 be performed under the direct supervision of a licensed 23 pharmacist who shall be responsible for all such acts 24 performed by persons under his supervision. No licensed 25 pharmacist shall supervise more than one pharmacy technician 26 unless otherwise permitted by the guidelines adopted by the 27 board. The board shall establish guidelines to be followed by 28 licensees or permittees in determining the circumstances under 29 which a licensed pharmacist may supervise more than one but 30 not more than three two pharmacy technicians. 31 121 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 86. Subsection (1) of section 465.0156, 2 Florida Statutes, is amended to read: 3 465.0156 Registration of nonresident pharmacies.-- 4 (1) Any pharmacy which is located outside this state 5 and which ships, mails, or delivers, in any manner, a 6 dispensed medicinal drug into this state shall be considered a 7 nonresident pharmacy, shall be registered with the board, 8 shall provide pharmacy services at a high level of protection 9 and competence, and shall disclose to the board the following 10 specific information: 11 (a) That it maintains at all times a valid, unexpired 12 license, permit, or registration to operate the pharmacy in 13 compliance with the laws of the state in which the dispensing 14 facility is located and from which the medicinal drugs shall 15 be dispensed; 16 (b) The location, names, and titles of all principal 17 corporate officers and the pharmacist who serves as the 18 prescription department manager for all pharmacists who are 19 dispensing medicinal drugs to residents of this state. This 20 disclosure shall be made on an annual basis and within 30 days 21 after any change of office location, corporate officer, or 22 pharmacist serving as the prescription department manager for 23 dispensing medicinal drugs to residents of this state; 24 (c) That it complies with all lawful directions and 25 requests for information from the regulatory or licensing 26 agency of all states in which it is licensed as well as with 27 all requests for information made by the board pursuant to 28 this section. It shall respond directly to all communications 29 from the board concerning emergency circumstances arising from 30 errors in the dispensing of medicinal drugs to the residents 31 of this state; 122 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (d) That it maintains its records of medicinal drugs 2 dispensed to patients in this state so that the records are 3 readily retrievable from the other business records of the 4 pharmacy and from the records of other medicinal drugs 5 dispensed; and 6 (e) That during its regular hours of operation but not 7 less than 6 days per week, for a minimum of 40 hours per week, 8 a toll-free telephone service shall be provided to facilitate 9 communication between patients in this state and a pharmacist 10 at the pharmacy who has access to the patient's records. This 11 toll-free number must be disclosed on the label affixed to 12 each container of dispensed medicinal drugs. 13 Section 87. Paragraph (o) of subsection (1) of section 14 465.016, Florida Statutes, is amended to read: 15 465.016 Disciplinary actions.-- 16 (1) The following acts shall be grounds for 17 disciplinary action set forth in this section: 18 (o) Failing to report to the department Division of 19 Medical Quality Assurance any licensee physician licensed 20 under chapter 458 or osteopathic physician licensed under 21 chapter 459 who the pharmacist knows has violated the grounds 22 for disciplinary action set out in the law under which that 23 person physician or osteopathic physician is licensed and who 24 provides health care services in a facility licensed under 25 chapter 395, or a health maintenance organization certificated 26 under part I of chapter 641, in which the pharmacist also 27 provides services. 28 Section 88. Section 465.035, Florida Statutes, is 29 amended to read: 30 465.035 Dispensing of medicinal medical drugs pursuant 31 to facsimile of prescription.-- 123 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) Notwithstanding any other provision of this 2 chapter, it is lawful for a pharmacy to dispense medicinal 3 drugs, including controlled substances authorized under 4 subsection (2), based on reception of an electronic facsimile 5 of the original prescription if all of the following 6 conditions are met: 7 (a) In the course of the transaction the pharmacy 8 complies with laws and administrative rules relating to 9 pharmacies and pharmacists. 10 (b) Except in the case of the transmission of a 11 prescription by a person authorized by law to prescribe 12 medicinal drugs: 13 1. The facsimile system making the transmission 14 provides the pharmacy receiving the transmission with audio 15 communication via telephonic, electronic, or similar means 16 with the person presenting the prescription. 17 2. At the time of the delivery of the medicinal drugs, 18 the pharmacy has in its possession the original prescription 19 for the medicinal drug involved. 20 3. The recipient of the prescription shall sign a log 21 and shall indicate the name and address of both the recipient 22 and the patient for whom the medicinal drug was prescribed. 23 (2) This section does not apply to the dispensing of 24 Controlled substances listed in Schedule II as defined in s. 25 893.03(2) may be dispensed as provided in this section to the 26 extent allowed by 21 C.F.R. s. 1306.11. 27 Section 89. Subsection (7) of section 466.003, Florida 28 Statutes, is amended to read: 29 466.003 Definitions.--As used in this chapter: 30 (7) "Department" means the Department of Health 31 Business and Professional Regulation. 124 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 90. Subsection (3) of section 466.006, Florida 2 Statutes, is amended to read: 3 466.006 Examination of dentists.-- 4 (3) If an applicant is a graduate of a dental college 5 or school not accredited in accordance with paragraph (2)(b) 6 or of a dental college or school not approved by the board, he 7 shall not be entitled to take the examinations required in 8 this section to practice dentistry until he meets the 9 following requirements: 10 (a) Furnishes evidence to the board of a score on the 11 examination of the National Board of Dental Examiners taken 12 within 10 years of the date of application, which score is at 13 least equal to the minimum score required for certification by 14 that board. If the applicant fails to attain the score needed 15 for certification on part I of the national board examination 16 in two attempts, or fails to attain the score needed for 17 certification on part II of the national board examination in 18 two attempts, he shall not be entitled to take the laboratory 19 model examination authorized in paragraph (c). 20 (b) Submits, upon meeting the requirements of 21 paragraph (a), the following credentials for review by the 22 board: 23 1. Transcripts of predental education and dental 24 education totaling 7 academic years of postsecondary 25 education, including 4 academic years of dental education; and 26 2. A dental school diploma. 27 28 The board shall not review the credentials specified in this 29 paragraph until the applicant has furnished to the board 30 evidence of satisfactory completion of the National Board of 31 Dental Examiners examination as required by paragraph (a). 125 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Such credentials shall be submitted in a manner provided by 2 rule of the board. The board shall approve those credentials 3 which comply with this paragraph and with rules of the board 4 adopted pursuant hereto. The provisions of this paragraph 5 notwithstanding, an applicant who cannot produce the 6 credentials required by this paragraph as a result of 7 political or other conditions in the country in which he 8 received his education may seek approval by the board of his 9 educational background prior to complying with the provisions 10 of paragraph (a) by submitting such other reasonable and 11 reliable evidence as may be set forth by rule of the board in 12 lieu of the credentials required in this paragraph. The board 13 shall not accept such alternative evidence until it has made a 14 reasonable attempt to obtain the credentials required by this 15 paragraph from the educational institutions the applicant is 16 alleged to have attended, unless the board is otherwise 17 satisfied that such credentials cannot be obtained. 18 (c) satisfies one of the following: 19 (a)1. Completes a program of study, as defined by the 20 board by rule, at an accredited American dental school and 21 demonstrates receipt of a D.D.S. or D.M.D. from said school; 22 or 23 (b)2. Completes a 2-year supplemental dental education 24 program at an accredited dental school and receives a dental 25 diploma, degree, or certificate as evidence of program 26 completion.; or 27 3. Exhibits manual skills on a laboratory model 28 pursuant to rules of the board. The board may charge a 29 reasonable fee, not to exceed $250, to cover the costs of 30 administering the exhibition of competency in manual skills. 31 If the applicant fails to exhibit competent clinical skills in 126 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 two attempts, he shall not be entitled to take the 2 examinations authorized in subsection (4). Effective December 3 31, 1991, no applicant may fulfill the requirements of this 4 paragraph by taking the laboratory model exam. On or after 5 said date, applicants must complete the educational 6 requirements set forth in subparagraph 1. or subparagraph 2. 7 8 The provisions of paragraph (a) and subparagraph (c)3. 9 notwithstanding, an applicant who is a graduate of a dental 10 college or school not accredited in accordance with paragraph 11 (2)(b) and who has failed to pass part I or part II of the 12 national board examination in two attempts may take the 13 laboratory model exam required in subparagraph (c)3. if the 14 board finds that he has taken remedial training in the subject 15 areas in which he tested below standard on said national board 16 examination and that he has subsequently passed that part of 17 such exam which he had previously failed, provided that no 18 applicant shall be entitled to this exception who fails either 19 part of the national board examination a total of three times. 20 Further, an applicant who has failed to pass the laboratory 21 model exam required in subparagraph (c)3. in two attempts may 22 be allowed by the board to make a third and final attempt if 23 the board finds that he has taken remedial training in 24 clinical subjects in which he tested below standard. Upon 25 passing said laboratory model exam, the applicant may take the 26 licensure examinations required in subsection (4). Further, 27 the educational requirements found in subparagraph (b)1. do 28 not apply to persons who began dental education prior to 29 October 1, 1983, and such persons shall be governed by the 30 educational requirements in existence on September 30, 1983. 31 127 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 91. Section 466.017, Florida Statutes, is 2 amended to read: 3 466.017 Prescription of drugs; anesthesia.-- 4 (1) A dentist shall have the right to prescribe drugs 5 or medicine, subject to limitations imposed by law; perform 6 surgical operations within the scope of his practice and 7 training; administer general or local anesthesia or sedation, 8 subject to limitations imposed by law; and use such appliances 9 as may be necessary to the proper practice of dentistry. 10 (2) Pharmacists licensed pursuant to chapter 465 may 11 fill prescriptions of legally licensed dentists in this state 12 for any drugs necessary for the practice of dentistry. 13 (3) The board shall adopt rules which: 14 (a) Define general anesthesia. 15 (b) Specify which methods of general or local 16 anesthesia or sedation, if any, are limited or prohibited for 17 use by dentists. 18 (c) Establish minimal training, education, experience, 19 or certification for a dentist to use general anesthesia or 20 sedation, which rules may exclude, in the board's discretion, 21 those dentists using general anesthesia or sedation in a 22 competent and effective manner as of the effective date of the 23 rules. 24 (d) Establish further requirements relating to the use 25 of general anesthesia or sedation, including, but not limited 26 to, office equipment and the training of dental assistants or 27 dental hygienists who work with dentists using general 28 anesthesia or sedation. 29 (e) Establish an administrative mechanism enabling the 30 board to verify compliance with training, education, 31 experience, equipment, or certification requirements of 128 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 dentists, dental hygienists, and dental assistants adopted 2 pursuant to this subsection. The board may charge a fee to 3 defray the cost of verifying compliance with requirements 4 adopted pursuant to this paragraph. 5 (4)(a) A licensed dentist who has been utilizing 6 general anesthesia on a regular and routine basis in a 7 competent and effective manner for a 10-year period preceding 8 January 1, 1980, shall be deemed to have fulfilled the 9 training requirements required by subsection (3) for general 10 anesthesia. 11 (b) A licensed dentist who has been utilizing 12 parenteral conscious sedation on an outpatient basis on a 13 regular and routine basis in a competent and effective manner 14 for the 3-year period preceding January 1, 1980, shall be 15 deemed to have fulfilled the training requirements required by 16 subsection (3) for parenteral conscious sedation. 17 (4)(5) A dentist who administers or employs the use of 18 any form of anesthesia must possess a certification in either 19 basic cardiopulmonary resuscitation for health professionals 20 or advanced cardiac life support approved by the American 21 Heart Association or the American Red Cross or an equivalent 22 agency-sponsored course with recertification every 2 years. 23 Each dental office which uses any form of anesthesia must have 24 immediately available and in good working order such 25 resuscitative equipment, oxygen, and other resuscitative drugs 26 as are specified by rule of the board in order to manage 27 possible adverse reactions. 28 (5)(6) A licensed dentist may utilize an X-ray 29 machine, expose dental X-ray films, and interpret or read such 30 films. The provisions of part IV of chapter 468 to the 31 contrary notwithstanding, a licensed dentist may authorize or 129 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 direct a dental assistant to operate such equipment and expose 2 such films under his direction and supervision, pursuant to 3 rules adopted by the board in accordance with s. 466.024 which 4 ensure that said assistant is competent by reason of training 5 and experience to operate said equipment in a safe and 6 efficient manner. The board may charge a fee not to exceed 7 $35 to defray the cost of verifying compliance with 8 requirements adopted pursuant to this section. 9 (6)(7) The provisions of s. 465.0276 notwithstanding, 10 a dentist need not register with the board or comply with the 11 continuing education requirements of that section if the 12 dentist confines his dispensing activity to the dispensing of 13 fluorides and chlorohexidine rinse solutions; provided that 14 the dentist complies with and is subject to all laws and rules 15 applicable to pharmacists and pharmacies, including, but not 16 limited to, chapters 465, 499, and 893, and all applicable 17 federal laws and regulations, when dispensing such products. 18 Section 92. Paragraphs (r) and (hh) of subsection (1) 19 of section 466.028, Florida Statutes, are amended to read: 20 466.028 Grounds for disciplinary action; action by the 21 board.-- 22 (1) The following acts shall constitute grounds for 23 which the disciplinary actions specified in subsection (2) may 24 be taken: 25 (r) Prescribing, procuring, ordering, dispensing, 26 administering, supplying, selling, or giving any drug which is 27 a Schedule II an amphetamine or a Schedule II sympathomimetic 28 amine drug or a compound thereof designated as a Schedule II 29 controlled substance, pursuant to chapter 893, to or for any 30 person except for the clinical investigation of the effects of 31 such drugs or compounds when an investigative protocol 130 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 therefor is submitted to, and reviewed and approved by, the 2 board before such investigation is begun. 3 (hh) Failing to report to the department Division of 4 Medical Quality Assurance any licensee physician licensed 5 under chapter 458 or osteopathic physician licensed under 6 chapter 459 who the dentist knows has violated the grounds for 7 disciplinary action set out in the law under which that person 8 physician or osteopathic physician is licensed and who 9 provides health care services in a facility licensed under 10 chapter 395, or a health maintenance organization certificated 11 under part I of chapter 641, in which the dentist also 12 provides services. 13 Section 93. Subsection (2) of section 468.1115, 14 Florida Statutes, is amended to read: 15 468.1115 Exemptions.-- 16 (2) The provisions of this part shall not apply to: 17 (a) Students actively engaged in a training program, 18 if such persons are acting under the direct supervision of a 19 licensed speech-language pathologist or a licensed 20 audiologist. 21 (b) Persons practicing a licensed profession or 22 operating within the scope of their profession, such as 23 doctors of medicine, clinical psychologists, nurses, or 24 hearing aid specialists, who are properly licensed under the 25 laws of this state. 26 (c) Persons certified in the areas of speech-language 27 impairment or hearing impairment A person licensed in this 28 state under chapter 231 when engaging in the profession for 29 which they are certified he is licensed, or any person under 30 the direct supervision of such a certified person, or of a 31 licensee under this chapter, when the person under such 131 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 supervision is performing hearing screenings in a school 2 setting for prekindergarten through grade 12 the licensee when 3 rendering services within the scope of the profession of the 4 licensee. 5 (d) Laryngectomized individuals, rendering guidance 6 and instruction to other laryngectomized individuals, who are 7 under the supervision of a speech-language pathologist 8 licensed under this part or of a physician licensed under 9 chapter 458 or chapter 459 and qualified to perform this 10 surgical procedure. 11 (e) Persons licensed by another state as a 12 speech-language pathologist or audiologist who provide 13 services within the applicable scope of practice set forth in 14 s. 468.1125(6) or (7) for no more than 5 calendar days per 15 month or 15 calendar days per year under the direct 16 supervision of a Florida-licensed speech-language pathologist 17 or audiologist. A person whose state of residence does not 18 license speech-language pathologists or audiologists may also 19 qualify for this exemption, if the person holds a certificate 20 of clinical competence from the American Speech-Language and 21 Hearing Association and meets all other requirements of this 22 paragraph. In either case, the board shall hold the 23 supervising Florida licensee fully accountable for the 24 services provided by the out-of-state licensee. 25 (f) Nonlicensed persons working in a hospital setting 26 who provide newborn infant hearing screenings, so long as 27 training, clinical interpretation of the screenings, and the 28 protocol for followup of infants who fail in-hospital 29 screenings are provided by a licensed audiologist. 30 Section 94. Subsection (5) of section 468.1125, 31 Florida Statutes, is amended to read: 132 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 468.1125 Definitions.--As used in this part, the term: 2 (5) "Department" means the Department of Health 3 Business and Professional Regulation. 4 Section 95. Section 468.1155, Florida Statutes, is 5 amended to read: 6 468.1155 Provisional license; requirements.-- 7 (1)(a) A provisional license shall be required of all 8 applicants who cannot document 9 months of supervised 9 professional employment experience and a passing score on the 10 national examination. 11 (b) Individuals who are required to hold a provisional 12 license under paragraph (a) shall apply to the department and 13 be certified by the board for licensure prior to initiating 14 the professional employment experience required pursuant to s. 15 468.1165. Any person desiring a provisional license to 16 practice speech-language pathology or audiology shall apply to 17 the department. 18 (2) The department shall issue a provisional license 19 to practice speech-language pathology to each applicant who 20 whom the board certifies has: 21 (a) Completed the application form and remitted the 22 required fees, including a nonrefundable application fee. 23 (b) Received a master's degree with a major emphasis 24 in speech-language pathology from an institution of higher 25 learning which, at the time the applicant was enrolled and 26 graduated, was accredited by an accrediting agency recognized 27 by the Commission on Recognition of Postsecondary 28 Accreditation or from an institution which is publicly 29 recognized as a member in good standing with the Association 30 of Universities and Colleges of Canada. An applicant who 31 graduated from a program at a university or college outside 133 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 the United States or Canada must shall present documentation 2 of the determination of equivalency to standards established 3 programs accredited by the Commission on Recognition of 4 Postsecondary Accreditation in order to qualify. The 5 applicant must shall have completed a total of 60 semester 6 hours that which include: 7 1. Fundamental information applicable to the normal 8 development and use of speech, hearing, and language;, and 9 information about training in management of speech, hearing, 10 and language disorders;, and which provide information 11 supplementary to these fields. 12 2. Six semester hours in audiology. 13 3. Thirty of the required 60 these semester hours 14 shall be in courses acceptable toward a graduate degree by the 15 college or university in which these courses were taken,. of 16 which these 30 semester hours, 24 semester hours must shall be 17 in speech-language pathology. 18 (c) Completed 300 supervised clinical clock hours of 19 supervised clinical practice with 200 clock hours in the area 20 of speech-language pathology. The supervised clinical clock 21 hours practice shall be completed within the training 22 institution or one of its cooperating programs. 23 (3) The department shall issue a provisional license 24 to practice audiology to each applicant who whom the board 25 certifies has: 26 (a) Completed the application form and remitted the 27 required fees, including a nonrefundable application fee. 28 (b) Received a master's degree with a major emphasis 29 in audiology from an institution of higher learning which at 30 the time the applicant was enrolled and graduated was 31 accredited by an accrediting agency recognized by the 134 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Commission on Recognition of Postsecondary Accreditation or 2 from an institution which is publicly recognized as a member 3 in good standing with the Association of Universities and 4 Colleges of Canada. An applicant who graduated from a program 5 at a university or college outside the United States or Canada 6 must shall present documentation of the determination of 7 equivalency to standards established programs accredited by 8 the Commission on Recognition of Postsecondary Accreditation 9 in order to qualify. The applicant must shall have completed 10 a total of 60 semester hours that which include: 11 1. Fundamental information applicable to the normal 12 development and use of speech, hearing, and language;, and 13 information about training in management of speech, hearing, 14 and language disorders;, and which provide information 15 supplementary to these fields. 16 2. Six semester hours in speech-language pathology. 17 3. Thirty of the required 60 these semester hours 18 shall be in courses acceptable toward a graduate degree by the 19 college or university in which these courses were taken,. of 20 which these 30 semester hours, 24 semester hours must shall be 21 in audiology. 22 (c) Completed 300 supervised clinical clock hours of 23 supervised clinical practice with 200 clock hours in the area 24 of audiology. The supervised clinical clock hours practice 25 shall be completed within the training institution or one of 26 its cooperating programs. 27 (4) An applicant for a provisional license who has 28 received a master's degree with a major emphasis in 29 speech-language pathology as provided in subsection (2), or 30 audiology as provided in subsection (3), and who seeks 31 licensure in the area in which the applicant is not currently 135 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 licensed, must have completed 30 semester hours in courses 2 acceptable toward a graduate degree and 200 supervised 3 clinical clock hours in the second discipline from an 4 accredited institution. 5 (5)(4) The board, by rule, shall establish 6 requirements for the renewal of a provisional license. 7 However, no person shall obtain a provisional license may not 8 exceed for a period of which exceeds 24 months. 9 Section 96. Paragraph (a) of subsection (2) and 10 paragraph (a) of subsection (3) of section 468.1185, Florida 11 Statutes, are amended to read: 12 468.1185 Licensure.-- 13 (2) The board shall certify for licensure any 14 applicant who has: 15 (a) Satisfied the education and supervised clinical 16 clock hour practice requirements of s. 468.1155. 17 (3) The board shall certify as qualified for a license 18 by endorsement as a speech-language pathologist or audiologist 19 an applicant who: 20 (a) Holds a valid license or certificate in another 21 state or territory of the United States to practice the 22 profession for which the application for licensure is made, if 23 the criteria for issuance of such license were substantially 24 equivalent to or more stringent than the licensure criteria 25 which existed in this state at the time the license was 26 issued; or 27 Section 97. Section 468.1195, Florida Statutes, is 28 amended to read: 29 468.1195 Renewal of license or certificate; continuing 30 education requirements; standards for approval of continuing 31 education providers.-- 136 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) The department shall renew a license or 2 certificate upon receipt of the renewal application, renewal 3 fee, and proof satisfactory to the board that, during the 2 4 years prior to the application for renewal, the licensee or 5 certificateholder has completed the participated in not less 6 than 20 hours of continuing education requirements established 7 by the board in each area of licensure or certification. A 8 licensee or certificateholder who receives initial licensure 9 or certification 6 months or less before the end of the 10 biennial licensure cycle is exempt from the continuing 11 education requirements for the first renewal of the license or 12 certificate. 13 (2) The department shall adopt rules establishing a 14 procedure for the biennial renewal of licenses and 15 certificates. 16 (3) The board may prescribe shall by rule prescribe 17 continuing education, not to exceed 60 hours biennially in 18 each area of licensure or certification, as a condition for 19 renewal of a license or a certificate. The board may 20 establish by rule standards for the approval of such 21 continuing education activities. The board may make exception 22 from the requirements of continuing education in emergency or 23 hardship cases. 24 (4) The board may establish by rule standards for the 25 approval of providers of continuing education activities. 26 Section 98. Section 468.1201, Florida Statutes, is 27 created to read: 28 468.1201 Requirement for instruction on human 29 immunodeficiency virus and acquired immune deficiency 30 syndrome.--The board shall require, as a condition of granting 31 a license under this part, that an applicant making initial 137 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 application for licensure complete an education course 2 acceptable to the board on human immunodeficiency virus and 3 acquired immune deficiency syndrome. An applicant who has not 4 taken a course at the time of licensure shall, upon submission 5 of an affidavit showing good cause, be allowed 6 months to 6 complete this requirement. 7 Section 99. Subsections (2), (3), and (4) of section 8 468.1215, Florida Statutes, are amended to read: 9 468.1215 Speech-language pathology assistant and 10 audiology assistant; certification.-- 11 (2) The department shall issue a certificate as a 12 speech-language pathology assistant or as an audiology 13 assistant to each applicant who whom the board certifies has: 14 (a) Completed the application form and remitted the 15 required fees, including a nonrefundable application fee. 16 (b) Completed at least 24 semester hours of coursework 17 as approved by the board at an institution accredited by an 18 accrediting agency recognized by the Commission on Recognition 19 of Postsecondary Accreditation. 20 (3) The board, by rule, shall establish minimum 21 education and on-the-job training and supervision requirements 22 for certification as a speech-language pathology assistant or 23 audiology assistant. 24 (4) The provisions of this section shall not apply to 25 any student, intern, or trainee performing speech-language 26 pathology or audiology services while completing the 27 supervised clinical clock hours experience as required in s. 28 468.1155. 29 Section 100. Subsection (2) of section 468.1245, 30 Florida Statutes, is amended to read: 31 138 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 468.1245 Itemized listing of prices; delivery of 2 hearing aid; receipt contract; guarantee; packaging; 3 disclaimer.-- 4 (2) Any licensee who fits and sells a hearing aid 5 shall, at the time of delivery, provide the purchaser with a 6 receipt contract containing the seller's signature, the 7 address of his regular place of business, and his license or 8 certification number, if applicable, together with the brand, 9 model, manufacturer or manufacturer's identification code, and 10 serial number of the hearing aid furnished and the amount 11 charged for the hearing aid. The receipt contract also shall 12 specify whether the hearing aid is new, used, or rebuilt, and 13 shall specify the length of time and other terms of the 14 guarantee and by whom the hearing aid is guaranteed. When the 15 client has requested an itemized list of prices, the receipt 16 contract shall also provide an itemization of the total 17 purchase price, including, but not limited to, the cost of the 18 aid, ear mold, batteries, and other accessories, and the cost 19 of any services. Notice of the availability of this service 20 must shall be displayed in a conspicuous manner in the office. 21 The receipt also shall state that any complaint concerning the 22 hearing aid and its guarantee therefor, if not reconciled with 23 the licensee from whom the hearing aid was purchased, should 24 be directed by the purchaser to the department Agency for 25 Health Care Administration. The address and telephone number 26 of such office shall be stated on the receipt contract. 27 Section 101. Section 468.1295, Florida Statutes, is 28 amended to read: 29 468.1295 Disciplinary proceedings.-- 30 (1) The following acts constitute grounds for both 31 disciplinary actions as set forth in subsection (2) and cease 139 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 and desist or other related actions by the department as set 2 forth in s. 455.228:. 3 (a) Procuring or attempting to procure a license by 4 bribery, by fraudulent misrepresentation, or through an error 5 of the department or the board. 6 (b) Having a license revoked, suspended, or otherwise 7 acted against, including denial of licensure, by the licensing 8 authority of another state, territory, or country. 9 (c) Being convicted or found guilty of, or entering a 10 plea of nolo contendere to, regardless of adjudication, a 11 crime in any jurisdiction which directly relates to the 12 practice of speech-language pathology or audiology. 13 (d) Making or filing a report or record which the 14 licensee knows to be false, intentionally or negligently 15 failing to file a report or records required by state or 16 federal law, willfully impeding or obstructing such filing, or 17 inducing another person to impede or obstruct such filing. 18 Such report or record shall include only those reports or 19 records which are signed in one's capacity as a licensed 20 speech-language pathologist or audiologist. 21 (e) Advertising goods or services in a manner which is 22 fraudulent, false, deceptive, or misleading in form or 23 content. 24 (f) Being proven guilty of fraud or deceit or of 25 negligence, incompetency, or misconduct in the practice of 26 speech-language pathology or audiology. 27 (g) Violating a lawful order of the board or 28 department previously entered in a disciplinary hearing, or 29 failing to comply with a lawfully issued subpoena of the board 30 or department. 31 140 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (h) Practicing with a revoked, suspended, inactive, or 2 delinquent license. 3 (i) Using, or causing or promoting the use of, any 4 advertising matter, promotional literature, testimonial, 5 guarantee, warranty, label, brand, insignia, or other 6 representation, however disseminated or published, which is 7 misleading, deceiving, or untruthful. 8 (j) Showing or demonstrating or, in the event of sale, 9 delivery of a product unusable or impractical for the purpose 10 represented or implied by such action. 11 (k) Failing to submit to the board on an annual basis, 12 or such other basis as may be provided by rule, certification 13 of testing and calibration of such equipment as designated by 14 the board and on the form approved by the board. 15 (l) Aiding, assisting, procuring, employing, or 16 advising any licensee or business entity licensed person to 17 practice speech-language pathology or audiology contrary to 18 this part, chapter 455, or any to a rule adopted pursuant 19 thereto of the department or the board. 20 (m) Violating any provision Violation or repeated 21 violation of this part or of chapter 455, or any rule rules 22 adopted pursuant thereto. 23 (n) Misrepresenting the Misrepresentation of 24 professional services available in the fitting, sale, 25 adjustment, service, or repair of a hearing aid, or using use 26 of any other term or title which might connote the 27 availability of professional services when such use is not 28 accurate. 29 (o) Representing, advertising, or implying 30 Representation, advertisement, or implication that a hearing 31 aid or its repair is guaranteed without providing full 141 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 disclosure of the identity of the guarantor; the nature, 2 extent, and duration of the guarantee; and the existence of 3 conditions or limitations imposed upon the guarantee. 4 (p) Representing, directly or by implication, that a 5 hearing aid utilizing bone conduction has certain specified 6 features, such as the absence of anything in the ear or 7 leading to the ear, or the like, without disclosing clearly 8 and conspicuously that the instrument operates on the bone 9 conduction principle and that in many cases of hearing loss 10 this type of instrument may not be suitable. 11 (q) Stating or implying that the use of any hearing 12 aid will improve or preserve hearing or prevent or retard the 13 progression of a hearing impairment or that it will have any 14 similar or opposite effect. 15 (r) Making any statement regarding the cure of the 16 cause of a hearing impairment by the use of a hearing aid. 17 (s) Representing or implying that a hearing aid is or 18 will be "custom-made," "made to order," or 19 "prescription-made," or in any other sense specially 20 fabricated for an individual person, when such is not the 21 case. 22 (t) Canvassing from house to house or by telephone, 23 either in person or by an agent, for the purpose of selling a 24 hearing aid, except that contacting persons who have evidenced 25 an interest in hearing aids, or have been referred as in need 26 of hearing aids, shall not be considered canvassing. 27 (u) Failing to notify the department in writing of a 28 change in current mailing and place-of-practice address within 29 30 days after such change Failure to submit to the board on an 30 annual basis, or such other basis as may be provided by rule, 31 142 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 certification of testing and calibration of audiometric 2 testing equipment on the form approved by the board. 3 (v) Failing to provide all information as described in 4 ss. s. 468.1225(5)(b), 468.1245(1), and 468.1246. 5 (w) Exercising influence on a client in such a manner 6 as to exploit the client for financial gain of the licensee or 7 of a third party. 8 (x) Practicing or offering to practice beyond the 9 scope permitted by law or accepting and performing 10 professional responsibilities the licensee or 11 certificateholder knows, or has reason to know, the licensee 12 or certificateholder is not competent to perform. 13 (y) Aiding, assisting, procuring, or employing any 14 unlicensed person to practice speech-language pathology or 15 audiology. 16 (z) Delegating or contracting for the performance of 17 professional responsibilities by a person when the licensee 18 delegating or contracting for performance of such 19 responsibilities knows, or has reason to know, such person is 20 not qualified by training, experience, and authorization to 21 perform them. 22 (aa) Committing any act upon a patient or client which 23 would constitute sexual battery or which would constitute 24 sexual misconduct as defined pursuant to s. 468.1296. 25 (bb) Being unable to practice the profession for which 26 he or she is licensed or certified under this chapter with 27 reasonable skill or competence as a result of any mental or 28 physical condition or by reason of illness, drunkenness, or 29 use of drugs, narcotics, chemicals, or any other substance. 30 In enforcing this paragraph, upon a finding by the secretary, 31 his or her designee, or the board that probable cause exists 143 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 to believe that the licensee or certificateholder is unable to 2 practice the profession because of the reasons stated in this 3 paragraph, the department shall have the authority to compel a 4 licensee or certificateholder to submit to a mental or 5 physical examination by a physician, psychologist, clinical 6 social worker, marriage and family therapist, or mental health 7 counselor designated by the department or board. If the 8 licensee or certificateholder refuses to comply with the 9 department's order directing the examination, such order may 10 be enforced by filing a petition for enforcement in the 11 circuit court in the circuit in which the licensee or 12 certificateholder resides or does business. The licensee or 13 certificateholder against whom the petition is filed shall not 14 be named or identified by initials in any public court records 15 or documents, and the proceedings shall be closed to the 16 public. The department shall be entitled to the summary 17 procedure provided in s. 51.011. A licensee or 18 certificateholder affected under this paragraph shall at 19 reasonable intervals be afforded an opportunity to demonstrate 20 that he or she can resume the competent practice for which he 21 or she is licensed or certified with reasonable skill and 22 safety to patients. 23 (2) When the board finds any person guilty of any of 24 the acts set forth in subsection (1), it may issue an order 25 imposing one or more of the following penalties: 26 (a) Refusal to certify, or to certify with 27 restrictions, Denial of an application for licensure. 28 (b) Revocation or Suspension or permanent revocation 29 of a license. 30 (c)(d) Issuance of a reprimand. 31 144 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (d)(f) Restriction of the authorized scope of 2 practice. 3 (e)(c) Imposition of an administrative fine not to 4 exceed $1,000 for each count or separate offense. 5 (f)(e) Placement of the licensee or certificateholder 6 on probation for a period of time and subject to such 7 conditions as the board may specify. Those conditions may 8 include, but are not limited to, including requiring the 9 licensee or certificateholder speech-language pathologist or 10 audiologist to undergo treatment, attend continuing education 11 courses, submit to be reexamined, or to work under the 12 supervision of another licensee, or satisfy any terms which 13 are reasonably tailored to the violation found speech-language 14 pathologist or audiologist. 15 (g) Corrective action. 16 (3) The department shall reissue the license or 17 certificate which of a speech-language pathologist or 18 audiologist who has been suspended or revoked disciplined upon 19 certification by the board that the licensee or 20 certificateholder person has complied with all of the terms 21 and conditions set forth in the final order. 22 Section 102. Section 468.1296, Florida Statutes, is 23 created to read: 24 468.1296 Sexual misconduct.--Sexual misconduct by any 25 person licensed or certified under this chapter, in the 26 practice of his profession, is prohibited. Sexual misconduct 27 shall be defined by rule of the board. 28 Section 103. Subsection (2) of section 468.1655, 29 Florida Statutes, is amended to read: 30 468.1655 Definitions.--As used in this part: 31 145 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) "Department" means the Department of Health 2 Business and Professional Regulation. 3 Section 104. Subsection (1) of section 468.1695, 4 Florida Statutes, is amended to read: 5 468.1695 Licensure by examination.-- 6 (1) Any person desiring to be licensed as a nursing 7 home administrator shall apply to the department to take the 8 licensure examination. The examination shall be given at 9 least two four times a year and shall include, but not be 10 limited to, questions on the subjects of nursing home 11 administration such as: 12 (a) Applicable standards of nursing home health and 13 safety; 14 (b) Federal, state, and local health and safety laws 15 and rules; 16 (c) General administration; 17 (d) Psychology of patient care; 18 (e) Principles of medical care; 19 (f) Personal and social care; 20 (g) Therapeutic and supportive care and services in 21 long-term care; 22 (h) Departmental organization and management; 23 (i) Community interrelationships; and 24 (j) Terminology. 25 26 The board may, by rule, adopt use of a national examination in 27 lieu of part or all of the examination required by this part. 28 Section 105. Subsections (2), (4), and (5) of section 29 468.203, Florida Statutes, are amended to read: 30 468.203 Definitions.--As used in this act, the term: 31 146 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) "Board" means the Board of Occupational Therapy 2 Practice Medicine. 3 (4) "Occupational therapy" means the use of purposeful 4 activity or interventions to achieve functional outcomes. 5 (a) For the purposes of this subsection: 6 1. "Achieving functional outcomes" means to maximize 7 the independence and the maintenance of health of any 8 individual who is limited by a physical injury or illness, a 9 cognitive impairment, a psychosocial dysfunction, a mental 10 illness, a developmental or a learning disability, or an 11 adverse environmental condition. 12 2. "Assessment" means the use of skilled observation 13 or the administration and interpretation of standardized or 14 nonstandardized tests and measurements to identify areas for 15 occupational therapy services. 16 (b) Occupational therapy services include, but are not 17 limited to: 18 1. The assessment, treatment, and education of or 19 consultation with the individual, family, or other persons. 20 2. Interventions directed toward developing daily 21 living skills, work readiness or work performance, play skills 22 or leisure capacities, or enhancing educational performance 23 skills. 24 3. Providing for the development of: sensory-motor, 25 perceptual, or neuromuscular functioning; range of motion; or 26 emotional, motivational, cognitive, or psychosocial components 27 of performance. 28 29 These services may require assessment of the need for use of 30 interventions such as the design, development, adaptation, 31 application, or training in the use of assistive technology 147 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 devices; the design, fabrication, or application of 2 rehabilitative technology such as selected orthotic devices; 3 training in the use of assistive technology; orthotic or 4 prosthetic devices; the application of physical agent 5 modalities as an adjunct to or in preparation for purposeful 6 activity; the use of ergonomic principles; the adaptation of 7 environments and processes to enhance functional performance; 8 or the promotion of health and wellness the evaluation and 9 treatment of individuals whose ability to cope with the tasks 10 of living are threatened or impaired by developmental 11 deficits, the aging process, poverty and cultural differences, 12 physical injury or illness, or psychological and social 13 disability. The treatment utilizes task-oriented activities 14 to prevent or correct physical or emotional deficits or to 15 minimize the disabling effect of these deficits in the life of 16 the individual. Specific occupational therapy techniques 17 include, but are not limited to, activities of daily living 18 (ADL), the fabrication and application of splints, 19 perceptual-motor activities, the use of specifically designed 20 crafts, guidance in the selection and use of adaptive 21 equipment, exercises to enhance functional performance, and 22 prevocational evaluation and treatment. Such techniques are 23 applied in the treatment of individual patients or clients, in 24 groups, or through social systems. 25 (c) The use of devices subject to 21 C.F.R. s. 801.109 26 and identified by the board is expressly prohibited except by 27 an occupational therapist or occupational therapy assistant 28 who has received training as specified by the board. The 29 board shall adopt rules to carry out the purpose of this 30 provision. 31 148 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (5) "Occupational therapy aide" means a person who 2 assists in the practice of occupational therapy, who works 3 under the direct supervision of a person licensed occupational 4 therapist or to practice occupational therapy assistant, and 5 whose activities require a general an understanding of 6 occupational therapy pursuant to board rules but do not 7 require professional or advanced training in the basic 8 anatomical, biological, psychological, and social sciences 9 involved in the practice of occupational therapy. 10 Section 106. Section 468.205, Florida Statutes, is 11 amended to read: 12 (Substantial rewording of section. See 13 s. 468.205, F.S., for present text.) 14 468.205 Board of Occupational Therapy Practice.-- 15 (1) There is created within the department the Board 16 of Occupational Therapy Practice, composed of seven members 17 appointed by the Governor, subject to confirmation by the 18 Senate. 19 (2) Four members shall be licensed occupational 20 therapists in good standing in this state who are residents of 21 this state and have been engaged in the practice of 22 occupational therapy for at least 4 years immediately prior to 23 their appointment. One member shall be a licensed occupational 24 therapy assistant in good standing in this state who is a 25 resident of the state and has been engaged in the practice of 26 occupational therapy for at least 4 years immediately prior to 27 the appointment. Two members shall be consumers who are 28 residents of the state who are not connected with the practice 29 of occupational therapy. 30 (3) Within 90 days after the effective date of this 31 act, the Governor shall appoint the board as follows: 149 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Two members for terms of 2 years each. 2 (b) Two members for terms of 3 years each. 3 (c) Three members for terms of 4 years each. 4 (4) As the terms of the members expire, the Governor 5 shall appoint successors for terms of 4 years and such members 6 shall serve until their successors are appointed. 7 (5) All provisions of chapter 455 relating to 8 activities of the board shall apply. 9 Section 107. Section 468.209, Florida Statutes, is 10 amended to read: 11 468.209 Requirements for licensure.-- 12 (1) An applicant applying for a license as an 13 occupational therapist or as an occupational therapy assistant 14 shall file a written application, accompanied by the 15 application for licensure fee prescribed in s. 468.221, on 16 forms provided by the department board, showing to the 17 satisfaction of the board that he: 18 (a) Is of good moral character. 19 (b) Has successfully completed the academic 20 requirements of an educational program in occupational therapy 21 recognized by the board, with concentration in biologic or 22 physical science, psychology, and sociology, and with 23 education in selected manual skills. For an occupational 24 therapist, Such a program shall be accredited by the American 25 Medical Association in collaboration with the American 26 Occupational Therapy Association's Accreditation Council for 27 Occupational Therapy Education, or its successor Association. 28 For an occupational therapy assistant, such a program shall be 29 approved by the American Occupational Therapy Association. 30 (c) Has successfully completed a period of supervised 31 fieldwork experience at a recognized educational institution 150 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 or a training program approved by the educational institution 2 where he met the academic requirements. For an occupational 3 therapist, a minimum of 6 months of supervised fieldwork 4 experience is required. For an occupational therapy assistant, 5 a minimum of 2 months of supervised fieldwork experience is 6 required. 7 (d) Has passed an examination conducted or adopted by 8 the board as provided in s. 468.211. 9 (2) An applicant who has practiced as a state-licensed 10 or American Occupational Therapy Association-certified 11 occupational therapy assistant for 4 years and who, prior to 12 January 24, 1988, has completed a minimum of 6 months of 13 supervised occupational-therapist-level fieldwork experience 14 may take the examination to be licensed as an occupational 15 therapist without meeting the educational requirements for 16 occupational therapists made otherwise applicable under 17 paragraph (1)(b). 18 (3) If the board determines that an applicant is 19 qualified to be licensed by endorsement under s. 468.213, the 20 board may issue the applicant a temporary permit to practice 21 occupational therapy until the next board meeting at which 22 license applications are to be considered, but not for a 23 longer period of time. Only one temporary permit by 24 endorsement shall be issued to an applicant, and it shall not 25 be renewable. 26 (4) If the board determines that the applicant has not 27 passed an examination, which examination is recognized by the 28 board, to determine competence to practice occupational 29 therapy and is not qualified to be licensed by endorsement, 30 but has otherwise met all the requirements of this section and 31 has made application for the next scheduled examination, the 151 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 board may issue the applicant a temporary permit allowing him 2 to practice occupational therapy under the supervision of a 3 licensed occupational therapist until notification of the 4 results of the examination. An individual who has passed the 5 examination may continue to practice occupational therapy 6 under his temporary permit until the next meeting of the 7 board. An individual who has failed the examination shall not 8 continue to practice occupational therapy under his temporary 9 permit; and such permit shall be deemed revoked upon 10 notification to the board of the examination results and the 11 subsequent, immediate notification by the board to the 12 applicant of the revocation. Only one temporary permit by 13 examination shall be issued to an applicant, and it shall not 14 be renewable. However, applicants enrolled in a full-time 15 advanced master's occupational therapy education program who 16 have completed all requirements for licensure except 17 examination shall, upon written request, be granted a 18 temporary permit valid for 6 months even if that period 19 extends beyond the next examination, provided the applicant 20 has not failed the examination. This permit shall remain 21 valid only while the applicant remains a full-time student 22 and, upon written request, shall be renewed once for an 23 additional 6 months. 24 (5) An applicant seeking reentry into the profession 25 who has not been in active practice within the last 5 years 26 must, prior to applying for licensure, submit to the board 27 documentation of continuing education as prescribed by rule. 28 Section 108. Subsection (6) is added to section 29 468.211, Florida Statutes, to read: 30 468.211 Examination for licensure.-- 31 152 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (6) If an applicant fails to pass the examination in 2 three attempts, the applicant shall not be eligible for 3 reexamination unless the applicant completes additional 4 education or training requirements prescribed by the board. 5 An applicant who has completed the additional education or 6 training requirements prescribed by the board may take the 7 examination on two more occasions. If the applicant has 8 failed to pass the examination after five attempts, the 9 applicant is no longer eligible to take the examination. 10 Section 109. Section 468.213, Florida Statutes, is 11 amended to read: 12 468.213 Licensure by endorsement.-- 13 (1) The board may waive the examination and grant a 14 license to any person who presents proof of current 15 certification as an occupational therapist or occupational 16 therapy assistant by a national certifying organization the 17 American Occupational Therapy Association if the board 18 determines the requirements for such certification to be 19 equivalent to the requirements for licensure in this act. 20 (2) The board may waive the examination and grant a 21 license to any applicant who presents proof of current 22 licensure as an occupational therapist or occupational therapy 23 assistant in another state, the District of Columbia, or any a 24 territory or jurisdiction of the United States or foreign 25 national jurisdiction which requires standards for licensure 26 determined by the board to be equivalent to the requirements 27 for licensure in this act. 28 Section 110. Section 468.225, Florida Statutes, is 29 amended to read: 30 468.225 Exemptions Persons and practices not 31 affected.-- 153 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) Nothing in this act shall be construed as 2 preventing or restricting the practice, services, or 3 activities of: 4 (a) Any person licensed in this state by any other law 5 from engaging in the profession or occupation for which he is 6 licensed. 7 (b) Any person employed as an occupational therapist 8 or occupational therapy assistant by the United States, if 9 such person provides occupational therapy solely under the 10 direction or control of the organization by which he is 11 employed. 12 (c) Any person pursuing a course of study leading to a 13 degree or certificate in occupational therapy at an accredited 14 or approved educational program, if such activities and 15 services constitute a part of a supervised course of study and 16 if such a person is designated by a title which clearly 17 indicates his or her status as a student or trainee. 18 (d) Any person fulfilling the supervised fieldwork 19 experience requirements of s. 468.209, if such activities and 20 services constitute a part of the experience necessary to meet 21 the requirements of that section. 22 (e) Any person employed by, or working under the 23 direct supervision of, an occupational therapist as an 24 occupational therapy aide. 25 (2) No provision of this act shall be construed to 26 prohibit physicians, physician assistants, nurses, physical 27 therapists, osteopathic physicians or surgeons, or clinical 28 psychologists, speech-language pathologists, or audiologists 29 from using occupational therapy as a part of or incidental to 30 their profession, when they practice their profession under 31 the statutes applicable to their profession. 154 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 111. Section 468.351, Florida Statutes, is 2 amended to read: 3 468.351 Purpose and intent; application.-- 4 (1)(a) The purpose in enacting this part is to provide 5 for the licensure certification and registration of persons 6 who deliver respiratory care services and who meet certain 7 requirements. The delivery of respiratory care services by 8 persons licensed certified or registered pursuant to this part 9 shall not be construed to permit the practice of medicine. 10 (b) It is the finding of the Legislature that the 11 delivery of respiratory care services by unskilled and 12 incompetent persons presents a danger to the public health and 13 safety. Because it is difficult for the public to make 14 informed choices related to respiratory care services and 15 since the consequences of wrong choices can seriously endanger 16 public health and safety, it is the intent of the Legislature 17 to prohibit the delivery of respiratory care services by 18 persons who are determined to possess less than minimum 19 competencies or who otherwise present a danger to the public. 20 (2) It is the intent of the Legislature that the 21 department of Health and Rehabilitative Services shall 22 continue to regulate blood gas laboratories and that the 23 supervision of health respiratory care practitioners, clinical 24 laboratory personnel, and other persons performing blood gas 25 analysis and specimen collection for the purpose of such 26 analysis be specified in rules pursuant to the applicable 27 practice act chapter 483. Further, it is the intent of the 28 Legislature that personnel licensed certified or registered 29 pursuant to this part shall be exempt from the licensure 30 provisions of chapter 483. 31 155 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 112. Subsections (2), (8), and (9) of section 2 468.352, Florida Statutes, are amended to read: 3 468.352 Definitions.--As used in this part, unless the 4 context otherwise requires, the term: 5 (2) "Department" means the Department of Health 6 Business and Professional Regulation. 7 (8) "Respiratory therapist" means any person licensed 8 registered pursuant to this part who is employed to deliver 9 respiratory care services under the order of a physician 10 licensed pursuant to chapter 458 or chapter 459, and in 11 accordance with protocols established by a hospital, other 12 health care provider, or the board, and who functions in 13 situations of unsupervised patient contact requiring 14 individual judgment. 15 (9) "Respiratory care practitioner" means any person 16 licensed certified pursuant to this part who is employed to 17 deliver respiratory care services under the order of a 18 physician licensed pursuant to chapter 458 or chapter 459, and 19 in accordance with protocols established by a hospital, other 20 health care provider, or the board. 21 Section 113. Paragraph (a) of subsection (5) of 22 section 468.354, Florida Statutes, is amended to read: 23 468.354 Advisory Council on Respiratory Care; 24 organization; function.-- 25 (5)(a) The council shall recommend to the department a 26 code of ethics for those persons licensed certified or 27 registered pursuant to this part. 28 Section 114. Section 468.355, Florida Statutes, is 29 amended to read: 30 468.355 Eligibility for licensure certification or 31 registration; temporary licensure certification.-- 156 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) To be eligible for licensure certification by the 2 board as a respiratory care practitioner, an applicant must: 3 (a) Be at least 18 years old. 4 (b) Possess a high school diploma or a graduate 5 equivalency diploma. 6 (c) Meet at least one of the following criteria: 7 1. The applicant has successfully completed a training 8 program for respiratory therapy technicians or respiratory 9 therapists approved by the Commission Committee on 10 Accreditation of Allied Health Education Programs and 11 Accreditation of the American Medical Association, or the 12 equivalent thereof, as accepted by the board. 13 2. The applicant is currently a "Certified Respiratory 14 Therapy Technician" certified by the National Board for 15 Respiratory Care, or the equivalent thereof, as accepted by 16 the board. 17 3. The applicant is currently a "Registered 18 Respiratory Therapist" registered by the National Board for 19 Respiratory Care, or the equivalent thereof, as accepted by 20 the board. 21 4. The applicant is currently employed in this state 22 as a respiratory care practitioner or respiratory therapist on 23 October 1, 1984. 24 25 The criteria set forth in subparagraphs 2. and 3. 26 notwithstanding, the board shall annually review the 27 examinations and standards of the National Board for 28 Respiratory Care and may reject those examinations and 29 standards if they are deemed inappropriate. 30 (2) To be eligible for licensure registration by the 31 board as a respiratory therapist, an applicant must: 157 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Be at least 18 years old. 2 (b) Possess a high school diploma or a graduate 3 equivalency diploma. 4 (c) Meet at least one of the following criteria: 5 1. The applicant has successfully completed a training 6 program for respiratory therapists approved by the Commission 7 Committee on Accreditation of Allied Health Education Programs 8 and Accreditation of the American Medical Association, or the 9 equivalent thereof, as accepted by the board. 10 2. The applicant is currently a "Registered 11 Respiratory Therapist" registered by the National Board for 12 Respiratory Care, or the equivalent thereof, as accepted by 13 the board. 14 15 The criteria set forth in subparagraphs 1. and 2. 16 notwithstanding, the board shall annually review the 17 examinations and standards of the National Board for 18 Respiratory Care and may reject those examinations and 19 standards if they are deemed inappropriate. 20 (3) With respect to the delivery of respiratory care 21 services, the board shall establish procedures for temporary 22 licensure certification of eligible individuals entering the 23 state and temporary licensure certification of those persons 24 who have graduated from a program approved by the board. Such 25 temporary licensure certification shall be for a period not to 26 exceed 1 year. 27 Section 115. Section 468.356, Florida Statutes, is 28 amended to read: 29 468.356 Approval of educational programs.-- 30 (1) Approval of educational programs shall be in 31 accordance with the Joint Review Committee for Respiratory 158 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Therapy Education through the Commission Committee on 2 Accreditation of Allied Health Education Programs, or other 3 accrediting agency recognized by the United States Office of 4 Education and Accreditation of the American Medical 5 Association. 6 (2) In the event that an educational program has not 7 yet received full American Medical Association approval, the 8 board, at its discretion, may require appropriate 9 documentation of the intent to achieve full accreditation 10 within a specified time period. Temporary approval for 11 graduates of such programs to sit for state licensure 12 certification or registration examinations may then be granted 13 by the board. 14 Section 116. Section 468.357, Florida Statutes, is 15 amended to read: 16 468.357 Licensure Certification by examination.-- 17 (1) A person who desires to be licensed certified as a 18 respiratory care practitioner may submit an application to the 19 department board to take the examination to be administered by 20 the department. 21 (a) The department shall examine each applicant who is 22 determined by the board to have: 23 1. Completed the application form and remitted the 24 applicable application fee set by the board; 25 2. Submitted required documentation as required in s. 26 468.355; and 27 3. Remitted an examination fee set by the board. 28 (b) The department shall conduct examinations for 29 licensure certification of respiratory care practitioners no 30 less than two times a year in such geographical locations as 31 are deemed advantageous to the majority of the applicants. 159 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 However, the examination shall be conducted no less than three 2 times a year through 1988 and in such geographical locations 3 as are deemed advantageous to the majority of the applicants. 4 (c) The examination given for respiratory care 5 practitioners shall be the same as that given by the National 6 Board for Respiratory Care for entry-level certification of 7 respiratory therapy technicians. However, an equivalent 8 examination may be accepted by the board in lieu of that 9 examination. 10 (2) Each applicant who passes the examination shall be 11 entitled to licensure certification as a respiratory care 12 practitioner, and the department shall issue a license 13 certificate pursuant to this part to any applicant who 14 successfully completes the examination in accordance with this 15 section. However, the department shall not issue a license 16 certificate to any applicant who is under investigation in 17 another jurisdiction for an offense which would constitute a 18 violation of this part. Upon completion of such an 19 investigation, if the applicant is found guilty of such an 20 offense, the applicable provisions of s. 468.365 will apply. 21 (3)(a) Any person who was employed in this state on or 22 before September 30, 1983, as a respiratory therapy technician 23 or respiratory therapist, and who has performed services in 24 such professional capacity for 4 years or more by October 1, 25 1987, under the supervision of a licensed physician or in a 26 hospital or licensed health care facility, shall be issued a 27 license certificate without examination, if such person 28 provides acceptable documentation of performance of such 29 services to the board. Such documentation shall include 30 certification by a physician licensed pursuant to chapter 458 31 or chapter 459 who has direct knowledge of the practice of, or 160 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 who has supervised, the person. If such person is not 2 determined to have performed critical care respiratory 3 services for at least 4 years, the board may limit the license 4 certificate of such person to the performance of noncritical 5 care respiratory services. Any person issued a certificate 6 pursuant to this paragraph shall complete at least 20 contact 7 hours of continuing education each year. 8 (b) Any person first employed in this state as a 9 respiratory therapy technician or respiratory therapist on or 10 after October 1, 1984, and prior to October 1, 1987, shall 11 have until December 31, 1988, to pass the examination for 12 certification under this part if the person has applied to 13 take the examination before March 1, 1988, and such person 14 shall be permitted to continue to perform respiratory care 15 services until December 31, 1988. 16 Section 117. Section 468.358, Florida Statutes, is 17 amended to read: 18 468.358 Licensure Certification or registration by 19 endorsement.-- 20 (1) Licensure Certification as a respiratory care 21 practitioner shall be granted by endorsement to an individual 22 who holds the "Certified Respiratory Therapy Technician" 23 credential issued by the National Board for Respiratory Care 24 or an equivalent credential acceptable to the board. Licensure 25 Certification by this mechanism requires verification by oath 26 and submission of evidence satisfactory to the board that such 27 credential is held. 28 (2) Licensure Registration as a respiratory therapist 29 shall be granted by endorsement to an individual who holds the 30 "Registered Respiratory Therapist" credential issued by the 31 National Board for Respiratory Care or an equivalent 161 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 credential acceptable to the board. Licensure Registration by 2 this mechanism requires verification by oath and submission of 3 evidence satisfactory to the board that such credential is 4 held. 5 (3) An individual who has been granted licensure, 6 certification, registration, or other authority, by whatever 7 name known, to deliver respiratory care services in another 8 state or country may petition the board for consideration for 9 licensure certification or registration in this state and, 10 upon verification by oath and submission of evidence of 11 licensure, certification, registration, or other authority 12 acceptable to the board, may be granted licensure 13 certification or registration by endorsement. 14 (4) Licensure Certification or registration shall not 15 be granted by endorsement as provided in this section without 16 the submission of a proper application and the payment of the 17 requisite fees therefor. 18 Section 118. Subsections (1), (2), and (5) of section 19 468.359, Florida Statutes, are amended to read: 20 468.359 Assumption of title and use of 21 abbreviations.-- 22 (1) Only persons who are licensed certified pursuant 23 to this part as respiratory care practitioners have the right 24 to use the title "Respiratory Care Practitioner" and the 25 abbreviation "RCP." 26 (2) Only persons who are licensed registered pursuant 27 to this part as respiratory therapists have the right to use 28 the title "Registered Respiratory Therapist" and the 29 abbreviation "RRT," provided such persons have passed the 30 Registry Examination for Respiratory Therapists given by the 31 National Board for Respiratory Care. 162 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (5) No person in this state shall deliver respiratory 2 care services; advertise as, or assume the title of, 3 respiratory care practitioner or respiratory therapist; or use 4 the abbreviation "RCP" or take any other action that would 5 lead the public to believe that such person is licensed 6 certified or registered pursuant to this part unless such 7 person is so licensed certified or registered. 8 Section 119. Section 468.36, Florida Statutes, is 9 amended to read: 10 468.36 Primary place of service delivery; notice of 11 address or change of address.--Every licensee 12 certificateholder or registrant shall file with the department 13 the licensee's current residence address as defined by board 14 rule of his primary place of service delivery within the state 15 prior to engaging in such service delivery. Prior to changing 16 such address, he shall notify the department of the address of 17 his new primary place of service delivery, whether or not 18 within the state. 19 Section 120. Section 468.361, Florida Statutes, is 20 amended, and section 468.362, Florida Statutes, is transferred 21 to said section and amended, to read: 22 468.361 Renewal of licensure certification or 23 registration; continuing education.-- 24 (1) The department shall provide by rule a method for 25 the biennial renewal of licensure certification or 26 registration at fees set by the board. 27 (2) The board shall prescribe by rule continuing 28 education requirements, not to exceed 24 hours biennially, as 29 a condition for renewal of licensure certification or 30 registration. The program criteria with respect thereto shall 31 be approved by the board. 163 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 468.362 Continuing education.-- 2 (1) A renewal of a certificate or registration shall 3 not be issued by the department until the certificateholder or 4 registrant submits proof satisfactory to the board that, 5 during the 2 years prior to his application for renewal, he 6 has participated in no fewer than 24 hours of continuing 7 professional respiratory care education in courses approved by 8 the board. 9 (3)(2) The board shall approve continuing education 10 courses which may be accepted in meeting the requirements of 11 this part. Providers of such courses shall also be approved 12 by the board. 13 (4)(3) The board may make exceptions from the 14 requirements of this section in emergency or hardship cases. 15 (4) The board may adopt rules, within the requirements 16 of this section, that are necessary for the implementation of 17 this section. 18 Section 121. Section 468.363, Florida Statutes, is 19 amended to read: 20 468.363 Reactivation of licensure certification or 21 registration; continuing education.--The board shall prescribe 22 by rule continuing education requirements as a condition of 23 reactivating a license certificate or registration. The 24 continuing education requirements for reactivating a license 25 certificate or registration may not exceed 12 classroom hours 26 for each year the license certificate or registration was 27 inactive. 28 Section 122. Subsection (1) of section 468.364, 29 Florida Statutes, is amended to read: 30 468.364 Fees; establishment; disposition.-- 31 164 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) The board shall establish by rule fees for the 2 following purposes: 3 (a) Application, fee: a fee not to exceed $50. 4 (b) Examination, fee: a fee not to exceed $125 plus 5 the actual per applicant cost to the department for purchase 6 of the examination from the National Board for Respiratory 7 Care or a similar national organization. 8 (c) Initial licensure, certification or registration 9 fee: a fee not to exceed $200. 10 (d) Renewal of licensure, certification or 11 registration fee: a fee not to exceed $200 biennially. 12 (e) Renewal of inactive licensure, certification or 13 registration: a fee not to exceed $50. 14 (f) Reactivation, fee: a fee not to exceed $50. 15 Section 123. Section 468.365, Florida Statutes, is 16 amended to read: 17 468.365 Disciplinary grounds and actions.-- 18 (1) The following acts constitute grounds for which 19 the disciplinary actions in subsection (2) may be taken: 20 (a) Procuring, attempting to procure, or renewing a 21 license certificate or registration as provided by this part 22 by bribery, by fraudulent misrepresentation, or through an 23 error of the department or the board. 24 (b) Having licensure, certification, registration, or 25 other authority, by whatever name known, to deliver 26 respiratory care services revoked, suspended, or otherwise 27 acted against, including the denial of licensure, 28 certification, registration, or other authority to deliver 29 respiratory care services by the licensing authority of 30 another state, territory, or country. 31 165 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (c) Being convicted or found guilty of, or entering a 2 plea of nolo contendere to, regardless of adjudication, of a 3 crime in any jurisdiction which directly relates to 4 respiratory care services or to the ability to deliver such 5 services. 6 (d) Willfully making or filing a false report or 7 record, willfully failing to file a report or record required 8 by state or federal law, or willfully impeding or obstructing 9 such filing or inducing another person to do so. Such reports 10 or records include only those reports or records which require 11 the signature of a certified respiratory care practitioner or 12 a respiratory therapist licensed registered pursuant to this 13 part. 14 (e) Circulating false, misleading, or deceptive 15 advertising. 16 (f) Unprofessional conduct, which includes, but is not 17 limited to, any departure from, or failure to conform to, 18 acceptable standards related to the delivery of respiratory 19 care services, as set forth by the board and the Advisory 20 Council on Respiratory Care in rules adopted pursuant to this 21 part. 22 (g) Engaging or attempting to engage in the 23 possession, sale, or distribution of controlled substances, as 24 set forth by law, for any purpose other than a legitimate 25 purpose. 26 (h) Willfully failing to report any violation of this 27 part. 28 (i) Willfully or repeatedly violating a rule of the 29 board or the department or a lawful order of the board or 30 department previously entered in a disciplinary hearing. 31 166 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (j) Violation of any rule adopted pursuant to this 2 part or chapter 455. 3 (k) Engaging in the delivery of respiratory care 4 services with a revoked, suspended, or inactive license 5 certificate or registration. 6 (l) Permitting, aiding, assisting, procuring, or 7 advising any person who is not licensed certified or 8 registered pursuant to this part, contrary to this part or to 9 any rule of the department or the board. 10 (m) Failing to perform any statutory or legal 11 obligation placed upon a certified respiratory care 12 practitioner or a respiratory therapist licensed registered 13 pursuant to this part. 14 (n) Accepting and performing professional 15 responsibilities which the licensee certificateholder or 16 registrant knows, or has reason to know, he is not competent 17 to perform. 18 (o) Delegating professional responsibilities to a 19 person when the licensee certificateholder or registrant 20 delegating such responsibilities knows, or has reason to know, 21 that such person is not qualified by training, experience, or 22 licensure certification or registration to perform them. 23 (p) Gross or repeated malpractice or the failure to 24 deliver respiratory care services with that level of care, 25 skill, and treatment which is recognized by a reasonably 26 prudent respiratory care practitioner or respiratory therapist 27 with similar professional training as being acceptable under 28 similar conditions and circumstances. 29 (q) Paying or receiving any commission, bonus, 30 kickback, or rebate to or from, or engaging in any split-fee 31 arrangement in any form whatsoever with, a person, 167 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 organization, or agency, either directly or indirectly, for 2 goods or services rendered to patients referred by or to 3 providers of health care goods and services, including, but 4 not limited to, hospitals, nursing homes, clinical 5 laboratories, ambulatory surgical centers, or pharmacies. The 6 provisions of this paragraph shall not be construed to prevent 7 the licensee certificateholder or registrant from receiving a 8 fee for professional consultation services. 9 (r) Exercising influence within a respiratory care 10 relationship for the purpose of engaging a patient in sexual 11 activity. A patient is presumed to be incapable of giving 12 free, full, and informed consent to sexual activity with the 13 patient's respiratory care practitioner or respiratory 14 therapist. 15 (s) Making deceptive, untrue, or fraudulent 16 representations in the delivery of respiratory care services 17 or employing a trick or scheme in the delivery of respiratory 18 care services if such a scheme or trick fails to conform to 19 the generally prevailing standards of other licensees 20 certificateholders or registrants within the community. 21 (t) Soliciting patients, either personally or through 22 an agent, through the use of fraud, deception, or otherwise 23 misleading statements or through the exercise of intimidation 24 or undue influence. 25 (u) Failing to keep written respiratory care records 26 justifying the reason for the action taken by the licensee 27 certificateholder or registrant. 28 (v) Exercising influence on the patient in such a 29 manner as to exploit the patient for the financial gain of the 30 licensee certificateholder or registrant or a third party, 31 168 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 which includes, but is not limited to, the promoting or 2 selling of services, goods, appliances, or drugs. 3 (w) Performing professional services which have not 4 been duly ordered by a physician licensed pursuant to chapter 5 458 or chapter 459 and which are not in accordance with 6 protocols established by the hospital, other health care 7 provider, or the board, except as provided in ss. 743.064, 8 766.103, and 768.13. 9 (x) Being unable to deliver respiratory care services 10 with reasonable skill and safety to patients by reason of 11 illness or use of alcohol, drugs, narcotics, chemicals, or any 12 other type of material as a result of any mental or physical 13 condition. In enforcing this paragraph, the department shall, 14 upon probable cause, have authority to compel a respiratory 15 care practitioner or respiratory therapist to submit to a 16 mental or physical examination by physicians designated by the 17 department. The cost of examination shall be borne by the 18 licensee certificateholder or registrant being examined. The 19 failure of a respiratory care practitioner or respiratory 20 therapist to submit to such an examination when so directed 21 constitutes an admission of the allegations against him, upon 22 which a default and a final order may be entered without the 23 taking of testimony or presentation of evidence, unless the 24 failure was due to circumstances beyond his control. A 25 respiratory care practitioner or respiratory therapist 26 affected under this paragraph shall at reasonable intervals be 27 afforded an opportunity to demonstrate that he can resume the 28 competent delivery of respiratory care services with 29 reasonable skill and safety to his patients. In any 30 proceeding under this paragraph, neither the record of 31 proceedings nor the orders entered by the board shall be used 169 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 against a respiratory care practitioner or respiratory 2 therapist in any other proceeding. 3 (2) If the board finds any person guilty of any of the 4 grounds set forth in subsection (1), it may enter an order 5 imposing one or more of the following penalties: 6 (a) Denial of an application for licensure 7 certification or registration. 8 (b) Revocation or suspension of licensure 9 certification or registration. 10 (c) Imposition of an administrative fine not to exceed 11 $1,000 for each count or separate offense. 12 (d) Placement of the respiratory care practitioner or 13 respiratory therapist on probation for such period of time and 14 subject to such conditions as the board may specify, 15 including, but not limited to, requiring the respiratory care 16 practitioner or respiratory therapist to submit to treatment, 17 to attend continuing education courses, or to work under the 18 supervision of another respiratory care practitioner or 19 respiratory therapist. 20 (e) Issuance of a reprimand. 21 (3) The board shall not reinstate licensure 22 certification or registration, or cause a license certificate 23 or registration to be issued to a person it has deemed 24 unqualified, until such time as it is satisfied that such 25 person has complied with all the terms and conditions set 26 forth in the final order and that the respiratory care 27 practitioner or respiratory therapist is capable of safely 28 engaging in the delivery of respiratory care services. 29 (4) The board may, by rule, establish guidelines for 30 the disposition of disciplinary cases involving specific types 31 of violations. Such guidelines may include minimum and 170 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 maximum fines, periods of supervision on probation, or 2 conditions upon probation or reissuance of a license 3 certificate or registration. 4 Section 124. Subsection (1) of section 468.366, 5 Florida Statutes, is amended to read: 6 468.366 Penalties for violations.-- 7 (1) It is a violation of law for any person, including 8 any firm, association, or corporation, to: 9 (a) Sell or fraudulently obtain, attempt to obtain, or 10 furnish to any person a diploma, license, certificate, 11 registration, or record, or aid or abet in the sale, 12 procurement, or attempted procurement thereof. 13 (b) Deliver respiratory care services, as defined by 14 this part or by rule of the board, under cover of any diploma, 15 license, certificate, registration, or record that was 16 illegally or fraudulently obtained or signed or issued 17 unlawfully or under fraudulent representation. 18 (c) Deliver respiratory care services, as defined by 19 this part or by rule of the board, unless such person is duly 20 licensed certified or registered to do so under the provisions 21 of this part or unless such person is exempted pursuant to s. 22 468.368. 23 (d) Use, in connection with his name, any designation 24 tending to imply that he is a respiratory care practitioner or 25 a respiratory therapist, duly licensed certified or registered 26 under the provisions of this part, unless he is so licensed 27 certified or registered. 28 (e) Advertise an educational program as meeting the 29 requirements of this part, or conduct an educational program 30 for the preparation of respiratory care practitioners or 31 171 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 respiratory therapists, unless such program has been approved 2 by the board. 3 (f) Knowingly employ unlicensed uncertified or 4 unregistered persons in the delivery of respiratory care 5 services, unless exempted by this part. 6 (g) Knowingly conceal information relative to any 7 violation of this part. 8 Section 125. Subsection (8) of section 468.368, 9 Florida Statutes, is amended to read: 10 468.368 Exemptions.--Nothing in this part shall be 11 construed to prohibit: 12 (8) The employment by a health care facility of a 13 student enrolled in the clinical portion of an approved 14 respiratory care educational program (who has demonstrated 15 such enrollment to the board by submission of evidence 16 satisfactory to the board) to deliver limited respiratory care 17 support services under the supervision of personnel licensed 18 certified or registered pursuant to this part. Such exemption 19 shall also apply to the graduates of such programs until the 20 receipt of temporary licensure certification issued pursuant 21 to the provisions of s. 468.355(3). However, such employees 22 shall not perform invasive procedures or procedures related to 23 critical respiratory care, including therapeutic, diagnostic, 24 and palliative procedures, nor shall they participate in 25 delivering certain services requiring unsupervised patient 26 contact, as determined by the board. 27 Section 126. Subsection (3) of section 478.42, Florida 28 Statutes, is amended to read: 29 478.42 Definitions.--As used in this chapter, the 30 term: 31 172 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (3) "Department" means the Department of Health 2 Business and Professional Regulation. 3 Section 127. Section 478.45, Florida Statutes, is 4 amended to read: 5 478.45 Requirements for licensure.-- 6 (1) An applicant applying for licensure as an 7 electrologist shall file a written application, accompanied by 8 the application for licensure fee prescribed in s. 478.55, on 9 a form provided by the board, showing to the satisfaction of 10 the board that the applicant: 11 (a) Is at least 18 years old. 12 (b) Is of good moral character. 13 (c) Is a resident of the state. 14 (c)(d) Possesses a high school diploma or a graduate 15 equivalency diploma. 16 (d)(e) Has not committed an act in any jurisdiction 17 which would constitute grounds for disciplining an 18 electrologist in this state. 19 (e)(f)1. Has successfully completed the academic 20 requirements of an electrolysis training program, not to 21 exceed 120 hours, and the practical application thereof as 22 approved by the board; or 23 2. Was engaged in the practice of electrology prior to 24 October 1, 1991, and filed an application for licensure within 25 90 days after the date established by the board or by February 26 1, 1995, whichever comes last. 27 (2) Each applicant for licensure shall successfully 28 pass a written examination developed by the department or a 29 national examination that has, both of which have been 30 approved by the board. The examinations shall test the 31 applicant's knowledge relating to the practice of electrology, 173 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 including the applicant's professional skills and judgment in 2 the use of electrolysis techniques and methods, and any other 3 subjects which are useful to determine the applicant's fitness 4 to practice. 5 (3) The department, upon approval of the board, may 6 adopt a the American Electrology Association examination or 7 any other national examination in lieu of any part of the 8 examination required by this section. The board, with the 9 assistance of the council, shall establish standards for 10 acceptable performance. 11 (4) The department shall issue a license to practice 12 electrology to any applicant who passes the examination, pays 13 the licensure fee as set forth in s. 478.55, and otherwise 14 meets the requirements of this chapter. 15 (5) The department shall conduct licensure 16 examinations at least two times a year biannually at locations 17 set by the board. However, such examinations may be conducted 18 at least three times each year through 1995. The department 19 board shall give public notice of the time and place of each 20 examination at least 60 days before it is administered and 21 shall mail notice of such examination to each applicant whose 22 application is timely filed, pursuant to board rule. 23 (6) The department may not issue a license to any 24 applicant who is under investigation in another jurisdiction 25 for an offense which would be a violation of this chapter, 26 until such investigation is complete. Upon completion of such 27 investigation, if the applicant is found guilty of such 28 offense, the board shall apply the applicable provisions of s. 29 478.52. 30 Section 128. Subsection (1) of section 478.46, Florida 31 Statutes, is amended to read: 174 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 478.46 Temporary permits.-- 2 (1) If the department executive director of the board 3 determines that an applicant is qualified to be licensed under 4 s. 478.47 478.45, the department board may issue the applicant 5 a temporary permit to practice electrolysis electrology until 6 the next board meeting at which license applications are to be 7 considered, but not for a longer period of time. Only one 8 temporary permit shall be issued to an applicant, and it shall 9 not be renewable. 10 Section 129. Section 478.47, Florida Statutes, is 11 amended to read: 12 478.47 Licensure by endorsement.--The department shall 13 issue a license by endorsement to any applicant who submits an 14 application and the required fees as set forth in s. 478.55 15 and who the board certifies has met the qualifications of s. 16 478.45(1) or who holds an active license or other authority to 17 practice electrology in a jurisdiction whose licensure 18 requirements are determined by the board to be equivalent to 19 the requirements for licensure in this state. 20 Section 130. Paragraph (d) of subsection (2) of 21 section 478.52, Florida Statutes, is amended, and paragraph 22 (u) is added to subsection (1) of said section, to read: 23 478.52 Disciplinary proceedings.-- 24 (1) The following acts are grounds for which the 25 disciplinary actions in subsection (2) may be taken: 26 (u) Operating any electrolysis facility unless it has 27 been duly licensed as provided in this chapter. 28 (2) When the board finds any person guilty of any of 29 the grounds set forth in subsection (1), including conduct 30 that would constitute a substantial violation of subsection 31 175 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) which occurred prior to licensure, it may enter an order 2 imposing one or more of the following penalties: 3 (d) Place the licensee on probation for a specified 4 time and subject the licensee to such conditions as the board 5 determines necessary, including, but not limited to, requiring 6 treatment, continuing education courses, reexamination, or 7 working under the supervision of another licensee. 8 Section 131. Subsections (1) and (2) of section 9 480.033, Florida Statutes, are amended to read: 10 480.033 Definitions.--As used in this act: 11 (1) "Board" means the Board of Massage Therapy. 12 (2) "Department" means the Department of Health 13 Business and Professional Regulation. 14 Section 132. Section 480.034, Florida Statutes, is 15 amended to read: 16 480.034 Exemptions.-- 17 (1) Nothing in this act shall modify or repeal any 18 provision of chapters 458-464, inclusive, or of chapter 476, 19 chapter 477, or chapter 486. 20 (2) Athletic trainers employed by or on behalf of a 21 professional athletic team performing or training within this 22 state shall be exempt from the provisions of this act. 23 (3) The state and its political subdivisions are 24 exempt from the registration requirements of this act. 25 (4) Treatments for the purpose of cleansing and 26 beautifying the skin or in conjunction with a weight loss 27 program, including herbal wraps, body scrubs, paraffin wax 28 treatments, and seaweed wraps, shall be exempt from the 29 provisions of this act. 30 31 176 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (4)(5) An exemption granted is effective to the extent 2 that an exempted person's practice or profession overlaps with 3 the practice of massage. 4 Section 133. Subsection (1) of section 480.035, 5 Florida Statutes, is amended to read: 6 480.035 Board of Massage Therapy.-- 7 (1) The Board of Massage Therapy is created within the 8 department. The board shall consist of seven members, who 9 shall be appointed by the Governor and whose function it shall 10 be to carry out the provisions of this act. 11 Section 134. Section 480.041, Florida Statutes, is 12 amended to read: 13 480.041 Massage therapists; qualifications; licensure; 14 endorsement; provisional licensure.-- 15 (1) Any person is qualified for licensure as a massage 16 therapist under this act who: 17 (a) Is at least 18 years of age or has received a high 18 school diploma or graduate equivalency diploma; 19 (b) Has completed a course of study at a 20 board-approved massage school or has completed an 21 apprenticeship program that meets standards adopted by the 22 board; and 23 (c) Has received a passing grade on an examination 24 administered by the department. 25 (2) Every person desiring to be examined for licensure 26 as a massage therapist shall apply to the department in 27 writing upon forms prepared and furnished by the department. 28 Such applicants shall be subject to the provisions of s. 29 480.046(1). Applicants may take an examination administered by 30 the department only upon meeting the requirements of this 31 section as determined by the board. 177 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (3) Upon an applicant's passing the examination and 2 paying the initial licensure fee, the department shall issue 3 to the applicant a license, valid until the next scheduled 4 renewal date, to practice massage. 5 (4)(a) The board may issue to an applicant, without 6 examination, a provisional license to practice massage, 7 provided such applicant meets all other conditions and 8 requirements relating to qualification for licensure and 9 submits a fee pursuant to s. 480.044. Such applicant for a 10 provisional license shall be associated with a licensed 11 massage therapist and shall practice only under the 12 supervision of such licensed massage therapist at a licensed 13 establishment. 14 (b) The provisional license, when granted, shall 15 include the name and address of the licensed massage therapist 16 with whom the applicant is associated. No licensed massage 17 therapist may supervise more than one provisional 18 licenseholder at the same time. 19 (c) The applicant must appear at the next examination 20 for licensure for which the applicant can be scheduled 21 according to the rules of the board and department. The 22 provisional license shall expire upon written notification by 23 the department that the applicant has failed the examination 24 or on the date of the scheduled examination, should the 25 applicant fail to appear. Acceptance of a provisional license 26 by an applicant shall be deemed to be consent for expiration 27 of that license in accordance with the provisions of this 28 chapter. 29 (d) No more than one provisional license may be issued 30 to an individual. No provisional license shall be issued to 31 an applicant who has previously failed the examination. 178 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (4)(5) The board shall adopt rules: 2 (a) Establishing a minimum training program for 3 apprentices. 4 (b) Specifying standards and procedures for issuance 5 of a provisional license. 6 (b)(c) Providing for educational standards, 7 examination, and certification for the practice of colonic 8 irrigation, as defined in s. 480.033(6), by massage 9 therapists. 10 (c)(d) Specifying licensing procedures for 11 practitioners desiring to be licensed in this state who hold 12 an active license and have practiced in any other state, 13 territory, or jurisdiction of the United States or any foreign 14 national jurisdiction which has licensing standards 15 substantially similar to, equivalent to, or more stringent 16 than the standards of this state. 17 Section 135. Section 480.0415, Florida Statutes, is 18 amended to read: 19 480.0415 License renewal.--The board shall prescribe 20 by rule the method for renewal of biennial licensure which 21 shall include continuing education requirements not to exceed 22 25 12 classroom hours per biennium. The board shall by rule 23 establish criteria for the approval of continuing education 24 programs or courses. The programs or courses approved by the 25 board may include correspondence courses that meet the 26 criteria for continuing education courses held in a classroom 27 setting. 28 Section 136. Subsection (1) of section 480.042, 29 Florida Statutes, is amended to read: 30 480.042 Examinations.-- 31 179 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (1) The board shall specify by rule the general areas 2 of competency to be covered by examinations for licensure. 3 These rules shall include the relative weight assigned in 4 grading each area, the grading criteria to be used by the 5 examiner, and the score necessary to achieve a passing grade. 6 The board shall ensure that examinations adequately measure 7 both an applicant's competency and his knowledge of related 8 statutory requirements. Professional testing services may be 9 utilized to formulate the examinations. 10 Section 137. Section 480.0425, Florida Statutes, as 11 amended by chapter 94-119, Laws of Florida, is repealed. 12 Section 138. Subsection (7) of section 480.043, 13 Florida Statutes, is amended to read: 14 480.043 Massage establishments; requisites; licensure; 15 inspection.-- 16 (7)(a) Once issued, no license for operation of a 17 massage establishment may be transferred from one owner 18 person, corporation, name, or location to another. 19 (b) A license may be transferred from one location to 20 another only after inspection and approval by the board and 21 receipt of an application and inspection fee set by rule of 22 the board, not to exceed $125. 23 (c) A license may be transferred from one business 24 name to another after approval by the board and receipt of an 25 application fee set by rule of the board, not to exceed $25. 26 Section 139. Subsection (1) of section 480.044, 27 Florida Statutes, is amended to read: 28 480.044 Fees; disposition.-- 29 (1) The board shall set fees according to the 30 following schedule: 31 180 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (a) Massage therapist application and examination fee: 2 not to exceed $250. 3 (b) Massage therapist initial licensure fee: not to 4 exceed $150. 5 (c) Establishment application fee: not to exceed 6 $200. 7 (d) Establishment licensure fee: not to exceed $150. 8 (e) Biennial establishment renewal fee: not to exceed 9 $150. 10 (f) Biennial massage therapist licensure renewal fee: 11 not to exceed $200. 12 (g) Massage therapist reexamination fee: not to 13 exceed $250. 14 (h) Fee for apprentice: not to exceed $100. 15 (i) Colonics examination fee: not to exceed $100. 16 (j) Colonics reexamination fee: not to exceed $100. 17 (k) Application and provisional licensure fee: not to 18 exceed $50. 19 (k)(l) Application and reactivation for inactive 20 status of a massage therapist license fee: not to exceed 21 $250. 22 (l)(m) Renewal fee for inactive status: not to exceed 23 $250. 24 Section 140. Paragraph (a) of subsection (1) of 25 section 480.047, Florida Statutes, is amended to read: 26 480.047 Penalties.-- 27 (1) It is unlawful for any person to: 28 (a) Hold himself or herself out as a massage therapist 29 or to practice massage unless duly licensed under this chapter 30 or unless otherwise specifically exempted from licensure under 31 this chapter as provided herein. 181 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 141. Section 480.0485, Florida Statutes, is 2 created to read: 3 480.0485 Sexual misconduct in the practice of massage 4 therapy.--The massage therapist-patient relationship is 5 founded on mutual trust. Sexual misconduct in the practice of 6 massage therapy means violation of the massage 7 therapist-patient relationship through which the massage 8 therapist uses that relationship to induce or attempt to 9 induce the patient to engage, or to engage or attempt to 10 engage the patient, in sexual activity outside the scope of 11 practice or the scope of generally accepted examination or 12 treatment of the patient. Sexual misconduct in the practice 13 of massage therapy is prohibited. 14 Section 142. Paragraph (f) of subsection (3) of 15 section 20.43, Florida Statutes, 1996 Supplement, is amended 16 to read: 17 20.43 Department of Health.--There is created a 18 Department of Health. 19 (3) The following divisions of the Department of 20 Health are established: 21 (f) Effective July 1, 1997, Division of Medical 22 Quality Assurance, which is responsible for the following 23 boards and professions established within the division: 24 1. Nursing assistants, as provided under s. 400.211. 25 2. Health care services pools, as provided under s. 26 402.48. 27 3. The Board of Acupuncture, created under chapter 28 457. 29 4. The Board of Medicine, created under chapter 458. 30 5. The Board of Osteopathic Medicine, created under 31 chapter 459. 182 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 6. The Board of Chiropractic, created under chapter 2 460. 3 7. The Board of Podiatric Medicine, created under 4 chapter 461. 5 8. Naturopathy, as provided under chapter 462. 6 9. The Board of Optometry, created under chapter 463. 7 10. The Board of Nursing, created under chapter 464. 8 11. The Board of Pharmacy, created under chapter 465. 9 12. The Board of Dentistry, created under chapter 466. 10 13. Midwifery, as provided under chapter 467. 11 14. The Board of Speech-Language Pathology and 12 Audiology, created under part I of chapter 468. 13 15. The Board of Nursing Home Administrators, created 14 under part II of chapter 468. 15 16. Occupational therapy, as provided under part III 16 of chapter 468. 17 17. Respiratory therapy, as provided under part V of 18 chapter 468. 19 18. Dietetics and nutrition practice, as provided 20 under part X of chapter 468. 21 19. Athletic trainers, as provided under part XIV of 22 chapter 468. 23 20. Electrolysis, as provided under chapter 478. 24 21. The Board of Massage Therapy, created under 25 chapter 480. 26 22. The Board of Clinical Laboratory Personnel, 27 created under part III IV of chapter 483. 28 23. Medical physicists, as provided under part IV V of 29 chapter 483. 30 24. The Board of Opticianry, created under part I of 31 chapter 484. 183 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 25. The Board of Hearing Aid Specialists, created 2 under part II of chapter 484. 3 26. The Board of Physical Therapy Practice, created 4 under chapter 486. 5 27. The Board of Psychology, created under chapter 6 490. 7 28. The Board of Clinical Social Work, Marriage and 8 Family Therapy, and Mental Health Counseling, created under 9 chapter 491. 10 11 The department shall contract with the Agency for Health Care 12 Administration who shall provide consumer complaint, 13 investigative, and prosecutorial services required by the 14 Division of Medical Quality Assurance, councils, or boards, as 15 appropriate. 16 Section 143. Paragraph (b) of subsection (2) of 17 section 381.81, Florida Statutes, is amended to read: 18 381.81 Minority Health Improvement Act.-- 19 (2) DEFINITIONS.--As used in this section, the 20 following words and terms shall have the following meanings, 21 unless the context indicates another meaning or intent: 22 (b) "Health profession" means any regulated health 23 profession, including occupational therapy, as regulated under 24 part III of chapter 468; respiratory therapy, as regulated 25 under part V of chapter 468; physical therapy, as regulated 26 under chapter 486; midwifery, as regulated under chapter 467; 27 dietetics and nutrition practice, as regulated under part X of 28 chapter 468; electrolysis, as regulated under chapter 478; 29 nursing assistants, as regulated under s. 400.211; and those 30 professions regulated by: the Board of Medicine, created 31 under chapter 458; the Board of Osteopathic Medicine, created 184 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 under chapter 459; the Board of Acupuncture, created under 2 chapter 457; the Board of Chiropractic, created under chapter 3 460; the Board of Clinical Social Work, Marriage and Family 4 Therapy, and Mental Health Counseling, created under chapter 5 491; the Board of Dentistry, created under chapter 466; the 6 Board of Optometry, created under chapter 463; the Board of 7 Podiatric Medicine, created under chapter 461; the Board of 8 Nursing, created by chapter 464; the Board of Psychological 9 Examiners, created under chapter 490; the Board of 10 Speech-Language Pathology and Audiology, created under part I 11 of chapter 468; the Board of Nursing Home Administrators, 12 created under part II of chapter 468; the Board of Clinical 13 Laboratory Personnel, created under part III IV of chapter 14 483; and the Board of Opticianry, created under part I of 15 chapter 484; and the Board of Hearing Aid Specialists, created 16 under part II of chapter 484. 17 Section 144. Section 483.800, Florida Statutes, is 18 amended to read: 19 483.800 Declaration of policy and statement of 20 purpose.--The purpose of this part is to protect the public 21 health, safety, and welfare of the people of this state from 22 the hazards of improper performance by clinical laboratory 23 personnel. Clinical laboratories provide essential services 24 to practitioners of the healing arts by furnishing vital 25 information that is essential to a determination of the 26 nature, cause, and extent of the condition involved. 27 Unreliable and inaccurate reports may cause unnecessary 28 anxiety, suffering, and financial burdens and may even 29 contribute directly to death. The protection of public and 30 individual health requires the licensure of clinical 31 laboratory personnel who meet minimum requirements for safe 185 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 practice. The Legislature finds that laboratory testing 2 technology continues to advance rapidly. The Legislature also 3 finds that a hospital training program under the direction of 4 the hospital clinical laboratory director offers an 5 opportunity for individuals already trained in health care 6 professions to expand the scope of their careers. The 7 Legislature further finds that there is an immediate need for 8 properly trained personnel to ensure patient access to 9 testing. Therefore, the Legislature recognizes the 10 patient-focused benefits of hospital-based training for 11 laboratory and nonlaboratory personnel for testing within 12 hospitals and commercial laboratories the laboratory and at 13 alternate sites, and recognizes the benefits of a training 14 program approved by the Board of Clinical Laboratory Personnel 15 under the direction of the hospital clinical laboratory 16 director. 17 Section 145. Subsection (3) is added to section 18 483.801, Florida Statutes, to read: 19 483.801 Exemptions.--This part applies to all clinical 20 laboratories and clinical laboratory personnel within this 21 state, except: 22 (3) Advanced registered nurse practitioners licensed 23 under chapter 464 who perform provider-performed microscopy 24 procedures (PPMP) in an exclusive-use laboratory setting. 25 Section 146. Section 483.803, Florida Statutes, is 26 amended to read: 27 483.803 Definitions.--As used in this part, the term: 28 (1) "Board" means the Board of Clinical Laboratory 29 Personnel. 30 (2) "Clinical laboratory" means a clinical laboratory 31 as defined in s. 483.041(2). 186 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (3) "Clinical laboratory examination" means an 2 examination performed on materials or specimens of the human 3 body to provide information or materials for use in the 4 diagnosis, prevention, or treatment of a disease or the 5 identification or assessment of a medical or physical 6 condition. 7 (4)(3) "Clinical laboratory personnel" includes a 8 clinical laboratory director, supervisor, technologist, blood 9 gas analyst, or technician who performs or is responsible for 10 laboratory test procedures, but the term does not include 11 trainees, persons who perform screening for blood banks or 12 plasmapheresis centers, phlebotomists, or persons employed by 13 a clinical laboratory to perform manual pretesting duties or 14 clerical, personnel, or other administrative responsibilities. 15 (5)(4) "Clinical laboratory trainee" means any person 16 having qualifying education who is enrolled in a clinical 17 laboratory training program approved pursuant to s. 483.811 18 and who is seeking experience required to meet minimum 19 qualifications for licensing in this state. Trainees may 20 perform procedures under direct and responsible supervision of 21 duly licensed clinical laboratory personnel, but they may not 22 report test results. 23 (6)(5) "Department" means the Department of Health 24 Business and Professional Regulation. 25 (7)(6) "Licensed practitioner of the healing arts" 26 means a physician licensed pursuant to chapter 458, chapter 27 459, or chapter 460; a dentist licensed pursuant to chapter 28 466; or a person licensed pursuant to chapter 461 or chapter 29 462. 30 (8) "Public health laboratory scientist" means any 31 licensed director, supervisor, technologist, or technician 187 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 engaged in laboratory testing of human specimens in a state, 2 county, or municipal public health laboratory. 3 Section 147. Subsections (1) and (2) of section 4 483.809, Florida Statutes, are amended to read: 5 483.809 Licensure; examinations; registration of 6 trainees; approval of curricula.-- 7 (1) LICENSING; QUALIFICATIONS.-- 8 (a) The department shall provide biennial licensure of 9 all clinical laboratory personnel who the board certifies have 10 met meeting the requirements of this part and shall prescribe 11 the qualifications necessary for such licensure. The license 12 of any person who fails to pay a required fee or otherwise 13 fails to qualify within 60 days after the date of expiration 14 of such license shall be automatically canceled without notice 15 or further proceedings unless the individual has made 16 application for inactive status pursuant to s. 483.819. 17 (b) Personnel qualifications may require appropriate 18 education, training, or experience or the passing of an 19 examination in appropriate subjects or any combination of 20 these, but no practitioner of the healing arts licensed to 21 practice in this state is required to obtain any license under 22 this part or to pay any fee hereunder except the fee required 23 for clinical laboratory licensure. 24 (2) EXAMINATIONS.--The department shall conduct 25 examinations required by board rules to determine in part the 26 qualification of clinical laboratory personnel for licensure. 27 An approved national certification examination may be accepted 28 in lieu of state examination for public health scientists. 29 Section 148. Section 483.812, Florida Statutes, is 30 created to read: 31 188 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 483.812 Public health laboratory scientists; 2 licensure.-- 3 (1) Applicants at the director and supervisor level in 4 the category of public health who are registered by the 5 National Registry of Clinical Chemistry Certification or the 6 American Society of Microbiology may qualify under board rules 7 by passing the appropriate supervision and administration 8 examination. 9 (2)(a) A technologist applicant for licensure in the 10 category of public health microbiology, with a baccalaureate 11 degree in one of the biological sciences from an accredited 12 institution, may use the American Society of Microbiology or 13 the National Registry of Microbiology Certification in Public 14 Health Microbiology to qualify for a technologist license in 15 public health microbiology. Such a technologist may work in a 16 public health microbiology laboratory. 17 (b) A technologist applicant for licensure in the 18 category of public health chemistry, with a baccalaureate 19 degree in one of the chemical, biological, or physical 20 sciences from an accredited institution, may use the National 21 Registry of Clinical Chemistry Certification to qualify for a 22 technologist license in public health chemistry. Such a 23 technologist may work in a public health chemistry laboratory. 24 (c) A technician applicant for licensure in the 25 category of public health, with a baccalaureate degree in one 26 of the chemical or biological sciences from an accredited 27 institution, may obtain a one-time, 3-year, conditional public 28 health technician license pending national certification by 29 the American Society of Microbiology or the National Registry 30 of Clinical Chemistry Certification. Such a technician may 31 189 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 perform testing only under the direct supervision of a 2 licensed pathologist, director, supervisor, or technologist. 3 (3) A person licensed by the Board of Clinical 4 Laboratory Personnel may work in a public health laboratory at 5 the appropriate level and specialty. 6 Section 149. Section 483.813, Florida Statutes, is 7 amended to read: 8 483.813 Clinical laboratory personnel license.--A 9 person may not conduct a clinical laboratory examination or 10 report the results of such examination unless such person is 11 licensed under this part to perform such procedures. However, 12 this provision does not apply to any practitioner of the 13 healing arts authorized to practice in this state. The 14 department may grant a temporary license to any candidate it 15 deems properly qualified, for a period not to exceed 1 year, 16 or a conditional license for a period not to exceed 3 years 6 17 months. 18 Section 150. Section 483.823, Florida Statutes, is 19 amended to read: 20 483.823 Qualifications of clinical laboratory 21 personnel.-- 22 (1) The board shall prescribe minimal qualifications 23 for clinical laboratory personnel and shall issue a license to 24 any person who meets the minimum qualifications and who 25 demonstrates that he possesses the character, training, and 26 ability to qualify in those areas for which the license is 27 sought. 28 (2) Personnel qualifications may require appropriate 29 education, training, or experience or the passing of an 30 examination in appropriate subjects or any combination of 31 these, but no practitioner of the healing arts licensed to 190 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 practice in this state is required to obtain any license under 2 this part or to pay any fee hereunder except the fee required 3 for clinical laboratory licensure. 4 Section 151. Section 483.825, Florida Statutes, is 5 amended to read: 6 483.825 Grounds for disciplinary action against 7 clinical laboratory personnel.--The following acts constitute 8 grounds for which disciplinary actions specified in s. 483.827 9 may be taken against applicants, registrants, and licensees 10 under this part clinical laboratory personnel: 11 (1) Attempting to obtain, obtaining, or renewing a 12 license or registration under this part by bribery, by 13 fraudulent misrepresentation, or through an error of the 14 department or the board Making a fraudulent statement on an 15 application for a license or any other document required by 16 the department. 17 (2) Engaging in or attempting to engage in, or 18 representing himself as entitled to perform, any clinical 19 laboratory procedure or category of procedures not authorized 20 pursuant to his license. 21 (3) Demonstrating incompetence or making consistent 22 errors in the performance of clinical laboratory examinations 23 or procedures or erroneous reporting. 24 (4) Performing a test and rendering a report thereon 25 to a person not authorized by law to receive such services. 26 (5) Having been convicted of a felony or of any crime 27 involving moral turpitude under the laws of any state or of 28 the United States. The record of conviction or a certified 29 copy thereof shall be conclusive evidence of such conviction. 30 (6) Having been adjudged mentally or physically 31 incompetent. 191 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (7) Violating or aiding and abetting in the violation 2 of any provision of this part or the rules adopted hereunder. 3 (8) Reporting a test result when no laboratory test 4 was performed on a clinical specimen. 5 (9) Knowingly advertising false services or 6 credentials. 7 (10) Having a license revoked, suspended, or otherwise 8 acted against, including the denial of licensure, by the 9 licensing authority of another jurisdiction. The licensing 10 authority's acceptance of a relinquishment of a license, 11 stipulation, consent order, or other settlement, offered in 12 response to or in anticipation of the filing of administrative 13 charges against the licensee, shall be construed as action 14 against the licensee. 15 (11) Failing to report to the board, in writing, 16 within 30 days if action under subsection (10) has been taken 17 against one's license to practice as clinical laboratory 18 personnel in another state, territory, or country. 19 (12) Being unable to perform or report clinical 20 laboratory examinations with reasonable skill and safety to 21 patients by reason of illness or use of alcohol, drugs, 22 narcotics, chemicals, or any other type of material or as a 23 result of any mental or physical condition. In enforcing this 24 paragraph, the department shall have, upon a finding of the 25 secretary or his or her designee that probable cause exists to 26 believe that the licensee is unable to practice because of the 27 reasons stated in this paragraph, the authority to issue an 28 order to compel a licensee to submit to a mental or physical 29 examination by physicians designated by the department. If 30 the licensee refuses to comply with such order, the 31 department's order directing such examination may be enforced 192 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 by filing a petition for enforcement in the circuit court 2 where the licensee resides or does business. The licensee 3 against whom the petition is filed may not be named or 4 identified by initials in any public court records or 5 documents, and the proceedings shall be closed to the public. 6 The department shall be entitled to the summary procedure 7 provided in s. 51.011. A licensee affected under this 8 paragraph shall at reasonable intervals be afforded an 9 opportunity to demonstrate that he or she can resume competent 10 practice with reasonable skill and safety to patients. 11 (13) Delegating professional responsibilities to a 12 person when the licensee delegating such responsibilities 13 knows, or has reason to know, that such person is not 14 qualified by training, experience, or licensure to perform 15 them. 16 Section 152. Section 483.828, Florida Statutes, is 17 created to read: 18 483.828 Penalty for violations.-- 19 (1) Each of the following acts constitutes a felony of 20 the third degree, punishable as provided in s. 775.082, s. 21 775.083, or s. 775.084: 22 (a) Practicing as clinical laboratory personnel 23 without an active license. 24 (b) Using or attempting to use a license to practice 25 as clinical laboratory personnel which is suspended or 26 revoked. 27 (c) Attempting to obtain or obtaining a license to 28 practice as clinical laboratory personnel by knowing 29 misrepresentation. 30 31 193 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) Each of the following act constitutes a 2 misdemeanor of the first degree, punishable as provided in s. 3 775.082 or s. 775.083: 4 (a) Knowingly concealing information relating to 5 violations of this part. 6 (b) Making any willfully false oath or affirmation 7 whenever an oath or affirmation is required by this part. 8 (c) Leading the public to believe that one is licensed 9 as clinical laboratory personnel, or is engaged in licensed 10 practice as clinical laboratory personnel, without holding a 11 valid, active license. 12 Section 153. Section 483.901, Florida Statutes, is 13 amended to read: 14 483.901 Medical physicists; definitions; licensure.-- 15 (1) SHORT TITLE.--This section may be cited as the 16 "Florida Medical Physicists Act." 17 (2) DECLARATION OF LEGISLATIVE POLICY.--The 18 Legislature finds that the practice of medical physics by 19 incompetent persons is a threat to the public health and 20 safety. It is, therefore, the responsibility of this state to 21 protect the public health and safety from the harmful effects 22 of excessive and unnecessary radiation by ensuring that the 23 practice of medical physics is entrusted only to persons who 24 are licensed under this section. 25 (3) DEFINITIONS.--As used in this section, the term: 26 (a) "Agency" means the Agency for Health Care 27 Administration or its successor. 28 (a)(b) "Council" means the Advisory Council of Medical 29 Physicists in the Department of Health Agency for Health Care 30 Administration. 31 (b) "Department" means the Department of Health. 194 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (c) "Diagnostic radiological physics" means the 2 specialty of medical physics which deals with the diagnostic 3 application and safe use of X rays, gamma rays from sealed 4 sources, ultrasonic radiation, radio frequency radiation, or 5 magnetic fields, and the use of equipment associated with the 6 production, use, measurement, and evaluation of the radiation 7 and the quality of the diagnostic image resulting from its 8 production and use. 9 (d) "License" means a certificate issued by the 10 department agency which authorizes the holder to practice 11 medical physics. 12 (e) "Licensed medical physicist" means a person who 13 holds a license issued under this section. 14 (f) "Medical health physics" means the specialty of 15 medical physics which deals with the safe use of X rays, gamma 16 rays, electron or other charged particle beams, neutrons, 17 radionuclides, and radiation from sealed sources, for both 18 diagnostic and therapeutic purposes in human beings and the 19 use of equipment required to perform appropriate tests and 20 measurements that do not involve the direct application of 21 radiation to humans for diagnostic or therapeutic procedures. 22 (g) "Medical nuclear radiological physics" means the 23 specialty of medical physics which deals with the therapeutic 24 and diagnostic application and safe use of radionuclides, 25 except those used in sealed sources for therapeutic purposes, 26 and the use of equipment associated with the production, use, 27 measurement, and evaluation of radionuclides. 28 (h) "Medical physics" means the branch of physics 29 which is associated with the practice of medicine. It 30 includes the fields of diagnostic radiological physics, 31 195 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 therapeutic radiological physics, medical nuclear radiological 2 physics, and medical health physics. 3 (i) "Physician" means a doctor of medicine, 4 osteopathic medicine osteopathy, podiatry, dentistry, or 5 chiropractic who is licensed in this state and who prescribes 6 a radiological procedure. 7 (j) "Practice of medical physics" means the use of 8 principles and accepted protocols of physics to ensure assure 9 the correct quality, quantity, and placement of radiation 10 during the performance of a radiological procedure prescribed 11 by a physician which will protect the patient and others from 12 harmful excessive radiation. The term includes radiation beam 13 calibration and characterization quality assurance, instrument 14 specification, acceptance testing, shielding design, 15 protection analysis on radiation-emitting equipment and 16 radiopharmaceuticals, and consultation with a physician to 17 ensure assure accurate radiation dosage to a specific patient. 18 (k) "Radiation" means ionizing or nonionizing 19 radiation above background levels which is used to perform a 20 diagnostic or therapeutic medical or dental radiological 21 procedure. 22 (l) "Radiological procedure" means a test, 23 measurement, calculation, or radiation exposure used in the 24 diagnosis or treatment of diseases or other medical or dental 25 conditions in human beings that includes therapeutic 26 radiation, diagnostic radiation, nuclear magnetic resonance, 27 or nuclear medicine procedures. 28 (m) "Therapeutic radiological physics" means that 29 specialty of medical physics which deals with the therapeutic 30 application and safe use of X rays, gamma rays, electron or 31 other charged particle beams, neutrons, or radiation from 196 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 radionuclide sources, and the use of equipment associated with 2 the production, use, measurement, and evaluation of that 3 radiation. 4 (4) COUNCIL.--The Advisory Council of Medical 5 Physicists is created in the Department of Health Agency for 6 Health Care Administration to advise the department in 7 regulating regulate the practice of medical physics in this 8 state. 9 (a) The council shall be composed of nine seven 10 members appointed by the secretary of the department director 11 as follows: 12 1. A licensed medical physicist who specializes in 13 diagnostic radiological physics. 14 2. A licensed medical physicist who specializes in 15 therapeutic radiological physics. 16 3. A licensed medical physicist who specializes in 17 medical nuclear radiological physics. 18 4. A physician who is board certified by the American 19 Board of Radiology or its equivalent. 20 5. A physician who is board certified by the American 21 Osteopathic Board of Radiology or its equivalent. 22 6. A physician who is board certified by the American 23 Chiropractic Radiology Board of Chiropractic Radiology or its 24 equivalent. 25 7. Three A consumer members member who are is not, and 26 have has never been, licensed as a medical physicist or 27 licensed in any closely related profession. 28 (b) The secretary of the department director shall 29 appoint the medical physicist members of the council from a 30 list of candidates who are licensed to practice medical 31 physics. 197 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (c) The secretary of the department director shall 2 appoint the physician members member of the council from a 3 list of candidates who are licensed to practice medicine in 4 this state and are board certified in diagnostic radiology, 5 therapeutic radiology, or radiation oncology. 6 (d) The secretary of the department director shall 7 appoint the public members member of the council. 8 (e) As the term of each member expires, the secretary 9 of the department director shall appoint the successor for a 10 term of 4 3 years. A member shall serve until the member's 11 his successor is appointed, unless physically unable to do so. 12 (f) An individual is ineligible to serve more than two 13 full consecutive 4-year 3-year terms. 14 (g) If a vacancy on the council occurs, the director 15 shall appoint a member to serve for a 4-year 3-year term. 16 (h) A council member must be a United States citizen 17 and must have been a resident of this state for 2 consecutive 18 years immediately before being appointed. 19 1. A member of the council who is a medical physicist 20 must have practiced for at least 6 years before being 21 appointed or be board certified for the specialty in which the 22 member practices. 23 2. A member of the council who is a physician must be 24 licensed to practice medicine in this state and must have 25 practiced diagnostic radiology or radiation oncology in this 26 state for at least 2 years before being appointed. 27 3. The public members member of the council must not 28 have a financial interest in any endeavor related to the 29 practice of medical physics. 30 (i) Notwithstanding any other provision of this 31 subsection, no later than January 1, 1996, the secretary of 198 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 the department director shall make the initial appointments to 2 the council as follows: 3 1. One member who is engaged in the practice of 4 medical physics, one physician member, and one public member, 5 each of whom is to be appointed to serve until June 30, 1996; 6 2. One member who is engaged in the practice of 7 medical physics and one physician member, each of whom is to 8 be appointed to serve until June 30, 1997; and 9 3. One member who is engaged in the practice of 10 medical physics and one physician member, each of whom is to 11 be appointed to serve until June 30, 1998. 12 (j) A council member may be removed from the council 13 if the member: 14 1. Did not have the required qualifications at the 15 time of appointment; 16 2. Does not maintain the required qualifications while 17 serving on the council; or 18 3. Fails to attend the regularly scheduled council 19 meetings in a calendar year as required by s. 455.207. 20 (k) Members of the council may not receive 21 compensation for their services; however, they are entitled to 22 reimbursement, from funds deposited in the Medical Quality 23 Assurance Health Care Trust Fund, for necessary travel 24 expenses as specified in s. 112.061 for each day they engage 25 in the business of the council. 26 (l) At the first regularly scheduled meeting of each 27 calendar year, the council shall elect a presiding officer and 28 an assistant presiding officer from among its members. The 29 council shall meet at least once each year and at other times 30 in accordance with department requirements agency rules. 31 199 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (m) The department agency shall provide administrative 2 support to the council for all licensing activities. 3 (n) The council may conduct its meetings 4 electronically. 5 (5) POWERS OF COUNCIL.--The council shall: 6 (a) Recommend rules to administer this section. 7 (b) Recommend practice standards for the practice of 8 medical physics which are consistent with the Guidelines for 9 Ethical Practice for Medical Physicists prepared by the 10 American Association of Physicists in Medicine and 11 disciplinary guidelines adopted under s. 455.2273. 12 (c) Develop and recommend continuing education 13 requirements for licensed medical physicists. 14 (6) LICENSE REQUIRED.--An individual may not engage in 15 the practice of medical physics, including the specialties of 16 diagnostic radiological physics, therapeutic radiological 17 physics, medical nuclear radiological physics, or medical 18 health physics, without a license issued by the department 19 agency for the appropriate specialty. 20 (a) The department agency shall adopt rules to 21 administer this section which specify license application and 22 renewal fees, continuing education requirements, and standards 23 for practicing medical physics. The council shall recommend 24 to the department agency continuing education requirements 25 that shall be a condition of license renewal. The department 26 agency shall require a minimum of 24 hours per biennium of 27 continuing education offered by an organization recommended by 28 the council and approved by the department. The department, 29 upon recommendation of the council, may adopt rules to specify 30 continuing education requirements for persons who hold a 31 license in more than one specialty. 200 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) In order to apply for a medical physicist license 2 in one or more specialties, a person must file an individual 3 application for each specialty with the department agency. 4 The application must be on a form prescribed by the department 5 agency and must be accompanied by a nonrefundable application 6 fee for each specialty. 7 (c) The department may issue a license to an eligible 8 applicant if the applicant meets all license requirements. At 9 any time before the department agency issues or renews a 10 license, the applicant may request in writing that the 11 application be withdrawn. To reapply, the applicant must 12 submit a new application and an additional nonrefundable 13 application fee and must meet all current licensure 14 requirements. 15 (d) The department agency shall review each completed 16 application for a license which the department agency 17 receives. 18 (e) The agency may issue a license to an eligible 19 applicant if the applicant meets all license requirements. 20 1. Licenses must be uniform and must include: 21 a. The name of the licensee; 22 b. The medical physics specialty that the licensee may 23 practice; and 24 c. The expiration date of the license. 25 2. A license certificate is the property of the agency 26 and must be surrendered on demand. 27 3. The agency shall adopt rules establishing a 28 procedure for the biennial renewal of licenses. 29 4. A person may renew an unexpired license by meeting 30 the renewal requirements, paying the nonrefundable renewal fee 31 201 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 before the expiration of the license, and meeting continuing 2 education requirements. 3 5. The cost to renew a license within 90 days after 4 the license has expired is the normal renewal fee plus a 5 penalty in the amount of half the renewal fee. 6 6. The cost to renew a license that has been expired 7 for more than 90 days but less than 2 years is the normal 8 renewal fee plus a penalty in the amount of the renewal fee. 9 7. A license may not be renewed after it has been 10 expired for more than 2 years. To be relicensed, a person 11 must comply with all current application requirements to 12 practice medical physics and must submit a new application and 13 nonrefundable application fee to the agency. 14 (e)(f) On receipt of an application and fee as 15 specified in this section, the department agency may issue a 16 license to practice medical physics in this state: 17 1. Until October 1, 1997, to a person who meets any of 18 the following requirements: 19 a. Earned from an accredited college or university a 20 doctoral degree in physics, medical physics, biophysics, 21 radiological physics, medical health physics, or nuclear 22 engineering and has at least 2 years' experience in the 23 practice of the medical physics specialty for which 24 application is made. 25 b. Earned from an accredited college or university a 26 master's degree in physics, medical physics, biophysics, 27 radiological physics, medical health physics, or nuclear 28 engineering and has at least 3 years' experience in the 29 practice of the medical physics specialty for which 30 application is made. 31 202 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 c. Earned from an accredited college or university a 2 bachelor's degree in physics and has at least 5 years' 3 experience in the practice of the medical physics specialty 4 for which application is made. 5 d. Has at least 8 years' experience in the practice of 6 the medical physics specialty for which application is made, 2 7 years of which must have been earned within the 4 years 8 immediately preceding application for licensure. 9 e. Is board certified in the medical physics specialty 10 in which the applicant applies to practice by the American 11 Board of Radiology for diagnostic radiological physics, 12 therapeutic radiological physics, or medical nuclear 13 radiological physics; by the American Board of Medical Physics 14 or the Canadian Board of Medical Physics for diagnostic 15 radiological physics, therapeutic radiological physics, or 16 medical nuclear radiological physics; or by the American Board 17 of Health Physics or an equivalent certifying body approved by 18 the agency. 19 1. Until October 1, 1997, to a person who has earned 20 from an accredited college or university a master's degree or 21 doctoral degree in physics, medical physics, biophysics, 22 radiological physics, medical health physics, or nuclear 23 engineering, and has at least 2 years of experience in the 24 practice of the medical physics specialty for which 25 application is made during the 4 years immediately before the 26 application is made. 27 2. On or after October 1, 1997, to a person who: 28 a. Holds a license to practice medical physics in this 29 state; or 30 b. is board certified in the medical physics specialty 31 in which the applicant applies to practice by the American 203 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Board of Radiology for diagnostic radiological physics, 2 therapeutic radiological physics, or medical nuclear 3 radiological physics; by the American Board of Medical Physics 4 for diagnostic radiological physics, therapeutic radiological 5 physics, or medical nuclear radiological physics; or by the 6 American Board of Health Physics or an equivalent certifying 7 body approved by the department agency. 8 (f)(g) A licensee shall: 9 1. Display the license in a place accessible to the 10 public; and 11 2. Report immediately any change in the licensee's 12 address or name to the department agency. 13 (g) The following acts are grounds for which the 14 disciplinary actions in paragraph (h) may be taken: 15 1. Obtaining or attempting to obtain a license by 16 bribery, fraud, knowing misrepresentation, or concealment of 17 material fact or through an error of the department. 18 2. Having a license denied, revoked, suspended, or 19 otherwise acted against in another jurisdiction. 20 3. Being convicted or found guilty of, or entering a 21 plea of nolo contendere to, regardless of adjudication, a 22 crime in any jurisdiction which relates to the practice of, or 23 the ability to practice, the profession of medical physics. 24 4. Willfully failing to file a report or record 25 required for medical physics or willfully impeding or 26 obstructing the filing of a report or record required by this 27 section or inducing another person to do so. 28 5. Making misleading, deceptive, or fraudulent 29 representations in or related to the practice of medical 30 physics. 31 204 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 6. Willfully failing to report any known violation of 2 this section or any rule adopted thereunder. 3 7. Willfully or repeatedly violating a rule adopted 4 under this section or an order of the department. 5 8. Failing to perform any statutory or legal 6 obligation placed upon a licensee. 7 9. Aiding, assisting, procuring, employing, or 8 advising any unlicensed person to practice medical physics 9 contrary to this section or any rule adopted thereunder. 10 10. Delegating or contracting for the performance of 11 professional responsibilities by a person when the licensee 12 delegating or contracting such responsibilities knows, or has 13 reason to know, such person is not qualified by training, 14 experience, and authorization to perform them. 15 11. Practicing or offering to practice beyond the 16 scope permitted by law or accepting and performing 17 professional responsibilities the licensee knows, or has 18 reason to know, the licensee is not competent to perform. 19 12. Gross or repeated malpractice or the inability to 20 practice medical physics with reasonable skill and safety. 21 13. Judicially determined mental incompetency. 22 14. Being unable to practice medical physics with 23 reasonable skill and safety because of a mental or physical 24 condition or illness or the use of alcohol, controlled 25 substances, or any other substance which impairs one's ability 26 to practice. 27 a. The department may, upon probable cause, compel a 28 licensee to submit to a mental or physical examination by 29 physicians designated by the department. The cost of an 30 examination shall be borne by the licensee, and the licensee's 31 failure to submit to such an examination constitutes an 205 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 admission of the allegations against the licensee, consequent 2 upon which a default and a final order may be entered without 3 the taking of testimony or presentation of evidence, unless 4 the failure was due to circumstances beyond the licensee's 5 control. 6 b. A licensee who is disciplined under this 7 subparagraph shall, at reasonable intervals, be afforded an 8 opportunity to demonstrate that the licensee can resume the 9 practice of medical physics with reasonable skill and safety. 10 c. With respect to any proceeding under this 11 subparagraph, the record of proceedings or the orders entered 12 by the department may not be used against a licensee in any 13 other proceeding. 14 (h) When the department finds any person guilty of any 15 of the grounds set forth in paragraph (g), including conduct 16 that would constitute a substantial violation of paragraph (g) 17 which occurred prior to licensure, it may enter an order 18 imposing one or more of the following penalties: 19 1. Deny the application for licensure. 20 2. Revoke or suspend the license. 21 3. Impose an administrative fine for each count or 22 separate offense. 23 4. Place the licensee on probation for a specified 24 time and subject the licensee to such conditions as the 25 department determines necessary, including requiring 26 treatment, continuing education courses, or working under the 27 monitoring or supervision of another licensee. 28 5. Restrict a licensee's practice. 29 6. Issue a reprimand to the licensee. 30 (i) The department may not issue or reinstate a 31 license to a person it has deemed unqualified until it is 206 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 satisfied that such person has complied with the terms and 2 conditions of the final order and that the licensee can safely 3 practice medical physics. 4 (h) The agency may refuse to issue or renew a license, 5 suspend or revoke a license, or reprimand the licensee for the 6 following: 7 1. Obtaining or renewing a license by means of fraud, 8 misrepresentation, or concealment of material fact; 9 2. Having made an application for or held a license 10 issued by the licensing authority of another state, territory, 11 or jurisdiction which was denied, suspended, or revoked by 12 that licensing authority without so informing the agency; 13 3. Engaging in unprofessional conduct related to the 14 practice of medical physics that has endangered or is likely 15 to endanger the health, safety, or welfare of the public; 16 4. Violating this section, a rule of the agency, or 17 the practice standards for medical physics; or 18 5. Being convicted of a felony or of a misdemeanor 19 that directly relates to a person's duties and 20 responsibilities as a licensed medical physicist. 21 (j)(i) The department agency may issue a temporary 22 license to an applicant pending completion of the application 23 process. 24 (7) FEES.--The fee for the initial license application 25 shall be $500 and is nonrefundable. The fee for license 26 renewal may not be more than $500. These fees may cover only 27 the costs incurred by the department agency and the council to 28 administer this section. By July 1 each year, the department 29 agency shall advise the council if the fees are insufficient 30 to administer this section. 31 207 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (8) DISPOSITION OF FEES.--The department agency shall 2 deposit all funds received into the Health Care Trust Fund. 3 (9) PENALTY FOR VIOLATIONS.--It is a felony of the 4 third degree, punishable as provided in s. 775.082, s. 5 775.083, or s. 775.084, to: 6 (a) Practice or attempt to practice medical physics or 7 hold oneself out to be a licensed medical physicist without 8 holding an active license. 9 (b) Practice or attempt to practice medical physics 10 under a name other than one's own. 11 (c) Use or attempt to use a revoked or suspended 12 license or the license of another. 13 (9) OFFENSES.--A person is in violation of this 14 section if the person intentionally or knowingly: 15 (a) Practices medical physics in violation of this 16 section; or 17 (b) Uses letters, terminology, symbols, or signs to 18 indicate or imply qualifications or licensure to practice 19 medical physics in any manner for which the person is not 20 licensed. 21 (10) PENALTIES.-- 22 (a) A person who violates this section or any rule 23 adopted under this section is guilty of a felony of the third 24 degree, punishable as provided in s. 775.082, s. 775.083, or 25 s. 775.084. 26 (b) The agency may modify, deny, suspend, or revoke a 27 license, or may impose an administrative fine not to exceed 28 $1,000 per violation, for the violation of any provision of 29 this section, rule adopted under this section, or terms or 30 conditions of any license issued by the agency. The agency 31 208 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 shall develop specific disciplinary guidelines in accordance 2 with s. 455.2273. 3 1. In determining the amount of a fine that is to be 4 levied for a violation, the following factors must be 5 considered: 6 a. The severity of the violation and the extent to 7 which this section, any rule adopted under this section, or 8 any term or condition of any license was violated. 9 b. Any action taken by the licensee to correct the 10 violation. 11 c. Any previous violation by the licensee. 12 2. All amounts collected under this section must be 13 deposited in the Health Care Trust Fund. 14 (c) If the agency determines that the licensee 15 presents a clear and present danger to the public health or 16 safety, the agency may issue an emergency order that 17 immediately suspends or revokes his license. 18 (10)(11) EXEMPTIONS.--This section does not apply to: 19 (a) A physician who is licensed by this state to the 20 extent that the physician he practices within the scope of the 21 physician's his training, education, and licensure; 22 (b) A person who is licensed under part IV of chapter 23 468 to the extent that the person he practices within the 24 scope of the person's his training, education, and licensure; 25 (c) A person who performs beam calibration and 26 characterization, quality assurance, instrument specification, 27 acceptance testing, shielding design, or protection analysis 28 on radiation-emitting equipment or radiopharmaceuticals in 29 connection with procedures that are not involved with the 30 diagnosis or treatment of disease or other medical or dental 31 conditions in humans; 209 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (d) A person who is employed by a federal or state 2 regulatory agency and is performing duties within the scope of 3 the person's employment; 4 (e) A student or intern who practices medical physics 5 in conjunction with a program at an accredited college or 6 university to the extent that the student or intern is 7 adequately supervised by a licensed medical physicist or 8 licensed physician; or 9 (f) A dentist or any person working under the 10 dentist's his supervision pursuant to chapter 466 to the 11 extent that the dentist or the person supervised by the 12 dentist is practicing within the scope of his or her training, 13 education, and licensure. 14 (12) LICENSURE EXCEPTION.--Notwithstanding the 15 provisions of subsections (1)-(11), any medical physicist who, 16 as of July 1, 1995, has practiced medical physics for 5 years 17 or longer is entitled to continue to so practice and need not 18 be licensed as a medical physicist. 19 Section 154. Subsection (2) of section 484.041, 20 Florida Statutes, is amended to read: 21 484.041 Definitions.--As used in this part, the term: 22 (2) "Department" means the Department of Health 23 Business and Professional Regulation. 24 Section 155. Subsection (1) of section 484.042, 25 Florida Statutes, is amended to read: 26 484.042 Board of Hearing Aid Specialists; membership, 27 appointment, terms.-- 28 (1) The Board of Hearing Aid Specialists is created 29 within the Department of Health Business and Professional 30 Regulation and shall consist of nine members to be appointed 31 by the Governor and confirmed by the Senate. 210 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 Section 156. Subsection (2) of section 484.051, 2 Florida Statutes, is amended to read: 3 484.051 Itemization of prices; delivery of hearing 4 aid; receipt, packaging, disclaimer, guarantee.-- 5 (2) Any person who fits and sells a hearing aid shall, 6 at the time of delivery, provide the purchaser with a receipt 7 containing the seller's signature, the address of his regular 8 place of business, and his license or trainee registration 9 number, if applicable, together with the brand, model, 10 manufacturer or manufacturer's identification code, and serial 11 number of the hearing aid furnished and the amount charged for 12 the hearing aid. The receipt also shall specify whether the 13 hearing aid is new, used, or rebuilt and shall specify the 14 length of time and other terms of the guarantee and by whom 15 the hearing aid is guaranteed. When the client has requested 16 an itemized list of prices, the receipt shall also provide an 17 itemization of the total purchase price, including, but not 18 limited to, the cost of the aid, earmold, batteries and other 19 accessories, and any services. Notice of the availability of 20 this service shall be displayed in a conspicuous manner in the 21 office. The receipt also shall state that any complaint 22 concerning the hearing aid and guarantee therefor, if not 23 reconciled with the licensee from whom the hearing aid was 24 purchased, should be directed by the purchaser to the 25 Department of Health Business and Professional Regulation. The 26 address and telephone number of such office shall be stated on 27 the receipt. 28 Section 157. Subsection (2) of section 486.021, 29 Florida Statutes, is amended to read: 30 486.021 Definitions.--In this chapter, unless the 31 context otherwise requires, the term: 211 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (2) "Department" means the Department of Health 2 Business and Professional Regulation. 3 Section 158. Section 486.023, Florida Statutes, is 4 amended to read: 5 486.023 Board of Physical Therapy Practice.-- 6 (1) There is created within the department the Board 7 of Physical Therapy Practice, composed of nine seven members, 8 recommended by the Florida Physical Therapy Association and 9 appointed by the Governor, subject to confirmation by the 10 Senate. 11 (2) Four Five board members shall be licensed physical 12 therapists, and one board member shall be a licensed physical 13 therapist assistant, in good standing in this state who are 14 residents of this state and have been engaged in the practice 15 of physical therapy for at least 4 years immediately prior to 16 their appointment. One licensed physical therapist board 17 member may be a full-time faculty member teaching in a 18 physical therapy curriculum in an educational institution in 19 this state. Three One of the four two remaining members shall 20 be residents a resident of this state who have has never been 21 a licensed health care practitioners practitioner. One of The 22 two remaining member members shall be a health care 23 practitioner licensed under chapter 458 or chapter 459 who is 24 a resident of this state and has been engaged as a licensed 25 health care practitioner for at least 4 years immediately 26 prior to his or her appointment. 27 (3) Within 90 days after October 1, 1989, the Governor 28 shall appoint the board as follows: 29 (a) Two members for terms of 2 years each. 30 (b) Two members for terms of 3 years each. 31 (c) Three members for terms of 4 years each. 212 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (3)(4) As the terms of the members expire, the 2 Governor shall appoint successors for terms of 4 years, and 3 such members shall serve until their successors are appointed. 4 (4)(5) All provisions of chapter 455 relating to 5 activities of the board shall apply. 6 Section 159. Section 486.031, Florida Statutes, is 7 amended to read: 8 486.031 Physical therapist; licensing 9 requirements.--To be eligible for licensing as a physical 10 therapist, an applicant must: 11 (1) Be at least 18 years old; 12 (2) Be of good moral character; and 13 (3)(a) Have been graduated from a school of physical 14 therapy which has been approved for the educational 15 preparation of physical therapists by the appropriate 16 accrediting agency recognized by the Commission on Recognition 17 of Postsecondary Accreditation (formerly the National 18 Commission on Accrediting and the Federation of Regional 19 Accrediting Commissions of Higher Education) or the United 20 States Department of Education at the time of his graduation 21 and have passed, to the satisfaction of the board, the 22 American Registry Examination prior to 1971 or a national an 23 examination approved administered by the board department to 24 determine his fitness for practice as a physical therapist as 25 hereinafter provided; or 26 (b) Have received a diploma from a program in physical 27 therapy in a foreign country and have educational credentials 28 deemed equivalent to those required for the educational 29 preparation of physical therapists in this country, as 30 recognized by the appropriate agency as identified by the 31 board, and have passed to the satisfaction of the board an 213 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 examination administered by the department to determine his 2 fitness for practice as a physical therapist as hereinafter 3 provided; or 4 (c) Be entitled to licensure without examination as 5 provided in s. 486.081. 6 Section 160. Section 486.041, Florida Statutes, is 7 amended to read: 8 486.041 Physical therapist; application for license; 9 fee; temporary permit.-- 10 (1) A person who desires to be licensed as a physical 11 therapist shall apply to the department board in writing on a 12 form furnished by the department. He shall embody in that 13 application evidence under oath, satisfactory to the board, of 14 his possessing the qualifications preliminary to examination 15 required by s. 486.031. He shall pay to the department at the 16 time of filing his application a fee not to exceed $100, as 17 fixed by the board, plus the actual per applicant cost to the 18 department for purchase of the examination from the 19 Professional Examination Services for the American Physical 20 Therapist's Association or a similar national organization. 21 If an applicant is deemed ineligible to take the examination, 22 that part of his application fee which is to be used for 23 examination expenses shall be returned. 24 (2) If a person desires to practice physical therapy 25 before becoming licensed through examination, he shall apply 26 to the board for a temporary permit in accordance with rules 27 adopted pursuant to this chapter. 28 (a) A temporary permit shall only be issued for a 29 limited period of time, not to exceed 1 year, and shall not be 30 renewable. A temporary permit shall automatically expire if an 31 applicant fails the examination. 214 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (b) An applicant for licensure by examination and 2 practicing under a temporary permit shall do so only under the 3 direct supervision of a licensed physical therapist. 4 Section 161. Section 486.051, Florida Statutes, is 5 amended to read: 6 486.051 Physical therapist; examination of 7 applicant.--The department shall provide for examination of 8 applicants for licensing as physical therapists at least once 9 a year, and more often at the discretion of the board, at a 10 time and place to be determined by the department. The 11 examinations of an applicant for licensing as a physical 12 therapist shall be administered by the department, in 13 accordance with rules adopted by the board, to test the 14 applicant's qualifications and shall include the taking of a 15 written test by the applicant. If an applicant fails to pass 16 the examination in three attempts, he shall not be eligible 17 for reexamination unless he completes additional educational 18 or training requirements prescribed by the board. An 19 applicant who has completed the additional educational or 20 training requirements prescribed by the board may take the 21 examination on two more occasions. If the applicant has 22 failed to pass the examination after five attempts, he is no 23 longer eligible to take the examination. 24 Section 162. Section 486.081, Florida Statutes, is 25 amended to read: 26 486.081 Physical therapist; issuance of license 27 without examination to person passing examination of another 28 authorized examining board; temporary permit; fee.-- 29 (1) The board may cause a license to be issued through 30 the department without examination to any applicant who 31 presents evidence satisfactory to the board of having passed 215 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 the American Registry Examination prior to 1971 or an 2 examination in physical therapy before a similar lawfully 3 authorized examining board of another state, the District of 4 Columbia, a territory, or a foreign country, if the standards 5 for licensure in physical therapy in such other state, 6 district, territory, or foreign country are determined by the 7 board to be as high as those of this state, as established by 8 rules adopted pursuant to this chapter. Any person who holds a 9 license pursuant to this section may use the words "physical 10 therapist" or "physiotherapist," or the letters "P.T.," in 11 connection with his name or place of business to denote his 12 licensure hereunder. 13 (2) At the time of making application for licensure 14 without examination pursuant to the terms of this section, the 15 applicant shall pay to the department a fee not to exceed $175 16 as fixed by the board, no part of which will be returned. 17 (3) If a person desires to practice physical therapy 18 before becoming licensed through endorsement, he shall apply 19 to the board for a temporary permit in accordance with rules 20 adopted pursuant to this chapter. A temporary permit shall 21 only be issued for a limited period of time, not to exceed 1 22 year, and shall not be renewable. 23 Section 163. Section 486.102, Florida Statutes, is 24 amended to read: 25 486.102 Physical therapist assistant; licensing 26 requirements.--To be eligible for licensing by the board as a 27 physical therapist assistant, an applicant must: 28 (1) Be at least 18 years old; 29 (2) Be of good moral character; and 30 (3)(a) Have been graduated from a school giving a 31 course of not less than 2 years for physical therapist 216 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 assistants, which has been approved for the educational 2 preparation of physical therapist assistants by the 3 appropriate accrediting agency recognized by the Commission on 4 Recognition of Postsecondary Accreditation (formerly the 5 National Commission on Accrediting and the Federation of 6 Regional Accrediting Commissions of Higher Education) or the 7 United States Department of Education at the time of his 8 graduation and have passed to the satisfaction of the board an 9 examination administered by the department to determine his 10 fitness for practice as a physical therapist assistant as 11 hereinafter provided; or 12 (b) Have been graduated from a school giving a course 13 for physical therapist assistants in a foreign country and 14 have educational credentials deemed equivalent to those 15 required for the educational preparation of physical therapist 16 assistants in this country, as recognized by the appropriate 17 agency as identified by the board, and passed to the 18 satisfaction of the board an examination conducted by the 19 department to determine his fitness for practice as a physical 20 therapist assistant as hereinafter provided; or 21 (c) Be entitled to licensure without examination as 22 provided in s. 486.107. 23 Section 164. Section 486.103, Florida Statutes, is 24 amended to read: 25 486.103 Physical therapist assistant; application for 26 license; fee; temporary permit.-- 27 (1) A person who desires to be licensed as a physical 28 therapist assistant shall apply to the department board in 29 writing on a form furnished by the department. He shall 30 embody in that application evidence under oath, satisfactory 31 to the board, of his possessing the qualifications preliminary 217 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 to examination required by s. 486.104. He shall pay to the 2 department at the time of filing his application a fee not to 3 exceed $100, as fixed by the board, plus the actual per 4 applicant cost to the department for purchase of the 5 examination from the Professional Examination Services for the 6 American Physical Therapist's Association or a similar 7 national organization. If an applicant is deemed ineligible 8 to take the examination, that part of his application fee 9 which is to be used for examination expenses shall be 10 returned. 11 (2) If a person desires to work as a physical 12 therapist assistant before being licensed through examination, 13 he shall apply for a temporary permit in accordance with rules 14 adopted pursuant to this chapter. 15 (a) A temporary permit shall only be issued for a 16 limited period of time, not to exceed 1 year, and shall not be 17 renewable. A temporary permit shall automatically expire if an 18 applicant fails the examination. 19 (b) An applicant for licensure by examination who is 20 practicing under a temporary permit shall do so only under the 21 direct supervision of a licensed physical therapist. 22 Section 165. Section 486.104, Florida Statutes, is 23 amended to read: 24 486.104 Physical therapist assistant; examination of 25 applicant.--The department shall provide for examination of 26 applicants for licensing as physical therapist assistants at 27 least once a year, and more often at the discretion of the 28 board, at a time and place to be determined by the department. 29 The examination of an applicant for licensing as a physical 30 therapist assistant shall be provided by the department, in 31 accordance with rules adopted by the board, to test the 218 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 applicant's qualifications and shall include the taking of a 2 written test by the applicant. If an applicant fails to pass 3 the examination in three attempts, he shall not be eligible 4 for reexamination unless he completes additional educational 5 or training requirements prescribed by the board. An 6 applicant who has completed the additional educational or 7 training requirements prescribed by the board may take the 8 examination on two more occasions. If the applicant has 9 failed to pass the examination after five attempts, he is no 10 longer eligible to take the examination. 11 Section 166. Section 486.123, Florida Statutes, is 12 created to read: 13 486.123 Sexual misconduct in the practice of physical 14 therapy.--The physical therapist-patient relationship is 15 founded on mutual trust. Sexual misconduct in the practice of 16 physical therapy means violation of the physical 17 therapist-patient relationship through which the physical 18 therapist uses that relationship to induce or attempt to 19 induce the patient to engage, or to engage or attempt to 20 engage the patient, in sexual activity outside the scope of 21 practice or the scope of generally accepted examination or 22 treatment of the patient. Sexual misconduct in the practice 23 of physical therapy is prohibited. 24 Section 167. Paragraph (g) is added to subsection (2) 25 of section 486.125, Florida Statutes, to read: 26 486.125 Refusal, revocation, or suspension of license; 27 administrative fines and other disciplinary measures.-- 28 (2) When the board finds any person guilty of any of 29 the grounds set forth in subsection (1), it may enter an order 30 imposing one or more of the following penalties: 31 219 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 (g) Recovery of actual costs of investigation and 2 prosecution. 3 Section 168. Subsection (11) is added to section 4 641.495, Florida Statutes, 1996 Supplement, to read: 5 641.495 Requirements for issuance and maintenance of 6 certificate.-- 7 (11) The organization shall designate a medical 8 director who is a physician licensed under chapter 458 or 9 chapter 459. 10 Section 169. Subsection (3) of section 499.012, 11 Florida Statutes, is amended to read: 12 499.012 Wholesale distribution; definitions; permits; 13 general requirements.-- 14 (3)(a) A person that engages in wholesale distribution 15 of prescription drugs in this state must have a wholesale 16 distributor's permit issued by the department, except as noted 17 in this section. Each establishment must be separately 18 permitted except as noted in this subsection. 19 (a) A separate establishment permit is not required 20 when a permitted prescription drug wholesaler consigns a 21 prescription drug to a pharmacy that is permitted under 22 chapter 465 and located in this state, provided that: 23 1. The consignor wholesaler notifies the department in 24 writing of the contract to consign prescription drugs to a 25 pharmacy along with the identity and location of each 26 consignee pharmacy; 27 2. The pharmacy maintains its permit under chapter 28 465; 29 3. The consignor wholesaler, which has no legal 30 authority to dispense prescription drugs, complies with all 31 wholesale distribution requirements of s. 499.0121 with 220 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 respect to the consigned drugs and maintains records 2 documenting the transfer of title or other completion of the 3 wholesale distribution of the consigned prescription drugs; 4 4. The distribution of the prescription drug is 5 otherwise lawful under this chapter and other applicable law; 6 5. Open packages containing prescription drugs within 7 a pharmacy are the responsibility of the pharmacy, regardless 8 of how the drugs are titled; and 9 6. The pharmacy dispenses the consigned prescription 10 drug in accordance with the limitations of its permit under 11 chapter 465 or returns the consigned prescription drug to the 12 consignor wholesaler. In addition, a person who holds title to 13 prescription drugs may transfer the drugs to a person 14 permitted or licensed to handle the reverse distribution or 15 destruction of drugs. Any other distribution by and means of 16 the consigned prescription drug by any person, not limited to 17 the consignor wholesaler or consignee pharmacy, to any other 18 person is prohibited. 19 (b) A wholesale distributor's permit is not required 20 for the one-time transfer of title of a pharmacy's lawfully 21 acquired prescription drug inventory by a pharmacy with a 22 valid permit issued under chapter 465 to a consignor 23 prescription drug wholesaler, permitted under this chapter, in 24 accordance with a written consignment agreement between the 25 pharmacy and that wholesaler if: the permitted pharmacy and 26 the permitted prescription drug wholesaler comply with all of 27 the provisions of paragraph (3)(a) and the prescription drugs 28 continue to be within the permitted pharmacy's inventory for 29 dispensing in accordance with the limitations of the pharmacy 30 permit under chapter 465. A consignor drug wholesaler may not 31 use the pharmacy as a wholesale distributor through which it 221 CODING: Words stricken are deletions; words underlined are additions. HB 2013, First Engrossed 1 distributes the legend drugs to other pharmacies. Nothing in 2 this section is intended to prevent a wholesale drug 3 distributor from obtaining this inventory in the event of 4 nonpayment by the pharmacy. 5 (c)(b) The department shall require information from 6 each wholesale distributor as part of the permit and renewal 7 of such permit, as required under s. 499.01. 8 Section 170. This act shall take effect July 1, 1997. 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 222