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House Bill 2013e2

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