House Bill 1467e2

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







                                      CS/HB 1467, Second 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. 455.557, F.S.; redefining the term

27         "health care practitioner" for purposes of

28         standardized credentializing; amending s.

29         455.564, F.S.; prescribing the expiration date

30         of an incomplete license application; revising

31         the form and style of licenses; providing


                                  1

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






                                      CS/HB 1467, Second Engrossed



  1         authority to the department when there is no

  2         board to adopt rules; revising and providing

  3         requirements relating to obtaining continuing

  4         education credit in risk management; correcting

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

  6         providing exceptions to certain application

  7         requirements; revising information required for

  8         licensure of designated health care

  9         professionals; revising requirements for

10         submitting fingerprints to the department for

11         renewal of licensure; amending s. 455.5651,

12         F.S.; prohibiting inclusion of certain

13         information in practitioner profiles; amending

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

15         and prohibiting it in the practice of a health

16         care profession; providing penalties; amending

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

18         to review of an examination after failure to

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

20         authority to the department when there is no

21         board to determine by rule the amount of

22         license fees for the profession regulated;

23         providing for a fee for issuance of a wall

24         certificate to certain licensees or for a

25         duplicate wall certificate; amending s.

26         455.604, F.S.; requiring instruction on human

27         immunodeficiency virus and acquired immune

28         deficiency syndrome as a condition of licensure

29         and relicensure to practice dietetics and

30         nutrition or nutrition counseling; amending s.

31         455.607, F.S.; correcting a reference; amending


                                  2

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






                                      CS/HB 1467, Second Engrossed



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

  2         grounds for discipline; providing penalties;

  3         providing for assessment of certain costs;

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

  5         health care practitioners to include a certain

  6         statement in advertisements for free or

  7         discounted services; correcting terminology;

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

  9         department to obtain patient records, billing

10         records, insurance information, provider

11         contracts, and all attachments thereto under

12         certain circumstances for purposes of

13         disciplinary proceedings; providing for charges

14         for making reports or records available for

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

16         providing for the suspension or restriction of

17         the license of any health care practitioner who

18         tests positive for drugs under certain

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

20         providing financial responsibility requirements

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

22         providing requirements for active status

23         licensure of certain business establishments;

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

25         "prescriptive rights" with respect to

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

27         correcting terminology and a reference;

28         removing an obsolete date; amending s. 458.309,

29         F.S.; providing for registration and inspection

30         of certain offices performing levels 2 and 3

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


                                  3

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






                                      CS/HB 1467, Second Engrossed



  1         provisions relating to licensure as a physician

  2         by examination; eliminating an obsolete

  3         provision relating to licensure of medical

  4         students from Nicaragua and another provision

  5         relating to taking the examination without

  6         applying for a license; amending s. 458.3115,

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

  8         458.313, F.S.; revising provisions relating to

  9         licensure by endorsement; repealing provisions

10         relating to reactivation of certain licenses

11         issued by endorsement; amending s. 458.315,

12         F.S.; providing additional requirements for

13         recipients of a temporary certificate for

14         practice in areas of critical need; amending s.

15         458.3165, F.S.; prescribing authorized

16         employment for holders of public psychiatry

17         certificates; correcting a reference; amending

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

19         an active license to a limited license for a

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

21         revising requirements for submitting

22         fingerprints to the department for renewal of

23         licensure as a physician; amending s. 458.331,

24         F.S.; providing grounds for discipline;

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

26         revising provisions relating to temporary

27         licensure as a physician assistant; amending s.

28         459.005, F.S.; providing for registration and

29         inspection of certain offices performing levels

30         2 and 3 surgery; amending s. 459.0075, F.S.;

31         providing for conversion of an active license


                                  4

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






                                      CS/HB 1467, Second Engrossed



  1         to a limited license for a specified purpose;

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

  3         requirements for submitting fingerprints to the

  4         department for renewal of licensure as an

  5         osteopathic physician; amending s. 459.015,

  6         F.S.; revising and providing grounds for

  7         discipline; providing penalties; amending s.

  8         460.402, F.S.; providing an exemption from

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

10         chiropractic, for certain students; amending s.

11         460.403, F.S.; defining the term

12         "community-based internship" for purposes of

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

14         supervision" and "registered chiropractic

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

16         requirements for licensure as a chiropractic

17         physician by examination to remove a provision

18         relating to a training program; amending s.

19         460.407, F.S.; revising requirements for

20         submitting fingerprints to the department for

21         renewal of licensure as a chiropractic

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

23         increasing the administrative fine; conforming

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

25         revising requirements for certification of

26         chiropractic physician's assistants; providing

27         for supervision of registered chiropractic

28         physician's assistants; providing for biennial

29         renewal; providing fees; providing

30         applicability to current certificateholders;

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


                                  5

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






                                      CS/HB 1467, Second Engrossed



  1         registered chiropractic assistants to be under

  2         the direct supervision of a certified

  3         chiropractic physician's assistant; amending s.

  4         461.003, F.S.; defining the term "certified

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

  6         supervision" with respect thereto; redefining

  7         the term "practice of podiatric medicine";

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

  9         residency requirement to practice podiatric

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

11         requirements for renewal of license to practice

12         podiatric medicine; revising requirements for

13         submitting fingerprints to the department for

14         renewal of licensure; amending s. 461.013,

15         F.S.; revising and providing grounds for

16         discipline; providing penalties; creating s.

17         461.0135, F.S.; providing requirements for

18         operation of X-ray machines by certified

19         podiatric X-ray assistants; amending s.

20         464.008, F.S.; providing for remediation upon

21         failure to pass the examination to practice

22         nursing a specified number of times; amending

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

24         regulation relating to remedial courses;

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

26         "data communication device"; revising the

27         definition of the term "practice of the

28         profession of pharmacy"; amending s.  465.016,

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

30         returned unit-dose medication by correctional

31         facilities under certain conditions; providing


                                  6

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






                                      CS/HB 1467, Second Engrossed



  1         a ground for which a pharmacist may be subject

  2         to discipline by the Board of Pharmacy;

  3         increasing the administrative fine; amending

  4         ss. 465.014, 465.015, 465.0196, 468.812,

  5         499.003, F.S.; correcting cross-references, to

  6         conform; creating the Task Force for the Study

  7         of Collaborative Drug Therapy Management;

  8         providing for staff support from the

  9         department; providing for participation by

10         specified associations and entities; providing

11         responsibilities; requiring a report to the

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

13         revising requirements relating to dental work

14         orders required of unlicensed persons; amending

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

16         provisional licensure to practice

17         speech-language pathology or audiology;

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

19         requirements for certification as a

20         speech-language pathologist or audiologist

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

22         authorizing the issuance of subcategory

23         certificates in the field of radiologic

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

25         correcting references; amending s. 468.701,

26         F.S.; revising and removing definitions;

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

28         Council of Athletic Training with a Board of

29         Athletic Training; providing for appointment of

30         board members and their successors; providing

31         for staggering of terms; providing for


                                  7

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






                                      CS/HB 1467, Second Engrossed



  1         applicability of other provisions of law

  2         relating to activities of regulatory boards;

  3         providing for the board's headquarters;

  4         amending ss. 468.705, 468.707, 468.709,

  5         468.711, 468.719, 468.721, F.S., relating to

  6         rulemaking authority, licensure by examination,

  7         fees, continuing education, disciplinary

  8         actions, and certain regulatory transition;

  9         transferring to the board certain duties of the

10         department relating to regulation of athletic

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

12         board under the Division of Medical Quality

13         Assurance of the department; providing for

14         termination of the council and the terms of

15         council members; authorizing consideration of

16         former council members for appointment to the

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

18         grandfathering provisions for the practice of

19         orthotics, prosthetics, or pedorthics; amending

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

21         continuing education providers; amending s.

22         478.42, F.S.; redefining the term "electrolysis

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

24         redefining the terms "clinical laboratory" and

25         "licensed practitioner" and defining the term

26         "clinical laboratory examination"; amending s.

27         483.803, F.S.; redefining the terms "clinical

28         laboratory examination" and "licensed

29         practitioner of the healing arts"; revising a

30         reference; amending s. 483.807, F.S.; revising

31         provisions relating to fees for approval as a


                                  8

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






                                      CS/HB 1467, Second Engrossed



  1         laboratory training program; amending s.

  2         483.809, F.S.; revising requirements relating

  3         to examination of clinical laboratory personnel

  4         for licensure and to registration of clinical

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

  6         revising qualification requirements for

  7         licensure of public health laboratory

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

  9         eliminating a provision authorizing conditional

10         licensure of clinical laboratory personnel for

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

12         authorizing continuing education or retraining

13         for candidates who fail an examination a

14         specified number of times; amending s. 483.824,

15         F.S.; revising qualifications of clinical

16         laboratory directors; amending s. 483.825,

17         F.S.; revising and providing grounds for

18         discipline; providing penalties; amending s.

19         483.901, F.S.; correcting a reference;

20         eliminating a provision authorizing temporary

21         licensure as a medical physicist; correcting

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

23         F.S.; revising requirements for opticians who

24         supervise apprentices; amending s. 484.0512,

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

26         refund within a specified period all moneys

27         required to be refunded under trial-period

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

29         increasing the penalty applicable to prohibited

30         acts relating to the dispensing of hearing

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


                                  9

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






                                      CS/HB 1467, Second Engrossed



  1         violation of trial-period requirements is a

  2         ground for disciplinary action; providing

  3         penalties; amending ss. 486.041, 486.081,

  4         486.103, and 486.107, F.S.; eliminating

  5         provisions authorizing issuance of a temporary

  6         permit to work as a physical therapist or

  7         physical therapist assistant; amending s.

  8         490.005, F.S.; revising educational

  9         requirements for licensure as a psychologist by

10         examination; changing a date, to defer certain

11         educational requirements; amending s. 490.006,

12         F.S.; providing additional requirements for

13         licensure as a psychologist by endorsement;

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

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

16         authorizing release of a patient's

17         psychological record to certain persons

18         pursuant to workers' compensation provisions;

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

20         requirements for registration as a clinical

21         social worker intern, marriage and family

22         therapist intern, or mental health counselor

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

24         requirements for provisional licensure of

25         clinical social workers, marriage and family

26         therapists, and mental health counselors;

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

28         requirements for licensure of clinical social

29         workers, marriage and family therapists, and

30         mental health counselors; providing for

31         certification of education of interns;


                                  10

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






                                      CS/HB 1467, Second Engrossed



  1         providing rulemaking authority to implement

  2         education and experience requirements for

  3         licensure as a clinical social worker, marriage

  4         and family therapist, or mental health

  5         counselor; revising future licensure

  6         requirements for mental health counselors and

  7         providing rulemaking authority for

  8         implementation thereof; amending s. 491.006,

  9         F.S.; revising requirements for licensure or

10         certification by endorsement; amending s.

11         491.0085, F.S.; requiring laws and rules

12         courses and providing for approval thereof,

13         including providers and programs; correcting

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

15         F.S.; revising an exemption from regulation

16         relating to certain temporally limited

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

18         the term "wholesale distribution," relating to

19         the distribution of prescription drugs, to

20         provide for the exclusion of certain

21         activities; amending ss. 626.883, 641.316,

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

23         provider by a fiscal intermediary to include an

24         explanation of services provided; creating a

25         Task Force on Telehealth; providing its duties;

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

27         redefining the term "board"; amending s.

28         468.353, F.S.; conforming provision; providing

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

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

31         providing for membership, powers, and duties;


                                  11

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






                                      CS/HB 1467, Second Engrossed



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

  2         periodic rather than annual review of certain

  3         examinations and standards; amending s.

  4         458.357, F.S.; conforming provisions; deleting

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

  6         deleting an examination fee; amending s.

  7         468.365, F.S.; conforming provisions; amending

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

  9         title "nurse" without being licensed or

10         certified is a crime; amending s. 458.3115,

11         F.S.; revising requirements with respect to

12         eligibility of certain foreign-licensed

13         physicians to take and pass standardized

14         examinations; amending s. 458.3124, F.S.;

15         changing the date by which application for a

16         restricted license must be submitted; amending

17         s. 301, ch. 98-166, Laws of Florida;

18         prescribing fees for foreign-licensed

19         physicians taking a certain examination;

20         amending s. 490.012, F.S.; revising a

21         prohibition against using titles relating to

22         the practice of psychology, for which there are

23         penalties; providing for a detailed study and

24         analysis of clinical laboratory services for

25         kidney dialysis patients; amending s. 455.651,

26         F.S.; providing for treble damages, reasonable

27         attorney fees, and costs for improper

28         disclosure of confidential information;

29         providing effective dates.

30

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


                                  12

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






                                      CS/HB 1467, Second Engrossed



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

  2  Services of the Department of Health shall contract with a

  3  private nonprofit provider affiliated with a teaching hospital

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

  5  institutional review board within the teaching hospital, on

  6  the use of the drug Secretin to treat autism.

  7         (2)  The private nonprofit provider shall report its

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

  9  President of the Senate, the Speaker of the House of

10  Representatives, and other appropriate bodies.

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

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

13  Health from the General Revenue Fund for the purpose of

14  implementing this act.

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

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

17         232.435  Extracurricular athletic activities; athletic

18  trainers.--

19         (3)

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

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

22  teacher apprentice trainer within the requirements of this

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

24  part XIII XIV of chapter 468.

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

26  Statutes, 1998 Supplement, is amended to read:

27         381.026  Florida Patient's Bill of Rights and

28  Responsibilities.--

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

30  381.0261, the term:

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


                                  13

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






                                      CS/HB 1467, Second Engrossed



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

  2  licensed under chapter 395.

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

  4  licensed under chapter 458, an osteopathic physician licensed

  5  under chapter 459, or a podiatric physician licensed under

  6  chapter 461.

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

  8  provider who is primarily responsible for patient care in a

  9  health care facility or provider's office.

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

11  Statutes, 1998 Supplement, is amended to read:

12         381.0261  Summary of patient's bill of rights;

13  distribution; penalty.--

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

15  Agency for Health Care Administration when any health care

16  provider or health care facility fails to make available to

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

18  this section. Initial nonwillful violations shall be subject

19  to corrective action and shall not be subject to an

20  administrative fine. The Agency for Health Care Administration

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

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

23  and willful violations. Each intentional and willful violation

24  constitutes a separate violation and is subject to a separate

25  fine.

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

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

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

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

30  and this section. Initial nonwillful violations shall be

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


                                  14

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






                                      CS/HB 1467, Second Engrossed



  1  administrative fine. The appropriate regulatory board or

  2  department agency may levy a fine against a health care

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

  4  $500 for willful violations. Each intentional and willful

  5  violation constitutes a separate violation and is subject to a

  6  separate fine.

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

  8  Florida Statutes, are amended to read:

  9         455.501  Definitions.--As used in this part, the term:

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

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

12  459; chapter 460; chapter 461; chapter 462; chapter 463;

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

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

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

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

17  chapter 491.

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

19  permit, registration, certificate, or license by the

20  department.

21         Section 7.  Section 455.507, Florida Statutes, is

22  amended to read:

23         455.507  Members of Armed Forces in good standing with

24  administrative boards or department.--

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

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

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

28  administrative board of the state, or the department when

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

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

31  in good standing by such administrative board, or the


                                  15

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






                                      CS/HB 1467, Second Engrossed



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

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

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

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

  5  6 months after his discharge from active duty as a member of

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

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

  8  the private sector for profit.

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

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

11  exempting the spouses of members of the Armed Forces of the

12  United States from licensure renewal provisions, but only in

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

14  duties with the Armed Forces.

15         Section 8.  Section 455.521, Florida Statutes, 1998

16  Supplement, is amended to read:

17         455.521  Department; powers and duties.--The

18  department, for the professions boards under its jurisdiction,

19  shall:

20         (1)  Adopt rules establishing a procedure for the

21  biennial renewal of licenses; however, the department may

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

23  notwithstanding any other provisions of law to the contrary.

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

25  individual professions on an annualized basis as authorized by

26  law.

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

28  subject to the approval of the board.

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

30  time and in the manner provided by law.

31


                                  16

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






                                      CS/HB 1467, Second Engrossed



  1         (4)  Develop a training program for persons newly

  2  appointed to membership on any board. The program shall

  3  familiarize such persons with the substantive and procedural

  4  laws and rules and fiscal information relating to the

  5  regulation of the appropriate profession and with the

  6  structure of the department.

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

  8  to implement the provisions of this part.

  9         (6)  Establish by rules procedures by which the

10  department shall use the expert or technical advice of the

11  appropriate board for the purposes of investigation,

12  inspection, evaluation of applications, other duties of the

13  department, or any other areas the department may deem

14  appropriate.

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

16  thereof and all formal or informal proceedings conducted by

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

18  officer with respect to licensing or discipline to be

19  electronically recorded in a manner sufficient to assure the

20  accurate transcription of all matters so recorded.

21         (8)  Select only those investigators, or consultants

22  who undertake investigations, who meet criteria established

23  with the advice of the respective boards.

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

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

26  support agency pursuant to s. 409.2598 to assure compliance

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

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

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

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

31  delinquent support obligation. The department shall issue or


                                  17

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






                                      CS/HB 1467, Second Engrossed



  1  reinstate the license without additional charge to the

  2  licensee when notified by the court that the licensee has

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

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

  5  resulting from the discharge of its duties under this

  6  subsection.

  7         Section 9.  Paragraph (k) of subsection (2) of section

  8  455.557, Florida Statutes, 1998 Supplement, is amended to

  9  read:

10         455.557  Standardized credentialing for health care

11  practitioners.--

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

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

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

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

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

17  chapter subsequently made subject to this section by the

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

19  person registered or applying for registration pursuant to s.

20  458.345 or 459.021.

21         Section 10.  Subsections (1), (2), (6), (7), (8), and

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

23  amended to read:

24         455.564  Department; general licensing provisions.--

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

26  within the jurisdiction of the department shall apply to the

27  department in writing to take the licensure examination.  The

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

29  the department and shall require the social security number of

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

31  reflect any material change in any circumstance or condition


                                  18

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






                                      CS/HB 1467, Second Engrossed



  1  stated in the application which takes place between the

  2  initial filing of the application and the final grant or

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

  4  the department. An incomplete application shall expire 1 year

  5  after initial filing. In order to further the economic

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

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

  8  the county tax collector for the purpose of appointing the

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

10  applications for licenses and applications for renewals of

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

12  tax collector must forward any applications and accompanying

13  application fees to the department.

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

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

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

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

18  department shall issue a license to any person certified by

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

20  licensure requirements imposed by law or rule. The license

21  licensee shall consist of be issued a wallet-size

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

23  5 inches. In addition to the two-part license, the department,

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

25  certificate suitable for conspicuous display, which shall be

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

27  surrender to the department the wallet-size identification

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

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

30  suspended or revoked. The department shall promptly return the

31  wallet-size identification card and the wall certificate to


                                  19

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






                                      CS/HB 1467, Second Engrossed



  1  the licensee upon reinstatement of a suspended or revoked

  2  license.

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

  4  of Medicine, the Board of Osteopathic Medicine, the Board of

  5  Chiropractic Medicine, and the Board of Podiatric Medicine

  6  shall each require licensees which they respectively regulate

  7  to periodically demonstrate their professional competency by

  8  completing at least 40 hours of continuing education every 2

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

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

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

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

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

14  cost containment. This provision shall not be construed to

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

16  management or cost containment to be credited toward

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

18  not be construed to require the boards to impose any

19  requirement on licensees except for the completion of at least

20  40 hours of continuing education every 2 years. Each of such

21  boards shall determine whether any specific continuing

22  education course requirements not otherwise mandated by law

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

24  content of, any continuing education course mandated by such

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

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

27  alternative methods of obtaining continuing education credits

28  in risk management. The alternative methods may include

29  attending a board meeting at which another a licensee is

30  disciplined, serving as a volunteer expert witness for the

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


                                  20

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






                                      CS/HB 1467, Second Engrossed



  1  probable cause panel following the expiration of a board

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

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

  4  adopt rules granting continuing education hours in risk

  5  management for attending a board meeting at which another

  6  licensee is disciplined, serving as a volunteer expert witness

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

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

  9  board member's term.

10         (7)  The respective boards within the jurisdiction of

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

12  adopt rules to provide for the use of approved videocassette

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

14  continuing education requirements of the professions they

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

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

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

18  a videocassette course validation form to be signed by the

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

20  with the license renewal application, for continuing education

21  credit.

22         (8)  Any board that currently requires continuing

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

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

25  continuing education courses.  The rules may provide that up

26  to a maximum of 25 percent of the required continuing

27  education hours can be fulfilled by the performance of pro

28  bono services to the indigent or to underserved populations or

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

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

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


                                  21

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






                                      CS/HB 1467, Second Engrossed



  1  in order to receive credit for continuing education under this

  2  subsection. The standard for determining indigency shall be

  3  that recognized by the Federal Poverty Income Guidelines

  4  produced by the United States Department of Health and Human

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

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

  7  continuing education hours can be fulfilled by performing

  8  research in critical need areas or for training leading to

  9  advanced professional certification.  The board, or the

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

11  underserved and critical need areas.  The department shall

12  adopt rules for administering continuing education

13  requirements adopted by the boards or the department if there

14  is no board.

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

16  elected official who is licensed under a practice act

17  administered by the Division of Medical Health Quality

18  Assurance may hold employment for compensation with any public

19  agency concurrent with such public service.  Such dual service

20  must be disclosed according to any disclosure required by

21  applicable law.

22         Section 11.  Subsections (1) and (4) of section

23  455.565, Florida Statutes, 1998 Supplement, are amended to

24  read:

25         455.565  Designated health care professionals;

26  information required for licensure.--

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

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

29  chapter 461, except a person applying for registration

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

31  application, and each physician who applies for license


                                  22

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






                                      CS/HB 1467, Second Engrossed



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

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

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

  4  license and under procedures adopted by the Department of

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

  6  required from the applicant, furnish the following information

  7  to the Department of Health:

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

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

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

11  education completed by the applicant, excluding any coursework

12  taken to satisfy medical licensure continuing education

13  requirements.

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

15  has privileges.

16         3.  The address at which the applicant will primarily

17  conduct his or her practice.

18         4.  Any certification that the applicant has received

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

20  which the applicant is applying.

21         5.  The year that the applicant began practicing

22  medicine in any jurisdiction.

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

24  which the applicant currently holds and an indication as to

25  whether the applicant has had the responsibility for graduate

26  medical education within the most recent 10 years.

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

28  applicant has been found guilty, regardless of whether

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

30  has pled guilty or nolo contendere.  A criminal offense

31  committed in another jurisdiction which would have been a


                                  23

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






                                      CS/HB 1467, Second Engrossed



  1  felony or misdemeanor if committed in this state must be

  2  reported. If the applicant indicates that a criminal offense

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

  4  that criminal offense, the department must state that the

  5  criminal offense is under appeal if the criminal offense is

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

  7  indicates to the department that a criminal offense is under

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

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

10  disposition.

11         8.  A description of any final disciplinary action

12  taken within the previous 10 years against the applicant by

13  the agency regulating the profession that the applicant is or

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

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

16  the American Board of Medical Specialities, the American

17  Osteopathic Association, or a similar national organization,

18  or by a licensed hospital, health maintenance organization,

19  prepaid health clinic, ambulatory surgical center, or nursing

20  home.  Disciplinary action includes resignation from or

21  nonrenewal of medical staff membership or the restriction of

22  privileges at a licensed hospital, health maintenance

23  organization, prepaid health clinic, ambulatory surgical

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

25  pending disciplinary case related to competence or character.

26  If the applicant indicates that the disciplinary action is

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

28  appeal of the disciplinary action, the department must state

29  that the disciplinary action is under appeal if the

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

31


                                  24

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






                                      CS/HB 1467, Second Engrossed



  1         (b)  In addition to the information required under

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

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

  4  practiced previously in this state or in another jurisdiction

  5  or a foreign country must provide the information required of

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

  7  applicant for licensure under chapter 460 who has practiced

  8  previously in this state or in another jurisdiction or a

  9  foreign country must provide the same information as is

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

11  455.697.

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

13  a set of fingerprints to the Department of Health in

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

15  458.313, s. 459.0055, s. 460.406, or s. 461.006.

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

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

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

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

20  that profession in accordance with procedures established

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

22         (c)  The Department of Health shall submit the

23  fingerprints provided by an applicant for initial licensure to

24  the Florida Department of Law Enforcement for a statewide

25  criminal history check, and the Florida Department of Law

26  Enforcement shall forward the fingerprints to the Federal

27  Bureau of Investigation for a national criminal history check

28  of the applicant. The department shall submit the fingerprints

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

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

31  Florida Department of Law Enforcement for a statewide criminal


                                  25

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






                                      CS/HB 1467, Second Engrossed



  1  history check, and the Florida Department of Law Enforcement

  2  shall forward the fingerprints to the Federal Bureau of

  3  Investigation for a national criminal history check for the

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

  5  2000.; For any subsequent renewal of the applicant's license

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

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

  8  submit the required information for a statewide criminal

  9  history check of the applicant.

10         Section 12.  Present subsections (5), (6), and (7) of

11  section 455.5651, Florida Statutes, 1998 Supplement, are

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

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

14         455.5651  Practitioner profile; creation.--

15         (5)  The Department of Health may not include

16  disciplinary action taken by a licensed hospital or an

17  ambulatory surgical center in the practitioner profile.

18         Section 13.  Section 455.567, Florida Statutes, is

19  amended to read:

20         455.567  Sexual misconduct; disqualification for

21  license, certificate, or registration.--

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

23  profession means violation of the professional relationship

24  through which the health care practitioner uses such

25  relationship to engage or attempt to engage the patient or

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

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

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

29  the professional practice of such health care profession.

30  Sexual misconduct in the practice of a health care profession

31  is prohibited.


                                  26

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






                                      CS/HB 1467, Second Engrossed



  1         (2)  Each board within the jurisdiction of the

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

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

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

  5  if the candidate or applicant has:

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

  7  to practice any profession or occupation revoked or

  8  surrendered based on a violation of sexual misconduct in the

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

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

11  not had that license, certificate, or registration reinstated

12  by the licensing authority of the jurisdiction that revoked

13  the license, certificate, or registration; or

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

15  territory or possession of the United States which if

16  committed in this state would constitute sexual misconduct.

17

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

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

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

21  administrative charges against the candidate's license

22  constitutes the surrender of the license.

23         Section 14.  Subsection (2) of section 455.574, Florida

24  Statutes, 1998 Supplement, is amended to read:

25         455.574  Department of Health; examinations.--

26         (2)  For each examination developed by the department

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

28  there is no board, shall adopt rules providing for

29  reexamination of any applicants who failed an examination

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

31  written and a practical examination are given, an applicant


                                  27

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






                                      CS/HB 1467, Second Engrossed



  1  shall be required to retake only the portion of the

  2  examination on which the applicant failed to achieve a passing

  3  grade, if the applicant successfully passes that portion

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

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

  6  portion. Except for national examinations approved and

  7  administered pursuant to this section, the department shall

  8  provide procedures for applicants who fail an examination

  9  developed by the department or a contracted vendor to review

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

11  grading key for the questions the candidate answered

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

13  failed. Applicants shall bear the actual cost for the

14  department to provide examination review pursuant to this

15  subsection. An applicant may waive in writing the

16  confidentiality of the applicant's examination grades.

17         Section 15.  Subsection (1) of section 455.587, Florida

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

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

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

21         455.587  Fees; receipts; disposition for boards within

22  the department.--

23         (1)  Each board within the jurisdiction of the

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

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

26  profession it regulates, based upon long-range estimates

27  prepared by the department of the revenue required to

28  implement laws relating to the regulation of professions by

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

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

31  adequate to cover all anticipated costs and to maintain a


                                  28

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






                                      CS/HB 1467, Second Engrossed



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

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

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

  4  department that license fees are projected to be inadequate,

  5  the department shall set license fees on behalf of the

  6  applicable board to cover anticipated costs and to maintain

  7  the required cash balance. The department shall include

  8  recommended fee cap increases in its annual report to the

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

10  regulated profession operate with a negative cash balance. The

11  department may provide by rule for advancing sufficient funds

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

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

14  years, and the regulated profession must pay interest.

15  Interest shall be calculated at the current rate earned on

16  investments of a trust fund used by the department to

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

18  various funds in accordance with the allocation of investment

19  earnings during the period of the advance.

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

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

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

23  455.564(2) requested by a licensee who was licensed prior to

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

25  certificate requested by any licensee.

26         Section 16.  Subsections (1) and (6) of section

27  455.604, Florida Statutes, 1998 Supplement, are amended to

28  read:

29         455.604  Requirement for instruction for certain

30  licensees on human immunodeficiency virus and acquired immune

31  deficiency syndrome.--


                                  29

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






                                      CS/HB 1467, Second Engrossed



  1         (1)  The appropriate board shall require each person

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

  3  459; chapter 460; chapter 461; chapter 463; chapter 464;

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

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

  6  educational course, approved by the board, on human

  7  immunodeficiency virus and acquired immune deficiency syndrome

  8  as part of biennial relicensure or recertification. The course

  9  shall consist of education on the modes of transmission,

10  infection control procedures, clinical management, and

11  prevention of human immunodeficiency virus and acquired immune

12  deficiency syndrome. Such course shall include information on

13  current Florida law on acquired immune deficiency syndrome and

14  its impact on testing, confidentiality of test results,

15  treatment of patients, and any protocols and procedures

16  applicable to human immunodeficiency virus counseling and

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

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

19  and 384.25.

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

21  a license under the chapters and parts specified in subsection

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

23  complete an educational course acceptable to the board on

24  human immunodeficiency virus and acquired immune deficiency

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

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

27  allowed 6 months to complete this requirement.

28         Section 17.  Subsection (1) of section 455.607, Florida

29  Statutes, is amended to read:

30

31


                                  30

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






                                      CS/HB 1467, Second Engrossed



  1         455.607  Athletic trainers and massage therapists;

  2  requirement for instruction on human immunodeficiency virus

  3  and acquired immune deficiency syndrome.--

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

  5  board, shall require each person licensed or certified under

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

  7  continuing educational course approved by the board, or the

  8  department where there is no board, on human immunodeficiency

  9  virus and acquired immune deficiency syndrome as part of

10  biennial relicensure or recertification.  The course shall

11  consist of education on modes of transmission, infection

12  control procedures, clinical management, and prevention of

13  human immunodeficiency virus and acquired immune deficiency

14  syndrome, with an emphasis on appropriate behavior and

15  attitude change.

16         Section 18.  Paragraphs (t), (u), (v), (w), and (x) are

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

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

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

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

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

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

23         455.624  Grounds for discipline; penalties;

24  enforcement.--

25         (1)  The following acts shall constitute grounds for

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

27  be taken:

28         (t)  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.


                                  31

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






                                      CS/HB 1467, Second Engrossed



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

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

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

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

  5  or physical sexual activity.

  6         (v)  Failing to comply with the requirements for

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

  8  failing to provide initial information, failing to timely

  9  provide updated information, or making misleading, untrue,

10  deceptive, or fraudulent representations on a profile,

11  credentialing, or initial or renewal licensure application.

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

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

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

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

16  crime in any jurisdiction. Convictions, findings,

17  adjudications, and pleas entered into prior to the enactment

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

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

20         (x)  Using information about people involved in motor

21  vehicle accidents which has been derived from accident reports

22  made by law enforcement officers or persons involved in

23  accidents pursuant to s. 316.066, or using information

24  published in a newspaper or other news publication or through

25  a radio or television broadcast that has used information

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

27  any other solicitation whatsoever of the people involved in

28  such accidents.

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

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

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


                                  32

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






                                      CS/HB 1467, Second Engrossed



  1  practice act, including conduct constituting a substantial

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

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

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

  5  penalties:

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

  7  restrictions, an application for a license.

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

  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)  Placement of the licensee on probation for a

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

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

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

17  licensee to undergo treatment, attend continuing education

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

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

20  tailored to the violations found.

21         (g)  Corrective action.

22         (h)  Imposition of an administrative fine in accordance

23  with s. 381.0261 for violations regarding patient rights.

24

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

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

27  sanctions are necessary to protect the public or to compensate

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

29  the disciplining authority consider and include in the order

30  requirements designed to rehabilitate the practitioner. All

31


                                  33

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






                                      CS/HB 1467, Second Engrossed



  1  costs associated with compliance with orders issued under this

  2  subsection are the obligation of the practitioner.

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

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

  5  to satisfy continuing education requirements established by

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

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

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

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

10  continuing education not completed or completed late, the

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

12  to take 1 additional hour of continuing education for each

13  hour not completed or completed late.

14         (4)(3)  In addition to any other discipline imposed

15  pursuant to this section or discipline imposed for a violation

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

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

18  prosecution of the case excluding costs associated with an

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

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

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

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

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

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

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

26  recover, the fine or assessment.

27         Section 19.  Section 455.664, Florida Statutes, is

28  amended to read:

29         455.664  Advertisement by a health care practitioner

30  provider of free or discounted services; required

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


                                  34

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






                                      CS/HB 1467, Second Engrossed



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

  2  care practitioner provider licensed under chapter 458, chapter

  3  459, chapter 460, chapter 461, chapter 462, chapter 463,

  4  chapter 464, chapter 465, chapter 466, chapter 467, chapter

  5  478, chapter 483, chapter 484, or chapter 486, chapter 490, or

  6  chapter 491, the following statement shall appear in capital

  7  letters clearly distinguishable from the rest of the text:

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

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

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

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

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

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

14  statement shall not be necessary as an accompaniment to an

15  advertisement of a licensed health care practitioner provider

16  defined by this section if the advertisement appears in a

17  classified directory the primary purpose of which is to

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

19  prices to consumers and in which the statement prominently

20  appears in at least one place.

21         Section 20.  Subsections (7) and (16) of section

22  455.667, Florida Statutes, 1998 Supplement, are amended to

23  read:

24         455.667  Ownership and control of patient records;

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

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

27  insurance information, if the complaint being investigated

28  alleges inadequate medical care based on termination of

29  insurance. The department may obtain patient access these

30  records pursuant to a subpoena without written authorization

31  from the patient if the department and the probable cause


                                  35

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






                                      CS/HB 1467, Second Engrossed



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

  2  to believe that a health care practitioner has excessively or

  3  inappropriately prescribed any controlled substance specified

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

  5  practice act or that a health care practitioner has practiced

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

  7  treatment required as defined by this part or any professional

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

  9  appropriate, reasonable attempts were made to obtain a patient

10  release.

11         2.  The department may obtain patient records and

12  insurance information pursuant to a subpoena without written

13  authorization from the patient if the department and the

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

15  reasonable cause to believe that a health care practitioner

16  has provided inadequate medical care based on termination of

17  insurance and also find that appropriate, reasonable attempts

18  were made to obtain a patient release.

19         3.  The department may obtain patient records, billing

20  records, insurance information, provider contracts, and all

21  attachments thereto pursuant to a subpoena without written

22  authorization from the patient if the department and probable

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

24  cause to believe that a health care practitioner has submitted

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

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

27  billing code that accurately describes the services performed,

28  requested payment for services that were not performed by that

29  health care practitioner, used information derived from a

30  written report of an automobile accident generated pursuant to

31  chapter 316 to solicit or obtain patients personally or


                                  36

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






                                      CS/HB 1467, Second Engrossed



  1  through an agent regardless of whether the information is

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

  3  or from another person, solicited patients fraudulently,

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

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

  6  caused to be presented a false or fraudulent insurance claim

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

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

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

10  deceased, incapacitated, or suspected of being a participant

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

12  specific and relevant records.

13         (b)  Patient records, billing records, insurance

14  information, provider contracts, and all attachments thereto

15  record obtained by the department pursuant to this subsection

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

17  appropriate regulatory board in disciplinary proceedings. The

18  records shall otherwise be confidential and exempt from s.

19  119.07(1). This section does not limit the assertion of the

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

21  records of treatment for mental or nervous disorders by a

22  medical practitioner licensed pursuant to chapter 458 or

23  chapter 459 who has primarily diagnosed and treated mental and

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

25  inclusive of psychiatric residency. However, the health care

26  practitioner shall release records of treatment for medical

27  conditions even if the health care practitioner has also

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

29  department has found reasonable cause under this section and

30  the psychotherapist-patient privilege is asserted, the

31  department may petition the circuit court for an in camera


                                  37

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






                                      CS/HB 1467, Second Engrossed



  1  review of the records by expert medical practitioners

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

  3  thereof are protected under the psychotherapist-patient

  4  privilege.

  5         (16)  A health care practitioner or records owner

  6  furnishing copies of reports or records or making the reports

  7  or records available for digital scanning pursuant to this

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

  9  including reasonable staff time, or the amount specified in

10  administrative rule by the appropriate board, or the

11  department when there is no board.

12         Section 21.  Subsection (3) is added to section

13  455.687, Florida Statutes, to read:

14         455.687  Certain health care practitioners; immediate

15  suspension of license.--

16         (3)  The department may issue an emergency order

17  suspending or restricting the license of any health care

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

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

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

21  112.0455, when the practitioner does not have a lawful

22  prescription and legitimate medical reason for using such

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

24  of notification to the practitioner of the confirmed test

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

26  emergency order is issued.

27         Section 22.  Section 455.694, Florida Statutes, 1998

28  Supplement, is amended to read:

29         455.694  Financial responsibility requirements for

30  Boards regulating certain health care practitioners.--

31


                                  38

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






                                      CS/HB 1467, Second Engrossed



  1         (1)  As a prerequisite for licensure or license

  2  renewal, the Board of Acupuncture, the Board of Chiropractic

  3  Medicine, the Board of Podiatric Medicine, and the Board of

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

  5  practitioners licensed under the respective board, and the

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

  7  registered nurse practitioners certified under s. 464.012, and

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

  9  medical malpractice insurance or provide proof of financial

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

11  board or department to be sufficient to cover claims arising

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

13  and services in this state.

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

15  application by practitioners meeting any of the following

16  criteria:

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

18  460, chapter 461, s. 464.012, or chapter 466, or chapter 467

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

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

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

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

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

24  insurance program authorized by the provisions of s.

25  768.28(15) or who is a volunteer under s. 110.501(1).

26         (b)  Any person whose license or certification has

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

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

29  practicing in this state.  Any person applying for

30  reactivation of a license must show either that such licensee

31  maintained tail insurance coverage which provided liability


                                  39

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






                                      CS/HB 1467, Second Engrossed



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

  2  1993, or the initial date of licensure in this state,

  3  whichever is later, and incidents that occurred before the

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

  5  must submit an affidavit stating that such licensee has no

  6  unsatisfied medical malpractice judgments or settlements at

  7  the time of application for reactivation.

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

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

10  license.

11         (d)  Any person licensed or certified under chapter

12  457, chapter 460, chapter 461, s. 464.012, or chapter 466, or

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

14  teaching duties at an accredited school or in its main

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

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

17  a necessary part of duties in connection with the teaching

18  position in the school.

19         (e)  Any person holding an active license or

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

21  464.012, or chapter 466, or chapter 467 who is not practicing

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

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

24  activity.

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

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

27  state.

28         (3)  Notwithstanding the provisions of this section,

29  the financial responsibility requirements of ss. 458.320 and

30  459.0085 shall continue to apply to practitioners licensed

31  under those chapters.


                                  40

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






                                      CS/HB 1467, Second Engrossed



  1         Section 23.  Section 455.712, Florida Statutes, is

  2  created to read:

  3         455.712  Business establishments; requirements for

  4  active status licenses.--

  5         (1)  A business establishment regulated by the Division

  6  of Medical Quality Assurance pursuant to this part may provide

  7  regulated services only if the business establishment has an

  8  active status license. A business establishment that provides

  9  regulated services without an active status license is in

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

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

12  the business establishment.

13         (2)  A business establishment must apply with a

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

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

16  license before the license expires. If a business

17  establishment fails to renew before the license expires, the

18  license becomes delinquent, except as otherwise provided in

19  statute, in the license cycle following expiration.

20         (3)  A delinquent business establishment must apply

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

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

23  within 6 months after becoming delinquent. Failure of a

24  delinquent business establishment to renew the license within

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

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

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

28  of applying for and meeting all requirements imposed on a

29  business establishment for new licensure.

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

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


                                  41

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






                                      CS/HB 1467, Second Engrossed



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

  2  impose discipline or to enforce discipline previously imposed

  3  on a business establishment for acts or omissions committed by

  4  the business establishment while holding a license, whether

  5  active or null.

  6         (5)  This section applies to any a business

  7  establishment registered, permitted, or licensed by the

  8  department to do business. Business establishments include,

  9  but are not limited to, dental laboratories, electrology

10  facilities, massage establishments, pharmacies, and health

11  care services pools.

12         Section 24.  Subsection (7) is added to section

13  457.102, Florida Statutes, 1998 Supplement, to read:

14         457.102  Definitions.--As used in this chapter:

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

16  administration, and use of needles and devices, restricted

17  devices, and prescription devices that are used in the

18  practice of acupuncture and oriental medicine.

19         Section 25.  Subsections (2) and (4) of section

20  458.307, Florida Statutes, 1998 Supplement, are amended to

21  read:

22         458.307  Board of Medicine.--

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

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

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

26  teaching of medicine for at least 4 years immediately

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

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

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

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

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


                                  42

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






                                      CS/HB 1467, Second Engrossed



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

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

  3  never have been, licensed health care practitioners.  One

  4  member must be a health care hospital risk manager licensed

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

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

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

  8  shall establish a disciplinary training program for board

  9  members. The program shall provide for initial and periodic

10  training in the grounds for disciplinary action, the actions

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

12  relevant statutes and rules, and any relevant judicial and

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

14  the board shall participate on probable cause panels or in

15  disciplinary decisions of the board unless he or she has

16  completed the disciplinary training program.

17         Section 26.  Subsection (3) is added to section

18  458.309, Florida Statutes, 1998 Supplement, to read:

19         458.309  Authority to make rules.--

20         (3)  All physicians who perform level 2 procedures

21  lasting more than 5 minutes and all level 3 surgical

22  procedures in an office setting must register the office with

23  the department unless that office is licensed as a facility

24  pursuant to chapter 395. Registration information shall not

25  include the specific type of surgery performed by the

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

27  annually unless the  office is accredited by a nationally

28  recognized accrediting agency  or an accrediting organization

29  subsequently approved by the Board of Medicine. The actual

30  costs for registration and inspection or accreditation shall

31


                                  43

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






                                      CS/HB 1467, Second Engrossed



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

  2  office setting in which office surgery is performed.

  3         Section 27.  Section 458.311, Florida Statutes, 1998

  4  Supplement, is amended to read:

  5         458.311  Licensure by examination; requirements;

  6  fees.--

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

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

  9  the department on forms furnished by the department to take

10  the licensure examination. The department shall license

11  examine each applicant who whom the board certifies:

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

13  nonrefundable application fee not to exceed $500 and an

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

15  applicant cost to the department for purchase of the

16  examination from the Federation of State Medical Boards of the

17  United States or a similar national organization, which is

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

19  the examination.

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

21         (c)  Is of good moral character.

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

23  any other jurisdiction which would constitute the basis for

24  disciplining a physician pursuant to s. 458.331.

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

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

27  2 academic years of preprofessional, postsecondary education,

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

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

30  chemistry prior to entering medical school.

31


                                  44

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






                                      CS/HB 1467, Second Engrossed



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

  2  postgraduate training requirements:

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

  4  allopathic college recognized and approved by an accrediting

  5  agency recognized by the United States Office of Education or

  6  is a graduate of an allopathic medical school or allopathic

  7  college within a territorial jurisdiction of the United States

  8  recognized by the accrediting agency of the governmental body

  9  of that jurisdiction;

10         b.  If the language of instruction of the medical

11  school is other than English, has demonstrated competency in

12  English through presentation of a satisfactory grade on the

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

14  similar test approved by rule of the board; and

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

16  year.

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

18  school registered with the World Health Organization and

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

20  required to accredit medical schools in the United States or

21  reasonably comparable standards;

22         b.  If the language of instruction of the foreign

23  medical school is other than English, has demonstrated

24  competency in English through presentation of the Educational

25  Commission for Foreign Medical Graduates English proficiency

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

27  English of the Educational Testing Service or a similar test

28  approved by rule of the board; and

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

30  year.

31


                                  45

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






                                      CS/HB 1467, Second Engrossed



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

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

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

  4  the Educational Commission for Foreign Medical Graduates,

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

  6  and has passed the examination utilized by that commission;

  7  and

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

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

10  completed an approved residency or fellowship of at least 2

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

12  fellowship experience and training must be counted toward

13  regular or subspecialty certification by a board recognized

14  and certified by the American Board of Medical Specialties.

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

16  fingerprints on a form and under procedures specified by the

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

18  costs incurred by the Department of Health for the criminal

19  background check of the applicant.

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

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

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

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

24  the examination of the Federation of State Medical Boards of

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

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

27  for the purpose of examination of any applicant who was

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

29  currently licensed in at least one other jurisdiction of the

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

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


                                  46

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






                                      CS/HB 1467, Second Engrossed



  1  Special Purpose Examination of the Federation of State Medical

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

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

  4  purpose of examination of any applicant who was licensed on

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

  6  currently licensed in at least three other jurisdictions of

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

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

  9  paragraph does not apply.

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

11  an applicant who does not pass the national licensing

12  examination after five attempts to complete additional

13  remedial education or training.  The board shall prescribe the

14  additional requirements in a manner that permits the applicant

15  to complete the requirements and be reexamined within 2 years

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

17  examination a sixth or subsequent time.

18         (3)  Notwithstanding the provisions of subparagraph

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

20  present the certificate issued by the Educational Commission

21  for Foreign Medical Graduates or pass the examination utilized

22  by that commission if the graduate:

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

24  accredited United States college or university.

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

26  recognized by the World Health Organization.

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

28  the foreign medical school, except the internship or social

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

30  Board of Medical Examiners examination or the Educational

31


                                  47

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






                                      CS/HB 1467, Second Engrossed



  1  Commission for Foreign Medical Graduates examination

  2  equivalent.

  3         (d)  Has completed an academic year of supervised

  4  clinical training in a hospital affiliated with a medical

  5  school approved by the Council on Medical Education of the

  6  American Medical Association and upon completion has passed

  7  part II of the National Board of Medical Examiners examination

  8  or the Educational Commission for Foreign Medical Graduates

  9  examination equivalent.

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

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

12  through an investigative process.  When the investigative

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

14  120.60(1) and the department or board has reason to believe

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

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

17  which shall be in writing and sufficient to notify the

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

19  subsection shall control over any conflicting provisions of s.

20  120.60(1).

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

22  licensure any applicant who is under investigation in another

23  jurisdiction for an offense which would constitute a violation

24  of this chapter until such investigation is completed. Upon

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

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

27  unrestricted license to any individual who has committed any

28  act or offense in any jurisdiction which would constitute the

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

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

31  or offense in any jurisdiction which would constitute the


                                  48

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






                                      CS/HB 1467, Second Engrossed



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

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

  3  terms set forth in subsection (9).

  4         (6)  Each applicant who passes the examination and

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

  6  physician, with rights as defined by law.

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

  8  shall impose conditions, limitations, or restrictions on a

  9  license by examination if the applicant is on probation in

10  another jurisdiction for an act which would constitute a

11  violation of this chapter.

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

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

14  satisfaction, each of the appropriate requirements set forth

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

16  of the following terms:

17         (a)  Refusal to certify to the department an

18  application for licensure, certification, or registration;

19         (b)  Certification to the department of an application

20  for licensure, certification, or registration with

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

22         (c)  Certification to the department of an application

23  for licensure, certification, or registration with placement

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

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

26  not limited to, requiring the physician to submit to

27  treatment, attend continuing education courses, submit to

28  reexamination, or work under the supervision of another

29  physician.

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

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


                                  49

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






                                      CS/HB 1467, Second Engrossed



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

  2  the time of application for licensure under this subsection,

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

  4  of the United States may make initial application to the

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

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

  7  receipt of such application, the department shall issue a

  8  2-year restricted license to any applicant therefor upon the

  9  applicant's successful completion of the licensure examination

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

11  has met the following requirements:

12         1.  Is a graduate of a World Health Organization

13  recognized foreign medical institution located in a country in

14  the Western Hemisphere.

15         2.  Received a medical education which has been

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

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

18  medical programs.

19         3.  Practiced medicine in the country of Nicaragua for

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

21  has lawful employment authority in the United States.

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

23  the Florida Board of Medicine.

24         5.  Successfully completed the Educational Commission

25  for Foreign Medical Graduates Examination or Foreign Medical

26  Graduate Examination in the Medical Sciences or successfully

27  completed a course developed for the University of Miami for

28  physician training equivalent to the course developed for such

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

30  person shall be permitted to enroll in the physician training

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


                                  50

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






                                      CS/HB 1467, Second Engrossed



  1  having met the requirements of this paragraph or conditionally

  2  certified by the board as having substantially complied with

  3  the requirements of this paragraph. Any person conditionally

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

  5  board's satisfaction, full compliance with all the

  6  requirements of this paragraph prior to completion of the

  7  physician training course and shall not be permitted to sit

  8  for the licensure examination unless the board certifies that

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

10

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

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

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

14  5 and 42, chapter 89-374, Laws of Florida, and renumbered as

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

16  not be eligible to apply under this subsection.

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

18  to this subsection may practice medicine for the first year

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

20  of a board-approved physician.

21         (c)  Upon recommendation of the supervising physician

22  and demonstration of clinical competency to the satisfaction

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

24  pursuant to this subsection has practiced for 1 year under

25  direct supervision, such licenseholder shall work for 1 year

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

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

28  determined by the board.  Prior to commencing such

29  supervision, the supervising physician shall notify the board.

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

31  general supervision and demonstration to the board that the


                                  51

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






                                      CS/HB 1467, Second Engrossed



  1  holder of the restricted license has satisfactorily completed

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

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

  4  constitute a violation of this chapter, the department shall

  5  issue an unrestricted license to such licenseholder.

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

  7  provisions of this subsection shall be promulgated by the

  8  board.

  9         (10)  Notwithstanding any other provision of this

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

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

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

13  person:

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

15  and II of the United States Medical Licensing Examination or

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

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

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

19  at the time of examination;

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

21  or she be administered the examination without applying for a

22  license as a physician in this state; and

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

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

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

26  of the examination from the Federation of State Medical Boards

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

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

29  ineligible to take the examination.

30         Section 28.  Section 458.3115, Florida Statutes, 1998

31  Supplement, is amended to read:


                                  52

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






                                      CS/HB 1467, Second Engrossed



  1         458.3115  Restricted license; certain foreign-licensed

  2  physicians; United States Medical Licensing Examination

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

  4  practice; full licensure.--

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

  6  department agency shall provide procedures under which certain

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

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

  9  agency-developed examination developed by the department, in

10  consultation with the board, to qualify for a restricted

11  license to practice medicine in this state. The

12  department-developed agency and board-developed examination

13  shall test the same areas of medical knowledge as the

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

15  (FLEX) previously administered by the Florida Board of

16  Medicine to grant medical licensure in Florida. The

17  department-developed agency-developed examination must be made

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

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

20  elects to take the department-developed agency and

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

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

23  required to retake or pass the equivalent parts of the

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

25  for the department-developed agency and board-developed

26  examination five times within 5 years.

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

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

29  the previously administered FLEX shall not be required to

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

31  year 2000.


                                  53

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






                                      CS/HB 1467, Second Engrossed



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

  2  examination for restricted licensure if the person:

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

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

  5  special preparatory medical update courses authorized by the

  6  board and the University of Miami Medical School and

  7  subsequently passed the final course examination; upon

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

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

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

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

12  one of the persons who took and successfully completed the

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

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

15  minimum, the documentation must include class attendance

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

17         2.  Applies to the department agency and submits an

18  application fee that is nonrefundable and equivalent to the

19  fee required for full licensure;

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

21  practice of medicine in another jurisdiction;

22         4.  Submits an examination fee that is nonrefundable

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

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

25  either examination described in this section;

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

27  other jurisdiction that would constitute a substantial basis

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

29  chapter 455; and

30         6.  Is not under discipline, investigation, or

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


                                  54

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






                                      CS/HB 1467, Second Engrossed



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

  2  chapter 455 and that substantially threatened or threatens the

  3  public health, safety, or welfare.

  4         (d)  Every person eligible for restricted licensure

  5  under this section may sit for the USMLE or the

  6  department-developed agency and board-developed examination

  7  five times within 5 calendar years.  Applicants desiring to

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

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

10  applicants applying under this section who fail the

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

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

13  second and subsequent times they take the examination.

14         (e)  The department Agency for Health Care

15  Administration and the board shall be responsible for working

16  with one or more organizations to offer a medical refresher

17  course designed to prepare applicants to take either licensure

18  examination described in this section.  The organizations may

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

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

21  specializes in developing such courses.

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

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

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

25  paid by the students taking the course.

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

27  restricted license to an applicant under this section, the

28  applicant must have passed either of the two examinations

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

30  reasonable restrictions on the applicant's license to

31


                                  55

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






                                      CS/HB 1467, Second Engrossed



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

  2  to:

  3         1.  Periodic and random department agency audits of the

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

  5  board or the department agency.

  6         2.  Periodic appearances of the licensee before the

  7  board or the department agency.

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

  9  department agency.

10         (b)  A restricted licensee under this section shall

11  practice under the supervision of a full licensee approved by

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

13  under direct supervision as defined by board rule and the

14  second year being under indirect supervision as defined by

15  board rule.

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

17  this subsection.

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

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

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

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

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

23  Upon expiration of such restricted license, a restricted

24  licensee shall become a full licensee if the restricted

25  licensee:

26         1.  Is not under discipline, investigation, or

27  prosecution for a violation which poses a substantial threat

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

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

30         (b)  The department agency shall renew a restricted

31  license under this section upon payment of the same fees


                                  56

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






                                      CS/HB 1467, Second Engrossed



  1  required for renewal for a full license if the restricted

  2  licensee is under discipline, investigation, or prosecution

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

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

  5  permanently revoked the restricted license. A restricted

  6  licensee who has renewed such restricted license shall become

  7  eligible for full licensure when the licensee is no longer

  8  under discipline, investigation, or prosecution.

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

10  the provisions of this section.

11         Section 29.  Subsections (1), (2), and (8) of section

12  458.313, Florida Statutes, are amended to read:

13         458.313  Licensure by endorsement; requirements;

14  fees.--

15         (1)  The department shall issue a license by

16  endorsement to any applicant who, upon applying to the

17  department on forms furnished by the department and remitting

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

19  the board certifies:

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

21  458.311(1)(b)-(g) or in s. 458.311(1)(b)-(e) and (g) and (3);

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

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

24  examination of the Federation of State Medical Boards of the

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

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

27  National Board of Medical Examiners, or on a combination

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

29  passing score on the United States Medical Licensing

30  Examination (USMLE) provided the board certifies as eligible

31  for licensure by endorsement any applicant who took the


                                  57

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






                                      CS/HB 1467, Second Engrossed



  1  required examinations more than 10 years prior to application;

  2  and

  3         (c)  Has submitted evidence of the active licensed

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

  5  of the immediately preceding 4 years, or evidence of

  6  successful completion of either a board-approved postgraduate

  7  training program within 2 years preceding filing of an

  8  application, or a board-approved clinical competency

  9  examination, within the year preceding the filing of an

10  application for licensure.  For purposes of this paragraph,

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

12  medicine by physicians, including those employed by any

13  governmental entity in community or public health, as defined

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

15  are practicing medicine, and those on the active teaching

16  faculty of an accredited medical school.

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

18  require an applicant who does not pass the licensing

19  examination after five attempts to complete additional

20  remedial education or training.  The board shall prescribe the

21  additional requirements in a manner that permits the applicant

22  to complete the requirements and be reexamined within 2 years

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

24  examination a sixth or subsequent time.

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

26  by endorsement to take and pass the appropriate licensure

27  examination prior to certifying the applicant as eligible for

28  licensure.

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

30  physician whose license has become void by failure to practice

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


                                  58

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






                                      CS/HB 1467, Second Engrossed



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

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

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

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

  5  applicable fees, and otherwise meets any continuing education

  6  requirements for reactivation of the license as determined by

  7  the board.

  8         Section 30.  Subsection (1) of section 458.315, Florida

  9  Statutes, is amended to read:

10         458.315  Temporary certificate for practice in areas of

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

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

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

14  certificate to practice in communities of Florida where there

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

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

17  department, correctional facility, community health center

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

19  Public Health Services Act, or other entity that provides

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

21  Health Officer.  The Board of Medicine may issue this

22  temporary certificate with the following restrictions:

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

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

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

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

27  limited to, health professional shortage areas designated by

28  the United States Department of Health and Human Services.

29         (a)  A recipient of a temporary certificate for

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

31


                                  59

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






                                      CS/HB 1467, Second Engrossed



  1  for any approved employer in any area of critical need

  2  approved by the board.

  3         (b)  The recipient of a temporary certificate for

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

  5  accepting employment, notify the board of all approved

  6  institutions in which the licensee practices and of all

  7  approved institutions where practice privileges have been

  8  denied.

  9         Section 31.  Section 458.3165, Florida Statutes, is

10  amended to read:

11         458.3165  Public psychiatry certificate.--The board

12  shall issue a public psychiatry certificate to an individual

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

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

15  licensed to practice medicine without restriction in another

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

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

18  use the certificate to work at any public mental health

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

20         (1)  Such certificate shall:

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

22  mental health facility or program funded in part or entirely

23  by state funds.

24         (b)  Be issued and renewable biennially if the

25  secretary of the Department of Health and Rehabilitative

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

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

28  of psychiatry at the accredited medical school at the

29  University of Miami recommend in writing that the certificate

30  be issued or renewed.

31


                                  60

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






                                      CS/HB 1467, Second Engrossed



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

  2  with a public mental health facility or program expires.

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

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

  5  chapter.

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

  7  certificateholder for noncompliance with any part of this

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

  9  subject to discipline.

10         Section 32.  Subsection (4) is added to section

11  458.317, Florida Statutes, 1998 Supplement, to read:

12         458.317  Limited licenses.--

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

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

15  license for the purpose of providing volunteer, uncompensated

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

17  statement from the employing agency or institution stating

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

19  involving the practice of medicine. The application and all

20  licensure fees, including neurological injury compensation

21  assessments, shall be waived.

22         Section 33.  Subsection (1) of section 458.319, Florida

23  Statutes, 1998 Supplement, is amended to read:

24         458.319  Renewal of license.--

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

26  of the renewal application, evidence that the applicant has

27  actively practiced medicine or has been on the active teaching

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

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

30  $500; provided, however, that if the licensee is either a

31  resident physician, assistant resident physician, fellow,


                                  61

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






                                      CS/HB 1467, Second Engrossed



  1  house physician, or intern in an approved postgraduate

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

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

  4  actively practiced medicine for at least 2 years of the

  5  immediately preceding 4 years, the board shall require that

  6  the licensee successfully complete a board-approved clinical

  7  competency examination prior to renewal of the license.

  8  "Actively practiced medicine" means that practice of medicine

  9  by physicians, including those employed by any governmental

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

11  chapter, including physicians practicing administrative

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

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

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

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

16  Department of Health for the statewide criminal background

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

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

19  1992, must submit a set of fingerprints to the Department of

20  Health on a form and under procedures specified by the

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

22  incurred by the department for a national criminal background

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

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

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

26  set of fingerprints to the department as required by this

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

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

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

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

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


                                  62

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






                                      CS/HB 1467, Second Engrossed



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

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

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

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

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

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

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

  8  matter in the citation with the department within 30 days

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

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

11  made by personal service or certified mail, restricted

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

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

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

15  national criminal background check. If an applicant has

16  received an initial license to practice in this state after

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

18  department for a national criminal history check upon initial

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

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

21  fee required for a statewide criminal history check.

22         Section 34.  Paragraph (mm) is added to subsection (1)

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

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

25         458.331  Grounds for disciplinary action; action by the

26  board and department.--

27         (1)  The following acts shall constitute grounds for

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

29  be taken:

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

31  381.026 and 381.0261 to provide patients with information


                                  63

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






                                      CS/HB 1467, Second Engrossed



  1  about their patient rights and how to file a patient

  2  complaint.

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

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

  5  that would constitute a substantial violation of subsection

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

  7  imposing one or more of the following penalties:

  8         (a)  Refusal to certify, or certification with

  9  restrictions, to the department an application for licensure,

10  certification, or registration.

11         (b)  Revocation or suspension of a license.

12         (c)  Restriction of practice.

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

14  $10,000 $5,000 for each count or separate offense.

15         (e)  Issuance of a reprimand.

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

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

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

19  physician to submit to treatment, to attend continuing

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

21  under the supervision of another physician.

22         (g)  Issuance of a letter of concern.

23         (h)  Corrective action.

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

25  patient.

26         (j)  Imposition of an administrative fine in accordance

27  with s. 381.0261 for violations regarding patient rights.

28

29  In determining what action is appropriate, the board must

30  first consider what sanctions are necessary to protect the

31  public or to compensate the patient.  Only after those


                                  64

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






                                      CS/HB 1467, Second Engrossed



  1  sanctions have been imposed may the disciplining authority

  2  consider and include in the order requirements designed to

  3  rehabilitate the physician.  All costs associated with

  4  compliance with orders issued under this subsection are the

  5  obligation of the physician.

  6         Section 35.  Subsection (7) of section 458.347, Florida

  7  Statutes, 1998 Supplement, is amended to read:

  8         458.347  Physician assistants.--

  9         (7)  PHYSICIAN ASSISTANT LICENSURE.--

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

11  assistant must apply to the department.  The department shall

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

13  having met the following requirements:

14         1.  Is at least 18 years of age.

15         2.  Has satisfactorily passed a proficiency examination

16  by an acceptable score established by the National Commission

17  on Certification of Physician Assistants.  If an applicant

18  does not hold a current certificate issued by the National

19  Commission on Certification of Physician Assistants and has

20  not actively practiced as a physician assistant within the

21  immediately preceding 4 years, the applicant must retake and

22  successfully complete the entry-level examination of the

23  National Commission on Certification of Physician Assistants

24  to be eligible for licensure.

25         3.  Has completed the application form and remitted an

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

27  application for licensure made by a physician assistant must

28  include:

29         a.  A certificate of completion of a physician

30  assistant training program specified in subsection (6).

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


                                  65

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






                                      CS/HB 1467, Second Engrossed



  1         c.  A sworn statement of any previous revocation or

  2  denial of licensure or certification in any state.

  3         d.  Two letters of recommendation.

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

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

  6  applicant who the Board of Medicine certifies:

  7         a.  Has completed the application form and remitted a

  8  nonrefundable application fee not to exceed $500 and an

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

10  the department to provide the examination.  The examination

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

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

13  applicant to pass a separate practical component of the

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

15  competencies measured through practical examinations shall be

16  incorporated into the written examination through a

17  multiple-choice format. The department shall translate the

18  examination into the native language of any applicant who

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

20  provided that the translation request is filed with the board

21  office no later than 9 months before the scheduled examination

22  and the applicant remits translation fees as specified by the

23  department no later than 6 months before the scheduled

24  examination, and provided that the applicant demonstrates to

25  the department the ability to communicate orally in basic

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

27  the applicant may take the next available examination in

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

29  application deadline and if the applicant is otherwise

30  eligible under this section. To demonstrate the ability to

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


                                  66

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






                                      CS/HB 1467, Second Engrossed



  1  is required, as determined by the department or organization

  2  that developed it, on one of the following English

  3  examinations:

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

  5  Educational Testing Service (ETS);

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

  7  (TOEFL), by ETS;

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

  9         (IV)  The English examination for citizenship,

10  Immigration and Naturalization Service.

11

12  A notarized copy of an Educational Commission for Foreign

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

14  demonstrate the ability to communicate in basic English.

15         b.  Is an unlicensed physician who graduated from a

16  foreign medical school listed with the World Health

17  Organization who has not previously taken and failed the

18  examination of the National Commission on Certification of

19  Physician Assistants and who has been certified by the Board

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

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

22  (3), (4), and (5), with the exception that the applicant is

23  not required to have completed an approved residency of at

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

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

26  valid, active certificate issued by the Educational Commission

27  for Foreign Medical Graduates.

28         c.  Was eligible and made initial application for

29  certification as a physician assistant in this state between

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

31


                                  67

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






                                      CS/HB 1467, Second 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


                                  68

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






                                      CS/HB 1467, Second 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


                                  69

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






                                      CS/HB 1467, Second 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


                                  70

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






                                      CS/HB 1467, Second Engrossed



  1  investigated for any act that constitutes a violation of this

  2  chapter or part II of chapter 455.

  3         Section 36.  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 who 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 physician's office

16  annually unless the office is accredited by a nationally

17  recognized accrediting agency or an accrediting organization

18  subsequently approved by the Board of Osteopathic Medicine.

19  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 37.  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


                                  71

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






                                      CS/HB 1467, Second 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 38.  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


                                  72

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






                                      CS/HB 1467, Second 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 39.  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.


                                  73

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






                                      CS/HB 1467, Second Engrossed



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

  2  the grounds set forth in subsection (1), it may enter an order

  3  imposing one or more of the following penalties:

  4         (a)  Refusal to certify, 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


                                  74

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






                                      CS/HB 1467, Second 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 40.  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 41.  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


                                  75

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






                                      CS/HB 1467, Second 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 42.  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.


                                  76

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






                                      CS/HB 1467, Second 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


                                  77

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






                                      CS/HB 1467, Second 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


                                  78

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






                                      CS/HB 1467, Second 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 43.  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,


                                  79

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






                                      CS/HB 1467, Second 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 44.  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:


                                  80

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






                                      CS/HB 1467, Second 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 45.  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.


                                  81

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






                                      CS/HB 1467, Second 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.


                                  82

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






                                      CS/HB 1467, Second 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


                                  83

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






                                      CS/HB 1467, Second 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


                                  84

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






                                      CS/HB 1467, Second 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,


                                  85

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






                                      CS/HB 1467, Second 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.


                                  86

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






                                      CS/HB 1467, Second Engrossed



  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


                                  87

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






                                      CS/HB 1467, Second Engrossed



  1  name, Florida chiropractic medical license number, specialty,

  2  and address of the supervising chiropractic physician.

  3         Section 46.  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 47.  Section 460.4166, Florida Statutes, 1998

13  Supplement, is 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:


                                  88

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






                                      CS/HB 1467, Second 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 48.  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


                                  89

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






                                      CS/HB 1467, Second 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


                                  90

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






                                      CS/HB 1467, Second Engrossed



  1  relate specifically to the scope of practice authorized

  2  herein.

  3         Section 49.  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


                                  91

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






                                      CS/HB 1467, Second Engrossed



  1  years as are required of podiatric physicians licensed in this

  2  state.

  3         Section 50.  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


                                  92

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






                                      CS/HB 1467, Second 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.


                                  93

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






                                      CS/HB 1467, Second Engrossed



  1         Section 51.  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


                                  94

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         Section 52.  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 53.  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.


                                  95

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  The board shall by rule establish guidelines for remedial

  2  courses.

  3         Section 54.  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 55.  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


                                  96

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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 56.  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


                                  97

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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 57.  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


                                  98

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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 58.  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 59.  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 60.  Subsection (3) of section 468.812, Florida

31  Statutes, is amended to read:


                                  99

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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 61.  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 62.  (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 13 members nominated by the


                                 100

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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         7.  Florida Academy of Family Physicians.

16         8.  Pharmaceutical Research Manufacturing Association.

17         9.  American Society of Consultant Pharmacists.

18         10.  American Society of Health-System Pharmacists.

19         (b)  One representative from each of the following

20  entities:

21         1.  Department of Health.

22         2.  Board of Medicine, which representative must be a

23  member of the board who is licensed under chapter 458, Florida

24  Statutes.

25         3.  Board of Osteopathic Medicine, which representative

26  must be a member of the board who is licensed under chapter

27  459, Florida Statutes.

28         4.  Board of Pharmacy, which representative must be a

29  member of the board who is licensed under chapter 465, Florida

30  Statutes.

31         5.  Agency for Health Care Administration.


                                 101

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (2)  The task force shall hold its first meeting no

  2  later than August 1, 1999, and shall report its findings to

  3  the President of the Senate, the Speaker of the House of

  4  Representatives, and the chairs of the applicable legislative

  5  committees of substance not later than December 31, 1999. All

  6  task force meetings must be held in Tallahassee at the

  7  department in order to minimize costs to the state.

  8         (3)  The task force shall be charged with the

  9  responsibility to:

10         (a)  Determine the states in which collaborative drug

11  therapy management has been enacted by law or administrative

12  rule and summarize the content of all such laws and rules.

13         (b)  Receive testimony from interested parties and

14  identify the extent to which collaborative drug therapy

15  management is currently being practiced in this state and

16  other states.

17         (c)  Determine the efficacy of collaborative drug

18  therapy management in improving health care outcomes of

19  patients.

20         Section 63.  Section 466.021, Florida Statutes, is

21  amended to read:

22         466.021  Employment of unlicensed persons by dentist;

23  penalty.--Every duly licensed dentist who uses the services of

24  any unlicensed person for the purpose of constructing,

25  altering, repairing, or duplicating any denture, partial

26  denture, bridge splint, or orthodontic or prosthetic appliance

27  shall be required to furnish such unlicensed person with a

28  written work order in such form as prescribed shall be

29  approved by rule of the board department. This form shall be

30  supplied to the dentist by the department at a cost not to

31  exceed that of printing and handling. The work order blanks


                                 102

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  shall be assigned to individual dentists and are not

  2  transferable. This form shall be dated and signed by such

  3  dentist and shall include the patient's name or number with

  4  sufficient descriptive information to clearly identify the

  5  case for each separate and individual piece of work. A; said

  6  work order shall be made in duplicate form, the duplicate copy

  7  of such work order shall to be retained in a permanent file in

  8  the dentist's office for a period of 2 years, and the original

  9  work order shall to be retained in a permanent file for a

10  period of 2 years by such said unlicensed person in her or his

11  place of business. Such permanent file of work orders to be

12  kept by such dentist or by such unlicensed person shall be

13  open to inspection at any reasonable time by the department or

14  its duly constituted agent. Failure of the dentist to keep

15  such permanent records of such said work orders shall subject

16  the dentist to suspension or revocation of her or his license

17  to practice dentistry. Failure of such unlicensed person to

18  have in her or his possession a work order as required by this

19  section above defined shall be admissible evidence of a

20  violation of this chapter and shall constitute a misdemeanor

21  of the second degree, punishable as provided in s. 775.082 or

22  s. 775.083. Nothing in this section shall preclude a

23  registered dental laboratory from working for another

24  registered dental laboratory, provided that such work is

25  performed pursuant to written authorization, in a form to be

26  prescribed by rule of the board department, which evidences

27  that the originating laboratory has obtained a valid work

28  order and which sets forth the work to be performed.

29  Furthermore, nothing in this section shall preclude a

30  registered laboratory from providing its services to dentists

31  licensed and practicing in another state, provided that such


                                 103

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  work is requested or otherwise authorized in written form

  2  which clearly identifies the name and address of the

  3  requesting dentist and which sets forth the work to be

  4  performed.

  5         Section 64.  Paragraph (b) of subsection (2), paragraph

  6  (b) of subsection (3), and subsection (4) of section 468.1155,

  7  Florida Statutes, are amended to read:

  8         468.1155  Provisional license; requirements.--

  9         (2)  The department shall issue a provisional license

10  to practice speech-language pathology to each applicant who

11  the board certifies has:

12         (b)  Received a master's degree or doctoral degree with

13  a major emphasis in speech-language pathology from an

14  institution of higher learning which, at the time the

15  applicant was enrolled and graduated, was accredited by an

16  accrediting agency recognized by the Commission on Recognition

17  of Postsecondary Accreditation or from an institution which is

18  publicly recognized as a member in good standing with the

19  Association of Universities and Colleges of Canada.  An

20  applicant who graduated from a program at a university or

21  college outside the United States or Canada must present

22  documentation of the determination of equivalency to standards

23  established by the Commission on Recognition of Postsecondary

24  Accreditation in order to qualify.  The applicant must have

25  completed 60 semester hours that include:

26         1.  Fundamental information applicable to the normal

27  development and use of speech, hearing, and language;

28  information about training in management of speech, hearing,

29  and language disorders; and information supplementary to these

30  fields.

31         2.  Six semester hours in audiology.


                                 104

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         3.  Thirty of the required 60 semester hours in courses

  2  acceptable toward a graduate degree by the college or

  3  university in which these courses were taken, of which 24

  4  semester hours must be in speech-language pathology.

  5         (3)  The department shall issue a provisional license

  6  to practice audiology to each applicant who the board

  7  certifies has:

  8         (b)  Received a master's degree or doctoral degree with

  9  a major emphasis in audiology from an institution of higher

10  learning which at the time the applicant was enrolled and

11  graduated was accredited by an accrediting agency recognized

12  by the Commission on Recognition of Postsecondary

13  Accreditation or from an institution which is publicly

14  recognized as a member in good standing with the Association

15  of Universities and Colleges of Canada.  An applicant who

16  graduated from a program at a university or college outside

17  the United States or Canada must present documentation of the

18  determination of equivalency to standards established by the

19  Commission on Recognition of Postsecondary Accreditation in

20  order to qualify.  The applicant must have completed 60

21  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 speech-language pathology.

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 audiology.


                                 105

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (4)  An applicant for a provisional license who has

  2  received a master's degree or doctoral degree with a major

  3  emphasis in speech-language pathology as provided in

  4  subsection (2), or audiology as provided in subsection (3),

  5  and who seeks licensure in the area in which the applicant is

  6  not currently licensed, must have completed 30 semester hours

  7  in courses acceptable toward a graduate degree and 200

  8  supervised clinical clock hours in the second discipline from

  9  an accredited institution.

10         Section 65.  Section 468.1215, Florida Statutes, is

11  amended to read:

12         468.1215  Speech-language pathology assistant and

13  audiology assistant; certification.--

14         (1)  A person desiring to be certified as a

15  speech-language pathology assistant or audiology assistant

16  shall apply to the department.

17         (1)(2)  The department shall issue a certificate as a

18  speech-language pathology assistant or as an audiology

19  assistant to each applicant who the board certifies has:

20         (a)  Completed the application form and remitted the

21  required fees, including a nonrefundable application fee.

22         (b)  Earned a bachelor's degree from a college or

23  university accredited by a regional association of colleges

24  and schools recognized by the Department of Education which

25  includes at least 24 semester hours of coursework as approved

26  by the board at an institution accredited by an accrediting

27  agency recognized by the Commission on Recognition of

28  Postsecondary Accreditation.

29         (2)  The department shall issue a certificate as an

30  audiology assistant to each applicant who the board certifies

31  has:


                                 106

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (a)  Completed the application form and remitted the

  2  required fees, including a nonrefundable application fee.

  3         (b)  Completed at least 24 semester hours of coursework

  4  as approved by the board at an institution accredited by an

  5  accrediting agency recognized by the Commission on Recognition

  6  of Postsecondary Accreditation.

  7         (3)  The board, by rule, shall establish minimum

  8  education and on-the-job training and supervision requirements

  9  for certification as a speech-language pathology assistant or

10  audiology assistant.

11         (4)  The provisions of this section shall not apply to

12  any student, intern, or trainee performing speech-language

13  pathology or audiology services while completing the

14  supervised clinical clock hours as required in s. 468.1155.

15         Section 66.  Subsection (1) of section 468.307, Florida

16  Statutes, 1998 Supplement, is amended to read:

17         468.307  Certificate; issuance; possession; display.--

18         (1)  The department shall issue a certificate to each

19  candidate who has met the requirements of ss. 468.304 and

20  468.306 or has qualified under s. 468.3065. The department may

21  by rule establish a subcategory of a certificate issued under

22  this part limiting the certificateholder to a specific

23  procedure or specific type of equipment.

24         Section 67.  Section 468.506, Florida Statutes, 1998

25  Supplement, is amended to read:

26         468.506  Dietetics and Nutrition Practice

27  Council.--There is created the Dietetics and Nutrition

28  Practice Council under the supervision of the board.  The

29  council shall consist of four persons licensed under this part

30  and one consumer who is 60 years of age or older.  Council

31  members shall be appointed by the board. Licensed members


                                 107

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  shall be appointed based on the proportion of licensees within

  2  each of the respective disciplines.  Members shall be

  3  appointed for 4-year staggered terms.  In order to be eligible

  4  for appointment, each licensed member must have been a

  5  licensee under this part for at least 3 years prior to his or

  6  her appointment.  No council member shall serve more than two

  7  successive terms.  The board may delegate such powers and

  8  duties to the council as it may deem proper to carry out the

  9  operations and procedures necessary to effectuate the

10  provisions of this part.  However, the powers and duties

11  delegated to the council by the board must encompass both

12  dietetics and nutrition practice and nutrition counseling. Any

13  time there is a vacancy on the council, any professional

14  association composed of persons licensed under this part may

15  recommend licensees to fill the vacancy to the board in a

16  number at least twice the number of vacancies to be filled,

17  and the board may appoint from the submitted list, in its

18  discretion, any of those persons so recommended.  Any

19  professional association composed of persons licensed under

20  this part may file an appeal regarding a council appointment

21  with the secretary director of the department agency, whose

22  decision shall be final.  The board shall fix council members'

23  compensation and pay their expenses in the same manner as

24  provided in s. 455.534.

25         Section 68.  Section 468.701, Florida Statutes, 1998

26  Supplement, is amended to read:

27         468.701  Definitions.--As used in this part, the term:

28         (1)  "Athlete" means a person who participates in an

29  athletic activity.

30         (2)  "Athletic activity" means the participation in an

31  activity, conducted by an educational institution, a


                                 108

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  professional athletic organization, or an amateur athletic

  2  organization, involving exercises, sports, games, or

  3  recreation requiring any of the physical attributes of

  4  strength, agility, flexibility, range of motion, speed, and

  5  stamina.

  6         (3)  "Athletic injury" means an injury sustained which

  7  affects the athlete's ability to participate or perform in

  8  athletic activity.

  9         (4)  "Athletic trainer" means a person licensed under

10  this part.

11         (5)  "Athletic training" means the recognition,

12  prevention, and treatment of athletic injuries.

13         (6)  "Board Council" means the Board Council of

14  Athletic Training.

15         (7)  "Department" means the Department of Health.

16         (8)  "Direct supervision" means the physical presence

17  of the supervisor on the premises so that the supervisor is

18  immediately available to the trainee when needed.

19         (9)  "Secretary" means the Secretary of Health.

20         (9)(10)  "Supervision" means the easy availability of

21  the supervisor to the athletic trainer, which includes the

22  ability to communicate by telecommunications.

23         Section 69.  Section 468.703, Florida Statutes, 1998

24  Supplement, is amended to read:

25         468.703  Board Council of Athletic Training.--

26         (1)  The Board Council of Athletic Training is created

27  within the department and shall consist of nine seven members

28  to be appointed by the Governor and confirmed by the Senate

29  secretary.

30         (2)  Five Four members of the board must council shall

31  be licensed athletic trainers. One member of the board must


                                 109

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  council shall be a physician licensed under chapter 458 or

  2  chapter 459. One member of the board must council shall be a

  3  physician licensed under chapter 460. Two members One member

  4  of the board shall be consumer members, each of whom must

  5  council shall be a resident of this state who has never worked

  6  as an athletic trainer, who has no financial interest in the

  7  practice of athletic training, and who has never been a

  8  licensed health care practitioner as defined in s. 455.501(4).

  9  Members of the council shall serve staggered 4-year terms as

10  determined by rule of the department; however, no member may

11  serve more than two consecutive terms.

12         (3)  For the purpose of staggering terms, the Governor

13  shall appoint the initial members of the board as follows:

14         (a)  Three members for terms of 2 years each.

15         (b)  Three members for terms of 3 years each.

16         (c)  Three members for terms of 4 years each.

17         (4)  As the terms of the members expire, the Governor

18  shall appoint successors for terms of 4 years and such members

19  shall serve until their successors are appointed.

20         (5)  All provisions of part II of chapter 455 relating

21  to activities of the board shall apply.

22         (6)  The board shall maintain its official headquarters

23  in Tallahassee.

24         (3)  The council shall advise and assist the department

25  in:

26         (a)  Developing rules relating to licensure

27  requirements, the licensure examination, continuing education

28  requirements, fees, records and reports to be filed by

29  licensees, and any other requirements necessary to regulate

30  the practice of athletic training.

31


                                 110

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (b)  Monitoring the practice of athletic training in

  2  other jurisdictions.

  3         (c)  Educating the public about the role of athletic

  4  trainers.

  5         (d)  Collecting and reviewing data regarding the

  6  licensed practice of athletic training.

  7         (e)  Addressing concerns and problems of athletic

  8  trainers in order to promote improved safety in the practice

  9  of athletic training.

10         (4)  Members of the council shall be entitled to

11  compensation and reimbursement for expenses in the same manner

12  as board members are compensated and reimbursed under s.

13  455.534.

14         Section 70.  Section 468.705, Florida Statutes, 1998

15  Supplement, is amended to read:

16         468.705  Rulemaking authority.--The board department is

17  authorized to adopt rules pursuant to ss. 120.536(1) and

18  120.54 to implement provisions of this part conferring duties

19  upon it. Such rules shall include, but not be limited to, the

20  allowable scope of practice regarding the use of equipment,

21  procedures, and medication, and requirements for a written

22  protocol between the athletic trainer and a supervising

23  physician, licensure requirements, licensure examination,

24  continuing education requirements, fees, records, and reports

25  to be filed by licensees, protocols, and any other

26  requirements necessary to regulate the practice of athletic

27  training.

28         Section 71.  Section 468.707, Florida Statutes, 1998

29  Supplement, is amended to read:

30         468.707  Licensure by examination; requirements.--

31


                                 111

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (1)  Any person desiring to be licensed as an athletic

  2  trainer shall apply to the department on a form approved by

  3  the department.

  4         (a)  The department shall license each applicant who:

  5         1.  Has completed the application form and remitted the

  6  required fees.

  7         2.  Is at least 21 years of age.

  8         3.  Has obtained a baccalaureate degree from a college

  9  or university accredited by an accrediting agency recognized

10  and approved by the United States Department of Education or

11  the Commission on Recognition of Postsecondary Accreditation,

12  or approved by the board department.

13         4.  Has completed coursework from a college or

14  university accredited by an accrediting agency recognized and

15  approved by the United States Department of Education or the

16  Commission on Recognition of Postsecondary Accreditation, or

17  approved by the board department, in each of the following

18  areas, as provided by rule: health, human anatomy,

19  kinesiology/biomechanics, human physiology, physiology of

20  exercise, basic athletic training, and advanced athletic

21  training.

22         5.  Has current certification in standard first aid and

23  cardiovascular pulmonary resuscitation from the American Red

24  Cross or an equivalent certification as determined by the

25  board department.

26         6.  Has, within 2 of the preceding 5 years, attained a

27  minimum of 800 hours of athletic training experience under the

28  direct supervision of a licensed athletic trainer or an

29  athletic trainer certified by the National Athletic Trainers'

30  Association or a comparable national athletic standards

31  organization.


                                 112

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         7.  Has passed an examination administered or approved

  2  by the board department.

  3         (b)  The department shall also license each applicant

  4  who:

  5         1.  Has completed the application form and remitted the

  6  required fees no later than October 1, 1996.

  7         2.  Is at least 21 years of age.

  8         3.  Has current certification in standard first aid and

  9  cardiovascular pulmonary resuscitation from the American Red

10  Cross or an equivalent certification as determined by the

11  board department.

12         4.a.  Has practiced athletic training for at least 3 of

13  the 5 years preceding application; or

14         b.  Is currently certified by the National Athletic

15  Trainers' Association or a comparable national athletic

16  standards organization.

17         (2)  Pursuant to the requirements of s. 455.607

18  455.604, each applicant shall complete a continuing education

19  course on human immunodeficiency virus and acquired immune

20  deficiency syndrome as part of initial licensure.

21         Section 72.  Section 468.709, Florida Statutes, is

22  amended to read:

23         468.709  Fees.--

24         (1)  The board department shall, by rule, establish

25  fees for the following purposes:

26         (a)  An application fee, not to exceed $100.

27         (b)  An examination fee, not to exceed $200.

28         (c)  An initial licensure fee, not to exceed $200.

29         (d)  A biennial renewal fee, not to exceed $200.

30         (e)  An inactive fee, not to exceed $100.

31         (f)  A delinquent fee, not to exceed $100.


                                 113

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (g)  A reactivation fee, not to exceed $100.

  2         (h)  A voluntary inactive fee, not to exceed $100.

  3         (2)  The board department shall establish fees at a

  4  level, not to exceed the statutory fee cap, that is adequate

  5  to ensure the continued operation of the regulatory program

  6  under this part. The board department shall neither set nor

  7  maintain the fees at a level that will substantially exceed

  8  this need.

  9         Section 73.  Subsections (2) and (3) of section

10  468.711, Florida Statutes, 1998 Supplement, are amended to

11  read:

12         468.711  Renewal of license; continuing education.--

13         (2)  The board department may, by rule, prescribe

14  continuing education requirements, not to exceed 24 hours

15  biennially. The criteria for continuing education shall be

16  approved by the board department and shall include 4 hours in

17  standard first aid and cardiovascular pulmonary resuscitation

18  from the American Red Cross or equivalent training as

19  determined by board department.

20         (3)  Pursuant to the requirements of s. 455.607

21  455.604, each licensee shall complete a continuing education

22  course on human immunodeficiency virus and acquired immune

23  deficiency syndrome as part of biennial relicensure.

24         Section 74.  Subsection (2) of section 468.719, Florida

25  Statutes, 1998 Supplement, is amended to read:

26         468.719  Disciplinary actions.--

27         (2)  When the board department finds any person guilty

28  of any of the acts set forth in subsection (1), the board

29  department may enter an order imposing one or more of the

30  penalties provided in s. 455.624.

31


                                 114

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         Section 75.  Section 468.721, Florida Statutes, is

  2  amended to read:

  3         468.721  Saving clause.--

  4         (1)  An athletic trainer registration which is valid on

  5  October 1, 1995, shall become for all purposes an athletic

  6  trainer license as required by this part, subject to any

  7  disciplinary or administrative action pending on October 1,

  8  1995, and shall be subject to all the same terms and

  9  conditions as athletic trainer licenses issued after October

10  1, 1995. The department shall retain jurisdiction to impose

11  discipline for any violation of this part which occurred prior

12  to October 1, 1995, but is discovered after October 1, 1995,

13  under the terms of this part prior to October 1, 1995.

14         (2)  No judicial or administrative proceeding pending

15  on July 1, 1995, shall be abated as a result of enactment of

16  any provision of this act.

17         (3)  Rules adopted by the department relating to the

18  regulation registration of athletic trainers under this part

19  prior to July 1, 1999, shall remain in effect until the board

20  department adopts rules relating to the regulation licensure

21  of athletic trainers under this part which supersede such

22  earlier rules.

23         Section 76.  Paragraph (g) of subsection (3) of section

24  20.43, Florida Statutes, 1998 Supplement, is amended to read:

25         20.43  Department of Health.--There is created a

26  Department of Health.

27         (3)  The following divisions of the Department of

28  Health are established:

29         (g)  Division of Medical Quality Assurance, which is

30  responsible for the following boards and professions

31  established within the division:


                                 115

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         1.  Nursing assistants, as provided under s. 400.211.

  2         2.  Health care services pools, as provided under s.

  3  402.48.

  4         3.  The Board of Acupuncture, created under chapter

  5  457.

  6         4.  The Board of Medicine, created under chapter 458.

  7         5.  The Board of Osteopathic Medicine, created under

  8  chapter 459.

  9         6.  The Board of Chiropractic Medicine, created under

10  chapter 460.

11         7.  The Board of Podiatric Medicine, created under

12  chapter 461.

13         8.  Naturopathy, as provided under chapter 462.

14         9.  The Board of Optometry, created under chapter 463.

15         10.  The Board of Nursing, created under chapter 464.

16         11.  The Board of Pharmacy, created under chapter 465.

17         12.  The Board of Dentistry, created under chapter 466.

18         13.  Midwifery, as provided under chapter 467.

19         14.  The Board of Speech-Language Pathology and

20  Audiology, created under part I of chapter 468.

21         15.  The Board of Nursing Home Administrators, created

22  under part II of chapter 468.

23         16.  The Board of Occupational Therapy, created under

24  part III of chapter 468.

25         17.  Respiratory therapy, as provided under part V of

26  chapter 468.

27         18.  Dietetics and nutrition practice, as provided

28  under part X of chapter 468.

29         19.  The Board of Athletic Training trainers, created

30  as provided under part XIII of chapter 468.

31


                                 116

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         20.  The Board of Orthotists and Prosthetists, created

  2  under part XIV of chapter 468.

  3         21.  Electrolysis, as provided under chapter 478.

  4         22.  The Board of Massage Therapy, created under

  5  chapter 480.

  6         23.  The Board of Clinical Laboratory Personnel,

  7  created under part III of chapter 483.

  8         24.  Medical physicists, as provided under part IV of

  9  chapter 483.

10         25.  The Board of Opticianry, created under part I of

11  chapter 484.

12         26.  The Board of Hearing Aid Specialists, created

13  under part II of chapter 484.

14         27.  The Board of Physical Therapy Practice, created

15  under chapter 486.

16         28.  The Board of Psychology, created under chapter

17  490.

18         29.  School psychologists, as provided under chapter

19  490.

20         30.  The Board of Clinical Social Work, Marriage and

21  Family Therapy, and Mental Health Counseling, created under

22  chapter 491.

23

24  The department may contract with the Agency for Health Care

25  Administration who shall provide consumer complaint,

26  investigative, and prosecutorial services required by the

27  Division of Medical Quality Assurance, councils, or boards, as

28  appropriate.

29         Section 77.  The Council of Athletic Training and the

30  terms of all council members are terminated on July 1, 1999.

31  However, such termination in no way precludes the Governor


                                 117

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  from considering any former council member for appointment to

  2  the Board of Athletic Training created by this act.

  3         Section 78.  Section 468.805, Florida Statutes, is

  4  amended to read:

  5         468.805  Grandfathering Licensure without examination;

  6  provisional licensure.--

  7         (1)  A person who has practiced orthotics, prosthetics,

  8  or pedorthics in this state for the required period since July

  9  1, 1990, who, before March 1, 1998, applies to the department

10  for a license to practice orthotics, prosthetics, or

11  pedorthics, may be licensed as a prosthetist, orthotist,

12  prosthetist-orthotist, orthotic fitter, orthotic fitter

13  assistant, or pedorthist, as determined from the person's

14  experience, certification, and educational preparation,

15  without meeting the educational requirements set forth in s.

16  468.803, upon receipt of the application fee and licensing fee

17  and after the board has completed an investigation into the

18  applicant's background and experience. The board shall require

19  an application fee not to exceed $500, which shall be

20  nonrefundable. The board shall complete its investigation

21  within 6 months after receipt of the completed application.

22  The period of experience required for licensure under this

23  section subsection is 5 years for a prosthetist; 2 years for

24  an orthotic fitter, an orthotic fitter assistant, or a

25  pedorthist; and 5 years for an orthotist whose scope of

26  practice is defined under s. 468.80(7).

27         (2)(a)  A person who has received certification as an

28  orthotist, a prosthetist, or a prosthetist-orthotist from a

29  national certifying body and who has practiced orthotics or

30  prosthetics in this state for at least 2 years but less than 5

31  years is eligible for a provisional license.


                                 118

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (b)  An applicant for provisional licensure shall

  2  submit proof that he or she has been actively practicing as a

  3  nationally certified orthotist, prosthetist, or

  4  prosthetist-orthotist, an application fee, and a provisional

  5  license fee.

  6         (c)  A provisional licensee is required to practice

  7  under supervision of a fully licensed orthotist, prosthetist,

  8  or prosthetist-orthotist for up to 3 years in order to meet

  9  the 5-year experience requirement of subsection (1) to be

10  licensed as an orthotist, prosthetist, or

11  prosthetist-orthotist.

12         (d)  After appropriate investigation, the board shall

13  license as an orthotist, prosthetist, or prosthetist-orthotist

14  the provisional licensee who has successfully completed the

15  period of experience required and otherwise meets the

16  requirements of subsection (1).

17         (e)  The board shall require an application fee, not to

18  exceed $500, which is nonrefundable, and a provisional

19  licensure fee, not to exceed $500.

20         (3)  An applicant who has received certification as an

21  orthotist, a prosthetist, a prosthetist-orthotist, or a

22  pedorthist from a national certifying body which requires the

23  successful completion of an examination, may be licensed under

24  this section without taking an additional examination. An

25  applicant who has not received certification from a national

26  certifying body which requires the successful completion of an

27  examination shall be required to take an examination as

28  determined by the board. This examination shall be designed to

29  determine if the applicant has the minimum qualifications

30  needed to be licensed under this section. The board may charge

31


                                 119

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  an examination fee and the actual per applicant cost to the

  2  department for purchase or development of the examination.

  3         (4)  An applicant who successfully completed prior to

  4  March 1, 1998, at least one-half of the examination required

  5  for national certification and successfully completed the

  6  remaining portion of the examination and became certified

  7  prior to July 1, 1998, shall be considered as nationally

  8  certified by March 1, 1998, for purposes of this section.

  9         (5)(4)  This section is repealed July 1, 2002.

10         Section 79.  Subsection (3) of section 468.806, Florida

11  Statutes, is amended to read:

12         468.806  Biennial renewal of license.--

13         (3)  The board may by rule prescribe continuing

14  education requirements and approve course criteria, not to

15  exceed 30 hours biennially, as a condition for license

16  renewal. The board shall establish a procedure for approving

17  continuing education courses and providers and may set a fee

18  for continuing education course and provider approval.

19         Section 80.  Subsection (5) of section 478.42, Florida

20  Statutes, is amended to read:

21         478.42  Definitions.--As used in this chapter, the

22  term:

23         (5)  "Electrolysis or electrology" means the permanent

24  removal of hair by destroying introducing, into and beneath

25  the skin, ionizing (galvanic current) or nonionizing radiation

26  (thermolysis or high-frequency current) to destroy the

27  hair-producing cells of the skin and vascular system, using

28  equipment and needle-type epilation devices approved by the

29  board which have been cleared by and that are registered with

30  the United States Food and Drug Administration and that are

31


                                 120

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  used pursuant to protocols approved by the council and the

  2  board.

  3         Section 81.  Section 483.041, Florida Statutes, is

  4  amended to read:

  5         483.041  Definitions.--As used in this part, the term:

  6         (1)  "Agency" means the Agency for Health Care

  7  Administration.

  8         (2)  "Clinical laboratory" means the physical location

  9  in which one or more of the following services a laboratory

10  where examinations are performed on materials or specimens

11  taken from the human body to provide information or materials

12  for use in the diagnosis, prevention, or treatment of a

13  disease or the identification or assessment of a medical or

14  physical condition.

15         (a)  Clinical laboratory services are the examinations

16  of fluids or other materials taken from the human body.

17         (b)  Anatomic laboratory services are the examinations

18  of tissue taken from the human body.

19         (c)  Cytology laboratory services are the examinations

20  of cells from individual tissues or fluid taken from the human

21  body.

22         (3)  "Clinical laboratory examination" means a

23  procedure performed to deliver the services defined in

24  subsection (2), including the oversight or interpretation

25  thereof.

26         (4)(3)  "Clinical laboratory proficiency testing

27  program" means a program approved by the agency for evaluating

28  the performance of clinical laboratories.

29         (5)(4)  "Collection station" or "branch office" means a

30  facility operated by a clinical laboratory where materials or

31  specimens are withdrawn or collected from patients or


                                 121

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  assembled after being withdrawn or collected from patients

  2  elsewhere, for subsequent delivery to another location for

  3  examination.

  4         (6)(5)  "Hospital laboratory" means a laboratory

  5  located in a hospital licensed under chapter 395 that provides

  6  services solely to that hospital and that is owned by the

  7  hospital and governed by the hospital medical staff or

  8  governing board.

  9         (7)(6)  "Licensed practitioner" means a physician

10  licensed under chapter 458, chapter 459, chapter 460, or

11  chapter 461; a dentist licensed under chapter 466; a person

12  licensed under chapter 462; or an advanced registered nurse

13  practitioner licensed under chapter 464 or a duly licensed

14  practitioner from another state licensed under similar

15  statutes who orders examinations on materials or specimens for

16  non residents of the State of Florida, but who reside in the

17  same state as the requesting licensed practitioner.

18         (8)(7)  "Person" means the State of Florida or any

19  individual, firm, partnership, association, corporation,

20  county, municipality, political subdivision, or other entity,

21  whether organized for profit or not.

22         (9)(8)  "Validation inspection" means an inspection of

23  a clinical laboratory by the agency to assess whether a review

24  by an accrediting organization has adequately evaluated the

25  clinical laboratory according to state standards.

26         (10)(9)  "Waived test" means a test that the federal

27  Health Care Financing Administration has determined qualifies

28  for a certificate of waiver under the federal Clinical

29  Laboratory Improvement Amendments of 1988, and the federal

30  rules adopted thereunder.

31


                                 122

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         Section 82.  Subsections (2), (3), and (7) of section

  2  483.803, Florida Statutes, are amended to read:

  3         483.803  Definitions.--As used in this part, the term:

  4         (2)  "Clinical laboratory" means a clinical laboratory

  5  as defined in s. 483.041(2).

  6         (3)  "Clinical laboratory examination" means a clinical

  7  laboratory examination as defined in s. 483.041 an examination

  8  performed on materials or specimens of the human body to

  9  provide information or materials for use in the diagnosis,

10  prevention, or treatment of a disease or the identification or

11  assessment of a medical or physical condition.

12         (7)  "Licensed practitioner of the healing arts" means

13  a physician licensed under pursuant to chapter 458, chapter

14  459, or chapter 460, or chapter 461; a dentist licensed under

15  pursuant to chapter 466; or a person licensed under pursuant

16  to chapter 461 or chapter 462.

17

18

19         Section 83.  Subsection (9) of section 483.807, Florida

20  Statutes, 1998 Supplement, is amended to read:

21         483.807  Fees; establishment; disposition.--

22         (9)  The initial application and renewal fee for

23  approval as a laboratory training program may not exceed $300.

24  The fee for late filing of a renewal application shall be $50.

25         Section 84.  Subsections (2) and (3) of section

26  483.809, Florida Statutes, are amended to read:

27         483.809  Licensure; examinations; registration of

28  trainees; approval of curricula.--

29         (2)  EXAMINATIONS.--The department shall conduct

30  examinations required by board rules to determine in part the

31  qualification of clinical laboratory personnel for licensure.


                                 123

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  The board by rule may designate a An approved national

  2  certification examination that may be accepted in lieu of

  3  state examination for clinical laboratory personnel or public

  4  health scientists.

  5         (3)  REGISTRATION OF TRAINEES.--The department shall

  6  provide for annual registration of clinical laboratory

  7  trainees who are enrolled in a training program employed by

  8  laboratories approved pursuant to s. 483.811, which

  9  registration may not be renewed except upon special

10  authorization of the board.

11         Section 85.  Section 483.812, Florida Statutes, is

12  amended to read:

13         483.812  Public health laboratory scientists;

14  licensure.--

15         (1)  Applicants at the director level in the category

16  of public health shall qualify under s. 483.824.

17         (2)(1)  Applicants at the director and supervisor level

18  in the category of public health who are certified registered

19  by the National Registry in of Clinical Chemistry

20  Certification or the American Society for of Microbiology,

21  licensed as a technologist, and have 5 years of pertinent

22  clinical laboratory experience may qualify under board rules

23  by passing the state-administered appropriate supervision and

24  administration examination.

25         (3)(2)(a)  A technologist applicant for licensure in

26  the category of public health microbiology, with a

27  baccalaureate degree in one of the biological sciences from an

28  accredited institution, may use the American Society for of

29  Microbiology or the National Registry in of Microbiology

30  Certification in Public Health Microbiology to qualify for a

31  technologist license in public health microbiology.  Such a


                                 124

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  technologist may work in a public health microbiology

  2  laboratory.

  3         (b)  A technologist applicant for licensure in the

  4  category of public health chemistry, with a baccalaureate

  5  degree in one of the chemical, biological, or physical

  6  sciences from an accredited institution, may use the National

  7  Registry of Clinical Chemistry Certification to qualify for a

  8  technologist license in public health chemistry.  Such a

  9  technologist may work in a public health chemistry laboratory.

10         (c)  A technician applicant for licensure in the

11  category of public health, with a baccalaureate degree in one

12  of the chemical or biological sciences from an accredited

13  institution, may obtain a 2-year one-time, 3-year, conditional

14  public health technician license, which may be renewed once

15  pending national certification by the American Society of

16  Microbiology or the National Registry of Clinical Chemistry

17  Certification. Such a technician may perform testing only

18  under the direct supervision of a licensed pathologist,

19  director, supervisor, or technologist.

20         (4)(3)  A person licensed by the Board of Clinical

21  Laboratory Personnel may work in a public health laboratory at

22  the appropriate level and specialty.

23         Section 86.  Section 483.813, Florida Statutes, is

24  amended to read:

25         483.813  Clinical laboratory personnel license.--A

26  person may not conduct a clinical laboratory examination or

27  report the results of such examination unless such person is

28  licensed under this part to perform such procedures. However,

29  this provision does not apply to any practitioner of the

30  healing arts authorized to practice in this state or to

31  persons engaged in testing performed by laboratories regulated


                                 125

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  under s. 483.035(1) or exempt from regulation under s.

  2  483.031(2). The department may grant a temporary license to

  3  any candidate it deems properly qualified, for a period not to

  4  exceed 1 year, or a conditional license for a period not to

  5  exceed 3 years.

  6         Section 87.  Subsection (3) is added to section

  7  483.821, Florida Statutes, to read:

  8         483.821  Periodic demonstration of competency;

  9  continuing education or reexamination.--

10         (3)  The board may, by rule, provide for continuing

11  education or retraining requirements for candidates failing an

12  examination two or more times.

13         Section 88.  Section 483.824, Florida Statutes, is

14  amended to read:

15         483.824  Qualifications of clinical laboratory

16  director.--A clinical laboratory director must have 4 years of

17  clinical laboratory experience with 2 years of experience in

18  the speciality to be directed or be nationally board certified

19  in the specialty to be directed, and must meet one of the

20  following requirements:

21         (1)  Be a physician licensed under chapter 458 or

22  chapter 459;

23         (2)  Hold an earned doctoral degree in a chemical,

24  physical, or biological science from a regionally accredited

25  institution and be nationally certified; or

26         (3)  For the subspecialty of oral pathology, be a

27  physician licensed under chapter 458 or chapter 459 or a

28  dentist licensed under chapter 466.

29         Section 89.  Section 483.825, Florida Statutes, is

30  amended to read:

31


                                 126

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         483.825  Grounds for disciplinary action.--The

  2  following acts constitute grounds for which disciplinary

  3  actions specified in s. 483.827 may be taken against

  4  applicants, registrants, and licensees under this part:

  5         (1)  Attempting to obtain, obtaining, or renewing a

  6  license or registration under this part by bribery, by

  7  fraudulent misrepresentation, or through an error of the

  8  department or the board.

  9         (2)  Engaging in or attempting to engage in, or

10  representing herself or himself as entitled to perform, any

11  clinical laboratory procedure or category of procedures not

12  authorized pursuant to her or his license.

13         (3)  Demonstrating incompetence or making consistent

14  errors in the performance of clinical laboratory examinations

15  or procedures or erroneous reporting.

16         (4)  Performing a test and rendering a report thereon

17  to a person not authorized by law to receive such services.

18         (5)  Has been convicted or found guilty of, or entered

19  a plea of nolo contendere to, regardless of adjudication, a

20  crime in any jurisdiction which directly relates to the

21  activities of clinical laboratory personnel or involves moral

22  turpitude or fraudulent or dishonest dealing. The record of a

23  conviction certified or authenticated in such form as to be

24  admissible in evidence under the laws of the state shall be

25  admissible as prima facie evidence of such guilt. Having been

26  convicted of a felony or of any crime involving moral

27  turpitude under the laws of any state or of the United States.

28  The record of conviction or a certified copy thereof shall be

29  conclusive evidence of such conviction.

30         (6)  Having been adjudged mentally or physically

31  incompetent.


                                 127

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (7)  Violating or aiding and abetting in the violation

  2  of any provision of this part or the rules adopted hereunder.

  3         (8)  Reporting a test result when no laboratory test

  4  was performed on a clinical specimen.

  5         (9)  Knowingly advertising false services or

  6  credentials.

  7         (10)  Having a license revoked, suspended, or otherwise

  8  acted against, including the denial of licensure, by the

  9  licensing authority of another jurisdiction. The licensing

10  authority's acceptance of a relinquishment of a license,

11  stipulation, consent order, or other settlement, offered in

12  response to or in anticipation of the filing of administrative

13  charges against the licensee, shall be construed as action

14  against the licensee.

15         (11)  Failing to report to the board, in writing,

16  within 30 days that an if action under subsection (5),

17  subsection (6), or subsection (10) has been taken against the

18  licensee or one's license to practice as clinical laboratory

19  personnel in another state, territory, or country, or other

20  jurisdiction.

21         (12)  Being unable to perform or report clinical

22  laboratory examinations with reasonable skill and safety to

23  patients by reason of illness or use of alcohol, drugs,

24  narcotics, chemicals, or any other type of material or as a

25  result of any mental or physical condition.  In enforcing this

26  subsection, the department shall have, upon a finding of the

27  secretary or his or her designee that probable cause exists to

28  believe that the licensee is unable to practice because of the

29  reasons stated in this subsection, the authority to issue an

30  order to compel a licensee to submit to a mental or physical

31  examination by physicians designated by the department.  If


                                 128

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  the licensee refuses to comply with such order, the

  2  department's order directing such examination may be enforced

  3  by filing a petition for enforcement in the circuit court

  4  where the licensee resides or does business.  The department

  5  shall be entitled to the summary procedure provided in s.

  6  51.011.  A licensee affected under this subsection shall at

  7  reasonable intervals be afforded an opportunity to demonstrate

  8  that he or she can resume competent practice with reasonable

  9  skill and safety to patients.

10         (13)  Delegating professional responsibilities to a

11  person when the licensee delegating such responsibilities

12  knows, or has reason to know, that such person is not

13  qualified by training, experience, or licensure to perform

14  them.

15         (14)  Violating a previous order of the board entered

16  in a disciplinary proceeding.

17         (15)  Failing to report to the department a person or

18  other licensee who the licensee knows is in violation of this

19  chapter or the rules of the department or board adopted

20  hereunder.

21         (16)  Making or filing a report which the licensee

22  knows to be false, intentionally or negligently failing to

23  file a report or record required by state or federal law,

24  willfully impeding or obstructing such filing or inducing

25  another person to do so, including, but not limited to,

26  impeding an agent of the state from obtaining a report or

27  record for investigative purposes. Such reports or records

28  shall include only those generated in the capacity as a

29  licensed clinical laboratory personnel.

30         (17)  Paying or receiving any commission, bonus,

31  kickback, or rebate, or engaging in any split-fee arrangement


                                 129

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  in any form whatsoever with a physician, organization, agency,

  2  or person, either directly or indirectly for patients referred

  3  to providers of health care goods and services including, but

  4  not limited to, hospitals, nursing homes, clinical

  5  laboratories, ambulatory surgical centers, or pharmacies. The

  6  provisions of this subsection shall not be construed to

  7  prevent a clinical laboratory professional from receiving a

  8  fee for professional consultation services.

  9         (18)  Exercising influence on a patient or client in

10  such a manner as to exploit the patient or client for the

11  financial gain of the licensee or other third party, which

12  shall include, but not be limited to, the promoting, selling,

13  or withholding of services, goods, appliances, referrals, or

14  drugs.

15         (19)  Practicing or offering to practice beyond the

16  scope permitted by law or rule, or accepting or performing

17  professional services or responsibilities which the licensee

18  knows or has reason to know that he or she is not competent to

19  perform.

20         (20)  Misrepresenting or concealing a material fact at

21  any time during any phase of the licensing, investigative, or

22  disciplinary process, procedure, or proceeding.

23         (21)  Improperly interfering with an investigation or

24  any disciplinary proceeding.

25         (22)  Engaging in or attempting to engage in sexual

26  misconduct, causing undue embarrassment or using disparaging

27  language or language of a sexual nature towards a patient,

28  exploiting superior/subordinate, professional/patient,

29  instructor/student relationships for personal gain, sexual

30  gratification, or advantage.

31


                                 130

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         Section 90.  Paragraph (g) of subsection (4) and

  2  subsections (6) and (8) of section 483.901, Florida Statutes,

  3  1998 Supplement, are amended to read:

  4         483.901  Medical physicists; definitions; licensure.--

  5         (4)  COUNCIL.--The Advisory Council of Medical

  6  Physicists is created in the Department of Health to advise

  7  the department in regulating the practice of medical physics

  8  in this state.

  9         (g)  If a vacancy on the council occurs, the secretary

10  director shall appoint a member to serve for a 4-year term.

11         (6)  LICENSE REQUIRED.--An individual may not engage in

12  the practice of medical physics, including the specialties of

13  diagnostic radiological physics, therapeutic radiological

14  physics, medical nuclear radiological physics, or medical

15  health physics, without a license issued by the department for

16  the appropriate specialty.

17         (a)  The department shall adopt rules to administer

18  this section which specify license application and renewal

19  fees, continuing education requirements, and standards for

20  practicing medical physics.  The council shall recommend to

21  the department continuing education requirements that shall be

22  a condition of license renewal.  The department shall require

23  a minimum of 24 hours per biennium of continuing education

24  offered by an organization recommended by the council and

25  approved by the department.  The department, upon

26  recommendation of the council, may adopt rules to specify

27  continuing education requirements for persons who hold a

28  license in more than one specialty.

29         (b)  In order to apply for a medical physicist license

30  in one or more specialties, a person must file an individual

31  application for each specialty with the department.  The


                                 131

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  application must be on a form prescribed by the department and

  2  must be accompanied by a nonrefundable application fee for

  3  each specialty.

  4         (c)  The department may issue a license to an eligible

  5  applicant if the applicant meets all license requirements.  At

  6  any time before the department issues a license, the applicant

  7  may request in writing that the application be withdrawn.  To

  8  reapply, the applicant must submit a new application and an

  9  additional nonrefundable application fee and must meet all

10  current licensure requirements.

11         (d)  The department shall review each completed

12  application for a license which the department receives.

13         (e)  On receipt of an application and fee as specified

14  in this section, the department may issue a license to

15  practice medical physics in this state:

16         1.  Until October 1, 1998, to a person who meets any of

17  the following requirements:

18         a.  Earned from an accredited college or university a

19  doctoral degree in physics, medical physics, biophysics,

20  radiological physics, medical health physics, or nuclear

21  engineering and has at least 2 years' experience in the

22  practice of the medical physics specialty for which

23  application is made.

24         b.  Earned from an accredited college or university a

25  master's degree in physics, medical physics, biophysics,

26  radiological physics, medical health physics, or nuclear

27  engineering and has at least 3 years' experience in the

28  practice of the medical physics specialty for which

29  application is made.

30         c.  Earned from an accredited college or university a

31  bachelor's degree in physics and has at least 5 years'


                                 132

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  experience in the practice of the medical physics specialty

  2  for which application is made.

  3         d.  Has at least 8 years' experience in the practice of

  4  the medical physics specialty for which application is made, 2

  5  years of which must have been earned within the 4 years

  6  immediately preceding application for licensure.

  7         e.  Is board certified in the medical physics specialty

  8  in which the applicant applies to practice by the American

  9  Board of Radiology for diagnostic radiological physics,

10  therapeutic radiological physics, or medical nuclear

11  radiological physics; by the American Board of Medical Physics

12  or the Canadian Board of Medical Physics for diagnostic

13  radiological physics, therapeutic radiological physics, or

14  medical nuclear radiological physics; or by the American Board

15  of Health Physics or an equivalent certifying body approved by

16  the agency.

17         2.  On or after October 1, 1997, to a person who is

18  board certified in the medical physics specialty in which the

19  applicant applies to practice by the American Board of

20  Radiology for diagnostic radiological physics, therapeutic

21  radiological physics, or medical nuclear radiological physics;

22  by the American Board of Medical Physics for diagnostic

23  radiological physics, therapeutic radiological physics, or

24  medical nuclear radiological physics; or by the American Board

25  of Health Physics or an equivalent certifying body approved by

26  the department.

27         (f)  A licensee shall:

28         1.  Display the license in a place accessible to the

29  public; and

30         2.  Report immediately any change in the licensee's

31  address or name to the department.


                                 133

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (g)  The following acts are grounds for which the

  2  disciplinary actions in paragraph (h) may be taken:

  3         1.  Obtaining or attempting to obtain a license by

  4  bribery, fraud, knowing misrepresentation, or concealment of

  5  material fact or through an error of the department.

  6         2.  Having a license denied, revoked, suspended, or

  7  otherwise acted against in another jurisdiction.

  8         3.  Being convicted or found guilty of, or entering a

  9  plea of nolo contendere to, regardless of adjudication, a

10  crime in any jurisdiction which relates to the practice of, or

11  the ability to practice, the profession of medical physics.

12         4.  Willfully failing to file a report or record

13  required for medical physics or willfully impeding or

14  obstructing the filing of a report or record required by this

15  section or inducing another person to do so.

16         5.  Making misleading, deceptive, or fraudulent

17  representations in or related to the practice of medical

18  physics.

19         6.  Willfully failing to report any known violation of

20  this section or any rule adopted thereunder.

21         7.  Willfully or repeatedly violating a rule adopted

22  under this section or an order of the department.

23         8.  Failing to perform any statutory or legal

24  obligation placed upon a licensee.

25         9.  Aiding, assisting, procuring, employing, or

26  advising any unlicensed person to practice medical physics

27  contrary to this section or any rule adopted thereunder.

28         10.  Delegating or contracting for the performance of

29  professional responsibilities by a person when the licensee

30  delegating or contracting such responsibilities knows, or has

31


                                 134

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  reason to know, such person is not qualified by training,

  2  experience, and authorization to perform them.

  3         11.  Practicing or offering to practice beyond the

  4  scope permitted by law or accepting and performing

  5  professional responsibilities the licensee knows, or has

  6  reason to know, the licensee is not competent to perform.

  7         12.  Gross or repeated malpractice or the inability to

  8  practice medical physics with reasonable skill and safety.

  9         13.  Judicially determined mental incompetency.

10         14.  Being unable to practice medical physics with

11  reasonable skill and safety because of a mental or physical

12  condition or illness or the use of alcohol, controlled

13  substances, or any other substance which impairs one's ability

14  to practice.

15         a.  The department may, upon probable cause, compel a

16  licensee to submit to a mental or physical examination by

17  physicians designated by the department.  The cost of an

18  examination shall be borne by the licensee, and the licensee's

19  failure to submit to such an examination constitutes an

20  admission of the allegations against the licensee, consequent

21  upon which a default and a final order may be entered without

22  the taking of testimony or presentation of evidence, unless

23  the failure was due to circumstances beyond the licensee's

24  control.

25         b.  A licensee who is disciplined under this

26  subparagraph shall, at reasonable intervals, be afforded an

27  opportunity to demonstrate that the licensee can resume the

28  practice of medical physics with reasonable skill and safety.

29         c.  With respect to any proceeding under this

30  subparagraph, the record of proceedings or the orders entered

31


                                 135

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  by the department may not be used against a licensee in any

  2  other proceeding.

  3         (h)  When the department finds any person guilty of any

  4  of the grounds set forth in paragraph (g), including conduct

  5  that would constitute a substantial violation of paragraph (g)

  6  which occurred prior to licensure, it may enter an order

  7  imposing one or more of the following penalties:

  8         1.  Deny the application for licensure.

  9         2.  Revoke or suspend the license.

10         3.  Impose an administrative fine for each count or

11  separate offense.

12         4.  Place the licensee on probation for a specified

13  time and subject the licensee to such conditions as the

14  department determines necessary, including requiring

15  treatment, continuing education courses, or working under the

16  monitoring or supervision of another licensee.

17         5.  Restrict a licensee's practice.

18         6.  Issue a reprimand to the licensee.

19         (i)  The department may not issue or reinstate a

20  license to a person it has deemed unqualified until it is

21  satisfied that such person has complied with the terms and

22  conditions of the final order and that the licensee can safely

23  practice medical physics.

24         (j)  The department may issue a temporary license to an

25  applicant pending completion of the application process for

26  board certification.

27         (j)(k)  Upon receipt of a complete application and the

28  fee set forth by rule, the department may issue a

29  physicist-in-training certificate to a person qualified to

30  practice medical physics under direct supervision. The

31  department may establish by rule requirements for initial


                                 136

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  certification and renewal of a physicist-in-training

  2  certificate.

  3         (8)  DISPOSITION OF FEES.--The department shall deposit

  4  all funds received into the Medical Quality Assurance Health

  5  Care Trust Fund.

  6         Section 91.  Paragraph (d) of subsection (1) of section

  7  484.007, Florida Statutes, is amended to read:

  8         484.007  Licensure of opticians; permitting of optical

  9  establishments.--

10         (1)  Any person desiring to practice opticianry shall

11  apply to the department, upon forms prescribed by it, to take

12  a licensure examination. The department shall examine each

13  applicant who the board certifies:

14         (d)1.  Has received an associate degree, or its

15  equivalent, in opticianry from an educational institution the

16  curriculum of which is accredited by an accrediting agency

17  recognized and approved by the United States Department of

18  Education or the Council on Postsecondary Education or

19  approved by the board;

20         2.  Is an individual licensed to practice the

21  profession of opticianry pursuant to a regulatory licensing

22  law of another state, territory, or jurisdiction of the United

23  States, who has actively practiced in such other state,

24  territory, or jurisdiction for more than 3 years immediately

25  preceding application, and who meets the examination

26  qualifications as provided in this subsection;

27         3.  Is an individual who has actively practiced in

28  another state, territory, or jurisdiction of the United States

29  for more than 5 years immediately preceding application and

30  who provides tax or business records, affidavits, or other

31


                                 137

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  satisfactory documentation of such practice and who meets the

  2  examination qualifications as provided in this subsection; or

  3         4.  Has registered as an apprentice with the department

  4  and paid a registration fee not to exceed $60, as set by rule

  5  of the board. The apprentice shall complete 6,240 hours of

  6  training under the supervision of an optician licensed in this

  7  state for at least 1 year or of, a physician, or an

  8  optometrist licensed under the laws of this state. These

  9  requirements must be met within 5 years after the date of

10  registration. However, any time spent in a recognized school

11  may be considered as part of the apprenticeship program

12  provided herein. The board may establish administrative

13  processing fees sufficient to cover the cost of administering

14  apprentice rules as promulgated by the board.

15         Section 92.  Subsection (3) is added to section

16  484.0512, Florida Statutes, to read:

17         484.0512  Thirty-day trial period; purchaser's right to

18  cancel; notice; refund; cancellation fee.--

19         (3)  Within 30 days after the return or attempted

20  return of the hearing aid, the seller shall refund all moneys

21  that must be refunded to a purchaser pursuant to this section.

22         Section 93.  Section 484.053, Florida Statutes, is

23  amended to read:

24         484.053  Prohibitions; penalties.--

25         (1)  A person may not:

26         (a)  Practice dispensing hearing aids unless the person

27  is a licensed hearing aid specialist;

28         (b)  Use the name or title "hearing aid specialist"

29  when the person has not been licensed under this part;

30         (c)  Present as her or his own the license of another;

31


                                 138

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (d)  Give false, incomplete, or forged evidence to the

  2  board or a member thereof for the purposes of obtaining a

  3  license;

  4         (e)  Use or attempt to use a hearing aid specialist

  5  license that is delinquent or has been suspended, revoked, or

  6  placed on inactive or delinquent status;

  7         (f)  Knowingly employ unlicensed persons in the

  8  practice of dispensing hearing aids; or

  9         (g)  Knowingly conceal information relative to

10  violations of this part.

11         (2)  Any person who violates any of the provisions of

12  this section is guilty of a felony misdemeanor of the third

13  second degree, punishable as provided in s. 775.082 or s.

14  775.083.

15         (3)  If a person licensed under this part allows the

16  sale of a hearing aid by an unlicensed person not registered

17  as a trainee or fails to comply with the requirements of s.

18  484.0445(2) relating to supervision of trainees, the board

19  shall, upon determination of that violation, order the full

20  refund of moneys paid by the purchaser upon return of the

21  hearing aid to the seller's place of business.

22         Section 94.  Paragraph (a) of subsection (1) of section

23  484.056, Florida Statutes, 1998 Supplement, is amended to

24  read:

25         484.056  Disciplinary proceedings.--

26         (1)  The following acts relating to the practice of

27  dispensing hearing aids shall be grounds for both disciplinary

28  action against a hearing aid specialist as set forth in this

29  section and cease and desist or other related action by the

30  department as set forth in s. 455.637 against any person

31


                                 139

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  owning or operating a hearing aid establishment who engages

  2  in, aids, or abets any such violation:

  3         (a)  Violation of any provision of s. 455.624(1), s.

  4  484.0512, or s. 484.053.

  5         Section 95.  Section 486.041, Florida Statutes, is

  6  amended to read:

  7         486.041  Physical therapist; application for license;

  8  fee; temporary permit.--

  9         (1)  A person who desires to be licensed as a physical

10  therapist shall apply to the department in writing on a form

11  furnished by the department.  She or he shall embody in that

12  application evidence under oath, satisfactory to the board, of

13  possession of the qualifications preliminary to examination

14  required by s. 486.031. The applicant shall pay to the

15  department at the time of filing the application a fee not to

16  exceed $100, as fixed by the board.

17         (2)  If a person desires to practice physical therapy

18  before becoming licensed through examination, she or he shall

19  apply for a temporary permit in accordance with rules adopted

20  pursuant to this chapter.

21         (a)  A temporary permit shall only be issued for a

22  limited period of time, not to exceed 1 year, and shall not be

23  renewable. A temporary permit shall automatically expire if an

24  applicant fails the examination.

25         (b)  An applicant for licensure by examination and

26  practicing under a temporary permit shall do so only under the

27  direct supervision of a licensed physical therapist.

28         Section 96.  Section 486.081, Florida Statutes, is

29  amended to read:

30

31


                                 140

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         486.081  Physical therapist; issuance of license

  2  without examination to person passing examination of another

  3  authorized examining board; temporary permit; fee.--

  4         (1)  The board may cause a license to be issued through

  5  the department without examination to any applicant who

  6  presents evidence satisfactory to the board of having passed

  7  the American Registry Examination prior to 1971 or an

  8  examination in physical therapy before a similar lawfully

  9  authorized examining board of another state, the District of

10  Columbia, a territory, or a foreign country, if the standards

11  for licensure in physical therapy in such other state,

12  district, territory, or foreign country are determined by the

13  board to be as high as those of this state, as established by

14  rules adopted pursuant to this chapter. Any person who holds a

15  license pursuant to this section may use the words "physical

16  therapist" or "physiotherapist," or the letters "P.T.," in

17  connection with her or his name or place of business to denote

18  her or his licensure hereunder.

19         (2)  At the time of making application for licensure

20  without examination pursuant to the terms of this section, the

21  applicant shall pay to the department a fee not to exceed $175

22  as fixed by the board, no part of which will be returned.

23         (3)  If a person desires to practice physical therapy

24  before becoming licensed through endorsement, she or he shall

25  apply to the board for a temporary permit in accordance with

26  rules adopted pursuant to this chapter. A temporary permit

27  shall only be issued for a limited period of time, not to

28  exceed 1 year, and shall not be renewable.

29         Section 97.  Section 486.103, Florida Statutes, is

30  amended to read:

31


                                 141

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         486.103  Physical therapist assistant; application for

  2  license; fee; temporary permit.--

  3         (1)  A person who desires to be licensed as a physical

  4  therapist assistant shall apply to the department in writing

  5  on a form furnished by the department.  She or he shall embody

  6  in that application evidence under oath, satisfactory to the

  7  board, of possession of the qualifications preliminary to

  8  examination required by s. 486.104. The applicant shall pay to

  9  the department at the time of filing the application a fee not

10  to exceed $100, as fixed by the board.

11         (2)  If a person desires to work as a physical

12  therapist assistant before being licensed through examination,

13  she or he shall apply for a temporary permit in accordance

14  with rules adopted pursuant to this chapter.

15         (a)  A temporary permit shall only be issued for a

16  limited period of time, not to exceed 1 year, and shall not be

17  renewable. A temporary permit shall automatically expire if an

18  applicant fails the examination.

19         (b)  An applicant for licensure by examination who is

20  practicing under a temporary permit shall do so only under the

21  direct supervision of a licensed physical therapist.

22         Section 98.  Section 486.107, Florida Statutes, is

23  amended to read:

24         486.107  Physical therapist assistant; issuance of

25  license without examination to person licensed in another

26  jurisdiction; temporary permit; fee.--

27         (1)  The board may cause a license to be issued through

28  the department without examination to any applicant who

29  presents evidence to the board, under oath, of licensure in

30  another state, the District of Columbia, or a territory, if

31  the standards for registering as a physical therapist


                                 142

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  assistant or licensing of a physical therapist assistant, as

  2  the case may be, in such other state are determined by the

  3  board to be as high as those of this state, as established by

  4  rules adopted pursuant to this chapter. Any person who holds a

  5  license pursuant to this section may use the words "physical

  6  therapist assistant," or the letters "P.T.A.," in connection

  7  with her or his name to denote licensure hereunder.

  8         (2)  At the time of making application for licensing

  9  without examination pursuant to the terms of this section, the

10  applicant shall pay to the department a fee not to exceed $175

11  as fixed by the board, no part of which will be returned.

12         (3)  If a person desires to work as a physical

13  therapist assistant before being licensed through endorsement,

14  she or he shall apply for a temporary permit in accordance

15  with rules adopted pursuant to this chapter.  A temporary

16  permit shall only be issued for a limited period of time, not

17  to exceed 1 year, and shall not be renewable.

18         Section 99.  Paragraph (b) of subsection (1) of section

19  490.005, Florida Statutes, 1998 Supplement, is amended to

20  read:

21         490.005  Licensure by examination.--

22         (1)  Any person desiring to be licensed as a

23  psychologist shall apply to the department to take the

24  licensure examination. The department shall license each

25  applicant who the board certifies has:

26         (b)  Submitted proof satisfactory to the board that the

27  applicant has:

28         1.  Received doctoral-level psychological education, as

29  defined in s. 490.003(3);

30         2.  Received the equivalent of a doctoral-level

31  psychological education, as defined in s. 490.003(3), from a


                                 143

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  program at a school or university located outside the United

  2  States of America and Canada, which was officially recognized

  3  by the government of the country in which it is located as an

  4  institution or program to train students to practice

  5  professional psychology.  The burden of establishing that the

  6  requirements of this provision have been met shall be upon the

  7  applicant;

  8         3.  Received and submitted to the board, prior to July

  9  1, 1999, certification of an augmented doctoral-level

10  psychological education from the program director of a

11  doctoral-level psychology program accredited by a programmatic

12  agency recognized and approved by the United States Department

13  of Education; or

14         4.  Received and submitted to the board, prior to

15  August 31, 2001 July 1, 2001, certification of a

16  doctoral-level program that at the time the applicant was

17  enrolled and graduated maintained a standard of education and

18  training comparable to the standard of training of programs

19  accredited by a programmatic agency recognized and approved by

20  the United States Department of Education, as such

21  comparability was determined by the Board of Psychological

22  Examiners immediately prior to the amendment of s. 490.005,

23  Florida Statutes, 1994 Supplement, by s. 5, chapter 95-279,

24  Laws of Florida. Such certification of comparability shall be

25  provided by the program director of a doctoral-level

26  psychology program accredited by a programmatic agency

27  recognized and approved by the United States Department of

28  Education.

29         Section 100.  Subsection (1) of section 490.006,

30  Florida Statutes, is amended to read:

31         490.006  Licensure by endorsement.--


                                 144

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (1)  The department shall license a person as a

  2  psychologist or school psychologist who, upon applying to the

  3  department and remitting the appropriate fee, demonstrates to

  4  the department or, in the case of psychologists, to the board

  5  that the applicant:

  6         (a)  Holds a valid license or certificate in another

  7  state to practice psychology or school psychology, as

  8  applicable, provided that, when the applicant secured such

  9  license or certificate, the requirements were substantially

10  equivalent to or more stringent than those set forth in this

11  chapter at that time; and, if no Florida law existed at that

12  time, then the requirements in the other state must have been

13  substantially equivalent to or more stringent than those set

14  forth in this chapter at the present time; or

15         (b)  Is a diplomate in good standing with the American

16  Board of Professional Psychology, Inc.; or

17         (c)  Possesses a doctoral degree in psychology as

18  described in s. 490.003 and has at least 20 years of

19  experience as a licensed psychologist in any jurisdiction or

20  territory of the United States within 25 years preceding the

21  date of application.

22         Section 101.  Subsection (2) of section 490.0085,

23  Florida Statutes, is amended to read:

24         490.0085  Continuing education; approval of providers,

25  programs, and courses; proof of completion.--

26         (2)  The department or, in the case of psychologists,

27  the board has the authority to set a fee not to exceed $500

28  for each applicant who applies for or renews provider status.

29  Such fees shall be deposited into the Medical Quality

30  Assurance Health Care Trust Fund.

31


                                 145

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         Section 102.  Section 490.0148, Florida Statutes, is

  2  amended to read:

  3         490.0148  Psychologist and school psychologist

  4  records.--Each psychologist and school psychologist who

  5  provides services as defined in this chapter shall maintain

  6  records.  The board or, in the case of a school psychologist,

  7  the department may adopt rules defining the minimum

  8  requirements for such records, including content, length of

  9  time such records shall be maintained, and transfer of such

10  records or of a summary of such records, or both, to a

11  subsequent treating practitioner or other individual with the

12  written consent of the client or clients. A patient's

13  psychological report may be released to an employer or

14  carrier, or the attorney for either, pursuant to s. 440.13.

15         Section 103.  Section 491.0045, Florida Statutes, is

16  amended to read:

17         491.0045  Intern registration; requirements.--

18         (1)  Effective January 1, 1998, an individual who

19  intends to practice in Florida to satisfy the postgraduate or

20  post-master's level experience requirements, as specified in

21  s. 491.005(1)(c), (3)(c), or (4)(c), must register as an

22  intern in the profession for which he or she is seeking

23  licensure prior to commencing the post-master's experience

24  requirement or an individual who intends to satisfy part of

25  the required graduate-level practicum, internship, or field

26  experience, outside the academic arena for any profession,

27  must register as an intern in the profession for which he or

28  she is seeking licensure prior to commencing the practicum,

29  internship, or field experience.

30         (2)  The department shall register as a clinical social

31  worker intern, marriage and family therapist intern, or mental


                                 146

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  health counselor intern each applicant who the board certifies

  2  has:

  3         (a)  Completed the application form and remitted a

  4  nonrefundable application fee not to exceed $200, as set by

  5  board rule;

  6         (b)1.  Completed the education requirements as

  7  specified in s. 491.005(1)(c), (3)(c), or (4)(c) for the

  8  profession for which he or she is applying for licensure, if

  9  needed; and

10         2.  Submitted an acceptable supervision plan, as

11  determined by the board, for meeting the practicum,

12  internship, or field work required for licensure that was not

13  satisfied in his or her graduate program.

14         (c)  Identified a qualified supervisor.

15         (3)  An individual registered under this section must

16  remain under supervision until he or she is in receipt of a

17  license or a letter from the department stating that he or she

18  is licensed to practice the profession for which he or she

19  applied.

20         (4)  An individual who has applied for intern

21  registration on or before December 31, 2001, and has satisfied

22  the education requirements of s. 491.005 that are in effect

23  through December 31, 2000, will have met the educational

24  requirements for licensure for the profession for which he or

25  she has applied.

26         (5)  Individuals who have commenced the experience

27  requirement as specified in s. 491.005(1)(c), (3)(c), or

28  (4)(c) but failed to register as required by subsection (1)

29  shall register with the department before January 1, 2000.

30  Individuals who fail to comply with this subsection shall not

31  be granted a license, and any time spent by the individual


                                 147

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  completing the experience requirement prior to registering as

  2  an intern shall not count toward completion of such

  3  requirement.

  4         Section 104.  Subsections (1) and (2) of section

  5  491.0046, Florida Statutes, are amended to read:

  6         491.0046  Provisional license; requirements.--

  7         (1)  An individual applying for licensure by

  8  examination who has satisfied the clinical experience

  9  requirements of s. 491.005 or an individual applying for

10  licensure by endorsement pursuant to s. 491.006 intending to

11  provide clinical social work, marriage and family therapy, or

12  mental health counseling services in Florida while satisfying

13  coursework or examination requirements for licensure must be

14  provisionally licensed in the profession for which he or she

15  is seeking licensure prior to beginning practice.

16         (2)  The department shall issue a provisional clinical

17  social worker license, provisional marriage and family

18  therapist license, or provisional mental health counselor

19  license to each applicant who the board certifies has:

20         (a)  Completed the application form and remitted a

21  nonrefundable application fee not to exceed $100, as set by

22  board rule; and

23         (b)1.  Earned a graduate degree in social work, a

24  graduate degree with a major emphasis in marriage and family

25  therapy or a closely related field, or a graduate degree in a

26  major related to the practice of mental health counseling;

27  and, and satisfied the clinical experience requirements for

28  licensure pursuant to s. 491.005; or

29         2.  Been approved for examination under the provisions

30  for licensure by endorsement pursuant to s. 491.006.

31


                                 148

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (c)  Has met the following minimum coursework

  2  requirements:

  3         1.  For clinical social work, a minimum of 15 semester

  4  hours or 22 quarter hours of the coursework required by s.

  5  491.005(1)(b)2.b.

  6         2.  For marriage and family therapy, ten of the courses

  7  required by s. 491.005(3)(b)1.a.-c., as determined by the

  8  board, and at least 6 semester hours or 9 quarter hours of the

  9  course credits must have been completed in the area of

10  marriage and family systems, theories, or techniques.

11         3.  For mental health counseling, a minimum of seven of

12  the courses required under s. 491.005(b)1.a.-c.

13         Section 105.  Section 491.005, Florida Statutes, is

14  amended to read:

15         491.005  Licensure by examination.--

16         (1)  CLINICAL SOCIAL WORK.--Upon verification of

17  documentation and payment of a fee not to exceed $200, as set

18  by board rule, plus the actual per applicant cost to the

19  department for purchase of the examination from the American

20  Association of State Social Worker's Boards or a similar

21  national organization, the department shall issue a license as

22  a clinical social worker to an applicant who the board

23  certifies:

24         (a)  Has made application therefor and paid the

25  appropriate fee.

26         (b)1.  Has received a doctoral degree in social work

27  from a graduate school of social work which at the time the

28  applicant graduated was accredited by an accrediting agency

29  recognized by the United States Department of Education or has

30  received a master's degree in social work from a graduate

31


                                 149

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  school of social work which at the time the applicant

  2  graduated:

  3         a.  Was accredited by the Council on Social Work

  4  Education;

  5         b.  Was accredited by the Canadian Association of

  6  Schools of Social Work; or

  7         c.  Has been determined to have been a program

  8  equivalent to programs approved by the Council on Social Work

  9  Education by the Foreign Equivalency Determination Service of

10  the Council on Social Work Education.  An applicant who

11  graduated from a program at a university or college outside of

12  the United States or Canada must present documentation of the

13  equivalency determination from the council in order to

14  qualify.

15         2.  The applicant's graduate program must have

16  emphasized direct clinical patient or client health care

17  services, including, but not limited to, coursework in

18  clinical social work, psychiatric social work, medical social

19  work, social casework, psychotherapy, or group therapy.  The

20  applicant's graduate program must have included all of the

21  following coursework:

22         a.  A supervised field placement which was part of the

23  applicant's advanced concentration in direct practice, during

24  which the applicant provided clinical services directly to

25  clients.

26         b.  Completion of 24 semester hours or 32 37 quarter

27  hours in theory of human behavior and practice methods as

28  courses in clinically oriented services, including a minimum

29  of one course in psychopathology, and no more than one course

30  in research, taken in a school of social work accredited or

31  approved pursuant to subparagraph 1.


                                 150

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         3.  If the course title which appears on the

  2  applicant's transcript does not clearly identify the content

  3  of the coursework, the applicant shall be required to provide

  4  additional documentation, including, but not limited to, a

  5  syllabus or catalog description published for the course.

  6         (c)  Has had not less than 2 years of clinical social

  7  work experience, which took place subsequent to completion of

  8  a graduate degree in social work at an institution meeting the

  9  accreditation requirements of this section, under the

10  supervision of a licensed clinical social worker or the

11  equivalent who is a qualified supervisor as determined by the

12  board. An individual who intends to practice in Florida to

13  satisfy clinical experience requirements must register

14  pursuant to s. 491.0045 prior to commencing practice.  If the

15  applicant's graduate program was not a program which

16  emphasized direct clinical patient or client health care

17  services as described in subparagraph (b)2. s. 491.003, the

18  supervised experience requirement must take place after the

19  applicant has completed a minimum of 15 semester hours or 22

20  quarter hours of the coursework required.  A doctoral

21  internship may be applied toward the clinical social work

22  experience requirement. The experience requirement may be met

23  by work performed on or off the premises of the supervising

24  clinical social worker or the equivalent, provided the

25  off-premises work is not the independent private practice

26  rendering of clinical social work that does not have a

27  licensed mental health professional, as determined by the

28  board, on the premises at the same time the intern is

29  providing services.

30         (d)  Has passed a theory and practice examination

31  provided by the department for this purpose.


                                 151

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second 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         (2)  CLINICAL SOCIAL WORK.--

  6         (a)  Notwithstanding the provisions of paragraph

  7  (1)(b), coursework which was taken at a baccalaureate level

  8  shall not be considered toward completion of education

  9  requirements for licensure unless an official of the graduate

10  program certifies in writing on the graduate school's

11  stationery that a specific course, which students enrolled in

12  the same graduate program were ordinarily required to complete

13  at the graduate level, was waived or exempted based on

14  completion of a similar course at the baccalaureate level.  If

15  this condition is met, the board shall apply the baccalaureate

16  course named toward the education requirements.

17         (b)  An applicant from a master's or doctoral program

18  in social work which did not emphasize direct patient or

19  client services may complete the clinical curriculum content

20  requirement by returning to a graduate program accredited by

21  the Council on Social Work Education or the Canadian

22  Association of Schools of Social Work, or to a clinical social

23  work graduate program with comparable standards, in order to

24  complete the education requirements for examination.  However,

25  a maximum of 6 semester or 9 quarter hours of the clinical

26  curriculum content requirement may be completed by credit

27  awarded for independent study coursework as defined by board

28  rule.

29         (3)  MARRIAGE AND FAMILY THERAPY.-- Upon verification

30  of documentation and payment of a fee not to exceed $200, as

31  set by board rule, plus the actual cost to the department for


                                 152

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  the purchase of the examination from the Association of

  2  Marital and Family Therapy Regulatory Board, or similar

  3  national organization, the department shall issue a license as

  4  a marriage and family therapist to an applicant who the board

  5  certifies:

  6         (a)  Has made application therefor and paid the

  7  appropriate fee.

  8         (b)1.  Has a minimum of a master's degree with major

  9  emphasis in marriage and family therapy, or a closely related

10  field, and has completed all of the following requirements:

11         a.  Twenty-seven semester hours or 41 quarter hours of

12  graduate coursework, which must include a minimum of 2

13  semester hours or 3 quarter hours of graduate-level course

14  credits in each of the following nine areas: dynamics of

15  marriage and family systems; marriage therapy and counseling

16  theory and techniques; family therapy and counseling theory

17  and techniques; individual human development theories

18  throughout the life cycle; personality theory;

19  psychopathology; human sexuality theory and counseling

20  techniques; general counseling theory and techniques; and

21  psychosocial theory. Content may be combined, provided no more

22  than two of the nine content areas are included in any one

23  graduate-level course and the applicant can document that the

24  equivalent of 2 semester hours of coursework was devoted to

25  each content area. Courses in research, evaluation, appraisal,

26  assessment, or testing theories and procedures; thesis or

27  dissertation work; or practicums, internships, or fieldwork

28  may not be applied toward this requirement.

29         b.  A minimum of one graduate-level course of 2

30  semester hours or 3 quarter hours in legal, ethical, and

31  professional standards issues in the practice of marriage and


                                 153

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  family therapy or a course determined by the board to be

  2  equivalent.

  3         c.  A minimum of one graduate-level course of 2

  4  semester hours or 3 quarter hours in diagnosis, appraisal,

  5  assessment, and testing for individual or interpersonal

  6  disorder or dysfunction; and a minimum of one 2-semester-hour

  7  or 3-quarter-hour graduate-level course in behavioral research

  8  which focuses on the interpretation and application of

  9  research data as it applies to clinical practice.  Credit for

10  thesis or dissertation work, practicums, internships, or

11  fieldwork may not be applied toward this requirement.

12         d.  A minimum of one supervised clinical practicum,

13  internship, or field experience in a marriage and family

14  counseling setting, during which the student provided 180

15  direct client contact hours of marriage and family therapy

16  services under the supervision of an individual who met the

17  requirements for supervision under paragraph (c).  This

18  requirement may be met by a supervised practice experience

19  which took place outside the academic arena, but which is

20  certified as equivalent to a graduate-level practicum or

21  internship program which required a minimum of 180 direct

22  client contact hours of marriage and family therapy services

23  currently offered within an academic program of a college or

24  university accredited by an accrediting agency approved by the

25  United States Department of Education, or an institution which

26  is publicly recognized as a member in good standing with the

27  Association of Universities and Colleges of Canada or a

28  training institution accredited by the Commission on

29  Accreditation for Marriage and Family Therapy Education

30  recognized by the United States Department of Education.

31


                                 154

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  Certification shall be required from an official of such

  2  college, university, or training institution.

  3         2.  If the course title which appears on the

  4  applicant's transcript does not clearly identify the content

  5  of the coursework, the applicant shall be required to provide

  6  additional documentation, including, but not limited to, a

  7  syllabus or catalog description published for the course.

  8

  9  The required master's degree must have been received in an

10  institution of higher education which at the time the

11  applicant graduated was:  fully accredited by a regional

12  accrediting body recognized by the Commission on Recognition

13  of Postsecondary Accreditation; publicly recognized as a

14  member in good standing with the Association of Universities

15  and Colleges of Canada; or an institution of higher education

16  located outside the United States and Canada, which at the

17  time the applicant was enrolled and at the time the applicant

18  graduated maintained a standard of training substantially

19  equivalent to the standards of training of those institutions

20  in the United States which are accredited by a regional

21  accrediting body recognized by the Commission on Recognition

22  of Postsecondary Accreditation.  Such foreign education and

23  training must have been received in an institution or program

24  of higher education officially recognized by the government of

25  the country in which it is located as an institution or

26  program to train students to practice as professional marriage

27  and family therapists or psychotherapists.  The burden of

28  establishing that the requirements of this provision have been

29  met shall be upon the applicant, and the board shall require

30  documentation, such as, but not limited to, an evaluation by a

31  foreign equivalency determination service, as evidence that


                                 155

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  the applicant's graduate degree program and education were

  2  equivalent to an accredited program in this country.  An

  3  applicant with a master's degree from a program which did not

  4  emphasize marriage and family therapy may complete the

  5  coursework requirement in a training institution fully

  6  accredited by the Commission on Accreditation for Marriage and

  7  Family Therapy Education recognized by the United States

  8  Department of Education.

  9         (c)  Has had not less than 2 years of clinical

10  experience during which 50 percent of the applicant's clients

11  were receiving marriage and family therapy services, which

12  must be at the post-master's level under the supervision of a

13  licensed marriage and family therapist with at least 5 years

14  of experience, or the equivalent, who is a qualified

15  supervisor as determined by the board.  An individual who

16  intends to practice in Florida to satisfy the clinical

17  experience requirements must register pursuant to s. 491.0045

18  prior to commencing practice.  If a graduate has a master's

19  degree with a major emphasis in marriage and family therapy or

20  a closely related field that did not include all the

21  coursework required under sub-subparagraphs (b)1.a.-c., credit

22  for the post-master's level clinical experience shall not

23  commence until the applicant has completed a minimum of 10 of

24  the courses required under sub-subparagraphs (b)1.a.-c., as

25  determined by the board, and at least 6 semester hours or 9

26  quarter hours of the course credits must have been completed

27  in the area of marriage and family systems, theories, or

28  techniques. Within the 3 years of required experience, the

29  applicant shall provide direct individual, group, or family

30  therapy and counseling, to include the following categories of

31  cases:  unmarried dyads, married couples, separating and


                                 156

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  divorcing couples, and family groups including children.  A

  2  doctoral internship may be applied toward the clinical

  3  experience requirement.  The clinical experience requirement

  4  may be met by work performed on or off the premises of the

  5  supervising marriage and family therapist or the equivalent,

  6  provided the off-premises work is not the independent private

  7  practice rendering of marriage and family therapy services

  8  that does not have a licensed mental health professional, as

  9  determined by the board, on the premises at the same time the

10  intern is providing services.

11         (d)  Has passed a theory and practice examination

12  provided by the department for this purpose.

13         (e)  Has demonstrated, in a manner designated by rule

14  of the board, knowledge of the laws and rules governing the

15  practice of clinical social work, marriage and family therapy,

16  and mental health counseling.

17         (f)  For the purposes of dual licensure, the department

18  shall license as a marriage and family therapist any person

19  who meets the requirements of s. 491.0057. Fees for dual

20  licensure shall not exceed those stated in this subsection.

21         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

22  documentation and payment of a fee not to exceed $200, as set

23  by board rule, plus the actual per applicant cost to the

24  department for purchase of the examination from the

25  Professional Examination Service for the National Academy of

26  Certified Clinical Mental Health Counselors or a similar

27  national organization, the department shall issue a license as

28  a mental health counselor to an applicant who the board

29  certifies:

30         (a)  Has made application therefor and paid the

31  appropriate fee.


                                 157

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (b)1.  Has received a minimum of an earned master's

  2  degree with a major related to the practice of mental health

  3  counseling, and has completed all of the following

  4  requirements:

  5         a.  Twenty-one semester hours or 32 quarter hours of

  6  graduate coursework, which must include a minimum of 2

  7  semester hours or 3 quarter hours of graduate-level coursework

  8  in each of the following seven content areas:  counseling

  9  theories and practice; human development theories; personality

10  theory; psychopathology or abnormal psychology; human

11  sexuality theories; group theories and practice; and

12  individual evaluation and assessment.  Content may be

13  combined, provided no more than two of the seven content areas

14  are included in any one graduate-level course and the

15  applicant can document that the equivalent of 2 semester hours

16  of content was devoted to each content area.  Courses in

17  research, thesis or dissertation work, practicums,

18  internships, or fieldwork may not be applied toward this

19  requirement.

20         b.  A minimum of one 2-semester-hour or 3-quarter-hour

21  graduate-level course in research or in career or vocational

22  counseling. Credit for thesis or dissertation work,

23  practicums, internships, or fieldwork may not be applied

24  toward this requirement.

25         c.  A minimum of 2 semester hours or 3 quarter hours of

26  graduate-level coursework in legal, ethical, and professional

27  standards issues in the practice of mental health counseling,

28  which includes goals and objectives of professional counseling

29  organizations, codes of ethics, legal considerations,

30  standards of preparation, certifications and licensing, and

31  the role identity of counselors.  Courses in research, thesis


                                 158

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  or dissertation work, practicums, internships, or fieldwork

  2  may not be applied toward this requirement.

  3         d.  A minimum of one supervised practicum, internship,

  4  or field experience in a counseling setting.  This requirement

  5  may be met by a supervised practice experience which takes

  6  place outside the academic arena, but which is certified as

  7  equivalent to a graduate-level practicum in a clinical mental

  8  health counseling setting currently offered within an academic

  9  program of a college or university accredited by an

10  accrediting agency approved by the United States Department of

11  Education. Such certification shall be required from an

12  official of such college or university.

13         2.  If the course title which appears on the

14  applicant's transcript does not clearly identify the content

15  of the coursework, the applicant shall be required to provide

16  additional documentation, including, but not limited to, a

17  syllabus or catalog description published for the course.

18

19  Except as provided in sub-subparagraph 1.d., education and

20  training in mental health counseling must have been received

21  in an institution of higher education which at the time the

22  applicant graduated was:  fully accredited by a regional

23  accrediting body recognized by the Commission on Recognition

24  of Postsecondary Accreditation; publicly recognized as a

25  member in good standing with the Association of Universities

26  and Colleges of Canada; or an institution of higher education

27  located outside the United States and Canada, which at the

28  time the applicant was enrolled and at the time the applicant

29  graduated maintained a standard of training substantially

30  equivalent to the standards of training of those institutions

31  in the United States which are accredited by a regional


                                 159

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  accrediting body recognized by the Commission on Recognition

  2  of Postsecondary Accreditation. Such foreign education and

  3  training must have been received in an institution or program

  4  of higher education officially recognized by the government of

  5  the country in which it is located as an institution or

  6  program to train students to practice as mental health

  7  counselors.  The burden of establishing that the requirements

  8  of this provision have been met shall be upon the applicant,

  9  and the board shall require documentation, such as, but not

10  limited to, an evaluation by a foreign equivalency

11  determination service, as evidence that the applicant's

12  graduate degree program and education were equivalent to an

13  accredited program in this country.

14         (c)  Has had not less than 2 years of clinical

15  experience in mental health counseling, which must be at the

16  post-master's level under the supervision of a licensed mental

17  health counselor or the equivalent who is a qualified

18  supervisor as determined by the board.  An individual who

19  intends to practice in Florida to satisfy the clinical

20  experience requirements must register pursuant to s. 491.0045

21  prior to commencing practice.  If a graduate has a master's

22  degree with a major related to the practice of mental health

23  counseling which did not include all the coursework required

24  under sub-subparagraphs (b)1.a.-c., credit for the

25  post-master's level clinical experience shall not commence

26  until the applicant has completed a minimum of seven of the

27  courses required under sub-subparagraphs (b)1.a.-c., as

28  determined by the board, one of which must be a course in

29  psychopathology or abnormal psychology. A doctoral internship

30  may be applied toward the clinical experience requirement. The

31  clinical experience requirement may be met by work performed


                                 160

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  on or off the premises of the supervising mental health

  2  counselor or the equivalent, provided the off-premises work is

  3  not the independent private practice rendering of services

  4  that does not have a licensed mental health professional, as

  5  determined by the board, on the premises at the same time the

  6  intern is providing services.

  7         (d)  Has passed a theory and practice examination

  8  provided by the department for this purpose.

  9         (e)  Has demonstrated, in a manner designated by rule

10  of the board, knowledge of the laws and rules governing the

11  practice of clinical social work, marriage and family therapy,

12  and mental health counseling.

13         (5)  INTERNSHIP.--An individual who is registered as an

14  intern and has satisfied all of the educational requirements

15  for the profession for which the applicant seeks licensure

16  shall be certified as having met the educational requirements

17  for licensure under this section.

18         (6)  RULES.--The board may adopt rules necessary to

19  implement any education or experience requirement of this

20  section for licensure as a clinical social worker, marriage

21  and family therapist, or mental health counselor.

22         Section 106.  Effective January 1, 2001, paragraph (b)

23  of subsection (4) of section 491.005, Florida Statutes, as

24  amended by section 13 of chapter 97-198 and section 205 of

25  chapter 97-264, Laws of Florida, and as amended by this act,

26  is amended, and subsection (6) of that section, as created by

27  this act, is reenacted, to read:

28         491.005  Licensure by examination.--

29         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

30  documentation and payment of a fee not to exceed $200, as set

31  by board rule, plus the actual per applicant cost to the


                                 161

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  department for purchase of the examination from the

  2  Professional Examination Service for the National Academy of

  3  Certified Clinical Mental Health Counselors or a similar

  4  national organization, the department shall issue a license as

  5  a mental health counselor to an applicant who the board

  6  certifies:

  7         (b)1.  Has a minimum of an earned master's degree from

  8  a mental health counseling program accredited by the Council

  9  for the Accreditation of Counseling and Related Educational

10  Programs that consists of at least 60 semester hours or 80

11  quarter hours of clinical and didactic instruction, including

12  a course in human sexuality and a course in substance abuse.

13  If the master's degree is earned from a program related to the

14  practice of mental health counseling that is not accredited by

15  the Council for the Accreditation of Counseling and Related

16  Educational Programs, then the coursework and practicum,

17  internship, or fieldwork must consist of at least 60 semester

18  hours or 80 quarter hours and meet the following requirements:

19         a.  Thirty-three Thirty-six semester hours or 44 48

20  quarter hours of graduate coursework, which must include a

21  minimum of 3 semester hours or 4 quarter hours of

22  graduate-level coursework in each of the following 11 12

23  content areas: counseling theories and practice; human growth

24  and development; diagnosis and treatment of psychopathology;

25  human sexuality; group theories and practice; individual

26  evaluation and assessment; career and lifestyle assessment;

27  research and program evaluation; social and cultural

28  foundations; foundations of mental health counseling;

29  counseling in community settings; and substance abuse. Courses

30  in research, thesis or dissertation work, practicums,

31


                                 162

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  internships, or fieldwork may not be applied toward this

  2  requirement.

  3         b.  A minimum of 3 semester hours or 4 quarter hours of

  4  graduate-level coursework in legal, ethical, and professional

  5  standards issues in the practice of mental health counseling,

  6  which includes goals, objectives, and practices of

  7  professional counseling organizations, codes of ethics, legal

  8  considerations, standards of preparation, certifications and

  9  licensing, and the role identity and professional obligations

10  of mental health counselors. Courses in research, thesis or

11  dissertation work, practicums, internships, or fieldwork may

12  not be applied toward this requirement.

13         c.  The equivalent, as determined by the board, of at

14  least 1,000 hours of university-sponsored supervised clinical

15  practicum, internship, or field experience as required in the

16  accrediting standards of the Council for Accreditation of

17  Counseling and Related Educational Programs for mental health

18  counseling programs. If the academic practicum, internship, or

19  field experience was less than 1,000 hours, experience gained

20  outside the academic arena in clinical mental health settings

21  under the supervision of a qualified supervisor as determined

22  by the board may be applied. This experience may not be used

23  to satisfy the post-master's clinical experience requirement.

24         2.  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

30  Education and training in mental health counseling must have

31  been received in an institution of higher education which at


                                 163

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  the time the applicant graduated was: fully accredited by a

  2  regional accrediting body recognized by the Commission on

  3  Recognition of Postsecondary Accreditation; publicly

  4  recognized as a member in good standing with the Association

  5  of Universities and Colleges of Canada; or an institution of

  6  higher education located outside the United States and Canada,

  7  which at the time the applicant was enrolled and at the time

  8  the applicant graduated maintained a standard of training

  9  substantially equivalent to the standards of training of those

10  institutions in the United States which are accredited by a

11  regional accrediting body recognized by the Commission on

12  Recognition of Postsecondary Accreditation. Such foreign

13  education and training must have been received in an

14  institution or program of higher education officially

15  recognized by the government of the country in which it is

16  located as an institution or program to train students to

17  practice as mental health counselors. The burden of

18  establishing that the requirements of this provision have been

19  met shall be upon the applicant, and the board shall require

20  documentation, such as, but not limited to, an evaluation by a

21  foreign equivalency determination service, as evidence that

22  the applicant's graduate degree program and education were

23  equivalent to an accredited program in this country.

24         (6)  RULES.--The board may adopt rules necessary to

25  implement any education or experience requirement of this

26  section for licensure as a clinical social worker, marriage

27  and family therapist, or mental health counselor.

28         Section 107.  Paragraph (b) of subsection (1) of

29  section 491.006, Florida Statutes, is amended to read:

30         491.006  Licensure or certification by endorsement.--

31


                                 164

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (1)  The department shall license or grant a

  2  certificate to a person in a profession regulated by this

  3  chapter who, upon applying to the department and remitting the

  4  appropriate fee, demonstrates to the board that he or she:

  5         (b)1.  Holds an active valid license to practice and

  6  has actively practiced the profession for which licensure is

  7  applied in another state for 3 of the last 5 years immediately

  8  preceding licensure.

  9         2.  Meets the education requirements of this chapter

10  for the profession for which licensure is applied.

11         3.  Has passed a substantially equivalent licensing

12  examination in another state or has passed the licensure

13  examination in this state in the profession for which the

14  applicant seeks licensure.

15         4.  Holds a license in good standing, is not under

16  investigation for an act which would constitute a violation of

17  this chapter, and has not been found to have committed any act

18  which would constitute a violation of this chapter.

19         Section 108.  Section 491.0085, Florida Statutes, is

20  amended to read:

21         491.0085  Continuing education and laws and rules

22  courses; approval of providers, programs, and courses; proof

23  of completion.--

24         (1)  Continuing education providers, programs, and

25  courses and laws and rules courses and their providers and

26  programs shall be approved by the department or the board.

27         (2)  The department or the board has the authority to

28  set a fee not to exceed $200 for each applicant who applies

29  for or renews provider status.  Such fees shall be deposited

30  into the Medical Quality Assurance Health Care Trust Fund.

31


                                 165

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (3)  Proof of completion of the required number of

  2  hours of continuing education and completion of the laws and

  3  rules course shall be submitted to the department or the board

  4  in the manner and time specified by rule and on forms provided

  5  by the department or the board.

  6         (4)  The department or the board shall adopt rules and

  7  guidelines to administer and enforce the provisions of this

  8  section.

  9         Section 109.  Paragraph (d) of subsection (4) of

10  section 491.014, Florida Statutes, 1998 Supplement, is amended

11  to read:

12         491.014  Exemptions.--

13         (4)  No person shall be required to be licensed,

14  provisionally licensed, registered, or certified under this

15  chapter who:

16         (d)  Is not a resident of this state but offers

17  services in this state, provided:

18         1.  Such services are performed for no more than 5 days

19  in any month and no more than 15 days in any calendar year;

20  and

21         2.  Such nonresident is licensed or certified to

22  practice the services provided by a state or territory of the

23  United States or by a foreign country or province.

24         Section 110.  Paragraph (a) of subsection (1) and

25  subsection (5) of section 499.012, Florida Statutes, 1998

26  Supplement, are amended to read:

27         499.012  Wholesale distribution; definitions; permits;

28  general requirements.--

29         (1)  As used in this section, the term:

30

31


                                 166

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (a)  "Wholesale distribution" means distribution of

  2  prescription drugs to persons other than a consumer or

  3  patient, but does not include:

  4         1.  Any of the following activities, which is not a

  5  violation of s. 499.005(21) if such activity is conducted in

  6  accordance with s. 499.014:

  7         a.  The purchase or other acquisition by a hospital or

  8  other health care entity that is a member of a group

  9  purchasing organization of a prescription drug for its own use

10  from the group purchasing organization or from other hospitals

11  or health care entities that are members of that organization.

12         b.  The sale, purchase, or trade of a prescription drug

13  or an offer to sell, purchase, or trade a prescription drug by

14  a charitable organization described in s. 501(c)(3) of the

15  Internal Revenue Code of 1986, as amended and revised, to a

16  nonprofit affiliate of the organization to the extent

17  otherwise permitted by law.

18         c.  The sale, purchase, or trade of a prescription drug

19  or an offer to sell, purchase, or trade a prescription drug

20  among hospitals or other health care entities that are under

21  common control. For purposes of this section, "common control"

22  means the power to direct or cause the direction of the

23  management and policies of a person or an organization,

24  whether by ownership of stock, by voting rights, by contract,

25  or otherwise.

26         d.  The sale, purchase, trade, or other transfer of a

27  prescription drug from or for any federal, state, or local

28  government agency or any entity eligible to purchase

29  prescription drugs at public health services prices pursuant

30  to s. 602 of Pub. L. No. 102-585 to a contract provider or its

31


                                 167

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  subcontractor for eligible patients of the agency or entity

  2  under the following conditions:

  3         (I)  The agency or entity must obtain written

  4  authorization for the sale, purchase, trade, or other transfer

  5  of a prescription drug under this sub-subparagraph from the

  6  Secretary of Health or his or her designee.

  7         (II)  The contract provider or subcontractor must be

  8  authorized by law to administer or dispense prescription

  9  drugs.

10         (III)  In the case of a subcontractor, the agency or

11  entity must be a party to and execute the subcontract.

12         (IV)  A contract provider or subcontractor must

13  maintain separate and apart from other prescription drug

14  inventory any prescription drugs of the agency or entity in

15  its possession.

16         (V)  The contract provider and subcontractor must

17  maintain and produce immediately for inspection all records of

18  movement or transfer of all the prescription drugs belonging

19  to the agency or entity, including, but not limited to, the

20  records of receipt and disposition of prescription drugs.

21  Each contractor and subcontractor dispensing or administering

22  these drugs must maintain and produce records documenting the

23  dispensing or administration.  Records that are required to be

24  maintained include, but are not limited to, a perpetual

25  inventory itemizing drugs received and drugs dispensed by

26  prescription number or administered by patient identifier,

27  which must be submitted to the agency or entity quarterly.

28         (VI)  The contract provider or subcontractor may

29  administer or dispense the prescription drugs only to the

30  eligible patients of the agency or entity or must return the

31  prescription drugs for or to the agency or entity.  The


                                 168

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  contract provider or subcontractor must require proof from

  2  each person seeking to fill a prescription or obtain treatment

  3  that the person is an eligible patient of the agency or entity

  4  and must, at a minimum, maintain a copy of this proof as part

  5  of the records of the contractor or subcontractor required

  6  under sub-sub-subparagraph (V).

  7         (VII)  The prescription drugs transferred pursuant to

  8  this sub-subparagraph may not be billed to Medicaid.

  9         (VIII)  In addition to the departmental inspection

10  authority set forth in s. 499.051, the establishment of the

11  contract provider and subcontractor and all records pertaining

12  to prescription drugs subject to this sub-subparagraph shall

13  be subject to inspection by the agency or entity.  All records

14  relating to prescription drugs of a manufacturer under this

15  sub-subparagraph shall be subject to audit by the manufacturer

16  of those drugs, without identifying individual patient

17  information.

18         2.  Any of the following activities, which is not a

19  violation of s. 499.005(21) if such activity is conducted in

20  accordance with rules established by the department:

21         a.  The sale, purchase, or trade of a prescription drug

22  among federal, state, or local government health care entities

23  that are under common control and are authorized to purchase

24  such prescription drug.

25         b.  The sale, purchase, or trade of a prescription drug

26  or an offer to sell, purchase, or trade a prescription drug

27  for emergency medical reasons.; For purposes of this

28  sub-subparagraph subparagraph, the term "emergency medical

29  reasons" includes transfers of prescription drugs by a retail

30  pharmacy to another retail pharmacy to alleviate a temporary

31  shortage.


                                 169

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         c.  The transfer purchase or acquisition of a

  2  prescription drug acquired by a medical director on behalf of

  3  a licensed an emergency medical services provider to that

  4  medical director for use by emergency medical services

  5  provider and its transport vehicles for use in accordance with

  6  the provider's license under providers acting within the scope

  7  of their professional practice pursuant to chapter 401.

  8         d.  The revocation of a sale or the return of a

  9  prescription drug to the person's prescription drug wholesale

10  supplier.

11         e.  The donation of a prescription drug by a health

12  care entity to a charitable organization that has been granted

13  an exemption under s. 501(c)(3) of the Internal Revenue Code

14  of 1986, as amended, and that is authorized to possess

15  prescription drugs.

16         f.  The transfer of a prescription drug by a person

17  authorized to purchase or receive prescription drugs to a

18  person licensed or permitted to handle reverse distributions

19  or destruction under the laws of the jurisdiction in which the

20  person handling the reverse distribution or destruction

21  receives the drug.

22         3.  The dispensing of a prescription drug pursuant to a

23  prescription;

24         3.4.  The distribution of prescription drug samples by

25  manufacturers' representatives or distributors'

26  representatives conducted in accordance with s. 499.028.; or

27         4.5.  The sale, purchase, or trade of blood and blood

28  components intended for transfusion.  As used in this

29  subparagraph section, the term "blood" means whole blood

30  collected from a single donor and processed either for

31  transfusion or further manufacturing, and the term "blood


                                 170

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  components" means that part of the blood separated by physical

  2  or mechanical means.

  3         5.  The lawful dispensing of a prescription drug in

  4  accordance with chapter 465.

  5         (5)  The department may adopt rules governing the

  6  recordkeeping, storage, and handling with respect to each of

  7  the distributions of prescription drugs specified in

  8  subparagraphs (1)(a)1.-4. (1)(a)1., 2., 4., and 5.

  9         Section 111.  Subsection (6) is added to section

10  626.883, Florida Statutes, to read:

11         626.883  Administrator as intermediary; collections

12  held in fiduciary capacity; establishment of account;

13  disbursement; payments on behalf of insurer.--

14         (6)  All payments to a health care provider by a fiscal

15  intermediary for noncapitated providers must include an

16  explanation of services being reimbursed which includes, at a

17  minimum, the patient's name, the date of service, the

18  procedure code, the amount of reimbursement, and the

19  identification of the plan on whose behalf the payment is

20  being made. For capitated providers, the statement of services

21  must include the number of patients covered by the contract,

22  the rate per patient, the total amount of the payment, and the

23  identification of the plan on whose behalf the payment is

24  being made.

25         Section 112.  Paragraph (a) of subsection (2) of

26  section 641.316, Florida Statutes, 1998 Supplement, is amended

27  to read:

28         641.316  Fiscal intermediary services.--

29         (2)(a)  The term "fiduciary" or "fiscal intermediary

30  services" means reimbursements received or collected on behalf

31  of health care professionals for services rendered, patient


                                 171

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  and provider accounting, financial reporting and auditing,

  2  receipts and collections management, compensation and

  3  reimbursement disbursement services, or other related

  4  fiduciary services pursuant to health care professional

  5  contracts with health maintenance organizations. All payments

  6  to a health care provider by a fiscal intermediary for

  7  noncapitated providers must include an explanation of services

  8  being reimbursed which includes, at a minimum, the patient's

  9  name, the date of service, the procedure code, the amount of

10  reimbursement, and the identification of the plan on whose

11  behalf the payment is being made. For capitated providers, the

12  statement of services must include the number of patients

13  covered by the contract, the rate per patient, the total

14  amount of the payment, and the identification of the plan on

15  whose behalf the payment is being made.

16         Section 113.  Task Force on Telehealth.--

17         (1)  Because telecommunications technology has made it

18  possible to provide a wide range of health care services

19  across state lines between healthcare practitioners and

20  patients, it is the intent of the Legislature to protect the

21  health and safety of all patients in this state receiving

22  services by means of such technology and to ensure the

23  accountability of the healthcare profession with respect to

24  unsafe and incompetent practitioners using such technology to

25  provide health care services to patients in this state.

26         (2)  The Secretary of Health shall appoint a task force

27  consisting of representatives from the affected medical and

28  allied health professions and other affected health care

29  industries.

30         (3)  The task force shall address the following:

31


                                 172

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (a)  Identification of various electronic

  2  communications or telecommunications technologies currently

  3  used within the state and by other states to provide

  4  healthcare information.

  5         (b)  Identification of laws, regulations, and

  6  reimbursement practices that serve as barriers to

  7  implementation of electronic communications related to health

  8  care.

  9         (c)  Recommendation of the appropriate level of

10  regulation of health care professionals necessary to protect

11  the health and safety of patients in this state, including

12  analysis of existing provisions governing in-state

13  professionals such as licensing, financial responsibility, and

14  medical malpractice insurance requirements.

15         (d)  Potential preemption of state regulation by the

16  Commerce Clause of the United States Constitution.

17         (e)  The effect of telehealth on access to health care

18  in rural and underserved areas.

19         (f)  Potential antitrust concerns.

20         (g)  The effect of regulations by other states or

21  jurisdictions on health care professionals in this state who

22  provide consultative services through telehealth to entities

23  and patients outside the state.

24         (h)  Research on other public and private data and

25  initiatives related to telehealth.

26         (i)  Any other issue affecting the health, safety, and

27  welfare of patients through telehealth identified by the task

28  force.

29         (4)  The task force shall submit a report of its

30  findings and recommendations by January 1, 2000, to the

31


                                 173

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  Governor, the President of the Senate, and the Speaker of the

  2  House of Representatives.

  3         Section 114.  Subsection (1) of section 468.352,

  4  Florida Statutes, is amended to read:

  5         468.352  Definitions.--As used in this part, unless the

  6  context otherwise requires, the term:

  7         (1)  "Board" means the Board of Respiratory Care

  8  Medicine.

  9         Section 115.  Section 468.353, Florida Statutes, is

10  amended to read:

11         468.353  Board of Respiratory Care Medicine; powers and

12  duties.--

13         (1)  The board, with the assistance of the Advisory

14  Council on Respiratory Care, is authorized to establish

15  minimum standards for the delivery of respiratory care

16  services and to adopt those rules necessary to administer this

17  part.

18         (2)  The board may administer oaths, summon witnesses,

19  and take testimony in all matters relating to its duties under

20  this part.

21         (3)  The board may adopt rules to administer this part,

22  including rules governing the investigation, inspection, and

23  review of schools and colleges that offer courses in

24  respiratory care in order to ascertain their compliance with

25  standards established by the board or appropriate accrediting

26  agencies delegate such powers and duties to the council as it

27  may deem proper.

28         Section 116.  Section 468.354, Florida Statutes, is

29  amended to read:

30         468.354  Board of Advisory Council on Respiratory Care;

31  organization; function.--


                                 174

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (1)  There is created within the department, the Board

  2  of Advisory Council on Respiratory Care, composed of seven

  3  members appointed by the Governor and confirmed by the Senate

  4  under the supervision of the board.

  5         (2)  The board council shall consist of five members

  6  appointed by the board and shall include:

  7         (a)  A registered respiratory therapist.

  8         (b)  A certified respiratory therapist care

  9  practitioner.

10         (c)  A respiratory care professional from each of the

11  following areas:

12         1.  Respiratory care education.

13         2.  Respiratory care management and supervision.

14         3.  Homecare/subacute Cardiopulmonary diagnostics.

15         (d)  Two consumer members, who are residents of this

16  state and have never been licensed as health care

17  practitioners.

18

19  Each member of the council shall be a respiratory care

20  professional on the board must have who has been actively

21  engaged in the delivery of respiratory care services in this

22  state for at least 4 consecutive years prior to appointment.

23         (3)(a)  Except as provided in paragraph (b), the term

24  of office for each board council member shall be 4 years.  No

25  member shall serve for more than two consecutive terms.  Any

26  time there is a vacancy to be filled on the council, all

27  professional organizations dealing with respiratory therapy

28  incorporated within the state as not for profit which register

29  their interest with the board shall recommend at least twice

30  as many persons to fill the vacancy to the council as the

31  number of vacancies to be filled, and the Governor board may


                                 175

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  appoint from the submitted list, in his its discretion, any of

  2  those persons so recommended.  The Governor board shall,

  3  insofar as possible, appoint persons from different

  4  geographical areas.

  5         (b)  In order To achieve staggering of terms, within

  6  120 days after July 1, 1999, October 1, 1984, the Governor

  7  board shall appoint the board members of the council as

  8  follows:

  9         1.  Two members One member shall be appointed for terms

10  a term of 2 years.

11         2.  Two members shall be appointed for terms of 3

12  years.

13         3.  Three Two members shall be appointed for terms of 4

14  years.

15         (c)  All provisions of part II of chapter 455, relating

16  to boards apply to this part.

17         (4)(a)  The board council shall annually elect from

18  among its members a chair and vice chair.

19         (b)  The board council shall meet at least twice a year

20  and shall hold such additional meetings as are deemed

21  necessary by the board.  Four Three members of the council

22  constitute a quorum.

23         (c)  Unless otherwise provided by law, a board council

24  member shall be compensated $50 for each day he or she attends

25  an official board meeting of the council and for each day he

26  or she participates in any other board business involving the

27  council.  A board council member shall also be entitled to

28  reimbursement for expenses pursuant to s. 112.061. Travel out

29  of the state shall require the prior approval of the secretary

30  of the department.

31


                                 176

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (5)(a)  The board may council shall recommend to the

  2  department a code of ethics for those persons licensed

  3  pursuant to this part.

  4         (b)  The council shall make recommendations to the

  5  department for the approval of continuing education courses.

  6         Section 117.  Section 468.355, Florida Statutes, is

  7  amended to read:

  8         468.355  Eligibility for licensure; temporary

  9  licensure.--

10         (1)  To be eligible for licensure by the board as a

11  respiratory care practitioner, an applicant must:

12         (a)  Be at least 18 years old.

13         (b)  Possess a high school diploma or a graduate

14  equivalency diploma.

15         (c)  Meet at least one of the following criteria:

16         1.  The applicant has successfully completed a training

17  program for respiratory therapy technicians or respiratory

18  therapists approved by the Commission on Accreditation of

19  Allied Health Education Programs, or the equivalent thereof,

20  as accepted by the board.

21         2.  The applicant is currently a "Certified Respiratory

22  Therapy Technician" certified by the National Board for

23  Respiratory Care, or the equivalent thereof, as accepted by

24  the board.

25         3.  The applicant is currently a "Registered

26  Respiratory Therapist" registered by the National Board for

27  Respiratory Care, or the equivalent thereof, as accepted by

28  the board.

29         4.  The applicant is currently employed in this state

30  as a respiratory care practitioner or respiratory therapist on

31  October 1, 1984.


                                 177

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1

  2  The criteria set forth in subparagraphs 2. and 3.

  3  notwithstanding, the board shall periodically annually review

  4  the examinations and standards of the National Board for

  5  Respiratory Care and may reject those examinations and

  6  standards if they are deemed inappropriate.

  7         (2)  To be eligible for licensure by the board as a

  8  respiratory therapist, an applicant must:

  9         (a)  Be at least 18 years old.

10         (b)  Possess a high school diploma or a graduate

11  equivalency diploma.

12         (c)  Meet at least one of the following criteria:

13         1.  The applicant has successfully completed a training

14  program for respiratory therapists approved by the Commission

15  on Accreditation of Allied Health Education Programs, or the

16  equivalent thereof, as accepted by the board.

17         2.  The applicant is currently a "Registered

18  Respiratory Therapist" registered by the National Board for

19  Respiratory Care, or the equivalent thereof, as accepted by

20  the board.

21

22  The criteria set forth in subparagraphs 1. and 2.

23  notwithstanding, the board shall periodically annually review

24  the examinations and standards of the National Board for

25  Respiratory Care and may reject those examinations and

26  standards if they are deemed inappropriate.

27         (3)  With respect to the delivery of respiratory care

28  services, the board shall establish procedures for temporary

29  licensure of eligible individuals entering the state and

30  temporary licensure of those persons who have graduated from a

31


                                 178

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  program approved by the board.  Such temporary licensure shall

  2  be for a period not to exceed 1 year.

  3         Section 118.  Section 468.357, Florida Statutes, is

  4  amended to read:

  5         468.357  Licensure by examination.--

  6         (1)  A person who desires to be licensed as a

  7  respiratory care practitioner may submit an application to the

  8  department to take the examination, in accordance with board

  9  rule to be administered by the department.

10         (a)  The department shall examine Each applicant may

11  take the examination who is determined by the board to have:

12         1.  Completed the application form and remitted the

13  applicable fee set by the board;

14         2.  Submitted required documentation as required in s.

15  468.355; and

16         3.  Remitted an examination fee set by the examination

17  provider board.

18         (b)  The department shall conduct Examinations for

19  licensure of respiratory care practitioners must be conducted

20  no less than two times a year in such geographical locations

21  or by such methods as are deemed advantageous to the majority

22  of the applicants.

23         (c)  The examination given for respiratory care

24  practitioners shall be the same as that given by the National

25  Board for Respiratory Care for entry-level certification of

26  respiratory therapy technicians.  However, an equivalent

27  examination may be accepted by the board in lieu of that

28  examination.

29         (2)  Each applicant who passes the examination shall be

30  entitled to licensure as a respiratory care practitioner, and

31  the department shall issue a license pursuant to this part to


                                 179

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  any applicant who successfully completes the examination in

  2  accordance with this section.  However, the department shall

  3  not issue a license to any applicant who is under

  4  investigation in another jurisdiction for an offense which

  5  would constitute a violation of this part.  Upon completion of

  6  such an investigation, if the applicant is found guilty of

  7  such an offense, the applicable provisions of s. 468.365 will

  8  apply.

  9         (3)  Any person who was employed in this state on or

10  before September 30, 1983, as a respiratory therapy technician

11  or respiratory therapist, and who has performed services in

12  such professional capacity for 4 years or more by October 1,

13  1987, under the supervision of a licensed physician or in a

14  hospital or licensed health care facility, shall be issued a

15  license without examination, if such person provides

16  acceptable documentation of performance of such services to

17  the board.  Such documentation shall include certification by

18  a physician licensed pursuant to chapter 458 or chapter 459

19  who has direct knowledge of the practice of, or who has

20  supervised, the person.  If such person is not determined to

21  have performed critical care respiratory services for at least

22  4 years, the board may limit the license of such person to the

23  performance of noncritical care respiratory services.

24         Section 119.  Section 468.364, Florida Statutes, 1998

25  Supplement, is amended to read:

26         468.364  Fees; establishment; disposition.--

27         (1)  The board shall establish by rule fees for the

28  following purposes:

29         (a)  Application, a fee not to exceed $50.

30         (b)  Examination, a fee not to exceed $125 plus the

31  actual per applicant cost to the department for purchase of


                                 180

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  the examination from the National Board for Respiratory Care

  2  or a similar national organization.

  3         (b)(c)  Initial licensure, a fee not to exceed $200.

  4         (c)(d)  Renewal of licensure, a fee not to exceed $200

  5  biennially.

  6         (d)(e)  Renewal of inactive licensure, a fee not to

  7  exceed $50.

  8         (e)(f)  Reactivation, a fee not to exceed $50.

  9         (2)  The fees established pursuant to subsection (1)

10  shall be based upon the actual costs incurred by the

11  department in carrying out its responsibilities under this

12  part.

13         (3)  All moneys collected by the department under this

14  part shall be deposited as required by s. 455.587.

15         Section 120.  Paragraph (f) of subsection (1) of

16  section 468.365, Florida Statutes, 1998 Supplement, is amended

17  to read:

18         468.365  Disciplinary grounds and actions.--

19         (1)  The following acts constitute grounds for which

20  the disciplinary actions in subsection (2) may be taken:

21         (f)  Unprofessional conduct, which includes, but is not

22  limited to, any departure from, or failure to conform to,

23  acceptable standards related to the delivery of respiratory

24  care services, as set forth by the board and the Advisory

25  Council on Respiratory Care in rules adopted pursuant to this

26  part.

27         Section 121.  Paragraph (a) of subsection (2) of

28  section 464.016, Florida Statutes, is amended to read:

29         464.016  Violations and penalties.--

30

31


                                 181

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (2)  Each of the following acts constitutes a

  2  misdemeanor of the first degree, punishable as provided in s.

  3  775.082 or s. 775.083:

  4         (a)  Using the name or title "Nurse," "Registered

  5  Nurse," "Licensed Practical Nurse," "Advanced Registered Nurse

  6  Practitioner," or any other name or title which implies that a

  7  person was licensed or certified as same, unless such person

  8  is duly licensed or certified.

  9         Section 122.  Paragraphs (b) and (c) of subsection (1)

10  of section 458.3115, Florida Statutes, 1998 Supplement, are

11  amended to read:

12         458.3115  Restricted license; certain foreign-licensed

13  physicians; United States Medical Licensing Examination

14  (USMLE) or agency-developed examination; restrictions on

15  practice; full licensure.--

16         (1)

17         (b)  A person who is eligible to take and elects to

18  take the USMLE who has previously passed part 1 or part 2 of

19  the previously administered FLEX shall not be required to

20  retake or pass the equivalent parts of the USMLE up to the

21  year 2002 2000.

22         (c)  A person shall be eligible to take such

23  examination for restricted licensure if the person:

24         1.  Has taken, upon approval by the board, and

25  completed, in November 1990 or November 1992, one of the

26  special preparatory medical update courses authorized by the

27  board and the University of Miami Medical School and

28  subsequently passed the final course examination; upon

29  approval by the board to take the course completed in 1990 or

30  in 1992, has a certificate of successful completion of that

31  course from the University of Miami or the Stanley H. Kaplan


                                 182

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  course; or can document to the department that he or she was

  2  one of the persons who took and successfully completed the

  3  Stanley H. Kaplan course that was approved by the Board of

  4  Medicine and supervised by the University of Miami. At a

  5  minimum, the documentation must include class attendance

  6  records and the test score on the final course examination;

  7         2.  Applies to the agency and submits an application

  8  fee that is nonrefundable and equivalent to the fee required

  9  for full licensure;

10         3.  Documents no less than 2 years of the active

11  practice of medicine in any another jurisdiction;

12         4.  Submits an examination fee that is nonrefundable

13  and equivalent to the fee required for full licensure plus the

14  actual per-applicant cost to the agency to provide either

15  examination described in this section;

16         5.  Has not committed any act or offense in this or any

17  other jurisdiction that would constitute a substantial basis

18  for disciplining a physician under this chapter or part II of

19  chapter 455; and

20         6.  Is not under discipline, investigation, or

21  prosecution in this or any other jurisdiction for an act that

22  would constitute a violation of this chapter or part II of

23  chapter 455 and that substantially threatened or threatens the

24  public health, safety, or welfare.

25         Section 123.  Subsection (2) of section 458.3124,

26  Florida Statutes, 1998 Supplement, is amended to read:

27         458.3124  Restricted license; certain experienced

28  foreign-trained physicians.--

29         (2)  A person applying for licensure under this section

30  must submit to the Department of Health on or before December

31  31, 2000 1998:


                                 183

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1         (a)  A completed application and documentation required

  2  by the Board of Medicine to prove compliance with subsection

  3  (1); and

  4         (b)  A nonrefundable application fee not to exceed $500

  5  and a nonrefundable examination fee not to exceed $300 plus

  6  the actual cost to purchase and administer the examination.

  7         Section 124.  Effective upon this act becoming a law,

  8  section 301 of chapter 98-166, Laws of Florida, is amended to

  9  read:

10         Section 301.  The sum of $1.2 million from the

11  unallocated balance in the Medical Quality Assurance Trust

12  Fund is appropriated to the Department of Health to allow the

13  department to develop the examination required for foreign

14  licensed physicians in section 458.3115(1)(a), Florida

15  Statutes, through a contract with the University of South

16  Florida. The department shall charge examinees a fee not to

17  exceed 25 percent of the cost of the actual costs of the first

18  examination administered pursuant to section 458.3115, Florida

19  Statutes, 1998 Supplement, and a fee not to exceed 75 percent

20  of the actual costs for any subsequent examination

21  administered pursuant to that section.

22         Section 125.  The Agency for Health Care

23  Administration, in conjunction with the Medicare Fraud

24  Division of the Office of the Attorney General, shall conduct

25  a detailed study and analysis of clinical laboratory services

26  for kidney dialysis patients in the State of Florida. The

27  study shall include, but not be limited to, an analysis of the

28  past and present utilization rates of clinical laboratory

29  services for dialysis patients, financial arrangements among

30  kidney dialysis centers, their medical directors, and any

31  business relationships and affiliations with clinical


                                 184

CODING: Words stricken are deletions; words underlined are additions.






                                      CS/HB 1467, Second Engrossed



  1  laboratories, any self referral to clinical laboratories, the

  2  quality and responsiveness of clinical laboratory services for

  3  dialysis patients in Florida, and the average annual revenue

  4  for dialysis patients for clinical laboratory services for the

  5  past ten years. The agency shall report back to the President

  6  of the Senate, Speaker of the House of Representatives, and

  7  chairs of the appropriate substantive committees of the

  8  Legislature on its findings no later than February 1, 2000.

  9         Section 126.  Subsection (3) is added to section

10  455.651, Florida Statutes, 1998 Supplement, to read:

11         455.651  Disclosure of confidential information.--

12         (1)  No officer, employee, or person under contract

13  with the department, or any board therein, or any subject of

14  an investigation shall convey knowledge or information to any

15  person who is not lawfully entitled to such knowledge or

16  information about any public meeting or public record, which

17  at the time such knowledge or information is conveyed is

18  exempt from the provisions of s. 119.01, s. 119.07(1), or s.

19  286.011.

20         (2)  Any person who willfully violates any provision of

21  this section is guilty of a misdemeanor of the first degree,

22  punishable as provided in s. 775.082 or s. 775.083, and may be

23  subject to discipline pursuant to s. 455.624, and, if

24  applicable, shall be removed from office, employment, or the

25  contractual relationship.

26         (3)  Any person injured as a result of a violation of

27  this section shall have a civil cause of action for treble

28  damages, reasonable attorney fees, and costs.

29         Section 127.  Except as otherwise provided in this act,

30  this act shall take effect July 1, 1999.

31


                                 185