Senate Bill 2562

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



    Florida Senate - 1999                                  SB 2562

    By Senator Saunders





    25-1160-99                                         See HB 1467

  1                      A bill to be entitled

  2         An act relating to regulation of health care

  3         practitioners; amending s. 232.435, F.S.;

  4         correcting a reference; amending s. 381.026,

  5         F.S.; providing a definition; amending s.

  6         381.0261, F.S.; providing that the Department

  7         of Health or a regulatory board, rather than

  8         the Agency for Health Care Administration, may

  9         impose an administrative fine against any

10         health care provider who fails to make

11         available to patients a summary of their rights

12         as required by law; amending s. 455.501, F.S.;

13         redefining the terms "health care practitioner"

14         and "licensee"; amending s. 455.507, F.S.;

15         revising provisions relating to good standing

16         of members of the Armed Forces with

17         administrative boards to provide applicability

18         to the department when there is no board;

19         providing gender neutral language; amending s.

20         455.521, F.S.; providing powers and duties of

21         the department for the professions, rather than

22         boards, under its jurisdiction; amending s.

23         455.564, F.S.; prescribing the expiration date

24         of an incomplete license application; revising

25         the form and style of licenses; providing

26         authority to the department when there is no

27         board to adopt rules on videocassette courses

28         used for continuing education purposes;

29         revising and providing requirements relating to

30         obtaining continuing education credit in risk

31         management; correcting a reference; amending s.

                                  1

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         455.565, F.S.; revising information required

  2         for licensure of designated health care

  3         professionals; amending s. 455.567, F.S.;

  4         defining sexual misconduct and prohibiting it

  5         in the practice of a health care profession;

  6         providing penalties; amending s. 455.574, F.S.;

  7         revising provisions relating to review of an

  8         examination after failure to pass it; amending

  9         s. 455.587, F.S.; providing authority to the

10         department when there is no board to determine

11         by rule the amount of license fees for the

12         profession regulated; providing for a fee for

13         issuance of a wall certificate to certain

14         licensees or for a duplicate wall certificate;

15         amending s. 455.604, F.S.; requiring

16         instruction on human immunodeficiency virus and

17         acquired immune deficiency syndrome as a

18         condition of licensure and relicensure to

19         practice dietetics and nutrition or nutrition

20         counseling; amending s. 455.607, F.S.;

21         correcting a reference; amending s. 455.624,

22         F.S.; revising and providing grounds for

23         discipline; providing penalties; providing for

24         assessment of certain costs; amending s.

25         455.654, F.S.; redefining the terms "health

26         care provider" and "referral" under the Patient

27         Self-Referral Act of 1992; amending s. 455.664,

28         F.S.; requiring additional health care

29         practitioners to include a certain statement in

30         advertisements for free or discounted services;

31         correcting terminology; amending s. 455.667,

                                  2

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         F.S.; authorizing the department to obtain

  2         patient records, billing records, insurance

  3         information, provider contracts, and all

  4         attachments thereto under certain circumstances

  5         for purposes of disciplinary proceedings;

  6         amending s. 455.687, F.S.; providing for the

  7         suspension or restriction of the license of any

  8         health care practitioner who tests positive for

  9         drugs under certain circumstances; amending s.

10         455.694, F.S.; providing financial

11         responsibility requirements for midwives;

12         creating s. 455.712, F.S.; providing

13         requirements for active status licensure of

14         certain business establishments; amending s.

15         457.102, F.S.; defining the term "prescriptive

16         rights" with respect to acupuncture; amending

17         s. 458.305, F.S.; redefining the term "practice

18         of medicine"; amending s. 458.307, F.S.;

19         correcting terminology and a reference;

20         removing an obsolete date; amending s. 458.311,

21         F.S.; revising provisions relating to licensure

22         as a physician by examination; eliminating an

23         obsolete provision relating to licensure of

24         medical students from Nicaragua and another

25         provision relating to taking the examination

26         without applying for a license; amending s.

27         458.3115, F.S.; updating terminology; amending

28         s. 458.313, F.S.; revising provisions relating

29         to licensure by endorsement; repealing

30         provisions relating to reactivation of certain

31         licenses issued by endorsement; amending s.

                                  3

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         458.315, F.S.; providing additional

  2         requirements for recipients of a temporary

  3         certificate for practice in areas of critical

  4         need; amending s. 458.3165, F.S.; prescribing

  5         authorized employment for holders of public

  6         psychiatry certificates; correcting a

  7         reference; amending s. 458.317, F.S.; providing

  8         for conversion of an active license to a

  9         limited license for a specified purpose;

10         amending s. 458.331, F.S.; revising and

11         providing grounds for discipline; providing

12         penalties; amending s. 458.347, F.S.; revising

13         provisions relating to temporary licensure as a

14         physician assistant; amending s. 459.003, F.S.;

15         redefining the term "practice of osteopathic

16         medicine"; amending s. 459.0075, F.S.;

17         providing for conversion of an active license

18         to a limited license for a specified purpose;

19         amending s. 459.015, F.S.; revising and

20         providing grounds for discipline; providing

21         penalties; amending s. 460.403, F.S.;

22         redefining the term "practice of chiropractic

23         medicine"; amending s. 460.406, F.S.; requiring

24         the Board of Chiropractic Medicine by rule to

25         establish qualifications for serving as a

26         supervising chiropractic physician and

27         procedures for approving a supervising

28         chiropractic physician; amending s. 460.413,

29         F.S.; increasing the administrative fine;

30         amending s. 461.003, F.S.; defining the term

31         "certified podiatric X-ray assistant" and the

                                  4

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         term "direct supervision" with respect thereto;

  2         redefining the term "practice of podiatric

  3         medicine"; amending s. 461.006, F.S.; revising

  4         the residency requirement to practice podiatric

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

  6         requirements for renewal of license to practice

  7         podiatric medicine; amending s. 461.013, F.S.;

  8         revising and providing grounds for discipline;

  9         providing penalties; creating s. 461.0135,

10         F.S.; providing requirements for operation of

11         X-ray machines by certified podiatric X-ray

12         assistants; amending s. 464.008, F.S.;

13         providing for remediation upon failure to pass

14         the examination to practice nursing a specified

15         number of times; amending s. 464.022, F.S.;

16         providing an exemption from regulation relating

17         to remedial courses; amending s. 465.003, F.S.;

18         defining the term "data communication device";

19         amending s. 465.016, F.S.; authorizing the

20         redispensing of unused or returned unit-dose

21         medication by correctional facilities under

22         certain conditions; providing a ground for

23         which a pharmacist may be subject to discipline

24         by the Board of Pharmacy; increasing the

25         administrative fine; amending s. 465.017, F.S.;

26         providing additional persons to whom and

27         entities to which records relating to the

28         filling of prescriptions and the dispensing of

29         medicinal drugs that are maintained by a

30         pharmacy may be furnished; specifying

31         authorized uses of patient records by pharmacy

                                  5

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         owners; providing restrictions on such records

  2         when transmitted through a data communication

  3         device; amending ss. 465.014, 465.015,

  4         465.0196, 468.812, 499.003, F.S.; correcting

  5         cross-references, to conform; amending s.

  6         465.017, F.S.; providing additional persons to

  7         whom and entities to which records relating to

  8         the filling of prescriptions and the dispensing

  9         of medicinal drugs that are maintained by a

10         pharmacy may be furnished; specifying

11         authorized uses of patient records by pharmacy

12         owners; providing restrictions on such records

13         when transmitted through a data communication

14         device; creating the Task Force for the Study

15         of Collaborative Drug Therapy Management;

16         providing for staff support from the

17         department; providing for participation by

18         specified associations and entities; providing

19         responsibilities; requiring a report to the

20         Legislature; amending s. 466.003, F.S.;

21         redefining the term "dentistry"; amending s.

22         466.021, F.S.; revising requirements relating

23         to dental work orders required of unlicensed

24         persons; amending s. 468.1115, F.S.; revising

25         an exemption from regulation as a

26         speech-language pathologist or audiologist;

27         amending s. 468.1155, F.S.; revising

28         requirements for provisional licensure to

29         practice speech-language pathology or

30         audiology; amending s. 468.1215, F.S.; revising

31         requirements for certification as a

                                  6

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         speech-language pathologist or audiologist

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

  3         authorizing the issuance of subcategory

  4         certificates in the field of radiologic

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

  6         correcting references; creating s. 468.519,

  7         F.S.; prohibiting sexual misconduct in the

  8         practice of dietetics and nutrition; providing

  9         penalties; amending s. 468.701, F.S.; revising

10         and removing definitions; amending s. 468.703,

11         F.S.; replacing the Council of Athletic

12         Training with a Board of Athletic Training;

13         providing for appointment of board members and

14         their successors; providing for staggering of

15         terms; providing for applicability of other

16         provisions of law relating to activities of

17         regulatory boards; providing for the board's

18         headquarters; amending ss. 468.705, 468.707,

19         468.709, 468.711, 468.719, 468.721, F.S.,

20         relating to rulemaking authority, licensure by

21         examination, fees, continuing education,

22         disciplinary actions, and certain regulatory

23         transition; transferring to the board certain

24         duties of the department relating to regulation

25         of athletic trainers; amending s. 20.43, F.S.;

26         placing the board under the Division of Medical

27         Quality Assurance of the department; providing

28         for termination of the council and the terms of

29         council members; authorizing consideration of

30         former council members for appointment to the

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

                                  7

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         grandfathering provisions for the practice of

  2         orthotics, prosthetics, or pedorthics; amending

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

  4         continuing education providers; amending s.

  5         478.42, F.S.; redefining the term "electrolysis

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

  7         redefining the terms "clinical laboratory" and

  8         "licensed practitioner" and defining the term

  9         "clinical laboratory examination"; amending s.

10         483.803, F.S.; redefining the terms "clinical

11         laboratory examination" and "licensed

12         practitioner of the healing arts"; revising a

13         reference; amending ss. 395.7015, 408.07, F.S.;

14         correcting cross-references, to conform;

15         amending s. 483.807, F.S.; revising provisions

16         relating to fees for approval as a laboratory

17         training program; amending s. 483.809, F.S.;

18         revising requirements relating to examination

19         of clinical laboratory personnel for licensure

20         and to registration of clinical laboratory

21         trainees; amending s. 483.812, F.S.; revising

22         qualification requirements for licensure of

23         public health laboratory scientists; amending

24         s. 483.813, F.S.; eliminating a provision

25         authorizing conditional licensure of clinical

26         laboratory personnel for a specified period;

27         amending s. 483.821, F.S.; authorizing

28         continuing education or retraining for

29         candidates who fail an examination a specified

30         number of times; amending s. 483.824, F.S.;

31         revising qualifications of clinical laboratory

                                  8

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         directors; amending s. 483.825, F.S.; revising

  2         and providing grounds for discipline; providing

  3         penalties; amending s. 483.901, F.S.;

  4         correcting a reference; eliminating a provision

  5         authorizing temporary licensure as a medical

  6         physicist; correcting the name of a trust fund;

  7         amending s. 484.007, F.S.; revising

  8         requirements for opticians who supervise

  9         apprentices; amending s. 484.0512, F.S.;

10         requiring sellers of hearing aids to refund

11         within a specified period all moneys required

12         to be refunded under trial-period provisions;

13         amending s. 484.053, F.S.; increasing the

14         penalty applicable to prohibited acts relating

15         to the dispensing of hearing aids; amending s.

16         484.056, F.S.; providing that violation of

17         trial-period requirements is a ground for

18         disciplinary action; providing penalties;

19         amending ss. 486.041, 486.081, 486.103, and

20         486.107, F.S.; eliminating provisions

21         authorizing issuance of a temporary permit to

22         work as a physical therapist or physical

23         therapist assistant; amending s. 490.003, F.S.;

24         deferring a revision to the definition of the

25         terms "doctoral-level psychological education"

26         and "doctoral degree in psychology"; amending

27         s. 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

                                  9

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  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

                                  10

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         services; amending ss. 626.883, 641.316, F.S.;

  2         providing for a detailed explanation of

  3         benefits to be included in all payments to a

  4         health care provider by a fiscal intermediary;

  5         providing effective dates.

  6

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

  8

  9         Section 1.  Paragraph (b) of subsection (3) of section

10  232.435, Florida Statutes, is amended to read:

11         232.435  Extracurricular athletic activities; athletic

12  trainers.--

13         (3)

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

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

16  teacher apprentice trainer within the requirements of this

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

18  part XIII XIV of chapter 468.

19         Section 2.  Subsection (2) of section 381.026, Florida

20  Statutes, 1998 Supplement, is amended to read:

21         381.026  Florida Patient's Bill of Rights and

22  Responsibilities.--

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

24  381.0261, the term:

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

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

27  licensed under chapter 395.

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

29  licensed under chapter 458, an osteopathic physician licensed

30  under chapter 459, or a podiatric physician licensed under

31  chapter 461.

                                  11

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  provider who is primarily responsible for patient care in a

  3  health care facility or provider's office.

  4         Section 3.  Subsection (4) of section 381.0261, Florida

  5  Statutes, 1998 Supplement, is amended to read:

  6         381.0261  Summary of patient's bill of rights;

  7  distribution; penalty.--

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

  9  Agency for Health Care Administration when any health care

10  provider or health care facility fails to make available to

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

12  this section. Initial nonwillful violations shall be subject

13  to corrective action and shall not be subject to an

14  administrative fine. The Agency for Health Care Administration

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

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

17  and willful violations. Each intentional and willful violation

18  constitutes a separate violation and is subject to a separate

19  fine.

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

21  appropriate regulatory board or department when any health

22  care provider fails to make available to patients a summary of

23  their rights, pursuant to s. 381.026 and this section. Initial

24  nonwillful violations shall be subject to corrective action

25  and shall not be subject to an administrative fine. The

26  appropriate regulatory board or department agency may levy a

27  fine against a health care provider of up to $100 for

28  nonwillful violations and up to $500 for willful violations.

29  Each intentional and willful violation constitutes a separate

30  violation and is subject to a separate fine.

31

                                  12

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  Florida Statutes, are amended to read:

  3         455.501  Definitions.--As used in this part, the term:

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

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

  6  459; chapter 460; chapter 461; chapter 462; chapter 463;

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

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

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

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

11  chapter 491.

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

13  permit, registration, certificate, or license by the

14  department.

15         Section 5.  Section 455.507, Florida Statutes, is

16  amended to read:

17         455.507  Members of Armed Forces in good standing with

18  administrative boards or department.--

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

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

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

22  administrative board of the state, or the department when

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

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

25  in good standing by such administrative board, or the

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

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

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

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

30  6 months after his discharge from active duty as a member of

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

                                  13

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  the private sector for profit.

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

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

  5  exempting the spouses of members of the Armed Forces of the

  6  United States from licensure renewal provisions, but only in

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

  8  duties with the Armed Forces.

  9         Section 6.  Section 455.521, Florida Statutes, 1998

10  Supplement, is amended to read:

11         455.521  Department; powers and duties.--The

12  department, for the professions boards under its jurisdiction,

13  shall:

14         (1)  Adopt rules establishing a procedure for the

15  biennial renewal of licenses; however, the department may

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

17  notwithstanding any other provisions of law to the contrary.

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

19  individual professions on an annualized basis as authorized by

20  law.

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

22  subject to the approval of the board.

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

24  time and in the manner provided by law.

25         (4)  Develop a training program for persons newly

26  appointed to membership on any board. The program shall

27  familiarize such persons with the substantive and procedural

28  laws and rules and fiscal information relating to the

29  regulation of the appropriate profession and with the

30  structure of the department.

31

                                  14

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  to implement the provisions of this part.

  3         (6)  Establish by rules procedures by which the

  4  department shall use the expert or technical advice of the

  5  appropriate board for the purposes of investigation,

  6  inspection, evaluation of applications, other duties of the

  7  department, or any other areas the department may deem

  8  appropriate.

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

10  thereof and all formal or informal proceedings conducted by

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

12  officer with respect to licensing or discipline to be

13  electronically recorded in a manner sufficient to assure the

14  accurate transcription of all matters so recorded.

15         (8)  Select only those investigators, or consultants

16  who undertake investigations, who meet criteria established

17  with the advice of the respective boards.

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

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

20  support agency pursuant to s. 409.2598 to assure compliance

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

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

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

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

25  delinquent support obligation. The department shall issue or

26  reinstate the license without additional charge to the

27  licensee when notified by the court that the licensee has

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

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

30  resulting from the discharge of its duties under this

31  subsection.

                                  15

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  section 455.564, Florida Statutes, 1998 Supplement, are

  3  amended to read:

  4         455.564  Department; general licensing provisions.--

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

  6  within the jurisdiction of the department shall apply to the

  7  department in writing to take the licensure examination.  The

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

  9  the department and shall require the social security number of

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

11  reflect any material change in any circumstance or condition

12  stated in the application which takes place between the

13  initial filing of the application and the final grant or

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

15  the department. An incomplete application shall expire 1 year

16  after initial filing. In order to further the economic

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

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

19  the county tax collector for the purpose of appointing the

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

21  applications for licenses and applications for renewals of

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

23  tax collector must forward any applications and accompanying

24  application fees to the department.

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

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

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

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

29  department shall issue a license to any person certified by

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

31  licensure requirements imposed by law or rule. The license

                                  16

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  licensee shall consist of be issued a wallet-size

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

  3  5 inches. In addition to the two-part license, the department,

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

  5  certificate suitable for conspicuous display, which shall be

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

  7  surrender to the department the wallet-size identification

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

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

10  suspended or revoked. The department shall promptly return the

11  wallet-size identification card and the wall certificate to

12  the licensee upon reinstatement of a suspended or revoked

13  license.

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

15  of Medicine, the Board of Osteopathic Medicine, the Board of

16  Chiropractic Medicine, and the Board of Podiatric Medicine

17  shall each require licensees which they respectively regulate

18  to periodically demonstrate their professional competency by

19  completing at least 40 hours of continuing education every 2

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

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

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

23  Each of such boards shall determine whether any specific

24  course requirements not otherwise mandated by law shall be

25  mandated and shall approve criteria for, and the content of,

26  any course mandated by such board. Notwithstanding any other

27  provision of law, the board, or the department when there is

28  no board, may approve by rule alternative methods of obtaining

29  continuing education credits in risk management. The

30  alternative methods may include attending a board meeting at

31  which another a licensee is disciplined, serving as a

                                  17

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  volunteer expert witness for the department in a disciplinary

  2  case, or serving as a member of a probable cause panel

  3  following the expiration of a board member's term. Other

  4  boards within the Division of Medical Quality Assurance, or

  5  the department if there is no board, may adopt rules granting

  6  continuing education hours in risk management for attending a

  7  board meeting at which another licensee is disciplined,

  8  serving as a volunteer expert witness for the department in a

  9  disciplinary case, or serving as a member of a probable cause

10  panel following the expiration of a board member's term.

11         (7)  The respective boards within the jurisdiction of

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

13  adopt rules to provide for the use of approved videocassette

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

15  continuing education requirements of the professions they

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

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

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

19  a videocassette course validation form to be signed by the

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

21  with the license renewal application, for continuing education

22  credit.

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

24  elected official who is licensed under a practice act

25  administered by the Division of Medical Health Quality

26  Assurance may hold employment for compensation with any public

27  agency concurrent with such public service.  Such dual service

28  must be disclosed according to any disclosure required by

29  applicable law.

30

31

                                  18

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         Section 8.  Paragraph (a) of subsection (1) of section

  2  455.565, Florida Statutes, 1998 Supplement, is amended to

  3  read:

  4         455.565  Designated health care professionals;

  5  information required for licensure.--

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

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

  8  chapter 461 must, at the time of application, and each

  9  physician who applies for license renewal under chapter 458,

10  chapter 459, chapter 460, or chapter 461 must, in conjunction

11  with the renewal of such license and under procedures adopted

12  by the Department of Health, and in addition to any other

13  information that may be required from the applicant, furnish

14  the following information to the Department of Health:

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

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

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

18  education completed by the applicant, excluding any coursework

19  taken to satisfy medical licensure continuing education

20  requirements.

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

22  has privileges.

23         3.  The address at which the applicant will primarily

24  conduct his or her practice.

25         4.  Any certification that the applicant has received

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

27  which the applicant is applying.

28         5.  The year that the applicant began practicing

29  medicine in any jurisdiction.

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

31  which the applicant currently holds and an indication as to

                                  19

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  whether the applicant has had the responsibility for graduate

  2  medical education within the most recent 10 years.

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

  4  applicant has been found guilty, regardless of whether

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

  6  has pled guilty or nolo contendere.  A criminal offense

  7  committed in another jurisdiction which would have been a

  8  felony or misdemeanor if committed in this state must be

  9  reported. If the applicant indicates that a criminal offense

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

11  that criminal offense, the department must state that the

12  criminal offense is under appeal if the criminal offense is

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

14  indicates to the department that a criminal offense is under

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

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

17  disposition.

18         8.  A description of any final disciplinary action

19  taken within the previous 10 years against the applicant by

20  the agency regulating the profession that the applicant is or

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

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

23  the American Board of Medical Specialities, the American

24  Osteopathic Association, or a similar national organization,

25  or by a licensed hospital, health maintenance organization,

26  prepaid health clinic, ambulatory surgical center, or nursing

27  home.  Disciplinary action includes resignation from or

28  nonrenewal of medical staff membership or the restriction of

29  privileges at a licensed hospital, health maintenance

30  organization, prepaid health clinic, ambulatory surgical

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

                                  20

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  pending disciplinary case related to competence or character.

  2  If the applicant indicates that the disciplinary action is

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

  4  appeal of the disciplinary action, the department must state

  5  that the disciplinary action is under appeal if the

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

  7         Section 9.  Section 455.567, Florida Statutes, is

  8  amended to read:

  9         455.567  Sexual misconduct; disqualification for

10  license, certificate, or registration.--

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

12  profession means violation of the professional relationship

13  through which the health care practitioner uses such

14  relationship to engage or attempt to engage the patient or

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

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

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

18  the professional practice of such health care profession.

19  Sexual misconduct in the practice of a health care profession

20  is prohibited.

21         (2)  Each board within the jurisdiction of the

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

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

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

25  if the candidate or applicant has:

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

27  to practice any profession or occupation revoked or

28  surrendered based on a violation of sexual misconduct in the

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

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

31  not had that license, certificate, or registration reinstated

                                  21

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  by the licensing authority of the jurisdiction that revoked

  2  the license, certificate, or registration; or

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

  4  territory or possession of the United States which if

  5  committed in this state would constitute sexual misconduct.

  6

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

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

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

10  administrative charges against the candidate's license

11  constitutes the surrender of the license.

12         Section 10.  Subsection (2) of section 455.574, Florida

13  Statutes, 1998 Supplement, is amended to read:

14         455.574  Department of Health; examinations.--

15         (2)  For each examination developed by the department

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

17  there is no board, shall adopt rules providing for

18  reexamination of any applicants who failed an examination

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

20  written and a practical examination are given, an applicant

21  shall be required to retake only the portion of the

22  examination on which the applicant failed to achieve a passing

23  grade, if the applicant successfully passes that portion

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

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

26  portion. Except for national examinations approved and

27  administered pursuant to this section, the department shall

28  provide procedures for applicants who fail an examination

29  developed by the department or a contracted vendor to review

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

31  grading key for the questions the candidate answered

                                  22

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  failed. Applicants shall bear the actual cost for the

  3  department to provide examination review pursuant to this

  4  subsection. An applicant may waive in writing the

  5  confidentiality of the applicant's examination grades.

  6         Section 11.  Subsection (1) of section 455.587, Florida

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

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

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

10         455.587  Fees; receipts; disposition for boards within

11  the department.--

12         (1)  Each board within the jurisdiction of the

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

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

15  profession it regulates, based upon long-range estimates

16  prepared by the department of the revenue required to

17  implement laws relating to the regulation of professions by

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

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

20  adequate to cover all anticipated costs and to maintain a

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

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

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

24  department that license fees are projected to be inadequate,

25  the department shall set license fees on behalf of the

26  applicable board to cover anticipated costs and to maintain

27  the required cash balance. The department shall include

28  recommended fee cap increases in its annual report to the

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

30  regulated profession operate with a negative cash balance. The

31  department may provide by rule for advancing sufficient funds

                                  23

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  years, and the regulated profession must pay interest.

  4  Interest shall be calculated at the current rate earned on

  5  investments of a trust fund used by the department to

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

  7  various funds in accordance with the allocation of investment

  8  earnings during the period of the advance.

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

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

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

12  455.564(2) requested by a licensee who was licensed prior to

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

14  certificate requested by any licensee.

15         Section 12.  Subsections (1) and (6) of section

16  455.604, Florida Statutes, 1998 Supplement, are amended to

17  read:

18         455.604  Requirement for instruction for certain

19  licensees on human immunodeficiency virus and acquired immune

20  deficiency syndrome.--

21         (1)  The appropriate board shall require each person

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

23  459; chapter 460; chapter 461; chapter 463; chapter 464;

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

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

26  educational course, approved by the board, on human

27  immunodeficiency virus and acquired immune deficiency syndrome

28  as part of biennial relicensure or recertification. The course

29  shall consist of education on the modes of transmission,

30  infection control procedures, clinical management, and

31  prevention of human immunodeficiency virus and acquired immune

                                  24

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  deficiency syndrome. Such course shall include information on

  2  current Florida law on acquired immune deficiency syndrome and

  3  its impact on testing, confidentiality of test results,

  4  treatment of patients, and any protocols and procedures

  5  applicable to human immunodeficiency virus counseling and

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

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

  8  and 384.25.

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

10  a license under the chapters and parts specified in subsection

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

12  complete an educational course acceptable to the board on

13  human immunodeficiency virus and acquired immune deficiency

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

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

16  allowed 6 months to complete this requirement.

17         Section 13.  Subsection (1) of section 455.607, Florida

18  Statutes, is amended to read:

19         455.607  Athletic trainers and massage therapists;

20  requirement for instruction on human immunodeficiency virus

21  and acquired immune deficiency syndrome.--

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

23  board, shall require each person licensed or certified under

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

25  continuing educational course approved by the board, or the

26  department where there is no board, on human immunodeficiency

27  virus and acquired immune deficiency syndrome as part of

28  biennial relicensure or recertification.  The course shall

29  consist of education on modes of transmission, infection

30  control procedures, clinical management, and prevention of

31  human immunodeficiency virus and acquired immune deficiency

                                  25

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  syndrome, with an emphasis on appropriate behavior and

  2  attitude change.

  3         Section 14.  Paragraphs (t), (u), (v), and (w) are

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

  5  and subsections (2) and (3) of that section are amended, to

  6  read:

  7         455.624  Grounds for discipline; penalties;

  8  enforcement.--

  9         (1)  The following acts shall constitute grounds for

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

11  be taken:

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

13  381.026 and 381.0261 to provide patients with information

14  about their patient rights and how to file a patient

15  complaint.

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

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

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

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

20  or physical sexual activity.

21         (v)  Failing to comply with the requirements for

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

23  failing to provide initial information, failing to timely

24  provide updated information, or making misleading, untrue,

25  deceptive, or fraudulent representations on a profile,

26  credentialing, or initial or renewal licensure application.

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

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

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

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

31  crime in any jurisdiction. Convictions, findings,

                                  26

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  adjudications, and pleas entered into prior to the enactment

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

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

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

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

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

  7  practice act, including conduct constituting a substantial

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

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

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

11  penalties:

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

13  restrictions, an application for a license.

14         (b)  Suspension or permanent revocation 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 licensee on probation for a

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

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

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

23  licensee to undergo treatment, attend continuing education

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

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

26  tailored to the violations found.

27         (g)  Corrective action.

28         (h)  Imposition of an administrative fine in accordance

29  with s. 381.0261 for violations regarding patient rights.

30

31

                                  27

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  sanctions are necessary to protect the public or to compensate

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

  5  the disciplining authority consider and include in the order

  6  requirements designed to rehabilitate the practitioner. All

  7  costs associated with compliance with orders issued under this

  8  subsection are the obligation of the practitioner.

  9         (3)  In addition to any other discipline imposed

10  pursuant to this section or discipline imposed for a violation

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

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

13  prosecution of the case excluding costs associated with an

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

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

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

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

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

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

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

21  recover, the fine or assessment.

22         Section 15.  Paragraphs (g) and (k) of subsection (3)

23  of section 455.654, Florida Statutes, 1998 Supplement, are

24  amended to read:

25         455.654  Financial arrangements between referring

26  health care providers and providers of health care services.--

27         (3)  DEFINITIONS.--For the purpose of this section, the

28  word, phrase, or term:

29         (g)  "Health care provider" means any physician

30  licensed under chapter 458, chapter 459, chapter 460, or

31  chapter 461;, or any health care provider licensed under

                                  28

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  chapter 463 or chapter 466; or any business entity that is

  2  operating as a provider for kidney dialysis or nephrology and

  3  is vertically integrated with another business entity

  4  providing clinical laboratory services, except for any such

  5  entity licensed under chapter 395.

  6         (k)  "Referral" means any referral of a patient by a

  7  health care provider for health care services, including,

  8  without limitation:

  9         1.  The forwarding of a patient by a health care

10  provider to another health care provider or to an entity which

11  provides or supplies designated health services or any other

12  health care item or service; or

13         2.  The request or establishment of a plan of care by a

14  health care provider, which includes the provision of

15  designated health services or other health care item or

16  service.

17         3.  The following orders, recommendations, or plans of

18  care shall not constitute a referral by a health care

19  provider:

20         a.  By a radiologist for diagnostic-imaging services.

21         b.  By a physician specializing in the provision of

22  radiation therapy services for such services.

23         c.  By a medical oncologist for drugs and solutions to

24  be prepared and administered intravenously to such

25  oncologist's patient, as well as for the supplies and

26  equipment used in connection therewith to treat such patient

27  for cancer and the complications thereof.

28         d.  By a cardiologist for cardiac catheterization

29  services.

30         e.  By a pathologist for diagnostic clinical laboratory

31  tests and pathological examination services, if furnished by

                                  29

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  or under the supervision of such pathologist pursuant to a

  2  consultation requested by another physician.

  3         f.  By a health care provider who is the sole provider

  4  or member of a group practice for designated health services

  5  or other health care items or services that are prescribed or

  6  provided solely for such referring health care provider's or

  7  group practice's own patients, and that are provided or

  8  performed by or under the direct supervision of such referring

  9  health care provider or group practice.

10         g.  By a health care provider for services provided by

11  an ambulatory surgical center licensed under chapter 395.

12         h.  By a health care provider for renal dialysis

13  diagnostic clinical laboratory services and supplies, but not

14  for designated health services, except those providers

15  licensed under chapter 395 where such services are directly

16  related to renal dialysis.

17         i.  By a urologist for lithotripsy services.

18         j.  By a dentist for dental services performed by an

19  employee of or health care provider who is an independent

20  contractor with the dentist or group practice of which the

21  dentist is a member.

22         k.  By a physician for infusion therapy services to a

23  patient of that physician or a member of that physician's

24  group practice.

25         l.  By a nephrologist for renal dialysis services and

26  supplies.

27         Section 16.  Section 455.664, Florida Statutes, is

28  amended to read:

29         455.664  Advertisement by a health care practitioner

30  provider of free or discounted services; required

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

                                  30

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  care practitioner provider licensed under chapter 458, chapter

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

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

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

  6  chapter 491, the following statement shall appear in capital

  7  letters clearly distinguishable from the rest of the text:

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

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

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

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

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

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

14  statement shall not be necessary as an accompaniment to an

15  advertisement of a licensed health care practitioner provider

16  defined by this section if the advertisement appears in a

17  classified directory the primary purpose of which is to

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

19  prices to consumers and in which the statement prominently

20  appears in at least one place.

21         Section 17.  Subsection (7) of section 455.667, Florida

22  Statutes, 1998 Supplement, is amended to read:

23         455.667  Ownership and control of patient records;

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

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

26  insurance information, if the complaint being investigated

27  alleges inadequate medical care based on termination of

28  insurance. The department may obtain patient access these

29  records pursuant to a subpoena without written authorization

30  from the patient if the department and the probable cause

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

                                  31

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  to believe that a health care practitioner has excessively or

  2  inappropriately prescribed any controlled substance specified

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

  4  practice act or that a health care practitioner has practiced

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

  6  treatment required as defined by this part or any professional

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

  8  appropriate, reasonable attempts were made to obtain a patient

  9  release.

10         2.  The department may obtain patient records and

11  insurance information pursuant to a subpoena without written

12  authorization from the patient if the department and the

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

14  reasonable cause to believe that a health care practitioner

15  has provided inadequate medical care based on termination of

16  insurance and also find that appropriate, reasonable attempts

17  were made to obtain a patient release.

18         3.  The department may obtain patient records, billing

19  records, insurance information, provider contracts, and all

20  attachments thereto pursuant to a subpoena without written

21  authorization from the patient if the department and probable

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

23  cause to believe that a health care practitioner has submitted

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

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

26  billing code that accurately describes the services performed,

27  requested payment for services that were not performed by that

28  health care practitioner, used information derived from a

29  written report of an automobile accident generated pursuant to

30  chapter 316 to solicit or obtain patients personally or

31  through an agent regardless of whether the information is

                                  32

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  or from another person, solicited patients fraudulently,

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

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

  5  caused to be presented a false or fraudulent insurance claim

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

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

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

  9  deceased, incapacitated, or suspected of being a participant

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

11  specific and relevant records.

12         (b)  Patient records, billing records, insurance

13  information, provider contracts, and all attachments thereto

14  record obtained by the department pursuant to this subsection

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

16  appropriate regulatory board in disciplinary proceedings. The

17  records shall otherwise be confidential and exempt from s.

18  119.07(1). This section does not limit the assertion of the

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

20  records of treatment for mental or nervous disorders by a

21  medical practitioner licensed pursuant to chapter 458 or

22  chapter 459 who has primarily diagnosed and treated mental and

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

24  inclusive of psychiatric residency. However, the health care

25  practitioner shall release records of treatment for medical

26  conditions even if the health care practitioner has also

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

28  department has found reasonable cause under this section and

29  the psychotherapist-patient privilege is asserted, the

30  department may petition the circuit court for an in camera

31  review of the records by expert medical practitioners

                                  33

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  thereof are protected under the psychotherapist-patient

  3  privilege.

  4         Section 18.  Subsection (3) is added to section

  5  455.687, Florida Statutes, to read:

  6         455.687  Certain health care practitioners; immediate

  7  suspension of license.--

  8         (3)  The department may issue an emergency order

  9  suspending or restricting the license of any health care

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

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

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

13  112.0455, when the practitioner does not have a lawful

14  prescription and legitimate medical reason for using such

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

16  of notification to the practitioner of the confirmed test

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

18  emergency order is issued.

19         Section 19.  Section 455.694, Florida Statutes, 1998

20  Supplement, is amended to read:

21         455.694  Financial responsibility requirements for

22  Boards regulating certain health care practitioners.--

23         (1)  As a prerequisite for licensure or license

24  renewal, the Board of Acupuncture, the Board of Chiropractic

25  Medicine, the Board of Podiatric Medicine, and the Board of

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

27  practitioners licensed under the respective board, and the

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

29  registered nurse practitioners certified under s. 464.012, and

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

31  medical malpractice insurance or provide proof of financial

                                  34

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  board or department to be sufficient to cover claims arising

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

  4  and services in this state.

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

  6  application by practitioners meeting any of the following

  7  criteria:

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

  9  460, chapter 461, s. 464.012, or chapter 466, or chapter 467

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

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

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

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

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

15  insurance program authorized by the provisions of s.

16  768.28(15) or who is a volunteer under s. 110.501(1).

17         (b)  Any person whose license or certification has

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

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

20  practicing in this state.  Any person applying for

21  reactivation of a license must show either that such licensee

22  maintained tail insurance coverage which provided liability

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

24  1993, or the initial date of licensure in this state,

25  whichever is later, and incidents that occurred before the

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

27  must submit an affidavit stating that such licensee has no

28  unsatisfied medical malpractice judgments or settlements at

29  the time of application for reactivation.

30

31

                                  35

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  license.

  4         (d)  Any person licensed or certified under chapter

  5  457, chapter 460, chapter 461, s. 464.012, or chapter 466, or

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

  7  teaching duties at an accredited school or in its main

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

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

10  a necessary part of duties in connection with the teaching

11  position in the school.

12         (e)  Any person holding an active license or

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

14  464.012, or chapter 466, or chapter 467 who is not practicing

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

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

17  activity.

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

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

20  state.

21         (3)  Notwithstanding the provisions of this section,

22  the financial responsibility requirements of ss. 458.320 and

23  459.0085 shall continue to apply to practitioners licensed

24  under those chapters.

25         Section 20.  Section 455.712, Florida Statutes, is

26  created to read:

27         455.712  Business establishments; requirements for

28  active status licenses.--

29         (1)  A business establishment regulated by the Division

30  of Medical Quality Assurance pursuant to this part may provide

31  regulated services only if the business establishment has an

                                  36

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  active status license. A business establishment that provides

  2  regulated services without an active status license is in

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

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

  5  the business establishment.

  6         (2)  A business establishment must apply with a

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

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

  9  license before the license expires. If a business

10  establishment fails to renew before the license expires, the

11  license becomes delinquent, except as otherwise provided in

12  statute, in the license cycle following expiration.

13         (3)  A delinquent business establishment must apply

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

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

16  within 6 months after becoming delinquent. Failure of a

17  delinquent business establishment to renew the license within

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

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

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

21  of applying for and meeting all requirements imposed on a

22  business establishment for new licensure.

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

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

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

26  impose discipline or to enforce discipline previously imposed

27  on a business establishment for acts or omissions committed by

28  the business establishment while holding a license, whether

29  active or null.

30         (5)  This section applies to any a business

31  establishment registered, permitted, or licensed by the

                                  37

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  department to do business. Business establishments include,

  2  but are not limited to, dental laboratories, electrology

  3  facilities, massage establishments, pharmacies, and health

  4  care services pools.

  5         Section 21.  Subsection (7) is added to section

  6  457.102, Florida Statutes, 1998 Supplement, to read:

  7         457.102  Definitions.--As used in this chapter:

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

  9  administration, and use of needles and devices, restricted

10  devices, and prescription devices that are used in the

11  practice of acupuncture and oriental medicine.

12         Section 22.  Subsection (3) of section 458.305, Florida

13  Statutes, is amended to read:

14         458.305  Definitions.--As used in this chapter:

15         (3)  "Practice of medicine" means making or approving a

16  the diagnosis, treatment, treatment plan, operation,

17  procedure, or prescription for any human disease, pain,

18  injury, deformity, or other physical or mental condition. The

19  "practice of medicine" does not include coverage decisions for

20  purposes of insurance benefits as long as medical judgments

21  are not involved.

22         Section 23.  Subsections (2) and (4) of section

23  458.307, Florida Statutes, 1998 Supplement, are amended to

24  read:

25         458.307  Board of Medicine.--

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

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

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

29  teaching of medicine for at least 4 years immediately

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

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

                                  38

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

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

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

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

  6  never have been, licensed health care practitioners.  One

  7  member must be a health care hospital risk manager licensed

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

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

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

11  shall establish a disciplinary training program for board

12  members. The program shall provide for initial and periodic

13  training in the grounds for disciplinary action, the actions

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

15  relevant statutes and rules, and any relevant judicial and

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

17  the board shall participate on probable cause panels or in

18  disciplinary decisions of the board unless he or she has

19  completed the disciplinary training program.

20         Section 24.  Section 458.311, Florida Statutes, 1998

21  Supplement, is amended to read:

22         458.311  Licensure by examination; requirements;

23  fees.--

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

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

26  the department on forms furnished by the department to take

27  the licensure examination. The department shall license

28  examine each applicant who whom the board certifies:

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

30  nonrefundable application fee not to exceed $500 and an

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

                                  39

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  applicant cost to the department for purchase of the

  2  examination from the Federation of State Medical Boards of the

  3  United States or a similar national organization, which is

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

  5  the examination.

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

  7         (c)  Is of good moral character.

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

  9  any other jurisdiction which would constitute the basis for

10  disciplining a physician pursuant to s. 458.331.

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

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

13  2 academic years of preprofessional, postsecondary education,

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

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

16  chemistry prior to entering medical school.

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

18  postgraduate training requirements:

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

20  allopathic college recognized and approved by an accrediting

21  agency recognized by the United States Office of Education or

22  is a graduate of an allopathic medical school or allopathic

23  college within a territorial jurisdiction of the United States

24  recognized by the accrediting agency of the governmental body

25  of that jurisdiction;

26         b.  If the language of instruction of the medical

27  school is other than English, has demonstrated competency in

28  English through presentation of a satisfactory grade on the

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

30  similar test approved by rule of the board; and

31

                                  40

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  year.

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

  4  school registered with the World Health Organization and

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

  6  required to accredit medical schools in the United States or

  7  reasonably comparable standards;

  8         b.  If the language of instruction of the foreign

  9  medical school is other than English, has demonstrated

10  competency in English through presentation of the Educational

11  Commission for Foreign Medical Graduates English proficiency

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

13  English of the Educational Testing Service or a similar test

14  approved by rule of the board; and

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

16  year.

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

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

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

20  the Educational Commission for Foreign Medical Graduates,

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

22  and has passed the examination utilized by that commission;

23  and

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

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

26  completed an approved residency or fellowship of at least 2

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

28  fellowship experience and training must be counted toward

29  regular or subspecialty certification by a board recognized

30  and certified by the American Board of Medical Specialties.

31

                                  41

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  fingerprints on a form and under procedures specified by the

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

  4  costs incurred by the Department of Health for the criminal

  5  background check of the applicant.

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

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

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

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

10  the examination of the Federation of State Medical Boards of

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

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

13  for the purpose of examination of any applicant who was

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

15  currently licensed in at least one other jurisdiction of the

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

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

18  Special Purpose Examination of the Federation of State Medical

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

20  score as established by rule of the board.

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

22  an applicant who does not pass the national licensing

23  examination after five attempts to complete additional

24  remedial education or training.  The board shall prescribe the

25  additional requirements in a manner that permits the applicant

26  to complete the requirements and be reexamined within 2 years

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

28  examination a sixth or subsequent time.

29         (3)  Notwithstanding the provisions of subparagraph

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

31  present the certificate issued by the Educational Commission

                                  42

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  for Foreign Medical Graduates or pass the examination utilized

  2  by that commission if the graduate:

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

  4  accredited United States college or university.

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

  6  recognized by the World Health Organization.

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

  8  the foreign medical school, except the internship or social

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

10  Board of Medical Examiners examination or the Educational

11  Commission for Foreign Medical Graduates examination

12  equivalent.

13         (d)  Has completed an academic year of supervised

14  clinical training in a hospital affiliated with a medical

15  school approved by the Council on Medical Education of the

16  American Medical Association and upon completion has passed

17  part II of the National Board of Medical Examiners examination

18  or the Educational Commission for Foreign Medical Graduates

19  examination equivalent.

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

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

22  through an investigative process.  When the investigative

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

24  120.60(1) and the department or board has reason to believe

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

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

27  which shall be in writing and sufficient to notify the

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

29  subsection shall control over any conflicting provisions of s.

30  120.60(1).

31

                                  43

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  licensure any applicant who is under investigation in another

  3  jurisdiction for an offense which would constitute a violation

  4  of this chapter until such investigation is completed. Upon

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

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

  7  unrestricted license to any individual who has committed any

  8  act or offense in any jurisdiction which would constitute the

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

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

11  or offense in any jurisdiction which would constitute the

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

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

14  terms set forth in subsection (9).

15         (6)  Each applicant who passes the examination and

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

17  physician, with rights as defined by law.

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

19  shall impose conditions, limitations, or restrictions on a

20  license by examination if the applicant is on probation in

21  another jurisdiction for an act which would constitute a

22  violation of this chapter.

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

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

25  satisfaction, each of the appropriate requirements set forth

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

27  of the following terms:

28         (a)  Refusal to certify to the department an

29  application for licensure, certification, or registration;

30

31

                                  44

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (b)  Certification to the department of an application

  2  for licensure, certification, or registration with

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

  4         (c)  Certification to the department of an application

  5  for licensure, certification, or registration with placement

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

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

  8  not limited to, requiring the physician to submit to

  9  treatment, attend continuing education courses, submit to

10  reexamination, or work under the supervision of another

11  physician.

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

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

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

15  the time of application for licensure under this subsection,

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

17  of the United States may make initial application to the

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

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

20  receipt of such application, the department shall issue a

21  2-year restricted license to any applicant therefor upon the

22  applicant's successful completion of the licensure examination

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

24  has met the following requirements:

25         1.  Is a graduate of a World Health Organization

26  recognized foreign medical institution located in a country in

27  the Western Hemisphere.

28         2.  Received a medical education which has been

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

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

31  medical programs.

                                  45

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         3.  Practiced medicine in the country of Nicaragua for

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

  3  has lawful employment authority in the United States.

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

  5  the Florida Board of Medicine.

  6         5.  Successfully completed the Educational Commission

  7  for Foreign Medical Graduates Examination or Foreign Medical

  8  Graduate Examination in the Medical Sciences or successfully

  9  completed a course developed for the University of Miami for

10  physician training equivalent to the course developed for such

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

12  person shall be permitted to enroll in the physician training

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

14  having met the requirements of this paragraph or conditionally

15  certified by the board as having substantially complied with

16  the requirements of this paragraph. Any person conditionally

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

18  board's satisfaction, full compliance with all the

19  requirements of this paragraph prior to completion of the

20  physician training course and shall not be permitted to sit

21  for the licensure examination unless the board certifies that

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

23

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

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

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

27  5 and 42, chapter 89-374, Laws of Florida, and renumbered as

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

29  not be eligible to apply under this subsection.

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

31  to this subsection may practice medicine for the first year

                                  46

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  of a board-approved physician.

  3         (c)  Upon recommendation of the supervising physician

  4  and demonstration of clinical competency to the satisfaction

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

  6  pursuant to this subsection has practiced for 1 year under

  7  direct supervision, such licenseholder shall work for 1 year

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

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

10  determined by the board.  Prior to commencing such

11  supervision, the supervising physician shall notify the board.

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

13  general supervision and demonstration to the board that the

14  holder of the restricted license has satisfactorily completed

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

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

17  constitute a violation of this chapter, the department shall

18  issue an unrestricted license to such licenseholder.

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

20  provisions of this subsection shall be promulgated by the

21  board.

22         (10)  Notwithstanding any other provision of this

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

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

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

26  person:

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

28  and II of the United States Medical Licensing Examination or

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

30

31

                                  47

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  at the time of examination;

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

  5  or she be administered the examination without applying for a

  6  license as a physician in this state; and

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

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

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

10  of the examination from the Federation of State Medical Boards

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

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

13  ineligible to take the examination.

14         Section 25.  Section 458.3115, Florida Statutes, 1998

15  Supplement, is amended to read:

16         458.3115  Restricted license; certain foreign-licensed

17  physicians; United States Medical Licensing Examination

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

19  practice; full licensure.--

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

21  department agency shall provide procedures under which certain

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

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

24  agency-developed examination developed by the department, in

25  consultation with the board, to qualify for a restricted

26  license to practice medicine in this state. The

27  department-developed agency and board-developed examination

28  shall test the same areas of medical knowledge as the

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

30  (FLEX) previously administered by the Florida Board of

31  Medicine to grant medical licensure in Florida. The

                                  48

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  department-developed agency-developed examination must be made

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

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

  4  elects to take the department-developed agency and

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

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

  7  required to retake or pass the equivalent parts of the

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

  9  for the department-developed agency and board-developed

10  examination five times within 5 years.

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

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

13  the previously administered FLEX shall not be required to

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

15  year 2000.

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

17  examination for restricted licensure if the person:

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

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

20  special preparatory medical update courses authorized by the

21  board and the University of Miami Medical School and

22  subsequently passed the final course examination; upon

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

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

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

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

27  one of the persons who took and successfully completed the

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

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

30  minimum, the documentation must include class attendance

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

                                  49

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         2.  Applies to the department agency and submits an

  2  application fee that is nonrefundable and equivalent to the

  3  fee required for full licensure;

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

  5  practice of medicine in another jurisdiction;

  6         4.  Submits an examination fee that is nonrefundable

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

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

  9  either examination described in this section;

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

11  other jurisdiction that would constitute a substantial basis

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

13  chapter 455; and

14         6.  Is not under discipline, investigation, or

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

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

17  chapter 455 and that substantially threatened or threatens the

18  public health, safety, or welfare.

19         (d)  Every person eligible for restricted licensure

20  under this section may sit for the USMLE or the

21  department-developed agency and board-developed examination

22  five times within 5 calendar years.  Applicants desiring to

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

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

25  applicants applying under this section who fail the

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

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

28  second and subsequent times they take the examination.

29         (e)  The department Agency for Health Care

30  Administration and the board shall be responsible for working

31  with one or more organizations to offer a medical refresher

                                  50

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  course designed to prepare applicants to take either licensure

  2  examination described in this section.  The organizations may

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

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

  5  specializes in developing such courses.

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

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

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

  9  paid by the students taking the course.

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

11  restricted license to an applicant under this section, the

12  applicant must have passed either of the two examinations

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

14  reasonable restrictions on the applicant's license to

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

16  to:

17         1.  Periodic and random department agency audits of the

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

19  board or the department agency.

20         2.  Periodic appearances of the licensee before the

21  board or the department agency.

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

23  department agency.

24         (b)  A restricted licensee under this section shall

25  practice under the supervision of a full licensee approved by

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

27  under direct supervision as defined by board rule and the

28  second year being under indirect supervision as defined by

29  board rule.

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

31  this subsection.

                                  51

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

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

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

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

  6  Upon expiration of such restricted license, a restricted

  7  licensee shall become a full licensee if the restricted

  8  licensee:

  9         1.  Is not under discipline, investigation, or

10  prosecution for a violation which poses a substantial threat

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

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

13         (b)  The department agency shall renew a restricted

14  license under this section upon payment of the same fees

15  required for renewal for a full license if the restricted

16  licensee is under discipline, investigation, or prosecution

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

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

19  permanently revoked the restricted license. A restricted

20  licensee who has renewed such restricted license shall become

21  eligible for full licensure when the licensee is no longer

22  under discipline, investigation, or prosecution.

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

24  the provisions of this section.

25         Section 26.  Subsections (1), (2), and (8) of section

26  458.313, Florida Statutes, are amended to read:

27         458.313  Licensure by endorsement; requirements;

28  fees.--

29         (1)  The department shall issue a license by

30  endorsement to any applicant who, upon applying to the

31  department on forms furnished by the department and remitting

                                  52

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  the board certifies:

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

  4  458.311(1)(b)-(g) or in s. 458.311(1)(b)-(e) and (g) and (3);

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

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

  7  examination of the Federation of State Medical Boards of the

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

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

10  National Board of Medical Examiners, or on a combination

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

12  passing score on the United States Medical Licensing

13  Examination (USMLE) provided the board certifies as eligible

14  for licensure by endorsement any applicant who took the

15  required examinations more than 10 years prior to application;

16  and

17         (c)  Has submitted evidence of the active licensed

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

19  of the immediately preceding 4 years, or evidence of

20  successful completion of either a board-approved postgraduate

21  training program within 2 years preceding filing of an

22  application, or a board-approved clinical competency

23  examination, within the year preceding the filing of an

24  application for licensure.  For purposes of this paragraph,

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

26  medicine by physicians, including those employed by any

27  governmental entity in community or public health, as defined

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

29  are practicing medicine, and those on the active teaching

30  faculty of an accredited medical school.

31

                                  53

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

  2  require an applicant who does not pass the licensing

  3  examination after five attempts to complete additional

  4  remedial education or training.  The board shall prescribe the

  5  additional requirements in a manner that permits the applicant

  6  to complete the requirements and be reexamined within 2 years

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

  8  examination a sixth or subsequent time.

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

10  by endorsement to take and pass the appropriate licensure

11  examination prior to certifying the applicant as eligible for

12  licensure.

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

14  physician whose license has become void by failure to practice

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

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

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

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

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

20  applicable fees, and otherwise meets any continuing education

21  requirements for reactivation of the license as determined by

22  the board.

23         Section 27.  Subsection (1) of section 458.315, Florida

24  Statutes, is amended to read:

25         458.315  Temporary certificate for practice in areas of

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

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

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

29  certificate to practice in communities of Florida where there

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

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

                                  54

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  department, correctional facility, community health center

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

  3  Public Health Services Act, or other entity that provides

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

  5  Health Officer.  The Board of Medicine may issue this

  6  temporary certificate with the following restrictions:

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

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

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

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

11  limited to, health professional shortage areas designated by

12  the United States Department of Health and Human Services.

13         (a)  A recipient of a temporary certificate for

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

15  for any approved employer in any area of critical need

16  approved by the board.

17         (b)  The recipient of a temporary certificate for

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

19  accepting employment, notify the board of all approved

20  institutions in which the licensee practices and of all

21  approved institutions where practice privileges have been

22  denied.

23         Section 28.  Section 458.3165, Florida Statutes, is

24  amended to read:

25         458.3165  Public psychiatry certificate.--The board

26  shall issue a public psychiatry certificate to an individual

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

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

29  licensed to practice medicine without restriction in another

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

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

                                  55

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  use the certificate to work at any public mental health

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

  3         (1)  Such certificate shall:

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

  5  mental health facility or program funded in part or entirely

  6  by state funds.

  7         (b)  Be issued and renewable biennially if the

  8  secretary of the Department of Health and Rehabilitative

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

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

11  of psychiatry at the accredited medical school at the

12  University of Miami recommend in writing that the certificate

13  be issued or renewed.

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

15  with a public mental health facility or program expires.

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

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

18  chapter.

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

20  certificateholder for noncompliance with any part of this

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

22  subject to discipline.

23         Section 29.  Subsection (4) is added to section

24  458.317, Florida Statutes, 1998 Supplement, to read:

25         458.317  Limited licenses.--

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

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

28  license for the purpose of providing volunteer, uncompensated

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

30  statement from the employing agency or institution stating

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

                                  56

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  involving the practice of medicine. The application and all

  2  licensure fees, including neurological injury compensation

  3  assessments, shall be waived.

  4         Section 30.  Paragraph (u) of subsection (1) of section

  5  458.331, Florida Statutes, 1998 Supplement, is amended,

  6  paragraph (mm) is added to that subsection, and subsection (2)

  7  of that section is amended, to read:

  8         458.331  Grounds for disciplinary action; action by the

  9  board and department.--

10         (1)  The following acts shall constitute grounds for

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

12  be taken:

13         (u)  Performing any procedure or prescribing any

14  therapy which, by the prevailing standards of medical practice

15  in the community, would constitute experimentation on a human

16  subject, without first obtaining full, informed, and written

17  consent. The Board of Medicine may designate by rule or by

18  declaratory statement specific experimental treatments that

19  may be performed on patients who are in need of emergency

20  medical intervention for a life-threatening medical condition,

21  but who cannot give full, informed, and written consent

22  because of their life-threatening medical condition and who do

23  not have a legally authorized person present to represent

24  them. Only experimental treatment that is the subject of U.S.

25  Food and Drug Administration-approved research activities

26  involving human subjects who are in need of emergency medical

27  intervention may be so designated.

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

29  381.026 and 381.0261 to provide patients with information

30  about their patient rights and how to file a patient

31  complaint.

                                  57

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  that would constitute a substantial violation of subsection

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

  5  imposing one or more of the following penalties:

  6         (a)  Refusal to certify, or certification with

  7  restrictions, to the department an application for licensure,

  8  certification, or registration.

  9         (b)  Revocation or suspension of a license.

10         (c)  Restriction of practice.

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

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

13         (e)  Issuance of a reprimand.

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

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

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

17  physician to submit to treatment, to attend continuing

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

19  under the supervision of another physician.

20         (g)  Issuance of a letter of concern.

21         (h)  Corrective action.

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

23  patient.

24         (j)  Imposition of an administrative fine in accordance

25  with s. 381.0261 for violations regarding patient rights.

26

27  In determining what action is appropriate, the board must

28  first consider what sanctions are necessary to protect the

29  public or to compensate the patient.  Only after those

30  sanctions have been imposed may the disciplining authority

31  consider and include in the order requirements designed to

                                  58

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  rehabilitate the physician.  All costs associated with

  2  compliance with orders issued under this subsection are the

  3  obligation of the physician.

  4         Section 31.  Subsection (7) of section 458.347, Florida

  5  Statutes, 1998 Supplement, is amended to read:

  6         458.347  Physician assistants.--

  7         (7)  PHYSICIAN ASSISTANT LICENSURE.--

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

  9  assistant must apply to the department.  The department shall

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

11  having met the following requirements:

12         1.  Is at least 18 years of age.

13         2.  Has satisfactorily passed a proficiency examination

14  by an acceptable score established by the National Commission

15  on Certification of Physician Assistants.  If an applicant

16  does not hold a current certificate issued by the National

17  Commission on Certification of Physician Assistants and has

18  not actively practiced as a physician assistant within the

19  immediately preceding 4 years, the applicant must retake and

20  successfully complete the entry-level examination of the

21  National Commission on Certification of Physician Assistants

22  to be eligible for licensure.

23         3.  Has completed the application form and remitted an

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

25  application for licensure made by a physician assistant must

26  include:

27         a.  A certificate of completion of a physician

28  assistant training program specified in subsection (6).

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

30         c.  A sworn statement of any previous revocation or

31  denial of licensure or certification in any state.

                                  59

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         d.  Two letters of recommendation.

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

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

  4  applicant who the Board of Medicine certifies:

  5         a.  Has completed the application form and remitted a

  6  nonrefundable application fee not to exceed $500 and an

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

  8  the department to provide the examination.  The examination

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

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

11  applicant to pass a separate practical component of the

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

13  competencies measured through practical examinations shall be

14  incorporated into the written examination through a

15  multiple-choice format. The department shall translate the

16  examination into the native language of any applicant who

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

18  provided that the translation request is filed with the board

19  office no later than 9 months before the scheduled examination

20  and the applicant remits translation fees as specified by the

21  department no later than 6 months before the scheduled

22  examination, and provided that the applicant demonstrates to

23  the department the ability to communicate orally in basic

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

25  the applicant may take the next available examination in

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

27  application deadline and if the applicant is otherwise

28  eligible under this section. To demonstrate the ability to

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

30  is required, as determined by the department or organization

31

                                  60

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  that developed it, on one of the following English

  2  examinations:

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

  4  Educational Testing Service (ETS);

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

  6  (TOEFL), by ETS;

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

  8         (IV)  The English examination for citizenship,

  9  Immigration and Naturalization Service.

10

11  A notarized copy of an Educational Commission for Foreign

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

13  demonstrate the ability to communicate in basic English.

14         b.  Is an unlicensed physician who graduated from a

15  foreign medical school listed with the World Health

16  Organization who has not previously taken and failed the

17  examination of the National Commission on Certification of

18  Physician Assistants and who has been certified by the Board

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

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

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

22  not required to have completed an approved residency of at

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

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

25  valid, active certificate issued by the Educational Commission

26  for Foreign Medical Graduates.

27         c.  Was eligible and made initial application for

28  certification as a physician assistant in this state between

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

30

31

                                  61

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




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

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

  3  a physician assistant on July 1, 1990.

  4         2.  The department may grant temporary licensure to an

  5  applicant who meets the requirements of subparagraph 1.

  6  Between meetings of the council, the department may grant

  7  temporary licensure to practice based on the completion of all

  8  temporary licensure requirements.  All such administratively

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

10  regular meeting of the council.  A temporary license expires

11  30 days after upon receipt and notice of scores to the

12  licenseholder from the first available examination specified

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

14  applicant who fails the proficiency examination is no longer

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

16  of temporary licensure after reapplying for the next available

17  examination. Extended licensure shall expire upon failure of

18  the licenseholder to sit for the next available examination or

19  upon receipt and notice of scores to the licenseholder from

20  such examination.

21         3.  Notwithstanding any other provision of law, the

22  examination specified pursuant to subparagraph 1. shall be

23  administered by the department only five times.  Applicants

24  certified by the board for examination shall receive at least

25  6 months' notice of eligibility prior to the administration of

26  the initial examination. Subsequent examinations shall be

27  administered at 1-year intervals following the reporting of

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

29  purposes of this paragraph, the department may develop,

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

31  examination, including a practical component, that adequately

                                  62

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  measures an applicant's ability to practice with reasonable

  2  skill and safety.  The minimum passing score on the

  3  examination shall be established by the department, with the

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

  5  examination or any subsequent examination shall receive notice

  6  of the administration of the next examination with the notice

  7  of scores following such examination.  Any applicant who

  8  passes the examination and meets the requirements of this

  9  section shall be licensed as a physician assistant with all

10  rights defined thereby.

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

12  renewal must include:

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

14  boards.

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

16  previous 2 years.

17         (d)  Each licensed physician assistant shall biennially

18  complete 100 hours of continuing medical education or shall

19  hold a current certificate issued by the National Commission

20  on Certification of Physician Assistants.

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

22  licensed physician assistant must notify the department in

23  writing within 30 days after such employment or after any

24  subsequent changes in the supervising physician. The

25  notification must include the full name, Florida medical

26  license number, specialty, and address of the supervising

27  physician.

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

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

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

31  examination administered by the National Commission on

                                  63

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  Certification of Physician Assistants available for

  2  registration after the applicant's graduation, a temporary

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

  4  upon receipt of scores of the proficiency examination

  5  administered by the National Commission on Certification of

  6  Physician Assistants.  Between meetings of the council, the

  7  department may grant a temporary license to practice based on

  8  the completion of all temporary licensure requirements.  All

  9  such administratively issued licenses shall be reviewed and

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

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

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

13  proficiency examination may be granted permanent licensure. An

14  applicant failing the proficiency examination is no longer

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

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

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

18  physician assistant until he or she passes the examination

19  administered by the National Commission on Certification of

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

21  may require an applicant who does not pass the licensing

22  examination after five or more attempts to complete additional

23  remedial education or training. The council shall prescribe

24  the additional requirements in a manner that permits the

25  applicant to complete the requirements and be reexamined

26  within 2 years after the date the applicant petitions the

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

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

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

30  physician assistant if the physician assistant or the

31  supervising physician has been found guilty of or is being

                                  64

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  investigated for any act that constitutes a violation of this

  2  chapter or part II of chapter 455.

  3         Section 32.  Subsection (3) of section 459.003, Florida

  4  Statutes, is amended to read:

  5         459.003  Definitions.--As used in this chapter:

  6         (3)  "Practice of osteopathic medicine" means making or

  7  approving a the diagnosis, treatment, treatment plan,

  8  operation, procedure, or prescription for any human disease,

  9  pain, injury, deformity, or other physical or mental

10  condition, which practice is based in part upon educational

11  standards and requirements which emphasize the importance of

12  the musculoskeletal structure and manipulative therapy in the

13  maintenance and restoration of health. The "practice of

14  osteopathic medicine" does not include coverage decisions for

15  purposes of insurance benefits as long as medical judgments

16  are not involved.

17         Section 33.  Subsection (7) is added to section

18  459.0075, Florida Statutes, to read:

19         459.0075  Limited licenses.--

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

21  osteopathic medicine in the state may convert that license to

22  a limited license for the purpose of providing volunteer,

23  uncompensated care for low-income Floridians. The applicant

24  must submit a statement from the employing agency or

25  institution stating that he or she will not receive

26  compensation for any service involving the practice of

27  osteopathic medicine. The application and all licensure fees,

28  including neurological injury compensation assessments, shall

29  be waived.

30

31

                                  65

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         Section 34.  Paragraph (oo) is added to subsection (1)

  2  of section 459.015, Florida Statutes, 1998 Supplement, and

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

  4         459.015  Grounds for disciplinary action by the

  5  board.--

  6         (1)  The following acts shall constitute grounds for

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

  8  be taken:

  9         (oo)  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, or certify with restrictions,

17  to the department an application for certification, licensure,

18  renewal, or reactivation.

19         (b)  Revocation or suspension of a license or

20  certificate.

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)  Issuance of a letter of concern.

26         (g)  Placement of the osteopathic physician on

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

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

29  requiring the osteopathic physician to submit to treatment,

30  attend continuing education courses, submit to reexamination,

31

                                  66

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  or work under the supervision of another osteopathic

  2  physician.

  3         (h)  Corrective action.

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

  5  patient.

  6         (j)  Imposition of an administrative fine in accordance

  7  with s. 381.0261 for violations regarding patient rights.

  8

  9  In determining what action is appropriate, the board must

10  first consider what sanctions are necessary to protect the

11  public or to compensate the patient.  Only after those

12  sanctions have been imposed may the disciplining authority

13  consider and include in the order requirements designed to

14  rehabilitate the physician.  All costs associated with

15  compliance with orders issued under this subsection are the

16  obligation of the physician.

17         Section 35.  Paragraph (a) of subsection (8) of section

18  460.403, Florida Statutes, 1998 Supplement, is amended to

19  read:

20         460.403  Definitions.--As used in this chapter, the

21  term:

22         (8)(a)  "Practice of chiropractic medicine" means a

23  noncombative principle and practice consisting of the science,

24  philosophy, and art of the adjustment, manipulation, and

25  treatment of the human body in which vertebral subluxations

26  and other malpositioned articulations and structures that are

27  interfering with the normal generation, transmission, and

28  expression of nerve impulse between the brain, organs, and

29  tissue cells of the body, thereby causing disease, are

30  adjusted, manipulated, or treated, thus restoring the normal

31  flow of nerve impulse which produces normal function and

                                  67

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  consequent health by chiropractic physicians using specific

  2  chiropractic adjustment or manipulation techniques taught in

  3  chiropractic colleges accredited by the Council on

  4  Chiropractic Education.  No person other than a licensed

  5  chiropractic physician may render chiropractic services,

  6  chiropractic adjustments, or chiropractic manipulations. The

  7  practice of chiropractic medicine also includes making or

  8  approving a manipulation or adjustment, diagnosis, treatment,

  9  treatment plan, procedure, or prescription. The practice of

10  chiropractic medicine does not include coverage decisions for

11  purposes of insurance benefits, so long as a medical judgment

12  is not involved.

13         Section 36.  Paragraph (e) of subsection (1) of section

14  460.406, Florida Statutes, 1998 Supplement, is amended to

15  read:

16         460.406  Licensure by examination.--

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

18  chiropractic physician shall apply to the department to take

19  the licensure examination. There shall be an application fee

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

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

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

23  department for purchase of portions of the examination from

24  the National Board of Chiropractic Examiners or a similar

25  national organization, which may be refundable if the

26  applicant is found ineligible to take the examination.  The

27  department shall examine each applicant who the board

28  certifies has:

29         (e)  Completed not less than a 3-month training program

30  in this state of not less than 300 hours with a chiropractic

31  physician licensed in this state. The chiropractic physician

                                  68

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  candidate may perform all services offered by the licensed

  2  chiropractic physician, but must be under the supervision of

  3  the licensed chiropractic physician until the results of the

  4  first licensure examination for which the candidate has

  5  qualified have been received, at which time the candidate's

  6  training program shall be terminated. The board by rule shall

  7  establish qualifications for serving as a supervising

  8  chiropractic physician and procedures for approving a

  9  supervising chiropractic physician. However, an applicant who

10  has practiced chiropractic medicine in any other state,

11  territory, or jurisdiction of the United States or any foreign

12  national jurisdiction for at least 5 years as a licensed

13  chiropractic physician need not be required to complete the

14  3-month training program as a requirement for licensure.

15         Section 37.  Paragraph (d) of subsection (2) of section

16  460.413, Florida Statutes, 1998 Supplement, is amended to

17  read:

18         460.413  Grounds for disciplinary action; action by the

19  board.--

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

21  the grounds set forth in subsection (1), it may enter an order

22  imposing one or more of the following penalties:

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

24  $10,000 $2,000 for each count or separate offense.

25

26  In determining what action is appropriate, the board must

27  first consider what sanctions are necessary to protect the

28  public or to compensate the patient. Only after those

29  sanctions have been imposed may the disciplining authority

30  consider and include in the order requirements designed to

31  rehabilitate the chiropractic physician. All costs associated

                                  69

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  with compliance with orders issued under this subsection are

  2  the obligation of the chiropractic physician.

  3         Section 38.  Section 461.003, Florida Statutes, 1998

  4  Supplement, is amended to read:

  5         461.003  Definitions.--As used in this chapter:

  6         (1)  "Department" means the Department of Health.

  7         (1)(2)  "Board" means the Board of Podiatric Medicine

  8  as created in this chapter.

  9         (2)  "Certified podiatric X-ray assistant" means a

10  person who is employed by and under the direct supervision of

11  a licensed podiatric physician to perform only those

12  radiographic functions that are within the scope of practice

13  of a podiatric physician licensed under this chapter. For

14  purposes of this subsection, the term "direct supervision"

15  means supervision whereby a podiatric physician orders the X

16  ray, remains on the premises while the X ray is being

17  performed and exposed, and approves the work performed before

18  dismissal of the patient.

19         (3)  "Department" means the Department of Health.

20         (3)  "Practice of podiatric medicine" means the

21  diagnosis or medical, surgical, palliative, and mechanical

22  treatment of ailments of the human foot and leg.  The surgical

23  treatment of ailments of the human foot and leg shall be

24  limited anatomically to that part below the anterior tibial

25  tubercle.  The practice of podiatric medicine shall include

26  the amputation of the toes or other parts of the foot but

27  shall not include the amputation of the foot or leg in its

28  entirety.  A podiatric physician may prescribe drugs that

29  relate specifically to the scope of practice authorized

30  herein.

31

                                  70

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (4)  "Podiatric physician" means any person licensed to

  2  practice podiatric medicine pursuant to this chapter.

  3         (5)  "Practice of podiatric medicine" means making or

  4  approving a treatment plan, procedure, operation, or the

  5  diagnosis or medical, surgical, palliative, and mechanical

  6  treatment of ailments of the human foot and leg.  The surgical

  7  treatment of ailments of the human foot and leg shall be

  8  limited anatomically to that part below the anterior tibial

  9  tubercle.  The practice of podiatric medicine shall include

10  the amputation of the toes or other parts of the foot but

11  shall not include the amputation of the foot or leg in its

12  entirety.  A podiatric physician may prescribe drugs that

13  relate specifically to the scope of practice authorized

14  herein. The practice of podiatric medicine does not include

15  coverage decisions for purposes of insurance benefits, so long

16  as medical judgment is not involved.

17         Section 39.  Paragraph (d) of subsection (1) of section

18  461.006, Florida Statutes, 1998 Supplement, is amended to

19  read:

20         461.006  Licensure by examination.--

21         (1)  Any person desiring to be licensed as a podiatric

22  physician shall apply to the department to take the licensure

23  examination. The department shall examine each applicant who

24  the board certifies:

25         (d)  Beginning October 1, 1995, Has satisfactorily

26  completed one of the following clinical experience

27  requirements:

28         1.  One year of residency in a residency program

29  approved by the board, and if it has been 4 or more years

30  since the completion of that residency, active licensed

31  practice of podiatric medicine in another jurisdiction for at

                                  71

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  least 2 of the immediately preceding 4 years, or successful

  2  completion of a board-approved postgraduate program or

  3  board-approved course within the year preceding the filing of

  4  the application. For the purpose of this subparagraph, "active

  5  licensed practice" means the licensed practice of podiatric

  6  medicine as defined in s. 461.003(5) by podiatric physicians,

  7  including podiatric physicians employed by any governmental

  8  entity, on the active teaching faculty of an accredited school

  9  of podiatric medicine, or practicing administrative podiatric

10  medicine.

11         2.  Ten years of continuous, active licensed practice

12  of podiatric medicine in another state immediately preceding

13  the submission of the application and completion of at least

14  the same continuing educational requirements during those 10

15  years as are required of podiatric physicians licensed in this

16  state.

17         Section 40.  Subsection (1) of section 461.007, Florida

18  Statutes, 1998 Supplement, is amended to read:

19         461.007  Renewal of license.--

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

21  of the renewal application and a fee not to exceed $350 set by

22  the board, and evidence that the applicant has actively

23  practiced podiatric medicine or has been on the active

24  teaching faculty of an accredited school of podiatric medicine

25  for at least 2 years of the immediately preceding 4 years. If

26  the licensee has not actively practiced podiatric medicine for

27  at least 2 years of the immediately preceding 4 years, the

28  board shall require that the licensee successfully complete a

29  board-approved course prior to renewal of the license. For

30  purposes of this subsection, "actively practiced podiatric

31  medicine" means the licensed practice of podiatric medicine as

                                  72

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  defined in s. 461.003(5) by podiatric physicians, including

  2  podiatric physicians employed by any governmental entity, on

  3  the active teaching faculty of an accredited school of

  4  podiatric medicine, or practicing administrative podiatric

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

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

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

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

  9  Department of Health for the statewide criminal background

10  check of the applicant. The applicant must submit a set of

11  fingerprints to the Department of Health on a form and under

12  procedures specified by the department, along with payment in

13  an amount equal to the costs incurred by the department for a

14  national criminal background check of the applicant for the

15  initial renewal of his or her license after January 1, 2000.

16  If the applicant fails to submit either the information

17  required under s. 455.565 or a set of fingerprints to the

18  department as required by this section, the department shall

19  issue a notice of noncompliance, and the applicant will be

20  given 30 additional days to comply. If the applicant fails to

21  comply within 30 days after the notice of noncompliance is

22  issued, the department or board, as appropriate, may issue a

23  citation to the applicant and may fine the applicant up to $50

24  for each day that the applicant is not in compliance with the

25  requirements of s. 455.565. The citation must clearly state

26  that the applicant may choose, in lieu of accepting the

27  citation, to follow the procedure under s. 455.621. If the

28  applicant disputes the matter in the citation, the procedures

29  set forth in s. 455.621 must be followed. However, if the

30  applicant does not dispute the matter in the citation with the

31  department within 30 days after the citation is served, the

                                  73

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  citation becomes a final order and constitutes discipline.

  2  Service of a citation may be made by personal service or

  3  certified mail, restricted delivery, to the subject at the

  4  applicant's last known address. If an applicant has submitted

  5  fingerprints to the department for a national criminal history

  6  check upon initial licensure and is renewing his or her

  7  license for the first time, then the applicant need only

  8  submit the information and fee required for a statewide

  9  criminal history check.

10         Section 41.  Paragraph (bb) is added to subsection (1)

11  of section 461.013, Florida Statutes, 1998 Supplement, and

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

13         461.013  Grounds for disciplinary action; action by the

14  board; investigations by department.--

15         (1)  The following acts shall constitute grounds for

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

17  be taken:

18         (bb)  Failing to comply with the requirements of ss.

19  381.026 and 381.0261 to provide patients with information

20  about their patient rights and how to file a patient

21  complaint.

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

23  the grounds set forth in subsection (1), it may enter an order

24  imposing one or more of the following penalties:

25         (a)  Refusal to certify to the department an

26  application for licensure.

27         (b)  Revocation or suspension of a license.

28         (c)  Restriction of practice.

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

30  $10,000 $1,000 for each count or separate offense.

31         (e)  Issuance of a reprimand.

                                  74

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (f)  Placing the podiatric physician on probation for a

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

  3  specify, including requiring the podiatric physician to submit

  4  to treatment, to attend continuing education courses, to

  5  submit to reexamination, and to work under the supervision of

  6  another podiatric physician.

  7         (g)  Imposition of an administrative fine in accordance

  8  with s. 381.0261 for violations regarding patient rights.

  9         Section 42.  Section 461.0135, Florida Statutes, is

10  created to read:

11         461.0135  Operation of X-ray machines by podiatric

12  X-ray assistants.--A licensed podiatric physician may utilize

13  an X-ray machine, expose X-ray films, and interpret or read

14  such films. The provision of part IV of chapter 468 to the

15  contrary notwithstanding, a licensed podiatric physician may

16  authorize or direct a certified podiatric X-ray assistant to

17  operate such equipment and expose such films under the

18  licensed podiatric physician's direction and supervision,

19  pursuant to rules adopted by the board in accordance with s.

20  461.004, which ensures that such certified podiatric X-ray

21  assistant is competent to operate such equipment in a safe and

22  efficient manner by reason of training, experience, and

23  passage of a board-approved course which includes an

24  examination. The board shall issue a certificate to an

25  individual who successfully completes the board-approved

26  course and passes the examination to be administered by the

27  training authority upon completion of such course.

28         Section 43.  Subsection (3) is added to section

29  464.008, Florida Statutes, to read:

30         464.008  Licensure by examination.--

31

                                  75

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  Any applicant who fails the examination three

  2  consecutive times, regardless of the jurisdiction in which the

  3  examination is taken, shall be required to complete a

  4  board-approved remedial course before the applicant will be

  5  approved for reexamination. After taking the remedial course,

  6  the applicant may be approved to retake the examination up to

  7  three additional times before the applicant is required to

  8  retake remediation. The applicant shall apply for

  9  reexamination within 6 months after completion of remediation.

10  The board shall by rule establish guidelines for remedial

11  courses.

12         Section 44.  Subsection (13) is added to section

13  464.022, Florida Statutes, to read:

14         464.022  Exceptions.--No provision of this chapter

15  shall be construed to prohibit:

16         (13)  The practice of nursing by individuals enrolled

17  in board-approved remedial courses.

18         Section 45.  Subsections (4) through (14) of section

19  465.003, Florida Statutes, are renumbered as subsections (5)

20  through (15), respectively, and a new subsection (4) is added

21  to that section, to read:

22         465.003  Definitions.--As used in this chapter, the

23  term:

24         (4)  "Data communication device" means an electronic

25  device that receives electronic information from one source

26  and transmits or routes it to another, including, but not

27  limited to, any such bridge, router, switch, or gateway.

28         Section 46.  Paragraph (l) of subsection (1) and

29  paragraph (c) of subsection (2) of section 465.016, Florida

30  Statutes, are amended, and paragraph (q) is added to

31  subsection (1) of that section, to read:

                                  76

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         465.016  Disciplinary actions.--

  2         (1)  The following acts shall be grounds for

  3  disciplinary action set forth in this section:

  4         (l)  Placing in the stock of any pharmacy any part of

  5  any prescription compounded or dispensed which is returned by

  6  a patient; however, in a hospital, nursing home, correctional

  7  facility, or extended care facility in which unit-dose

  8  medication is dispensed to inpatients, each dose being

  9  individually sealed and the individual unit dose or unit-dose

10  system labeled with the name of the drug, dosage strength,

11  manufacturer's control number, and expiration date, if any,

12  the unused unit dose of medication may be returned to the

13  pharmacy for redispensing.  Each pharmacist shall maintain

14  appropriate records for any unused or returned medicinal

15  drugs.

16         (q)  Using or releasing a patient's records except as

17  authorized by this chapter and chapter 455.

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

19  the grounds set forth in subsection (1), it may enter an order

20  imposing one or more of the following penalties:

21         (c)  Imposition of an administrative fine not to exceed

22  $5,000 $1,000 for each count or separate offense.

23         Section 47.  Subsection (2) of section 465.017, Florida

24  Statutes, is amended to read:

25         465.017  Authority to inspect.--

26         (2)  Except as permitted by this chapter, and chapters

27  406, 409, 455, 499, and 893, records maintained by in a

28  pharmacy relating to the filling of prescriptions and the

29  dispensing of medicinal drugs shall not be furnished, except

30  upon the written authorization of the patient, to any person

31  other than to the patient for whom the drugs were dispensed,

                                  77

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  or her or his legal representative, or to the department

  2  pursuant to existing law, or, in the event that the patient is

  3  incapacitated or unable to request such said records, her or

  4  his spouse; to the department pursuant to law; to health care

  5  practitioners and pharmacists consulting with or dispensing to

  6  the patient; or to insurance carriers or other payors

  7  authorized by the patient to receive such records.  For

  8  purposes of this section, records held in a pharmacy shall be

  9  considered owned by the owner of the pharmacy.  The pharmacy

10  owner may use such records in the aggregate without patient

11  identification data, regardless of where such records are

12  held, for purposes reasonably related to the business and

13  practice of pharmacy except upon the written authorization of

14  such patient.  Such records may be furnished in any civil or

15  criminal proceeding, upon the issuance of a subpoena from a

16  court of competent jurisdiction and proper notice to the

17  patient or her or his legal representative by the party

18  seeking such records.  Such records or any part thereof, if

19  transmitted through a data communication device and not

20  directly between a pharmacy and a treating practitioner, may

21  not be accessed, used, or maintained by the operator or owner

22  of the data communication device unless specifically

23  authorized by this section.  It is the intent of this

24  subsection to allow the use and sharing of such records to

25  improve patient care, provided the pharmacist acts in the best

26  interests of her or his patient.  Nothing in this subsection

27  may be construed to authorize or expand solicitation or

28  marketing to patients or potential patients in any manner not

29  otherwise specifically authorized by law.

30         Section 48.  Section 465.014, Florida Statutes, is

31  amended to read:

                                  78

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         465.014  Pharmacy technician.--No person other than a

  2  licensed pharmacist or pharmacy intern may engage in the

  3  practice of the profession of pharmacy, except that a licensed

  4  pharmacist may delegate to nonlicensed pharmacy technicians

  5  those duties, tasks, and functions which do not fall within

  6  the purview of s. 465.003(13)(12).  All such delegated acts

  7  shall be performed under the direct supervision of a licensed

  8  pharmacist who shall be responsible for all such acts

  9  performed by persons under his or her supervision.  A pharmacy

10  technician, under the supervision of a pharmacist, may

11  initiate or receive communications with a practitioner or his

12  or her agent, on behalf of a patient, regarding refill

13  authorization requests.  No licensed pharmacist shall

14  supervise more than one pharmacy technician unless otherwise

15  permitted by the guidelines adopted by the board.  The board

16  shall establish guidelines to be followed by licensees or

17  permittees in determining the circumstances under which a

18  licensed pharmacist may supervise more than one but not more

19  than three pharmacy technicians.

20         Section 49.  Paragraph (c) of subsection (2) of section

21  465.015, Florida Statutes, is amended to read:

22         465.015  Violations and penalties.--

23         (2)  It is unlawful for any person:

24         (c)  To sell or dispense drugs as defined in s.

25  465.003(8)(7) without first being furnished with a

26  prescription.

27         Section 50.  Section 465.0196, Florida Statutes, is

28  amended to read:

29         465.0196  Special pharmacy permits.--Any person

30  desiring a permit to operate a pharmacy which does not fall

31  within the definitions set forth in s. 465.003(11)(10)(a)1.,

                                  79

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  2., and 3. shall apply to the department for a special

  2  pharmacy permit.  If the board certifies that the application

  3  complies with the applicable laws and rules of the board

  4  governing the practice of the profession of pharmacy, the

  5  department shall issue the permit.  No permit shall be issued

  6  unless a licensed pharmacist is designated to undertake the

  7  professional supervision of the compounding and dispensing of

  8  all drugs dispensed by the pharmacy.  The licensed pharmacist

  9  shall be responsible for maintaining all drug records and for

10  providing for the security of the area in the facility in

11  which the compounding, storing, and dispensing of medicinal

12  drugs occurs.  The permittee shall notify the department

13  within 10 days of any change of the licensed pharmacist

14  responsible for such duties.

15         Section 51.  Subsection (3) of section 468.812, Florida

16  Statutes, is amended to read:

17         468.812  Exemptions from licensure.--

18         (3)  The provisions of this act relating to orthotics

19  or pedorthics do not apply to any licensed pharmacist or to

20  any person acting under the supervision of a licensed

21  pharmacist.  The practice of orthotics or pedorthics by a

22  pharmacist or any of the pharmacist's employees acting under

23  the supervision of a pharmacist shall be construed to be

24  within the meaning of the term "practice of the profession of

25  pharmacy" as set forth in s. 465.003(13)(12), and shall be

26  subject to regulation in the same manner as any other pharmacy

27  practice.  The Board of Pharmacy shall develop rules regarding

28  the practice of orthotics and pedorthics by a pharmacist.  Any

29  pharmacist or person under the supervision of a pharmacist

30  engaged in the practice of orthotics or pedorthics shall not

31

                                  80

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  be precluded from continuing that practice pending adoption of

  2  these rules.

  3         Section 52.  Subsection (19) of section 499.003,

  4  Florida Statutes, is amended to read:

  5         499.003  Definitions of terms used in ss.

  6  499.001-499.081.--As used in ss. 499.001-499.081, the term:

  7         (19)  "Legend drug," "prescription drug," or "medicinal

  8  drug" means any drug, including, but not limited to, finished

  9  dosage forms, or active ingredients subject to, defined by, or

10  described by s. 503(b) of the Federal Food, Drug, and Cosmetic

11  Act or s. 465.003(8)(7), s. 499.007(12), or s. 499.0122(1)(b)

12  or (c).

13         Section 53.  Subsection (2) of section 465.017, Florida

14  Statutes, is amended to read:

15         465.017  Authority to inspect.--

16         (2)  Except as permitted by this chapter, and chapters

17  406, 409, 455, 499, and 893, records maintained by in a

18  pharmacy relating to the filling of prescriptions and the

19  dispensing of medicinal drugs shall not be furnished, except

20  upon the written authorization of the patient, to any person

21  other than to the patient for whom the drugs were dispensed,

22  or her or his legal representative, or to the department

23  pursuant to existing law, or, in the event that the patient is

24  incapacitated or unable to request such said records, her or

25  his spouse; to the department pursuant to law; to health care

26  practitioners and pharmacists consulting with or dispensing to

27  the patient, including physicians who are part of independent

28  practice associations, physician hospital organizations, or

29  other such organized provider groups; to entities that provide

30  compliance services; or to insurance carriers or other payors

31  authorized by the patient to receive such records.  For

                                  81

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  purposes of this section, records held in a pharmacy shall be

  2  considered owned by the owner of the pharmacy.  The pharmacy

  3  owner may use such records internally in the aggregate without

  4  patient identification data, regardless of where such records

  5  are held, for purposes reasonably related to the business and

  6  practice of only that pharmacy except upon the written

  7  authorization of such patient.  Such records may be furnished

  8  in any civil or criminal proceeding, upon the issuance of a

  9  subpoena from a court of competent jurisdiction and proper

10  notice to the patient or her or his legal representative by

11  the party seeking such records.  Such records or any part

12  thereof, if transmitted through a data communication device

13  not under the control or ownership of a pharmacy or affiliated

14  company or not directly between a pharmacy and a treating

15  practitioner, may not be accessed, used, or maintained by the

16  operator or owner of the data communication device unless

17  specifically authorized by this section.  It is the intent of

18  this subsection to allow the use and sharing of such records

19  to improve patient care, provided the pharmacist acts in the

20  best interests of her or his patient.  Nothing in this

21  subsection may be construed to authorize or expand

22  solicitation or marketing to patients or potential patients in

23  any manner not otherwise specifically authorized by law.

24         Section 54.  (1)  There is created within the

25  Department of Health a Task Force for the Study of

26  Collaborative Drug Therapy Management. The department shall

27  provide staff support for the task force. The task force shall

28  consist of not more than 10 members nominated by the

29  associations and entities named in this section and appointed

30  by the Secretary of Health. Members of the task force shall

31  not receive compensation, per diem, or reimbursement for

                                  82

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  travel expenses for service on the task force. Participation

  2  in the task force is optional and at the discretion of each

  3  identified group or entity. The task force shall include:

  4         (a)  One representative from each of the following

  5  associations:

  6         1.  Florida Society of Health-System Pharmacists.

  7         2.  Florida Pharmacy Association.

  8         3.  Florida Medical Association.

  9         4.  Florida Osteopathic Medical Association.

10         5.  Florida Retail Federation.

11         (b)  One representative from each of the following

12  entities:

13         1.  Department of Health.

14         2.  Board of Medicine, which representative must be a

15  member of the board who is licensed under chapter 458, Florida

16  Statutes.

17         3.  Board of Osteopathic Medicine, which representative

18  must be a member of the board who is licensed under chapter

19  459, Florida Statutes.

20         4.  Board of Pharmacy, which representative must be a

21  member of the board who is licensed under chapter 465, Florida

22  Statutes.

23         5.  Agency for Health Care Administration.

24         (2)  The task force shall hold its first meeting no

25  later than August 1, 1999, and shall report its findings to

26  the President of the Senate, the Speaker of the House of

27  Representatives, and the chairs of the applicable legislative

28  committees of substance not later than December 31, 1999. All

29  task force meetings must be held in Tallahassee at the

30  department in order to minimize costs to the state.

31

                                  83

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  The task force shall be charged with the

  2  responsibility to:

  3         (a)  Determine the states in which collaborative drug

  4  therapy management has been enacted by law or administrative

  5  rule and summarize the content of all such laws and rules.

  6         (b)  Receive testimony from interested parties and

  7  identify the extent to which collaborative drug therapy

  8  management is currently being practiced in this state and

  9  other states.

10         (c)  Determine the efficacy of collaborative drug

11  therapy management in improving health care outcomes of

12  patients.

13         Section 55.  Paragraph (j) is added to subsection (3)

14  of section 466.003, Florida Statutes, to read:

15         466.003  Definitions.--As used in this chapter:

16         (3)  "Dentistry" means the healing art which is

17  concerned with the examination, diagnosis, treatment planning,

18  and care of conditions within the human oral cavity and its

19  adjacent tissues and structures.  It includes the performance

20  or attempted performance of any dental operation, or oral or

21  oral-maxillofacial surgery and any procedures adjunct thereto,

22  including physical evaluation directly related to such

23  operation or surgery pursuant to hospital rules and

24  regulations.  It also includes dental service of any kind

25  gratuitously or for any remuneration paid, or to be paid,

26  directly or indirectly, to any person or agency.  The term

27  "dentistry" shall also include the following:

28         (j)  Making or approving a diagnosis, treatment,

29  treatment plan, operation, procedure, or prescription. The

30  "practice of dentistry" does not include coverage decisions

31

                                  84

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  for purposes of insurance benefits as long as medical

  2  judgments are not involved.

  3         Section 56.  Section 466.021, Florida Statutes, is

  4  amended to read:

  5         466.021  Employment of unlicensed persons by dentist;

  6  penalty.--Every duly licensed dentist who uses the services of

  7  any unlicensed person for the purpose of constructing,

  8  altering, repairing, or duplicating any denture, partial

  9  denture, bridge splint, or orthodontic or prosthetic appliance

10  shall be required to furnish such unlicensed person with a

11  written work order in such form as prescribed shall be

12  approved by rule of the board department. This form shall be

13  supplied to the dentist by the department at a cost not to

14  exceed that of printing and handling. The work order blanks

15  shall be assigned to individual dentists and are not

16  transferable. This form shall be dated and signed by such

17  dentist and shall include the patient's name or number with

18  sufficient descriptive information to clearly identify the

19  case for each separate and individual piece of work. A; said

20  work order shall be made in duplicate form, the duplicate copy

21  of such work order shall to be retained in a permanent file in

22  the dentist's office for a period of 2 years, and the original

23  work order shall to be retained in a permanent file for a

24  period of 2 years by such said unlicensed person in her or his

25  place of business. Such permanent file of work orders to be

26  kept by such dentist or by such unlicensed person shall be

27  open to inspection at any reasonable time by the department or

28  its duly constituted agent. Failure of the dentist to keep

29  such permanent records of such said work orders shall subject

30  the dentist to suspension or revocation of her or his license

31  to practice dentistry. Failure of such unlicensed person to

                                  85

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  have in her or his possession a work order as required by this

  2  section above defined shall be admissible evidence of a

  3  violation of this chapter and shall constitute a misdemeanor

  4  of the second degree, punishable as provided in s. 775.082 or

  5  s. 775.083. Nothing in this section shall preclude a

  6  registered dental laboratory from working for another

  7  registered dental laboratory, provided that such work is

  8  performed pursuant to written authorization, in a form to be

  9  prescribed by rule of the board department, which evidences

10  that the originating laboratory has obtained a valid work

11  order and which sets forth the work to be performed.

12  Furthermore, nothing in this section shall preclude a

13  registered laboratory from providing its services to dentists

14  licensed and practicing in another state, provided that such

15  work is requested or otherwise authorized in written form

16  which clearly identifies the name and address of the

17  requesting dentist and which sets forth the work to be

18  performed.

19         Section 57.  Paragraph (c) of subsection (2) of section

20  468.1115, Florida Statutes, is amended to read:

21         468.1115  Exemptions.--

22         (2)  The provisions of this part shall not apply to:

23         (c)  Persons certified in the areas of speech-language

24  impairment or hearing impairment in this state under chapter

25  231 when engaging in the profession for which they are

26  certified through January 1, 2000, or any person under the

27  direct supervision of such a certified person through January

28  1, 2000, or of a licensee under this chapter, when the person

29  under such supervision is performing hearing screenings in a

30  school setting for prekindergarten through grade 12.

31

                                  86

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         Section 58.  Paragraph (b) of subsection (2), paragraph

  2  (b) of subsection (3), and subsection (4) of section 468.1155,

  3  Florida Statutes, are amended to read:

  4         468.1155  Provisional license; requirements.--

  5         (2)  The department shall issue a provisional license

  6  to practice speech-language pathology to each applicant who

  7  the board certifies has:

  8         (b)  Received a master's degree or doctoral degree with

  9  a major emphasis in speech-language pathology from an

10  institution of higher learning which, at the time the

11  applicant was enrolled and graduated, was accredited by an

12  accrediting agency recognized by the Commission on Recognition

13  of Postsecondary Accreditation or from an institution which is

14  publicly recognized as a member in good standing with the

15  Association of Universities and Colleges of Canada.  An

16  applicant who graduated from a program at a university or

17  college outside the United States or Canada must present

18  documentation of the determination of equivalency to standards

19  established by the Commission on Recognition of Postsecondary

20  Accreditation in order to qualify.  The applicant must have

21  completed 60 semester hours that include:

22         1.  Fundamental information applicable to the normal

23  development and use of speech, hearing, and language;

24  information about training in management of speech, hearing,

25  and language disorders; and information supplementary to these

26  fields.

27         2.  Six semester hours in audiology.

28         3.  Thirty of the required 60 semester hours in courses

29  acceptable toward a graduate degree by the college or

30  university in which these courses were taken, of which 24

31  semester hours must be in speech-language pathology.

                                  87

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  The department shall issue a provisional license

  2  to practice audiology to each applicant who the board

  3  certifies has:

  4         (b)  Received a master's degree or doctoral degree with

  5  a major emphasis in audiology from an institution of higher

  6  learning which at the time the applicant was enrolled and

  7  graduated was accredited by an accrediting agency recognized

  8  by the Commission on Recognition of Postsecondary

  9  Accreditation or from an institution which is publicly

10  recognized as a member in good standing with the Association

11  of Universities and Colleges of Canada.  An applicant who

12  graduated from a program at a university or college outside

13  the United States or Canada must present documentation of the

14  determination of equivalency to standards established by the

15  Commission on Recognition of Postsecondary Accreditation in

16  order to qualify.  The applicant must have completed 60

17  semester hours that include:

18         1.  Fundamental information applicable to the normal

19  development and use of speech, hearing, and language;

20  information about training in management of speech, hearing,

21  and language disorders; and information supplementary to these

22  fields.

23         2.  Six semester hours in speech-language pathology.

24         3.  Thirty of the required 60 semester hours in courses

25  acceptable toward a graduate degree by the college or

26  university in which these courses were taken, of which 24

27  semester hours must be in audiology.

28         (4)  An applicant for a provisional license who has

29  received a master's degree or doctoral degree with a major

30  emphasis in speech-language pathology as provided in

31  subsection (2), or audiology as provided in subsection (3),

                                  88

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  and who seeks licensure in the area in which the applicant is

  2  not currently licensed, must have completed 30 semester hours

  3  in courses acceptable toward a graduate degree and 200

  4  supervised clinical clock hours in the second discipline from

  5  an accredited institution.

  6         Section 59.  Section 468.1215, Florida Statutes, is

  7  amended to read:

  8         468.1215  Speech-language pathology assistant and

  9  audiology assistant; certification.--

10         (1)  A person desiring to be certified as a

11  speech-language pathology assistant or audiology assistant

12  shall apply to the department.

13         (1)(2)  The department shall issue a certificate as a

14  speech-language pathology assistant or as an audiology

15  assistant to each applicant who the board certifies has:

16         (a)  Completed the application form and remitted the

17  required fees, including a nonrefundable application fee.

18         (b)  Earned a bachelor's degree from a college or

19  university accredited by a regional association of colleges

20  and schools recognized by the Department of Education which

21  includes at least 24 semester hours of coursework as approved

22  by the board at an institution accredited by an accrediting

23  agency recognized by the Commission on Recognition of

24  Postsecondary Accreditation.

25         (2)  The department shall issue a certificate as an

26  audiology assistant to each applicant who the board certifies

27  has:

28         (a)  Completed the application form and remitted the

29  required fees, including a nonrefundable application fee.

30         (b)  Completed at least 24 semester hours of coursework

31  as approved by the board at an institution accredited by an

                                  89

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  accrediting agency recognized by the Commission on Recognition

  2  of Postsecondary Accreditation.

  3         (3)  The board, by rule, shall establish minimum

  4  education and on-the-job training and supervision requirements

  5  for certification as a speech-language pathology assistant or

  6  audiology assistant.

  7         (4)  The provisions of this section shall not apply to

  8  any student, intern, or trainee performing speech-language

  9  pathology or audiology services while completing the

10  supervised clinical clock hours as required in s. 468.1155.

11         Section 60.  Subsection (1) of section 468.307, Florida

12  Statutes, 1998 Supplement, is amended to read:

13         468.307  Certificate; issuance; possession; display.--

14         (1)  The department shall issue a certificate to each

15  candidate who has met the requirements of ss. 468.304 and

16  468.306 or has qualified under s. 468.3065. The department may

17  by rule establish a subcategory of a certificate issued under

18  this part limiting the certificateholder to a specific

19  procedure or specific type of equipment.

20         Section 61.  Section 468.506, Florida Statutes, 1998

21  Supplement, is amended to read:

22         468.506  Dietetics and Nutrition Practice

23  Council.--There is created the Dietetics and Nutrition

24  Practice Council under the supervision of the board.  The

25  council shall consist of four persons licensed under this part

26  and one consumer who is 60 years of age or older.  Council

27  members shall be appointed by the board. Licensed members

28  shall be appointed based on the proportion of licensees within

29  each of the respective disciplines.  Members shall be

30  appointed for 4-year staggered terms.  In order to be eligible

31  for appointment, each licensed member must have been a

                                  90

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  licensee under this part for at least 3 years prior to his or

  2  her appointment.  No council member shall serve more than two

  3  successive terms.  The board may delegate such powers and

  4  duties to the council as it may deem proper to carry out the

  5  operations and procedures necessary to effectuate the

  6  provisions of this part.  However, the powers and duties

  7  delegated to the council by the board must encompass both

  8  dietetics and nutrition practice and nutrition counseling. Any

  9  time there is a vacancy on the council, any professional

10  association composed of persons licensed under this part may

11  recommend licensees to fill the vacancy to the board in a

12  number at least twice the number of vacancies to be filled,

13  and the board may appoint from the submitted list, in its

14  discretion, any of those persons so recommended.  Any

15  professional association composed of persons licensed under

16  this part may file an appeal regarding a council appointment

17  with the secretary director of the department agency, whose

18  decision shall be final.  The board shall fix council members'

19  compensation and pay their expenses in the same manner as

20  provided in s. 455.534.

21         Section 62.  Section 468.519, Florida Statutes, is

22  created to read:

23         468.519  Sexual misconduct in the practice of dietetics

24  and nutrition.--The dietitian/nutritionist-client or nutrition

25  counselor-client relationship is founded on mutual trust.

26  "Sexual misconduct in the practice of dietetics and nutrition"

27  means violation of the dietitian/nutritionist-client or

28  nutrition counselor-client relationship through which the

29  dietitian/nutritionist or nutrition counselor uses that

30  relationship to induce or attempt to induce the client to

31  engage, or to engage or attempt to engage the client, in

                                  91

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  sexual activity outside the scope of practice or the scope of

  2  generally accepted examination or treatment of the client.

  3  Sexual misconduct in the practice of dietetics and nutrition

  4  is prohibited.

  5         Section 63.  Section 468.701, Florida Statutes, 1998

  6  Supplement, is amended to read:

  7         468.701  Definitions.--As used in this part, the term:

  8         (1)  "Athlete" means a person who participates in an

  9  athletic activity.

10         (2)  "Athletic activity" means the participation in an

11  activity, conducted by an educational institution, a

12  professional athletic organization, or an amateur athletic

13  organization, involving exercises, sports, games, or

14  recreation requiring any of the physical attributes of

15  strength, agility, flexibility, range of motion, speed, and

16  stamina.

17         (3)  "Athletic injury" means an injury sustained which

18  affects the athlete's ability to participate or perform in

19  athletic activity.

20         (4)  "Athletic trainer" means a person licensed under

21  this part.

22         (5)  "Athletic training" means the recognition,

23  prevention, and treatment of athletic injuries.

24         (6)  "Board Council" means the Board Council of

25  Athletic Training.

26         (7)  "Department" means the Department of Health.

27         (8)  "Direct supervision" means the physical presence

28  of the supervisor on the premises so that the supervisor is

29  immediately available to the trainee when needed.

30         (9)  "Secretary" means the Secretary of Health.

31

                                  92

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (9)(10)  "Supervision" means the easy availability of

  2  the supervisor to the athletic trainer, which includes the

  3  ability to communicate by telecommunications.

  4         Section 64.  Section 468.703, Florida Statutes, 1998

  5  Supplement, is amended to read:

  6         468.703  Board Council of Athletic Training.--

  7         (1)  The Board Council of Athletic Training is created

  8  within the department and shall consist of nine seven members

  9  to be appointed by the Governor and confirmed by the Senate

10  secretary.

11         (2)  Five Four members of the board must council shall

12  be licensed athletic trainers. One member of the board must

13  council shall be a physician licensed under chapter 458 or

14  chapter 459. One member of the board must council shall be a

15  physician licensed under chapter 460. Two members One member

16  of the board shall be consumer members, each of whom must

17  council shall be a resident of this state who has never worked

18  as an athletic trainer, who has no financial interest in the

19  practice of athletic training, and who has never been a

20  licensed health care practitioner as defined in s. 455.501(4).

21  Members of the council shall serve staggered 4-year terms as

22  determined by rule of the department; however, no member may

23  serve more than two consecutive terms.

24         (3)  For the purpose of staggering terms, the Governor

25  shall appoint the initial members of the board as follows:

26         (a)  Three members for terms of 2 years each.

27         (b)  Three members for terms of 3 years each.

28         (c)  Three members for terms of 4 years each.

29         (4)  As the terms of the members expire, the Governor

30  shall appoint successors for terms of 4 years and such members

31  shall serve until their successors are appointed.

                                  93

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (5)  All provisions of part II of chapter 455 relating

  2  to activities of the board shall apply.

  3         (6)  The board shall maintain its official headquarters

  4  in Tallahassee.

  5         (3)  The council shall advise and assist the department

  6  in:

  7         (a)  Developing rules relating to licensure

  8  requirements, the licensure examination, continuing education

  9  requirements, fees, records and reports to be filed by

10  licensees, and any other requirements necessary to regulate

11  the practice of athletic training.

12         (b)  Monitoring the practice of athletic training in

13  other jurisdictions.

14         (c)  Educating the public about the role of athletic

15  trainers.

16         (d)  Collecting and reviewing data regarding the

17  licensed practice of athletic training.

18         (e)  Addressing concerns and problems of athletic

19  trainers in order to promote improved safety in the practice

20  of athletic training.

21         (4)  Members of the council shall be entitled to

22  compensation and reimbursement for expenses in the same manner

23  as board members are compensated and reimbursed under s.

24  455.534.

25         Section 65.  Section 468.705, Florida Statutes, 1998

26  Supplement, is amended to read:

27         468.705  Rulemaking authority.--The board department is

28  authorized to adopt rules pursuant to ss. 120.536(1) and

29  120.54 to implement provisions of this part conferring duties

30  upon it. Such rules shall include, but not be limited to, the

31  allowable scope of practice regarding the use of equipment,

                                  94

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  procedures, and medication, and requirements for a written

  2  protocol between the athletic trainer and a supervising

  3  physician, licensure requirements, licensure examination,

  4  continuing education requirements, fees, records, and reports

  5  to be filed by licensees, protocols, and any other

  6  requirements necessary to regulate the practice of athletic

  7  training.

  8         Section 66.  Section 468.707, Florida Statutes, 1998

  9  Supplement, is amended to read:

10         468.707  Licensure by examination; requirements.--

11         (1)  Any person desiring to be licensed as an athletic

12  trainer shall apply to the department on a form approved by

13  the department.

14         (a)  The department shall license each applicant who:

15         1.  Has completed the application form and remitted the

16  required fees.

17         2.  Is at least 21 years of age.

18         3.  Has obtained a baccalaureate degree from a college

19  or university accredited by an accrediting agency recognized

20  and approved by the United States Department of Education or

21  the Commission on Recognition of Postsecondary Accreditation,

22  or approved by the board department.

23         4.  Has completed coursework from a college or

24  university accredited by an accrediting agency recognized and

25  approved by the United States Department of Education or the

26  Commission on Recognition of Postsecondary Accreditation, or

27  approved by the board department, in each of the following

28  areas, as provided by rule: health, human anatomy,

29  kinesiology/biomechanics, human physiology, physiology of

30  exercise, basic athletic training, and advanced athletic

31  training.

                                  95

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         5.  Has current certification in standard first aid and

  2  cardiovascular pulmonary resuscitation from the American Red

  3  Cross or an equivalent certification as determined by the

  4  board department.

  5         6.  Has, within 2 of the preceding 5 years, attained a

  6  minimum of 800 hours of athletic training experience under the

  7  direct supervision of a licensed athletic trainer or an

  8  athletic trainer certified by the National Athletic Trainers'

  9  Association or a comparable national athletic standards

10  organization.

11         7.  Has passed an examination administered or approved

12  by the board department.

13         (b)  The department shall also license each applicant

14  who:

15         1.  Has completed the application form and remitted the

16  required fees no later than October 1, 1996.

17         2.  Is at least 21 years of age.

18         3.  Has current certification in standard first aid and

19  cardiovascular pulmonary resuscitation from the American Red

20  Cross or an equivalent certification as determined by the

21  board department.

22         4.a.  Has practiced athletic training for at least 3 of

23  the 5 years preceding application; or

24         b.  Is currently certified by the National Athletic

25  Trainers' Association or a comparable national athletic

26  standards organization.

27         (2)  Pursuant to the requirements of s. 455.607

28  455.604, each applicant shall complete a continuing education

29  course on human immunodeficiency virus and acquired immune

30  deficiency syndrome as part of initial licensure.

31

                                  96

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         Section 67.  Section 468.709, Florida Statutes, is

  2  amended to read:

  3         468.709  Fees.--

  4         (1)  The board department shall, by rule, establish

  5  fees for the following purposes:

  6         (a)  An application fee, not to exceed $100.

  7         (b)  An examination fee, not to exceed $200.

  8         (c)  An initial licensure fee, not to exceed $200.

  9         (d)  A biennial renewal fee, not to exceed $200.

10         (e)  An inactive fee, not to exceed $100.

11         (f)  A delinquent fee, not to exceed $100.

12         (g)  A reactivation fee, not to exceed $100.

13         (h)  A voluntary inactive fee, not to exceed $100.

14         (2)  The board department shall establish fees at a

15  level, not to exceed the statutory fee cap, that is adequate

16  to ensure the continued operation of the regulatory program

17  under this part. The board department shall neither set nor

18  maintain the fees at a level that will substantially exceed

19  this need.

20         Section 68.  Subsections (2) and (3) of section

21  468.711, Florida Statutes, 1998 Supplement, are amended to

22  read:

23         468.711  Renewal of license; continuing education.--

24         (2)  The board department may, by rule, prescribe

25  continuing education requirements, not to exceed 24 hours

26  biennially. The criteria for continuing education shall be

27  approved by the board department and shall include 4 hours in

28  standard first aid and cardiovascular pulmonary resuscitation

29  from the American Red Cross or equivalent training as

30  determined by board department.

31

                                  97

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  Pursuant to the requirements of s. 455.607

  2  455.604, each licensee shall complete a continuing education

  3  course on human immunodeficiency virus and acquired immune

  4  deficiency syndrome as part of biennial relicensure.

  5         Section 69.  Subsection (2) of section 468.719, Florida

  6  Statutes, 1998 Supplement, is amended to read:

  7         468.719  Disciplinary actions.--

  8         (2)  When the board department finds any person guilty

  9  of any of the acts set forth in subsection (1), the board

10  department may enter an order imposing one or more of the

11  penalties provided in s. 455.624.

12         Section 70.  Section 468.721, Florida Statutes, is

13  amended to read:

14         468.721  Saving clause.--

15         (1)  An athletic trainer registration which is valid on

16  October 1, 1995, shall become for all purposes an athletic

17  trainer license as required by this part, subject to any

18  disciplinary or administrative action pending on October 1,

19  1995, and shall be subject to all the same terms and

20  conditions as athletic trainer licenses issued after October

21  1, 1995. The department shall retain jurisdiction to impose

22  discipline for any violation of this part which occurred prior

23  to October 1, 1995, but is discovered after October 1, 1995,

24  under the terms of this part prior to October 1, 1995.

25         (2)  No judicial or administrative proceeding pending

26  on July 1, 1995, shall be abated as a result of enactment of

27  any provision of this act.

28         (3)  Rules adopted by the department relating to the

29  regulation registration of athletic trainers under this part

30  prior to July 1, 1999, shall remain in effect until the board

31  department adopts rules relating to the regulation licensure

                                  98

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  of athletic trainers under this part which supersede such

  2  earlier rules.

  3         Section 71.  Paragraph (g) of subsection (3) of section

  4  20.43, Florida Statutes, 1998 Supplement, is amended to read:

  5         20.43  Department of Health.--There is created a

  6  Department of Health.

  7         (3)  The following divisions of the Department of

  8  Health are established:

  9         (g)  Division of Medical Quality Assurance, which is

10  responsible for the following boards and professions

11  established within the division:

12         1.  Nursing assistants, as provided under s. 400.211.

13         2.  Health care services pools, as provided under s.

14  402.48.

15         3.  The Board of Acupuncture, created under chapter

16  457.

17         4.  The Board of Medicine, created under chapter 458.

18         5.  The Board of Osteopathic Medicine, created under

19  chapter 459.

20         6.  The Board of Chiropractic Medicine, created under

21  chapter 460.

22         7.  The Board of Podiatric Medicine, created under

23  chapter 461.

24         8.  Naturopathy, as provided under chapter 462.

25         9.  The Board of Optometry, created under chapter 463.

26         10.  The Board of Nursing, created under chapter 464.

27         11.  The Board of Pharmacy, created under chapter 465.

28         12.  The Board of Dentistry, created under chapter 466.

29         13.  Midwifery, as provided under chapter 467.

30         14.  The Board of Speech-Language Pathology and

31  Audiology, created under part I of chapter 468.

                                  99

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         15.  The Board of Nursing Home Administrators, created

  2  under part II of chapter 468.

  3         16.  The Board of Occupational Therapy, created under

  4  part III of chapter 468.

  5         17.  Respiratory therapy, as provided under part V of

  6  chapter 468.

  7         18.  Dietetics and nutrition practice, as provided

  8  under part X of chapter 468.

  9         19.  The Board of Athletic Training trainers, created

10  as provided under part XIII of chapter 468.

11         20.  The Board of Orthotists and Prosthetists, created

12  under part XIV of chapter 468.

13         21.  Electrolysis, as provided under chapter 478.

14         22.  The Board of Massage Therapy, created under

15  chapter 480.

16         23.  The Board of Clinical Laboratory Personnel,

17  created under part III of chapter 483.

18         24.  Medical physicists, as provided under part IV of

19  chapter 483.

20         25.  The Board of Opticianry, created under part I of

21  chapter 484.

22         26.  The Board of Hearing Aid Specialists, created

23  under part II of chapter 484.

24         27.  The Board of Physical Therapy Practice, created

25  under chapter 486.

26         28.  The Board of Psychology, created under chapter

27  490.

28         29.  School psychologists, as provided under chapter

29  490.

30

31

                                 100

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         30.  The Board of Clinical Social Work, Marriage and

  2  Family Therapy, and Mental Health Counseling, created under

  3  chapter 491.

  4

  5  The department may contract with the Agency for Health Care

  6  Administration who shall provide consumer complaint,

  7  investigative, and prosecutorial services required by the

  8  Division of Medical Quality Assurance, councils, or boards, as

  9  appropriate.

10         Section 72.  The Council of Athletic Training and the

11  terms of all council members are terminated on July 1, 1999.

12  However, such termination in no way precludes the Governor

13  from considering any former council member for appointment to

14  the Board of Athletic Training created by this act.

15         Section 73.  Section 468.805, Florida Statutes, is

16  amended to read:

17         468.805  Grandfathering Licensure without examination;

18  provisional licensure.--

19         (1)  A person who has practiced orthotics, prosthetics,

20  or pedorthics in this state for the required period since July

21  1, 1990, who, before March 1, 1998, applies to the department

22  for a license to practice orthotics, prosthetics, or

23  pedorthics, may be licensed as a prosthetist, orthotist,

24  prosthetist-orthotist, orthotic fitter, orthotic fitter

25  assistant, or pedorthist, as determined from the person's

26  experience, certification, and educational preparation,

27  without meeting the educational requirements set forth in s.

28  468.803, upon receipt of the application fee and licensing fee

29  and after the board has completed an investigation into the

30  applicant's background and experience. The board shall require

31  an application fee not to exceed $500, which shall be

                                 101

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  nonrefundable. The board shall complete its investigation

  2  within 6 months after receipt of the completed application.

  3  The period of experience required for licensure under this

  4  section subsection is 5 years for a prosthetist; 2 years for

  5  an orthotic fitter, an orthotic fitter assistant, or a

  6  pedorthist; and 5 years for an orthotist whose scope of

  7  practice is defined under s. 468.80(7).

  8         (2)(a)  A person who has received certification as an

  9  orthotist, a prosthetist, or a prosthetist-orthotist from a

10  national certifying body and who has practiced orthotics or

11  prosthetics in this state for at least 2 years but less than 5

12  years is eligible for a provisional license.

13         (b)  An applicant for provisional licensure shall

14  submit proof that he or she has been actively practicing as a

15  nationally certified orthotist, prosthetist, or

16  prosthetist-orthotist, an application fee, and a provisional

17  license fee.

18         (c)  A provisional licensee is required to practice

19  under supervision of a fully licensed orthotist, prosthetist,

20  or prosthetist-orthotist for up to 3 years in order to meet

21  the 5-year experience requirement of subsection (1) to be

22  licensed as an orthotist, prosthetist, or

23  prosthetist-orthotist.

24         (d)  After appropriate investigation, the board shall

25  license as an orthotist, prosthetist, or prosthetist-orthotist

26  the provisional licensee who has successfully completed the

27  period of experience required and otherwise meets the

28  requirements of subsection (1).

29         (e)  The board shall require an application fee, not to

30  exceed $500, which is nonrefundable, and a provisional

31  licensure fee, not to exceed $500.

                                 102

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  An applicant who has received certification as an

  2  orthotist, a prosthetist, a prosthetist-orthotist, or a

  3  pedorthist from a national certifying body which requires the

  4  successful completion of an examination, may be licensed under

  5  this section without taking an additional examination. An

  6  applicant who has not received certification from a national

  7  certifying body which requires the successful completion of an

  8  examination shall be required to take an examination as

  9  determined by the board. This examination shall be designed to

10  determine if the applicant has the minimum qualifications

11  needed to be licensed under this section. The board may charge

12  an examination fee and the actual per applicant cost to the

13  department for purchase or development of the examination.

14         (4)  An applicant who successfully completed prior to

15  March 1, 1998, at least one-half of the examination required

16  for national certification and successfully completed the

17  remaining portion of the examination and became certified

18  prior to July 1, 1998, shall be considered as nationally

19  certified by March 1, 1998, for purposes of this section.

20         (5)(4)  This section is repealed July 1, 2002.

21         Section 74.  Subsection (3) of section 468.806, Florida

22  Statutes, is amended to read:

23         468.806  Biennial renewal of license.--

24         (3)  The board may by rule prescribe continuing

25  education requirements and approve course criteria, not to

26  exceed 30 hours biennially, as a condition for license

27  renewal. The board shall establish a procedure for approving

28  continuing education courses or providers and may set a fee

29  for continuing education course or provider approval.

30         Section 75.  Subsection (5) of section 478.42, Florida

31  Statutes, is amended to read:

                                 103

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         478.42  Definitions.--As used in this chapter, the

  2  term:

  3         (5)  "Electrolysis or electrology" means the permanent

  4  removal of hair by destroying introducing, into and beneath

  5  the skin, ionizing (galvanic current) or nonionizing radiation

  6  (thermolysis or high-frequency current) to destroy the

  7  hair-producing cells of the skin and vascular system, using

  8  equipment and needle-type epilation devices approved by the

  9  board which have been cleared by and that are registered with

10  the United States Food and Drug Administration and that are

11  used pursuant to protocols approved by the council and the

12  board.

13         Section 76.  Section 483.041, Florida Statutes, is

14  amended to read:

15         483.041  Definitions.--As used in this part, the term:

16         (1)  "Agency" means the Agency for Health Care

17  Administration.

18         (2)  "Clinical laboratory" means the physical location

19  in which one or more of the following services a laboratory

20  where examinations are performed on materials or specimens

21  taken from the human body to provide information or materials

22  for use in the diagnosis, prevention, or treatment of a

23  disease or the identification or assessment of a medical or

24  physical condition.

25         (a)  Clinical laboratory services are the examinations

26  of fluids or other materials taken from the human body.

27         (b)  Anatomic laboratory services are the examinations

28  of tissue taken from the human body.

29         (c)  Cytology laboratory services are the examinations

30  of cells from individual tissues or fluid taken from the human

31  body.

                                 104

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  "Clinical laboratory examination" means a

  2  procedure performed to deliver the services defined in

  3  subsection (2), including the oversight or interpretation

  4  thereof.

  5         (4)(3)  "Clinical laboratory proficiency testing

  6  program" means a program approved by the agency for evaluating

  7  the performance of clinical laboratories.

  8         (5)(4)  "Collection station" or "branch office" means a

  9  facility operated by a clinical laboratory where materials or

10  specimens are withdrawn or collected from patients or

11  assembled after being withdrawn or collected from patients

12  elsewhere, for subsequent delivery to another location for

13  examination.

14         (6)(5)  "Hospital laboratory" means a laboratory

15  located in a hospital licensed under chapter 395 that provides

16  services solely to that hospital and that is owned by the

17  hospital and governed by the hospital medical staff or

18  governing board.

19         (7)(6)  "Licensed practitioner" means a physician

20  licensed under chapter 458, chapter 459, chapter 460, or

21  chapter 461; a dentist licensed under chapter 466; a person

22  licensed under chapter 462; or an advanced registered nurse

23  practitioner licensed under chapter 464.

24         (8)(7)  "Person" means the State of Florida or any

25  individual, firm, partnership, association, corporation,

26  county, municipality, political subdivision, or other entity,

27  whether organized for profit or not.

28         (9)(8)  "Validation inspection" means an inspection of

29  a clinical laboratory by the agency to assess whether a review

30  by an accrediting organization has adequately evaluated the

31  clinical laboratory according to state standards.

                                 105

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (10)(9)  "Waived test" means a test that the federal

  2  Health Care Financing Administration has determined qualifies

  3  for a certificate of waiver under the federal Clinical

  4  Laboratory Improvement Amendments of 1988, and the federal

  5  rules adopted thereunder.

  6         Section 77.  Subsections (2), (3), and (7) of section

  7  483.803, Florida Statutes, are amended to read:

  8         483.803  Definitions.--As used in this part, the term:

  9         (2)  "Clinical laboratory" means a clinical laboratory

10  as defined in s. 483.041(2).

11         (3)  "Clinical laboratory examination" means a clinical

12  laboratory examination as defined in s. 483.041 an examination

13  performed on materials or specimens of the human body to

14  provide information or materials for use in the diagnosis,

15  prevention, or treatment of a disease or the identification or

16  assessment of a medical or physical condition.

17         (7)  "Licensed practitioner of the healing arts" means

18  a physician licensed under pursuant to chapter 458, chapter

19  459, or chapter 460, or chapter 461; a dentist licensed under

20  pursuant to chapter 466; or a person licensed under pursuant

21  to chapter 461 or chapter 462.

22         Section 78.  Paragraph (b) of subsection (2) of section

23  395.7015, Florida Statutes, 1998 Supplement, is amended to

24  read:

25         395.7015  Annual assessment on health care entities.--

26         (2)  There is imposed an annual assessment against

27  certain health care entities as described in this section:

28         (b)  For the purpose of this section, "health care

29  entities" include the following:

30         1.  Ambulatory surgical centers and mobile surgical

31  facilities licensed under s. 395.003. This subsection shall

                                 106

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  only apply to mobile surgical facilities operating under

  2  contracts entered into on or after July 1, 1998.

  3         2.  Clinical laboratories licensed under s. 483.091,

  4  excluding any hospital laboratory defined under s. 483.041(5),

  5  any clinical laboratory operated by the state or a political

  6  subdivision of the state, any clinical laboratory which

  7  qualifies as an exempt organization under s. 501(c)(3) of the

  8  Internal Revenue Code of 1986, as amended, and which receives

  9  70 percent or more of its gross revenues from services to

10  charity patients or Medicaid patients, and any blood, plasma,

11  or tissue bank procuring, storing, or distributing blood,

12  plasma, or tissue either for future manufacture or research or

13  distributed on a nonprofit basis, and further excluding any

14  clinical laboratory which is wholly owned and operated by 6 or

15  fewer physicians who are licensed pursuant to chapter 458 or

16  chapter 459 and who practice in the same group practice, and

17  at which no clinical laboratory work is performed for patients

18  referred by any health care provider who is not a member of

19  the same group.

20         3.  Diagnostic-imaging centers that are freestanding

21  outpatient facilities that provide specialized services for

22  the identification or determination of a disease through

23  examination and also provide sophisticated radiological

24  services, and in which services are rendered by a physician

25  licensed by the Board of Medicine under s. 458.311, s.

26  458.313, or s. 458.317, or by an osteopathic physician

27  licensed by the Board of Osteopathic Medicine under s.

28  459.006, s. 459.007, or s. 459.0075.  For purposes of this

29  paragraph, "sophisticated radiological services" means the

30  following:  magnetic resonance imaging; nuclear medicine;

31  angiography; arteriography; computed tomography; positron

                                 107

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  emission tomography; digital vascular imaging; bronchography;

  2  lymphangiography; splenography; ultrasound, excluding

  3  ultrasound providers that are part of a private physician's

  4  office practice or when ultrasound is provided by two or more

  5  physicians licensed under chapter 458 or chapter 459 who are

  6  members of the same professional association and who practice

  7  in the same medical specialties; and such other sophisticated

  8  radiological services, excluding mammography, as adopted in

  9  rule by the board.

10         Section 79.  Subsection (11) of section 408.07, Florida

11  Statutes, 1998 Supplement, is amended to read:

12         408.07  Definitions.--As used in this chapter, with the

13  exception of ss. 408.031-408.045, the term:

14         (11)  "Clinical laboratory" means a facility licensed

15  under s. 483.091, excluding:  any hospital laboratory defined

16  under s. 483.041(5); any clinical laboratory operated by the

17  state or a political subdivision of the state; any blood or

18  tissue bank where the majority of revenues are received from

19  the sale of blood or tissue and where blood, plasma, or tissue

20  is procured from volunteer donors and donated, processed,

21  stored, or distributed on a nonprofit basis; and any clinical

22  laboratory which is wholly owned and operated by physicians

23  who are licensed pursuant to chapter 458 or chapter 459 and

24  who practice in the same group practice, and at which no

25  clinical laboratory work is performed for patients referred by

26  any health care provider who is not a member of that same

27  group practice.

28         Section 80.  Subsection (9) of section 483.807, Florida

29  Statutes, 1998 Supplement, is amended to read:

30         483.807  Fees; establishment; disposition.--

31

                                 108

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (9)  The initial application and renewal fee for

  2  approval as a laboratory training program may not exceed $300.

  3  The fee for late filing of a renewal application shall be $50.

  4         Section 81.  Subsections (2) and (3) of section

  5  483.809, Florida Statutes, are amended to read:

  6         483.809  Licensure; examinations; registration of

  7  trainees; approval of curricula.--

  8         (2)  EXAMINATIONS.--The department shall conduct

  9  examinations required by board rules to determine in part the

10  qualification of clinical laboratory personnel for licensure.

11  The board by rule may designate a An approved national

12  certification examination that may be accepted in lieu of

13  state examination for clinical laboratory personnel or public

14  health scientists.

15         (3)  REGISTRATION OF TRAINEES.--The department shall

16  provide for annual registration of clinical laboratory

17  trainees who are enrolled in a training program employed by

18  laboratories approved pursuant to s. 483.811, which

19  registration may not be renewed except upon special

20  authorization of the board.

21         Section 82.  Section 483.812, Florida Statutes, is

22  amended to read:

23         483.812  Public health laboratory scientists;

24  licensure.--

25         (1)  Applicants at the director level in the category

26  of public health shall qualify under s. 483.824.

27         (2)(1)  Applicants at the director and supervisor level

28  in the category of public health who are certified registered

29  by the National Registry in of Clinical Chemistry

30  Certification or the American Society for of Microbiology,

31  licensed as a technologist, and have 5 years of pertinent

                                 109

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  clinical laboratory experience may qualify under board rules

  2  by passing the state-administered appropriate supervision and

  3  administration examination.

  4         (3)(2)(a)  A technologist applicant for licensure in

  5  the category of public health microbiology, with a

  6  baccalaureate degree in one of the biological sciences from an

  7  accredited institution, may use the American Society for of

  8  Microbiology or the National Registry in of Microbiology

  9  Certification in Public Health Microbiology to qualify for a

10  technologist license in public health microbiology.  Such a

11  technologist may work in a public health microbiology

12  laboratory.

13         (b)  A technologist applicant for licensure in the

14  category of public health chemistry, with a baccalaureate

15  degree in one of the chemical, biological, or physical

16  sciences from an accredited institution, may use the National

17  Registry of Clinical Chemistry Certification to qualify for a

18  technologist license in public health chemistry.  Such a

19  technologist may work in a public health chemistry laboratory.

20         (c)  A technician applicant for licensure in the

21  category of public health, with a baccalaureate degree in one

22  of the chemical or biological sciences from an accredited

23  institution, may obtain a 2-year one-time, 3-year, conditional

24  public health technician license, which may be renewed once

25  pending national certification by the American Society of

26  Microbiology or the National Registry of Clinical Chemistry

27  Certification. Such a technician may perform testing only

28  under the direct supervision of a licensed pathologist,

29  director, supervisor, or technologist.

30

31

                                 110

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (4)(3)  A person licensed by the Board of Clinical

  2  Laboratory Personnel may work in a public health laboratory at

  3  the appropriate level and specialty.

  4         Section 83.  Section 483.813, Florida Statutes, is

  5  amended to read:

  6         483.813  Clinical laboratory personnel license.--A

  7  person may not conduct a clinical laboratory examination or

  8  report the results of such examination unless such person is

  9  licensed under this part to perform such procedures. However,

10  this provision does not apply to any practitioner of the

11  healing arts authorized to practice in this state or to

12  persons engaged in testing performed by laboratories regulated

13  under s. 483.035(1) or exempt from regulation under s.

14  483.031(2). The department may grant a temporary license to

15  any candidate it deems properly qualified, for a period not to

16  exceed 1 year, or a conditional license for a period not to

17  exceed 3 years.

18         Section 84.  Subsection (3) is added to section

19  483.821, Florida Statutes, to read:

20         483.821  Periodic demonstration of competency;

21  continuing education or reexamination.--

22         (3)  The board may, by rule, provide for continuing

23  education or retraining requirements for candidates failing an

24  examination two or more times.

25         Section 85.  Section 483.824, Florida Statutes, is

26  amended to read:

27         483.824  Qualifications of clinical laboratory

28  director.--A clinical laboratory director must have 4 years of

29  clinical laboratory experience with 2 years of experience in

30  the speciality to be directed or be nationally board certified

31

                                 111

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  in the specialty to be directed, and must meet one of the

  2  following requirements:

  3         (1)  Be a physician licensed under chapter 458 or

  4  chapter 459;

  5         (2)  Hold an earned doctoral degree in a chemical,

  6  physical, or biological science from a regionally accredited

  7  institution and be nationally certified; or

  8         (3)  For the subspecialty of oral pathology, be a

  9  physician licensed under chapter 458 or chapter 459 or a

10  dentist licensed under chapter 466.

11         Section 86.  Section 483.825, Florida Statutes, is

12  amended to read:

13         483.825  Grounds for disciplinary action.--The

14  following acts constitute grounds for which disciplinary

15  actions specified in s. 483.827 may be taken against

16  applicants, registrants, and licensees under this part:

17         (1)  Attempting to obtain, obtaining, or renewing a

18  license or registration under this part by bribery, by

19  fraudulent misrepresentation, or through an error of the

20  department or the board.

21         (2)  Engaging in or attempting to engage in, or

22  representing herself or himself as entitled to perform, any

23  clinical laboratory procedure or category of procedures not

24  authorized pursuant to her or his license.

25         (3)  Demonstrating incompetence or making consistent

26  errors in the performance of clinical laboratory examinations

27  or procedures or erroneous reporting.

28         (4)  Performing a test and rendering a report thereon

29  to a person not authorized by law to receive such services.

30         (5)  Has been convicted or found guilty of, or entered

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

                                 112

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  crime in any jurisdiction which directly relates to the

  2  activities of clinical laboratory personnel or involves moral

  3  turpitude or fraudulent or dishonest dealing. The record of a

  4  conviction certified or authenticated in such form as to be

  5  admissible in evidence under the laws of the state shall be

  6  admissible as prima facie evidence of such guilt. Having been

  7  convicted of a felony or of any crime involving moral

  8  turpitude under the laws of any state or of the United States.

  9  The record of conviction or a certified copy thereof shall be

10  conclusive evidence of such conviction.

11         (6)  Having been adjudged mentally or physically

12  incompetent.

13         (7)  Violating or aiding and abetting in the violation

14  of any provision of this part or the rules adopted hereunder.

15         (8)  Reporting a test result when no laboratory test

16  was performed on a clinical specimen.

17         (9)  Knowingly advertising false services or

18  credentials.

19         (10)  Having a license revoked, suspended, or otherwise

20  acted against, including the denial of licensure, by the

21  licensing authority of another jurisdiction. The licensing

22  authority's acceptance of a relinquishment of a license,

23  stipulation, consent order, or other settlement, offered in

24  response to or in anticipation of the filing of administrative

25  charges against the licensee, shall be construed as action

26  against the licensee.

27         (11)  Failing to report to the board, in writing,

28  within 30 days that an if action under subsection (5),

29  subsection (6), or subsection (10) has been taken against the

30  licensee or one's license to practice as clinical laboratory

31

                                 113

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  personnel in another state, territory, or country, or other

  2  jurisdiction.

  3         (12)  Being unable to perform or report clinical

  4  laboratory examinations with reasonable skill and safety to

  5  patients by reason of illness or use of alcohol, drugs,

  6  narcotics, chemicals, or any other type of material or as a

  7  result of any mental or physical condition.  In enforcing this

  8  subsection, the department shall have, upon a finding of the

  9  secretary or his or her designee that probable cause exists to

10  believe that the licensee is unable to practice because of the

11  reasons stated in this subsection, the authority to issue an

12  order to compel a licensee to submit to a mental or physical

13  examination by physicians designated by the department.  If

14  the licensee refuses to comply with such order, the

15  department's order directing such examination may be enforced

16  by filing a petition for enforcement in the circuit court

17  where the licensee resides or does business.  The department

18  shall be entitled to the summary procedure provided in s.

19  51.011.  A licensee affected under this subsection shall at

20  reasonable intervals be afforded an opportunity to demonstrate

21  that he or she can resume competent practice with reasonable

22  skill and safety to patients.

23         (13)  Delegating professional responsibilities to a

24  person when the licensee delegating such responsibilities

25  knows, or has reason to know, that such person is not

26  qualified by training, experience, or licensure to perform

27  them.

28         (14)  Violating a previous order of the board entered

29  in a disciplinary proceeding.

30         (15)  Failing to report to the department a person or

31  other licensee who the licensee knows is in violation of this

                                 114

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  chapter or the rules of the department or board adopted

  2  hereunder.

  3         (16)  Making or filing a report which the licensee

  4  knows to be false, intentionally or negligently failing to

  5  file a report or record required by state or federal law,

  6  willfully impeding or obstructing such filing or inducing

  7  another person to do so, including, but not limited to,

  8  impeding an agent of the state from obtaining a report or

  9  record for investigative purposes. Such reports or records

10  shall include only those generated in the capacity as a

11  licensed clinical laboratory personnel.

12         (17)  Paying or receiving any commission, bonus,

13  kickback, or rebate, or engaging in any split-fee arrangement

14  in any form whatsoever with a physician, organization, agency,

15  or person, either directly or indirectly for patients referred

16  to providers of health care goods and services including, but

17  not limited to, hospitals, nursing homes, clinical

18  laboratories, ambulatory surgical centers, or pharmacies. The

19  provisions of this subsection shall not be construed to

20  prevent a clinical laboratory professional from receiving a

21  fee for professional consultation services.

22         (18)  Exercising influence on a patient or client in

23  such a manner as to exploit the patient or client for the

24  financial gain of the licensee or other third party, which

25  shall include, but not be limited to, the promoting, selling,

26  or withholding of services, goods, appliances, referrals, or

27  drugs.

28         (19)  Practicing or offering to practice beyond the

29  scope permitted by law or rule, or accepting or performing

30  professional services or responsibilities which the licensee

31

                                 115

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  knows or has reason to know that he or she is not competent to

  2  perform.

  3         (20)  Misrepresenting or concealing a material fact at

  4  any time during any phase of the licensing, investigative, or

  5  disciplinary process, procedure, or proceeding.

  6         (21)  Improperly interfering with an investigation or

  7  any disciplinary proceeding.

  8         (22)  Engaging in or attempting to engage in sexual

  9  misconduct, causing undue embarrassment or using disparaging

10  language or language of a sexual nature towards a patient,

11  exploiting superior/subordinate, professional/patient,

12  instructor/student relationships for personal gain, sexual

13  gratification, or advantage.

14         Section 87.  Paragraph (g) of subsection (4) and

15  subsections (6) and (8) of section 483.901, Florida Statutes,

16  1998 Supplement, are amended to read:

17         483.901  Medical physicists; definitions; licensure.--

18         (4)  COUNCIL.--The Advisory Council of Medical

19  Physicists is created in the Department of Health to advise

20  the department in regulating the practice of medical physics

21  in this state.

22         (g)  If a vacancy on the council occurs, the secretary

23  director shall appoint a member to serve for a 4-year term.

24         (6)  LICENSE REQUIRED.--An individual may not engage in

25  the practice of medical physics, including the specialties of

26  diagnostic radiological physics, therapeutic radiological

27  physics, medical nuclear radiological physics, or medical

28  health physics, without a license issued by the department for

29  the appropriate specialty.

30         (a)  The department shall adopt rules to administer

31  this section which specify license application and renewal

                                 116

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  fees, continuing education requirements, and standards for

  2  practicing medical physics.  The council shall recommend to

  3  the department continuing education requirements that shall be

  4  a condition of license renewal.  The department shall require

  5  a minimum of 24 hours per biennium of continuing education

  6  offered by an organization recommended by the council and

  7  approved by the department.  The department, upon

  8  recommendation of the council, may adopt rules to specify

  9  continuing education requirements for persons who hold a

10  license in more than one specialty.

11         (b)  In order to apply for a medical physicist license

12  in one or more specialties, a person must file an individual

13  application for each specialty with the department.  The

14  application must be on a form prescribed by the department and

15  must be accompanied by a nonrefundable application fee for

16  each specialty.

17         (c)  The department may issue a license to an eligible

18  applicant if the applicant meets all license requirements.  At

19  any time before the department issues a license, the applicant

20  may request in writing that the application be withdrawn.  To

21  reapply, the applicant must submit a new application and an

22  additional nonrefundable application fee and must meet all

23  current licensure requirements.

24         (d)  The department shall review each completed

25  application for a license which the department receives.

26         (e)  On receipt of an application and fee as specified

27  in this section, the department may issue a license to

28  practice medical physics in this state:

29         1.  Until October 1, 1998, to a person who meets any of

30  the following requirements:

31

                                 117

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         a.  Earned from an accredited college or university a

  2  doctoral degree in physics, medical physics, biophysics,

  3  radiological physics, medical health physics, or nuclear

  4  engineering and has at least 2 years' experience in the

  5  practice of the medical physics specialty for which

  6  application is made.

  7         b.  Earned from an accredited college or university a

  8  master's degree in physics, medical physics, biophysics,

  9  radiological physics, medical health physics, or nuclear

10  engineering and has at least 3 years' experience in the

11  practice of the medical physics specialty for which

12  application is made.

13         c.  Earned from an accredited college or university a

14  bachelor's degree in physics and has at least 5 years'

15  experience in the practice of the medical physics specialty

16  for which application is made.

17         d.  Has at least 8 years' experience in the practice of

18  the medical physics specialty for which application is made, 2

19  years of which must have been earned within the 4 years

20  immediately preceding application for licensure.

21         e.  Is board certified in the medical physics specialty

22  in which the applicant applies to practice by the American

23  Board of Radiology for diagnostic radiological physics,

24  therapeutic radiological physics, or medical nuclear

25  radiological physics; by the American Board of Medical Physics

26  or the Canadian Board of Medical Physics for diagnostic

27  radiological physics, therapeutic radiological physics, or

28  medical nuclear radiological physics; or by the American Board

29  of Health Physics or an equivalent certifying body approved by

30  the agency.

31

                                 118

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         2.  On or after October 1, 1997, to a person who is

  2  board certified in the medical physics specialty in which the

  3  applicant applies to practice by the American Board of

  4  Radiology for diagnostic radiological physics, therapeutic

  5  radiological physics, or medical nuclear radiological physics;

  6  by the American Board of Medical Physics for diagnostic

  7  radiological physics, therapeutic radiological physics, or

  8  medical nuclear radiological physics; or by the American Board

  9  of Health Physics or an equivalent certifying body approved by

10  the department.

11         (f)  A licensee shall:

12         1.  Display the license in a place accessible to the

13  public; and

14         2.  Report immediately any change in the licensee's

15  address or name to the department.

16         (g)  The following acts are grounds for which the

17  disciplinary actions in paragraph (h) may be taken:

18         1.  Obtaining or attempting to obtain a license by

19  bribery, fraud, knowing misrepresentation, or concealment of

20  material fact or through an error of the department.

21         2.  Having a license denied, revoked, suspended, or

22  otherwise acted against in another jurisdiction.

23         3.  Being convicted or found guilty of, or entering a

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

25  crime in any jurisdiction which relates to the practice of, or

26  the ability to practice, the profession of medical physics.

27         4.  Willfully failing to file a report or record

28  required for medical physics or willfully impeding or

29  obstructing the filing of a report or record required by this

30  section or inducing another person to do so.

31

                                 119

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         5.  Making misleading, deceptive, or fraudulent

  2  representations in or related to the practice of medical

  3  physics.

  4         6.  Willfully failing to report any known violation of

  5  this section or any rule adopted thereunder.

  6         7.  Willfully or repeatedly violating a rule adopted

  7  under this section or an order of the department.

  8         8.  Failing to perform any statutory or legal

  9  obligation placed upon a licensee.

10         9.  Aiding, assisting, procuring, employing, or

11  advising any unlicensed person to practice medical physics

12  contrary to this section or any rule adopted thereunder.

13         10.  Delegating or contracting for the performance of

14  professional responsibilities by a person when the licensee

15  delegating or contracting such responsibilities knows, or has

16  reason to know, such person is not qualified by training,

17  experience, and authorization to perform them.

18         11.  Practicing or offering to practice beyond the

19  scope permitted by law or accepting and performing

20  professional responsibilities the licensee knows, or has

21  reason to know, the licensee is not competent to perform.

22         12.  Gross or repeated malpractice or the inability to

23  practice medical physics with reasonable skill and safety.

24         13.  Judicially determined mental incompetency.

25         14.  Being unable to practice medical physics with

26  reasonable skill and safety because of a mental or physical

27  condition or illness or the use of alcohol, controlled

28  substances, or any other substance which impairs one's ability

29  to practice.

30         a.  The department may, upon probable cause, compel a

31  licensee to submit to a mental or physical examination by

                                 120

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  physicians designated by the department.  The cost of an

  2  examination shall be borne by the licensee, and the licensee's

  3  failure to submit to such an examination constitutes an

  4  admission of the allegations against the licensee, consequent

  5  upon which a default and a final order may be entered without

  6  the taking of testimony or presentation of evidence, unless

  7  the failure was due to circumstances beyond the licensee's

  8  control.

  9         b.  A licensee who is disciplined under this

10  subparagraph shall, at reasonable intervals, be afforded an

11  opportunity to demonstrate that the licensee can resume the

12  practice of medical physics with reasonable skill and safety.

13         c.  With respect to any proceeding under this

14  subparagraph, the record of proceedings or the orders entered

15  by the department may not be used against a licensee in any

16  other proceeding.

17         (h)  When the department finds any person guilty of any

18  of the grounds set forth in paragraph (g), including conduct

19  that would constitute a substantial violation of paragraph (g)

20  which occurred prior to licensure, it may enter an order

21  imposing one or more of the following penalties:

22         1.  Deny the application for licensure.

23         2.  Revoke or suspend the license.

24         3.  Impose an administrative fine for each count or

25  separate offense.

26         4.  Place the licensee on probation for a specified

27  time and subject the licensee to such conditions as the

28  department determines necessary, including requiring

29  treatment, continuing education courses, or working under the

30  monitoring or supervision of another licensee.

31         5.  Restrict a licensee's practice.

                                 121

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         6.  Issue a reprimand to the licensee.

  2         (i)  The department may not issue or reinstate a

  3  license to a person it has deemed unqualified until it is

  4  satisfied that such person has complied with the terms and

  5  conditions of the final order and that the licensee can safely

  6  practice medical physics.

  7         (j)  The department may issue a temporary license to an

  8  applicant pending completion of the application process for

  9  board certification.

10         (j)(k)  Upon receipt of a complete application and the

11  fee set forth by rule, the department may issue a

12  physicist-in-training certificate to a person qualified to

13  practice medical physics under direct supervision. The

14  department may establish by rule requirements for initial

15  certification and renewal of a physicist-in-training

16  certificate.

17         (8)  DISPOSITION OF FEES.--The department shall deposit

18  all funds received into the Medical Quality Assurance Health

19  Care Trust Fund.

20         Section 88.  Paragraph (d) of subsection (1) of section

21  484.007, Florida Statutes, is amended to read:

22         484.007  Licensure of opticians; permitting of optical

23  establishments.--

24         (1)  Any person desiring to practice opticianry shall

25  apply to the department, upon forms prescribed by it, to take

26  a licensure examination. The department shall examine each

27  applicant who the board certifies:

28         (d)1.  Has received an associate degree, or its

29  equivalent, in opticianry from an educational institution the

30  curriculum of which is accredited by an accrediting agency

31  recognized and approved by the United States Department of

                                 122

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  Education or the Council on Postsecondary Education or

  2  approved by the board;

  3         2.  Is an individual licensed to practice the

  4  profession of opticianry pursuant to a regulatory licensing

  5  law of another state, territory, or jurisdiction of the United

  6  States, who has actively practiced in such other state,

  7  territory, or jurisdiction for more than 3 years immediately

  8  preceding application, and who meets the examination

  9  qualifications as provided in this subsection;

10         3.  Is an individual who has actively practiced in

11  another state, territory, or jurisdiction of the United States

12  for more than 5 years immediately preceding application and

13  who provides tax or business records, affidavits, or other

14  satisfactory documentation of such practice and who meets the

15  examination qualifications as provided in this subsection; or

16         4.  Has registered as an apprentice with the department

17  and paid a registration fee not to exceed $60, as set by rule

18  of the board. The apprentice shall complete 6,240 hours of

19  training under the supervision of an optician licensed in this

20  state for at least 1 year or of, a physician, or an

21  optometrist licensed under the laws of this state. These

22  requirements must be met within 5 years after the date of

23  registration. However, any time spent in a recognized school

24  may be considered as part of the apprenticeship program

25  provided herein. The board may establish administrative

26  processing fees sufficient to cover the cost of administering

27  apprentice rules as promulgated by the board.

28         Section 89.  Subsection (3) is added to section

29  484.0512, Florida Statutes, to read:

30         484.0512  Thirty-day trial period; purchaser's right to

31  cancel; notice; refund; cancellation fee.--

                                 123

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  Within 30 days after the return or attempted

  2  return of the hearing aid, the seller shall refund all moneys

  3  that must be refunded to a purchaser pursuant to this section.

  4         Section 90.  Section 484.053, Florida Statutes, is

  5  amended to read:

  6         484.053  Prohibitions; penalties.--

  7         (1)  A person may not:

  8         (a)  Practice dispensing hearing aids unless the person

  9  is a licensed hearing aid specialist;

10         (b)  Use the name or title "hearing aid specialist"

11  when the person has not been licensed under this part;

12         (c)  Present as her or his own the license of another;

13         (d)  Give false, incomplete, or forged evidence to the

14  board or a member thereof for the purposes of obtaining a

15  license;

16         (e)  Use or attempt to use a hearing aid specialist

17  license that is delinquent or has been suspended, revoked, or

18  placed on inactive or delinquent status;

19         (f)  Knowingly employ unlicensed persons in the

20  practice of dispensing hearing aids; or

21         (g)  Knowingly conceal information relative to

22  violations of this part.

23         (2)  Any person who violates any of the provisions of

24  this section is guilty of a felony misdemeanor of the third

25  second degree, punishable as provided in s. 775.082 or s.

26  775.083.

27         (3)  If a person licensed under this part allows the

28  sale of a hearing aid by an unlicensed person not registered

29  as a trainee or fails to comply with the requirements of s.

30  484.0445(2) relating to supervision of trainees, the board

31  shall, upon determination of that violation, order the full

                                 124

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  refund of moneys paid by the purchaser upon return of the

  2  hearing aid to the seller's place of business.

  3         Section 91.  Paragraph (a) of subsection (1) of section

  4  484.056, Florida Statutes, 1998 Supplement, is amended to

  5  read:

  6         484.056  Disciplinary proceedings.--

  7         (1)  The following acts relating to the practice of

  8  dispensing hearing aids shall be grounds for both disciplinary

  9  action against a hearing aid specialist as set forth in this

10  section and cease and desist or other related action by the

11  department as set forth in s. 455.637 against any person

12  owning or operating a hearing aid establishment who engages

13  in, aids, or abets any such violation:

14         (a)  Violation of any provision of s. 455.624(1), s.

15  484.0512, or s. 484.053.

16         Section 92.  Section 486.041, Florida Statutes, is

17  amended to read:

18         486.041  Physical therapist; application for license;

19  fee; temporary permit.--

20         (1)  A person who desires to be licensed as a physical

21  therapist shall apply to the department in writing on a form

22  furnished by the department.  She or he shall embody in that

23  application evidence under oath, satisfactory to the board, of

24  possession of the qualifications preliminary to examination

25  required by s. 486.031. The applicant shall pay to the

26  department at the time of filing the application a fee not to

27  exceed $100, as fixed by the board.

28         (2)  If a person desires to practice physical therapy

29  before becoming licensed through examination, she or he shall

30  apply for a temporary permit in accordance with rules adopted

31  pursuant to this chapter.

                                 125

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (a)  A temporary permit shall only be issued for a

  2  limited period of time, not to exceed 1 year, and shall not be

  3  renewable. A temporary permit shall automatically expire if an

  4  applicant fails the examination.

  5         (b)  An applicant for licensure by examination and

  6  practicing under a temporary permit shall do so only under the

  7  direct supervision of a licensed physical therapist.

  8         Section 93.  Section 486.081, Florida Statutes, is

  9  amended to read:

10         486.081  Physical therapist; issuance of license

11  without examination to person passing examination of another

12  authorized examining board; temporary permit; fee.--

13         (1)  The board may cause a license to be issued through

14  the department without examination to any applicant who

15  presents evidence satisfactory to the board of having passed

16  the American Registry Examination prior to 1971 or an

17  examination in physical therapy before a similar lawfully

18  authorized examining board of another state, the District of

19  Columbia, a territory, or a foreign country, if the standards

20  for licensure in physical therapy in such other state,

21  district, territory, or foreign country are determined by the

22  board to be as high as those of this state, as established by

23  rules adopted pursuant to this chapter. Any person who holds a

24  license pursuant to this section may use the words "physical

25  therapist" or "physiotherapist," or the letters "P.T.," in

26  connection with her or his name or place of business to denote

27  her or his licensure hereunder.

28         (2)  At the time of making application for licensure

29  without examination pursuant to the terms of this section, the

30  applicant shall pay to the department a fee not to exceed $175

31  as fixed by the board, no part of which will be returned.

                                 126

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (3)  If a person desires to practice physical therapy

  2  before becoming licensed through endorsement, she or he shall

  3  apply to the board for a temporary permit in accordance with

  4  rules adopted pursuant to this chapter. A temporary permit

  5  shall only be issued for a limited period of time, not to

  6  exceed 1 year, and shall not be renewable.

  7         Section 94.  Section 486.103, Florida Statutes, is

  8  amended to read:

  9         486.103  Physical therapist assistant; application for

10  license; fee; temporary permit.--

11         (1)  A person who desires to be licensed as a physical

12  therapist assistant shall apply to the department in writing

13  on a form furnished by the department.  She or he shall embody

14  in that application evidence under oath, satisfactory to the

15  board, of possession of the qualifications preliminary to

16  examination required by s. 486.104. The applicant shall pay to

17  the department at the time of filing the application a fee not

18  to exceed $100, as fixed by the board.

19         (2)  If a person desires to work as a physical

20  therapist assistant before being licensed through examination,

21  she or he shall apply for a temporary permit in accordance

22  with rules adopted pursuant to this chapter.

23         (a)  A temporary permit shall only be issued for a

24  limited period of time, not to exceed 1 year, and shall not be

25  renewable. A temporary permit shall automatically expire if an

26  applicant fails the examination.

27         (b)  An applicant for licensure by examination who is

28  practicing under a temporary permit shall do so only under the

29  direct supervision of a licensed physical therapist.

30         Section 95.  Section 486.107, Florida Statutes, is

31  amended to read:

                                 127

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         486.107  Physical therapist assistant; issuance of

  2  license without examination to person licensed in another

  3  jurisdiction; temporary permit; fee.--

  4         (1)  The board may cause a license to be issued through

  5  the department without examination to any applicant who

  6  presents evidence to the board, under oath, of licensure in

  7  another state, the District of Columbia, or a territory, if

  8  the standards for registering as a physical therapist

  9  assistant or licensing of a physical therapist assistant, as

10  the case may be, in such other state are determined by the

11  board to be as high as those of this state, as established by

12  rules adopted pursuant to this chapter. Any person who holds a

13  license pursuant to this section may use the words "physical

14  therapist assistant," or the letters "P.T.A.," in connection

15  with her or his name to denote licensure hereunder.

16         (2)  At the time of making application for licensing

17  without examination pursuant to the terms of this section, the

18  applicant shall pay to the department a fee not to exceed $175

19  as fixed by the board, no part of which will be returned.

20         (3)  If a person desires to work as a physical

21  therapist assistant before being licensed through endorsement,

22  she or he shall apply for a temporary permit in accordance

23  with rules adopted pursuant to this chapter.  A temporary

24  permit shall only be issued for a limited period of time, not

25  to exceed 1 year, and shall not be renewable.

26         Section 96.  Subsection (3) of section 490.003, Florida

27  Statutes, is amended to read:

28         490.003  Definitions.--As used in this chapter:

29         (3)(a)  Prior to August 31, 2001 July 1, 1999,

30  "doctoral-level psychological education" and "doctoral degree

31

                                 128

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  in psychology" mean a Psy.D., an Ed.D. in psychology, or a

  2  Ph.D. in psychology from:

  3         1.  An educational institution which, at the time the

  4  applicant was enrolled and graduated, had institutional

  5  accreditation from an agency recognized and approved by the

  6  United States Department of Education or was recognized as a

  7  member in good standing with the Association of Universities

  8  and Colleges of Canada; and

  9         2.  A psychology program within that educational

10  institution which, at the time the applicant was enrolled and

11  graduated, had programmatic accreditation from an accrediting

12  agency recognized and approved by the United States Department

13  of Education or was comparable to such programs.

14         (b)  Effective August 31, 2001 July 1, 1999,

15  "doctoral-level psychological education" and "doctoral degree

16  in psychology" mean a Psy.D., an Ed.D. in psychology, or a

17  Ph.D. in psychology from:

18         1.  An educational institution which, at the time the

19  applicant was enrolled and graduated, had institutional

20  accreditation from an agency recognized and approved by the

21  United States Department of Education or was recognized as a

22  member in good standing with the Association of Universities

23  and Colleges of Canada; and

24         2.  A psychology program within that educational

25  institution which, at the time the applicant was enrolled and

26  graduated, had programmatic accreditation from an agency

27  recognized and approved by the United States Department of

28  Education.

29         Section 97.  Paragraph (b) of subsection (1) of section

30  490.005, Florida Statutes, 1998 Supplement, is amended to

31  read:

                                 129

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         490.005  Licensure by examination.--

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

  3  psychologist shall apply to the department to take the

  4  licensure examination. The department shall license each

  5  applicant who the board certifies has:

  6         (b)  Submitted proof satisfactory to the board that the

  7  applicant has:

  8         1.  Received doctoral-level psychological education, as

  9  defined in s. 490.003(3);

10         2.  Received the equivalent of a doctoral-level

11  psychological education, as defined in s. 490.003(3), from a

12  program at a school or university located outside the United

13  States of America and Canada, which was officially recognized

14  by the government of the country in which it is located as an

15  institution or program to train students to practice

16  professional psychology.  The burden of establishing that the

17  requirements of this provision have been met shall be upon the

18  applicant;

19         3.  Received and submitted to the board, prior to

20  August 31, 2001 July 1, 1999, certification of an augmented

21  doctoral-level psychological education from the program

22  director of a doctoral-level psychology program accredited by

23  a programmatic agency recognized and approved by the United

24  States Department of Education; or

25         4.  Received and submitted to the board, prior to

26  August 31, 2001 July 1, 2001, certification of a

27  doctoral-level program that at the time the applicant was

28  enrolled and graduated maintained a standard of education and

29  training comparable to the standard of training of programs

30  accredited by a programmatic agency recognized and approved by

31  the United States Department of Education, as such

                                 130

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  comparability was determined by the Board of Psychological

  2  Examiners immediately prior to the amendment of s. 490.005,

  3  Florida Statutes, 1994 Supplement, by s. 5, chapter 95-279,

  4  Laws of Florida. Such certification of comparability shall be

  5  provided by the program director of a doctoral-level

  6  psychology program accredited by a programmatic agency

  7  recognized and approved by the United States Department of

  8  Education.

  9         Section 98.  Subsection (1) of section 490.006, Florida

10  Statutes, is amended to read:

11         490.006  Licensure by endorsement.--

12         (1)  The department shall license a person as a

13  psychologist or school psychologist who, upon applying to the

14  department and remitting the appropriate fee, demonstrates to

15  the department or, in the case of psychologists, to the board

16  that the applicant:

17         (a)  Holds a valid license or certificate in another

18  state to practice psychology or school psychology, as

19  applicable, provided that, when the applicant secured such

20  license or certificate, the requirements were substantially

21  equivalent to or more stringent than those set forth in this

22  chapter at that time; and, if no Florida law existed at that

23  time, then the requirements in the other state must have been

24  substantially equivalent to or more stringent than those set

25  forth in this chapter at the present time; or

26         (b)  Is a diplomate in good standing with the American

27  Board of Professional Psychology, Inc.; or

28         (c)  Possesses a doctoral degree in psychology as

29  described in s. 490.003 and has at least 20 years of

30  experience as a licensed psychologist in any jurisdiction or

31

                                 131

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  territory of the United States within 25 years preceding the

  2  date of application.

  3         Section 99.  Subsection (2) of section 490.0085,

  4  Florida Statutes, is amended to read:

  5         490.0085  Continuing education; approval of providers,

  6  programs, and courses; proof of completion.--

  7         (2)  The department or, in the case of psychologists,

  8  the board has the authority to set a fee not to exceed $500

  9  for each applicant who applies for or renews provider status.

10  Such fees shall be deposited into the Medical Quality

11  Assurance Health Care Trust Fund.

12         Section 100.  Section 491.0045, Florida Statutes, is

13  amended to read:

14         491.0045  Intern registration; requirements.--

15         (1)  Effective January 1, 1998, an individual who

16  intends to practice in Florida to satisfy the postgraduate or

17  post-master's level experience requirements, as specified in

18  s. 491.005(1)(c), (3)(c), or (4)(c), must register as an

19  intern in the profession for which he or she is seeking

20  licensure prior to commencing the post-master's experience

21  requirement or an individual who intends to satisfy part of

22  the required graduate-level practicum, internship, or field

23  experience, outside the academic arena for any profession,

24  must register as an intern in the profession for which he or

25  she is seeking licensure prior to commencing the practicum,

26  internship, or field experience.

27         (2)  The department shall register as a clinical social

28  worker intern, marriage and family therapist intern, or mental

29  health counselor intern each applicant who the board certifies

30  has:

31

                                 132

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (a)  Completed the application form and remitted a

  2  nonrefundable application fee not to exceed $200, as set by

  3  board rule;

  4         (b)1.  Completed the education requirements as

  5  specified in s. 491.005(1)(c), (3)(c), or (4)(c) for the

  6  profession for which he or she is applying for licensure, if

  7  needed; and

  8         2.  Submitted an acceptable supervision plan, as

  9  determined by the board, for meeting the practicum,

10  internship, or field work required for licensure that was not

11  satisfied in his or her graduate program.

12         (c)  Identified a qualified supervisor.

13         (3)  An individual registered under this section must

14  remain under supervision until he or she is in receipt of a

15  license or a letter from the department stating that he or she

16  is licensed to practice the profession for which he or she

17  applied.

18         (4)  An individual who has applied for intern

19  registration on or before December 31, 2001, and has satisfied

20  the education requirements of s. 491.005 that are in effect

21  through December 31, 2000, will have met the educational

22  requirements for licensure for the profession for which he or

23  she has applied.

24         Section 101.  Subsections (1) and (2) of section

25  491.0046, Florida Statutes, are amended to read:

26         491.0046  Provisional license; requirements.--

27         (1)  An individual applying for licensure by

28  examination who has satisfied the clinical experience

29  requirements of s. 491.005 or an individual applying for

30  licensure by endorsement pursuant to s. 491.006 intending to

31  provide clinical social work, marriage and family therapy, or

                                 133

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  mental health counseling services in Florida while satisfying

  2  coursework or examination requirements for licensure must be

  3  provisionally licensed in the profession for which he or she

  4  is seeking licensure prior to beginning practice.

  5         (2)  The department shall issue a provisional clinical

  6  social worker license, provisional marriage and family

  7  therapist license, or provisional mental health counselor

  8  license to each applicant who the board certifies has:

  9         (a)  Completed the application form and remitted a

10  nonrefundable application fee not to exceed $100, as set by

11  board rule; and

12         (b)1.  Earned a graduate degree in social work, a

13  graduate degree with a major emphasis in marriage and family

14  therapy or a closely related field, or a graduate degree in a

15  major related to the practice of mental health counseling;

16  and, and satisfied the clinical experience requirements for

17  licensure pursuant to s. 491.005; or

18         2.  Been approved for examination under the provisions

19  for licensure by endorsement pursuant to s. 491.006.

20         (c)  Has met the following minimum coursework

21  requirements:

22         1.  For clinical social work, a minimum of 15 semester

23  hours or 22 quarter hours of the coursework required by s.

24  491.005(1)(b)2.b.

25         2.  For marriage and family therapy, ten of the courses

26  required by s. 491.005(3)(b)1.a.-c., as determined by the

27  board, and at least 6 semester hours or 9 quarter hours of the

28  course credits must have been completed in the area of

29  marriage and family systems, theories, or techniques.

30         3.  For mental health counseling, a minimum of seven of

31  the courses required under s. 491.005(b)1.a.-c.

                                 134

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         Section 102.  Section 491.005, Florida Statutes, is

  2  amended to read:

  3         491.005  Licensure by examination.--

  4         (1)  Upon verification of documentation and payment of

  5  a fee not to exceed $200, as set by board rule, plus the

  6  actual per applicant cost to the department for purchase of

  7  the examination from the American Association of State Social

  8  Worker's Boards or a similar national organization, the

  9  department shall issue a license as a clinical social worker

10  to an applicant who the board certifies:

11         (a)  Has made application therefor and paid the

12  appropriate fee.

13         (b)1.  Has received a doctoral degree in social work

14  from a graduate school of social work which at the time the

15  applicant graduated was accredited by an accrediting agency

16  recognized by the United States Department of Education or has

17  received a master's degree in social work from a graduate

18  school of social work which at the time the applicant

19  graduated:

20         a.  Was accredited by the Council on Social Work

21  Education;

22         b.  Was accredited by the Canadian Association of

23  Schools of Social Work; or

24         c.  Has been determined to have been a program

25  equivalent to programs approved by the Council on Social Work

26  Education by the Foreign Equivalency Determination Service of

27  the Council on Social Work Education.  An applicant who

28  graduated from a program at a university or college outside of

29  the United States or Canada must present documentation of the

30  equivalency determination from the council in order to

31  qualify.

                                 135

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         2.  The applicant's graduate program must have

  2  emphasized direct clinical patient or client health care

  3  services, including, but not limited to, coursework in

  4  clinical social work, psychiatric social work, medical social

  5  work, social casework, psychotherapy, or group therapy.  The

  6  applicant's graduate program must have included all of the

  7  following coursework:

  8         a.  A supervised field placement which was part of the

  9  applicant's advanced concentration in direct practice, during

10  which the applicant provided clinical services directly to

11  clients.

12         b.  Completion of 24 semester hours or 32 37 quarter

13  hours in theory of human behavior and practice methods as

14  courses in clinically oriented services, including a minimum

15  of one course in psychopathology, and no more than one course

16  in research, taken in a school of social work accredited or

17  approved pursuant to subparagraph 1.

18         3.  If the course title which appears on the

19  applicant's transcript does not clearly identify the content

20  of the coursework, the applicant shall be required to provide

21  additional documentation, including, but not limited to, a

22  syllabus or catalog description published for the course.

23         (c)  Has had not less than 2 years of clinical social

24  work experience, which took place subsequent to completion of

25  a graduate degree in social work at an institution meeting the

26  accreditation requirements of this section, under the

27  supervision of a licensed clinical social worker or the

28  equivalent who is a qualified supervisor as determined by the

29  board. An individual who intends to practice in Florida to

30  satisfy clinical experience requirements must register

31  pursuant to s. 491.0045 prior to commencing practice.  If the

                                 136

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  applicant's graduate program was not a program which

  2  emphasized direct clinical patient or client health care

  3  services as described in subparagraph (b)2. s. 491.003, the

  4  supervised experience requirement must take place after the

  5  applicant has completed a minimum of 15 semester hours or 22

  6  quarter hours of the coursework required.  A doctoral

  7  internship may be applied toward the clinical social work

  8  experience requirement. The experience requirement may be met

  9  by work performed on or off the premises of the supervising

10  clinical social worker or the equivalent, provided the

11  off-premises work is not the independent private practice

12  rendering of clinical social work that does not have a

13  licensed mental health professional, as determined by the

14  board, on the premises at the same time the intern is

15  providing services.

16         (d)  Has passed a theory and practice examination

17  provided by the department for this purpose.

18         (e)  Has demonstrated, in a manner designated by rule

19  of the board, knowledge of the laws and rules governing the

20  practice of clinical social work, marriage and family therapy,

21  and mental health counseling.

22         (2)(a)  Notwithstanding the provisions of paragraph

23  (1)(b), coursework which was taken at a baccalaureate level

24  shall not be considered toward completion of education

25  requirements for licensure unless an official of the graduate

26  program certifies in writing on the graduate school's

27  stationery that a specific course, which students enrolled in

28  the same graduate program were ordinarily required to complete

29  at the graduate level, was waived or exempted based on

30  completion of a similar course at the baccalaureate level.  If

31

                                 137

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  this condition is met, the board shall apply the baccalaureate

  2  course named toward the education requirements.

  3         (b)  An applicant from a master's or doctoral program

  4  in social work which did not emphasize direct patient or

  5  client services may complete the clinical curriculum content

  6  requirement by returning to a graduate program accredited by

  7  the Council on Social Work Education or the Canadian

  8  Association of Schools of Social Work, or to a clinical social

  9  work graduate program with comparable standards, in order to

10  complete the education requirements for examination.  However,

11  a maximum of 6 semester or 9 quarter hours of the clinical

12  curriculum content requirement may be completed by credit

13  awarded for independent study coursework as defined by board

14  rule.

15         (3)  Upon verification of documentation and payment of

16  a fee not to exceed $200, as set by board rule, plus the

17  actual cost to the department for the purchase of the

18  examination from the Association of Marital and Family Therapy

19  Regulatory Board, or similar national organization, the

20  department shall issue a license as a marriage and family

21  therapist to an applicant who the board certifies:

22         (a)  Has made application therefor and paid the

23  appropriate fee.

24         (b)1.  Has a minimum of a master's degree with major

25  emphasis in marriage and family therapy, or a closely related

26  field, and has completed all of the following requirements:

27         a.  Twenty-seven semester hours or 41 quarter hours of

28  graduate coursework, which must include a minimum of 2

29  semester hours or 3 quarter hours of graduate-level course

30  credits in each of the following nine areas: dynamics of

31  marriage and family systems; marriage therapy and counseling

                                 138

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  theory and techniques; family therapy and counseling theory

  2  and techniques; individual human development theories

  3  throughout the life cycle; personality theory;

  4  psychopathology; human sexuality theory and counseling

  5  techniques; general counseling theory and techniques; and

  6  psychosocial theory. Content may be combined, provided no more

  7  than two of the nine content areas are included in any one

  8  graduate-level course and the applicant can document that the

  9  equivalent of 2 semester hours of coursework was devoted to

10  each content area. Courses in research, evaluation, appraisal,

11  assessment, or testing theories and procedures; thesis or

12  dissertation work; or practicums, internships, or fieldwork

13  may not be applied toward this requirement.

14         b.  A minimum of one graduate-level course of 2

15  semester hours or 3 quarter hours in legal, ethical, and

16  professional standards issues in the practice of marriage and

17  family therapy or a course determined by the board to be

18  equivalent.

19         c.  A minimum of one graduate-level course of 2

20  semester hours or 3 quarter hours in diagnosis, appraisal,

21  assessment, and testing for individual or interpersonal

22  disorder or dysfunction; and a minimum of one 2-semester-hour

23  or 3-quarter-hour graduate-level course in behavioral research

24  which focuses on the interpretation and application of

25  research data as it applies to clinical practice.  Credit for

26  thesis or dissertation work, practicums, internships, or

27  fieldwork may not be applied toward this requirement.

28         d.  A minimum of one supervised clinical practicum,

29  internship, or field experience in a marriage and family

30  counseling setting, during which the student provided 180

31  direct client contact hours of marriage and family therapy

                                 139

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  services under the supervision of an individual who met the

  2  requirements for supervision under paragraph (c).  This

  3  requirement may be met by a supervised practice experience

  4  which took place outside the academic arena, but which is

  5  certified as equivalent to a graduate-level practicum or

  6  internship program which required a minimum of 180 direct

  7  client contact hours of marriage and family therapy services

  8  currently offered within an academic program of a college or

  9  university accredited by an accrediting agency approved by the

10  United States Department of Education, or an institution which

11  is publicly recognized as a member in good standing with the

12  Association of Universities and Colleges of Canada or a

13  training institution accredited by the Commission on

14  Accreditation for Marriage and Family Therapy Education

15  recognized by the United States Department of Education.

16  Certification shall be required from an official of such

17  college, university, or training institution.

18         2.  If the course title which appears on the

19  applicant's transcript does not clearly identify the content

20  of the coursework, the applicant shall be required to provide

21  additional documentation, including, but not limited to, a

22  syllabus or catalog description published for the course.

23

24  The required master's degree must have been received in an

25  institution of higher education which at the time the

26  applicant graduated was:  fully accredited by a regional

27  accrediting body recognized by the Commission on Recognition

28  of Postsecondary Accreditation; publicly recognized as a

29  member in good standing with the Association of Universities

30  and Colleges of Canada; or an institution of higher education

31  located outside the United States and Canada, which at the

                                 140

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  time the applicant was enrolled and at the time the applicant

  2  graduated maintained a standard of training substantially

  3  equivalent to the standards of training of those institutions

  4  in the United States which are accredited by a regional

  5  accrediting body recognized by the Commission on Recognition

  6  of Postsecondary Accreditation.  Such foreign education and

  7  training must have been received in an institution or program

  8  of higher education officially recognized by the government of

  9  the country in which it is located as an institution or

10  program to train students to practice as professional marriage

11  and family therapists or psychotherapists.  The burden of

12  establishing that the requirements of this provision have been

13  met shall be upon the applicant, and the board shall require

14  documentation, such as, but not limited to, an evaluation by a

15  foreign equivalency determination service, as evidence that

16  the applicant's graduate degree program and education were

17  equivalent to an accredited program in this country.  An

18  applicant with a master's degree from a program which did not

19  emphasize marriage and family therapy may complete the

20  coursework requirement in a training institution fully

21  accredited by the Commission on Accreditation for Marriage and

22  Family Therapy Education recognized by the United States

23  Department of Education.

24         (c)  Has had not less than 2 years of clinical

25  experience during which 50 percent of the applicant's clients

26  were receiving marriage and family therapy services, which

27  must be at the post-master's level under the supervision of a

28  licensed marriage and family therapist with at least 5 years

29  of experience, or the equivalent, who is a qualified

30  supervisor as determined by the board.  An individual who

31  intends to practice in Florida to satisfy the clinical

                                 141

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  experience requirements must register pursuant to s. 491.0045

  2  prior to commencing practice.  If a graduate has a master's

  3  degree with a major emphasis in marriage and family therapy or

  4  a closely related field that did not include all the

  5  coursework required under sub-subparagraphs (b)1.a.-c., credit

  6  for the post-master's level clinical experience shall not

  7  commence until the applicant has completed a minimum of 10 of

  8  the courses required under sub-subparagraphs (b)1.a.-c., as

  9  determined by the board, and at least 6 semester hours or 9

10  quarter hours of the course credits must have been completed

11  in the area of marriage and family systems, theories, or

12  techniques. Within the 3 years of required experience, the

13  applicant shall provide direct individual, group, or family

14  therapy and counseling, to include the following categories of

15  cases:  unmarried dyads, married couples, separating and

16  divorcing couples, and family groups including children.  A

17  doctoral internship may be applied toward the clinical

18  experience requirement.  The clinical experience requirement

19  may be met by work performed on or off the premises of the

20  supervising marriage and family therapist or the equivalent,

21  provided the off-premises work is not the independent private

22  practice rendering of marriage and family therapy services

23  that does not have a licensed mental health professional, as

24  determined by the board, on the premises at the same time the

25  intern is providing services.

26         (d)  Has passed a theory and practice examination

27  provided by the department for this purpose.

28         (e)  Has demonstrated, in a manner designated by rule

29  of the board, knowledge of the laws and rules governing the

30  practice of clinical social work, marriage and family therapy,

31  and mental health counseling.

                                 142

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (f)  For the purposes of dual licensure, the department

  2  shall license as a marriage and family therapist any person

  3  who meets the requirements of s. 491.0057. Fees for dual

  4  licensure shall not exceed those stated in this subsection.

  5         (4)  Upon verification of documentation and payment of

  6  a fee not to exceed $200, as set by board rule, plus the

  7  actual per applicant cost to the department for purchase of

  8  the examination from the Professional Examination Service for

  9  the National Academy of Certified Clinical Mental Health

10  Counselors or a similar national organization, the department

11  shall issue a license as a mental health counselor to an

12  applicant who the board certifies:

13         (a)  Has made application therefor and paid the

14  appropriate fee.

15         (b)1.  Has received a minimum of an earned master's

16  degree with a major related to the practice of mental health

17  counseling, and has completed all of the following

18  requirements:

19         a.  Twenty-one semester hours or 32 quarter hours of

20  graduate coursework, which must include a minimum of 2

21  semester hours or 3 quarter hours of graduate-level coursework

22  in each of the following seven content areas:  counseling

23  theories and practice; human development theories; personality

24  theory; psychopathology or abnormal psychology; human

25  sexuality theories; group theories and practice; and

26  individual evaluation and assessment.  Content may be

27  combined, provided no more than two of the seven content areas

28  are included in any one graduate-level course and the

29  applicant can document that the equivalent of 2 semester hours

30  of content was devoted to each content area.  Courses in

31  research, thesis or dissertation work, practicums,

                                 143

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  internships, or fieldwork may not be applied toward this

  2  requirement.

  3         b.  A minimum of one 2-semester-hour or 3-quarter-hour

  4  graduate-level course in research or in career or vocational

  5  counseling. Credit for thesis or dissertation work,

  6  practicums, internships, or fieldwork may not be applied

  7  toward this requirement.

  8         c.  A minimum of 2 semester hours or 3 quarter hours of

  9  graduate-level coursework in legal, ethical, and professional

10  standards issues in the practice of mental health counseling,

11  which includes goals and objectives of professional counseling

12  organizations, codes of ethics, legal considerations,

13  standards of preparation, certifications and licensing, and

14  the role identity of counselors.  Courses in research, thesis

15  or dissertation work, practicums, internships, or fieldwork

16  may not be applied toward this requirement.

17         d.  A minimum of one supervised practicum, internship,

18  or field experience in a counseling setting.  This requirement

19  may be met by a supervised practice experience which takes

20  place outside the academic arena, but which is certified as

21  equivalent to a graduate-level practicum in a clinical mental

22  health counseling setting currently offered within an academic

23  program of a college or university accredited by an

24  accrediting agency approved by the United States Department of

25  Education. Such certification shall be required from an

26  official of such college or university.

27         2.  If the course title which appears on the

28  applicant's transcript does not clearly identify the content

29  of the coursework, the applicant shall be required to provide

30  additional documentation, including, but not limited to, a

31  syllabus or catalog description published for the course.

                                 144

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1

  2  Except as provided in sub-subparagraph 1.d., education and

  3  training in mental health counseling must have been received

  4  in an institution of higher education which at the time the

  5  applicant graduated was:  fully accredited by a regional

  6  accrediting body recognized by the Commission on Recognition

  7  of Postsecondary Accreditation; publicly recognized as a

  8  member in good standing with the Association of Universities

  9  and Colleges of Canada; or an institution of higher education

10  located outside the United States and Canada, which at the

11  time the applicant was enrolled and at the time the applicant

12  graduated maintained a standard of training substantially

13  equivalent to the standards of training of those institutions

14  in the United States which are accredited by a regional

15  accrediting body recognized by the Commission on Recognition

16  of Postsecondary Accreditation. Such foreign education and

17  training must have been received in an institution or program

18  of higher education officially recognized by the government of

19  the country in which it is located as an institution or

20  program to train students to practice as mental health

21  counselors.  The burden of establishing that the requirements

22  of this provision have been met shall be upon the applicant,

23  and the board shall require documentation, such as, but not

24  limited to, an evaluation by a foreign equivalency

25  determination service, as evidence that the applicant's

26  graduate degree program and education were equivalent to an

27  accredited program in this country.

28         (c)  Has had not less than 2 years of clinical

29  experience in mental health counseling, which must be at the

30  post-master's level under the supervision of a licensed mental

31  health counselor or the equivalent who is a qualified

                                 145

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  supervisor as determined by the board.  An individual who

  2  intends to practice in Florida to satisfy the clinical

  3  experience requirements must register pursuant to s. 491.0045

  4  prior to commencing practice.  If a graduate has a master's

  5  degree with a major related to the practice of mental health

  6  counseling which did not include all the coursework required

  7  under sub-subparagraphs (b)1.a.-c., credit for the

  8  post-master's level clinical experience shall not commence

  9  until the applicant has completed a minimum of seven of the

10  courses required under sub-subparagraphs (b)1.a.-c., as

11  determined by the board, one of which must be a course in

12  psychopathology or abnormal psychology. A doctoral internship

13  may be applied toward the clinical experience requirement. The

14  clinical experience requirement may be met by work performed

15  on or off the premises of the supervising mental health

16  counselor or the equivalent, provided the off-premises work is

17  not the independent private practice rendering of services

18  that does not have a licensed mental health professional, as

19  determined by the board, on the premises at the same time the

20  intern is providing services.

21         (d)  Has passed a theory and practice examination

22  provided by the department for this purpose.

23         (e)  Has demonstrated, in a manner designated by rule

24  of the board, knowledge of the laws and rules governing the

25  practice of clinical social work, marriage and family therapy,

26  and mental health counseling.

27         (5)  An individual who is registered as an intern and

28  has satisfied all of the educational requirements for the

29  profession for which the applicant seeks licensure shall be

30  certified as having met the educational requirements for

31  licensure under this section.

                                 146

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         (6)  The board may adopt rules necessary to implement

  2  any education or experience requirement of this section for

  3  licensure as a clinical social worker, marriage and family

  4  therapist, or mental health counselor.

  5         Section 103.  Effective January 1, 2001, paragraph (b)

  6  of subsection (4) of section 491.005, Florida Statutes, as

  7  amended by section 13 of chapter 97-198 and section 205 of

  8  chapter 97-264, Laws of Florida, is amended, and subsection

  9  (6) of that section is reenacted, to read:

10         491.005  Licensure by examination.--

11         (4)  Upon verification of documentation and payment of

12  a fee not to exceed $200, as set by board rule, plus the

13  actual per applicant cost to the department for purchase of

14  the examination from the Professional Examination Service for

15  the National Academy of Certified Clinical Mental Health

16  Counselors or a similar national organization, the department

17  shall issue a license as a mental health counselor to an

18  applicant who the board certifies:

19         (b)1.  Has a minimum of an earned master's degree from

20  a mental health counseling program accredited by the Council

21  for the Accreditation of Counseling and Related Educational

22  Programs that consists of at least 60 semester hours or 80

23  quarter hours of clinical and didactic instruction, including

24  a course in human sexuality and a course in substance abuse.

25  If the master's degree is earned from a program related to the

26  practice of mental health counseling that is not accredited by

27  the Council for the Accreditation of Counseling and Related

28  Educational Programs, then the coursework and practicum,

29  internship, or fieldwork must consist of at least 60 semester

30  hours or 80 quarter hours and meet the following requirements:

31

                                 147

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         a.  Thirty-three Thirty-six semester hours or 44 48

  2  quarter hours of graduate coursework, which must include a

  3  minimum of 3 semester hours or 4 quarter hours of

  4  graduate-level coursework in each of the following 11 12

  5  content areas: counseling theories and practice; human growth

  6  and development; diagnosis and treatment of psychopathology;

  7  human sexuality; group theories and practice; individual

  8  evaluation and assessment; career and lifestyle assessment;

  9  research and program evaluation; social and cultural

10  foundations; foundations of mental health counseling;

11  counseling in community settings; and substance abuse. Courses

12  in research, thesis or dissertation work, practicums,

13  internships, or fieldwork may not be applied toward this

14  requirement.

15         b.  A minimum of 3 semester hours or 4 quarter hours of

16  graduate-level coursework in legal, ethical, and professional

17  standards issues in the practice of mental health counseling,

18  which includes goals, objectives, and practices of

19  professional counseling organizations, codes of ethics, legal

20  considerations, standards of preparation, certifications and

21  licensing, and the role identity and professional obligations

22  of mental health counselors. Courses in research, thesis or

23  dissertation work, practicums, internships, or fieldwork may

24  not be applied toward this requirement.

25         c.  The equivalent, as determined by the board, of at

26  least 1,000 hours of university-sponsored supervised clinical

27  practicum, internship, or field experience as required in the

28  accrediting standards of the Council for Accreditation of

29  Counseling and Related Educational Programs for mental health

30  counseling programs. If the academic practicum, internship, or

31  field experience was less than 1,000 hours, experience gained

                                 148

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  outside the academic arena in clinical mental health settings

  2  under the supervision of a qualified supervisor as determined

  3  by the board may be applied. This experience may not be used

  4  to satisfy the post-master's clinical experience requirement.

  5         2.  If the course title which appears on the

  6  applicant's transcript does not clearly identify the content

  7  of the coursework, the applicant shall be required to provide

  8  additional documentation, including, but not limited to, a

  9  syllabus or catalog description published for the course.

10

11  Education and training in mental health counseling must have

12  been received in an institution of higher education which at

13  the time the applicant graduated was: fully accredited by a

14  regional accrediting body recognized by the Commission on

15  Recognition of Postsecondary Accreditation; publicly

16  recognized as a member in good standing with the Association

17  of Universities and Colleges of Canada; or an institution of

18  higher education located outside the United States and Canada,

19  which at the time the applicant was enrolled and at the time

20  the applicant graduated maintained a standard of training

21  substantially equivalent to the standards of training of those

22  institutions in the United States which are accredited by a

23  regional accrediting body recognized by the Commission on

24  Recognition of Postsecondary Accreditation. Such foreign

25  education and training must have been received in an

26  institution or program of higher education officially

27  recognized by the government of the country in which it is

28  located as an institution or program to train students to

29  practice as mental health counselors. The burden of

30  establishing that the requirements of this provision have been

31  met shall be upon the applicant, and the board shall require

                                 149

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  documentation, such as, but not limited to, an evaluation by a

  2  foreign equivalency determination service, as evidence that

  3  the applicant's graduate degree program and education were

  4  equivalent to an accredited program in this country.

  5         (6)  The board may adopt rules necessary to implement

  6  any education or experience requirement of this section for

  7  licensure as a clinical social worker, marriage and family

  8  therapist, or mental health counselor.

  9         Section 104.  Paragraph (b) of subsection (1) of

10  section 491.006, Florida Statutes, is amended to read:

11         491.006  Licensure or certification by endorsement.--

12         (1)  The department shall license or grant a

13  certificate to a person in a profession regulated by this

14  chapter who, upon applying to the department and remitting the

15  appropriate fee, demonstrates to the board that he or she:

16         (b)1.  Holds an active valid license to practice and

17  has actively practiced the profession for which licensure is

18  applied in another state for 3 of the last 5 years immediately

19  preceding licensure.

20         2.  Meets the education requirements of this chapter

21  for the profession for which licensure is applied.

22         3.  Has passed a substantially equivalent licensing

23  examination in another state or has passed the licensure

24  examination in this state in the profession for which the

25  applicant seeks licensure.

26         4.  Holds a license in good standing, is not under

27  investigation for an act which would constitute a violation of

28  this chapter, and has not been found to have committed any act

29  which would constitute a violation of this chapter.

30         Section 105.  Section 491.0085, Florida Statutes, is

31  amended to read:

                                 150

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         491.0085  Continuing education and laws and rules

  2  courses; approval of providers, programs, and courses; proof

  3  of completion.--

  4         (1)  Continuing education providers, programs, and

  5  courses and laws and rules courses and their providers and

  6  programs shall be approved by the department or the board.

  7         (2)  The department or the board has the authority to

  8  set a fee not to exceed $200 for each applicant who applies

  9  for or renews provider status.  Such fees shall be deposited

10  into the Medical Quality Assurance Health Care Trust Fund.

11         (3)  Proof of completion of the required number of

12  hours of continuing education and completion of the laws and

13  rules course shall be submitted to the department or the board

14  in the manner and time specified by rule and on forms provided

15  by the department or the board.

16         (4)  The department or the board shall adopt rules and

17  guidelines to administer and enforce the provisions of this

18  section.

19         Section 106.  Paragraph (d) of subsection (4) of

20  section 491.014, Florida Statutes, 1998 Supplement, is amended

21  to read:

22         491.014  Exemptions.--

23         (4)  No person shall be required to be licensed,

24  provisionally licensed, registered, or certified under this

25  chapter who:

26         (d)  Is not a resident of this state but offers

27  services in this state, provided:

28         1.  Such services are performed for no more than 5 days

29  in any month and no more than 15 days in any calendar year;

30  and

31

                                 151

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1         2.  Such nonresident is licensed or certified to

  2  practice the services provided by a state or territory of the

  3  United States or by a foreign country or province.

  4         Section 107.  Subsection (6) is added to section

  5  626.883, Florida Statutes, to read:

  6         626.883  Administrator as intermediary; collections

  7  held in fiduciary capacity; establishment of account;

  8  disbursement; payments on behalf of insurer.--

  9         (6)  All payments to a health care provider by a fiscal

10  intermediary must include an explanation of services being

11  reimbursed which includes, at a minimum, the patient's name,

12  the date of service, the provider code, the amount of

13  reimbursement for noncapitated providers, and the

14  identification of the plan on whose behalf the payment is

15  being made. For capitated providers, the statement of services

16  must include the number of patients covered by the contract,

17  the rate per patient, the total amount of the payment, and the

18  identification of the plan on whose behalf the payment is

19  being made.

20         Section 108.  Paragraph (a) of subsection (2) of

21  section 641.316, Florida Statutes, 1998 Supplement, is amended

22  to read:

23         641.316  Fiscal intermediary services.--

24         (2)(a)  The term "fiduciary" or "fiscal intermediary

25  services" means reimbursements received or collected on behalf

26  of health care professionals for services rendered, patient

27  and provider accounting, financial reporting and auditing,

28  receipts and collections management, compensation and

29  reimbursement disbursement services, or other related

30  fiduciary services pursuant to health care professional

31  contracts with health maintenance organizations. All payments

                                 152

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






    Florida Senate - 1999                                  SB 2562
    25-1160-99                                         See HB 1467




  1  to a health care provider by a fiscal intermediary must

  2  include an explanation of services being reimbursed which

  3  includes, at a minimum, the patient's name, the date of

  4  service, the provider code, the amount of reimbursement for

  5  noncapitated providers, and the identification of the plan on

  6  whose behalf the payment is being made. For capitated

  7  providers, the statement of services must include the number

  8  of patients covered by the contract, the rate per patient, the

  9  total amount of the payment, and the identification of the

10  plan on whose behalf the payment is being made.

11         Section 109.  Except as otherwise provided in this act,

12  this act shall take effect July 1, 1999.

13

14            *****************************************

15                       LEGISLATIVE SUMMARY

16    Amends or creates various provisions of law regulating
      health care practitioners. (See bill for details.)
17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

                                 153