Senate Bill 1068c1

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    Florida Senate - 1999                           CS for SB 1068

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Sullivan




    317-2053-99

  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, 459.022, F.S.; providing

  9         for the appointment of a formulary committee to

10         establish a formulary of medicinal drugs that

11         physician assistants may prescribe; providing

12         for terms and meetings of the formulary

13         committee; providing standards for formulary

14         drugs; providing for the Board of Medicine and

15         the Board of Osteopathic Medicine to adopt the

16         formularies; providing an effective date.

17

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

19

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

21  Statutes, 1998 Supplement, is amended to read:

22         39.304  Photographs, medical examinations, X rays, and

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

24         (1)  Any person required to investigate cases of

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

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

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

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

29  examination, or if the child verbally complains or otherwise

30  exhibits distress as a result of injury through suspected

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

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    Florida Senate - 1999                           CS for SB 1068
    317-2053-99




  1  been sexually abused, the person required to investigate may

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

  3  physician or an emergency department in a hospital without the

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

  5  Such an examination may be performed by an advanced registered

  6  nurse practitioner licensed under pursuant to chapter 464 or a

  7  physician assistant licensed under chapter 458 or chapter 459.

  8  Any licensed physician, physician assistant licensed under

  9  chapter 458 or chapter 459, or advanced registered nurse

10  practitioner licensed under pursuant to chapter 464, who has

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

12  child abuse, abandonment, or neglect may authorize a

13  radiological examination to be performed on the child without

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

15  custodian.

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

17  458.347, Florida Statutes, 1998 Supplement, is amended to

18  read:

19         458.347  Physician assistants.--

20         (4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--

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

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

23  composed of one fully licensed physician assistant licensed

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

25  licensed under pursuant to this chapter, one of whom

26  supervises a fully licensed physician assistant, one

27  osteopathic physician licensed under pursuant to chapter 459,

28  and one pharmacist licensed under pursuant to chapter 465 who

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

30  All members of the formulary committee shall be appointed for

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

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    Florida Senate - 1999                           CS for SB 1068
    317-2053-99




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

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

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

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

  5  meet at least quarterly to establish a formulary of medicinal

  6  drugs that for which a fully licensed physician assistant may

  7  prescribe. The formulary may not include controlled substances

  8  as defined in chapter 893, antineoplastics, antipsychotics,

  9  radiopharmaceuticals, general anesthetics, or radiographic

10  contrast materials, or any parenteral preparations except

11  insulin and epinephrine.

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

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

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

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

16  addition, deletion, or modification should be made.

17         3.  The boards shall adopt the formulary required by

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

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

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

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

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

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

24  licensed physician assistant and to each pharmacy licensed by

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

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

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

28  required by this paragraph and shall adopt each subsequent

29  change at its next regular meeting following receipt of the

30  formulary from the formulary committee.

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    Florida Senate - 1999                           CS for SB 1068
    317-2053-99




  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

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    Florida Senate - 1999                           CS for SB 1068
    317-2053-99




  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          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
20                         Senate Bill 1068

21

22  The Committee Substitute for SB 1068 no longer authorizes a
    physician assistant who has completed a 1-hour course in
23  substance abuse to prescribe controlled substances listed in
    Schedule III, Schedule IV, or Schedule V of ch. 893, Florida
24  Statutes. The committee substitute requires the formulary
    committee to meet quarterly instead of at least twice
25  annually.

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