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





                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
                                   .
                                   .
 1                                 .
                                   .
 2                                 .
                                   .
 3                                 .
                                   .
 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  Representative(s) Fasano offered the following:

12

13         Amendment (with title amendment) 

14         On page 80, line 17 through page 85, line 18,

15  remove from the bill:  all of said lines

16

17  and insert in lieu thereof:

18         Section 43.  Section 458.3135, Florida Statutes, is

19  created to read:

20         458.3135  Temporary certificate for visiting physicians

21  to practice in approved cancer centers.--

22         (1)  Any physician who has been accepted for a course

23  of training by a cancer center approved by the board and who

24  meets all of the qualifications set forth in this section may

25  be issued a temporary certificate to practice in a

26  board-approved cancer center under the International Cancer

27  Center Visiting Physician Program. A certificate may be issued

28  to a physician who will be training under the direct

29  supervision of a physician employed by or under contract with

30  an approved cancer center for a period of no more than 1 year.

31  The purpose of the International Cancer Center Visiting

                                  1

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  Physician Program is to provide to internationally respected

 2  and highly qualified physicians advanced education and

 3  training on cancer treatment techniques developed at an

 4  approved cancer center. The board may issue this temporary

 5  certificate in accordance with the restrictions set forth in

 6  this section.

 7         (2)  A temporary certificate for practice in an

 8  approved cancer center may be issued without examination to an

 9  individual who:

10         (a)  Is a graduate of an accredited medical school or

11  its equivalent, or is a graduate of a foreign medical school

12  listed with the World Health Organization;

13         (b)  Holds a valid and unencumbered license to practice

14  medicine in another country;

15         (c)  Has completed the application form adopted by the

16  board and remitted a nonrefundable application fee not to

17  exceed $300;

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

19  jurisdiction which would constitute the basis for disciplining

20  a physician under s. 455.624 or s. 458.331;

21         (e)  Meets the financial responsibility requirements of

22  s. 458.320; and

23         (f)  Has been accepted for a course of training by a

24  cancer center approved by the board.

25         (3)  The board shall by rule establish qualifications

26  for approval of cancer centers under this section, which at a

27  minimum shall require the cancer center to be licensed under

28  chapter 395 and have met the standards required to be a

29  National Cancer Institute-designated cancer center. The board

30  shall review the cancer centers approved under this section

31  not less than annually to ascertain that the minimum

                                  2

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  requirements of this chapter and the rules adopted thereunder

 2  are being complied with. If it is determined that such minimum

 3  requirements are not being met by an approved cancer center,

 4  the board shall rescind its approval of that cancer center and

 5  no temporary certificate for that cancer center shall be valid

 6  until such time as the board reinstates its approval of that

 7  cancer center.

 8         (4)  A recipient of a temporary certificate for

 9  practice in an approved cancer center may use the certificate

10  to practice for the duration of the course of training at the

11  approved cancer center so long as the duration of the course

12  does not exceed 1 year. If at any time the cancer center is no

13  longer approved by the board, the temporary certificate shall

14  expire and the recipient shall no longer be authorized to

15  practice in this state.

16         (5)  A recipient of a temporary certificate for

17  practice in an approved cancer center is limited to practicing

18  in facilities owned or operated by that approved cancer center

19  and is limited to only practicing under the direct supervision

20  of a physician who holds a valid, active, and unencumbered

21  license to practice medicine in this state issued under this

22  chapter or chapter 459.

23         (6)  The board shall not issue a temporary certificate

24  for practice in an approved cancer center to any physician who

25  is under investigation in another jurisdiction for an act that

26  would constitute a violation of this chapter or chapter 455

27  until such time as the investigation is complete and the

28  physician is found innocent of all charges.

29         (7)  A physician applying under this section is exempt

30  from the requirements of ss. 455.565-455.5656. All other

31  provisions of chapters 455 and 458 apply.

                                  3

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         (8)  In any year, the maximum number of temporary

 2  certificates that may be issued by the board under this

 3  section may not exceed 10 at each approved cancer center.

 4         (9)  The board may adopt rules pursuant to ss.

 5  120.536(1) and 120.54 as necessary to implement this section.

 6         (10)  Nothing in this section may be construed to

 7  authorize a physician who is not licensed to practice medicine

 8  in this state to qualify for or otherwise engage in the

 9  practice of medicine in this state, except as provided in this

10  section.

11         Section 44.  Paragraph (i) of subsection (1), and

12  subsection (4) of section 458.3145, Florida Statutes, are

13  amended to read:

14           458.3145  Medical faculty certificate.--

15         (1)  A medical faculty certificate may be issued

16  without examination to an individual who:

17         (a)  Is a graduate of an accredited medical school or

18  its equivalent, or is a graduate of a foreign medical school

19  listed with the World Health Organization;

20         (b)  Holds a valid, current license to practice

21  medicine in another jurisdiction;

22         (c)  Has completed the application form and remitted a

23  nonrefundable application fee not to exceed $500;

24         (d)  Has completed an approved residency or fellowship

25  of at least 1 year or has received training which has been

26  determined by the board to be equivalent to the 1-year

27  residency requirement;

28         (e)  Is at least 21 years of age;

29         (f)  Is of good moral character;

30         (g)  Has not committed any act in this or any other

31  jurisdiction which would constitute the basis for disciplining

                                  4

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  a physician under s. 458.331;

 2         (h)  For any applicant who has graduated from medical

 3  school after October 1, 1992, has completed, before entering

 4  medical school, the equivalent of 2 academic years of

 5  preprofessional, postsecondary education, as determined by

 6  rule of the board, which must include, at a minimum, courses

 7  in such fields as anatomy, biology, and chemistry; and

 8         (i)  Has been offered and has accepted a full-time

 9  faculty appointment to teach in a program of medicine at:

10         1.  The University of Florida,

11         2.  The University of Miami,

12         3.  The University of South Florida, or

13         4.  The Florida State University, or

14         54.  The Mayo Medical School at the Mayo Clinic in

15  Jacksonville, Florida.

16         (2)  The certificate authorizes the holder to practice

17  only in conjunction with his or her faculty position at an

18  accredited medical school and its affiliated clinical

19  facilities or teaching hospitals that are registered with the

20  Board of Medicine as sites at which holders of medical faculty

21  certificates will be practicing.  Such certificate

22  automatically expires when the holder's relationship with the

23  medical school is terminated or after a period of 24 months,

24  whichever occurs sooner, and is renewable every 2 years by a

25  holder who applies to the board on a form prescribed by the

26  board and provides certification by the dean of the medical

27  school that the holder is a distinguished medical scholar and

28  an outstanding practicing physician.

29         (3)  The holder of a medical faculty certificate issued

30  under this section has all rights and responsibilities

31  prescribed by law for the holder of a license issued under s.

                                  5

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  458.311, except as specifically provided otherwise by law.

 2  Such responsibilities include compliance with continuing

 3  medical education requirements as set forth by rule of the

 4  board. A hospital or ambulatory surgical center licensed under

 5  chapter 395, health maintenance organization certified under

 6  chapter 641, insurer as defined in s. 624.03,

 7  multiple-employer welfare arrangement as defined in s.

 8  624.437, or any other entity in this state, in considering and

 9  acting upon an application for staff membership, clinical

10  privileges, or other credentials as a health care provider,

11  may not deny the application of an otherwise qualified

12  physician for such staff membership, clinical privileges, or

13  other credentials solely because the applicant is a holder of

14  a medical faculty certificate under this section.

15         (4)  In any year, the maximum number of extended

16  medical faculty certificateholders as provided in subsection

17  (2) may not exceed 15 persons at each institution named in

18  subparagraphs (1)(i)1.-43. and at the facility named in s.

19  240.512 and may not exceed 5 persons at the institution named

20  in subparagraph (1)(i)54.

21         5.  Annual review of all such certificate recipients

22  will be made by the deans of the accredited 4-year medical

23  schools within this state and reported to the Board of

24  Medicine.

25         (5)  Notwithstanding subsection (1), any physician,

26  when providing medical care or treatment in connection with

27  the education of students, residents, or faculty at the

28  request of the dean of an accredited medical school within

29  this state or at the request of the medical director of a

30  statutory teaching hospital as defined in s. 408.07, may do so

31  upon registration with the board and demonstration of

                                  6

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  financial responsibility pursuant to s. 458.320(1) or (2)

 2  unless such physician is exempt under s. 458.320(5)(a).  The

 3  performance of such medical care or treatment must be limited

 4  to a single period of time, which may not exceed 180

 5  consecutive days, and must be rendered within a facility

 6  registered under subsection (2) or within a statutory teaching

 7  hospital as defined in s. 408.07.  A registration fee not to

 8  exceed $300, as set by the board, is required of each

 9  physician registered under this subsection. However, no more

10  than three physicians per year per institution may be

11  registered under this subsection, and an exemption under this

12  subsection may not be granted to a physician more than once in

13  any given 5-year period.

14         Section 45.  Subsection (5) is added to section

15  458.315, Florida Statutes, to read:

16         458.315  Temporary certificate for practice in areas of

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

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

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

20  certificate to practice in communities of Florida where there

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

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

23  department, correctional facility, community health center

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

25  Public Health Services Act, or other entity that provides

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

27  Health Officer.  The Board of Medicine may issue this

28  temporary certificate with the following restrictions:

29         (5)  The application fee and all licensure fees,

30  including neurological injury compensation assessments, shall

31  be waived for those persons obtaining a temporary certificate

                                  7

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  to practice in areas of critical need for the purpose of

 2  providing volunteer, uncompensated care for low-income

 3  Floridians. The applicant must submit an affidavit from the

 4  employing agency or institution stating that the physician

 5  will not receive any compensation for any service involving

 6  the practice of medicine.

 7         Section 46.  Section 458.345, Florida Statutes, is

 8  amended to read:

 9         458.345  Registration of resident physicians, interns,

10  and fellows; list of hospital employees; prescribing of

11  medicinal drugs; penalty.--

12         (1)  Any person desiring to practice as a resident

13  physician, assistant resident physician, house physician,

14  intern, or fellow in fellowship training which leads to

15  subspecialty board certification in this state, or any person

16  desiring to practice as a resident physician, assistant

17  resident physician, house physician, intern, or fellow in

18  fellowship training in a teaching hospital in this state as

19  defined in s. 408.07(44) or s. 395.805(2), who does not hold a

20  valid, active license issued under this chapter shall apply to

21  the department to be registered and shall remit a fee not to

22  exceed $300 as set by the board.  The department shall

23  register any applicant the board certifies has met the

24  following requirements:

25         (a)  Is at least 21 years of age.

26         (b)  Has not committed any act or offense within or

27  without the state which would constitute the basis for refusal

28  to certify an application for licensure pursuant to s.

29  458.331.

30         (c)  Is a graduate of a medical school or college as

31  specified in s. 458.311(1)(f).

                                  8

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         (2)  The board shall not certify to the department for

 2  registration any applicant who is under investigation in any

 3  state or jurisdiction for an act which would constitute the

 4  basis for imposing a disciplinary penalty specified in s.

 5  458.331(2)(b) until such time as the investigation is

 6  completed, at which time the provisions of s. 458.331 shall

 7  apply.

 8         (3)  Every hospital or teaching hospital employing or

 9  utilizing the services of a resident physician, assistant

10  resident physician, house physician, intern, or fellow in

11  fellowship training registered under this section which leads

12  to subspecialty board certification shall designate a person

13  who shall, on dates designated by the board, in consultation

14  with the department, furnish the department with a list of

15  such the hospital's employees and such other information as

16  the board may direct.  The chief executive officer of each

17  such hospital shall provide the executive director of the

18  board with the name, title, and address of the person

19  responsible for furnishing such reports.

20         (4)  Registration under this section shall

21  automatically expire after 2 years without further action by

22  the board or the department unless an application for renewal

23  is approved by the board.  No person registered under this

24  section may be employed or utilized as a house physician or

25  act as a resident physician, an assistant resident physician,

26  an intern, or a fellow in fellowship training which leads to a

27  subspecialty board certification in a hospital or teaching

28  hospital of this state for more than 2 years without a valid,

29  active license or renewal of registration under this section.

30  Requirements for renewal of registration shall be established

31  by rule of the board.  An application fee not to exceed $300

                                  9

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  as set by the board shall accompany the application for

 2  renewal, except that resident physicians, assistant resident

 3  physicians, interns, and fellows in fellowship training

 4  registered under this section which leads to subspecialty

 5  board certification shall be exempt from payment of any

 6  renewal fees.

 7         (5)  Notwithstanding any provision of this section or

 8  s. 120.52 to the contrary, any person who is registered under

 9  this section is subject to the provisions of s. 458.331.

10         (6)  A person registered as a resident physician under

11  this section may in the normal course of his or her employment

12  prescribe medicinal drugs described in schedules set out in

13  chapter 893 when:

14         (a)  The person prescribes such medicinal drugs through

15  use of a Drug Enforcement Administration number issued to the

16  hospital or teaching hospital by which the person is employed

17  or at which the person's services are used;

18         (b)  The person is identified by a discrete suffix to

19  the identification number issued to such the hospital; and

20         (c)  The use of the institutional identification number

21  and individual suffixes conforms to the requirements of the

22  federal Drug Enforcement Administration.

23         (7)  Any person willfully violating this section

24  commits a misdemeanor of the first degree, punishable as

25  provided in s. 775.082 or s. 775.083.

26         (8)  The board shall promulgate rules pursuant to ss.

27  120.536(1) and 120.54 as necessary to implement this section.

28         Section 47.  Subsection (3) of section 458.348, Florida

29  Statutes, is created to read:

30         458.348  Formal supervisory relationships, standing

31  orders, and established protocols; notice; standards.--

                                  10

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         (3)  PROTOCOLS REQUIRING DIRECT SUPERVISION.--All

 2  protocols relating to electrolysis or electrology using laser

 3  or light-based hair removal or reduction by persons other than

 4  physicians licensed under this chapter or chapter 459 shall

 5  require the person performing such service to be appropriately

 6  trained and work only under the direct supervision and

 7  responsibility of a physician licensed under this chapter or

 8  chapter 459.

 9         Section 48.  Section 459.021, Florida Statutes, is

10  amended to read:

11         459.021  Registration of resident physicians, interns,

12  and fellows; list of hospital employees; penalty.--

13         (1)  Any person who holds a degree of Doctor of

14  Osteopathic Medicine from a college of osteopathic medicine

15  recognized and approved by the American Osteopathic

16  Association who desires to practice as a resident physician,

17  assistant resident physician, house physician, intern, or

18  fellow in fellowship training which leads to subspecialty

19  board certification in this state, or any person desiring to

20  practice as a resident physician, assistant resident

21  physician, house physician, intern, or fellow in fellowship

22  training in a teaching hospital in this state as defined in s.

23  408.07(44) or s. 395.805(2), who does not hold an active

24  license issued under this chapter shall apply to the

25  department to be registered, on an application provided by the

26  department, within 30 days of commencing such a training

27  program and shall remit a fee not to exceed $300 as set by the

28  board.

29         (2)  Any person required to be registered under this

30  section shall renew such registration annually.  Such

31  registration shall be terminated upon the registrant's receipt

                                  11

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  of an active license issued under this chapter.  No person

 2  shall be registered under this section for an aggregate of

 3  more than 5 years, unless additional years are approved by the

 4  board.

 5         (3)  Every hospital or teaching hospital having

 6  employed or contracted with or utilized the services of a

 7  person who holds a degree of Doctor of Osteopathic Medicine

 8  from a college of osteopathic medicine recognized and approved

 9  by the American Osteopathic Association as a resident

10  physician, assistant resident physician, house physician,

11  intern, or fellow in fellowship training registered under this

12  section which leads to subspecialty board certification shall

13  designate a person who shall furnish, on dates designated by

14  the board, in consultation with the department, to the

15  department a list of all such persons who have served in such

16  the hospital during the preceding 6-month period. The chief

17  executive officer of each such hospital shall provide the

18  executive director of the board with the name, title, and

19  address of the person responsible for filing such reports.

20         (4)  The registration may be revoked or the department

21  may refuse to issue any registration for any cause which would

22  be a ground for its revocation or refusal to issue a license

23  to practice osteopathic medicine, as well as on the following

24  grounds:

25         (a)  Omission of the name of an intern, resident

26  physician, assistant resident physician, house physician, or

27  fellow in fellowship training from the list of employees

28  required by subsection (3) to be furnished to the department

29  by the hospital or teaching hospital served by the employee.

30         (b)  Practicing osteopathic medicine outside of a bona

31  fide hospital training program.

                                  12

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         (5)  It is a misdemeanor of the second degree,

 2  punishable as provided in s. 775.082 or s. 775.083 for any

 3  hospital or teaching hospital, and also for the

 4  superintendent, administrator, and other person or persons

 5  having administrative authority in such a hospital:

 6         (a)  To employ the services in such the hospital of any

 7  person listed in subsection (3), unless such person is

 8  registered with the department under the law or the holder of

 9  a license to practice osteopathic medicine under this chapter.

10         (b)  To fail to furnish to the department the list and

11  information required by subsection (3).

12         (6)  Any person desiring registration pursuant to this

13  section shall meet all the requirements of s. 459.0055.

14         (7)  The board shall promulgate rules pursuant to ss.

15  120.536(1) and 120.54 as necessary to implement this section.

16         (8)  Notwithstanding any provision of this section or

17  s. 120.52 to the contrary, any person who is registered under

18  this section is subject to the provisions of s. 459.015.

19         (9)  A person registered as a resident physician under

20  this section may in the normal course of his or her employment

21  prescribe medicinal drugs described in schedules set out in

22  chapter 893 when:

23         (a)  The person prescribes such medicinal drugs through

24  use of a Drug Enforcement Administration number issued to the

25  hospital or teaching hospital by which the person is employed

26  or at which the person's services are used;

27         (b)  The person is identified by a discrete suffix to

28  the identification number issued to such the hospital; and

29         (c)  The use of the institutional identification number

30  and individual suffixes conforms to the requirements of the

31  federal Drug Enforcement Administration.

                                  13

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         Section 49.  Paragraph (d) is added to subsection (9)

 2  of section 458.347, Florida Statutes, to read:

 3         458.347  Physician assistants.--

 4         (9)  COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on

 5  Physician Assistants is created within the department.

 6         (a)  The council shall consist of five members

 7  appointed as follows:

 8         1.  The chairperson of the Board of Medicine shall

 9  appoint three members who are physicians and members of the

10  Board of Medicine.  One of the physicians must supervise a

11  physician assistant in the physician's practice.

12         2.  The chairperson of the Board of Osteopathic

13  Medicine shall appoint one member who is a physician and a

14  member of the Board of Osteopathic Medicine.

15         3.  The secretary of the department or his or her

16  designee shall appoint a fully licensed physician assistant

17  licensed under this chapter or chapter 459.

18         (b)  Two of the members appointed to the council must

19  be physicians who supervise physician assistants in their

20  practice. Members shall be appointed to terms of 4 years,

21  except that of the initial appointments, two members shall be

22  appointed to terms of 2 years, two members shall be appointed

23  to terms of 3 years, and one member shall be appointed to a

24  term of 4 years, as established by rule of the boards.

25  Council members may not serve more than two consecutive terms.

26  The council shall annually elect a chairperson from among its

27  members.

28         (c)  The council shall:

29         1.  Recommend to the department the licensure of

30  physician assistants.

31         2.  Develop all rules regulating the use of physician

                                  14

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  assistants by physicians under this chapter and chapter 459,

 2  except for rules relating to the formulary developed under

 3  paragraph (4)(f). The council shall also develop rules to

 4  ensure that the continuity of supervision is maintained in

 5  each practice setting.  The boards shall consider adopting a

 6  proposed rule developed by the council at the regularly

 7  scheduled meeting immediately following the submission of the

 8  proposed rule by the council.  A proposed rule submitted by

 9  the council may not be adopted by either board unless both

10  boards have accepted and approved the identical language

11  contained in the proposed rule. The language of all proposed

12  rules submitted by the council must be approved by both boards

13  pursuant to each respective board's guidelines and standards

14  regarding the adoption of proposed rules. If either board

15  rejects the council's proposed rule, that board must specify

16  its objection to the council with particularity and include

17  any recommendations it may have for the modification of the

18  proposed rule.

19         3.  Make recommendations to the boards regarding all

20  matters relating to physician assistants.

21         4.  Address concerns and problems of practicing

22  physician assistants in order to improve safety in the

23  clinical practices of licensed physician assistants.

24         (d)  When the Council finds that an applicant for

25  licensure has failed to meet, to the Council's satisfaction,

26  each of the requirements for licensure set forth in this

27  section, the Council may enter an order to:

28         1.  Refuse to certify the applicant for licensure;

29         2.  Approve the applicant for licensure with

30  restrictions on the scope of practice or license; or

31         3.  Approve the applicant for conditional licensure.

                                  15

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  Such conditions may include placement of the licensee on

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

 3  as the Council may specify, including but not limited to,

 4  requiring the licensee to undergo treatment, to attend

 5  continuing education courses, to work under the direct

 6  supervision of a physician licensed in this state, or to take

 7  corrective action.

 8         Section 50.  Paragraph (d) is added to subsection (9)

 9  of section 459.022, Florida Statutes, to read:

10         459.022  Physician assistants.--

11         (9)  COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on

12  Physician Assistants is created within the department.

13         (a)  The council shall consist of five members

14  appointed as follows:

15         1.  The chairperson of the Board of Medicine shall

16  appoint three members who are physicians and members of the

17  Board of Medicine.  One of the physicians must supervise a

18  physician assistant in the physician's practice.

19         2.  The chairperson of the Board of Osteopathic

20  Medicine shall appoint one member who is a physician and a

21  member of the Board of Osteopathic Medicine.

22         3.  The secretary of the department or her or his

23  designee shall appoint a fully licensed physician assistant

24  licensed under chapter 458 or this chapter.

25         (b)  Two of the members appointed to the council must

26  be physicians who supervise physician assistants in their

27  practice. Members shall be appointed to terms of 4 years,

28  except that of the initial appointments, two members shall be

29  appointed to terms of 2 years, two members shall be appointed

30  to terms of 3 years, and one member shall be appointed to a

31  term of 4 years, as established by rule of the boards.

                                  16

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  Council members may not serve more than two consecutive terms.

 2  The council shall annually elect a chairperson from among its

 3  members.

 4         (c)  The council shall:

 5         1.  Recommend to the department the licensure of

 6  physician assistants.

 7         2.  Develop all rules regulating the use of physician

 8  assistants by physicians under chapter 458 and this chapter,

 9  except for rules relating to the formulary developed under s.

10  458.347(4)(f). The council shall also develop rules to ensure

11  that the continuity of supervision is maintained in each

12  practice setting. The boards shall consider adopting a

13  proposed rule developed by the council at the regularly

14  scheduled meeting immediately following the submission of the

15  proposed rule by the council.  A proposed rule submitted by

16  the council may not be adopted by either board unless both

17  boards have accepted and approved the identical language

18  contained in the proposed rule. The language of all proposed

19  rules submitted by the council must be approved by both boards

20  pursuant to each respective board's guidelines and standards

21  regarding the adoption of proposed rules.  If either board

22  rejects the council's proposed rule, that board must specify

23  its objection to the council with particularity and include

24  any recommendations it may have for the modification of the

25  proposed rule.

26         3.  Make recommendations to the boards regarding all

27  matters relating to physician assistants.

28         4.  Address concerns and problems of practicing

29  physician assistants in order to improve safety in the

30  clinical practices of licensed physician assistants.

31         (d)  When the Council finds that an applicant for

                                  17

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1  licensure has failed to meet, to the Council's satisfaction,

 2  each of the requirements for licensure set forth in this

 3  section, the Council may enter an order to:

 4         1.  Refuse to certify the applicant for licensure;

 5         2.  Approve the applicant for licensure with

 6  restrictions on the scope of practice or license; or

 7         3.  Approve the applicant for conditional licensure.

 8  Such conditions may include placement of the licensee on

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

10  as the Council may specify, including but not limited to,

11  requiring the licensee to undergo treatment, to attend

12  continuing education courses, to work under the direct

13  supervision of a physician licensed in this state, or to take

14  corrective action.

15

16  (Renumber subsequent sections)

17

18

19  ================ T I T L E   A M E N D M E N T ===============

20  And the title is amended as follows:

21         On page 6, line 4, after the semicolon

22

23  insert:

24         creating s. 458.3135, F.S.; providing for

25         temporary certification for visiting physicians

26         to practice in approved cancer centers;

27         providing certification requirements; providing

28         fees; providing for approval of cancer centers

29         and annual review of such approval; providing

30         practice limitations and conditions; limiting

31         the number of certificates that may be issued;

                                  18

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161




                                                   HOUSE AMENDMENT

                                     Bill No. CS/HB 1659, 1st Eng.

    Amendment No.     (for drafter's use only)





 1         providing rulemaking authority; amending s.

 2         458.3145, F.S.; adding medical schools to list

 3         of programs at which medical faculty

 4         certificateholders may practice; amending s.

 5         458.315, F.S.; waiving application and

 6         licensure fees for physicians obtaining a

 7         temporary certificate to practice in areas of

 8         critical need when such practice is limited to

 9         volunteer, uncompensated care for low-income

10         persons; amending ss. 458.345 and 459.021,

11         F.S.; providing for registration of persons

12         desiring to practice as a resident physician,

13         assistant resident physician, house physician,

14         intern, or fellow in fellowship training in a

15         statutory teaching hospital; providing

16         requirements; providing fees; providing

17         penalties; providing rulemaking authority;

18         amending s. 458.348, F.S.; requiring protocols

19         to contain specified requirements;

20

21

22

23

24

25

26

27

28

29

30

31

                                  19

    File original & 9 copies    05/02/00
    hcs0005                     12:03 pm         01659-0045-231161