House Bill 1467e1

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                                       CS/HB 1467, First Engrossed



  1                      A bill to be entitled

  2         An act relating to regulation of health care

  3         practitioners; providing for clinical trials to

  4         be conducted on the use of the drug Secretin by

  5         a nonprofit provider; requiring a report;

  6         providing an appropriation; amending s.

  7         232.435, F.S.; correcting a reference; amending

  8         s. 381.026, F.S.; providing a definition;

  9         amending s. 381.0261, F.S.; providing that the

10         Department of Health or a regulatory board,

11         rather than the Agency for Health Care

12         Administration, may impose an administrative

13         fine against any health care provider who fails

14         to make available to patients a summary of

15         their rights as required by law; amending s.

16         455.501, F.S.; redefining the terms "health

17         care practitioner" and "licensee"; amending s.

18         455.507, F.S.; revising provisions relating to

19         good standing of members of the Armed Forces

20         with administrative boards to provide

21         applicability to the department when there is

22         no board; providing gender neutral language;

23         amending s. 455.521, F.S.; providing powers and

24         duties of the department for the professions,

25         rather than boards, under its jurisdiction;

26         amending s. 455.544, F.S.; stating the purpose

27         of department and board rules; amending s.

28         455.557, F.S.; redefining the term "health care

29         practitioner" for purposes of standardized

30         credentializing; amending s. 455.564, F.S.;

31         prescribing the expiration date of an


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                                       CS/HB 1467, First Engrossed



  1         incomplete license application; revising the

  2         form and style of licenses; providing authority

  3         to the department when there is no board to

  4         adopt rules; revising and providing

  5         requirements relating to obtaining continuing

  6         education credit in risk management; correcting

  7         a reference; amending s. 455.565, F.S.;

  8         providing exceptions to certain application

  9         requirements; revising information required for

10         licensure of designated health care

11         professionals; revising requirements for

12         submitting fingerprints to the department for

13         renewal of licensure; amending s. 455.5651,

14         F.S.; prohibiting inclusion of certain

15         information in practitioner profiles; amending

16         s. 455.567, F.S.; defining sexual misconduct

17         and prohibiting it in the practice of a health

18         care profession; providing penalties; amending

19         s. 455.574, F.S.; revising provisions relating

20         to review of an examination after failure to

21         pass it; amending s. 455.587, F.S.; providing

22         authority to the department when there is no

23         board to determine by rule the amount of

24         license fees for the profession regulated;

25         providing for a fee for issuance of a wall

26         certificate to certain licensees or for a

27         duplicate wall certificate; amending s.

28         455.604, F.S.; requiring instruction on human

29         immunodeficiency virus and acquired immune

30         deficiency syndrome as a condition of licensure

31         and relicensure to practice dietetics and


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                                       CS/HB 1467, First Engrossed



  1         nutrition or nutrition counseling; amending s.

  2         455.607, F.S.; correcting a reference; amending

  3         s. 455.624, F.S.; revising and providing

  4         grounds for discipline; providing penalties;

  5         providing for assessment of certain costs;

  6         amending s. 455.664, F.S.; requiring additional

  7         health care practitioners to include a certain

  8         statement in advertisements for free or

  9         discounted services; correcting terminology;

10         amending s. 455.667, F.S.; authorizing the

11         department to obtain patient records, billing

12         records, insurance information, provider

13         contracts, and all attachments thereto under

14         certain circumstances for purposes of

15         disciplinary proceedings; providing for charges

16         for making reports or records available for

17         digital scanning; amending s. 455.687, F.S.;

18         providing for the suspension or restriction of

19         the license of any health care practitioner who

20         tests positive for drugs under certain

21         circumstances; amending s. 455.694, F.S.;

22         providing financial responsibility requirements

23         for midwives; creating s. 455.712, F.S.;

24         providing requirements for active status

25         licensure of certain business establishments;

26         amending s. 457.102, F.S.; defining the term

27         "prescriptive rights" with respect to

28         acupuncture; amending s. 458.307, F.S.;

29         correcting terminology and a reference;

30         removing an obsolete date; amending s. 458.309,

31         F.S.; providing for licensing and inspecting


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                                       CS/HB 1467, First Engrossed



  1         certain offices performing levels 2 and 3

  2         surgery; amending s. 458.311, F.S.; revising

  3         provisions relating to licensure as a physician

  4         by examination; eliminating an obsolete

  5         provision relating to licensure of medical

  6         students from Nicaragua and another provision

  7         relating to taking the examination without

  8         applying for a license; amending s. 458.3115,

  9         F.S.; updating terminology; amending s.

10         458.313, F.S.; revising provisions relating to

11         licensure by endorsement; repealing provisions

12         relating to reactivation of certain licenses

13         issued by endorsement; amending s. 458.315,

14         F.S.; providing additional requirements for

15         recipients of a temporary certificate for

16         practice in areas of critical need; amending s.

17         458.3165, F.S.; prescribing authorized

18         employment for holders of public psychiatry

19         certificates; correcting a reference; amending

20         s. 458.317, F.S.; providing for conversion of

21         an active license to a limited license for a

22         specified purpose; amending s. 458.319, F.S.;

23         revising requirements for submitting

24         fingerprints to the department for renewal of

25         licensure as a physician; amending s. 458.331,

26         F.S.; providing grounds for discipline;

27         providing penalties; amending s. 458.347, F.S.;

28         revising provisions relating to temporary

29         licensure as a physician assistant; amending s.

30         459.005, F.S.; providing for licensing and

31         inspecting certain offices performing levels 2


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                                       CS/HB 1467, First Engrossed



  1         and 3 surgery; amending s. 459.0075, F.S.;

  2         providing for conversion of an active license

  3         to a limited license for a specified purpose;

  4         amending s. 459.008, F.S.; revising

  5         requirements for submitting fingerprints to the

  6         department for renewal of licensure as an

  7         osteopathic physician; amending s. 459.015,

  8         F.S.; revising and providing grounds for

  9         discipline; providing penalties; amending s.

10         460.402, F.S.; providing an exemption from

11         regulation under ch. 460, F.S., relating to

12         chiropractic, for certain students; amending s.

13         460.403, F.S.; defining the term

14         "community-based internship" for purposes of

15         ch. 460, F.S.; redefining the terms "direct

16         supervision" and "registered chiropractic

17         assistant"; amending s. 460.406, F.S.; revising

18         requirements for licensure as a chiropractic

19         physician by examination to remove a provision

20         relating to a training program; amending s.

21         460.407, F.S.; revising requirements for

22         submitting fingerprints to the department for

23         renewal of licensure as a chiropractic

24         physician; amending s. 460.413, F.S.;

25         increasing the administrative fine; conforming

26         cross-references; amending s. 460.4165, F.S.;

27         revising requirements for certification of

28         chiropractic physician's assistants; providing

29         for supervision of registered chiropractic

30         physician's assistants; providing for biennial

31         renewal; providing fees; providing


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                                       CS/HB 1467, First Engrossed



  1         applicability to current certificateholders;

  2         amending s. 460.4166, F.S.; authorizing

  3         registered chiropractic assistants to be under

  4         the direct supervision of a certified

  5         chiropractic physician's assistant; amending s.

  6         461.003, F.S.; defining the term "certified

  7         podiatric X-ray assistant" and the term "direct

  8         supervision" with respect thereto; redefining

  9         the term "practice of podiatric medicine";

10         amending s. 461.006, F.S.; revising the

11         residency requirement to practice podiatric

12         medicine; amending s. 461.007, F.S.; revising

13         requirements for renewal of license to practice

14         podiatric medicine; revising requirements for

15         submitting fingerprints to the department for

16         renewal of licensure; amending s. 461.013,

17         F.S.; revising and providing grounds for

18         discipline; providing penalties; creating s.

19         461.0135, F.S.; providing requirements for

20         operation of X-ray machines by certified

21         podiatric X-ray assistants; amending s.

22         464.008, F.S.; providing for remediation upon

23         failure to pass the examination to practice

24         nursing a specified number of times; amending

25         s. 464.022, F.S.; providing an exemption from

26         regulation relating to remedial courses;

27         amending s. 465.003, F.S.; defining the term

28         "data communication device"; revising the

29         definition of the term "practice of the

30         profession of pharmacy"; amending s.  465.016,

31         F.S.; authorizing the redispensing of unused or


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                                       CS/HB 1467, First Engrossed



  1         returned unit-dose medication by correctional

  2         facilities under certain conditions; providing

  3         a ground for which a pharmacist may be subject

  4         to discipline by the Board of Pharmacy;

  5         increasing the administrative fine; amending

  6         ss. 465.014, 465.015, 465.0196, 468.812,

  7         499.003, F.S.; correcting cross-references, to

  8         conform; creating the Task Force for the Study

  9         of Collaborative Drug Therapy Management;

10         providing for staff support from the

11         department; providing for participation by

12         specified associations and entities; providing

13         responsibilities; requiring a report to the

14         Legislature; amending s. 466.021, F.S.;

15         revising requirements relating to dental work

16         orders required of unlicensed persons; amending

17         s. 468.1155, F.S.; revising requirements for

18         provisional licensure to practice

19         speech-language pathology or audiology;

20         amending s. 468.1215, F.S.; revising

21         requirements for certification as a

22         speech-language pathologist or audiologist

23         assistant; amending s. 468.307, F.S.;

24         authorizing the issuance of subcategory

25         certificates in the field of radiologic

26         technology; amending s. 468.506, F.S.;

27         correcting references; amending s. 468.701,

28         F.S.; revising and removing definitions;

29         amending s. 468.703, F.S.; replacing the

30         Council of Athletic Training with a Board of

31         Athletic Training; providing for appointment of


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                                       CS/HB 1467, First Engrossed



  1         board members and their successors; providing

  2         for staggering of terms; providing for

  3         applicability of other provisions of law

  4         relating to activities of regulatory boards;

  5         providing for the board's headquarters;

  6         amending ss. 468.705, 468.707, 468.709,

  7         468.711, 468.719, 468.721, F.S., relating to

  8         rulemaking authority, licensure by examination,

  9         fees, continuing education, disciplinary

10         actions, and certain regulatory transition;

11         transferring to the board certain duties of the

12         department relating to regulation of athletic

13         trainers; amending s. 20.43, F.S.; placing the

14         board under the Division of Medical Quality

15         Assurance of the department; providing for

16         termination of the council and the terms of

17         council members; authorizing consideration of

18         former council members for appointment to the

19         board; amending s. 468.805, F.S.; revising

20         grandfathering provisions for the practice of

21         orthotics, prosthetics, or pedorthics; amending

22         s. 468.806, F.S.; providing for approval of

23         continuing education providers; amending s.

24         478.42, F.S.; redefining the term "electrolysis

25         or electrology"; amending s. 483.041, F.S.,

26         redefining the terms "clinical laboratory" and

27         "licensed practitioner" and defining the term

28         "clinical laboratory examination"; amending s.

29         483.807, F.S.; 483.803, F.S.; redefining the

30         terms "clinical laboratory examination" and

31         "licensed practitioner of the healing arts";


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                                       CS/HB 1467, First Engrossed



  1         revising a reference; amending s. revising

  2         provisions relating to fees for approval as a

  3         laboratory training program; amending s.

  4         483.809, F.S.; revising requirements relating

  5         to examination of clinical laboratory personnel

  6         for licensure and to registration of clinical

  7         laboratory trainees; amending s. 483.812, F.S.;

  8         revising qualification requirements for

  9         licensure of public health laboratory

10         scientists; amending s. 483.813, F.S.;

11         eliminating a provision authorizing conditional

12         licensure of clinical laboratory personnel for

13         a specified period; amending s. 483.821, F.S.;

14         authorizing continuing education or retraining

15         for candidates who fail an examination a

16         specified number of times; amending s. 483.824,

17         F.S.; revising qualifications of clinical

18         laboratory directors; amending s. 483.825,

19         F.S.; revising and providing grounds for

20         discipline; providing penalties; amending s.

21         483.901, F.S.; correcting a reference;

22         eliminating a provision authorizing temporary

23         licensure as a medical physicist; correcting

24         the name of a trust fund; amending s. 484.007,

25         F.S.; revising requirements for opticians who

26         supervise apprentices; amending s. 484.0512,

27         F.S.; requiring sellers of hearing aids to

28         refund within a specified period all moneys

29         required to be refunded under trial-period

30         provisions; amending s. 484.053, F.S.;

31         increasing the penalty applicable to prohibited


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                                       CS/HB 1467, First Engrossed



  1         acts relating to the dispensing of hearing

  2         aids; amending s. 484.056, F.S.; providing that

  3         violation of trial-period requirements is a

  4         ground for disciplinary action; providing

  5         penalties; amending ss. 486.041, 486.081,

  6         486.103, and 486.107, F.S.; eliminating

  7         provisions authorizing issuance of a temporary

  8         permit to work as a physical therapist or

  9         physical therapist assistant; amending s.

10         490.005, F.S.; revising educational

11         requirements for licensure as a psychologist by

12         examination; changing a date, to defer certain

13         educational requirements; amending s. 490.006,

14         F.S.; providing additional requirements for

15         licensure as a psychologist by endorsement;

16         amending s. 490.0085, F.S.; correcting the name

17         of a trust fund; amending s. 490.0148, F.S.;

18         authorizing release of a patient's

19         psychological record to certain persons

20         pursuant to workers' compensation provisions;

21         amending s. 491.0045, F.S.; revising

22         requirements for registration as a clinical

23         social worker intern, marriage and family

24         therapist intern, or mental health counselor

25         intern; amending s. 491.0046, F.S.; revising

26         requirements for provisional licensure of

27         clinical social workers, marriage and family

28         therapists, and mental health counselors;

29         amending s. 491.005, F.S.; revising

30         requirements for licensure of clinical social

31         workers, marriage and family therapists, and


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                                       CS/HB 1467, First Engrossed



  1         mental health counselors; providing for

  2         certification of education of interns;

  3         providing rulemaking authority to implement

  4         education and experience requirements for

  5         licensure as a clinical social worker, marriage

  6         and family therapist, or mental health

  7         counselor; revising future licensure

  8         requirements for mental health counselors and

  9         providing rulemaking authority for

10         implementation thereof; amending s. 491.006,

11         F.S.; revising requirements for licensure or

12         certification by endorsement; amending s.

13         491.0085, F.S.; requiring laws and rules

14         courses and providing for approval thereof,

15         including providers and programs; correcting

16         the name of a trust fund; amending s. 491.014,

17         F.S.; revising an exemption from regulation

18         relating to certain temporally limited

19         services; amending s. 499.012, F.S.; redefining

20         the term "wholesale distribution," relating to

21         the distribution of prescription drugs, to

22         provide for the exclusion of certain

23         activities; amending ss. 626.883, 641.316,

24         F.S.; requiring payments to a health care

25         provider by a fiscal intermediary to include an

26         explanation of services provided; creating a

27         Task Force on Telehealth; providing its duties;

28         requiring a report; amending s. 468.352, F.S.;

29         redefining the term "board"; amending s.

30         468.353, F.S.; conforming provision; providing

31         for the adoption of rules; amending s. 468.354,


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                                       CS/HB 1467, First Engrossed



  1         F.S.; creating the Board of Respiratory Care;

  2         providing for membership, powers, and duties;

  3         amending s. 468.355, F.S.; providing for

  4         periodic rather than annual review of certain

  5         examinations and standards; amending s.

  6         458.357, F.S.; conforming provisions; deleting

  7         obsolete provisions; amending s. 468.364, F.S.;

  8         deleting an examination fee; amending s.

  9         468.365, F.S.; conforming provisions; amending

10         s. 464.016, F.S., providing that the use of the

11         title "nurse" without being licensed or

12         certified is a crime; providing for a detailed

13         study and analysis of clinical laboratory

14         services for kidney dialysis patients; amending

15         s. 455.651, F.S.; providing for treble damages,

16         reasonable attorney fees, and costs for

17         improper disclosure of confidential

18         information; providing effective dates.

19

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

21

22         Section 1.  (1)  The Division of Children's Medical

23  Services of the Department of Health shall contract with a

24  private nonprofit provider affiliated with a teaching hospital

25  to conduct clinical trials, approved by a federally-sanctioned

26  institutional review board within the teaching hospital, on

27  the use of the drug Secretin to treat autism.

28         (2)  The private nonprofit provider shall report its

29  findings to the Division of Children's Medical Services, the

30  President of the Senate, the Speaker of the House of

31  Representatives, and other appropriate bodies.


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                                       CS/HB 1467, First Engrossed



  1         Section 2.  The sum of $50,000 is appropriated to the

  2  Division of Children's Medical Services of the Department of

  3  Health from the General Revenue Fund for the purpose of

  4  implementing this act.

  5         Section 3.    Paragraph (b) of subsection (3) of

  6  section 232.435, Florida Statutes, is amended to read:

  7         232.435  Extracurricular athletic activities; athletic

  8  trainers.--

  9         (3)

10         (b)  If a school district uses the services of an

11  athletic trainer who is not a teacher athletic trainer or a

12  teacher apprentice trainer within the requirements of this

13  section, such athletic trainer must be licensed as required by

14  part XIII XIV of chapter 468.

15         Section 4.  Subsection (2) of section 381.026, Florida

16  Statutes, 1998 Supplement, is amended to read:

17         381.026  Florida Patient's Bill of Rights and

18  Responsibilities.--

19         (2)  DEFINITIONS.--As used in this section and s.

20  381.0261, the term:

21         (a)  "Department" means the Department of Health.

22         (b)(a)  "Health care facility" means a facility

23  licensed under chapter 395.

24         (c)(b)  "Health care provider" means a physician

25  licensed under chapter 458, an osteopathic physician licensed

26  under chapter 459, or a podiatric physician licensed under

27  chapter 461.

28         (d)(c)  "Responsible provider" means a health care

29  provider who is primarily responsible for patient care in a

30  health care facility or provider's office.

31


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                                       CS/HB 1467, First Engrossed



  1         Section 5.  Subsection (4) of section 381.0261, Florida

  2  Statutes, 1998 Supplement, is amended to read:

  3         381.0261  Summary of patient's bill of rights;

  4  distribution; penalty.--

  5         (4)(a)  An administrative fine may be imposed by the

  6  Agency for Health Care Administration when any health care

  7  provider or health care facility fails to make available to

  8  patients a summary of their rights, pursuant to s. 381.026 and

  9  this section. Initial nonwillful violations shall be subject

10  to corrective action and shall not be subject to an

11  administrative fine. The Agency for Health Care Administration

12  may levy a fine against a health care facility of up to $5,000

13  for nonwillful violations, and up to $25,000 for intentional

14  and willful violations. Each intentional and willful violation

15  constitutes a separate violation and is subject to a separate

16  fine.

17         (b)  An administrative fine may be imposed by the

18  appropriate regulatory board, or the department if there is no

19  board, when any health care provider fails to make available

20  to patients a summary of their rights, pursuant to s. 381.026

21  and this section. Initial nonwillful violations shall be

22  subject to corrective action and shall not be subject to an

23  administrative fine. The appropriate regulatory board or

24  department agency may levy a fine against a health care

25  provider of up to $100 for nonwillful violations and up to

26  $500 for willful violations. Each intentional and willful

27  violation constitutes a separate violation and is subject to a

28  separate fine.

29         Section 6.  Subsections (4) and (6) of section 455.501,

30  Florida Statutes, are amended to read:

31         455.501  Definitions.--As used in this part, the term:


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                                       CS/HB 1467, First Engrossed



  1         (4)  "Health care practitioner" means any person

  2  licensed under s. 400.211; chapter 457; chapter 458; chapter

  3  459; chapter 460; chapter 461; chapter 462; chapter 463;

  4  chapter 464; chapter 465; chapter 466; chapter 467; part I,

  5  part II, part III, part V, or part X, part XIII, or part XIV

  6  of chapter 468; chapter 478; chapter 480; part III or part IV

  7  of chapter 483; chapter 484; chapter 486; chapter 490; or

  8  chapter 491.

  9         (6)  "Licensee" means any person or entity issued a

10  permit, registration, certificate, or license by the

11  department.

12         Section 7.  Section 455.507, Florida Statutes, is

13  amended to read:

14         455.507  Members of Armed Forces in good standing with

15  administrative boards or department.--

16         (1)  Any member of the Armed Forces of the United

17  States now or hereafter on active duty who, at the time of his

18  becoming such a member, was in good standing with any

19  administrative board of the state, or the department when

20  there is no board, and was entitled to practice or engage in

21  his or her profession or vocation in the state shall be kept

22  in good standing by such administrative board, or the

23  department when there is no board, without registering, paying

24  dues or fees, or performing any other act on his or her part

25  to be performed, as long as he or she is a member of the Armed

26  Forces of the United States on active duty and for a period of

27  6 months after his discharge from active duty as a member of

28  the Armed Forces of the United States, provided he or she is

29  not engaged in his or her licensed profession or vocation in

30  the private sector for profit.

31


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                                       CS/HB 1467, First Engrossed



  1         (2)  The boards listed in s. ss. 20.165 and 20.43, or

  2  the department when there is no board, shall adopt rules

  3  exempting the spouses of members of the Armed Forces of the

  4  United States from licensure renewal provisions, but only in

  5  cases of absence from the state because of their spouses'

  6  duties with the Armed Forces.

  7         Section 8.  Section 455.521, Florida Statutes, 1998

  8  Supplement, is amended to read:

  9         455.521  Department; powers and duties.--The

10  department, for the professions boards under its jurisdiction,

11  shall:

12         (1)  Adopt rules establishing a procedure for the

13  biennial renewal of licenses; however, the department may

14  issue up to a 4-year license to selected licensees

15  notwithstanding any other provisions of law to the contrary.

16  Fees for such renewal shall not exceed the fee caps for

17  individual professions on an annualized basis as authorized by

18  law.

19         (2)  Appoint the executive director of each board,

20  subject to the approval of the board.

21         (3)  Submit an annual budget to the Legislature at a

22  time and in the manner provided by law.

23         (4)  Develop a training program for persons newly

24  appointed to membership on any board. The program shall

25  familiarize such persons with the substantive and procedural

26  laws and rules and fiscal information relating to the

27  regulation of the appropriate profession and with the

28  structure of the department.

29         (5)  Adopt rules pursuant to ss. 120.536(1) and 120.54

30  to implement the provisions of this part.

31


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                                       CS/HB 1467, First Engrossed



  1         (6)  Establish by rules procedures by which the

  2  department shall use the expert or technical advice of the

  3  appropriate board for the purposes of investigation,

  4  inspection, evaluation of applications, other duties of the

  5  department, or any other areas the department may deem

  6  appropriate.

  7         (7)  Require all proceedings of any board or panel

  8  thereof and all formal or informal proceedings conducted by

  9  the department, an administrative law judge, or a hearing

10  officer with respect to licensing or discipline to be

11  electronically recorded in a manner sufficient to assure the

12  accurate transcription of all matters so recorded.

13         (8)  Select only those investigators, or consultants

14  who undertake investigations, who meet criteria established

15  with the advice of the respective boards.

16         (9)  Allow applicants for new or renewal licenses and

17  current licensees to be screened by the Title IV-D child

18  support agency pursuant to s. 409.2598 to assure compliance

19  with a support obligation. The purpose of this subsection is

20  to promote the public policy of this state as established in

21  s. 409.2551. The department shall, when directed by the court,

22  suspend or deny the license of any licensee found to have a

23  delinquent support obligation. The department shall issue or

24  reinstate the license without additional charge to the

25  licensee when notified by the court that the licensee has

26  complied with the terms of the court order. The department

27  shall not be held liable for any license denial or suspension

28  resulting from the discharge of its duties under this

29  subsection.

30         Section 9.

31


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                                       CS/HB 1467, First Engrossed



  1         Section 10.  Paragraph (k) of subsection (2) of section

  2  455.557, Florida Statutes, 1998 Supplement, is amended to

  3  read:

  4         455.557  Standardized credentialing for health care

  5  practitioners.--

  6         (2)  DEFINITIONS.--As used in this section, the term:

  7         (k)  "Health care practitioner" means any person

  8  licensed, or, for credentialing purposes only, any person

  9  applying for licensure, under chapter 458, chapter 459,

10  chapter 460, or chapter 461 or any person licensed under a

11  chapter subsequently made subject to this section by the

12  department with the approval of the applicable board, except a

13  person registered or applying for registration pursuant to s.

14  458.345 or 459.021.

15         Section 11.  Subsections (1), (2), (6), (7), (8), and

16  (9) of section 455.564, Florida Statutes, 1998 Supplement, are

17  amended to read:

18         455.564  Department; general licensing provisions.--

19         (1)  Any person desiring to be licensed in a profession

20  within the jurisdiction of the department shall apply to the

21  department in writing to take the licensure examination.  The

22  application shall be made on a form prepared and furnished by

23  the department and shall require the social security number of

24  the applicant.  The form shall be supplemented as needed to

25  reflect any material change in any circumstance or condition

26  stated in the application which takes place between the

27  initial filing of the application and the final grant or

28  denial of the license and which might affect the decision of

29  the department. An incomplete application shall expire 1 year

30  after initial filing. In order to further the economic

31  development goals of the state, and notwithstanding any law to


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                                       CS/HB 1467, First Engrossed



  1  the contrary, the department may enter into an agreement with

  2  the county tax collector for the purpose of appointing the

  3  county tax collector as the department's agent to accept

  4  applications for licenses and applications for renewals of

  5  licenses. The agreement must specify the time within which the

  6  tax collector must forward any applications and accompanying

  7  application fees to the department.

  8         (2)  Before the issuance of any license, the department

  9  may charge an initial license fee as determined by rule of the

10  applicable board or, if no such board exists, by rule of the

11  department.  Upon receipt of the appropriate license fee, the

12  department shall issue a license to any person certified by

13  the appropriate board, or its designee, as having met the

14  licensure requirements imposed by law or rule. The license

15  licensee shall consist of be issued a wallet-size

16  identification card and a wall card measuring 6 1/2 inches by

17  5 inches. In addition to the two-part license, the department,

18  at the time of initial licensure, shall issue a wall

19  certificate suitable for conspicuous display, which shall be

20  no smaller than 8 1/2  inches by 14 inches. The licensee shall

21  surrender to the department the wallet-size identification

22  card, the wall card, and the wall certificate, if one has been

23  issued by the department, if the licensee's license is

24  suspended or revoked. The department shall promptly return the

25  wallet-size identification card and the wall certificate to

26  the licensee upon reinstatement of a suspended or revoked

27  license.

28         (6)  As a condition of renewal of a license, the Board

29  of Medicine, the Board of Osteopathic Medicine, the Board of

30  Chiropractic Medicine, and the Board of Podiatric Medicine

31  shall each require licensees which they respectively regulate


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                                       CS/HB 1467, First Engrossed



  1  to periodically demonstrate their professional competency by

  2  completing at least 40 hours of continuing education every 2

  3  years, which may include up to 1 hour of risk management or

  4  cost containment and up to 2 hours of other topics related to

  5  the applicable medical specialty, if required by board rule.

  6  The boards may require by rule that up to 1 hour of the

  7  required 40 or more hours be in the area of risk management or

  8  cost containment. This provision shall not be construed to

  9  limit the number of hours that a licensee may obtain in risk

10  management or cost containment to be credited toward

11  satisfying the 40 or more required hours. This provision shall

12  not be construed to require the boards to impose any

13  requirement on licensees except for the completion of at least

14  40 hours of continuing education every 2 years. Each of such

15  boards shall determine whether any specific continuing

16  education course requirements not otherwise mandated by law

17  shall be mandated and shall approve criteria for, and the

18  content of, any continuing education course mandated by such

19  board. Notwithstanding any other provision of law, the board,

20  or the department when there is no board, may approve by rule

21  alternative methods of obtaining continuing education credits

22  in risk management. The alternative methods may include

23  attending a board meeting at which another a licensee is

24  disciplined, serving as a volunteer expert witness for the

25  department in a disciplinary case, or serving as a member of a

26  probable cause panel following the expiration of a board

27  member's term. Other boards within the Division of Medical

28  Quality Assurance, or the department if there is no board, may

29  adopt rules granting continuing education hours in risk

30  management for attending a board meeting at which another

31  licensee is disciplined, serving as a volunteer expert witness


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                                       CS/HB 1467, First Engrossed



  1  for the department in a disciplinary case, or serving as a

  2  member of a probable cause panel following the expiration of a

  3  board member's term.

  4         (7)  The respective boards within the jurisdiction of

  5  the department, or the department when there is no board, may

  6  adopt rules to provide for the use of approved videocassette

  7  courses, not to exceed 5 hours per subject, to fulfill the

  8  continuing education requirements of the professions they

  9  regulate. Such rules shall provide for prior board approval of

10  the board, or the department when there is no board, of the

11  criteria for and content of such courses and shall provide for

12  a videocassette course validation form to be signed by the

13  vendor and the licensee and submitted to the department, along

14  with the license renewal application, for continuing education

15  credit.

16         (8)  Any board that currently requires continuing

17  education for renewal of a license, or the department if there

18  is no board, shall adopt rules to establish the criteria for

19  continuing education courses.  The rules may provide that up

20  to a maximum of 25 percent of the required continuing

21  education hours can be fulfilled by the performance of pro

22  bono services to the indigent or to underserved populations or

23  in areas of critical need within the state where the licensee

24  practices. The board, or the department if there is no board,

25  must require that any pro bono services be approved in advance

26  in order to receive credit for continuing education under this

27  subsection. The standard for determining indigency shall be

28  that recognized by the Federal Poverty Income Guidelines

29  produced by the United States Department of Health and Human

30  Services.  The rules may provide for approval by the board, or

31  the department if there is no board, that a part of the


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                                       CS/HB 1467, First Engrossed



  1  continuing education hours can be fulfilled by performing

  2  research in critical need areas or for training leading to

  3  advanced professional certification.  The board, or the

  4  department if there is no board, may make rules to define

  5  underserved and critical need areas.  The department shall

  6  adopt rules for administering continuing education

  7  requirements adopted by the boards or the department if there

  8  is no board.

  9         (9)  Notwithstanding any law to the contrary, an

10  elected official who is licensed under a practice act

11  administered by the Division of Medical Health Quality

12  Assurance may hold employment for compensation with any public

13  agency concurrent with such public service.  Such dual service

14  must be disclosed according to any disclosure required by

15  applicable law.

16         Section 12.  Subsections (1) and (4) of section

17  455.565, Florida Statutes, 1998 Supplement, are amended to

18  read:

19         455.565  Designated health care professionals;

20  information required for licensure.--

21         (1)  Each person who applies for initial licensure as a

22  physician under chapter 458, chapter 459, chapter 460, or

23  chapter 461, except a person applying for registration

24  pursuant to s. 458.345 or s. 459.021, must, at the time of

25  application, and each physician who applies for license

26  renewal under chapter 458, chapter 459, chapter 460, or

27  chapter 461, except a person registered pursuant to s. 458.345

28  or s. 459.021, must, in conjunction with the renewal of such

29  license and under procedures adopted by the Department of

30  Health, and in addition to any other information that may be

31


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                                       CS/HB 1467, First Engrossed



  1  required from the applicant, furnish the following information

  2  to the Department of Health:

  3         (a)1.  The name of each medical school that the

  4  applicant has attended, with the dates of attendance and the

  5  date of graduation, and a description of all graduate medical

  6  education completed by the applicant, excluding any coursework

  7  taken to satisfy medical licensure continuing education

  8  requirements.

  9         2.  The name of each hospital at which the applicant

10  has privileges.

11         3.  The address at which the applicant will primarily

12  conduct his or her practice.

13         4.  Any certification that the applicant has received

14  from a specialty board that is recognized by the board to

15  which the applicant is applying.

16         5.  The year that the applicant began practicing

17  medicine in any jurisdiction.

18         6.  Any appointment to the faculty of a medical school

19  which the applicant currently holds and an indication as to

20  whether the applicant has had the responsibility for graduate

21  medical education within the most recent 10 years.

22         7.  A description of any criminal offense of which the

23  applicant has been found guilty, regardless of whether

24  adjudication of guilt was withheld, or to which the applicant

25  has pled guilty or nolo contendere.  A criminal offense

26  committed in another jurisdiction which would have been a

27  felony or misdemeanor if committed in this state must be

28  reported. If the applicant indicates that a criminal offense

29  is under appeal and submits a copy of the notice for appeal of

30  that criminal offense, the department must state that the

31  criminal offense is under appeal if the criminal offense is


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                                       CS/HB 1467, First Engrossed



  1  reported in the applicant's profile. If the applicant

  2  indicates to the department that a criminal offense is under

  3  appeal, the applicant must, upon disposition of the appeal,

  4  submit to the department a copy of the final written order of

  5  disposition.

  6         8.  A description of any final disciplinary action

  7  taken within the previous 10 years against the applicant by

  8  the agency regulating the profession that the applicant is or

  9  has been licensed to practice, whether in this state or in any

10  other jurisdiction, by a specialty board that is recognized by

11  the American Board of Medical Specialities, the American

12  Osteopathic Association, or a similar national organization,

13  or by a licensed hospital, health maintenance organization,

14  prepaid health clinic, ambulatory surgical center, or nursing

15  home.  Disciplinary action includes resignation from or

16  nonrenewal of medical staff membership or the restriction of

17  privileges at a licensed hospital, health maintenance

18  organization, prepaid health clinic, ambulatory surgical

19  center, or nursing home taken in lieu of or in settlement of a

20  pending disciplinary case related to competence or character.

21  If the applicant indicates that the disciplinary action is

22  under appeal and submits a copy of the document initiating an

23  appeal of the disciplinary action, the department must state

24  that the disciplinary action is under appeal if the

25  disciplinary action is reported in the applicant's profile.

26         (b)  In addition to the information required under

27  paragraph (a), each applicant who seeks licensure under

28  chapter 458, chapter 459, or chapter 461, and who has

29  practiced previously in this state or in another jurisdiction

30  or a foreign country must provide the information required of

31  licensees under those chapters pursuant to s. 455.697.  An


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                                       CS/HB 1467, First Engrossed



  1  applicant for licensure under chapter 460 who has practiced

  2  previously in this state or in another jurisdiction or a

  3  foreign country must provide the same information as is

  4  required of licensees under chapter 458, pursuant to s.

  5  455.697.

  6         (4)(a)  An applicant for initial licensure must submit

  7  a set of fingerprints to the Department of Health in

  8  accordance with s. 458.311, s. 458.3115, s. 458.3124, s.

  9  458.313, s. 459.0055, s. 460.406, or s. 461.006.

10         (b)  An applicant for renewed licensure who received an

11  initial license in this state after January 1, 1992, must

12  submit a set of fingerprints for the initial renewal of his or

13  her license after January 1, 2000, to the agency regulating

14  that profession in accordance with procedures established

15  under s. 458.319, s. 459.008, s. 460.407, or s. 461.007.

16         (c)  The Department of Health shall submit the

17  fingerprints provided by an applicant for initial licensure to

18  the Florida Department of Law Enforcement for a statewide

19  criminal history check, and the Florida Department of Law

20  Enforcement shall forward the fingerprints to the Federal

21  Bureau of Investigation for a national criminal history check

22  of the applicant. The department shall submit the fingerprints

23  provided by an applicant for a renewed license who received an

24  initial license in this state after January 1, 1992, to the

25  Florida Department of Law Enforcement for a statewide criminal

26  history check, and the Florida Department of Law Enforcement

27  shall forward the fingerprints to the Federal Bureau of

28  Investigation for a national criminal history check for the

29  initial renewal of the applicant's license after January 1,

30  2000.; For any subsequent renewal of the applicant's license

31  and of any applicant who received an initial license in this


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                                       CS/HB 1467, First Engrossed



  1  state on or before January 1, 1992, the department shall

  2  submit the required information for a statewide criminal

  3  history check of the applicant.

  4         Section 13.  Present subsections (5), (6), and (7) of

  5  section 455.5651, Florida Statutes, 1998 Supplement, are

  6  renumbered as subsections (6), (7), and (8), respectively, and

  7  a new subsection (5) is added to that section, to read:

  8         455.5651  Practitioner profile; creation.--

  9         (5)  The Department of Health may not include

10  disciplinary action taken by a licensed hospital or an

11  ambulatory surgical center in the practitioner profile.

12         Section 14.  Section 455.567, Florida Statutes, is

13  amended to read:

14         455.567  Sexual misconduct; disqualification for

15  license, certificate, or registration.--

16         (1)  Sexual misconduct in the practice of a health care

17  profession means violation of the professional relationship

18  through which the health care practitioner uses such

19  relationship to engage or attempt to engage the patient or

20  client, or an immediate family member of the patient or client

21  in, or to induce or attempt to induce such person to engage

22  in, verbal or physical sexual activity outside the scope of

23  the professional practice of such health care profession.

24  Sexual misconduct in the practice of a health care profession

25  is prohibited.

26         (2)  Each board within the jurisdiction of the

27  department, or the department if there is no board, shall

28  refuse to admit a candidate to any examination and refuse to

29  issue a license, certificate, or registration to any applicant

30  if the candidate or applicant has:

31


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                                       CS/HB 1467, First Engrossed



  1         (a)(1)  Had any license, certificate, or registration

  2  to practice any profession or occupation revoked or

  3  surrendered based on a violation of sexual misconduct in the

  4  practice of that profession under the laws of any other state

  5  or any territory or possession of the United States and has

  6  not had that license, certificate, or registration reinstated

  7  by the licensing authority of the jurisdiction that revoked

  8  the license, certificate, or registration; or

  9         (b)(2)  Committed any act in any other state or any

10  territory or possession of the United States which if

11  committed in this state would constitute sexual misconduct.

12

13  For purposes of this subsection, a licensing authority's

14  acceptance of a candidate's relinquishment of a license which

15  is offered in response to or in anticipation of the filing of

16  administrative charges against the candidate's license

17  constitutes the surrender of the license.

18         Section 15.  Subsection (2) of section 455.574, Florida

19  Statutes, 1998 Supplement, is amended to read:

20         455.574  Department of Health; examinations.--

21         (2)  For each examination developed by the department

22  or a contracted vendor, the board, or the department when

23  there is no board, shall adopt rules providing for

24  reexamination of any applicants who failed an examination

25  developed by the department or a contracted vendor. If both a

26  written and a practical examination are given, an applicant

27  shall be required to retake only the portion of the

28  examination on which the applicant failed to achieve a passing

29  grade, if the applicant successfully passes that portion

30  within a reasonable time, as determined by rule of the board,

31  or the department when there is no board, of passing the other


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                                       CS/HB 1467, First Engrossed



  1  portion. Except for national examinations approved and

  2  administered pursuant to this section, the department shall

  3  provide procedures for applicants who fail an examination

  4  developed by the department or a contracted vendor to review

  5  their examination questions, answers, papers, grades, and

  6  grading key for the questions the candidate answered

  7  incorrectly or, if not feasible, the parts of the examination

  8  failed. Applicants shall bear the actual cost for the

  9  department to provide examination review pursuant to this

10  subsection. An applicant may waive in writing the

11  confidentiality of the applicant's examination grades.

12         Section 16.  Subsection (1) of section 455.587, Florida

13  Statutes, is amended, present subsections (2) through (7) are

14  renumbered as subsections (3) through (8), respectively, and a

15  new subsection (2) is added to that section, to read:

16         455.587  Fees; receipts; disposition for boards within

17  the department.--

18         (1)  Each board within the jurisdiction of the

19  department, or the department when there is no board, shall

20  determine by rule the amount of license fees for the its

21  profession it regulates, based upon long-range estimates

22  prepared by the department of the revenue required to

23  implement laws relating to the regulation of professions by

24  the department and the board.  Each board, or the department

25  if there is no board, shall ensure that license fees are

26  adequate to cover all anticipated costs and to maintain a

27  reasonable cash balance, as determined by rule of the agency,

28  with advice of the applicable board. If sufficient action is

29  not taken by a board within 1 year after notification by the

30  department that license fees are projected to be inadequate,

31  the department shall set license fees on behalf of the


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                                       CS/HB 1467, First Engrossed



  1  applicable board to cover anticipated costs and to maintain

  2  the required cash balance. The department shall include

  3  recommended fee cap increases in its annual report to the

  4  Legislature.  Further, it is the legislative intent that no

  5  regulated profession operate with a negative cash balance. The

  6  department may provide by rule for advancing sufficient funds

  7  to any profession operating with a negative cash balance. The

  8  advancement may be for a period not to exceed 2 consecutive

  9  years, and the regulated profession must pay interest.

10  Interest shall be calculated at the current rate earned on

11  investments of a trust fund used by the department to

12  implement this part. Interest earned shall be allocated to the

13  various funds in accordance with the allocation of investment

14  earnings during the period of the advance.

15         (2)  Each board, or the department if there is no

16  board, may charge a fee not to exceed $25, as determined by

17  rule, for the issuance of a wall certificate pursuant to s.

18  455.564(2) requested by a licensee who was licensed prior to

19  July 1, 1998, or for the issuance of a duplicate wall

20  certificate requested by any licensee.

21         Section 17.  Subsections (1) and (6) of section

22  455.604, Florida Statutes, 1998 Supplement, are amended to

23  read:

24         455.604  Requirement for instruction for certain

25  licensees on human immunodeficiency virus and acquired immune

26  deficiency syndrome.--

27         (1)  The appropriate board shall require each person

28  licensed or certified under chapter 457; chapter 458; chapter

29  459; chapter 460; chapter 461; chapter 463; chapter 464;

30  chapter 465; chapter 466; part II, part III, or part V, or

31  part X of chapter 468; or chapter 486 to complete a continuing


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                                       CS/HB 1467, First Engrossed



  1  educational course, approved by the board, on human

  2  immunodeficiency virus and acquired immune deficiency syndrome

  3  as part of biennial relicensure or recertification. The course

  4  shall consist of education on the modes of transmission,

  5  infection control procedures, clinical management, and

  6  prevention of human immunodeficiency virus and acquired immune

  7  deficiency syndrome. Such course shall include information on

  8  current Florida law on acquired immune deficiency syndrome and

  9  its impact on testing, confidentiality of test results,

10  treatment of patients, and any protocols and procedures

11  applicable to human immunodeficiency virus counseling and

12  testing, reporting, the offering of HIV testing to pregnant

13  women, and partner notification issues pursuant to ss. 381.004

14  and 384.25.

15         (6)  The board shall require as a condition of granting

16  a license under the chapters and parts specified in subsection

17  (1) that an applicant making initial application for licensure

18  complete an educational course acceptable to the board on

19  human immunodeficiency virus and acquired immune deficiency

20  syndrome. An applicant who has not taken a course at the time

21  of licensure shall, upon an affidavit showing good cause, be

22  allowed 6 months to complete this requirement.

23         Section 18.  Subsection (1) of section 455.607, Florida

24  Statutes, is amended to read:

25         455.607  Athletic trainers and massage therapists;

26  requirement for instruction on human immunodeficiency virus

27  and acquired immune deficiency syndrome.--

28         (1)  The board, or the department where there is no

29  board, shall require each person licensed or certified under

30  part XIII XIV of chapter 468 or chapter 480 to complete a

31  continuing educational course approved by the board, or the


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                                       CS/HB 1467, First Engrossed



  1  department where there is no board, on human immunodeficiency

  2  virus and acquired immune deficiency syndrome as part of

  3  biennial relicensure or recertification.  The course shall

  4  consist of education on modes of transmission, infection

  5  control procedures, clinical management, and prevention of

  6  human immunodeficiency virus and acquired immune deficiency

  7  syndrome, with an emphasis on appropriate behavior and

  8  attitude change.

  9         Section 19.  Paragraphs (t), (u), (v), (w), and (x) are

10  added to subsection (1) of section 455.624, Florida Statutes,

11  subsection (2) of that section is amended, present subsection

12  (3) of that section is renumbered as subsection (4) and

13  amended, present subsections (4) and (5) of that subsection

14  are renumbered as subsections (5) and (6), respectively, and a

15  new subsection (3) is added to that section, to read:

16         455.624  Grounds for discipline; penalties;

17  enforcement.--

18         (1)  The following acts shall constitute grounds for

19  which the disciplinary actions specified in subsection (2) may

20  be taken:

21         (t)  Failing to comply with the requirements of ss.

22  381.026 and 381.0261 to provide patients with information

23  about their patient rights and how to file a patient

24  complaint.

25         (u)  Engaging or attempting to engage a patient or

26  client in verbal or physical sexual activity. For the purposes

27  of this section, a patient or client shall be presumed to be

28  incapable of giving free, full, and informed consent to verbal

29  or physical sexual activity.

30         (v)  Failing to comply with the requirements for

31  profiling and credentialing, including, but not limited to,


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                                       CS/HB 1467, First Engrossed



  1  failing to provide initial information, failing to timely

  2  provide updated information, or making misleading, untrue,

  3  deceptive, or fraudulent representations on a profile,

  4  credentialing, or initial or renewal licensure application.

  5         (w)  Failing to report to the board, or the department

  6  if there is no board, in writing within 30 days after the

  7  licensee has been convicted or found guilty of, or entered a

  8  plea of nolo contendere to, regardless of adjudication, a

  9  crime in any jurisdiction. Convictions, findings,

10  adjudications, and pleas entered into prior to the enactment

11  of this paragraph must be reported in writing to the board, or

12  department if there is no board, on or before October 1, 1999.

13         (x)  Using information about people involved in motor

14  vehicle accidents which has been derived from accident reports

15  made by law enforcement officers or persons involved in

16  accidents pursuant to s. 316.066, or using information

17  published in a newspaper or other news publication or through

18  a radio or television broadcast that has used information

19  gained from such reports, for the purposes of commercial or

20  any other solicitation whatsoever of the people involved in

21  such accidents.

22         (2)  When the board, or the department when there is no

23  board, finds any person guilty of the grounds set forth in

24  subsection (1) or of any grounds set forth in the applicable

25  practice act, including conduct constituting a substantial

26  violation of subsection (1) or a violation of the applicable

27  practice act which occurred prior to obtaining a license, it

28  may enter an order imposing one or more of the following

29  penalties:

30         (a)  Refusal to certify, or to certify with

31  restrictions, an application for a license.


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                                       CS/HB 1467, First Engrossed



  1         (b)  Suspension or permanent revocation of a license.

  2         (c)  Restriction of practice.

  3         (d)  Imposition of an administrative fine not to exceed

  4  $10,000 $5,000 for each count or separate offense.

  5         (e)  Issuance of a reprimand.

  6         (f)  Placement of the licensee on probation for a

  7  period of time and subject to such conditions as the board, or

  8  the department when there is no board, may specify. Those

  9  conditions may include, but are not limited to, requiring the

10  licensee to undergo treatment, attend continuing education

11  courses, submit to be reexamined, work under the supervision

12  of another licensee, or satisfy any terms which are reasonably

13  tailored to the violations found.

14         (g)  Corrective action.

15         (h)  Imposition of an administrative fine in accordance

16  with s. 381.0261 for violations regarding patient rights.

17

18  In determining what action is appropriate, the board, or

19  department when there is no board, must first consider what

20  sanctions are necessary to protect the public or to compensate

21  the patient. Only after those sanctions have been imposed may

22  the disciplining authority consider and include in the order

23  requirements designed to rehabilitate the practitioner. All

24  costs associated with compliance with orders issued under this

25  subsection are the obligation of the practitioner.

26         (3)  Notwithstanding subsection (2), if the ground for

27  disciplinary action is the first-time failure of the licensee

28  to satisfy continuing education requirements established by

29  the board, or by the department if there is no board, the

30  board or department, as applicable, shall issue a citation in

31  accordance with s. 455.617 and assess a fine, as determined by


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                                       CS/HB 1467, First Engrossed



  1  the board or department by rule. In addition, for each hour of

  2  continuing education not completed or completed late, the

  3  board or department, as applicable, may require the licensee

  4  to take 1 additional hour of continuing education for each

  5  hour not completed or completed late.

  6         (4)(3)  In addition to any other discipline imposed

  7  pursuant to this section or discipline imposed for a violation

  8  of any practice act, the board, or the department when there

  9  is no board, may assess costs related to the investigation and

10  prosecution of the case excluding costs associated with an

11  attorney's time. In any case where the board or the department

12  imposes a fine or assessment and the fine or assessment is not

13  paid within a reasonable time, such reasonable time to be

14  prescribed in the rules of the board, or the department when

15  there is no board, or in the order assessing such fines or

16  costs, the department or the Department of Legal Affairs may

17  contract for the collection of, or bring a civil action to

18  recover, the fine or assessment.

19         Section 20.  Section 455.664, Florida Statutes, is

20  amended to read:

21         455.664  Advertisement by a health care practitioner

22  provider of free or discounted services; required

23  statement.--In any advertisement for a free, discounted fee,

24  or reduced fee service, examination, or treatment by a health

25  care practitioner provider licensed under chapter 458, chapter

26  459, chapter 460, chapter 461, chapter 462, chapter 463,

27  chapter 464, chapter 465, chapter 466, chapter 467, chapter

28  478, chapter 483, chapter 484, or chapter 486, chapter 490, or

29  chapter 491, the following statement shall appear in capital

30  letters clearly distinguishable from the rest of the text:

31  THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A


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                                       CS/HB 1467, First Engrossed



  1  RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR

  2  PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT

  3  IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING

  4  TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED

  5  FEE SERVICE, EXAMINATION, OR TREATMENT. However, the required

  6  statement shall not be necessary as an accompaniment to an

  7  advertisement of a licensed health care practitioner provider

  8  defined by this section if the advertisement appears in a

  9  classified directory the primary purpose of which is to

10  provide products and services at free, reduced, or discounted

11  prices to consumers and in which the statement prominently

12  appears in at least one place.

13         Section 21.  Subsection (7) of section 455.667, Florida

14  Statutes, 1998 Supplement, is amended to read:

15         455.667  Ownership and control of patient records;

16  report or copies of records to be furnished.--

17         (7)(a)1.  The department may obtain patient records and

18  insurance information, if the complaint being investigated

19  alleges inadequate medical care based on termination of

20  insurance. The department may obtain patient access these

21  records pursuant to a subpoena without written authorization

22  from the patient if the department and the probable cause

23  panel of the appropriate board, if any, find reasonable cause

24  to believe that a health care practitioner has excessively or

25  inappropriately prescribed any controlled substance specified

26  in chapter 893 in violation of this part or any professional

27  practice act or that a health care practitioner has practiced

28  his or her profession below that level of care, skill, and

29  treatment required as defined by this part or any professional

30  practice act; provided, however, the and also find that

31


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                                       CS/HB 1467, First Engrossed



  1  appropriate, reasonable attempts were made to obtain a patient

  2  release.

  3         2.  The department may obtain patient records and

  4  insurance information pursuant to a subpoena without written

  5  authorization from the patient if the department and the

  6  probable cause panel of the appropriate board, if any, find

  7  reasonable cause to believe that a health care practitioner

  8  has provided inadequate medical care based on termination of

  9  insurance and also find that appropriate, reasonable attempts

10  were made to obtain a patient release.

11         3.  The department may obtain patient records, billing

12  records, insurance information, provider contracts, and all

13  attachments thereto pursuant to a subpoena without written

14  authorization from the patient if the department and probable

15  cause panel of the appropriate board, if any, find reasonable

16  cause to believe that a health care practitioner has submitted

17  a claim, statement, or bill using a billing code that would

18  result in payment greater in amount than would be paid using a

19  billing code that accurately describes the services performed,

20  requested payment for services that were not performed by that

21  health care practitioner, used information derived from a

22  written report of an automobile accident generated pursuant to

23  chapter 316 to solicit or obtain patients personally or

24  through an agent regardless of whether the information is

25  derived directly from the report or a summary of that report

26  or from another person, solicited patients fraudulently,

27  received a kickback as defined in s. 455.657, violated the

28  patient brokering provisions of s. 817.505, or presented or

29  caused to be presented a false or fraudulent insurance claim

30  within the meaning of s. 817.234(1)(a), and also find that,

31  within the meaning of s. 817.234(1)(a), patient authorization


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                                       CS/HB 1467, First Engrossed



  1  cannot be obtained because the patient cannot be located or is

  2  deceased, incapacitated, or suspected of being a participant

  3  in the fraud or scheme, and if the subpoena is issued for

  4  specific and relevant records.

  5         (b)  Patient records, billing records, insurance

  6  information, provider contracts, and all attachments thereto

  7  record obtained by the department pursuant to this subsection

  8  shall be used solely for the purpose of the department and the

  9  appropriate regulatory board in disciplinary proceedings. The

10  records shall otherwise be confidential and exempt from s.

11  119.07(1). This section does not limit the assertion of the

12  psychotherapist-patient privilege under s. 90.503 in regard to

13  records of treatment for mental or nervous disorders by a

14  medical practitioner licensed pursuant to chapter 458 or

15  chapter 459 who has primarily diagnosed and treated mental and

16  nervous disorders for a period of not less than 3 years,

17  inclusive of psychiatric residency. However, the health care

18  practitioner shall release records of treatment for medical

19  conditions even if the health care practitioner has also

20  treated the patient for mental or nervous disorders. If the

21  department has found reasonable cause under this section and

22  the psychotherapist-patient privilege is asserted, the

23  department may petition the circuit court for an in camera

24  review of the records by expert medical practitioners

25  appointed by the court to determine if the records or any part

26  thereof are protected under the psychotherapist-patient

27  privilege.

28         Section 22.   Subsection (16) of section 455.667,

29  Florida Statutes, is amended to read:

30         455.667  Ownership and control of patient records;

31  report or copies of records to be furnished.--


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                                       CS/HB 1467, First Engrossed



  1         (16)  A health care practitioner or records owner

  2  furnishing copies of reports or records or making the reports

  3  or records available for digital scanning pursuant to this

  4  section shall charge no more than the actual cost of copying,

  5  including reasonable staff time, or the amount specified in

  6  administrative rule by the appropriate board, or the

  7  department when there is no board.

  8         Section 23.  Subsection (3) is added to section

  9  455.687, Florida Statutes, to read:

10         455.687  Certain health care practitioners; immediate

11  suspension of license.--

12         (3)  The department may issue an emergency order

13  suspending or restricting the license of any health care

14  practitioner as defined in s. 455.501(4) who tests positive

15  for any drug on any government or private-sector preemployment

16  or employer-ordered confirmed drug test, as defined in s.

17  112.0455, when the practitioner does not have a lawful

18  prescription and legitimate medical reason for using such

19  drug. The practitioner shall be given 48 hours from the time

20  of notification to the practitioner of the confirmed test

21  result to produce a lawful prescription for the drug before an

22  emergency order is issued.

23         Section 24.  Section 455.694, Florida Statutes, 1998

24  Supplement, is amended to read:

25         455.694  Financial responsibility requirements for

26  Boards regulating certain health care practitioners.--

27         (1)  As a prerequisite for licensure or license

28  renewal, the Board of Acupuncture, the Board of Chiropractic

29  Medicine, the Board of Podiatric Medicine, and the Board of

30  Dentistry shall, by rule, require that all health care

31  practitioners licensed under the respective board, and the


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                                       CS/HB 1467, First Engrossed



  1  Board of Nursing shall, by rule, require that advanced

  2  registered nurse practitioners certified under s. 464.012, and

  3  the department shall, by rule, require that midwives maintain

  4  medical malpractice insurance or provide proof of financial

  5  responsibility in an amount and in a manner determined by the

  6  board or department to be sufficient to cover claims arising

  7  out of the rendering of or failure to render professional care

  8  and services in this state.

  9         (2)  The board or department may grant exemptions upon

10  application by practitioners meeting any of the following

11  criteria:

12         (a)  Any person licensed under chapter 457, chapter

13  460, chapter 461, s. 464.012, or chapter 466, or chapter 467

14  who practices exclusively as an officer, employee, or agent of

15  the Federal Government or of the state or its agencies or its

16  subdivisions.  For the purposes of this subsection, an agent

17  of the state, its agencies, or its subdivisions is a person

18  who is eligible for coverage under any self-insurance or

19  insurance program authorized by the provisions of s.

20  768.28(15) or who is a volunteer under s. 110.501(1).

21         (b)  Any person whose license or certification has

22  become inactive under chapter 457, chapter 460, chapter 461,

23  chapter 464, or chapter 466, or chapter 467 and who is not

24  practicing in this state.  Any person applying for

25  reactivation of a license must show either that such licensee

26  maintained tail insurance coverage which provided liability

27  coverage for incidents that occurred on or after October 1,

28  1993, or the initial date of licensure in this state,

29  whichever is later, and incidents that occurred before the

30  date on which the license became inactive; or such licensee

31  must submit an affidavit stating that such licensee has no


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                                       CS/HB 1467, First Engrossed



  1  unsatisfied medical malpractice judgments or settlements at

  2  the time of application for reactivation.

  3         (c)  Any person holding a limited license pursuant to

  4  s. 455.561, and practicing under the scope of such limited

  5  license.

  6         (d)  Any person licensed or certified under chapter

  7  457, chapter 460, chapter 461, s. 464.012, or chapter 466, or

  8  chapter 467 who practices only in conjunction with his or her

  9  teaching duties at an accredited school or in its main

10  teaching hospitals. Such person may engage in the practice of

11  medicine to the extent that such practice is incidental to and

12  a necessary part of duties in connection with the teaching

13  position in the school.

14         (e)  Any person holding an active license or

15  certification under chapter 457, chapter 460, chapter 461, s.

16  464.012, or chapter 466, or chapter 467 who is not practicing

17  in this state.  If such person initiates or resumes practice

18  in this state, he or she must notify the department of such

19  activity.

20         (f)  Any person who can demonstrate to the board or

21  department that he or she has no malpractice exposure in the

22  state.

23         (3)  Notwithstanding the provisions of this section,

24  the financial responsibility requirements of ss. 458.320 and

25  459.0085 shall continue to apply to practitioners licensed

26  under those chapters.

27         Section 25.  Section 455.712, Florida Statutes, is

28  created to read:

29         455.712  Business establishments; requirements for

30  active status licenses.--

31


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                                       CS/HB 1467, First Engrossed



  1         (1)  A business establishment regulated by the Division

  2  of Medical Quality Assurance pursuant to this part may provide

  3  regulated services only if the business establishment has an

  4  active status license. A business establishment that provides

  5  regulated services without an active status license is in

  6  violation of this section and s. 455.624, and the board, or

  7  the department if there is no board, may impose discipline on

  8  the business establishment.

  9         (2)  A business establishment must apply with a

10  complete application, as defined by rule of the board, or the

11  department if there is no board, to renew an active status

12  license before the license expires. If a business

13  establishment fails to renew before the license expires, the

14  license becomes delinquent, except as otherwise provided in

15  statute, in the license cycle following expiration.

16         (3)  A delinquent business establishment must apply

17  with a complete application, as defined by rule of the board,

18  or the department if there is no board, for active status

19  within 6 months after becoming delinquent. Failure of a

20  delinquent business establishment to renew the license within

21  the 6 months after the expiration date of the license renders

22  the license null without any further action by the board or

23  the department. Any subsequent licensure shall be as a result

24  of applying for and meeting all requirements imposed on a

25  business establishment for new licensure.

26         (4)  The status or a change in status of a business

27  establishment license does not alter in any way the right of

28  the board, or of the department if there is no board, to

29  impose discipline or to enforce discipline previously imposed

30  on a business establishment for acts or omissions committed by

31


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                                       CS/HB 1467, First Engrossed



  1  the business establishment while holding a license, whether

  2  active or null.

  3         (5)  This section applies to any a business

  4  establishment registered, permitted, or licensed by the

  5  department to do business. Business establishments include,

  6  but are not limited to, dental laboratories, electrology

  7  facilities, massage establishments, pharmacies, and health

  8  care services pools.

  9         Section 26.  Subsection (7) is added to section

10  457.102, Florida Statutes, 1998 Supplement, to read:

11         457.102  Definitions.--As used in this chapter:

12         (7)  "Prescriptive rights" means the prescription,

13  administration, and use of needles and devices, restricted

14  devices, and prescription devices that are used in the

15  practice of acupuncture and oriental medicine.

16         Section 27.  Subsections (2) and (4) of section

17  458.307, Florida Statutes, 1998 Supplement, are amended to

18  read:

19         458.307  Board of Medicine.--

20         (2)  Twelve members of the board must be licensed

21  physicians in good standing in this state who are residents of

22  the state and who have been engaged in the active practice or

23  teaching of medicine for at least 4 years immediately

24  preceding their appointment.  One of the physicians must be on

25  the full-time faculty of a medical school in this state, and

26  one of the physicians must be in private practice and on the

27  full-time staff of a statutory teaching hospital in this state

28  as defined in s. 408.07.  At least one of the physicians must

29  be a graduate of a foreign medical school.  The remaining

30  three members must be residents of the state who are not, and

31  never have been, licensed health care practitioners.  One


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                                       CS/HB 1467, First Engrossed



  1  member must be a health care hospital risk manager licensed

  2  certified under s. 395.10974 part IX of chapter 626.  At least

  3  one member of the board must be 60 years of age or older.

  4         (4)  The board, in conjunction with the department,

  5  shall establish a disciplinary training program for board

  6  members. The program shall provide for initial and periodic

  7  training in the grounds for disciplinary action, the actions

  8  which may be taken by the board and the department, changes in

  9  relevant statutes and rules, and any relevant judicial and

10  administrative decisions. After January 1, 1989, No member of

11  the board shall participate on probable cause panels or in

12  disciplinary decisions of the board unless he or she has

13  completed the disciplinary training program.

14         Section 28.  Subsection (3) is added to section

15  458.309, Florida Statutes, 1998 Supplement, to read:

16         458.309  Authority to make rules.--

17         (3)  All physicians which perform level 2 procedures

18  lasting more than 5 minutes and all level 3 surgical

19  procedures in an office setting must register the office with

20  the department unless that office is licensed as a facility

21  pursuant to chapter 395. Registration information shall not

22  include the specific type of surgery performed by the

23  physician. The department shall inspect the physician's office

24  annually unless the  office is accredited by a nationally

25  recognized accrediting agency  or an accrediting organzation

26  subsequently approved by the Board of Medicine. The actual

27  costs for registration and inspection or accrediatation shall

28  be paid by the person seeking to register and operate the

29  office setting in which office surgery is performed.

30         Section 29.  Section 458.311, Florida Statutes, 1998

31  Supplement, is amended to read:


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                                       CS/HB 1467, First Engrossed



  1         458.311  Licensure by examination; requirements;

  2  fees.--

  3         (1)  Any person desiring to be licensed as a physician,

  4  who does not hold a valid license in any state, shall apply to

  5  the department on forms furnished by the department to take

  6  the licensure examination. The department shall license

  7  examine each applicant who whom the board certifies:

  8         (a)  Has completed the application form and remitted a

  9  nonrefundable application fee not to exceed $500 and an

10  examination fee not to exceed $300 plus the actual per

11  applicant cost to the department for purchase of the

12  examination from the Federation of State Medical Boards of the

13  United States or a similar national organization, which is

14  refundable if the applicant is found to be ineligible to take

15  the examination.

16         (b)  Is at least 21 years of age.

17         (c)  Is of good moral character.

18         (d)  Has not committed any act or offense in this or

19  any other jurisdiction which would constitute the basis for

20  disciplining a physician pursuant to s. 458.331.

21         (e)  For any applicant who has graduated from medical

22  school after October 1, 1992, has completed the equivalent of

23  2 academic years of preprofessional, postsecondary education,

24  as determined by rule of the board, which shall include, at a

25  minimum, courses in such fields as anatomy, biology, and

26  chemistry prior to entering medical school.

27         (f)  Meets one of the following medical education and

28  postgraduate training requirements:

29         1.a.  Is a graduate of an allopathic medical school or

30  allopathic college recognized and approved by an accrediting

31  agency recognized by the United States Office of Education or


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                                       CS/HB 1467, First Engrossed



  1  is a graduate of an allopathic medical school or allopathic

  2  college within a territorial jurisdiction of the United States

  3  recognized by the accrediting agency of the governmental body

  4  of that jurisdiction;

  5         b.  If the language of instruction of the medical

  6  school is other than English, has demonstrated competency in

  7  English through presentation of a satisfactory grade on the

  8  Test of Spoken English of the Educational Testing Service or a

  9  similar test approved by rule of the board; and

10         c.  Has completed an approved residency of at least 1

11  year.

12         2.a.  Is a graduate of an allopathic a foreign medical

13  school registered with the World Health Organization and

14  certified pursuant to s. 458.314 as having met the standards

15  required to accredit medical schools in the United States or

16  reasonably comparable standards;

17         b.  If the language of instruction of the foreign

18  medical school is other than English, has demonstrated

19  competency in English through presentation of the Educational

20  Commission for Foreign Medical Graduates English proficiency

21  certificate or by a satisfactory grade on the Test of Spoken

22  English of the Educational Testing Service or a similar test

23  approved by rule of the board; and

24         c.  Has completed an approved residency of at least 1

25  year.

26         3.a.  Is a graduate of an allopathic a foreign medical

27  school which has not been certified pursuant to s. 458.314;

28         b.  Has had his or her medical credentials evaluated by

29  the Educational Commission for Foreign Medical Graduates,

30  holds an active, valid certificate issued by that commission,

31


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                                       CS/HB 1467, First Engrossed



  1  and has passed the examination utilized by that commission;

  2  and

  3         c.  Has completed an approved residency of at least 1

  4  year; however, after October 1, 1992, the applicant shall have

  5  completed an approved residency or fellowship of at least 2

  6  years in one specialty area.  However, to be acceptable, the

  7  fellowship experience and training must be counted toward

  8  regular or subspecialty certification by a board recognized

  9  and certified by the American Board of Medical Specialties.

10         (g)  Has submitted to the department a set of

11  fingerprints on a form and under procedures specified by the

12  department, along with a payment in an amount equal to the

13  costs incurred by the Department of Health for the criminal

14  background check of the applicant.

15         (h)  Has obtained a passing score, as established by

16  rule of the board, on the licensure examination of the United

17  States Medical Licensing Examination (USMLE); or a combination

18  of the United States Medical Licensing Examination (USMLE),

19  the examination of the Federation of State Medical Boards of

20  the United States, Inc. (FLEX), or the examination of the

21  National Board of Medical Examiners up to the year 2000; or

22  for the purpose of examination of any applicant who was

23  licensed on the basis of a state board examination and who is

24  currently licensed in at least one other jurisdiction of the

25  United States or Canada, and who has practiced pursuant to

26  such licensure for a period of at least 10 years, use of the

27  Special Purpose Examination of the Federation of State Medical

28  Boards of the United States (SPEX) upon receipt of a passing

29  score as established by rule of the board. However, for the

30  purpose of examination of any applicant who was licensed on

31  the basis of a state board examination prior to 1974, who is


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                                       CS/HB 1467, First Engrossed



  1  currently licensed in at least three other jurisdictions of

  2  the United States or Canada, and who has practiced pursuant to

  3  such licensure for a period of at least 20 years, this

  4  paragraph does not apply.

  5         (2)  As prescribed by board rule, the board may require

  6  an applicant who does not pass the national licensing

  7  examination after five attempts to complete additional

  8  remedial education or training.  The board shall prescribe the

  9  additional requirements in a manner that permits the applicant

10  to complete the requirements and be reexamined within 2 years

11  after the date the applicant petitions the board to retake the

12  examination a sixth or subsequent time.

13         (3)  Notwithstanding the provisions of subparagraph

14  (1)(f)3., a graduate of a foreign medical school need not

15  present the certificate issued by the Educational Commission

16  for Foreign Medical Graduates or pass the examination utilized

17  by that commission if the graduate:

18         (a)  Has received a bachelor's degree from an

19  accredited United States college or university.

20         (b)  Has studied at a medical school which is

21  recognized by the World Health Organization.

22         (c)  Has completed all of the formal requirements of

23  the foreign medical school, except the internship or social

24  service requirements, and has passed part I of the National

25  Board of Medical Examiners examination or the Educational

26  Commission for Foreign Medical Graduates examination

27  equivalent.

28         (d)  Has completed an academic year of supervised

29  clinical training in a hospital affiliated with a medical

30  school approved by the Council on Medical Education of the

31  American Medical Association and upon completion has passed


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                                       CS/HB 1467, First Engrossed



  1  part II of the National Board of Medical Examiners examination

  2  or the Educational Commission for Foreign Medical Graduates

  3  examination equivalent.

  4         (4)  The department and the board shall assure that

  5  applicants for licensure meet the criteria in subsection (1)

  6  through an investigative process.  When the investigative

  7  process is not completed within the time set out in s.

  8  120.60(1) and the department or board has reason to believe

  9  that the applicant does not meet the criteria, the secretary

10  or the secretary's designee may issue a 90-day licensure delay

11  which shall be in writing and sufficient to notify the

12  applicant of the reason for the delay.  The provisions of this

13  subsection shall control over any conflicting provisions of s.

14  120.60(1).

15         (5)  The board may not certify to the department for

16  licensure any applicant who is under investigation in another

17  jurisdiction for an offense which would constitute a violation

18  of this chapter until such investigation is completed. Upon

19  completion of the investigation, the provisions of s. 458.331

20  shall apply. Furthermore, the department may not issue an

21  unrestricted license to any individual who has committed any

22  act or offense in any jurisdiction which would constitute the

23  basis for disciplining a physician pursuant to s. 458.331.

24  When the board finds that an individual has committed an act

25  or offense in any jurisdiction which would constitute the

26  basis for disciplining a physician pursuant to s. 458.331,

27  then the board may enter an order imposing one or more of the

28  terms set forth in subsection (9).

29         (6)  Each applicant who passes the examination and

30  meets the requirements of this chapter shall be licensed as a

31  physician, with rights as defined by law.


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                                       CS/HB 1467, First Engrossed



  1         (7)  Upon certification by the board, the department

  2  shall impose conditions, limitations, or restrictions on a

  3  license by examination if the applicant is on probation in

  4  another jurisdiction for an act which would constitute a

  5  violation of this chapter.

  6         (8)  When the board determines that any applicant for

  7  licensure by examination has failed to meet, to the board's

  8  satisfaction, each of the appropriate requirements set forth

  9  in this section, it may enter an order requiring one or more

10  of the following terms:

11         (a)  Refusal to certify to the department an

12  application for licensure, certification, or registration;

13         (b)  Certification to the department of an application

14  for licensure, certification, or registration with

15  restrictions on the scope of practice of the licensee; or

16         (c)  Certification to the department of an application

17  for licensure, certification, or registration with placement

18  of the physician on probation for a period of time and subject

19  to such conditions as the board may specify, including, but

20  not limited to, requiring the physician to submit to

21  treatment, attend continuing education courses, submit to

22  reexamination, or work under the supervision of another

23  physician.

24         (9)(a)  Notwithstanding any of the provisions of this

25  section, an applicant who, at the time of his or her medical

26  education, was a citizen of the country of Nicaragua and, at

27  the time of application for licensure under this subsection,

28  is either a citizen of the country of Nicaragua or a citizen

29  of the United States may make initial application to the

30  department on or before July 1, 1992, for licensure subject to

31  this subsection and may reapply pursuant to board rule.  Upon


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                                       CS/HB 1467, First Engrossed



  1  receipt of such application, the department shall issue a

  2  2-year restricted license to any applicant therefor upon the

  3  applicant's successful completion of the licensure examination

  4  as described in paragraph (1)(a) and who the board certifies

  5  has met the following requirements:

  6         1.  Is a graduate of a World Health Organization

  7  recognized foreign medical institution located in a country in

  8  the Western Hemisphere.

  9         2.  Received a medical education which has been

10  determined by the board to be substantially similar, at the

11  time of the applicant's graduation, to approved United States

12  medical programs.

13         3.  Practiced medicine in the country of Nicaragua for

14  a period of 1 year prior to residing in the United States and

15  has lawful employment authority in the United States.

16         4.  Has had his or her medical education verified by

17  the Florida Board of Medicine.

18         5.  Successfully completed the Educational Commission

19  for Foreign Medical Graduates Examination or Foreign Medical

20  Graduate Examination in the Medical Sciences or successfully

21  completed a course developed for the University of Miami for

22  physician training equivalent to the course developed for such

23  purposes pursuant to chapter 74-105, Laws of Florida.  No

24  person shall be permitted to enroll in the physician training

25  course until he or she has been certified by the board as

26  having met the requirements of this paragraph or conditionally

27  certified by the board as having substantially complied with

28  the requirements of this paragraph. Any person conditionally

29  certified by the board shall be required to establish, to the

30  board's satisfaction, full compliance with all the

31  requirements of this paragraph prior to completion of the


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                                       CS/HB 1467, First Engrossed



  1  physician training course and shall not be permitted to sit

  2  for the licensure examination unless the board certifies that

  3  all of the requirements of this paragraph have been met.

  4

  5  However, applicants eligible for licensure under s. 455.581 or

  6  subsection (9), 1988 Supplement to the Florida Statutes 1987,

  7  as amended by s. 18, chapter 89-162, Laws of Florida, and ss.

  8  5 and 42, chapter 89-374, Laws of Florida, and renumbered as

  9  subsection (8) by s. 5, chapter 89-374, Laws of Florida, shall

10  not be eligible to apply under this subsection.

11         (b)  The holder of a restricted license issued pursuant

12  to this subsection may practice medicine for the first year

13  only under the direct supervision, as defined by board rule,

14  of a board-approved physician.

15         (c)  Upon recommendation of the supervising physician

16  and demonstration of clinical competency to the satisfaction

17  of the board that the holder of a restricted license issued

18  pursuant to this subsection has practiced for 1 year under

19  direct supervision, such licenseholder shall work for 1 year

20  under general supervision, as defined by board rule, of a

21  Florida-licensed physician in an area of critical need as

22  determined by the board.  Prior to commencing such

23  supervision, the supervising physician shall notify the board.

24         (d)  Upon completion of the 1 year of work under

25  general supervision and demonstration to the board that the

26  holder of the restricted license has satisfactorily completed

27  the requirements of this subsection, and has not committed any

28  act or is not under investigation for any act which would

29  constitute a violation of this chapter, the department shall

30  issue an unrestricted license to such licenseholder.

31


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                                       CS/HB 1467, First Engrossed



  1         (e)  Rules necessary to implement and carry out the

  2  provisions of this subsection shall be promulgated by the

  3  board.

  4         (10)  Notwithstanding any other provision of this

  5  section, the department shall examine any person who meets the

  6  criteria set forth in sub-subparagraph (1)(f)1.a.,

  7  sub-subparagraphs (1)(f)3.a. and b., or subsection (3), if the

  8  person:

  9         (a)  Submits proof of successful completion of Steps I

10  and II of the United States Medical Licensing Examination or

11  the equivalent, as defined by rule of the board;

12         (b)  Is participating in an allocated slot in an

13  allopathic training program in this state on a full-time basis

14  at the time of examination;

15         (c)  Makes a written request to the department that he

16  or she be administered the examination without applying for a

17  license as a physician in this state; and

18         (d)  Remits a nonrefundable administration fee, not to

19  exceed $50, and an examination fee, not to exceed $300, plus

20  the actual cost per person to the department for the purchase

21  of the examination from the Federation of State Medical Boards

22  of the United States or a similar national organization.  The

23  examination fee is refundable if the person is found to be

24  ineligible to take the examination.

25         Section 30.  Section 458.3115, Florida Statutes, 1998

26  Supplement, is amended to read:

27         458.3115  Restricted license; certain foreign-licensed

28  physicians; United States Medical Licensing Examination

29  (USMLE) or agency-developed examination; restrictions on

30  practice; full licensure.--

31


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                                       CS/HB 1467, First Engrossed



  1         (1)(a)  Notwithstanding any other provision of law, the

  2  department agency shall provide procedures under which certain

  3  physicians who are or were foreign-licensed and have practiced

  4  medicine no less than 2 years may take the USMLE or an

  5  agency-developed examination developed by the department, in

  6  consultation with the board, to qualify for a restricted

  7  license to practice medicine in this state. The

  8  department-developed agency and board-developed examination

  9  shall test the same areas of medical knowledge as the

10  Federation of State Medical Boards of the United States, Inc.

11  (FLEX) previously administered by the Florida Board of

12  Medicine to grant medical licensure in Florida. The

13  department-developed agency-developed examination must be made

14  available no later than December 31, 1998, to a physician who

15  qualifies for licensure. A person who is eligible to take and

16  elects to take the department-developed agency and

17  board-developed examination, who has previously passed part 1

18  or part 2 of the previously administered FLEX shall not be

19  required to retake or pass the equivalent parts of the

20  department-developed agency-developed examination, and may sit

21  for the department-developed agency and board-developed

22  examination five times within 5 years.

23         (b)  A person who is eligible to take and elects to

24  take the USMLE who has previously passed part 1 or part 2 of

25  the previously administered FLEX shall not be required to

26  retake or pass the equivalent parts of the USMLE up to the

27  year 2000.

28         (c)  A person shall be eligible to take such

29  examination for restricted licensure if the person:

30         1.  Has taken, upon approval by the board, and

31  completed, in November 1990 or November 1992, one of the


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                                       CS/HB 1467, First Engrossed



  1  special preparatory medical update courses authorized by the

  2  board and the University of Miami Medical School and

  3  subsequently passed the final course examination; upon

  4  approval by the board to take the course completed in 1990 or

  5  in 1992, has a certificate of successful completion of that

  6  course from the University of Miami or the Stanley H. Kaplan

  7  course; or can document to the department that he or she was

  8  one of the persons who took and successfully completed the

  9  Stanley H. Kaplan course that was approved by the board of

10  Medicine and supervised by the University of Miami. At a

11  minimum, the documentation must include class attendance

12  records and the test score on the final course examination;

13         2.  Applies to the department agency and submits an

14  application fee that is nonrefundable and equivalent to the

15  fee required for full licensure;

16         3.  Documents no less than 2 years of the active

17  practice of medicine in another jurisdiction;

18         4.  Submits an examination fee that is nonrefundable

19  and equivalent to the fee required for full licensure plus the

20  actual per-applicant cost to the department agency to provide

21  either examination described in this section;

22         5.  Has not committed any act or offense in this or any

23  other jurisdiction that would constitute a substantial basis

24  for disciplining a physician under this chapter or part II of

25  chapter 455; and

26         6.  Is not under discipline, investigation, or

27  prosecution in this or any other jurisdiction for an act that

28  would constitute a violation of this chapter or part II of

29  chapter 455 and that substantially threatened or threatens the

30  public health, safety, or welfare.

31


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                                       CS/HB 1467, First Engrossed



  1         (d)  Every person eligible for restricted licensure

  2  under this section may sit for the USMLE or the

  3  department-developed agency and board-developed examination

  4  five times within 5 calendar years.  Applicants desiring to

  5  use portions of the FLEX and the USMLE may do so up to the

  6  year 2000.  However, notwithstanding subparagraph (c)3.,

  7  applicants applying under this section who fail the

  8  examination up to a total of five times will only be required

  9  to pay the examination fee required for full licensure for the

10  second and subsequent times they take the examination.

11         (e)  The department Agency for Health Care

12  Administration and the board shall be responsible for working

13  with one or more organizations to offer a medical refresher

14  course designed to prepare applicants to take either licensure

15  examination described in this section.  The organizations may

16  develop the medical refresher course, purchase such a course,

17  or contract for such a course from a private organization that

18  specializes in developing such courses.

19         (f)  The course shall require no less than two 16-week

20  semesters of 16 contact hours per week for a total of 256

21  contact hours per student for each semester. The cost is to be

22  paid by the students taking the course.

23         (2)(a)  Before the department agency may issue a

24  restricted license to an applicant under this section, the

25  applicant must have passed either of the two examinations

26  described in this section.  However, the board may impose

27  reasonable restrictions on the applicant's license to

28  practice.  These restrictions may include, but are not limited

29  to:

30

31


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                                       CS/HB 1467, First Engrossed



  1         1.  Periodic and random department agency audits of the

  2  licensee's patient records and review of those records by the

  3  board or the department agency.

  4         2.  Periodic appearances of the licensee before the

  5  board or the department agency.

  6         3.  Submission of written reports to the board or the

  7  department agency.

  8         (b)  A restricted licensee under this section shall

  9  practice under the supervision of a full licensee approved by

10  the board with the first year of the licensure period being

11  under direct supervision as defined by board rule and the

12  second year being under indirect supervision as defined by

13  board rule.

14         (c)  The board may adopt rules necessary to implement

15  this subsection.

16         (3)(a)  A restricted license issued by the department

17  agency under this section is valid for 2 years unless sooner

18  revoked or suspended, and a restricted licensee is subject to

19  the requirements of this chapter, part II of chapter 455, and

20  any other provision of law not in conflict with this section.

21  Upon expiration of such restricted license, a restricted

22  licensee shall become a full licensee if the restricted

23  licensee:

24         1.  Is not under discipline, investigation, or

25  prosecution for a violation which poses a substantial threat

26  to the public health, safety, or welfare; and

27         2.  Pays all renewal fees required of a full licensee.

28         (b)  The department agency shall renew a restricted

29  license under this section upon payment of the same fees

30  required for renewal for a full license if the restricted

31  licensee is under discipline, investigation, or prosecution


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                                       CS/HB 1467, First Engrossed



  1  for a violation which posed or poses a substantial threat to

  2  the public health, safety, or welfare and the board has not

  3  permanently revoked the restricted license. A restricted

  4  licensee who has renewed such restricted license shall become

  5  eligible for full licensure when the licensee is no longer

  6  under discipline, investigation, or prosecution.

  7         (4)  The board shall adopt rules necessary to carry out

  8  the provisions of this section.

  9         Section 31.  Subsections (1), (2), and (8) of section

10  458.313, Florida Statutes, are amended to read:

11         458.313  Licensure by endorsement; requirements;

12  fees.--

13         (1)  The department shall issue a license by

14  endorsement to any applicant who, upon applying to the

15  department on forms furnished by the department and remitting

16  a fee set by the board not to exceed $500 set by the board,

17  the board certifies:

18         (a)  Has met the qualifications for licensure in s.

19  458.311(1)(b)-(g) or in s. 458.311(1)(b)-(e) and (g) and (3);

20         (b)  Prior to January 1, 2000, has obtained a passing

21  score, as established by rule of the board, on the licensure

22  examination of the Federation of State Medical Boards of the

23  United States, Inc. (FLEX), on or of the United States Medical

24  Licensing Examination (USMLE), or on the examination of the

25  National Board of Medical Examiners, or on a combination

26  thereof, and on or after January 1, 2000, has obtained a

27  passing score on the United States Medical Licensing

28  Examination (USMLE) provided the board certifies as eligible

29  for licensure by endorsement any applicant who took the

30  required examinations more than 10 years prior to application;

31  and


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                                       CS/HB 1467, First Engrossed



  1         (c)  Has submitted evidence of the active licensed

  2  practice of medicine in another jurisdiction, for at least 2

  3  of the immediately preceding 4 years, or evidence of

  4  successful completion of either a board-approved postgraduate

  5  training program within 2 years preceding filing of an

  6  application, or a board-approved clinical competency

  7  examination, within the year preceding the filing of an

  8  application for licensure.  For purposes of this paragraph,

  9  "active licensed practice of medicine" means that practice of

10  medicine by physicians, including those employed by any

11  governmental entity in community or public health, as defined

12  by this chapter, medical directors under s. 641.495(11) who

13  are practicing medicine, and those on the active teaching

14  faculty of an accredited medical school.

15         (2)(a)  As prescribed by board rule, the board may

16  require an applicant who does not pass the licensing

17  examination after five attempts to complete additional

18  remedial education or training.  The board shall prescribe the

19  additional requirements in a manner that permits the applicant

20  to 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.

23         (b)  The board may require an applicant for licensure

24  by endorsement to take and pass the appropriate licensure

25  examination prior to certifying the applicant as eligible for

26  licensure.

27         (8)  The department shall reactivate the license of any

28  physician whose license has become void by failure to practice

29  in Florida for a period of 1 year within 3 years after

30  issuance of the license by endorsement, if the physician was

31  issued a license by endorsement prior to 1989, has actively


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                                       CS/HB 1467, First Engrossed



  1  practiced medicine in another state for the last 4 years,

  2  applies for licensure before October 1, 1998, pays the

  3  applicable fees, and otherwise meets any continuing education

  4  requirements for reactivation of the license as determined by

  5  the board.

  6         Section 32.  Subsection (1) of section 458.315, Florida

  7  Statutes, is amended to read:

  8         458.315  Temporary certificate for practice in areas of

  9  critical need.--Any physician who is licensed to practice in

10  any other state, whose license is currently valid, and who

11  pays an application fee of $300 may be issued a temporary

12  certificate to practice in communities of Florida where there

13  is a critical need for physicians.  A certificate may be

14  issued to a physician who will be employed by a county health

15  department, correctional facility, community health center

16  funded by s. 329, s. 330, or s. 340 of the United States

17  Public Health Services Act, or other entity that provides

18  health care to indigents and that is approved by the State

19  Health Officer.  The Board of Medicine may issue this

20  temporary certificate with the following restrictions:

21         (1)  The board shall determine the areas of critical

22  need, and the physician so certified may practice in any of

23  those areas only in that specific area for a time to be

24  determined by the board.  Such areas shall include, but not be

25  limited to, health professional shortage areas designated by

26  the United States Department of Health and Human Services.

27         (a)  A recipient of a temporary certificate for

28  practice in areas of critical need may use the license to work

29  for any approved employer in any area of critical need

30  approved by the board.

31


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                                       CS/HB 1467, First Engrossed



  1         (b)  The recipient of a temporary certificate for

  2  practice in areas of critical need shall, within 30 days after

  3  accepting employment, notify the board of all approved

  4  institutions in which the licensee practices and of all

  5  approved institutions where practice privileges have been

  6  denied.

  7         Section 33.  Section 458.3165, Florida Statutes, is

  8  amended to read:

  9         458.3165  Public psychiatry certificate.--The board

10  shall issue a public psychiatry certificate to an individual

11  who remits an application fee not to exceed $300, as set by

12  the board, who is a board-certified psychiatrist, who is

13  licensed to practice medicine without restriction in another

14  state, and who meets the requirements in s. 458.311(1)(a)-(g)

15  and (5). A recipient of a public psychiatry certificate may

16  use the certificate to work at any public mental health

17  facility or program funded in part or entirely by state funds.

18         (1)  Such certificate shall:

19         (a)  Authorize the holder to practice only in a public

20  mental health facility or program funded in part or entirely

21  by state funds.

22         (b)  Be issued and renewable biennially if the

23  secretary of the Department of Health and Rehabilitative

24  Services and the chair of the department of psychiatry at one

25  of the public medical schools or the chair of the department

26  of psychiatry at the accredited medical school at the

27  University of Miami recommend in writing that the certificate

28  be issued or renewed.

29         (c)  Automatically expire if the holder's relationship

30  with a public mental health facility or program expires.

31


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                                       CS/HB 1467, First Engrossed



  1         (d)  Not be issued to a person who has been adjudged

  2  unqualified or guilty of any of the prohibited acts in this

  3  chapter.

  4         (2)  The board may take disciplinary action against a

  5  certificateholder for noncompliance with any part of this

  6  section or for any reason for which a regular licensee may be

  7  subject to discipline.

  8         Section 34.  Subsection (4) is added to section

  9  458.317, Florida Statutes, 1998 Supplement, to read:

10         458.317  Limited licenses.--

11         (4)  Any person holding an active license to practice

12  medicine in the state may convert that license to a limited

13  license for the purpose of providing volunteer, uncompensated

14  care for low-income Floridians. The applicant must submit a

15  statement from the employing agency or institution stating

16  that he or she will not receive compensation for any service

17  involving the practice of medicine. The application and all

18  licensure fees, including neurological injury compensation

19  assessments, shall be waived.

20         Section 35.  Subsection (1) of section 458.319, Florida

21  Statutes, 1998 Supplement, is amended to read:

22         458.319  Renewal of license.--

23         (1)  The department shall renew a license upon receipt

24  of the renewal application, evidence that the applicant has

25  actively practiced medicine or has been on the active teaching

26  faculty of an accredited medical school for at least 2 years

27  of the immediately preceding 4 years, and a fee not to exceed

28  $500; provided, however, that if the licensee is either a

29  resident physician, assistant resident physician, fellow,

30  house physician, or intern in an approved postgraduate

31  training program, as defined by the board by rule, the fee


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                                       CS/HB 1467, First Engrossed



  1  shall not exceed $100 per annum.  If the licensee has not

  2  actively practiced medicine for at least 2 years of the

  3  immediately preceding 4 years, the board shall require that

  4  the licensee successfully complete a board-approved clinical

  5  competency examination prior to renewal of the license.

  6  "Actively practiced medicine" means that practice of medicine

  7  by physicians, including those employed by any governmental

  8  entity in community or public health, as defined by this

  9  chapter, including physicians practicing administrative

10  medicine. An applicant for a renewed license must also submit

11  the information required under s. 455.565 to the department on

12  a form and under procedures specified by the department, along

13  with payment in an amount equal to the costs incurred by the

14  Department of Health for the statewide criminal background

15  check of the applicant. An The applicant for a renewed license

16  who received an initial license in this state after January 1,

17  1992, must submit a set of fingerprints to the Department of

18  Health on a form and under procedures specified by the

19  department, along with payment in an amount equal to the costs

20  incurred by the department for a national criminal background

21  check of the applicant for the initial renewal of his or her

22  license after January 1, 2000. If the applicant fails to

23  submit either the information required under s. 455.565 or a

24  set of fingerprints to the department as required by this

25  section, the department shall issue a notice of noncompliance,

26  and the applicant will be given 30 additional days to comply.

27  If the applicant fails to comply within 30 days after the

28  notice of noncompliance is issued, the department or board, as

29  appropriate, may issue a citation to the applicant and may

30  fine the applicant up to $50 for each day that the applicant

31  is not in compliance with the requirements of s. 455.565. The


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                                       CS/HB 1467, First Engrossed



  1  citation must clearly state that the applicant may choose, in

  2  lieu of accepting the citation, to follow the procedure under

  3  s. 455.621. If the applicant disputes the matter in the

  4  citation, the procedures set forth in s. 455.621 must be

  5  followed. However, if the applicant does not dispute the

  6  matter in the citation with the department within 30 days

  7  after the citation is served, the citation becomes a final

  8  order and constitutes discipline. Service of a citation may be

  9  made by personal service or certified mail, restricted

10  delivery, to the subject at the applicant's last known

11  address. The department may not delay renewing a license due

12  to the processing of a statewide criminal history check or a

13  national criminal background check. If an applicant has

14  received an initial license to practice in this state after

15  January 1, 1992, and has submitted fingerprints to the

16  department for a national criminal history check upon initial

17  licensure and is renewing his or her license for the first

18  time, then the applicant need only submit the information and

19  fee required for a statewide criminal history check.

20         Section 36.  Paragraph (mm) is added to subsection (1)

21  of section 458.331, Florida Statutes, 1998 Supplement, and

22  subsection (2) of that section is amended to read:

23         458.331  Grounds for disciplinary action; action by the

24  board and department.--

25         (1)  The following acts shall constitute grounds for

26  which the disciplinary actions specified in subsection (2) may

27  be taken:

28         (mm)  Failing to comply with the requirements of ss.

29  381.026 and 381.0261 to provide patients with information

30  about their patient rights and how to file a patient

31  complaint.


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  1         (2)  When the board finds any person guilty of any of

  2  the grounds set forth in subsection (1), including conduct

  3  that would constitute a substantial violation of subsection

  4  (1) which occurred prior to licensure, it may enter an order

  5  imposing one or more of the following penalties:

  6         (a)  Refusal to certify, or certification with

  7  restrictions, to the department an application for licensure,

  8  certification, or registration.

  9         (b)  Revocation or suspension of a license.

10         (c)  Restriction of practice.

11         (d)  Imposition of an administrative fine not to exceed

12  $10,000 $5,000 for each count or separate offense.

13         (e)  Issuance of a reprimand.

14         (f)  Placement of the physician on probation for a

15  period of time and subject to such conditions as the board may

16  specify, including, but not limited to, requiring the

17  physician to submit to treatment, to attend continuing

18  education courses, to submit to reexamination, or to work

19  under the supervision of another physician.

20         (g)  Issuance of a letter of concern.

21         (h)  Corrective action.

22         (i)  Refund of fees billed to and collected from the

23  patient.

24         (j)  Imposition of an administrative fine in accordance

25  with s. 381.0261 for violations regarding patient rights.

26

27  In determining what action is appropriate, the board must

28  first consider what sanctions are necessary to protect the

29  public or to compensate the patient.  Only after those

30  sanctions have been imposed may the disciplining authority

31  consider and include in the order requirements designed to


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                                       CS/HB 1467, First Engrossed



  1  rehabilitate the physician.  All costs associated with

  2  compliance with orders issued under this subsection are the

  3  obligation of the physician.

  4         Section 37.  Subsection (7) of section 458.347, Florida

  5  Statutes, 1998 Supplement, is amended to read:

  6         458.347  Physician assistants.--

  7         (7)  PHYSICIAN ASSISTANT LICENSURE.--

  8         (a)  Any person desiring to be licensed as a physician

  9  assistant must apply to the department.  The department shall

10  issue a license to any person certified by the council as

11  having met the following requirements:

12         1.  Is at least 18 years of age.

13         2.  Has satisfactorily passed a proficiency examination

14  by an acceptable score established by the National Commission

15  on Certification of Physician Assistants.  If an applicant

16  does not hold a current certificate issued by the National

17  Commission on Certification of Physician Assistants and has

18  not actively practiced as a physician assistant within the

19  immediately preceding 4 years, the applicant must retake and

20  successfully complete the entry-level examination of the

21  National Commission on Certification of Physician Assistants

22  to be eligible for licensure.

23         3.  Has completed the application form and remitted an

24  application fee not to exceed $300 as set by the boards. An

25  application for licensure made by a physician assistant must

26  include:

27         a.  A certificate of completion of a physician

28  assistant training program specified in subsection (6).

29         b.  A sworn statement of any prior felony convictions.

30         c.  A sworn statement of any previous revocation or

31  denial of licensure or certification in any state.


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                                       CS/HB 1467, First Engrossed



  1         d.  Two letters of recommendation.

  2         (b)1.  Notwithstanding subparagraph (a)2. and

  3  sub-subparagraph (a)3.a., the department shall examine each

  4  applicant who the Board of Medicine certifies:

  5         a.  Has completed the application form and remitted a

  6  nonrefundable application fee not to exceed $500 and an

  7  examination fee not to exceed $300, plus the actual cost to

  8  the department to provide the examination.  The examination

  9  fee is refundable if the applicant is found to be ineligible

10  to take the examination.  The department shall not require the

11  applicant to pass a separate practical component of the

12  examination. For examinations given after July 1, 1998,

13  competencies measured through practical examinations shall be

14  incorporated into the written examination through a

15  multiple-choice format. The department shall translate the

16  examination into the native language of any applicant who

17  requests and agrees to pay all costs of such translation,

18  provided that the translation request is filed with the board

19  office no later than 9 months before the scheduled examination

20  and the applicant remits translation fees as specified by the

21  department no later than 6 months before the scheduled

22  examination, and provided that the applicant demonstrates to

23  the department the ability to communicate orally in basic

24  English. If the applicant is unable to pay translation costs,

25  the applicant may take the next available examination in

26  English if the applicant submits a request in writing by the

27  application deadline and if the applicant is otherwise

28  eligible under this section. To demonstrate the ability to

29  communicate orally in basic English, a passing score or grade

30  is required, as determined by the department or organization

31


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                                       CS/HB 1467, First Engrossed



  1  that developed it, on one of the following English

  2  examinations:

  3         (I)  The test for spoken English (TSE) by the

  4  Educational Testing Service (ETS);

  5         (II)  The test of English as a foreign language

  6  (TOEFL), by ETS;

  7         (III)  A high school or college level English course;

  8         (IV)  The English examination for citizenship,

  9  Immigration and Naturalization Service.

10

11  A notarized copy of an Educational Commission for Foreign

12  Medical Graduates (ECFMG) certificate may also be used to

13  demonstrate the ability to communicate in basic English.

14         b.  Is an unlicensed physician who graduated from a

15  foreign medical school listed with the World Health

16  Organization who has not previously taken and failed the

17  examination of the National Commission on Certification of

18  Physician Assistants and who has been certified by the Board

19  of Medicine as having met the requirements for licensure as a

20  medical doctor by examination as set forth in s. 458.311(1),

21  (3), (4), and (5), with the exception that the applicant is

22  not required to have completed an approved residency of at

23  least 1 year and the applicant is not required to have passed

24  the licensing examination specified under s. 458.311 or hold a

25  valid, active certificate issued by the Educational Commission

26  for Foreign Medical Graduates.

27         c.  Was eligible and made initial application for

28  certification as a physician assistant in this state between

29  July 1, 1990, and June 30, 1991.

30

31


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                                       CS/HB 1467, First Engrossed



  1         d.  Was a resident of this state on July 1, 1990, or

  2  was licensed or certified in any state in the United States as

  3  a physician assistant on July 1, 1990.

  4         2.  The department may grant temporary licensure to an

  5  applicant who meets the requirements of subparagraph 1.

  6  Between meetings of the council, the department may grant

  7  temporary licensure to practice based on the completion of all

  8  temporary licensure requirements.  All such administratively

  9  issued licenses shall be reviewed and acted on at the next

10  regular meeting of the council.  A temporary license expires

11  30 days after upon receipt and notice of scores to the

12  licenseholder from the first available examination specified

13  in subparagraph 1. following licensure by the department.  An

14  applicant who fails the proficiency examination is no longer

15  temporarily licensed, but may apply for a one-time extension

16  of temporary licensure after reapplying for the next available

17  examination. Extended licensure shall expire upon failure of

18  the licenseholder to sit for the next available examination or

19  upon receipt and notice of scores to the licenseholder from

20  such examination.

21         3.  Notwithstanding any other provision of law, the

22  examination specified pursuant to subparagraph 1. shall be

23  administered by the department only five times.  Applicants

24  certified by the board for examination shall receive at least

25  6 months' notice of eligibility prior to the administration of

26  the initial examination. Subsequent examinations shall be

27  administered at 1-year intervals following the reporting of

28  the scores of the first and subsequent examinations.  For the

29  purposes of this paragraph, the department may develop,

30  contract for the development of, purchase, or approve an

31  examination, including a practical component, that adequately


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                                       CS/HB 1467, First Engrossed



  1  measures an applicant's ability to practice with reasonable

  2  skill and safety.  The minimum passing score on the

  3  examination shall be established by the department, with the

  4  advice of the board.  Those applicants failing to pass that

  5  examination or any subsequent examination shall receive notice

  6  of the administration of the next examination with the notice

  7  of scores following such examination.  Any applicant who

  8  passes the examination and meets the requirements of this

  9  section shall be licensed as a physician assistant with all

10  rights defined thereby.

11         (c)  The license must be renewed biennially.  Each

12  renewal must include:

13         1.  A renewal fee not to exceed $500 as set by the

14  boards.

15         2.  A sworn statement of no felony convictions in the

16  previous 2 years.

17         (d)  Each licensed physician assistant shall biennially

18  complete 100 hours of continuing medical education or shall

19  hold a current certificate issued by the National Commission

20  on Certification of Physician Assistants.

21         (e)  Upon employment as a physician assistant, a

22  licensed physician assistant must notify the department in

23  writing within 30 days after such employment or after any

24  subsequent changes in the supervising physician. The

25  notification must include the full name, Florida medical

26  license number, specialty, and address of the supervising

27  physician.

28         (f)  Notwithstanding subparagraph (a)2., the department

29  may grant to a recent graduate of an approved program, as

30  specified in subsection (6), who expects to take the first

31  examination administered by the National Commission on


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                                       CS/HB 1467, First Engrossed



  1  Certification of Physician Assistants available for

  2  registration after the applicant's graduation, a temporary

  3  license. The temporary license shall to expire 30 days after

  4  upon receipt of scores of the proficiency examination

  5  administered by the National Commission on Certification of

  6  Physician Assistants.  Between meetings of the council, the

  7  department may grant a temporary license to practice based on

  8  the completion of all temporary licensure requirements.  All

  9  such administratively issued licenses shall be reviewed and

10  acted on at the next regular meeting of the council. The

11  recent graduate may be licensed prior to employment, but must

12  comply with paragraph (e). An applicant who has passed the

13  proficiency examination may be granted permanent licensure. An

14  applicant failing the proficiency examination is no longer

15  temporarily licensed, but may reapply for a 1-year extension

16  of temporary licensure.  An applicant may not be granted more

17  than two temporary licenses and may not be licensed as a

18  physician assistant until he or she passes the examination

19  administered by the National Commission on Certification of

20  Physician Assistants. As prescribed by board rule, the council

21  may require an applicant who does not pass the licensing

22  examination after five or more attempts to complete additional

23  remedial education or training. The council shall prescribe

24  the additional requirements in a manner that permits the

25  applicant to complete the requirements and be reexamined

26  within 2 years after the date the applicant petitions the

27  council to retake the examination a sixth or subsequent time.

28         (g)  The Board of Medicine may impose any of the

29  penalties specified in ss. 455.624 and 458.331(2) upon a

30  physician assistant if the physician assistant or the

31  supervising physician has been found guilty of or is being


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                                       CS/HB 1467, First Engrossed



  1  investigated for any act that constitutes a violation of this

  2  chapter or part II of chapter 455.

  3         Section 38.  Section 459.005, Florida Statutes, 1998

  4  Supplement, is amended to read:

  5         459.005  Rulemaking authority.--

  6         (1)  The board has authority to adopt rules pursuant to

  7  ss. 120.536(1) and 120.54 to implement the provisions of this

  8  chapter conferring duties upon it.

  9         (2)  All physicians which perform level 2 procedures

10  lasting more than 5 minutes and all level 3 surgical

11  procedures in an office setting must register the office with

12  the department unless that office is licensed as a facility

13  pursuant to chapter 395. Registration information shall not

14  include the specific type of surgery performed by the

15  physician. The department shall inspect the phyisician's

16  office annually unless the office is accredited by a

17  nationally recognized accrediting agency or an accrediting

18  organization subsequently approved by the Board of Osteopathic

19  Medicine. The actual costs for registration and inspection or

20  accreditation shall be paid by the person seeking to register

21  and operate the office setting in which office surgery is

22  performed.

23         Section 39.  Subsection (7) is added to section

24  459.0075, Florida Statutes, to read:

25         459.0075  Limited licenses.--

26         (7)  Any person holding an active license to practice

27  osteopathic medicine in the state may convert that license to

28  a limited license for the purpose of providing volunteer,

29  uncompensated care for low-income Floridians. The applicant

30  must submit a statement from the employing agency or

31  institution stating that he or she will not receive


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                                       CS/HB 1467, First Engrossed



  1  compensation for any service involving the practice of

  2  osteopathic medicine. The application and all licensure fees,

  3  including neurological injury compensation assessments, shall

  4  be waived.

  5         Section 40.  Subsection (1) of section 459.008, Florida

  6  Statutes, 1998 Supplement, is amended to read:

  7         459.008  Renewal of licenses and certificates.--

  8         (1)  The department shall renew a license or

  9  certificate upon receipt of the renewal application and fee.

10  An applicant for a renewed license must also submit the

11  information required under s. 455.565 to the department on a

12  form and under procedures specified by the department, along

13  with payment in an amount equal to the costs incurred by the

14  Department of Health for the statewide criminal background

15  check of the applicant. An The applicant for a renewed license

16  who received an initial license in this state after January 1,

17  1992, must submit a set of fingerprints to the Department of

18  Health on a form and under procedures specified by the

19  department, along with payment in an amount equal to the costs

20  incurred by the department for a national criminal background

21  check of the applicant for the initial renewal of his or her

22  license after January 1, 2000. If the applicant fails to

23  submit either the information required under s. 455.565 or a

24  set of fingerprints to the department as required by this

25  section, the department shall issue a notice of noncompliance,

26  and the applicant will be given 30 additional days to comply.

27  If the applicant fails to comply within 30 days after the

28  notice of noncompliance is issued, the department or board, as

29  appropriate, may issue a citation to the applicant and may

30  fine the applicant up to $50 for each day that the applicant

31  is not in compliance with the requirements of s. 455.565. The


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                                       CS/HB 1467, First Engrossed



  1  citation must clearly state that the applicant may choose, in

  2  lieu of accepting the citation, to follow the procedure under

  3  s. 455.621. If the applicant disputes the matter in the

  4  citation, the procedures set forth in s. 455.621 must be

  5  followed. However, if the applicant does not dispute the

  6  matter in the citation with the department within 30 days

  7  after the citation is served, the citation becomes a final

  8  order and constitutes discipline. Service of a citation may be

  9  made by personal service or certified mail, restricted

10  delivery, to the subject at the applicant's last known

11  address. The department may not delay renewing a license due

12  to the processing of a statewide criminal history check or a

13  national criminal background check. If an applicant has

14  received an initial license to practice in this state after

15  January 1, 1992, and has submitted fingerprints to the

16  department for a national criminal history check upon initial

17  licensure and is renewing his or her license for the first

18  time, then the applicant need only submit the information and

19  fee required for a statewide criminal history check.

20         Section 41.  Paragraph (oo) is added to subsection (1)

21  of section 459.015, F.S., 1998 supplement, and subsection (2)

22  of this section is amended to read:

23         459.015  Grounds for disciplinary action by the

24  board.--

25         (1)  The following acts shall constitute grounds for

26  which the disciplinary actions specified in subsection (2) may

27  be taken:

28         (oo)  Failing to comply with the requirements of ss.

29  381.026 and 381.0261 to provide patients with information

30  about their patient rights and how to file a patient

31  complaint.


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                                       CS/HB 1467, First Engrossed



  1         (2)  When the board finds any person guilty of any of

  2  the grounds set forth in subsection (1), it may enter an order

  3  imposing one or more of the following penalties:

  4         (a)  Refusal to certify, or certify with restrictions,

  5  to the department an application for certification, licensure,

  6  renewal, or reactivation.

  7         (b)  Revocation or suspension of a license or

  8  certificate.

  9         (c)  Restriction of practice.

10         (d)  Imposition of an administrative fine not to exceed

11  $10,000 $5,000 for each count or separate offense.

12         (e)  Issuance of a reprimand.

13         (f)  Issuance of a letter of concern.

14         (g)  Placement of the osteopathic physician on

15  probation for a period of time and subject to such conditions

16  as the board may specify, including, but not limited to,

17  requiring the osteopathic physician to submit to treatment,

18  attend continuing education courses, submit to reexamination,

19  or work under the supervision of another osteopathic

20  physician.

21         (h)  Corrective action.

22         (i)  Refund of fees billed to and collected from the

23  patient.

24         (j)  Imposition of an administrative fine in accordance

25  with s. 381.0261 for violations regarding patient rights.

26

27  In determining what action is appropriate, the board must

28  first consider what sanctions are necessary to protect the

29  public or to compensate the patient.  Only after those

30  sanctions have been imposed may the disciplining authority

31  consider and include in the order requirements designed to


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                                       CS/HB 1467, First Engrossed



  1  rehabilitate the physician.  All costs associated with

  2  compliance with orders issued under this subsection are the

  3  obligation of the physician.

  4         Section 42.  Subsection (6) is added to section

  5  460.402, Florida Statutes, to read:

  6         460.402  Exceptions.--The provisions of this chapter

  7  shall not apply to:

  8         (6)  A chiropractic student enrolled in a chiropractic

  9  college accredited by the Council on Chiropractic Education

10  and participating in a community-based internship under the

11  direct supervision of a doctor of chiropractic medicine who is

12  credentialed as an adjunct faculty member of a chiropractic

13  college in which the student is enrolled.

14         Section 43.  Present subsections (4) through (10) of

15  section 460.403, Florida Statutes, 1998 Supplement, are

16  renumbered as subsections (5) through (11), respectively, a

17  new subsection (4) is added to that section, and present

18  subsections (6) and (9) are amended, to read:

19         460.403  Definitions.--As used in this chapter, the

20  term:

21         (4)  "Community-based internship" means a program in

22  which a student enrolled in the last year of a chiropractic

23  college accredited by the Council on Chiropractic Education is

24  approved to obtain required pregraduation clinical experience

25  in a chiropractic clinic or practice under the direct

26  supervision of a doctor of chiropractic medicine approved as

27  an adjunct faculty member of the chiropractic college in which

28  the student is enrolled, according to the teaching protocols

29  for the clinical practice requirements of the college.

30         (7)(6)  "Direct supervision" means responsible

31  supervision and control, with the licensed chiropractic


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                                       CS/HB 1467, First Engrossed



  1  physician assuming legal liability for the services rendered

  2  by a registered chiropractic assistant or a chiropractic

  3  student enrolled in a community-based intern program.  Except

  4  in cases of emergency, direct supervision shall require the

  5  physical presence of the licensed chiropractic physician for

  6  consultation and direction of the actions of the registered

  7  chiropractic assistant or a chiropractic student enrolled in a

  8  community-based intern program.  The board shall further

  9  establish rules as to what constitutes responsible direct

10  supervision of a registered chiropractic assistant.

11         (10)(9)  "Registered chiropractic assistant" means a

12  person who is registered by the board to perform chiropractic

13  services under the direct supervision of a chiropractic

14  physician or certified chiropractic physician's assistant.

15         Section 44.  Subsection (1) of section 460.406, Florida

16  Statutes, 1998 Supplement, is amended to read:

17         460.406  Licensure by examination.--

18         (1)  Any person desiring to be licensed as a

19  chiropractic physician shall apply to the department to take

20  the licensure examination. There shall be an application fee

21  set by the board not to exceed $100 which shall be

22  nonrefundable.  There shall also be an examination fee not to

23  exceed $500 plus the actual per applicant cost to the

24  department for purchase of portions of the examination from

25  the National Board of Chiropractic Examiners or a similar

26  national organization, which may be refundable if the

27  applicant is found ineligible to take the examination.  The

28  department shall examine each applicant who the board

29  certifies has:

30         (a)  Completed the application form and remitted the

31  appropriate fee.


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                                       CS/HB 1467, First Engrossed



  1         (b)  Submitted proof satisfactory to the department

  2  that he or she is not less than 18 years of age.

  3         (c)  Submitted proof satisfactory to the department

  4  that he or she is a graduate of a chiropractic college which

  5  is accredited by or has status with the Council on

  6  Chiropractic Education or its predecessor agency. However, any

  7  applicant who is a graduate of a chiropractic college that was

  8  initially accredited by the Council on Chiropractic Education

  9  in 1995, who graduated from such college within the 4 years

10  immediately preceding such accreditation, and who is otherwise

11  qualified shall be eligible to take the examination.  No

12  application for a license to practice chiropractic medicine

13  shall be denied solely because the applicant is a graduate of

14  a chiropractic college that subscribes to one philosophy of

15  chiropractic medicine as distinguished from another.

16         (d)1.  For an applicant who has matriculated in a

17  chiropractic college prior to July 2, 1990, completed at least

18  2 years of residence college work, consisting of a minimum of

19  one-half the work acceptable for a bachelor's degree granted

20  on the basis of a 4-year period of study, in a college or

21  university accredited by an accrediting agency recognized and

22  approved by the United States Department of Education.

23  However, prior to being certified by the board to sit for the

24  examination, each applicant who has matriculated in a

25  chiropractic college after July 1, 1990, shall have been

26  granted a bachelor's degree, based upon 4 academic years of

27  study, by a college or university accredited by a regional

28  accrediting agency which is a member of the Commission on

29  Recognition of Postsecondary Accreditation.

30         2.  Effective July 1, 2000, completed, prior to

31  matriculation in a chiropractic college, at least 3 years of


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                                       CS/HB 1467, First Engrossed



  1  residence college work, consisting of a minimum of 90 semester

  2  hours leading to a bachelor's degree in a liberal arts college

  3  or university accredited by an accrediting agency recognized

  4  and approved by the United States Department of Education.

  5  However, prior to being certified by the board to sit for the

  6  examination, each applicant who has matriculated in a

  7  chiropractic college after July 1, 2000, shall have been

  8  granted a bachelor's degree from an institution holding

  9  accreditation for that degree from a regional accrediting

10  agency which is recognized by the United States Department of

11  Education.  The applicant's chiropractic degree must consist

12  of credits earned in the chiropractic program and may not

13  include academic credit for courses from the bachelor's

14  degree.

15         (e)  Completed not less than a 3-month training program

16  in this state of not less than 300 hours with a chiropractic

17  physician licensed in this state. The chiropractic physician

18  candidate may perform all services offered by the licensed

19  chiropractic physician, but must be under the supervision of

20  the licensed chiropractic physician until the results of the

21  first licensure examination for which the candidate has

22  qualified have been received, at which time the candidate's

23  training program shall be terminated. However, an applicant

24  who has practiced chiropractic medicine in any other state,

25  territory, or jurisdiction of the United States or any foreign

26  national jurisdiction for at least 5 years as a licensed

27  chiropractic physician need not be required to complete the

28  3-month training program as a requirement for licensure.

29         (e)(f)  Successfully completed the National Board of

30  Chiropractic Examiners certification examination in parts I

31  and II and clinical competency, with a score approved by the


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                                       CS/HB 1467, First Engrossed



  1  board, within 10 years immediately preceding application to

  2  the department for licensure.

  3         (f)(g)  Submitted to the department a set of

  4  fingerprints on a form and under procedures specified by the

  5  department, along with payment in an amount equal to the costs

  6  incurred by the Department of Health for the criminal

  7  background check of the applicant.

  8         Section 45.  Subsection (1) of section 460.407, Florida

  9  Statutes, 1998 Supplement, is amended to read:

10         460.407  Renewal of license.--

11         (1)  The department shall renew a license upon receipt

12  of the renewal application and the fee set by the board not to

13  exceed $500. An applicant for a renewed license must also

14  submit the information required under s. 455.565 to the

15  department on a form and under procedures specified by the

16  department, along with payment in an amount equal to the costs

17  incurred by the Department of Health for the statewide

18  criminal background check of the applicant. An The applicant

19  for a renewed license who received an initial license in this

20  state after January 1, 1992, must submit a set of fingerprints

21  to the Department of Health on a form and under procedures

22  specified by the department, along with payment in an amount

23  equal to the costs incurred by the department for a national

24  criminal background check of the applicant for the initial

25  renewal of his or her license after January 1, 2000. If the

26  applicant fails to submit either the information required

27  under s. 455.565 or a set of fingerprints to the department as

28  required by this section, the department shall issue a notice

29  of noncompliance, and the applicant will be given 30

30  additional days to comply. If the applicant fails to comply

31  within 30 days after the notice of noncompliance is issued,


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                                       CS/HB 1467, First Engrossed



  1  the department or board, as appropriate, may issue a citation

  2  to the applicant and may fine the applicant up to $50 for each

  3  day that the applicant is not in compliance with the

  4  requirements of s. 455.565. The citation must clearly state

  5  that the applicant may choose, in lieu of accepting the

  6  citation, to follow the procedure under s. 455.621. If the

  7  applicant disputes the matter in the citation, the procedures

  8  set forth in s. 455.621 must be followed. However, if the

  9  applicant does not dispute the matter in the citation with the

10  department within 30 days after the citation is served, the

11  citation becomes a final order and constitutes discipline.

12  Service of a citation may be made by personal service or

13  certified mail, restricted delivery, to the subject at the

14  applicant's last known address. The department may not delay

15  renewing a license due to the processing of a statewide

16  criminal history check or a national criminal background

17  check. If an applicant has received an initial license to

18  practice in this state after January 1, 1992, and has

19  submitted fingerprints to the department for a national

20  criminal history check upon initial licensure and is renewing

21  his or her license for the first time, then the applicant need

22  only submit the information and fee required for a statewide

23  criminal history check.

24         Section 46.  Paragraphs (p) and (dd) of subsection (1)

25  and paragraph (b) of subsection (2) of section 460.413,

26  Florida Statutes, 1998 Supplement, are amended to read:

27         460.413  Grounds for disciplinary action; action by the

28  board.--

29         (1)  The following acts shall constitute grounds for

30  which the disciplinary actions specified in subsection (2) may

31  be taken:


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                                       CS/HB 1467, First Engrossed



  1         (p)  Prescribing, dispensing, or administering any

  2  medicinal drug except as authorized by s. 460.403(9)(c)2. s.

  3  460.403(8)(c)2., performing any surgery, or practicing

  4  obstetrics.

  5         (dd)  Using acupuncture without being certified

  6  pursuant to s. 460.403(9)(f) s. 460.403(8)(f).

  7         (2)  When the board finds any person guilty of any of

  8  the grounds set forth in subsection (1), it may enter an order

  9  imposing one or more of the following penalties:

10         (d)  Imposition of an administrative fine not to exceed

11  $10,000 $2,000 for each count or separate offense.

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         Section 47.  Section 460.4165, Florida Statutes, is

22  amended to read:

23         460.4165  Certified chiropractic physician's

24  assistants.--

25         (1)  LEGISLATIVE INTENT.--The purpose of this section

26  is to encourage the more effective utilization of the skills

27  of chiropractic physicians by enabling them to delegate health

28  care tasks to qualified assistants when such delegation is

29  consistent with the patient's health and welfare and to allow

30  for innovative development of programs for the education of

31  physician's assistants.


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                                       CS/HB 1467, First Engrossed



  1         (2)  PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S

  2  ASSISTANT.--Notwithstanding any other provision of law, a

  3  certified chiropractic physician's assistant may perform

  4  chiropractic services in the specialty area or areas for which

  5  the certified chiropractic physician's assistant is trained or

  6  experienced when such services are rendered under the

  7  supervision of a licensed chiropractic physician or group of

  8  chiropractic physicians certified by the board.  Any certified

  9  chiropractic physician's assistant certified under this

10  section to perform services may perform those services only:

11         (a)  In the office of the chiropractic physician to

12  whom the certified chiropractic physician's assistant has been

13  assigned, in which office such physician maintains her or his

14  primary practice;

15         (b)  Under indirect supervision of When the

16  chiropractic physician to whom she or he is assigned as

17  defined by rule of the board is present;

18         (c)  In a hospital in which the chiropractic physician

19  to whom she or he is assigned is a member of the staff; or

20         (d)  On calls outside of the said office of the

21  chiropractic physician to whom she or he is assigned, on the

22  direct order of the chiropractic physician to whom she or he

23  is assigned.

24         (3)  THIRD-PARTY PAYORS.--This chapter does not prevent

25  third-party payors from reimbursing employers of chiropractic

26  physicians' assistants for covered services rendered by

27  certified chiropractic physicians' assistants.

28         (4)(3)  PERFORMANCE BY TRAINEES.--Notwithstanding any

29  other provision of law, a trainee may perform chiropractic

30  services when such services are rendered within the scope of

31  an approved program.


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                                       CS/HB 1467, First Engrossed



  1         (5)(4)  PROGRAM APPROVAL.--The department shall issue

  2  certificates of approval for programs for the education and

  3  training of certified chiropractic physician's assistants

  4  which meet board standards.  Any basic program curriculum

  5  certified by the board shall cover a period of 24 months. The

  6  curriculum must consist of at least 200 didactic classroom

  7  hours during those 24 months.

  8         (a)  In developing criteria for program approval, the

  9  board shall give consideration to, and encourage, the

10  utilization of equivalency and proficiency testing and other

11  mechanisms whereby full credit is given to trainees for past

12  education and experience in health fields.

13         (b)  The board shall create groups of specialty

14  classifications of training for certified chiropractic

15  physician's assistants.  These classifications shall reflect

16  the training and experience of the certified chiropractic

17  physician's assistant. The certified chiropractic physician's

18  assistant may receive training in one or more such

19  classifications, which shall be shown on the certificate

20  issued.

21         (c)  The board shall adopt and publish standards to

22  ensure that such programs operate in a manner which does not

23  endanger the health and welfare of the patients who receive

24  services within the scope of the program.  The board shall

25  review the quality of the curricula, faculties, and facilities

26  of such programs; issue certificates of approval; and take

27  whatever other action is necessary to determine that the

28  purposes of this section are being met.

29         (6)(5)  APPLICATION APPROVAL.--Any person desiring to

30  be licensed as a certified chiropractic physician's assistant

31  must apply to the department. The department shall issue a


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                                       CS/HB 1467, First Engrossed



  1  certificate to any person certified by the board as having met

  2  the following requirements:

  3         (a)  Is at least 18 years of age.

  4         (b)  Is a graduate of an approved program or its

  5  equivalent and is fully certified by reason of experience and

  6  education, as defined by board rule, to perform chiropractic

  7  services under the responsible supervision of a licensed

  8  chiropractic physician and when the board is satisfied that

  9  the public will be adequately protected by the arrangement

10  proposed in the application.

11         (c)  Has completed the application form and remitted an

12  application fee set by the board pursuant to this section. An

13  application for certification made by a chiropractic

14  physician's assistant must include:

15         1.  A certificate of completion of a physician's

16  assistant training program specified in subsection (5).

17         2.  A sworn statement of any prior felony conviction in

18  any jurisdiction.

19         3.  A sworn statement of any previous revocation or

20  denial of licensure or certification in any state or

21  jurisdiction.

22         (a)  The board shall adopt rules for the consideration

23  of applications by a licensed chiropractic physician or a

24  group of licensed chiropractic physicians to supervise

25  certified chiropractic physician's assistants.  Each

26  application made by a chiropractic physician or group of

27  chiropractic physicians shall include all of the following:

28         1.  The qualifications, including related experience,

29  of the certified chiropractic physician's assistant intended

30  to be employed.

31


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                                       CS/HB 1467, First Engrossed



  1         2.  The professional background and specialty of the

  2  chiropractic physician or the group of chiropractic

  3  physicians.

  4         3.  A description by the chiropractic physician of her

  5  or his practice, or by the chiropractic physicians of their

  6  practice, and of the way in which the assistant or assistants

  7  are to be utilized.

  8

  9  The board shall certify an application by a licensed

10  chiropractic physician to supervise a certified chiropractic

11  physician's assistant when the proposed assistant is a

12  graduate of an approved program or its equivalent and is fully

13  qualified by reason of experience and education to perform

14  chiropractic services under the responsible supervision of a

15  licensed chiropractic physician and when the board is

16  satisfied that the public will be adequately protected by the

17  arrangement proposed in the application.

18         (b)  The board shall certify no more than two certified

19  chiropractic physician's assistants for any chiropractic

20  physician practicing alone; no more than four chiropractic

21  physician's assistants for two chiropractic physicians

22  practicing together formally or informally; or no more than a

23  ratio of two certified chiropractic physician's assistants to

24  three chiropractic physicians in any group of chiropractic

25  physicians practicing together formally or informally.

26         (7)(6)  PENALTY.--Any person who has not been certified

27  by the board and approved by the department and who represents

28  herself or himself as a certified chiropractic physician's

29  assistant or who uses any other term in indicating or implying

30  that she or he is a certified chiropractic physician's

31  assistant is guilty of a felony of the third degree,


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                                       CS/HB 1467, First Engrossed



  1  punishable as provided in s. 775.082 or s. 775.084 or by a

  2  fine not exceeding $5,000.

  3         (8)(7)  REVOCATION OF APPROVAL.--The certificate of

  4  approval to supervise a certified chiropractic physician's

  5  assistant held by any chiropractic physician or group of

  6  chiropractic physicians may be revoked when the board

  7  determines that the intent of this section is not being

  8  carried out.

  9         (9)(8)  FEES.--

10         (a)  A fee not to exceed $100 set by the board shall

11  accompany the application by a chiropractic physician for

12  authorization to supervise a certified chiropractic

13  physician's assistant.

14         (b)  Upon approval of an application for certification

15  of a certified chiropractic physician's assistant in a

16  specialty area, the applicant shall be charged an initial

17  certification fee for the first biennium not to exceed $250;

18  and a biennial renewal fee not to exceed $250 shall accompany

19  each application for renewal of the certified chiropractic

20  physician's assistant certificate.

21         (10)(9)  EXISTING PROGRAMS.--Nothing in this section

22  shall be construed to eliminate or supersede existing laws

23  relating to other paramedical professions or services.  It is

24  the intent of this section to supplement all such existing

25  programs relating to the certification and the practice of

26  paramedical professions as may be authorized by law.

27         (11)(10)  LIABILITY.--Each chiropractic physician or

28  group of chiropractic physicians utilizing certified

29  chiropractic physician's assistants shall be liable for any

30  act or omission of any physician's assistant acting under her

31  or his or its supervision and control.


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  1         (12)  SUPERVISION OF REGISTERED CHIROPRACTIC

  2  ASSISTANT.--A certified chiropractic physician's assistant may

  3  directly supervise a registered chiropractic assistant and

  4  other persons who are not licensed as chiropractic physicians

  5  who are employed or supervised by the chiropractic physician

  6  to whom the certified chiropractic physician's assistant is

  7  assigned.

  8         (13)  CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION

  9  RENEWAL.--The certification must be renewed biennially.

10         (a)  Each renewal must include:

11         1.  A renewal fee as set by board pursuant to this

12  section.

13         2.  A sworn statement of no felony convictions in the

14  previous 2 years in any jurisdiction.

15         (b)  Each certified chiropractic physician's assistant

16  shall biennially complete 24 hours of continuing education

17  courses sponsored by chiropractic colleges accredited by the

18  Council on Chiropractic Education and approved by the board.

19  The board shall approve those courses that build upon the

20  basic courses required for the practice of chiropractic

21  medicine, and the board may also approve courses in adjunctive

22  modalities. The board may make exception from the requirements

23  of this section in emergency or hardship cases. The board may

24  adopt rules within the requirements of this section which are

25  necessary for its implementation.

26         (c)  Upon employment as a certified chiropractic

27  physician's assistant, a certified chiropractic physician's

28  assistant must notify the department in writing within 30 days

29  after such employment or any change of the supervising

30  chiropractic physician. The notification must include the full

31


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                                       CS/HB 1467, First Engrossed



  1  name, Florida chiropractic medical license number, specialty,

  2  and address of the supervising chiropractic physician.

  3         Section 48.  Persons holding certificates as certified

  4  chiropractic physicians' assistants on the effective date of

  5  this act need not reapply for certification, but must comply

  6  with biennial renewal requirements as provided in section

  7  460.4165(6), Florida Statutes. The requirement for completion

  8  of the continuing education requirements for biennial renewal

  9  of the certificate shall not take effect until the beginning

10  of the next biennial renewal period following the effective

11  date of this act.

12         Section 49.  Section 460.4166, Florida Statutes, is

13  amended to read:

14         460.4166  Registered chiropractic assistants.--

15         (1)  DEFINITION.--As used in this section, "registered

16  chiropractic assistant" means a professional, multiskilled

17  person dedicated to assisting in all aspects of chiropractic

18  medical practice under the direct supervision and

19  responsibility of a chiropractic physician or certified

20  chiropractic physician's assistant.  A registered chiropractic

21  assistant assists with patient care management, executes

22  administrative and clinical procedures, and often performs

23  managerial and supervisory functions. Competence in the field

24  also requires that a registered chiropractic assistant adhere

25  to ethical and legal standards of professional practice,

26  recognize and respond to emergencies, and demonstrate

27  professional characteristics.

28         (2)  DUTIES.--Under the direct supervision and

29  responsibility of a licensed chiropractic physician or

30  certified chiropractic physician's assistant, a registered

31  chiropractic assistant may:


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                                       CS/HB 1467, First Engrossed



  1         (a)  Perform clinical procedures, which include:

  2         1.  Preparing patients for the chiropractic physician's

  3  care.

  4         2.  Taking vital signs.

  5         3.  Observing and reporting patients' signs or

  6  symptoms.

  7         (b)  Administer basic first aid.

  8         (c)  Assist with patient examinations or treatments

  9  other than manipulations or adjustments.

10         (d)  Operate office equipment.

11         (e)  Collect routine laboratory specimens as directed

12  by the chiropractic physician or certified chiropractic

13  physician's assistant.

14         (f)  Administer nutritional supplements as directed by

15  the chiropractic physician or certified chiropractic

16  physician's assistant.

17         (g)  Perform office procedures required by the

18  chiropractic physician or certified chiropractic physician's

19  assistant under direct supervision of the chiropractic

20  physician or certified chiropractic physician's assistant.

21         (3)  REGISTRATION.--Registered chiropractic assistants

22  may be registered by the board for a biennial fee not to

23  exceed $25.

24         Section 50.  Section 461.003, Florida Statutes, 1998

25  Supplement, is amended to read:

26         461.003  Definitions.--As used in this chapter:

27         (1)  "Department" means the Department of Health.

28         (1)(2)  "Board" means the Board of Podiatric Medicine

29  as created in this chapter.

30         (2)  "Certified podiatric X-ray assistant" means a

31  person who is employed by and under the direct supervision of


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                                       CS/HB 1467, First Engrossed



  1  a licensed podiatric physician to perform only those

  2  radiographic functions that are within the scope of practice

  3  of a podiatric physician licensed under this chapter. For

  4  purposes of this subsection, the term "direct supervision"

  5  means supervision whereby a podiatric physician orders the X

  6  ray, remains on the premises while the X ray is being

  7  performed and exposed, and approves the work performed before

  8  dismissal of the patient.

  9         (3)  "Department" means the Department of Health.

10         (3)  "Practice of podiatric medicine" means the

11  diagnosis or medical, surgical, palliative, and mechanical

12  treatment of ailments of the human foot and leg.  The surgical

13  treatment of ailments of the human foot and leg shall be

14  limited anatomically to that part below the anterior tibial

15  tubercle.  The practice of podiatric medicine shall include

16  the amputation of the toes or other parts of the foot but

17  shall not include the amputation of the foot or leg in its

18  entirety.  A podiatric physician may prescribe drugs that

19  relate specifically to the scope of practice authorized

20  herein.

21         (4)  "Podiatric physician" means any person licensed to

22  practice podiatric medicine pursuant to this chapter.

23         (5)  "Practice of podiatric medicine" means the

24  diagnosis or medical, surgical, palliative, and mechanical

25  treatment of ailments of the human foot and leg.  The surgical

26  treatment of ailments of the human foot and leg shall be

27  limited anatomically to that part below the anterior tibial

28  tubercle.  The practice of podiatric medicine shall include

29  the amputation of the toes or other parts of the foot but

30  shall not include the amputation of the foot or leg in its

31  entirety.  A podiatric physician may prescribe drugs that


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                                       CS/HB 1467, First Engrossed



  1  relate specifically to the scope of practice authorized

  2  herein.

  3         Section 51.  Paragraph (d) of subsection (1) of section

  4  461.006, Florida Statutes, 1998 Supplement, is amended to

  5  read:

  6         461.006  Licensure by examination.--

  7         (1)  Any person desiring to be licensed as a podiatric

  8  physician shall apply to the department to take the licensure

  9  examination. The department shall examine each applicant who

10  the board certifies:

11         (d)  Beginning October 1, 1995, Has satisfactorily

12  completed one of the following clinical experience

13  requirements:

14         1.  One year of residency in a residency program

15  approved by the board, and if it has been 4 or more years

16  since the completion of that residency, active licensed

17  practice of podiatric medicine in another jurisdiction for at

18  least 2 of the immediately preceding 4 years, or successful

19  completion of a board-approved postgraduate program or

20  board-approved course within the year preceding the filing of

21  the application. For the purpose of this subparagraph, "active

22  licensed practice" means the licensed practice of podiatric

23  medicine as defined in s. 461.003(5) by podiatric physicians,

24  including podiatric physicians employed by any governmental

25  entity, on the active teaching faculty of an accredited school

26  of podiatric medicine, or practicing administrative podiatric

27  medicine.

28         2.  Ten years of continuous, active licensed practice

29  of podiatric medicine in another state immediately preceding

30  the submission of the application and completion of at least

31  the same continuing educational requirements during those 10


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                                       CS/HB 1467, First Engrossed



  1  years as are required of podiatric physicians licensed in this

  2  state.

  3         Section 52.  Subsection (1) of section 461.007, Florida

  4  Statutes, 1998 Supplement, is amended to read:

  5         461.007  Renewal of license.--

  6         (1)  The department shall renew a license upon receipt

  7  of the renewal application and a fee not to exceed $350 set by

  8  the board, and evidence that the applicant has actively

  9  practiced podiatric medicine or has been on the active

10  teaching faculty of an accredited school of podiatric medicine

11  for at least 2 years of the immediately preceding 4 years. If

12  the licensee has not actively practiced podiatric medicine for

13  at least 2 years of the immediately preceding 4 years, the

14  board shall require that the licensee successfully complete a

15  board-approved course prior to renewal of the license. For

16  purposes of this subsection, "actively practiced podiatric

17  medicine" means the licensed practice of podiatric medicine as

18  defined in s. 461.003(5) by podiatric physicians, including

19  podiatric physicians employed by any governmental entity, on

20  the active teaching faculty of an accredited school of

21  podiatric medicine, or practicing administrative podiatric

22  medicine. An applicant for a renewed license must also submit

23  the information required under s. 455.565 to the department on

24  a form and under procedures specified by the department, along

25  with payment in an amount equal to the costs incurred by the

26  Department of Health for the statewide criminal background

27  check of the applicant. An The applicant for a renewed license

28  who received an initial license in this state after January 1,

29  1992, must submit a set of fingerprints to the Department of

30  Health on a form and under procedures specified by the

31  department, along with payment in an amount equal to the costs


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                                       CS/HB 1467, First Engrossed



  1  incurred by the department for a national criminal background

  2  check of the applicant for the initial renewal of his or her

  3  license after January 1, 2000. If the applicant fails to

  4  submit either the information required under s. 455.565 or a

  5  set of fingerprints to the department as required by this

  6  section, the department shall issue a notice of noncompliance,

  7  and the applicant will be given 30 additional days to comply.

  8  If the applicant fails to comply within 30 days after the

  9  notice of noncompliance is issued, the department or board, as

10  appropriate, may issue a citation to the applicant and may

11  fine the applicant up to $50 for each day that the applicant

12  is not in compliance with the requirements of s. 455.565. The

13  citation must clearly state that the applicant may choose, in

14  lieu of accepting the citation, to follow the procedure under

15  s. 455.621. If the applicant disputes the matter in the

16  citation, the procedures set forth in s. 455.621 must be

17  followed. However, if the applicant does not dispute the

18  matter in the citation with the department within 30 days

19  after the citation is served, the citation becomes a final

20  order and constitutes discipline. Service of a citation may be

21  made by personal service or certified mail, restricted

22  delivery, to the subject at the applicant's last known

23  address. The department may not delay renewing a license due

24  to the processing of a statewide criminal history check or a

25  national criminal background check. If an applicant has

26  received an initial license to practice in this state after

27  January 1, 1992, and has submitted fingerprints to the

28  department for a national criminal history check upon initial

29  licensure and is renewing his or her license for the first

30  time, then the applicant need only submit the information and

31  fee required for a statewide criminal history check.


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                                       CS/HB 1467, First Engrossed



  1         Section 53.  Paragraph (bb) is added to subsection (1)

  2  of section 461.013, Florida Statutes, 1998 Supplement, and

  3  subsection (2) of that section is amended, to read:

  4         461.013  Grounds for disciplinary action; action by the

  5  board; investigations by department.--

  6         (1)  The following acts shall constitute grounds for

  7  which the disciplinary actions specified in subsection (2) may

  8  be taken:

  9         (bb)  Failing to comply with the requirements of ss.

10  381.026 and 381.0261 to provide patients with information

11  about their patient rights and how to file a patient

12  complaint.

13         (2)  When the board finds any person guilty of any of

14  the grounds set forth in subsection (1), it may enter an order

15  imposing one or more of the following penalties:

16         (a)  Refusal to certify to the department an

17  application for licensure.

18         (b)  Revocation or suspension of a license.

19         (c)  Restriction of practice.

20         (d)  Imposition of an administrative fine not to exceed

21  $10,000 $1,000 for each count or separate offense.

22         (e)  Issuance of a reprimand.

23         (f)  Placing the podiatric physician on probation for a

24  period of time and subject to such conditions as the board may

25  specify, including requiring the podiatric physician to submit

26  to treatment, to attend continuing education courses, to

27  submit to reexamination, and to work under the supervision of

28  another podiatric physician.

29         (g)  Imposition of an administrative fine in accordance

30  with s. 381.0261 for violations regarding patient rights.

31


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                                       CS/HB 1467, First Engrossed



  1         Section 54.  Section 461.0135, Florida Statutes, is

  2  created to read:

  3         461.0135  Operation of X-ray machines by podiatric

  4  X-ray assistants.--A licensed podiatric physician may utilize

  5  an X-ray machine, expose X-ray films, and interpret or read

  6  such films. The provision of part IV of chapter 468 to the

  7  contrary notwithstanding, a licensed podiatric physician may

  8  authorize or direct a certified podiatric X-ray assistant to

  9  operate such equipment and expose such films under the

10  licensed podiatric physician's direction and supervision,

11  pursuant to rules adopted by the board in accordance with s.

12  461.004, which ensures that such certified podiatric X-ray

13  assistant is competent to operate such equipment in a safe and

14  efficient manner by reason of training, experience, and

15  passage of a board-approved course which includes an

16  examination. The board shall issue a certificate to an

17  individual who successfully completes the board-approved

18  course and passes the examination to be administered by the

19  training authority upon completion of such course.

20         Section 55.  Subsection (3) is added to section

21  464.008, Florida Statutes, to read:

22         464.008  Licensure by examination.--

23         (3)  Any applicant who fails the examination three

24  consecutive times, regardless of the jurisdiction in which the

25  examination is taken, shall be required to complete a

26  board-approved remedial course before the applicant will be

27  approved for reexamination. After taking the remedial course,

28  the applicant may be approved to retake the examination up to

29  three additional times before the applicant is required to

30  retake remediation. The applicant shall apply for

31  reexamination within 6 months after completion of remediation.


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                                       CS/HB 1467, First Engrossed



  1  The board shall by rule establish guidelines for remedial

  2  courses.

  3         Section 56.  Subsection (13) is added to section

  4  464.022, Florida Statutes, to read:

  5         464.022  Exceptions.--No provision of this chapter

  6  shall be construed to prohibit:

  7         (13)  The practice of nursing by individuals enrolled

  8  in board-approved remedial courses.

  9         Section 57.  Subsection (12) of section 465.003,

10  Florida Statutes, is amended, subsections (4) through (14) of

11  said section are renumbered as subsections (5) through (15),

12  respectively, and a new subsection (4) is added to said

13  section, to read:

14         465.003  Definitions.--As used in this chapter, the

15  term:

16         (4)  "Data communication device" means an electronic

17  device that receives electronic information from one source

18  and transmits or routes it to another, including, but not

19  limited to, any such bridge, router, switch, or gateway.

20         (13)(12)  "Practice of the profession of pharmacy"

21  includes compounding, dispensing, and consulting concerning

22  contents, therapeutic values, and uses of any medicinal drug;

23  and consulting concerning therapeutic values and interactions

24  of patent or proprietary preparations, whether pursuant to

25  prescriptions or in the absence and entirely independent of

26  such prescriptions or orders; and other pharmaceutical

27  services. For purposes of this subsection, "other

28  pharmaceutical services" means the monitoring of the patient's

29  drug therapy and assisting the patient in the management of

30  his or her drug therapy, and includes review of the patient's

31  drug therapy and communication with the patient's prescribing


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                                       CS/HB 1467, First Engrossed



  1  health care provider as licensed under chapter 458, chapter

  2  459, chapter 461, or chapter 466, or similar statutory

  3  provision in another jurisdiction, or such provider's agent or

  4  such other persons as specifically authorized by the patient,

  5  regarding the drug therapy. However, nothing in this

  6  subsection may be interpreted to permit an alteration of a

  7  prescriber's directions, the diagnosis or treatment of any

  8  disease, the initiation of any drug therapy, the practice of

  9  medicine, or the practice of osteopathic medicine, unless

10  otherwise permitted by law. "Practice of the profession of

11  pharmacy" The phrase also includes any other act, service,

12  operation, research, or transaction incidental to, or forming

13  a part of, any of the foregoing acts, requiring, involving, or

14  employing the science or art of any branch of the

15  pharmaceutical profession, study, or training, and shall

16  expressly permit a pharmacist to transmit information from

17  persons authorized to prescribe medicinal drugs to their

18  patients.

19         Section 58.  Paragraph (l) of subsection (1) and

20  paragraph (c) of subsection (2) of section 465.016, Florida

21  Statutes, are amended, and paragraph (q) is added to

22  subsection (1) of that section, to read:

23         465.016  Disciplinary actions.--

24         (1)  The following acts shall be grounds for

25  disciplinary action set forth in this section:

26         (l)  Placing in the stock of any pharmacy any part of

27  any prescription compounded or dispensed which is returned by

28  a patient; however, in a hospital, nursing home, correctional

29  facility, or extended care facility in which unit-dose

30  medication is dispensed to inpatients, each dose being

31  individually sealed and the individual unit dose or unit-dose


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                                       CS/HB 1467, First Engrossed



  1  system labeled with the name of the drug, dosage strength,

  2  manufacturer's control number, and expiration date, if any,

  3  the unused unit dose of medication may be returned to the

  4  pharmacy for redispensing.  Each pharmacist shall maintain

  5  appropriate records for any unused or returned medicinal

  6  drugs.

  7         (q)  Using or releasing a patient's records except as

  8  authorized by this chapter and chapter 455.

  9         (2)  When the board finds any person guilty of any of

10  the grounds set forth in subsection (1), it may enter an order

11  imposing one or more of the following penalties:

12         (c)  Imposition of an administrative fine not to exceed

13  $5,000 $1,000 for each count or separate offense.

14         Section 59.  Section 465.014, Florida Statutes, is

15  amended to read:

16         465.014  Pharmacy technician.--No person other than a

17  licensed pharmacist or pharmacy intern may engage in the

18  practice of the profession of pharmacy, except that a licensed

19  pharmacist may delegate to nonlicensed pharmacy technicians

20  those duties, tasks, and functions which do not fall within

21  the purview of s. 465.003(13)(12).  All such delegated acts

22  shall be performed under the direct supervision of a licensed

23  pharmacist who shall be responsible for all such acts

24  performed by persons under his or her supervision.  A pharmacy

25  technician, under the supervision of a pharmacist, may

26  initiate or receive communications with a practitioner or his

27  or her agent, on behalf of a patient, regarding refill

28  authorization requests.  No licensed pharmacist shall

29  supervise more than one pharmacy technician unless otherwise

30  permitted by the guidelines adopted by the board.  The board

31  shall establish guidelines to be followed by licensees or


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                                       CS/HB 1467, First Engrossed



  1  permittees in determining the circumstances under which a

  2  licensed pharmacist may supervise more than one but not more

  3  than three pharmacy technicians.

  4         Section 60.  Paragraph (c) of subsection (2) of section

  5  465.015, Florida Statutes, is amended to read:

  6         465.015  Violations and penalties.--

  7         (2)  It is unlawful for any person:

  8         (c)  To sell or dispense drugs as defined in s.

  9  465.003(8)(7) without first being furnished with a

10  prescription.

11         Section 61.  Section 465.0196, Florida Statutes, is

12  amended to read:

13         465.0196  Special pharmacy permits.--Any person

14  desiring a permit to operate a pharmacy which does not fall

15  within the definitions set forth in s. 465.003(11)(10)(a)1.,

16  2., and 3. shall apply to the department for a special

17  pharmacy permit.  If the board certifies that the application

18  complies with the applicable laws and rules of the board

19  governing the practice of the profession of pharmacy, the

20  department shall issue the permit.  No permit shall be issued

21  unless a licensed pharmacist is designated to undertake the

22  professional supervision of the compounding and dispensing of

23  all drugs dispensed by the pharmacy.  The licensed pharmacist

24  shall be responsible for maintaining all drug records and for

25  providing for the security of the area in the facility in

26  which the compounding, storing, and dispensing of medicinal

27  drugs occurs.  The permittee shall notify the department

28  within 10 days of any change of the licensed pharmacist

29  responsible for such duties.

30         Section 62.  Subsection (3) of section 468.812, Florida

31  Statutes, is amended to read:


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                                       CS/HB 1467, First Engrossed



  1         468.812  Exemptions from licensure.--

  2         (3)  The provisions of this act relating to orthotics

  3  or pedorthics do not apply to any licensed pharmacist or to

  4  any person acting under the supervision of a licensed

  5  pharmacist.  The practice of orthotics or pedorthics by a

  6  pharmacist or any of the pharmacist's employees acting under

  7  the supervision of a pharmacist shall be construed to be

  8  within the meaning of the term "practice of the profession of

  9  pharmacy" as set forth in s. 465.003(13)(12), and shall be

10  subject to regulation in the same manner as any other pharmacy

11  practice.  The Board of Pharmacy shall develop rules regarding

12  the practice of orthotics and pedorthics by a pharmacist.  Any

13  pharmacist or person under the supervision of a pharmacist

14  engaged in the practice of orthotics or pedorthics shall not

15  be precluded from continuing that practice pending adoption of

16  these rules.

17         Section 63.  Subsection (19) of section 499.003,

18  Florida Statutes, is amended to read:

19         499.003  Definitions of terms used in ss.

20  499.001-499.081.--As used in ss. 499.001-499.081, the term:

21         (19)  "Legend drug," "prescription drug," or "medicinal

22  drug" means any drug, including, but not limited to, finished

23  dosage forms, or active ingredients subject to, defined by, or

24  described by s. 503(b) of the Federal Food, Drug, and Cosmetic

25  Act or s. 465.003(8)(7), s. 499.007(12), or s. 499.0122(1)(b)

26  or (c).

27         Section 64.  (1)  There is created within the

28  Department of Health a Task Force for the Study of

29  Collaborative Drug Therapy Management. The department shall

30  provide staff support for the task force. The task force shall

31  consist of not more than 10 members nominated by the


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                                       CS/HB 1467, First Engrossed



  1  associations and entities named in this section and appointed

  2  by the Secretary of Health. Members of the task force shall

  3  not receive compensation, per diem, or reimbursement for

  4  travel expenses for service on the task force. Participation

  5  in the task force is optional and at the discretion of each

  6  identified group or entity. The task force shall include:

  7         (a)  One representative from each of the following

  8  associations:

  9         1.  Florida Society of Health-System Pharmacists.

10         2.  Florida Pharmacy Association.

11         3.  Florida Medical Association.

12         4.  Florida Osteopathic Medical Association.

13         5.  Florida Retail Federation.

14         6.  Florida Nurses Association.

15         (b)  One representative from each of the following

16  entities:

17         1.  Department of Health.

18         2.  Board of Medicine, which representative must be a

19  member of the board who is licensed under chapter 458, Florida

20  Statutes.

21         3.  Board of Osteopathic Medicine, which representative

22  must be a member of the board who is licensed under chapter

23  459, Florida Statutes.

24         4.  Board of Pharmacy, which representative must be a

25  member of the board who is licensed under chapter 465, Florida

26  Statutes.

27         5.  Agency for Health Care Administration.

28         (2)  The task force shall hold its first meeting no

29  later than August 1, 1999, and shall report its findings to

30  the President of the Senate, the Speaker of the House of

31  Representatives, and the chairs of the applicable legislative


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  1  committees of substance not later than December 31, 1999. All

  2  task force meetings must be held in Tallahassee at the

  3  department in order to minimize costs to the state.

  4         (3)  The task force shall be charged with the

  5  responsibility to:

  6         (a)  Determine the states in which collaborative drug

  7  therapy management has been enacted by law or administrative

  8  rule and summarize the content of all such laws and rules.

  9         (b)  Receive testimony from interested parties and

10  identify the extent to which collaborative drug therapy

11  management is currently being practiced in this state and

12  other states.

13         (c)  Determine the efficacy of collaborative drug

14  therapy management in improving health care outcomes of

15  patients.

16         Section 65.  Section 466.021, Florida Statutes, is

17  amended to read:

18         466.021  Employment of unlicensed persons by dentist;

19  penalty.--Every duly licensed dentist who uses the services of

20  any unlicensed person for the purpose of constructing,

21  altering, repairing, or duplicating any denture, partial

22  denture, bridge splint, or orthodontic or prosthetic appliance

23  shall be required to furnish such unlicensed person with a

24  written work order in such form as prescribed shall be

25  approved by rule of the board department. This form shall be

26  supplied to the dentist by the department at a cost not to

27  exceed that of printing and handling. The work order blanks

28  shall be assigned to individual dentists and are not

29  transferable. This form shall be dated and signed by such

30  dentist and shall include the patient's name or number with

31  sufficient descriptive information to clearly identify the


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  1  case for each separate and individual piece of work. A; said

  2  work order shall be made in duplicate form, the duplicate copy

  3  of such work order shall to be retained in a permanent file in

  4  the dentist's office for a period of 2 years, and the original

  5  work order shall to be retained in a permanent file for a

  6  period of 2 years by such said unlicensed person in her or his

  7  place of business. Such permanent file of work orders to be

  8  kept by such dentist or by such unlicensed person shall be

  9  open to inspection at any reasonable time by the department or

10  its duly constituted agent. Failure of the dentist to keep

11  such permanent records of such said work orders shall subject

12  the dentist to suspension or revocation of her or his license

13  to practice dentistry. Failure of such unlicensed person to

14  have in her or his possession a work order as required by this

15  section above defined shall be admissible evidence of a

16  violation of this chapter and shall constitute a misdemeanor

17  of the second degree, punishable as provided in s. 775.082 or

18  s. 775.083. Nothing in this section shall preclude a

19  registered dental laboratory from working for another

20  registered dental laboratory, provided that such work is

21  performed pursuant to written authorization, in a form to be

22  prescribed by rule of the board department, which evidences

23  that the originating laboratory has obtained a valid work

24  order and which sets forth the work to be performed.

25  Furthermore, nothing in this section shall preclude a

26  registered laboratory from providing its services to dentists

27  licensed and practicing in another state, provided that such

28  work is requested or otherwise authorized in written form

29  which clearly identifies the name and address of the

30  requesting dentist and which sets forth the work to be

31  performed.


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  1         Section 66.  Paragraph (b) of subsection (2), paragraph

  2  (b) of subsection (3), and subsection (4) of section 468.1155,

  3  Florida Statutes, are amended to read:

  4         468.1155  Provisional license; requirements.--

  5         (2)  The department shall issue a provisional license

  6  to practice speech-language pathology to each applicant who

  7  the board certifies has:

  8         (b)  Received a master's degree or doctoral degree with

  9  a major emphasis in speech-language pathology from an

10  institution of higher learning which, at the time the

11  applicant was enrolled and graduated, was accredited by an

12  accrediting agency recognized by the Commission on Recognition

13  of Postsecondary Accreditation or from an institution which is

14  publicly recognized as a member in good standing with the

15  Association of Universities and Colleges of Canada.  An

16  applicant who graduated from a program at a university or

17  college outside the United States or Canada must present

18  documentation of the determination of equivalency to standards

19  established by the Commission on Recognition of Postsecondary

20  Accreditation in order to qualify.  The applicant must have

21  completed 60 semester hours that include:

22         1.  Fundamental information applicable to the normal

23  development and use of speech, hearing, and language;

24  information about training in management of speech, hearing,

25  and language disorders; and information supplementary to these

26  fields.

27         2.  Six semester hours in audiology.

28         3.  Thirty of the required 60 semester hours in courses

29  acceptable toward a graduate degree by the college or

30  university in which these courses were taken, of which 24

31  semester hours must be in speech-language pathology.


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                                       CS/HB 1467, First Engrossed



  1         (3)  The department shall issue a provisional license

  2  to practice audiology to each applicant who the board

  3  certifies has:

  4         (b)  Received a master's degree or doctoral degree with

  5  a major emphasis in audiology from an institution of higher

  6  learning which at the time the applicant was enrolled and

  7  graduated was accredited by an accrediting agency recognized

  8  by the Commission on Recognition of Postsecondary

  9  Accreditation or from an institution which is publicly

10  recognized as a member in good standing with the Association

11  of Universities and Colleges of Canada.  An applicant who

12  graduated from a program at a university or college outside

13  the United States or Canada must present documentation of the

14  determination of equivalency to standards established by the

15  Commission on Recognition of Postsecondary Accreditation in

16  order to qualify.  The applicant must have completed 60

17  semester hours that include:

18         1.  Fundamental information applicable to the normal

19  development and use of speech, hearing, and language;

20  information about training in management of speech, hearing,

21  and language disorders; and information supplementary to these

22  fields.

23         2.  Six semester hours in speech-language pathology.

24         3.  Thirty of the required 60 semester hours in courses

25  acceptable toward a graduate degree by the college or

26  university in which these courses were taken, of which 24

27  semester hours must be in audiology.

28         (4)  An applicant for a provisional license who has

29  received a master's degree or doctoral degree with a major

30  emphasis in speech-language pathology as provided in

31  subsection (2), or audiology as provided in subsection (3),


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                                       CS/HB 1467, First Engrossed



  1  and who seeks licensure in the area in which the applicant is

  2  not currently licensed, must have completed 30 semester hours

  3  in courses acceptable toward a graduate degree and 200

  4  supervised clinical clock hours in the second discipline from

  5  an accredited institution.

  6         Section 67.  Section 468.1215, Florida Statutes, is

  7  amended to read:

  8         468.1215  Speech-language pathology assistant and

  9  audiology assistant; certification.--

10         (1)  A person desiring to be certified as a

11  speech-language pathology assistant or audiology assistant

12  shall apply to the department.

13         (1)(2)  The department shall issue a certificate as a

14  speech-language pathology assistant or as an audiology

15  assistant to each applicant who the board certifies has:

16         (a)  Completed the application form and remitted the

17  required fees, including a nonrefundable application fee.

18         (b)  Earned a bachelor's degree from a college or

19  university accredited by a regional association of colleges

20  and schools recognized by the Department of Education which

21  includes at least 24 semester hours of coursework as approved

22  by the board at an institution accredited by an accrediting

23  agency recognized by the Commission on Recognition of

24  Postsecondary Accreditation.

25         (2)  The department shall issue a certificate as an

26  audiology assistant to each applicant who the board certifies

27  has:

28         (a)  Completed the application form and remitted the

29  required fees, including a nonrefundable application fee.

30         (b)  Completed at least 24 semester hours of coursework

31  as approved by the board at an institution accredited by an


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                                       CS/HB 1467, First Engrossed



  1  accrediting agency recognized by the Commission on Recognition

  2  of Postsecondary Accreditation.

  3         (3)  The board, by rule, shall establish minimum

  4  education and on-the-job training and supervision requirements

  5  for certification as a speech-language pathology assistant or

  6  audiology assistant.

  7         (4)  The provisions of this section shall not apply to

  8  any student, intern, or trainee performing speech-language

  9  pathology or audiology services while completing the

10  supervised clinical clock hours as required in s. 468.1155.

11         Section 68.  Subsection (1) of section 468.307, Florida

12  Statutes, 1998 Supplement, is amended to read:

13         468.307  Certificate; issuance; possession; display.--

14         (1)  The department shall issue a certificate to each

15  candidate who has met the requirements of ss. 468.304 and

16  468.306 or has qualified under s. 468.3065. The department may

17  by rule establish a subcategory of a certificate issued under

18  this part limiting the certificateholder to a specific

19  procedure or specific type of equipment.

20         Section 69.  Section 468.506, Florida Statutes, 1998

21  Supplement, is amended to read:

22         468.506  Dietetics and Nutrition Practice

23  Council.--There is created the Dietetics and Nutrition

24  Practice Council under the supervision of the board.  The

25  council shall consist of four persons licensed under this part

26  and one consumer who is 60 years of age or older.  Council

27  members shall be appointed by the board. Licensed members

28  shall be appointed based on the proportion of licensees within

29  each of the respective disciplines.  Members shall be

30  appointed for 4-year staggered terms.  In order to be eligible

31  for appointment, each licensed member must have been a


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                                       CS/HB 1467, First Engrossed



  1  licensee under this part for at least 3 years prior to his or

  2  her appointment.  No council member shall serve more than two

  3  successive terms.  The board may delegate such powers and

  4  duties to the council as it may deem proper to carry out the

  5  operations and procedures necessary to effectuate the

  6  provisions of this part.  However, the powers and duties

  7  delegated to the council by the board must encompass both

  8  dietetics and nutrition practice and nutrition counseling. Any

  9  time there is a vacancy on the council, any professional

10  association composed of persons licensed under this part may

11  recommend licensees to fill the vacancy to the board in a

12  number at least twice the number of vacancies to be filled,

13  and the board may appoint from the submitted list, in its

14  discretion, any of those persons so recommended.  Any

15  professional association composed of persons licensed under

16  this part may file an appeal regarding a council appointment

17  with the secretary director of the department agency, whose

18  decision shall be final.  The board shall fix council members'

19  compensation and pay their expenses in the same manner as

20  provided in s. 455.534.

21         Section 70.  Section 468.701, Florida Statutes, 1998

22  Supplement, is amended to read:

23         468.701  Definitions.--As used in this part, the term:

24         (1)  "Athlete" means a person who participates in an

25  athletic activity.

26         (2)  "Athletic activity" means the participation in an

27  activity, conducted by an educational institution, a

28  professional athletic organization, or an amateur athletic

29  organization, involving exercises, sports, games, or

30  recreation requiring any of the physical attributes of

31


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                                       CS/HB 1467, First Engrossed



  1  strength, agility, flexibility, range of motion, speed, and

  2  stamina.

  3         (3)  "Athletic injury" means an injury sustained which

  4  affects the athlete's ability to participate or perform in

  5  athletic activity.

  6         (4)  "Athletic trainer" means a person licensed under

  7  this part.

  8         (5)  "Athletic training" means the recognition,

  9  prevention, and treatment of athletic injuries.

10         (6)  "Board Council" means the Board Council of

11  Athletic Training.

12         (7)  "Department" means the Department of Health.

13         (8)  "Direct supervision" means the physical presence

14  of the supervisor on the premises so that the supervisor is

15  immediately available to the trainee when needed.

16         (9)  "Secretary" means the Secretary of Health.

17         (9)(10)  "Supervision" means the easy availability of

18  the supervisor to the athletic trainer, which includes the

19  ability to communicate by telecommunications.

20         Section 71.  Section 468.703, Florida Statutes, 1998

21  Supplement, is amended to read:

22         468.703  Board Council of Athletic Training.--

23         (1)  The Board Council of Athletic Training is created

24  within the department and shall consist of nine seven members

25  to be appointed by the Governor and confirmed by the Senate

26  secretary.

27         (2)  Five Four members of the board must council shall

28  be licensed athletic trainers. One member of the board must

29  council shall be a physician licensed under chapter 458 or

30  chapter 459. One member of the board must council shall be a

31  physician licensed under chapter 460. Two members One member


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                                       CS/HB 1467, First Engrossed



  1  of the board shall be consumer members, each of whom must

  2  council shall be a resident of this state who has never worked

  3  as an athletic trainer, who has no financial interest in the

  4  practice of athletic training, and who has never been a

  5  licensed health care practitioner as defined in s. 455.501(4).

  6  Members of the council shall serve staggered 4-year terms as

  7  determined by rule of the department; however, no member may

  8  serve more than two consecutive terms.

  9         (3)  For the purpose of staggering terms, the Governor

10  shall appoint the initial members of the board as follows:

11         (a)  Three members for terms of 2 years each.

12         (b)  Three members for terms of 3 years each.

13         (c)  Three members for terms of 4 years each.

14         (4)  As the terms of the members expire, the Governor

15  shall appoint successors for terms of 4 years and such members

16  shall serve until their successors are appointed.

17         (5)  All provisions of part II of chapter 455 relating

18  to activities of the board shall apply.

19         (6)  The board shall maintain its official headquarters

20  in Tallahassee.

21         (3)  The council shall advise and assist the department

22  in:

23         (a)  Developing rules relating to licensure

24  requirements, the licensure examination, continuing education

25  requirements, fees, records and reports to be filed by

26  licensees, and any other requirements necessary to regulate

27  the practice of athletic training.

28         (b)  Monitoring the practice of athletic training in

29  other jurisdictions.

30         (c)  Educating the public about the role of athletic

31  trainers.


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                                       CS/HB 1467, First Engrossed



  1         (d)  Collecting and reviewing data regarding the

  2  licensed practice of athletic training.

  3         (e)  Addressing concerns and problems of athletic

  4  trainers in order to promote improved safety in the practice

  5  of athletic training.

  6         (4)  Members of the council shall be entitled to

  7  compensation and reimbursement for expenses in the same manner

  8  as board members are compensated and reimbursed under s.

  9  455.534.

10         Section 72.  Section 468.705, Florida Statutes, 1998

11  Supplement, is amended to read:

12         468.705  Rulemaking authority.--The board department is

13  authorized to adopt rules pursuant to ss. 120.536(1) and

14  120.54 to implement provisions of this part conferring duties

15  upon it. Such rules shall include, but not be limited to, the

16  allowable scope of practice regarding the use of equipment,

17  procedures, and medication, and requirements for a written

18  protocol between the athletic trainer and a supervising

19  physician, licensure requirements, licensure examination,

20  continuing education requirements, fees, records, and reports

21  to be filed by licensees, protocols, and any other

22  requirements necessary to regulate the practice of athletic

23  training.

24         Section 73.  Section 468.707, Florida Statutes, 1998

25  Supplement, is amended to read:

26         468.707  Licensure by examination; requirements.--

27         (1)  Any person desiring to be licensed as an athletic

28  trainer shall apply to the department on a form approved by

29  the department.

30         (a)  The department shall license each applicant who:

31


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                                       CS/HB 1467, First Engrossed



  1         1.  Has completed the application form and remitted the

  2  required fees.

  3         2.  Is at least 21 years of age.

  4         3.  Has obtained a baccalaureate degree from a college

  5  or university accredited by an accrediting agency recognized

  6  and approved by the United States Department of Education or

  7  the Commission on Recognition of Postsecondary Accreditation,

  8  or approved by the board department.

  9         4.  Has completed coursework from a college or

10  university accredited by an accrediting agency recognized and

11  approved by the United States Department of Education or the

12  Commission on Recognition of Postsecondary Accreditation, or

13  approved by the board department, in each of the following

14  areas, as provided by rule: health, human anatomy,

15  kinesiology/biomechanics, human physiology, physiology of

16  exercise, basic athletic training, and advanced athletic

17  training.

18         5.  Has current certification in standard first aid and

19  cardiovascular pulmonary resuscitation from the American Red

20  Cross or an equivalent certification as determined by the

21  board department.

22         6.  Has, within 2 of the preceding 5 years, attained a

23  minimum of 800 hours of athletic training experience under the

24  direct supervision of a licensed athletic trainer or an

25  athletic trainer certified by the National Athletic Trainers'

26  Association or a comparable national athletic standards

27  organization.

28         7.  Has passed an examination administered or approved

29  by the board department.

30         (b)  The department shall also license each applicant

31  who:


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                                       CS/HB 1467, First Engrossed



  1         1.  Has completed the application form and remitted the

  2  required fees no later than October 1, 1996.

  3         2.  Is at least 21 years of age.

  4         3.  Has current certification in standard first aid and

  5  cardiovascular pulmonary resuscitation from the American Red

  6  Cross or an equivalent certification as determined by the

  7  board department.

  8         4.a.  Has practiced athletic training for at least 3 of

  9  the 5 years preceding application; or

10         b.  Is currently certified by the National Athletic

11  Trainers' Association or a comparable national athletic

12  standards organization.

13         (2)  Pursuant to the requirements of s. 455.607

14  455.604, each applicant shall complete a continuing education

15  course on human immunodeficiency virus and acquired immune

16  deficiency syndrome as part of initial licensure.

17         Section 74.  Section 468.709, Florida Statutes, is

18  amended to read:

19         468.709  Fees.--

20         (1)  The board department shall, by rule, establish

21  fees for the following purposes:

22         (a)  An application fee, not to exceed $100.

23         (b)  An examination fee, not to exceed $200.

24         (c)  An initial licensure fee, not to exceed $200.

25         (d)  A biennial renewal fee, not to exceed $200.

26         (e)  An inactive fee, not to exceed $100.

27         (f)  A delinquent fee, not to exceed $100.

28         (g)  A reactivation fee, not to exceed $100.

29         (h)  A voluntary inactive fee, not to exceed $100.

30         (2)  The board department shall establish fees at a

31  level, not to exceed the statutory fee cap, that is adequate


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                                       CS/HB 1467, First Engrossed



  1  to ensure the continued operation of the regulatory program

  2  under this part. The board department shall neither set nor

  3  maintain the fees at a level that will substantially exceed

  4  this need.

  5         Section 75.  Subsections (2) and (3) of section

  6  468.711, Florida Statutes, 1998 Supplement, are amended to

  7  read:

  8         468.711  Renewal of license; continuing education.--

  9         (2)  The board department may, by rule, prescribe

10  continuing education requirements, not to exceed 24 hours

11  biennially. The criteria for continuing education shall be

12  approved by the board department and shall include 4 hours in

13  standard first aid and cardiovascular pulmonary resuscitation

14  from the American Red Cross or equivalent training as

15  determined by board department.

16         (3)  Pursuant to the requirements of s. 455.607

17  455.604, each licensee shall complete a continuing education

18  course on human immunodeficiency virus and acquired immune

19  deficiency syndrome as part of biennial relicensure.

20         Section 76.  Subsection (2) of section 468.719, Florida

21  Statutes, 1998 Supplement, is amended to read:

22         468.719  Disciplinary actions.--

23         (2)  When the board department finds any person guilty

24  of any of the acts set forth in subsection (1), the board

25  department may enter an order imposing one or more of the

26  penalties provided in s. 455.624.

27         Section 77.  Section 468.721, Florida Statutes, is

28  amended to read:

29         468.721  Saving clause.--

30         (1)  An athletic trainer registration which is valid on

31  October 1, 1995, shall become for all purposes an athletic


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                                       CS/HB 1467, First Engrossed



  1  trainer license as required by this part, subject to any

  2  disciplinary or administrative action pending on October 1,

  3  1995, and shall be subject to all the same terms and

  4  conditions as athletic trainer licenses issued after October

  5  1, 1995. The department shall retain jurisdiction to impose

  6  discipline for any violation of this part which occurred prior

  7  to October 1, 1995, but is discovered after October 1, 1995,

  8  under the terms of this part prior to October 1, 1995.

  9         (2)  No judicial or administrative proceeding pending

10  on July 1, 1995, shall be abated as a result of enactment of

11  any provision of this act.

12         (3)  Rules adopted by the department relating to the

13  regulation registration of athletic trainers under this part

14  prior to July 1, 1999, shall remain in effect until the board

15  department adopts rules relating to the regulation licensure

16  of athletic trainers under this part which supersede such

17  earlier rules.

18         Section 78.  Paragraph (g) of subsection (3) of section

19  20.43, Florida Statutes, 1998 Supplement, is amended to read:

20         20.43  Department of Health.--There is created a

21  Department of Health.

22         (3)  The following divisions of the Department of

23  Health are established:

24         (g)  Division of Medical Quality Assurance, which is

25  responsible for the following boards and professions

26  established within the division:

27         1.  Nursing assistants, as provided under s. 400.211.

28         2.  Health care services pools, as provided under s.

29  402.48.

30         3.  The Board of Acupuncture, created under chapter

31  457.


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                                       CS/HB 1467, First Engrossed



  1         4.  The Board of Medicine, created under chapter 458.

  2         5.  The Board of Osteopathic Medicine, created under

  3  chapter 459.

  4         6.  The Board of Chiropractic Medicine, created under

  5  chapter 460.

  6         7.  The Board of Podiatric Medicine, created under

  7  chapter 461.

  8         8.  Naturopathy, as provided under chapter 462.

  9         9.  The Board of Optometry, created under chapter 463.

10         10.  The Board of Nursing, created under chapter 464.

11         11.  The Board of Pharmacy, created under chapter 465.

12         12.  The Board of Dentistry, created under chapter 466.

13         13.  Midwifery, as provided under chapter 467.

14         14.  The Board of Speech-Language Pathology and

15  Audiology, created under part I of chapter 468.

16         15.  The Board of Nursing Home Administrators, created

17  under part II of chapter 468.

18         16.  The Board of Occupational Therapy, created under

19  part III of chapter 468.

20         17.  Respiratory therapy, as provided under part V of

21  chapter 468.

22         18.  Dietetics and nutrition practice, as provided

23  under part X of chapter 468.

24         19.  The Board of Athletic Training trainers, created

25  as provided under part XIII of chapter 468.

26         20.  The Board of Orthotists and Prosthetists, created

27  under part XIV of chapter 468.

28         21.  Electrolysis, as provided under chapter 478.

29         22.  The Board of Massage Therapy, created under

30  chapter 480.

31


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                                       CS/HB 1467, First Engrossed



  1         23.  The Board of Clinical Laboratory Personnel,

  2  created under part III of chapter 483.

  3         24.  Medical physicists, as provided under part IV of

  4  chapter 483.

  5         25.  The Board of Opticianry, created under part I of

  6  chapter 484.

  7         26.  The Board of Hearing Aid Specialists, created

  8  under part II of chapter 484.

  9         27.  The Board of Physical Therapy Practice, created

10  under chapter 486.

11         28.  The Board of Psychology, created under chapter

12  490.

13         29.  School psychologists, as provided under chapter

14  490.

15         30.  The Board of Clinical Social Work, Marriage and

16  Family Therapy, and Mental Health Counseling, created under

17  chapter 491.

18

19  The department may contract with the Agency for Health Care

20  Administration who shall provide consumer complaint,

21  investigative, and prosecutorial services required by the

22  Division of Medical Quality Assurance, councils, or boards, as

23  appropriate.

24         Section 79.  The Council of Athletic Training and the

25  terms of all council members are terminated on July 1, 1999.

26  However, such termination in no way precludes the Governor

27  from considering any former council member for appointment to

28  the Board of Athletic Training created by this act.

29         Section 80.  Section 468.805, Florida Statutes, is

30  amended to read:

31


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                                       CS/HB 1467, First Engrossed



  1         468.805  Grandfathering Licensure without examination;

  2  provisional licensure.--

  3         (1)  A person who has practiced orthotics, prosthetics,

  4  or pedorthics in this state for the required period since July

  5  1, 1990, who, before March 1, 1998, applies to the department

  6  for a license to practice orthotics, prosthetics, or

  7  pedorthics, may be licensed as a prosthetist, orthotist,

  8  prosthetist-orthotist, orthotic fitter, orthotic fitter

  9  assistant, or pedorthist, as determined from the person's

10  experience, certification, and educational preparation,

11  without meeting the educational requirements set forth in s.

12  468.803, upon receipt of the application fee and licensing fee

13  and after the board has completed an investigation into the

14  applicant's background and experience. The board shall require

15  an application fee not to exceed $500, which shall be

16  nonrefundable. The board shall complete its investigation

17  within 6 months after receipt of the completed application.

18  The period of experience required for licensure under this

19  section subsection is 5 years for a prosthetist; 2 years for

20  an orthotic fitter, an orthotic fitter assistant, or a

21  pedorthist; and 5 years for an orthotist whose scope of

22  practice is defined under s. 468.80(7).

23         (2)(a)  A person who has received certification as an

24  orthotist, a prosthetist, or a prosthetist-orthotist from a

25  national certifying body and who has practiced orthotics or

26  prosthetics in this state for at least 2 years but less than 5

27  years is eligible for a provisional license.

28         (b)  An applicant for provisional licensure shall

29  submit proof that he or she has been actively practicing as a

30  nationally certified orthotist, prosthetist, or

31


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                                       CS/HB 1467, First Engrossed



  1  prosthetist-orthotist, an application fee, and a provisional

  2  license fee.

  3         (c)  A provisional licensee is required to practice

  4  under supervision of a fully licensed orthotist, prosthetist,

  5  or prosthetist-orthotist for up to 3 years in order to meet

  6  the 5-year experience requirement of subsection (1) to be

  7  licensed as an orthotist, prosthetist, or

  8  prosthetist-orthotist.

  9         (d)  After appropriate investigation, the board shall

10  license as an orthotist, prosthetist, or prosthetist-orthotist

11  the provisional licensee who has successfully completed the

12  period of experience required and otherwise meets the

13  requirements of subsection (1).

14         (e)  The board shall require an application fee, not to

15  exceed $500, which is nonrefundable, and a provisional

16  licensure fee, not to exceed $500.

17         (3)  An applicant who has received certification as an

18  orthotist, a prosthetist, a prosthetist-orthotist, or a

19  pedorthist from a national certifying body which requires the

20  successful completion of an examination, may be licensed under

21  this section without taking an additional examination. An

22  applicant who has not received certification from a national

23  certifying body which requires the successful completion of an

24  examination shall be required to take an examination as

25  determined by the board. This examination shall be designed to

26  determine if the applicant has the minimum qualifications

27  needed to be licensed under this section. The board may charge

28  an examination fee and the actual per applicant cost to the

29  department for purchase or development of the examination.

30         (4)  An applicant who successfully completed prior to

31  March 1, 1998, at least one-half of the examination required


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                                       CS/HB 1467, First Engrossed



  1  for national certification and successfully completed the

  2  remaining portion of the examination and became certified

  3  prior to July 1, 1998, shall be considered as nationally

  4  certified by March 1, 1998, for purposes of this section.

  5         (5)(4)  This section is repealed July 1, 2002.

  6         Section 81.  Subsection (3) of section 468.806, Florida

  7  Statutes, is amended to read:

  8         468.806  Biennial renewal of license.--

  9         (3)  The board may by rule prescribe continuing

10  education requirements and approve course criteria, not to

11  exceed 30 hours biennially, as a condition for license

12  renewal. The board shall establish a procedure for approving

13  continuing education courses and providers and may set a fee

14  for continuing education course and provider approval.

15         Section 82.  Subsection (5) of section 478.42, Florida

16  Statutes, is amended to read:

17         478.42  Definitions.--As used in this chapter, the

18  term:

19         (5)  "Electrolysis or electrology" means the permanent

20  removal of hair by destroying introducing, into and beneath

21  the skin, ionizing (galvanic current) or nonionizing radiation

22  (thermolysis or high-frequency current) to destroy the

23  hair-producing cells of the skin and vascular system, using

24  equipment and needle-type epilation devices approved by the

25  board which have been cleared by and that are registered with

26  the United States Food and Drug Administration and that are

27  used pursuant to protocols approved by the council and the

28  board.

29         Section 83.  Section 483.041, Florida Statutes, is

30  amended to read:

31         483.041  Definitions.--As used in this part, the term:


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                                       CS/HB 1467, First Engrossed



  1         (1)  "Agency" means the Agency for Health Care

  2  Administration.

  3         (2)  "Clinical laboratory" means the physical location

  4  in which one or more of the following services a laboratory

  5  where examinations are performed on materials or specimens

  6  taken from the human body to provide information or materials

  7  for use in the diagnosis, prevention, or treatment of a

  8  disease or the identification or assessment of a medical or

  9  physical condition.

10         (a)  Clinical laboratory services are the examinations

11  of fluids or other materials taken from the human body.

12         (b)  Anatomic laboratory services are the examinations

13  of tissue taken from the human body.

14         (c)  Cytology laboratory services are the examinations

15  of cells from individual tissues or fluid taken from the human

16  body.

17         (3)  "Clinical laboratory examination" means a

18  procedure performed to deliver the services defined in

19  subsection (2), including the oversight or interpretation

20  thereof.

21         (4)(3)  "Clinical laboratory proficiency testing

22  program" means a program approved by the agency for evaluating

23  the performance of clinical laboratories.

24         (5)(4)  "Collection station" or "branch office" means a

25  facility operated by a clinical laboratory where materials or

26  specimens are withdrawn or collected from patients or

27  assembled after being withdrawn or collected from patients

28  elsewhere, for subsequent delivery to another location for

29  examination.

30         (6)(5)  "Hospital laboratory" means a laboratory

31  located in a hospital licensed under chapter 395 that provides


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                                       CS/HB 1467, First Engrossed



  1  services solely to that hospital and that is owned by the

  2  hospital and governed by the hospital medical staff or

  3  governing board.

  4         (7)(6)  "Licensed practitioner" means a physician

  5  licensed under chapter 458, chapter 459, chapter 460, or

  6  chapter 461; a dentist licensed under chapter 466; a person

  7  licensed under chapter 462; or an advanced registered nurse

  8  practitioner licensed under chapter 464 or a duly licensed

  9  practitioner from another state licensed under similar

10  statutes who orders examinations on materials or specimens for

11  non residents of the State of Florida, but who reside in the

12  same state as the requesting licensed practitioner.

13         (8)(7)  "Person" means the State of Florida or any

14  individual, firm, partnership, association, corporation,

15  county, municipality, political subdivision, or other entity,

16  whether organized for profit or not.

17         (9)(8)  "Validation inspection" means an inspection of

18  a clinical laboratory by the agency to assess whether a review

19  by an accrediting organization has adequately evaluated the

20  clinical laboratory according to state standards.

21         (10)(9)  "Waived test" means a test that the federal

22  Health Care Financing Administration has determined qualifies

23  for a certificate of waiver under the federal Clinical

24  Laboratory Improvement Amendments of 1988, and the federal

25  rules adopted thereunder.

26         Section 84.  Subsections (2), (3), and (7) of section

27  483.803, Florida Statutes, are amended to read:

28         483.803  Definitions.--As used in this part, the term:

29         (2)  "Clinical laboratory" means a clinical laboratory

30  as defined in s. 483.041(2).

31


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                                       CS/HB 1467, First Engrossed



  1         (3)  "Clinical laboratory examination" means a clinical

  2  laboratory examination as defined in s. 483.041 an examination

  3  performed on materials or specimens of the human body to

  4  provide information or materials for use in the diagnosis,

  5  prevention, or treatment of a disease or the identification or

  6  assessment of a medical or physical condition.

  7         (7)  "Licensed practitioner of the healing arts" means

  8  a physician licensed under pursuant to chapter 458, chapter

  9  459, or chapter 460, or chapter 461; a dentist licensed under

10  pursuant to chapter 466; or a person licensed under pursuant

11  to chapter 461 or chapter 462.

12

13

14         Section 85.  Subsection (9) of section 483.807, Florida

15  Statutes, 1998 Supplement, is amended to read:

16         483.807  Fees; establishment; disposition.--

17         (9)  The initial application and renewal fee for

18  approval as a laboratory training program may not exceed $300.

19  The fee for late filing of a renewal application shall be $50.

20         Section 86.  Subsections (2) and (3) of section

21  483.809, Florida Statutes, are amended to read:

22         483.809  Licensure; examinations; registration of

23  trainees; approval of curricula.--

24         (2)  EXAMINATIONS.--The department shall conduct

25  examinations required by board rules to determine in part the

26  qualification of clinical laboratory personnel for licensure.

27  The board by rule may designate a An approved national

28  certification examination that may be accepted in lieu of

29  state examination for clinical laboratory personnel or public

30  health scientists.

31


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                                       CS/HB 1467, First Engrossed



  1         (3)  REGISTRATION OF TRAINEES.--The department shall

  2  provide for annual registration of clinical laboratory

  3  trainees who are enrolled in a training program employed by

  4  laboratories approved pursuant to s. 483.811, which

  5  registration may not be renewed except upon special

  6  authorization of the board.

  7         Section 87.  Section 483.812, Florida Statutes, is

  8  amended to read:

  9         483.812  Public health laboratory scientists;

10  licensure.--

11         (1)  Applicants at the director level in the category

12  of public health shall qualify under s. 483.824.

13         (2)(1)  Applicants at the director and supervisor level

14  in the category of public health who are certified registered

15  by the National Registry in of Clinical Chemistry

16  Certification or the American Society for of Microbiology,

17  licensed as a technologist, and have 5 years of pertinent

18  clinical laboratory experience may qualify under board rules

19  by passing the state-administered appropriate supervision and

20  administration examination.

21         (3)(2)(a)  A technologist applicant for licensure in

22  the category of public health microbiology, with a

23  baccalaureate degree in one of the biological sciences from an

24  accredited institution, may use the American Society for of

25  Microbiology or the National Registry in of Microbiology

26  Certification in Public Health Microbiology to qualify for a

27  technologist license in public health microbiology.  Such a

28  technologist may work in a public health microbiology

29  laboratory.

30         (b)  A technologist applicant for licensure in the

31  category of public health chemistry, with a baccalaureate


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                                       CS/HB 1467, First Engrossed



  1  degree in one of the chemical, biological, or physical

  2  sciences from an accredited institution, may use the National

  3  Registry of Clinical Chemistry Certification to qualify for a

  4  technologist license in public health chemistry.  Such a

  5  technologist may work in a public health chemistry laboratory.

  6         (c)  A technician applicant for licensure in the

  7  category of public health, with a baccalaureate degree in one

  8  of the chemical or biological sciences from an accredited

  9  institution, may obtain a 2-year one-time, 3-year, conditional

10  public health technician license, which may be renewed once

11  pending national certification by the American Society of

12  Microbiology or the National Registry of Clinical Chemistry

13  Certification. Such a technician may perform testing only

14  under the direct supervision of a licensed pathologist,

15  director, supervisor, or technologist.

16         (4)(3)  A person licensed by the Board of Clinical

17  Laboratory Personnel may work in a public health laboratory at

18  the appropriate level and specialty.

19         Section 88.  Section 483.813, Florida Statutes, is

20  amended to read:

21         483.813  Clinical laboratory personnel license.--A

22  person may not conduct a clinical laboratory examination or

23  report the results of such examination unless such person is

24  licensed under this part to perform such procedures. However,

25  this provision does not apply to any practitioner of the

26  healing arts authorized to practice in this state or to

27  persons engaged in testing performed by laboratories regulated

28  under s. 483.035(1) or exempt from regulation under s.

29  483.031(2). The department may grant a temporary license to

30  any candidate it deems properly qualified, for a period not to

31


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                                       CS/HB 1467, First Engrossed



  1  exceed 1 year, or a conditional license for a period not to

  2  exceed 3 years.

  3         Section 89.  Subsection (3) is added to section

  4  483.821, Florida Statutes, to read:

  5         483.821  Periodic demonstration of competency;

  6  continuing education or reexamination.--

  7         (3)  The board may, by rule, provide for continuing

  8  education or retraining requirements for candidates failing an

  9  examination two or more times.

10         Section 90.  Section 483.824, Florida Statutes, is

11  amended to read:

12         483.824  Qualifications of clinical laboratory

13  director.--A clinical laboratory director must have 4 years of

14  clinical laboratory experience with 2 years of experience in

15  the speciality to be directed or be nationally board certified

16  in the specialty to be directed, and must meet one of the

17  following requirements:

18         (1)  Be a physician licensed under chapter 458 or

19  chapter 459;

20         (2)  Hold an earned doctoral degree in a chemical,

21  physical, or biological science from a regionally accredited

22  institution and be nationally certified; or

23         (3)  For the subspecialty of oral pathology, be a

24  physician licensed under chapter 458 or chapter 459 or a

25  dentist licensed under chapter 466.

26         Section 91.  Section 483.825, Florida Statutes, is

27  amended to read:

28         483.825  Grounds for disciplinary action.--The

29  following acts constitute grounds for which disciplinary

30  actions specified in s. 483.827 may be taken against

31  applicants, registrants, and licensees under this part:


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                                       CS/HB 1467, First Engrossed



  1         (1)  Attempting to obtain, obtaining, or renewing a

  2  license or registration under this part by bribery, by

  3  fraudulent misrepresentation, or through an error of the

  4  department or the board.

  5         (2)  Engaging in or attempting to engage in, or

  6  representing herself or himself as entitled to perform, any

  7  clinical laboratory procedure or category of procedures not

  8  authorized pursuant to her or 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)  Has been convicted or found guilty of, or entered

15  a plea of nolo contendere to, regardless of adjudication, a

16  crime in any jurisdiction which directly relates to the

17  activities of clinical laboratory personnel or involves moral

18  turpitude or fraudulent or dishonest dealing. The record of a

19  conviction certified or authenticated in such form as to be

20  admissible in evidence under the laws of the state shall be

21  admissible as prima facie evidence of such guilt. Having been

22  convicted of a felony or of any crime involving moral

23  turpitude under the laws of any state or of the United States.

24  The record of conviction or a certified copy thereof shall be

25  conclusive evidence of such conviction.

26         (6)  Having been adjudged mentally or physically

27  incompetent.

28         (7)  Violating or aiding and abetting in the violation

29  of any provision of this part or the rules adopted hereunder.

30         (8)  Reporting a test result when no laboratory test

31  was performed on a clinical specimen.


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                                       CS/HB 1467, First Engrossed



  1         (9)  Knowingly advertising false services or

  2  credentials.

  3         (10)  Having a license revoked, suspended, or otherwise

  4  acted against, including the denial of licensure, by the

  5  licensing authority of another jurisdiction. The licensing

  6  authority's acceptance of a relinquishment of a license,

  7  stipulation, consent order, or other settlement, offered in

  8  response to or in anticipation of the filing of administrative

  9  charges against the licensee, shall be construed as action

10  against the licensee.

11         (11)  Failing to report to the board, in writing,

12  within 30 days that an if action under subsection (5),

13  subsection (6), or subsection (10) has been taken against the

14  licensee or one's license to practice as clinical laboratory

15  personnel in another state, territory, or country, or other

16  jurisdiction.

17         (12)  Being unable to perform or report clinical

18  laboratory examinations with reasonable skill and safety to

19  patients by reason of illness or use of alcohol, drugs,

20  narcotics, chemicals, or any other type of material or as a

21  result of any mental or physical condition.  In enforcing this

22  subsection, the department shall have, upon a finding of the

23  secretary or his or her designee that probable cause exists to

24  believe that the licensee is unable to practice because of the

25  reasons stated in this subsection, the authority to issue an

26  order to compel a licensee to submit to a mental or physical

27  examination by physicians designated by the department.  If

28  the licensee refuses to comply with such order, the

29  department's order directing such examination may be enforced

30  by filing a petition for enforcement in the circuit court

31  where the licensee resides or does business.  The department


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                                       CS/HB 1467, First Engrossed



  1  shall be entitled to the summary procedure provided in s.

  2  51.011.  A licensee affected under this subsection shall at

  3  reasonable intervals be afforded an opportunity to demonstrate

  4  that he or she can resume competent practice with reasonable

  5  skill and safety to patients.

  6         (13)  Delegating professional responsibilities to a

  7  person when the licensee delegating such responsibilities

  8  knows, or has reason to know, that such person is not

  9  qualified by training, experience, or licensure to perform

10  them.

11         (14)  Violating a previous order of the board entered

12  in a disciplinary proceeding.

13         (15)  Failing to report to the department a person or

14  other licensee who the licensee knows is in violation of this

15  chapter or the rules of the department or board adopted

16  hereunder.

17         (16)  Making or filing a report which the licensee

18  knows to be false, intentionally or negligently failing to

19  file a report or record required by state or federal law,

20  willfully impeding or obstructing such filing or inducing

21  another person to do so, including, but not limited to,

22  impeding an agent of the state from obtaining a report or

23  record for investigative purposes. Such reports or records

24  shall include only those generated in the capacity as a

25  licensed clinical laboratory personnel.

26         (17)  Paying or receiving any commission, bonus,

27  kickback, or rebate, or engaging in any split-fee arrangement

28  in any form whatsoever with a physician, organization, agency,

29  or person, either directly or indirectly for patients referred

30  to providers of health care goods and services including, but

31  not limited to, hospitals, nursing homes, clinical


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                                       CS/HB 1467, First Engrossed



  1  laboratories, ambulatory surgical centers, or pharmacies. The

  2  provisions of this subsection shall not be construed to

  3  prevent a clinical laboratory professional from receiving a

  4  fee for professional consultation services.

  5         (18)  Exercising influence on a patient or client in

  6  such a manner as to exploit the patient or client for the

  7  financial gain of the licensee or other third party, which

  8  shall include, but not be limited to, the promoting, selling,

  9  or withholding of services, goods, appliances, referrals, or

10  drugs.

11         (19)  Practicing or offering to practice beyond the

12  scope permitted by law or rule, or accepting or performing

13  professional services or responsibilities which the licensee

14  knows or has reason to know that he or she is not competent to

15  perform.

16         (20)  Misrepresenting or concealing a material fact at

17  any time during any phase of the licensing, investigative, or

18  disciplinary process, procedure, or proceeding.

19         (21)  Improperly interfering with an investigation or

20  any disciplinary proceeding.

21         (22)  Engaging in or attempting to engage in sexual

22  misconduct, causing undue embarrassment or using disparaging

23  language or language of a sexual nature towards a patient,

24  exploiting superior/subordinate, professional/patient,

25  instructor/student relationships for personal gain, sexual

26  gratification, or advantage.

27         Section 92.  Paragraph (g) of subsection (4) and

28  subsections (6) and (8) of section 483.901, Florida Statutes,

29  1998 Supplement, are amended to read:

30         483.901  Medical physicists; definitions; licensure.--

31


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                                       CS/HB 1467, First Engrossed



  1         (4)  COUNCIL.--The Advisory Council of Medical

  2  Physicists is created in the Department of Health to advise

  3  the department in regulating the practice of medical physics

  4  in this state.

  5         (g)  If a vacancy on the council occurs, the secretary

  6  director shall appoint a member to serve for a 4-year term.

  7         (6)  LICENSE REQUIRED.--An individual may not engage in

  8  the practice of medical physics, including the specialties of

  9  diagnostic radiological physics, therapeutic radiological

10  physics, medical nuclear radiological physics, or medical

11  health physics, without a license issued by the department for

12  the appropriate specialty.

13         (a)  The department shall adopt rules to administer

14  this section which specify license application and renewal

15  fees, continuing education requirements, and standards for

16  practicing medical physics.  The council shall recommend to

17  the department continuing education requirements that shall be

18  a condition of license renewal.  The department shall require

19  a minimum of 24 hours per biennium of continuing education

20  offered by an organization recommended by the council and

21  approved by the department.  The department, upon

22  recommendation of the council, may adopt rules to specify

23  continuing education requirements for persons who hold a

24  license in more than one specialty.

25         (b)  In order to apply for a medical physicist license

26  in one or more specialties, a person must file an individual

27  application for each specialty with the department.  The

28  application must be on a form prescribed by the department and

29  must be accompanied by a nonrefundable application fee for

30  each specialty.

31


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                                       CS/HB 1467, First Engrossed



  1         (c)  The department may issue a license to an eligible

  2  applicant if the applicant meets all license requirements.  At

  3  any time before the department issues a license, the applicant

  4  may request in writing that the application be withdrawn.  To

  5  reapply, the applicant must submit a new application and an

  6  additional nonrefundable application fee and must meet all

  7  current licensure requirements.

  8         (d)  The department shall review each completed

  9  application for a license which the department receives.

10         (e)  On receipt of an application and fee as specified

11  in this section, the department may issue a license to

12  practice medical physics in this state:

13         1.  Until October 1, 1998, to a person who meets any of

14  the following requirements:

15         a.  Earned from an accredited college or university a

16  doctoral degree in physics, medical physics, biophysics,

17  radiological physics, medical health physics, or nuclear

18  engineering and has at least 2 years' experience in the

19  practice of the medical physics specialty for which

20  application is made.

21         b.  Earned from an accredited college or university a

22  master's degree in physics, medical physics, biophysics,

23  radiological physics, medical health physics, or nuclear

24  engineering and has at least 3 years' experience in the

25  practice of the medical physics specialty for which

26  application is made.

27         c.  Earned from an accredited college or university a

28  bachelor's degree in physics and has at least 5 years'

29  experience in the practice of the medical physics specialty

30  for which application is made.

31


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                                       CS/HB 1467, First Engrossed



  1         d.  Has at least 8 years' experience in the practice of

  2  the medical physics specialty for which application is made, 2

  3  years of which must have been earned within the 4 years

  4  immediately preceding application for licensure.

  5         e.  Is board certified in the medical physics specialty

  6  in which the applicant applies to practice by the American

  7  Board of Radiology for diagnostic radiological physics,

  8  therapeutic radiological physics, or medical nuclear

  9  radiological physics; by the American Board of Medical Physics

10  or the Canadian Board of Medical Physics for diagnostic

11  radiological physics, therapeutic radiological physics, or

12  medical nuclear radiological physics; or by the American Board

13  of Health Physics or an equivalent certifying body approved by

14  the agency.

15         2.  On or after October 1, 1997, to a person who is

16  board certified in the medical physics specialty in which the

17  applicant applies to practice by the American Board of

18  Radiology for diagnostic radiological physics, therapeutic

19  radiological physics, or medical nuclear radiological physics;

20  by the American Board of Medical Physics for diagnostic

21  radiological physics, therapeutic radiological physics, or

22  medical nuclear radiological physics; or by the American Board

23  of Health Physics or an equivalent certifying body approved by

24  the department.

25         (f)  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.

30         (g)  The following acts are grounds for which the

31  disciplinary actions in paragraph (h) may be taken:


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                                       CS/HB 1467, First 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


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  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


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  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         (j)  The department may issue a temporary license to an

23  applicant pending completion of the application process for

24  board certification.

25         (j)(k)  Upon receipt of a complete application and the

26  fee set forth by rule, the department may issue a

27  physicist-in-training certificate to a person qualified to

28  practice medical physics under direct supervision. The

29  department may establish by rule requirements for initial

30  certification and renewal of a physicist-in-training

31  certificate.


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  1         (8)  DISPOSITION OF FEES.--The department shall deposit

  2  all funds received into the Medical Quality Assurance Health

  3  Care Trust Fund.

  4         Section 93.  Paragraph (d) of subsection (1) of section

  5  484.007, Florida Statutes, is amended to read:

  6         484.007  Licensure of opticians; permitting of optical

  7  establishments.--

  8         (1)  Any person desiring to practice opticianry shall

  9  apply to the department, upon forms prescribed by it, to take

10  a licensure examination. The department shall examine each

11  applicant who the board certifies:

12         (d)1.  Has received an associate degree, or its

13  equivalent, in opticianry from an educational institution the

14  curriculum of which is accredited by an accrediting agency

15  recognized and approved by the United States Department of

16  Education or the Council on Postsecondary Education or

17  approved by the board;

18         2.  Is an individual licensed to practice the

19  profession of opticianry pursuant to a regulatory licensing

20  law of another state, territory, or jurisdiction of the United

21  States, who has actively practiced in such other state,

22  territory, or jurisdiction for more than 3 years immediately

23  preceding application, and who meets the examination

24  qualifications as provided in this subsection;

25         3.  Is an individual who has actively practiced in

26  another state, territory, or jurisdiction of the United States

27  for more than 5 years immediately preceding application and

28  who provides tax or business records, affidavits, or other

29  satisfactory documentation of such practice and who meets the

30  examination qualifications as provided in this subsection; or

31


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  1         4.  Has registered as an apprentice with the department

  2  and paid a registration fee not to exceed $60, as set by rule

  3  of the board. The apprentice shall complete 6,240 hours of

  4  training under the supervision of an optician licensed in this

  5  state for at least 1 year or of, a physician, or an

  6  optometrist licensed under the laws of this state. These

  7  requirements must be met within 5 years after the date of

  8  registration. However, any time spent in a recognized school

  9  may be considered as part of the apprenticeship program

10  provided herein. The board may establish administrative

11  processing fees sufficient to cover the cost of administering

12  apprentice rules as promulgated by the board.

13         Section 94.  Subsection (3) is added to section

14  484.0512, Florida Statutes, to read:

15         484.0512  Thirty-day trial period; purchaser's right to

16  cancel; notice; refund; cancellation fee.--

17         (3)  Within 30 days after the return or attempted

18  return of the hearing aid, the seller shall refund all moneys

19  that must be refunded to a purchaser pursuant to this section.

20         Section 95.  Section 484.053, Florida Statutes, is

21  amended to read:

22         484.053  Prohibitions; penalties.--

23         (1)  A person may not:

24         (a)  Practice dispensing hearing aids unless the person

25  is a licensed hearing aid specialist;

26         (b)  Use the name or title "hearing aid specialist"

27  when the person has not been licensed under this part;

28         (c)  Present as her or his own the license of another;

29         (d)  Give false, incomplete, or forged evidence to the

30  board or a member thereof for the purposes of obtaining a

31  license;


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                                       CS/HB 1467, First Engrossed



  1         (e)  Use or attempt to use a hearing aid specialist

  2  license that is delinquent or has been suspended, revoked, or

  3  placed on inactive or delinquent status;

  4         (f)  Knowingly employ unlicensed persons in the

  5  practice of dispensing hearing aids; or

  6         (g)  Knowingly conceal information relative to

  7  violations of this part.

  8         (2)  Any person who violates any of the provisions of

  9  this section is guilty of a felony misdemeanor of the third

10  second degree, punishable as provided in s. 775.082 or s.

11  775.083.

12         (3)  If a person licensed under this part allows the

13  sale of a hearing aid by an unlicensed person not registered

14  as a trainee or fails to comply with the requirements of s.

15  484.0445(2) relating to supervision of trainees, the board

16  shall, upon determination of that violation, order the full

17  refund of moneys paid by the purchaser upon return of the

18  hearing aid to the seller's place of business.

19         Section 96.  Paragraph (a) of subsection (1) of section

20  484.056, Florida Statutes, 1998 Supplement, is amended to

21  read:

22         484.056  Disciplinary proceedings.--

23         (1)  The following acts relating to the practice of

24  dispensing hearing aids shall be grounds for both disciplinary

25  action against a hearing aid specialist as set forth in this

26  section and cease and desist or other related action by the

27  department as set forth in s. 455.637 against any person

28  owning or operating a hearing aid establishment who engages

29  in, aids, or abets any such violation:

30         (a)  Violation of any provision of s. 455.624(1), s.

31  484.0512, or s. 484.053.


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                                       CS/HB 1467, First Engrossed



  1         Section 97.  Section 486.041, Florida Statutes, is

  2  amended to read:

  3         486.041  Physical therapist; application for license;

  4  fee; temporary permit.--

  5         (1)  A person who desires to be licensed as a physical

  6  therapist shall apply to the department in writing on a form

  7  furnished by the department.  She or he shall embody in that

  8  application evidence under oath, satisfactory to the board, of

  9  possession of the qualifications preliminary to examination

10  required by s. 486.031. The applicant shall pay to the

11  department at the time of filing the application a fee not to

12  exceed $100, as fixed by the board.

13         (2)  If a person desires to practice physical therapy

14  before becoming licensed through examination, she or he shall

15  apply for a temporary permit in accordance with rules adopted

16  pursuant to this chapter.

17         (a)  A temporary permit shall only be issued for a

18  limited period of time, not to exceed 1 year, and shall not be

19  renewable. A temporary permit shall automatically expire if an

20  applicant fails the examination.

21         (b)  An applicant for licensure by examination and

22  practicing under a temporary permit shall do so only under the

23  direct supervision of a licensed physical therapist.

24         Section 98.  Section 486.081, Florida Statutes, is

25  amended to read:

26         486.081  Physical therapist; issuance of license

27  without examination to person passing examination of another

28  authorized examining board; temporary permit; fee.--

29         (1)  The board may cause a license to be issued through

30  the department without examination to any applicant who

31  presents evidence satisfactory to the board of having passed


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  1  the American Registry Examination prior to 1971 or an

  2  examination in physical therapy before a similar lawfully

  3  authorized examining board of another state, the District of

  4  Columbia, a territory, or a foreign country, if the standards

  5  for licensure in physical therapy in such other state,

  6  district, territory, or foreign country are determined by the

  7  board to be as high as those of this state, as established by

  8  rules adopted pursuant to this chapter. Any person who holds a

  9  license pursuant to this section may use the words "physical

10  therapist" or "physiotherapist," or the letters "P.T.," in

11  connection with her or his name or place of business to denote

12  her or his licensure hereunder.

13         (2)  At the time of making application for licensure

14  without examination pursuant to the terms of this section, the

15  applicant shall pay to the department a fee not to exceed $175

16  as fixed by the board, no part of which will be returned.

17         (3)  If a person desires to practice physical therapy

18  before becoming licensed through endorsement, she or he shall

19  apply to the board for a temporary permit in accordance with

20  rules adopted pursuant to this chapter. A temporary permit

21  shall only be issued for a limited period of time, not to

22  exceed 1 year, and shall not be renewable.

23         Section 99.  Section 486.103, Florida Statutes, is

24  amended to read:

25         486.103  Physical therapist assistant; application for

26  license; fee; temporary permit.--

27         (1)  A person who desires to be licensed as a physical

28  therapist assistant shall apply to the department in writing

29  on a form furnished by the department.  She or he shall embody

30  in that application evidence under oath, satisfactory to the

31  board, of possession of the qualifications preliminary to


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                                       CS/HB 1467, First Engrossed



  1  examination required by s. 486.104. The applicant shall pay to

  2  the department at the time of filing the application a fee not

  3  to exceed $100, as fixed by the board.

  4         (2)  If a person desires to work as a physical

  5  therapist assistant before being licensed through examination,

  6  she or he shall apply for a temporary permit in accordance

  7  with rules adopted pursuant to this chapter.

  8         (a)  A temporary permit shall only be issued for a

  9  limited period of time, not to exceed 1 year, and shall not be

10  renewable. A temporary permit shall automatically expire if an

11  applicant fails the examination.

12         (b)  An applicant for licensure by examination who is

13  practicing under a temporary permit shall do so only under the

14  direct supervision of a licensed physical therapist.

15         Section 100.  Section 486.107, Florida Statutes, is

16  amended to read:

17         486.107  Physical therapist assistant; issuance of

18  license without examination to person licensed in another

19  jurisdiction; temporary permit; fee.--

20         (1)  The board may cause a license to be issued through

21  the department without examination to any applicant who

22  presents evidence to the board, under oath, of licensure in

23  another state, the District of Columbia, or a territory, if

24  the standards for registering as a physical therapist

25  assistant or licensing of a physical therapist assistant, as

26  the case may be, in such other state are determined by the

27  board to be as high as those of this state, as established by

28  rules adopted pursuant to this chapter. Any person who holds a

29  license pursuant to this section may use the words "physical

30  therapist assistant," or the letters "P.T.A.," in connection

31  with her or his name to denote licensure hereunder.


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                                       CS/HB 1467, First Engrossed



  1         (2)  At the time of making application for licensing

  2  without examination pursuant to the terms of this section, the

  3  applicant shall pay to the department a fee not to exceed $175

  4  as fixed by the board, no part of which will be returned.

  5         (3)  If a person desires to work as a physical

  6  therapist assistant before being licensed through endorsement,

  7  she or he shall apply for a temporary permit in accordance

  8  with rules adopted pursuant to this chapter.  A temporary

  9  permit shall only be issued for a limited period of time, not

10  to exceed 1 year, and shall not be renewable.

11         Section 101.  Paragraph (b) of subsection (1) of

12  section 490.005, Florida Statutes, 1998 Supplement, is amended

13  to read:

14         490.005  Licensure by examination.--

15         (1)  Any person desiring to be licensed as a

16  psychologist shall apply to the department to take the

17  licensure examination. The department shall license each

18  applicant who the board certifies has:

19         (b)  Submitted proof satisfactory to the board that the

20  applicant has:

21         1.  Received doctoral-level psychological education, as

22  defined in s. 490.003(3);

23         2.  Received the equivalent of a doctoral-level

24  psychological education, as defined in s. 490.003(3), from a

25  program at a school or university located outside the United

26  States of America and Canada, which was officially recognized

27  by the government of the country in which it is located as an

28  institution or program to train students to practice

29  professional psychology.  The burden of establishing that the

30  requirements of this provision have been met shall be upon the

31  applicant;


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                                       CS/HB 1467, First Engrossed



  1         3.  Received and submitted to the board, prior to July

  2  1, 1999, certification of an augmented doctoral-level

  3  psychological education from the program director of a

  4  doctoral-level psychology program accredited by a programmatic

  5  agency recognized and approved by the United States Department

  6  of Education; or

  7         4.  Received and submitted to the board, prior to

  8  August 31, 2001 July 1, 2001, certification of a

  9  doctoral-level program that at the time the applicant was

10  enrolled and graduated maintained a standard of education and

11  training comparable to the standard of training of programs

12  accredited by a programmatic agency recognized and approved by

13  the United States Department of Education, as such

14  comparability was determined by the Board of Psychological

15  Examiners immediately prior to the amendment of s. 490.005,

16  Florida Statutes, 1994 Supplement, by s. 5, chapter 95-279,

17  Laws of Florida. Such certification of comparability shall be

18  provided by the program director of a doctoral-level

19  psychology program accredited by a programmatic agency

20  recognized and approved by the United States Department of

21  Education.

22         Section 102.  Subsection (1) of section 490.006,

23  Florida Statutes, is amended to read:

24         490.006  Licensure by endorsement.--

25         (1)  The department shall license a person as a

26  psychologist or school psychologist who, upon applying to the

27  department and remitting the appropriate fee, demonstrates to

28  the department or, in the case of psychologists, to the board

29  that the applicant:

30         (a)  Holds a valid license or certificate in another

31  state to practice psychology or school psychology, as


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                                       CS/HB 1467, First Engrossed



  1  applicable, provided that, when the applicant secured such

  2  license or certificate, the requirements were substantially

  3  equivalent to or more stringent than those set forth in this

  4  chapter at that time; and, if no Florida law existed at that

  5  time, then the requirements in the other state must have been

  6  substantially equivalent to or more stringent than those set

  7  forth in this chapter at the present time; or

  8         (b)  Is a diplomate in good standing with the American

  9  Board of Professional Psychology, Inc.; or

10         (c)  Possesses a doctoral degree in psychology as

11  described in s. 490.003 and has at least 20 years of

12  experience as a licensed psychologist in any jurisdiction or

13  territory of the United States within 25 years preceding the

14  date of application.

15         Section 103.  Subsection (2) of section 490.0085,

16  Florida Statutes, is amended to read:

17         490.0085  Continuing education; approval of providers,

18  programs, and courses; proof of completion.--

19         (2)  The department or, in the case of psychologists,

20  the board has the authority to set a fee not to exceed $500

21  for each applicant who applies for or renews provider status.

22  Such fees shall be deposited into the Medical Quality

23  Assurance Health Care Trust Fund.

24         Section 104.  Section 490.0148, Florida Statutes, is

25  amended to read:

26         490.0148  Psychologist and school psychologist

27  records.--Each psychologist and school psychologist who

28  provides services as defined in this chapter shall maintain

29  records.  The board or, in the case of a school psychologist,

30  the department may adopt rules defining the minimum

31  requirements for such records, including content, length of


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                                       CS/HB 1467, First Engrossed



  1  time such records shall be maintained, and transfer of such

  2  records or of a summary of such records, or both, to a

  3  subsequent treating practitioner or other individual with the

  4  written consent of the client or clients. A patient's

  5  psychological report may be released to an employer or

  6  carrier, or the attorney for either, pursuant to s. 440.13.

  7         Section 105.  Section 491.0045, Florida Statutes, is

  8  amended to read:

  9         491.0045  Intern registration; requirements.--

10         (1)  Effective January 1, 1998, an individual who

11  intends to practice in Florida to satisfy the postgraduate or

12  post-master's level experience requirements, as specified in

13  s. 491.005(1)(c), (3)(c), or (4)(c), must register as an

14  intern in the profession for which he or she is seeking

15  licensure prior to commencing the post-master's experience

16  requirement or an individual who intends to satisfy part of

17  the required graduate-level practicum, internship, or field

18  experience, outside the academic arena for any profession,

19  must register as an intern in the profession for which he or

20  she is seeking licensure prior to commencing the practicum,

21  internship, or field experience.

22         (2)  The department shall register as a clinical social

23  worker intern, marriage and family therapist intern, or mental

24  health counselor intern each applicant who the board certifies

25  has:

26         (a)  Completed the application form and remitted a

27  nonrefundable application fee not to exceed $200, as set by

28  board rule;

29         (b)1.  Completed the education requirements as

30  specified in s. 491.005(1)(c), (3)(c), or (4)(c) for the

31


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                                       CS/HB 1467, First Engrossed



  1  profession for which he or she is applying for licensure, if

  2  needed; and

  3         2.  Submitted an acceptable supervision plan, as

  4  determined by the board, for meeting the practicum,

  5  internship, or field work required for licensure that was not

  6  satisfied in his or her graduate program.

  7         (c)  Identified a qualified supervisor.

  8         (3)  An individual registered under this section must

  9  remain under supervision until he or she is in receipt of a

10  license or a letter from the department stating that he or she

11  is licensed to practice the profession for which he or she

12  applied.

13         (4)  An individual who has applied for intern

14  registration on or before December 31, 2001, and has satisfied

15  the education requirements of s. 491.005 that are in effect

16  through December 31, 2000, will have met the educational

17  requirements for licensure for the profession for which he or

18  she has applied.

19         (5)  Individuals who have commenced the experience

20  requirement as specified in s. 491.005(1)(c), (3)(c), or

21  (4)(c) but failed to register as required by subsection (1)

22  shall register with the department before January 1, 2000.

23  Individuals who fail to comply with this subsection shall not

24  be granted a license, and any time spent by the individual

25  completing the experience requirement prior to registering as

26  an intern shall not count toward completion of such

27  requirement.

28         Section 106.  Subsections (1) and (2) of section

29  491.0046, Florida Statutes, are amended to read:

30         491.0046  Provisional license; requirements.--

31


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                                       CS/HB 1467, First Engrossed



  1         (1)  An individual applying for licensure by

  2  examination who has satisfied the clinical experience

  3  requirements of s. 491.005 or an individual applying for

  4  licensure by endorsement pursuant to s. 491.006 intending to

  5  provide clinical social work, marriage and family therapy, or

  6  mental health counseling services in Florida while satisfying

  7  coursework or examination requirements for licensure must be

  8  provisionally licensed in the profession for which he or she

  9  is seeking licensure prior to beginning practice.

10         (2)  The department shall issue a provisional clinical

11  social worker license, provisional marriage and family

12  therapist license, or provisional mental health counselor

13  license to each applicant who the board certifies has:

14         (a)  Completed the application form and remitted a

15  nonrefundable application fee not to exceed $100, as set by

16  board rule; and

17         (b)1.  Earned a graduate degree in social work, a

18  graduate degree with a major emphasis in marriage and family

19  therapy or a closely related field, or a graduate degree in a

20  major related to the practice of mental health counseling;

21  and, and satisfied the clinical experience requirements for

22  licensure pursuant to s. 491.005; or

23         2.  Been approved for examination under the provisions

24  for licensure by endorsement pursuant to s. 491.006.

25         (c)  Has met the following minimum coursework

26  requirements:

27         1.  For clinical social work, a minimum of 15 semester

28  hours or 22 quarter hours of the coursework required by s.

29  491.005(1)(b)2.b.

30         2.  For marriage and family therapy, ten of the courses

31  required by s. 491.005(3)(b)1.a.-c., as determined by the


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                                       CS/HB 1467, First Engrossed



  1  board, and at least 6 semester hours or 9 quarter hours of the

  2  course credits must have been completed in the area of

  3  marriage and family systems, theories, or techniques.

  4         3.  For mental health counseling, a minimum of seven of

  5  the courses required under s. 491.005(b)1.a.-c.

  6         Section 107.  Section 491.005, Florida Statutes, is

  7  amended to read:

  8         491.005  Licensure by examination.--

  9         (1)  CLINICAL SOCIAL WORK.--Upon verification of

10  documentation and payment of a fee not to exceed $200, as set

11  by board rule, plus the actual per applicant cost to the

12  department for purchase of the examination from the American

13  Association of State Social Worker's Boards or a similar

14  national organization, the department shall issue a license as

15  a clinical social worker to an applicant who the board

16  certifies:

17         (a)  Has made application therefor and paid the

18  appropriate fee.

19         (b)1.  Has received a doctoral degree in social work

20  from a graduate school of social work which at the time the

21  applicant graduated was accredited by an accrediting agency

22  recognized by the United States Department of Education or has

23  received a master's degree in social work from a graduate

24  school of social work which at the time the applicant

25  graduated:

26         a.  Was accredited by the Council on Social Work

27  Education;

28         b.  Was accredited by the Canadian Association of

29  Schools of Social Work; or

30         c.  Has been determined to have been a program

31  equivalent to programs approved by the Council on Social Work


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                                       CS/HB 1467, First Engrossed



  1  Education by the Foreign Equivalency Determination Service of

  2  the Council on Social Work Education.  An applicant who

  3  graduated from a program at a university or college outside of

  4  the United States or Canada must present documentation of the

  5  equivalency determination from the council in order to

  6  qualify.

  7         2.  The applicant's graduate program must have

  8  emphasized direct clinical patient or client health care

  9  services, including, but not limited to, coursework in

10  clinical social work, psychiatric social work, medical social

11  work, social casework, psychotherapy, or group therapy.  The

12  applicant's graduate program must have included all of the

13  following coursework:

14         a.  A supervised field placement which was part of the

15  applicant's advanced concentration in direct practice, during

16  which the applicant provided clinical services directly to

17  clients.

18         b.  Completion of 24 semester hours or 32 37 quarter

19  hours in theory of human behavior and practice methods as

20  courses in clinically oriented services, including a minimum

21  of one course in psychopathology, and no more than one course

22  in research, taken in a school of social work accredited or

23  approved pursuant to subparagraph 1.

24         3.  If the course title which appears on the

25  applicant's transcript does not clearly identify the content

26  of the coursework, the applicant shall be required to provide

27  additional documentation, including, but not limited to, a

28  syllabus or catalog description published for the course.

29         (c)  Has had not less than 2 years of clinical social

30  work experience, which took place subsequent to completion of

31  a graduate degree in social work at an institution meeting the


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                                       CS/HB 1467, First Engrossed



  1  accreditation requirements of this section, under the

  2  supervision of a licensed clinical social worker or the

  3  equivalent who is a qualified supervisor as determined by the

  4  board. An individual who intends to practice in Florida to

  5  satisfy clinical experience requirements must register

  6  pursuant to s. 491.0045 prior to commencing practice.  If the

  7  applicant's graduate program was not a program which

  8  emphasized direct clinical patient or client health care

  9  services as described in subparagraph (b)2. s. 491.003, the

10  supervised experience requirement must take place after the

11  applicant has completed a minimum of 15 semester hours or 22

12  quarter hours of the coursework required.  A doctoral

13  internship may be applied toward the clinical social work

14  experience requirement. The experience requirement may be met

15  by work performed on or off the premises of the supervising

16  clinical social worker or the equivalent, provided the

17  off-premises work is not the independent private practice

18  rendering of clinical social work that does not have a

19  licensed mental health professional, as determined by the

20  board, on the premises at the same time the intern is

21  providing services.

22         (d)  Has passed a theory and practice examination

23  provided by the department for this purpose.

24         (e)  Has demonstrated, in a manner designated by rule

25  of the board, knowledge of the laws and rules governing the

26  practice of clinical social work, marriage and family therapy,

27  and mental health counseling.

28         (2)  CLINICAL SOCIAL WORK.--

29         (a)  Notwithstanding the provisions of paragraph

30  (1)(b), coursework which was taken at a baccalaureate level

31  shall not be considered toward completion of education


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                                       CS/HB 1467, First Engrossed



  1  requirements for licensure unless an official of the graduate

  2  program certifies in writing on the graduate school's

  3  stationery that a specific course, which students enrolled in

  4  the same graduate program were ordinarily required to complete

  5  at the graduate level, was waived or exempted based on

  6  completion of a similar course at the baccalaureate level.  If

  7  this condition is met, the board shall apply the baccalaureate

  8  course named toward the education requirements.

  9         (b)  An applicant from a master's or doctoral program

10  in social work which did not emphasize direct patient or

11  client services may complete the clinical curriculum content

12  requirement by returning to a graduate program accredited by

13  the Council on Social Work Education or the Canadian

14  Association of Schools of Social Work, or to a clinical social

15  work graduate program with comparable standards, in order to

16  complete the education requirements for examination.  However,

17  a maximum of 6 semester or 9 quarter hours of the clinical

18  curriculum content requirement may be completed by credit

19  awarded for independent study coursework as defined by board

20  rule.

21         (3)  MARRIAGE AND FAMILY THERAPY.-- Upon verification

22  of documentation and payment of a fee not to exceed $200, as

23  set by board rule, plus the actual cost to the department for

24  the purchase of the examination from the Association of

25  Marital and Family Therapy Regulatory Board, or similar

26  national organization, the department shall issue a license as

27  a marriage and family therapist to an applicant who the board

28  certifies:

29         (a)  Has made application therefor and paid the

30  appropriate fee.

31


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                                       CS/HB 1467, First Engrossed



  1         (b)1.  Has a minimum of a master's degree with major

  2  emphasis in marriage and family therapy, or a closely related

  3  field, and has completed all of the following requirements:

  4         a.  Twenty-seven semester hours or 41 quarter hours of

  5  graduate coursework, which must include a minimum of 2

  6  semester hours or 3 quarter hours of graduate-level course

  7  credits in each of the following nine areas: dynamics of

  8  marriage and family systems; marriage therapy and counseling

  9  theory and techniques; family therapy and counseling theory

10  and techniques; individual human development theories

11  throughout the life cycle; personality theory;

12  psychopathology; human sexuality theory and counseling

13  techniques; general counseling theory and techniques; and

14  psychosocial theory. Content may be combined, provided no more

15  than two of the nine content areas are included in any one

16  graduate-level course and the applicant can document that the

17  equivalent of 2 semester hours of coursework was devoted to

18  each content area. Courses in research, evaluation, appraisal,

19  assessment, or testing theories and procedures; thesis or

20  dissertation work; or practicums, internships, or fieldwork

21  may not be applied toward this requirement.

22         b.  A minimum of one graduate-level course of 2

23  semester hours or 3 quarter hours in legal, ethical, and

24  professional standards issues in the practice of marriage and

25  family therapy or a course determined by the board to be

26  equivalent.

27         c.  A minimum of one graduate-level course of 2

28  semester hours or 3 quarter hours in diagnosis, appraisal,

29  assessment, and testing for individual or interpersonal

30  disorder or dysfunction; and a minimum of one 2-semester-hour

31  or 3-quarter-hour graduate-level course in behavioral research


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                                       CS/HB 1467, First Engrossed



  1  which focuses on the interpretation and application of

  2  research data as it applies to clinical practice.  Credit for

  3  thesis or dissertation work, practicums, internships, or

  4  fieldwork may not be applied toward this requirement.

  5         d.  A minimum of one supervised clinical practicum,

  6  internship, or field experience in a marriage and family

  7  counseling setting, during which the student provided 180

  8  direct client contact hours of marriage and family therapy

  9  services under the supervision of an individual who met the

10  requirements for supervision under paragraph (c).  This

11  requirement may be met by a supervised practice experience

12  which took place outside the academic arena, but which is

13  certified as equivalent to a graduate-level practicum or

14  internship program which required a minimum of 180 direct

15  client contact hours of marriage and family therapy services

16  currently offered within an academic program of a college or

17  university accredited by an accrediting agency approved by the

18  United States Department of Education, or an institution which

19  is publicly recognized as a member in good standing with the

20  Association of Universities and Colleges of Canada or a

21  training institution accredited by the Commission on

22  Accreditation for Marriage and Family Therapy Education

23  recognized by the United States Department of Education.

24  Certification shall be required from an official of such

25  college, university, or training institution.

26         2.  If the course title which appears on the

27  applicant's transcript does not clearly identify the content

28  of the coursework, the applicant shall be required to provide

29  additional documentation, including, but not limited to, a

30  syllabus or catalog description published for the course.

31


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                                       CS/HB 1467, First Engrossed



  1  The required master's degree must have been received in an

  2  institution of higher education which at the time the

  3  applicant graduated was:  fully accredited by a regional

  4  accrediting body recognized by the Commission on Recognition

  5  of Postsecondary Accreditation; publicly recognized as a

  6  member in good standing with the Association of Universities

  7  and Colleges of Canada; or an institution of higher education

  8  located outside the United States and Canada, which at the

  9  time the applicant was enrolled and at the time the applicant

10  graduated maintained a standard of training substantially

11  equivalent to the standards of training of those institutions

12  in the United States which are accredited by a regional

13  accrediting body recognized by the Commission on Recognition

14  of Postsecondary Accreditation.  Such foreign education and

15  training must have been received in an institution or program

16  of higher education officially recognized by the government of

17  the country in which it is located as an institution or

18  program to train students to practice as professional marriage

19  and family therapists or psychotherapists.  The burden of

20  establishing that the requirements of this provision have been

21  met shall be upon the applicant, and the board shall require

22  documentation, such as, but not limited to, an evaluation by a

23  foreign equivalency determination service, as evidence that

24  the applicant's graduate degree program and education were

25  equivalent to an accredited program in this country.  An

26  applicant with a master's degree from a program which did not

27  emphasize marriage and family therapy may complete the

28  coursework requirement in a training institution fully

29  accredited by the Commission on Accreditation for Marriage and

30  Family Therapy Education recognized by the United States

31  Department of Education.


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                                       CS/HB 1467, First Engrossed



  1         (c)  Has had not less than 2 years of clinical

  2  experience during which 50 percent of the applicant's clients

  3  were receiving marriage and family therapy services, which

  4  must be at the post-master's level under the supervision of a

  5  licensed marriage and family therapist with at least 5 years

  6  of experience, or the equivalent, who is a qualified

  7  supervisor as determined by the board.  An individual who

  8  intends to practice in Florida to satisfy the clinical

  9  experience requirements must register pursuant to s. 491.0045

10  prior to commencing practice.  If a graduate has a master's

11  degree with a major emphasis in marriage and family therapy or

12  a closely related field that did not include all the

13  coursework required under sub-subparagraphs (b)1.a.-c., credit

14  for the post-master's level clinical experience shall not

15  commence until the applicant has completed a minimum of 10 of

16  the courses required under sub-subparagraphs (b)1.a.-c., as

17  determined by the board, and at least 6 semester hours or 9

18  quarter hours of the course credits must have been completed

19  in the area of marriage and family systems, theories, or

20  techniques. Within the 3 years of required experience, the

21  applicant shall provide direct individual, group, or family

22  therapy and counseling, to include the following categories of

23  cases:  unmarried dyads, married couples, separating and

24  divorcing couples, and family groups including children.  A

25  doctoral internship may be applied toward the clinical

26  experience requirement.  The clinical experience requirement

27  may be met by work performed on or off the premises of the

28  supervising marriage and family therapist or the equivalent,

29  provided the off-premises work is not the independent private

30  practice rendering of marriage and family therapy services

31  that does not have a licensed mental health professional, as


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                                       CS/HB 1467, First Engrossed



  1  determined by the board, on the premises at the same time the

  2  intern is providing services.

  3         (d)  Has passed a theory and practice examination

  4  provided by the department for this purpose.

  5         (e)  Has demonstrated, in a manner designated by rule

  6  of the board, knowledge of the laws and rules governing the

  7  practice of clinical social work, marriage and family therapy,

  8  and mental health counseling.

  9         (f)  For the purposes of dual licensure, the department

10  shall license as a marriage and family therapist any person

11  who meets the requirements of s. 491.0057. Fees for dual

12  licensure shall not exceed those stated in this subsection.

13         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

14  documentation and payment of a fee not to exceed $200, as set

15  by board rule, plus the actual per applicant cost to the

16  department for purchase of the examination from the

17  Professional Examination Service for the National Academy of

18  Certified Clinical Mental Health Counselors or a similar

19  national organization, the department shall issue a license as

20  a mental health counselor to an applicant who the board

21  certifies:

22         (a)  Has made application therefor and paid the

23  appropriate fee.

24         (b)1.  Has received a minimum of an earned master's

25  degree with a major related to the practice of mental health

26  counseling, and has completed all of the following

27  requirements:

28         a.  Twenty-one semester hours or 32 quarter hours of

29  graduate coursework, which must include a minimum of 2

30  semester hours or 3 quarter hours of graduate-level coursework

31  in each of the following seven content areas:  counseling


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                                       CS/HB 1467, First Engrossed



  1  theories and practice; human development theories; personality

  2  theory; psychopathology or abnormal psychology; human

  3  sexuality theories; group theories and practice; and

  4  individual evaluation and assessment.  Content may be

  5  combined, provided no more than two of the seven content areas

  6  are included in any one graduate-level course and the

  7  applicant can document that the equivalent of 2 semester hours

  8  of content was devoted to each content area.  Courses in

  9  research, thesis or dissertation work, practicums,

10  internships, or fieldwork may not be applied toward this

11  requirement.

12         b.  A minimum of one 2-semester-hour or 3-quarter-hour

13  graduate-level course in research or in career or vocational

14  counseling. Credit for thesis or dissertation work,

15  practicums, internships, or fieldwork may not be applied

16  toward this requirement.

17         c.  A minimum of 2 semester hours or 3 quarter hours of

18  graduate-level coursework in legal, ethical, and professional

19  standards issues in the practice of mental health counseling,

20  which includes goals and objectives of professional counseling

21  organizations, codes of ethics, legal considerations,

22  standards of preparation, certifications and licensing, and

23  the role identity of counselors.  Courses in research, thesis

24  or dissertation work, practicums, internships, or fieldwork

25  may not be applied toward this requirement.

26         d.  A minimum of one supervised practicum, internship,

27  or field experience in a counseling setting.  This requirement

28  may be met by a supervised practice experience which takes

29  place outside the academic arena, but which is certified as

30  equivalent to a graduate-level practicum in a clinical mental

31  health counseling setting currently offered within an academic


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                                       CS/HB 1467, First Engrossed



  1  program of a college or university accredited by an

  2  accrediting agency approved by the United States Department of

  3  Education. Such certification shall be required from an

  4  official of such college or university.

  5         2.  If the course title which appears on the

  6  applicant's transcript does not clearly identify the content

  7  of the coursework, the applicant shall be required to provide

  8  additional documentation, including, but not limited to, a

  9  syllabus or catalog description published for the course.

10

11  Except as provided in sub-subparagraph 1.d., education and

12  training in mental health counseling must have been received

13  in an institution of higher education which at the time the

14  applicant graduated was:  fully accredited by a regional

15  accrediting body recognized by the Commission on Recognition

16  of Postsecondary Accreditation; publicly recognized as a

17  member in good standing with the Association of Universities

18  and Colleges of Canada; or an institution of higher education

19  located outside the United States and Canada, which at the

20  time the applicant was enrolled and at the time the applicant

21  graduated maintained a standard of training substantially

22  equivalent to the standards of training of those institutions

23  in the United States which are accredited by a regional

24  accrediting body recognized by the Commission on Recognition

25  of Postsecondary Accreditation. Such foreign education and

26  training must have been received in an institution or program

27  of higher education officially recognized by the government of

28  the country in which it is located as an institution or

29  program to train students to practice as mental health

30  counselors.  The burden of establishing that the requirements

31  of this provision have been met shall be upon the applicant,


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                                       CS/HB 1467, First Engrossed



  1  and the board shall require documentation, such as, but not

  2  limited to, an evaluation by a foreign equivalency

  3  determination service, as evidence that the applicant's

  4  graduate degree program and education were equivalent to an

  5  accredited program in this country.

  6         (c)  Has had not less than 2 years of clinical

  7  experience in mental health counseling, which must be at the

  8  post-master's level under the supervision of a licensed mental

  9  health counselor or the equivalent who is a qualified

10  supervisor as determined by the board.  An individual who

11  intends to practice in Florida to satisfy the clinical

12  experience requirements must register pursuant to s. 491.0045

13  prior to commencing practice.  If a graduate has a master's

14  degree with a major related to the practice of mental health

15  counseling which did not include all the coursework required

16  under sub-subparagraphs (b)1.a.-c., credit for the

17  post-master's level clinical experience shall not commence

18  until the applicant has completed a minimum of seven of the

19  courses required under sub-subparagraphs (b)1.a.-c., as

20  determined by the board, one of which must be a course in

21  psychopathology or abnormal psychology. A doctoral internship

22  may be applied toward the clinical experience requirement. The

23  clinical experience requirement may be met by work performed

24  on or off the premises of the supervising mental health

25  counselor or the equivalent, provided the off-premises work is

26  not the independent private practice rendering of services

27  that does not have a licensed mental health professional, as

28  determined by the board, on the premises at the same time the

29  intern is providing services.

30         (d)  Has passed a theory and practice examination

31  provided by the department for this purpose.


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                                       CS/HB 1467, First Engrossed



  1         (e)  Has demonstrated, in a manner designated by rule

  2  of the board, knowledge of the laws and rules governing the

  3  practice of clinical social work, marriage and family therapy,

  4  and mental health counseling.

  5         (5)  INTERNSHIP.--An individual who is registered as an

  6  intern and has satisfied all of the educational requirements

  7  for the profession for which the applicant seeks licensure

  8  shall be certified as having met the educational requirements

  9  for licensure under this section.

10         (6)  RULES.--The board may adopt rules necessary to

11  implement any education or experience requirement of this

12  section for licensure as a clinical social worker, marriage

13  and family therapist, or mental health counselor.

14         Section 108.  Effective January 1, 2001, paragraph (b)

15  of subsection (4) of section 491.005, Florida Statutes, as

16  amended by section 13 of chapter 97-198 and section 205 of

17  chapter 97-264, Laws of Florida, is amended, and subsection

18  (6) of that section is reenacted, to read:

19         491.005  Licensure by examination.--

20         (4)  Upon verification of documentation and payment of

21  a fee not to exceed $200, as set by board rule, plus the

22  actual per applicant cost to the department for purchase of

23  the examination from the Professional Examination Service for

24  the National Academy of Certified Clinical Mental Health

25  Counselors or a similar national organization, the department

26  shall issue a license as a mental health counselor to an

27  applicant who the board certifies:

28         (b)1.  Has a minimum of an earned master's degree from

29  a mental health counseling program accredited by the Council

30  for the Accreditation of Counseling and Related Educational

31  Programs that consists of at least 60 semester hours or 80


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                                       CS/HB 1467, First Engrossed



  1  quarter hours of clinical and didactic instruction, including

  2  a course in human sexuality and a course in substance abuse.

  3  If the master's degree is earned from a program related to the

  4  practice of mental health counseling that is not accredited by

  5  the Council for the Accreditation of Counseling and Related

  6  Educational Programs, then the coursework and practicum,

  7  internship, or fieldwork must consist of at least 60 semester

  8  hours or 80 quarter hours and meet the following requirements:

  9         a.  Thirty-three Thirty-six semester hours or 44 48

10  quarter hours of graduate coursework, which must include a

11  minimum of 3 semester hours or 4 quarter hours of

12  graduate-level coursework in each of the following 11 12

13  content areas: counseling theories and practice; human growth

14  and development; diagnosis and treatment of psychopathology;

15  human sexuality; group theories and practice; individual

16  evaluation and assessment; career and lifestyle assessment;

17  research and program evaluation; social and cultural

18  foundations; foundations of mental health counseling;

19  counseling in community settings; and substance abuse. Courses

20  in research, thesis or dissertation work, practicums,

21  internships, or fieldwork may not be applied toward this

22  requirement.

23         b.  A minimum of 3 semester hours or 4 quarter hours of

24  graduate-level coursework in legal, ethical, and professional

25  standards issues in the practice of mental health counseling,

26  which includes goals, objectives, and practices of

27  professional counseling organizations, codes of ethics, legal

28  considerations, standards of preparation, certifications and

29  licensing, and the role identity and professional obligations

30  of mental health counselors. Courses in research, thesis or

31


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                                       CS/HB 1467, First Engrossed



  1  dissertation work, practicums, internships, or fieldwork may

  2  not be applied toward this requirement.

  3         c.  The equivalent, as determined by the board, of at

  4  least 1,000 hours of university-sponsored supervised clinical

  5  practicum, internship, or field experience as required in the

  6  accrediting standards of the Council for Accreditation of

  7  Counseling and Related Educational Programs for mental health

  8  counseling programs. If the academic practicum, internship, or

  9  field experience was less than 1,000 hours, experience gained

10  outside the academic arena in clinical mental health settings

11  under the supervision of a qualified supervisor as determined

12  by the board may be applied. This experience may not be used

13  to satisfy the post-master's clinical experience requirement.

14         2.  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

20  Education and training in mental health counseling must have

21  been received in an institution of higher education which at

22  the time the applicant graduated was: fully accredited by a

23  regional accrediting body recognized by the Commission on

24  Recognition of Postsecondary Accreditation; publicly

25  recognized as a member in good standing with the Association

26  of Universities and Colleges of Canada; or an institution of

27  higher education located outside the United States and Canada,

28  which at the time the applicant was enrolled and at the time

29  the applicant graduated maintained a standard of training

30  substantially equivalent to the standards of training of those

31  institutions in the United States which are accredited by a


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                                       CS/HB 1467, First Engrossed



  1  regional accrediting body recognized by the Commission on

  2  Recognition of Postsecondary Accreditation. Such foreign

  3  education and training must have been received in an

  4  institution or program of higher education officially

  5  recognized by the government of the country in which it is

  6  located as an institution or program to train students to

  7  practice as mental health counselors. The burden of

  8  establishing that the requirements of this provision have been

  9  met shall be upon the applicant, and the board shall require

10  documentation, such as, but not limited to, an evaluation by a

11  foreign equivalency determination service, as evidence that

12  the applicant's graduate degree program and education were

13  equivalent to an accredited program in this country.

14         (6)  The board may adopt rules necessary to implement

15  any education or experience requirement of this section for

16  licensure as a clinical social worker, marriage and family

17  therapist, or mental health counselor.

18         Section 109.  Paragraph (b) of subsection (1) of

19  section 491.006, Florida Statutes, is amended to read:

20         491.006  Licensure or certification by endorsement.--

21         (1)  The department shall license or grant a

22  certificate to a person in a profession regulated by this

23  chapter who, upon applying to the department and remitting the

24  appropriate fee, demonstrates to the board that he or she:

25         (b)1.  Holds an active valid license to practice and

26  has actively practiced the profession for which licensure is

27  applied in another state for 3 of the last 5 years immediately

28  preceding licensure.

29         2.  Meets the education requirements of this chapter

30  for the profession for which licensure is applied.

31


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                                       CS/HB 1467, First Engrossed



  1         3.  Has passed a substantially equivalent licensing

  2  examination in another state or has passed the licensure

  3  examination in this state in the profession for which the

  4  applicant seeks licensure.

  5         4.  Holds a license in good standing, is not under

  6  investigation for an act which would constitute a violation of

  7  this chapter, and has not been found to have committed any act

  8  which would constitute a violation of this chapter.

  9         Section 110.  Section 491.0085, Florida Statutes, is

10  amended to read:

11         491.0085  Continuing education and laws and rules

12  courses; approval of providers, programs, and courses; proof

13  of completion.--

14         (1)  Continuing education providers, programs, and

15  courses and laws and rules courses and their providers and

16  programs shall be approved by the department or the board.

17         (2)  The department or the board has the authority to

18  set a fee not to exceed $200 for each applicant who applies

19  for or renews provider status.  Such fees shall be deposited

20  into the Medical Quality Assurance Health Care Trust Fund.

21         (3)  Proof of completion of the required number of

22  hours of continuing education and completion of the laws and

23  rules course shall be submitted to the department or the board

24  in the manner and time specified by rule and on forms provided

25  by the department or the board.

26         (4)  The department or the board shall adopt rules and

27  guidelines to administer and enforce the provisions of this

28  section.

29         Section 111.  Paragraph (d) of subsection (4) of

30  section 491.014, Florida Statutes, 1998 Supplement, is amended

31  to read:


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  1         491.014  Exemptions.--

  2         (4)  No person shall be required to be licensed,

  3  provisionally licensed, registered, or certified under this

  4  chapter who:

  5         (d)  Is not a resident of this state but offers

  6  services in this state, provided:

  7         1.  Such services are performed for no more than 5 days

  8  in any month and no more than 15 days in any calendar year;

  9  and

10         2.  Such nonresident is licensed or certified to

11  practice the services provided by a state or territory of the

12  United States or by a foreign country or province.

13         Section 112.  Paragraph (a) of subsection (1) and

14  subsection (5) of section 499.012, Florida Statutes, 1998

15  Supplement, are amended to read:

16         499.012  Wholesale distribution; definitions; permits;

17  general requirements.--

18         (1)  As used in this section, the term:

19         (a)  "Wholesale distribution" means distribution of

20  prescription drugs to persons other than a consumer or

21  patient, but does not include:

22         1.  Any of the following activities, which is not a

23  violation of s. 499.005(21) if such activity is conducted in

24  accordance with s. 499.014:

25         a.  The purchase or other acquisition by a hospital or

26  other health care entity that is a member of a group

27  purchasing organization of a prescription drug for its own use

28  from the group purchasing organization or from other hospitals

29  or health care entities that are members of that organization.

30         b.  The sale, purchase, or trade of a prescription drug

31  or an offer to sell, purchase, or trade a prescription drug by


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  1  a charitable organization described in s. 501(c)(3) of the

  2  Internal Revenue Code of 1986, as amended and revised, to a

  3  nonprofit affiliate of the organization to the extent

  4  otherwise permitted by law.

  5         c.  The sale, purchase, or trade of a prescription drug

  6  or an offer to sell, purchase, or trade a prescription drug

  7  among hospitals or other health care entities that are under

  8  common control. For purposes of this section, "common control"

  9  means the power to direct or cause the direction of the

10  management and policies of a person or an organization,

11  whether by ownership of stock, by voting rights, by contract,

12  or otherwise.

13         d.  The sale, purchase, trade, or other transfer of a

14  prescription drug from or for any federal, state, or local

15  government agency or any entity eligible to purchase

16  prescription drugs at public health services prices pursuant

17  to s. 602 of Pub. L. No. 102-585 to a contract provider or its

18  subcontractor for eligible patients of the agency or entity

19  under the following conditions:

20         (I)  The agency or entity must obtain written

21  authorization for the sale, purchase, trade, or other transfer

22  of a prescription drug under this sub-subparagraph from the

23  Secretary of Health or his or her designee.

24         (II)  The contract provider or subcontractor must be

25  authorized by law to administer or dispense prescription

26  drugs.

27         (III)  In the case of a subcontractor, the agency or

28  entity must be a party to and execute the subcontract.

29         (IV)  A contract provider or subcontractor must

30  maintain separate and apart from other prescription drug

31


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                                       CS/HB 1467, First Engrossed



  1  inventory any prescription drugs of the agency or entity in

  2  its possession.

  3         (V)  The contract provider and subcontractor must

  4  maintain and produce immediately for inspection all records of

  5  movement or transfer of all the prescription drugs belonging

  6  to the agency or entity, including, but not limited to, the

  7  records of receipt and disposition of prescription drugs.

  8  Each contractor and subcontractor dispensing or administering

  9  these drugs must maintain and produce records documenting the

10  dispensing or administration.  Records that are required to be

11  maintained include, but are not limited to, a perpetual

12  inventory itemizing drugs received and drugs dispensed by

13  prescription number or administered by patient identifier,

14  which must be submitted to the agency or entity quarterly.

15         (VI)  The contract provider or subcontractor may

16  administer or dispense the prescription drugs only to the

17  eligible patients of the agency or entity or must return the

18  prescription drugs for or to the agency or entity.  The

19  contract provider or subcontractor must require proof from

20  each person seeking to fill a prescription or obtain treatment

21  that the person is an eligible patient of the agency or entity

22  and must, at a minimum, maintain a copy of this proof as part

23  of the records of the contractor or subcontractor required

24  under sub-sub-subparagraph (V).

25         (VII)  The prescription drugs transferred pursuant to

26  this sub-subparagraph may not be billed to Medicaid.

27         (VIII)  In addition to the departmental inspection

28  authority set forth in s. 499.051, the establishment of the

29  contract provider and subcontractor and all records pertaining

30  to prescription drugs subject to this sub-subparagraph shall

31  be subject to inspection by the agency or entity.  All records


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                                       CS/HB 1467, First Engrossed



  1  relating to prescription drugs of a manufacturer under this

  2  sub-subparagraph shall be subject to audit by the manufacturer

  3  of those drugs, without identifying individual patient

  4  information.

  5         2.  Any of the following activities, which is not a

  6  violation of s. 499.005(21) if such activity is conducted in

  7  accordance with rules established by the department:

  8         a.  The sale, purchase, or trade of a prescription drug

  9  among federal, state, or local government health care entities

10  that are under common control and are authorized to purchase

11  such prescription drug.

12         b.  The sale, purchase, or trade of a prescription drug

13  or an offer to sell, purchase, or trade a prescription drug

14  for emergency medical reasons.; For purposes of this

15  sub-subparagraph subparagraph, the term "emergency medical

16  reasons" includes transfers of prescription drugs by a retail

17  pharmacy to another retail pharmacy to alleviate a temporary

18  shortage.

19         c.  The transfer purchase or acquisition of a

20  prescription drug acquired by a medical director on behalf of

21  a licensed an emergency medical services provider to that

22  medical director for use by emergency medical services

23  provider and its transport vehicles for use in accordance with

24  the provider's license under providers acting within the scope

25  of their professional practice pursuant to chapter 401.

26         d.  The revocation of a sale or the return of a

27  prescription drug to the person's prescription drug wholesale

28  supplier.

29         e.  The donation of a prescription drug by a health

30  care entity to a charitable organization that has been granted

31  an exemption under s. 501(c)(3) of the Internal Revenue Code


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                                       CS/HB 1467, First Engrossed



  1  of 1986, as amended, and that is authorized to possess

  2  prescription drugs.

  3         f.  The transfer of a prescription drug by a person

  4  authorized to purchase or receive prescription drugs to a

  5  person licensed or permitted to handle reverse distributions

  6  or destruction under the laws of the jurisdiction in which the

  7  person handling the reverse distribution or destruction

  8  receives the drug.

  9         3.  The dispensing of a prescription drug pursuant to a

10  prescription;

11         3.4.  The distribution of prescription drug samples by

12  manufacturers' representatives or distributors'

13  representatives conducted in accordance with s. 499.028.; or

14         4.5.  The sale, purchase, or trade of blood and blood

15  components intended for transfusion.  As used in this

16  subparagraph section, the term "blood" means whole blood

17  collected from a single donor and processed either for

18  transfusion or further manufacturing, and the term "blood

19  components" means that part of the blood separated by physical

20  or mechanical means.

21         5.  The lawful dispensing of a prescription drug in

22  accordance with chapter 465.

23         (5)  The department may adopt rules governing the

24  recordkeeping, storage, and handling with respect to each of

25  the distributions of prescription drugs specified in

26  subparagraphs (1)(a)1.-4. (1)(a)1., 2., 4., and 5.

27         Section 113.  Subsection (6) is added to section

28  626.883, Florida Statutes, to read:

29         626.883  Administrator as intermediary; collections

30  held in fiduciary capacity; establishment of account;

31  disbursement; payments on behalf of insurer.--


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                                       CS/HB 1467, First Engrossed



  1         (6)  All payments to a health care provider by a fiscal

  2  intermediary for noncapitated providers must include an

  3  explanation of services being reimbursed which includes, at a

  4  minimum, the patient's name, the date of service, the

  5  procedure code, the amount of reimbursement, and the

  6  identification of the plan on whose behalf the payment is

  7  being made. For capitated providers, the statement of services

  8  must include the number of patients covered by the contract,

  9  the rate per patient, the total amount of the payment, and the

10  identification of the plan on whose behalf the payment is

11  being made.

12         Section 114.  Paragraph (a) of subsection (2) of

13  section 641.316, Florida Statutes, 1998 Supplement, is amended

14  to read:

15         641.316  Fiscal intermediary services.--

16         (2)(a)  The term "fiduciary" or "fiscal intermediary

17  services" means reimbursements received or collected on behalf

18  of health care professionals for services rendered, patient

19  and provider accounting, financial reporting and auditing,

20  receipts and collections management, compensation and

21  reimbursement disbursement services, or other related

22  fiduciary services pursuant to health care professional

23  contracts with health maintenance organizations. All payments

24  to a health care provider by a fiscal intermediary for

25  noncapitated providers must include an explanation of services

26  being reimbursed which includes, at a minimum, the patient's

27  name, the date of service, the procedure code, the amount of

28  reimbursement, and the identification of the plan on whose

29  behalf the payment is being made. For capitated providers, the

30  statement of services must include the number of patients

31  covered by the contract, the rate per patient, the total


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                                       CS/HB 1467, First Engrossed



  1  amount of the payment, and the identification of the plan on

  2  whose behalf the payment is being made.

  3         Section 115.  Task Force on Telehealth.--

  4         (1)  Because telecommunications technology has made it

  5  possible to provide a wide range of health care services

  6  across state lines between healthcare practitioners and

  7  patients, it is the intent of the Legislature to protect the

  8  health and safety of all patients in this state receiving

  9  services by means of such technology and to ensure the

10  accountability of the healthcare profession with respect to

11  unsafe and incompetent practitioners using such technology to

12  provide health care services to patients in this state.

13         (2)  The Secretary of Health shall appoint a task force

14  consisting of representatives from the affected medical and

15  allied health professions and other affected health care

16  industries.

17         (3)  The task force shall address the following:

18         (a)  Identification of various electronic

19  communications or telecommunications technologies currently

20  used within the state and by other states to provide

21  healthcare information.

22         (b)  Identification of laws, regulations, and

23  reimbursement practices that serve as barriers to

24  implementation of electronic communications related to health

25  care.

26         (c)  Recommendation of the appropriate level of

27  regulation of health care professionals necessary to protect

28  the health and safety of patients in this state, including

29  analysis of existing provisions governing in-state

30  professionals such as licensing, financial responsibility, and

31  medical malpractice insurance requirements.


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  1         (d)  Potential preemption of state regulation by the

  2  Commerce Clause of the United States Constitution.

  3         (e)  The effect of telehealth on access to health care

  4  in rural and under-served areas.

  5         (f)  Potential antitrust concerns.

  6         (g)  The effect of regulations by other states or

  7  jurisdictions on health care professionals in this state who

  8  provide consultative services through telehealth to entities

  9  and patients outside the state.

10         (h)  Research on other public and private data and

11  initiatives related to telehealth.

12         (i)  Any other issue affecting the health, safety, and

13  welfare of patients through telehealth identified by the task

14  force.

15         (4)  The task force shall submit a report of its

16  findings and recommendations by January 1, 2000, to the

17  Governor, the President of the Senate, and the Speaker of the

18  House of Representatives.

19         Section 116.  Subsection (1) of section 468.352,

20  Florida Statutes, is amended to read:

21         468.352  Definitions.--As used in this part, unless the

22  context otherwise requires, the term:

23         (1)  "Board" means the Board of Respiratory Care

24  Medicine.

25         Section 117.  Section 468.353, Florida Statutes, is

26  amended to read:

27         468.353  Board of Respiratory Care Medicine; powers and

28  duties.--

29         (1)  The board, with the assistance of the Advisory

30  Council on Respiratory Care, is authorized to establish

31  minimum standards for the delivery of respiratory care


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                                       CS/HB 1467, First Engrossed



  1  services and to adopt those rules necessary to administer this

  2  part.

  3         (2)  The board may administer oaths, summon witnesses,

  4  and take testimony in all matters relating to its duties under

  5  this part.

  6         (3)  The board may adopt rules to administer this part,

  7  including rules governing the investigation, inspection, and

  8  review of schools and colleges that offer courses in

  9  respiratory care in order to ascertain their compliance with

10  standards established by the board or appropriate accrediting

11  agencies delegate such powers and duties to the council as it

12  may deem proper.

13         Section 118.  Section 468.354, Florida Statutes, is

14  amended to read:

15         468.354  Board of Advisory Council on Respiratory Care;

16  organization; function.--

17         (1)  There is created within the department, the Board

18  of Advisory Council on Respiratory Care, composed of seven

19  members appointed by the Governor and confirmed by the Senate

20  under the supervision of the board.

21         (2)  The board council shall consist of five members

22  appointed by the board and shall include:

23         (a)  A registered respiratory therapist.

24         (b)  A certified respiratory therapist care

25  practitioner.

26         (c)  A respiratory care professional from each of the

27  following areas:

28         1.  Respiratory care education.

29         2.  Respiratory care management and supervision.

30         3.  Homecare/subacute Cardiopulmonary diagnostics.

31


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                                       CS/HB 1467, First Engrossed



  1         (d)  Two consumer members, who are residents of this

  2  state and have never been licensed as health care

  3  practitioners.

  4

  5  Each member of the council shall be a respiratory care

  6  professional on the board must have who has been actively

  7  engaged in the delivery of respiratory care services in this

  8  state for at least 4 consecutive years prior to appointment.

  9         (3)(a)  Except as provided in paragraph (b), the term

10  of office for each board council member shall be 4 years.  No

11  member shall serve for more than two consecutive terms.  Any

12  time there is a vacancy to be filled on the council, all

13  professional organizations dealing with respiratory therapy

14  incorporated within the state as not for profit which register

15  their interest with the board shall recommend at least twice

16  as many persons to fill the vacancy to the council as the

17  number of vacancies to be filled, and the Governor board may

18  appoint from the submitted list, in his its discretion, any of

19  those persons so recommended.  The Governor board shall,

20  insofar as possible, appoint persons from different

21  geographical areas.

22         (b)  In order To achieve staggering of terms, within

23  120 days after July 1, 1999, October 1, 1984, the Governor

24  board shall appoint the board members of the council as

25  follows:

26         1.  Two members One member shall be appointed for terms

27  a term of 2 years.

28         2.  Two members shall be appointed for terms of 3

29  years.

30         3.  Three Two members shall be appointed for terms of 4

31  years.


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                                       CS/HB 1467, First Engrossed



  1         (c)  All provisions of part II of chapter 455, relating

  2  to boards apply to this part.

  3         (4)(a)  The board council shall annually elect from

  4  among its members a chair and vice chair.

  5         (b)  The board council shall meet at least twice a year

  6  and shall hold such additional meetings as are deemed

  7  necessary by the board.  Four Three members of the council

  8  constitute a quorum.

  9         (c)  Unless otherwise provided by law, a board council

10  member shall be compensated $50 for each day he or she attends

11  an official board meeting of the council and for each day he

12  or she participates in any other board business involving the

13  council.  A board council member shall also be entitled to

14  reimbursement for expenses pursuant to s. 112.061. Travel out

15  of the state shall require the prior approval of the secretary

16  of the department.

17         (5)(a)  The board may council shall recommend to the

18  department a code of ethics for those persons licensed

19  pursuant to this part.

20         (b)  The council shall make recommendations to the

21  department for the approval of continuing education courses.

22         Section 119.  Section 468.355, Florida Statutes, is

23  amended to read:

24         468.355  Eligibility for licensure; temporary

25  licensure.--

26         (1)  To be eligible for licensure by the board as a

27  respiratory care practitioner, an applicant must:

28         (a)  Be at least 18 years old.

29         (b)  Possess a high school diploma or a graduate

30  equivalency diploma.

31         (c)  Meet at least one of the following criteria:


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                                       CS/HB 1467, First Engrossed



  1         1.  The applicant has successfully completed a training

  2  program for respiratory therapy technicians or respiratory

  3  therapists approved by the Commission on Accreditation of

  4  Allied Health Education Programs, or the equivalent thereof,

  5  as accepted by the board.

  6         2.  The applicant is currently a "Certified Respiratory

  7  Therapy Technician" certified by the National Board for

  8  Respiratory Care, or the equivalent thereof, as accepted by

  9  the board.

10         3.  The applicant is currently a "Registered

11  Respiratory Therapist" registered by the National Board for

12  Respiratory Care, or the equivalent thereof, as accepted by

13  the board.

14         4.  The applicant is currently employed in this state

15  as a respiratory care practitioner or respiratory therapist on

16  October 1, 1984.

17

18  The criteria set forth in subparagraphs 2. and 3.

19  notwithstanding, the board shall periodically annually review

20  the examinations and standards of the National Board for

21  Respiratory Care and may reject those examinations and

22  standards if they are deemed inappropriate.

23         (2)  To be eligible for licensure by the board as a

24  respiratory therapist, an applicant must:

25         (a)  Be at least 18 years old.

26         (b)  Possess a high school diploma or a graduate

27  equivalency diploma.

28         (c)  Meet at least one of the following criteria:

29         1.  The applicant has successfully completed a training

30  program for respiratory therapists approved by the Commission

31


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                                       CS/HB 1467, First Engrossed



  1  on Accreditation of Allied Health Education Programs, or the

  2  equivalent thereof, as accepted by the board.

  3         2.  The applicant is currently a "Registered

  4  Respiratory Therapist" registered by the National Board for

  5  Respiratory Care, or the equivalent thereof, as accepted by

  6  the board.

  7

  8  The criteria set forth in subparagraphs 1. and 2.

  9  notwithstanding, the board shall periodically annually review

10  the examinations and standards of the National Board for

11  Respiratory Care and may reject those examinations and

12  standards if they are deemed inappropriate.

13         (3)  With respect to the delivery of respiratory care

14  services, the board shall establish procedures for temporary

15  licensure of eligible individuals entering the state and

16  temporary licensure of those persons who have graduated from a

17  program approved by the board.  Such temporary licensure shall

18  be for a period not to exceed 1 year.

19         Section 120.  Section 468.357, Florida Statutes, is

20  amended to read:

21         468.357  Licensure by examination.--

22         (1)  A person who desires to be licensed as a

23  respiratory care practitioner may submit an application to the

24  department to take the examination, in accordance with board

25  rule to be administered by the department.

26         (a)  The department shall examine Each applicant may

27  take the examination who is determined by the board to have:

28         1.  Completed the application form and remitted the

29  applicable fee set by the board;

30         2.  Submitted required documentation as required in s.

31  468.355; and


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                                       CS/HB 1467, First Engrossed



  1         3.  Remitted an examination fee set by the examination

  2  provider board.

  3         (b)  The department shall conduct Examinations for

  4  licensure of respiratory care practitioners must be conducted

  5  no less than two times a year in such geographical locations

  6  or by such methods as are deemed advantageous to the majority

  7  of the applicants.

  8         (c)  The examination given for respiratory care

  9  practitioners shall be the same as that given by the National

10  Board for Respiratory Care for entry-level certification of

11  respiratory therapy technicians.  However, an equivalent

12  examination may be accepted by the board in lieu of that

13  examination.

14         (2)  Each applicant who passes the examination shall be

15  entitled to licensure as a respiratory care practitioner, and

16  the department shall issue a license pursuant to this part to

17  any applicant who successfully completes the examination in

18  accordance with this section.  However, the department shall

19  not issue a license to any applicant who is under

20  investigation in another jurisdiction for an offense which

21  would constitute a violation of this part.  Upon completion of

22  such an investigation, if the applicant is found guilty of

23  such an offense, the applicable provisions of s. 468.365 will

24  apply.

25         (3)  Any person who was employed in this state on or

26  before September 30, 1983, as a respiratory therapy technician

27  or respiratory therapist, and who has performed services in

28  such professional capacity for 4 years or more by October 1,

29  1987, under the supervision of a licensed physician or in a

30  hospital or licensed health care facility, shall be issued a

31  license without examination, if such person provides


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                                       CS/HB 1467, First Engrossed



  1  acceptable documentation of performance of such services to

  2  the board.  Such documentation shall include certification by

  3  a physician licensed pursuant to chapter 458 or chapter 459

  4  who has direct knowledge of the practice of, or who has

  5  supervised, the person.  If such person is not determined to

  6  have performed critical care respiratory services for at least

  7  4 years, the board may limit the license of such person to the

  8  performance of noncritical care respiratory services.

  9         Section 121.  Section 468.364, Florida Statutes, 1998

10  Supplement, is amended to read:

11         468.364  Fees; establishment; disposition.--

12         (1)  The board shall establish by rule fees for the

13  following purposes:

14         (a)  Application, a fee not to exceed $50.

15         (b)  Examination, a fee not to exceed $125 plus the

16  actual per applicant cost to the department for purchase of

17  the examination from the National Board for Respiratory Care

18  or a similar national organization.

19         (b)(c)  Initial licensure, a fee not to exceed $200.

20         (c)(d)  Renewal of licensure, a fee not to exceed $200

21  biennially.

22         (d)(e)  Renewal of inactive licensure, a fee not to

23  exceed $50.

24         (e)(f)  Reactivation, a fee not to exceed $50.

25         (2)  The fees established pursuant to subsection (1)

26  shall be based upon the actual costs incurred by the

27  department in carrying out its responsibilities under this

28  part.

29         (3)  All moneys collected by the department under this

30  part shall be deposited as required by s. 455.587.

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  1         Section 122.  Paragraph (f) of subsection (1) of

  2  section 468.365, Florida Statutes, 1998 Supplement, is amended

  3  to read:

  4         468.365  Disciplinary grounds and actions.--

  5         (1)  The following acts constitute grounds for which

  6  the disciplinary actions in subsection (2) may be taken:

  7         (f)  Unprofessional conduct, which includes, but is not

  8  limited to, any departure from, or failure to conform to,

  9  acceptable standards related to the delivery of respiratory

10  care services, as set forth by the board and the Advisory

11  Council on Respiratory Care in rules adopted pursuant to this

12  part.

13         Section 123.  Paragraph (a) of subsection (2) of

14  section 464.016, Florida Statutes, is amended to read:

15         464.016  Violations and penalties.--

16         (2)  Each of the following acts constitutes a

17  misdemeanor of the first degree, punishable as provided in s.

18  775.082 or s. 775.083:

19         (a)  Using the name or title "Nurse," "Registered

20  Nurse," "Licensed Practical Nurse," "Advanced Registered Nurse

21  Practitioner," or any other name or title which implies that a

22  person was licensed or certified as same, unless such person

23  is duly licensed or certified.

24         Section 124.  Paragraphs (b) and (c) of subsection (1)

25  of section 458.3115, Florida Statutes, 1998 Supplement, are

26  amended to read:

27         458.3115  Restricted license; certain foreign-licensed

28  physicians; United States Medical Licensing Examination

29  (USMLE) or agency-developed examination; restrictions on

30  practice; full licensure.--

31         (1)


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                                       CS/HB 1467, First Engrossed



  1         (b)  A person who is eligible to take and elects to

  2  take the USMLE who has previously passed part 1 or part 2 of

  3  the previously administered FLEX shall not be required to

  4  retake or pass the equivalent parts of the USMLE up to the

  5  year 2002 2000.

  6         (c)  A person shall be eligible to take such

  7  examination for restricted licensure if the person:

  8         1.  Has taken, upon approval by the board, and

  9  completed, in November 1990 or November 1992, one of the

10  special preparatory medical update courses authorized by the

11  board and the University of Miami Medical School and

12  subsequently passed the final course examination; upon

13  approval by the board to take the course completed in 1990 or

14  in 1992, has a certificate of successful completion of that

15  course from the University of Miami or the Stanley H. Kaplan

16  course; or can document to the department that he or she was

17  one of the persons who took and successfully completed the

18  Stanley H. Kaplan course that was approved by the Board of

19  Medicine and supervised by the University of Miami. At a

20  minimum, the documentation must include class attendance

21  records and the test score on the final course examination;

22         2.  Applies to the agency and submits an application

23  fee that is nonrefundable and equivalent to the fee required

24  for full licensure;

25         3.  Documents no less than 2 years of the active

26  practice of medicine in any another jurisdiction;

27         4.  Submits an examination fee that is nonrefundable

28  and equivalent to the fee required for full licensure plus the

29  actual per-applicant cost to the agency to provide either

30  examination described in this section;

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                                       CS/HB 1467, First Engrossed



  1         5.  Has not committed any act or offense in this or any

  2  other jurisdiction that would constitute a substantial basis

  3  for disciplining a physician under this chapter or part II of

  4  chapter 455; and

  5         6.  Is not under discipline, investigation, or

  6  prosecution in this or any other jurisdiction for an act that

  7  would constitute a violation of this chapter or part II of

  8  chapter 455 and that substantially threatened or threatens the

  9  public health, safety, or welfare.

10         Section 125.  Subsection (2) of section 458.3124,

11  Florida Statutes, 1998 Supplement, is amended to read:

12         458.3124  Restricted license; certain experienced

13  foreign-trained physicians.--

14         (2)  A person applying for licensure under this section

15  must submit to the Department of Health on or before December

16  31, 2000 1998:

17         (a)  A completed application and documentation required

18  by the Board of Medicine to prove compliance with subsection

19  (1); and

20         (b)  A nonrefundable application fee not to exceed $500

21  and a nonrefundable examination fee not to exceed $300 plus

22  the actual cost to purchase and administer the examination.

23         Section 126.  Effective upon this act becoming a law,

24  section 301 of chapter 98-166, Laws of Florida, is amended to

25  read:

26         Section 301.  The sum of $1.2 million from the

27  unallocated balance in the Medical Quality Assurance Trust

28  Fund is appropriated to the Department of Health to allow the

29  department to develop the examination required for foreign

30  licensed physicians in section 458.3115(1)(a), Florida

31  Statutes, through a contract with the University of South


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                                       CS/HB 1467, First Engrossed



  1  Florida. The department shall charge examinees a fee not to

  2  exceed 25 percent of the cost of the actual costs of the first

  3  examination administered pursuant to section 458.3115, Florida

  4  Statutes, 1998 Supplement, and a fee not to exceed 75 percent

  5  of the actual costs for any subsequent examination

  6  administered pursuant to that section.

  7         Section 127.  Subsection (1)(a) of section 490.012,

  8  Florida Statutes, is amended to read:

  9         490.012  Violations; penalties; injunction.--

10         (1)(a)  No person shall hold herself or himself out by

11  any title or description incorporating the words, or

12  permutations of them, "psychologist," "psychology,"

13  "psychological," "psychodiagnostic," or "school psychologist,"

14  or describe any test or report as psychological, unless such

15  person holds a valid, active license under this chapter,

16  chapter 458 or chapter 459 or is exempt from the provisions of

17  this chapter.

18         Section 128.  The Agency for Health Care

19  Administration, in conjunction with the Medicare Fraud

20  Division of the Office of the Attorney General, shall conduct

21  a detailed study and analysis of clinical laboratory services

22  for kidney dialysis patients in the State of Florida. The

23  study shall include, but not be limited to, an analysis of the

24  past and present utilization rates of clinical laboratory

25  services for dialysis patients, financial arrangements among

26  kidney dialysis centers, their medical directors, and any

27  business relationships and affiliations with clinical

28  laboratories, any self referral to clinical labs, the quality

29  and responsiveness of clinical laboratory services for

30  dialysis patients in Florida, and the average annual revenue

31  for dialysis patients for clinical laboratory services for the


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                                       CS/HB 1467, First Engrossed



  1  past ten years. The agency shall report back to the President

  2  of the Senate, Speaker of the House of Representatives, and

  3  chairs of the appropriate substantive committees of the

  4  Legislature on its findings no later than February 1, 2000.

  5         Section 129.  Subsection (3) is added to section

  6  455.651, Florida Statutes, 1998 Supplement, to read:

  7         455.651  Disclosure of confidential information.--

  8         (1)  No officer, employee, or person under contract

  9  with the department, or any board therein, or any subject of

10  an investigation shall convey knowledge or information to any

11  person who is not lawfully entitled to such knowledge or

12  information about any public meeting or public record, which

13  at the time such knowledge or information is conveyed is

14  exempt from the provisions of s. 119.01, s. 119.07(1), or s.

15  286.011.

16         (2)  Any person who willfully violates any provision of

17  this section is guilty of a misdemeanor of the first degree,

18  punishable as provided in s. 775.082 or s. 775.083, and may be

19  subject to discipline pursuant to s. 455.624, and, if

20  applicable, shall be removed from office, employment, or the

21  contractual relationship.

22         (3)  Any person injured as a result of a violation of

23  this section shall have a civil cause of action for treble

24  damages, reasonable attorney fees, and costs.

25         Section 130.  Except as otherwise provided in this act,

26  this act shall take effect July 1, 1999.

27

28

29

30

31


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