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House Bill 2013er

ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2 An act relating to regulation of health care 3 professions; amending s. 468.1645, F.S.; 4 revising an exemption from licensure as a 5 nursing home administrator relating to persons 6 employed to administer in facilities or 7 institutions operated by and for persons who 8 rely exclusively upon treatment by spiritual 9 means through prayer; amending s. 458.3115, 10 F.S.; revising requirements for the development 11 of examinations administered to certain 12 foreign-licensed physicians; prescribing 13 eligibility requirements for certain 14 foreign-trained physicians to take a 15 restricted-license examination; amending s. 16 402.48, F.S., relating to health care services 17 pools; increasing the period of registration; 18 updating a definition and a provision relating 19 to meeting financial responsibility 20 requirements; amending s. 455.225, F.S.; 21 providing legislative intent; revising 22 procedures to discipline professionals; 23 requiring the Agency for Health Care 24 Administration, the Department of Business and 25 Professional Regulation, or appropriate 26 regulatory boards to establish plans to resolve 27 incomplete investigations or disciplinary 28 proceedings; amending s. 455.2285, F.S.; 29 revising requirements for information that is 30 disclosed in the annual report; amending s. 31 457.102, F.S.; revising definitions applicable 1 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 to the regulation of acupuncture; amending s. 2 457.105, F.S.; revising qualifications for 3 licensure to practice acupuncture; revising 4 fees; conforming terminology; amending s. 5 457.107, F.S.; revising licensure renewal fees; 6 conforming terminology; amending s. 457.1085, 7 F.S.; revising requirements on the adoption of 8 rules relating to infection control and on the 9 use of acupuncture needles; amending ss. 10 457.103, 457.108, 457.109, and 457.116, F.S., 11 to conform; amending s. 458.303, F.S.; 12 eliminating references to physician's trained 13 assistants; amending s. 458.305, F.S.; updating 14 the definition of "department"; amending s. 15 458.307, F.S.; revising provisions relating to 16 probable cause panels of the Board of Medicine; 17 amending s. 455.206, F.S.; conforming a 18 cross-reference; amending s. 458.311, F.S.; 19 revising requirements for licensure of 20 physicians by examination; revising an 21 educational and postgraduate training 22 requirement; allowing certain applicants to 23 complete a specified fellowship to partially 24 satisfy the licensing requirements; providing 25 for additional remedial education or training 26 upon failure to pass the licensing examination 27 after a certain number of attempts; authorizing 28 persons in certain training programs to take 29 the examination under certain circumstances; 30 amending s. 458.313, F.S.; revising 31 requirements for licensure of physicians by 2 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 endorsement; eliminating a provision 2 authorizing oral examinations; providing for 3 additional remedial education or training upon 4 failure to pass the licensing examination after 5 a certain number of attempts; authorizing 6 additional requirements prior to certification 7 of eligibility for licensure; conforming a 8 cross-reference; eliminating a provision 9 authorizing licensure under a period of 10 supervision; providing conditions for 11 reactivation of certain licenses issued by 12 endorsement; amending s. 458.317, F.S., 13 relating to limited licenses; eliminating the 14 requirement that applicants for a limited 15 license be retired from the practice of 16 medicine; restricting certain limited licensees 17 to noncompensated practice; requiring the 18 payment of fees if a person receives 19 compensation for the practice of medicine; 20 amending s. 458.319, F.S.; clarifying 21 requirements for renewal of license to practice 22 medicine; revising recent-practice 23 requirements; amending s. 458.320, F.S.; 24 conforming a cross-reference; requiring 25 physicians not carrying medical malpractice 26 insurance to post notice and provide a written 27 statement thereof; providing for acknowledgment 28 that the patient has been so informed; amending 29 s. 458.331, F.S.; revising and providing 30 grounds for disciplinary action; providing 31 penalties; creating s. 458.3312, F.S.; 3 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 prohibiting physicians from falsely 2 representing that they are board-certified 3 specialists; amending s. 458.345, F.S., 4 relating to registration of resident 5 physicians, interns, and fellows; providing for 6 designation of a person responsible at each 7 hospital using such residents for the 8 hospital's semiannual reports to the 9 department; requiring certain notice to the 10 executive director of the board; providing that 11 registrants are subject to specified 12 disciplinary provisions; providing requirements 13 for the prescribing of medicinal drugs; 14 amending s. 458.346, F.S.; providing for 15 meetings of the Public Sector Physician 16 Advisory Committee; amending ss. 458.347 and 17 459.022, F.S.; revising requirements for 18 certification as a physician assistant; 19 updating terminology; amending s. 458.3485, 20 F.S.; requiring medical assistants to be under 21 the direct supervision of a licensed physician; 22 providing for rules; amending s. 459.003, F.S.; 23 updating the definition of "department"; 24 providing that certain terms are equivalent; 25 amending s. 459.021, F.S.; revising terminology 26 relating to osteopathic medicine; revising 27 provisions relating to registration of resident 28 physicians, interns, and fellows; providing for 29 designation of a person responsible for the 30 hospital's semiannual reports to the 31 department; requiring certain notice to the 4 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 executive director of the board; providing that 2 registrants are subject to specified 3 disciplinary provisions; authorizing resident 4 physicians to prescribe drugs appearing on 5 schedules of controlled substances under 6 certain circumstances; repealing s. 7 460.413(1)(bb) and (cc), F.S., relating to 8 grounds for disciplinary action; amending s. 9 459.0075, F.S., relating to limited licenses; 10 eliminating the requirement that applicants for 11 a limited license be retired from the practice 12 of osteopathic medicine; restricting certain 13 limited licensees to noncompensated practice; 14 requiring the payment of fees if a person 15 receives compensation for the practice of 16 osteopathic medicine; amending s. 459.0085, 17 F.S.; conforming a cross-reference; requiring 18 osteopathic physicians not carrying medical 19 malpractice insurance to post notice and 20 provide a written statement thereof; providing 21 for acknowledgment that the patient has been so 22 informed; amending s. 459.015, F.S.; revising 23 and providing grounds for disciplinary action; 24 providing penalties; creating s. 459.0152, 25 F.S.; prohibiting osteopathic physicians from 26 falsely representing that they are 27 board-certified specialists; amending ss. 28 240.4067, 390.011, 395.0191, 408.035, 409.905, 29 415.102, 415.1034, 415.504, 440.106, 440.13, 30 440.134, 440.15, 456.31, 459.006, 462.01, 31 468.301, 468.302, 476.044, 477.0135, 483.291, 5 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 621.03, 627.351, 627.357, 627.6482, 725.01, 2 766.101, 766.103, 766.105, 766.110, 817.234, 3 and 945.047, F.S.; conforming and correcting 4 terminology relating to osteopathic medicine; 5 amending s. 460.403, F.S.; updating the 6 definition of "department"; amending s. 7 460.413, F.S.; repealing ss. 460.413(1)(bb) and 8 460.413(1)(cc), relating to grounds for 9 disciplinary action; revising grounds for 10 disciplinary action; providing penalties; 11 providing criteria for determining the 12 applicable penalty; providing certain 13 evidentiary standards; providing authority and 14 procedure to enjoin a chiropractor from 15 providing medical services under certain 16 circumstances; reenacting ss. 320.0848(9), 17 455.236(4)(g), and 766.111(2), F.S., relating 18 to parking permits for disabled persons, 19 prohibited referrals to home health agencies, 20 and unnecessary diagnostic testing, to 21 incorporate the amendment to s. 460.413, F.S., 22 in references thereto; amending s. 460.4165, 23 F.S.; revising a provision relating to the fee 24 accompanying applications to supervise 25 chiropractic physician's assistants; amending 26 s. 461.003, F.S.; updating the definition of 27 "department"; amending s. 461.013, F.S.; 28 revising a ground for disciplinary action; 29 providing penalties; amending s. 461.018, F.S.; 30 clarifying a provision relating to the limited 31 practice of podiatry in designated areas of 6 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 need; amending s. 464.003, F.S.; revising a 2 definition to update authority over regulation 3 of nursing; amending ss. 464.004, 464.008, 4 464.009, 464.012, 464.013, and 464.014, F.S., 5 to conform; amending s. 464.018, F.S.; revising 6 grounds for disciplinary action; providing 7 penalties; conforming terminology; amending s. 8 464.019, F.S., relating to approval of nursing 9 programs; providing for a program review fee; 10 conforming terminology; creating s. 464.0205, 11 F.S.; providing for certification of retired 12 volunteer nurses; providing requirements, 13 qualifications, fees, and restrictions; 14 amending s. 464.022, F.S.; providing an 15 exemption from regulation relating to certain 16 nurses accompanying and caring for patients 17 temporarily residing in this state; amending s. 18 465.003, F.S.; revising the definitions of the 19 terms "pharmacy" and "department"; amending s. 20 465.004, F.S.; increasing the membership of the 21 Board of Pharmacy; revising membership 22 qualifications; amending s. 465.0125, F.S.; 23 providing responsibilities of consultant 24 pharmacists and doctors of pharmacy; providing 25 for rules; amending s. 465.0156, F.S.; revising 26 information required for registration of 27 nonresident pharmacies; amending s. 465.016, 28 F.S.; revising grounds for disciplinary 29 actions; providing penalties; amending s. 30 465.0196, F.S., relating to special pharmacy 31 permits; conforming a cross-reference; amending 7 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 s. 465.026, F.S.; revising provisions relating 2 to the filling of prescriptions transferred by 3 electronic or other means; amending s. 465.035, 4 F.S.; allowing the dispensing of controlled 5 substances based on electronic facsimiles of 6 the original prescriptions; amending s. 7 465.186, F.S.; providing for inclusion of 8 certain products and over-the-counter 9 proprietary drugs in the formulary of 10 authorized medicinal drug products and 11 dispensing procedures; amending s. 893.03, 12 F.S.; adding butorphanol tartrate as a Schedule 13 IV controlled substance; reenacting ss. 14 316.193(5), 327.35(5), 440.102(11)(b), 15 458.326(3), 817.563(1), 831.31(1)(a) and (2), 16 856.015(1)(d), 893.02(4), 893.08(1)(b), 17 893.13(1)(a), (c), and (d), (2)(a), (4)(b), and 18 (5)(b), F.S., relating to driving under the 19 influence, boating under the influence, 20 drug-free workplace program requirements, 21 authorized treatment of intractable pain, sales 22 of substances in lieu of controlled substances, 23 counterfeit controlled substances, open house 24 parties, definitions applicable to regulation 25 of controlled substances, exceptions to 26 required prescription for distribution at 27 retail, and prohibited acts relating to 28 controlled substances, respectively, to 29 incorporate the amendment to s. 893.03, F.S., 30 in references thereto; amending s. 466.003, 31 F.S.; updating the definition of "department"; 8 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 amending s. 466.006, F.S., relating to the 2 examination of dentists; revising prerequisites 3 for certain applicants to take the examination; 4 amending s. 466.017, F.S.; eliminating obsolete 5 provisions relating to the utilization of 6 general anesthesia and parenteral conscious 7 sedation by licensed dentists; amending s. 8 466.028, F.S.; revising grounds for 9 disciplinary action; providing penalties; 10 amending s. 468.1115, F.S.; revising and 11 providing exemptions from regulation as a 12 speech-language pathologist or audiologist; 13 amending s. 468.1125, F.S.; updating the 14 definition of "department"; amending s. 15 468.1155, F.S.; revising provisional licensure 16 requirements; providing requirements for 17 cross-discipline licensure; amending s. 18 468.1185, F.S.; revising licensure 19 requirements; conforming a reference; amending 20 s. 468.1195, F.S.; revising continuing 21 education requirements; providing for adoption 22 of standards of approval of continuing 23 education providers; creating s. 468.1201, 24 F.S.; requiring instruction on human 25 immunodeficiency virus and acquired immune 26 deficiency syndrome as a condition of being 27 granted a license or certificate to practice 28 speech-language pathology or audiology; 29 amending s. 468.1215, F.S.; revising 30 requirements for certification as a 31 speech-language pathology or audiology 9 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 assistant; conforming a reference; amending s. 2 468.1245, F.S.; revising provisions relating to 3 certain complaints concerning hearing aids; 4 amending s. 468.1295, F.S.; revising and 5 providing grounds for disciplinary action; 6 revising and providing penalties; creating s. 7 468.1296, F.S.; prohibiting sexual misconduct 8 in the practice of speech-language pathology 9 and audiology, for which there are penalties; 10 amending s. 468.1655, F.S.; updating the 11 definition of "department"; amending s. 12 468.1695, F.S.; reducing the number of times a 13 year the examination for licensure as a nursing 14 home administrator must be given; amending s. 15 468.203, F.S.; revising definitions applicable 16 to regulation of occupational therapy; amending 17 s. 468.205, F.S.; replacing the Occupational 18 Therapy Council with a Board of Occupational 19 Therapy Practice; providing for qualifications, 20 appointments, and terms of board members; 21 providing for the filling of vacancies on the 22 board; amending s. 468.209, F.S.; revising 23 educational requirements for licensure as an 24 occupational therapist or occupational therapy 25 assistant; providing for licensure of certain 26 applicants without meeting such educational 27 requirements; providing for certain temporary 28 permits; requiring documentation of continuing 29 education for certain applicants; amending s. 30 468.211, F.S.; providing a restriction on the 31 number of times an applicant may fail the 10 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 examination and requiring remediation after a 2 certain number; amending s. 468.213, F.S.; 3 revising requirements for licensure by 4 endorsement; amending s. 468.225, F.S.; 5 providing exemptions from regulation of 6 occupational therapy; amending ss. 468.351, 7 468.352, 468.354, 468.355, 468.356, 468.357, 8 468.358, 468.359, 468.36, 468.361, 468.363, 9 468.364, 468.365, 468.366, and 468.368, F.S.; 10 repealing s. 468.362, F.S., relating to 11 continuing education; providing for licensure 12 of respiratory care practitioners and 13 respiratory therapists; eliminating references 14 to certification and registration; updating the 15 definition of "department"; revising 16 terminology; revising approval of educational 17 programs; eliminating annual continuing 18 education requirements for certain persons; 19 providing penalties; amending s. 478.42, F.S.; 20 updating the definition of "department"; 21 amending s. 478.45, F.S.; revising requirements 22 for licensure as an electrologist; amending s. 23 478.46, F.S.; revising requirements relating to 24 issuance of temporary permits; conforming a 25 cross-reference and terminology; amending s. 26 478.47, F.S.; revising requirements for 27 licensure by endorsement; amending s. 478.52, 28 F.S.; prohibiting the operation of unlicensed 29 electrolysis facilities; providing penalties; 30 amending s. 480.033, F.S.; revising the 31 definition of "board"; updating the definition 11 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of "department"; amending s. 480.034, F.S.; 2 eliminating an exemption from regulation 3 applicable to certain skin treatments and 4 weight-loss programs; amending s. 480.035, 5 F.S.; renaming the Board of Massage as the 6 Board of Massage Therapy; amending s. 480.041, 7 F.S.; eliminating provisional licensure to 8 practice massage therapy; amending s. 480.0415, 9 F.S.; authorizing an increase in the number of 10 classroom hours of continuing education that 11 may be required for renewal of a license to 12 practice massage therapy; amending s. 480.042, 13 F.S.; revising what examinations must measure; 14 repealing s. 480.0425, F.S., relating to 15 inactive status; amending s. 480.043, F.S.; 16 revising provisions relating to the transfer of 17 licenses; amending s. 480.044, F.S.; revising 18 provisions relating to fees; amending s. 19 480.047, F.S.; prohibiting the practice of 20 massage therapy without a license unless 21 exempted from licensure; creating s. 480.0485, 22 F.S.; prohibiting sexual misconduct in the 23 practice of massage therapy, for which there 24 are disciplinary actions; amending s. 20.43, 25 F.S., relating to the Department of Health; 26 conforming terminology; updating a reference; 27 amending s. 381.81, F.S., to conform; amending 28 s. 483.800, F.S.; revising policy and purpose 29 relating to regulation of clinical laboratory 30 personnel; amending s. 483.801, F.S.; providing 31 a regulatory exemption relating to advanced 12 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 registered nurse practitioners; amending s. 2 483.803, F.S.; updating the definition of 3 "department"; providing definitions; amending 4 s. 483.809, F.S.; revising licensing 5 provisions; authorizing an alternative 6 examination for public health laboratory 7 scientists; creating s. 483.812, F.S.; 8 providing for licensure of public health 9 laboratory scientists; amending s. 483.813, 10 F.S.; extending the period of a temporary 11 license for clinical laboratory personnel; 12 providing a period for a conditional license; 13 amending s. 483.823, F.S.; revising provisions 14 relating to qualifications of clinical 15 laboratory personnel; amending s. 483.825, 16 F.S.; revising and providing grounds for 17 disciplinary action; providing penalties; 18 creating s. 483.828, F.S.; providing penalties 19 for specified violations; amending s. 483.901, 20 F.S., the "Florida Medical Physicists Act"; 21 providing that the Advisory Council of Medical 22 Physicists is an advisory rather than a 23 regulatory body; increasing the number and 24 terms of council members; clarifying initial 25 and other appointment provisions; revising 26 provisions relating to council meetings; 27 revising licensure requirements; clarifying 28 that the required continuing education hours 29 are to be satisfied biennially and that the 30 organizations providing such education must be 31 approved by the Department of Health; revising 13 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 and providing grounds for disciplinary action; 2 revising and providing criminal acts; providing 3 an administrative fine; providing penalties; 4 eliminating a provision authorizing a licensure 5 exception; amending s. 484.041, F.S.; updating 6 the definition of "department"; amending s. 7 484.042, F.S.; updating a reference, to 8 conform; amending s. 484.051, F.S.; updating a 9 reference, to conform; amending s. 486.021, 10 F.S.; updating the definition of "department"; 11 amending s. 486.023, F.S.; changing the 12 membership of the Board of Physical Therapy 13 Practice; amending ss. 486.031 and 486.081, 14 F.S.; providing an alternative licensure 15 examination; revising accreditation provisions 16 relating to licensure as a physical therapist; 17 amending s. 486.041, F.S.; revising provisions 18 relating to applying for a license as a 19 physical therapist and to the fee therefor; 20 amending s. 486.051, F.S.; revising provisions 21 relating to examination of applicants for 22 licensure as a physical therapist; amending s. 23 486.102, F.S.; revising accreditation 24 provisions relating to licensure as a physical 25 therapist assistant; amending s. 486.103, F.S.; 26 revising provisions relating to applying for a 27 license as a physical therapist assistant and 28 to the fee therefor; amending s. 486.104, F.S.; 29 revising provisions relating to examination of 30 applicants for licensure as a physical 31 therapist assistant; creating s. 486.123, F.S.; 14 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 prohibiting sexual misconduct in the practice 2 of physical therapy, for which there are 3 disciplinary actions; amending s. 486.125, 4 F.S.; providing for recovery of the actual 5 costs of investigation and prosecution; 6 amending s. 641.495, F.S.; requiring a health 7 maintenance organization to designate as 8 medical director a state-licensed physician or 9 osteopathic physician; amending s. 499.012, 10 F.S.; clarifying and providing for additional 11 wholesale distribution exceptions; requiring 12 the Board of Medicine to establish guidelines 13 for physicians to prescribe certain drugs used 14 to treat obesity; requiring the Board of 15 Osteopathic Medicine to establish guidelines 16 for physicians to prescribe certain drugs used 17 to treat obesity; amending s. 409.9122, F.S.; 18 providing for chiropractic and podiatric 19 services under the MediPass program; creating a 20 Task Force on Exemptions from Licensure under 21 s. 468.505(1)(k), F.S., which exempts certain 22 persons employed by a hospital, nursing home, 23 assisted living facility, or continuing care 24 facility; providing for membership and meetings 25 of the task force, including place of meetings; 26 requiring a report to certain legislative 27 leaders; providing responsibilities of the task 28 force; providing for dissolution of the task 29 force; amending s. 465.014, F.S.; amending the 30 duties of pharmacy technicians; increasing the 31 number of pharmacy technicians a licensed 15 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 pharmacist may supervise; amending s. 456.32, 2 F.S.; including specified mental health 3 professionals within the definition of 4 "practitioner of the healing arts"; amending s. 5 490.003, F.S.; revising and providing 6 definitions relating to the regulation of 7 psychological services; amending s. 490.005, 8 F.S.; conforming cross-references; creating s. 9 490.0051, F.S.; providing for provisional 10 licensure; repealing s. 490.008, F.S., relating 11 to inactive status; amending s. 490.009, F.S.; 12 revising and providing grounds for disciplinary 13 action; amending s. 490.012, F.S.; providing 14 requirements for display of licenses and 15 provisional licenses; eliminating a requirement 16 relating to use of the license number on 17 professional advertisements; providing 18 requirements for promotional materials of 19 provisional licensees; conforming 20 cross-references; providing penalties; amending 21 s. 490.014, F.S.; clarifying applicability of 22 exemption provisions; removing an obsolete 23 licensing exemption that required registration 24 of certain trainees or interns; amending s. 25 491.003, F.S.; revising and providing 26 definitions relating to the regulation of 27 clinical, counseling, and psychotherapy 28 services; creating s. 491.0045, F.S.; requiring 29 registration of interns and providing 30 requirements thereof; creating s. 491.0046, 31 F.S.; providing for provisional licensure; 16 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 amending s. 491.005, F.S.; revising 2 requirements for licensure by examination; 3 providing for additional educational 4 requirements at a future date; creating s. 5 491.0057, F.S.; providing for dual licensure as 6 a marriage and family therapist; amending s. 7 491.007, F.S.; providing for biennial renewal 8 of registrations; providing for fees; amending 9 s. 491.009, F.S.; revising and providing 10 grounds for disciplinary action; amending s. 11 491.012, F.S.; prohibiting the use of certain 12 titles under certain circumstances; providing a 13 penalty; amending s. 491.014, F.S.; revising 14 and clarifying exemption provisions; removing 15 an obsolete licensing exemption that required 16 registration of certain trainees or interns; 17 amending s. 491.0149, F.S.; requiring display 18 of registrations and provisional licenses and 19 use of applicable professional titles on 20 promotional materials; amending ss. 232.02, 21 394.455, F.S.; conforming cross-references; 22 creating s. 458.3124, F.S.; providing for 23 certain foreign-trained and licensed physicians 24 to take certain licensure examinations; 25 providing restrictions and establishing fees; 26 restricting the practice of such persons; 27 providing for eligibility for full licensure; 28 providing for the adoption of rules; providing 29 an effective date. 30 31 Be It Enacted by the Legislature of the State of Florida: 17 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 1. Subsection (2) of section 468.1645, Florida 2 Statutes, is amended to read: 3 468.1645 Administrator license required.-- 4 (2) Nothing in this part or in the rules adopted 5 hereunder shall require an administrator of any facility or 6 institution operated by and a recognized church or religious 7 denomination for persons who rely exclusively upon treatment 8 by spiritual means through prayer, in accordance with the 9 creed or tenets of any organized church or religious 10 denomination, to be licensed as a nursing home administrator 11 if the administrator who is employed only to administer in 12 such facilities or institutions accredited by such church or 13 denomination for the care and treatment of the sick in 14 accordance with its teachings, to be licensed as a nursing 15 home administrator. 16 Section 2. Effective upon this act becoming a law, 17 paragraph (c) of subsection (1) of section 458.3115, Florida 18 Statutes, 1996 Supplement, is amended to read: 19 458.3115 Restricted license; certain foreign-licensed 20 physicians; United States Medical Licensing Examination 21 (USMLE) or agency-developed examination; restrictions on 22 practice; full licensure.-- 23 (1) 24 (c) A person shall be eligible to take such 25 examination for restricted licensure if the person: 26 1. Has taken, upon approval by the board, and 27 completed, in November 1990 or November 1992, one of the 28 special preparatory medical update courses authorized by the 29 board and the University of Miami Medical School and 30 subsequently passed the final course examination; or upon 31 approval by the board to take the course completed in 1990 or 18 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 in 1992, has a certificate of successful completion of that 2 course from the University of Miami or the Stanley H. Kaplan 3 course; or can document to the department that he or she was 4 one of the persons who took and successfully completed the 5 Stanley H. Kaplan course that was approved by the Board of 6 Medicine and supervised by the University of Miami. At a 7 minimum, the documentation must include class attendance 8 records and the test score on the final course examination; 9 2. Applies to the agency and submits an application 10 fee that is nonrefundable and equivalent to the fee required 11 for full licensure; 12 3. Documents no less than 2 years of the active 13 practice of medicine in another jurisdiction; 14 4. Submits an examination fee that is nonrefundable 15 and equivalent to the fee required for full licensure plus the 16 actual per-applicant cost to the agency to provide either 17 examination described in this section; 18 5. Has not committed any act or offense in this or any 19 other jurisdiction that would constitute a substantial basis 20 for disciplining a physician under this chapter or chapter 21 455; and 22 6. Is not under discipline, investigation, or 23 prosecution in this or any other jurisdiction for an act that 24 would constitute a violation of this chapter or chapter 455 25 and that substantially threatened or threatens the public 26 health, safety, or welfare. 27 Section 3. Paragraph (a) of subsection (1), subsection 28 (4), and paragraph (g) of subsection (8) of section 402.48, 29 Florida Statutes, 1996 Supplement, are amended to read: 30 402.48 Health care services pools.-- 31 (1) As used in this section, the term: 19 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (a) "Department" means the Department of Health 2 Business and Professional Regulation. 3 (4) Each registration shall be for a period of 2 years 4 1 year. A new registration is required upon the sale of a 5 controlling interest in a health care services pool. 6 (8) 7 (g) Meeting the financial responsibility requirements 8 of this section must be established at the time of issuance or 9 renewal of a certificate of registration on or after January 10 1, 1991. 11 Section 4. Subsections (2), (4), and (9) of section 12 455.225, Florida Statutes, 1996 Supplement, are amended to 13 read: 14 455.225 Disciplinary proceedings.--Disciplinary 15 proceedings for each board shall be within the jurisdiction of 16 the department or the Agency for Health Care Administration, 17 as appropriate. 18 (2) The department and the Agency for Health Care 19 Administration shall allocate sufficient and adequately 20 trained staff to expeditiously and thoroughly determine legal 21 sufficiency and investigate all legally sufficient complaints. 22 For purposes of this section, it is the intent of the 23 Legislature that the term "expeditiously" means that the 24 agency, for disciplinary cases under its jurisdiction, shall 25 complete the report of its initial investigative findings and 26 recommendations concerning the existence of probable cause 27 within 6 months after its receipt of the complaint. The 28 failure of the agency, for disciplinary cases under its 29 jurisdiction, to comply with the time limits in this section 30 while investigating a complaint against a licensee constitutes 31 harmless error in any subsequent disciplinary action unless a 20 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 court finds that either the fairness of the proceeding or the 2 correctness of the action may have been impaired by a material 3 error in procedure or a failure to follow prescribed 4 procedure. When its investigation is complete and legally 5 sufficient, the department or the agency shall prepare and 6 submit to the probable cause panel of the appropriate 7 regulatory board the investigative report of the department or 8 the agency. The report shall contain the investigative 9 findings and the recommendations of the department or the 10 agency concerning the existence of probable cause. At any time 11 after legal sufficiency is found, the department or the agency 12 may dismiss any case, or any part thereof, if the department 13 or the agency determines that there is insufficient evidence 14 to support the prosecution of allegations contained therein. 15 The department or the agency shall provide a detailed report 16 to the appropriate probable cause panel prior to dismissal of 17 any case or part thereof, and to the subject of the complaint 18 after dismissal of any case or part thereof, under this 19 section. For cases dismissed prior to a finding of probable 20 cause, such report is confidential and exempt from s. 21 119.07(1). The probable cause panel shall have access, upon 22 request, to the investigative files pertaining to a case prior 23 to dismissal of such case. If the department or the agency 24 dismisses a case, the probable cause panel may retain 25 independent legal counsel, employ investigators, and continue 26 the investigation and prosecution of the case as it deems 27 necessary. 28 (4) The determination as to whether probable cause 29 exists shall be made by majority vote of a probable cause 30 panel of the board, or by the department or the Agency for 31 Health Care Administration, as appropriate. Each regulatory 21 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 board shall provide by rule that the determination of probable 2 cause shall be made by a panel of its members or by the 3 department or the agency. Each board may provide by rule for 4 multiple probable cause panels composed of at least two 5 members. Each board may provide by rule that one or more 6 members of the panel or panels may be a former board member. 7 The length of term or repetition of service of any such former 8 board member on a probable cause panel may vary according to 9 the direction of the board when authorized by board rule. Any 10 probable cause panel must include one of the board's former or 11 present consumer members, if one is available, willing to 12 serve, and is authorized to do so by the board chairman. Any 13 probable cause panel must include a present board member. Any 14 probable cause panel must include a former or present 15 professional board member. However, any former professional 16 board member serving on the probable cause panel must hold an 17 active valid license for that profession. All proceedings of 18 the panel are exempt from s. 286.011 until 10 days after 19 probable cause has been found to exist by the panel or until 20 the subject of the investigation waives his privilege of 21 confidentiality. The probable cause panel may make a 22 reasonable request, and upon such request the department or 23 the agency shall provide such additional investigative 24 information as is necessary to the determination of probable 25 cause. A request for additional investigative information 26 shall be made within 15 days from the date of receipt by the 27 probable cause panel of the investigative report of the 28 department or the agency. The probable cause panel or the 29 department or the agency, as may be appropriate, shall make 30 its determination of probable cause within 30 days after 31 receipt by it of the final investigative report of the 22 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 department or the agency. The secretary may grant extensions 2 of the 15-day and the 30-day time limits. If the probable 3 cause panel does not find probable cause within the 30-day 4 time limit, as may be extended, or if the probable cause panel 5 finds no probable cause, the department or the agency may 6 determine, within 10 days after the panel fails to determine 7 probable cause or 10 days after the time limit has elapsed, 8 that probable cause exists. In lieu of a finding of probable 9 cause, the probable cause panel, or the department or the 10 agency when there is no board, may issue a letter of guidance 11 to the subject. If within the 30-day time limit, as may be 12 extended, the probable cause panel does not make a 13 determination regarding the existence of probable cause or 14 does not issue a letter of guidance in lieu of a finding of 15 probable cause, the agency, for disciplinary cases under its 16 jurisdiction, must make a determination regarding the 17 existence of probable cause within 10 days after the 18 expiration of the time limit. If the probable cause panel 19 finds that probable cause exists, it shall direct the 20 department or the agency to file a formal complaint against 21 the licensee. The department or the agency shall follow the 22 directions of the probable cause panel regarding the filing of 23 a formal complaint. If directed to do so, the department or 24 the agency shall file a formal complaint against the subject 25 of the investigation and prosecute that complaint pursuant to 26 chapter 120. However, the department or the agency may decide 27 not to prosecute the complaint if it finds that probable cause 28 had been improvidently found by the panel. In such cases, the 29 department or the agency shall refer the matter to the board. 30 The board may then file a formal complaint and prosecute the 31 complaint pursuant to chapter 120. The department or the 23 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 agency shall also refer to the board any investigation or 2 disciplinary proceeding not before the Division of 3 Administrative Hearings pursuant to chapter 120 or otherwise 4 completed by the department or the agency within 1 year after 5 the filing of a complaint. The agency, for disciplinary cases 6 under its jurisdiction, must establish a uniform reporting 7 system to quarterly refer to each board the status of any 8 investigation or disciplinary proceeding that is not before 9 the Division of Administrative Hearings or otherwise completed 10 by the department or agency within 1 year after the filing of 11 the complaint. Annually, the agency, for disciplinary cases 12 under its jurisdiction, if there is no board, or each board 13 must establish a plan to reduce or otherwise close any 14 investigation or disciplinary proceeding that is not before 15 the Division of Administrative Hearings or otherwise completed 16 by the agency within 1 year after the filing of the complaint. 17 A probable cause panel or a board may retain independent legal 18 counsel, employ investigators, and continue the investigation 19 as it deems necessary; all costs thereof shall be paid from 20 the Health Care Trust Fund or the Professional Regulation 21 Trust Fund, as appropriate. All proceedings of the probable 22 cause panel are exempt from s. 120.525. 23 (9)(a) The department or the Agency for Health Care 24 Administration, as appropriate, shall periodically notify the 25 person who filed the complaint of the status of the 26 investigation, whether probable cause has been found, and the 27 status of any civil action or administrative proceeding or 28 appeal. 29 (b) In any disciplinary case under the jurisdiction of 30 the Agency for Health Care Administration for which probable 31 cause has been found, the Agency for Health Care 24 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Administration shall provide to the person who filed the 2 complaint a copy of the administrative complaint, including: 3 1. A written explanation of how an administrative 4 complaint is resolved by the disciplinary process. 5 2. A written explanation of how and when the person 6 may participate in the disciplinary process. 7 3. A written notice of any hearing before the Division 8 of Administrative Hearings or the regulatory board at which 9 final agency action is taken. 10 (c) In any disciplinary case for which probable cause 11 is not found, the Agency for Health Care Administration shall 12 so inform the person who filed the complaint and notify that 13 person that he or she may, within 60 days, provide any 14 additional information to the probable cause panel which may 15 be relevant to the decision. In any administrative proceeding 16 under s. 120.57, the person who filed the disciplinary 17 complaint shall have the right to present oral or written 18 communication relating to the alleged disciplinary violations 19 or to the appropriate penalty. 20 Section 5. Present subsections (8) and (9) of section 21 455.2285, Florida Statutes, are redesignated as subsections 22 (9) and (10), respectively, and a new subsection (8) is added 23 to that section, to read: 24 455.2285 Annual report concerning finances, 25 administrative complaints, disciplinary actions, and 26 recommendations.--The department and the Agency for Health 27 Care Administration are each directed to prepare and submit a 28 report to the President of the Senate and Speaker of the House 29 of Representatives by November 1 of each year. In addition to 30 finances and any other information the Legislature may 31 25 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 require, the report shall include statistics and relevant 2 information, profession by profession, detailing: 3 (8) A description of any effort by the agency, for any 4 disciplinary cases under its jurisdiction, to reduce or 5 otherwise close any investigation or disciplinary proceeding 6 not before the Division of Administrative Hearings under 7 chapter 120 or otherwise not completed within 1 year after the 8 initial filing of a complaint under this chapter. 9 Section 6. 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 7. Subsection (1) of section 457.103, Florida 30 Statutes, is amended to read: 31 26 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 8. 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 27 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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; 28 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 9. Section 457.107, Florida Statutes, is 30 amended to read: 31 29 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 10. 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 30 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 11. 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 31 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 12. 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 32 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 33 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 34 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 35 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 13. 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 36 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 14. 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 37 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 15. 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 16. 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 38 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 17. 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 18. 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: 39 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 40 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 41 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 19. 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. 42 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 43 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 44 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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; 45 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 20. 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 46 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 47 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 21. 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 22. 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.-- 48 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 49 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 50 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 23. 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 51 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 52 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 24. 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 25. Section 458.345, Florida Statutes, is 29 amended to read: 30 31 53 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 458.345 Registration of resident physicians, interns, 2 and fellows; list of hospital employees; prescribing of 3 medicinal drugs; 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, 54 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 person registered as a resident physician under 28 this section may in the normal course of his or her employment 29 prescribe medicinal drugs described in schedules set out in 30 chapter 893 when: 31 55 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (a) The person prescribes such medicinal drugs through 2 use of a Drug Enforcement Administration number issued to the 3 hospital by which the person is employed or at which the 4 person's services are used; 5 (b) The person is identified by a discrete suffix to 6 the identification number issued to the hospital; and 7 (c) The use of the institutional identification number 8 and individual suffixes conforms to the requirements of the 9 federal Drug Enforcement Administration. 10 (7)(5) Any person willfully violating this section 11 commits a misdemeanor of the first degree, punishable as 12 provided in s. 775.082 or s. 775.083. 13 Section 26. Subsection (2) of section 458.346, Florida 14 Statutes, is amended to read: 15 458.346 Public Sector Physician Advisory Committee.-- 16 (2) PUBLIC SECTOR PHYSICIAN ADVISORY COMMITTEE.--There 17 is hereby created a Public Sector Physician Advisory Committee 18 which shall be comprised of three physicians. One physician 19 shall be appointed by the chair chairman of the Board of 20 Medicine. The two remaining physicians shall be appointed by 21 the secretary of the department from recommendations of the 22 appropriate organization, if any, representing such physicians 23 for the purpose of collective bargaining. The chair chairman 24 of the committee shall be one of the two public sector 25 physicians who shall be elected by majority vote of the 26 committee members. Members of the committee shall serve 27 3-year terms and shall meet at least once each year or upon 28 the call of the committee chair on a quarterly basis. The 29 initial term for one public sector physician shall be for 2 30 years, and the other for 3 years. Members of the committee 31 56 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 are subject to reappointment. Committee members shall receive 2 reimbursement for per diem and travel expenses. 3 Section 27. Section 458.347, Florida Statutes, 1996 4 Supplement, is amended to read: 5 458.347 Physician assistants.-- 6 (1) LEGISLATIVE INTENT.-- 7 (a) The purpose of this section is to encourage more 8 effective utilization of the skills of physicians or groups of 9 physicians by enabling them to delegate health care tasks to 10 qualified assistants when such delegation is consistent with 11 the patient's health and welfare. 12 (b) In order that maximum skills may be obtained 13 within a minimum time period of education, a physician 14 assistant shall be specialized to the extent that he can 15 operate efficiently and effectively in the specialty areas in 16 which he has been trained or is experienced. 17 (c) The purpose of this section is to encourage the 18 utilization of physician assistants by physicians and to allow 19 for innovative development of programs for the education of 20 physician assistants. 21 (2) DEFINITIONS.--As used in this section: 22 (a) "Agency" means the Agency for Health Care 23 Administration. 24 (a)(b) "Approved program" means a program, formally 25 approved by the boards, for the education of physician 26 assistants. 27 (b)(c) "Boards" means the Board of Medicine and the 28 Board of Osteopathic Medicine. 29 (c)(d) "Council" means the Council on Physician 30 Assistants. 31 57 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d)(e) "Trainee" means a person who is currently 2 enrolled in an approved program. 3 (e)(f) "Physician assistant" means a person who is a 4 graduate of an approved program or its equivalent or meets 5 standards approved by the boards and is certified to perform 6 medical services delegated by the supervising physician. 7 (f)(g) "Supervision" means responsible supervision and 8 control. Except in cases of emergency, supervision requires 9 the easy availability or physical presence of the licensed 10 physician for consultation and direction of the actions of the 11 physician assistant. For the purposes of this definition, the 12 term "easy availability" includes the ability to communicate 13 by way of telecommunication. The boards shall establish rules 14 as to what constitutes responsible supervision of the 15 physician assistant. 16 (g)(h) "Proficiency examination" means an entry-level 17 examination approved by the boards, including, but not limited 18 to, those examinations administered by the National Commission 19 on Certification of Physician Assistants. 20 (h)(i) "Continuing medical education" means courses 21 recognized and approved by the boards, the American Academy of 22 Physician Assistants, the American Medical Association, the 23 American Osteopathic Association, or the Accreditation Council 24 on Continuing Medical Education. 25 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.--Each 26 physician or group of physicians supervising a certified 27 physician assistant must be qualified in the medical areas in 28 which the physician assistant is to perform and shall be 29 individually or collectively responsible and liable for the 30 performance and the acts and omissions of the physician 31 58 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 assistant. A physician may not supervise more than four 2 currently certified physician assistants at any one time. 3 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.-- 4 (a) The boards shall adopt, by rule, the general 5 principles that supervising physicians must use in developing 6 the scope of practice of a physician assistant under direct 7 supervision and under indirect supervision. These principles 8 shall recognize the diversity of both specialty and practice 9 settings in which physician assistants are used. 10 (b) This chapter does not prevent third-party payors 11 from reimbursing employers of physician assistants for covered 12 services rendered by certified physician assistants. 13 (c) Certified physician assistants may not be denied 14 clinical hospital privileges, except for cause, so long as the 15 supervising physician is a staff member in good standing. 16 (d) A supervisory physician may delegate to a 17 certified physician assistant, pursuant to a written protocol, 18 the authority to act according to s. 154.04(1)(c)(d). Such 19 delegated authority is limited to the supervising physician's 20 practice in connection with a county public health department 21 unit as defined and established pursuant to chapter 154. The 22 boards shall adopt rules governing the supervision of 23 physician assistants by physicians in county public health 24 departments units. 25 (e) A supervisory physician may delegate to a fully 26 certified physician assistant the authority to prescribe any 27 medication used in the supervisory physician's practice if 28 such medication is listed on the formulary created pursuant to 29 paragraph (f). A fully certified physician assistant may only 30 prescribe such medication under the following circumstances: 31 59 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 1. A physician assistant must clearly identify to the 2 patient that he is a physician assistant. Furthermore, the 3 physician assistant must inform the patient that the patient 4 has the right to see the physician prior to any prescription 5 being prescribed by the physician assistant. 6 2. The supervisory physician must notify the 7 department agency of his intent to delegate, on a 8 department-approved an agency-approved form, before delegating 9 such authority and with each certification renewal application 10 filed by the physician assistant. 11 3. The physician assistant must file with the 12 department agency, before commencing to prescribe, evidence 13 that he has completed a continuing medical education course of 14 at least 3 classroom hours in prescriptive practice, conducted 15 by an accredited program approved by the boards, which course 16 covers the limitations, responsibilities, and privileges 17 involved in prescribing medicinal drugs, or evidence that he 18 has received education comparable to the continuing education 19 course as part of an accredited physician assistant training 20 program. 21 4. The physician assistant must file with the 22 department agency, before commencing to prescribe, evidence 23 that the physician assistant has a minimum of 3 months of 24 clinical experience in the specialty area of the supervising 25 physician. 26 5. The physician assistant must file with the 27 department agency a signed affidavit that he has completed a 28 minimum of 10 continuing medical education hours in the 29 specialty practice in which the physician assistant has 30 prescriptive privileges with each certification renewal 31 application. 60 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 6. The department agency shall issue certification and 2 a prescriber number to the physician assistant granting 3 authority for the prescribing of medicinal drugs authorized 4 within this paragraph upon completion of the foregoing 5 requirements. 6 7. The prescription must be written in a form that 7 complies with chapter 499 and must contain, in addition to the 8 supervisory physician's name, address, and telephone number, 9 the physician assistant's prescriber number. The prescription 10 must be filled in a pharmacy permitted under chapter 465 and 11 must be dispensed in that pharmacy by a pharmacist licensed 12 under chapter 465. The appearance of the prescriber number 13 creates a presumption that the physician assistant is 14 authorized to prescribe the medicinal drug and the 15 prescription is valid. 16 8. The physician assistant must note the prescription 17 in the appropriate medical record, and the supervisory 18 physician must review and sign each notation. For dispensing 19 purposes only, the failure of the supervisory physician to 20 comply with these requirements does not affect the validity of 21 the prescription. 22 9. This paragraph does not prohibit a supervisory 23 physician from delegating to a physician assistant the 24 authority to order medication for a hospitalized patient of 25 the supervisory physician. 26 27 This paragraph does not apply to facilities licensed pursuant 28 to chapter 395. 29 (f)1. There is created a five-member committee 30 appointed by the Director of Health Care Administration. The 31 committee must be composed of one fully certified physician 61 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 assistant certified pursuant to this section or s. 459.022 2 458.022, two physicians licensed pursuant to this chapter, one 3 of whom supervises a fully licensed physician assistant, one 4 osteopathic physician licensed pursuant to chapter 459, and 5 one pharmacist licensed pursuant to chapter 465 who is not 6 licensed pursuant to this chapter or chapter 459. The 7 committee shall establish a formulary of medicinal drugs for 8 which a fully certified physician assistant may prescribe. 9 The formulary may not include controlled substances as defined 10 in chapter 893, antineoplastics, antipsychotics, 11 radiopharmaceuticals, general anesthetics or radiographic 12 contrast materials, or any parenteral preparations except 13 insulin and epinephrine. 14 2. Only the committee shall add to, delete from, or 15 modify the formulary. Any person who requests an addition, 16 deletion, or modification of a medicinal drug listed on such 17 formulary has the burden of proof to show cause why such 18 addition, deletion, or modification should be made. 19 3. The boards shall adopt the formulary required by 20 this paragraph, and each addition, deletion, or modification 21 to the formulary, by rule. Notwithstanding any provision of 22 chapter 120 to the contrary, the formulary rule shall be 23 effective 60 days after the date it is filed with the 24 Secretary of State. Upon adoption of the formulary, the 25 department agency shall mail a copy of such formulary to each 26 fully certified physician assistant and to each pharmacy 27 licensed by the state. The boards shall establish, by rule, a 28 fee not to exceed $200 to fund the provisions of this 29 paragraph and paragraph (e). 30 31 62 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (5) PERFORMANCE BY TRAINEES.--Notwithstanding any 2 other law, a trainee may perform medical services when such 3 services are rendered within the scope of an approved program. 4 (6) PROGRAM APPROVAL.-- 5 (a) The boards shall approve programs, based on 6 recommendations by the council, for the education and training 7 of physician assistants which meet standards established by 8 rule of the boards. The council may recommend only those 9 physician assistant programs that hold full accreditation or 10 provisional accreditation from the Commission on Accreditation 11 of Allied Health Programs or its successor organization. Any 12 educational institution offering a physician assistant program 13 approved by the boards pursuant to this paragraph may also 14 offer the physician assistant program authorized in paragraph 15 (c) for unlicensed physicians. 16 (b) The boards shall adopt and publish standards to 17 ensure that such programs operate in a manner that does not 18 endanger the health or welfare of the patients who receive 19 services within the scope of the programs. The boards shall 20 review the quality of the curricula, faculties, and facilities 21 of such programs and take whatever other action is necessary 22 to determine that the purposes of this section are being met. 23 (c) Any community college with the approval of the 24 State Board of Community Colleges may conduct a physician 25 assistant program which shall apply for national accreditation 26 through the American Medical Association's Committee on Allied 27 Health, Education, and Accreditation, or its successor 28 organization, and which may admit unlicensed physicians, as 29 authorized in subsection (7), who are graduates of foreign 30 medical schools listed with the World Health Organization. 31 The unlicensed physician must have been a resident of this 63 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 state for a minimum of 12 months immediately prior to 2 admission to the program. An evaluation of knowledge base by 3 examination shall be required to grant advanced academic 4 credit and to fulfill the necessary requirements to graduate. 5 A minimum of one 16-week semester of supervised clinical and 6 didactic education, which may be completed simultaneously, 7 shall be required before graduation from the program. All 8 other provisions of this section shall remain in effect. 9 (7) PHYSICIAN ASSISTANT CERTIFICATION.-- 10 (a) Any person desiring to be certified as a physician 11 assistant must apply to the department agency. The department 12 agency shall issue a certificate to any person certified by 13 the council as having met the following requirements: 14 1. Is at least 18 years of age. 15 2. Has satisfactorily passed a proficiency examination 16 by an acceptable score established by the National Commission 17 on Certification of Physician Assistants. If an applicant 18 does not hold a current certificate issued by the National 19 Commission on Certification of Physician Assistants and has 20 not actively practiced as a physician assistant within the 21 immediately preceding 4 years, the applicant must retake and 22 successfully complete the entry-level examination of the 23 National Commission on Certification of Physician Assistants 24 to be eligible for certification. 25 3. Has completed the application form and remitted an 26 application fee not to exceed $300 as set by the boards. An 27 application for certification made by a physician assistant 28 must include: 29 a. A certificate of completion of a physician 30 assistant training program specified in subsection (6). 31 b. A sworn statement of any prior felony convictions. 64 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 c. A sworn statement of any previous revocation or 2 denial of licensure or certification in any state. 3 d. Two letters of recommendation. 4 (b)1. Notwithstanding subparagraph (a)2. and 5 sub-subparagraph (a)3.a., the department agency shall examine 6 each applicant who the Board of Medicine certifies: 7 a. Has completed the application form and remitted a 8 nonrefundable application fee not to exceed $500 and an 9 examination fee not to exceed $300, plus the actual cost to 10 the department agency to provide the examination. The 11 examination fee is refundable if the applicant is found to be 12 ineligible to take the examination. The department agency 13 shall translate the examination into the native language of 14 any applicant who requests and agrees to pay all costs of such 15 translation, provided the applicant demonstrates to the 16 department agency the ability to communicate orally in basic 17 English. 18 b. Is an unlicensed physician who graduated from a 19 foreign medical school listed with the World Health 20 Organization who has not previously taken and failed the 21 examination of the National Commission on Certification of 22 Physician Assistants and who has been certified by the Board 23 of Medicine as having met the requirements for licensure as a 24 medical doctor by examination as set forth in s. 458.311(1), 25 (3), (4), and (5), with the exception that the applicant is 26 not required to have completed an approved residency of at 27 least 1 year and the applicant is not required to have passed 28 the licensing examination specified under s. 458.311 or hold a 29 valid, active certificate issued by the Educational Commission 30 for Foreign Medical Graduates. 31 65 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 c. Was eligible and made initial application for 2 certification as a physician assistant in this state between 3 July 1, 1990, and June 30, 1991. 4 d. Was a resident of this state on July 1, 1990, or 5 was licensed or certified in any state in the United States as 6 a physician assistant on July 1, 1990. 7 2. The department agency may grant temporary 8 certification to an applicant who meets the requirements of 9 subparagraph 1. 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. A temporary certificate 15 expires upon receipt and notice of scores to the 16 certificateholder from the first available examination 17 specified in subparagraph 1. following certification by the 18 department agency. An applicant who fails the proficiency 19 examination is no longer temporarily certified, but may apply 20 for a one-time extension of temporary certification after 21 reapplying for the next available examination. Extended 22 certification shall expire upon failure of the 23 certificateholder to sit for the next available examination or 24 upon receipt and notice of scores to the certificateholder 25 from such examination. 26 3. Notwithstanding any other provision of law, the 27 examination specified pursuant to subparagraph 1. shall be 28 administered by the department agency only five times. 29 Applicants certified by the board for examination shall 30 receive at least 6 months' notice of eligibility prior to the 31 administration of the initial examination. Subsequent 66 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 examinations shall be administered at intervals determined by 2 the department agency after the reporting of the scores of the 3 first examination. For the purposes of this paragraph, the 4 department agency may develop, contract for the development 5 of, purchase, or approve an examination, including a practical 6 component, that adequately measures an applicant's ability to 7 practice with reasonable skill and safety. The minimum 8 passing score on the examination shall be established by the 9 department agency, with the advice of the board. Those 10 applicants failing to pass that examination or any subsequent 11 examination shall receive notice of the administration of the 12 next examination with the notice of scores following such 13 examination. Any applicant who passes the examination and 14 meets the requirements of this section shall be certified as a 15 physician assistant with all rights defined thereby. 16 (c) The certification must be renewed biennially. 17 Each renewal must include: 18 1. A renewal fee not to exceed $500 as set by the 19 boards. 20 2. A sworn statement of no felony convictions in the 21 previous 2 years. 22 (d) Each certified physician assistant shall 23 biennially complete 100 hours of continuing medical education 24 or shall hold a current certificate issued by the National 25 Commission on Certification of Physician Assistants. 26 (e) Upon employment as a physician assistant, a 27 certified physician assistant must notify the department 28 agency in writing within 30 days after such employment or 29 after any subsequent changes in the supervising physician. The 30 notification must include the full name, Florida medical 31 67 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 license number, specialty, and address of the supervising 2 physician. 3 (f) Notwithstanding subparagraph (a)2., the department 4 agency may grant to a recent graduate of an approved program, 5 as specified in subsection (6), temporary certification to 6 expire upon receipt of scores of the proficiency examination 7 administered by the National Commission on Certification of 8 Physician Assistants. Between meetings of the council, the 9 department agency may grant temporary certification to 10 practice based on the completion of all temporary 11 certification requirements. All such administratively issued 12 certifications shall be reviewed and acted on at the next 13 regular meeting of the council. The recent graduate may be 14 certified prior to employment, but must comply with paragraph 15 (e). An applicant who has passed the proficiency examination 16 may be granted permanent certification. An applicant failing 17 the proficiency examination is no longer temporarily 18 certified, but may reapply for a 1-year extension of temporary 19 certification. An applicant may not be granted more than two 20 temporary certificates and may not be certified as a physician 21 assistant until he passes the examination administered by the 22 National Commission on Certification of Physician Assistants. 23 As prescribed by board rule, the council may require an 24 applicant who does not pass the licensing examination after 25 five or more attempts to complete additional remedial 26 education or training. The council 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 council to retake 30 the examination a sixth or subsequent time. 31 68 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 69 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 70 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 71 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 28. 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. 72 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 29. Subsection (2) of section 459.003, Florida 14 Statutes, is amended, and subsection (5) is added to said 15 section, to read: 16 459.003 Definitions.--As used in this chapter: 17 (2) "Department" means the Department of Health 18 Business and Professional Regulation. 19 (5) "Doctor of Osteopathy" and "Doctor of Osteopathic 20 Medicine," when referring to degrees, shall be construed to be 21 equivalent and equal degrees. 22 Section 30. Subsections (1) and (3) and paragraph (b) 23 of subsection (5) of section 459.021, Florida Statutes, are 24 amended, and subsections (8) and (9) are added to that 25 section, to read: 26 459.021 Registration of resident physicians, interns, 27 and fellows; list of hospital employees; penalty.-- 28 (1) Any person who holds a degree of Doctor of 29 Osteopathic Medicine Osteopathy from a college of osteopathic 30 medicine recognized and approved by the American Osteopathic 31 Association who desires to practice as a resident physician, 73 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 assistant resident physician, house physician, intern, or 2 fellow in fellowship training which leads to subspecialty 3 board certification in this state who does not hold an active 4 license issued under this chapter shall apply to the 5 department to be registered, on an application provided by the 6 department, within 30 days of commencing such a training 7 program and shall remit a fee not to exceed $300 as set by the 8 board. 9 (3) Every hospital having employed or contracted with 10 or utilized the services of a person who holds a degree of 11 Doctor of Osteopathic Medicine Osteopathy from a college of 12 osteopathic medicine recognized and approved by the American 13 Osteopathic Association as a resident physician, assistant 14 resident physician, house physician, intern, or fellow in 15 fellowship training which leads to subspecialty board 16 certification shall designate a person who shall furnish, in 17 January and July of each year, to the department a list of all 18 such persons who have served in the hospital during the 19 preceding 6-month period. The chief executive officer of each 20 such hospital shall provide the executive director of the 21 board with the name, title, and address of the person 22 responsible for filing such reports. 23 (5) It is a misdemeanor of the second degree, 24 punishable as provided in s. 775.082 or s. 775.083 for any 25 hospital, and also for the superintendent, administrator, and 26 other person or persons having administrative authority in a 27 hospital: 28 (b) To fail to furnish to the department the list and 29 information required by subsection (3). 30 31 74 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (8) Notwithstanding any provision of this section or 2 s. 120.52 to the contrary, any person who is registered under 3 this section is subject to the provisions of s. 459.015. 4 (9) A person registered as a resident physician under 5 this section may in the normal course of his or her employment 6 prescribe medicinal drugs described in schedules set out in 7 chapter 893 when: 8 (a) The person prescribes such medicinal drugs through 9 use of a Drug Enforcement Administration number issued to the 10 hospital by which the person is employed or at which the 11 person's services are used; 12 (b) The person is identified by a discrete suffix to 13 the identification number issued to the hospital; and 14 (c) The use of the institutional identification number 15 and individual suffixes conforms to the requirements of the 16 federal Drug Enforcement Administration. 17 Section 31. Subsection (1) of section 459.0075, 18 Florida Statutes, is amended to read: 19 459.0075 Limited licenses.-- 20 (1) Any person desiring to obtain a limited license 21 shall: 22 (a) Submit to the board a licensure application and 23 fee required by this chapter. However, an osteopathic 24 physician who is not fully retired in all jurisdictions, may 25 use a limited license only for noncompensated practice. 26 However, If the person applying for a limited license submits 27 a notarized statement from the employing agency or institution 28 stating that he will not receive monetary compensation for any 29 service involving the practice of osteopathic medicine, the 30 application fee and all licensure fees shall be waived. 31 However, any person who receives a waiver of fees for a 75 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 limited license shall pay such fees if the person receives 2 compensation for the practice of osteopathic medicine. 3 (b) Submit an affidavit that such osteopathic 4 physician has been licensed to practice osteopathic medicine 5 in any jurisdiction in the United States in good standing and 6 pursuant to law for at least 10 years and has now retired and 7 that he was in good standing at the time of his retirement. 8 (c) Complete an amount of continuing education 9 established by the board. 10 Section 32. Paragraphs (a) and (g) of subsection (5) 11 of section 459.0085, Florida Statutes, 1996 Supplement, are 12 amended to read: 13 459.0085 Financial responsibility.-- 14 (5) The requirements of subsections (1), (2), and (3) 15 shall not apply to: 16 (a) Any person licensed under this chapter who 17 practices medicine exclusively as an officer, employee, or 18 agent of the Federal Government or of the state or its 19 agencies or its subdivisions. For the purposes of this 20 subsection, an agent of the state, its agencies, or its and 21 subdivisions is a person who is eligible for coverage under 22 any self-insurance or insurance program authorized by the 23 provisions of s. 768.28(15)(14). 24 (g) Any person holding an active license under this 25 chapter who agrees to meet all of the following criteria: 26 1. Upon the entry of an adverse final judgment arising 27 from a medical malpractice arbitration award, from a claim of 28 medical malpractice either in contract or tort, or from 29 noncompliance with the terms of a settlement agreement arising 30 from a claim of medical malpractice either in contract or 31 tort, the licensee shall pay the judgment creditor the lesser 76 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of the entire amount of the judgment with all accrued interest 2 or either $100,000, if the osteopathic physician is licensed 3 pursuant to this chapter but does not maintain hospital staff 4 privileges, or $250,000, if the osteopathic physician is 5 licensed pursuant to this chapter and maintains hospital staff 6 privileges, within 60 days after the date such judgment became 7 final and subject to execution, unless otherwise mutually 8 agreed to in writing by the parties. Such adverse final 9 judgment shall include any cross-claim, counterclaim, or claim 10 for indemnity or contribution arising from the claim of 11 medical malpractice. Upon notification of the existence of an 12 unsatisfied judgment or payment pursuant to this subparagraph, 13 the department shall notify the licensee by certified mail 14 that he shall be subject to disciplinary action unless, within 15 30 days from the date of mailing, he either: 16 a. Shows proof that the unsatisfied judgment has been 17 paid in the amount specified in this subparagraph; or 18 b. Furnishes the department with a copy of a timely 19 filed notice of appeal and either: 20 (I) A copy of a supersedeas bond properly posted in 21 the amount required by law; or 22 (II) An order from a court of competent jurisdiction 23 staying execution on the final judgment, pending disposition 24 of the appeal. 25 2. Upon the next meeting of the probable cause panel 26 of the board following 30 days after the date of mailing the 27 notice of disciplinary action to the licensee, the panel shall 28 make a determination of whether probable cause exists to take 29 disciplinary action against the licensee pursuant to 30 subparagraph 1. 31 77 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 3. If the board determines that the factual 2 requirements of subparagraph 1. are met, it shall take 3 disciplinary action as it deems appropriate against the 4 licensee. Such disciplinary action shall include, at a 5 minimum, probation of the license with the restriction that 6 the licensee must make payments to the judgment creditor on a 7 schedule determined by the board to be reasonable and within 8 the financial capability of the osteopathic physician. 9 Notwithstanding any other disciplinary penalty imposed, the 10 disciplinary penalty may include suspension of the license for 11 a period not to exceed 5 years. In the event that an 12 agreement to satisfy a judgment has been met, the board shall 13 remove any restriction on the license. 14 4. The licensee has completed a form supplying 15 necessary information as required by the department. 16 17 A licensee who meets the requirements of this paragraph shall 18 be required to either post notice in the form of a sign 19 prominently displayed in the reception area and clearly 20 noticeable by all patients and or provide a written statement 21 to any person to whom medical services are being provided. A 22 copy of the written statement shall be given to each patient 23 to sign, acknowledging receipt thereof, and the signed copy 24 shall be maintained in the patient's file. If the patient 25 refuses to sign or is unable to sign the written statement, 26 the licensee shall so note it on the form. Such sign and or 27 statement shall state that: "Under Florida law, osteopathic 28 physicians are generally required to carry medical malpractice 29 insurance or otherwise demonstrate financial responsibility to 30 cover potential claims for medical malpractice. YOUR 31 OSTEOPATHIC PHYSICIAN HAS DECIDED NOT TO CARRY MEDICAL 78 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 MALPRACTICE INSURANCE. This is permitted under Florida law 2 subject to certain conditions. Florida law imposes strict 3 penalties against noninsured osteopathic physicians who fail 4 to satisfy adverse judgments arising from claims of medical 5 malpractice. This notice is provided pursuant to Florida 6 law." 7 Section 33. Paragraphs (o), (gg), and (ll) of 8 subsection (1) of section 459.015, Florida Statutes, 1996 9 Supplement, are amended, and paragraph (nn) is added to said 10 subsection, to read: 11 459.015 Grounds for disciplinary action by the 12 board.-- 13 (1) The following acts shall constitute grounds for 14 which the disciplinary actions specified in subsection (2) may 15 be taken: 16 (o) Failing to keep legible, as defined by department 17 rule in consultation with the board, written medical records 18 that identify the licensed osteopathic physician or the 19 osteopathic physician extender and supervising osteopathic 20 physician by name and professional title who is or are 21 responsible for rendering, ordering, supervising, or billing 22 for each diagnostic or treatment procedure and that justify 23 justifying the course of treatment of the patient, including, 24 but not limited to, patient histories; examination results; 25 test results; records of drugs prescribed, dispensed, or 26 administered; and reports of consultations and 27 hospitalizations. 28 (gg) Prescribing, ordering, dispensing, administering, 29 supplying, selling, or giving any drug which is a Schedule II 30 amphetamine or Schedule II sympathomimetic amine drug or any 31 79 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 compound thereof, pursuant to chapter 893, to or for any 2 person except for: 3 1. The treatment of narcolepsy; hyperkinesis; 4 behavioral syndrome in children characterized by the 5 developmentally inappropriate symptoms of moderate to severe 6 distractability, short attention span, hyperactivity, 7 emotional lability, and impulsivity; or drug-induced brain 8 dysfunction; 9 2. The differential diagnostic psychiatric evaluation 10 of depression or the treatment of depression shown to be 11 refractory to other therapeutic modalities; or 12 3. The clinical investigation of the effects of such 13 drugs or compounds when an investigative protocol therefor is 14 submitted to, reviewed, and approved by the board before such 15 investigation is begun. 16 (ll) Failing to report to the department Division of 17 Medical Quality Assurance any licensee physician licensed 18 under chapter 458 or osteopathic physician licensed under this 19 chapter who the osteopathic physician or physician assistant 20 knows has violated the grounds for disciplinary action set out 21 in the law under which that person physician or osteopathic 22 physician is licensed and who provides health care services in 23 a facility licensed under chapter 395, or a health maintenance 24 organization certificated under part I of chapter 641, in 25 which the osteopathic physician or physician assistant also 26 provides services. 27 (nn) Advertising or holding oneself out as a 28 board-certified specialist in violation of this chapter. 29 Section 34. Section 459.0152, Florida Statutes, is 30 created to read: 31 80 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 459.0152 Specialties.--An osteopathic physician 2 licensed under this chapter may not hold himself or herself 3 out as a board-certified specialist unless the osteopathic 4 physician has successfully completed the requirements for 5 certification by the American Osteopathic Association or the 6 Accreditation Council on Graduate Medical Education and is 7 certified as a specialist by a certifying agency approved by 8 the board. However, an osteopathic physician may indicate the 9 services offered and may state that his or her practice is 10 limited to one or more types of services when this accurately 11 reflects the scope of practice of the osteopathic physician. 12 Section 35. Section 459.022, Florida Statutes, 1996 13 Supplement, is amended to read: 14 459.022 Physician assistants.-- 15 (1) LEGISLATIVE INTENT.-- 16 (a) The purpose of this section is to encourage more 17 effective utilization of the skills of osteopathic physicians 18 or groups of osteopathic physicians by enabling them to 19 delegate health care tasks to qualified assistants when such 20 delegation is consistent with the patient's health and 21 welfare. 22 (b) In order that maximum skills may be obtained 23 within a minimum time period of education, a physician 24 assistant shall be specialized to the extent that he can 25 operate efficiently and effectively in the specialty areas in 26 which he has been trained or is experienced. 27 (c) The purpose of this section is to encourage the 28 utilization of physician assistants by osteopathic physicians 29 and to allow for innovative development of programs for the 30 education of physician assistants. 31 (2) DEFINITIONS.--As used in this section: 81 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (a) "Agency" means the Agency for Health Care 2 Administration. 3 (a)(b) "Approved program" means a program, formally 4 approved by the boards, for the education of physician 5 assistants. 6 (b)(c) "Boards" means the Board of Medicine and the 7 Board of Osteopathic Medicine. 8 (c)(d) "Council" means the Council on Physician 9 Assistants. 10 (d)(e) "Trainee" means a person who is currently 11 enrolled in an approved program. 12 (e)(f) "Physician assistant" means a person who is a 13 graduate of an approved program or its equivalent or meets 14 standards approved by the boards and is certified to perform 15 medical services delegated by the supervising physician. 16 (f)(g) "Supervision" means responsible supervision and 17 control. Except in cases of emergency, supervision requires 18 the easy availability or physical presence of the licensed 19 physician for consultation and direction of the actions of the 20 physician assistant. For the purposes of this definition, the 21 term "easy availability" includes the ability to communicate 22 by way of telecommunication. The boards shall establish rules 23 as to what constitutes responsible supervision of the 24 physician assistant. 25 (g)(h) "Proficiency examination" means an entry-level 26 examination approved by the boards, including, but not limited 27 to, those examinations administered by the National Commission 28 on Certification of Physician Assistants. 29 (h)(i) "Continuing medical education" means courses 30 recognized and approved by the boards, the American Academy of 31 Physician Assistants, the American Medical Association, the 82 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 American Osteopathic Association, or the Accreditation Council 2 on Continuing Medical Education. 3 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.--Each 4 physician or group of physicians supervising a certified 5 physician assistant must be qualified in the medical areas in 6 which the physician assistant is to perform and shall be 7 individually or collectively responsible and liable for the 8 performance and the acts and omissions of the physician 9 assistant. A physician may not supervise more than four 10 currently certified physician assistants at any one time. 11 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.-- 12 (a) The boards shall adopt, by rule, the general 13 principles that supervising physicians must use in developing 14 the scope of practice of a physician assistant under direct 15 supervision and under indirect supervision. These principles 16 shall recognize the diversity of both specialty and practice 17 settings in which physician assistants are used. 18 (b) This chapter does not prevent third-party payors 19 from reimbursing employers of physician assistants for covered 20 services rendered by certified physician assistants. 21 (c) Certified physician assistants may not be denied 22 clinical hospital privileges, except for cause, so long as the 23 supervising physician is a staff member in good standing. 24 (d) A supervisory physician may delegate to a 25 certified physician assistant, pursuant to a written protocol, 26 the authority to act according to s. 154.04(1)(c)(d). Such 27 delegated authority is limited to the supervising physician's 28 practice in connection with a county public health department 29 unit as defined and established pursuant to chapter 154. The 30 boards shall adopt rules governing the supervision of 31 83 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physician assistants by physicians in county public health 2 departments units. 3 (e) A supervisory physician may delegate to a fully 4 certified physician assistant the authority to prescribe any 5 medication used in the supervisory physician's practice if 6 such medication is listed on the formulary created pursuant to 7 s. 458.347. A fully certified physician assistant may only 8 prescribe such medication under the following circumstances: 9 1. A physician assistant must clearly identify to the 10 patient that he is a physician assistant. Furthermore, the 11 physician assistant must inform the patient that the patient 12 has the right to see the physician prior to any prescription 13 being prescribed by the physician assistant. 14 2. The supervisory physician must notify the 15 department agency of his intent to delegate, on a 16 department-approved an agency-approved form, before delegating 17 such authority and with each certification renewal application 18 filed by the physician assistant. 19 3. The physician assistant must file with the 20 department agency, before commencing to prescribe, evidence 21 that he has completed a continuing medical education course of 22 at least 3 classroom hours in prescriptive practice, conducted 23 by an accredited program approved by the boards, which course 24 covers the limitations, responsibilities, and privileges 25 involved in prescribing medicinal drugs, or evidence that he 26 has received education comparable to the continuing education 27 course as part of an accredited physician assistant training 28 program. 29 4. The physician assistant must file with the 30 department agency, before commencing to prescribe, evidence 31 that the physician assistant has a minimum of 3 months of 84 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 clinical experience in the specialty area of the supervising 2 physician. 3 5. The physician assistant must file with the 4 department agency a signed affidavit that he has completed a 5 minimum of 10 continuing medical education hours in the 6 specialty practice in which the physician assistant has 7 prescriptive privileges with each certification renewal 8 application. 9 6. The department agency shall issue certification and 10 a prescriber number to the physician assistant granting 11 authority for the prescribing of medicinal drugs authorized 12 within this paragraph upon completion of the foregoing 13 requirements. 14 7. The prescription must be written in a form that 15 complies with chapter 499 and must contain, in addition to the 16 supervisory physician's name, address, and telephone number, 17 the physician assistant's prescriber number. The prescription 18 must be filled in a pharmacy permitted under chapter 465, and 19 must be dispensed in that pharmacy by a pharmacist licensed 20 under chapter 465. The appearance of the prescriber number 21 creates a presumption that the physician assistant is 22 authorized to prescribe the medicinal drug and the 23 prescription is valid. 24 8. The physician assistant must note the prescription 25 in the appropriate medical record, and the supervisory 26 physician must review and sign each notation. For dispensing 27 purposes only, the failure of the supervisory physician to 28 comply with these requirements does not affect the validity of 29 the prescription. 30 9. This paragraph does not prohibit a supervisory 31 physician from delegating to a physician assistant the 85 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 authority to order medication for a hospitalized patient of 2 the supervisory physician. 3 4 This paragraph does not apply to facilities licensed pursuant 5 to chapter 395. 6 (f)1. There is created a five-member committee 7 appointed by the Director of Health Care Administration. The 8 committee must be composed of one fully certified physician 9 assistant certified pursuant to this section or s. 458.347, 10 two physicians licensed pursuant to chapter 458, one of whom 11 supervises a fully licensed physician assistant, one 12 osteopathic physician licensed pursuant to this chapter, and 13 one pharmacist licensed pursuant to chapter 465 who is not 14 licensed pursuant to this chapter or chapter 458. The 15 committee shall establish a formulary of medicinal drugs for 16 which a fully certified physician assistant may prescribe. 17 The formulary may not include controlled substances as defined 18 in chapter 893, antineoplastics, antipsychotics, 19 radiopharmaceuticals, general anesthetics or radiographic 20 contrast materials, or any parenteral preparations except 21 insulin and epinephrine. 22 2. Only the committee shall add to, delete from, or 23 modify the formulary. Any person who requests an addition, 24 deletion, or modification of a medicinal drug listed on such 25 formulary has the burden of proof to show cause why such 26 addition, deletion, or modification should be made. 27 3. The boards shall adopt the formulary required by 28 this paragraph, and each addition, deletion, or modification 29 to the formulary, by rule. Notwithstanding any provision of 30 chapter 120 to the contrary, the formulary rule shall be 31 effective 60 days after the date it is filed with the 86 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Secretary of State. Upon adoption of the formulary, the 2 department agency shall mail a copy of such formulary to each 3 fully certified physician assistant and to each pharmacy 4 licensed by the state. The boards shall establish, by rule, a 5 fee not to exceed $200 to fund the provisions of this 6 paragraph and paragraph (e). 7 (5) PERFORMANCE BY TRAINEES.--Notwithstanding any 8 other law, a trainee may perform medical services when such 9 services are rendered within the scope of an approved program. 10 (6) PROGRAM APPROVAL.-- 11 (a) The boards shall approve programs, based on 12 recommendations by the council, for the education and training 13 of physician assistants which meet standards established by 14 rule of the boards. The council may recommend only those 15 physician assistant programs that hold full accreditation or 16 provisional accreditation from the Commission on Accreditation 17 of Allied Health Programs or its successor organization. 18 (b) The boards shall adopt and publish standards to 19 ensure that such programs operate in a manner that does not 20 endanger the health or welfare of the patients who receive 21 services within the scope of the programs. The boards shall 22 review the quality of the curricula, faculties, and facilities 23 of such programs and take whatever other action is necessary 24 to determine that the purposes of this section are being met. 25 (7) PHYSICIAN ASSISTANT CERTIFICATION.-- 26 (a) Any person desiring to be certified as a physician 27 assistant must apply to the department agency. The department 28 agency shall issue a certificate to any person certified by 29 the council as having met the following requirements: 30 1. Is at least 18 years of age. 31 87 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2. Has satisfactorily passed a proficiency examination 2 by an acceptable score established by the National Commission 3 on Certification of Physician Assistants. If an applicant 4 does not hold a current certificate issued by the National 5 Commission on Certification of Physician Assistants and has 6 not actively practiced as a physician assistant within the 7 immediately preceding 4 years, the applicant must retake and 8 successfully complete the entry-level examination of the 9 National Commission on Certification of Physician Assistants 10 to be eligible for certification. 11 3. Has completed the application form and remitted an 12 application fee not to exceed $300 as set by the boards. An 13 application for certification made by a physician assistant 14 must include: 15 a. A certificate of completion of a physician 16 assistant training program specified in subsection (6). 17 b. A sworn statement of any prior felony convictions. 18 c. A sworn statement of any previous revocation or 19 denial of licensure or certification in any state. 20 d. Two letters of recommendation. 21 (b) The certification must be renewed biennially. 22 Each renewal must include: 23 1. A renewal fee not to exceed $500 as set by the 24 boards. 25 2. A sworn statement of no felony convictions in the 26 previous 2 years. 27 (c) Each certified physician assistant shall 28 biennially complete 100 hours of continuing medical education 29 or shall hold a current certificate issued by the National 30 Commission on Certification of Physician Assistants. 31 88 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) Upon employment as a physician assistant, a 2 certified physician assistant must notify the department 3 agency in writing within 30 days after such employment or 4 after any subsequent changes in the supervising physician. 5 The notification must include the full name, Florida medical 6 license number, specialty, and address of the supervising 7 physician. 8 (e) Notwithstanding subparagraph (a)2., the department 9 agency may grant to a recent graduate of an approved program, 10 as specified in subsection (6), temporary certification to 11 expire upon receipt of scores of the proficiency examination 12 administered by the National Commission on Certification of 13 Physician Assistants. Between meetings of the council, the 14 department agency may grant temporary certification to 15 practice to physician assistant applicants based on the 16 completion of all temporary certification requirements. All 17 such administratively issued certifications shall be reviewed 18 and acted on at the next regular meeting of the council. The 19 recent graduate may be certified prior to employment, but must 20 comply with paragraph (d). An applicant who has passed the 21 proficiency examination may be granted permanent 22 certification. An applicant failing the proficiency 23 examination is no longer temporarily certified, but may 24 reapply for a 1-year extension of temporary certification. An 25 applicant may not be granted more than two temporary 26 certificates and may not be certified as a physician assistant 27 until he passes the examination administered by the National 28 Commission on Certification of Physician Assistants. As 29 prescribed by board rule, the council may require an applicant 30 who does not pass the licensing examination after five or more 31 attempts to complete additional remedial education or 89 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 training. The council shall prescribe the additional 2 requirements in a manner that permits the applicant to 3 complete the requirements and be reexamined within 2 years 4 after the date the applicant petitions the council to retake 5 the examination a sixth or subsequent time. 6 (f) The Board of Osteopathic Medicine may impose any 7 of the penalties specified in ss. 455.227 and 459.015(2) upon 8 a physician assistant if the physician assistant or the 9 supervising physician has been found guilty of or is being 10 investigated for any act that constitutes a violation of this 11 chapter or chapter 455. 12 (8) DELEGATION OF POWERS AND DUTIES.--The boards may 13 delegate such powers and duties to the council as they may 14 deem proper. 15 (9) COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on 16 Physician Assistants is created within the department Agency 17 for Health Care Administration. 18 (a) The council shall consist of five members 19 appointed as follows: 20 1. The chairperson of the Board of Medicine shall 21 appoint three members who are physicians and members of the 22 Board of Medicine. One of the physicians must supervise a 23 physician assistant in the physician's practice. 24 2. The chairperson of the Board of Osteopathic 25 Medicine shall appoint one member who is a physician, 26 supervises a physician assistant in the physician's practice, 27 and is a member of the Board of Osteopathic Medicine. 28 3. The secretary of the department head of the agency 29 or his designee shall appoint a fully certified physician 30 assistant licensed under chapter 458 or this chapter. 31 90 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (b) Two of the members appointed to the council must 2 be physicians who supervise physician assistants in their 3 practice. Members shall be appointed to terms of 4 years, 4 except that of the initial appointments, two members shall be 5 appointed to terms of 2 years, two members shall be appointed 6 to terms of 3 years, and one member shall be appointed to a 7 term of 4 years, as established by rule of the boards. 8 Council members may not serve more than two consecutive terms. 9 The council shall annually elect a chairperson from among its 10 members. 11 (c) The council shall: 12 1. Recommend to the department agency the 13 certification of physician assistants. 14 2. Develop all rules regulating the use of physician 15 assistants by physicians under chapter 458 and this chapter, 16 except for rules relating to the formulary developed under s. 17 458.347(4)(f). The council shall also develop rules to ensure 18 that the continuity of supervision is maintained in each 19 practice setting. The boards shall consider adopting a 20 proposed rule developed by the council at the regularly 21 scheduled meeting immediately following the submission of the 22 proposed rule by the council. A proposed rule submitted by 23 the council may not be adopted by either board unless both 24 boards have accepted and approved the identical language 25 contained in the proposed rule. The language of all proposed 26 rules submitted by the council must be approved by both boards 27 pursuant to each respective board's guidelines and standards 28 regarding the adoption of proposed rules. If either board 29 rejects the council's proposed rule, that board must specify 30 its objection to the council with particularity and include 31 91 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 any recommendations it may have for the modification of the 2 proposed rule. 3 3. Make recommendations to the boards regarding all 4 matters relating to physician assistants. 5 4. Address concerns and problems of practicing 6 physician assistants in order to improve safety in the 7 clinical practices of certified physician assistants. 8 (10) INACTIVE AND DELINQUENT STATUS.--A certificate on 9 inactive or delinquent status may be reactivated only as 10 provided in s. 455.271. 11 (11) PENALTY.--Any person who has not been certified 12 by the council and approved by the department agency and who 13 holds himself out as a physician assistant or who uses any 14 other term in indicating or implying that he is a physician 15 assistant commits a felony of the third degree, punishable as 16 provided in s. 775.082 or s. 775.084 or by a fine not 17 exceeding $5,000. 18 (12) DENIAL, SUSPENSION, OR REVOCATION OF 19 CERTIFICATION.--The boards may deny, suspend, or revoke a 20 physician assistant certification if a board determines that 21 the physician assistant has violated this chapter. 22 (13) RULES.--The boards shall adopt rules to implement 23 this section, including rules detailing the contents of the 24 application for certification and notification pursuant to 25 subsection (7) and rules to ensure both the continued 26 competency of physician assistants and the proper utilization 27 of them by physicians or groups of physicians. 28 (14) EXISTING PROGRAMS.--This section does not 29 eliminate or supersede existing laws relating to other 30 paramedical professions or services and is supplemental to all 31 92 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 such existing laws relating to the certification and practice 2 of paramedical professions. 3 (15) LIABILITY.--Each supervising physician using a 4 physician assistant is liable for any acts or omissions of the 5 physician assistant acting under the physician's supervision 6 and control. 7 (16) LEGAL SERVICES.--The Department of Legal Affairs 8 shall provide legal services to the council as authorized in 9 s. 455.221(1). 10 (17) FEES.--The department agency shall allocate the 11 fees collected under this section to the council. 12 Section 36. Subsection (1) of section 240.4067, 13 Florida Statutes, is amended to read: 14 240.4067 Medical Education Reimbursement and Loan 15 Repayment Program.-- 16 (1) To encourage qualified medical professionals to 17 practice in underserved locations where there are shortages of 18 such personnel, there is established the Medical Education 19 Reimbursement and Loan Repayment Program. The function of the 20 program is to make payments that offset loans and educational 21 expenses incurred by students for studies leading to a medical 22 or nursing degree, medical or nursing licensure, or advanced 23 registered nurse practitioner or physician's assistant 24 certification. The following licensed or certified health 25 care professionals are eligible to participate in this 26 program: medical doctors with primary care specialties, 27 doctors of osteopathic medicine osteopathy with primary care 28 specialties, physician's assistants, licensed practical nurses 29 and registered nurses, and advanced registered nurse 30 practitioners with primary care specialties such as certified 31 nurse midwives. Primary care medical specialties for 93 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physicians include obstetrics, gynecology, general and family 2 practice, internal medicine, pediatrics, and other specialties 3 which may be identified by the Department of Health and 4 Rehabilitative Services. 5 Section 37. Subsection (5) of section 390.011, Florida 6 Statutes, is amended to read: 7 390.011 Definitions.--As used in this act: 8 (5) "Physician" means a physician licensed under 9 chapter 458 or chapter 459 or a physician practicing medicine 10 or osteopathic medicine osteopathy in the employment of the 11 United States or this state. 12 Section 38. Subsection (1) of section 395.0191, 13 Florida Statutes, is amended to read: 14 395.0191 Staff membership and clinical privileges.-- 15 (1) No licensed facility, in considering and acting 16 upon an application for staff membership or clinical 17 privileges, shall deny the application of a qualified doctor 18 of medicine licensed under chapter 458, a doctor of 19 osteopathic medicine osteopathy licensed under chapter 459, a 20 doctor of dentistry licensed under chapter 466, a doctor of 21 podiatry licensed under chapter 461, or a psychologist 22 licensed under chapter 490 for such staff membership or 23 clinical privileges within the scope of his or her respective 24 licensure solely because the applicant is licensed under any 25 of such chapters. 26 Section 39. Paragraph (g) of subsection (1) of section 27 408.035, Florida Statutes, is amended to read: 28 408.035 Review criteria.-- 29 (1) The agency shall determine the reviewability of 30 applications and shall review applications for 31 certificate-of-need determinations for health care facilities 94 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 and services, hospices, and health maintenance organizations 2 in context with the following criteria: 3 (g) The need for research and educational facilities, 4 including, but not limited to, institutional training programs 5 and community training programs for health care practitioners 6 and for doctors of osteopathic medicine osteopathy and 7 medicine at the student, internship, and residency training 8 levels. 9 Section 40. Subsection (9) of section 409.905, Florida 10 Statutes, 1996 Supplement, is amended to read: 11 409.905 Mandatory Medicaid services.--The agency may 12 make payments for the following services, which are required 13 of the state by Title XIX of the Social Security Act, 14 furnished by Medicaid providers to recipients who are 15 determined to be eligible on the dates on which the services 16 were provided. Any service under this section shall be 17 provided only when medically necessary and in accordance with 18 state and federal law. Nothing in this section shall be 19 construed to prevent or limit the agency from adjusting fees, 20 reimbursement rates, lengths of stay, number of visits, number 21 of services, or any other adjustments necessary to comply with 22 the availability of moneys and any limitations or directions 23 provided for in the General Appropriations Act or chapter 216. 24 (9) PHYSICIAN SERVICES.--The agency shall pay for 25 covered services and procedures rendered to a recipient by, or 26 under the personal supervision of, a person licensed under 27 state law to practice medicine or osteopathic medicine 28 osteopathy. These services may be furnished in the 29 physician's office, the Medicaid recipient's home, a hospital, 30 a nursing facility, or elsewhere, but shall be medically 31 necessary for the treatment of an injury, illness, or disease 95 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 within the scope of the practice of medicine or osteopathic 2 medicine osteopathy as defined by state law. The agency shall 3 not pay for services that are clinically unproven, 4 experimental, or for purely cosmetic purposes. 5 Section 41. Subsection (33) of section 415.102, 6 Florida Statutes, is amended to read: 7 415.102 Definitions of terms used in ss. 8 415.101-415.113.--As used in ss. 415.101-415.113, the term: 9 (33) "Specified medical personnel" means licensed or 10 certified physicians, osteopathic physicians osteopaths, 11 nurses, paramedics, advanced registered nurse practitioners, 12 psychologists, psychiatrists, mental health professionals, or 13 any other licensed or certified medical personnel. 14 Section 42. Paragraph (a) of subsection (1) of section 15 415.1034, Florida Statutes, is amended to read: 16 415.1034 Mandatory reporting of abuse, neglect, or 17 exploitation of disabled adults or elderly persons; mandatory 18 reports of death.-- 19 (1) MANDATORY REPORTING.-- 20 (a) Any person, including, but not limited to, any: 21 1. Physician, osteopathic physician osteopath, medical 22 examiner, chiropractor, nurse, or hospital personnel engaged 23 in the admission, examination, care, or treatment of disabled 24 adults or elderly persons; 25 2. Health professional or mental health professional 26 other than one listed in subparagraph 1.; 27 3. Practitioner who relies solely on spiritual means 28 for healing; 29 4. Nursing home staff; assisted living facility staff; 30 adult day care center staff; adult family-care home staff; 31 96 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 social worker; or other professional adult care, residential, 2 or institutional staff; 3 5. State, county, or municipal criminal justice 4 employee or law enforcement officer; 5 6. Human rights advocacy committee or long-term care 6 ombudsman council member; or 7 7. Bank, savings and loan, or credit union officer, 8 trustee, or employee, 9 10 who knows, or has reasonable cause to suspect, that a disabled 11 adult or an elderly person has been or is being abused, 12 neglected, or exploited shall immediately report such 13 knowledge or suspicion to the central abuse registry and 14 tracking system on the single statewide toll-free telephone 15 number. 16 Section 43. Paragraph (a) of subsection (1) of section 17 415.504, Florida Statutes, 1996 Supplement, is amended to 18 read: 19 415.504 Mandatory reports of child abuse or neglect; 20 mandatory reports of death; central abuse hotline.-- 21 (1) Any person, including, but not limited to, any: 22 (a) Physician, osteopathic physician osteopath, 23 medical examiner, chiropractor, nurse, or hospital personnel 24 engaged in the admission, examination, care, or treatment of 25 persons; 26 27 who knows, or has reasonable cause to suspect, that a child is 28 an abused, abandoned, or neglected child shall report such 29 knowledge or suspicion to the department in the manner 30 prescribed in subsection (2). 31 97 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 44. Subsection (2) of section 440.106, Florida 2 Statutes, is amended to read: 3 440.106 Civil remedies; administrative penalties.-- 4 (2) Whenever a physician, osteopathic physician 5 osteopath, chiropractor, podiatrist, or other practitioner is 6 determined to have violated s. 440.105, the Board of Medicine 7 Medical Examiners as set forth in chapter 458, the Board of 8 Osteopathic Medicine Medical Examiners as set forth in chapter 9 459, the Board of Chiropractic as set forth in chapter 460, 10 the Board of Podiatric Medicine as set forth in chapter 461, 11 or other appropriate licensing authority, shall hold an 12 administrative hearing to consider the imposition of 13 administrative sanctions as provided by law against said 14 physician, osteopathic physician osteopath, chiropractor, or 15 other practitioner. 16 Section 45. Paragraph (r) of subsection (1) of section 17 440.13, Florida Statutes, 1996 Supplement, is amended to read: 18 440.13 Medical services and supplies; penalty for 19 violations; limitations.-- 20 (1) DEFINITIONS.--As used in this section, the term: 21 (r) "Physician" or "doctor" means a medical doctor or 22 doctor of osteopathy licensed under chapter 458, a physician 23 licensed under chapter 458, an osteopathic physician osteopath 24 licensed under chapter 459, a chiropractor licensed under 25 chapter 460, a podiatrist licensed under chapter 461, an 26 optometrist licensed under chapter 463, or a dentist licensed 27 under chapter 466, each of whom must be certified by the 28 division as a health care provider. 29 Section 46. Paragraphs (i) and (k) of subsection (1) 30 of section 440.134, Florida Statutes, are amended to read: 31 98 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 440.134 Workers' compensation managed care 2 arrangement.-- 3 (1) As used in this section, the term: 4 (i) "Medical care coordinator" means a primary care 5 provider within a provider network who is responsible for 6 managing the medical care of an injured worker including 7 determining other health care providers and health care 8 facilities to which the injured employee will be referred for 9 evaluation or treatment. A medical care coordinator shall be a 10 physician licensed under chapter 458 or an osteopathic 11 physician osteopath licensed under chapter 459. 12 (k) "Primary care provider" means, except in the case 13 of emergency treatment, the initial treating physician and, 14 when appropriate, continuing treating physician, who may be a 15 family practitioner, general practitioner, or internist 16 physician licensed under chapter 458; a family practitioner, 17 general practitioner, or internist osteopathic physician 18 osteopath licensed under chapter 459; a chiropractor licensed 19 under chapter 460; a podiatrist licensed under chapter 461; an 20 optometrist licensed under chapter 463; or a dentist licensed 21 under chapter 466. 22 Section 47. Paragraph (a) of subsection (3) of section 23 440.15, Florida Statutes, 1996 Supplement, is amended to read: 24 440.15 Compensation for disability.--Compensation for 25 disability shall be paid to the employee, subject to the 26 limits provided in s. 440.12(2), as follows: 27 (3) PERMANENT IMPAIRMENT AND WAGE-LOSS BENEFITS.-- 28 (a) Impairment benefits.-- 29 1. Once the employee has reached the date of maximum 30 medical improvement, impairment benefits are due and payable 31 99 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 within 20 days after the carrier has knowledge of the 2 impairment. 3 2. The three-member panel, in cooperation with the 4 division, shall establish and use a uniform permanent 5 impairment rating schedule. This schedule must be based on 6 medically or scientifically demonstrable findings as well as 7 the systems and criteria set forth in the American Medical 8 Association's Guides to the Evaluation of Permanent 9 Impairment; the Snellen Charts, published by American Medical 10 Association Committee for Eye Injuries; and the Minnesota 11 Department of Labor and Industry Disability Schedules. The 12 schedule should be based upon objective findings. The schedule 13 shall be more comprehensive than the AMA Guides to the 14 Evaluation of Permanent Impairment and shall expand the areas 15 already addressed and address additional areas not currently 16 contained in the guides. On August 1, 1979, and pending the 17 adoption, by rule, of a permanent schedule, Guides to the 18 Evaluation of Permanent Impairment, copyright 1977, 1971, 19 1988, by the American Medical Association, shall be the 20 temporary schedule and shall be used for the purposes hereof. 21 For injuries after July 1, 1990, pending the adoption by 22 division rule of a uniform disability rating schedule, the 23 Minnesota Department of Labor and Industry Disability Schedule 24 shall be used unless that schedule does not address an injury. 25 In such case, the Guides to the Evaluation of Permanent 26 Impairment by the American Medical Association shall be used. 27 Determination of permanent impairment under this schedule must 28 be made by a physician licensed under chapter 458, a doctor of 29 osteopathic medicine osteopathy licensed under chapters 458 30 and 459, a chiropractor licensed under chapter 460, a 31 podiatrist licensed under chapter 461, an optometrist licensed 100 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 under chapter 463, or a dentist licensed under chapter 466, as 2 appropriate considering the nature of the injury. No other 3 persons are authorized to render opinions regarding the 4 existence of or the extent of permanent impairment. 5 3. All impairment income benefits shall be based on an 6 impairment rating using the impairment schedule referred to in 7 subparagraph 2. Impairment income benefits are paid weekly at 8 the rate of 50 percent of the employee's average weekly 9 temporary total disability benefit not to exceed the maximum 10 weekly benefit under s. 440.12. An employee's entitlement to 11 impairment income benefits begins the day after the employee 12 reaches maximum medical improvement or the expiration of 13 temporary benefits, whichever occurs earlier, and continues 14 until the earlier of: 15 a. The expiration of a period computed at the rate of 16 3 weeks for each percentage point of impairment; or 17 b. The death of the employee. 18 4. After the employee has been certified by a doctor 19 as having reached maximum medical improvement or 6 weeks 20 before the expiration of temporary benefits, whichever occurs 21 earlier, the certifying doctor shall evaluate the condition of 22 the employee and assign an impairment rating, using the 23 impairment schedule referred to in subparagraph 2. 24 Compensation is not payable for the mental, psychological, or 25 emotional injury arising out of depression from being out of 26 work. If the certification and evaluation are performed by a 27 doctor other than the employee's treating doctor, the 28 certification and evaluation must be submitted to the treating 29 doctor, and the treating doctor must indicate agreement or 30 disagreement with the certification and evaluation. The 31 certifying doctor shall issue a written report to the 101 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 division, the employee, and the carrier certifying that 2 maximum medical improvement has been reached, stating the 3 impairment rating, and providing any other information 4 required by the division. If the employee has not been 5 certified as having reached maximum medical improvement before 6 the expiration of 102 weeks after the date temporary total 7 disability benefits begin to accrue, the carrier shall notify 8 the treating doctor of the requirements of this section. 9 5. The carrier shall pay the employee impairment 10 income benefits for a period based on the impairment rating. 11 Section 48. Subsection (2) of section 456.31, Florida 12 Statutes, is amended to read: 13 456.31 Legislative intent.-- 14 (2) It is the intent of the Legislature to provide for 15 certain practitioners of the healing arts, such as a trained 16 and qualified dentist, to use hypnosis for hypnoanesthesia or 17 for the allaying of anxiety in relation to dental work; 18 however, under no circumstances shall it be legal or proper 19 for the dentist or the individual to whom the dentist may 20 refer the patient, to use hypnosis for the treatment of the 21 neurotic difficulties of a patient. The same applies to the 22 optometrist, podiatrist, chiropractor, osteopathic physician 23 osteopath, or physician of medicine. 24 Section 49. Subsection (1) of section 459.006, Florida 25 Statutes, is amended to read: 26 459.006 Licensure by examination.--Any person desiring 27 to be licensed by examination shall: 28 (1) Have successfully completed a resident internship 29 of not less than 12 months in a hospital approved for this 30 purpose by the Board of Trustees of the American Osteopathic 31 Association or any other internship program approved by the 102 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 board upon a showing of good cause by the applicant. This 2 requirement may be waived for applicants who matriculated in a 3 college of osteopathic medicine osteopathy during or before 4 1948. 5 Section 50. Subsection (1) of section 462.01, Florida 6 Statutes, is amended to read: 7 462.01 Definitions.--As used in this chapter: 8 (1) "Natureopathy" and "Naturopathy" shall be 9 construed as synonymous terms and mean the use and practice of 10 psychological, mechanical, and material health sciences to aid 11 in purifying, cleansing, and normalizing human tissues for the 12 preservation or restoration of health, according to the 13 fundamental principles of anatomy, physiology, and applied 14 psychology, as may be required. Naturopathic practice 15 employs, among other agencies, phytotherapy, dietetics, 16 psychotherapy, suggestotherapy, hydrotherapy, zone therapy, 17 biochemistry, external applications, electrotherapy, 18 mechanotherapy, mechanical and electrical appliances, hygiene, 19 first aid, sanitation, and heliotherapy; provided, however, 20 that nothing in this chapter shall be held or construed to 21 authorize any naturopathic physician licensed hereunder to 22 practice materia medica or surgery or chiropractic, nor shall 23 the provisions of this law in any manner apply to or affect 24 the practice of osteopathic medicine osteopathy, chiropractic, 25 Christian Science, or any other treatment authorized and 26 provided for by law for the cure or prevention of disease and 27 ailments. 28 Section 51. Subsection (10) of section 468.301, 29 Florida Statutes, is amended to read: 30 468.301 Definitions.--As used in this part, the term: 31 103 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (10) "Licensed practitioner" means a person who is 2 licensed or otherwise authorized by law to practice medicine, 3 podiatry, chiropody, osteopathic medicine osteopathy, 4 naturopathy, or chiropractic in this state. 5 Section 52. Paragraph (a) of subsection (6) of section 6 468.302, Florida Statutes, 1996 Supplement, is amended to 7 read: 8 468.302 Use of radiation; identification of certified 9 persons; limitations; exceptions.-- 10 (6) Requirement for certification does not apply to: 11 (a) A hospital resident who is not a licensed 12 practitioner in this state or a student enrolled in and 13 attending a school or college of medicine, osteopathic 14 medicine osteopathy, chiropody, podiatry, or chiropractic or a 15 radiologic technology educational program and who applies 16 radiation to a human being while under the direct supervision 17 of a licensed practitioner. 18 Section 53. Section 476.044, Florida Statutes, is 19 amended to read: 20 476.044 Exemptions.--This chapter does not apply to 21 the following persons when practicing pursuant to their 22 professional responsibilities and duties: 23 (1) Persons authorized under the laws of this state to 24 practice medicine, surgery, osteopathic medicine osteopathy, 25 chiropractic, naturopathy, or podiatry; 26 (2) Commissioned medical or surgical officers of the 27 United States Armed Forces hospital service; 28 (3) Licensed nurses under the laws of this state; 29 (4) Persons practicing cosmetology under the laws of 30 this state; 31 104 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (5) Persons employed in federal, state, or local 2 institutions, hospitals, or military bases as barbers whose 3 practice is limited to the inmates, patients, or authorized 4 military personnel of such institutions, hospitals, or bases; 5 or 6 (6) Persons who practice only shampooing as defined in 7 s. 477.013 and whose practice is limited to the acts described 8 therein; or. 9 (7) Persons whose occupation or practice is confined 10 solely to cutting, trimming, polishing, or cleansing the 11 fingernails of any person when said cutting, trimming, 12 polishing, or cleansing is done in a barbershop licensed 13 pursuant to this chapter which is carrying on a regular and 14 customary business of barbering, and such individual has been 15 practicing the activities set forth in this subsection prior 16 to October 1, 1985. 17 Section 54. Paragraph (a) of subsection (1) of section 18 477.0135, Florida Statutes, is amended to read: 19 477.0135 Exemptions.-- 20 (1) This chapter does not apply to the following 21 persons when practicing pursuant to their professional or 22 occupational responsibilities and duties: 23 (a) Persons authorized under the laws of this state to 24 practice medicine, surgery, osteopathic medicine osteopathy, 25 chiropractic, massage, naturopathy, or podiatry. 26 Section 55. Paragraph (a) of subsection (8) of section 27 483.291, Florida Statutes, is amended to read: 28 483.291 Powers and duties of the agency; rules.--The 29 agency shall adopt rules to implement this part, which rules 30 must include the following: 31 105 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (8) PERSONNEL.--The agency shall prescribe minimum 2 qualifications for center personnel. A center may employ as a 3 medical assistant a person who has at least one of the 4 following qualifications: 5 (a) Prior experience of not less than 6 months as a 6 medical assistant in the office of a licensed medical doctor 7 or osteopathic physician osteopath or in a hospital, an 8 ambulatory surgical center, a home health agency, or a health 9 maintenance organization. 10 Section 56. Subsection (1) of section 621.03, Florida 11 Statutes, is amended to read: 12 621.03 Definitions.--As used in this act the following 13 words shall have the meaning indicated: 14 (1) The term "professional service" means any type of 15 personal service to the public which requires as a condition 16 precedent to the rendering of such service the obtaining of a 17 license or other legal authorization. By way of example and 18 without limiting the generality thereof, the personal services 19 which come within the provisions of this act are the personal 20 services rendered by certified public accountants, public 21 accountants, chiropractors, dentists, osteopathic physicians 22 osteopaths, physicians and surgeons, doctors of medicine, 23 doctors of dentistry, podiatrists, chiropodists, architects, 24 veterinarians, attorneys at law, and life insurance agents. 25 Section 57. Paragraph (h) of subsection (4) of section 26 627.351, Florida Statutes, 1996 Supplement, is amended to 27 read: 28 627.351 Insurance risk apportionment plans.-- 29 (4) MEDICAL MALPRACTICE RISK APPORTIONMENT.-- 30 (h) As used in this subsection: 31 106 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 1. "Health care provider" means hospitals licensed 2 under chapter 395; physicians licensed under chapter 458; 3 osteopathic physicians osteopaths licensed under chapter 459; 4 podiatrists licensed under chapter 461; dentists licensed 5 under chapter 466; chiropractors licensed under chapter 460; 6 naturopaths licensed under chapter 462; nurses licensed under 7 chapter 464; midwives licensed under chapter 467; clinical 8 laboratories registered under chapter 483; physician 9 assistants certified under chapter 458; physical therapists 10 and physical therapist assistants licensed under chapter 486; 11 health maintenance organizations certificated under part I of 12 chapter 641; ambulatory surgical centers licensed under 13 chapter 395; other medical facilities as defined in 14 subparagraph 2.; blood banks, plasma centers, industrial 15 clinics, and renal dialysis facilities; or professional 16 associations, partnerships, corporations, joint ventures, or 17 other associations for professional activity by health care 18 providers. 19 2. "Other medical facility" means a facility the 20 primary purpose of which is to provide human medical 21 diagnostic services or a facility providing nonsurgical human 22 medical treatment, to which facility the patient is admitted 23 and from which facility the patient is discharged within the 24 same working day, and which facility is not part of a 25 hospital. However, a facility existing for the primary 26 purpose of performing terminations of pregnancy or an office 27 maintained by a physician or dentist for the practice of 28 medicine shall not be construed to be an "other medical 29 facility." 30 3. "Health care facility" means any hospital licensed 31 under chapter 395, health maintenance organization 107 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 certificated under part I of chapter 641, ambulatory surgical 2 center licensed under chapter 395, or other medical facility 3 as defined in subparagraph 2. 4 Section 58. Paragraph (b) of subsection (1) of section 5 627.357, Florida Statutes, is amended to read: 6 627.357 Medical malpractice self-insurance.-- 7 (1) DEFINITIONS.--As used in this section, the term: 8 (b) "Health care provider" means any: 9 1. Hospital licensed under chapter 395. 10 2. Physician licensed, or physician assistant 11 certified, under chapter 458. 12 3. Osteopathic physician Osteopath licensed under 13 chapter 459. 14 4. Podiatrist licensed under chapter 461. 15 5. Health maintenance organization certificated under 16 part I of chapter 641. 17 6. Ambulatory surgical center licensed under chapter 18 395. 19 7. Chiropractor licensed under chapter 460. 20 8. Psychologist licensed under chapter 490. 21 9. Optometrist licensed under chapter 463. 22 10. Dentist licensed under chapter 466. 23 11. Pharmacist licensed under chapter 465. 24 12. Registered nurse, licensed practical nurse, or 25 advanced registered nurse practitioner licensed or registered 26 under chapter 464. 27 13. Other medical facility. 28 14. Professional association, partnership, 29 corporation, joint venture, or other association established 30 by the individuals set forth in subparagraphs 2., 3., 4., 7., 31 8., 9., 10., 11., and 12. for professional activity. 108 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 59. Subsection (10) of section 627.6482, 2 Florida Statutes, is amended to read: 3 627.6482 Definitions.--As used in ss. 4 627.648-627.6498, the term: 5 (10) "Physician" means a physician licensed under 6 chapter 458; an osteopathic physician osteopath licensed under 7 chapter 459; a chiropractor licensed under chapter 460; a 8 podiatrist licensed under chapter 461; or, for purposes of 9 oral surgery only, a dental surgeon licensed under chapter 10 466. 11 Section 60. Section 725.01, Florida Statutes, is 12 amended to read: 13 725.01 Promise to pay another's debt, etc.--No action 14 shall be brought whereby to charge any executor or 15 administrator upon any special promise to answer or pay any 16 debt or damages out of his own estate, or whereby to charge 17 the defendant upon any special promise to answer for the debt, 18 default or miscarriage of another person or to charge any 19 person upon any agreement made upon consideration of marriage, 20 or upon any contract for the sale of lands, tenements or 21 hereditaments, or of any uncertain interest in or concerning 22 them, or for any lease thereof for a period longer than 1 23 year, or upon any agreement that is not to be performed within 24 the space of 1 year from the making thereof, or whereby to 25 charge any health care provider upon any guarantee, warranty, 26 or assurance as to the results of any medical, surgical, or 27 diagnostic procedure performed by any physician licensed under 28 chapter 458, osteopathic physician osteopath licensed under 29 chapter 459, chiropractor licensed under chapter 460, 30 podiatrist licensed under chapter 461, or dentist licensed 31 under chapter 466, unless the agreement or promise upon which 109 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 such action shall be brought, or some note or memorandum 2 thereof shall be in writing and signed by the party to be 3 charged therewith or by some other person by him thereunto 4 lawfully authorized. 5 Section 61. Paragraph (b) of subsection (1) of section 6 766.101, Florida Statutes, 1996 Supplement, is amended to 7 read: 8 766.101 Medical review committee, immunity from 9 liability.-- 10 (1) As used in this section: 11 (b) The term "health care providers" means physicians 12 licensed under chapter 458, osteopathic physicians osteopaths 13 licensed under chapter 459, podiatrists licensed under chapter 14 461, optometrists licensed under chapter 463, dentists 15 licensed under chapter 466, chiropractors licensed under 16 chapter 460, pharmacists licensed under chapter 465, or 17 hospitals or ambulatory surgical centers licensed under 18 chapter 395. 19 Section 62. Subsection (3) of section 766.103, Florida 20 Statutes, is amended to read: 21 766.103 Florida Medical Consent Law.-- 22 (3) No recovery shall be allowed in any court in this 23 state against any physician licensed under chapter 458, 24 osteopathic physician osteopath licensed under chapter 459, 25 chiropractor licensed under chapter 460, podiatrist licensed 26 under chapter 461, or dentist licensed under chapter 466 in an 27 action brought for treating, examining, or operating on a 28 patient without his informed consent when: 29 (a)1. The action of the physician, osteopathic 30 physician osteopath, chiropractor, podiatrist, or dentist in 31 obtaining the consent of the patient or another person 110 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 authorized to give consent for the patient was in accordance 2 with an accepted standard of medical practice among members of 3 the medical profession with similar training and experience in 4 the same or similar medical community; and 5 2. A reasonable individual, from the information 6 provided by the physician, osteopathic physician osteopath, 7 chiropractor, podiatrist, or dentist, under the circumstances, 8 would have a general understanding of the procedure, the 9 medically acceptable alternative procedures or treatments, and 10 the substantial risks and hazards inherent in the proposed 11 treatment or procedures, which are recognized among other 12 physicians, osteopathic physicians osteopaths, chiropractors, 13 podiatrists, or dentists in the same or similar community who 14 perform similar treatments or procedures; or 15 (b) The patient would reasonably, under all the 16 surrounding circumstances, have undergone such treatment or 17 procedure had he been advised by the physician, osteopathic 18 physician osteopath, chiropractor, podiatrist, or dentist in 19 accordance with the provisions of paragraph (a). 20 Section 63. Paragraphs (b) and (i) of subsection (1) 21 and paragraph (e) of subsection (2) of section 766.105, 22 Florida Statutes, 1996 Supplement, are amended to read: 23 766.105 Florida Patient's Compensation Fund.-- 24 (1) DEFINITIONS.--The following definitions apply in 25 the interpretation and enforcement of this section: 26 (b) The term "health care provider" means any: 27 1. Hospital licensed under chapter 395. 28 2. Physician licensed, or physician assistant 29 certified, under chapter 458. 30 3. Osteopathic physician Osteopath licensed under 31 chapter 459. 111 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 4. Podiatrist licensed under chapter 461. 2 5. Health maintenance organization certificated under 3 part I of chapter 641. 4 6. Ambulatory surgical center licensed under chapter 5 395. 6 7. "Other medical facility" as defined in paragraph 7 (c). 8 8. Professional association, partnership, corporation, 9 joint venture, or other association by the individuals set 10 forth in subparagraphs 2., 3., and 4. for professional 11 activity. 12 (i) The term "house physician" means any physician, 13 osteopathic physician osteopath, podiatrist, or dentist 14 except: a physician, osteopathic physician osteopath, 15 podiatrist, or dentist with staff privileges at a hospital; a 16 physician, osteopathic physician osteopath, podiatrist, or 17 dentist providing emergency room services; an 18 anesthesiologist, pathologist, or radiologist; or a physician, 19 osteopathic physician osteopath, podiatrist, or dentist who 20 performs a service for a fee. 21 (2) COVERAGE.-- 22 (e) The coverage afforded by the fund for a 23 participating hospital or ambulatory surgical center shall 24 apply to the officers, trustees, volunteer workers, trainees, 25 committee members (including physicians, osteopathic 26 physicians osteopaths, podiatrists, and dentists), and 27 employees of the hospital or ambulatory surgical center, other 28 than employed physicians licensed under chapter 458, physician 29 assistants licensed under chapter 458, osteopathic physicians 30 osteopaths licensed under chapter 459, dentists licensed under 31 chapter 466, and podiatrists licensed under chapter 461. 112 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 However, the coverage afforded by the fund for a participating 2 hospital shall apply to house physicians, interns, employed 3 physician residents in a resident training program, or 4 physicians performing purely administrative duties for the 5 participating hospitals other than the treatment of patients. 6 This coverage shall apply to the hospital or ambulatory 7 surgical center and those included in this subsection as one 8 health care provider. 9 Section 64. Subsection (2) of section 766.110, Florida 10 Statutes, is amended to read: 11 766.110 Liability of health care facilities.-- 12 (2) Every hospital licensed under chapter 395 may 13 carry liability insurance or adequately insure itself in an 14 amount of not less than $1.5 million per claim, $5 million 15 annual aggregate to cover all medical injuries to patients 16 resulting from negligent acts or omissions on the part of 17 those members of its medical staff who are covered thereby in 18 furtherance of the requirements of ss. 458.320 and 459.0085. 19 Self-insurance coverage extended hereunder to a member of a 20 hospital's medical staff meets the financial responsibility 21 requirements of ss. 458.320 and 459.0085 if the physician's 22 coverage limits are not less than the minimum limits 23 established in ss. 458.320 and 459.0085 and the hospital is a 24 verified trauma center as of July 1, 1990, that has extended 25 self-insurance coverage continuously to members of its medical 26 staff for activities both inside and outside of the hospital 27 since January 1, 1987. Any insurer authorized to write 28 casualty insurance may make available, but shall not be 29 required to write, such coverage. The hospital may assess on 30 an equitable and pro rata basis the following professional 31 health care providers for a portion of the total hospital 113 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 insurance cost for this coverage: physicians licensed under 2 chapter 458, osteopathic physicians osteopaths licensed under 3 chapter 459, podiatrists licensed under chapter 461, dentists 4 licensed under chapter 466, and nurses licensed under chapter 5 464. The hospital may provide for a deductible amount to be 6 applied against any individual health care provider found 7 liable in a law suit in tort or for breach of contract. The 8 legislative intent in providing for the deductible to be 9 applied to individual health care providers found negligent or 10 in breach of contract is to instill in each individual health 11 care provider the incentive to avoid the risk of injury to the 12 fullest extent and ensure that the citizens of this state 13 receive the highest quality health care obtainable. 14 Section 65. Subsection (2) of section 817.234, Florida 15 Statutes, is amended to read: 16 817.234 False and fraudulent insurance claims.-- 17 (2) Any physician licensed under chapter 458, 18 osteopathic physician osteopath licensed under chapter 459, 19 chiropractor licensed under chapter 460, or other practitioner 20 licensed under the laws of this state who knowingly and 21 willfully assists, conspires with, or urges any insured party 22 to fraudulently violate any of the provisions of this section 23 or part XI of chapter 627, or any person who, due to such 24 assistance, conspiracy, or urging by said physician, 25 osteopathic physician osteopath, chiropractor, or 26 practitioner, knowingly and willfully benefits from the 27 proceeds derived from the use of such fraud, is guilty of a 28 felony of the third degree, punishable as provided in s. 29 775.082, s. 775.083, or s. 775.084. In the event that a 30 physician, osteopathic physician osteopath, chiropractor, or 31 practitioner is adjudicated guilty of a violation of this 114 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 section, the Board of Medicine as set forth in chapter 458, 2 the Board of Osteopathic Medicine as set forth in chapter 459, 3 the Board of Chiropractic as set forth in chapter 460, or 4 other appropriate licensing authority shall hold an 5 administrative hearing to consider the imposition of 6 administrative sanctions as provided by law against said 7 physician, osteopathic physician osteopath, chiropractor, or 8 practitioner. 9 Section 66. Subsection (1) of section 945.047, Florida 10 Statutes, is amended to read: 11 945.047 Licensing requirements for physicians, 12 osteopathic physicians, and chiropractors employed by the 13 department.-- 14 (1) The Department of Corrections shall employ only 15 physicians, osteopathic physicians, or chiropractic physicians 16 holding licenses in good standing to practice medicine in this 17 state, except that, by October 1, 1980, no more than 10 18 percent of the total number of such physicians employed by the 19 department may be exempted from the provisions of this 20 subsection. Each such exempted physician shall hold a valid 21 license to practice medicine, osteopathic medicine osteopathy, 22 or chiropractic in another state and shall have been certified 23 by the appropriate board as eligible for admission for 24 examination in this state under chapter 458, chapter 459, or 25 chapter 460, as applicable. The appropriate board shall not 26 certify as eligible for admission for examination any person 27 who has been adjudged unqualified or guilty of any of the acts 28 enumerated in the disciplinary provisions contained in chapter 29 458, chapter 459, or chapter 460, as applicable. 30 Section 67. Subsection (1) of section 460.403, Florida 31 Statutes, 1996 Supplement, is amended to read: 115 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 460.403 Definitions.--As used in this chapter, the 2 term: 3 (1) "Department" means the Department of Health 4 Business and Professional Regulation. 5 Section 68. Paragraphs (bb) and (cc) of subsection (1) 6 of section 460.413, Florida Statutes, 1996 Supplement, are 7 repealed, paragraphs (q) and (gg) of subsection (1) and 8 subsection (2) of that section are amended, and subsections 9 (6) and (7) are added to that section, to read: 10 460.413 Grounds for disciplinary action; action by the 11 board.-- 12 (1) The following acts shall constitute grounds for 13 which the disciplinary actions specified in subsection (2) may 14 be taken: 15 (q) Being unable to practice chiropractic with 16 reasonable skill and safety to patients by reason of illness 17 or use of alcohol, drugs, narcotics, chemicals, or any other 18 type of material or as a result of any mental or physical 19 condition. In enforcing this paragraph, upon a finding by the 20 secretary of the department, or his or her designee, or the 21 probable cause panel of the board that probable cause exists 22 to believe that the licensee is unable to practice the 23 profession because of reasons stated in this paragraph, the 24 department shall have the authority to compel a licensee to 25 submit to a mental or physical examination by a physician 26 designated by the department. If the licensee refuses to 27 comply with the department's order, the department may file a 28 petition for enforcement in the circuit court of the circuit 29 in which the licensee resides or does business. The 30 department shall be entitled to the summary procedure provided 31 in s. 51.011. The record of proceedings to obtain a compelled 116 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 mental or physical examination shall not be used against a 2 licensee in any other proceedings. A chiropractic physician 3 affected under this paragraph shall at reasonable intervals be 4 afforded an opportunity to demonstrate that he can resume the 5 competent practice of chiropractic with reasonable skill and 6 safety to patients. 7 (gg) Failing to report to the department Division of 8 Medical Quality Assurance any licensee physician licensed 9 under chapter 458 or osteopathic physician licensed under 10 chapter 459 who the chiropractic physician or chiropractic 11 physician's assistant knows has violated the grounds for 12 disciplinary action set out in the law under which that person 13 physician or osteopathic physician is licensed and who 14 provides health care services in a facility licensed under 15 chapter 395, or a health maintenance organization certificated 16 under part I of chapter 641, in which the chiropractic 17 physician or chiropractic physician's assistant also provides 18 services. 19 (2) When the board finds any person guilty of any of 20 the grounds set forth in subsection (1), it may enter an order 21 imposing one or more of the following penalties: 22 (a) Refusal to certify to the department an 23 application for licensure. 24 (b) Revocation or suspension of a license. 25 (c) Restriction of practice. 26 (d) Imposition of an administrative fine not to exceed 27 $2,000 for each count or separate offense. 28 (e) Issuance of a reprimand. 29 (f) Placement of the chiropractic physician on 30 probation for a period of time and subject to such conditions 31 as the board may specify, including requiring the chiropractic 117 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physician to submit to treatment, to attend continuing 2 education courses, to submit to reexamination, or to work 3 under the supervision of another chiropractic physician. 4 (g) Imposition of costs of the investigation and 5 prosecution. 6 (h) Requirement that the chiropractic physician 7 undergo remedial education. 8 (i) Issuance of a letter of concern. 9 (j) Corrective action. 10 (k) Refund of fees billed to and collected from the 11 patient or a third party. 12 13 In determining what action is appropriate, the board must 14 first consider what sanctions are necessary to protect the 15 public or to compensate the patient. Only after those 16 sanctions have been imposed may the disciplining authority 17 consider and include in the order requirements designed to 18 rehabilitate the chiropractic physician. All costs associated 19 with compliance with orders issued under this subsection are 20 the obligation of the chiropractic physician. 21 (6) In any administrative action against a 22 chiropractic physician which does not involve revocation or 23 suspension of license, the department shall have the burden, 24 by the greater weight of the evidence, to establish the 25 existence of grounds for disciplinary action. The department 26 shall establish grounds for revocation or suspension of 27 license by clear and convincing evidence. 28 (7) If any chiropractic physician is guilty of such 29 unprofessional conduct, negligence, or mental or physical 30 incapacity or impairment that the department determines that 31 the chiropractic physician is unable to practice with 118 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 reasonable skill and safety and presents a danger to patients, 2 the department shall be authorized to maintain an action in 3 circuit court enjoining such chiropractic physician from 4 providing medical services to the public until the 5 chiropractic physician demonstrates the ability to practice 6 with reasonable skill and safety and without danger to 7 patients. 8 Section 69. For the purpose of incorporating the 9 amendment to section 460.413, Florida Statutes, 1996 10 Supplement, in a reference thereto, subsection (9) of section 11 320.0848, Florida Statutes, is reenacted to read: 12 320.0848 Persons who have disabilities; issuance of 13 disabled parking permits; temporary permits; permits for 14 certain providers of transportation services to persons who 15 have disabilities.-- 16 (9) A violation of this section is grounds for 17 disciplinary action under s. 458.331, s. 459.015, s. 460.413, 18 or s. 461.013, as applicable. 19 Section 70. For the purpose of incorporating the 20 amendment to section 460.413, Florida Statutes, 1996 21 Supplement, in a reference thereto, paragraph (g) of 22 subsection (4) of section 455.236, Florida Statutes, is 23 reenacted to read: 24 455.236 Financial arrangements between referring 25 health care providers and providers of health care services.-- 26 (4) PROHIBITED REFERRALS AND CLAIMS FOR 27 PAYMENT.--Except as provided in this section: 28 (g) A violation of this section by a health care 29 provider shall constitute grounds for disciplinary action to 30 be taken by the applicable board pursuant to s. 458.331(2), s. 31 459.015(2), s. 460.413(2), s. 461.013(2), s. 463.016(2), or s. 119 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 466.028(2). Any hospital licensed under chapter 395 found in 2 violation of this section shall be subject to the rules 3 adopted by the Department of Health and Rehabilitative 4 Services pursuant to s. 395.0185(2). 5 Section 71. For the purpose of incorporating the 6 amendment to section 460.413, Florida Statutes, 1996 7 Supplement, in a reference thereto, subsection (2) of section 8 766.111, Florida Statutes, is reenacted to read: 9 766.111 Engaging in unnecessary diagnostic testing; 10 penalties.-- 11 (2) A violation of this section shall be grounds for 12 disciplinary action pursuant to s. 458.331, s. 459.015, s. 13 460.413, s. 461.013, or s. 466.028, as applicable. 14 Section 72. Paragraph (a) of subsection (8) of section 15 460.4165, Florida Statutes, is amended to read: 16 460.4165 Chiropractic physician's assistants.-- 17 (8) FEES.-- 18 (a) A fee not to exceed $100 set by the board shall 19 accompany the annual application by a chiropractic physician 20 or group of chiropractic physicians for authorization to 21 supervise a certified chiropractic physician's assistant. 22 Section 73. Subsection (1) of section 461.003, Florida 23 Statutes, is amended to read: 24 461.003 Definitions.--As used in this chapter: 25 (1) "Department" means the Department of Health 26 Business and Professional Regulation. 27 Section 74. Paragraph (aa) of subsection (1) of 28 section 461.013, Florida Statutes, is amended to read: 29 461.013 Grounds for disciplinary action; action by the 30 board; investigations by department.-- 31 120 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) The following acts shall constitute grounds for 2 which the disciplinary actions specified in subsection (2) may 3 be taken: 4 (aa) Failing to report to the department Division of 5 Medical Quality Assurance any licensee physician licensed 6 under chapter 458 or osteopathic physician licensed under 7 chapter 459 who the podiatrist knows has violated the grounds 8 for disciplinary action set out in the law under which that 9 person physician or osteopathic physician is licensed and who 10 provides health care services in a facility licensed under 11 chapter 395, or a health maintenance organization certificated 12 under part I of chapter 641, in which the podiatrist also 13 provides services. 14 Section 75. Section 461.018, Florida Statutes, 1996 15 Supplement, is amended to read: 16 461.018 Limited scope of practice; area of 17 need.--Those persons holding valid certificates on October 1, 18 1991, who were certified pursuant to chapters 88-205 and 19 88-392, Laws of Florida, and who have been practicing under a 20 board-approved protocol for at least 2 years are eligible to 21 receive a podiatry license to practice without supervision 22 under their present limited scope of practice of the 23 nonsurgical treatment of corns, calluses, and ingrown toenails 24 in a specially designated area of need as provided by rule of 25 the board. 26 Section 76. Subsection (1) and paragraph (c) of 27 subsection (3) of section 464.003, Florida Statutes, 1996 28 Supplement, are amended to read: 29 464.003 Definitions.--As used in this chapter: 30 (1) "Department Agency" means the Department of Agency 31 for Health Care Administration. 121 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (3) 2 (c) "Advanced or specialized nursing practice" means, 3 in addition to the practice of professional nursing, the 4 performance of advanced-level nursing acts approved by the 5 board which, by virtue of postbasic specialized education, 6 training, and experience, are proper to be performed by an 7 advanced registered nurse practitioner. Within the context of 8 advanced or specialized nursing practice, the advanced 9 registered nurse practitioner may perform acts of nursing 10 diagnosis and nursing treatment of alterations of the health 11 status. The advanced registered nurse practitioner may also 12 perform acts of medical diagnosis and treatment, prescription, 13 and operation which are identified and approved by a joint 14 committee composed of three members appointed by the Board of 15 Nursing, two of whom shall be advanced registered nurse 16 practitioners; three members appointed by the Board of 17 Medicine, two of whom shall have had work experience with 18 advanced registered nurse practitioners; and the secretary 19 director of the department agency or the secretary's 20 director's designee. Each committee member appointed by a 21 board shall be appointed to a term of 4 years unless a shorter 22 term is required to establish or maintain staggered terms. The 23 Board of Nursing shall adopt rules authorizing the performance 24 of any such acts approved by the joint committee. Unless 25 otherwise specified by the joint committee, such acts shall be 26 performed under the general supervision of a practitioner 27 licensed under chapter 458, chapter 459, or chapter 466 within 28 the framework of standing protocols which identify the medical 29 acts to be performed and the conditions for their performance. 30 The department agency may, by rule, require that a copy of the 31 122 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 protocol be filed with the department agency along with the 2 notice required by s. 458.348. 3 Section 77. Subsection (1) of section 464.004, Florida 4 Statutes, 1996 Supplement, is amended to read: 5 464.004 Board of Nursing; membership; appointment; 6 terms.-- 7 (1) The Board of Nursing is created within the 8 department agency and shall consist of 13 members to be 9 appointed by the Governor and confirmed by the Senate. 10 Section 78. Subsection (1) of section 464.008, Florida 11 Statutes, 1996 Supplement, is amended to read: 12 464.008 Licensure by examination.-- 13 (1) Any person desiring to be licensed as a registered 14 nurse or licensed practical nurse shall apply to the 15 department agency to take the licensure examination. The 16 department agency shall examine each applicant who: 17 (a) Has completed the application form and remitted a 18 fee set by the board not to exceed $150 and has remitted an 19 examination fee set by the board not to exceed $75 plus the 20 actual per applicant cost to the department agency for 21 purchase of the examination from the National Council of State 22 Boards of Nursing or a similar national organization. 23 (b) Has provided sufficient information on or after 24 October 1, 1989, which must be submitted by the department 25 agency for a statewide criminal records correspondence check 26 through the Department of Law Enforcement. 27 (c) Is in good mental and physical health, is a 28 recipient of a high school diploma or the equivalent, and has 29 completed the requirements for graduation from an approved 30 program for the preparation of registered nurses or licensed 31 practical nurses, whichever is applicable. Courses 123 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 successfully completed in a professional nursing program which 2 are at least equivalent to a practical nursing program may be 3 used to satisfy the education requirements for licensure as a 4 licensed practical nurse. 5 (d) Has the ability to communicate in the English 6 language, which may be determined by an examination given by 7 the department agency. 8 Section 79. Subsections (1) and (3) of section 9 464.009, Florida Statutes, 1996 Supplement, are amended to 10 read: 11 464.009 Licensure by endorsement.-- 12 (1) The department agency shall issue the appropriate 13 license by endorsement to practice professional or practical 14 nursing to an applicant who, upon applying to the department 15 agency and remitting a fee set by the board not to exceed 16 $100, demonstrates to the board that he: 17 (a) Holds a valid license to practice professional or 18 practical nursing in another state of the United States, 19 provided that, when the applicant secured his original 20 license, the requirements for licensure were substantially 21 equivalent to or more stringent than those existing in Florida 22 at that time; or 23 (b) Meets the qualifications for licensure in s. 24 464.008 and has successfully completed a state, regional, or 25 national examination which is substantially equivalent to or 26 more stringent than the examination given by the department 27 agency. 28 (3) The department agency shall not issue a license by 29 endorsement to any applicant who is under investigation in 30 another state for an act which would constitute a violation of 31 124 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 this chapter until such time as the investigation is complete, 2 at which time the provisions of s. 464.018 shall apply. 3 Section 80. Subsections (1) and (5) of section 4 464.012, Florida Statutes, 1996 Supplement, are amended to 5 read: 6 464.012 Certification of advanced registered nurse 7 practitioners; fees.-- 8 (1) Any nurse desiring to be certified as an advanced 9 registered nurse practitioner shall apply to the department 10 agency and submit proof that he holds a current license to 11 practice professional nursing and that he meets one or more of 12 the following requirements as determined by the board: 13 (a) Satisfactory completion of a formal postbasic 14 educational program of at least one academic year, the primary 15 purpose of which is to prepare nurses for advanced or 16 specialized practice. 17 (b) Certification by an appropriate specialty board. 18 Such certification shall be required for initial state 19 certification and any recertification as a registered nurse 20 anesthetist or nurse midwife. The board may by rule provide 21 for provisional state certification of graduate nurse 22 anesthetists and nurse midwives for a period of time 23 determined to be appropriate for preparing for and passing the 24 national certification examination. 25 (c) Graduation from a program leading to a master's 26 degree in a nursing clinical specialty area with preparation 27 in specialized practitioner skills. For applicants graduating 28 on or after October 1, 1998, graduation from a master's degree 29 program shall be required for initial certification as a nurse 30 practitioner under paragraph (4)(c). For applicants 31 graduating on or after October 1, 2001, graduation from a 125 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 master's degree program shall be required for initial 2 certification as a registered nurse anesthetist under 3 paragraph (4)(a). 4 (5) The board shall certify, and the department agency 5 shall issue a certificate to, any nurse meeting the 6 qualifications in this section. The board shall establish an 7 application fee not to exceed $100 and a biennial renewal fee 8 not to exceed $50. The board is authorized to adopt such 9 other rules as are necessary to implement the provisions of 10 this section. 11 Section 81. Subsections (1) and (2) of section 12 464.013, Florida Statutes, 1996 Supplement, are amended to 13 read: 14 464.013 Renewal of license or certificate.-- 15 (1) The department agency shall renew a license upon 16 receipt of the renewal application and fee. 17 (2) The department agency shall adopt rules 18 establishing a procedure for the biennial renewal of licenses. 19 Section 82. Subsection (2) of section 464.014, Florida 20 Statutes, 1996 Supplement, is amended to read: 21 464.014 Inactive status.-- 22 (2) The department agency may not reactivate a license 23 unless the inactive or delinquent licensee has paid any 24 applicable biennial renewal or delinquency fee, or both, and a 25 reactivation fee. 26 Section 83. Paragraphs (a), (c), (j), (k), (l), and 27 (m) of subsection (1) and paragraph (a) of subsection (2) of 28 section 464.018, Florida Statutes, 1996 Supplement, are 29 amended to read: 30 464.018 Disciplinary actions.-- 31 126 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) The following acts shall be grounds for 2 disciplinary action set forth in this section: 3 (a) Procuring, attempting to procure, or renewing a 4 license to practice nursing by bribery, by knowing 5 misrepresentations, or through an error of the department 6 agency or the board. 7 (c) Being convicted or found guilty of, or entering a 8 plea of nolo contendere to, regardless of adjudication, of a 9 crime in any jurisdiction which directly relates to the 10 practice of nursing or to the ability to practice nursing. 11 (j) Being unable to practice nursing with reasonable 12 skill and safety to patients by reason of illness or use of 13 alcohol, drugs, narcotics, or chemicals or any other type of 14 material or as a result of any mental or physical condition. 15 In enforcing this paragraph, the department agency shall have, 16 upon a finding of the secretary director or the secretary's 17 his designee that probable cause exists to believe that the 18 licensee is unable to practice nursing because of the reasons 19 stated in this paragraph, the authority to issue an order to 20 compel a licensee to submit to a mental or physical 21 examination by physicians designated by the department agency. 22 If the licensee refuses to comply with such order, the 23 department's agency's order directing such examination may be 24 enforced by filing a petition for enforcement in the circuit 25 court where the licensee resides or does business. The 26 licensee against whom the petition is filed shall not be named 27 or identified by initials in any public court records or 28 documents, and the proceedings shall be closed to the public. 29 The department agency shall be entitled to the summary 30 procedure provided in s. 51.011. A nurse affected by the 31 provisions of this paragraph shall at reasonable intervals be 127 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 afforded an opportunity to demonstrate that he can resume the 2 competent practice of nursing with reasonable skill and safety 3 to patients. 4 (k) Failing to report to the department agency any 5 person who the licensee knows is in violation of this chapter 6 or of the rules of the department agency or the board; 7 however, if the licensee verifies that such person is actively 8 participating in a board-approved program for the treatment of 9 a physical or mental condition, the licensee is required to 10 report such person only to an impaired professionals 11 consultant. 12 (l) Knowingly violating any provision of this chapter, 13 a rule of the board or the department agency, or a lawful 14 order of the board or department agency previously entered in 15 a disciplinary proceeding or failing to comply with a lawfully 16 issued subpoena of the department agency. 17 (m) Failing to report to the department Division of 18 Health Quality Assurance any licensee physician licensed under 19 chapter 458 or osteopathic physician licensed under chapter 20 459 who the nurse knows has violated the grounds for 21 disciplinary action set out in the law under which that person 22 physician or osteopathic physician is licensed and who 23 provides health care services in a facility licensed under 24 chapter 395, or a health maintenance organization certificated 25 under part I of chapter 641, in which the nurse also provides 26 services. 27 (2) When the board finds any person guilty of any of 28 the grounds set forth in subsection (1), it may enter an order 29 imposing one or more of the following penalties: 30 (a) Refusal to certify to the department agency an 31 application for licensure. 128 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 84. Subsections (1), (3), and (4) of section 2 464.019, Florida Statutes, 1996 Supplement, are amended to 3 read: 4 464.019 Approval of nursing programs.-- 5 (1) An institution desiring to conduct an approved 6 program for the education of professional or practical nurses 7 shall apply to the department agency and submit such evidence 8 as may be required to show that it complies with the 9 provisions of this chapter and with the rules of the board. 10 The application shall include a program review fee, as set by 11 the board, not to exceed $1,000. 12 (3) The department agency shall survey each 13 institution applying for approval and submit its findings to 14 the board. If the board is satisfied that the program meets 15 the requirements of this chapter and rules pursuant thereto, 16 it shall certify the program for approval and the department 17 agency shall approve the program. 18 (4) If the board, through an investigation by the 19 department agency, finds that an approved program no longer 20 meets the required standards, it may place the program on 21 probationary status until such time as the standards are 22 restored. If a program fails to correct these conditions 23 within a specified period of time, the board may rescind the 24 approval. Any program having its approval rescinded shall 25 have the right to reapply. 26 Section 85. Section 464.0205, Florida Statutes, is 27 created to read: 28 464.0205 Retired volunteer nurse certificate.-- 29 (1) Any retired practical or registered nurse desiring 30 to serve indigent, underserved, or critical need populations 31 129 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 in this state may apply to the department for a retired 2 volunteer nurse certificate by providing: 3 (a) A complete application. 4 (b) An application and processing fee of $25. 5 (c) Verification that the applicant had been licensed 6 to practice nursing in any jurisdiction in the United States 7 for at least 10 years, had retired or plans to retire, intends 8 to practice nursing only pursuant to the limitations provided 9 by the retired volunteer nurse certificate, and has not 10 committed any act that would constitute a violation under s. 11 464.018(1). 12 (d) Proof that the applicant meets the requirements 13 for licensure under s. 464.008 or s. 464.009. 14 (2) All related administrative costs shall be borne by 15 the applicant. 16 (3) The board may deny a retired volunteer nurse 17 certificate to any applicant who has committed, or who is 18 under investigation or prosecution for, any act that would 19 constitute a ground for disciplinary action under s. 464.018. 20 (4) A retired volunteer nurse receiving certification 21 from the board shall: 22 (a) Work under the direct supervision of the director 23 of a county health department, a physician working under a 24 limited license issued pursuant to s. 458.317 or s. 459.0075, 25 a physician licensed under chapter 458 or chapter 459, an 26 advanced registered nurse practitioner certified under s. 27 464.012, or a registered nurse licensed under s. 464.008 or s. 28 464.009. 29 (b) Comply with the minimum standards of practice for 30 nurses and be subject to disciplinary action for violations of 31 s. 464.018, except that the scope of practice for certified 130 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 volunteers shall be limited to primary and preventive health 2 care, or as further defined by board rule. 3 (c) Work only in a setting for which there are 4 provisions for professional liability coverage for acts or 5 omissions of the retired volunteer nurse. 6 (d) Provide services under the certificate only in 7 settings whose sponsors have been approved by the board. 8 (5) A retired volunteer nurse receiving certification 9 from the board shall not: 10 (a) Administer controlled substances. 11 (b) Supervise other nurses. 12 (c) Receive monetary compensation. 13 (6) A retired volunteer nurse certified under this 14 section may practice only in board-approved settings in public 15 agencies or institutions or in nonprofit agencies or 16 institutions meeting the requirements of s. 501(c)(3) of the 17 Internal Revenue Code, which agencies or institutions are 18 located in areas of critical nursing need as determined by the 19 board. Determination of underserved areas shall be made by 20 the board after consultation with the Department of Health, 21 the Department of Children and Family Services, the Agency for 22 Health Care Administration, and the Department of Elderly 23 Affairs; however, such determination shall include, but not be 24 limited to, health manpower shortage areas designated by the 25 United States Department of Health and Human Services. The 26 sponsoring agencies desiring to use certified retired 27 volunteer nurses shall submit to the board verification of 28 their status under s. 501(c)(3) of the Internal Revenue Code, 29 the sites at which such volunteer nurses would work, the 30 duties and scope of practice intended for such volunteer 31 131 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 nurses, and the training or skills validation for such 2 volunteer nurses. 3 (7) The retired volunteer nurse certificate shall be 4 valid for 2 years, and a certificateholder may reapply for a 5 certificate so long as the certificateholder continues to meet 6 the eligibility requirements of this section. Any 7 legislatively mandated continuing education on specific topics 8 must be completed by the certificateholder prior to renewal; 9 otherwise, the provisions of s. 464.013 do not apply. 10 Section 86. Subsection (12) is added to section 11 464.022, Florida Statutes, to read: 12 464.022 Exceptions.--No provision of this chapter 13 shall be construed to prohibit: 14 (12) The practice of nursing by any legally qualified 15 nurse of another state whose employment requires the nurse to 16 accompany and care for a patient temporarily residing in this 17 state for not more than 30 consecutive days, provided the 18 patient is not in an inpatient setting, the board is notified 19 prior to arrival of the patient and nurse, the nurse has the 20 standing physician orders and current medical status of the 21 patient available, and prearrangements with the appropriate 22 licensed health care providers in this state have been made in 23 case the patient needs placement in an inpatient setting. 24 Section 87. Subsections (4) and (10) of section 25 465.003, Florida Statutes, are amended to read: 26 465.003 Definitions.--As used in this chapter, the 27 term: 28 (4) "Department" means the Department of Health 29 Business and Professional Regulation. 30 31 132 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (10)(a) "Pharmacy" includes a community pharmacy, an 2 institutional pharmacy, a nuclear pharmacy, and a special 3 pharmacy. 4 1.(a) The term "community pharmacy" includes every 5 location where medicinal drugs are compounded, dispensed, 6 stored, or sold or where prescriptions are filled or dispensed 7 on an outpatient basis. 8 2.(b) The term "institutional pharmacy" includes every 9 location in a hospital, clinic, nursing home, dispensary, 10 sanitarium, extended care facility, or other facility, 11 hereinafter referred to as "health care institutions," where 12 medicinal drugs are compounded, dispensed, stored, or sold. 13 3.(c) The term "nuclear pharmacy" includes every 14 location where radioactive drugs and chemicals within the 15 classification of medicinal drugs are compounded, dispensed, 16 stored, or sold. The term "nuclear pharmacy" does not include 17 hospitals licensed under chapter 395 or the nuclear medicine 18 facilities of such hospitals. 19 4.(d) The term "special pharmacy" includes every 20 location where medicinal drugs are compounded, dispensed, 21 stored, or sold if such locations are not otherwise defined in 22 this subsection. 23 (b) The pharmacy department of any permittee shall be 24 considered closed whenever a Florida licensed pharmacist is 25 not present and on duty. The term "not present and on duty" 26 shall not be construed to prevent a pharmacist from exiting 27 the prescription department for the purposes of consulting or 28 responding to inquiries or providing assistance to patients or 29 customers, attending to personal hygiene needs, or performing 30 any other function for which the pharmacist is responsible, 31 provided that such activities are conducted in a manner 133 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 consistent with the pharmacist's responsibility to provide 2 pharmacy services. 3 Section 88. 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 currently engaged in the 15 practice of pharmacy in a community pharmacy, one must be 16 currently engaged in the practice of pharmacy in a Class II 17 institutional pharmacy or a Modified Class II institutional 18 pharmacy, and five shall be pharmacists licensed in this state 19 irrespective of practice setting. The remaining two members 20 must be residents of the state who have never been licensed as 21 pharmacists and who are in no way connected with the practice 22 of the profession of pharmacy. No person may be appointed as 23 a consumer lay member who is in any way connected with a drug 24 manufacturer or wholesaler. At least one member of the board 25 must be 60 years of age or older. 26 Section 89. Section 465.0125, Florida Statutes, is 27 amended to read: 28 465.0125 Consultant pharmacist license; application, 29 renewal, fees; responsibilities; rules.-- 30 (1) The department shall issue or renew a consultant 31 pharmacist license upon receipt of an initial or renewal 134 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 application which conforms to the requirements for consultant 2 pharmacist initial licensure or renewal as promulgated by the 3 board by rule and a fee set by the board not to exceed $250. 4 The consultant pharmacist shall be responsible for maintaining 5 all drug records required by law and for establishing drug 6 handling procedures for the safe handling and storage of 7 drugs. The consultant pharmacist may also be responsible for 8 ordering and evaluating any laboratory or clinical testing 9 when, in the judgment of the consultant pharmacist, such 10 activity is necessary for the proper performance of the 11 consultant pharmacist's responsibilities. Such laboratory or 12 clinical testing may be ordered only with regard to patients 13 residing in a nursing home facility, and then only when 14 authorized by the medical director of the nursing home 15 facility. The consultant pharmacist must have completed such 16 additional training and demonstrate such additional 17 qualifications in the practice of institutional pharmacy as 18 shall be required by the board of Pharmacy in addition to 19 licensure as a registered pharmacist. The board shall 20 promulgate rules necessary to implement and administer this 21 section. 22 (2) Notwithstanding the provisions of subsection (1), 23 a consultant pharmacist or a doctor of pharmacy licensed in 24 this state may also be responsible for ordering and evaluating 25 any laboratory or clinical testing for persons under the care 26 of a licensed home health agency when, in the judgment of the 27 consultant pharmacist or doctor of pharmacy, such activity is 28 necessary for the proper performance of his or her 29 responsibilities and only when authorized by a practitioner 30 licensed under chapter 458, chapter 459, chapter 461, or 31 chapter 466. In order for the consultant pharmacist or doctor 135 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of pharmacy to qualify and accept this authority, he or she 2 must receive 3 hours of continuing education relating to 3 laboratory and clinical testing as established by the board. 4 (3) The board shall promulgate rules necessary to 5 implement and administer this section. 6 Section 90. Subsection (1) of section 465.0156, 7 Florida Statutes, is amended to read: 8 465.0156 Registration of nonresident pharmacies.-- 9 (1) Any pharmacy which is located outside this state 10 and which ships, mails, or delivers, in any manner, a 11 dispensed medicinal drug into this state shall be considered a 12 nonresident pharmacy, shall be registered with the board, 13 shall provide pharmacy services at a high level of protection 14 and competence, and shall disclose to the board the following 15 specific information: 16 (a) That it maintains at all times a valid, unexpired 17 license, permit, or registration to operate the pharmacy in 18 compliance with the laws of the state in which the dispensing 19 facility is located and from which the medicinal drugs shall 20 be dispensed; 21 (b) The location, names, and titles of all principal 22 corporate officers and the pharmacist who serves as the 23 prescription department manager for all pharmacists who are 24 dispensing medicinal drugs to residents of this state. This 25 disclosure shall be made on an annual basis and within 30 days 26 after any change of office location, corporate officer, or 27 pharmacist serving as the prescription department manager for 28 dispensing medicinal drugs to residents of this state; 29 (c) That it complies with all lawful directions and 30 requests for information from the regulatory or licensing 31 agency of all states in which it is licensed as well as with 136 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 all requests for information made by the board pursuant to 2 this section. It shall respond directly to all communications 3 from the board concerning emergency circumstances arising from 4 errors in the dispensing of medicinal drugs to the residents 5 of this state; 6 (d) That it maintains its records of medicinal drugs 7 dispensed to patients in this state so that the records are 8 readily retrievable from the other business records of the 9 pharmacy and from the records of other medicinal drugs 10 dispensed; and 11 (e) That during its regular hours of operation but not 12 less than 6 days per week, for a minimum of 40 hours per week, 13 a toll-free telephone service shall be provided to facilitate 14 communication between patients in this state and a pharmacist 15 at the pharmacy who has access to the patient's records. This 16 toll-free number must be disclosed on the label affixed to 17 each container of dispensed medicinal drugs. 18 Section 91. Paragraph (o) of subsection (1) and 19 paragraph (e) of subsection (2) of section 465.016, Florida 20 Statutes, are amended to read: 21 465.016 Disciplinary actions.-- 22 (1) The following acts shall be grounds for 23 disciplinary action set forth in this section: 24 (o) Failing to report to the department Division of 25 Medical Quality Assurance any licensee physician licensed 26 under chapter 458 or osteopathic physician licensed under 27 chapter 459 who the pharmacist knows has violated the grounds 28 for disciplinary action set out in the law under which that 29 person physician or osteopathic physician is licensed and who 30 provides health care services in a facility licensed under 31 chapter 395, or a health maintenance organization certificated 137 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 under part I of chapter 641, in which the pharmacist also 2 provides 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 (e) Placement of the pharmacist on probation for a 7 period of time and subject to such conditions as the board may 8 specify, including, but not limited to, requiring the 9 pharmacist to submit to treatment, to attend continuing 10 education courses, to submit to reexamination, or to work 11 under the supervision of another pharmacist. 12 Section 92. Section 465.0196, Florida Statutes, is 13 amended to read: 14 465.0196 Special pharmacy permits.--Any person 15 desiring a permit to operate a pharmacy which does not fall 16 within the definitions set forth in s. 465.003(10)(a)1., 17 2.(b), and 3.(c) shall apply to the department for a special 18 pharmacy permit. If the board certifies that the application 19 complies with the applicable laws and rules of the board 20 governing the practice of the profession of pharmacy, the 21 department shall issue the permit. No permit shall be issued 22 unless a licensed pharmacist is designated to undertake the 23 professional supervision of the compounding and dispensing of 24 all drugs dispensed by the pharmacy. The licensed pharmacist 25 shall be responsible for maintaining all drug records and for 26 providing for the security of the area in the facility in 27 which the compounding, storing, and dispensing of medicinal 28 drugs occurs. The permittee shall notify the department 29 within 10 days of any change of the licensed pharmacist 30 responsible for such duties. 31 138 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 93. Section 465.026, Florida Statutes, is 2 amended to read: 3 465.026 Filling of certain prescriptions.--Nothing 4 contained in this chapter shall be construed to prohibit a 5 pharmacist licensed in this state from filling or refilling a 6 valid prescription which is on file in a pharmacy located in 7 this state or in another state and has been transferred from 8 one pharmacy to another by any means, including any electronic 9 means transfer by way of electronic data processing equipment, 10 under the following conditions: 11 (1) Prior to dispensing any transferred pursuant to 12 any such prescription, the dispensing pharmacist must, either 13 verbally or by any electronic means, do all of the following 14 shall: 15 (a) Advise the patient that the prescription on file 16 at the such other pharmacy must be canceled before it may be 17 filled or refilled he will be able to fill or refill it. 18 (b) Determine from the requested pharmacist that the 19 prescription is valid and on file at the such other pharmacy 20 and that the such prescription may be filled or refilled, as 21 requested, in accordance with the prescriber's intent 22 expressed on the such prescription. 23 (c) Notify the pharmacist or at the pharmacy where the 24 prescription is on file that the prescription must be 25 canceled. 26 (d) Record in writing, or by any electronic means, or 27 cause to be recorded by data processing equipment the 28 prescription order, the name of the pharmacy at which the 29 prescription was on file, the prescription number, the name of 30 the drug and the original amount dispensed, the date of 31 139 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 original dispensing, and the number of remaining authorized 2 refills. 3 (e) Obtain the consent of the prescriber to the 4 refilling of the prescription when the prescription, in the 5 dispensing pharmacist's professional judgment of the 6 dispensing pharmacist, so requires. Any interference with the 7 professional judgment of the dispensing pharmacist by any 8 pharmacist or pharmacy permittee, or its agents, or employees, 9 shall be grounds for discipline revocation or suspension of 10 the permit issued to the pharmacy. 11 (2) Upon receipt of a request for prescription 12 transfer request information set forth in paragraph (1)(d), if 13 the requested pharmacist is satisfied in his professional 14 judgment that the such request is valid, or if the request has 15 been validated by any electronic means, the requested 16 pharmacist or pharmacy must do all of the following shall: 17 (a) Transfer the information required by paragraph 18 (1)(d) Provide such information accurately and completely. 19 (b) Record on the prescription, or by any electronic 20 means, or record with data processing equipment the name of 21 the requesting pharmacy and pharmacist and the date of 22 request. 23 (c) Cancel the prescription on file by electronic 24 means or by recording the word "void" on the prescription 25 record. No further prescription information shall be given or 26 medication dispensed pursuant to the said original 27 prescription. 28 (3) If a transferred prescription is not dispensed 29 within a reasonable time, the pharmacist shall, by any means, 30 so notify the transferring pharmacy. In the event that, after 31 the information set forth in paragraph (1)(d) has been 140 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 provided, a prescription is not dispensed by the requesting 2 pharmacist, then such pharmacist shall provide notice of this 3 fact to the pharmacy from which said information was obtained; 4 Such notice shall serve to revalidate the canceled voided 5 prescription. The pharmacist who has served such notice shall 6 then cancel the prescription in the same manner as set forth 7 in paragraph (2)(c). 8 (4) In the case of a prescription to be transferred 9 from or to a pharmacy located in another outside of the state, 10 it shall be the responsibility of the pharmacist or pharmacy 11 located in the State of Florida to verify, whether by 12 electronic means or otherwise, assure that the person or 13 entity involved in the performing the act of transfer is a 14 licensed pharmacist or pharmacy in the other state from 15 outside the state is a practitioner licensed to practice 16 pharmacy in the jurisdiction wherein the non-Florida pharmacy 17 involved is located. 18 (5) Electronic transfers of prescriptions are 19 permitted regardless of whether the transferor or transferee 20 pharmacy is open for business. 21 (6)(5) The transfer of a prescription for medicinal 22 drugs listed in Schedules III, IV, and V appearing in chapter 23 893 for the purpose of refill dispensing is permissible, 24 between pharmacies on a one-time basis subject to the 25 requirements of this section and federal law. Compliance with 26 federal law shall be deemed compliance with the requirements 27 of this section. 28 Section 94. Section 465.035, Florida Statutes, is 29 amended to read: 30 465.035 Dispensing of medicinal medical drugs pursuant 31 to facsimile of prescription.-- 141 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) Notwithstanding any other provision of this 2 chapter, it is lawful for a pharmacy to dispense medicinal 3 drugs, including controlled substances authorized under 4 subsection (2), based on reception of an electronic facsimile 5 of the original prescription if all of the following 6 conditions are met: 7 (a) In the course of the transaction the pharmacy 8 complies with laws and administrative rules relating to 9 pharmacies and pharmacists. 10 (b) Except in the case of the transmission of a 11 prescription by a person authorized by law to prescribe 12 medicinal drugs: 13 1. The facsimile system making the transmission 14 provides the pharmacy receiving the transmission with audio 15 communication via telephonic, electronic, or similar means 16 with the person presenting the prescription. 17 2. At the time of the delivery of the medicinal drugs, 18 the pharmacy has in its possession the original prescription 19 for the medicinal drug involved. 20 3. The recipient of the prescription shall sign a log 21 and shall indicate the name and address of both the recipient 22 and the patient for whom the medicinal drug was prescribed. 23 (2) This section does not apply to the dispensing of 24 Controlled substances listed in Schedule II as defined in s. 25 893.03(2) may be dispensed as provided in this section to the 26 extent allowed by 21 C.F.R. s. 1306.11. 27 Section 95. Subsection (1) of section 465.186, Florida 28 Statutes, is amended to read: 29 465.186 Pharmacist's order for medicinal drugs; 30 dispensing procedure; development of formulary.-- 31 142 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) There is hereby created a committee composed of 2 two members of the Board of Medicine licensed under chapter 3 458 chosen by said board, one member of the Board of 4 Osteopathic Medicine licensed under chapter 459 chosen by said 5 board, three members of the Board of Pharmacy licensed under 6 this chapter and chosen by said board, and one additional 7 person with a background in health care or pharmacology chosen 8 by the committee. The committee shall establish a formulary 9 of medicinal drug products and dispensing procedures which 10 shall be used by a pharmacist when ordering and dispensing 11 such drug products to the public. Dispensing procedures may 12 include matters related to reception of patient, description 13 of his or her condition, patient interview, patient physician 14 referral, product selection, and dispensing and use 15 limitations. In developing the formulary of medicinal drug 16 products, the committee may include products falling within 17 the following categories: 18 (a) Any medicinal drug of single or multiple active 19 ingredients in any strengths when such active ingredients have 20 been approved individually or in combination for 21 over-the-counter sale by the United States Food and Drug 22 Administration. 23 (b) Any medicinal drug recommended by the United 24 States Food and Drug Administration Advisory Panel for 25 transfer to over-the-counter status pending approval by the 26 United States Food and Drug Administration. 27 (c) Any medicinal drug containing any antihistamine or 28 decongestant as a single active ingredient or in combination. 29 (d) Any medicinal drug containing fluoride in any 30 strength. 31 143 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (e) Any medicinal drug containing lindane in any 2 strength. 3 (f) Any over-the-counter proprietary drug under 4 federal law that has been approved for reimbursement by the 5 Florida Medicaid Program. 6 (g) Any topical anti-infectives excluding eye and ear 7 topical anti-infectives. 8 9 However, any drug which is sold as an over-the-counter 10 proprietary drug under federal law shall not be included in 11 the formulary or otherwise affected by this section. 12 Section 96. Paragraph (iii) is added to subsection (4) 13 of section 893.03, Florida Statutes, 1996 Supplement, to read: 14 893.03 Standards and schedules.--The substances 15 enumerated in this section are controlled by this chapter. 16 The controlled substances listed or to be listed in Schedules 17 I, II, III, IV, and V are included by whatever official, 18 common, usual, chemical, or trade name designated. The 19 provisions of this section shall not be construed to include 20 within any of the schedules contained in this section any 21 excluded drugs listed within the purview of 21 C.F.R. s. 22 1308.22, styled "Excluded Substances"; 21 C.F.R. s. 1308.24, 23 styled "Exempt Chemical Preparations"; 21 C.F.R. s. 1308.32, 24 styled "Exempted Prescription Products"; or 21 C.F.R. s. 25 1308.34, styled "Exempt Anabolic Steroid Products." 26 (4) SCHEDULE IV.--A substance in Schedule IV has a low 27 potential for abuse relative to the substances in Schedule III 28 and has a currently accepted medical use in treatment in the 29 United States, and abuse of the substance may lead to limited 30 physical or psychological dependence relative to the 31 substances in Schedule III. Unless specifically excepted or 144 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 unless listed in another schedule, any material, compound, 2 mixture, or preparation which contains any quantity of the 3 following substances, including its salts, isomers, and salts 4 of isomers whenever the existence of such salts, isomers, and 5 salts of isomers is possible within the specific chemical 6 designation, are controlled in Schedule IV: 7 (iii) Butorphanol tartrate. 8 Section 97. For the purpose of incorporating the 9 amendment to section 893.03, Florida Statutes, 1996 10 Supplement, in references thereto, subsection (5) of section 11 316.193, Florida Statutes, 1996 Supplement, is reenacted to 12 read: 13 316.193 Driving under the influence; penalties.-- 14 (5) The court shall place any offender convicted of 15 violating this section on monthly reporting probation and 16 shall require attendance at a substance abuse course licensed 17 by the department; and the agency conducting the course may 18 refer the offender to an authorized service provider for 19 substance abuse evaluation and treatment, in addition to any 20 sentence or fine imposed under this section. The offender 21 shall assume reasonable costs for such education, evaluation, 22 and treatment, with completion of all such education, 23 evaluation, and treatment being a condition of reporting 24 probation. Treatment resulting from a psychosocial evaluation 25 may not be waived without a supporting psychosocial evaluation 26 conducted by an agency appointed by the court and with access 27 to the original evaluation. The offender shall bear the cost 28 of this procedure. The term "substance abuse" means the abuse 29 of alcohol or any substance named or described in Schedules I 30 through V of s. 893.03. If an offender referred to treatment 31 under this subsection fails to report for or complete such 145 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 treatment or fails to complete the substance abuse education 2 course, the DUI program shall notify the court and the 3 department of the failure. Upon receipt of the notice, the 4 department shall cancel the offender's driving privilege. The 5 department shall reinstate the driving privilege when the 6 offender completes the substance abuse education course or 7 enters treatment required under this subsection. The 8 organization that conducts the substance abuse education and 9 evaluation may not provide required substance abuse treatment 10 unless a waiver has been granted to that organization by the 11 department. A waiver may be granted only if the department 12 determines, in accordance with its rules, that the service 13 provider that conducts the substance abuse education and 14 evaluation is the most appropriate service provider and is 15 licensed under chapter 397 or is exempt from such licensure. 16 All DUI treatment programs providing treatment services on 17 January 1, 1994, shall be allowed to continue to provide such 18 services until the department determines whether a waiver 19 should be granted. A statistical referral report shall be 20 submitted quarterly to the department by each organization 21 authorized to provide services under this section. 22 Section 98. For the purpose of incorporating the 23 amendment to section 893.03, Florida Statutes, 1996 24 Supplement, in references thereto, subsection (5) of section 25 327.35, Florida Statutes, 1996 Supplement, is reenacted to 26 read: 27 327.35 Boating under the influence; penalties.-- 28 (5) In addition to any sentence or fine, the court 29 shall place any offender convicted of violating this section 30 on monthly reporting probation and shall require attendance at 31 a substance abuse course specified by the court; and the 146 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 agency conducting the course may refer the offender to an 2 authorized service provider for substance abuse evaluation and 3 treatment, in addition to any sentence or fine imposed under 4 this section. The offender shall assume reasonable costs for 5 such education, evaluation, and treatment, with completion of 6 all such education, evaluation, and treatment being a 7 condition of reporting probation. Treatment resulting from a 8 psychosocial evaluation may not be waived without a supporting 9 psychosocial evaluation conducted by an agency appointed by 10 the court and with access to the original evaluation. The 11 offender shall bear the cost of this procedure. The term 12 "substance abuse" means the abuse of alcohol or any substance 13 named or described in Schedules I through V of s. 893.03. 14 Section 99. For the purpose of incorporating the 15 amendment to section 893.03, Florida Statutes, 1996 16 Supplement, in references thereto, paragraph (b) of subsection 17 (11) of section 440.102, Florida Statutes, 1996 Supplement, is 18 reenacted to read: 19 440.102 Drug-free workplace program requirements.--The 20 following provisions apply to a drug-free workplace program 21 implemented pursuant to law or to rules adopted by the Agency 22 for Health Care Administration: 23 (11) PUBLIC EMPLOYEES IN SAFETY-SENSITIVE OR 24 SPECIAL-RISK POSITIONS.-- 25 (b) An employee who is employed by a public employer 26 in a special-risk position may be discharged or disciplined by 27 a public employer for the first positive confirmed test result 28 if the drug confirmed is an illicit drug under s. 893.03. A 29 special-risk employee who is participating in an employee 30 assistance program or drug rehabilitation program may not be 31 allowed to continue to work in any special-risk or 147 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 safety-sensitive position of the public employer, but may be 2 assigned to a position other than a safety-sensitive position 3 or placed on leave while the employee is participating in the 4 program. However, the employee shall be permitted to use any 5 accumulated annual leave credits before leave may be ordered 6 without pay. 7 Section 100. For the purpose of incorporating the 8 amendment to section 893.03, Florida Statutes, 1996 9 Supplement, in references thereto, subsection (3) of section 10 458.326, Florida Statutes, is reenacted to read: 11 458.326 Intractable pain; authorized treatment.-- 12 (3) Notwithstanding any other provision of law, a 13 physician may prescribe or administer any controlled substance 14 under Schedules II-V, as provided for in s. 893.03, to a 15 person for the treatment of intractable pain, provided the 16 physician does so in accordance with that level of care, 17 skill, and treatment recognized by a reasonably prudent 18 physician under similar conditions and circumstances. 19 Section 101. For the purpose of incorporating the 20 amendment to section 893.03, Florida Statutes, 1996 21 Supplement, in references thereto, subsection (1) of section 22 817.563, Florida Statutes, is reenacted to read: 23 817.563 Controlled substance named or described in s. 24 893.03; sale of substance in lieu thereof.--It is unlawful for 25 any person to agree, consent, or in any manner offer to 26 unlawfully sell to any person a controlled substance named or 27 described in s. 893.03 and then sell to such person any other 28 substance in lieu of such controlled substance. Any person who 29 violates this section with respect to: 30 (1) A controlled substance named or described in s. 31 893.03(1), (2), (3), or (4) is guilty of a felony of the third 148 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 degree, punishable as provided in s. 775.082, s. 775.083, or 2 s. 775.084. 3 Section 102. For the purpose of incorporating the 4 amendment to section 893.03, Florida Statutes, 1996 5 Supplement, in references thereto, section 831.31, Florida 6 Statutes, is reenacted to read: 7 831.31 Counterfeit controlled substance; sale, 8 manufacture, delivery, or possession with intent to sell, 9 manufacture, or deliver.-- 10 (1) It is unlawful for any person to sell, 11 manufacture, or deliver, or to possess with intent to sell, 12 manufacture, or deliver, a counterfeit controlled substance. 13 Any person who violates this subsection with respect to: 14 (a) A controlled substance named or described in s. 15 893.03(1), (2), (3), or (4) is guilty of a felony of the third 16 degree, punishable as provided in s. 775.082, s. 775.083, or 17 s. 775.084. 18 (2) For purposes of this section, "counterfeit 19 controlled substance" means: 20 (a) A controlled substance named or described in s. 21 893.03 which, or the container or labeling of which, without 22 authorization bears the trademark, trade name, or other 23 identifying mark, imprint, or number, or any likeness thereof, 24 of a manufacturer other than the person who in fact 25 manufactured the controlled substance; or 26 (b) Any substance which is falsely identified as a 27 controlled substance named or described in s. 893.03. 28 Section 103. For the purpose of incorporating the 29 amendment to section 893.03, Florida Statutes, 1996 30 Supplement, in references thereto, paragraph (d) of subsection 31 149 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) of section 856.015, Florida Statutes, is reenacted to 2 read: 3 856.015 Open house parties.-- 4 (1) Definitions.--As used in this section: 5 (d) "Drug" means a controlled substance, as that term 6 is defined in ss. 893.02(4) and 893.03. 7 Section 104. For the purpose of incorporating the 8 amendment to section 893.03, Florida Statutes, 1996 9 Supplement, in references thereto, subsection (4) of section 10 893.02, Florida Statutes, is reenacted to read: 11 893.02 Definitions.--The following words and phrases 12 as used in this chapter shall have the following meanings, 13 unless the context otherwise requires: 14 (4) "Controlled substance" means any substance named 15 or described in Schedules I through V of s. 893.03. Laws 16 controlling the manufacture, distribution, preparation, 17 dispensing, or administration of such substances are drug 18 abuse laws. 19 Section 105. For the purpose of incorporating the 20 amendment to section 893.03, Florida Statutes, 1996 21 Supplement, in references thereto, paragraph (b) of subsection 22 (1) of section 893.08, Florida Statutes, is reenacted to read: 23 893.08 Exceptions.-- 24 (1) The following may be distributed at retail without 25 a prescription, but only by a registered pharmacist: 26 (b) Any compound, mixture, or preparation containing 27 any depressant or stimulant substance described in s. 28 893.03(2)(a) or (c) except any amphetamine drug or 29 sympathomimetic amine drug or compound designated as a 30 Schedule II controlled substance pursuant to this chapter; in 31 s. 893.03(3)(a); or in Schedule IV, if: 150 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 1. The compound, mixture, or preparation contains one 2 or more active medicinal ingredients not having depressant or 3 stimulant effect on the central nervous system, and 4 2. Such ingredients are included therein in such 5 combinations, quantity, proportion, or concentration as to 6 vitiate the potential for abuse of the controlled substances 7 which do have a depressant or stimulant effect on the central 8 nervous system. 9 Section 106. For the purpose of incorporating the 10 amendment to section 893.03, Florida Statutes, 1996 11 Supplement, in references thereto, paragraphs (a), (c), and 12 (d) of subsection (1), paragraph (a) of subsection (2), 13 paragraph (b) of subsection (4), and paragraph (b) of 14 subsection (5) of section 893.13, Florida Statutes, 1996 15 Supplement, are reenacted to read: 16 893.13 Prohibited acts; penalties.-- 17 (1)(a) Except as authorized by this chapter and 18 chapter 499, it is unlawful for any person to sell, 19 manufacture, or deliver, or possess with intent to sell, 20 manufacture, or deliver, a controlled substance. Any person 21 who violates this provision with respect to: 22 1. A controlled substance named or described in s. 23 893.03(1)(a), (1)(b), (1)(d), (2)(a), or (2)(b) commits a 24 felony of the second degree, punishable as provided in s. 25 775.082, s. 775.083, or s. 775.084. 26 2. A controlled substance named or described in s. 27 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 28 third degree, punishable as provided in s. 775.082, s. 29 775.083, or s. 775.084. 30 31 151 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 3. A controlled substance named or described in s. 2 893.03(5) commits a misdemeanor of the first degree, 3 punishable as provided in s. 775.082 or s. 775.083. 4 (c) Except as authorized by this chapter, it is 5 unlawful for any person to sell, manufacture, or deliver, or 6 possess with intent to sell, manufacture, or deliver a 7 controlled substance in, on, or within 1,000 feet of the real 8 property comprising a public or private elementary, middle, or 9 secondary school between the hours of 6 a.m. and 12 a.m. Any 10 person who violates this paragraph with respect to: 11 1. A controlled substance named or described in s. 12 893.03(1)(a), (1)(b), (1)(d), (2)(a), or (2)(b) commits a 13 felony of the first degree, punishable as provided in s. 14 775.082, s. 775.083, or s. 775.084 and must be sentenced to a 15 minimum term of imprisonment of 3 calendar years. 16 2. A controlled substance named or described in s. 17 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 18 second degree, punishable as provided in s. 775.082, s. 19 775.083, or s. 775.084. 20 3. Any other controlled substance, except as lawfully 21 sold, manufactured, or delivered, must be sentenced to pay a 22 $500 fine and to serve 100 hours of public service in addition 23 to any other penalty prescribed by law. 24 (d) Except as authorized by this chapter, it is 25 unlawful for any person to sell, manufacture, or deliver, or 26 possess with intent to sell, manufacture, or deliver, a 27 controlled substance in, on, or within 200 feet of the real 28 property comprising a public housing facility, within 200 feet 29 of the real property comprising a public or private college, 30 university, or other postsecondary educational institution, or 31 152 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 within 200 feet of any public park. Any person who violates 2 this paragraph with respect to: 3 1. A controlled substance named or described in s. 4 893.03(1)(a), (1)(b), (1)(d), (2)(a), or (2)(b) commits a 5 felony of the first degree, punishable as provided in s. 6 775.082, s. 775.083, or s. 775.084. 7 2. A controlled substance named or described in s. 8 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 9 second degree, punishable as provided in s. 775.082, s. 10 775.083, or s. 775.084. 11 3. Any other controlled substance, except as lawfully 12 sold, manufactured, or delivered, must be sentenced to pay a 13 $500 fine and to serve 100 hours of public service in addition 14 to any other penalty prescribed by law. 15 (2)(a) Except as authorized by this chapter and 16 chapter 499, it is unlawful for any person to purchase, or 17 possess with intent to purchase, a controlled substance. Any 18 person who violates this provision with respect to: 19 1. A controlled substance named or described in s. 20 893.03(1)(a), (1)(b), (1)(d), (2)(a), or (2)(b) commits a 21 felony of the second degree, punishable as provided in s. 22 775.082, s. 775.083, or s. 775.084. 23 2. A controlled substance named or described in s. 24 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 25 third degree, punishable as provided in s. 775.082, s. 26 775.083, or s. 775.084. 27 3. A controlled substance named or described in s. 28 893.03(5) commits a misdemeanor of the first degree, 29 punishable as provided in s. 775.082 or s. 775.083. 30 (4) Except as authorized by this chapter, it is 31 unlawful for any person 18 years of age or older to deliver 153 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 any controlled substance to a person under the age of 18 2 years, or to use or hire a person under the age of 18 years as 3 an agent or employee in the sale or delivery of such a 4 substance, or to use such person to assist in avoiding 5 detection or apprehension for a violation of this chapter. 6 Any person who violates this provision with respect to: 7 (b) A controlled substance named or described in s. 8 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 9 second degree, punishable as provided in s. 775.082, s. 10 775.083, or s. 775.084. 11 12 Imposition of sentence may not be suspended or deferred, nor 13 shall the person so convicted be placed on probation. 14 (5) It is unlawful for any person to bring into this 15 state any controlled substance unless the possession of such 16 controlled substance is authorized by this chapter or unless 17 such person is licensed to do so by the appropriate federal 18 agency. Any person who violates this provision with respect 19 to: 20 (b) A controlled substance named or described in s. 21 893.03(1)(c), (2)(c), (3), or (4) commits a felony of the 22 third degree, punishable as provided in s. 775.082, s. 23 775.083, or s. 775.084. 24 Section 107. Subsection (7) of section 466.003, 25 Florida Statutes, is amended to read: 26 466.003 Definitions.--As used in this chapter: 27 (7) "Department" means the Department of Health 28 Business and Professional Regulation. 29 Section 108. Subsection (3) of section 466.006, 30 Florida Statutes, is amended to read: 31 466.006 Examination of dentists.-- 154 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (3) If an applicant is a graduate of a dental college 2 or school not accredited in accordance with paragraph (2)(b) 3 or of a dental college or school not approved by the board, he 4 shall not be entitled to take the examinations required in 5 this section to practice dentistry until he meets the 6 following requirements: 7 (a) Furnishes evidence to the board of a score on the 8 examination of the National Board of Dental Examiners taken 9 within 10 years of the date of application, which score is at 10 least equal to the minimum score required for certification by 11 that board. If the applicant fails to attain the score needed 12 for certification on part I of the national board examination 13 in two attempts, or fails to attain the score needed for 14 certification on part II of the national board examination in 15 two attempts, he shall not be entitled to take the laboratory 16 model examination authorized in paragraph (c). 17 (b) Submits, upon meeting the requirements of 18 paragraph (a), the following credentials for review by the 19 board: 20 1. Transcripts of predental education and dental 21 education totaling 7 academic years of postsecondary 22 education, including 4 academic years of dental education; and 23 2. A dental school diploma. 24 25 The board shall not review the credentials specified in this 26 paragraph until the applicant has furnished to the board 27 evidence of satisfactory completion of the National Board of 28 Dental Examiners examination as required by paragraph (a). 29 Such credentials shall be submitted in a manner provided by 30 rule of the board. The board shall approve those credentials 31 which comply with this paragraph and with rules of the board 155 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 adopted pursuant hereto. The provisions of this paragraph 2 notwithstanding, an applicant who cannot produce the 3 credentials required by this paragraph as a result of 4 political or other conditions in the country in which he 5 received his education may seek approval by the board of his 6 educational background prior to complying with the provisions 7 of paragraph (a) by submitting such other reasonable and 8 reliable evidence as may be set forth by rule of the board in 9 lieu of the credentials required in this paragraph. The board 10 shall not accept such alternative evidence until it has made a 11 reasonable attempt to obtain the credentials required by this 12 paragraph from the educational institutions the applicant is 13 alleged to have attended, unless the board is otherwise 14 satisfied that such credentials cannot be obtained. 15 (c) satisfies one of the following: 16 (a)1. Completes a program of study, as defined by the 17 board by rule, at an accredited American dental school and 18 demonstrates receipt of a D.D.S. or D.M.D. from said school; 19 or 20 (b)2. Completes a 2-year supplemental dental education 21 program at an accredited dental school and receives a dental 22 diploma, degree, or certificate as evidence of program 23 completion.; or 24 3. Exhibits manual skills on a laboratory model 25 pursuant to rules of the board. The board may charge a 26 reasonable fee, not to exceed $250, to cover the costs of 27 administering the exhibition of competency in manual skills. 28 If the applicant fails to exhibit competent clinical skills in 29 two attempts, he shall not be entitled to take the 30 examinations authorized in subsection (4). Effective December 31 31, 1991, no applicant may fulfill the requirements of this 156 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 paragraph by taking the laboratory model exam. On or after 2 said date, applicants must complete the educational 3 requirements set forth in subparagraph 1. or subparagraph 2. 4 5 The provisions of paragraph (a) and subparagraph (c)3. 6 notwithstanding, an applicant who is a graduate of a dental 7 college or school not accredited in accordance with paragraph 8 (2)(b) and who has failed to pass part I or part II of the 9 national board examination in two attempts may take the 10 laboratory model exam required in subparagraph (c)3. if the 11 board finds that he has taken remedial training in the subject 12 areas in which he tested below standard on said national board 13 examination and that he has subsequently passed that part of 14 such exam which he had previously failed, provided that no 15 applicant shall be entitled to this exception who fails either 16 part of the national board examination a total of three times. 17 Further, an applicant who has failed to pass the laboratory 18 model exam required in subparagraph (c)3. in two attempts may 19 be allowed by the board to make a third and final attempt if 20 the board finds that he has taken remedial training in 21 clinical subjects in which he tested below standard. Upon 22 passing said laboratory model exam, the applicant may take the 23 licensure examinations required in subsection (4). Further, 24 the educational requirements found in subparagraph (b)1. do 25 not apply to persons who began dental education prior to 26 October 1, 1983, and such persons shall be governed by the 27 educational requirements in existence on September 30, 1983. 28 Section 109. Section 466.017, Florida Statutes, is 29 amended to read: 30 466.017 Prescription of drugs; anesthesia.-- 31 157 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) A dentist shall have the right to prescribe drugs 2 or medicine, subject to limitations imposed by law; perform 3 surgical operations within the scope of his practice and 4 training; administer general or local anesthesia or sedation, 5 subject to limitations imposed by law; and use such appliances 6 as may be necessary to the proper practice of dentistry. 7 (2) Pharmacists licensed pursuant to chapter 465 may 8 fill prescriptions of legally licensed dentists in this state 9 for any drugs necessary for the practice of dentistry. 10 (3) The board shall adopt rules which: 11 (a) Define general anesthesia. 12 (b) Specify which methods of general or local 13 anesthesia or sedation, if any, are limited or prohibited for 14 use by dentists. 15 (c) Establish minimal training, education, experience, 16 or certification for a dentist to use general anesthesia or 17 sedation, which rules may exclude, in the board's discretion, 18 those dentists using general anesthesia or sedation in a 19 competent and effective manner as of the effective date of the 20 rules. 21 (d) Establish further requirements relating to the use 22 of general anesthesia or sedation, including, but not limited 23 to, office equipment and the training of dental assistants or 24 dental hygienists who work with dentists using general 25 anesthesia or sedation. 26 (e) Establish an administrative mechanism enabling the 27 board to verify compliance with training, education, 28 experience, equipment, or certification requirements of 29 dentists, dental hygienists, and dental assistants adopted 30 pursuant to this subsection. The board may charge a fee to 31 158 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 defray the cost of verifying compliance with requirements 2 adopted pursuant to this paragraph. 3 (4)(a) A licensed dentist who has been utilizing 4 general anesthesia on a regular and routine basis in a 5 competent and effective manner for a 10-year period preceding 6 January 1, 1980, shall be deemed to have fulfilled the 7 training requirements required by subsection (3) for general 8 anesthesia. 9 (b) A licensed dentist who has been utilizing 10 parenteral conscious sedation on an outpatient basis on a 11 regular and routine basis in a competent and effective manner 12 for the 3-year period preceding January 1, 1980, shall be 13 deemed to have fulfilled the training requirements required by 14 subsection (3) for parenteral conscious sedation. 15 (4)(5) A dentist who administers or employs the use of 16 any form of anesthesia must possess a certification in either 17 basic cardiopulmonary resuscitation for health professionals 18 or advanced cardiac life support approved by the American 19 Heart Association or the American Red Cross or an equivalent 20 agency-sponsored course with recertification every 2 years. 21 Each dental office which uses any form of anesthesia must have 22 immediately available and in good working order such 23 resuscitative equipment, oxygen, and other resuscitative drugs 24 as are specified by rule of the board in order to manage 25 possible adverse reactions. 26 (5)(6) A licensed dentist may utilize an X-ray 27 machine, expose dental X-ray films, and interpret or read such 28 films. The provisions of part IV of chapter 468 to the 29 contrary notwithstanding, a licensed dentist may authorize or 30 direct a dental assistant to operate such equipment and expose 31 such films under his direction and supervision, pursuant to 159 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 rules adopted by the board in accordance with s. 466.024 which 2 ensure that said assistant is competent by reason of training 3 and experience to operate said equipment in a safe and 4 efficient manner. The board may charge a fee not to exceed 5 $35 to defray the cost of verifying compliance with 6 requirements adopted pursuant to this section. 7 (6)(7) The provisions of s. 465.0276 notwithstanding, 8 a dentist need not register with the board or comply with the 9 continuing education requirements of that section if the 10 dentist confines his dispensing activity to the dispensing of 11 fluorides and chlorohexidine rinse solutions; provided that 12 the dentist complies with and is subject to all laws and rules 13 applicable to pharmacists and pharmacies, including, but not 14 limited to, chapters 465, 499, and 893, and all applicable 15 federal laws and regulations, when dispensing such products. 16 Section 110. Paragraphs (r) and (hh) of subsection (1) 17 of section 466.028, Florida Statutes, are amended to read: 18 466.028 Grounds for disciplinary action; action by the 19 board.-- 20 (1) The following acts shall constitute grounds for 21 which the disciplinary actions specified in subsection (2) may 22 be taken: 23 (r) Prescribing, procuring, ordering, dispensing, 24 administering, supplying, selling, or giving any drug which is 25 a Schedule II an amphetamine or a Schedule II sympathomimetic 26 amine drug or a compound thereof designated as a Schedule II 27 controlled substance, pursuant to chapter 893, to or for any 28 person except for the clinical investigation of the effects of 29 such drugs or compounds when an investigative protocol 30 therefor is submitted to, and reviewed and approved by, the 31 board before such investigation is begun. 160 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (hh) Failing to report to the department Division of 2 Medical Quality Assurance any licensee physician licensed 3 under chapter 458 or osteopathic physician licensed under 4 chapter 459 who the dentist knows has violated the grounds for 5 disciplinary action set out in the law under which that person 6 physician or osteopathic physician is licensed and who 7 provides health care services in a facility licensed under 8 chapter 395, or a health maintenance organization certificated 9 under part I of chapter 641, in which the dentist also 10 provides services. 11 Section 111. Subsection (2) of section 468.1115, 12 Florida Statutes, is amended to read: 13 468.1115 Exemptions.-- 14 (2) The provisions of this part shall not apply to: 15 (a) Students actively engaged in a training program, 16 if such persons are acting under the direct supervision of a 17 licensed speech-language pathologist or a licensed 18 audiologist. 19 (b) Persons practicing a licensed profession or 20 operating within the scope of their profession, such as 21 doctors of medicine, clinical psychologists, nurses, or 22 hearing aid specialists, who are properly licensed under the 23 laws of this state. 24 (c) Persons certified in the areas of speech-language 25 impairment or hearing impairment A person licensed in this 26 state under chapter 231 when engaging in the profession for 27 which they are certified he is licensed, or any person under 28 the direct supervision of such a certified person, or of a 29 licensee under this chapter, when the person under such 30 supervision is performing hearing screenings in a school 31 setting for prekindergarten through grade 12 the licensee when 161 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 rendering services within the scope of the profession of the 2 licensee. 3 (d) Laryngectomized individuals, rendering guidance 4 and instruction to other laryngectomized individuals, who are 5 under the supervision of a speech-language pathologist 6 licensed under this part or of a physician licensed under 7 chapter 458 or chapter 459 and qualified to perform this 8 surgical procedure. 9 (e) Persons licensed by another state as a 10 speech-language pathologist or audiologist who provide 11 services within the applicable scope of practice set forth in 12 s. 468.1125(6) or (7) for no more than 5 calendar days per 13 month or 15 calendar days per year under the direct 14 supervision of a Florida-licensed speech-language pathologist 15 or audiologist. A person whose state of residence does not 16 license speech-language pathologists or audiologists may also 17 qualify for this exemption, if the person holds a certificate 18 of clinical competence from the American Speech-Language and 19 Hearing Association and meets all other requirements of this 20 paragraph. In either case, the board shall hold the 21 supervising Florida licensee fully accountable for the 22 services provided by the out-of-state licensee. 23 (f) Nonlicensed persons working in a hospital setting 24 who provide newborn infant hearing screenings, so long as 25 training, clinical interpretation of the screenings, and the 26 protocol for followup of infants who fail in-hospital 27 screenings are provided by a licensed audiologist. 28 Section 112. Subsection (5) of section 468.1125, 29 Florida Statutes, is amended to read: 30 468.1125 Definitions.--As used in this part, the term: 31 162 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (5) "Department" means the Department of Health 2 Business and Professional Regulation. 3 Section 113. Section 468.1155, Florida Statutes, is 4 amended to read: 5 468.1155 Provisional license; requirements.-- 6 (1)(a) A provisional license shall be required of all 7 applicants who cannot document 9 months of supervised 8 professional employment experience and a passing score on the 9 national examination. 10 (b) Individuals who are required to hold a provisional 11 license under paragraph (a) shall apply to the department and 12 be certified by the board for licensure prior to initiating 13 the professional employment experience required pursuant to s. 14 468.1165. Any person desiring a provisional license to 15 practice speech-language pathology or audiology shall apply to 16 the department. 17 (2) The department shall issue a provisional license 18 to practice speech-language pathology to each applicant who 19 whom the board certifies has: 20 (a) Completed the application form and remitted the 21 required fees, including a nonrefundable application fee. 22 (b) Received a master's degree with a major emphasis 23 in speech-language pathology from an institution of higher 24 learning which, at the time the applicant was enrolled and 25 graduated, was accredited by an accrediting agency recognized 26 by the Commission on Recognition of Postsecondary 27 Accreditation or from an institution which is publicly 28 recognized as a member in good standing with the Association 29 of Universities and Colleges of Canada. An applicant who 30 graduated from a program at a university or college outside 31 the United States or Canada must shall present documentation 163 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of the determination of equivalency to standards established 2 programs accredited by the Commission on Recognition of 3 Postsecondary Accreditation in order to qualify. The 4 applicant must shall have completed a total of 60 semester 5 hours that which include: 6 1. Fundamental information applicable to the normal 7 development and use of speech, hearing, and language;, and 8 information about training in management of speech, hearing, 9 and language disorders;, and which provide information 10 supplementary to these fields. 11 2. Six semester hours in audiology. 12 3. Thirty of the required 60 these semester hours 13 shall be in courses acceptable toward a graduate degree by the 14 college or university in which these courses were taken,. of 15 which these 30 semester hours, 24 semester hours must shall be 16 in speech-language pathology. 17 (c) Completed 300 supervised clinical clock hours of 18 supervised clinical practice with 200 clock hours in the area 19 of speech-language pathology. The supervised clinical clock 20 hours practice shall be completed within the training 21 institution or one of its cooperating programs. 22 (3) The department shall issue a provisional license 23 to practice audiology to each applicant who whom the board 24 certifies has: 25 (a) Completed the application form and remitted the 26 required fees, including a nonrefundable application fee. 27 (b) Received a master's degree with a major emphasis 28 in audiology from an institution of higher learning which at 29 the time the applicant was enrolled and graduated was 30 accredited by an accrediting agency recognized by the 31 Commission on Recognition of Postsecondary Accreditation or 164 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 from an institution which is publicly recognized as a member 2 in good standing with the Association of Universities and 3 Colleges of Canada. An applicant who graduated from a program 4 at a university or college outside the United States or Canada 5 must shall present documentation of the determination of 6 equivalency to standards established programs accredited by 7 the Commission on Recognition of Postsecondary Accreditation 8 in order to qualify. The applicant must shall have completed 9 a total of 60 semester hours that which include: 10 1. Fundamental information applicable to the normal 11 development and use of speech, hearing, and language;, and 12 information about training in management of speech, hearing, 13 and language disorders;, and which provide information 14 supplementary to these fields. 15 2. Six semester hours in speech-language pathology. 16 3. Thirty of the required 60 these semester hours 17 shall be in courses acceptable toward a graduate degree by the 18 college or university in which these courses were taken,. of 19 which these 30 semester hours, 24 semester hours must shall be 20 in audiology. 21 (c) Completed 300 supervised clinical clock hours of 22 supervised clinical practice with 200 clock hours in the area 23 of audiology. The supervised clinical clock hours practice 24 shall be completed within the training institution or one of 25 its cooperating programs. 26 (4) An applicant for a provisional license who has 27 received a master's degree with a major emphasis in 28 speech-language pathology as provided in subsection (2), or 29 audiology as provided in subsection (3), and who seeks 30 licensure in the area in which the applicant is not currently 31 licensed, must have completed 30 semester hours in courses 165 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 acceptable toward a graduate degree and 200 supervised 2 clinical clock hours in the second discipline from an 3 accredited institution. 4 (5)(4) The board, by rule, shall establish 5 requirements for the renewal of a provisional license. 6 However, no person shall obtain a provisional license may not 7 exceed for a period of which exceeds 24 months. 8 Section 114. Paragraph (a) of subsection (2) and 9 subsection (3) of section 468.1185, Florida Statutes, are 10 amended to read: 11 468.1185 Licensure.-- 12 (2) The board shall certify for licensure any 13 applicant who has: 14 (a) Satisfied the education and supervised clinical 15 clock hour practice requirements of s. 468.1155. 16 (3) The board shall certify as qualified for a license 17 by endorsement as a speech-language pathologist or audiologist 18 an applicant who: 19 (a) Holds a valid license or certificate in another 20 state or territory of the United States to practice the 21 profession for which the application for licensure is made, if 22 the criteria for issuance of such license were substantially 23 equivalent to or more stringent than the licensure criteria 24 which existed in this state at the time the license was 25 issued; or 26 (b) Has received the certificate of clinical 27 competence of the American Speech-Language and Hearing 28 Association. 29 Section 115. Section 468.1195, Florida Statutes, is 30 amended to read: 31 166 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 468.1195 Renewal of license or certificate; continuing 2 education requirements; standards for approval of continuing 3 education providers.-- 4 (1) The department shall renew a license or 5 certificate upon receipt of the renewal application, renewal 6 fee, and proof satisfactory to the board that, during the 2 7 years prior to the application for renewal, the licensee or 8 certificateholder has completed the participated in not less 9 than 20 hours of continuing education requirements established 10 by the board in each area of licensure or certification. A 11 licensee or certificateholder who receives initial licensure 12 or certification 6 months or less before the end of the 13 biennial licensure cycle is exempt from the continuing 14 education requirements for the first renewal of the license or 15 certificate. 16 (2) The department shall adopt rules establishing a 17 procedure for the biennial renewal of licenses and 18 certificates. 19 (3) The board may prescribe shall by rule prescribe 20 continuing education, not to exceed 60 hours biennially in 21 each area of licensure or certification, as a condition for 22 renewal of a license or a certificate. The board may 23 establish by rule standards for the approval of such 24 continuing education activities. The board may make exception 25 from the requirements of continuing education in emergency or 26 hardship cases. 27 (4) The board may establish by rule standards for the 28 approval of providers of continuing education activities. 29 Section 116. Section 468.1201, Florida Statutes, is 30 created to read: 31 167 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 468.1201 Requirement for instruction on human 2 immunodeficiency virus and acquired immune deficiency 3 syndrome.--The board shall require, as a condition of granting 4 a license under this part, that an applicant making initial 5 application for licensure complete an education course 6 acceptable to the board on human immunodeficiency virus and 7 acquired immune deficiency syndrome. An applicant who has not 8 taken a course at the time of licensure shall, upon submission 9 of an affidavit showing good cause, be allowed 6 months to 10 complete this requirement. 11 Section 117. Subsections (2), (3), and (4) of section 12 468.1215, Florida Statutes, are amended to read: 13 468.1215 Speech-language pathology assistant and 14 audiology assistant; certification.-- 15 (2) The department shall issue a certificate as a 16 speech-language pathology assistant or as an audiology 17 assistant to each applicant who whom the board certifies has: 18 (a) Completed the application form and remitted the 19 required fees, including a nonrefundable application fee. 20 (b) Completed at least 24 semester hours of coursework 21 as approved by the board at an institution accredited by an 22 accrediting agency recognized by the Commission on Recognition 23 of Postsecondary Accreditation. 24 (3) The board, by rule, shall establish minimum 25 education and on-the-job training and supervision requirements 26 for certification as a speech-language pathology assistant or 27 audiology assistant. 28 (4) The provisions of this section shall not apply to 29 any student, intern, or trainee performing speech-language 30 pathology or audiology services while completing the 31 168 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 supervised clinical clock hours experience as required in s. 2 468.1155. 3 Section 118. Subsection (2) of section 468.1245, 4 Florida Statutes, is amended to read: 5 468.1245 Itemized listing of prices; delivery of 6 hearing aid; receipt contract; guarantee; packaging; 7 disclaimer.-- 8 (2) Any licensee who fits and sells a hearing aid 9 shall, at the time of delivery, provide the purchaser with a 10 receipt contract containing the seller's signature, the 11 address of his regular place of business, and his license or 12 certification number, if applicable, together with the brand, 13 model, manufacturer or manufacturer's identification code, and 14 serial number of the hearing aid furnished and the amount 15 charged for the hearing aid. The receipt contract also shall 16 specify whether the hearing aid is new, used, or rebuilt, and 17 shall specify the length of time and other terms of the 18 guarantee and by whom the hearing aid is guaranteed. When the 19 client has requested an itemized list of prices, the receipt 20 contract shall also provide an itemization of the total 21 purchase price, including, but not limited to, the cost of the 22 aid, ear mold, batteries, and other accessories, and the cost 23 of any services. Notice of the availability of this service 24 must shall be displayed in a conspicuous manner in the office. 25 The receipt also shall state that any complaint concerning the 26 hearing aid and its guarantee therefor, if not reconciled with 27 the licensee from whom the hearing aid was purchased, should 28 be directed by the purchaser to the department Agency for 29 Health Care Administration. The address and telephone number 30 of such office shall be stated on the receipt contract. 31 169 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 119. Section 468.1295, Florida Statutes, is 2 amended to read: 3 468.1295 Disciplinary proceedings.-- 4 (1) The following acts constitute grounds for both 5 disciplinary actions as set forth in subsection (2) and cease 6 and desist or other related actions by the department as set 7 forth in s. 455.228:. 8 (a) Procuring or attempting to procure a license by 9 bribery, by fraudulent misrepresentation, or through an error 10 of the department or the board. 11 (b) Having a license revoked, suspended, or otherwise 12 acted against, including denial of licensure, by the licensing 13 authority of another state, territory, or country. 14 (c) Being convicted or found guilty of, or entering a 15 plea of nolo contendere to, regardless of adjudication, a 16 crime in any jurisdiction which directly relates to the 17 practice of speech-language pathology or audiology. 18 (d) Making or filing a report or record which the 19 licensee knows to be false, intentionally or negligently 20 failing to file a report or records required by state or 21 federal law, willfully impeding or obstructing such filing, or 22 inducing another person to impede or obstruct such filing. 23 Such report or record shall include only those reports or 24 records which are signed in one's capacity as a licensed 25 speech-language pathologist or audiologist. 26 (e) Advertising goods or services in a manner which is 27 fraudulent, false, deceptive, or misleading in form or 28 content. 29 (f) Being proven guilty of fraud or deceit or of 30 negligence, incompetency, or misconduct in the practice of 31 speech-language pathology or audiology. 170 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (g) Violating a lawful order of the board or 2 department previously entered in a disciplinary hearing, or 3 failing to comply with a lawfully issued subpoena of the board 4 or department. 5 (h) Practicing with a revoked, suspended, inactive, or 6 delinquent license. 7 (i) Using, or causing or promoting the use of, any 8 advertising matter, promotional literature, testimonial, 9 guarantee, warranty, label, brand, insignia, or other 10 representation, however disseminated or published, which is 11 misleading, deceiving, or untruthful. 12 (j) Showing or demonstrating or, in the event of sale, 13 delivery of a product unusable or impractical for the purpose 14 represented or implied by such action. 15 (k) Failing to submit to the board on an annual basis, 16 or such other basis as may be provided by rule, certification 17 of testing and calibration of such equipment as designated by 18 the board and on the form approved by the board. 19 (l) Aiding, assisting, procuring, employing, or 20 advising any licensee or business entity licensed person to 21 practice speech-language pathology or audiology contrary to 22 this part, chapter 455, or any to a rule adopted pursuant 23 thereto of the department or the board. 24 (m) Violating any provision Violation or repeated 25 violation of this part or of chapter 455, or any rule rules 26 adopted pursuant thereto. 27 (n) Misrepresenting the Misrepresentation of 28 professional services available in the fitting, sale, 29 adjustment, service, or repair of a hearing aid, or using use 30 of any other term or title which might connote the 31 171 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 availability of professional services when such use is not 2 accurate. 3 (o) Representing, advertising, or implying 4 Representation, advertisement, or implication that a hearing 5 aid or its repair is guaranteed without providing full 6 disclosure of the identity of the guarantor; the nature, 7 extent, and duration of the guarantee; and the existence of 8 conditions or limitations imposed upon the guarantee. 9 (p) Representing, directly or by implication, that a 10 hearing aid utilizing bone conduction has certain specified 11 features, such as the absence of anything in the ear or 12 leading to the ear, or the like, without disclosing clearly 13 and conspicuously that the instrument operates on the bone 14 conduction principle and that in many cases of hearing loss 15 this type of instrument may not be suitable. 16 (q) Stating or implying that the use of any hearing 17 aid will improve or preserve hearing or prevent or retard the 18 progression of a hearing impairment or that it will have any 19 similar or opposite effect. 20 (r) Making any statement regarding the cure of the 21 cause of a hearing impairment by the use of a hearing aid. 22 (s) Representing or implying that a hearing aid is or 23 will be "custom-made," "made to order," or 24 "prescription-made," or in any other sense specially 25 fabricated for an individual person, when such is not the 26 case. 27 (t) Canvassing from house to house or by telephone, 28 either in person or by an agent, for the purpose of selling a 29 hearing aid, except that contacting persons who have evidenced 30 an interest in hearing aids, or have been referred as in need 31 of hearing aids, shall not be considered canvassing. 172 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (u) Failing to notify the department in writing of a 2 change in current mailing and place-of-practice address within 3 30 days after such change Failure to submit to the board on an 4 annual basis, or such other basis as may be provided by rule, 5 certification of testing and calibration of audiometric 6 testing equipment on the form approved by the board. 7 (v) Failing to provide all information as described in 8 ss. 468.1225(5)(b), s. 468.1245(1), and 468.1246. 9 (w) Exercising influence on a client in such a manner 10 as to exploit the client for financial gain of the licensee or 11 of a third party. 12 (x) Practicing or offering to practice beyond the 13 scope permitted by law or accepting and performing 14 professional responsibilities the licensee or 15 certificateholder knows, or has reason to know, the licensee 16 or certificateholder is not competent to perform. 17 (y) Aiding, assisting, procuring, or employing any 18 unlicensed person to practice speech-language pathology or 19 audiology. 20 (z) Delegating or contracting for the performance of 21 professional responsibilities by a person when the licensee 22 delegating or contracting for performance of such 23 responsibilities knows, or has reason to know, such person is 24 not qualified by training, experience, and authorization to 25 perform them. 26 (aa) Committing any act upon a patient or client which 27 would constitute sexual battery or which would constitute 28 sexual misconduct as defined pursuant to s. 468.1296. 29 (bb) Being unable to practice the profession for which 30 he or she is licensed or certified under this chapter with 31 reasonable skill or competence as a result of any mental or 173 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physical condition or by reason of illness, drunkenness, or 2 use of drugs, narcotics, chemicals, or any other substance. 3 In enforcing this paragraph, upon a finding by the secretary, 4 his or her designee, or the board that probable cause exists 5 to believe that the licensee or certificateholder is unable to 6 practice the profession because of the reasons stated in this 7 paragraph, the department shall have the authority to compel a 8 licensee or certificateholder to submit to a mental or 9 physical examination by a physician, psychologist, clinical 10 social worker, marriage and family therapist, or mental health 11 counselor designated by the department or board. If the 12 licensee or certificateholder refuses to comply with the 13 department's order directing the examination, such order may 14 be enforced by filing a petition for enforcement in the 15 circuit court in the circuit in which the licensee or 16 certificateholder resides or does business. The department 17 shall be entitled to the summary procedure provided in s. 18 51.011. A licensee or certificateholder affected under this 19 paragraph shall at reasonable intervals be afforded an 20 opportunity to demonstrate that he or she can resume the 21 competent practice for which he or she is licensed or 22 certified with reasonable skill and safety to patients. 23 (2) When the board finds any person guilty of any of 24 the acts set forth in subsection (1), it may issue an order 25 imposing one or more of the following penalties: 26 (a) Refusal to certify, or to certify with 27 restrictions, Denial of an application for licensure. 28 (b) Revocation or Suspension or permanent revocation 29 of a license. 30 (c)(d) Issuance of a reprimand. 31 174 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d)(f) Restriction of the authorized scope of 2 practice. 3 (e)(c) Imposition of an administrative fine not to 4 exceed $1,000 for each count or separate offense. 5 (f)(e) Placement of the licensee or certificateholder 6 on probation for a period of time and subject to such 7 conditions as the board may specify. Those conditions may 8 include, but are not limited to, including requiring the 9 licensee or certificateholder speech-language pathologist or 10 audiologist to undergo treatment, attend continuing education 11 courses, submit to be reexamined, or to work under the 12 supervision of another licensee, or satisfy any terms which 13 are reasonably tailored to the violation found speech-language 14 pathologist or audiologist. 15 (g) Corrective action. 16 (3) The department shall reissue the license or 17 certificate which of a speech-language pathologist or 18 audiologist who has been suspended or revoked disciplined upon 19 certification by the board that the licensee or 20 certificateholder person has complied with all of the terms 21 and conditions set forth in the final order. 22 Section 120. Section 468.1296, Florida Statutes, is 23 created to read: 24 468.1296 Sexual misconduct.--Sexual misconduct by any 25 person licensed or certified in the practice of his or her 26 profession is prohibited. Sexual misconduct means to induce or 27 to attempt to induce the patient to engage, or to engage or to 28 attempt to engage the patient, in sexual activity outside the 29 scope of practice or the scope of generally accepted 30 examination or treatment of the patient. 31 175 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 121. Subsection (2) of section 468.1655, 2 Florida Statutes, is amended to read: 3 468.1655 Definitions.--As used in this part: 4 (2) "Department" means the Department of Health 5 Business and Professional Regulation. 6 Section 122. Subsection (1) of section 468.1695, 7 Florida Statutes, is amended to read: 8 468.1695 Licensure by examination.-- 9 (1) Any person desiring to be licensed as a nursing 10 home administrator shall apply to the department to take the 11 licensure examination. The examination shall be given at 12 least two four times a year and shall include, but not be 13 limited to, questions on the subjects of nursing home 14 administration such as: 15 (a) Applicable standards of nursing home health and 16 safety; 17 (b) Federal, state, and local health and safety laws 18 and rules; 19 (c) General administration; 20 (d) Psychology of patient care; 21 (e) Principles of medical care; 22 (f) Personal and social care; 23 (g) Therapeutic and supportive care and services in 24 long-term care; 25 (h) Departmental organization and management; 26 (i) Community interrelationships; and 27 (j) Terminology. 28 29 The board may, by rule, adopt use of a national examination in 30 lieu of part or all of the examination required by this part. 31 176 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 123. Subsections (2), (4), and (5) of section 2 468.203, Florida Statutes, are amended to read: 3 468.203 Definitions.--As used in this act, the term: 4 (2) "Board" means the Board of Occupational Therapy 5 Practice Medicine. 6 (4) "Occupational therapy" means the use of purposeful 7 activity or interventions to achieve functional outcomes. 8 (a) For the purposes of this subsection: 9 1. "Achieving functional outcomes" means to maximize 10 the independence and the maintenance of health of any 11 individual who is limited by a physical injury or illness, a 12 cognitive impairment, a psychosocial dysfunction, a mental 13 illness, a developmental or a learning disability, or an 14 adverse environmental condition. 15 2. "Assessment" means the use of skilled observation 16 or the administration and interpretation of standardized or 17 nonstandardized tests and measurements to identify areas for 18 occupational therapy services. 19 (b) Occupational therapy services include, but are not 20 limited to: 21 1. The assessment, treatment, and education of or 22 consultation with the individual, family, or other persons. 23 2. Interventions directed toward developing daily 24 living skills, work readiness or work performance, play skills 25 or leisure capacities, or enhancing educational performance 26 skills. 27 3. Providing for the development of: sensory-motor, 28 perceptual, or neuromuscular functioning; range of motion; or 29 emotional, motivational, cognitive, or psychosocial components 30 of performance. 31 177 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 These services may require assessment of the need for use of 2 interventions such as the design, development, adaptation, 3 application, or training in the use of assistive technology 4 devices; the design, fabrication, or application of 5 rehabilitative technology such as selected orthotic devices; 6 training in the use of assistive technology; orthotic or 7 prosthetic devices; the application of physical agent 8 modalities as an adjunct to or in preparation for purposeful 9 activity; the use of ergonomic principles; the adaptation of 10 environments and processes to enhance functional performance; 11 or the promotion of health and wellness the evaluation and 12 treatment of individuals whose ability to cope with the tasks 13 of living are threatened or impaired by developmental 14 deficits, the aging process, poverty and cultural differences, 15 physical injury or illness, or psychological and social 16 disability. The treatment utilizes task-oriented activities 17 to prevent or correct physical or emotional deficits or to 18 minimize the disabling effect of these deficits in the life of 19 the individual. Specific occupational therapy techniques 20 include, but are not limited to, activities of daily living 21 (ADL), the fabrication and application of splints, 22 perceptual-motor activities, the use of specifically designed 23 crafts, guidance in the selection and use of adaptive 24 equipment, exercises to enhance functional performance, and 25 prevocational evaluation and treatment. Such techniques are 26 applied in the treatment of individual patients or clients, in 27 groups, or through social systems. 28 (c) The use of devices subject to 21 C.F.R. s. 801.109 29 and identified by the board is expressly prohibited except by 30 an occupational therapist or occupational therapy assistant 31 who has received training as specified by the board. The 178 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 board shall adopt rules to carry out the purpose of this 2 provision. 3 (5) "Occupational therapy aide" means a person who 4 assists in the practice of occupational therapy, who works 5 under the direct supervision of a person licensed occupational 6 therapist or to practice occupational therapy assistant, and 7 whose activities require a general an understanding of 8 occupational therapy pursuant to board rules but do not 9 require professional or advanced training in the basic 10 anatomical, biological, psychological, and social sciences 11 involved in the practice of occupational therapy. 12 Section 124. Section 468.205, Florida Statutes, is 13 amended to read: 14 (Substantial rewording of section. See 15 s. 468.205, F.S., for present text.) 16 468.205 Board of Occupational Therapy Practice.-- 17 (1) There is created within the department the Board 18 of Occupational Therapy Practice, composed of seven members 19 appointed by the Governor, subject to confirmation by the 20 Senate. 21 (2) Four members shall be licensed occupational 22 therapists in good standing in this state who are residents of 23 this state and have been engaged in the practice of 24 occupational therapy for at least 4 years immediately prior to 25 their appointment. One member shall be a licensed occupational 26 therapy assistant in good standing in this state who is a 27 resident of the state and has been engaged in the practice of 28 occupational therapy for at least 4 years immediately prior to 29 the appointment. Two members shall be consumers who are 30 residents of the state who are not connected with the practice 31 of occupational therapy. 179 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (3) Within 90 days after the effective date of this 2 act, the Governor shall appoint the board as follows: 3 (a) Two members for terms of 2 years each. 4 (b) Two members for terms of 3 years each. 5 (c) Three members for terms of 4 years each. 6 (4) As the terms of the members expire, the Governor 7 shall appoint successors for terms of 4 years and such members 8 shall serve until their successors are appointed. 9 (5) All provisions of chapter 455 relating to 10 activities of the board shall apply. 11 Section 125. Section 468.209, Florida Statutes, is 12 amended to read: 13 468.209 Requirements for licensure.-- 14 (1) An applicant applying for a license as an 15 occupational therapist or as an occupational therapy assistant 16 shall file a written application, accompanied by the 17 application for licensure fee prescribed in s. 468.221, on 18 forms provided by the department board, showing to the 19 satisfaction of the board that he: 20 (a) Is of good moral character. 21 (b) Has successfully completed the academic 22 requirements of an educational program in occupational therapy 23 recognized by the board, with concentration in biologic or 24 physical science, psychology, and sociology, and with 25 education in selected manual skills. For an occupational 26 therapist, Such a program shall be accredited by the American 27 Medical Association in collaboration with the American 28 Occupational Therapy Association's Accreditation Council for 29 Occupational Therapy Education, or its successor Association. 30 For an occupational therapy assistant, such a program shall be 31 approved by the American Occupational Therapy Association. 180 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (c) Has successfully completed a period of supervised 2 fieldwork experience at a recognized educational institution 3 or a training program approved by the educational institution 4 where he met the academic requirements. For an occupational 5 therapist, a minimum of 6 months of supervised fieldwork 6 experience is required. For an occupational therapy assistant, 7 a minimum of 2 months of supervised fieldwork experience is 8 required. 9 (d) Has passed an examination conducted or adopted by 10 the board as provided in s. 468.211. 11 (2) An applicant who has practiced as a state-licensed 12 or American Occupational Therapy Association-certified 13 occupational therapy assistant for 4 years and who, prior to 14 January 24, 1988, has completed a minimum of 6 months of 15 supervised occupational-therapist-level fieldwork experience 16 may take the examination to be licensed as an occupational 17 therapist without meeting the educational requirements for 18 occupational therapists made otherwise applicable under 19 paragraph (1)(b). 20 (3) If the board determines that an applicant is 21 qualified to be licensed by endorsement under s. 468.213, the 22 board may issue the applicant a temporary permit to practice 23 occupational therapy until the next board meeting at which 24 license applications are to be considered, but not for a 25 longer period of time. Only one temporary permit by 26 endorsement shall be issued to an applicant, and it shall not 27 be renewable. 28 (4) If the board determines that the applicant has not 29 passed an examination, which examination is recognized by the 30 board, to determine competence to practice occupational 31 therapy and is not qualified to be licensed by endorsement, 181 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 but has otherwise met all the requirements of this section and 2 has made application for the next scheduled examination, the 3 board may issue the applicant a temporary permit allowing him 4 to practice occupational therapy under the supervision of a 5 licensed occupational therapist until notification of the 6 results of the examination. An individual who has passed the 7 examination may continue to practice occupational therapy 8 under his temporary permit until the next meeting of the 9 board. An individual who has failed the examination shall not 10 continue to practice occupational therapy under his temporary 11 permit; and such permit shall be deemed revoked upon 12 notification to the board of the examination results and the 13 subsequent, immediate notification by the board to the 14 applicant of the revocation. Only one temporary permit by 15 examination shall be issued to an applicant, and it shall not 16 be renewable. However, applicants enrolled in a full-time 17 advanced master's occupational therapy education program who 18 have completed all requirements for licensure except 19 examination shall, upon written request, be granted a 20 temporary permit valid for 6 months even if that period 21 extends beyond the next examination, provided the applicant 22 has not failed the examination. This permit shall remain 23 valid only while the applicant remains a full-time student 24 and, upon written request, shall be renewed once for an 25 additional 6 months. 26 (5) An applicant seeking reentry into the profession 27 who has not been in active practice within the last 5 years 28 must, prior to applying for licensure, submit to the board 29 documentation of continuing education as prescribed by rule. 30 Section 126. Subsection (6) is added to section 31 468.211, Florida Statutes, to read: 182 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 468.211 Examination for licensure.-- 2 (6) If an applicant fails to pass the examination in 3 three attempts, the applicant shall not be eligible for 4 reexamination unless the applicant completes additional 5 education or training requirements prescribed by the board. 6 An applicant who has completed the additional education or 7 training requirements prescribed by the board may take the 8 examination on two more occasions. If the applicant has 9 failed to pass the examination after five attempts, the 10 applicant is no longer eligible to take the examination. 11 Section 127. Section 468.213, Florida Statutes, is 12 amended to read: 13 468.213 Licensure by endorsement.-- 14 (1) The board may waive the examination and grant a 15 license to any person who presents proof of current 16 certification as an occupational therapist or occupational 17 therapy assistant by a national certifying organization the 18 American Occupational Therapy Association if the board 19 determines the requirements for such certification to be 20 equivalent to the requirements for licensure in this act. 21 (2) The board may waive the examination and grant a 22 license to any applicant who presents proof of current 23 licensure as an occupational therapist or occupational therapy 24 assistant in another state, the District of Columbia, or any a 25 territory or jurisdiction of the United States or foreign 26 national jurisdiction which requires standards for licensure 27 determined by the board to be equivalent to the requirements 28 for licensure in this act. 29 Section 128. Section 468.225, Florida Statutes, is 30 amended to read: 31 183 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 468.225 Exemptions Persons and practices not 2 affected.-- 3 (1) Nothing in this act shall be construed as 4 preventing or restricting the practice, services, or 5 activities of: 6 (a) Any person licensed in this state by any other law 7 from engaging in the profession or occupation for which he is 8 licensed. 9 (b) Any person employed as an occupational therapist 10 or occupational therapy assistant by the United States, if 11 such person provides occupational therapy solely under the 12 direction or control of the organization by which he is 13 employed. 14 (c) Any person pursuing a course of study leading to a 15 degree or certificate in occupational therapy at an accredited 16 or approved educational program, if such activities and 17 services constitute a part of a supervised course of study and 18 if such a person is designated by a title which clearly 19 indicates his or her status as a student or trainee. 20 (d) Any person fulfilling the supervised fieldwork 21 experience requirements of s. 468.209, if such activities and 22 services constitute a part of the experience necessary to meet 23 the requirements of that section. 24 (e) Any person employed by, or working under the 25 direct supervision of, an occupational therapist as an 26 occupational therapy aide. 27 (2) No provision of this act shall be construed to 28 prohibit physicians, physician assistants, nurses, physical 29 therapists, osteopathic physicians or surgeons, or clinical 30 psychologists, speech-language pathologists, or audiologists 31 from using occupational therapy as a part of or incidental to 184 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 their profession, when they practice their profession under 2 the statutes applicable to their profession. 3 Section 129. Section 468.351, Florida Statutes, is 4 amended to read: 5 468.351 Purpose and intent; application.-- 6 (1)(a) The purpose in enacting this part is to provide 7 for the licensure certification and registration of persons 8 who deliver respiratory care services and who meet certain 9 requirements. The delivery of respiratory care services by 10 persons licensed certified or registered pursuant to this part 11 shall not be construed to permit the practice of medicine. 12 (b) It is the finding of the Legislature that the 13 delivery of respiratory care services by unskilled and 14 incompetent persons presents a danger to the public health and 15 safety. Because it is difficult for the public to make 16 informed choices related to respiratory care services and 17 since the consequences of wrong choices can seriously endanger 18 public health and safety, it is the intent of the Legislature 19 to prohibit the delivery of respiratory care services by 20 persons who are determined to possess less than minimum 21 competencies or who otherwise present a danger to the public. 22 (2) It is the intent of the Legislature that the 23 department of Health and Rehabilitative Services shall 24 continue to regulate blood gas laboratories and that the 25 supervision of health respiratory care practitioners, clinical 26 laboratory personnel, and other persons performing blood gas 27 analysis and specimen collection for the purpose of such 28 analysis be specified in rules pursuant to the applicable 29 practice act chapter 483. Further, it is the intent of the 30 Legislature that personnel licensed certified or registered 31 185 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 pursuant to this part shall be exempt from the licensure 2 provisions of chapter 483. 3 Section 130. Subsections (2), (8), and (9) of section 4 468.352, Florida Statutes, are amended to read: 5 468.352 Definitions.--As used in this part, unless the 6 context otherwise requires, the term: 7 (2) "Department" means the Department of Health 8 Business and Professional Regulation. 9 (8) "Respiratory therapist" means any person licensed 10 registered pursuant to this part who is employed to deliver 11 respiratory care services under the order of a physician 12 licensed pursuant to chapter 458 or chapter 459, and in 13 accordance with protocols established by a hospital, other 14 health care provider, or the board, and who functions in 15 situations of unsupervised patient contact requiring 16 individual judgment. 17 (9) "Respiratory care practitioner" means any person 18 licensed certified pursuant to this part who is employed to 19 deliver respiratory care services under the order of a 20 physician licensed pursuant to chapter 458 or chapter 459, and 21 in accordance with protocols established by a hospital, other 22 health care provider, or the board. 23 Section 131. Paragraph (a) of subsection (5) of 24 section 468.354, Florida Statutes, is amended to read: 25 468.354 Advisory Council on Respiratory Care; 26 organization; function.-- 27 (5)(a) The council shall recommend to the department a 28 code of ethics for those persons licensed certified or 29 registered pursuant to this part. 30 Section 132. Section 468.355, Florida Statutes, is 31 amended to read: 186 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 468.355 Eligibility for licensure certification or 2 registration; temporary licensure certification.-- 3 (1) To be eligible for licensure certification by the 4 board as a respiratory care practitioner, an applicant must: 5 (a) Be at least 18 years old. 6 (b) Possess a high school diploma or a graduate 7 equivalency diploma. 8 (c) Meet at least one of the following criteria: 9 1. The applicant has successfully completed a training 10 program for respiratory therapy technicians or respiratory 11 therapists approved by the Commission Committee on 12 Accreditation of Allied Health Education Programs and 13 Accreditation of the American Medical Association, or the 14 equivalent thereof, as accepted by the board. 15 2. The applicant is currently a "Certified Respiratory 16 Therapy Technician" certified by the National Board for 17 Respiratory Care, or the equivalent thereof, as accepted by 18 the board. 19 3. The applicant is currently a "Registered 20 Respiratory Therapist" registered by the National Board for 21 Respiratory Care, or the equivalent thereof, as accepted by 22 the board. 23 4. The applicant is currently employed in this state 24 as a respiratory care practitioner or respiratory therapist on 25 October 1, 1984. 26 27 The criteria set forth in subparagraphs 2. and 3. 28 notwithstanding, the board shall annually review the 29 examinations and standards of the National Board for 30 Respiratory Care and may reject those examinations and 31 standards if they are deemed inappropriate. 187 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) To be eligible for licensure registration by the 2 board as a respiratory therapist, an applicant must: 3 (a) Be at least 18 years old. 4 (b) Possess a high school diploma or a graduate 5 equivalency diploma. 6 (c) Meet at least one of the following criteria: 7 1. The applicant has successfully completed a training 8 program for respiratory therapists approved by the Commission 9 Committee on Accreditation of Allied Health Education Programs 10 and Accreditation of the American Medical Association, or the 11 equivalent thereof, as accepted by the board. 12 2. The applicant is currently a "Registered 13 Respiratory Therapist" registered by the National Board for 14 Respiratory Care, or the equivalent thereof, as accepted by 15 the board. 16 17 The criteria set forth in subparagraphs 1. and 2. 18 notwithstanding, the board shall annually review the 19 examinations and standards of the National Board for 20 Respiratory Care and may reject those examinations and 21 standards if they are deemed inappropriate. 22 (3) With respect to the delivery of respiratory care 23 services, the board shall establish procedures for temporary 24 licensure certification of eligible individuals entering the 25 state and temporary licensure certification of those persons 26 who have graduated from a program approved by the board. Such 27 temporary licensure certification shall be for a period not to 28 exceed 1 year. 29 Section 133. Section 468.356, Florida Statutes, is 30 amended to read: 31 468.356 Approval of educational programs.-- 188 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) Approval of educational programs shall be in 2 accordance with the Joint Review Committee for Respiratory 3 Therapy Education through the Commission Committee on 4 Accreditation of Allied Health Education Programs, or other 5 accrediting agency recognized by the United States Office of 6 Education and Accreditation of the American Medical 7 Association. 8 (2) In the event that an educational program has not 9 yet received full American Medical Association approval, the 10 board, at its discretion, may require appropriate 11 documentation of the intent to achieve full accreditation 12 within a specified time period. Temporary approval for 13 graduates of such programs to sit for state licensure 14 certification or registration examinations may then be granted 15 by the board. 16 Section 134. Section 468.357, Florida Statutes, is 17 amended to read: 18 468.357 Licensure Certification by examination.-- 19 (1) A person who desires to be licensed certified as a 20 respiratory care practitioner may submit an application to the 21 department board to take the examination to be administered by 22 the department. 23 (a) The department shall examine each applicant who is 24 determined by the board to have: 25 1. Completed the application form and remitted the 26 applicable application fee set by the board; 27 2. Submitted required documentation as required in s. 28 468.355; and 29 3. Remitted an examination fee set by the board. 30 (b) The department shall conduct examinations for 31 licensure certification of respiratory care practitioners no 189 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 less than two times a year in such geographical locations as 2 are deemed advantageous to the majority of the applicants. 3 However, the examination shall be conducted no less than three 4 times a year through 1988 and in such geographical locations 5 as are deemed advantageous to the majority of the applicants. 6 (c) The examination given for respiratory care 7 practitioners shall be the same as that given by the National 8 Board for Respiratory Care for entry-level certification of 9 respiratory therapy technicians. However, an equivalent 10 examination may be accepted by the board in lieu of that 11 examination. 12 (2) Each applicant who passes the examination shall be 13 entitled to licensure certification as a respiratory care 14 practitioner, and the department shall issue a license 15 certificate pursuant to this part to any applicant who 16 successfully completes the examination in accordance with this 17 section. However, the department shall not issue a license 18 certificate to any applicant who is under investigation in 19 another jurisdiction for an offense which would constitute a 20 violation of this part. Upon completion of such an 21 investigation, if the applicant is found guilty of such an 22 offense, the applicable provisions of s. 468.365 will apply. 23 (3)(a) Any person who was employed in this state on or 24 before September 30, 1983, as a respiratory therapy technician 25 or respiratory therapist, and who has performed services in 26 such professional capacity for 4 years or more by October 1, 27 1987, under the supervision of a licensed physician or in a 28 hospital or licensed health care facility, shall be issued a 29 license certificate without examination, if such person 30 provides acceptable documentation of performance of such 31 services to the board. Such documentation shall include 190 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 certification by a physician licensed pursuant to chapter 458 2 or chapter 459 who has direct knowledge of the practice of, or 3 who has supervised, the person. If such person is not 4 determined to have performed critical care respiratory 5 services for at least 4 years, the board may limit the license 6 certificate of such person to the performance of noncritical 7 care respiratory services. Any person issued a certificate 8 pursuant to this paragraph shall complete at least 20 contact 9 hours of continuing education each year. 10 (b) Any person first employed in this state as a 11 respiratory therapy technician or respiratory therapist on or 12 after October 1, 1984, and prior to October 1, 1987, shall 13 have until December 31, 1988, to pass the examination for 14 certification under this part if the person has applied to 15 take the examination before March 1, 1988, and such person 16 shall be permitted to continue to perform respiratory care 17 services until December 31, 1988. 18 Section 135. Section 468.358, Florida Statutes, is 19 amended to read: 20 468.358 Licensure Certification or registration by 21 endorsement.-- 22 (1) Licensure Certification as a respiratory care 23 practitioner shall be granted by endorsement to an individual 24 who holds the "Certified Respiratory Therapy Technician" 25 credential issued by the National Board for Respiratory Care 26 or an equivalent credential acceptable to the board. Licensure 27 Certification by this mechanism requires verification by oath 28 and submission of evidence satisfactory to the board that such 29 credential is held. 30 (2) Licensure Registration as a respiratory therapist 31 shall be granted by endorsement to an individual who holds the 191 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 "Registered Respiratory Therapist" credential issued by the 2 National Board for Respiratory Care or an equivalent 3 credential acceptable to the board. Licensure Registration by 4 this mechanism requires verification by oath and submission of 5 evidence satisfactory to the board that such credential is 6 held. 7 (3) An individual who has been granted licensure, 8 certification, registration, or other authority, by whatever 9 name known, to deliver respiratory care services in another 10 state or country may petition the board for consideration for 11 licensure certification or registration in this state and, 12 upon verification by oath and submission of evidence of 13 licensure, certification, registration, or other authority 14 acceptable to the board, may be granted licensure 15 certification or registration by endorsement. 16 (4) Licensure Certification or registration shall not 17 be granted by endorsement as provided in this section without 18 the submission of a proper application and the payment of the 19 requisite fees therefor. 20 Section 136. Subsections (1), (2), and (5) of section 21 468.359, Florida Statutes, are amended to read: 22 468.359 Assumption of title and use of 23 abbreviations.-- 24 (1) Only persons who are licensed certified pursuant 25 to this part as respiratory care practitioners have the right 26 to use the title "Respiratory Care Practitioner" and the 27 abbreviation "RCP." 28 (2) Only persons who are licensed registered pursuant 29 to this part as respiratory therapists have the right to use 30 the title "Registered Respiratory Therapist" and the 31 abbreviation "RRT," provided such persons have passed the 192 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Registry Examination for Respiratory Therapists given by the 2 National Board for Respiratory Care. 3 (5) No person in this state shall deliver respiratory 4 care services; advertise as, or assume the title of, 5 respiratory care practitioner or respiratory therapist; or use 6 the abbreviation "RCP" or take any other action that would 7 lead the public to believe that such person is licensed 8 certified or registered pursuant to this part unless such 9 person is so licensed certified or registered. 10 Section 137. Section 468.36, Florida Statutes, is 11 amended to read: 12 468.36 Primary place of service delivery; notice of 13 address or change of address.--Every licensee 14 certificateholder or registrant shall file with the department 15 the licensee's current residence address as defined by board 16 rule of his primary place of service delivery within the state 17 prior to engaging in such service delivery. Prior to changing 18 such address, he shall notify the department of the address of 19 his new primary place of service delivery, whether or not 20 within the state. 21 Section 138. Section 468.362, Florida Statutes, is 22 repealed, and section 468.361, Florida Statutes, is amended to 23 read: 24 468.361 Renewal of licensure certification or 25 registration; continuing education.-- 26 (1) The department shall provide by rule a method for 27 the biennial renewal of licensure certification or 28 registration at fees set by the board. 29 (2) The board shall prescribe by rule continuing 30 education requirements, not to exceed 24 hours biennially, as 31 a condition for renewal of licensure certification or 193 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 registration. The program criteria with respect thereto shall 2 be approved by the board. 3 (3) The board shall approve continuing education 4 courses which may be accepted in meeting the requirements of 5 this part. Providers of such courses shall also be approved 6 by the board. 7 (4) The board may make exceptions from the 8 requirements of this section in emergency or hardship cases. 9 Section 139. Section 468.363, Florida Statutes, is 10 amended to read: 11 468.363 Reactivation of licensure certification or 12 registration; continuing education.--The board shall prescribe 13 by rule continuing education requirements as a condition of 14 reactivating a license certificate or registration. The 15 continuing education requirements for reactivating a license 16 certificate or registration may not exceed 12 classroom hours 17 for each year the license certificate or registration was 18 inactive. 19 Section 140. Subsection (1) of section 468.364, 20 Florida Statutes, is amended to read: 21 468.364 Fees; establishment; disposition.-- 22 (1) The board shall establish by rule fees for the 23 following purposes: 24 (a) Application, fee: a fee not to exceed $50. 25 (b) Examination, fee: a fee not to exceed $125 plus 26 the actual per applicant cost to the department for purchase 27 of the examination from the National Board for Respiratory 28 Care or a similar national organization. 29 (c) Initial licensure, certification or registration 30 fee: a fee not to exceed $200. 31 194 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) Renewal of licensure, certification or 2 registration fee: a fee not to exceed $200 biennially. 3 (e) Renewal of inactive licensure, certification or 4 registration: a fee not to exceed $50. 5 (f) Reactivation, fee: a fee not to exceed $50. 6 Section 141. Section 468.365, Florida Statutes, is 7 amended to read: 8 468.365 Disciplinary grounds and actions.-- 9 (1) The following acts constitute grounds for which 10 the disciplinary actions in subsection (2) may be taken: 11 (a) Procuring, attempting to procure, or renewing a 12 license certificate or registration as provided by this part 13 by bribery, by fraudulent misrepresentation, or through an 14 error of the department or the board. 15 (b) Having licensure, certification, registration, or 16 other authority, by whatever name known, to deliver 17 respiratory care services revoked, suspended, or otherwise 18 acted against, including the denial of licensure, 19 certification, registration, or other authority to deliver 20 respiratory care services by the licensing authority of 21 another state, territory, or country. 22 (c) Being convicted or found guilty of, or entering a 23 plea of nolo contendere to, regardless of adjudication, of a 24 crime in any jurisdiction which directly relates to 25 respiratory care services or to the ability to deliver such 26 services. 27 (d) Willfully making or filing a false report or 28 record, willfully failing to file a report or record required 29 by state or federal law, or willfully impeding or obstructing 30 such filing or inducing another person to do so. Such reports 31 or records include only those reports or records which require 195 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the signature of a certified respiratory care practitioner or 2 a respiratory therapist licensed registered pursuant to this 3 part. 4 (e) Circulating false, misleading, or deceptive 5 advertising. 6 (f) Unprofessional conduct, which includes, but is not 7 limited to, any departure from, or failure to conform to, 8 acceptable standards related to the delivery of respiratory 9 care services, as set forth by the board and the Advisory 10 Council on Respiratory Care in rules adopted pursuant to this 11 part. 12 (g) Engaging or attempting to engage in the 13 possession, sale, or distribution of controlled substances, as 14 set forth by law, for any purpose other than a legitimate 15 purpose. 16 (h) Willfully failing to report any violation of this 17 part. 18 (i) Willfully or repeatedly violating a rule of the 19 board or the department or a lawful order of the board or 20 department previously entered in a disciplinary hearing. 21 (j) Violation of any rule adopted pursuant to this 22 part or chapter 455. 23 (k) Engaging in the delivery of respiratory care 24 services with a revoked, suspended, or inactive license 25 certificate or registration. 26 (l) Permitting, aiding, assisting, procuring, or 27 advising any person who is not licensed certified or 28 registered pursuant to this part, contrary to this part or to 29 any rule of the department or the board. 30 (m) Failing to perform any statutory or legal 31 obligation placed upon a certified respiratory care 196 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 practitioner or a respiratory therapist licensed registered 2 pursuant to this part. 3 (n) Accepting and performing professional 4 responsibilities which the licensee certificateholder or 5 registrant knows, or has reason to know, he is not competent 6 to perform. 7 (o) Delegating professional responsibilities to a 8 person when the licensee certificateholder or registrant 9 delegating such responsibilities knows, or has reason to know, 10 that such person is not qualified by training, experience, or 11 licensure certification or registration to perform them. 12 (p) Gross or repeated malpractice or the failure to 13 deliver respiratory care services with that level of care, 14 skill, and treatment which is recognized by a reasonably 15 prudent respiratory care practitioner or respiratory therapist 16 with similar professional training as being acceptable under 17 similar conditions and circumstances. 18 (q) Paying or receiving any commission, bonus, 19 kickback, or rebate to or from, or engaging in any split-fee 20 arrangement in any form whatsoever with, a person, 21 organization, or agency, either directly or indirectly, for 22 goods or services rendered to patients referred by or to 23 providers of health care goods and services, including, but 24 not limited to, hospitals, nursing homes, clinical 25 laboratories, ambulatory surgical centers, or pharmacies. The 26 provisions of this paragraph shall not be construed to prevent 27 the licensee certificateholder or registrant from receiving a 28 fee for professional consultation services. 29 (r) Exercising influence within a respiratory care 30 relationship for the purpose of engaging a patient in sexual 31 activity. A patient is presumed to be incapable of giving 197 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 free, full, and informed consent to sexual activity with the 2 patient's respiratory care practitioner or respiratory 3 therapist. 4 (s) Making deceptive, untrue, or fraudulent 5 representations in the delivery of respiratory care services 6 or employing a trick or scheme in the delivery of respiratory 7 care services if such a scheme or trick fails to conform to 8 the generally prevailing standards of other licensees 9 certificateholders or registrants within the community. 10 (t) Soliciting patients, either personally or through 11 an agent, through the use of fraud, deception, or otherwise 12 misleading statements or through the exercise of intimidation 13 or undue influence. 14 (u) Failing to keep written respiratory care records 15 justifying the reason for the action taken by the licensee 16 certificateholder or registrant. 17 (v) Exercising influence on the patient in such a 18 manner as to exploit the patient for the financial gain of the 19 licensee certificateholder or registrant or a third party, 20 which includes, but is not limited to, the promoting or 21 selling of services, goods, appliances, or drugs. 22 (w) Performing professional services which have not 23 been duly ordered by a physician licensed pursuant to chapter 24 458 or chapter 459 and which are not in accordance with 25 protocols established by the hospital, other health care 26 provider, or the board, except as provided in ss. 743.064, 27 766.103, and 768.13. 28 (x) Being unable to deliver respiratory care services 29 with reasonable skill and safety to patients by reason of 30 illness or use of alcohol, drugs, narcotics, chemicals, or any 31 other type of material as a result of any mental or physical 198 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 condition. In enforcing this paragraph, the department shall, 2 upon probable cause, have authority to compel a respiratory 3 care practitioner or respiratory therapist to submit to a 4 mental or physical examination by physicians designated by the 5 department. The cost of examination shall be borne by the 6 licensee certificateholder or registrant being examined. The 7 failure of a respiratory care practitioner or respiratory 8 therapist to submit to such an examination when so directed 9 constitutes an admission of the allegations against him, upon 10 which a default and a final order may be entered without the 11 taking of testimony or presentation of evidence, unless the 12 failure was due to circumstances beyond his control. A 13 respiratory care practitioner or respiratory therapist 14 affected under this paragraph shall at reasonable intervals be 15 afforded an opportunity to demonstrate that he can resume the 16 competent delivery of respiratory care services with 17 reasonable skill and safety to his patients. In any 18 proceeding under this paragraph, neither the record of 19 proceedings nor the orders entered by the board shall be used 20 against a respiratory care practitioner or respiratory 21 therapist in any other proceeding. 22 (2) If the board finds any person guilty of any of the 23 grounds set forth in subsection (1), it may enter an order 24 imposing one or more of the following penalties: 25 (a) Denial of an application for licensure 26 certification or registration. 27 (b) Revocation or suspension of licensure 28 certification or registration. 29 (c) Imposition of an administrative fine not to exceed 30 $1,000 for each count or separate offense. 31 199 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) Placement of the respiratory care practitioner or 2 respiratory therapist on probation for such period of time and 3 subject to such conditions as the board may specify, 4 including, but not limited to, requiring the respiratory care 5 practitioner or respiratory therapist to submit to treatment, 6 to attend continuing education courses, or to work under the 7 supervision of another respiratory care practitioner or 8 respiratory therapist. 9 (e) Issuance of a reprimand. 10 (3) The board shall not reinstate licensure 11 certification or registration, or cause a license certificate 12 or registration to be issued to a person it has deemed 13 unqualified, until such time as it is satisfied that such 14 person has complied with all the terms and conditions set 15 forth in the final order and that the respiratory care 16 practitioner or respiratory therapist is capable of safely 17 engaging in the delivery of respiratory care services. 18 (4) The board may, by rule, establish guidelines for 19 the disposition of disciplinary cases involving specific types 20 of violations. Such guidelines may include minimum and 21 maximum fines, periods of supervision on probation, or 22 conditions upon probation or reissuance of a license 23 certificate or registration. 24 Section 142. Subsection (1) of section 468.366, 25 Florida Statutes, is amended to read: 26 468.366 Penalties for violations.-- 27 (1) It is a violation of law for any person, including 28 any firm, association, or corporation, to: 29 (a) Sell or fraudulently obtain, attempt to obtain, or 30 furnish to any person a diploma, license, certificate, 31 200 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 registration, or record, or aid or abet in the sale, 2 procurement, or attempted procurement thereof. 3 (b) Deliver respiratory care services, as defined by 4 this part or by rule of the board, under cover of any diploma, 5 license, certificate, registration, or record that was 6 illegally or fraudulently obtained or signed or issued 7 unlawfully or under fraudulent representation. 8 (c) Deliver respiratory care services, as defined by 9 this part or by rule of the board, unless such person is duly 10 licensed certified or registered to do so under the provisions 11 of this part or unless such person is exempted pursuant to s. 12 468.368. 13 (d) Use, in connection with his name, any designation 14 tending to imply that he is a respiratory care practitioner or 15 a respiratory therapist, duly licensed certified or registered 16 under the provisions of this part, unless he is so licensed 17 certified or registered. 18 (e) Advertise an educational program as meeting the 19 requirements of this part, or conduct an educational program 20 for the preparation of respiratory care practitioners or 21 respiratory therapists, unless such program has been approved 22 by the board. 23 (f) Knowingly employ unlicensed uncertified or 24 unregistered persons in the delivery of respiratory care 25 services, unless exempted by this part. 26 (g) Knowingly conceal information relative to any 27 violation of this part. 28 Section 143. Subsection (8) of section 468.368, 29 Florida Statutes, is amended to read: 30 468.368 Exemptions.--Nothing in this part shall be 31 construed to prohibit: 201 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (8) The employment by a health care facility of a 2 student enrolled in the clinical portion of an approved 3 respiratory care educational program (who has demonstrated 4 such enrollment to the board by submission of evidence 5 satisfactory to the board) to deliver limited respiratory care 6 support services under the supervision of personnel licensed 7 certified or registered pursuant to this part. Such exemption 8 shall also apply to the graduates of such programs until the 9 receipt of temporary licensure certification issued pursuant 10 to the provisions of s. 468.355(3). However, such employees 11 shall not perform invasive procedures or procedures related to 12 critical respiratory care, including therapeutic, diagnostic, 13 and palliative procedures, nor shall they participate in 14 delivering certain services requiring unsupervised patient 15 contact, as determined by the board. 16 Section 144. Subsection (3) of section 478.42, Florida 17 Statutes, is amended to read: 18 478.42 Definitions.--As used in this chapter, the 19 term: 20 (3) "Department" means the Department of Health 21 Business and Professional Regulation. 22 Section 145. Section 478.45, Florida Statutes, is 23 amended to read: 24 478.45 Requirements for licensure.-- 25 (1) An applicant applying for licensure as an 26 electrologist shall file a written application, accompanied by 27 the application for licensure fee prescribed in s. 478.55, on 28 a form provided by the board, showing to the satisfaction of 29 the board that the applicant: 30 (a) Is at least 18 years old. 31 (b) Is of good moral character. 202 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (c) Is a resident of the state. 2 (c)(d) Possesses a high school diploma or a graduate 3 equivalency diploma. 4 (d)(e) Has not committed an act in any jurisdiction 5 which would constitute grounds for disciplining an 6 electrologist in this state. 7 (e)(f)1. Has successfully completed the academic 8 requirements of an electrolysis training program, not to 9 exceed 120 hours, and the practical application thereof as 10 approved by the board; or 11 2. Was engaged in the practice of electrology prior to 12 October 1, 1991, and filed an application for licensure within 13 90 days after the date established by the board or by February 14 1, 1995, whichever comes last. 15 (2) Each applicant for licensure shall successfully 16 pass a written examination developed by the department or a 17 national examination that has, both of which have been 18 approved by the board. The examinations shall test the 19 applicant's knowledge relating to the practice of electrology, 20 including the applicant's professional skills and judgment in 21 the use of electrolysis techniques and methods, and any other 22 subjects which are useful to determine the applicant's fitness 23 to practice. 24 (3) The department, upon approval of the board, may 25 adopt a the American Electrology Association examination or 26 any other national examination in lieu of any part of the 27 examination required by this section. The board, with the 28 assistance of the council, shall establish standards for 29 acceptable performance. 30 (4) The department shall issue a license to practice 31 electrology to any applicant who passes the examination, pays 203 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the licensure fee as set forth in s. 478.55, and otherwise 2 meets the requirements of this chapter. 3 (5) The department shall conduct licensure 4 examinations at least two times a year biannually at locations 5 set by the board. However, such examinations may be conducted 6 at least three times each year through 1995. The department 7 board shall give public notice of the time and place of each 8 examination at least 60 days before it is administered and 9 shall mail notice of such examination to each applicant whose 10 application is timely filed, pursuant to board rule. 11 (6) The department may not issue a license to any 12 applicant who is under investigation in another jurisdiction 13 for an offense which would be a violation of this chapter, 14 until such investigation is complete. Upon completion of such 15 investigation, if the applicant is found guilty of such 16 offense, the board shall apply the applicable provisions of s. 17 478.52. 18 Section 146. Subsection (1) of section 478.46, Florida 19 Statutes, is amended to read: 20 478.46 Temporary permits.-- 21 (1) If the department executive director of the board 22 determines that an applicant is qualified to be licensed under 23 s. 478.47 478.45, the department board may issue the applicant 24 a temporary permit to practice electrolysis electrology until 25 the next board meeting at which license applications are to be 26 considered, but not for a longer period of time. Only one 27 temporary permit shall be issued to an applicant, and it shall 28 not be renewable. 29 Section 147. Section 478.47, Florida Statutes, is 30 amended to read: 31 204 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 478.47 Licensure by endorsement.--The department shall 2 issue a license by endorsement to any applicant who submits an 3 application and the required fees as set forth in s. 478.55 4 and who the board certifies has met the qualifications of s. 5 478.45(1) or who holds an active license or other authority to 6 practice electrology in a jurisdiction whose licensure 7 requirements are determined by the board to be equivalent to 8 the requirements for licensure in this state. 9 Section 148. Paragraph (d) of subsection (2) of 10 section 478.52, Florida Statutes, is amended, and paragraph 11 (u) is added to subsection (1) of said section, to read: 12 478.52 Disciplinary proceedings.-- 13 (1) The following acts are grounds for which the 14 disciplinary actions in subsection (2) may be taken: 15 (u) Operating any electrolysis facility unless it has 16 been duly licensed as provided in this chapter. 17 (2) When the board finds any person guilty of any of 18 the grounds set forth in subsection (1), including conduct 19 that would constitute a substantial violation of subsection 20 (1) which occurred prior to licensure, it may enter an order 21 imposing one or more of the following penalties: 22 (d) Place the licensee on probation for a specified 23 time and subject the licensee to such conditions as the board 24 determines necessary, including, but not limited to, requiring 25 treatment, continuing education courses, reexamination, or 26 working under the supervision of another licensee. 27 Section 149. Subsections (1) and (2) of section 28 480.033, Florida Statutes, are amended to read: 29 480.033 Definitions.--As used in this act: 30 (1) "Board" means the Board of Massage Therapy. 31 205 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) "Department" means the Department of Health 2 Business and Professional Regulation. 3 Section 150. Section 480.034, Florida Statutes, is 4 amended to read: 5 480.034 Exemptions.-- 6 (1) Nothing in this act shall modify or repeal any 7 provision of chapters 458-464, inclusive, or of chapter 476, 8 chapter 477, or chapter 486. 9 (2) Athletic trainers employed by or on behalf of a 10 professional athletic team performing or training within this 11 state shall be exempt from the provisions of this act. 12 (3) The state and its political subdivisions are 13 exempt from the registration requirements of this act. 14 (4) Treatments for the purpose of cleansing and 15 beautifying the skin or in conjunction with a weight loss 16 program, including herbal wraps, body scrubs, paraffin wax 17 treatments, and seaweed wraps, shall be exempt from the 18 provisions of this act. 19 (4)(5) An exemption granted is effective to the extent 20 that an exempted person's practice or profession overlaps with 21 the practice of massage. 22 Section 151. Subsection (1) of section 480.035, 23 Florida Statutes, is amended to read: 24 480.035 Board of Massage Therapy.-- 25 (1) The Board of Massage Therapy is created within the 26 department. The board shall consist of seven members, who 27 shall be appointed by the Governor and whose function it shall 28 be to carry out the provisions of this act. 29 Section 152. Section 480.041, Florida Statutes, is 30 amended to read: 31 206 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 480.041 Massage therapists; qualifications; licensure; 2 endorsement; provisional licensure.-- 3 (1) Any person is qualified for licensure as a massage 4 therapist under this act who: 5 (a) Is at least 18 years of age or has received a high 6 school diploma or graduate equivalency diploma; 7 (b) Has completed a course of study at a 8 board-approved massage school or has completed an 9 apprenticeship program that meets standards adopted by the 10 board; and 11 (c) Has received a passing grade on an examination 12 administered by the department. 13 (2) Every person desiring to be examined for licensure 14 as a massage therapist shall apply to the department in 15 writing upon forms prepared and furnished by the department. 16 Such applicants shall be subject to the provisions of s. 17 480.046(1). Applicants may take an examination administered by 18 the department only upon meeting the requirements of this 19 section as determined by the board. 20 (3) Upon an applicant's passing the examination and 21 paying the initial licensure fee, the department shall issue 22 to the applicant a license, valid until the next scheduled 23 renewal date, to practice massage. 24 (4)(a) The board may issue to an applicant, without 25 examination, a provisional license to practice massage, 26 provided such applicant meets all other conditions and 27 requirements relating to qualification for licensure and 28 submits a fee pursuant to s. 480.044. Such applicant for a 29 provisional license shall be associated with a licensed 30 massage therapist and shall practice only under the 31 207 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 supervision of such licensed massage therapist at a licensed 2 establishment. 3 (b) The provisional license, when granted, shall 4 include the name and address of the licensed massage therapist 5 with whom the applicant is associated. No licensed massage 6 therapist may supervise more than one provisional 7 licenseholder at the same time. 8 (c) The applicant must appear at the next examination 9 for licensure for which the applicant can be scheduled 10 according to the rules of the board and department. The 11 provisional license shall expire upon written notification by 12 the department that the applicant has failed the examination 13 or on the date of the scheduled examination, should the 14 applicant fail to appear. Acceptance of a provisional license 15 by an applicant shall be deemed to be consent for expiration 16 of that license in accordance with the provisions of this 17 chapter. 18 (d) No more than one provisional license may be issued 19 to an individual. No provisional license shall be issued to 20 an applicant who has previously failed the examination. 21 (4)(5) The board shall adopt rules: 22 (a) Establishing a minimum training program for 23 apprentices. 24 (b) Specifying standards and procedures for issuance 25 of a provisional license. 26 (b)(c) Providing for educational standards, 27 examination, and certification for the practice of colonic 28 irrigation, as defined in s. 480.033(6), by massage 29 therapists. 30 (c)(d) Specifying licensing procedures for 31 practitioners desiring to be licensed in this state who hold 208 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 an active license and have practiced in any other state, 2 territory, or jurisdiction of the United States or any foreign 3 national jurisdiction which has licensing standards 4 substantially similar to, equivalent to, or more stringent 5 than the standards of this state. 6 Section 153. Section 480.0415, Florida Statutes, is 7 amended to read: 8 480.0415 License renewal.--The board shall prescribe 9 by rule the method for renewal of biennial licensure which 10 shall include continuing education requirements not to exceed 11 25 12 classroom hours per biennium. The board shall by rule 12 establish criteria for the approval of continuing education 13 programs or courses. The programs or courses approved by the 14 board may include correspondence courses that meet the 15 criteria for continuing education courses held in a classroom 16 setting. 17 Section 154. Subsection (1) of section 480.042, 18 Florida Statutes, is amended to read: 19 480.042 Examinations.-- 20 (1) The board shall specify by rule the general areas 21 of competency to be covered by examinations for licensure. 22 These rules shall include the relative weight assigned in 23 grading each area, the grading criteria to be used by the 24 examiner, and the score necessary to achieve a passing grade. 25 The board shall ensure that examinations adequately measure 26 both an applicant's competency and his knowledge of related 27 statutory requirements. Professional testing services may be 28 utilized to formulate the examinations. 29 Section 155. Section 480.0425, Florida Statutes, as 30 amended by chapter 94-119, Laws of Florida, is repealed. 31 209 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 156. Subsection (7) of section 480.043, 2 Florida Statutes, is amended to read: 3 480.043 Massage establishments; requisites; licensure; 4 inspection.-- 5 (7)(a) Once issued, no license for operation of a 6 massage establishment may be transferred from one owner 7 person, corporation, name, or location to another. 8 (b) A license may be transferred from one location to 9 another only after inspection and approval by the board and 10 receipt of an application and inspection fee set by rule of 11 the board, not to exceed $125. 12 (c) A license may be transferred from one business 13 name to another after approval by the board and receipt of an 14 application fee set by rule of the board, not to exceed $25. 15 Section 157. Subsection (1) of section 480.044, 16 Florida Statutes, is amended to read: 17 480.044 Fees; disposition.-- 18 (1) The board shall set fees according to the 19 following schedule: 20 (a) Massage therapist application and examination fee: 21 not to exceed $250. 22 (b) Massage therapist initial licensure fee: not to 23 exceed $150. 24 (c) Establishment application fee: not to exceed 25 $200. 26 (d) Establishment licensure fee: not to exceed $150. 27 (e) Biennial establishment renewal fee: not to exceed 28 $150. 29 (f) Biennial massage therapist licensure renewal fee: 30 not to exceed $200. 31 210 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (g) Massage therapist reexamination fee: not to 2 exceed $250. 3 (h) Fee for apprentice: not to exceed $100. 4 (i) Colonics examination fee: not to exceed $100. 5 (j) Colonics reexamination fee: not to exceed $100. 6 (k) Application and provisional licensure fee: not to 7 exceed $50. 8 (k)(l) Application and reactivation for inactive 9 status of a massage therapist license fee: not to exceed 10 $250. 11 (l)(m) Renewal fee for inactive status: not to exceed 12 $250. 13 Section 158. Paragraph (a) of subsection (1) of 14 section 480.047, Florida Statutes, is amended to read: 15 480.047 Penalties.-- 16 (1) It is unlawful for any person to: 17 (a) Hold himself or herself out as a massage therapist 18 or to practice massage unless duly licensed under this chapter 19 or unless otherwise specifically exempted from licensure under 20 this chapter as provided herein. 21 Section 159. Section 480.0485, Florida Statutes, is 22 created to read: 23 480.0485 Sexual misconduct in the practice of massage 24 therapy.--The massage therapist-patient relationship is 25 founded on mutual trust. Sexual misconduct in the practice of 26 massage therapy means violation of the massage 27 therapist-patient relationship through which the massage 28 therapist uses that relationship to induce or attempt to 29 induce the patient to engage, or to engage or attempt to 30 engage the patient, in sexual activity outside the scope of 31 practice or the scope of generally accepted examination or 211 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 treatment of the patient. Sexual misconduct in the practice 2 of massage therapy is prohibited. 3 Section 160. Paragraph (f) of subsection (3) of 4 section 20.43, Florida Statutes, 1996 Supplement, is amended 5 to read: 6 20.43 Department of Health.--There is created a 7 Department of Health. 8 (3) The following divisions of the Department of 9 Health are established: 10 (f) Effective July 1, 1997, Division of Medical 11 Quality Assurance, which is responsible for the following 12 boards and professions established within the division: 13 1. Nursing assistants, as provided under s. 400.211. 14 2. Health care services pools, as provided under s. 15 402.48. 16 3. The Board of Acupuncture, created under chapter 17 457. 18 4. The Board of Medicine, created under chapter 458. 19 5. The Board of Osteopathic Medicine, created under 20 chapter 459. 21 6. The Board of Chiropractic, created under chapter 22 460. 23 7. The Board of Podiatric Medicine, created under 24 chapter 461. 25 8. Naturopathy, as provided under chapter 462. 26 9. The Board of Optometry, created under chapter 463. 27 10. The Board of Nursing, created under chapter 464. 28 11. The Board of Pharmacy, created under chapter 465. 29 12. The Board of Dentistry, created under chapter 466. 30 13. Midwifery, as provided under chapter 467. 31 212 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 14. The Board of Speech-Language Pathology and 2 Audiology, created under part I of chapter 468. 3 15. The Board of Nursing Home Administrators, created 4 under part II of chapter 468. 5 16. Occupational therapy, as provided under part III 6 of chapter 468. 7 17. Respiratory therapy, as provided under part V of 8 chapter 468. 9 18. Dietetics and nutrition practice, as provided 10 under part X of chapter 468. 11 19. Athletic trainers, as provided under part XIV of 12 chapter 468. 13 20. Electrolysis, as provided under chapter 478. 14 21. The Board of Massage Therapy, created under 15 chapter 480. 16 22. The Board of Clinical Laboratory Personnel, 17 created under part III IV of chapter 483. 18 23. Medical physicists, as provided under part IV V of 19 chapter 483. 20 24. The Board of Opticianry, created under part I of 21 chapter 484. 22 25. The Board of Hearing Aid Specialists, created 23 under part II of chapter 484. 24 26. The Board of Physical Therapy Practice, created 25 under chapter 486. 26 27. The Board of Psychology, created under chapter 27 490. 28 28. The Board of Clinical Social Work, Marriage and 29 Family Therapy, and Mental Health Counseling, created under 30 chapter 491. 31 213 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 The department shall contract with the Agency for Health Care 2 Administration who shall provide consumer complaint, 3 investigative, and prosecutorial services required by the 4 Division of Medical Quality Assurance, councils, or boards, as 5 appropriate. 6 Section 161. Paragraph (b) of subsection (2) of 7 section 381.81, Florida Statutes, is amended to read: 8 381.81 Minority Health Improvement Act.-- 9 (2) DEFINITIONS.--As used in this section, the 10 following words and terms shall have the following meanings, 11 unless the context indicates another meaning or intent: 12 (b) "Health profession" means any regulated health 13 profession, including occupational therapy, as regulated under 14 part III of chapter 468; respiratory therapy, as regulated 15 under part V of chapter 468; physical therapy, as regulated 16 under chapter 486; midwifery, as regulated under chapter 467; 17 dietetics and nutrition practice, as regulated under part X of 18 chapter 468; electrolysis, as regulated under chapter 478; 19 nursing assistants, as regulated under s. 400.211; and those 20 professions regulated by: the Board of Medicine, created 21 under chapter 458; the Board of Osteopathic Medicine, created 22 under chapter 459; the Board of Acupuncture, created under 23 chapter 457; the Board of Chiropractic, created under chapter 24 460; the Board of Clinical Social Work, Marriage and Family 25 Therapy, and Mental Health Counseling, created under chapter 26 491; the Board of Dentistry, created under chapter 466; the 27 Board of Optometry, created under chapter 463; the Board of 28 Podiatric Medicine, created under chapter 461; the Board of 29 Nursing, created by chapter 464; the Board of Psychological 30 Examiners, created under chapter 490; the Board of 31 Speech-Language Pathology and Audiology, created under part I 214 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of chapter 468; the Board of Nursing Home Administrators, 2 created under part II of chapter 468; the Board of Clinical 3 Laboratory Personnel, created under part III IV of chapter 4 483; and the Board of Opticianry, created under part I of 5 chapter 484; and the Board of Hearing Aid Specialists, created 6 under part II of chapter 484. 7 Section 162. Section 483.800, Florida Statutes, is 8 amended to read: 9 483.800 Declaration of policy and statement of 10 purpose.--The purpose of this part is to protect the public 11 health, safety, and welfare of the people of this state from 12 the hazards of improper performance by clinical laboratory 13 personnel. Clinical laboratories provide essential services 14 to practitioners of the healing arts by furnishing vital 15 information that is essential to a determination of the 16 nature, cause, and extent of the condition involved. 17 Unreliable and inaccurate reports may cause unnecessary 18 anxiety, suffering, and financial burdens and may even 19 contribute directly to death. The protection of public and 20 individual health requires the licensure of clinical 21 laboratory personnel who meet minimum requirements for safe 22 practice. The Legislature finds that laboratory testing 23 technology continues to advance rapidly. The Legislature also 24 finds that a hospital training program under the direction of 25 the hospital clinical laboratory director offers an 26 opportunity for individuals already trained in health care 27 professions to expand the scope of their careers. The 28 Legislature further finds that there is an immediate need for 29 properly trained personnel to ensure patient access to 30 testing. Therefore, the Legislature recognizes the 31 patient-focused benefits of hospital-based training for 215 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 laboratory and nonlaboratory personnel for testing within 2 hospitals and commercial laboratories the laboratory and at 3 alternate sites, and recognizes the benefits of a training 4 program approved by the Board of Clinical Laboratory Personnel 5 under the direction of the hospital clinical laboratory 6 director. 7 Section 163. Subsection (3) is added to section 8 483.801, Florida Statutes, to read: 9 483.801 Exemptions.--This part applies to all clinical 10 laboratories and clinical laboratory personnel within this 11 state, except: 12 (3) Advanced registered nurse practitioners licensed 13 under chapter 464 who perform provider-performed microscopy 14 procedures (PPMP) in an exclusive-use laboratory setting. 15 Section 164. Section 483.803, Florida Statutes, is 16 amended to read: 17 483.803 Definitions.--As used in this part, the term: 18 (1) "Board" means the Board of Clinical Laboratory 19 Personnel. 20 (2) "Clinical laboratory" means a clinical laboratory 21 as defined in s. 483.041(2). 22 (3) "Clinical laboratory examination" means an 23 examination performed on materials or specimens of the human 24 body to provide information or materials for use in the 25 diagnosis, prevention, or treatment of a disease or the 26 identification or assessment of a medical or physical 27 condition. 28 (4)(3) "Clinical laboratory personnel" includes a 29 clinical laboratory director, supervisor, technologist, blood 30 gas analyst, or technician who performs or is responsible for 31 laboratory test procedures, but the term does not include 216 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 trainees, persons who perform screening for blood banks or 2 plasmapheresis centers, phlebotomists, or persons employed by 3 a clinical laboratory to perform manual pretesting duties or 4 clerical, personnel, or other administrative responsibilities. 5 (5)(4) "Clinical laboratory trainee" means any person 6 having qualifying education who is enrolled in a clinical 7 laboratory training program approved pursuant to s. 483.811 8 and who is seeking experience required to meet minimum 9 qualifications for licensing in this state. Trainees may 10 perform procedures under direct and responsible supervision of 11 duly licensed clinical laboratory personnel, but they may not 12 report test results. 13 (6)(5) "Department" means the Department of Health 14 Business and Professional Regulation. 15 (7)(6) "Licensed practitioner of the healing arts" 16 means a physician licensed pursuant to chapter 458, chapter 17 459, or chapter 460; a dentist licensed pursuant to chapter 18 466; or a person licensed pursuant to chapter 461 or chapter 19 462. 20 (8) "Public health laboratory scientist" means any 21 licensed director, supervisor, technologist, or technician 22 engaged in laboratory testing of human specimens in a state, 23 county, or municipal public health laboratory. 24 Section 165. Subsections (1) and (2) of section 25 483.809, Florida Statutes, are amended to read: 26 483.809 Licensure; examinations; registration of 27 trainees; approval of curricula.-- 28 (1) LICENSING; QUALIFICATIONS.-- 29 (a) The department shall provide biennial licensure of 30 all clinical laboratory personnel who the board certifies have 31 met meeting the requirements of this part and shall prescribe 217 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the qualifications necessary for such licensure. The license 2 of any person who fails to pay a required fee or otherwise 3 fails to qualify within 60 days after the date of expiration 4 of such license shall be automatically canceled without notice 5 or further proceedings unless the individual has made 6 application for inactive status pursuant to s. 483.819. 7 (b) Personnel qualifications may require appropriate 8 education, training, or experience or the passing of an 9 examination in appropriate subjects or any combination of 10 these, but no practitioner of the healing arts licensed to 11 practice in this state is required to obtain any license under 12 this part or to pay any fee hereunder except the fee required 13 for clinical laboratory licensure. 14 (2) EXAMINATIONS.--The department shall conduct 15 examinations required by board rules to determine in part the 16 qualification of clinical laboratory personnel for licensure. 17 An approved national certification examination may be accepted 18 in lieu of state examination for public health scientists. 19 Section 166. Section 483.812, Florida Statutes, is 20 created to read: 21 483.812 Public health laboratory scientists; 22 licensure.-- 23 (1) Applicants at the director and supervisor level in 24 the category of public health who are registered by the 25 National Registry of Clinical Chemistry Certification or the 26 American Society of Microbiology may qualify under board rules 27 by passing the appropriate supervision and administration 28 examination. 29 (2)(a) A technologist applicant for licensure in the 30 category of public health microbiology, with a baccalaureate 31 degree in one of the biological sciences from an accredited 218 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 institution, may use the American Society of Microbiology or 2 the National Registry of Microbiology Certification in Public 3 Health Microbiology to qualify for a technologist license in 4 public health microbiology. Such a technologist may work in a 5 public health microbiology laboratory. 6 (b) A technologist applicant for licensure in the 7 category of public health chemistry, with a baccalaureate 8 degree in one of the chemical, biological, or physical 9 sciences from an accredited institution, may use the National 10 Registry of Clinical Chemistry Certification to qualify for a 11 technologist license in public health chemistry. Such a 12 technologist may work in a public health chemistry laboratory. 13 (c) A technician applicant for licensure in the 14 category of public health, with a baccalaureate degree in one 15 of the chemical or biological sciences from an accredited 16 institution, may obtain a one-time, 3-year, conditional public 17 health technician license pending national certification by 18 the American Society of Microbiology or the National Registry 19 of Clinical Chemistry Certification. Such a technician may 20 perform testing only under the direct supervision of a 21 licensed pathologist, director, supervisor, or technologist. 22 (3) A person licensed by the Board of Clinical 23 Laboratory Personnel may work in a public health laboratory at 24 the appropriate level and specialty. 25 Section 167. Section 483.813, Florida Statutes, is 26 amended to read: 27 483.813 Clinical laboratory personnel license.--A 28 person may not conduct a clinical laboratory examination or 29 report the results of such examination unless such person is 30 licensed under this part to perform such procedures. However, 31 this provision does not apply to any practitioner of the 219 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 healing arts authorized to practice in this state. The 2 department may grant a temporary license to any candidate it 3 deems properly qualified, for a period not to exceed 1 year, 4 or a conditional license for a period not to exceed 3 years 6 5 months. 6 Section 168. Section 483.823, Florida Statutes, is 7 amended to read: 8 483.823 Qualifications of clinical laboratory 9 personnel.-- 10 (1) The board shall prescribe minimal qualifications 11 for clinical laboratory personnel and shall issue a license to 12 any person who meets the minimum qualifications and who 13 demonstrates that he possesses the character, training, and 14 ability to qualify in those areas for which the license is 15 sought. 16 (2) Personnel qualifications may require appropriate 17 education, training, or experience or the passing of an 18 examination in appropriate subjects or any combination of 19 these, but no practitioner of the healing arts licensed to 20 practice in this state is required to obtain any license under 21 this part or to pay any fee hereunder except the fee required 22 for clinical laboratory licensure. 23 Section 169. Section 483.825, Florida Statutes, is 24 amended to read: 25 483.825 Grounds for disciplinary action against 26 clinical laboratory personnel.--The following acts constitute 27 grounds for which disciplinary actions specified in s. 483.827 28 may be taken against applicants, registrants, and licensees 29 under this part clinical laboratory personnel: 30 (1) Attempting to obtain, obtaining, or renewing a 31 license or registration under this part by bribery, by 220 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 fraudulent misrepresentation, or through an error of the 2 department or the board Making a fraudulent statement on an 3 application for a license or any other document required by 4 the department. 5 (2) Engaging in or attempting to engage in, or 6 representing himself as entitled to perform, any clinical 7 laboratory procedure or category of procedures not authorized 8 pursuant to his license. 9 (3) Demonstrating incompetence or making consistent 10 errors in the performance of clinical laboratory examinations 11 or procedures or erroneous reporting. 12 (4) Performing a test and rendering a report thereon 13 to a person not authorized by law to receive such services. 14 (5) Having been convicted of a felony or of any crime 15 involving moral turpitude under the laws of any state or of 16 the United States. The record of conviction or a certified 17 copy thereof shall be conclusive evidence of such conviction. 18 (6) Having been adjudged mentally or physically 19 incompetent. 20 (7) Violating or aiding and abetting in the violation 21 of any provision of this part or the rules adopted hereunder. 22 (8) Reporting a test result when no laboratory test 23 was performed on a clinical specimen. 24 (9) Knowingly advertising false services or 25 credentials. 26 (10) Having a license revoked, suspended, or otherwise 27 acted against, including the denial of licensure, by the 28 licensing authority of another jurisdiction. The licensing 29 authority's acceptance of a relinquishment of a license, 30 stipulation, consent order, or other settlement, offered in 31 response to or in anticipation of the filing of administrative 221 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 charges against the licensee, shall be construed as action 2 against the licensee. 3 (11) Failing to report to the board, in writing, 4 within 30 days if action under subsection (10) has been taken 5 against one's license to practice as clinical laboratory 6 personnel in another state, territory, or country. 7 (12) Being unable to perform or report clinical 8 laboratory examinations with reasonable skill and safety to 9 patients by reason of illness or use of alcohol, drugs, 10 narcotics, chemicals, or any other type of material or as a 11 result of any mental or physical condition. In enforcing this 12 paragraph, the department shall have, upon a finding of the 13 secretary or his or her designee that probable cause exists to 14 believe that the licensee is unable to practice because of the 15 reasons stated in this paragraph, the authority to issue an 16 order to compel a licensee to submit to a mental or physical 17 examination by physicians designated by the department. If 18 the licensee refuses to comply with such order, the 19 department's order directing such examination may be enforced 20 by filing a petition for enforcement in the circuit court 21 where the licensee resides or does business. The department 22 shall be entitled to the summary procedure provided in s. 23 51.011. A licensee affected under this paragraph shall at 24 reasonable intervals be afforded an opportunity to demonstrate 25 that he or she can resume competent practice with reasonable 26 skill and safety to patients. 27 (13) Delegating professional responsibilities to a 28 person when the licensee delegating such responsibilities 29 knows, or has reason to know, that such person is not 30 qualified by training, experience, or licensure to perform 31 them. 222 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 170. Section 483.828, Florida Statutes, is 2 created to read: 3 483.828 Penalty for violations.-- 4 (1) Each of the following acts constitutes a felony of 5 the third degree, punishable as provided in s. 775.082, s. 6 775.083, or s. 775.084: 7 (a) Practicing as clinical laboratory personnel 8 without an active license. 9 (b) Using or attempting to use a license to practice 10 as clinical laboratory personnel which is suspended or 11 revoked. 12 (c) Attempting to obtain or obtaining a license to 13 practice as clinical laboratory personnel by knowing 14 misrepresentation. 15 (2) Each of the following act constitutes a 16 misdemeanor of the first degree, punishable as provided in s. 17 775.082 or s. 775.083: 18 (a) Knowingly concealing information relating to 19 violations of this part. 20 (b) Making any willfully false oath or affirmation 21 whenever an oath or affirmation is required by this part. 22 (c) Leading the public to believe that one is licensed 23 as clinical laboratory personnel, or is engaged in licensed 24 practice as clinical laboratory personnel, without holding a 25 valid, active license. 26 Section 171. Section 483.901, Florida Statutes, is 27 amended to read: 28 483.901 Medical physicists; definitions; licensure.-- 29 (1) SHORT TITLE.--This section may be cited as the 30 "Florida Medical Physicists Act." 31 223 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) DECLARATION OF LEGISLATIVE POLICY.--The 2 Legislature finds that the practice of medical physics by 3 incompetent persons is a threat to the public health and 4 safety. It is, therefore, the responsibility of this state to 5 protect the public health and safety from the harmful effects 6 of excessive and unnecessary radiation by ensuring that the 7 practice of medical physics is entrusted only to persons who 8 are licensed under this section. 9 (3) DEFINITIONS.--As used in this section, the term: 10 (a) "Agency" means the Agency for Health Care 11 Administration or its successor. 12 (a)(b) "Council" means the Advisory Council of Medical 13 Physicists in the Department of Health Agency for Health Care 14 Administration. 15 (b) "Department" means the Department of Health. 16 (c) "Diagnostic radiological physics" means the 17 specialty of medical physics which deals with the diagnostic 18 application and safe use of X rays, gamma rays from sealed 19 sources, ultrasonic radiation, radio frequency radiation, or 20 magnetic fields, and the use of equipment associated with the 21 production, use, measurement, and evaluation of the radiation 22 and the quality of the diagnostic image resulting from its 23 production and use. 24 (d) "License" means a certificate issued by the 25 department agency which authorizes the holder to practice 26 medical physics. 27 (e) "Licensed medical physicist" means a person who 28 holds a license issued under this section. 29 (f) "Medical health physics" means the specialty of 30 medical physics which deals with the safe use of X rays, gamma 31 rays, electron or other charged particle beams, neutrons, 224 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 radionuclides, and radiation from sealed sources, for both 2 diagnostic and therapeutic purposes in human beings and the 3 use of equipment required to perform appropriate tests and 4 measurements that do not involve the direct application of 5 radiation to humans for diagnostic or therapeutic procedures. 6 (g) "Medical nuclear radiological physics" means the 7 specialty of medical physics which deals with the therapeutic 8 and diagnostic application and safe use of radionuclides, 9 except those used in sealed sources for therapeutic purposes, 10 and the use of equipment associated with the production, use, 11 measurement, and evaluation of radionuclides. 12 (h) "Medical physics" means the branch of physics 13 which is associated with the practice of medicine. It 14 includes the fields of diagnostic radiological physics, 15 therapeutic radiological physics, medical nuclear radiological 16 physics, and medical health physics. 17 (i) "Physician" means a doctor of medicine, 18 osteopathic medicine osteopathy, podiatry, dentistry, or 19 chiropractic who is licensed in this state and who prescribes 20 a radiological procedure. 21 (j) "Practice of medical physics" means the use of 22 principles and accepted protocols of physics to ensure assure 23 the correct quality, quantity, and placement of radiation 24 during the performance of a radiological procedure prescribed 25 by a physician which will protect the patient and others from 26 harmful excessive radiation. The term includes radiation beam 27 calibration and characterization quality assurance, instrument 28 specification, acceptance testing, shielding design, 29 protection analysis on radiation-emitting equipment and 30 radiopharmaceuticals, and consultation with a physician to 31 ensure assure accurate radiation dosage to a specific patient. 225 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (k) "Radiation" means ionizing or nonionizing 2 radiation above background levels which is used to perform a 3 diagnostic or therapeutic medical or dental radiological 4 procedure. 5 (l) "Radiological procedure" means a test, 6 measurement, calculation, or radiation exposure used in the 7 diagnosis or treatment of diseases or other medical or dental 8 conditions in human beings that includes therapeutic 9 radiation, diagnostic radiation, nuclear magnetic resonance, 10 or nuclear medicine procedures. 11 (m) "Therapeutic radiological physics" means that 12 specialty of medical physics which deals with the therapeutic 13 application and safe use of X rays, gamma rays, electron or 14 other charged particle beams, neutrons, or radiation from 15 radionuclide sources, and the use of equipment associated with 16 the production, use, measurement, and evaluation of that 17 radiation. 18 (4) COUNCIL.--The Advisory Council of Medical 19 Physicists is created in the Department of Health Agency for 20 Health Care Administration to advise the department in 21 regulating regulate the practice of medical physics in this 22 state. 23 (a) The council shall be composed of nine seven 24 members appointed by the secretary of the department director 25 as follows: 26 1. A licensed medical physicist who specializes in 27 diagnostic radiological physics. 28 2. A licensed medical physicist who specializes in 29 therapeutic radiological physics. 30 3. A licensed medical physicist who specializes in 31 medical nuclear radiological physics. 226 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 4. A physician who is board certified by the American 2 Board of Radiology or its equivalent. 3 5. A physician who is board certified by the American 4 Osteopathic Board of Radiology or its equivalent. 5 6. A physician who is board certified by the American 6 Chiropractic Radiology Board of Chiropractic Radiology or its 7 equivalent. 8 7. Three A consumer members member who are is not, and 9 have has never been, licensed as a medical physicist or 10 licensed in any closely related profession. 11 (b) The secretary of the department director shall 12 appoint the medical physicist members of the council from a 13 list of candidates who are licensed to practice medical 14 physics. 15 (c) The secretary of the department director shall 16 appoint the physician members member of the council from a 17 list of candidates who are licensed to practice medicine in 18 this state and are board certified in diagnostic radiology, 19 therapeutic radiology, or radiation oncology. 20 (d) The secretary of the department director shall 21 appoint the public members member of the council. 22 (e) As the term of each member expires, the secretary 23 of the department director shall appoint the successor for a 24 term of 4 3 years. A member shall serve until the member's 25 his successor is appointed, unless physically unable to do so. 26 (f) An individual is ineligible to serve more than two 27 full consecutive 4-year 3-year terms. 28 (g) If a vacancy on the council occurs, the director 29 shall appoint a member to serve for a 4-year 3-year term. 30 31 227 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (h) A council member must be a United States citizen 2 and must have been a resident of this state for 2 consecutive 3 years immediately before being appointed. 4 1. A member of the council who is a medical physicist 5 must have practiced for at least 6 years before being 6 appointed or be board certified for the specialty in which the 7 member practices. 8 2. A member of the council who is a physician must be 9 licensed to practice medicine in this state and must have 10 practiced diagnostic radiology or radiation oncology in this 11 state for at least 2 years before being appointed. 12 3. The public members member of the council must not 13 have a financial interest in any endeavor related to the 14 practice of medical physics. 15 (i) Notwithstanding any other provision of this 16 subsection, no later than January 1, 1996, the secretary of 17 the department director shall make the initial appointments to 18 the council as follows: 19 1. One member who is engaged in the practice of 20 medical physics, one physician member, and one public member, 21 each of whom is to be appointed to serve until June 30, 1996; 22 2. One member who is engaged in the practice of 23 medical physics and one physician member, each of whom is to 24 be appointed to serve until June 30, 1997; and 25 3. One member who is engaged in the practice of 26 medical physics and one physician member, each of whom is to 27 be appointed to serve until June 30, 1998. 28 (j) A council member may be removed from the council 29 if the member: 30 1. Did not have the required qualifications at the 31 time of appointment; 228 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2. Does not maintain the required qualifications while 2 serving on the council; or 3 3. Fails to attend the regularly scheduled council 4 meetings in a calendar year as required by s. 455.207. 5 (k) Members of the council may not receive 6 compensation for their services; however, they are entitled to 7 reimbursement, from funds deposited in the Medical Quality 8 Assurance Health Care Trust Fund, for necessary travel 9 expenses as specified in s. 112.061 for each day they engage 10 in the business of the council. 11 (l) At the first regularly scheduled meeting of each 12 calendar year, the council shall elect a presiding officer and 13 an assistant presiding officer from among its members. The 14 council shall meet at least once each year and at other times 15 in accordance with department requirements agency rules. 16 (m) The department agency shall provide administrative 17 support to the council for all licensing activities. 18 (n) The council may conduct its meetings 19 electronically. 20 (5) POWERS OF COUNCIL.--The council shall: 21 (a) Recommend rules to administer this section. 22 (b) Recommend practice standards for the practice of 23 medical physics which are consistent with the Guidelines for 24 Ethical Practice for Medical Physicists prepared by the 25 American Association of Physicists in Medicine and 26 disciplinary guidelines adopted under s. 455.2273. 27 (c) Develop and recommend continuing education 28 requirements for licensed medical physicists. 29 (6) LICENSE REQUIRED.--An individual may not engage in 30 the practice of medical physics, including the specialties of 31 diagnostic radiological physics, therapeutic radiological 229 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physics, medical nuclear radiological physics, or medical 2 health physics, without a license issued by the department 3 agency for the appropriate specialty. 4 (a) The department agency shall adopt rules to 5 administer this section which specify license application and 6 renewal fees, continuing education requirements, and standards 7 for practicing medical physics. The council shall recommend 8 to the department agency continuing education requirements 9 that shall be a condition of license renewal. The department 10 agency shall require a minimum of 24 hours per biennium of 11 continuing education offered by an organization recommended by 12 the council and approved by the department. The department, 13 upon recommendation of the council, may adopt rules to specify 14 continuing education requirements for persons who hold a 15 license in more than one specialty. 16 (b) In order to apply for a medical physicist license 17 in one or more specialties, a person must file an individual 18 application for each specialty with the department agency. 19 The application must be on a form prescribed by the department 20 agency and must be accompanied by a nonrefundable application 21 fee for each specialty. 22 (c) The department may issue a license to an eligible 23 applicant if the applicant meets all license requirements. At 24 any time before the department agency issues or renews a 25 license, the applicant may request in writing that the 26 application be withdrawn. To reapply, the applicant must 27 submit a new application and an additional nonrefundable 28 application fee and must meet all current licensure 29 requirements. 30 31 230 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) The department agency shall review each completed 2 application for a license which the department agency 3 receives. 4 (e) The agency may issue a license to an eligible 5 applicant if the applicant meets all license requirements. 6 1. Licenses must be uniform and must include: 7 a. The name of the licensee; 8 b. The medical physics specialty that the licensee may 9 practice; and 10 c. The expiration date of the license. 11 2. A license certificate is the property of the agency 12 and must be surrendered on demand. 13 3. The agency shall adopt rules establishing a 14 procedure for the biennial renewal of licenses. 15 4. A person may renew an unexpired license by meeting 16 the renewal requirements, paying the nonrefundable renewal fee 17 before the expiration of the license, and meeting continuing 18 education requirements. 19 5. The cost to renew a license within 90 days after 20 the license has expired is the normal renewal fee plus a 21 penalty in the amount of half the renewal fee. 22 6. The cost to renew a license that has been expired 23 for more than 90 days but less than 2 years is the normal 24 renewal fee plus a penalty in the amount of the renewal fee. 25 7. A license may not be renewed after it has been 26 expired for more than 2 years. To be relicensed, a person 27 must comply with all current application requirements to 28 practice medical physics and must submit a new application and 29 nonrefundable application fee to the agency. 30 31 231 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 232 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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: 233 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 31 234 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 31 235 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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; 31 236 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 31 237 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 238 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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. 239 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 172. 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 173. 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 174. 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 240 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third 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 175. 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 176. 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 seven members, 26 recommended by the Florida Physical Therapy Association and 27 appointed by the Governor and, subject to confirmation by the 28 Senate. 29 (2) Five board members shall be licensed physical 30 therapists in good standing in this state who are residents of 31 this state and who have been engaged in the practice of 241 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 physical therapy for at least 4 years immediately prior to 2 their appointment. One licensed physical therapist board 3 member may be a full-time faculty member teaching in a 4 physical therapy curriculum in an educational institution in 5 this state. One of The two remaining members shall be 6 residents a resident of this state who have has never been a 7 licensed health care practitioners practitioner. One of the 8 two remaining members shall be a health care practitioner 9 licensed under chapter 458 or chapter 459 who is a resident of 10 this state and has been engaged as a licensed health care 11 practitioner for at least 4 years immediately prior to his or 12 her appointment. 13 (3) Within 90 days after October 1, 1989, the Governor 14 shall appoint the board as follows: 15 (a) Two members for terms of 2 years each. 16 (b) Two members for terms of 3 years each. 17 (c) Three members for terms of 4 years each. 18 (3)(4) As the terms of the members expire, the 19 Governor shall appoint successors for terms of 4 years, and 20 such members shall serve until their successors are appointed. 21 (4)(5) All provisions of chapter 455 relating to 22 activities of the board shall apply. 23 Section 177. Section 486.031, Florida Statutes, is 24 amended to read: 25 486.031 Physical therapist; licensing 26 requirements.--To be eligible for licensing as a physical 27 therapist, an applicant must: 28 (1) Be at least 18 years old; 29 (2) Be of good moral character; and 30 (3)(a) Have been graduated from a school of physical 31 therapy which has been approved for the educational 242 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 preparation of physical therapists by the appropriate 2 accrediting agency recognized by the Commission on Recognition 3 of Postsecondary Accreditation (formerly the National 4 Commission on Accrediting and the Federation of Regional 5 Accrediting Commissions of Higher Education) or the United 6 States Department of Education at the time of his graduation 7 and have passed, to the satisfaction of the board, the 8 American Registry Examination prior to 1971 or a national an 9 examination approved administered by the board department to 10 determine his fitness for practice as a physical therapist as 11 hereinafter provided; or 12 (b) Have received a diploma from a program in physical 13 therapy in a foreign country and have educational credentials 14 deemed equivalent to those required for the educational 15 preparation of physical therapists in this country, as 16 recognized by the appropriate agency as identified by the 17 board, and have passed to the satisfaction of the board an 18 examination administered by the department to determine his 19 fitness for practice as a physical therapist as hereinafter 20 provided; or 21 (c) Be entitled to licensure without examination as 22 provided in s. 486.081. 23 Section 178. Section 486.041, Florida Statutes, is 24 amended to read: 25 486.041 Physical therapist; application for license; 26 fee; temporary permit.-- 27 (1) A person who desires to be licensed as a physical 28 therapist shall apply to the department board in writing on a 29 form furnished by the department. He shall embody in that 30 application evidence under oath, satisfactory to the board, of 31 his possessing the qualifications preliminary to examination 243 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 required by s. 486.031. He shall pay to the department at the 2 time of filing his application a fee not to exceed $100, as 3 fixed by the board, plus the actual per applicant cost to the 4 department for purchase of the examination from the 5 Professional Examination Services for the American Physical 6 Therapist's Association or a similar national organization. 7 If an applicant is deemed ineligible to take the examination, 8 that part of his application fee which is to be used for 9 examination expenses shall be returned. 10 (2) If a person desires to practice physical therapy 11 before becoming licensed through examination, he shall apply 12 to the board for a temporary permit in accordance with rules 13 adopted pursuant to this chapter. 14 (a) A temporary permit shall only be issued for a 15 limited period of time, not to exceed 1 year, and shall not be 16 renewable. A temporary permit shall automatically expire if an 17 applicant fails the examination. 18 (b) An applicant for licensure by examination and 19 practicing under a temporary permit shall do so only under the 20 direct supervision of a licensed physical therapist. 21 Section 179. Section 486.051, Florida Statutes, is 22 amended to read: 23 486.051 Physical therapist; examination of 24 applicant.--The department shall provide for examination of 25 applicants for licensing as physical therapists at least once 26 a year, and more often at the discretion of the board, at a 27 time and place to be determined by the department. The 28 examinations of an applicant for licensing as a physical 29 therapist shall be administered by the department, in 30 accordance with rules adopted by the board, to test the 31 applicant's qualifications and shall include the taking of a 244 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 written test by the applicant. If an applicant fails to pass 2 the examination in three attempts, he shall not be eligible 3 for reexamination unless he completes additional educational 4 or training requirements prescribed by the board. An 5 applicant who has completed the additional educational or 6 training requirements prescribed by the board may take the 7 examination on two more occasions. If the applicant has 8 failed to pass the examination after five attempts, he is no 9 longer eligible to take the examination. 10 Section 180. Section 486.081, Florida Statutes, is 11 amended to read: 12 486.081 Physical therapist; issuance of license 13 without examination to person passing examination of another 14 authorized examining board; temporary permit; fee.-- 15 (1) The board may cause a license to be issued through 16 the department without examination to any applicant who 17 presents evidence satisfactory to the board of having passed 18 the American Registry Examination prior to 1971 or an 19 examination in physical therapy before a similar lawfully 20 authorized examining board of another state, the District of 21 Columbia, a territory, or a foreign country, if the standards 22 for licensure in physical therapy in such other state, 23 district, territory, or foreign country are determined by the 24 board to be as high as those of this state, as established by 25 rules adopted pursuant to this chapter. Any person who holds a 26 license pursuant to this section may use the words "physical 27 therapist" or "physiotherapist," or the letters "P.T.," in 28 connection with his name or place of business to denote his 29 licensure hereunder. 30 (2) At the time of making application for licensure 31 without examination pursuant to the terms of this section, the 245 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 applicant shall pay to the department a fee not to exceed $175 2 as fixed by the board, no part of which will be returned. 3 (3) If a person desires to practice physical therapy 4 before becoming licensed through endorsement, he shall apply 5 to the board for a temporary permit in accordance with rules 6 adopted pursuant to this chapter. A temporary permit shall 7 only be issued for a limited period of time, not to exceed 1 8 year, and shall not be renewable. 9 Section 181. Section 486.102, Florida Statutes, is 10 amended to read: 11 486.102 Physical therapist assistant; licensing 12 requirements.--To be eligible for licensing by the board as a 13 physical therapist assistant, an applicant must: 14 (1) Be at least 18 years old; 15 (2) Be of good moral character; and 16 (3)(a) Have been graduated from a school giving a 17 course of not less than 2 years for physical therapist 18 assistants, which has been approved for the educational 19 preparation of physical therapist assistants by the 20 appropriate accrediting agency recognized by the Commission on 21 Recognition of Postsecondary Accreditation (formerly the 22 National Commission on Accrediting and the Federation of 23 Regional Accrediting Commissions of Higher Education) or the 24 United States Department of Education at the time of his 25 graduation and have passed to the satisfaction of the board an 26 examination administered by the department to determine his 27 fitness for practice as a physical therapist assistant as 28 hereinafter provided; or 29 (b) Have been graduated from a school giving a course 30 for physical therapist assistants in a foreign country and 31 have educational credentials deemed equivalent to those 246 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 required for the educational preparation of physical therapist 2 assistants in this country, as recognized by the appropriate 3 agency as identified by the board, and passed to the 4 satisfaction of the board an examination conducted by the 5 department to determine his fitness for practice as a physical 6 therapist assistant as hereinafter provided; or 7 (c) Be entitled to licensure without examination as 8 provided in s. 486.107. 9 Section 182. Section 486.103, Florida Statutes, is 10 amended to read: 11 486.103 Physical therapist assistant; application for 12 license; fee; temporary permit.-- 13 (1) A person who desires to be licensed as a physical 14 therapist assistant shall apply to the department board in 15 writing on a form furnished by the department. He shall 16 embody in that application evidence under oath, satisfactory 17 to the board, of his possessing the qualifications preliminary 18 to examination required by s. 486.104. He shall pay to the 19 department at the time of filing his application a fee not to 20 exceed $100, as fixed by the board, plus the actual per 21 applicant cost to the department for purchase of the 22 examination from the Professional Examination Services for the 23 American Physical Therapist's Association or a similar 24 national organization. If an applicant is deemed ineligible 25 to take the examination, that part of his application fee 26 which is to be used for examination expenses shall be 27 returned. 28 (2) If a person desires to work as a physical 29 therapist assistant before being licensed through examination, 30 he shall apply for a temporary permit in accordance with rules 31 adopted pursuant to this chapter. 247 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (a) A temporary permit shall only be issued for a 2 limited period of time, not to exceed 1 year, and shall not be 3 renewable. A temporary permit shall automatically expire if an 4 applicant fails the examination. 5 (b) An applicant for licensure by examination who is 6 practicing under a temporary permit shall do so only under the 7 direct supervision of a licensed physical therapist. 8 Section 183. Section 486.104, Florida Statutes, is 9 amended to read: 10 486.104 Physical therapist assistant; examination of 11 applicant.--The department shall provide for examination of 12 applicants for licensing as physical therapist assistants at 13 least once a year, and more often at the discretion of the 14 board, at a time and place to be determined by the department. 15 The examination of an applicant for licensing as a physical 16 therapist assistant shall be provided by the department, in 17 accordance with rules adopted by the board, to test the 18 applicant's qualifications and shall include the taking of a 19 written test by the applicant. If an applicant fails to pass 20 the examination in three attempts, he shall not be eligible 21 for reexamination unless he completes additional educational 22 or training requirements prescribed by the board. An 23 applicant who has completed the additional educational or 24 training requirements prescribed by the board may take the 25 examination on two more occasions. If the applicant has 26 failed to pass the examination after five attempts, he is no 27 longer eligible to take the examination. 28 Section 184. Section 486.123, Florida Statutes, is 29 created to read: 30 486.123 Sexual misconduct in the practice of physical 31 therapy.--The physical therapist-patient relationship is 248 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 founded on mutual trust. Sexual misconduct in the practice of 2 physical therapy means violation of the physical 3 therapist-patient relationship through which the physical 4 therapist uses that relationship to induce or attempt to 5 induce the patient to engage, or to engage or attempt to 6 engage the patient, in sexual activity outside the scope of 7 practice or the scope of generally accepted examination or 8 treatment of the patient. Sexual misconduct in the practice 9 of physical therapy is prohibited. 10 Section 185. Paragraph (g) is added to subsection (2) 11 of section 486.125, Florida Statutes, to read: 12 486.125 Refusal, revocation, or suspension of license; 13 administrative fines and other disciplinary measures.-- 14 (2) When the board finds any person guilty of any of 15 the grounds set forth in subsection (1), it may enter an order 16 imposing one or more of the following penalties: 17 (g) Recovery of actual costs of investigation and 18 prosecution. 19 Section 186. Subsection (11) is added to section 20 641.495, Florida Statutes, 1996 Supplement, to read: 21 641.495 Requirements for issuance and maintenance of 22 certificate.-- 23 (11) The organization shall designate a medical 24 director who is a physician licensed under chapter 458 or 25 chapter 459. 26 Section 187. Subsection (3) of section 499.012, 27 Florida Statutes, is amended to read: 28 499.012 Wholesale distribution; definitions; permits; 29 general requirements.-- 30 (3)(a) A person that engages in wholesale distribution 31 of prescription drugs in this state must have a wholesale 249 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 distributor's permit issued by the department, except as noted 2 in this section. Each establishment must be separately 3 permitted except as noted in this subsection. 4 (a) A separate establishment permit is not required 5 when a permitted prescription drug wholesaler consigns a 6 prescription drug to a pharmacy that is permitted under 7 chapter 465 and located in this state, provided that: 8 1. The consignor wholesaler notifies the department in 9 writing of the contract to consign prescription drugs to a 10 pharmacy along with the identity and location of each 11 consignee pharmacy; 12 2. The pharmacy maintains its permit under chapter 13 465; 14 3. The consignor wholesaler, which has no legal 15 authority to dispense prescription drugs, complies with all 16 wholesale distribution requirements of s. 499.0121 with 17 respect to the consigned drugs and maintains records 18 documenting the transfer of title or other completion of the 19 wholesale distribution of the consigned prescription drugs; 20 4. The distribution of the prescription drug is 21 otherwise lawful under this chapter and other applicable law; 22 5. Open packages containing prescription drugs within 23 a pharmacy are the responsibility of the pharmacy, regardless 24 of how the drugs are titled; and 25 6. The pharmacy dispenses the consigned prescription 26 drug in accordance with the limitations of its permit under 27 chapter 465 or returns the consigned prescription drug to the 28 consignor wholesaler. In addition, a person who holds title to 29 prescription drugs may transfer the drugs to a person 30 permitted or licensed to handle the reverse distribution or 31 destruction of drugs. Any other distribution by and means of 250 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the consigned prescription drug by any person, not limited to 2 the consignor wholesaler or consignee pharmacy, to any other 3 person is prohibited. 4 (b) A wholesale distributor's permit is not required 5 for the one-time transfer of title of a pharmacy's lawfully 6 acquired prescription drug inventory by a pharmacy with a 7 valid permit issued under chapter 465 to a consignor 8 prescription drug wholesaler, permitted under this chapter, in 9 accordance with a written consignment agreement between the 10 pharmacy and that wholesaler if: the permitted pharmacy and 11 the permitted prescription drug wholesaler comply with all of 12 the provisions of paragraph (3)(a) and the prescription drugs 13 continue to be within the permitted pharmacy's inventory for 14 dispensing in accordance with the limitations of the pharmacy 15 permit under chapter 465. A consignor drug wholesaler may not 16 use the pharmacy as a wholesale distributor through which it 17 distributes the legend drugs to other pharmacies. Nothing in 18 this section is intended to prevent a wholesale drug 19 distributor from obtaining this inventory in the event of 20 nonpayment by the pharmacy. 21 (c)(b) The department shall require information from 22 each wholesale distributor as part of the permit and renewal 23 of such permit, as required under s. 499.01. 24 Section 188. The Board of Medicine shall adopt rules 25 to establish practice guidelines for physicians to safely 26 prescribe phentermine, fenfluramine, and other drugs used to 27 treat obesity. 28 Section 189. The Board of Osteopathic Medicine shall 29 adopt rules to establish practice guidelines for physicians to 30 safely prescribe phentermine, fenfluramine, and other drugs 31 used to treat obesity. 251 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 190. Subsections (6) through (11) of section 2 409.9122, Florida Statutes, 1996 Supplement, are redesignated 3 as subsections (7) through (12), respectively, and a new 4 subsection (6) is added to that section to read: 5 409.9122 Mandatory Medicaid managed care enrollment; 6 programs and procedures.-- 7 (6) MediPass enrolled recipients may receive up to 10 8 visits of reimbursable services by participating Medicaid 9 physicians licensed under chapter 460 and up to four visits of 10 reimbursable services by participating Medicaid physicians 11 licensed under chapter 461. Any further visits must be by 12 prior authorization by the MediPass primary care provider. 13 However, nothing in this subsection may be construed to 14 increase the total number of visits or the total amount of 15 dollars per year per person under current Medicaid rules, 16 unless otherwise provided for in the General Appropriations 17 Act. 18 Section 191. (1) There is created within the 19 Department of Health a Task Force on Exemptions from Licensure 20 under section 468.505(1)(k), Florida Statutes. The Department 21 of Health shall provide staff support for the task force. The 22 task force shall consist of not more than 15 members nominated 23 by the associations and entities named in this section and 24 appointed by the Secretary of Health. Members of the task 25 force shall not receive compensation, per diem, or 26 reimbursement for travel expenses for service on the task 27 force. Participation in the task force is optional and at the 28 discretion of each identified group or entity. If all 29 identified groups and entities participate, the task force 30 shall include: 31 252 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (a) One representative from each of the following 2 associations: 3 1. The Florida Dietetic Association. 4 2. The Florida Health Care Association. 5 3. The Florida Association of Homes for the Aging. 6 4. The Florida Assisted Living Association. 7 5. The Florida League of Health Systems. 8 6. The Association of Community Hospitals and Health 9 Systems of Florida, Inc. 10 7. The Florida Hospital Association. 11 8. The Florida Medical Association. 12 9. The Florida Osteopathic Medical Association. 13 (b) One representative from each of the following 14 entities: 15 1. The Department of Health. 16 2. The Dietetics and Nutrition Practice Council. 17 3. The Board of Medicine, which representative must be 18 a member of the board who is licensed under chapter 458, 19 Florida Statutes. 20 4. The Board of Osteopathic Medicine, which 21 representative must be a member of the board who is licensed 22 under chapter 459, Florida Statutes. 23 5. The Department of Elderly Affairs. 24 6. The Agency for Health Care Administration. 25 (2) The task force shall hold its first meeting no 26 later than August 1, 1997, and shall report its findings to 27 the President of the Senate, the Speaker of the House of 28 Representatives, and the chairs of the applicable legislative 29 committees of substance not later than December 31, 1997. All 30 task force meetings must be held in Tallahassee at the 31 Department of Health in order to minimize costs to the state. 253 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (3) The task force shall be charged with the 2 responsibility to: 3 (a) Determine the number of licensed dietitians, the 4 number of registered dietitians, and the number of dietitians 5 who are neither licensed nor registered who are employed by or 6 under contract with a hospital licensed under chapter 395, 7 Florida Statutes, a nursing home or assisted living facility 8 licensed under part II or part III of chapter 400, Florida 9 Statutes, or a continuing care facility certified under 10 chapter 651, Florida Statutes; and 11 (b) Assess the need and make recommendations for 12 retaining the exemptions from licensure under section 13 468.505(1)(k), Florida Statutes, in light of the legislative 14 purpose and intent of licensure as set forth in section 15 468.502, Florida Statutes, and review the quality of dietetic 16 and nutrition services provided in the settings set forth in 17 section 468.505(1)(k), Florida Statutes. 18 (4) The task force is dissolved effective January 1, 19 1998. 20 Section 192. Section 465.014, Florida Statutes, is 21 amended to read: 22 465.014 Pharmacy technician.--No person other than a 23 licensed pharmacist or pharmacy intern may engage in the 24 practice of the profession of pharmacy, except that a licensed 25 pharmacist may delegate to nonlicensed pharmacy technicians 26 those duties, tasks, and functions which do not fall within 27 the purview of s. 465.003(12). All such delegated acts shall 28 be performed under the direct supervision of a licensed 29 pharmacist who shall be responsible for all such acts 30 performed by persons under his or her supervision. A pharmacy 31 technician, under the supervision of a pharmacist, may 254 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 initiate or receive communications with a practitioner or his 2 or her agent, on behalf of a patient, regarding refill 3 authorization requests. No licensed pharmacist shall supervise 4 more than one pharmacy technician unless otherwise permitted 5 by the guidelines adopted by the board. The board shall 6 establish guidelines to be followed by licensees or permittees 7 in determining the circumstances under which a licensed 8 pharmacist may supervise more than one but not more than three 9 two pharmacy technicians. 10 Section 193. Subsection (3) of section 456.32, Florida 11 Statutes, is amended to read: 12 456.32 Definitions.--In construing this chapter, the 13 words, phrases, or terms, unless the context otherwise 14 indicates, shall have the following meanings: 15 (3) "Practitioner of the healing arts" shall mean a 16 person licensed under the laws of the state to practice 17 medicine, surgery, psychiatry, dentistry, osteopathic 18 medicine, chiropractic, naturopathy, podiatry, chiropody, 19 psychology, clinical social work, marriage and family therapy, 20 mental health counseling, or optometry within the scope of his 21 professional training and competence and within the purview of 22 the statutes applicable to his respective profession, and who 23 may refer a patient for treatment by a qualified person, who 24 shall employ hypnotic techniques under the supervision, 25 direction, prescription, and responsibility of such referring 26 practitioner. 27 Section 194. Section 490.003, Florida Statutes, is 28 amended to read: 29 490.003 Definitions.--As used in this chapter: 30 (1)(2) "Board" means the Board of Psychology. 31 255 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2)(1) "Department" means the Department of Health 2 Business and Professional Regulation. 3 (3)(7)(a) Prior to July 1, 1999, "doctoral-level 4 psychological education" and "doctoral degree in psychology" 5 mean a Psy.D., an and Ed.D. in psychology, or a Ph.D. in 6 psychology from: 7 1. An educational institution which, at the time the 8 applicant was enrolled and graduated, had institutional 9 accreditation from an agency recognized and approved by the 10 United States Department of Education or was recognized as a 11 member in good standing with the Association of Universities 12 and Colleges of Canada; and 13 2. A psychology program within that educational 14 institution which, at the time the applicant was enrolled and 15 graduated, had programmatic accreditation from an accrediting 16 agency recognized and approved by the United States Department 17 of Education or was comparable to such programs. 18 (b) Effective July 1, 1999, "doctoral-level 19 psychological education" and "doctoral degree in psychology" 20 mean a Psy.D., an Ed.D. in psychology, or a Ph.D. in 21 psychology from: 22 1. An educational institution which, at the time the 23 applicant was enrolled and graduated, had institutional 24 accreditation from an agency recognized and approved by the 25 United States Department of Education or was recognized as a 26 member in good standing with the Association of Universities 27 and Colleges of Canada; and 28 2. A psychology program within that educational 29 institution which, at the time the applicant was enrolled and 30 graduated, had programmatic accreditation from an agency 31 256 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 recognized and approved by the United States Department of 2 Education. 3 (4) "Practice of psychology" means the observations, 4 description, evaluation, interpretation, and modification of 5 human behavior, by the use of scientific and applied 6 psychological principles, methods, and procedures, for the 7 purpose of describing, preventing, alleviating, or eliminating 8 symptomatic, maladaptive, or undesired behavior and of 9 enhancing interpersonal behavioral health and mental or 10 psychological health. The ethical practice of psychology 11 includes, but is not limited to, psychological testing and the 12 evaluation or assessment of personal characteristics such as 13 intelligence, personality, abilities, interests, aptitudes, 14 and neuropsychological functioning, including evaluation of 15 mental competency to manage one's affairs and to participate 16 in legal proceedings; counseling, psychoanalysis, all forms of 17 psychotherapy, sex therapy, hypnosis, biofeedback, and 18 behavioral analysis and therapy; psychoeducational evaluation, 19 therapy, remediation, and consultation; and use of 20 psychological methods to diagnose and treat mental, nervous, 21 psychological, marital, or emotional disorders, illness, or 22 disability, alcoholism and substance abuse, and disorders of 23 habit or conduct, as well as the psychological aspects of 24 physical illness, accident, injury, or disability, including 25 neuropsychological evaluation, diagnosis, prognosis, etiology, 26 and treatment. 27 (a) Psychological services may be rendered to 28 individuals, couples, families, groups, and the public without 29 regard to place of service. 30 31 257 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (b) The use of specific modalities within the practice 2 of psychology is restricted to psychologists appropriately 3 trained in the use of such modalities. 4 (c) The practice of psychology shall be construed 5 within the meaning of this definition without regard to 6 whether payment is requested or received for services 7 rendered. 8 (5)(6) "Practice of school psychology" means the 9 rendering or offering to render to an individual, a group, an 10 organization, a government agency, or the public any of the 11 following services: 12 (a) Assessment, which includes psychoeducational, 13 developmental, and vocational assessment; evaluation and 14 interpretation of intelligence, aptitudes, interests, academic 15 achievement, adjustment, and motivations, or any other 16 attributes, in individuals or groups, that relate to learning, 17 educational, or adjustment needs. 18 (b) Counseling, which includes short-term 19 situation-oriented professional interaction with children, 20 parents, or other adults for amelioration or prevention of 21 learning and adjustment problems. Counseling services 22 relative to the practice of school psychology include verbal 23 interaction, interviewing, behavior techniques, developmental 24 and vocational intervention, environmental management, and 25 group processes. 26 (c) Consultation, which includes psychoeducational, 27 developmental, and vocational assistance or direct educational 28 services to schools, agencies, organizations, families, or 29 individuals related to learning problems and adjustments to 30 those problems. 31 258 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) Development of programs, which includes designing, 2 implementing, or evaluating educationally and psychologically 3 sound learning environments; acting as a catalyst for teacher 4 involvement in adaptations and innovations; and facilitating 5 the psychoeducational development of individual families or 6 groups. 7 (6) "Provisional psychologist licensee" means a person 8 provisionally licensed under this chapter to provide 9 psychological services under supervision. 10 (7)(3) "Psychologist" means a person licensed pursuant 11 to s. 490.005(1), s. 490.006, or the provision identified as 12 s. 490.013(2) in s. 1, chapter 81-235, Laws of Florida. 13 (8)(5) "School psychologist" means a person licensed 14 pursuant to s. 490.005(2), s. 490.006, or the provision 15 identified as s. 490.013(1) in s. 1, chapter 81-235, Laws of 16 Florida. 17 Section 195. Paragraph (b) of subsection (1) of 18 section 490.005, Florida Statutes, is amended to read: 19 490.005 Licensure by examination.-- 20 (1) Any person desiring to be licensed as a 21 psychologist shall apply to the department to take the 22 licensure examination. The department shall license each 23 applicant who the board certifies has: 24 (b) Submitted proof satisfactory to the board that the 25 applicant has: 26 1. Received doctoral-level psychological education, as 27 defined in s. 490.003(3)(7); 28 2. Received the equivalent of a doctoral-level 29 psychological education, as defined in s. 490.003(3)(7), from 30 a program at a school or university located outside the United 31 States of America and Canada, which was officially recognized 259 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 by the government of the country in which it is located as an 2 institution or program to train students to practice 3 professional psychology. The burden of establishing that the 4 requirements of this provision have been met shall be upon the 5 applicant; or 6 3. Received and submitted to the board, prior to July 7 1, 1999, certification of an augmented doctoral-level 8 psychological education from the program director of a 9 doctoral-level psychology program accredited by a programmatic 10 agency recognized and approved by the United States Department 11 of Education. 12 Section 196. Section 490.0051, Florida Statutes, is 13 created to read: 14 490.0051 Provisional licensure; requirements.-- 15 (1) The department shall issue a provisional 16 psychology license to each applicant who the board certifies 17 has: 18 (a) Completed the application form and remitted a 19 nonrefundable application fee not to exceed $250, as set by 20 board rule. 21 (b) Earned a doctoral degree in psychology as defined 22 in s. 490.003(3). 23 (c) Met any additional requirements established by 24 board rule. 25 (2) A provisional licensee must work under the 26 supervision of a licensed psychologist until the provisional 27 licensee is in receipt of a license or a letter from the 28 department stating that he or she is licensed as a 29 psychologist. 30 (3) A provisional license expires 24 months after the 31 date it is issued and may not be renewed or reissued. 260 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 197. Section 490.008, Florida Statutes, as 2 amended by chapter 94-119, Laws of Florida, is repealed. 3 Section 198. Section 490.009, Florida Statutes, 1996 4 Supplement, is amended to read: 5 490.009 Discipline.-- 6 (1) When the department or, in the case of 7 psychologists, the board finds that an applicant, provisional 8 licensee, or licensee whom it regulates under this chapter has 9 committed any of the acts set forth in subsection (2), it may 10 issue an order imposing one or more of the following 11 penalties: 12 (a) Denial of an application for licensure, either 13 temporarily or permanently. 14 (b) Revocation of an application for licensure, either 15 temporarily or permanently. 16 (c) Suspension for a period of up to 5 years or 17 revocation of a license, after hearing. 18 (d) Immediate suspension of a license pursuant to s. 19 120.60(6). 20 (e) Imposition of an administrative fine not to exceed 21 $5,000 for each count or separate offense. 22 (f) Issuance of a public reprimand. 23 (g) Placement of an applicant or licensee on probation 24 for a period of time and subject to conditions specified by 25 the department or, in the case of psychologists, by the board, 26 including, but not limited to, requiring the applicant or 27 licensee to submit to treatment, to attend continuing 28 education courses, to submit to reexamination, or to work 29 under the supervision of a designated licensee. 30 (h) Restriction of practice. 31 261 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) The following acts of a licensee, provisional 2 licensee, or applicant are grounds for which the disciplinary 3 actions listed in subsection (1) may be taken: 4 (a) Attempting to obtain, obtaining, or renewing a 5 license under this chapter by bribery or fraudulent 6 misrepresentation or through an error of the board or 7 department. 8 (b) Having a license to practice a comparable 9 profession revoked, suspended, or otherwise acted against, 10 including the denial of certification or licensure by another 11 state, territory, or country. 12 (c) Being convicted or found guilty, regardless of 13 adjudication, of a crime in any jurisdiction which directly 14 relates to the practice of his profession or the ability to 15 practice his profession. A plea of nolo contendere creates a 16 rebuttable presumption of guilt of the underlying criminal 17 charges. However, the board shall allow the person who is the 18 subject of the disciplinary proceeding to present any evidence 19 relevant to the underlying charges and circumstances 20 surrounding the plea. 21 (d) False, deceptive, or misleading advertising or 22 obtaining a fee or other thing of value on the representation 23 that beneficial results from any treatment will be guaranteed. 24 (e) Advertising, practicing, or attempting to practice 25 under a name other than one's own. 26 (f) Maintaining a professional association with any 27 person who whom the applicant or licensee knows, or has reason 28 to believe, is in violation of this chapter or of a rule of 29 the department or, in the case of psychologists, of the 30 department or the board. 31 262 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (g) Knowingly aiding, assisting, procuring, or 2 advising any nonlicensed person to hold himself out as 3 licensed under this chapter. 4 (h) Failing to perform any statutory or legal 5 obligation placed upon a person licensed under this chapter. 6 (i) Willfully making or filing a false report or 7 record; failing to file a report or record required by state 8 or federal law; willfully impeding or obstructing the filing 9 of a report or record; or inducing another person to make or 10 file a false report or record or to impede or obstruct the 11 filing of a report or record. Such report or record includes 12 only a report or record which requires the signature of a 13 person licensed under this chapter. 14 (j) Paying a kickback, rebate, bonus, or other 15 remuneration for receiving a patient or client, or receiving a 16 kickback, rebate, bonus, or other remuneration for referring a 17 patient or client to another provider of mental health care 18 services or to a provider of health care services or goods; 19 referring a patient or client to oneself for services on a 20 fee-paid basis when those services are already being paid for 21 by some other public or private entity; or entering into a 22 reciprocal referral agreement. 23 (k) Committing any act upon a patient or client which 24 would constitute sexual battery or which would constitute 25 sexual misconduct as defined in s. 490.0111. 26 (l) Making misleading, deceptive, untrue, or 27 fraudulent representations in the practice of any profession 28 licensed under this chapter. 29 (m) Soliciting patients or clients personally, or 30 through an agent, through the use of fraud, intimidation, 31 263 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 undue influence, or a form of overreaching or vexatious 2 conduct. 3 (n) Failing to make available to a patient or client, 4 upon written request, copies of test results, reports, or 5 documents in the possession or under the control of the 6 licensee which have been prepared for and paid for by the 7 patient or client. 8 (o) Failing to respond within 30 days to a written 9 communication from the department concerning any investigation 10 by the department or to make available any relevant records 11 with respect to any investigation about the licensee's conduct 12 or background. 13 (p) Being unable to practice the profession for which 14 he is licensed under this chapter with reasonable skill or 15 competence as a result of any mental or physical condition or 16 by reason of illness; drunkenness; or excessive use of drugs, 17 narcotics, chemicals, or any other substance. In enforcing 18 this paragraph, upon a finding by the secretary, his designee, 19 or the board that probable cause exists to believe that the 20 licensee is unable to practice the profession because of the 21 reasons stated in this paragraph, the department shall have 22 the authority to compel a licensee to submit to a mental or 23 physical examination by psychologists or physicians designated 24 by the department or board. If the licensee refuses to comply 25 with the department's order, the department may file a 26 petition for enforcement in the circuit court of the circuit 27 in which the licensee resides or does business. The licensee 28 shall not be named or identified by initials in the petition 29 or in any other public court records or documents, and the 30 enforcement proceedings shall be closed to the public. The 31 department shall be entitled to the summary procedure provided 264 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 in s. 51.011. A licensee affected under this paragraph shall 2 be afforded an opportunity at reasonable intervals to 3 demonstrate that he can resume the competent practice for 4 which he is licensed with reasonable skill and safety to 5 patients. 6 (q) Violating provisions of this chapter, or of 7 chapter 455, or any rules adopted pursuant thereto. 8 (r) Performing any treatment or prescribing any 9 therapy which, by the prevailing standards of the mental 10 health professions in the community, would constitute 11 experimentation on human subjects, without first obtaining 12 full, informed, and written consent. 13 (s) Failing to meet the minimum standards of 14 performance in professional activities when measured against 15 generally prevailing peer performance, including the 16 undertaking of activities for which the licensee is not 17 qualified by training or experience. 18 (t) Delegating professional responsibilities to a 19 person whom the licensee knows or has reason to know is not 20 qualified by training or experience to perform such 21 responsibilities. 22 (u) Violating a rule relating to the regulation of the 23 profession or a lawful order of the department previously 24 entered in a disciplinary hearing. 25 (v) Failing to maintain in confidence a communication 26 made by a patient or client in the context of such services, 27 except as provided in s. 490.0147 by written permission or in 28 the face of a clear and immediate probability of bodily harm 29 to the patient or client or to others. 30 31 265 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (w) Making public statements which are derived from 2 test data, client contacts, or behavioral research and which 3 identify or damage research subjects or clients. 4 Section 199. Section 490.012, Florida Statutes, is 5 amended to read: 6 490.012 Violations; penalties; injunction.-- 7 (1)(a) No person shall hold himself out by any title 8 or description incorporating the words, or permutations of 9 them, "psychologist," "psychology," "psychological," 10 "psychodiagnostic," or "school psychologist," or describe any 11 test or report as psychological, unless such person holds a 12 valid, active license under this chapter or is exempt from the 13 provisions of this chapter. 14 (b) No person shall hold himself out by any title or 15 description incorporating the word, or a permutation of the 16 word, "psychotherapy" unless such person holds a valid, active 17 license under chapter 458, chapter 459, chapter 490, or 18 chapter 491, or such person is certified as an advanced 19 registered nurse practitioner, pursuant to s. 464.012, who has 20 been determined by the Board of Nursing as a specialist in 21 psychiatric mental psychiatric/mental health nursing. 22 (c) No person licensed or provisionally licensed 23 pursuant to this chapter shall hold himself out by any title 24 or description which indicates licensure other than that which 25 has been granted to him. 26 (2)(a) A licensed psychologist shall conspicuously 27 display the valid, active license issued by the department or 28 a true copy thereof at each location at which the licensee 29 practices his or her profession. 30 (b) A licensed psychologist shall include the words 31 "licensed psychologist" and his license number on all 266 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 professional advertisements, including, but not limited to, 2 advertisements in any newspaper, magazine, other print medium, 3 airwave or broadcast transmission, or phone directory listing 4 purchased by or on behalf of a person licensed according to 5 this chapter. 6 (3)(a) A person provisionally licensed under this 7 chapter as a provisional psychologist licensee shall 8 conspicuously display the valid provisional license issued by 9 the department or a true copy thereof at each location at 10 which the provisional licensee is providing services. 11 (b) A provisional psychologist licensee shall include 12 the words "provisional psychologist licensee" on all 13 promotional materials, including cards, brochures, stationery, 14 advertisements, and signs, naming the provisional licensee. 15 (4)(3) Any person who violates any provision of this 16 section, except for subsections (2) and (3), commits a 17 misdemeanor of the first degree, punishable as provided in s. 18 775.082 or s. 775.083. Any person who violates any provision 19 of subsection (2) or subsection (3) is subject to disciplinary 20 action under s. 490.009. 21 (5)(4) The department may institute appropriate 22 proceedings to enjoin violation of subsection (1). 23 (6)(5) Beginning October 1, 1992, No person shall 24 practice psychology in this state, as such practice is defined 25 in s. 490.003(4), for compensation, unless such person holds 26 an active, valid license to practice psychology issued 27 pursuant to this chapter. Nothing in this subsection shall be 28 construed to limit the practice of school psychology, as such 29 practice is defined in s. 490.003(5)(6). 30 (7)(6) Beginning October 1, 1992, No person shall 31 practice school psychology in this state, as such practice is 267 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 defined in s. 490.003(5)(6), for compensation, unless such 2 person holds an active, valid license to practice school 3 psychology issued pursuant to this chapter. 4 Section 200. Section 490.014, Florida Statutes, is 5 amended to read: 6 490.014 Exemptions.-- 7 (1)(a) No provision of this chapter shall be construed 8 to limit the practice of physicians licensed pursuant to 9 chapter 458 or chapter 459 so long as they do not hold 10 themselves out to the public as psychologists or use a 11 professional title protected by this chapter. 12 (b) No provision of this chapter shall be construed to 13 limit the practice of nursing, clinical social work, marriage 14 and family therapy, mental health counseling, or other 15 recognized businesses or professions, or to prevent qualified 16 members of other professions from doing work of a nature 17 consistent with their training, so long as they do not hold 18 themselves out to the public as psychologists or use a title 19 protected by this chapter. Nothing in this subsection shall 20 be construed to exempt any person from the provisions of s. 21 490.012. 22 (2) No person shall be required to be licensed or 23 provisionally licensed under this chapter who: 24 (a) Is a salaried employee of a government agency; 25 developmental services program, mental health, alcohol, or 26 drug abuse facility operating pursuant to chapter 393, chapter 27 394, or chapter 397; subsidized child care program, subsidized 28 child care case management program, or child care resource and 29 referral program, operating pursuant to chapter 402; 30 child-placing or child-caring agency licensed pursuant to 31 chapter 409; domestic violence center certified pursuant to 268 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 chapter 415; accredited academic institution; or research 2 institution, if such employee is performing duties for which 3 he was trained and hired solely within the confines of such 4 agency, facility, or institution. 5 (b) Is a salaried employee of a private, nonprofit 6 organization providing counseling services to children, youth, 7 and families, if such services are provided for no charge, if 8 such employee is performing duties for which he was trained 9 and hired. 10 (c) Is a student who is pursuing a course of study 11 which leads to a degree in medicine or a profession regulated 12 by this chapter who is providing services in a training 13 setting, provided such activities or services constitute part 14 of a supervised course of study, or is a graduate accumulating 15 the experience required for any licensure under this chapter, 16 provided such graduate or student is designated by a title 17 such as "intern" or "trainee" which clearly indicates the 18 in-training status of the student. 19 (d) Is certified in school psychology by the 20 Department of Education and is performing psychological 21 services as an employee of a public or private educational 22 institution. Such exemption shall not be construed to 23 authorize any unlicensed practice which is not performed as a 24 direct employee of an educational institution. 25 (e) Is not a resident of the state but offers services 26 in this state, provided: 27 1. Such services are performed for no more than 5 days 28 in any month and no more than 15 days in any calendar year; 29 and 30 2. Such nonresident is licensed or certified by a 31 state or territory of the United States, or by a foreign 269 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 country or province, the standards of which were, at the date 2 of his licensure or certification, equivalent to or higher 3 than the requirements of this chapter in the opinion of the 4 department or, in the case of psychologists, in the opinion of 5 the board. 6 (f) Is a rabbi, priest, minister, or clergyman of any 7 religious denomination or sect when engaging in activities 8 which are within the scope of the performance of his regular 9 or specialized ministerial duties and for which no separate 10 charge is made, or when such activities are performed, with or 11 without charge, for or under the auspices or sponsorship, 12 individually or in conjunction with others, of an established 13 and legally cognizable church, denomination, or sect, and when 14 the person rendering service remains accountable to the 15 established authority thereof. 16 (3) No provision of this chapter shall be construed to 17 limit the practice of any individual who solely engages in 18 behavior analysis so long as he does not hold himself out to 19 the public as possessing a license issued pursuant to this 20 chapter or use a title protected by this chapter. 21 (4) Nothing in this section shall exempt any person 22 from the provision of s. 490.012(1)(a)-(b). 23 (5) Except as stipulated by the board, the exemptions 24 contained in this section do not apply to any person licensed 25 under this chapter whose license has been suspended or revoked 26 by the board or another jurisdiction. 27 (5) Any person who is not licensed under this chapter 28 by October 1, 1992, and who desires to become so licensed 29 shall register with the department that person's intent to 30 become fully licensed no later than October 1, 1995. The 31 costs to the department of such registration shall be borne by 270 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the registrant. The department may require affidavits and 2 supporting documentation sufficient to demonstrate that the 3 registrant is preparing for examination by October 1, 1995, 4 under this chapter. The department may adopt rules to 5 implement this section. Upon receipt of the department's 6 notice of registration, the registrant may practice services 7 as defined in s. 490.003(4) and (6), provided that the 8 registrant uses "trainee" or "intern" with any title or 9 description of the registrant's work and on any business 10 correspondence and work product, including, but not limited 11 to, a business card, letterhead, sign, billing, or report 12 unless exempt pursuant to this chapter. 13 Section 201. Section 491.003, Florida Statutes, is 14 amended to read: 15 491.003 Definitions.--As used in this chapter: 16 (1)(2) "Board" means the Board of Clinical Social 17 Work, Marriage and Family Therapy, and Mental Health 18 Counseling. 19 (2)(3) "Clinical social worker" means a person 20 licensed under this chapter to practice clinical social work. 21 (3)(4) "Clinical social work experience" is defined as 22 a period during which the applicant provides clinical social 23 work services, including assessment, diagnosis, treatment, and 24 evaluation of clients; provided that at least 50 percent of 25 the hours worked consist of providing psychotherapy and 26 counseling services directly to clients. 27 (4)(1) "Department" means the Department of Health 28 Business and Professional Regulation. 29 (5) "Marriage and family therapist" means a person 30 licensed under this chapter to practice marriage and family 31 therapy. 271 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (6) "Mental health counselor" means a person licensed 2 under this chapter to practice mental health counseling. 3 (7) The "practice of clinical social work" is defined 4 as the use of scientific and applied knowledge, theories, and 5 methods for the purpose of describing, preventing, evaluating, 6 and treating individual, couple, marital, family, or group 7 behavior, based on the person-in-situation perspective of 8 psychosocial development, normal and abnormal behavior, 9 psychopathology, unconscious motivation, interpersonal 10 relationships, environmental stress, differential assessment, 11 differential planning, and data gathering. The purpose of 12 such services is the prevention and treatment of undesired 13 behavior and enhancement of mental health. The Such practice 14 of clinical social work includes the use of methods of a 15 psychological nature used to evaluate, assess, diagnose, 16 treat, and prevent emotional and mental disorders and 17 dysfunctions, (whether cognitive, affective, or behavioral),; 18 sexual dysfunction,; behavioral disorders,; alcoholism,; and 19 substance abuse. The practice of clinical social work 20 includes, but is not limited to, psychotherapy, hypnotherapy, 21 and sex therapy. The practice of clinical social work also 22 includes counseling, behavior modification, consultation, 23 client-centered advocacy, crisis intervention, and the 24 provision of needed information and education to clients, when 25 using methods of a psychological nature to evaluate, assess, 26 diagnose, treat, and prevent emotional and mental disorders 27 and dysfunctions (whether cognitive, affective, or 28 behavioral), sexual dysfunction, behavioral disorders, 29 alcoholism, or substance abuse. The practice of clinical 30 social work may also include clinical research into more 31 272 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 effective psychotherapeutic modalities for the treatment and 2 prevention of such conditions. 3 (a) Clinical social work treatment includes, but is 4 not limited to: 5 1. Counseling. 6 2. Psychotherapy. 7 3. Behavior modification. 8 4. Hypnotherapy. 9 5. Sex therapy. 10 6. Consultation. 11 7. Client-centered advocacy. 12 8. Crisis intervention. 13 9. Providing needed information and education to 14 clients. 15 (a)(b) Clinical social work may be rendered to 16 individuals, including individuals affected by the termination 17 of marriage, and to marriages, couples, families, groups, 18 organizations, and communities. 19 (b)(c) The use of specific methods, techniques, or 20 modalities within the practice of clinical social work is 21 restricted to clinical social workers appropriately trained in 22 the use of such methods, techniques, or modalities. 23 (c)(d) The terms "diagnose" and "treat," as used in 24 this chapter, when considered in isolation or in conjunction 25 with any provision of the rules of the board, shall not be 26 construed to permit the performance of any act which clinical 27 social workers are not educated and trained to perform, 28 including, but not limited to, admitting persons to hospitals 29 for treatment of the foregoing conditions, treating persons in 30 hospitals without medical supervision, prescribing medicinal 31 drugs as defined in chapter 465, authorizing clinical 273 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 laboratory procedures pursuant to chapter 483, or radiological 2 procedures, or use of electroconvulsive therapy. In addition, 3 this definition shall not be construed to permit any person 4 licensed, provisionally licensed, registered, or certified 5 pursuant to this chapter to describe or label any test, 6 report, or procedure as "psychological," except to relate 7 specifically to the definition of practice authorized in this 8 subsection. 9 (d)(e) The definition of "clinical social work" 10 contained in this subsection includes all services offered 11 directly to the general public or through organizations, 12 whether public or private, and applies whether payment is 13 requested or received for services rendered. 14 (8) The "practice of marriage and family therapy" is 15 defined as the use of scientific and applied marriage and 16 family theories, methods, and procedures for the purpose of 17 describing, evaluating, and modifying marital, family, and 18 individual behavior, within the context of marital and family 19 systems, including the context of marital formation and 20 dissolution, and is based on marriage and family systems 21 theory, marriage and family development, human development, 22 normal and abnormal behavior, psychopathology, human 23 sexuality, psychotherapeutic and marriage and family therapy 24 theories and techniques. The Such practice of marriage and 25 family therapy includes the use of methods of a psychological 26 nature used to evaluate, assess, diagnose, treat, and prevent 27 emotional and mental disorders or dysfunctions, (whether 28 cognitive, affective, or behavioral),; sexual dysfunction,; 29 behavioral disorders,; alcoholism,; and substance abuse. The 30 practice of marriage and family therapy includes, but is not 31 limited to, marriage and family therapy, psychotherapy, 274 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 including behavioral family therapy, hypnotherapy, and sex 2 therapy. The practice of marriage and family therapy also 3 includes counseling, behavior modification, consultation, 4 client-centered advocacy, crisis intervention, and the 5 provision of needed information and education to clients, when 6 using methods of a psychological nature to evaluate, assess, 7 diagnose, treat, and prevent emotional and mental disorders 8 and dysfunctions (whether cognitive, affective, or 9 behavioral), sexual dysfunction, behavioral disorders, 10 alcoholism, or substance abuse. The practice of marriage and 11 family therapy may also include clinical research into more 12 effective psychotherapeutic modalities for the treatment and 13 prevention of such conditions. 14 (a) Marriage and family therapy treatment includes, 15 but is not limited to: 16 1. Marriage and family therapy. 17 2. Counseling. 18 3. Psychotherapy, including behavioral family therapy. 19 4. Behavior modification. 20 5. Hypnotherapy. 21 6. Sex therapy. 22 7. Consultation. 23 8. Client advocacy. 24 9. Crisis intervention. 25 10. Providing needed information and education to 26 clients. 27 (a)(b) Marriage and family therapy may be rendered to 28 individuals, including individuals affected by termination of 29 marriage, to couples, whether married or unmarried, to 30 families, or to groups. 31 275 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (b)(c) The use of specific methods, techniques, or 2 modalities within the practice of marriage and family therapy 3 is restricted to marriage and family therapists appropriately 4 trained in the use of such methods, techniques, or modalities. 5 (c)(d) The terms "diagnose" and "treat," as used in 6 this chapter, when considered in isolation or in conjunction 7 with any provision of the rules of the board, shall not be 8 construed to permit the performance of any act which marriage 9 and family therapists are not educated and trained to perform, 10 including, but not limited to, admitting persons to hospitals 11 for treatment of the foregoing conditions, treating persons in 12 hospitals without medical supervision, prescribing medicinal 13 drugs as defined in chapter 465, authorizing clinical 14 laboratory procedures pursuant to chapter 483, or radiological 15 procedures, or use of electroconvulsive therapy. In addition, 16 this definition shall not be construed to permit any person 17 licensed, provisionally licensed, registered, or certified 18 pursuant to this chapter to describe or label any test, 19 report, or procedure as "psychological," except to relate 20 specifically to the definition of practice authorized in this 21 subsection. 22 (d)(e) The definition of "marriage and family therapy" 23 contained in this subsection paragraphs (a)-(d) includes all 24 services offered directly to the general public or through 25 organizations, whether public or private, and applies whether 26 payment is requested or received for services rendered. 27 (9) The "practice of mental health counseling" is 28 defined as the use of scientific and applied behavioral 29 science theories, methods, and techniques for the purpose of 30 describing, preventing, and treating undesired behavior and 31 enhancing mental health and human development and is based on 276 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the person-in-situation perspectives derived from research and 2 theory in personality, family, group, and organizational 3 dynamics and development, career planning, cultural diversity, 4 human growth and development, human sexuality, normal and 5 abnormal behavior, psychopathology, psychotherapy, and 6 rehabilitation. The Such practice of mental health counseling 7 includes the use of methods of a psychological nature used to 8 evaluate, assess, diagnose, and treat emotional and mental 9 dysfunctions or disorders, (whether cognitive, affective, or 10 behavioral),; behavioral disorders,; interpersonal 11 relationships,; sexual dysfunction,; alcoholism,; and 12 substance abuse. The practice of mental health counseling 13 includes, but is not limited to, psychotherapy, hypnotherapy, 14 and sex therapy. The practice of mental health counseling 15 also includes counseling, behavior modification, consultation, 16 client-centered advocacy, crisis intervention, and the 17 provision of needed information and education to clients, when 18 using methods of a psychological nature to evaluate, assess, 19 diagnose, treat, and prevent emotional and mental disorders 20 and dysfunctions (whether cognitive, affective, or 21 behavioral), behavioral disorders, sexual dysfunction, 22 alcoholism, or substance abuse. The practice of mental health 23 counseling may also include clinical research into more 24 effective psychotherapeutic modalities for the treatment and 25 prevention of such conditions. 26 (a) Mental health counseling treatment includes, but 27 is not limited to: 28 1. Counseling. 29 2. Psychotherapy. 30 3. Behavior modification. 31 4. Hypnotherapy. 277 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 5. Sex therapy. 2 6. Consultation. 3 7. Client advocacy. 4 8. Crisis intervention. 5 9. Providing needed information and education to 6 clients. 7 (a)(b) Mental health counseling may be rendered to 8 individuals, including individuals affected by the termination 9 of marriage, and to couples, families, groups, organizations, 10 and communities. 11 (b)(c) The use of specific methods, techniques, or 12 modalities within the practice of mental health counseling is 13 restricted to mental health counselors appropriately trained 14 in the use of such methods, techniques, or modalities. 15 (c)(d) The terms "diagnose" and "treat," as used in 16 this chapter, when considered in isolation or in conjunction 17 with any provision of the rules of the board, shall not be 18 construed to permit the performance of any act which mental 19 health counselors are not educated and trained to perform, 20 including, but not limited to, admitting persons to hospitals 21 for treatment of the foregoing conditions, treating persons in 22 hospitals without medical supervision, prescribing medicinal 23 drugs as defined in chapter 465, authorizing clinical 24 laboratory procedures pursuant to chapter 483, or radiological 25 procedures, or use of electroconvulsive therapy. In addition, 26 this definition shall not be construed to permit any person 27 licensed, provisionally licensed, registered, or certified 28 pursuant to this chapter to describe or label any test, 29 report, or procedure as "psychological," except to relate 30 specifically to the definition of practice authorized in this 31 subsection. 278 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) The definition of "mental health counseling" 2 contained in this subsection includes all services offered 3 directly to the general public or through organizations, 4 whether public or private, and applies whether payment is 5 requested or received for services rendered. 6 (10) "Provisional clinical social worker licensee" 7 means a person provisionally licensed under this chapter to 8 provide clinical social work services under supervision. 9 (11) "Provisional marriage and family therapist 10 licensee" means a person provisionally licensed under this 11 chapter to provide marriage and family therapy services under 12 supervision. 13 (12) "Provisional mental health counselor licensee" 14 means a person provisionally licensed under this chapter to 15 provide mental health counseling services under supervision. 16 (13)(10) "Psychotherapist" means a clinical social 17 worker, marriage and family therapist, or mental health 18 counselor licensed pursuant to this chapter. 19 (14) "Registered clinical social worker intern" means 20 a person registered under this chapter who is completing the 21 postgraduate clinical social work experience requirement 22 specified in s. 491.005(1)(c). 23 (15) "Registered marriage and family therapist intern" 24 means a person registered under this chapter who is completing 25 the post-master's clinical experience requirement specified in 26 s. 491.005(3)(c). 27 (16) "Registered mental health counselor intern" means 28 a person registered under this chapter who is completing the 29 post-master's clinical experience requirement specified in s. 30 491.005(4)(c). 31 279 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 202. Section 491.0045, Florida Statutes, is 2 created to read: 3 491.0045 Intern registration; requirements.-- 4 (1) Effective January 1, 1998, an individual who 5 intends to practice in Florida to satisfy the postgraduate or 6 post-master's level experience requirements, as specified in 7 s. 491.005(1)(c), (3)(c), or (4)(c), must register as an 8 intern in the profession for which he or she is seeking 9 licensure prior to commencing the experience requirement. 10 (2) The department shall register as a clinical social 11 worker intern, marriage and family therapist intern, or mental 12 health counselor intern each applicant who the board certifies 13 has: 14 (a) Completed the application form and remitted a 15 nonrefundable application fee not to exceed $200, as set by 16 board rule; 17 (b) Completed the education requirements as specified 18 in s. 491.005 for the profession for which he or she is 19 applying for licensure; and 20 (c) Identified a qualified supervisor. 21 (3) An individual registered under this section must 22 remain under supervision until he or she is in receipt of a 23 license or a letter from the department stating that he or she 24 is licensed to practice the profession for which he or she 25 applied. 26 Section 203. Section 491.0046, Florida Statutes, is 27 created to read: 28 491.0046 Provisional license; requirements.-- 29 (1) An individual who has satisfied the clinical 30 experience requirements of s. 491.005 intending to provide 31 clinical social work, marriage and family therapy, or mental 280 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 health counseling services in Florida while satisfying 2 coursework or examination requirements for licensure must be 3 provisionally licensed in the profession for which he or she 4 is seeking licensure prior to beginning practice. 5 (2) The department shall issue a provisional clinical 6 social worker license, provisional marriage and family 7 therapist license, or provisional mental health counselor 8 license to each applicant who the board certifies has: 9 (a) Completed the application form and remitted a 10 nonrefundable application fee not to exceed $100, as set by 11 board rule; and 12 (b)1. Earned a graduate degree in social work, a 13 graduate degree with a major emphasis in marriage and family 14 therapy or a closely related field, or a graduate degree in a 15 major related to the practice of mental health counseling, and 16 satisfied the clinical experience requirements for licensure 17 pursuant to s. 491.005; or 18 2. Been approved for examination under the provisions 19 for licensure by endorsement pursuant to s. 491.006. 20 (3) A provisional licensee must work under the 21 supervision of a licensed mental health professional, as 22 defined by the board, until the provisional licensee is in 23 receipt of a license or a letter from the department stating 24 that he or she is licensed as a clinical social worker, 25 marriage and family therapist, or mental health counselor. 26 (4) A provisional license expires 24 months after the 27 date it is issued and may not be renewed or reissued. 28 Section 204. Section 491.005, Florida Statutes, is 29 amended to read: 30 491.005 Licensure by examination.-- 31 281 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (1) Upon verification of documentation and payment of 2 a fee not to exceed $200, as set by board rule, plus the 3 actual per applicant cost to the department for purchase of 4 the examination from the American Association of State Social 5 Worker's Boards or a similar national organization, the 6 department shall issue a license as a clinical social worker 7 to an applicant who the board certifies: 8 (a) Has made application therefor and paid the 9 appropriate fee. 10 (b)1. Has received a doctoral degree in social work 11 from a graduate school of social work which at the time the 12 applicant graduated was accredited by an accrediting agency 13 recognized by the United States Department of Education or has 14 received a master's degree in social work from a graduate 15 school of social work which at the time the applicant 16 graduated: 17 a.1. Was accredited by the Council on Social Work 18 Education; 19 b.2. Was accredited by the Canadian Association of 20 Schools of Social Work; or 21 c.3. Has been determined to have been a program 22 equivalent to programs approved by the Council on Social Work 23 Education by the Foreign Equivalency Determination Service of 24 the Council on Social Work Education. An applicant who 25 graduated from a program at a university or college outside of 26 the United States or Canada must present documentation of the 27 equivalency determination from the council in order to 28 qualify. 29 2. The applicant's graduate program must have 30 emphasized direct clinical patient or client health care 31 services, as provided in subsection (2), including, but not 282 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 limited to, coursework in clinical social work, psychiatric 2 social work, medical social work, social casework, 3 psychotherapy, or group therapy. The applicant's graduate 4 program must have included all of the following coursework: 5 a. A supervised field placement which was part of the 6 applicant's advanced concentration in direct practice, during 7 which the applicant provided clinical services directly to 8 clients. 9 b. Completion of 24 semester hours or 37 quarter hours 10 in theory of human behavior and practice methods as courses in 11 clinically oriented services, including a minimum of one 12 course in psychopathology taken in a school of social work 13 accredited or approved pursuant to subparagraph (b)1. 14 3. If the course title which appears on the 15 applicant's transcript does not clearly identify the content 16 of the coursework, the applicant shall be required to provide 17 additional documentation, including, but not limited to, a 18 syllabus or catalog description published for the course. 19 (c) Has had not less than 2 at least 3 years of 20 clinical social work experience, 2 years of which must be 21 experience which took place subsequent to completion of a 22 graduate degree in social work at an institution meeting the 23 accreditation requirements of this section, under the 24 supervision of a licensed clinical social worker or the 25 equivalent who is a qualified supervisor as determined by the 26 board. An individual who intends to practice in Florida to 27 satisfy clinical experience requirements must register 28 pursuant to s. 491.0045 prior to commencing practice. If the 29 applicant's graduate program was not a program which 30 emphasized direct clinical patient or client health care 31 services as described in s. 491.003, the supervised experience 283 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 requirement must take place after the applicant has completed 2 a minimum of 15 semester hours or 22 quarter hours of the 3 coursework required. A doctoral internship may be applied 4 toward the clinical social work experience supervision 5 requirement. The experience requirement may be met by work 6 performed on or off the premises of the supervising clinical 7 social worker or the equivalent, provided the off-premises 8 work is not the independent private practice rendering of 9 clinical social work that does not have a licensed mental 10 health professional clinical social worker or the equivalent, 11 as determined by the board, as a member of the group actually 12 rendering services on the premises at the same time the intern 13 is providing services. 14 (d) Has passed a theory and practice an examination 15 provided by the department for this purpose. 16 (e) Has demonstrated, in a manner designated by rule 17 of the board, knowledge of the laws and rules governing the 18 practice of clinical social work, marriage and family therapy, 19 and mental health counseling. 20 (2)(a) The applicant's program shall be considered to 21 be a program which emphasized direct clinical patient or 22 client health care services if it included all of the 23 following coursework: 24 (a) A supervised field placement which was part of the 25 applicant's advanced concentration in direct practice, during 26 which the applicant provided clinical services directly to 27 clients. 28 (b)1. Completion of 24 semester hours or 37 quarter 29 hours in theory of human behavior and practice methods as 30 courses in clinically oriented services, including a minimum 31 of one course in psychopathology taken in a school of social 284 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 work accredited by the Council on Social Work Education. 2 However, applicants who had completed the required 3 graduate-level degree in social work prior to October 1, 1990, 4 and who submit a completed application for licensure prior to 5 January 1, 1993, shall be required to complete only 21 of the 6 24 required semester hours or 31 of the 37 required quarter 7 hours in clinically oriented services. If the course title 8 which appears on the applicant's transcript does not clearly 9 identify the content of the coursework, the applicant shall be 10 required to provide additional documentation, including, but 11 not limited to, a syllabus or catalog description published 12 for the course. 13 2. Notwithstanding the provisions of paragraph (1)(b) 14 subparagraph 1., coursework which was taken at a baccalaureate 15 level shall not be considered toward completion of education 16 requirements for licensure unless an official of the graduate 17 program certifies in writing on the graduate school's 18 stationery that a specific course, which students enrolled in 19 the same graduate program were ordinarily required to complete 20 at the graduate level, was waived or exempted based on 21 completion of a similar course at the baccalaureate level. If 22 this condition is met, the board shall apply the baccalaureate 23 course named toward the education requirements. 24 (b) An applicant from a master's or doctoral program 25 in social work which did not emphasize direct patient or 26 client services may complete the clinical curriculum content 27 requirement by returning to a graduate program accredited by 28 the Council on Social Work Education or the Canadian 29 Association of Schools of Social Work, or to a clinical social 30 work graduate program with comparable standards, in order to 31 complete the education requirements for examination. However, 285 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 a maximum of 6 semester or 9 quarter hours of the clinical 2 curriculum content requirement may be completed by credit 3 awarded for independent study coursework as defined by board 4 rule. 5 (3) Upon verification of documentation and payment of 6 a fee not to exceed $200, as set by board rule, plus the 7 actual cost to the department for the purchase of the 8 examination from the Association of Marital and Family Therapy 9 Regulatory Board, or similar national organization, the 10 department shall issue a license as a marriage and family 11 therapist to an applicant who the board certifies: 12 (a) Has made application therefor and paid the 13 appropriate fee. 14 (b)1. Has a minimum of a master's degree with major 15 emphasis in marriage and family therapy, or a closely related 16 field, and has completed all of the following requirements: 17 a.1. Twenty-seven semester hours or 41 quarter hours 18 of graduate coursework, which must include a minimum of 2 19 semester hours or 3 quarter hours of graduate-level course 20 credits in each of the following nine areas: dynamics of 21 marriage and family systems; marriage therapy and counseling 22 theory and techniques; family therapy and counseling theory 23 and techniques; individual human development theories 24 throughout the life cycle; personality theory; 25 psychopathology; human sexuality theory and counseling 26 techniques; general counseling theory and techniques; and 27 psychosocial theory. Content may be combined, provided no 28 more than two of the nine content areas are included in any 29 one graduate-level course and the applicant can document that 30 the equivalent of 2 semester hours of coursework was devoted 31 to each content area. Courses in research, evaluation, 286 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 appraisal, assessment, or testing theories and procedures; 2 thesis or dissertation work; or practicums, internships, or 3 fieldwork may not be applied toward this requirement. 4 b.2. A minimum of one graduate-level course of 2 5 semester hours or 3 quarter hours in legal, ethical, and 6 professional standards issues in the practice of marriage and 7 family therapy or a course determined by the board to be 8 equivalent. 9 c.3. A minimum of one graduate-level course of 2 10 semester hours or 3 quarter hours in diagnosis, appraisal, 11 assessment, and testing for individual or interpersonal 12 disorder or dysfunction; and a minimum of one 2-semester-hour 13 or 3-quarter-hour graduate-level course in behavioral research 14 which focuses on the interpretation and application of 15 research data as it applies to clinical practice. Credit for 16 thesis or dissertation work, practicums, internships, or 17 fieldwork may not be applied toward this requirement. 18 d.4. A minimum of one supervised clinical practicum, 19 internship, or field experience in a marriage and family 20 counseling setting, during which the student provided 180 21 direct client contact hours of marriage and family therapy 22 services under the supervision of an individual who met the 23 requirements for supervision under paragraph (c). This 24 requirement may be met by a supervised practice experience 25 which took place outside the academic arena, but which is 26 certified as equivalent to a graduate-level practicum or 27 internship program which required a minimum of 180 direct 28 client contact hours of marriage and family therapy services 29 currently offered within an academic program of a college or 30 university accredited by an accrediting agency approved by the 31 United States Department of Education, or an institution which 287 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 is publicly recognized as a member in good standing with the 2 Association of Universities and Colleges of Canada or a 3 training institution accredited by the Commission on 4 Accreditation for Marriage and Family Therapy Education 5 recognized by the United States Department of Education. 6 Certification shall be required from an official of such 7 college, university, or training institution. 8 2. If the course title which appears on the 9 applicant's transcript does not clearly identify the content 10 of the coursework, the applicant shall be required to provide 11 additional documentation, including, but not limited to, a 12 syllabus or catalog description published for the course. 13 14 The required master's degree must have been received in an 15 institution of higher education which at the time the 16 applicant graduated was: fully accredited by a regional 17 accrediting body recognized by the Commission on Recognition 18 of Postsecondary Accreditation; publicly recognized as a 19 member in good standing with the Association of Universities 20 and Colleges of Canada; or an institution of higher education 21 located outside the United States and Canada, which at the 22 time the applicant was enrolled and at the time the applicant 23 graduated maintained a standard of training substantially 24 equivalent to the standards of training of those institutions 25 in the United States which are accredited by a regional 26 accrediting body recognized by the Commission on Recognition 27 of Postsecondary Accreditation. Such foreign education and 28 training must have been received in an institution or program 29 of higher education officially recognized by the government of 30 the country in which it is located as an institution or 31 program to train students to practice as professional marriage 288 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 and family therapists or psychotherapists. The burden of 2 establishing that the requirements of this provision have been 3 met shall be upon the applicant, and the board shall may 4 require documentation, such as, but not limited to, an 5 evaluation by a foreign equivalency determination service, as 6 evidence that the applicant's graduate degree program and 7 education were equivalent to an accredited program in this 8 country. An applicant with a master's degree from a program 9 which did not emphasize marriage and family therapy may 10 complete the coursework requirement in a training institution 11 fully accredited by the Commission on Accreditation for 12 Marriage and Family Therapy Education recognized by the United 13 States Department of Education. 14 (c) Has had not less than 2 3 years of clinical 15 experience during which 50 percent of the applicant's clients 16 were receiving marriage and family therapy services, 2 years 17 of which must be at the post-master's level under the 18 supervision of a licensed marriage and family therapist with 19 at least 5 years of experience, or the equivalent, who is a 20 qualified supervisor as determined by the board. An 21 individual who intends to practice in Florida to satisfy the 22 clinical experience requirements must register pursuant to s. 23 491.0045 prior to commencing practice. If a graduate has a 24 master's degree with a major emphasis in marriage and family 25 therapy or a closely related field that did not include all 26 the coursework required under sub-subparagraphs (b)1.a.-c., 27 credit for the post-master's level clinical experience shall 28 not commence until the applicant has completed a minimum of 10 29 of the courses required under sub-subparagraphs (b)1.a.-c., as 30 determined by the board, and at least 6 semester hours or 9 31 quarter hours of the course credits must have been completed 289 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 in the area of marriage and family systems, theories, or 2 techniques. Within the 3 years of required experience for 3 licensure as a marriage and family therapist, the applicant 4 shall provide direct individual, group, or family therapy and 5 counseling, to include the following categories of cases: 6 unmarried dyads, married couples, separating and divorcing 7 couples, and family groups including children. A doctoral 8 internship may be applied toward the clinical experience 9 supervision requirement. The clinical experience requirement 10 may be met by work performed on or off the premises of the 11 supervising marriage and family therapist or the equivalent, 12 provided the off-premises work is not the independent private 13 practice rendering of marriage and family therapy services 14 that does not have a licensed mental health professional 15 marriage and family therapist or the equivalent, as determined 16 by the board, as a member of the group actually rendering 17 services on the premises at the same time the intern is 18 providing services. 19 (d) Has passed a theory and practice an examination 20 provided by the department for this purpose. 21 (e) Has demonstrated, in a manner designated by rule 22 of the board, knowledge of the laws and rules governing the 23 practice of clinical social work, marriage and family therapy, 24 and mental health counseling. 25 (4) Upon verification of documentation and payment of 26 a fee not to exceed $200, as set by board rule, plus the 27 actual per applicant cost to the department for purchase of 28 the examination from the Professional Examination Service for 29 the National Academy of Certified Clinical Mental Health 30 Counselors or a similar national organization, the department 31 290 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 shall issue a license as a mental health counselor to an 2 applicant who the board certifies: 3 (a) Has made application therefor and paid the 4 appropriate fee. 5 (b)1. Has received a minimum of an earned master's 6 degree with a major related to the practice of mental health 7 counseling, and has completed all of the following 8 requirements: 9 a.1. Twenty-one semester hours or 32 quarter hours of 10 graduate coursework, which must include a minimum of 2 11 semester hours or 3 quarter hours of graduate-level coursework 12 in each of the following seven content areas: counseling 13 theories and practice; human development theories; personality 14 theory; psychopathology or abnormal psychology; human 15 sexuality theories; group theories and practice; and 16 individual evaluation and assessment. Content may be 17 combined, provided no more than two of the seven content areas 18 are included in any one graduate-level course and the 19 applicant can document that the equivalent of 2 semester hours 20 of content was devoted to each content area. Courses in 21 research, thesis or dissertation work, practicums, 22 internships, or fieldwork may not be applied toward this 23 requirement. 24 b.2. A minimum of one 2-semester-hour or 25 3-quarter-hour graduate-level course in research or in career 26 or vocational counseling. Credit for thesis or dissertation 27 work, practicums, internships, or fieldwork may not be applied 28 toward this requirement. 29 c.3. A minimum of 2 semester hours or 3 quarter hours 30 of graduate-level coursework in legal, ethical, and 31 professional standards issues in the practice of mental health 291 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 counseling, which includes goals and objectives of 2 professional counseling organizations, codes of ethics, legal 3 considerations, standards of preparation, certifications and 4 licensing, and the role identity of counselors. Courses in 5 research, thesis or dissertation work, practicums, 6 internships, or fieldwork may not be applied toward this 7 requirement. 8 d.4. A minimum of one supervised practicum, 9 internship, or field experience in a counseling setting. This 10 requirement may be met by a supervised practice experience 11 which takes place outside the academic arena, but which is 12 certified as equivalent to a graduate-level practicum in a 13 clinical mental health counseling setting currently offered 14 within an academic program of a college or university 15 accredited by an accrediting agency approved by the United 16 States Department of Education. Such certification shall be 17 required from an official of such college or university. 18 2. If the course title which appears on the 19 applicant's transcript does not clearly identify the content 20 of the coursework, the applicant shall be required to provide 21 additional documentation, including, but not limited to, a 22 syllabus or catalog description published for the course. 23 24 Except as provided in sub-subparagraph 1.d. subparagraph 4., 25 education and training in mental health counseling must have 26 been received in an institution of higher education which at 27 the time the applicant graduated was: fully accredited by a 28 regional accrediting body recognized by the Commission on 29 Recognition of Postsecondary Accreditation; publicly 30 recognized as a member in good standing with the Association 31 of Universities and Colleges of Canada; or an institution of 292 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 higher education located outside the United States and Canada, 2 which at the time the applicant was enrolled and at the time 3 the applicant graduated maintained a standard of training 4 substantially equivalent to the standards of training of those 5 institutions in the United States which are accredited by a 6 regional accrediting body recognized by the Commission on 7 Recognition of Postsecondary Accreditation. Such foreign 8 education and training must have been received in an 9 institution or program of higher education officially 10 recognized by the government of the country in which it is 11 located as an institution or program to train students to 12 practice as mental health counselors. The burden of 13 establishing that the requirements of this provision have been 14 met shall be upon the applicant, and the board shall may 15 require documentation, such as, but not limited to, an 16 evaluation by a foreign equivalency determination service, as 17 evidence that the applicant's graduate degree program and 18 education were equivalent to an accredited program in this 19 country. 20 (c) Has had not less than 2 years of a minimum of 3 21 years' clinical experience in mental health counseling, 2 22 years of which must be at the post-master's level under the 23 supervision of a licensed mental health counselor or the 24 equivalent who is a qualified supervisor as determined by the 25 board. An individual who intends to practice in Florida to 26 satisfy the clinical experience requirements must register 27 pursuant to s. 491.0045 prior to commencing practice. If a 28 graduate has a master's degree with a major related to the 29 practice of mental health counseling which did not include all 30 the coursework required under sub-subparagraphs (b)1.a.-c., 31 credit for the post-master's level clinical experience shall 293 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 not commence until the applicant has completed a minimum of 2 seven of the courses required under sub-subparagraphs 3 (b)1.a.-c., as determined by the board, one of which must be a 4 course in psychopathology or abnormal psychology. A doctoral 5 internship may be applied toward the clinical experience 6 supervision requirement. The clinical experience requirement 7 may be met by work performed on or off the premises of the 8 supervising mental health counselor or the equivalent, 9 provided the off-premises work is not the independent private 10 practice rendering of services that does not have a licensed 11 mental health professional counselor or the equivalent, as 12 determined by the board, as a member of the group actually 13 rendering services on the premises at the same time the intern 14 is providing services. 15 (d) Has passed a theory and practice an examination 16 provided by the department for this purpose. 17 (e) Has demonstrated, in a manner designated by rule 18 of the board, knowledge of the laws and rules governing the 19 practice of clinical social work, marriage and family therapy, 20 and mental health counseling. 21 Section 205. Effective January 1, 2001, paragraph (b) 22 of subsection (3) and paragraphs (b) and (c) of subsection (4) 23 of section 491.005, Florida Statutes, as amended by this act, 24 are amended to read: 25 491.005 Licensure by examination.-- 26 (3) Upon verification of documentation and payment of 27 a fee not to exceed $200, as set by board rule, plus the 28 actual cost to the department for the purchase of the 29 examination from the Association of Marital and Family Therapy 30 Regulatory Board, or similar national organization, the 31 294 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 department shall issue a license as a marriage and family 2 therapist to an applicant who the board certifies: 3 (b)1. Has a minimum of a master's degree with major 4 emphasis in marriage and family therapy, or a closely related 5 field, and has completed all of the following requirements: 6 a. Thirty-six Twenty-seven semester hours or 48 41 7 quarter hours of graduate coursework, which must include a 8 minimum of 3 2 semester hours or 4 3 quarter hours of 9 graduate-level course credits in each of the following nine 10 areas: dynamics of marriage and family systems; marriage 11 therapy and counseling theory and techniques; family therapy 12 and counseling theory and techniques; individual human 13 development theories throughout the life cycle; personality 14 theory or general counseling theory and techniques; 15 psychopathology; human sexuality theory and counseling 16 techniques; general counseling theory and techniques; and 17 psychosocial theory; and substance abuse theory and counseling 18 techniques. Content may be combined, provided no more than 19 two of the nine content areas are included in any one 20 graduate-level course and the applicant can document that the 21 equivalent of 2 semester hours of coursework was devoted to 22 each content area. Courses in research, evaluation, 23 appraisal, assessment, or testing theories and procedures; 24 thesis or dissertation work; or practicums, internships, or 25 fieldwork may not be applied toward this requirement. 26 b. A minimum of one graduate-level course of 3 2 27 semester hours or 4 3 quarter hours in legal, ethical, and 28 professional standards issues in the practice of marriage and 29 family therapy or a course determined by the board to be 30 equivalent. 31 295 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 c. A minimum of one graduate-level course of 3 2 2 semester hours or 4 3 quarter hours in diagnosis, appraisal, 3 assessment, and testing for individual or interpersonal 4 disorder or dysfunction; and a minimum of one 3-semester-hour 5 2-semester-hour or 4-quarter-hour 3-quarter-hour 6 graduate-level course in behavioral research which focuses on 7 the interpretation and application of research data as it 8 applies to clinical practice. Credit for thesis or 9 dissertation work, practicums, internships, or fieldwork may 10 not be applied toward this requirement. 11 d. A minimum of one supervised clinical practicum, 12 internship, or field experience in a marriage and family 13 counseling setting, during which the student provided 180 14 direct client contact hours of marriage and family therapy 15 services under the supervision of an individual who met the 16 requirements for supervision under paragraph (c). This 17 requirement may be met by a supervised practice experience 18 which took place outside the academic arena, but which is 19 certified as equivalent to a graduate-level practicum or 20 internship program which required a minimum of 180 direct 21 client contact hours of marriage and family therapy services 22 currently offered within an academic program of a college or 23 university accredited by an accrediting agency approved by the 24 United States Department of Education, or an institution which 25 is publicly recognized as a member in good standing with the 26 Association of Universities and Colleges of Canada or a 27 training institution accredited by the Commission on 28 Accreditation for Marriage and Family Therapy Education 29 recognized by the United States Department of Education. 30 Certification shall be required from an official of such 31 college, university, or training institution. 296 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2. If the course title which appears on the 2 applicant's transcript does not clearly identify the content 3 of the coursework, the applicant shall be required to provide 4 additional documentation, including, but not limited to, a 5 syllabus or catalog description published for the course. 6 7 The required master's degree must have been received in an 8 institution of higher education which at the time the 9 applicant graduated was: fully accredited by a regional 10 accrediting body recognized by the Commission on Recognition 11 of Postsecondary Accreditation; publicly recognized as a 12 member in good standing with the Association of Universities 13 and Colleges of Canada; or an institution of higher education 14 located outside the United States and Canada, which at the 15 time the applicant was enrolled and at the time the applicant 16 graduated maintained a standard of training substantially 17 equivalent to the standards of training of those institutions 18 in the United States which are accredited by a regional 19 accrediting body recognized by the Commission on Recognition 20 of Postsecondary Accreditation. Such foreign education and 21 training must have been received in an institution or program 22 of higher education officially recognized by the government of 23 the country in which it is located as an institution or 24 program to train students to practice as professional marriage 25 and family therapists or psychotherapists. The burden of 26 establishing that the requirements of this provision have been 27 met shall be upon the applicant, and the board shall require 28 documentation, such as, but not limited to, an evaluation by a 29 foreign equivalency determination service, as evidence that 30 the applicant's graduate degree program and education were 31 equivalent to an accredited program in this country. An 297 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 applicant with a master's degree from a program which did not 2 emphasize marriage and family therapy may complete the 3 coursework requirement in a training institution fully 4 accredited by the Commission on Accreditation for Marriage and 5 Family Therapy Education recognized by the United States 6 Department of Education. 7 (4) Upon verification of documentation and payment of 8 a fee not to exceed $200, as set by board rule, plus the 9 actual per applicant cost to the department for purchase of 10 the examination from the Professional Examination Service for 11 the National Academy of Certified Clinical Mental Health 12 Counselors or a similar national organization, the department 13 shall issue a license as a mental health counselor to an 14 applicant who the board certifies: 15 (b)1. Has received a minimum of an earned master's 16 degree from a with a major related to the practice of mental 17 health counseling program accredited by the Council for the 18 Accreditation of Counseling and Related Educational Programs 19 that consists of at least 60 semester hours or 80 quarter 20 hours of clinical and didactic instruction, including a course 21 in human sexuality and substance abuse. If the master's 22 degree is earned from a program related to the practice of 23 mental health counseling that is not accredited by the Council 24 for the Accreditation of Counseling and Related Educational 25 Programs, then the coursework and practicum, internship, or 26 fieldwork must meet, and has completed all of the following 27 requirements: 28 a. Thirty-six Twenty-one semester hours or 48 32 29 quarter hours of graduate coursework, which must include a 30 minimum of 3 2 semester hours or 4 3 quarter hours of 31 graduate-level coursework in each of the following 12 seven 298 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 content areas: counseling theories and practice; human growth 2 and development theories; personality theory; diagnosis and 3 treatment of psychopathology or abnormal psychology; human 4 sexuality theories; group theories and practice; and 5 individual evaluation and assessment; career and lifestyle 6 assessment; research and program evaluation; social and 7 cultural foundations; foundations of mental health counseling; 8 counseling in community settings; and substance abuse. 9 Content may be combined, provided no more than two of the 10 seven content areas are included in any one graduate-level 11 course and the applicant can document that the equivalent of 2 12 semester hours of content was devoted to each content area. 13 Courses in research, thesis or dissertation work, practicums, 14 internships, or fieldwork may not be applied toward this 15 requirement. 16 b. A minimum of one 2-semester-hour or 3-quarter-hour 17 graduate-level course in research or in career or vocational 18 counseling. Credit for thesis or dissertation work, 19 practicums, internships, or fieldwork may not be applied 20 toward this requirement. 21 b.c. A minimum of 3 2 semester hours or 4 3 quarter 22 hours of graduate-level coursework in legal, ethical, and 23 professional standards issues in the practice of mental health 24 counseling, which includes goals, and objectives, and 25 practices of professional counseling organizations, codes of 26 ethics, legal considerations, standards of preparation, 27 certifications and licensing, and the role identity and 28 professional obligations of mental health counselors. Courses 29 in research, thesis or dissertation work, practicums, 30 internships, or fieldwork may not be applied toward this 31 requirement. 299 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 c.d. The equivalent of at least 1,000 hours of 2 university-sponsored A minimum of one supervised clinical 3 practicum, internship, or field experience as required in the 4 accrediting standards of the Council for Accreditation of 5 Counseling and Related Educational Programs for mental health 6 counseling programs. If the academic practicum, internship, 7 or field experience was less than 1,000 hours, experience 8 gained outside the academic arena in clinical mental health 9 settings under the supervision of a qualified supervisor as 10 determined by the board may be applied. This experience may 11 not be used to satisfy the post-master's clinical experience 12 requirement in a counseling setting. This requirement may be 13 met by a supervised practice experience which takes place 14 outside the academic arena, but which is certified as 15 equivalent to a graduate-level practicum in a clinical mental 16 health counseling setting currently offered within an academic 17 program of a college or university accredited by an 18 accrediting agency approved by the United States Department of 19 Education. Such certification shall be required from an 20 official of such college or university. 21 2. If the course title which appears on the 22 applicant's transcript does not clearly identify the content 23 of the coursework, the applicant shall be required to provide 24 additional documentation, including, but not limited to, a 25 syllabus or catalog description published for the course. 26 27 Except as provided in subparagraph 4., Education and training 28 in mental health counseling must have been received in an 29 institution of higher education which at the time the 30 applicant graduated was: fully accredited by a regional 31 accrediting body recognized by the Commission on Recognition 300 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 of Postsecondary Accreditation; publicly recognized as a 2 member in good standing with the Association of Universities 3 and Colleges of Canada; or an institution of higher education 4 located outside the United States and Canada, which at the 5 time the applicant was enrolled and at the time the applicant 6 graduated maintained a standard of training substantially 7 equivalent to the standards of training of those institutions 8 in the United States which are accredited by a regional 9 accrediting body recognized by the Commission on Recognition 10 of Postsecondary Accreditation. Such foreign education and 11 training must have been received in an institution or program 12 of higher education officially recognized by the government of 13 the country in which it is located as an institution or 14 program to train students to practice as mental health 15 counselors. The burden of establishing that the requirements 16 of this provision have been met shall be upon the applicant, 17 and the board shall require documentation, such as, but not 18 limited to, an evaluation by a foreign equivalency 19 determination service, as evidence that the applicant's 20 graduate degree program and education were equivalent to an 21 accredited program in this country. 22 (c) Has had not less than 2 years of clinical 23 experience in mental health counseling, which must be at the 24 post-master's level under the supervision of a licensed mental 25 health counselor or the equivalent who is a qualified 26 supervisor as determined by the board. An individual who 27 intends to practice in Florida to satisfy the clinical 28 experience requirements must register pursuant to s. 491.0045 29 prior to commencing practice. If a graduate has a master's 30 degree with a major related to the practice of mental health 31 counseling that did not include all the coursework required 301 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 under sub-subparagraphs (b)1.a.-b. (b)1.a.-c., credit for the 2 post-master's level clinical experience shall not commence 3 until the applicant has completed a minimum of seven of the 4 courses required under sub-subparagraphs (b)1.a.-b. 5 (b)1.a.-c., as determined by the board, one of which must be a 6 course in psychopathology or abnormal psychology. A doctoral 7 internship may be applied toward the clinical experience 8 requirement. The clinical experience requirement may be met 9 by work performed on or off the premises of the supervising 10 mental health counselor or the equivalent, provided the 11 off-premises work is not the independent private practice 12 rendering of services that does not have a licensed mental 13 health professional, as determined by the board, on the 14 premises at the same time the intern is providing services. 15 Section 206. Section 491.0057, Florida Statutes, is 16 created to read: 17 491.0057 Dual licensure as a marriage and family 18 therapist.--The department shall license as a marriage and 19 family therapist any person who demonstrates to the board that 20 he or she: 21 (1) Holds a valid, active license as a psychologist 22 under chapter 490 or as a clinical social worker or mental 23 health counselor under this chapter, or is certified under s. 24 464.012 as an advanced registered nurse practitioner who has 25 been determined by the Board of Nursing as a specialist in 26 psychiatric mental health. 27 (2) Has held a valid, active license for at least 3 28 years. 29 (3) Has passed the examination provided by the 30 department for marriage and family therapy. 31 302 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 Section 207. Subsection (3) is added to section 2 491.007, Florida Statutes, to read: 3 491.007 Renewal of license, registration, or 4 certificate.-- 5 (3) The board or department shall prescribe by rule a 6 method for the biennial renewal of an intern registration at a 7 fee set by rule, not to exceed $100. 8 Section 208. Section 491.009, Florida Statutes, 1996 9 Supplement, is amended to read: 10 491.009 Discipline.-- 11 (1) When the department or the board finds that an 12 applicant, licensee, provisional licensee, registered intern, 13 or certificateholder whom it regulates under this chapter has 14 committed any of the acts set forth in subsection (2), it may 15 issue an order imposing one or more of the following 16 penalties: 17 (a) Denial of an application for licensure, 18 registration, or certification, either temporarily or 19 permanently. 20 (b) Revocation of an application for licensure, 21 registration, or certification, either temporarily or 22 permanently. 23 (c) Suspension for a period of up to 5 years or 24 revocation of a license, registration, or certificate, after 25 hearing. 26 (d) Immediate suspension of a license, registration, 27 or certificate pursuant to s. 120.60(6). 28 (e) Imposition of an administrative fine not to exceed 29 $1,000 for each count or separate offense. 30 (f) Issuance of a public reprimand. 31 303 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (g) Placement of an applicant, licensee, registered 2 intern, or certificateholder on probation for a period of time 3 and subject to such conditions as the board may specify, 4 including, but not limited to, requiring the applicant, 5 licensee, registered intern, or certificateholder to submit to 6 treatment, to attend continuing education courses, to submit 7 to reexamination, or to work under the supervision of a 8 designated licensee or certificateholder. 9 (h) Restriction of practice. 10 (2) The following acts of a licensee, provisional 11 licensee, registered intern, certificateholder, or applicant 12 are grounds for which the disciplinary actions listed in 13 subsection (1) may be taken: 14 (a) Attempting to obtain, obtaining, or renewing a 15 license, registration, or certificate under this chapter by 16 bribery or fraudulent misrepresentation or through an error of 17 the board or the department. 18 (b) Having a license, registration, or certificate to 19 practice a comparable profession revoked, suspended, or 20 otherwise acted against, including the denial of certification 21 or licensure by another state, territory, or country. 22 (c) Being convicted or found guilty of, regardless of 23 adjudication, or having entered a plea of nolo contendere to, 24 a crime in any jurisdiction which directly relates to the 25 practice of his profession or the ability to practice his 26 profession. However, in the case of a plea of nolo 27 contendere, the board shall allow the person who is the 28 subject of the disciplinary proceeding to present evidence in 29 mitigation relevant to the underlying charges and 30 circumstances surrounding the plea. 31 304 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (d) False, deceptive, or misleading advertising or 2 obtaining a fee or other thing of value on the representation 3 that beneficial results from any treatment will be guaranteed. 4 (e) Advertising, practicing, or attempting to practice 5 under a name other than one's own. 6 (f) Maintaining a professional association with any 7 person who whom the applicant, licensee, registered intern, or 8 certificateholder knows, or has reason to believe, is in 9 violation of this chapter or of a rule of the department or 10 the board. 11 (g) Knowingly aiding, assisting, procuring, or 12 advising any nonlicensed, nonregistered, or noncertified 13 person to hold himself out as licensed, registered, or 14 certified under this chapter. 15 (h) Failing to perform any statutory or legal 16 obligation placed upon a person licensed, registered, or 17 certified under this chapter. 18 (i) Willfully making or filing a false report or 19 record; failing to file a report or record required by state 20 or federal law; willfully impeding or obstructing the filing 21 of a report or record; or inducing another person to make or 22 file a false report or record or to impede or obstruct the 23 filing of a report or record. Such report or record includes 24 only a report or record which requires the signature of a 25 person licensed, registered, or certified under this chapter. 26 (j) Paying a kickback, rebate, bonus, or other 27 remuneration for receiving a patient or client, or receiving a 28 kickback, rebate, bonus, or other remuneration for referring a 29 patient or client to another provider of mental health care 30 services or to a provider of health care services or goods; 31 referring a patient or client to oneself for services on a 305 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 fee-paid basis when those services are already being paid for 2 by some other public or private entity; or entering into a 3 reciprocal referral agreement. 4 (k) Committing any act upon a patient or client which 5 would constitute sexual battery or which would constitute 6 sexual misconduct as defined pursuant to s. 491.0111. 7 (l) Making misleading, deceptive, untrue, or 8 fraudulent representations in the practice of any profession 9 licensed, registered, or certified under this chapter. 10 (m) Soliciting patients or clients personally, or 11 through an agent, through the use of fraud, intimidation, 12 undue influence, or a form of overreaching or vexatious 13 conduct. 14 (n) Failing to make available to a patient or client, 15 upon written request, copies of tests, reports, or documents 16 in the possession or under the control of the licensee, 17 registered intern, or certificateholder which have been 18 prepared for and paid for by the patient or client. 19 (o) Failing to respond within 30 days to a written 20 communication from the department or the board concerning any 21 investigation by the department or the board, or failing to 22 make available any relevant records with respect to any 23 investigation about the licensee's, registered intern's, or 24 the certificateholder's conduct or background. 25 (p) Being unable to practice the profession for which 26 he is licensed, registered, or certified under this chapter 27 with reasonable skill or competence as a result of any mental 28 or physical condition or by reason of illness; drunkenness; or 29 excessive use of drugs, narcotics, chemicals, or any other 30 substance. In enforcing this paragraph, upon a finding by the 31 secretary, his designee, or the board that probable cause 306 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 exists to believe that the licensee, registered intern, or 2 certificateholder is unable to practice the profession because 3 of the reasons stated in this paragraph, the department shall 4 have the authority to compel a licensee, registered intern, or 5 certificateholder to submit to a mental or physical 6 examination by psychologists, physicians, or other licensees 7 under this chapter, designated by the department or board. If 8 the licensee, registered intern, or certificateholder refuses 9 to comply with such order, the department's order directing 10 the examination may be enforced by filing a petition for 11 enforcement in the circuit court in the circuit in which the 12 licensee, registered intern, or certificateholder resides or 13 does business. The licensee, registered intern, or 14 certificateholder against whom the petition is filed shall not 15 be named or identified by initials in any public court records 16 or documents, and the proceedings shall be closed to the 17 public. The department shall be entitled to the summary 18 procedure provided in s. 51.011. A licensee, registered 19 intern, or certificateholder affected under this paragraph 20 shall at reasonable intervals be afforded an opportunity to 21 demonstrate that he can resume the competent practice for 22 which he is licensed, registered, or certified with reasonable 23 skill and safety to patients. 24 (q) Violating provisions of this chapter, or of 25 chapter 455, or any rules adopted pursuant thereto. 26 (r) Performing any treatment or prescribing any 27 therapy which, by the prevailing standards of the mental 28 health professions in the community, would constitute 29 experimentation on human subjects, without first obtaining 30 full, informed, and written consent. 31 307 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (s) Failing to meet the minimum standards of 2 performance in professional activities when measured against 3 generally prevailing peer performance, including the 4 undertaking of activities for which the licensee, registered 5 intern, or certificateholder is not qualified by training or 6 experience. 7 (t) Delegating professional responsibilities to a 8 person whom the licensee, registered intern, or 9 certificateholder knows or has reason to know is not qualified 10 by training or experience to perform such responsibilities. 11 (u) Violating a rule relating to the regulation of the 12 profession or a lawful order of the department or the board 13 previously entered in a disciplinary hearing. 14 (v) Failure of the licensee, registered intern, or 15 certificateholder to maintain in confidence a communication 16 made by a patient or client in the context of such services, 17 except as provided in s. 491.0147 by written permission or in 18 the face of a clear and immediate probability of bodily harm 19 to the patient or client or to others. 20 (w) Making public statements which are derived from 21 test data, client contacts, or behavioral research and which 22 identify or damage research subjects or clients. 23 Section 209. Section 491.012, Florida Statutes, is 24 amended to read: 25 491.012 Violations; penalty; injunction.-- 26 (1) It is unlawful and a violation of this chapter for 27 any person to: 28 (a) Use the following titles or any combination 29 thereof, unless he holds a valid, active license as a clinical 30 social worker issued pursuant to this chapter: 31 1. "Licensed clinical social worker." 308 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2. "Clinical social worker." 2 3. "Licensed social worker." 3 4. "Psychiatric social worker." 4 5. "Psychosocial worker." 5 (b) Use the following titles or any combination 6 thereof, unless he holds a valid, active license as a marriage 7 and family therapist issued pursuant to this chapter: 8 1. "Licensed marriage and family therapist." 9 2. "Marriage and family therapist." 10 3. "Marriage counselor." 11 4. "Marriage consultant." 12 5. "Family therapist." 13 6. "Family counselor." 14 7. "Family consultant." 15 (c) Use the following titles or any combination 16 thereof, unless he holds a valid, active license as a mental 17 health counselor issued pursuant to this chapter: 18 1. "Licensed mental health counselor." 19 2. "Mental health counselor." 20 3. "Mental health therapist." 21 4. "Mental health consultant." 22 (d) Use the terms psychotherapist or sex therapist, 23 unless such person is licensed pursuant to this chapter or 24 chapter 490, or is certified under s. 464.012 as an advanced 25 registered nurse practitioner who has been determined by the 26 Board of Nursing as a specialist in the category of 27 psychiatric mental health and the use of such terms is within 28 the scope of his practice based on education, training, and 29 licensure. 30 31 309 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (e) Present as his own the clinical social work, 2 marriage and family therapy, or mental health counseling 3 license of another. 4 (f) Give false or forged evidence to the board or a 5 member thereof for the purpose of obtaining a license. 6 (g) Use or attempt to use a license issued pursuant to 7 this chapter which has been revoked or is under suspension. 8 (h) Knowingly conceal information relative to 9 violations of this chapter. 10 (i) Beginning October 1, 1992, Practice clinical 11 social work in this state, as the practice is defined in s. 12 491.003(7), for compensation, unless the person holds a valid, 13 an active license to practice clinical social work issued 14 pursuant to this chapter. 15 (j) Beginning October 1, 1992, Practice marriage and 16 family therapy in this state, as the practice is defined in s. 17 491.003(8), for compensation, unless the person holds a valid, 18 an active license to practice marriage and family therapy 19 issued pursuant to this chapter. 20 (k) Beginning October 1, 1992, Practice mental health 21 counseling in this state, as the practice is defined in s. 22 491.003(9), for compensation, unless the person holds a valid, 23 an active license to practice mental health counseling issued 24 pursuant to this chapter. 25 (l) Use the following titles or any combination 26 thereof, unless he or she holds a valid registration as an 27 intern issued pursuant to this chapter: 28 1. "Registered clinical social worker intern." 29 2. "Registered marriage and family therapist intern." 30 3. "Registered mental health counselor intern." 31 310 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (m) Use the following titles or any combination 2 thereof, unless he or she holds a valid provisional license 3 issued pursuant to this chapter: 4 1. "Provisional clinical social worker licensee." 5 2. "Provisional marriage and family therapist 6 licensee." 7 3. "Provisional mental health counselor licensee." 8 (2) It is unlawful and a violation of this chapter for 9 any person to describe his services using the following terms 10 or any derivative thereof, unless such person holds a valid, 11 active license under this chapter or chapter 490, or is 12 certified under s. 464.012 as an advanced registered nurse 13 practitioner who has been determined by the Board of Nursing 14 as a specialist in the category of psychiatric mental health 15 under s. 464.012, and the use of such terms is within the 16 scope of his practice based on education, training, and 17 licensure: 18 (a) "Psychotherapy." 19 (b) "Sex therapy." 20 (c) "Sex counseling." 21 (d) "Clinical social work." 22 (e) "Psychiatric social work." 23 (f) "Marriage and family therapy." 24 (g) "Marriage and family counseling." 25 (h) "Marriage counseling." 26 (i) "Family counseling." 27 (j) "Mental health counseling." 28 (3) Any person who violates any provision of 29 subsection (1) or subsection (2) commits a misdemeanor of the 30 first degree, punishable as provided in s. 775.082 or s. 31 775.083. 311 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (4) The department may institute appropriate judicial 2 proceedings to enjoin violation of this section. 3 Section 210. Section 491.014, Florida Statutes, is 4 amended to read: 5 491.014 Exemptions.-- 6 (1) No provision of this chapter shall be construed to 7 limit the practice of physicians licensed pursuant to chapter 8 458 or chapter 459, or psychologists licensed pursuant to 9 chapter 490, so long as they do not unlawfully hold themselves 10 out to the public as possessing a license, provisional 11 license, registration, or certificate issued pursuant to this 12 chapter or use a professional title protected by this chapter. 13 (2) No provision of this chapter shall be construed to 14 limit the practice of nursing, school psychology, or 15 psychology, or to prevent qualified members of other 16 professions from doing work of a nature consistent with their 17 training and licensure, so long as they do not hold themselves 18 out to the public as possessing a license, provisional 19 license, registration, or certificate issued pursuant to this 20 chapter or use a title protected by this chapter. 21 (3) No provision of this chapter shall be construed to 22 limit the performance of activities of a rabbi, priest, 23 minister, or clergyman of any religious denomination or sect, 24 or use of the terms "Christian counselor" or "Christian 25 clinical counselor" when the activities are within the scope 26 of the performance of his regular or specialized ministerial 27 duties and no compensation is received by him, or when such 28 activities are performed, with or without compensation, by a 29 person for or under the auspices or sponsorship, individually 30 or in conjunction with others, of an established and legally 31 cognizable church, denomination, or sect, and when the person 312 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 rendering service remains accountable to the established 2 authority thereof. 3 (4) No person shall be required to be licensed, 4 provisionally licensed, registered, or certified under this 5 chapter who: 6 (a) Is a salaried employee of a government agency; 7 developmental services program, mental health, alcohol, or 8 drug abuse facility operating pursuant to chapter 393, chapter 9 394, or chapter 397; subsidized child care program, subsidized 10 child care case management program, or child care resource and 11 referral program, operating pursuant to chapter 402; 12 child-placing or child-caring agency licensed pursuant to 13 chapter 409; domestic violence center certified pursuant to 14 chapter 415; accredited academic institution; or research 15 institution, if such employee is performing duties for which 16 he was trained and hired solely within the confines of such 17 agency, facility, or institution. 18 (b) Is a salaried employee of a private, nonprofit 19 organization providing counseling services to children, youth, 20 and families, if such services are provided for no charge, if 21 such employee is performing duties for which he was trained 22 and hired. 23 (c) Is a student providing services regulated under 24 this chapter who is pursuing a course of study which leads to 25 a degree in medicine or a profession regulated by this 26 chapter, who is providing services in a training setting, 27 provided such activities or services and associated activities 28 constitute part of a supervised course of study, and or is a 29 graduate accumulating the experience required for any 30 licensure or certification under this chapter, provided such 31 graduate or student is designated by the a title such as 313 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 "student intern." or "trainee" which clearly indicates the 2 in-training status of the student. 3 (d) Is not a resident of this state but offers 4 services in this state, provided: 5 1. Such services are performed for no more than 5 days 6 in any month and no more than 15 days in any calendar year; 7 and 8 2. Such nonresident is licensed or certified to 9 practice the services provided by a state or territory of the 10 United States or by a foreign country or province. 11 (5) No provision of this chapter shall be construed to 12 limit the practice of any individual who solely engages in 13 behavior analysis so long as he does not hold himself out to 14 the public as possessing a license issued pursuant to this 15 chapter or use a title protected by this chapter. 16 (6) Nothing in subsections (2)-(4) shall exempt any 17 person from the provisions of s. 491.012(1)(a)-(c), (l), and 18 (m). 19 (7) Any person who is not licensed under this chapter 20 by October 1, 1992, and who desires to become so licensed 21 shall register with the department that person's intent to 22 become fully licensed no later than October 1, 1995. The 23 costs to the department of such registration shall be borne by 24 the registrant. The department may require affidavits and 25 supporting documentation sufficient to demonstrate that the 26 registrant is preparing for examination by October 1, 1995, 27 under this chapter. The department may adopt rules to 28 implement this section. Upon receipt of the department's 29 notice of registration, the registrant may practice services 30 as defined in s. 491.003(7), (8), and (9), provided that the 31 registrant uses "trainee" or "intern" with any title or 314 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 description of the registrant's work and on any business 2 correspondence and work product, including, but not limited 3 to, a business card, letterhead, sign, billing, or report 4 unless exempt pursuant to this chapter. 5 (7)(8) Except as stipulated by the board, the 6 exemptions contained in this section subsection (4) do not 7 apply to any person licensed under this chapter whose license 8 has been suspended or revoked by the board or another 9 jurisdiction. 10 (8)(9) Nothing in this section shall be construed to 11 exempt a person from meeting the minimum standards of 12 performance in professional activities when measured against 13 generally prevailing peer performance, including the 14 undertaking of activities for which the person is not 15 qualified by training or experience. 16 Section 211. Section 491.0149, Florida Statutes, is 17 amended to read: 18 491.0149 Display of license; use of professional title 19 on promotional materials.-- 20 (1)(a) A person licensed under this chapter as a 21 clinical social worker, marriage and family therapist, or 22 mental health counselor, or certified as a master social 23 worker shall conspicuously display the valid license issued by 24 the department or a true copy thereof at each location at 25 which the licensee practices his profession. 26 (b)1.(2) A licensed clinical social worker shall 27 include the words "licensed clinical social worker" or the 28 letters "LCSW" on all promotional materials, including cards, 29 brochures, stationery, advertisements, and signs, naming the 30 licensee. 31 315 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 2.(4) A licensed marriage and family therapist shall 2 include the words "licensed marriage and family therapist" or 3 the letters "LMFT" on all promotional materials, including 4 cards, brochures, stationery, advertisements, and signs, 5 naming the licensee. 6 3.(3) A licensed mental health counselor shall include 7 the words "licensed mental health counselor" or the letters 8 "LMHC" on all promotional materials, including cards, 9 brochures, stationery, advertisements, and signs, naming the 10 licensee. 11 (2)(a) A person registered under this chapter as a 12 clinical social worker intern, marriage and family therapist 13 intern, or mental health counselor intern shall conspicuously 14 display the valid registration issued by the department or a 15 true copy thereof at each location at which the registered 16 intern is completing the experience requirements. 17 (b) A registered clinical social worker intern shall 18 include the words "registered clinical social worker intern," 19 a registered marriage and family therapist intern shall 20 include the words "registered marriage and family therapist 21 intern," and a registered mental health counselor intern shall 22 include the words "registered mental health counselor intern" 23 on all promotional materials, including cards, brochures, 24 stationery, advertisements, and signs, naming the registered 25 intern. 26 (3)(a) A person provisionally licensed under this 27 chapter as a provisional clinical social worker licensee, 28 provisional marriage and family therapist licensee, or 29 provisional mental health counselor licensee shall 30 conspicuously display the valid provisional license issued by 31 316 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 the department or a true copy thereof at each location at 2 which the provisional licensee is providing services. 3 (b) A provisional clinical social worker licensee 4 shall include the words "provisional clinical social worker 5 licensee," a provisional marriage and family therapist 6 licensee shall include the words "provisional marriage and 7 family therapist licensee," and a provisional mental health 8 counselor licensee shall include the words "provisional mental 9 health counselor licensee" on all promotional materials, 10 including cards, brochures, stationery, advertisements, and 11 signs, naming the provisional licensee. 12 Section 212. Paragraph (b) of subsection (4) of 13 section 232.02, Florida Statutes, is amended to read: 14 232.02 Regular school attendance.--Regular attendance 15 is the actual attendance of a pupil during the school day as 16 defined by law and regulations of the state board. Regular 17 attendance within the intent of s. 232.01 may be achieved by 18 attendance in: 19 (4) A home education program as defined in s. 228.041, 20 provided that at least one of the following conditions is met: 21 (b) The parent does not hold a valid regular Florida 22 certificate to teach and complies with the following 23 requirements: 24 1. Notifies the superintendent of schools of the 25 county in which the parent resides of her or his intent to 26 establish and maintain a home education program. The notice 27 shall be in writing, signed by the parent, and shall include 28 the names, addresses, and birthdates of all children who shall 29 be enrolled as students in the home education program. The 30 notice shall be filed in the superintendent's office within 30 31 days of the establishment of the home education program. A 317 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 written notice of termination of the home education program 2 shall be filed in the superintendent's office within 30 days 3 of said termination. 4 2. Maintains a portfolio of records and materials. 5 The portfolio shall consist of a log, made contemporaneously 6 with the instruction, which designates by title the reading 7 materials used and samples of any writings, worksheets, 8 workbooks, and creative materials used or developed by the 9 student. The portfolio shall be preserved by the parent for 2 10 years and shall be made available for inspection by the 11 superintendent, or the superintendent's agent, upon 15 days' 12 written notice. 13 3. Provides for an annual educational evaluation in 14 which is documented the pupil's demonstration of educational 15 progress at a level commensurate with her or his ability. A 16 copy of the evaluation shall be filed annually with the 17 district school board office in the county in which the pupil 18 resides. The annual educational evaluation shall consist of 19 one of the following: 20 a. A teacher selected by the parent shall evaluate the 21 pupil's educational progress upon review of the portfolio and 22 discussion with the pupil. Such teacher shall hold a valid 23 regular Florida certificate to teach academic subjects at the 24 elementary or secondary level. The teacher shall submit a 25 written evaluation to the school superintendent; 26 b. The pupil shall take any nationally normed student 27 achievement test used by the district and administered by a 28 certified teacher. Such test results shall be reported to the 29 school superintendent; 30 31 318 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 c. The pupil shall take a state student assessment 2 test. Such test results shall be reported to the school 3 superintendent; 4 d. The pupil shall be evaluated by an individual 5 holding a valid, active license pursuant to the provisions of 6 s. 490.003(7)(3) or (8)(5). Such results shall be reported to 7 the school superintendent; or 8 e. The pupil shall be evaluated with any other valid 9 measurement tool as mutually agreed upon by the school 10 superintendent of the district in which the pupil resides and 11 the pupil's parent or guardian. Such results shall be 12 reported to the superintendent. 13 14 The school superintendent shall review and accept the results 15 of the annual educational evaluation of the pupil in a home 16 education program. If the pupil does not demonstrate 17 educational progress at a level commensurate with her or his 18 ability, the superintendent shall notify the parent, in 19 writing, that such progress has not been achieved. The parent 20 shall have 1 year from the date of receipt of the written 21 notification to provide remedial instruction to the pupil. At 22 the end of the 1-year probationary period, the pupil shall be 23 reevaluated as specified in this subparagraph. Continuation 24 in a home education program shall be contingent upon the pupil 25 demonstrating educational progress commensurate with her or 26 his ability at the end of the probationary period. 27 Section 213. Subsection (2) of section 394.455, 28 Florida Statutes, 1996 Supplement, is amended to read: 29 394.455 Definitions.--As used in this part, unless the 30 context clearly requires otherwise, the term: 31 319 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) "Clinical psychologist" means a psychologist as 2 defined in s. 490.003(7)(3) with 3 years of postdoctoral 3 experience in the practice of clinical psychology, inclusive 4 of the experience required for licensure, or a psychologist 5 employed by a facility operated by the United States 6 Department of Veterans Affairs that qualifies as a receiving 7 or treatment facility under this part. 8 Section 214. Section 458.3124, Florida Statutes, is 9 created to read: 10 458.3124 Restricted license; certain experienced 11 foreign-trained physicians.-- 12 (1) A person who was trained in a medical school that 13 is listed in the World Directory of Medical Schools published 14 by the World Health Organization and is located in a country 15 other than the United States, Canada, or Puerto Rico may apply 16 to take Step III of the United States Medical Licensing 17 Examination, if the person: 18 (a) Legally practiced medicine for at least 5 years in 19 the country in which the school is located; 20 (b) Has passed Steps I and II of the United States 21 Medical Licensing Examination; 22 (c) Is certified by the Education Commission for 23 Foreign Medical Graduates as qualified for a restricted 24 license to practice medicine; 25 (d) Is not subject to discipline, investigation, or 26 prosecution in any jurisdiction for acts that threaten the 27 public health, safety, or welfare or violate chapters 455 or 28 458; and 29 (e) Has been a resident of this state since July 1, 30 1996. 31 320 CODING: Words stricken are deletions; words underlined are additions. ENROLLED 1997 Legislature HB 2013, Third Engrossed 1 (2) A person applying for licensure under this section 2 must submit to the Department of Health on or before December 3 31, 1998: 4 (a) A completed application and documentation required 5 by the Board of Medicine to prove compliance with subsection 6 (1); and 7 (b) A nonrefundable application fee not to exceed $500 8 and a nonrefundable examination fee not to exceed $300 plus 9 the actual cost to purchase and administer the examination. 10 (3) A person applying under this section may take the 11 examination a maximum of 5 times within 5 years. 12 (4) A restricted licensee under this section must 13 practice under the supervision of a licensee approved by the 14 board, with the first year of licensure under direct 15 supervision and the second year in community service under 16 indirect supervision, including practicing with organizations 17 that serve indigent populations, such as section 501(c)(3) 18 agencies, public health units, prisons, or other organizations 19 approved by the board. 20 (5) Notwithstanding s. 458.311(1)(f), a person who 21 successfully meets the requirements of this section and who 22 successfully passes Step III of the United States Medical 23 Licensing Examination is eligible for full licensure as a 24 physician. 25 (6) The board shall adopt rules to implement this 26 section. 27 Section 215. This act shall take effect July 1, 1997. 28 29 30 31 321