House Bill 1031e1

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







                                          HB 1031, First Engrossed



  1                      A bill to be entitled

  2         An act relating to physician assistants;

  3         amending s. 39.304, F.S.; allowing a physician

  4         assistant to perform a medical examination, and

  5         to authorize a radiological examination to be

  6         performed, on a child who is suspected to be a

  7         victim of abuse, abandonment, or neglect;

  8         amending ss. 458.347 and 459.022, F.S.;

  9         providing for the appointment of a formulary

10         committee to establish a formulary of medicinal

11         drugs that physician assistants may prescribe;

12         providing for terms and meetings of the

13         formulary committee; providing standards for

14         formulary drugs; providing for the Board of

15         Medicine and the Board of Osteopathic Medicine

16         to adopt the formularies; providing an

17         effective date.

18

19  Be It Enacted by the Legislature of the State of Florida:

20

21         Section 1.  Subsection (1) of section 39.304, Florida

22  Statutes, 1998 Supplement, is amended to read:

23         39.304  Photographs, medical examinations, X rays, and

24  medical treatment of abused, abandoned, or neglected child.--

25         (1)  Any person required to investigate cases of

26  suspected child abuse, abandonment, or neglect may take or

27  cause to be taken photographs of the areas of trauma visible

28  on a child who is the subject of a report.  If the areas of

29  trauma visible on a child indicate a need for a medical

30  examination, or if the child verbally complains or otherwise

31  exhibits distress as a result of injury through suspected


                                  1

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






                                          HB 1031, First Engrossed



  1  child abuse, abandonment, or neglect, or is alleged to have

  2  been sexually abused, the person required to investigate may

  3  cause the child to be referred for diagnosis to a licensed

  4  physician or an emergency department in a hospital without the

  5  consent of the child's parents, caregiver, or legal custodian.

  6  Such an examination may be performed by an advanced registered

  7  nurse practitioner licensed under pursuant to chapter 464 or a

  8  physician assistant licensed under chapter 458 or chapter 459.

  9  Any licensed physician, physician assistant licensed under

10  chapter 458 or chapter 459, or advanced registered nurse

11  practitioner licensed under pursuant to chapter 464, who has

12  reasonable cause to suspect that an injury was the result of

13  child abuse, abandonment, or neglect may authorize a

14  radiological examination to be performed on the child without

15  the consent of the child's parent, caregiver, or legal

16  custodian.

17         Section 2.  Paragraph (f) of subsection (4) of section

18  458.347, Florida Statutes, 1998 Supplement, is amended to

19  read:

20         458.347  Physician assistants.--

21         (4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--

22         (f)1.  There is created a five-member committee

23  appointed by the Secretary of Health.  The committee must be

24  composed of one fully licensed physician assistant licensed

25  under pursuant to this section or s. 459.022, two physicians

26  licensed under pursuant to this chapter, one of whom

27  supervises a fully licensed physician assistant, one

28  osteopathic physician licensed under pursuant to chapter 459,

29  and one pharmacist licensed under pursuant to chapter 465 who

30  is not licensed under pursuant to this chapter or chapter 459.

31  All members of the formulary committee shall be appointed for


                                  2

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






                                          HB 1031, First Engrossed



  1  initial terms commencing July 1, 1999. Committee members shall

  2  be appointed to terms of 4 years, except that, of the initial

  3  appointments, two members shall be appointed for terms of 2

  4  years, two shall be appointed for terms of 3 years, and one

  5  shall be appointed for a term of 4 years. The committee shall

  6  meet at least quarterly to establish a formulary of medicinal

  7  drugs that for which a fully licensed physician assistant may

  8  prescribe. The formulary may not include controlled substances

  9  as defined in chapter 893, antineoplastics, antipsychotics,

10  radiopharmaceuticals, general anesthetics, or radiographic

11  contrast materials, or any parenteral preparations except

12  insulin and epinephrine.

13         2.  Only the committee shall add to, delete from, or

14  modify the formulary.  Any person who requests an addition,

15  deletion, or modification of a medicinal drug listed on such

16  formulary has the burden of proof to show cause why such

17  addition, deletion, or modification should be made.

18         3.  The boards shall adopt the formulary required by

19  this paragraph, and each addition, deletion, or modification

20  to the formulary, by rule. Notwithstanding any provision of

21  chapter 120 to the contrary, the formulary rule shall be

22  effective 60 days after the date it is filed with the

23  Secretary of State.  Upon adoption of the formulary, the

24  department shall mail a copy of such formulary to each fully

25  licensed physician assistant and to each pharmacy licensed by

26  the state.  The boards shall establish, by rule, a fee not to

27  exceed $200 to fund the provisions of this paragraph and

28  paragraph (e). The Board of Medicine shall adopt the formulary

29  required by this paragraph and shall adopt each subsequent

30  change at its next regular meeting following receipt of the

31  formulary from the formulary committee.


                                  3

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






                                          HB 1031, First Engrossed



  1         Section 3.  Paragraph (f) of subsection (4) of section

  2  459.022, Florida Statutes, 1998 Supplement, is amended to

  3  read:

  4         459.022  Physician assistants.--

  5         (4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--

  6         (f)1.  There is created a five-member committee

  7  appointed by the Secretary of Health.  The committee must be

  8  composed of one fully licensed physician assistant licensed

  9  under pursuant to this section or s. 458.347, two physicians

10  licensed under pursuant to chapter 458, one of whom supervises

11  a fully licensed physician assistant, one osteopathic

12  physician licensed under pursuant to this chapter, and one

13  pharmacist licensed under pursuant to chapter 465 who is not

14  licensed under pursuant to this chapter or chapter 458.  All

15  members of the formulary committee shall be appointed for

16  initial terms commencing July 1, 1999. Committee members shall

17  be appointed to terms of 4 years, except that, of the initial

18  appointments, two members shall be appointed for terms of 2

19  years, two shall be appointed for terms of 3 years, and one

20  shall be appointed for a term of 4 years. The committee shall

21  meet at least quarterly to establish a formulary of medicinal

22  drugs that for which a fully licensed physician assistant may

23  prescribe. The formulary may not include controlled substances

24  as defined in chapter 893, antineoplastics, antipsychotics,

25  radiopharmaceuticals, general anesthetics, or radiographic

26  contrast materials, or any parenteral preparations except

27  insulin and epinephrine.

28         2.  Only the committee shall add to, delete from, or

29  modify the formulary.  Any person who requests an addition,

30  deletion, or modification of a medicinal drug listed on such

31


                                  4

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






                                          HB 1031, First Engrossed



  1  formulary has the burden of proof to show cause why such

  2  addition, deletion, or modification should be made.

  3         3.  The boards shall adopt the formulary required by

  4  this paragraph, and each addition, deletion, or modification

  5  to the formulary, by rule. Notwithstanding any provision of

  6  chapter 120 to the contrary, the formulary rule shall be

  7  effective 60 days after the date it is filed with the

  8  Secretary of State.  Upon adoption of the formulary, the

  9  department shall mail a copy of such formulary to each fully

10  licensed physician assistant and to each pharmacy licensed by

11  the state.  The boards shall establish, by rule, a fee not to

12  exceed $200 to fund the provisions of this paragraph and

13  paragraph (e). The Board of Osteopathic Medicine shall adopt

14  the formulary required by this paragraph and shall adopt each

15  subsequent change at its next regular meeting following

16  receipt of the formulary from the formulary committee.

17         Section 4.  This act shall take effect July 1, 1999.

18

19

20

21

22

23

24

25

26

27

28

29

30

31


                                  5