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





                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    

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10                                                                

11  Senator Silver moved the following amendment:

12

13         Senate Amendment (with title amendment) 

14         On page 69, between lines 9 and 10

15

16  insert:

17         Section 56.  (1)  The Division of Children's Medical

18  Services of the Department of Health shall contract with a

19  private nonprofit provider affiliated with a teaching hospital

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

21  institutional review board within the teaching hospital, on

22  the use of the drug Secretin to treat autism.

23         (2)  The private nonprofit provider shall report its

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

25  President of the Senate, the Speaker of the House of

26  Representatives, and other appropriate bodies.

27         Section 57.  The sum of $50,000 is appropriated to the

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

29  Health from the General Revenue Fund for the purpose of

30  implementing this act.

31         Section 58.    Paragraph (b) of subsection (3) of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2         232.435  Extracurricular athletic activities; athletic

 3  trainers.--

 4         (3)

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

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

 7  teacher apprentice trainer within the requirements of this

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

 9  part XIII XIV of chapter 468.

10         Section 59.  Subsection (2) of section 381.026, Florida

11  Statutes, 1998 Supplement, is amended to read:

12         381.026  Florida Patient's Bill of Rights and

13  Responsibilities.--

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

15  381.0261, the term:

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

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

18  licensed under chapter 395.

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

20  licensed under chapter 458, an osteopathic physician licensed

21  under chapter 459, or a podiatric physician licensed under

22  chapter 461.

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

24  provider who is primarily responsible for patient care in a

25  health care facility or provider's office.

26         Section 60.  Subsection (4) of section 381.0261,

27  Florida Statutes, 1998 Supplement, is amended to read:

28         381.0261  Summary of patient's bill of rights;

29  distribution; penalty.--

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

31  Agency for Health Care Administration when any health care

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  provider or health care facility fails to make available to

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

 3  this section. Initial nonwillful violations shall be subject

 4  to corrective action and shall not be subject to an

 5  administrative fine. The Agency for Health Care Administration

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

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

 8  and willful violations. Each intentional and willful violation

 9  constitutes a separate violation and is subject to a separate

10  fine.

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

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

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

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

15  and this section. Initial nonwillful violations shall be

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

17  administrative fine. The appropriate regulatory board or

18  department agency may levy a fine against a health care

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

20  $500 for willful violations. Each intentional and willful

21  violation constitutes a separate violation and is subject to a

22  separate fine.

23         Section 61.  Subsections (4) and (6) of section

24  455.501, Florida Statutes, are amended to read:

25         455.501  Definitions.--As used in this part, the term:

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

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

28  459; chapter 460; chapter 461; chapter 462; chapter 463;

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

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  chapter 491.

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

 4  permit, registration, certificate, or license by the

 5  department.

 6         Section 62.  Section 455.507, Florida Statutes, is

 7  amended to read:

 8         455.507  Members of Armed Forces in good standing with

 9  administrative boards or department.--

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

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

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

13  administrative board of the state, or the department when

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

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

16  in good standing by such administrative board, or the

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

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

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

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

21  6 months after his discharge from active duty as a member of

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

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

24  the private sector for profit.

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

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

27  exempting the spouses of members of the Armed Forces of the

28  United States from licensure renewal provisions, but only in

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

30  duties with the Armed Forces.

31         Section 63.  Section 455.521, Florida Statutes, 1998

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  Supplement, is amended to read:

 2         455.521  Department; powers and duties.--The

 3  department, for the professions boards under its jurisdiction,

 4  shall:

 5         (1)  Adopt rules establishing a procedure for the

 6  biennial renewal of licenses; however, the department may

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

 8  notwithstanding any other provisions of law to the contrary.

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

10  individual professions on an annualized basis as authorized by

11  law.

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

13  subject to the approval of the board.

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

15  time and in the manner provided by law.

16         (4)  Develop a training program for persons newly

17  appointed to membership on any board. The program shall

18  familiarize such persons with the substantive and procedural

19  laws and rules and fiscal information relating to the

20  regulation of the appropriate profession and with the

21  structure of the department.

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

23  to implement the provisions of this part.

24         (6)  Establish by rules procedures by which the

25  department shall use the expert or technical advice of the

26  appropriate board for the purposes of investigation,

27  inspection, evaluation of applications, other duties of the

28  department, or any other areas the department may deem

29  appropriate.

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

31  thereof and all formal or informal proceedings conducted by

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  officer with respect to licensing or discipline to be

 3  electronically recorded in a manner sufficient to assure the

 4  accurate transcription of all matters so recorded.

 5         (8)  Select only those investigators, or consultants

 6  who undertake investigations, who meet criteria established

 7  with the advice of the respective boards.

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

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

10  support agency pursuant to s. 409.2598 to assure compliance

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

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

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

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

15  delinquent support obligation. The department shall issue or

16  reinstate the license without additional charge to the

17  licensee when notified by the court that the licensee has

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

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

20  resulting from the discharge of its duties under this

21  subsection.

22         Section 64.  Paragraph (k) of subsection (2) of section

23  455.557, Florida Statutes, 1998 Supplement, is amended to

24  read:

25         455.557  Standardized credentialing for health care

26  practitioners.--

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

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

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

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  chapter subsequently made subject to this section by the

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

 3  person registered or applying for registration pursuant to s.

 4  458.345 or 459.021.

 5         Section 65.  Subsections (1), (2), (6), (7), (8), and

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

 7  amended to read:

 8         455.564  Department; general licensing provisions.--

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

10  within the jurisdiction of the department shall apply to the

11  department in writing to take the licensure examination.  The

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

13  the department and shall require the social security number of

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

15  reflect any material change in any circumstance or condition

16  stated in the application which takes place between the

17  initial filing of the application and the final grant or

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

19  the department. An incomplete application shall expire 1 year

20  after initial filing. In order to further the economic

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

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

23  the county tax collector for the purpose of appointing the

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

25  applications for licenses and applications for renewals of

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

27  tax collector must forward any applications and accompanying

28  application fees to the department.

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

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  department shall issue a license to any person certified by

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

 4  licensure requirements imposed by law or rule. The license

 5  licensee shall consist of be issued a wallet-size

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

 7  5 inches. In addition to the two-part license, the department,

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

 9  certificate suitable for conspicuous display, which shall be

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

11  surrender to the department the wallet-size identification

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

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

14  suspended or revoked. The department shall promptly return the

15  wallet-size identification card and the wall certificate to

16  the licensee upon reinstatement of a suspended or revoked

17  license.

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

19  of Medicine, the Board of Osteopathic Medicine, the Board of

20  Chiropractic Medicine, and the Board of Podiatric Medicine

21  shall each require licensees which they respectively regulate

22  to periodically demonstrate their professional competency by

23  completing at least 40 hours of continuing education every 2

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

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

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

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

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

29  cost containment. This provision shall not be construed to

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

31  management or cost containment to be credited toward

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  not be construed to require the boards to impose any

 3  requirement on licensees except for the completion of at least

 4  40 hours of continuing education every 2 years. Each of such

 5  boards shall determine whether any specific continuing

 6  education course requirements not otherwise mandated by law

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

 8  content of, any continuing education course mandated by such

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

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

11  alternative methods of obtaining continuing education credits

12  in risk management. The alternative methods may include

13  attending a board meeting at which another a licensee is

14  disciplined, serving as a volunteer expert witness for the

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

16  probable cause panel following the expiration of a board

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

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

19  adopt rules granting continuing education hours in risk

20  management for attending a board meeting at which another

21  licensee is disciplined, serving as a volunteer expert witness

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

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

24  board member's term.

25         (7)  The respective boards within the jurisdiction of

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

27  adopt rules to provide for the use of approved videocassette

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

29  continuing education requirements of the professions they

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  a videocassette course validation form to be signed by the

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

 4  with the license renewal application, for continuing education

 5  credit.

 6         (8)  Any board that currently requires continuing

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

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

 9  continuing education courses.  The rules may provide that up

10  to a maximum of 25 percent of the required continuing

11  education hours can be fulfilled by the performance of pro

12  bono services to the indigent or to underserved populations or

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

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

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

16  in order to receive credit for continuing education under this

17  subsection. The standard for determining indigency shall be

18  that recognized by the Federal Poverty Income Guidelines

19  produced by the United States Department of Health and Human

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

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

22  continuing education hours can be fulfilled by performing

23  research in critical need areas or for training leading to

24  advanced professional certification.  The board, or the

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

26  underserved and critical need areas.  The department shall

27  adopt rules for administering continuing education

28  requirements adopted by the boards or the department if there

29  is no board.

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

31  elected official who is licensed under a practice act

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  administered by the Division of Medical Health Quality

 2  Assurance may hold employment for compensation with any public

 3  agency concurrent with such public service.  Such dual service

 4  must be disclosed according to any disclosure required by

 5  applicable law.

 6         Section 66.  Subsections (1) and (4) of section

 7  455.565, Florida Statutes, 1998 Supplement, are amended to

 8  read:

 9         455.565  Designated health care professionals;

10  information required for licensure.--

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

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

13  chapter 461, except a person applying for registration

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

15  application, and each physician who applies for license

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

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

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

19  license and under procedures adopted by the Department of

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

21  required from the applicant, furnish the following information

22  to the Department of Health:

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

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

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

26  education completed by the applicant, excluding any coursework

27  taken to satisfy medical licensure continuing education

28  requirements.

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

30  has privileges.

31         3.  The address at which the applicant will primarily

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  conduct his or her practice.

 2         4.  Any certification that the applicant has received

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

 4  which the applicant is applying.

 5         5.  The year that the applicant began practicing

 6  medicine in any jurisdiction.

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

 8  which the applicant currently holds and an indication as to

 9  whether the applicant has had the responsibility for graduate

10  medical education within the most recent 10 years.

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

12  applicant has been found guilty, regardless of whether

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

14  has pled guilty or nolo contendere.  A criminal offense

15  committed in another jurisdiction which would have been a

16  felony or misdemeanor if committed in this state must be

17  reported. If the applicant indicates that a criminal offense

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

19  that criminal offense, the department must state that the

20  criminal offense is under appeal if the criminal offense is

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

22  indicates to the department that a criminal offense is under

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

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

25  disposition.

26         8.  A description of any final disciplinary action

27  taken within the previous 10 years against the applicant by

28  the agency regulating the profession that the applicant is or

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

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

31  the American Board of Medical Specialities, the American

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  Osteopathic Association, or a similar national organization,

 2  or by a licensed hospital, health maintenance organization,

 3  prepaid health clinic, ambulatory surgical center, or nursing

 4  home.  Disciplinary action includes resignation from or

 5  nonrenewal of medical staff membership or the restriction of

 6  privileges at a licensed hospital, health maintenance

 7  organization, prepaid health clinic, ambulatory surgical

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

 9  pending disciplinary case related to competence or character.

10  If the applicant indicates that the disciplinary action is

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

12  appeal of the disciplinary action, the department must state

13  that the disciplinary action is under appeal if the

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

15         (b)  In addition to the information required under

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

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

18  practiced previously in this state or in another jurisdiction

19  or a foreign country must provide the information required of

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

21  applicant for licensure under chapter 460 who has practiced

22  previously in this state or in another jurisdiction or a

23  foreign country must provide the same information as is

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

25  455.697.

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

27  a set of fingerprints to the Department of Health in

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

29  458.313, s. 459.0055, s. 460.406, or s. 461.006.

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

 3  that profession in accordance with procedures established

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

 5         (c)  The Department of Health shall submit the

 6  fingerprints provided by an applicant for initial licensure to

 7  the Florida Department of Law Enforcement for a statewide

 8  criminal history check, and the Florida Department of Law

 9  Enforcement shall forward the fingerprints to the Federal

10  Bureau of Investigation for a national criminal history check

11  of the applicant. The department shall submit the fingerprints

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

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

14  Florida Department of Law Enforcement for a statewide criminal

15  history check, and the Florida Department of Law Enforcement

16  shall forward the fingerprints to the Federal Bureau of

17  Investigation for a national criminal history check for the

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

19  2000.; For any subsequent renewal of the applicant's license

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

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

22  submit the required information for a statewide criminal

23  history check of the applicant.

24         Section 67.  Present subsections (5), (6), and (7) of

25  section 455.5651, Florida Statutes, 1998 Supplement, are

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

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

28         455.5651  Practitioner profile; creation.--

29         (5)  The Department of Health may not include

30  disciplinary action taken by a licensed hospital or an

31  ambulatory surgical center in the practitioner profile.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         Section 68.  Section 455.567, Florida Statutes, is

 2  amended to read:

 3         455.567  Sexual misconduct; disqualification for

 4  license, certificate, or registration.--

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

 6  profession means violation of the professional relationship

 7  through which the health care practitioner uses such

 8  relationship to engage or attempt to engage the patient or

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

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

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

12  the professional practice of such health care profession.

13  Sexual misconduct in the practice of a health care profession

14  is prohibited.

15         (2)  Each board within the jurisdiction of the

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

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

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

19  if the candidate or applicant has:

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

21  to practice any profession or occupation revoked or

22  surrendered based on a violation of sexual misconduct in the

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

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

25  not had that license, certificate, or registration reinstated

26  by the licensing authority of the jurisdiction that revoked

27  the license, certificate, or registration; or

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

29  territory or possession of the United States which if

30  committed in this state would constitute sexual misconduct.

31

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

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

 4  administrative charges against the candidate's license

 5  constitutes the surrender of the license.

 6         Section 69.  Subsection (2) of section 455.574, Florida

 7  Statutes, 1998 Supplement, is amended to read:

 8         455.574  Department of Health; examinations.--

 9         (2)  For each examination developed by the department

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

11  there is no board, shall adopt rules providing for

12  reexamination of any applicants who failed an examination

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

14  written and a practical examination are given, an applicant

15  shall be required to retake only the portion of the

16  examination on which the applicant failed to achieve a passing

17  grade, if the applicant successfully passes that portion

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

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

20  portion. Except for national examinations approved and

21  administered pursuant to this section, the department shall

22  provide procedures for applicants who fail an examination

23  developed by the department or a contracted vendor to review

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

25  grading key for the questions the candidate answered

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

27  failed. Applicants shall bear the actual cost for the

28  department to provide examination review pursuant to this

29  subsection. An applicant may waive in writing the

30  confidentiality of the applicant's examination grades.

31         Section 70.  Subsection (1) of section 455.587, Florida

                                  16
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

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

 4         455.587  Fees; receipts; disposition for boards within

 5  the department.--

 6         (1)  Each board within the jurisdiction of the

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

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

 9  profession it regulates, based upon long-range estimates

10  prepared by the department of the revenue required to

11  implement laws relating to the regulation of professions by

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

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

14  adequate to cover all anticipated costs and to maintain a

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

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

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

18  department that license fees are projected to be inadequate,

19  the department shall set license fees on behalf of the

20  applicable board to cover anticipated costs and to maintain

21  the required cash balance. The department shall include

22  recommended fee cap increases in its annual report to the

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

24  regulated profession operate with a negative cash balance. The

25  department may provide by rule for advancing sufficient funds

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

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

28  years, and the regulated profession must pay interest.

29  Interest shall be calculated at the current rate earned on

30  investments of a trust fund used by the department to

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

                                  17
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  various funds in accordance with the allocation of investment

 2  earnings during the period of the advance.

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

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

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

 6  455.564(2) requested by a licensee who was licensed prior to

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

 8  certificate requested by any licensee.

 9         Section 71.  Subsections (1) and (6) of section

10  455.604, Florida Statutes, 1998 Supplement, are amended to

11  read:

12         455.604  Requirement for instruction for certain

13  licensees on human immunodeficiency virus and acquired immune

14  deficiency syndrome.--

15         (1)  The appropriate board shall require each person

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

17  459; chapter 460; chapter 461; chapter 463; chapter 464;

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

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

20  educational course, approved by the board, on human

21  immunodeficiency virus and acquired immune deficiency syndrome

22  as part of biennial relicensure or recertification. The course

23  shall consist of education on the modes of transmission,

24  infection control procedures, clinical management, and

25  prevention of human immunodeficiency virus and acquired immune

26  deficiency syndrome. Such course shall include information on

27  current Florida law on acquired immune deficiency syndrome and

28  its impact on testing, confidentiality of test results,

29  treatment of patients, and any protocols and procedures

30  applicable to human immunodeficiency virus counseling and

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

                                  18
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  and 384.25.

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

 4  a license under the chapters and parts specified in subsection

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

 6  complete an educational course acceptable to the board on

 7  human immunodeficiency virus and acquired immune deficiency

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

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

10  allowed 6 months to complete this requirement.

11         Section 72.  Subsection (1) of section 455.607, Florida

12  Statutes, is amended to read:

13         455.607  Athletic trainers and massage therapists;

14  requirement for instruction on human immunodeficiency virus

15  and acquired immune deficiency syndrome.--

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

17  board, shall require each person licensed or certified under

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

19  continuing educational course approved by the board, or the

20  department where there is no board, on human immunodeficiency

21  virus and acquired immune deficiency syndrome as part of

22  biennial relicensure or recertification.  The course shall

23  consist of education on modes of transmission, infection

24  control procedures, clinical management, and prevention of

25  human immunodeficiency virus and acquired immune deficiency

26  syndrome, with an emphasis on appropriate behavior and

27  attitude change.

28         Section 73.  Paragraphs (t), (u), (v), (w), and (x) are

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

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

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

                                  19
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

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

 4         455.624  Grounds for discipline; penalties;

 5  enforcement.--

 6         (1)  The following acts shall constitute grounds for

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

 8  be taken:

 9         (t)  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         (u)  Engaging or attempting to engage a patient or

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

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

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

17  or physical sexual activity.

18         (v)  Failing to comply with the requirements for

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

20  failing to provide initial information, failing to timely

21  provide updated information, or making misleading, untrue,

22  deceptive, or fraudulent representations on a profile,

23  credentialing, or initial or renewal licensure application.

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

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

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

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

28  crime in any jurisdiction. Convictions, findings,

29  adjudications, and pleas entered into prior to the enactment

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

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

                                  20
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         (x)  Using information about people involved in motor

 2  vehicle accidents which has been derived from accident reports

 3  made by law enforcement officers or persons involved in

 4  accidents pursuant to s. 316.066, or using information

 5  published in a newspaper or other news publication or through

 6  a radio or television broadcast that has used information

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

 8  any other solicitation whatsoever of the people involved in

 9  such accidents.

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

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

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

13  practice act, including conduct constituting a substantial

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

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

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

17  penalties:

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

19  restrictions, an application for a license.

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

21         (c)  Restriction of practice.

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

23  $10,000 $5,000 for each count or separate offense.

24         (e)  Issuance of a reprimand.

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

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

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

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

29  licensee to undergo treatment, attend continuing education

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

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

                                  21
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  tailored to the violations found.

 2         (g)  Corrective action.

 3         (h)  Imposition of an administrative fine in accordance

 4  with s. 381.0261 for violations regarding patient rights.

 5

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

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

 8  sanctions are necessary to protect the public or to compensate

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

10  the disciplining authority consider and include in the order

11  requirements designed to rehabilitate the practitioner. All

12  costs associated with compliance with orders issued under this

13  subsection are the obligation of the practitioner.

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

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

16  to satisfy continuing education requirements established by

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

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

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

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

21  continuing education not completed or completed late, the

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

23  to take 1 additional hour of continuing education for each

24  hour not completed or completed late.

25         (4)(3)  In addition to any other discipline imposed

26  pursuant to this section or discipline imposed for a violation

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

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

29  prosecution of the case excluding costs associated with an

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

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

                                  22
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

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

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

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

 6  recover, the fine or assessment.

 7         Section 74.  Section 455.664, Florida Statutes, is

 8  amended to read:

 9         455.664  Advertisement by a health care practitioner

10  provider of free or discounted services; required

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

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

13  care practitioner provider licensed under chapter 458, chapter

14  459, chapter 460, chapter 461, chapter 462, chapter 463,

15  chapter 464, chapter 465, chapter 466, chapter 467, chapter

16  478, chapter 483, chapter 484, or chapter 486, chapter 490, or

17  chapter 491, the following statement shall appear in capital

18  letters clearly distinguishable from the rest of the text:

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

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

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

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

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

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

25  statement shall not be necessary as an accompaniment to an

26  advertisement of a licensed health care practitioner provider

27  defined by this section if the advertisement appears in a

28  classified directory the primary purpose of which is to

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

30  prices to consumers and in which the statement prominently

31  appears in at least one place.

                                  23
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         Section 75.  Subsections (7) and (16) of section

 2  455.667, Florida Statutes, 1998 Supplement, are amended to

 3  read:

 4         455.667  Ownership and control of patient records;

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

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

 7  insurance information, if the complaint being investigated

 8  alleges inadequate medical care based on termination of

 9  insurance. The department may obtain patient access these

10  records pursuant to a subpoena without written authorization

11  from the patient if the department and the probable cause

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

13  to believe that a health care practitioner has excessively or

14  inappropriately prescribed any controlled substance specified

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

16  practice act or that a health care practitioner has practiced

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

18  treatment required as defined by this part or any professional

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

20  appropriate, reasonable attempts were made to obtain a patient

21  release.

22         2.  The department may obtain patient records and

23  insurance information pursuant to a subpoena without written

24  authorization from the patient if the department and the

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

26  reasonable cause to believe that a health care practitioner

27  has provided inadequate medical care based on termination of

28  insurance and also find that appropriate, reasonable attempts

29  were made to obtain a patient release.

30         3.  The department may obtain patient records, billing

31  records, insurance information, provider contracts, and all

                                  24
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  attachments thereto pursuant to a subpoena without written

 2  authorization from the patient if the department and probable

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

 4  cause to believe that a health care practitioner has submitted

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

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

 7  billing code that accurately describes the services performed,

 8  requested payment for services that were not performed by that

 9  health care practitioner, used information derived from a

10  written report of an automobile accident generated pursuant to

11  chapter 316 to solicit or obtain patients personally or

12  through an agent regardless of whether the information is

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

14  or from another person, solicited patients fraudulently,

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

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

17  caused to be presented a false or fraudulent insurance claim

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

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

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

21  deceased, incapacitated, or suspected of being a participant

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

23  specific and relevant records.

24         (b)  Patient records, billing records, insurance

25  information, provider contracts, and all attachments thereto

26  record obtained by the department pursuant to this subsection

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

28  appropriate regulatory board in disciplinary proceedings. The

29  records shall otherwise be confidential and exempt from s.

30  119.07(1). This section does not limit the assertion of the

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

                                  25
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  records of treatment for mental or nervous disorders by a

 2  medical practitioner licensed pursuant to chapter 458 or

 3  chapter 459 who has primarily diagnosed and treated mental and

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

 5  inclusive of psychiatric residency. However, the health care

 6  practitioner shall release records of treatment for medical

 7  conditions even if the health care practitioner has also

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

 9  department has found reasonable cause under this section and

10  the psychotherapist-patient privilege is asserted, the

11  department may petition the circuit court for an in camera

12  review of the records by expert medical practitioners

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

14  thereof are protected under the psychotherapist-patient

15  privilege.

16         (16)  A health care practitioner or records owner

17  furnishing copies of reports or records or making the reports

18  or records available for digital scanning pursuant to this

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

20  including reasonable staff time, or the amount specified in

21  administrative rule by the appropriate board, or the

22  department when there is no board.

23         Section 76.  Subsection (3) is added to section

24  455.687, Florida Statutes, to read:

25         455.687  Certain health care practitioners; immediate

26  suspension of license.--

27         (3)  The department may issue an emergency order

28  suspending or restricting the license of any health care

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

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

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

                                  26
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  112.0455, when the practitioner does not have a lawful

 2  prescription and legitimate medical reason for using such

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

 4  of notification to the practitioner of the confirmed test

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

 6  emergency order is issued.

 7         Section 77.  Section 455.694, Florida Statutes, 1998

 8  Supplement, is amended to read:

 9         455.694  Financial responsibility requirements for

10  Boards regulating certain health care practitioners.--

11         (1)  As a prerequisite for licensure or license

12  renewal, the Board of Acupuncture, the Board of Chiropractic

13  Medicine, the Board of Podiatric Medicine, and the Board of

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

15  practitioners licensed under the respective board, and the

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

17  registered nurse practitioners certified under s. 464.012, and

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

19  medical malpractice insurance or provide proof of financial

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

21  board or department to be sufficient to cover claims arising

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

23  and services in this state.

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

25  application by practitioners meeting any of the following

26  criteria:

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

28  460, chapter 461, s. 464.012, or chapter 466, or chapter 467

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

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

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

                                  27
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

 3  insurance program authorized by the provisions of s.

 4  768.28(15) or who is a volunteer under s. 110.501(1).

 5         (b)  Any person whose license or certification has

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

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

 8  practicing in this state.  Any person applying for

 9  reactivation of a license must show either that such licensee

10  maintained tail insurance coverage which provided liability

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

12  1993, or the initial date of licensure in this state,

13  whichever is later, and incidents that occurred before the

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

15  must submit an affidavit stating that such licensee has no

16  unsatisfied medical malpractice judgments or settlements at

17  the time of application for reactivation.

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

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

20  license.

21         (d)  Any person licensed or certified under chapter

22  457, chapter 460, chapter 461, s. 464.012, or chapter 466, or

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

24  teaching duties at an accredited school or in its main

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

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

27  a necessary part of duties in connection with the teaching

28  position in the school.

29         (e)  Any person holding an active license or

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

31  464.012, or chapter 466, or chapter 467 who is not practicing

                                  28
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

 3  activity.

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

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

 6  state.

 7         (3)  Notwithstanding the provisions of this section,

 8  the financial responsibility requirements of ss. 458.320 and

 9  459.0085 shall continue to apply to practitioners licensed

10  under those chapters.

11         Section 78.  Section 455.712, Florida Statutes, is

12  created to read:

13         455.712  Business establishments; requirements for

14  active status licenses.--

15         (1)  A business establishment regulated by the Division

16  of Medical Quality Assurance pursuant to this part may provide

17  regulated services only if the business establishment has an

18  active status license. A business establishment that provides

19  regulated services without an active status license is in

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

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

22  the business establishment.

23         (2)  A business establishment must apply with a

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

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

26  license before the license expires. If a business

27  establishment fails to renew before the license expires, the

28  license becomes delinquent, except as otherwise provided in

29  statute, in the license cycle following expiration.

30         (3)  A delinquent business establishment must apply

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

                                  29
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  within 6 months after becoming delinquent. Failure of a

 3  delinquent business establishment to renew the license within

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

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

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

 7  of applying for and meeting all requirements imposed on a

 8  business establishment for new licensure.

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

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

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

12  impose discipline or to enforce discipline previously imposed

13  on a business establishment for acts or omissions committed by

14  the business establishment while holding a license, whether

15  active or null.

16         (5)  This section applies to any a business

17  establishment registered, permitted, or licensed by the

18  department to do business. Business establishments include,

19  but are not limited to, dental laboratories, electrology

20  facilities, massage establishments, pharmacies, and health

21  care services pools.

22         Section 79.  Subsection (7) is added to section

23  457.102, Florida Statutes, 1998 Supplement, to read:

24         457.102  Definitions.--As used in this chapter:

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

26  administration, and use of needles and devices, restricted

27  devices, and prescription devices that are used in the

28  practice of acupuncture and oriental medicine.

29         Section 80.  Subsections (2) and (4) of section

30  458.307, Florida Statutes, 1998 Supplement, are amended to

31  read:

                                  30
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         458.307  Board of Medicine.--

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

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

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

 5  teaching of medicine for at least 4 years immediately

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

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

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

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

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

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

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

13  never have been, licensed health care practitioners.  One

14  member must be a health care hospital risk manager licensed

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

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

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

18  shall establish a disciplinary training program for board

19  members. The program shall provide for initial and periodic

20  training in the grounds for disciplinary action, the actions

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

22  relevant statutes and rules, and any relevant judicial and

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

24  the board shall participate on probable cause panels or in

25  disciplinary decisions of the board unless he or she has

26  completed the disciplinary training program.

27         Section 81.  Subsection (3) is added to section

28  458.309, Florida Statutes, 1998 Supplement, to read:

29         458.309  Authority to make rules.--

30         (3)  All physicians who perform level 2 procedures

31  lasting more than 5 minutes and all level 3 surgical

                                  31
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  procedures in an office setting must register the office with

 2  the department unless that office is licensed as a facility

 3  pursuant to chapter 395. Registration information shall not

 4  include the specific type of surgery performed by the

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

 6  annually unless the  office is accredited by a nationally

 7  recognized accrediting agency  or an accrediting organization

 8  subsequently approved by the Board of Medicine. The actual

 9  costs for registration and inspection or accreditation shall

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

11  office setting in which office surgery is performed.

12         Section 82.  Section 458.311, Florida Statutes, 1998

13  Supplement, is amended to read:

14         458.311  Licensure by examination; requirements;

15  fees.--

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

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

18  the department on forms furnished by the department to take

19  the licensure examination. The department shall license

20  examine each applicant who whom the board certifies:

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

22  nonrefundable application fee not to exceed $500 and an

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

24  applicant cost to the department for purchase of the

25  examination from the Federation of State Medical Boards of the

26  United States or a similar national organization, which is

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

28  the examination.

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

30         (c)  Is of good moral character.

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

                                  32
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  any other jurisdiction which would constitute the basis for

 2  disciplining a physician pursuant to s. 458.331.

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

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

 5  2 academic years of preprofessional, postsecondary education,

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

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

 8  chemistry prior to entering medical school.

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

10  postgraduate training requirements:

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

12  allopathic college recognized and approved by an accrediting

13  agency recognized by the United States Office of Education or

14  is a graduate of an allopathic medical school or allopathic

15  college within a territorial jurisdiction of the United States

16  recognized by the accrediting agency of the governmental body

17  of that jurisdiction;

18         b.  If the language of instruction of the medical

19  school is other than English, has demonstrated competency in

20  English through presentation of a satisfactory grade on the

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

22  similar test approved by rule of the board; and

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

24  year.

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

26  school registered with the World Health Organization and

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

28  required to accredit medical schools in the United States or

29  reasonably comparable standards;

30         b.  If the language of instruction of the foreign

31  medical school is other than English, has demonstrated

                                  33
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  competency in English through presentation of the Educational

 2  Commission for Foreign Medical Graduates English proficiency

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

 4  English of the Educational Testing Service or a similar test

 5  approved by rule of the board; and

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

 7  year.

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

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

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

11  the Educational Commission for Foreign Medical Graduates,

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

13  and has passed the examination utilized by that commission;

14  and

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

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

17  completed an approved residency or fellowship of at least 2

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

19  fellowship experience and training must be counted toward

20  regular or subspecialty certification by a board recognized

21  and certified by the American Board of Medical Specialties.

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

23  fingerprints on a form and under procedures specified by the

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

25  costs incurred by the Department of Health for the criminal

26  background check of the applicant.

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

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

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

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

31  the examination of the Federation of State Medical Boards of

                                  34
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

 3  for the purpose of examination of any applicant who was

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

 5  currently licensed in at least one other jurisdiction of the

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

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

 8  Special Purpose Examination of the Federation of State Medical

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

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

11  purpose of examination of any applicant who was licensed on

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

13  currently licensed in at least three other jurisdictions of

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

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

16  paragraph does not apply.

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

18  an applicant who does not pass the national 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         (3)  Notwithstanding the provisions of subparagraph

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

27  present the certificate issued by the Educational Commission

28  for Foreign Medical Graduates or pass the examination utilized

29  by that commission if the graduate:

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

31  accredited United States college or university.

                                  35
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  recognized by the World Health Organization.

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

 4  the foreign medical school, except the internship or social

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

 6  Board of Medical Examiners examination or the Educational

 7  Commission for Foreign Medical Graduates examination

 8  equivalent.

 9         (d)  Has completed an academic year of supervised

10  clinical training in a hospital affiliated with a medical

11  school approved by the Council on Medical Education of the

12  American Medical Association and upon completion has passed

13  part II of the National Board of Medical Examiners examination

14  or the Educational Commission for Foreign Medical Graduates

15  examination equivalent.

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

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

18  through an investigative process.  When the investigative

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

20  120.60(1) and the department or board has reason to believe

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

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

23  which shall be in writing and sufficient to notify the

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

25  subsection shall control over any conflicting provisions of s.

26  120.60(1).

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

28  licensure any applicant who is under investigation in another

29  jurisdiction for an offense which would constitute a violation

30  of this chapter until such investigation is completed. Upon

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

                                  36
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  unrestricted license to any individual who has committed any

 3  act or offense in any jurisdiction which would constitute the

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

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

 6  or offense in any jurisdiction which would constitute the

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

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

 9  terms set forth in subsection (9).

10         (6)  Each applicant who passes the examination and

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

12  physician, with rights as defined by law.

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

14  shall impose conditions, limitations, or restrictions on a

15  license by examination if the applicant is on probation in

16  another jurisdiction for an act which would constitute a

17  violation of this chapter.

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

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

20  satisfaction, each of the appropriate requirements set forth

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

22  of the following terms:

23         (a)  Refusal to certify to the department an

24  application for licensure, certification, or registration;

25         (b)  Certification to the department of an application

26  for licensure, certification, or registration with

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

28         (c)  Certification to the department of an application

29  for licensure, certification, or registration with placement

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

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

                                  37
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  not limited to, requiring the physician to submit to

 2  treatment, attend continuing education courses, submit to

 3  reexamination, or work under the supervision of another

 4  physician.

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

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

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

 8  the time of application for licensure under this subsection,

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

10  of the United States may make initial application to the

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

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

13  receipt of such application, the department shall issue a

14  2-year restricted license to any applicant therefor upon the

15  applicant's successful completion of the licensure examination

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

17  has met the following requirements:

18         1.  Is a graduate of a World Health Organization

19  recognized foreign medical institution located in a country in

20  the Western Hemisphere.

21         2.  Received a medical education which has been

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

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

24  medical programs.

25         3.  Practiced medicine in the country of Nicaragua for

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

27  has lawful employment authority in the United States.

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

29  the Florida Board of Medicine.

30         5.  Successfully completed the Educational Commission

31  for Foreign Medical Graduates Examination or Foreign Medical

                                  38
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  Graduate Examination in the Medical Sciences or successfully

 2  completed a course developed for the University of Miami for

 3  physician training equivalent to the course developed for such

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

 5  person shall be permitted to enroll in the physician training

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

 7  having met the requirements of this paragraph or conditionally

 8  certified by the board as having substantially complied with

 9  the requirements of this paragraph. Any person conditionally

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

11  board's satisfaction, full compliance with all the

12  requirements of this paragraph prior to completion of the

13  physician training course and shall not be permitted to sit

14  for the licensure examination unless the board certifies that

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

16

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

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

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

20  5 and 42, chapter 89-374, Laws of Florida, and renumbered as

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

22  not be eligible to apply under this subsection.

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

24  to this subsection may practice medicine for the first year

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

26  of a board-approved physician.

27         (c)  Upon recommendation of the supervising physician

28  and demonstration of clinical competency to the satisfaction

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

30  pursuant to this subsection has practiced for 1 year under

31  direct supervision, such licenseholder shall work for 1 year

                                  39
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

 3  determined by the board.  Prior to commencing such

 4  supervision, the supervising physician shall notify the board.

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

 6  general supervision and demonstration to the board that the

 7  holder of the restricted license has satisfactorily completed

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

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

10  constitute a violation of this chapter, the department shall

11  issue an unrestricted license to such licenseholder.

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

13  provisions of this subsection shall be promulgated by the

14  board.

15         (10)  Notwithstanding any other provision of this

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

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

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

19  person:

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

21  and II of the United States Medical Licensing Examination or

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

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

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

25  at the time of examination;

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

27  or she be administered the examination without applying for a

28  license as a physician in this state; and

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

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

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

                                  40
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  of the examination from the Federation of State Medical Boards

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

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

 4  ineligible to take the examination.

 5         Section 83.  Section 458.3115, Florida Statutes, 1998

 6  Supplement, is amended to read:

 7         458.3115  Restricted license; certain foreign-licensed

 8  physicians; United States Medical Licensing Examination

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

10  practice; full licensure.--

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

12  department agency shall provide procedures under which certain

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

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

15  agency-developed examination developed by the department, in

16  consultation with the board, to qualify for a restricted

17  license to practice medicine in this state. The

18  department-developed agency and board-developed examination

19  shall test the same areas of medical knowledge as the

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

21  (FLEX) previously administered by the Florida Board of

22  Medicine to grant medical licensure in Florida. The

23  department-developed agency-developed examination must be made

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

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

26  elects to take the department-developed agency and

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

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

29  required to retake or pass the equivalent parts of the

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

31  for the department-developed agency and board-developed

                                  41
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  examination five times within 5 years.

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

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

 4  the previously administered FLEX shall not be required to

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

 6  year 2000.

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

 8  examination for restricted licensure if the person:

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

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

11  special preparatory medical update courses authorized by the

12  board and the University of Miami Medical School and

13  subsequently passed the final course examination; upon

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

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

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

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

18  one of the persons who took and successfully completed the

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

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

21  minimum, the documentation must include class attendance

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

23         2.  Applies to the department agency and submits an

24  application fee that is nonrefundable and equivalent to the

25  fee required for full licensure;

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

27  practice of medicine in another jurisdiction;

28         4.  Submits an examination fee that is nonrefundable

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

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

31  either examination described in this section;

                                  42
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  other jurisdiction that would constitute a substantial basis

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

 4  chapter 455; and

 5         6.  Is not under discipline, investigation, or

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

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

 8  chapter 455 and that substantially threatened or threatens the

 9  public health, safety, or welfare.

10         (d)  Every person eligible for restricted licensure

11  under this section may sit for the USMLE or the

12  department-developed agency and board-developed examination

13  five times within 5 calendar years.  Applicants desiring to

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

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

16  applicants applying under this section who fail the

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

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

19  second and subsequent times they take the examination.

20         (e)  The department Agency for Health Care

21  Administration and the board shall be responsible for working

22  with one or more organizations to offer a medical refresher

23  course designed to prepare applicants to take either licensure

24  examination described in this section.  The organizations may

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

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

27  specializes in developing such courses.

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

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

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

31  paid by the students taking the course.

                                  43
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  restricted license to an applicant under this section, the

 3  applicant must have passed either of the two examinations

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

 5  reasonable restrictions on the applicant's license to

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

 7  to:

 8         1.  Periodic and random department agency audits of the

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

10  board or the department agency.

11         2.  Periodic appearances of the licensee before the

12  board or the department agency.

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

14  department agency.

15         (b)  A restricted licensee under this section shall

16  practice under the supervision of a full licensee approved by

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

18  under direct supervision as defined by board rule and the

19  second year being under indirect supervision as defined by

20  board rule.

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

22  this subsection.

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

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

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

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

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

28  Upon expiration of such restricted license, a restricted

29  licensee shall become a full licensee if the restricted

30  licensee:

31         1.  Is not under discipline, investigation, or

                                  44
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  prosecution for a violation which poses a substantial threat

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

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

 4         (b)  The department agency shall renew a restricted

 5  license under this section upon payment of the same fees

 6  required for renewal for a full license if the restricted

 7  licensee is under discipline, investigation, or prosecution

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

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

10  permanently revoked the restricted license. A restricted

11  licensee who has renewed such restricted license shall become

12  eligible for full licensure when the licensee is no longer

13  under discipline, investigation, or prosecution.

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

15  the provisions of this section.

16         Section 84.  Subsections (1), (2), and (8) of section

17  458.313, Florida Statutes, are amended to read:

18         458.313  Licensure by endorsement; requirements;

19  fees.--

20         (1)  The department shall issue a license by

21  endorsement to any applicant who, upon applying to the

22  department on forms furnished by the department and remitting

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

24  the board certifies:

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

26  458.311(1)(b)-(g) or in s. 458.311(1)(b)-(e) and (g) and (3);

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

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

29  examination of the Federation of State Medical Boards of the

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

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

                                  45
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  National Board of Medical Examiners, or on a combination

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

 3  passing score on the United States Medical Licensing

 4  Examination (USMLE) provided the board certifies as eligible

 5  for licensure by endorsement any applicant who took the

 6  required examinations more than 10 years prior to application;

 7  and

 8         (c)  Has submitted evidence of the active licensed

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

10  of the immediately preceding 4 years, or evidence of

11  successful completion of either a board-approved postgraduate

12  training program within 2 years preceding filing of an

13  application, or a board-approved clinical competency

14  examination, within the year preceding the filing of an

15  application for licensure.  For purposes of this paragraph,

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

17  medicine by physicians, including those employed by any

18  governmental entity in community or public health, as defined

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

20  are practicing medicine, and those on the active teaching

21  faculty of an accredited medical school.

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

23  require an applicant who does not pass the licensing

24  examination after five attempts to complete additional

25  remedial education or training.  The board shall prescribe the

26  additional requirements in a manner that permits the applicant

27  to complete the requirements and be reexamined within 2 years

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

29  examination a sixth or subsequent time.

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

31  by endorsement to take and pass the appropriate licensure

                                  46
    10:35 AM   04/27/99                             s2220c1c-38x9z




                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  examination prior to certifying the applicant as eligible for

 2  licensure.

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

 4  physician whose license has become void by failure to practice

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

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

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

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

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

10  applicable fees, and otherwise meets any continuing education

11  requirements for reactivation of the license as determined by

12  the board.

13         Section 85.  Subsection (1) of section 458.315, Florida

14  Statutes, is amended to read:

15         458.315  Temporary certificate for practice in areas of

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

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

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

19  certificate to practice in communities of Florida where there

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

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

22  department, correctional facility, community health center

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

24  Public Health Services Act, or other entity that provides

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

26  Health Officer.  The Board of Medicine may issue this

27  temporary certificate with the following restrictions:

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

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

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

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  limited to, health professional shortage areas designated by

 2  the United States Department of Health and Human Services.

 3         (a)  A recipient of a temporary certificate for

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

 5  for any approved employer in any area of critical need

 6  approved by the board.

 7         (b)  The recipient of a temporary certificate for

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

 9  accepting employment, notify the board of all approved

10  institutions in which the licensee practices and of all

11  approved institutions where practice privileges have been

12  denied.

13         Section 86.  Section 458.3165, Florida Statutes, is

14  amended to read:

15         458.3165  Public psychiatry certificate.--The board

16  shall issue a public psychiatry certificate to an individual

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

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

19  licensed to practice medicine without restriction in another

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

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

22  use the certificate to work at any public mental health

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

24         (1)  Such certificate shall:

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

26  mental health facility or program funded in part or entirely

27  by state funds.

28         (b)  Be issued and renewable biennially if the

29  secretary of the Department of Health and Rehabilitative

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

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

                                  48
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  of psychiatry at the accredited medical school at the

 2  University of Miami recommend in writing that the certificate

 3  be issued or renewed.

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

 5  with a public mental health facility or program expires.

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

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

 8  chapter.

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

10  certificateholder for noncompliance with any part of this

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

12  subject to discipline.

13         Section 87.  Subsection (4) is added to section

14  458.317, Florida Statutes, 1998 Supplement, to read:

15         458.317  Limited licenses.--

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

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

18  license for the purpose of providing volunteer, uncompensated

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

20  statement from the employing agency or institution stating

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

22  involving the practice of medicine. The application and all

23  licensure fees, including neurological injury compensation

24  assessments, shall be waived.

25         Section 88.  Subsection (1) of section 458.319, Florida

26  Statutes, 1998 Supplement, is amended to read:

27         458.319  Renewal of license.--

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

29  of the renewal application, evidence that the applicant has

30  actively practiced medicine or has been on the active teaching

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

                                  49
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  $500; provided, however, that if the licensee is either a

 3  resident physician, assistant resident physician, fellow,

 4  house physician, or intern in an approved postgraduate

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

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

 7  actively practiced medicine for at least 2 years of the

 8  immediately preceding 4 years, the board shall require that

 9  the licensee successfully complete a board-approved clinical

10  competency examination prior to renewal of the license.

11  "Actively practiced medicine" means that practice of medicine

12  by physicians, including those employed by any governmental

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

14  chapter, including physicians practicing administrative

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

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

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

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

19  Department of Health for the statewide criminal background

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

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

22  1992, must submit a set of fingerprints to the Department of

23  Health on a form and under procedures specified by the

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

25  incurred by the department for a national criminal background

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

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

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

29  set of fingerprints to the department as required by this

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

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

                                  50
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

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

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

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

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

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

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

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

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

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

11  matter in the citation with the department within 30 days

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

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

14  made by personal service or certified mail, restricted

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

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

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

18  national criminal background check. If an applicant has

19  received an initial license to practice in this state after

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

21  department for a national criminal history check upon initial

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

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

24  fee required for a statewide criminal history check.

25         Section 89.  Paragraph (mm) is added to subsection (1)

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

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

28         458.331  Grounds for disciplinary action; action by the

29  board and department.--

30         (1)  The following acts shall constitute grounds for

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  be taken:

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

 3  381.026 and 381.0261 to provide patients with information

 4  about their patient rights and how to file a patient

 5  complaint.

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

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

 8  that would constitute a substantial violation of subsection

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

10  imposing one or more of the following penalties:

11         (a)  Refusal to certify, or certification with

12  restrictions, to the department an application for licensure,

13  certification, or registration.

14         (b)  Revocation or suspension of a license.

15         (c)  Restriction of practice.

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

17  $10,000 $5,000 for each count or separate offense.

18         (e)  Issuance of a reprimand.

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

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

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

22  physician to submit to treatment, to attend continuing

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

24  under the supervision of another physician.

25         (g)  Issuance of a letter of concern.

26         (h)  Corrective action.

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

28  patient.

29         (j)  Imposition of an administrative fine in accordance

30  with s. 381.0261 for violations regarding patient rights.

31

                                  52
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  In determining what action is appropriate, the board must

 2  first consider what sanctions are necessary to protect the

 3  public or to compensate the patient.  Only after those

 4  sanctions have been imposed may the disciplining authority

 5  consider and include in the order requirements designed to

 6  rehabilitate the physician.  All costs associated with

 7  compliance with orders issued under this subsection are the

 8  obligation of the physician.

 9         Section 90.  Subsection (7) of section 458.347, Florida

10  Statutes, 1998 Supplement, is amended to read:

11         458.347  Physician assistants.--

12         (7)  PHYSICIAN ASSISTANT LICENSURE.--

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

14  assistant must apply to the department.  The department shall

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

16  having met the following requirements:

17         1.  Is at least 18 years of age.

18         2.  Has satisfactorily passed a proficiency examination

19  by an acceptable score established by the National Commission

20  on Certification of Physician Assistants.  If an applicant

21  does not hold a current certificate issued by the National

22  Commission on Certification of Physician Assistants and has

23  not actively practiced as a physician assistant within the

24  immediately preceding 4 years, the applicant must retake and

25  successfully complete the entry-level examination of the

26  National Commission on Certification of Physician Assistants

27  to be eligible for licensure.

28         3.  Has completed the application form and remitted an

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

30  application for licensure made by a physician assistant must

31  include:

                                  53
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         a.  A certificate of completion of a physician

 2  assistant training program specified in subsection (6).

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

 4         c.  A sworn statement of any previous revocation or

 5  denial of licensure or certification in any state.

 6         d.  Two letters of recommendation.

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

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

 9  applicant who the Board of Medicine certifies:

10         a.  Has completed the application form and remitted a

11  nonrefundable application fee not to exceed $500 and an

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

13  the department to provide the examination.  The examination

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

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

16  applicant to pass a separate practical component of the

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

18  competencies measured through practical examinations shall be

19  incorporated into the written examination through a

20  multiple-choice format. The department shall translate the

21  examination into the native language of any applicant who

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

23  provided that the translation request is filed with the board

24  office no later than 9 months before the scheduled examination

25  and the applicant remits translation fees as specified by the

26  department no later than 6 months before the scheduled

27  examination, and provided that the applicant demonstrates to

28  the department the ability to communicate orally in basic

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

30  the applicant may take the next available examination in

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

                                  54
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  application deadline and if the applicant is otherwise

 2  eligible under this section. To demonstrate the ability to

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

 4  is required, as determined by the department or organization

 5  that developed it, on one of the following English

 6  examinations:

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

 8  Educational Testing Service (ETS);

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

10  (TOEFL), by ETS;

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

12         (IV)  The English examination for citizenship,

13  Immigration and Naturalization Service.

14

15  A notarized copy of an Educational Commission for Foreign

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

17  demonstrate the ability to communicate in basic English.

18         b.  Is an unlicensed physician who graduated from a

19  foreign medical school listed with the World Health

20  Organization who has not previously taken and failed the

21  examination of the National Commission on Certification of

22  Physician Assistants and who has been certified by the Board

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

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

25  (3), (4), and (5), with the exception that the applicant is

26  not required to have completed an approved residency of at

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

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

29  valid, active certificate issued by the Educational Commission

30  for Foreign Medical Graduates.

31         c.  Was eligible and made initial application for

                                  55
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  certification as a physician assistant in this state between

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

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

 4  was licensed or certified in any state in the United States as

 5  a physician assistant on July 1, 1990.

 6         2.  The department may grant temporary licensure to an

 7  applicant who meets the requirements of subparagraph 1.

 8  Between meetings of the council, the department may grant

 9  temporary licensure to practice based on the completion of all

10  temporary licensure requirements.  All such administratively

11  issued licenses shall be reviewed and acted on at the next

12  regular meeting of the council.  A temporary license expires

13  30 days after upon receipt and notice of scores to the

14  licenseholder from the first available examination specified

15  in subparagraph 1. following licensure by the department.  An

16  applicant who fails the proficiency examination is no longer

17  temporarily licensed, but may apply for a one-time extension

18  of temporary licensure after reapplying for the next available

19  examination. Extended licensure shall expire upon failure of

20  the licenseholder to sit for the next available examination or

21  upon receipt and notice of scores to the licenseholder from

22  such examination.

23         3.  Notwithstanding any other provision of law, the

24  examination specified pursuant to subparagraph 1. shall be

25  administered by the department only five times.  Applicants

26  certified by the board for examination shall receive at least

27  6 months' notice of eligibility prior to the administration of

28  the initial examination. Subsequent examinations shall be

29  administered at 1-year intervals following the reporting of

30  the scores of the first and subsequent examinations.  For the

31  purposes of this paragraph, the department may develop,

                                  56
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  contract for the development of, purchase, or approve an

 2  examination, including a practical component, that adequately

 3  measures an applicant's ability to practice with reasonable

 4  skill and safety.  The minimum passing score on the

 5  examination shall be established by the department, with the

 6  advice of the board.  Those applicants failing to pass that

 7  examination or any subsequent examination shall receive notice

 8  of the administration of the next examination with the notice

 9  of scores following such examination.  Any applicant who

10  passes the examination and meets the requirements of this

11  section shall be licensed as a physician assistant with all

12  rights defined thereby.

13         (c)  The license must be renewed biennially.  Each

14  renewal must include:

15         1.  A renewal fee not to exceed $500 as set by the

16  boards.

17         2.  A sworn statement of no felony convictions in the

18  previous 2 years.

19         (d)  Each licensed physician assistant shall biennially

20  complete 100 hours of continuing medical education or shall

21  hold a current certificate issued by the National Commission

22  on Certification of Physician Assistants.

23         (e)  Upon employment as a physician assistant, a

24  licensed physician assistant must notify the department in

25  writing within 30 days after such employment or after any

26  subsequent changes in the supervising physician. The

27  notification must include the full name, Florida medical

28  license number, specialty, and address of the supervising

29  physician.

30         (f)  Notwithstanding subparagraph (a)2., the department

31  may grant to a recent graduate of an approved program, as

                                  57
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  specified in subsection (6), who expects to take the first

 2  examination administered by the National Commission on

 3  Certification of Physician Assistants available for

 4  registration after the applicant's graduation, a temporary

 5  license. The temporary license shall to expire 30 days after

 6  upon receipt of scores of the proficiency examination

 7  administered by the National Commission on Certification of

 8  Physician Assistants.  Between meetings of the council, the

 9  department may grant a temporary license to practice based on

10  the completion of all temporary licensure requirements.  All

11  such administratively issued licenses shall be reviewed and

12  acted on at the next regular meeting of the council. The

13  recent graduate may be licensed prior to employment, but must

14  comply with paragraph (e). An applicant who has passed the

15  proficiency examination may be granted permanent licensure. An

16  applicant failing the proficiency examination is no longer

17  temporarily licensed, but may reapply for a 1-year extension

18  of temporary licensure.  An applicant may not be granted more

19  than two temporary licenses and may not be licensed as a

20  physician assistant until he or she passes the examination

21  administered by the National Commission on Certification of

22  Physician Assistants. As prescribed by board rule, the council

23  may require an applicant who does not pass the licensing

24  examination after five or more attempts to complete additional

25  remedial education or training. The council shall prescribe

26  the additional requirements in a manner that permits the

27  applicant to complete the requirements and be reexamined

28  within 2 years after the date the applicant petitions the

29  council to retake the examination a sixth or subsequent time.

30         (g)  The Board of Medicine may impose any of the

31  penalties specified in ss. 455.624 and 458.331(2) upon a

                                  58
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  physician assistant if the physician assistant or the

 2  supervising physician has been found guilty of or is being

 3  investigated for any act that constitutes a violation of this

 4  chapter or part II of chapter 455.

 5         Section 91.  Section 459.005, Florida Statutes, 1998

 6  Supplement, is amended to read:

 7         459.005  Rulemaking authority.--

 8         (1)  The board has authority to adopt rules pursuant to

 9  ss. 120.536(1) and 120.54 to implement the provisions of this

10  chapter conferring duties upon it.

11         (2)  All physicians who perform level 2 procedures

12  lasting more than 5 minutes and all level 3 surgical

13  procedures in an office setting must register the office with

14  the department unless that office is licensed as a facility

15  pursuant to chapter 395. Registration information shall not

16  include the specific type of surgery performed by the

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

18  annually unless the office is accredited by a nationally

19  recognized accrediting agency or an accrediting organization

20  subsequently approved by the Board of Osteopathic Medicine.

21  The actual costs for registration and inspection or

22  accreditation shall be paid by the person seeking to register

23  and operate the office setting in which office surgery is

24  performed.

25         Section 92.  Subsection (7) is added to section

26  459.0075, Florida Statutes, to read:

27         459.0075  Limited licenses.--

28         (7)  Any person holding an active license to practice

29  osteopathic medicine in the state may convert that license to

30  a limited license for the purpose of providing volunteer,

31  uncompensated care for low-income Floridians. The applicant

                                  59
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  must submit a statement from the employing agency or

 2  institution stating that he or she will not receive

 3  compensation for any service involving the practice of

 4  osteopathic medicine. The application and all licensure fees,

 5  including neurological injury compensation assessments, shall

 6  be waived.

 7         Section 93.  Subsection (1) of section 459.008, Florida

 8  Statutes, 1998 Supplement, is amended to read:

 9         459.008  Renewal of licenses and certificates.--

10         (1)  The department shall renew a license or

11  certificate upon receipt of the renewal application and fee.

12  An applicant for a renewed license must also submit the

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

14  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

                                  60
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 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 94.  Paragraph (oo) is added to subsection (1)

23  of section 459.015, F.S., 1998 supplement, and subsection (2)

24  of this section is amended to read:

25         459.015  Grounds for disciplinary action by the

26  board.--

27         (1)  The following acts shall constitute grounds for

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

29  be taken:

30         (oo)  Failing to comply with the requirements of ss.

31  381.026 and 381.0261 to provide patients with information

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 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), it may enter an order

 5  imposing one or more of the following penalties:

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

 7  to the department an application for certification, licensure,

 8  renewal, or reactivation.

 9         (b)  Revocation or suspension of a license or

10  certificate.

11         (c)  Restriction of practice.

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

13  $10,000 $5,000 for each count or separate offense.

14         (e)  Issuance of a reprimand.

15         (f)  Issuance of a letter of concern.

16         (g)  Placement of the osteopathic physician on

17  probation for a period of time and subject to such conditions

18  as the board may specify, including, but not limited to,

19  requiring the osteopathic physician to submit to treatment,

20  attend continuing education courses, submit to reexamination,

21  or work under the supervision of another osteopathic

22  physician.

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

                                  62
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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 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 95.  Subsection (6) is added to section

 7  460.402, Florida Statutes, to read:

 8         460.402  Exceptions.--The provisions of this chapter

 9  shall not apply to:

10         (6)  A chiropractic student enrolled in a chiropractic

11  college accredited by the Council on Chiropractic Education

12  and participating in a community-based internship under the

13  direct supervision of a doctor of chiropractic medicine who is

14  credentialed as an adjunct faculty member of a chiropractic

15  college in which the student is enrolled.

16         Section 96.  Present subsections (4) through (10) of

17  section 460.403, Florida Statutes, 1998 Supplement, are

18  renumbered as subsections (5) through (11), respectively, a

19  new subsection (4) is added to that section, and present

20  subsections (6) and (9) are amended, to read:

21         460.403  Definitions.--As used in this chapter, the

22  term:

23         (4)  "Community-based internship" means a program in

24  which a student enrolled in the last year of a chiropractic

25  college accredited by the Council on Chiropractic Education is

26  approved to obtain required pregraduation clinical experience

27  in a chiropractic clinic or practice under the direct

28  supervision of a doctor of chiropractic medicine approved as

29  an adjunct faculty member of the chiropractic college in which

30  the student is enrolled, according to the teaching protocols

31  for the clinical practice requirements of the college.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         (7)(6)  "Direct supervision" means responsible

 2  supervision and control, with the licensed chiropractic

 3  physician assuming legal liability for the services rendered

 4  by a registered chiropractic assistant or a chiropractic

 5  student enrolled in a community-based intern program.  Except

 6  in cases of emergency, direct supervision shall require the

 7  physical presence of the licensed chiropractic physician for

 8  consultation and direction of the actions of the registered

 9  chiropractic assistant or a chiropractic student enrolled in a

10  community-based intern program.  The board shall further

11  establish rules as to what constitutes responsible direct

12  supervision of a registered chiropractic assistant.

13         (10)(9)  "Registered chiropractic assistant" means a

14  person who is registered by the board to perform chiropractic

15  services under the direct supervision of a chiropractic

16  physician or certified chiropractic physician's assistant.

17         Section 97.  Subsection (1) of section 460.406, Florida

18  Statutes, 1998 Supplement, is amended to read:

19         460.406  Licensure by examination.--

20         (1)  Any person desiring to be licensed as a

21  chiropractic physician shall apply to the department to take

22  the licensure examination. There shall be an application fee

23  set by the board not to exceed $100 which shall be

24  nonrefundable.  There shall also be an examination fee not to

25  exceed $500 plus the actual per applicant cost to the

26  department for purchase of portions of the examination from

27  the National Board of Chiropractic Examiners or a similar

28  national organization, which may be refundable if the

29  applicant is found ineligible to take the examination.  The

30  department shall examine each applicant who the board

31  certifies has:

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         (a)  Completed the application form and remitted the

 2  appropriate fee.

 3         (b)  Submitted proof satisfactory to the department

 4  that he or she is not less than 18 years of age.

 5         (c)  Submitted proof satisfactory to the department

 6  that he or she is a graduate of a chiropractic college which

 7  is accredited by or has status with the Council on

 8  Chiropractic Education or its predecessor agency. However, any

 9  applicant who is a graduate of a chiropractic college that was

10  initially accredited by the Council on Chiropractic Education

11  in 1995, who graduated from such college within the 4 years

12  immediately preceding such accreditation, and who is otherwise

13  qualified shall be eligible to take the examination.  No

14  application for a license to practice chiropractic medicine

15  shall be denied solely because the applicant is a graduate of

16  a chiropractic college that subscribes to one philosophy of

17  chiropractic medicine as distinguished from another.

18         (d)1.  For an applicant who has matriculated in a

19  chiropractic college prior to July 2, 1990, completed at least

20  2 years of residence college work, consisting of a minimum of

21  one-half the work acceptable for a bachelor's degree granted

22  on the basis of a 4-year period of study, in a college or

23  university accredited by an accrediting agency recognized and

24  approved by the United States Department of Education.

25  However, prior to being certified by the board to sit for the

26  examination, each applicant who has matriculated in a

27  chiropractic college after July 1, 1990, shall have been

28  granted a bachelor's degree, based upon 4 academic years of

29  study, by a college or university accredited by a regional

30  accrediting agency which is a member of the Commission on

31  Recognition of Postsecondary Accreditation.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         2.  Effective July 1, 2000, completed, prior to

 2  matriculation in a chiropractic college, at least 3 years of

 3  residence college work, consisting of a minimum of 90 semester

 4  hours leading to a bachelor's degree in a liberal arts college

 5  or university accredited by an accrediting agency recognized

 6  and approved by the United States Department of Education.

 7  However, prior to being certified by the board to sit for the

 8  examination, each applicant who has matriculated in a

 9  chiropractic college after July 1, 2000, shall have been

10  granted a bachelor's degree from an institution holding

11  accreditation for that degree from a regional accrediting

12  agency which is recognized by the United States Department of

13  Education.  The applicant's chiropractic degree must consist

14  of credits earned in the chiropractic program and may not

15  include academic credit for courses from the bachelor's

16  degree.

17         (e)  Completed not less than a 3-month training program

18  in this state of not less than 300 hours with a chiropractic

19  physician licensed in this state. The chiropractic physician

20  candidate may perform all services offered by the licensed

21  chiropractic physician, but must be under the supervision of

22  the licensed chiropractic physician until the results of the

23  first licensure examination for which the candidate has

24  qualified have been received, at which time the candidate's

25  training program shall be terminated. However, an applicant

26  who has practiced chiropractic medicine in any other state,

27  territory, or jurisdiction of the United States or any foreign

28  national jurisdiction for at least 5 years as a licensed

29  chiropractic physician need not be required to complete the

30  3-month training program as a requirement for licensure.

31         (e)(f)  Successfully completed the National Board of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  Chiropractic Examiners certification examination in parts I

 2  and II and clinical competency, with a score approved by the

 3  board, within 10 years immediately preceding application to

 4  the department for licensure.

 5         (f)(g)  Submitted to the department a set of

 6  fingerprints on a form and under procedures specified by the

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

 8  incurred by the Department of Health for the criminal

 9  background check of the applicant.

10         Section 98.  Subsection (1) of section 460.407, Florida

11  Statutes, 1998 Supplement, is amended to read:

12         460.407  Renewal of license.--

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

14  of the renewal application and the fee set by the board not to

15  exceed $500. An applicant for a renewed license must also

16  submit the information required under s. 455.565 to the

17  department on a form and under procedures specified by the

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

19  incurred by the Department of Health for the statewide

20  criminal background check of the applicant. An The applicant

21  for a renewed license who received an initial license in this

22  state after January 1, 1992, must submit a set of fingerprints

23  to the Department of Health on a form and under procedures

24  specified by the department, along with payment in an amount

25  equal to the costs incurred by the department for a national

26  criminal background check of the applicant for the initial

27  renewal of his or her license after January 1, 2000. If the

28  applicant fails to submit either the information required

29  under s. 455.565 or a set of fingerprints to the department as

30  required by this section, the department shall issue a notice

31  of noncompliance, and the applicant will be given 30

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  additional days to comply. If the applicant fails to comply

 2  within 30 days after the notice of noncompliance is issued,

 3  the department or board, as appropriate, may issue a citation

 4  to the applicant and may fine the applicant up to $50 for each

 5  day that the applicant is not in compliance with the

 6  requirements of s. 455.565. The citation must clearly state

 7  that the applicant may choose, in lieu of accepting the

 8  citation, to follow the procedure under s. 455.621. If the

 9  applicant disputes the matter in the citation, the procedures

10  set forth in s. 455.621 must be followed. However, if the

11  applicant does not dispute the matter in the citation with the

12  department within 30 days after the citation is served, the

13  citation becomes a final order and constitutes discipline.

14  Service of a citation may be made by personal service or

15  certified mail, restricted delivery, to the subject at the

16  applicant's last known address. The department may not delay

17  renewing a license due to the processing of a statewide

18  criminal history check or a national criminal background

19  check. If an applicant has received an initial license to

20  practice in this state after January 1, 1992, and has

21  submitted fingerprints to the department for a national

22  criminal history check upon initial licensure and is renewing

23  his or her license for the first time, then the applicant need

24  only submit the information and fee required for a statewide

25  criminal history check.

26         Section 99.  Paragraphs (p) and (dd) of subsection (1)

27  and paragraph (b) of subsection (2) of section 460.413,

28  Florida Statutes, 1998 Supplement, are amended to read:

29         460.413  Grounds for disciplinary action; action by the

30  board.--

31         (1)  The following acts shall constitute grounds for

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2  be taken:

 3         (p)  Prescribing, dispensing, or administering any

 4  medicinal drug except as authorized by s. 460.403(9)(c)2. s.

 5  460.403(8)(c)2., performing any surgery, or practicing

 6  obstetrics.

 7         (dd)  Using acupuncture without being certified

 8  pursuant to s. 460.403(9)(f) s. 460.403(8)(f).

 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         (d)  Imposition of an administrative fine not to exceed

13  $10,000 $2,000 for each count or separate offense.

14

15  In determining what action is appropriate, the board must

16  first consider what sanctions are necessary to protect the

17  public or to compensate the patient. Only after those

18  sanctions have been imposed may the disciplining authority

19  consider and include in the order requirements designed to

20  rehabilitate the chiropractic physician. All costs associated

21  with compliance with orders issued under this subsection are

22  the obligation of the chiropractic physician.

23         Section 100.  Section 460.4165, Florida Statutes, is

24  amended to read:

25         460.4165  Certified chiropractic physician's

26  assistants.--

27         (1)  LEGISLATIVE INTENT.--The purpose of this section

28  is to encourage the more effective utilization of the skills

29  of chiropractic physicians by enabling them to delegate health

30  care tasks to qualified assistants when such delegation is

31  consistent with the patient's health and welfare and to allow

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  for innovative development of programs for the education of

 2  physician's assistants.

 3         (2)  PERFORMANCE BY CERTIFIED CHIROPRACTIC PHYSICIAN'S

 4  ASSISTANT.--Notwithstanding any other provision of law, a

 5  certified chiropractic physician's assistant may perform

 6  chiropractic services in the specialty area or areas for which

 7  the certified chiropractic physician's assistant is trained or

 8  experienced when such services are rendered under the

 9  supervision of a licensed chiropractic physician or group of

10  chiropractic physicians certified by the board.  Any certified

11  chiropractic physician's assistant certified under this

12  section to perform services may perform those services only:

13         (a)  In the office of the chiropractic physician to

14  whom the certified chiropractic physician's assistant has been

15  assigned, in which office such physician maintains her or his

16  primary practice;

17         (b)  Under indirect supervision of When the

18  chiropractic physician to whom she or he is assigned as

19  defined by rule of the board is present;

20         (c)  In a hospital in which the chiropractic physician

21  to whom she or he is assigned is a member of the staff; or

22         (d)  On calls outside of the said office of the

23  chiropractic physician to whom she or he is assigned, on the

24  direct order of the chiropractic physician to whom she or he

25  is assigned.

26         (3)  THIRD-PARTY PAYORS.--This chapter does not prevent

27  third-party payors from reimbursing employers of chiropractic

28  physicians' assistants for covered services rendered by

29  certified chiropractic physicians' assistants.

30         (4)(3)  PERFORMANCE BY TRAINEES.--Notwithstanding any

31  other provision of law, a trainee may perform chiropractic

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  services when such services are rendered within the scope of

 2  an approved program.

 3         (5)(4)  PROGRAM APPROVAL.--The department shall issue

 4  certificates of approval for programs for the education and

 5  training of certified chiropractic physician's assistants

 6  which meet board standards.  Any basic program curriculum

 7  certified by the board shall cover a period of 24 months. The

 8  curriculum must consist of at least 200 didactic classroom

 9  hours during those 24 months.

10         (a)  In developing criteria for program approval, the

11  board shall give consideration to, and encourage, the

12  utilization of equivalency and proficiency testing and other

13  mechanisms whereby full credit is given to trainees for past

14  education and experience in health fields.

15         (b)  The board shall create groups of specialty

16  classifications of training for certified chiropractic

17  physician's assistants.  These classifications shall reflect

18  the training and experience of the certified chiropractic

19  physician's assistant. The certified chiropractic physician's

20  assistant may receive training in one or more such

21  classifications, which shall be shown on the certificate

22  issued.

23         (c)  The board shall adopt and publish standards to

24  ensure that such programs operate in a manner which does not

25  endanger the health and welfare of the patients who receive

26  services within the scope of the program.  The board shall

27  review the quality of the curricula, faculties, and facilities

28  of such programs; issue certificates of approval; and take

29  whatever other action is necessary to determine that the

30  purposes of this section are being met.

31         (6)(5)  APPLICATION APPROVAL.--Any person desiring to

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  be licensed as a certified chiropractic physician's assistant

 2  must apply to the department. The department shall issue a

 3  certificate to any person certified by the board as having met

 4  the following requirements:

 5         (a)  Is at least 18 years of age.

 6         (b)  Is a graduate of an approved program or its

 7  equivalent and is fully certified by reason of experience and

 8  education, as defined by board rule, to perform chiropractic

 9  services under the responsible supervision of a licensed

10  chiropractic physician and when the board is satisfied that

11  the public will be adequately protected by the arrangement

12  proposed in the application.

13         (c)  Has completed the application form and remitted an

14  application fee set by the board pursuant to this section. An

15  application for certification made by a chiropractic

16  physician's assistant must include:

17         1.  A certificate of completion of a physician's

18  assistant training program specified in subsection (5).

19         2.  A sworn statement of any prior felony conviction in

20  any jurisdiction.

21         3.  A sworn statement of any previous revocation or

22  denial of licensure or certification in any state or

23  jurisdiction.

24         (a)  The board shall adopt rules for the consideration

25  of applications by a licensed chiropractic physician or a

26  group of licensed chiropractic physicians to supervise

27  certified chiropractic physician's assistants.  Each

28  application made by a chiropractic physician or group of

29  chiropractic physicians shall include all of the following:

30         1.  The qualifications, including related experience,

31  of the certified chiropractic physician's assistant intended

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  to be employed.

 2         2.  The professional background and specialty of the

 3  chiropractic physician or the group of chiropractic

 4  physicians.

 5         3.  A description by the chiropractic physician of her

 6  or his practice, or by the chiropractic physicians of their

 7  practice, and of the way in which the assistant or assistants

 8  are to be utilized.

 9

10  The board shall certify an application by a licensed

11  chiropractic physician to supervise a certified chiropractic

12  physician's assistant when the proposed assistant is a

13  graduate of an approved program or its equivalent and is fully

14  qualified by reason of experience and education to perform

15  chiropractic services under the responsible supervision of a

16  licensed chiropractic physician and when the board is

17  satisfied that the public will be adequately protected by the

18  arrangement proposed in the application.

19         (b)  The board shall certify no more than two certified

20  chiropractic physician's assistants for any chiropractic

21  physician practicing alone; no more than four chiropractic

22  physician's assistants for two chiropractic physicians

23  practicing together formally or informally; or no more than a

24  ratio of two certified chiropractic physician's assistants to

25  three chiropractic physicians in any group of chiropractic

26  physicians practicing together formally or informally.

27         (7)(6)  PENALTY.--Any person who has not been certified

28  by the board and approved by the department and who represents

29  herself or himself as a certified chiropractic physician's

30  assistant or who uses any other term in indicating or implying

31  that she or he is a certified chiropractic physician's

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  assistant is guilty of a felony of the third degree,

 2  punishable as provided in s. 775.082 or s. 775.084 or by a

 3  fine not exceeding $5,000.

 4         (8)(7)  REVOCATION OF APPROVAL.--The certificate of

 5  approval to supervise a certified chiropractic physician's

 6  assistant held by any chiropractic physician or group of

 7  chiropractic physicians may be revoked when the board

 8  determines that the intent of this section is not being

 9  carried out.

10         (9)(8)  FEES.--

11         (a)  A fee not to exceed $100 set by the board shall

12  accompany the application by a chiropractic physician for

13  authorization to supervise a certified chiropractic

14  physician's assistant.

15         (b)  Upon approval of an application for certification

16  of a certified chiropractic physician's assistant in a

17  specialty area, the applicant shall be charged an initial

18  certification fee for the first biennium not to exceed $250;

19  and a biennial renewal fee not to exceed $250 shall accompany

20  each application for renewal of the certified chiropractic

21  physician's assistant certificate.

22         (10)(9)  EXISTING PROGRAMS.--Nothing in this section

23  shall be construed to eliminate or supersede existing laws

24  relating to other paramedical professions or services.  It is

25  the intent of this section to supplement all such existing

26  programs relating to the certification and the practice of

27  paramedical professions as may be authorized by law.

28         (11)(10)  LIABILITY.--Each chiropractic physician or

29  group of chiropractic physicians utilizing certified

30  chiropractic physician's assistants shall be liable for any

31  act or omission of any physician's assistant acting under her

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  or his or its supervision and control.

 2         (12)  SUPERVISION OF REGISTERED CHIROPRACTIC

 3  ASSISTANT.--A certified chiropractic physician's assistant may

 4  directly supervise a registered chiropractic assistant and

 5  other persons who are not licensed as chiropractic physicians

 6  who are employed or supervised by the chiropractic physician

 7  to whom the certified chiropractic physician's assistant is

 8  assigned.

 9         (13)  CERTIFIED CHIROPRACTIC ASSISTANT CERTIFICATION

10  RENEWAL.--The certification must be renewed biennially.

11         (a)  Each renewal must include:

12         1.  A renewal fee as set by board pursuant to this

13  section.

14         2.  A sworn statement of no felony convictions in the

15  previous 2 years in any jurisdiction.

16         (b)  Each certified chiropractic physician's assistant

17  shall biennially complete 24 hours of continuing education

18  courses sponsored by chiropractic colleges accredited by the

19  Council on Chiropractic Education and approved by the board.

20  The board shall approve those courses that build upon the

21  basic courses required for the practice of chiropractic

22  medicine, and the board may also approve courses in adjunctive

23  modalities. The board may make exception from the requirements

24  of this section in emergency or hardship cases. The board may

25  adopt rules within the requirements of this section which are

26  necessary for its implementation.

27         (c)  Upon employment as a certified chiropractic

28  physician's assistant, a certified chiropractic physician's

29  assistant must notify the department in writing within 30 days

30  after such employment or any change of the supervising

31  chiropractic physician. The notification must include the full

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  name, Florida chiropractic medical license number, specialty,

 2  and address of the supervising chiropractic physician.

 3         Section 101.  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 102.  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:

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 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 103.  Section 461.003, Florida Statutes, 1998

25  Supplement, is amended to read:

26         461.003  Definitions.--As used in this chapter:

27         (1)  "Department" means the Department of Health.

28         (1)(2)  "Board" means the Board of Podiatric Medicine

29  as created in this chapter.

30         (2)  "Certified podiatric X-ray assistant" means a

31  person who is employed by and under the direct supervision of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  a licensed podiatric physician to perform only those

 2  radiographic functions that are within the scope of practice

 3  of a podiatric physician licensed under this chapter. For

 4  purposes of this subsection, the term "direct supervision"

 5  means supervision whereby a podiatric physician orders the X

 6  ray, remains on the premises while the X ray is being

 7  performed and exposed, and approves the work performed before

 8  dismissal of the patient.

 9         (3)  "Department" means the Department of Health.

10         (3)  "Practice of podiatric medicine" means the

11  diagnosis or medical, surgical, palliative, and mechanical

12  treatment of ailments of the human foot and leg.  The surgical

13  treatment of ailments of the human foot and leg shall be

14  limited anatomically to that part below the anterior tibial

15  tubercle.  The practice of podiatric medicine shall include

16  the amputation of the toes or other parts of the foot but

17  shall not include the amputation of the foot or leg in its

18  entirety.  A podiatric physician may prescribe drugs that

19  relate specifically to the scope of practice authorized

20  herein.

21         (4)  "Podiatric physician" means any person licensed to

22  practice podiatric medicine pursuant to this chapter.

23         (5)  "Practice of podiatric medicine" means the

24  diagnosis or medical, surgical, palliative, and mechanical

25  treatment of ailments of the human foot and leg.  The surgical

26  treatment of ailments of the human foot and leg shall be

27  limited anatomically to that part below the anterior tibial

28  tubercle.  The practice of podiatric medicine shall include

29  the amputation of the toes or other parts of the foot but

30  shall not include the amputation of the foot or leg in its

31  entirety.  A podiatric physician may prescribe drugs that

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 1  relate specifically to the scope of practice authorized

 2  herein.

 3         Section 104.  Paragraph (d) of subsection (1) of

 4  section 461.006, Florida Statutes, 1998 Supplement, is amended

 5  to read:

 6         461.006  Licensure by examination.--

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

 8  physician shall apply to the department to take the licensure

 9  examination. The department shall examine each applicant who

10  the board certifies:

11         (d)  Beginning October 1, 1995, Has satisfactorily

12  completed one of the following clinical experience

13  requirements:

14         1.  One year of residency in a residency program

15  approved by the board, and if it has been 4 or more years

16  since the completion of that residency, active licensed

17  practice of podiatric medicine in another jurisdiction for at

18  least 2 of the immediately preceding 4 years, or successful

19  completion of a board-approved postgraduate program or

20  board-approved course within the year preceding the filing of

21  the application. For the purpose of this subparagraph, "active

22  licensed practice" means the licensed practice of podiatric

23  medicine as defined in s. 461.003(5) by podiatric physicians,

24  including podiatric physicians employed by any governmental

25  entity, on the active teaching faculty of an accredited school

26  of podiatric medicine, or practicing administrative podiatric

27  medicine.

28         2.  Ten years of continuous, active licensed practice

29  of podiatric medicine in another state immediately preceding

30  the submission of the application and completion of at least

31  the same continuing educational requirements during those 10

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 1  years as are required of podiatric physicians licensed in this

 2  state.

 3         Section 105.  Subsection (1) of section 461.007,

 4  Florida Statutes, 1998 Supplement, is amended to read:

 5         461.007  Renewal of license.--

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

 7  of the renewal application and a fee not to exceed $350 set by

 8  the board, and evidence that the applicant has actively

 9  practiced podiatric medicine or has been on the active

10  teaching faculty of an accredited school of podiatric medicine

11  for at least 2 years of the immediately preceding 4 years. If

12  the licensee has not actively practiced podiatric medicine for

13  at least 2 years of the immediately preceding 4 years, the

14  board shall require that the licensee successfully complete a

15  board-approved course prior to renewal of the license. For

16  purposes of this subsection, "actively practiced podiatric

17  medicine" means the licensed practice of podiatric medicine as

18  defined in s. 461.003(5) by podiatric physicians, including

19  podiatric physicians employed by any governmental entity, on

20  the active teaching faculty of an accredited school of

21  podiatric medicine, or practicing administrative podiatric

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

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

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

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

26  Department of Health for the statewide criminal background

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

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

29  1992, must submit a set of fingerprints to the Department of

30  Health on a form and under procedures specified by the

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

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 1  incurred by the department for a national criminal background

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

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

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

 5  set of fingerprints to the department as required by this

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

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

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

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

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

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

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

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

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

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

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

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

18  matter in the citation with the department within 30 days

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

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

21  made by personal service or certified mail, restricted

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

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

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

25  national criminal background check. If an applicant has

26  received an initial license to practice in this state after

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

28  department for a national criminal history check upon initial

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

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

31  fee required for a statewide criminal history check.

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 1         Section 106.  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         Section 107.  Section 461.0135, Florida Statutes, is

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 1  created to read:

 2         461.0135  Operation of X-ray machines by podiatric

 3  X-ray assistants.--A licensed podiatric physician may utilize

 4  an X-ray machine, expose X-ray films, and interpret or read

 5  such films. The provision of part IV of chapter 468 to the

 6  contrary notwithstanding, a licensed podiatric physician may

 7  authorize or direct a certified podiatric X-ray assistant to

 8  operate such equipment and expose such films under the

 9  licensed podiatric physician's direction and supervision,

10  pursuant to rules adopted by the board in accordance with s.

11  461.004, which ensures that such certified podiatric X-ray

12  assistant is competent to operate such equipment in a safe and

13  efficient manner by reason of training, experience, and

14  passage of a board-approved course which includes an

15  examination. The board shall issue a certificate to an

16  individual who successfully completes the board-approved

17  course and passes the examination to be administered by the

18  training authority upon completion of such course.

19         Section 108.  Subsection (3) is added to section

20  464.008, Florida Statutes, to read:

21         464.008  Licensure by examination.--

22         (3)  Any applicant who fails the examination three

23  consecutive times, regardless of the jurisdiction in which the

24  examination is taken, shall be required to complete a

25  board-approved remedial course before the applicant will be

26  approved for reexamination. After taking the remedial course,

27  the applicant may be approved to retake the examination up to

28  three additional times before the applicant is required to

29  retake remediation. The applicant shall apply for

30  reexamination within 6 months after completion of remediation.

31  The board shall by rule establish guidelines for remedial

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 1  courses.

 2         Section 109.  Subsection (13) is added to section

 3  464.022, Florida Statutes, to read:

 4         464.022  Exceptions.--No provision of this chapter

 5  shall be construed to prohibit:

 6         (13)  The practice of nursing by individuals enrolled

 7  in board-approved remedial courses.

 8         Section 110.  Subsection (12) of section 465.003,

 9  Florida Statutes, is amended, subsections (4) through (14) of

10  said section are renumbered as subsections (5) through (15),

11  respectively, and a new subsection (4) is added to said

12  section, to read:

13         465.003  Definitions.--As used in this chapter, the

14  term:

15         (4)  "Data communication device" means an electronic

16  device that receives electronic information from one source

17  and transmits or routes it to another, including, but not

18  limited to, any such bridge, router, switch, or gateway.

19         (13)(12)  "Practice of the profession of pharmacy"

20  includes compounding, dispensing, and consulting concerning

21  contents, therapeutic values, and uses of any medicinal drug;

22  and consulting concerning therapeutic values and interactions

23  of patent or proprietary preparations, whether pursuant to

24  prescriptions or in the absence and entirely independent of

25  such prescriptions or orders; and other pharmaceutical

26  services. For purposes of this subsection, "other

27  pharmaceutical services" means the monitoring of the patient's

28  drug therapy and assisting the patient in the management of

29  his or her drug therapy, and includes review of the patient's

30  drug therapy and communication with the patient's prescribing

31  health care provider as licensed under chapter 458, chapter

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 1  459, chapter 461, or chapter 466, or similar statutory

 2  provision in another jurisdiction, or such provider's agent or

 3  such other persons as specifically authorized by the patient,

 4  regarding the drug therapy. However, nothing in this

 5  subsection may be interpreted to permit an alteration of a

 6  prescriber's directions, the diagnosis or treatment of any

 7  disease, the initiation of any drug therapy, the practice of

 8  medicine, or the practice of osteopathic medicine, unless

 9  otherwise permitted by law. "Practice of the profession of

10  pharmacy" The phrase also includes any other act, service,

11  operation, research, or transaction incidental to, or forming

12  a part of, any of the foregoing acts, requiring, involving, or

13  employing the science or art of any branch of the

14  pharmaceutical profession, study, or training, and shall

15  expressly permit a pharmacist to transmit information from

16  persons authorized to prescribe medicinal drugs to their

17  patients.

18         Section 111.  Paragraph (l) of subsection (1) and

19  paragraph (c) of subsection (2) of section 465.016, Florida

20  Statutes, are amended, and paragraph (q) is added to

21  subsection (1) of that section, to read:

22         465.016  Disciplinary actions.--

23         (1)  The following acts shall be grounds for

24  disciplinary action set forth in this section:

25         (l)  Placing in the stock of any pharmacy any part of

26  any prescription compounded or dispensed which is returned by

27  a patient; however, in a hospital, nursing home, correctional

28  facility, or extended care facility in which unit-dose

29  medication is dispensed to inpatients, each dose being

30  individually sealed and the individual unit dose or unit-dose

31  system labeled with the name of the drug, dosage strength,

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 1  manufacturer's control number, and expiration date, if any,

 2  the unused unit dose of medication may be returned to the

 3  pharmacy for redispensing.  Each pharmacist shall maintain

 4  appropriate records for any unused or returned medicinal

 5  drugs.

 6         (q)  Using or releasing a patient's records except as

 7  authorized by this chapter and chapter 455.

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

 9  the grounds set forth in subsection (1), it may enter an order

10  imposing one or more of the following penalties:

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

12  $5,000 $1,000 for each count or separate offense.

13         Section 112.  Section 465.014, Florida Statutes, is

14  amended to read:

15         465.014  Pharmacy technician.--No person other than a

16  licensed pharmacist or pharmacy intern may engage in the

17  practice of the profession of pharmacy, except that a licensed

18  pharmacist may delegate to nonlicensed pharmacy technicians

19  those duties, tasks, and functions which do not fall within

20  the purview of s. 465.003(13)(12).  All such delegated acts

21  shall be performed under the direct supervision of a licensed

22  pharmacist who shall be responsible for all such acts

23  performed by persons under his or her supervision.  A pharmacy

24  technician, under the supervision of a pharmacist, may

25  initiate or receive communications with a practitioner or his

26  or her agent, on behalf of a patient, regarding refill

27  authorization requests.  No licensed pharmacist shall

28  supervise more than one pharmacy technician unless otherwise

29  permitted by the guidelines adopted by the board.  The board

30  shall establish guidelines to be followed by licensees or

31  permittees in determining the circumstances under which a

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                                                  SENATE AMENDMENT

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 1  licensed pharmacist may supervise more than one but not more

 2  than three pharmacy technicians.

 3         Section 113.  Paragraph (c) of subsection (2) of

 4  section 465.015, Florida Statutes, is amended to read:

 5         465.015  Violations and penalties.--

 6         (2)  It is unlawful for any person:

 7         (c)  To sell or dispense drugs as defined in s.

 8  465.003(8)(7) without first being furnished with a

 9  prescription.

10         Section 114.  Section 465.0196, Florida Statutes, is

11  amended to read:

12         465.0196  Special pharmacy permits.--Any person

13  desiring a permit to operate a pharmacy which does not fall

14  within the definitions set forth in s. 465.003(11)(10)(a)1.,

15  2., and 3. shall apply to the department for a special

16  pharmacy permit.  If the board certifies that the application

17  complies with the applicable laws and rules of the board

18  governing the practice of the profession of pharmacy, the

19  department shall issue the permit.  No permit shall be issued

20  unless a licensed pharmacist is designated to undertake the

21  professional supervision of the compounding and dispensing of

22  all drugs dispensed by the pharmacy.  The licensed pharmacist

23  shall be responsible for maintaining all drug records and for

24  providing for the security of the area in the facility in

25  which the compounding, storing, and dispensing of medicinal

26  drugs occurs.  The permittee shall notify the department

27  within 10 days of any change of the licensed pharmacist

28  responsible for such duties.

29         Section 115.  Subsection (3) of section 468.812,

30  Florida Statutes, is amended to read:

31         468.812  Exemptions from licensure.--

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 1         (3)  The provisions of this act relating to orthotics

 2  or pedorthics do not apply to any licensed pharmacist or to

 3  any person acting under the supervision of a licensed

 4  pharmacist.  The practice of orthotics or pedorthics by a

 5  pharmacist or any of the pharmacist's employees acting under

 6  the supervision of a pharmacist shall be construed to be

 7  within the meaning of the term "practice of the profession of

 8  pharmacy" as set forth in s. 465.003(13)(12), and shall be

 9  subject to regulation in the same manner as any other pharmacy

10  practice.  The Board of Pharmacy shall develop rules regarding

11  the practice of orthotics and pedorthics by a pharmacist.  Any

12  pharmacist or person under the supervision of a pharmacist

13  engaged in the practice of orthotics or pedorthics shall not

14  be precluded from continuing that practice pending adoption of

15  these rules.

16         Section 116.  Subsection (19) of section 499.003,

17  Florida Statutes, is amended to read:

18         499.003  Definitions of terms used in ss.

19  499.001-499.081.--As used in ss. 499.001-499.081, the term:

20         (19)  "Legend drug," "prescription drug," or "medicinal

21  drug" means any drug, including, but not limited to, finished

22  dosage forms, or active ingredients subject to, defined by, or

23  described by s. 503(b) of the Federal Food, Drug, and Cosmetic

24  Act or s. 465.003(8)(7), s. 499.007(12), or s. 499.0122(1)(b)

25  or (c).

26         Section 117.  (1)  There is created within the

27  Department of Health a Task Force for the Study of

28  Collaborative Drug Therapy Management. The department shall

29  provide staff support for the task force. The task force shall

30  consist of not more than 13 members nominated by the

31  associations and entities named in this section and appointed

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 1  by the Secretary of Health. Members of the task force shall

 2  not receive compensation, per diem, or reimbursement for

 3  travel expenses for service on the task force. Participation

 4  in the task force is optional and at the discretion of each

 5  identified group or entity. The task force shall include:

 6         (a)  One representative from each of the following

 7  associations:

 8         1.  Florida Society of Health-System Pharmacists.

 9         2.  Florida Pharmacy Association.

10         3.  Florida Medical Association.

11         4.  Florida Osteopathic Medical Association.

12         5.  Florida Retail Federation.

13         6.  Florida Nurses Association.

14         7.  Florida Academy of Family Physicians.

15         8.  Pharmaceutical Research Manufacturing Association.

16         9.  American Society of Consultant Pharmacists.

17         10.  American Society of Health-System Pharmacists.

18         (b)  One representative from each of the following

19  entities:

20         1.  Department of Health.

21         2.  Board of Medicine, which representative must be a

22  member of the board who is licensed under chapter 458, Florida

23  Statutes.

24         3.  Board of Osteopathic Medicine, which representative

25  must be a member of the board who is licensed under chapter

26  459, Florida Statutes.

27         4.  Board of Pharmacy, which representative must be a

28  member of the board who is licensed under chapter 465, Florida

29  Statutes.

30         5.  Agency for Health Care Administration.

31         (2)  The task force shall hold its first meeting no

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 1  later than August 1, 1999, and shall report its findings to

 2  the President of the Senate, the Speaker of the House of

 3  Representatives, and the chairs of the applicable legislative

 4  committees of substance not later than December 31, 1999. All

 5  task force meetings must be held in Tallahassee at the

 6  department in order to minimize costs to the state.

 7         (3)  The task force shall be charged with the

 8  responsibility to:

 9         (a)  Determine the states in which collaborative drug

10  therapy management has been enacted by law or administrative

11  rule and summarize the content of all such laws and rules.

12         (b)  Receive testimony from interested parties and

13  identify the extent to which collaborative drug therapy

14  management is currently being practiced in this state and

15  other states.

16         (c)  Determine the efficacy of collaborative drug

17  therapy management in improving health care outcomes of

18  patients.

19         Section 118.  Section 466.021, Florida Statutes, is

20  amended to read:

21         466.021  Employment of unlicensed persons by dentist;

22  penalty.--Every duly licensed dentist who uses the services of

23  any unlicensed person for the purpose of constructing,

24  altering, repairing, or duplicating any denture, partial

25  denture, bridge splint, or orthodontic or prosthetic appliance

26  shall be required to furnish such unlicensed person with a

27  written work order in such form as prescribed shall be

28  approved by rule of the board department. This form shall be

29  supplied to the dentist by the department at a cost not to

30  exceed that of printing and handling. The work order blanks

31  shall be assigned to individual dentists and are not

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 1  transferable. This form shall be dated and signed by such

 2  dentist and shall include the patient's name or number with

 3  sufficient descriptive information to clearly identify the

 4  case for each separate and individual piece of work. A; said

 5  work order shall be made in duplicate form, the duplicate copy

 6  of such work order shall to be retained in a permanent file in

 7  the dentist's office for a period of 2 years, and the original

 8  work order shall to be retained in a permanent file for a

 9  period of 2 years by such said unlicensed person in her or his

10  place of business. Such permanent file of work orders to be

11  kept by such dentist or by such unlicensed person shall be

12  open to inspection at any reasonable time by the department or

13  its duly constituted agent. Failure of the dentist to keep

14  such permanent records of such said work orders shall subject

15  the dentist to suspension or revocation of her or his license

16  to practice dentistry. Failure of such unlicensed person to

17  have in her or his possession a work order as required by this

18  section above defined shall be admissible evidence of a

19  violation of this chapter and shall constitute a misdemeanor

20  of the second degree, punishable as provided in s. 775.082 or

21  s. 775.083. Nothing in this section shall preclude a

22  registered dental laboratory from working for another

23  registered dental laboratory, provided that such work is

24  performed pursuant to written authorization, in a form to be

25  prescribed by rule of the board department, which evidences

26  that the originating laboratory has obtained a valid work

27  order and which sets forth the work to be performed.

28  Furthermore, nothing in this section shall preclude a

29  registered laboratory from providing its services to dentists

30  licensed and practicing in another state, provided that such

31  work is requested or otherwise authorized in written form

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 1  which clearly identifies the name and address of the

 2  requesting dentist and which sets forth the work to be

 3  performed.

 4         Section 119.  Paragraph (b) of subsection (2),

 5  paragraph (b) of subsection (3), and subsection (4) of section

 6  468.1155, Florida Statutes, are amended to read:

 7         468.1155  Provisional license; requirements.--

 8         (2)  The department shall issue a provisional license

 9  to practice speech-language pathology to each applicant who

10  the board certifies has:

11         (b)  Received a master's degree or doctoral degree with

12  a major emphasis in speech-language pathology from an

13  institution of higher learning which, at the time the

14  applicant was enrolled and graduated, was accredited by an

15  accrediting agency recognized by the Commission on Recognition

16  of Postsecondary Accreditation or from an institution which is

17  publicly recognized as a member in good standing with the

18  Association of Universities and Colleges of Canada.  An

19  applicant who graduated from a program at a university or

20  college outside the United States or Canada must present

21  documentation of the determination of equivalency to standards

22  established by the Commission on Recognition of Postsecondary

23  Accreditation in order to qualify.  The applicant must have

24  completed 60 semester hours that include:

25         1.  Fundamental information applicable to the normal

26  development and use of speech, hearing, and language;

27  information about training in management of speech, hearing,

28  and language disorders; and information supplementary to these

29  fields.

30         2.  Six semester hours in audiology.

31         3.  Thirty of the required 60 semester hours in courses

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 1  acceptable toward a graduate degree by the college or

 2  university in which these courses were taken, of which 24

 3  semester hours must be in speech-language pathology.

 4         (3)  The department shall issue a provisional license

 5  to practice audiology to each applicant who the board

 6  certifies has:

 7         (b)  Received a master's degree or doctoral degree with

 8  a major emphasis in audiology from an institution of higher

 9  learning which at the time the applicant was enrolled and

10  graduated was accredited by an accrediting agency recognized

11  by the Commission on Recognition of Postsecondary

12  Accreditation or from an institution which is publicly

13  recognized as a member in good standing with the Association

14  of Universities and Colleges of Canada.  An applicant who

15  graduated from a program at a university or college outside

16  the United States or Canada must present documentation of the

17  determination of equivalency to standards established by the

18  Commission on Recognition of Postsecondary Accreditation in

19  order to qualify.  The applicant must have completed 60

20  semester hours that include:

21         1.  Fundamental information applicable to the normal

22  development and use of speech, hearing, and language;

23  information about training in management of speech, hearing,

24  and language disorders; and information supplementary to these

25  fields.

26         2.  Six semester hours in speech-language pathology.

27         3.  Thirty of the required 60 semester hours in courses

28  acceptable toward a graduate degree by the college or

29  university in which these courses were taken, of which 24

30  semester hours must be in audiology.

31         (4)  An applicant for a provisional license who has

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 1  received a master's degree or doctoral degree with a major

 2  emphasis in speech-language pathology as provided in

 3  subsection (2), or audiology as provided in subsection (3),

 4  and who seeks licensure in the area in which the applicant is

 5  not currently licensed, must have completed 30 semester hours

 6  in courses acceptable toward a graduate degree and 200

 7  supervised clinical clock hours in the second discipline from

 8  an accredited institution.

 9         Section 120.  Section 468.1215, Florida Statutes, is

10  amended to read:

11         468.1215  Speech-language pathology assistant and

12  audiology assistant; certification.--

13         (1)  A person desiring to be certified as a

14  speech-language pathology assistant or audiology assistant

15  shall apply to the department.

16         (1)(2)  The department shall issue a certificate as a

17  speech-language pathology assistant or as an audiology

18  assistant to each applicant who the board certifies has:

19         (a)  Completed the application form and remitted the

20  required fees, including a nonrefundable application fee.

21         (b)  Earned a bachelor's degree from a college or

22  university accredited by a regional association of colleges

23  and schools recognized by the Department of Education which

24  includes at least 24 semester hours of coursework as approved

25  by the board at an institution accredited by an accrediting

26  agency recognized by the Commission on Recognition of

27  Postsecondary Accreditation.

28         (2)  The department shall issue a certificate as an

29  audiology assistant to each applicant who the board certifies

30  has:

31         (a)  Completed the application form and remitted the

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 1  required fees, including a nonrefundable application fee.

 2         (b)  Completed at least 24 semester hours of coursework

 3  as approved by the board at an institution accredited by an

 4  accrediting agency recognized by the Commission on Recognition

 5  of Postsecondary Accreditation.

 6         (3)  The board, by rule, shall establish minimum

 7  education and on-the-job training and supervision requirements

 8  for certification as a speech-language pathology assistant or

 9  audiology assistant.

10         (4)  The provisions of this section shall not apply to

11  any student, intern, or trainee performing speech-language

12  pathology or audiology services while completing the

13  supervised clinical clock hours as required in s. 468.1155.

14         Section 121.  Subsection (1) of section 468.307,

15  Florida Statutes, 1998 Supplement, is amended to read:

16         468.307  Certificate; issuance; possession; display.--

17         (1)  The department shall issue a certificate to each

18  candidate who has met the requirements of ss. 468.304 and

19  468.306 or has qualified under s. 468.3065. The department may

20  by rule establish a subcategory of a certificate issued under

21  this part limiting the certificateholder to a specific

22  procedure or specific type of equipment.

23         Section 122.  Section 468.506, Florida Statutes, 1998

24  Supplement, is amended to read:

25         468.506  Dietetics and Nutrition Practice

26  Council.--There is created the Dietetics and Nutrition

27  Practice Council under the supervision of the board.  The

28  council shall consist of four persons licensed under this part

29  and one consumer who is 60 years of age or older.  Council

30  members shall be appointed by the board. Licensed members

31  shall be appointed based on the proportion of licensees within

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 1  each of the respective disciplines.  Members shall be

 2  appointed for 4-year staggered terms.  In order to be eligible

 3  for appointment, each licensed member must have been a

 4  licensee under this part for at least 3 years prior to his or

 5  her appointment.  No council member shall serve more than two

 6  successive terms.  The board may delegate such powers and

 7  duties to the council as it may deem proper to carry out the

 8  operations and procedures necessary to effectuate the

 9  provisions of this part.  However, the powers and duties

10  delegated to the council by the board must encompass both

11  dietetics and nutrition practice and nutrition counseling. Any

12  time there is a vacancy on the council, any professional

13  association composed of persons licensed under this part may

14  recommend licensees to fill the vacancy to the board in a

15  number at least twice the number of vacancies to be filled,

16  and the board may appoint from the submitted list, in its

17  discretion, any of those persons so recommended.  Any

18  professional association composed of persons licensed under

19  this part may file an appeal regarding a council appointment

20  with the secretary director of the department agency, whose

21  decision shall be final.  The board shall fix council members'

22  compensation and pay their expenses in the same manner as

23  provided in s. 455.534.

24         Section 123.  Section 468.701, Florida Statutes, 1998

25  Supplement, is amended to read:

26         468.701  Definitions.--As used in this part, the term:

27         (1)  "Athlete" means a person who participates in an

28  athletic activity.

29         (2)  "Athletic activity" means the participation in an

30  activity, conducted by an educational institution, a

31  professional athletic organization, or an amateur athletic

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 1  organization, involving exercises, sports, games, or

 2  recreation requiring any of the physical attributes of

 3  strength, agility, flexibility, range of motion, speed, and

 4  stamina.

 5         (3)  "Athletic injury" means an injury sustained which

 6  affects the athlete's ability to participate or perform in

 7  athletic activity.

 8         (4)  "Athletic trainer" means a person licensed under

 9  this part.

10         (5)  "Athletic training" means the recognition,

11  prevention, and treatment of athletic injuries.

12         (6)  "Board Council" means the Board Council of

13  Athletic Training.

14         (7)  "Department" means the Department of Health.

15         (8)  "Direct supervision" means the physical presence

16  of the supervisor on the premises so that the supervisor is

17  immediately available to the trainee when needed.

18         (9)  "Secretary" means the Secretary of Health.

19         (9)(10)  "Supervision" means the easy availability of

20  the supervisor to the athletic trainer, which includes the

21  ability to communicate by telecommunications.

22         Section 124.  Section 468.703, Florida Statutes, 1998

23  Supplement, is amended to read:

24         468.703  Board Council of Athletic Training.--

25         (1)  The Board Council of Athletic Training is created

26  within the department and shall consist of nine seven members

27  to be appointed by the Governor and confirmed by the Senate

28  secretary.

29         (2)  Five Four members of the board must council shall

30  be licensed athletic trainers. One member of the board must

31  council shall be a physician licensed under chapter 458 or

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 1  chapter 459. One member of the board must council shall be a

 2  physician licensed under chapter 460. Two members One member

 3  of the board shall be consumer members, each of whom must

 4  council shall be a resident of this state who has never worked

 5  as an athletic trainer, who has no financial interest in the

 6  practice of athletic training, and who has never been a

 7  licensed health care practitioner as defined in s. 455.501(4).

 8  Members of the council shall serve staggered 4-year terms as

 9  determined by rule of the department; however, no member may

10  serve more than two consecutive terms.

11         (3)  For the purpose of staggering terms, the Governor

12  shall appoint the initial members of the board as follows:

13         (a)  Three members for terms of 2 years each.

14         (b)  Three members for terms of 3 years each.

15         (c)  Three members for terms of 4 years each.

16         (4)  As the terms of the members expire, the Governor

17  shall appoint successors for terms of 4 years and such members

18  shall serve until their successors are appointed.

19         (5)  All provisions of part II of chapter 455 relating

20  to activities of the board shall apply.

21         (6)  The board shall maintain its official headquarters

22  in Tallahassee.

23         (3)  The council shall advise and assist the department

24  in:

25         (a)  Developing rules relating to licensure

26  requirements, the licensure examination, continuing education

27  requirements, fees, records and reports to be filed by

28  licensees, and any other requirements necessary to regulate

29  the practice of athletic training.

30         (b)  Monitoring the practice of athletic training in

31  other jurisdictions.

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 1         (c)  Educating the public about the role of athletic

 2  trainers.

 3         (d)  Collecting and reviewing data regarding the

 4  licensed practice of athletic training.

 5         (e)  Addressing concerns and problems of athletic

 6  trainers in order to promote improved safety in the practice

 7  of athletic training.

 8         (4)  Members of the council shall be entitled to

 9  compensation and reimbursement for expenses in the same manner

10  as board members are compensated and reimbursed under s.

11  455.534.

12         Section 125.  Section 468.705, Florida Statutes, 1998

13  Supplement, is amended to read:

14         468.705  Rulemaking authority.--The board department is

15  authorized to adopt rules pursuant to ss. 120.536(1) and

16  120.54 to implement provisions of this part conferring duties

17  upon it. Such rules shall include, but not be limited to, the

18  allowable scope of practice regarding the use of equipment,

19  procedures, and medication, and requirements for a written

20  protocol between the athletic trainer and a supervising

21  physician, licensure requirements, licensure examination,

22  continuing education requirements, fees, records, and reports

23  to be filed by licensees, protocols, and any other

24  requirements necessary to regulate the practice of athletic

25  training.

26         Section 126.  Section 468.707, Florida Statutes, 1998

27  Supplement, is amended to read:

28         468.707  Licensure by examination; requirements.--

29         (1)  Any person desiring to be licensed as an athletic

30  trainer shall apply to the department on a form approved by

31  the department.

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 1         (a)  The department shall license each applicant who:

 2         1.  Has completed the application form and remitted the

 3  required fees.

 4         2.  Is at least 21 years of age.

 5         3.  Has obtained a baccalaureate degree from a college

 6  or university accredited by an accrediting agency recognized

 7  and approved by the United States Department of Education or

 8  the Commission on Recognition of Postsecondary Accreditation,

 9  or approved by the board department.

10         4.  Has completed coursework from a college or

11  university accredited by an accrediting agency recognized and

12  approved by the United States Department of Education or the

13  Commission on Recognition of Postsecondary Accreditation, or

14  approved by the board department, in each of the following

15  areas, as provided by rule: health, human anatomy,

16  kinesiology/biomechanics, human physiology, physiology of

17  exercise, basic athletic training, and advanced athletic

18  training.

19         5.  Has current certification in standard first aid and

20  cardiovascular pulmonary resuscitation from the American Red

21  Cross or an equivalent certification as determined by the

22  board department.

23         6.  Has, within 2 of the preceding 5 years, attained a

24  minimum of 800 hours of athletic training experience under the

25  direct supervision of a licensed athletic trainer or an

26  athletic trainer certified by the National Athletic Trainers'

27  Association or a comparable national athletic standards

28  organization.

29         7.  Has passed an examination administered or approved

30  by the board department.

31         (b)  The department shall also license each applicant

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

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 1  who:

 2         1.  Has completed the application form and remitted the

 3  required fees no later than October 1, 1996.

 4         2.  Is at least 21 years of age.

 5         3.  Has current certification in standard first aid and

 6  cardiovascular pulmonary resuscitation from the American Red

 7  Cross or an equivalent certification as determined by the

 8  board department.

 9         4.a.  Has practiced athletic training for at least 3 of

10  the 5 years preceding application; or

11         b.  Is currently certified by the National Athletic

12  Trainers' Association or a comparable national athletic

13  standards organization.

14         (2)  Pursuant to the requirements of s. 455.607

15  455.604, each applicant shall complete a continuing education

16  course on human immunodeficiency virus and acquired immune

17  deficiency syndrome as part of initial licensure.

18         Section 127.  Section 468.709, Florida Statutes, is

19  amended to read:

20         468.709  Fees.--

21         (1)  The board department shall, by rule, establish

22  fees for the following purposes:

23         (a)  An application fee, not to exceed $100.

24         (b)  An examination fee, not to exceed $200.

25         (c)  An initial licensure fee, not to exceed $200.

26         (d)  A biennial renewal fee, not to exceed $200.

27         (e)  An inactive fee, not to exceed $100.

28         (f)  A delinquent fee, not to exceed $100.

29         (g)  A reactivation fee, not to exceed $100.

30         (h)  A voluntary inactive fee, not to exceed $100.

31         (2)  The board department shall establish fees at a

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 1  level, not to exceed the statutory fee cap, that is adequate

 2  to ensure the continued operation of the regulatory program

 3  under this part. The board department shall neither set nor

 4  maintain the fees at a level that will substantially exceed

 5  this need.

 6         Section 128.  Subsections (2) and (3) of section

 7  468.711, Florida Statutes, 1998 Supplement, are amended to

 8  read:

 9         468.711  Renewal of license; continuing education.--

10         (2)  The board department may, by rule, prescribe

11  continuing education requirements, not to exceed 24 hours

12  biennially. The criteria for continuing education shall be

13  approved by the board department and shall include 4 hours in

14  standard first aid and cardiovascular pulmonary resuscitation

15  from the American Red Cross or equivalent training as

16  determined by board department.

17         (3)  Pursuant to the requirements of s. 455.607

18  455.604, each licensee shall complete a continuing education

19  course on human immunodeficiency virus and acquired immune

20  deficiency syndrome as part of biennial relicensure.

21         Section 129.  Subsection (2) of section 468.719,

22  Florida Statutes, 1998 Supplement, is amended to read:

23         468.719  Disciplinary actions.--

24         (2)  When the board department finds any person guilty

25  of any of the acts set forth in subsection (1), the board

26  department may enter an order imposing one or more of the

27  penalties provided in s. 455.624.

28         Section 130.  Section 468.721, Florida Statutes, is

29  amended to read:

30         468.721  Saving clause.--

31         (1)  An athletic trainer registration which is valid on

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 1  October 1, 1995, shall become for all purposes an athletic

 2  trainer license as required by this part, subject to any

 3  disciplinary or administrative action pending on October 1,

 4  1995, and shall be subject to all the same terms and

 5  conditions as athletic trainer licenses issued after October

 6  1, 1995. The department shall retain jurisdiction to impose

 7  discipline for any violation of this part which occurred prior

 8  to October 1, 1995, but is discovered after October 1, 1995,

 9  under the terms of this part prior to October 1, 1995.

10         (2)  No judicial or administrative proceeding pending

11  on July 1, 1995, shall be abated as a result of enactment of

12  any provision of this act.

13         (3)  Rules adopted by the department relating to the

14  regulation registration of athletic trainers under this part

15  prior to July 1, 1999, shall remain in effect until the board

16  department adopts rules relating to the regulation licensure

17  of athletic trainers under this part which supersede such

18  earlier rules.

19         Section 131.  Paragraph (g) of subsection (3) of

20  section 20.43, Florida Statutes, 1998 Supplement, is amended

21  to read:

22         20.43  Department of Health.--There is created a

23  Department of Health.

24         (3)  The following divisions of the Department of

25  Health are established:

26         (g)  Division of Medical Quality Assurance, which is

27  responsible for the following boards and professions

28  established within the division:

29         1.  Nursing assistants, as provided under s. 400.211.

30         2.  Health care services pools, as provided under s.

31  402.48.

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 1         3.  The Board of Acupuncture, created under chapter

 2  457.

 3         4.  The Board of Medicine, created under chapter 458.

 4         5.  The Board of Osteopathic Medicine, created under

 5  chapter 459.

 6         6.  The Board of Chiropractic Medicine, created under

 7  chapter 460.

 8         7.  The Board of Podiatric Medicine, created under

 9  chapter 461.

10         8.  Naturopathy, as provided under chapter 462.

11         9.  The Board of Optometry, created under chapter 463.

12         10.  The Board of Nursing, created under chapter 464.

13         11.  The Board of Pharmacy, created under chapter 465.

14         12.  The Board of Dentistry, created under chapter 466.

15         13.  Midwifery, as provided under chapter 467.

16         14.  The Board of Speech-Language Pathology and

17  Audiology, created under part I of chapter 468.

18         15.  The Board of Nursing Home Administrators, created

19  under part II of chapter 468.

20         16.  The Board of Occupational Therapy, created under

21  part III of chapter 468.

22         17.  Respiratory therapy, as provided under part V of

23  chapter 468.

24         18.  Dietetics and nutrition practice, as provided

25  under part X of chapter 468.

26         19.  The Board of Athletic Training trainers, created

27  as provided under part XIII of chapter 468.

28         20.  The Board of Orthotists and Prosthetists, created

29  under part XIV of chapter 468.

30         21.  Electrolysis, as provided under chapter 478.

31         22.  The Board of Massage Therapy, created under

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 1  chapter 480.

 2         23.  The Board of Clinical Laboratory Personnel,

 3  created under part III of chapter 483.

 4         24.  Medical physicists, as provided under part IV of

 5  chapter 483.

 6         25.  The Board of Opticianry, created under part I of

 7  chapter 484.

 8         26.  The Board of Hearing Aid Specialists, created

 9  under part II of chapter 484.

10         27.  The Board of Physical Therapy Practice, created

11  under chapter 486.

12         28.  The Board of Psychology, created under chapter

13  490.

14         29.  School psychologists, as provided under chapter

15  490.

16         30.  The Board of Clinical Social Work, Marriage and

17  Family Therapy, and Mental Health Counseling, created under

18  chapter 491.

19

20  The department may contract with the Agency for Health Care

21  Administration who shall provide consumer complaint,

22  investigative, and prosecutorial services required by the

23  Division of Medical Quality Assurance, councils, or boards, as

24  appropriate.

25         Section 132.  The Council of Athletic Training and the

26  terms of all council members are terminated on July 1, 1999.

27  However, such termination in no way precludes the Governor

28  from considering any former council member for appointment to

29  the Board of Athletic Training created by this act.

30         Section 133.  Section 468.805, Florida Statutes, is

31  amended to read:

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 1         468.805  Grandfathering Licensure without examination;

 2  provisional licensure.--

 3         (1)  A person who has practiced orthotics, prosthetics,

 4  or pedorthics in this state for the required period since July

 5  1, 1990, who, before March 1, 1998, applies to the department

 6  for a license to practice orthotics, prosthetics, or

 7  pedorthics, may be licensed as a prosthetist, orthotist,

 8  prosthetist-orthotist, orthotic fitter, orthotic fitter

 9  assistant, or pedorthist, as determined from the person's

10  experience, certification, and educational preparation,

11  without meeting the educational requirements set forth in s.

12  468.803, upon receipt of the application fee and licensing fee

13  and after the board has completed an investigation into the

14  applicant's background and experience. The board shall require

15  an application fee not to exceed $500, which shall be

16  nonrefundable. The board shall complete its investigation

17  within 6 months after receipt of the completed application.

18  The period of experience required for licensure under this

19  section subsection is 5 years for a prosthetist; 2 years for

20  an orthotic fitter, an orthotic fitter assistant, or a

21  pedorthist; and 5 years for an orthotist whose scope of

22  practice is defined under s. 468.80(7).

23         (2)(a)  A person who has received certification as an

24  orthotist, a prosthetist, or a prosthetist-orthotist from a

25  national certifying body and who has practiced orthotics or

26  prosthetics in this state for at least 2 years but less than 5

27  years is eligible for a provisional license.

28         (b)  An applicant for provisional licensure shall

29  submit proof that he or she has been actively practicing as a

30  nationally certified orthotist, prosthetist, or

31  prosthetist-orthotist, an application fee, and a provisional

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 1  license fee.

 2         (c)  A provisional licensee is required to practice

 3  under supervision of a fully licensed orthotist, prosthetist,

 4  or prosthetist-orthotist for up to 3 years in order to meet

 5  the 5-year experience requirement of subsection (1) to be

 6  licensed as an orthotist, prosthetist, or

 7  prosthetist-orthotist.

 8         (d)  After appropriate investigation, the board shall

 9  license as an orthotist, prosthetist, or prosthetist-orthotist

10  the provisional licensee who has successfully completed the

11  period of experience required and otherwise meets the

12  requirements of subsection (1).

13         (e)  The board shall require an application fee, not to

14  exceed $500, which is nonrefundable, and a provisional

15  licensure fee, not to exceed $500.

16         (3)  An applicant who has received certification as an

17  orthotist, a prosthetist, a prosthetist-orthotist, or a

18  pedorthist from a national certifying body which requires the

19  successful completion of an examination, may be licensed under

20  this section without taking an additional examination. An

21  applicant who has not received certification from a national

22  certifying body which requires the successful completion of an

23  examination shall be required to take an examination as

24  determined by the board. This examination shall be designed to

25  determine if the applicant has the minimum qualifications

26  needed to be licensed under this section. The board may charge

27  an examination fee and the actual per applicant cost to the

28  department for purchase or development of the examination.

29         (4)  An applicant who successfully completed prior to

30  March 1, 1998, at least one-half of the examination required

31  for national certification and successfully completed the

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 1  remaining portion of the examination and became certified

 2  prior to July 1, 1998, shall be considered as nationally

 3  certified by March 1, 1998, for purposes of this section.

 4         (5)(4)  This section is repealed July 1, 2002.

 5         Section 134.  Subsection (3) of section 468.806,

 6  Florida Statutes, is amended to read:

 7         468.806  Biennial renewal of license.--

 8         (3)  The board may by rule prescribe continuing

 9  education requirements and approve course criteria, not to

10  exceed 30 hours biennially, as a condition for license

11  renewal. The board shall establish a procedure for approving

12  continuing education courses and providers and may set a fee

13  for continuing education course and provider approval.

14         Section 135.  Subsection (5) of section 478.42, Florida

15  Statutes, is amended to read:

16         478.42  Definitions.--As used in this chapter, the

17  term:

18         (5)  "Electrolysis or electrology" means the permanent

19  removal of hair by destroying introducing, into and beneath

20  the skin, ionizing (galvanic current) or nonionizing radiation

21  (thermolysis or high-frequency current) to destroy the

22  hair-producing cells of the skin and vascular system, using

23  equipment and needle-type epilation devices approved by the

24  board which have been cleared by and that are registered with

25  the United States Food and Drug Administration and that are

26  used pursuant to protocols approved by the council and the

27  board.

28         Section 136.  Section 483.041, Florida Statutes, is

29  amended to read:

30         483.041  Definitions.--As used in this part, the term:

31         (1)  "Agency" means the Agency for Health Care

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 1  Administration.

 2         (2)  "Clinical laboratory" means the physical location

 3  in which one or more of the following services a laboratory

 4  where examinations are performed on materials or specimens

 5  taken from the human body to provide information or materials

 6  for use in the diagnosis, prevention, or treatment of a

 7  disease or the identification or assessment of a medical or

 8  physical condition.

 9         (a)  Clinical laboratory services are the examinations

10  of fluids or other materials taken from the human body.

11         (b)  Anatomic laboratory services are the examinations

12  of tissue taken from the human body.

13         (c)  Cytology laboratory services are the examinations

14  of cells from individual tissues or fluid taken from the human

15  body.

16         (3)  "Clinical laboratory examination" means a

17  procedure performed to deliver the services defined in

18  subsection (2), including the oversight or interpretation

19  thereof.

20         (4)(3)  "Clinical laboratory proficiency testing

21  program" means a program approved by the agency for evaluating

22  the performance of clinical laboratories.

23         (5)(4)  "Collection station" or "branch office" means a

24  facility operated by a clinical laboratory where materials or

25  specimens are withdrawn or collected from patients or

26  assembled after being withdrawn or collected from patients

27  elsewhere, for subsequent delivery to another location for

28  examination.

29         (6)(5)  "Hospital laboratory" means a laboratory

30  located in a hospital licensed under chapter 395 that provides

31  services solely to that hospital and that is owned by the

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 1  hospital and governed by the hospital medical staff or

 2  governing board.

 3         (7)(6)  "Licensed practitioner" means a physician

 4  licensed under chapter 458, chapter 459, chapter 460, or

 5  chapter 461; a dentist licensed under chapter 466; a person

 6  licensed under chapter 462; or an advanced registered nurse

 7  practitioner licensed under chapter 464 or a duly licensed

 8  practitioner from another state licensed under similar

 9  statutes who orders examinations on materials or specimens for

10  non residents of the State of Florida, but who reside in the

11  same state as the requesting licensed practitioner.

12         (8)(7)  "Person" means the State of Florida or any

13  individual, firm, partnership, association, corporation,

14  county, municipality, political subdivision, or other entity,

15  whether organized for profit or not.

16         (9)(8)  "Validation inspection" means an inspection of

17  a clinical laboratory by the agency to assess whether a review

18  by an accrediting organization has adequately evaluated the

19  clinical laboratory according to state standards.

20         (10)(9)  "Waived test" means a test that the federal

21  Health Care Financing Administration has determined qualifies

22  for a certificate of waiver under the federal Clinical

23  Laboratory Improvement Amendments of 1988, and the federal

24  rules adopted thereunder.

25         Section 137.  Subsections (2), (3), and (7) of section

26  483.803, Florida Statutes, are amended to read:

27         483.803  Definitions.--As used in this part, the term:

28         (2)  "Clinical laboratory" means a clinical laboratory

29  as defined in s. 483.041(2).

30         (3)  "Clinical laboratory examination" means a clinical

31  laboratory examination as defined in s. 483.041 an examination

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 1  performed on materials or specimens of the human body to

 2  provide information or materials for use in the diagnosis,

 3  prevention, or treatment of a disease or the identification or

 4  assessment of a medical or physical condition.

 5         (7)  "Licensed practitioner of the healing arts" means

 6  a physician licensed under pursuant to chapter 458, chapter

 7  459, or chapter 460, or chapter 461; a dentist licensed under

 8  pursuant to chapter 466; or a person licensed under pursuant

 9  to chapter 461 or chapter 462.

10

11

12         Section 138.  Subsection (9) of section 483.807,

13  Florida Statutes, 1998 Supplement, is amended to read:

14         483.807  Fees; establishment; disposition.--

15         (9)  The initial application and renewal fee for

16  approval as a laboratory training program may not exceed $300.

17  The fee for late filing of a renewal application shall be $50.

18         Section 139.  Subsections (2) and (3) of section

19  483.809, Florida Statutes, are amended to read:

20         483.809  Licensure; examinations; registration of

21  trainees; approval of curricula.--

22         (2)  EXAMINATIONS.--The department shall conduct

23  examinations required by board rules to determine in part the

24  qualification of clinical laboratory personnel for licensure.

25  The board by rule may designate a An approved national

26  certification examination that may be accepted in lieu of

27  state examination for clinical laboratory personnel or public

28  health scientists.

29         (3)  REGISTRATION OF TRAINEES.--The department shall

30  provide for annual registration of clinical laboratory

31  trainees who are enrolled in a training program employed by

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                                                  SENATE AMENDMENT

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 1  laboratories approved pursuant to s. 483.811, which

 2  registration may not be renewed except upon special

 3  authorization of the board.

 4         Section 140.  Section 483.812, Florida Statutes, is

 5  amended to read:

 6         483.812  Public health laboratory scientists;

 7  licensure.--

 8         (1)  Applicants at the director level in the category

 9  of public health shall qualify under s. 483.824.

10         (2)(1)  Applicants at the director and supervisor level

11  in the category of public health who are certified registered

12  by the National Registry in of Clinical Chemistry

13  Certification or the American Society for of Microbiology,

14  licensed as a technologist, and have 5 years of pertinent

15  clinical laboratory experience may qualify under board rules

16  by passing the state-administered appropriate supervision and

17  administration examination.

18         (3)(2)(a)  A technologist applicant for licensure in

19  the category of public health microbiology, with a

20  baccalaureate degree in one of the biological sciences from an

21  accredited institution, may use the American Society for of

22  Microbiology or the National Registry in of Microbiology

23  Certification in Public Health Microbiology to qualify for a

24  technologist license in public health microbiology.  Such a

25  technologist may work in a public health microbiology

26  laboratory.

27         (b)  A technologist applicant for licensure in the

28  category of public health chemistry, with a baccalaureate

29  degree in one of the chemical, biological, or physical

30  sciences from an accredited institution, may use the National

31  Registry of Clinical Chemistry Certification to qualify for a

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    Bill No. CS for SB 2220

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 1  technologist license in public health chemistry.  Such a

 2  technologist may work in a public health chemistry laboratory.

 3         (c)  A technician applicant for licensure in the

 4  category of public health, with a baccalaureate degree in one

 5  of the chemical or biological sciences from an accredited

 6  institution, may obtain a 2-year one-time, 3-year, conditional

 7  public health technician license, which may be renewed once

 8  pending national certification by the American Society of

 9  Microbiology or the National Registry of Clinical Chemistry

10  Certification. Such a technician may perform testing only

11  under the direct supervision of a licensed pathologist,

12  director, supervisor, or technologist.

13         (4)(3)  A person licensed by the Board of Clinical

14  Laboratory Personnel may work in a public health laboratory at

15  the appropriate level and specialty.

16         Section 141.  Section 483.813, Florida Statutes, is

17  amended to read:

18         483.813  Clinical laboratory personnel license.--A

19  person may not conduct a clinical laboratory examination or

20  report the results of such examination unless such person is

21  licensed under this part to perform such procedures. However,

22  this provision does not apply to any practitioner of the

23  healing arts authorized to practice in this state or to

24  persons engaged in testing performed by laboratories regulated

25  under s. 483.035(1) or exempt from regulation under s.

26  483.031(2). The department may grant a temporary license to

27  any candidate it deems properly qualified, for a period not to

28  exceed 1 year, or a conditional license for a period not to

29  exceed 3 years.

30         Section 142.  Subsection (3) is added to section

31  483.821, Florida Statutes, to read:

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

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 1         483.821  Periodic demonstration of competency;

 2  continuing education or reexamination.--

 3         (3)  The board may, by rule, provide for continuing

 4  education or retraining requirements for candidates failing an

 5  examination two or more times.

 6         Section 143.  Section 483.824, Florida Statutes, is

 7  amended to read:

 8         483.824  Qualifications of clinical laboratory

 9  director.--A clinical laboratory director must have 4 years of

10  clinical laboratory experience with 2 years of experience in

11  the speciality to be directed or be nationally board certified

12  in the specialty to be directed, and must meet one of the

13  following requirements:

14         (1)  Be a physician licensed under chapter 458 or

15  chapter 459;

16         (2)  Hold an earned doctoral degree in a chemical,

17  physical, or biological science from a regionally accredited

18  institution and be nationally certified; or

19         (3)  For the subspecialty of oral pathology, be a

20  physician licensed under chapter 458 or chapter 459 or a

21  dentist licensed under chapter 466.

22         Section 144.  Section 483.825, Florida Statutes, is

23  amended to read:

24         483.825  Grounds for disciplinary action.--The

25  following acts constitute grounds for which disciplinary

26  actions specified in s. 483.827 may be taken against

27  applicants, registrants, and licensees under this part:

28         (1)  Attempting to obtain, obtaining, or renewing a

29  license or registration under this part by bribery, by

30  fraudulent misrepresentation, or through an error of the

31  department or the board.

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                                                  SENATE AMENDMENT

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 1         (2)  Engaging in or attempting to engage in, or

 2  representing herself or himself as entitled to perform, any

 3  clinical laboratory procedure or category of procedures not

 4  authorized pursuant to her or his license.

 5         (3)  Demonstrating incompetence or making consistent

 6  errors in the performance of clinical laboratory examinations

 7  or procedures or erroneous reporting.

 8         (4)  Performing a test and rendering a report thereon

 9  to a person not authorized by law to receive such services.

10         (5)  Has been convicted or found guilty of, or entered

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

12  crime in any jurisdiction which directly relates to the

13  activities of clinical laboratory personnel or involves moral

14  turpitude or fraudulent or dishonest dealing. The record of a

15  conviction certified or authenticated in such form as to be

16  admissible in evidence under the laws of the state shall be

17  admissible as prima facie evidence of such guilt. Having been

18  convicted of a felony or of any crime involving moral

19  turpitude under the laws of any state or of the United States.

20  The record of conviction or a certified copy thereof shall be

21  conclusive evidence of such conviction.

22         (6)  Having been adjudged mentally or physically

23  incompetent.

24         (7)  Violating or aiding and abetting in the violation

25  of any provision of this part or the rules adopted hereunder.

26         (8)  Reporting a test result when no laboratory test

27  was performed on a clinical specimen.

28         (9)  Knowingly advertising false services or

29  credentials.

30         (10)  Having a license revoked, suspended, or otherwise

31  acted against, including the denial of licensure, by the

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  licensing authority of another jurisdiction. The licensing

 2  authority's acceptance of a relinquishment of a license,

 3  stipulation, consent order, or other settlement, offered in

 4  response to or in anticipation of the filing of administrative

 5  charges against the licensee, shall be construed as action

 6  against the licensee.

 7         (11)  Failing to report to the board, in writing,

 8  within 30 days that an if action under subsection (5),

 9  subsection (6), or subsection (10) has been taken against the

10  licensee or one's license to practice as clinical laboratory

11  personnel in another state, territory, or country, or other

12  jurisdiction.

13         (12)  Being unable to perform or report clinical

14  laboratory examinations with reasonable skill and safety to

15  patients by reason of illness or use of alcohol, drugs,

16  narcotics, chemicals, or any other type of material or as a

17  result of any mental or physical condition.  In enforcing this

18  subsection, the department shall have, upon a finding of the

19  secretary or his or her designee that probable cause exists to

20  believe that the licensee is unable to practice because of the

21  reasons stated in this subsection, the authority to issue an

22  order to compel a licensee to submit to a mental or physical

23  examination by physicians designated by the department.  If

24  the licensee refuses to comply with such order, the

25  department's order directing such examination may be enforced

26  by filing a petition for enforcement in the circuit court

27  where the licensee resides or does business.  The department

28  shall be entitled to the summary procedure provided in s.

29  51.011.  A licensee affected under this subsection shall at

30  reasonable intervals be afforded an opportunity to demonstrate

31  that he or she can resume competent practice with reasonable

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  skill and safety to patients.

 2         (13)  Delegating professional responsibilities to a

 3  person when the licensee delegating such responsibilities

 4  knows, or has reason to know, that such person is not

 5  qualified by training, experience, or licensure to perform

 6  them.

 7         (14)  Violating a previous order of the board entered

 8  in a disciplinary proceeding.

 9         (15)  Failing to report to the department a person or

10  other licensee who the licensee knows is in violation of this

11  chapter or the rules of the department or board adopted

12  hereunder.

13         (16)  Making or filing a report which the licensee

14  knows to be false, intentionally or negligently failing to

15  file a report or record required by state or federal law,

16  willfully impeding or obstructing such filing or inducing

17  another person to do so, including, but not limited to,

18  impeding an agent of the state from obtaining a report or

19  record for investigative purposes. Such reports or records

20  shall include only those generated in the capacity as a

21  licensed clinical laboratory personnel.

22         (17)  Paying or receiving any commission, bonus,

23  kickback, or rebate, or engaging in any split-fee arrangement

24  in any form whatsoever with a physician, organization, agency,

25  or person, either directly or indirectly for patients referred

26  to providers of health care goods and services including, but

27  not limited to, hospitals, nursing homes, clinical

28  laboratories, ambulatory surgical centers, or pharmacies. The

29  provisions of this subsection shall not be construed to

30  prevent a clinical laboratory professional from receiving a

31  fee for professional consultation services.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         (18)  Exercising influence on a patient or client in

 2  such a manner as to exploit the patient or client for the

 3  financial gain of the licensee or other third party, which

 4  shall include, but not be limited to, the promoting, selling,

 5  or withholding of services, goods, appliances, referrals, or

 6  drugs.

 7         (19)  Practicing or offering to practice beyond the

 8  scope permitted by law or rule, or accepting or performing

 9  professional services or responsibilities which the licensee

10  knows or has reason to know that he or she is not competent to

11  perform.

12         (20)  Misrepresenting or concealing a material fact at

13  any time during any phase of the licensing, investigative, or

14  disciplinary process, procedure, or proceeding.

15         (21)  Improperly interfering with an investigation or

16  any disciplinary proceeding.

17         (22)  Engaging in or attempting to engage in sexual

18  misconduct, causing undue embarrassment or using disparaging

19  language or language of a sexual nature towards a patient,

20  exploiting superior/subordinate, professional/patient,

21  instructor/student relationships for personal gain, sexual

22  gratification, or advantage.

23         Section 145.  Paragraph (g) of subsection (4) and

24  subsections (6) and (8) of section 483.901, Florida Statutes,

25  1998 Supplement, are amended to read:

26         483.901  Medical physicists; definitions; licensure.--

27         (4)  COUNCIL.--The Advisory Council of Medical

28  Physicists is created in the Department of Health to advise

29  the department in regulating the practice of medical physics

30  in this state.

31         (g)  If a vacancy on the council occurs, the secretary

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  director shall appoint a member to serve for a 4-year term.

 2         (6)  LICENSE REQUIRED.--An individual may not engage in

 3  the practice of medical physics, including the specialties of

 4  diagnostic radiological physics, therapeutic radiological

 5  physics, medical nuclear radiological physics, or medical

 6  health physics, without a license issued by the department for

 7  the appropriate specialty.

 8         (a)  The department shall adopt rules to administer

 9  this section which specify license application and renewal

10  fees, continuing education requirements, and standards for

11  practicing medical physics.  The council shall recommend to

12  the department continuing education requirements that shall be

13  a condition of license renewal.  The department shall require

14  a minimum of 24 hours per biennium of continuing education

15  offered by an organization recommended by the council and

16  approved by the department.  The department, upon

17  recommendation of the council, may adopt rules to specify

18  continuing education requirements for persons who hold a

19  license in more than one specialty.

20         (b)  In order to apply for a medical physicist license

21  in one or more specialties, a person must file an individual

22  application for each specialty with the department.  The

23  application must be on a form prescribed by the department and

24  must be accompanied by a nonrefundable application fee for

25  each specialty.

26         (c)  The department may issue a license to an eligible

27  applicant if the applicant meets all license requirements.  At

28  any time before the department issues a license, the applicant

29  may request in writing that the application be withdrawn.  To

30  reapply, the applicant must submit a new application and an

31  additional nonrefundable application fee and must meet all

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  current licensure requirements.

 2         (d)  The department shall review each completed

 3  application for a license which the department receives.

 4         (e)  On receipt of an application and fee as specified

 5  in this section, the department may issue a license to

 6  practice medical physics in this state:

 7         1.  Until October 1, 1998, to a person who meets any of

 8  the following requirements:

 9         a.  Earned from an accredited college or university a

10  doctoral degree in physics, medical physics, biophysics,

11  radiological physics, medical health physics, or nuclear

12  engineering and has at least 2 years' experience in the

13  practice of the medical physics specialty for which

14  application is made.

15         b.  Earned from an accredited college or university a

16  master's degree in physics, medical physics, biophysics,

17  radiological physics, medical health physics, or nuclear

18  engineering and has at least 3 years' experience in the

19  practice of the medical physics specialty for which

20  application is made.

21         c.  Earned from an accredited college or university a

22  bachelor's degree in physics and has at least 5 years'

23  experience in the practice of the medical physics specialty

24  for which application is made.

25         d.  Has at least 8 years' experience in the practice of

26  the medical physics specialty for which application is made, 2

27  years of which must have been earned within the 4 years

28  immediately preceding application for licensure.

29         e.  Is board certified in the medical physics specialty

30  in which the applicant applies to practice by the American

31  Board of Radiology for diagnostic radiological physics,

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  therapeutic radiological physics, or medical nuclear

 2  radiological physics; by the American Board of Medical Physics

 3  or the Canadian Board of Medical Physics for diagnostic

 4  radiological physics, therapeutic radiological physics, or

 5  medical nuclear radiological physics; or by the American Board

 6  of Health Physics or an equivalent certifying body approved by

 7  the agency.

 8         2.  On or after October 1, 1997, to a person who is

 9  board certified in the medical physics specialty in which the

10  applicant applies to practice by the American Board of

11  Radiology for diagnostic radiological physics, therapeutic

12  radiological physics, or medical nuclear radiological physics;

13  by the American Board of Medical Physics for diagnostic

14  radiological physics, therapeutic radiological physics, or

15  medical nuclear radiological physics; or by the American Board

16  of Health Physics or an equivalent certifying body approved by

17  the department.

18         (f)  A licensee shall:

19         1.  Display the license in a place accessible to the

20  public; and

21         2.  Report immediately any change in the licensee's

22  address or name to the department.

23         (g)  The following acts are grounds for which the

24  disciplinary actions in paragraph (h) may be taken:

25         1.  Obtaining or attempting to obtain a license by

26  bribery, fraud, knowing misrepresentation, or concealment of

27  material fact or through an error of the department.

28         2.  Having a license denied, revoked, suspended, or

29  otherwise acted against in another jurisdiction.

30         3.  Being convicted or found guilty of, or entering a

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  crime in any jurisdiction which relates to the practice of, or

 2  the ability to practice, the profession of medical physics.

 3         4.  Willfully failing to file a report or record

 4  required for medical physics or willfully impeding or

 5  obstructing the filing of a report or record required by this

 6  section or inducing another person to do so.

 7         5.  Making misleading, deceptive, or fraudulent

 8  representations in or related to the practice of medical

 9  physics.

10         6.  Willfully failing to report any known violation of

11  this section or any rule adopted thereunder.

12         7.  Willfully or repeatedly violating a rule adopted

13  under this section or an order of the department.

14         8.  Failing to perform any statutory or legal

15  obligation placed upon a licensee.

16         9.  Aiding, assisting, procuring, employing, or

17  advising any unlicensed person to practice medical physics

18  contrary to this section or any rule adopted thereunder.

19         10.  Delegating or contracting for the performance of

20  professional responsibilities by a person when the licensee

21  delegating or contracting such responsibilities knows, or has

22  reason to know, such person is not qualified by training,

23  experience, and authorization to perform them.

24         11.  Practicing or offering to practice beyond the

25  scope permitted by law or accepting and performing

26  professional responsibilities the licensee knows, or has

27  reason to know, the licensee is not competent to perform.

28         12.  Gross or repeated malpractice or the inability to

29  practice medical physics with reasonable skill and safety.

30         13.  Judicially determined mental incompetency.

31         14.  Being unable to practice medical physics with

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  reasonable skill and safety because of a mental or physical

 2  condition or illness or the use of alcohol, controlled

 3  substances, or any other substance which impairs one's ability

 4  to practice.

 5         a.  The department may, upon probable cause, compel a

 6  licensee to submit to a mental or physical examination by

 7  physicians designated by the department.  The cost of an

 8  examination shall be borne by the licensee, and the licensee's

 9  failure to submit to such an examination constitutes an

10  admission of the allegations against the licensee, consequent

11  upon which a default and a final order may be entered without

12  the taking of testimony or presentation of evidence, unless

13  the failure was due to circumstances beyond the licensee's

14  control.

15         b.  A licensee who is disciplined under this

16  subparagraph shall, at reasonable intervals, be afforded an

17  opportunity to demonstrate that the licensee can resume the

18  practice of medical physics with reasonable skill and safety.

19         c.  With respect to any proceeding under this

20  subparagraph, the record of proceedings or the orders entered

21  by the department may not be used against a licensee in any

22  other proceeding.

23         (h)  When the department finds any person guilty of any

24  of the grounds set forth in paragraph (g), including conduct

25  that would constitute a substantial violation of paragraph (g)

26  which occurred prior to licensure, it may enter an order

27  imposing one or more of the following penalties:

28         1.  Deny the application for licensure.

29         2.  Revoke or suspend the license.

30         3.  Impose an administrative fine for each count or

31  separate offense.

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         4.  Place the licensee on probation for a specified

 2  time and subject the licensee to such conditions as the

 3  department determines necessary, including requiring

 4  treatment, continuing education courses, or working under the

 5  monitoring or supervision of another licensee.

 6         5.  Restrict a licensee's practice.

 7         6.  Issue a reprimand to the licensee.

 8         (i)  The department may not issue or reinstate a

 9  license to a person it has deemed unqualified until it is

10  satisfied that such person has complied with the terms and

11  conditions of the final order and that the licensee can safely

12  practice medical physics.

13         (j)  The department may issue a temporary license to an

14  applicant pending completion of the application process for

15  board certification.

16         (j)(k)  Upon receipt of a complete application and the

17  fee set forth by rule, the department may issue a

18  physicist-in-training certificate to a person qualified to

19  practice medical physics under direct supervision. The

20  department may establish by rule requirements for initial

21  certification and renewal of a physicist-in-training

22  certificate.

23         (8)  DISPOSITION OF FEES.--The department shall deposit

24  all funds received into the Medical Quality Assurance Health

25  Care Trust Fund.

26         Section 146.  Paragraph (d) of subsection (1) of

27  section 484.007, Florida Statutes, is amended to read:

28         484.007  Licensure of opticians; permitting of optical

29  establishments.--

30         (1)  Any person desiring to practice opticianry shall

31  apply to the department, upon forms prescribed by it, to take

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  a licensure examination. The department shall examine each

 2  applicant who the board certifies:

 3         (d)1.  Has received an associate degree, or its

 4  equivalent, in opticianry from an educational institution the

 5  curriculum of which is accredited by an accrediting agency

 6  recognized and approved by the United States Department of

 7  Education or the Council on Postsecondary Education or

 8  approved by the board;

 9         2.  Is an individual licensed to practice the

10  profession of opticianry pursuant to a regulatory licensing

11  law of another state, territory, or jurisdiction of the United

12  States, who has actively practiced in such other state,

13  territory, or jurisdiction for more than 3 years immediately

14  preceding application, and who meets the examination

15  qualifications as provided in this subsection;

16         3.  Is an individual who has actively practiced in

17  another state, territory, or jurisdiction of the United States

18  for more than 5 years immediately preceding application and

19  who provides tax or business records, affidavits, or other

20  satisfactory documentation of such practice and who meets the

21  examination qualifications as provided in this subsection; or

22         4.  Has registered as an apprentice with the department

23  and paid a registration fee not to exceed $60, as set by rule

24  of the board. The apprentice shall complete 6,240 hours of

25  training under the supervision of an optician licensed in this

26  state for at least 1 year or of, a physician, or an

27  optometrist licensed under the laws of this state. These

28  requirements must be met within 5 years after the date of

29  registration. However, any time spent in a recognized school

30  may be considered as part of the apprenticeship program

31  provided herein. The board may establish administrative

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  processing fees sufficient to cover the cost of administering

 2  apprentice rules as promulgated by the board.

 3         Section 147.  Subsection (3) is added to section

 4  484.0512, Florida Statutes, to read:

 5         484.0512  Thirty-day trial period; purchaser's right to

 6  cancel; notice; refund; cancellation fee.--

 7         (3)  Within 30 days after the return or attempted

 8  return of the hearing aid, the seller shall refund all moneys

 9  that must be refunded to a purchaser pursuant to this section.

10         Section 148.  Section 484.053, Florida Statutes, is

11  amended to read:

12         484.053  Prohibitions; penalties.--

13         (1)  A person may not:

14         (a)  Practice dispensing hearing aids unless the person

15  is a licensed hearing aid specialist;

16         (b)  Use the name or title "hearing aid specialist"

17  when the person has not been licensed under this part;

18         (c)  Present as her or his own the license of another;

19         (d)  Give false, incomplete, or forged evidence to the

20  board or a member thereof for the purposes of obtaining a

21  license;

22         (e)  Use or attempt to use a hearing aid specialist

23  license that is delinquent or has been suspended, revoked, or

24  placed on inactive or delinquent status;

25         (f)  Knowingly employ unlicensed persons in the

26  practice of dispensing hearing aids; or

27         (g)  Knowingly conceal information relative to

28  violations of this part.

29         (2)  Any person who violates any of the provisions of

30  this section is guilty of a felony misdemeanor of the third

31  second degree, punishable as provided in s. 775.082 or s.

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 1  775.083.

 2         (3)  If a person licensed under this part allows the

 3  sale of a hearing aid by an unlicensed person not registered

 4  as a trainee or fails to comply with the requirements of s.

 5  484.0445(2) relating to supervision of trainees, the board

 6  shall, upon determination of that violation, order the full

 7  refund of moneys paid by the purchaser upon return of the

 8  hearing aid to the seller's place of business.

 9         Section 149.  Paragraph (a) of subsection (1) of

10  section 484.056, Florida Statutes, 1998 Supplement, is amended

11  to read:

12         484.056  Disciplinary proceedings.--

13         (1)  The following acts relating to the practice of

14  dispensing hearing aids shall be grounds for both disciplinary

15  action against a hearing aid specialist as set forth in this

16  section and cease and desist or other related action by the

17  department as set forth in s. 455.637 against any person

18  owning or operating a hearing aid establishment who engages

19  in, aids, or abets any such violation:

20         (a)  Violation of any provision of s. 455.624(1), s.

21  484.0512, or s. 484.053.

22         Section 150.  Section 486.041, Florida Statutes, is

23  amended to read:

24         486.041  Physical therapist; application for license;

25  fee; temporary permit.--

26         (1)  A person who desires to be licensed as a physical

27  therapist shall apply to the department in writing on a form

28  furnished by the department.  She or he shall embody in that

29  application evidence under oath, satisfactory to the board, of

30  possession of the qualifications preliminary to examination

31  required by s. 486.031. The applicant shall pay to the

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 1  department at the time of filing the application a fee not to

 2  exceed $100, as fixed by the board.

 3         (2)  If a person desires to practice physical therapy

 4  before becoming licensed through examination, she or he shall

 5  apply for a temporary permit in accordance with rules adopted

 6  pursuant to this chapter.

 7         (a)  A temporary permit shall only be issued for a

 8  limited period of time, not to exceed 1 year, and shall not be

 9  renewable. A temporary permit shall automatically expire if an

10  applicant fails the examination.

11         (b)  An applicant for licensure by examination and

12  practicing under a temporary permit shall do so only under the

13  direct supervision of a licensed physical therapist.

14         Section 151.  Section 486.081, Florida Statutes, is

15  amended to read:

16         486.081  Physical therapist; issuance of license

17  without examination to person passing examination of another

18  authorized examining board; temporary permit; fee.--

19         (1)  The board may cause a license to be issued through

20  the department without examination to any applicant who

21  presents evidence satisfactory to the board of having passed

22  the American Registry Examination prior to 1971 or an

23  examination in physical therapy before a similar lawfully

24  authorized examining board of another state, the District of

25  Columbia, a territory, or a foreign country, if the standards

26  for licensure in physical therapy in such other state,

27  district, territory, or foreign country are determined by the

28  board to be as high as those of this state, as established by

29  rules adopted pursuant to this chapter. Any person who holds a

30  license pursuant to this section may use the words "physical

31  therapist" or "physiotherapist," or the letters "P.T.," in

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 1  connection with her or his name or place of business to denote

 2  her or his licensure hereunder.

 3         (2)  At the time of making application for licensure

 4  without examination pursuant to the terms of this section, the

 5  applicant shall pay to the department a fee not to exceed $175

 6  as fixed by the board, no part of which will be returned.

 7         (3)  If a person desires to practice physical therapy

 8  before becoming licensed through endorsement, she or he shall

 9  apply to the board for a temporary permit in accordance with

10  rules adopted pursuant to this chapter. A temporary permit

11  shall only be issued for a limited period of time, not to

12  exceed 1 year, and shall not be renewable.

13         Section 152.  Section 486.103, Florida Statutes, is

14  amended to read:

15         486.103  Physical therapist assistant; application for

16  license; fee; temporary permit.--

17         (1)  A person who desires to be licensed as a physical

18  therapist assistant shall apply to the department in writing

19  on a form furnished by the department.  She or he shall embody

20  in that application evidence under oath, satisfactory to the

21  board, of possession of the qualifications preliminary to

22  examination required by s. 486.104. The applicant shall pay to

23  the department at the time of filing the application a fee not

24  to exceed $100, as fixed by the board.

25         (2)  If a person desires to work as a physical

26  therapist assistant before being licensed through examination,

27  she or he shall apply for a temporary permit in accordance

28  with rules adopted pursuant to this chapter.

29         (a)  A temporary permit shall only be issued for a

30  limited period of time, not to exceed 1 year, and shall not be

31  renewable. A temporary permit shall automatically expire if an

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 1  applicant fails the examination.

 2         (b)  An applicant for licensure by examination who is

 3  practicing under a temporary permit shall do so only under the

 4  direct supervision of a licensed physical therapist.

 5         Section 153.  Section 486.107, Florida Statutes, is

 6  amended to read:

 7         486.107  Physical therapist assistant; issuance of

 8  license without examination to person licensed in another

 9  jurisdiction; temporary permit; fee.--

10         (1)  The board may cause a license to be issued through

11  the department without examination to any applicant who

12  presents evidence to the board, under oath, of licensure in

13  another state, the District of Columbia, or a territory, if

14  the standards for registering as a physical therapist

15  assistant or licensing of a physical therapist assistant, as

16  the case may be, in such other state are determined by the

17  board to be as high as those of this state, as established by

18  rules adopted pursuant to this chapter. Any person who holds a

19  license pursuant to this section may use the words "physical

20  therapist assistant," or the letters "P.T.A.," in connection

21  with her or his name to denote licensure hereunder.

22         (2)  At the time of making application for licensing

23  without examination pursuant to the terms of this section, the

24  applicant shall pay to the department a fee not to exceed $175

25  as fixed by the board, no part of which will be returned.

26         (3)  If a person desires to work as a physical

27  therapist assistant before being licensed through endorsement,

28  she or he shall apply for a temporary permit in accordance

29  with rules adopted pursuant to this chapter.  A temporary

30  permit shall only be issued for a limited period of time, not

31  to exceed 1 year, and shall not be renewable.

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 1         Section 154.  Paragraph (b) of subsection (1) of

 2  section 490.005, Florida Statutes, 1998 Supplement, is amended

 3  to read:

 4         490.005  Licensure by examination.--

 5         (1)  Any person desiring to be licensed as a

 6  psychologist shall apply to the department to take the

 7  licensure examination. The department shall license each

 8  applicant who the board certifies has:

 9         (b)  Submitted proof satisfactory to the board that the

10  applicant has:

11         1.  Received doctoral-level psychological education, as

12  defined in s. 490.003(3);

13         2.  Received the equivalent of a doctoral-level

14  psychological education, as defined in s. 490.003(3), from a

15  program at a school or university located outside the United

16  States of America and Canada, which was officially recognized

17  by the government of the country in which it is located as an

18  institution or program to train students to practice

19  professional psychology.  The burden of establishing that the

20  requirements of this provision have been met shall be upon the

21  applicant;

22         3.  Received and submitted to the board, prior to July

23  1, 1999, certification of an augmented doctoral-level

24  psychological education from the program director of a

25  doctoral-level psychology program accredited by a programmatic

26  agency recognized and approved by the United States Department

27  of Education; or

28         4.  Received and submitted to the board, prior to

29  August 31, 2001 July 1, 2001, certification of a

30  doctoral-level program that at the time the applicant was

31  enrolled and graduated maintained a standard of education and

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 1  training comparable to the standard of training of programs

 2  accredited by a programmatic agency recognized and approved by

 3  the United States Department of Education, as such

 4  comparability was determined by the Board of Psychological

 5  Examiners immediately prior to the amendment of s. 490.005,

 6  Florida Statutes, 1994 Supplement, by s. 5, chapter 95-279,

 7  Laws of Florida. Such certification of comparability shall be

 8  provided by the program director of a doctoral-level

 9  psychology program accredited by a programmatic agency

10  recognized and approved by the United States Department of

11  Education.

12         Section 155.  Subsection (1) of section 490.006,

13  Florida Statutes, is amended to read:

14         490.006  Licensure by endorsement.--

15         (1)  The department shall license a person as a

16  psychologist or school psychologist who, upon applying to the

17  department and remitting the appropriate fee, demonstrates to

18  the department or, in the case of psychologists, to the board

19  that the applicant:

20         (a)  Holds a valid license or certificate in another

21  state to practice psychology or school psychology, as

22  applicable, provided that, when the applicant secured such

23  license or certificate, the requirements were substantially

24  equivalent to or more stringent than those set forth in this

25  chapter at that time; and, if no Florida law existed at that

26  time, then the requirements in the other state must have been

27  substantially equivalent to or more stringent than those set

28  forth in this chapter at the present time; or

29         (b)  Is a diplomate in good standing with the American

30  Board of Professional Psychology, Inc.; or

31         (c)  Possesses a doctoral degree in psychology as

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 1  described in s. 490.003 and has at least 20 years of

 2  experience as a licensed psychologist in any jurisdiction or

 3  territory of the United States within 25 years preceding the

 4  date of application.

 5         Section 156.  Subsection (2) of section 490.0085,

 6  Florida Statutes, is amended to read:

 7         490.0085  Continuing education; approval of providers,

 8  programs, and courses; proof of completion.--

 9         (2)  The department or, in the case of psychologists,

10  the board has the authority to set a fee not to exceed $500

11  for each applicant who applies for or renews provider status.

12  Such fees shall be deposited into the Medical Quality

13  Assurance Health Care Trust Fund.

14         Section 157.  Section 491.0045, Florida Statutes, is

15  amended to read:

16         491.0045  Intern registration; requirements.--

17         (1)  Effective January 1, 1998, an individual who

18  intends to practice in Florida to satisfy the postgraduate or

19  post-master's level experience requirements, as specified in

20  s. 491.005(1)(c), (3)(c), or (4)(c), must register as an

21  intern in the profession for which he or she is seeking

22  licensure prior to commencing the post-master's experience

23  requirement or an individual who intends to satisfy part of

24  the required graduate-level practicum, internship, or field

25  experience, outside the academic arena for any profession,

26  must register as an intern in the profession for which he or

27  she is seeking licensure prior to commencing the practicum,

28  internship, or field experience.

29         (2)  The department shall register as a clinical social

30  worker intern, marriage and family therapist intern, or mental

31  health counselor intern each applicant who the board certifies

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 1  has:

 2         (a)  Completed the application form and remitted a

 3  nonrefundable application fee not to exceed $200, as set by

 4  board rule;

 5         (b)1.  Completed the education requirements as

 6  specified in s. 491.005(1)(c), (3)(c), or (4)(c) for the

 7  profession for which he or she is applying for licensure, if

 8  needed; and

 9         2.  Submitted an acceptable supervision plan, as

10  determined by the board, for meeting the practicum,

11  internship, or field work required for licensure that was not

12  satisfied in his or her graduate program.

13         (c)  Identified a qualified supervisor.

14         (3)  An individual registered under this section must

15  remain under supervision until he or she is in receipt of a

16  license or a letter from the department stating that he or she

17  is licensed to practice the profession for which he or she

18  applied.

19         (4)  An individual who has applied for intern

20  registration on or before December 31, 2001, and has satisfied

21  the education requirements of s. 491.005 that are in effect

22  through December 31, 2000, will have met the educational

23  requirements for licensure for the profession for which he or

24  she has applied.

25         (5)  Individuals who have commenced the experience

26  requirement as specified in s. 491.005(1)(c), (3)(c), or

27  (4)(c) but failed to register as required by subsection (1)

28  shall register with the department before January 1, 2000.

29  Individuals who fail to comply with this subsection shall not

30  be granted a license, and any time spent by the individual

31  completing the experience requirement prior to registering as

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    Bill No. CS for SB 2220

    Amendment No.    





 1  an intern shall not count toward completion of such

 2  requirement.

 3         Section 158.  Subsections (1) and (2) of section

 4  491.0046, Florida Statutes, are amended to read:

 5         491.0046  Provisional license; requirements.--

 6         (1)  An individual applying for licensure by

 7  examination who has satisfied the clinical experience

 8  requirements of s. 491.005 or an individual applying for

 9  licensure by endorsement pursuant to s. 491.006 intending to

10  provide clinical social work, marriage and family therapy, or

11  mental health counseling services in Florida while satisfying

12  coursework or examination requirements for licensure must be

13  provisionally licensed in the profession for which he or she

14  is seeking licensure prior to beginning practice.

15         (2)  The department shall issue a provisional clinical

16  social worker license, provisional marriage and family

17  therapist license, or provisional mental health counselor

18  license to each applicant who the board certifies has:

19         (a)  Completed the application form and remitted a

20  nonrefundable application fee not to exceed $100, as set by

21  board rule; and

22         (b)1.  Earned a graduate degree in social work, a

23  graduate degree with a major emphasis in marriage and family

24  therapy or a closely related field, or a graduate degree in a

25  major related to the practice of mental health counseling;

26  and, and satisfied the clinical experience requirements for

27  licensure pursuant to s. 491.005; or

28         2.  Been approved for examination under the provisions

29  for licensure by endorsement pursuant to s. 491.006.

30         (c)  Has met the following minimum coursework

31  requirements:

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 1         1.  For clinical social work, a minimum of 15 semester

 2  hours or 22 quarter hours of the coursework required by s.

 3  491.005(1)(b)2.b.

 4         2.  For marriage and family therapy, ten of the courses

 5  required by s. 491.005(3)(b)1.a.-c., as determined by the

 6  board, and at least 6 semester hours or 9 quarter hours of the

 7  course credits must have been completed in the area of

 8  marriage and family systems, theories, or techniques.

 9         3.  For mental health counseling, a minimum of seven of

10  the courses required under s. 491.005(b)1.a.-c.

11         Section 159.  Section 491.005, Florida Statutes, is

12  amended to read:

13         491.005  Licensure by examination.--

14         (1)  CLINICAL SOCIAL WORK.--Upon verification of

15  documentation and payment of a fee not to exceed $200, as set

16  by board rule, plus the actual per applicant cost to the

17  department for purchase of the examination from the American

18  Association of State Social Worker's Boards or a similar

19  national organization, the department shall issue a license as

20  a clinical social worker to an applicant who the board

21  certifies:

22         (a)  Has made application therefor and paid the

23  appropriate fee.

24         (b)1.  Has received a doctoral degree in social work

25  from a graduate school of social work which at the time the

26  applicant graduated was accredited by an accrediting agency

27  recognized by the United States Department of Education or has

28  received a master's degree in social work from a graduate

29  school of social work which at the time the applicant

30  graduated:

31         a.  Was accredited by the Council on Social Work

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 1  Education;

 2         b.  Was accredited by the Canadian Association of

 3  Schools of Social Work; or

 4         c.  Has been determined to have been a program

 5  equivalent to programs approved by the Council on Social Work

 6  Education by the Foreign Equivalency Determination Service of

 7  the Council on Social Work Education.  An applicant who

 8  graduated from a program at a university or college outside of

 9  the United States or Canada must present documentation of the

10  equivalency determination from the council in order to

11  qualify.

12         2.  The applicant's graduate program must have

13  emphasized direct clinical patient or client health care

14  services, including, but not limited to, coursework in

15  clinical social work, psychiatric social work, medical social

16  work, social casework, psychotherapy, or group therapy.  The

17  applicant's graduate program must have included all of the

18  following coursework:

19         a.  A supervised field placement which was part of the

20  applicant's advanced concentration in direct practice, during

21  which the applicant provided clinical services directly to

22  clients.

23         b.  Completion of 24 semester hours or 32 37 quarter

24  hours in theory of human behavior and practice methods as

25  courses in clinically oriented services, including a minimum

26  of one course in psychopathology, and no more than one course

27  in research, taken in a school of social work accredited or

28  approved pursuant to subparagraph 1.

29         3.  If the course title which appears on the

30  applicant's transcript does not clearly identify the content

31  of the coursework, the applicant shall be required to provide

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 1  additional documentation, including, but not limited to, a

 2  syllabus or catalog description published for the course.

 3         (c)  Has had not less than 2 years of clinical social

 4  work experience, which took place subsequent to completion of

 5  a graduate degree in social work at an institution meeting the

 6  accreditation requirements of this section, under the

 7  supervision of a licensed clinical social worker or the

 8  equivalent who is a qualified supervisor as determined by the

 9  board. An individual who intends to practice in Florida to

10  satisfy clinical experience requirements must register

11  pursuant to s. 491.0045 prior to commencing practice.  If the

12  applicant's graduate program was not a program which

13  emphasized direct clinical patient or client health care

14  services as described in subparagraph (b)2. s. 491.003, the

15  supervised experience requirement must take place after the

16  applicant has completed a minimum of 15 semester hours or 22

17  quarter hours of the coursework required.  A doctoral

18  internship may be applied toward the clinical social work

19  experience requirement. The experience requirement may be met

20  by work performed on or off the premises of the supervising

21  clinical social worker or the equivalent, provided the

22  off-premises work is not the independent private practice

23  rendering of clinical social work that does not have a

24  licensed mental health professional, as determined by the

25  board, on the premises at the same time the intern is

26  providing services.

27         (d)  Has passed a theory and practice examination

28  provided by the department for this purpose.

29         (e)  Has demonstrated, in a manner designated by rule

30  of the board, knowledge of the laws and rules governing the

31  practice of clinical social work, marriage and family therapy,

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 1  and mental health counseling.

 2         (2)  CLINICAL SOCIAL WORK.--

 3         (a)  Notwithstanding the provisions of paragraph

 4  (1)(b), coursework which was taken at a baccalaureate level

 5  shall not be considered toward completion of education

 6  requirements for licensure unless an official of the graduate

 7  program certifies in writing on the graduate school's

 8  stationery that a specific course, which students enrolled in

 9  the same graduate program were ordinarily required to complete

10  at the graduate level, was waived or exempted based on

11  completion of a similar course at the baccalaureate level.  If

12  this condition is met, the board shall apply the baccalaureate

13  course named toward the education requirements.

14         (b)  An applicant from a master's or doctoral program

15  in social work which did not emphasize direct patient or

16  client services may complete the clinical curriculum content

17  requirement by returning to a graduate program accredited by

18  the Council on Social Work Education or the Canadian

19  Association of Schools of Social Work, or to a clinical social

20  work graduate program with comparable standards, in order to

21  complete the education requirements for examination.  However,

22  a maximum of 6 semester or 9 quarter hours of the clinical

23  curriculum content requirement may be completed by credit

24  awarded for independent study coursework as defined by board

25  rule.

26         (3)  MARRIAGE AND FAMILY THERAPY.-- Upon verification

27  of documentation and payment of a fee not to exceed $200, as

28  set by board rule, plus the actual cost to the department for

29  the purchase of the examination from the Association of

30  Marital and Family Therapy Regulatory Board, or similar

31  national organization, the department shall issue a license as

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 1  a marriage and family therapist to an applicant who the board

 2  certifies:

 3         (a)  Has made application therefor and paid the

 4  appropriate fee.

 5         (b)1.  Has a minimum of a master's degree with major

 6  emphasis in marriage and family therapy, or a closely related

 7  field, and has completed all of the following requirements:

 8         a.  Twenty-seven semester hours or 41 quarter hours of

 9  graduate coursework, which must include a minimum of 2

10  semester hours or 3 quarter hours of graduate-level course

11  credits in each of the following nine areas: dynamics of

12  marriage and family systems; marriage therapy and counseling

13  theory and techniques; family therapy and counseling theory

14  and techniques; individual human development theories

15  throughout the life cycle; personality theory;

16  psychopathology; human sexuality theory and counseling

17  techniques; general counseling theory and techniques; and

18  psychosocial theory. Content may be combined, provided no more

19  than two of the nine content areas are included in any one

20  graduate-level course and the applicant can document that the

21  equivalent of 2 semester hours of coursework was devoted to

22  each content area. Courses in research, evaluation, appraisal,

23  assessment, or testing theories and procedures; thesis or

24  dissertation work; or practicums, internships, or fieldwork

25  may not be applied toward this requirement.

26         b.  A minimum of one graduate-level course of 2

27  semester hours or 3 quarter hours in legal, ethical, and

28  professional standards issues in the practice of marriage and

29  family therapy or a course determined by the board to be

30  equivalent.

31         c.  A minimum of one graduate-level course of 2

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 1  semester hours or 3 quarter hours in diagnosis, appraisal,

 2  assessment, and testing for individual or interpersonal

 3  disorder or dysfunction; and a minimum of one 2-semester-hour

 4  or 3-quarter-hour graduate-level course in behavioral research

 5  which focuses on the interpretation and application of

 6  research data as it applies to clinical practice.  Credit for

 7  thesis or dissertation work, practicums, internships, or

 8  fieldwork may not be applied toward this requirement.

 9         d.  A minimum of one supervised clinical practicum,

10  internship, or field experience in a marriage and family

11  counseling setting, during which the student provided 180

12  direct client contact hours of marriage and family therapy

13  services under the supervision of an individual who met the

14  requirements for supervision under paragraph (c).  This

15  requirement may be met by a supervised practice experience

16  which took place outside the academic arena, but which is

17  certified as equivalent to a graduate-level practicum or

18  internship program which required a minimum of 180 direct

19  client contact hours of marriage and family therapy services

20  currently offered within an academic program of a college or

21  university accredited by an accrediting agency approved by the

22  United States Department of Education, or an institution which

23  is publicly recognized as a member in good standing with the

24  Association of Universities and Colleges of Canada or a

25  training institution accredited by the Commission on

26  Accreditation for Marriage and Family Therapy Education

27  recognized by the United States Department of Education.

28  Certification shall be required from an official of such

29  college, university, or training institution.

30         2.  If the course title which appears on the

31  applicant's transcript does not clearly identify the content

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 1  of the coursework, the applicant shall be required to provide

 2  additional documentation, including, but not limited to, a

 3  syllabus or catalog description published for the course.

 4

 5  The required master's degree must have been received in an

 6  institution of higher education which at the time the

 7  applicant graduated was:  fully accredited by a regional

 8  accrediting body recognized by the Commission on Recognition

 9  of Postsecondary Accreditation; publicly recognized as a

10  member in good standing with the Association of Universities

11  and Colleges of Canada; or an institution of higher education

12  located outside the United States and Canada, which at the

13  time the applicant was enrolled and at the time the applicant

14  graduated maintained a standard of training substantially

15  equivalent to the standards of training of those institutions

16  in the United States which are accredited by a regional

17  accrediting body recognized by the Commission on Recognition

18  of Postsecondary Accreditation.  Such foreign education and

19  training must have been received in an institution or program

20  of higher education officially recognized by the government of

21  the country in which it is located as an institution or

22  program to train students to practice as professional marriage

23  and family therapists or psychotherapists.  The burden of

24  establishing that the requirements of this provision have been

25  met shall be upon the applicant, and the board shall require

26  documentation, such as, but not limited to, an evaluation by a

27  foreign equivalency determination service, as evidence that

28  the applicant's graduate degree program and education were

29  equivalent to an accredited program in this country.  An

30  applicant with a master's degree from a program which did not

31  emphasize marriage and family therapy may complete the

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    Amendment No.    





 1  coursework requirement in a training institution fully

 2  accredited by the Commission on Accreditation for Marriage and

 3  Family Therapy Education recognized by the United States

 4  Department of Education.

 5         (c)  Has had not less than 2 years of clinical

 6  experience during which 50 percent of the applicant's clients

 7  were receiving marriage and family therapy services, which

 8  must be at the post-master's level under the supervision of a

 9  licensed marriage and family therapist with at least 5 years

10  of experience, or the equivalent, who is a qualified

11  supervisor as determined by the board.  An individual who

12  intends to practice in Florida to satisfy the clinical

13  experience requirements must register pursuant to s. 491.0045

14  prior to commencing practice.  If a graduate has a master's

15  degree with a major emphasis in marriage and family therapy or

16  a closely related field that did not include all the

17  coursework required under sub-subparagraphs (b)1.a.-c., credit

18  for the post-master's level clinical experience shall not

19  commence until the applicant has completed a minimum of 10 of

20  the courses required under sub-subparagraphs (b)1.a.-c., as

21  determined by the board, and at least 6 semester hours or 9

22  quarter hours of the course credits must have been completed

23  in the area of marriage and family systems, theories, or

24  techniques. Within the 3 years of required experience, the

25  applicant shall provide direct individual, group, or family

26  therapy and counseling, to include the following categories of

27  cases:  unmarried dyads, married couples, separating and

28  divorcing couples, and family groups including children.  A

29  doctoral internship may be applied toward the clinical

30  experience requirement.  The clinical experience requirement

31  may be met by work performed on or off the premises of the

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 1  supervising marriage and family therapist or the equivalent,

 2  provided the off-premises work is not the independent private

 3  practice rendering of marriage and family therapy 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         (f)  For the purposes of dual licensure, the department

14  shall license as a marriage and family therapist any person

15  who meets the requirements of s. 491.0057. Fees for dual

16  licensure shall not exceed those stated in this subsection.

17         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

18  documentation and payment of a fee not to exceed $200, as set

19  by board rule, plus the actual per applicant cost to the

20  department for purchase of the examination from the

21  Professional Examination Service for the National Academy of

22  Certified Clinical Mental Health Counselors or a similar

23  national organization, the department shall issue a license as

24  a mental health counselor to an applicant who the board

25  certifies:

26         (a)  Has made application therefor and paid the

27  appropriate fee.

28         (b)1.  Has received a minimum of an earned master's

29  degree with a major related to the practice of mental health

30  counseling, and has completed all of the following

31  requirements:

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    Bill No. CS for SB 2220

    Amendment No.    





 1         a.  Twenty-one semester hours or 32 quarter hours of

 2  graduate coursework, which must include a minimum of 2

 3  semester hours or 3 quarter hours of graduate-level coursework

 4  in each of the following seven content areas:  counseling

 5  theories and practice; human development theories; personality

 6  theory; psychopathology or abnormal psychology; human

 7  sexuality theories; group theories and practice; and

 8  individual evaluation and assessment.  Content may be

 9  combined, provided no more than two of the seven content areas

10  are included in any one graduate-level course and the

11  applicant can document that the equivalent of 2 semester hours

12  of content was devoted to each content area.  Courses in

13  research, thesis or dissertation work, practicums,

14  internships, or fieldwork may not be applied toward this

15  requirement.

16         b.  A minimum of one 2-semester-hour or 3-quarter-hour

17  graduate-level course in research or in career or vocational

18  counseling. Credit for thesis or dissertation work,

19  practicums, internships, or fieldwork may not be applied

20  toward this requirement.

21         c.  A minimum of 2 semester hours or 3 quarter hours of

22  graduate-level coursework in legal, ethical, and professional

23  standards issues in the practice of mental health counseling,

24  which includes goals and objectives of professional counseling

25  organizations, codes of ethics, legal considerations,

26  standards of preparation, certifications and licensing, and

27  the role identity of counselors.  Courses in research, thesis

28  or dissertation work, practicums, internships, or fieldwork

29  may not be applied toward this requirement.

30         d.  A minimum of one supervised practicum, internship,

31  or field experience in a counseling setting.  This requirement

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    Bill No. CS for SB 2220

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 1  may be met by a supervised practice experience which takes

 2  place outside the academic arena, but which is certified as

 3  equivalent to a graduate-level practicum in a clinical mental

 4  health counseling setting currently offered within an academic

 5  program of a college or university accredited by an

 6  accrediting agency approved by the United States Department of

 7  Education. Such certification shall be required from an

 8  official of such college or university.

 9         2.  If the course title which appears on the

10  applicant's transcript does not clearly identify the content

11  of the coursework, the applicant shall be required to provide

12  additional documentation, including, but not limited to, a

13  syllabus or catalog description published for the course.

14

15  Except as provided in sub-subparagraph 1.d., education and

16  training in mental health counseling must have been received

17  in an institution of higher education which at the time the

18  applicant graduated was:  fully accredited by a regional

19  accrediting body recognized by the Commission on Recognition

20  of Postsecondary Accreditation; publicly recognized as a

21  member in good standing with the Association of Universities

22  and Colleges of Canada; or an institution of higher education

23  located outside the United States and Canada, which at the

24  time the applicant was enrolled and at the time the applicant

25  graduated maintained a standard of training substantially

26  equivalent to the standards of training of those institutions

27  in the United States which are accredited by a regional

28  accrediting body recognized by the Commission on Recognition

29  of Postsecondary Accreditation. Such foreign education and

30  training must have been received in an institution or program

31  of higher education officially recognized by the government of

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    Bill No. CS for SB 2220

    Amendment No.    





 1  the country in which it is located as an institution or

 2  program to train students to practice as mental health

 3  counselors.  The burden of establishing that the requirements

 4  of this provision have been met shall be upon the applicant,

 5  and the board shall require documentation, such as, but not

 6  limited to, an evaluation by a foreign equivalency

 7  determination service, as evidence that the applicant's

 8  graduate degree program and education were equivalent to an

 9  accredited program in this country.

10         (c)  Has had not less than 2 years of clinical

11  experience in mental health counseling, which must be at the

12  post-master's level under the supervision of a licensed mental

13  health counselor or the equivalent who is a qualified

14  supervisor as determined by the board.  An individual who

15  intends to practice in Florida to satisfy the clinical

16  experience requirements must register pursuant to s. 491.0045

17  prior to commencing practice.  If a graduate has a master's

18  degree with a major related to the practice of mental health

19  counseling which did not include all the coursework required

20  under sub-subparagraphs (b)1.a.-c., credit for the

21  post-master's level clinical experience shall not commence

22  until the applicant has completed a minimum of seven of the

23  courses required under sub-subparagraphs (b)1.a.-c., as

24  determined by the board, one of which must be a course in

25  psychopathology or abnormal psychology. A doctoral internship

26  may be applied toward the clinical experience requirement. The

27  clinical experience requirement may be met by work performed

28  on or off the premises of the supervising mental health

29  counselor or the equivalent, provided the off-premises work is

30  not the independent private practice rendering of services

31  that does not have a licensed mental health professional, as

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1  determined by the board, on the premises at the same time the

 2  intern is providing services.

 3         (d)  Has passed a theory and practice examination

 4  provided by the department for this purpose.

 5         (e)  Has demonstrated, in a manner designated by rule

 6  of the board, knowledge of the laws and rules governing the

 7  practice of clinical social work, marriage and family therapy,

 8  and mental health counseling.

 9         (5)  INTERNSHIP.--An individual who is registered as an

10  intern and has satisfied all of the educational requirements

11  for the profession for which the applicant seeks licensure

12  shall be certified as having met the educational requirements

13  for licensure under this section.

14         (6)  RULES.--The board may adopt rules necessary to

15  implement any education or experience requirement of this

16  section for licensure as a clinical social worker, marriage

17  and family therapist, or mental health counselor.

18         Section 160.  Effective January 1, 2001, paragraph (b)

19  of subsection (4) of section 491.005, Florida Statutes, as

20  amended by section 13 of chapter 97-198 and section 205 of

21  chapter 97-264, Laws of Florida, and as amended by this act,

22  is amended, and subsection (6) of that section, as created by

23  this act, is reenacted, to read:

24         491.005  Licensure by examination.--

25         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

26  documentation and payment of a fee not to exceed $200, as set

27  by board rule, plus the actual per applicant cost to the

28  department for purchase of the examination from the

29  Professional Examination Service for the National Academy of

30  Certified Clinical Mental Health Counselors or a similar

31  national organization, the department shall issue a license as

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    Bill No. CS for SB 2220

    Amendment No.    





 1  a mental health counselor to an applicant who the board

 2  certifies:

 3         (b)1.  Has a minimum of an earned master's degree from

 4  a mental health counseling program accredited by the Council

 5  for the Accreditation of Counseling and Related Educational

 6  Programs that consists of at least 60 semester hours or 80

 7  quarter hours of clinical and didactic instruction, including

 8  a course in human sexuality and a course in substance abuse.

 9  If the master's degree is earned from a program related to the

10  practice of mental health counseling that is not accredited by

11  the Council for the Accreditation of Counseling and Related

12  Educational Programs, then the coursework and practicum,

13  internship, or fieldwork must consist of at least 60 semester

14  hours or 80 quarter hours and meet the following requirements:

15         a.  Thirty-three Thirty-six semester hours or 44 48

16  quarter hours of graduate coursework, which must include a

17  minimum of 3 semester hours or 4 quarter hours of

18  graduate-level coursework in each of the following 11 12

19  content areas: counseling theories and practice; human growth

20  and development; diagnosis and treatment of psychopathology;

21  human sexuality; group theories and practice; individual

22  evaluation and assessment; career and lifestyle assessment;

23  research and program evaluation; social and cultural

24  foundations; foundations of mental health counseling;

25  counseling in community settings; and substance abuse. Courses

26  in research, thesis or dissertation work, practicums,

27  internships, or fieldwork may not be applied toward this

28  requirement.

29         b.  A minimum of 3 semester hours or 4 quarter hours of

30  graduate-level coursework in legal, ethical, and professional

31  standards issues in the practice of mental health counseling,

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 1  which includes goals, objectives, and practices of

 2  professional counseling organizations, codes of ethics, legal

 3  considerations, standards of preparation, certifications and

 4  licensing, and the role identity and professional obligations

 5  of mental health counselors. Courses in research, thesis or

 6  dissertation work, practicums, internships, or fieldwork may

 7  not be applied toward this requirement.

 8         c.  The equivalent, as determined by the board, of at

 9  least 1,000 hours of university-sponsored supervised clinical

10  practicum, internship, or field experience as required in the

11  accrediting standards of the Council for Accreditation of

12  Counseling and Related Educational Programs for mental health

13  counseling programs. If the academic practicum, internship, or

14  field experience was less than 1,000 hours, experience gained

15  outside the academic arena in clinical mental health settings

16  under the supervision of a qualified supervisor as determined

17  by the board may be applied. This experience may not be used

18  to satisfy the post-master's clinical experience requirement.

19         2.  If the course title which appears on the

20  applicant's transcript does not clearly identify the content

21  of the coursework, the applicant shall be required to provide

22  additional documentation, including, but not limited to, a

23  syllabus or catalog description published for the course.

24

25  Education and training in mental health counseling must have

26  been received in an institution of higher education which at

27  the time the applicant graduated was: fully accredited by a

28  regional accrediting body recognized by the Commission on

29  Recognition of Postsecondary Accreditation; publicly

30  recognized as a member in good standing with the Association

31  of Universities and Colleges of Canada; or an institution of

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    Bill No. CS for SB 2220

    Amendment No.    





 1  higher education located outside the United States and Canada,

 2  which at the time the applicant was enrolled and at the time

 3  the applicant graduated maintained a standard of training

 4  substantially equivalent to the standards of training of those

 5  institutions in the United States which are accredited by a

 6  regional accrediting body recognized by the Commission on

 7  Recognition of Postsecondary Accreditation. Such foreign

 8  education and training must have been received in an

 9  institution or program of higher education officially

10  recognized by the government of the country in which it is

11  located as an institution or program to train students to

12  practice as mental health counselors. The burden of

13  establishing that the requirements of this provision have been

14  met shall be upon the applicant, and the board shall require

15  documentation, such as, but not limited to, an evaluation by a

16  foreign equivalency determination service, as evidence that

17  the applicant's graduate degree program and education were

18  equivalent to an accredited program in this country.

19         (6)  RULES.--The board may adopt rules necessary to

20  implement any education or experience requirement of this

21  section for licensure as a clinical social worker, marriage

22  and family therapist, or mental health counselor.

23         Section 161.  Paragraph (b) of subsection (1) of

24  section 491.006, Florida Statutes, is amended to read:

25         491.006  Licensure or certification by endorsement.--

26         (1)  The department shall license or grant a

27  certificate to a person in a profession regulated by this

28  chapter who, upon applying to the department and remitting the

29  appropriate fee, demonstrates to the board that he or she:

30         (b)1.  Holds an active valid license to practice and

31  has actively practiced the profession for which licensure is

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    Amendment No.    





 1  applied in another state for 3 of the last 5 years immediately

 2  preceding licensure.

 3         2.  Meets the education requirements of this chapter

 4  for the profession for which licensure is applied.

 5         3.  Has passed a substantially equivalent licensing

 6  examination in another state or has passed the licensure

 7  examination in this state in the profession for which the

 8  applicant seeks licensure.

 9         4.  Holds a license in good standing, is not under

10  investigation for an act which would constitute a violation of

11  this chapter, and has not been found to have committed any act

12  which would constitute a violation of this chapter.

13         Section 162.  Section 491.0085, Florida Statutes, is

14  amended to read:

15         491.0085  Continuing education and laws and rules

16  courses; approval of providers, programs, and courses; proof

17  of completion.--

18         (1)  Continuing education providers, programs, and

19  courses and laws and rules courses and their providers and

20  programs shall be approved by the department or the board.

21         (2)  The department or the board has the authority to

22  set a fee not to exceed $200 for each applicant who applies

23  for or renews provider status.  Such fees shall be deposited

24  into the Medical Quality Assurance Health Care Trust Fund.

25         (3)  Proof of completion of the required number of

26  hours of continuing education and completion of the laws and

27  rules course shall be submitted to the department or the board

28  in the manner and time specified by rule and on forms provided

29  by the department or the board.

30         (4)  The department or the board shall adopt rules and

31  guidelines to administer and enforce the provisions of this

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    Bill No. CS for SB 2220

    Amendment No.    





 1  section.

 2         Section 163.  Paragraph (d) of subsection (4) of

 3  section 491.014, Florida Statutes, 1998 Supplement, is amended

 4  to read:

 5         491.014  Exemptions.--

 6         (4)  No person shall be required to be licensed,

 7  provisionally licensed, registered, or certified under this

 8  chapter who:

 9         (d)  Is not a resident of this state but offers

10  services in this state, provided:

11         1.  Such services are performed for no more than 5 days

12  in any month and no more than 15 days in any calendar year;

13  and

14         2.  Such nonresident is licensed or certified to

15  practice the services provided by a state or territory of the

16  United States or by a foreign country or province.

17         Section 164.  Paragraph (a) of subsection (1) and

18  subsection (5) of section 499.012, Florida Statutes, 1998

19  Supplement, are amended to read:

20         499.012  Wholesale distribution; definitions; permits;

21  general requirements.--

22         (1)  As used in this section, the term:

23         (a)  "Wholesale distribution" means distribution of

24  prescription drugs to persons other than a consumer or

25  patient, but does not include:

26         1.  Any of the following activities, which is not a

27  violation of s. 499.005(21) if such activity is conducted in

28  accordance with s. 499.014:

29         a.  The purchase or other acquisition by a hospital or

30  other health care entity that is a member of a group

31  purchasing organization of a prescription drug for its own use

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    Amendment No.    





 1  from the group purchasing organization or from other hospitals

 2  or health care entities that are members of that organization.

 3         b.  The sale, purchase, or trade of a prescription drug

 4  or an offer to sell, purchase, or trade a prescription drug by

 5  a charitable organization described in s. 501(c)(3) of the

 6  Internal Revenue Code of 1986, as amended and revised, to a

 7  nonprofit affiliate of the organization to the extent

 8  otherwise permitted by law.

 9         c.  The sale, purchase, or trade of a prescription drug

10  or an offer to sell, purchase, or trade a prescription drug

11  among hospitals or other health care entities that are under

12  common control. For purposes of this section, "common control"

13  means the power to direct or cause the direction of the

14  management and policies of a person or an organization,

15  whether by ownership of stock, by voting rights, by contract,

16  or otherwise.

17         d.  The sale, purchase, trade, or other transfer of a

18  prescription drug from or for any federal, state, or local

19  government agency or any entity eligible to purchase

20  prescription drugs at public health services prices pursuant

21  to s. 602 of Pub. L. No. 102-585 to a contract provider or its

22  subcontractor for eligible patients of the agency or entity

23  under the following conditions:

24         (I)  The agency or entity must obtain written

25  authorization for the sale, purchase, trade, or other transfer

26  of a prescription drug under this sub-subparagraph from the

27  Secretary of Health or his or her designee.

28         (II)  The contract provider or subcontractor must be

29  authorized by law to administer or dispense prescription

30  drugs.

31         (III)  In the case of a subcontractor, the agency or

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    Bill No. CS for SB 2220

    Amendment No.    





 1  entity must be a party to and execute the subcontract.

 2         (IV)  A contract provider or subcontractor must

 3  maintain separate and apart from other prescription drug

 4  inventory any prescription drugs of the agency or entity in

 5  its possession.

 6         (V)  The contract provider and subcontractor must

 7  maintain and produce immediately for inspection all records of

 8  movement or transfer of all the prescription drugs belonging

 9  to the agency or entity, including, but not limited to, the

10  records of receipt and disposition of prescription drugs.

11  Each contractor and subcontractor dispensing or administering

12  these drugs must maintain and produce records documenting the

13  dispensing or administration.  Records that are required to be

14  maintained include, but are not limited to, a perpetual

15  inventory itemizing drugs received and drugs dispensed by

16  prescription number or administered by patient identifier,

17  which must be submitted to the agency or entity quarterly.

18         (VI)  The contract provider or subcontractor may

19  administer or dispense the prescription drugs only to the

20  eligible patients of the agency or entity or must return the

21  prescription drugs for or to the agency or entity.  The

22  contract provider or subcontractor must require proof from

23  each person seeking to fill a prescription or obtain treatment

24  that the person is an eligible patient of the agency or entity

25  and must, at a minimum, maintain a copy of this proof as part

26  of the records of the contractor or subcontractor required

27  under sub-sub-subparagraph (V).

28         (VII)  The prescription drugs transferred pursuant to

29  this sub-subparagraph may not be billed to Medicaid.

30         (VIII)  In addition to the departmental inspection

31  authority set forth in s. 499.051, the establishment of the

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    Amendment No.    





 1  contract provider and subcontractor and all records pertaining

 2  to prescription drugs subject to this sub-subparagraph shall

 3  be subject to inspection by the agency or entity.  All records

 4  relating to prescription drugs of a manufacturer under this

 5  sub-subparagraph shall be subject to audit by the manufacturer

 6  of those drugs, without identifying individual patient

 7  information.

 8         2.  Any of the following activities, which is not a

 9  violation of s. 499.005(21) if such activity is conducted in

10  accordance with rules established by the department:

11         a.  The sale, purchase, or trade of a prescription drug

12  among federal, state, or local government health care entities

13  that are under common control and are authorized to purchase

14  such prescription drug.

15         b.  The sale, purchase, or trade of a prescription drug

16  or an offer to sell, purchase, or trade a prescription drug

17  for emergency medical reasons.; For purposes of this

18  sub-subparagraph subparagraph, the term "emergency medical

19  reasons" includes transfers of prescription drugs by a retail

20  pharmacy to another retail pharmacy to alleviate a temporary

21  shortage.

22         c.  The transfer purchase or acquisition of a

23  prescription drug acquired by a medical director on behalf of

24  a licensed an emergency medical services provider to that

25  medical director for use by emergency medical services

26  provider and its transport vehicles for use in accordance with

27  the provider's license under providers acting within the scope

28  of their professional practice pursuant to chapter 401.

29         d.  The revocation of a sale or the return of a

30  prescription drug to the person's prescription drug wholesale

31  supplier.

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    Amendment No.    





 1         e.  The donation of a prescription drug by a health

 2  care entity to a charitable organization that has been granted

 3  an exemption under s. 501(c)(3) of the Internal Revenue Code

 4  of 1986, as amended, and that is authorized to possess

 5  prescription drugs.

 6         f.  The transfer of a prescription drug by a person

 7  authorized to purchase or receive prescription drugs to a

 8  person licensed or permitted to handle reverse distributions

 9  or destruction under the laws of the jurisdiction in which the

10  person handling the reverse distribution or destruction

11  receives the drug.

12         3.  The dispensing of a prescription drug pursuant to a

13  prescription;

14         3.4.  The distribution of prescription drug samples by

15  manufacturers' representatives or distributors'

16  representatives conducted in accordance with s. 499.028.; or

17         4.5.  The sale, purchase, or trade of blood and blood

18  components intended for transfusion.  As used in this

19  subparagraph section, the term "blood" means whole blood

20  collected from a single donor and processed either for

21  transfusion or further manufacturing, and the term "blood

22  components" means that part of the blood separated by physical

23  or mechanical means.

24         5.  The lawful dispensing of a prescription drug in

25  accordance with chapter 465.

26         (5)  The department may adopt rules governing the

27  recordkeeping, storage, and handling with respect to each of

28  the distributions of prescription drugs specified in

29  subparagraphs (1)(a)1.-4. (1)(a)1., 2., 4., and 5.

30         Section 165.  Subsection (6) is added to section

31  626.883, Florida Statutes, to read:

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 1         626.883  Administrator as intermediary; collections

 2  held in fiduciary capacity; establishment of account;

 3  disbursement; payments on behalf of insurer.--

 4         (6)  All payments to a health care provider by a fiscal

 5  intermediary for noncapitated providers must include an

 6  explanation of services being reimbursed which includes, at a

 7  minimum, the patient's name, the date of service, the

 8  procedure code, the amount of reimbursement, and the

 9  identification of the plan on whose behalf the payment is

10  being made. For capitated providers, the statement of services

11  must include the number of patients covered by the contract,

12  the rate per patient, the total amount of the payment, and the

13  identification of the plan on whose behalf the payment is

14  being made.

15         Section 166.  Paragraph (a) of subsection (2) of

16  section 641.316, Florida Statutes, 1998 Supplement, is amended

17  to read:

18         641.316  Fiscal intermediary services.--

19         (2)(a)  The term "fiduciary" or "fiscal intermediary

20  services" means reimbursements received or collected on behalf

21  of health care professionals for services rendered, patient

22  and provider accounting, financial reporting and auditing,

23  receipts and collections management, compensation and

24  reimbursement disbursement services, or other related

25  fiduciary services pursuant to health care professional

26  contracts with health maintenance organizations. All payments

27  to a health care provider by a fiscal intermediary for

28  noncapitated providers must include an explanation of services

29  being reimbursed which includes, at a minimum, the patient's

30  name, the date of service, the procedure code, the amount of

31  reimbursement, and the identification of the plan on whose

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 1  behalf the payment is being made. For capitated providers, the

 2  statement of services must include the number of patients

 3  covered by the contract, the rate per patient, the total

 4  amount of the payment, and the identification of the plan on

 5  whose behalf the payment is being made.

 6         Section 167.  Task Force on Telehealth.--

 7         (1)  Because telecommunications technology has made it

 8  possible to provide a wide range of health care services

 9  across state lines between healthcare practitioners and

10  patients, it is the intent of the Legislature to protect the

11  health and safety of all patients in this state receiving

12  services by means of such technology and to ensure the

13  accountability of the healthcare profession with respect to

14  unsafe and incompetent practitioners using such technology to

15  provide health care services to patients in this state.

16         (2)  The Secretary of Health shall appoint a task force

17  consisting of representatives from the affected medical and

18  allied health professions and other affected health care

19  industries.

20         (3)  The task force shall address the following:

21         (a)  Identification of various electronic

22  communications or telecommunications technologies currently

23  used within the state and by other states to provide

24  healthcare information.

25         (b)  Identification of laws, regulations, and

26  reimbursement practices that serve as barriers to

27  implementation of electronic communications related to health

28  care.

29         (c)  Recommendation of the appropriate level of

30  regulation of health care professionals necessary to protect

31  the health and safety of patients in this state, including

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 1  analysis of existing provisions governing in-state

 2  professionals such as licensing, financial responsibility, and

 3  medical malpractice insurance requirements.

 4         (d)  Potential preemption of state regulation by the

 5  Commerce Clause of the United States Constitution.

 6         (e)  The effect of telehealth on access to health care

 7  in rural and underserved areas.

 8         (f)  Potential antitrust concerns.

 9         (g)  The effect of regulations by other states or

10  jurisdictions on health care professionals in this state who

11  provide consultative services through telehealth to entities

12  and patients outside the state.

13         (h)  Research on other public and private data and

14  initiatives related to telehealth.

15         (i)  Any other issue affecting the health, safety, and

16  welfare of patients through telehealth identified by the task

17  force.

18         (4)  The task force shall submit a report of its

19  findings and recommendations by January 1, 2000, to the

20  Governor, the President of the Senate, and the Speaker of the

21  House of Representatives.

22         Section 168.  Subsection (1) of section 468.352,

23  Florida Statutes, is amended to read:

24         468.352  Definitions.--As used in this part, unless the

25  context otherwise requires, the term:

26         (1)  "Board" means the Board of Respiratory Care

27  Medicine.

28         Section 169.  Section 468.353, Florida Statutes, is

29  amended to read:

30         468.353  Board of Respiratory Care Medicine; powers and

31  duties.--

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 1         (1)  The board, with the assistance of the Advisory

 2  Council on Respiratory Care, is authorized to establish

 3  minimum standards for the delivery of respiratory care

 4  services and to adopt those rules necessary to administer this

 5  part.

 6         (2)  The board may administer oaths, summon witnesses,

 7  and take testimony in all matters relating to its duties under

 8  this part.

 9         (3)  The board may adopt rules to administer this part,

10  including rules governing the investigation, inspection, and

11  review of schools and colleges that offer courses in

12  respiratory care in order to ascertain their compliance with

13  standards established by the board or appropriate accrediting

14  agencies delegate such powers and duties to the council as it

15  may deem proper.

16         Section 170.  Section 468.354, Florida Statutes, is

17  amended to read:

18         468.354  Board of Advisory Council on Respiratory Care;

19  organization; function.--

20         (1)  There is created within the department, the Board

21  of Advisory Council on Respiratory Care, composed of seven

22  members appointed by the Governor and confirmed by the Senate

23  under the supervision of the board.

24         (2)  The board council shall consist of five members

25  appointed by the board and shall include:

26         (a)  A registered respiratory therapist.

27         (b)  A certified respiratory therapist care

28  practitioner.

29         (c)  A respiratory care professional from each of the

30  following areas:

31         1.  Respiratory care education.

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 1         2.  Respiratory care management and supervision.

 2         3.  Homecare/subacute Cardiopulmonary diagnostics.

 3         (d)  Two consumer members, who are residents of this

 4  state and have never been licensed as health care

 5  practitioners.

 6

 7  Each member of the council shall be a respiratory care

 8  professional on the board must have who has been actively

 9  engaged in the delivery of respiratory care services in this

10  state for at least 4 consecutive years prior to appointment.

11         (3)(a)  Except as provided in paragraph (b), the term

12  of office for each board council member shall be 4 years.  No

13  member shall serve for more than two consecutive terms.  Any

14  time there is a vacancy to be filled on the council, all

15  professional organizations dealing with respiratory therapy

16  incorporated within the state as not for profit which register

17  their interest with the board shall recommend at least twice

18  as many persons to fill the vacancy to the council as the

19  number of vacancies to be filled, and the Governor board may

20  appoint from the submitted list, in his its discretion, any of

21  those persons so recommended.  The Governor board shall,

22  insofar as possible, appoint persons from different

23  geographical areas.

24         (b)  In order To achieve staggering of terms, within

25  120 days after July 1, 1999, October 1, 1984, the Governor

26  board shall appoint the board members of the council as

27  follows:

28         1.  Two members One member shall be appointed for terms

29  a term of 2 years.

30         2.  Two members shall be appointed for terms of 3

31  years.

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 1         3.  Three Two members shall be appointed for terms of 4

 2  years.

 3         (c)  All provisions of part II of chapter 455, relating

 4  to boards apply to this part.

 5         (4)(a)  The board council shall annually elect from

 6  among its members a chair and vice chair.

 7         (b)  The board council shall meet at least twice a year

 8  and shall hold such additional meetings as are deemed

 9  necessary by the board.  Four Three members of the council

10  constitute a quorum.

11         (c)  Unless otherwise provided by law, a board council

12  member shall be compensated $50 for each day he or she attends

13  an official board meeting of the council and for each day he

14  or she participates in any other board business involving the

15  council.  A board council member shall also be entitled to

16  reimbursement for expenses pursuant to s. 112.061. Travel out

17  of the state shall require the prior approval of the secretary

18  of the department.

19         (5)(a)  The board may council shall recommend to the

20  department a code of ethics for those persons licensed

21  pursuant to this part.

22         (b)  The council shall make recommendations to the

23  department for the approval of continuing education courses.

24         Section 171.  Section 468.355, Florida Statutes, is

25  amended to read:

26         468.355  Eligibility for licensure; temporary

27  licensure.--

28         (1)  To be eligible for licensure by the board as a

29  respiratory care practitioner, an applicant must:

30         (a)  Be at least 18 years old.

31         (b)  Possess a high school diploma or a graduate

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 1  equivalency diploma.

 2         (c)  Meet at least one of the following criteria:

 3         1.  The applicant has successfully completed a training

 4  program for respiratory therapy technicians or respiratory

 5  therapists approved by the Commission on Accreditation of

 6  Allied Health Education Programs, or the equivalent thereof,

 7  as accepted by the board.

 8         2.  The applicant is currently a "Certified Respiratory

 9  Therapy Technician" certified by the National Board for

10  Respiratory Care, or the equivalent thereof, as accepted by

11  the board.

12         3.  The applicant is currently a "Registered

13  Respiratory Therapist" registered by the National Board for

14  Respiratory Care, or the equivalent thereof, as accepted by

15  the board.

16         4.  The applicant is currently employed in this state

17  as a respiratory care practitioner or respiratory therapist on

18  October 1, 1984.

19

20  The criteria set forth in subparagraphs 2. and 3.

21  notwithstanding, the board shall periodically annually review

22  the examinations and standards of the National Board for

23  Respiratory Care and may reject those examinations and

24  standards if they are deemed inappropriate.

25         (2)  To be eligible for licensure by the board as a

26  respiratory therapist, an applicant must:

27         (a)  Be at least 18 years old.

28         (b)  Possess a high school diploma or a graduate

29  equivalency diploma.

30         (c)  Meet at least one of the following criteria:

31         1.  The applicant has successfully completed a training

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 1  program for respiratory therapists approved by the Commission

 2  on Accreditation of Allied Health Education Programs, or the

 3  equivalent thereof, as accepted by the board.

 4         2.  The applicant is currently a "Registered

 5  Respiratory Therapist" registered by the National Board for

 6  Respiratory Care, or the equivalent thereof, as accepted by

 7  the board.

 8

 9  The criteria set forth in subparagraphs 1. and 2.

10  notwithstanding, the board shall periodically annually review

11  the examinations and standards of the National Board for

12  Respiratory Care and may reject those examinations and

13  standards if they are deemed inappropriate.

14         (3)  With respect to the delivery of respiratory care

15  services, the board shall establish procedures for temporary

16  licensure of eligible individuals entering the state and

17  temporary licensure of those persons who have graduated from a

18  program approved by the board.  Such temporary licensure shall

19  be for a period not to exceed 1 year.

20         Section 172.  Section 468.357, Florida Statutes, is

21  amended to read:

22         468.357  Licensure by examination.--

23         (1)  A person who desires to be licensed as a

24  respiratory care practitioner may submit an application to the

25  department to take the examination, in accordance with board

26  rule to be administered by the department.

27         (a)  The department shall examine Each applicant may

28  take the examination who is determined by the board to have:

29         1.  Completed the application form and remitted the

30  applicable fee set by the board;

31         2.  Submitted required documentation as required in s.

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 1  468.355; and

 2         3.  Remitted an examination fee set by the examination

 3  provider board.

 4         (b)  The department shall conduct Examinations for

 5  licensure of respiratory care practitioners must be conducted

 6  no less than two times a year in such geographical locations

 7  or by such methods as are deemed advantageous to the majority

 8  of the applicants.

 9         (c)  The examination given for respiratory care

10  practitioners shall be the same as that given by the National

11  Board for Respiratory Care for entry-level certification of

12  respiratory therapy technicians.  However, an equivalent

13  examination may be accepted by the board in lieu of that

14  examination.

15         (2)  Each applicant who passes the examination shall be

16  entitled to licensure as a respiratory care practitioner, and

17  the department shall issue a license pursuant to this part to

18  any applicant who successfully completes the examination in

19  accordance with this section.  However, the department shall

20  not issue a license to any applicant who is under

21  investigation in another jurisdiction for an offense which

22  would constitute a violation of this part.  Upon completion of

23  such an investigation, if the applicant is found guilty of

24  such an offense, the applicable provisions of s. 468.365 will

25  apply.

26         (3)  Any person who was employed in this state on or

27  before September 30, 1983, as a respiratory therapy technician

28  or respiratory therapist, and who has performed services in

29  such professional capacity for 4 years or more by October 1,

30  1987, under the supervision of a licensed physician or in a

31  hospital or licensed health care facility, shall be issued a

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 1  license without examination, if such person provides

 2  acceptable documentation of performance of such services to

 3  the board.  Such documentation shall include certification by

 4  a physician licensed pursuant to chapter 458 or chapter 459

 5  who has direct knowledge of the practice of, or who has

 6  supervised, the person.  If such person is not determined to

 7  have performed critical care respiratory services for at least

 8  4 years, the board may limit the license of such person to the

 9  performance of noncritical care respiratory services.

10         Section 173.  Section 468.364, Florida Statutes, 1998

11  Supplement, is amended to read:

12         468.364  Fees; establishment; disposition.--

13         (1)  The board shall establish by rule fees for the

14  following purposes:

15         (a)  Application, a fee not to exceed $50.

16         (b)  Examination, a fee not to exceed $125 plus the

17  actual per applicant cost to the department for purchase of

18  the examination from the National Board for Respiratory Care

19  or a similar national organization.

20         (b)(c)  Initial licensure, a fee not to exceed $200.

21         (c)(d)  Renewal of licensure, a fee not to exceed $200

22  biennially.

23         (d)(e)  Renewal of inactive licensure, a fee not to

24  exceed $50.

25         (e)(f)  Reactivation, a fee not to exceed $50.

26         (2)  The fees established pursuant to subsection (1)

27  shall be based upon the actual costs incurred by the

28  department in carrying out its responsibilities under this

29  part.

30         (3)  All moneys collected by the department under this

31  part shall be deposited as required by s. 455.587.

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 1         Section 174.  Paragraph (f) of subsection (1) of

 2  section 468.365, Florida Statutes, 1998 Supplement, is amended

 3  to read:

 4         468.365  Disciplinary grounds and actions.--

 5         (1)  The following acts constitute grounds for which

 6  the disciplinary actions in subsection (2) may be taken:

 7         (f)  Unprofessional conduct, which includes, but is not

 8  limited to, any departure from, or failure to conform to,

 9  acceptable standards related to the delivery of respiratory

10  care services, as set forth by the board and the Advisory

11  Council on Respiratory Care in rules adopted pursuant to this

12  part.

13         Section 175.  Paragraph (a) of subsection (2) of

14  section 464.016, Florida Statutes, is amended to read:

15         464.016  Violations and penalties.--

16         (2)  Each of the following acts constitutes a

17  misdemeanor of the first degree, punishable as provided in s.

18  775.082 or s. 775.083:

19         (a)  Using the name or title "Nurse," "Registered

20  Nurse," "Licensed Practical Nurse," "Advanced Registered Nurse

21  Practitioner," or any other name or title which implies that a

22  person was licensed or certified as same, unless such person

23  is duly licensed or certified.

24         Section 176.  Paragraphs (b) and (c) of subsection (1)

25  of section 458.3115, Florida Statutes, 1998 Supplement, are

26  amended to read:

27         458.3115  Restricted license; certain foreign-licensed

28  physicians; United States Medical Licensing Examination

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

30  practice; full licensure.--

31         (1)

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

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

 3  the previously administered FLEX shall not be required to

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

 5  year 2002 2000.

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

 7  examination for restricted licensure if the person:

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

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

10  special preparatory medical update courses authorized by the

11  board and the University of Miami Medical School and

12  subsequently passed the final course examination; upon

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

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

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

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

17  one of the persons who took and successfully completed the

18  Stanley H. Kaplan course that was approved by the Board of

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

20  minimum, the documentation must include class attendance

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

22         2.  Applies to the agency and submits an application

23  fee that is nonrefundable and equivalent to the fee required

24  for full licensure;

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

26  practice of medicine in any another jurisdiction;

27         4.  Submits an examination fee that is nonrefundable

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

29  actual per-applicant cost to the agency to provide either

30  examination described in this section;

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

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 1  other jurisdiction that would constitute a substantial basis

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

 3  chapter 455; and

 4         6.  Is not under discipline, investigation, or

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

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

 7  chapter 455 and that substantially threatened or threatens the

 8  public health, safety, or welfare.

 9         Section 177.  Subsection (2) of section 458.3124,

10  Florida Statutes, 1998 Supplement, is amended to read:

11         458.3124  Restricted license; certain experienced

12  foreign-trained physicians.--

13         (2)  A person applying for licensure under this section

14  must submit to the Department of Health on or before December

15  31, 2000 1998:

16         (a)  A completed application and documentation required

17  by the Board of Medicine to prove compliance with subsection

18  (1); and

19         (b)  A nonrefundable application fee not to exceed $500

20  and a nonrefundable examination fee not to exceed $300 plus

21  the actual cost to purchase and administer the examination.

22         Section 178.  Effective upon this act becoming a law,

23  section 301 of chapter 98-166, Laws of Florida, is amended to

24  read:

25         Section 301.  The sum of $1.2 million from the

26  unallocated balance in the Medical Quality Assurance Trust

27  Fund is appropriated to the Department of Health to allow the

28  department to develop the examination required for foreign

29  licensed physicians in section 458.3115(1)(a), Florida

30  Statutes, through a contract with the University of South

31  Florida. The department shall charge examinees a fee not to

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 1  exceed 25 percent of the cost of the actual costs of the first

 2  examination administered pursuant to section 458.3115, Florida

 3  Statutes, 1998 Supplement, and a fee not to exceed 75 percent

 4  of the actual costs for any subsequent examination

 5  administered pursuant to that section.

 6         Section 179.  The Agency for Health Care

 7  Administration, in conjunction with the Medicare Fraud

 8  Division of the Office of the Attorney General, shall conduct

 9  a detailed study and analysis of clinical laboratory services

10  for kidney dialysis patients in the State of Florida. The

11  study shall include, but not be limited to, an analysis of the

12  past and present utilization rates of clinical laboratory

13  services for dialysis patients, financial arrangements among

14  kidney dialysis centers, their medical directors, and any

15  business relationships and affiliations with clinical

16  laboratories, any self referral to clinical laboratories, the

17  quality and responsiveness of clinical laboratory services for

18  dialysis patients in Florida, and the average annual revenue

19  for dialysis patients for clinical laboratory services for the

20  past ten years. The agency shall report back to the President

21  of the Senate, Speaker of the House of Representatives, and

22  chairs of the appropriate substantive committees of the

23  Legislature on its findings no later than February 1, 2000.

24         Section 180.  Subsection (3) is added to section

25  455.651, Florida Statutes, 1998 Supplement, to read:

26         455.651  Disclosure of confidential information.--

27         (1)  No officer, employee, or person under contract

28  with the department, or any board therein, or any subject of

29  an investigation shall convey knowledge or information to any

30  person who is not lawfully entitled to such knowledge or

31  information about any public meeting or public record, which

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 1  at the time such knowledge or information is conveyed is

 2  exempt from the provisions of s. 119.01, s. 119.07(1), or s.

 3  286.011.

 4         (2)  Any person who willfully violates any provision of

 5  this section is guilty of a misdemeanor of the first degree,

 6  punishable as provided in s. 775.082 or s. 775.083, and may be

 7  subject to discipline pursuant to s. 455.624, and, if

 8  applicable, shall be removed from office, employment, or the

 9  contractual relationship.

10         (3)  Any person injured as a result of a violation of

11  this section shall have a civil cause of action for treble

12  damages, reasonable attorney fees, and costs.

13

14  (Redesignate subsequent sections.)

15

16

17  ================ T I T L E   A M E N D M E N T ===============

18  And the title is amended as follows:

19         On page 5, line 14, after the semicolon,

20

21  insert:

22         providing for clinical trials to be conducted

23         on the use of the drug Secretin by a nonprofit

24         provider; requiring a report; providing an

25         appropriation; amending s. 232.435, F.S.;

26         correcting a reference; amending s. 381.026,

27         F.S.; providing a definition; amending s.

28         381.0261, F.S.; providing that the Department

29         of Health or a regulatory board, rather than

30         the Agency for Health Care Administration, may

31         impose an administrative fine against any

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 1         health care provider who fails to make

 2         available to patients a summary of their rights

 3         as required by law; amending s. 455.501, F.S.;

 4         redefining the terms "health care practitioner"

 5         and "licensee"; amending s. 455.507, F.S.;

 6         revising provisions relating to good standing

 7         of members of the Armed Forces with

 8         administrative boards to provide applicability

 9         to the department when there is no board;

10         providing gender neutral language; amending s.

11         455.521, F.S.; providing powers and duties of

12         the department for the professions, rather than

13         boards, under its jurisdiction; amending s.

14         455.557, F.S.; redefining the term "health care

15         practitioner" for purposes of standardized

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

17         prescribing the expiration date of an

18         incomplete license application; revising the

19         form and style of licenses; providing authority

20         to the department when there is no board to

21         adopt rules; revising and providing

22         requirements relating to obtaining continuing

23         education credit in risk management; correcting

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

25         providing exceptions to certain application

26         requirements; revising information required for

27         licensure of designated health care

28         professionals; revising requirements for

29         submitting fingerprints to the department for

30         renewal of licensure; amending s. 455.5651,

31         F.S.; prohibiting inclusion of certain

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         information in practitioner profiles; amending

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

 3         and prohibiting it in the practice of a health

 4         care profession; providing penalties; amending

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

 6         to review of an examination after failure to

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

 8         authority to the department when there is no

 9         board to determine by rule the amount of

10         license fees for the profession regulated;

11         providing for a fee for issuance of a wall

12         certificate to certain licensees or for a

13         duplicate wall certificate; amending s.

14         455.604, F.S.; requiring instruction on human

15         immunodeficiency virus and acquired immune

16         deficiency syndrome as a condition of licensure

17         and relicensure to practice dietetics and

18         nutrition or nutrition counseling; amending s.

19         455.607, F.S.; correcting a reference; amending

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

21         grounds for discipline; providing penalties;

22         providing for assessment of certain costs;

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

24         health care practitioners to include a certain

25         statement in advertisements for free or

26         discounted services; correcting terminology;

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

28         department to obtain patient records, billing

29         records, insurance information, provider

30         contracts, and all attachments thereto under

31         certain circumstances for purposes of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         disciplinary proceedings; providing for charges

 2         for making reports or records available for

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

 4         providing for the suspension or restriction of

 5         the license of any health care practitioner who

 6         tests positive for drugs under certain

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

 8         providing financial responsibility requirements

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

10         providing requirements for active status

11         licensure of certain business establishments;

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

13         "prescriptive rights" with respect to

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

15         correcting terminology and a reference;

16         removing an obsolete date; amending s. 458.309,

17         F.S.; providing for registration and inspection

18         of certain offices performing levels 2 and 3

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

20         provisions relating to licensure as a physician

21         by examination; eliminating an obsolete

22         provision relating to licensure of medical

23         students from Nicaragua and another provision

24         relating to taking the examination without

25         applying for a license; amending s. 458.3115,

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

27         458.313, F.S.; revising provisions relating to

28         licensure by endorsement; repealing provisions

29         relating to reactivation of certain licenses

30         issued by endorsement; amending s. 458.315,

31         F.S.; providing additional requirements for

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         recipients of a temporary certificate for

 2         practice in areas of critical need; amending s.

 3         458.3165, F.S.; prescribing authorized

 4         employment for holders of public psychiatry

 5         certificates; correcting a reference; amending

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

 7         an active license to a limited license for a

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

 9         revising requirements for submitting

10         fingerprints to the department for renewal of

11         licensure as a physician; amending s. 458.331,

12         F.S.; providing grounds for discipline;

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

14         revising provisions relating to temporary

15         licensure as a physician assistant; amending s.

16         459.005, F.S.; providing for registration and

17         inspection of certain offices performing levels

18         2 and 3 surgery; amending s. 459.0075, F.S.;

19         providing for conversion of an active license

20         to a limited license for a specified purpose;

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

22         requirements for submitting fingerprints to the

23         department for renewal of licensure as an

24         osteopathic physician; amending s. 459.015,

25         F.S.; revising and providing grounds for

26         discipline; providing penalties; amending s.

27         460.402, F.S.; providing an exemption from

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

29         chiropractic, for certain students; amending s.

30         460.403, F.S.; defining the term

31         "community-based internship" for purposes of

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2         supervision" and "registered chiropractic

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

 4         requirements for licensure as a chiropractic

 5         physician by examination to remove a provision

 6         relating to a training program; amending s.

 7         460.407, F.S.; revising requirements for

 8         submitting fingerprints to the department for

 9         renewal of licensure as a chiropractic

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

11         increasing the administrative fine; conforming

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

13         revising requirements for certification of

14         chiropractic physician's assistants; providing

15         for supervision of registered chiropractic

16         physician's assistants; providing for biennial

17         renewal; providing fees; providing

18         applicability to current certificateholders;

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

20         registered chiropractic assistants to be under

21         the direct supervision of a certified

22         chiropractic physician's assistant; amending s.

23         461.003, F.S.; defining the term "certified

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

25         supervision" with respect thereto; redefining

26         the term "practice of podiatric medicine";

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

28         residency requirement to practice podiatric

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

30         requirements for renewal of license to practice

31         podiatric medicine; revising requirements for

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         submitting fingerprints to the department for

 2         renewal of licensure; amending s. 461.013,

 3         F.S.; revising and providing grounds for

 4         discipline; providing penalties; creating s.

 5         461.0135, F.S.; providing requirements for

 6         operation of X-ray machines by certified

 7         podiatric X-ray assistants; amending s.

 8         464.008, F.S.; providing for remediation upon

 9         failure to pass the examination to practice

10         nursing a specified number of times; amending

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

12         regulation relating to remedial courses;

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

14         "data communication device"; revising the

15         definition of the term "practice of the

16         profession of pharmacy"; amending s.  465.016,

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

18         returned unit-dose medication by correctional

19         facilities under certain conditions; providing

20         a ground for which a pharmacist may be subject

21         to discipline by the Board of Pharmacy;

22         increasing the administrative fine; amending

23         ss. 465.014, 465.015, 465.0196, 468.812,

24         499.003, F.S.; correcting cross-references, to

25         conform; creating the Task Force for the Study

26         of Collaborative Drug Therapy Management;

27         providing for staff support from the

28         department; providing for participation by

29         specified associations and entities; providing

30         responsibilities; requiring a report to the

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

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         revising requirements relating to dental work

 2         orders required of unlicensed persons; amending

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

 4         provisional licensure to practice

 5         speech-language pathology or audiology;

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

 7         requirements for certification as a

 8         speech-language pathologist or audiologist

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

10         authorizing the issuance of subcategory

11         certificates in the field of radiologic

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

13         correcting references; amending s. 468.701,

14         F.S.; revising and removing definitions;

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

16         Council of Athletic Training with a Board of

17         Athletic Training; providing for appointment of

18         board members and their successors; providing

19         for staggering of terms; providing for

20         applicability of other provisions of law

21         relating to activities of regulatory boards;

22         providing for the board's headquarters;

23         amending ss. 468.705, 468.707, 468.709,

24         468.711, 468.719, 468.721, F.S., relating to

25         rulemaking authority, licensure by examination,

26         fees, continuing education, disciplinary

27         actions, and certain regulatory transition;

28         transferring to the board certain duties of the

29         department relating to regulation of athletic

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

31         board under the Division of Medical Quality

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         Assurance of the department; providing for

 2         termination of the council and the terms of

 3         council members; authorizing consideration of

 4         former council members for appointment to the

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

 6         grandfathering provisions for the practice of

 7         orthotics, prosthetics, or pedorthics; amending

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

 9         continuing education providers; amending s.

10         478.42, F.S.; redefining the term "electrolysis

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

12         redefining the terms "clinical laboratory" and

13         "licensed practitioner" and defining the term

14         "clinical laboratory examination"; amending s.

15         483.803, F.S.; redefining the terms "clinical

16         laboratory examination" and "licensed

17         practitioner of the healing arts"; revising a

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

19         provisions relating to fees for approval as a

20         laboratory training program; amending s.

21         483.809, F.S.; revising requirements relating

22         to examination of clinical laboratory personnel

23         for licensure and to registration of clinical

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

25         revising qualification requirements for

26         licensure of public health laboratory

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

28         eliminating a provision authorizing conditional

29         licensure of clinical laboratory personnel for

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

31         authorizing continuing education or retraining

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         for candidates who fail an examination a

 2         specified number of times; amending s. 483.824,

 3         F.S.; revising qualifications of clinical

 4         laboratory directors; amending s. 483.825,

 5         F.S.; revising and providing grounds for

 6         discipline; providing penalties; amending s.

 7         483.901, F.S.; correcting a reference;

 8         eliminating a provision authorizing temporary

 9         licensure as a medical physicist; correcting

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

11         F.S.; revising requirements for opticians who

12         supervise apprentices; amending s. 484.0512,

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

14         refund within a specified period all moneys

15         required to be refunded under trial-period

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

17         increasing the penalty applicable to prohibited

18         acts relating to the dispensing of hearing

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

20         violation of trial-period requirements is a

21         ground for disciplinary action; providing

22         penalties; amending ss. 486.041, 486.081,

23         486.103, and 486.107, F.S.; eliminating

24         provisions authorizing issuance of a temporary

25         permit to work as a physical therapist or

26         physical therapist assistant; amending s.

27         490.005, F.S.; revising educational

28         requirements for licensure as a psychologist by

29         examination; changing a date, to defer certain

30         educational requirements; amending s. 490.006,

31         F.S.; providing additional requirements for

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





 1         licensure as a psychologist by endorsement;

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

 3         of a trust fund;  amending s. 491.0045, F.S.;

 4         revising requirements for registration as a

 5         clinical social worker intern, marriage and

 6         family therapist intern, or mental health

 7         counselor intern; amending s. 491.0046, F.S.;

 8         revising requirements for provisional licensure

 9         of clinical social workers, marriage and family

10         therapists, and mental health counselors;

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

12         requirements for licensure of clinical social

13         workers, marriage and family therapists, and

14         mental health counselors; providing for

15         certification of education of interns;

16         providing rulemaking authority to implement

17         education and experience requirements for

18         licensure as a clinical social worker, marriage

19         and family therapist, or mental health

20         counselor; revising future licensure

21         requirements for mental health counselors and

22         providing rulemaking authority for

23         implementation thereof; amending s. 491.006,

24         F.S.; revising requirements for licensure or

25         certification by endorsement; amending s.

26         491.0085, F.S.; requiring laws and rules

27         courses and providing for approval thereof,

28         including providers and programs; correcting

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

30         F.S.; revising an exemption from regulation

31         relating to certain temporally limited

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2         the term "wholesale distribution," relating to

 3         the distribution of prescription drugs, to

 4         provide for the exclusion of certain

 5         activities; amending ss. 626.883, 641.316,

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

 7         provider by a fiscal intermediary to include an

 8         explanation of services provided; creating a

 9         Task Force on Telehealth; providing its duties;

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

11         redefining the term "board"; amending s.

12         468.353, F.S.; conforming provision; providing

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

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

15         providing for membership, powers, and duties;

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

17         periodic rather than annual review of certain

18         examinations and standards; amending s.

19         458.357, F.S.; conforming provisions; deleting

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

21         deleting an examination fee; amending s.

22         468.365, F.S.; conforming provisions; amending

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

24         title "nurse" without being licensed or

25         certified is a crime; amending s. 458.3115,

26         F.S.; revising requirements with respect to

27         eligibility of certain foreign-licensed

28         physicians to take and pass standardized

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

30         changing the date by which application for a

31         restricted license must be submitted; amending

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                                                  SENATE AMENDMENT

    Bill No. CS for SB 2220

    Amendment No.    





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

 2         prescribing fees for foreign-licensed

 3         physicians taking a certain examination;

 4         providing for a detailed study and analysis of

 5         clinical laboratory services for kidney

 6         dialysis patients; amending s. 455.651, F.S.;

 7         providing for treble damages, reasonable

 8         attorney fees, and costs for improper

 9         disclosure of confidential information;

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

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