Senate Bill 2628e1

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    CS for SB 2628                           First Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to rulemaking authority of the

  3         Department of Health (RAB); amending s.

  4         154.011, F.S., relating to primary care

  5         services; requiring the department to adopt

  6         certain rules developed by the State Health

  7         Officer; amending s. 154.06, F.S.; requiring

  8         the adoption of rules with respect to fees for

  9         services rendered through county health

10         departments; amending s. 381.003, F.S.,

11         relating to prevention and control of

12         communicable diseases and acquired immune

13         deficiency syndrome; authorizing rules

14         governing procedures for managing diseases;

15         amending s. 381.004, F.S., relating to testing

16         for human immunodeficiency virus; providing

17         additional rulemaking authority; amending s.

18         381.0051, F.S., relating to family planning

19         services; providing for rules administering the

20         provision of such services; amending s.

21         381.0056, F.S., relating to the school health

22         services program; authorizing the department to

23         adopt rules in cooperation with the Department

24         of Education; amending s. 381.0057, F.S.;

25         providing requirements for the services

26         provided by school health programs; amending s.

27         381.006, F.S., relating to public health;

28         providing additional rulemaking authority;

29         amending s. 381.0062, F.S., relating to the

30         regulation of water systems; providing

31         additional requirements for obtaining an


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    CS for SB 2628                           First Engrossed (ntc)



  1         exemption from the department; amending s.

  2         381.0065, F.S.; redefining the term "onsite

  3         sewage treatment and disposal system";

  4         providing additional rulemaking authority;

  5         revising requirements for sewage treatment and

  6         disposal systems; amending s. 381.0072, F.S.;

  7         requiring the department to adopt additional

  8         rules with respect to food service protection;

  9         amending s. 381.0086, F.S.; requiring the

10         department to adopt additional rules with

11         respect to the health and safety of migrant

12         farm workers; amending s. 381.0098, F.S.;

13         prohibiting the transfer of a permit for a

14         biomedical waste facility or a biomedical waste

15         transporter; providing requirements for a

16         permit application; amending s. 381.0101, F.S.,

17         relating to environmental health professionals;

18         providing additional rulemaking authority with

19         respect to standards for certification;

20         amending s. 381.0203, F.S.; authorizing the

21         department to adopt rules governing pharmacy

22         services; amending s. 381.89, F.S.; authorizing

23         the department to issue a stop-use order

24         against a tanning facility; amending s.

25         383.011, F.S., relating to maternal and child

26         health programs; providing additional

27         rulemaking authority; amending s. 383.14, F.S.;

28         providing for rules governing screening for

29         metabolic disorders, hereditary disorders, and

30         environmental risk factors; amending s. 383.19,

31         F.S.; providing for rules governing perinatal


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    CS for SB 2628                           First Engrossed (ntc)



  1         intensive care centers; amending s. 383.216,

  2         F.S.; revising requirements for prenatal and

  3         infant health care coalitions; providing

  4         additional rulemaking authority; amending s.

  5         384.33, F.S.; authorizing rules governing

  6         screenings and investigations to control the

  7         spread of sexually transmitted diseases;

  8         amending s. 385.207, F.S., relating to care and

  9         assistance of persons with epilepsy; providing

10         additional rulemaking authority; amending s.

11         391.026, F.S., relating to the Children's

12         Medical Services Act; requiring the department

13         to adopt rules to administer the act; amending

14         s. 392.66, F.S.; requiring the department to

15         adopt rules to administer the Tuberculosis

16         Control Act; amending ss. 395.401, 395.402,

17         F.S.; requiring the department to adopt rules

18         governing the procedures for establishing a

19         trauma agency and for performance evaluations;

20         requiring the department to establish the

21         number of trauma centers within each service

22         area; amending s. 401.35, F.S.; requiring the

23         department to adopt rules governing medical

24         transportation services; amending s. 403.862,

25         F.S.; authorizing the department to adopt rules

26         governing water systems; amending s. 404.056,

27         F.S., relating to environmental radiation

28         standards and programs; providing additional

29         rulemaking authority; amending s. 404.22, F.S.;

30         authorizing the department to adopt rules

31         governing the operation of radiation machines


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    CS for SB 2628                           First Engrossed (ntc)



  1         and components; amending s. 489.553, F.S.,

  2         relating to septic tank contracting; providing

  3         additional rulemaking authority; amending ss.

  4         491.006, 491.0145, F.S., relating to clinical,

  5         counseling, and psychotherapy services;

  6         providing for nonrefundable application fees;

  7         amending s. 499.003, F.S.; defining the terms

  8         "distribute or distribution" for purposes of

  9         ch. 499, F.S., relating to the Florida Drug and

10         Cosmetic Act; amending s. 499.005, F.S.;

11         prohibiting charging certain fees or dispensing

12         certain drugs; amending s. 499.0054, F.S.;

13         prohibiting certain labels or advertisements;

14         amending s. 499.01, F.S.; providing additional

15         requirements for closing an establishment

16         permitted under the Florida Drug and Cosmetic

17         Act; amending s. 499.0121, F.S.; providing

18         additional requirements for a vehicle that

19         contains prescription drugs; amending s.

20         499.0122, F.S., relating to medical oxygen and

21         veterinary legend drugs; providing additional

22         rulemaking authority; amending s. 499.013,

23         F.S., relating to manufacturers of drugs,

24         devices, and cosmetics; exempting manufacturers

25         of a device for a specific patient from certain

26         requirements; requiring that manufacturers

27         maintain certain records; amending ss. 499.015,

28         499.024, 499.03, F.S.; providing certain

29         limitations on the registration of products or

30         drugs; conforming cross-references to changes

31         made by the act; amending s. 499.05, F.S.;


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    CS for SB 2628                           First Engrossed (ntc)



  1         requiring the department to adopt additional

  2         rules to administer the Florida Drug and

  3         Cosmetic Act; amending s. 499.701, F.S.,

  4         relating to the regulation of ether; providing

  5         additional rulemaking authority; amending s.

  6         501.122, F.S.; requiring the department to

  7         adopt rules governing radiation surveys;

  8         amending s. 513.05, F.S., relating to mobile

  9         home and recreational vehicle parks; providing

10         additional rulemaking authority; amending s.

11         514.021, F.S.; authorizing the department to

12         adopt rules governing public swimming and

13         bathing facilities; amending s. 766.1115, F.S.,

14         relating to the Access to Health Care Act;

15         providing for rules governing services and

16         procedures; providing an effective date.

17

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

19

20         Section 1.  Subsection (5) of section 154.011, Florida

21  Statutes, is amended to read:

22         154.011  Primary care services.--

23         (5)  The department shall adopt rules to govern the

24  operation of primary care programs authorized by this section.

25  Such rules may shall include, but need not be limited to,

26  requirements for income eligibility, income verification,

27  continuity of care, client services, client enrollment and

28  disenrollment, eligibility, intake, recordkeeping, coverage,

29  quality control, quality of care, case management, and

30  Medicaid participation and shall be developed by the State

31  Health Officer. Rules governing services to clients under 21


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    CS for SB 2628                           First Engrossed (ntc)



  1  years of age shall be developed in conjunction with children's

  2  medical services and shall at a minimum include preventive

  3  services as set forth in s. 627.6579.

  4         Section 2.  Subsection (1) of section 154.06, Florida

  5  Statutes, is amended to read:

  6         154.06  Fees and services rendered; authority.--

  7         (1)  The Department of Health may is authorized to

  8  establish by rule fee schedules for public health services

  9  rendered through the county health departments. Such rules may

10  include provisions for fee assessments, copayments, sliding

11  fee scales, fee waivers, and fee exemptions. In addition, the

12  department shall adopt by rule a uniform statewide fee

13  schedule for all regulatory activities performed through the

14  environmental health program. Each county may establish, and

15  each county health department may collect, fees for primary

16  care services, provided that a schedule of such fees is

17  established by resolution of the board of county commissioners

18  or by rule of the department, respectively. Fees for primary

19  care services and communicable disease control services may

20  not be less than Medicaid reimbursement rates unless otherwise

21  required by federal or state law or regulation.

22         Section 3.  Subsection (2) of section 381.003, Florida

23  Statutes, is amended to read:

24         381.003  Communicable disease and acquired immune

25  deficiency syndrome prevention and control.--

26         (2)  The department may adopt, repeal, and amend rules

27  related to the prevention and control of communicable

28  diseases, including procedures for investigating disease,

29  timeframes for reporting disease, definitions, procedures for

30  managing specific diseases, requirements for followup reports

31  of known or suspected exposure to disease, and procedures for


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    CS for SB 2628                           First Engrossed (ntc)



  1  providing access to confidential information necessary for

  2  disease investigations.

  3         Section 4.  Subsection (10) of section 381.004, Florida

  4  Statutes, is amended to read:

  5         381.004  Testing for human immunodeficiency virus.--

  6         (10)  RULES.--The Department of Health may adopt such

  7  rules as are necessary to implement this section, including

  8  definitions of terms, procedures for accessing confidential

  9  information, requirements for testing, and requirements for

10  registered testing sites.

11         Section 5.  Subsection (7) of section 381.0051, Florida

12  Statutes, is amended to read:

13         381.0051  Family planning.--

14         (7)  RULES.--The Department of Health may adopt rules

15  to implement this section, including rules regarding

16  definitions of terms and requirements for eligibility,

17  informed-consent services, revisits, temporary contraceptive

18  methods, voluntary sterilization, and infertility services.

19         Section 6.  Subsection (8) of section 381.0056, Florida

20  Statutes, is amended to read:

21         381.0056  School health services program.--

22         (8)  The Department of Health, in cooperation with the

23  Department of Education, may adopt rules necessary to

24  implement this section. The rules may include standards and

25  requirements for developing school health services plans,

26  conducting school health screening, meeting emergency health

27  needs, maintaining school health records, and coordinating

28  with education programs for exceptional students.

29         Section 7.  Subsection (7) is added to section

30  381.0057, Florida Statutes, to read:

31         381.0057  Funding for school health services.--


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    CS for SB 2628                           First Engrossed (ntc)



  1         (7)  The services provided by a comprehensive school

  2  health program must focus attention on promoting the health of

  3  students, reducing risk-taking behavior, and reducing teen

  4  pregnancy. Services provided under this section are in

  5  addition to the services provided under s. 381.0056 and are

  6  intended to supplement, rather than supplant, those services.

  7         Section 8.  Subsection (16) of section 381.006, Florida

  8  Statutes, is amended to read:

  9         381.006  Environmental health.--The department shall

10  conduct an environmental health program as part of fulfilling

11  the state's public health mission. The purpose of this program

12  is to detect and prevent disease caused by natural and manmade

13  factors in the environment.  The environmental health program

14  shall include, but not be limited to:

15         (16)  A group-care-facilities function, where a

16  group-care facility means any public or private school,

17  housing, building or buildings, section of a building, or

18  distinct part of a building or other place, whether operated

19  for profit or not, which undertakes, through its ownership or

20  management, to provide one or more personal services, care,

21  protection, and supervision to persons who require such

22  services and who are not related to the owner or

23  administrator. The department may adopt rules necessary to

24  protect the health and safety of residents, staff, and patrons

25  of group-care facilities, such as child care facilities,

26  family day-care homes, assisted-living facilities, adult

27  day-care centers, adult family-care homes, hospices,

28  residential treatment facilities, crisis-stabilization units,

29  pediatric extended-care centers, intermediate-care facilities

30  for the developmentally disabled, group-care homes, and,

31  jointly with the Department of Education, private and public


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    CS for SB 2628                           First Engrossed (ntc)



  1  schools. These rules may include definitions of terms;

  2  provisions relating to operation and maintenance of

  3  facilities, buildings, grounds, equipment, furnishings, and

  4  occupant-space requirements; lighting; heating, cooling, and

  5  ventilation; food service; water supply and, plumbing; sewage;

  6  sanitary facilities; insect and rodent control; garbage;

  7  safety; personnel health, hygiene, and work practices; and

  8  other matters the department finds are appropriate or

  9  necessary to protect the safety and health of the residents,

10  staff, or patrons. The department may not adopt rules that

11  conflict with rules adopted by the licensing or certifying

12  agency. The department may enter and inspect at reasonable

13  hours to determine compliance with applicable statutes or

14  rules. In addition to any sanctions that the department may

15  impose for violations of rules adopted under this section, the

16  department shall also report such violations to any agency

17  responsible for licensing or certifying the group-care

18  facility. The licensing or certifying agency may also impose

19  any sanction based solely on the findings of the department.

20

21  The department may adopt rules to carry out the provisions of

22  this section.

23         Section 9.  Subsection (6) of section 381.0062, Florida

24  Statutes, is amended to read:

25         381.0062  Supervision; private and certain public water

26  systems.--

27         (6)  VARIANCES AND EXEMPTIONS.--

28         (a)  The department may grant variances and exemptions

29  from the rules adopted promulgated under the provisions of

30  this section through procedures set forth by the rule of the

31  department.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (b)  Any establishment with a limited use commercial

  2  public water system which does not make tap water available

  3  for public consumption and meets the water quality standards

  4  and installation requirements established by the department

  5  shall be exempt from obtaining an annual operating permit from

  6  the department, if the supplier of water:

  7         1.  Registers with the department; if the establishment

  8  changes ownership or business activity, it must register; and

  9  pay a $15 registration fee; and

10         2.  Performs an initial water quality clearance of the

11  water supply system.

12

13  A system exempt under this subsection may, in order to retain

14  potable water status, conduct annual testing for bacteria in

15  the form of one satisfactory microbiological sample per

16  calendar year.

17         Section 10.  Subsections (2), (3), and (4) of section

18  381.0065, Florida Statutes, are amended to read:

19         381.0065  Onsite sewage treatment and disposal systems;

20  regulation.--

21         (2)  DEFINITIONS.--As used in ss. 381.0065-381.0067,

22  the term:

23         (a)  "Available," as applied to a publicly owned or

24  investor-owned sewerage system, means that the publicly owned

25  or investor-owned sewerage system is capable of being

26  connected to the plumbing of an establishment or residence, is

27  not under a Department of Environmental Protection moratorium,

28  and has adequate permitted capacity to accept the sewage to be

29  generated by the establishment or residence; and:

30         1.  For a residential subdivision lot, a single-family

31  residence, or an establishment, any of which has an estimated


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    CS for SB 2628                           First Engrossed (ntc)



  1  sewage flow of 1,000 gallons per day or less, a gravity sewer

  2  line to maintain gravity flow from the property's drain to the

  3  sewer line, or a low pressure or vacuum sewage collection line

  4  in those areas approved for low pressure or vacuum sewage

  5  collection, exists in a public easement or right-of-way that

  6  abuts the property line of the lot, residence, or

  7  establishment.

  8         2.  For an establishment with an estimated sewage flow

  9  exceeding 1,000 gallons per day, a sewer line, force main, or

10  lift station exists in a public easement or right-of-way that

11  abuts the property of the establishment or is within 50 feet

12  of the property line of the establishment as accessed via

13  existing rights-of-way or easements.

14         3.  For proposed residential subdivisions with more

15  than 50 lots, for proposed commercial subdivisions with more

16  than 5 lots, and for areas zoned or used for an industrial or

17  manufacturing purpose or its equivalent, a sewerage system

18  exists within one-fourth mile of the development as measured

19  and accessed via existing easements or rights-of-way.

20         4.  For repairs or modifications within areas zoned or

21  used for an industrial or manufacturing purpose or its

22  equivalent, a sewerage system exists within 500 feet of an

23  establishment's or residence's sewer stub-out as measured and

24  accessed via existing rights-of-way or easements.

25         (b)  "Blackwater" means that part of domestic sewage

26  carried off by toilets, urinals, and kitchen drains.

27         (c)  "Domestic sewage" means human body waste and

28  wastewater, including bath and toilet waste, residential

29  laundry waste, residential kitchen waste, and other similar

30  waste from appurtenances at a residence or establishment.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (d)  "Graywater" means that part of domestic sewage

  2  that is not blackwater, including waste from the bath,

  3  lavatory, laundry, and sink, except kitchen sink waste.

  4         (e)  "Florida Keys" means those islands of the state

  5  located within the boundaries of Monroe County.

  6         (f)  "Injection well" means an open vertical hole at

  7  least 90 feet in depth, cased and grouted to at least 60 feet

  8  in depth which is used to dispose of effluent from an onsite

  9  sewage treatment and disposal system.

10         (g)  "Innovative system" means an onsite sewage

11  treatment and disposal system that, in whole or in part,

12  employs materials, devices, or techniques that are novel or

13  unique and that have not been successfully field-tested under

14  sound scientific and engineering principles under climatic and

15  soil conditions found in this state.

16         (h)  "Lot" means a parcel or tract of land described by

17  reference to recorded plats or by metes and bounds, or the

18  least fractional part of subdivided lands having limited fixed

19  boundaries or an assigned number, letter, or any other legal

20  description by which it can be identified.

21         (i)  "Mean annual flood line" means the elevation

22  determined by calculating the arithmetic mean of the

23  elevations of the highest yearly flood stage or discharge for

24  the period of record, to include at least the most recent

25  10-year period. If at least 10 years of data is not available,

26  the mean annual flood line shall be as determined based upon

27  the data available and field verification conducted by a

28  certified professional surveyor and mapper with experience in

29  the determination of flood water elevation lines or, at the

30  option of the applicant, by department personnel. Field

31  verification of the mean annual flood line shall be performed


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    CS for SB 2628                           First Engrossed (ntc)



  1  using a combination of those indicators listed in

  2  subparagraphs 1. through 7. that are present on the site, and

  3  that reflect flooding that recurs on an annual basis. In those

  4  situations where any one or more of these indicators reflect a

  5  rare or aberrant event, such indicator or indicators shall not

  6  be utilized in determining the mean annual flood line. The

  7  indicators that may be considered are:

  8         1.  Water stains on the ground surface, trees, and

  9  other fixed objects;

10         2.  Hydric adventitious roots;

11         3.  Drift lines;

12         4.  Rafted debris;

13         5.  Aquatic mosses and liverworts;

14         6.  Moss collars; and

15         7.  Lichen lines.

16         (j)  "Onsite sewage treatment and disposal system"

17  means a system that contains a standard subsurface, filled, or

18  mound drainfield system; an aerobic treatment unit; a

19  graywater system tank; a laundry wastewater system tank; a

20  septic tank; a grease interceptor; a pump dosing tank; a

21  solids or effluent pump; a waterless, incinerating, or organic

22  waste-composting toilet; or a sanitary pit privy that is

23  installed or proposed to be installed beyond the building

24  sewer on land of the owner or on other land to which the owner

25  has the legal right to install a system. The term includes any

26  item placed within, or intended to be used as a part of or in

27  conjunction with, the system. This term does not include

28  package sewage treatment facilities and other treatment works

29  regulated under chapter 403.

30         (k)  "Permanent nontidal surface water body" means a

31  perennial stream, a perennial river, an intermittent stream, a


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    CS for SB 2628                           First Engrossed (ntc)



  1  perennial lake, a submerged marsh or swamp, a submerged wooded

  2  marsh or swamp, a spring, or a seep, as identified on the most

  3  recent quadrangle map, 7.5 minute series (topographic),

  4  produced by the United States Geological Survey. "Permanent

  5  nontidal surface water body" shall also mean an artificial

  6  surface water body that does not have an impermeable bottom

  7  and side and that is designed to hold, or does hold, visible

  8  standing water for at least 180 days of the year. However, a

  9  nontidal surface water body that is drained, either naturally

10  or artificially, where the intent or the result is that such

11  drainage be temporary, shall be considered a permanent

12  nontidal surface water body. A nontidal surface water body

13  that is drained of all visible surface water, where the lawful

14  intent or the result of such drainage is that such drainage

15  will be permanent, shall not be considered a permanent

16  nontidal surface water body. The boundary of a permanent

17  nontidal surface water body shall be the mean annual flood

18  line.

19         (l)  "Potable water line" means any water line that is

20  connected to a potable water supply source, but the term does

21  not include an irrigation line with any of the following types

22  of backflow devices:

23         1.  For irrigation systems into which chemicals are not

24  injected, any atmospheric or pressure vacuum breaker or double

25  check valve or any detector check assembly.

26         2.  For irrigation systems into which chemicals such as

27  fertilizers, pesticides, or herbicides are injected, any

28  reduced pressure backflow preventer.

29         (m)  "Septage" means a mixture of sludge, fatty

30  materials, human feces, and wastewater removed during the

31  pumping of an onsite sewage treatment and disposal system.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (n)  "Subdivision" means, for residential use, any

  2  tract or plot of land divided into two or more lots or parcels

  3  of which at least one is 1 acre or less in size for sale,

  4  lease, or rent.  A subdivision for commercial or industrial

  5  use is any tract or plot of land divided into two or more lots

  6  or parcels of which at least one is 5 acres or less in size

  7  and which is for sale, lease, or rent. A subdivision shall be

  8  deemed to be proposed until such time as an application is

  9  submitted to the local government for subdivision approval or,

10  in those areas where no local government subdivision approval

11  is required, until such time as a plat of the subdivision is

12  recorded.

13         (o)  "Tidally influenced surface water body" means a

14  body of water that is subject to the ebb and flow of the tides

15  and has as its boundary a mean high-water line as defined by

16  s. 177.27(15).

17         (p)  "Toxic or hazardous chemical" means a substance

18  that poses a serious danger to human health or the

19  environment.

20         (3)  DUTIES AND POWERS OF THE DEPARTMENT OF

21  HEALTH.--The department shall:

22         (a)  Adopt rules to administer ss. 381.0065-381.0067,

23  including definitions that are consistent with the definitions

24  in this section, decreases to setback requirements where no

25  health hazard exists, increases for the lot-flow allowance for

26  performance-based systems, requirements for separation from

27  water table elevation during the wettest season, requirements

28  for the design and construction of any component part of an

29  onsite sewage treatment and disposal system, application and

30  permit requirements for persons who maintain an onsite sewage

31  treatment and disposal system, requirements for maintenance


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    CS for SB 2628                           First Engrossed (ntc)



  1  and service agreements for aerobic treatment units and

  2  performance-based treatment systems, and recommended

  3  standards, including disclosure requirements, for voluntary

  4  system inspections to be performed by individuals who are

  5  authorized by law to perform such inspections and who shall

  6  inform a person having ownership, control, or use of an onsite

  7  sewage treatment and disposal system of the inspection

  8  standards and of that person's authority to request an

  9  inspection based on all or part of the standards.

10         (b)  Perform application reviews and site evaluations,

11  issue permits, and conduct inspections and complaint

12  investigations associated with the construction, installation,

13  maintenance, modification, abandonment, operation, use, or

14  repair of an onsite sewage treatment and disposal system for a

15  residence or establishment with an estimated domestic sewage

16  flow of 10,000 gallons or less per day, or an estimated

17  commercial sewage flow of 5,000 gallons or less per day, which

18  is not currently regulated under chapter 403.

19         (c)  Develop a comprehensive program to ensure that

20  onsite sewage treatment and disposal systems regulated by the

21  department are sized, designed, constructed, installed,

22  repaired, modified, abandoned, used, operated, and maintained

23  in compliance with this section and rules adopted under this

24  section to prevent groundwater contamination and surface water

25  contamination and to preserve the public health.  The

26  department is the final administrative interpretive authority

27  regarding rule interpretation.  In the event of a conflict

28  regarding rule interpretation, the Division Director for

29  Environmental Health of the department, or his or her

30  designee, shall timely assign a staff person to resolve the

31  dispute.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (d)  Grant variances in hardship cases under the

  2  conditions prescribed in this section and rules adopted under

  3  this section.

  4         (e)  Permit the use of a limited number of innovative

  5  systems for a specific period of time, when there is

  6  compelling evidence that the system will function properly and

  7  reliably to meet the requirements of this section and rules

  8  adopted under this section.

  9         (f)  Issue annual operating permits under this section.

10         (g)  Establish and collect fees as established under s.

11  381.0066 for services provided with respect to onsite sewage

12  treatment and disposal systems.

13         (h)  Conduct enforcement activities, including imposing

14  fines, issuing citations, suspensions, revocations,

15  injunctions, and emergency orders for violations of this

16  section, part I of chapter 386, or part III of chapter 489 or

17  for a violation of any rule adopted under this section, part I

18  of chapter 386, or part III of chapter 489.

19         (i)  Provide or conduct education and training of

20  department personnel, service providers, and the public

21  regarding onsite sewage treatment and disposal systems.

22         (j)  Supervise research on, demonstration of, and

23  training on the performance, environmental impact, and public

24  health impact of onsite sewage treatment and disposal systems

25  within this state.  Research fees collected under s.

26  381.0066(2)(k) must be used to develop and fund hands-on

27  training centers designed to provide practical information

28  about onsite sewage treatment and disposal systems to septic

29  tank contractors, master septic tank contractors, contractors,

30  inspectors, engineers, and the public and must also be used to

31  fund research projects which focus on improvements of onsite


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    CS for SB 2628                           First Engrossed (ntc)



  1  sewage treatment and disposal systems, including use of

  2  performance-based standards and reduction of environmental

  3  impact.  Research projects shall be initially approved by the

  4  technical advisory panel and shall be applicable to and

  5  reflect the soil conditions specific to Florida.  Such

  6  projects shall be awarded through competitive negotiation,

  7  using the procedures provided in s. 287.055, to public or

  8  private entities that have experience in onsite sewage

  9  treatment and disposal systems in Florida and that are

10  principally located in Florida.  Research projects shall not

11  be awarded to firms or entities that employ or are associated

12  with persons who serve on either the technical advisory panel

13  or the research review and advisory committee.

14         (k)  Approve the installation of individual graywater

15  disposal systems in which blackwater is treated by a central

16  sewerage system.

17         (l)  Regulate and permit the sanitation, handling,

18  treatment, storage, reuse, and disposal of byproducts from any

19  system regulated under this chapter and septage-stabilization

20  and disposal facilities not regulated by the Department of

21  Environmental Protection.

22         (m)  Permit and inspect portable or temporary toilet

23  services and holding tanks. The department shall review

24  applications, perform site evaluations, and issue permits for

25  the temporary use of holding tanks, privies, portable toilet

26  services, or any other toilet facility that is intended for

27  use on a permanent or nonpermanent basis, including facilities

28  placed on construction sites when workers are present. The

29  department may specify standards for the construction,

30  maintenance, use, and operation of any such facility for

31  temporary use.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (4)  PERMITS; INSTALLATION; AND CONDITIONS.--A person

  2  may not construct, repair, modify, abandon, or operate an

  3  onsite sewage treatment and disposal system without first

  4  obtaining a permit approved by the department. The department

  5  may issue permits to carry out this section, but shall not

  6  make the issuance of such permits contingent upon prior

  7  approval by the Department of Environmental Protection. A

  8  construction permit is valid for 18 months from the issuance

  9  date and may be extended by the department for one 90-day

10  period under rules adopted by the department.  A repair permit

11  is valid for 90 days from the date of issuance. An operating

12  permit must be obtained prior to the use of any aerobic

13  treatment unit or if the establishment generates commercial

14  waste. Buildings or establishments that use an aerobic

15  treatment unit or generate commercial waste shall be inspected

16  by the department at least annually to assure compliance with

17  the terms of the operating permit. The operating permit is

18  valid for 1 year from the date of issuance and must be renewed

19  annually.  If all information pertaining to the siting,

20  location, and installation conditions or repair of an onsite

21  sewage treatment and disposal system remains the same, a

22  construction or repair permit for the onsite sewage treatment

23  and disposal system may be transferred to another person, if

24  the transferee files, within 60 days after the transfer of

25  ownership, an amended application providing all corrected

26  information and proof of ownership of the property.  There is

27  no fee associated with the processing of this supplemental

28  information.  A person may not contract to construct, modify,

29  alter, repair, service, abandon, or maintain any portion of an

30  onsite sewage treatment and disposal system without being

31  registered under part III of chapter 489.  A property owner


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    CS for SB 2628                           First Engrossed (ntc)



  1  who personally performs construction, maintenance, or repairs

  2  to a system serving his or her own owner-occupied

  3  single-family residence is exempt from registration

  4  requirements for performing such construction, maintenance, or

  5  repairs on that residence, but is subject to all permitting

  6  requirements. A municipality or political subdivision of the

  7  state may not issue a building or plumbing permit for any

  8  building that requires the use of an onsite sewage treatment

  9  and disposal system unless the owner or builder has received a

10  construction permit for such system from the department. A

11  building or structure may not be occupied and a municipality,

12  political subdivision, or any state or federal agency may not

13  authorize occupancy until the department approves the final

14  installation of the onsite sewage treatment and disposal

15  system. A municipality or political subdivision of the state

16  may not approve any change in occupancy or tenancy of a

17  building that uses an onsite sewage treatment and disposal

18  system until the department has reviewed the use of the system

19  with the proposed change, approved the change, and amended the

20  operating permit.

21         (a)  Subdivisions and lots in which each lot has a

22  minimum area of at least one-half acre and either a minimum

23  dimension of 100 feet or a mean of at least 100 feet of the

24  side bordering the street and the distance formed by a line

25  parallel to the side bordering the street drawn between the

26  two most distant points of the remainder of the lot may be

27  developed with a water system regulated under s. 381.0062 and

28  onsite sewage treatment and disposal systems, provided the

29  projected daily domestic sewage flow does not exceed an

30  average of 1,500 gallons per acre per day, and provided

31  satisfactory drinking water can be obtained and all distance


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    CS for SB 2628                           First Engrossed (ntc)



  1  and setback, soil condition, water table elevation, and other

  2  related requirements of this section and rules adopted under

  3  this section can be met.

  4         (b)  Subdivisions and lots using a public water system

  5  as defined in s. 403.852 may use onsite sewage treatment and

  6  disposal systems, provided there are no more than four lots

  7  per acre, provided the projected daily domestic sewage flow

  8  does not exceed an average of 2,500 gallons per acre per day,

  9  and provided that all distance and setback, soil condition,

10  water table elevation, and other related requirements that are

11  generally applicable to the use of onsite sewage treatment and

12  disposal systems are met.

13         (c)  Notwithstanding the provisions of paragraphs (a)

14  and (b), for subdivisions platted of record on or before

15  October 1, 1991, when a developer or other appropriate entity

16  has previously made or makes provisions, including financial

17  assurances or other commitments, acceptable to the Department

18  of Health, that a central water system will be installed by a

19  regulated public utility based on a density formula, private

20  potable wells may be used with onsite sewage treatment and

21  disposal systems until the agreed-upon densities are reached.

22  The department may consider assurances filed with the

23  Department of Business and Professional Regulation under

24  chapter 498 in determining the adequacy of the financial

25  assurance required by this paragraph.  In a subdivision

26  regulated by this paragraph, the average daily domestic sewage

27  flow may not exceed 2,500 gallons per acre per day.  This

28  section does not affect the validity of existing prior

29  agreements. After October 1, 1991, the exception provided

30  under this paragraph is not available to a developer or other

31  appropriate entity.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (d)  Paragraphs (a) and (b) do not apply to any

  2  proposed residential subdivision with more than 50 lots or to

  3  any proposed commercial subdivision with more than 5 lots

  4  where a publicly owned or investor-owned sewerage system is

  5  available.  It is the intent of this paragraph not to allow

  6  development of additional proposed subdivisions in order to

  7  evade the requirements of this paragraph.  The department

  8  shall report to the Legislature by February 1 of each

  9  odd-numbered year concerning the success in meeting this

10  intent.

11         (e)  Onsite sewage treatment and disposal systems must

12  not be placed closer than:

13         1.  Seventy-five feet from a private potable well.

14         2.  Two hundred feet from a public potable well serving

15  a residential or nonresidential establishment having a total

16  sewage flow of greater than 2,000 gallons per day.

17         3.  One hundred feet from a public potable well serving

18  a residential or nonresidential establishment having a total

19  sewage flow of less than or equal to 2,000 gallons per day.

20         4.  Fifty feet from any nonpotable well.

21         5.  Ten feet from any storm sewer pipe, to the maximum

22  extent possible, but in no instance shall the setback be less

23  than 5 feet.

24         6.  Seventy-five feet from the mean high-water line of

25  a tidally influenced surface water body;

26         7.  Seventy-five feet from the normal annual flood line

27  of a permanent nontidal surface water body;

28         8.  Fifteen feet from the design high-water line of

29  retention areas, detention areas, or swales designed to

30  contain standing or flowing water for less than 72 hours after

31  a rainfall or the design high-water level of normally dry


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    CS for SB 2628                           First Engrossed (ntc)



  1  drainage ditches or normally dry individual lot stormwater

  2  retention areas.

  3         (f)  Except as provided under paragraphs (e) and (t),

  4  no limitations shall be imposed by rule, relating to the

  5  distance between an onsite disposal system and any area that

  6  either permanently or temporarily has visible surface water.

  7         (g)  All provisions of this section and rules adopted

  8  under this section relating to soil condition, water table

  9  elevation, distance, and other setback requirements must be

10  equally applied to all lots, with the following exceptions:

11         1.  Any residential lot that was platted and recorded

12  on or after January 1, 1972, or that is part of a residential

13  subdivision that was approved by the appropriate permitting

14  agency on or after January 1, 1972, and that was eligible for

15  an onsite sewage treatment and disposal system construction

16  permit on the date of such platting and recording or approval

17  shall be eligible for an onsite sewage treatment and disposal

18  system construction permit, regardless of when the application

19  for a permit is made. If rules in effect at the time the

20  permit application is filed cannot be met, residential lots

21  platted and recorded or approved on or after January 1, 1972,

22  shall, to the maximum extent possible, comply with the rules

23  in effect at the time the permit application is filed.  At a

24  minimum, however, those residential lots platted and recorded

25  or approved on or after January 1, 1972, but before January 1,

26  1983, shall comply with those rules in effect on January 1,

27  1983, and those residential lots platted and recorded or

28  approved on or after January 1, 1983, shall comply with those

29  rules in effect at the time of such platting and recording or

30  approval.  In determining the maximum extent of compliance

31  with current rules that is possible, the department shall


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    CS for SB 2628                           First Engrossed (ntc)



  1  allow structures and appurtenances thereto which were

  2  authorized at the time such lots were platted and recorded or

  3  approved.

  4         2.  Lots platted before 1972 are subject to a 50-foot

  5  minimum surface water setback and are not subject to lot size

  6  requirements.  The projected daily flow for domestic onsite

  7  sewage treatment and disposal systems for lots platted before

  8  1972 may not exceed:

  9         a.  Two thousand five hundred gallons per acre per day

10  for lots served by public water systems as defined in s.

11  403.852.

12         b.  One thousand five hundred gallons per acre per day

13  for lots served by water systems regulated under s. 381.0062.

14         (h)1.  The department may grant variances in hardship

15  cases which may be less restrictive than the provisions

16  specified in this section.  If a variance is granted and the

17  onsite sewage treatment and disposal system construction

18  permit has been issued, the variance may be transferred with

19  the system construction permit, if the transferee files,

20  within 60 days after the transfer of ownership, an amended

21  construction permit application providing all corrected

22  information and proof of ownership of the property and if the

23  same variance would have been required for the new owner of

24  the property as was originally granted to the original

25  applicant for the variance.  There is no fee associated with

26  the processing of this supplemental information.  A variance

27  may not be granted under this section until the department is

28  satisfied that:

29         a.  The hardship was not caused intentionally by the

30  action of the applicant;

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         b.  No reasonable alternative, taking into

  2  consideration factors such as cost, exists for the treatment

  3  of the sewage; and

  4         c.  The discharge from the onsite sewage treatment and

  5  disposal system will not adversely affect the health of the

  6  applicant or the public or significantly degrade the

  7  groundwater or surface waters.

  8

  9  Where soil conditions, water table elevation, and setback

10  provisions are determined by the department to be

11  satisfactory, special consideration must be given to those

12  lots platted before 1972.

13         2.  The department shall appoint and staff a variance

14  review and advisory committee, which shall meet monthly to

15  recommend agency action on variance requests. The committee

16  shall make its recommendations on variance requests at the

17  meeting in which the application is scheduled for

18  consideration, except for an extraordinary change in

19  circumstances, the receipt of new information that raises new

20  issues, or when the applicant requests an extension. The

21  committee shall consider the criteria in subparagraph 1. in

22  its recommended agency action on variance requests and shall

23  also strive to allow property owners the full use of their

24  land where possible. The committee consists of the following:

25         a.  The Division Director for Environmental Health of

26  the department or his or her designee.

27         b.  A representative from the county health

28  departments.

29         c.  A representative from the home building industry

30  recommended by the Florida Home Builders Association.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         d.  A representative from the septic tank industry

  2  recommended by the Florida Septic Tank Association.

  3         e.  A representative from the Department of

  4  Environmental Protection.

  5         f.  A representative from the real estate industry who

  6  is also a developer in this state who develops lots using

  7  onsite sewage treatment and disposal systems, recommended by

  8  the Florida Association of Realtors.

  9         g.  A representative from the engineering profession

10  recommended by the Florida Engineering Society.

11

12  Members shall be appointed for a term of 3 years, with such

13  appointments being staggered so that the terms of no more than

14  two members expire in any one year.  Members shall serve

15  without remuneration, but if requested, shall be reimbursed

16  for per diem and travel expenses as provided in s. 112.061.

17         (i)  A construction permit may not be issued for an

18  onsite sewage treatment and disposal system in any area zoned

19  or used for industrial or manufacturing purposes, or its

20  equivalent, where a publicly owned or investor-owned sewage

21  treatment system is available, or where a likelihood exists

22  that the system will receive toxic, hazardous, or industrial

23  waste.  An existing onsite sewage treatment and disposal

24  system may be repaired if a publicly owned or investor-owned

25  sewerage system is not available within 500 feet of the

26  building sewer stub-out and if system construction and

27  operation standards can be met.  This paragraph does not

28  require publicly owned or investor-owned sewerage treatment

29  systems to accept anything other than domestic wastewater.

30         1.  A building located in an area zoned or used for

31  industrial or manufacturing purposes, or its equivalent, when


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    CS for SB 2628                           First Engrossed (ntc)



  1  such building is served by an onsite sewage treatment and

  2  disposal system, must not be occupied until the owner or

  3  tenant has obtained written approval from the department.  The

  4  department shall not grant approval when the proposed use of

  5  the system is to dispose of toxic, hazardous, or industrial

  6  wastewater or toxic or hazardous chemicals.

  7         2.  Each person who owns or operates a business or

  8  facility in an area zoned or used for industrial or

  9  manufacturing purposes, or its equivalent, or who owns or

10  operates a business that has the potential to generate toxic,

11  hazardous, or industrial wastewater or toxic or hazardous

12  chemicals, and uses an onsite sewage treatment and disposal

13  system that is installed on or after July 5, 1989, must obtain

14  an annual system operating permit from the department.  A

15  person who owns or operates a business that uses an onsite

16  sewage treatment and disposal system that was installed and

17  approved before July 5, 1989, need not obtain a system

18  operating permit. However, upon change of ownership or

19  tenancy, the new owner or operator must notify the department

20  of the change, and the new owner or operator must obtain an

21  annual system operating permit, regardless of the date that

22  the system was installed or approved.

23         3.  The department shall periodically review and

24  evaluate the continued use of onsite sewage treatment and

25  disposal systems in areas zoned or used for industrial or

26  manufacturing purposes, or its equivalent, and may require the

27  collection and analyses of samples from within and around such

28  systems.  If the department finds that toxic or hazardous

29  chemicals or toxic, hazardous, or industrial wastewater have

30  been or are being disposed of through an onsite sewage

31  treatment and disposal system, the department shall initiate


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    CS for SB 2628                           First Engrossed (ntc)



  1  enforcement actions against the owner or tenant to ensure

  2  adequate cleanup, treatment, and disposal.

  3         (j)  An onsite sewage treatment and disposal system for

  4  a single-family residence that is designed by a professional

  5  engineer registered in the state and certified by such

  6  engineer as complying with performance criteria adopted by the

  7  department must be approved by the department subject to the

  8  following:

  9         1.  The performance criteria applicable to

10  engineer-designed systems must be limited to those necessary

11  to ensure that such systems do not adversely affect the public

12  health or significantly degrade the groundwater or surface

13  water.  Such performance criteria shall include consideration

14  of the quality of system effluent, the proposed total sewage

15  flow per acre, wastewater treatment capabilities of the

16  natural or replaced soil, water quality classification of the

17  potential surface-water-receiving body, and the structural and

18  maintenance viability of the system for the treatment of

19  domestic wastewater.  However, performance criteria shall

20  address only the performance of a system and not a system's

21  design.

22         2.  The technical review and advisory panel shall

23  assist the department in the development of performance

24  criteria applicable to engineer-designed systems.  Workshops

25  on the development of the rules delineating such criteria

26  shall commence not later than September 1, 1996, and the

27  department shall advertise such rules for public hearing no

28  later than October 1, 1997.

29         3.  A person electing to utilize an engineer-designed

30  system shall, upon completion of the system design, submit

31  such design, certified by a registered professional engineer,


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    CS for SB 2628                           First Engrossed (ntc)



  1  to the county health department.  The county health department

  2  may utilize an outside consultant to review the

  3  engineer-designed system, with the actual cost of such review

  4  to be borne by the applicant. Within 5 working days after

  5  receiving an engineer-designed system permit application, the

  6  county health department shall request additional information

  7  if the application is not complete.  Within 15 working days

  8  after receiving a complete application for an

  9  engineer-designed system, the county health department either

10  shall issue the permit or, if it determines that the system

11  does not comply with the performance criteria, shall notify

12  the applicant of that determination and refer the application

13  to the department for a determination as to whether the system

14  should be approved, disapproved, or approved with

15  modification. The department engineer's determination shall

16  prevail over the action of the county health department.  The

17  applicant shall be notified in writing of the department's

18  determination and of the applicant's rights to pursue a

19  variance or seek review under the provisions of chapter 120.

20         4.  The owner of an engineer-designed performance-based

21  system must obtain an annual system operating permit from the

22  department.  The department shall inspect the system at least

23  annually and may collect system-effluent samples if

24  appropriate to determine compliance with the performance

25  criteria. The fee for the annual operating permit shall be

26  collected beginning with the second year of system operation.

27         5.  If an engineer-designed system fails to properly

28  function or fails to meet performance standards, the system

29  shall be re-engineered, if necessary, to bring the system into

30  compliance with the provisions of this section.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (k)  An innovative system may be approved in

  2  conjunction with an engineer-designed site-specific system

  3  which is certified by the engineer to meet the

  4  performance-based criteria adopted by the department.

  5         (l)  For the Florida Keys, the department shall adopt a

  6  special rule for the construction, installation, modification,

  7  operation, repair, maintenance, and performance of onsite

  8  sewage treatment and disposal systems which considers the

  9  unique soil conditions and which considers water table

10  elevations, densities, and setback requirements.  On lots

11  where a setback distance of 75 feet from surface waters,

12  saltmarsh, and buttonwood association habitat areas cannot be

13  met, an injection well, approved and permitted by the

14  department, may be used for disposal of effluent from onsite

15  sewage treatment and disposal systems.

16         (m)  No product sold in the state for use in onsite

17  sewage treatment and disposal systems may contain any

18  substance in concentrations or amounts that would interfere

19  with or prevent the successful operation of such system, or

20  that would cause discharges from such systems to violate

21  applicable water quality standards. The department shall

22  publish criteria for products known or expected to meet the

23  conditions of this paragraph. In the event a product does not

24  meet such criteria, such product may be sold if the

25  manufacturer satisfactorily demonstrates to the department

26  that the conditions of this paragraph are met.

27         (n)  Evaluations for determining the seasonal

28  high-water table elevations or the suitability of soils for

29  the use of a new onsite sewage treatment and disposal system

30  shall be performed by department personnel, professional

31  engineers registered in the state, or such other persons with


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    CS for SB 2628                           First Engrossed (ntc)



  1  expertise, as defined by rule, in making such evaluations.

  2  Evaluations for determining mean annual flood lines shall be

  3  performed by those persons identified in paragraph (2)(i). The

  4  department shall accept evaluations submitted by professional

  5  engineers and such other persons as meet the expertise

  6  established by this section or by rule unless the department

  7  has a reasonable scientific basis for questioning the accuracy

  8  or completeness of the evaluation.

  9         (o)  The department shall appoint a research review and

10  advisory committee, which shall meet at least semiannually.

11  The committee shall advise the department on directions for

12  new research, review and rank proposals for research

13  contracts, and review draft research reports and make

14  comments.  The committee is comprised of:

15         1.  A representative of the Division of Environmental

16  Health of the Department of Health.

17         2.  A representative from the septic tank industry.

18         3.  A representative from the home building industry.

19         4.  A representative from an environmental interest

20  group.

21         5.  A representative from the State University System,

22  from a department knowledgeable about onsite sewage treatment

23  and disposal systems.

24         6.  A professional engineer registered in this state

25  who has work experience in onsite sewage treatment and

26  disposal systems.

27         7.  A representative from the real estate profession.

28         8.  A representative from the restaurant industry.

29         9.  A consumer.

30

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  Members shall be appointed for a term of 3 years, with the

  2  appointments being staggered so that the terms of no more than

  3  four members expire in any one year.  Members shall serve

  4  without remuneration, but are entitled to reimbursement for

  5  per diem and travel expenses as provided in s. 112.061.

  6         (p)  An application for an onsite sewage treatment and

  7  disposal system permit shall be completed in full, signed by

  8  the owner or the owner's authorized representative, or by a

  9  contractor licensed under chapter 489, and shall be

10  accompanied by all required exhibits and fees. No specific

11  documentation of property ownership shall be required as a

12  prerequisite to the review of an application or the issuance

13  of a permit.  The issuance of a permit does not constitute

14  determination by the department of property ownership.

15         (q)  The department may not require any form of

16  subdivision analysis of property by an owner, developer, or

17  subdivider prior to submission of an application for an onsite

18  sewage treatment and disposal system.

19         (r)  Nothing in this section limits the power of a

20  municipality or county to enforce other laws for the

21  protection of the public health and safety.

22         (s)  In the siting of onsite sewage treatment and

23  disposal systems, including drainfields, shoulders, and

24  slopes, guttering shall not be required on single-family

25  residential dwelling units for systems located greater than 5

26  feet from the roof drip line of the house.  If guttering is

27  used on residential dwelling units, the downspouts shall be

28  directed away from the drainfield.

29         (t)  Notwithstanding the provisions of subparagraph

30  (f)1., onsite sewage treatment and disposal systems located in

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  floodways of the Suwannee and Aucilla Rivers must adhere to

  2  the following requirements:

  3         1.  The absorption surface of the drainfield shall not

  4  be subject to flooding based on 10-year flood elevations.

  5  Provided, however, for lots or parcels created by the

  6  subdivision of land in accordance with applicable local

  7  government regulations prior to January 17, 1990, if an

  8  applicant cannot construct a drainfield system with the

  9  absorption surface of the drainfield at an elevation equal to

10  or above 10-year flood elevation, the department shall issue a

11  permit for an onsite sewage treatment and disposal system

12  within the 10-year floodplain of rivers, streams, and other

13  bodies of flowing water if all of the following criteria are

14  met:

15         a.  The lot is at least one-half acre in size;

16         b.  The bottom of the drainfield is at least 36 inches

17  above the 2-year flood elevation; and

18         c.  The applicant installs either:  a waterless,

19  incinerating, or organic waste composting toilet and a

20  graywater system and drainfield in accordance with department

21  rules; an aerobic treatment unit and drainfield in accordance

22  with department rules; a system approved by the State Health

23  Office that is capable of reducing effluent nitrate by at

24  least 50 percent; or a system approved by the county health

25  department pursuant to department rule other than a system

26  using alternative drainfield materials.  The United States

27  Department of Agriculture Soil Conservation Service soil maps,

28  State of Florida Water Management District data, and Federal

29  Emergency Management Agency Flood Insurance maps are resources

30  that shall be used to identify flood-prone areas.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         2.  The use of fill or mounding to elevate a drainfield

  2  system out of the 10-year floodplain of rivers, streams, or

  3  other bodies of flowing water shall not be permitted if such a

  4  system lies within a regulatory floodway of the Suwannee and

  5  Aucilla Rivers.  In cases where the 10-year flood elevation

  6  does not coincide with the boundaries of the regulatory

  7  floodway, the regulatory floodway will be considered for the

  8  purposes of this subsection to extend at a minimum to the

  9  10-year flood elevation.

10         Section 11.  Paragraph (a) of subsection (2) of section

11  381.0072, Florida Statutes, is amended to read:

12         381.0072  Food service protection.--It shall be the

13  duty of the Department of Health to adopt and enforce

14  sanitation rules consistent with law to ensure the protection

15  of the public from food-borne illness. These rules shall

16  provide the standards and requirements for the storage,

17  preparation, serving, or display of food in food service

18  establishments as defined in this section and which are not

19  permitted or licensed under chapter 500 or chapter 509.

20         (2)  DUTIES.--

21         (a)  The department shall adopt rules, including

22  definitions of terms which are consistent with law prescribing

23  minimum sanitation standards and manager certification

24  requirements as prescribed in s. 509.039, and which shall be

25  enforced in food service establishments as defined in this

26  section. The sanitation standards must address the

27  construction, operation, and maintenance of the establishment;

28  lighting, ventilation, laundry rooms, lockers, use and storage

29  of toxic materials and cleaning compounds, and first-aid

30  supplies; plan review; design, construction, installation,

31  location, maintenance, sanitation, and storage of food


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    CS for SB 2628                           First Engrossed (ntc)



  1  equipment and utensils; employee training, health, hygiene,

  2  and work practices; food supplies, preparation, storage,

  3  transportation, and service, including access to the areas

  4  where food is stored or prepared; and sanitary facilities and

  5  controls, including water supply and sewage disposal; plumbing

  6  and toilet facilities; garbage and refuse collection, storage,

  7  and disposal; and vermin control. Public and private schools,

  8  hospitals licensed under chapter 395, nursing homes licensed

  9  under part II of chapter 400, child care facilities as defined

10  in s. 402.301, and residential facilities colocated with a

11  nursing home or hospital if all food is prepared in a central

12  kitchen that complies with nursing or hospital regulations

13  shall be exempt from the rules developed for manager

14  certification. The department shall administer a comprehensive

15  inspection, monitoring, and sampling program to ensure such

16  standards are maintained. With respect to food service

17  establishments permitted or licensed under chapter 500 or

18  chapter 509, the department shall assist the Division of

19  Hotels and Restaurants of the Department of Business and

20  Professional Regulation and the Department of Agriculture and

21  Consumer Services with rulemaking by providing technical

22  information.

23         Section 12.  Subsection (1) of section 381.0086,

24  Florida Statutes, is amended to read:

25         381.0086  Rules; variances; penalties.--

26         (1)  The department shall adopt rules necessary to

27  protect the health and safety of migrant farm workers and

28  other migrant labor camp or residential migrant housing

29  occupants, including rules governing field-sanitation

30  facilities.  These rules must include definitions of terms,

31  provisions relating to plan review of the construction of new,


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    CS for SB 2628                           First Engrossed (ntc)



  1  expanded, or remodeled camps, sites, buildings and structures,

  2  personal hygiene facilities, lighting, sewage disposal,

  3  safety, minimum living space per occupant, bedding, food

  4  equipment, food storage and preparation, insect and rodent

  5  control, garbage, heating equipment, water supply, maintenance

  6  and operation of the camp, housing, or roads, and such other

  7  matters as the department finds to be appropriate or necessary

  8  to protect the life and health of the occupants.  Housing

  9  operated by a public housing authority is exempt from the

10  provisions of any administrative rule that conflicts with or

11  is more stringent than the federal standards applicable to the

12  housing.

13         Section 13.  Subsections (3), (4), and (5) of section

14  381.0098, Florida Statutes, are amended to read:

15         381.0098  Biomedical waste.--

16         (3)  OPERATING STANDARDS.--The department shall adopt

17  rules necessary to protect the health, safety, and welfare of

18  the public and to carry out the purpose of this section.  Such

19  rules shall address, but need not be limited to, definitions

20  of terms, the packaging of biomedical waste, including

21  specific requirements for the segregation of the waste at the

22  point of generation; the safe packaging of sharps; the

23  placement of the waste in containers that will protect waste

24  handlers and the public from exposure; the appropriate

25  labeling of containers of waste; written operating plans for

26  managing biomedical waste; and the transport, storage, and

27  treatment of biomedical wastes.

28         (4)  PERMITS AND FEES.--

29         (a)  All persons who generate, store, or treat

30  biomedical waste shall obtain a permit from the department

31  prior to commencing operation, except that a biomedical waste


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    CS for SB 2628                           First Engrossed (ntc)



  1  generator generating less than 25 pounds of biomedical waste

  2  in each 30-day period shall be exempt from the registration

  3  and fee requirements of this subsection.  A biomedical waste

  4  generator need not obtain a separate permit if such generator

  5  works less than 6 hours in a 7-day period at a location

  6  different than the location specified on the permit.  The

  7  department may issue combined permits for generation, storage,

  8  and treatment as appropriate to streamline permitting

  9  procedures.  Application for such permit shall be made on an

10  application form provided by the department and within the

11  timeframes and in the manner prescribed by department rule.

12         (b)  Once the department determines that the person

13  generating, storing, or treating biomedical waste is capable

14  of constructing a facility or operating in compliance with

15  this section and the rules adopted under this section, the

16  department shall grant the permit.

17         (c)  If the department determines that the person

18  generating, storing, or treating biomedical waste does not

19  meet the provisions outlined in this section or the rules

20  adopted under this section, the department shall deny the

21  application for the permit pursuant to provisions of chapter

22  120.  Such denial shall be in writing and shall list the

23  circumstances for denial.  Upon correction of such

24  circumstances the permit shall be issued.

25         (d)  The permit for a biomedical waste facility may

26  generator shall not be transferred from one owner to another.

27  When the ownership, control, or name of a biomedical waste

28  facility generator is changed and continues to operate, the

29  new owner shall apply to the department, upon forms provided

30  by the department, for issuance of a permit in the timeframe

31  and manner prescribed by rule of the department.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (e)  A permit which the department may require by rule,

  2  for the storage or treatment of biomedical waste, may not be

  3  transferred by the permittee to any other entity, except in

  4  conformity with the requirements of this paragraph.

  5         1.  Within 30 days after the sale or legal transfer of

  6  a permitted facility, the permittee shall file with the

  7  department an application for transfer of a permit on such

  8  form as the department shall establish by rule. The form must

  9  be completed with the notarized signatures of both the

10  transferring permittee and the proposed permittee.

11         2.  The department shall approve the transfer of a

12  permit unless it determines that the proposed permittee has

13  not provided reasonable assurances that the proposed permittee

14  has the administrative, technical, and financial capability to

15  properly satisfy the requirements and conditions of the

16  permit, as determined by department rule.  The determination

17  shall be limited solely to the ability of the proposed

18  permittee to comply with the conditions of the existing

19  permit, and it shall not concern the adequacy of the permit

20  conditions. If the department proposes to deny the transfer,

21  it shall provide both the transferring permittee and the

22  proposed permittee a written objection to such transfer

23  together with notice of a right to request a proceeding on

24  such determination under chapter 120.

25         3.  Within 90 days after receiving a properly completed

26  application for transfer of a permit, the department shall

27  issue a final determination. The department may toll the time

28  for making a determination on the transfer by notifying both

29  the transferring permittee and the proposed permittee that

30  additional information is required to adequately review the

31  transfer request. Such notification shall be provided within


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    CS for SB 2628                           First Engrossed (ntc)



  1  30 days after receipt of an application for transfer of the

  2  permit, completed pursuant to this paragraph. If the

  3  department fails to take action to approve or deny the

  4  transfer within 90 days after receipt of the completed

  5  application or within 90 days after receipt of the last item

  6  of timely requested additional information, the transfer shall

  7  be deemed approved.

  8         4.  The transferring permittee is encouraged to apply

  9  for a permit transfer well in advance of the sale or legal

10  transfer of a permitted facility.  However, the transfer of

11  the permit shall not be effective prior to the sale or legal

12  transfer of the facility.

13         5.  Until the transfer of the permit is approved by the

14  department, the transferring permittee and any other person

15  constructing, operating, or maintaining the permitted facility

16  shall be liable for compliance with the terms of the permit.

17  Nothing in this section shall relieve the transferring

18  permittee of liability for corrective actions that may be

19  required as a result of any violations occurring prior to the

20  legal transfer of the permit.

21         (e)(f)  The department shall establish a schedule of

22  fees for such permits. Fees assessed under this section shall

23  be in an amount sufficient to meet the costs of carrying out

24  the provisions of this section and rules adopted under this

25  section.  The fee schedule shall not be less than $50 or more

26  than $400 for each year the permit is valid.  Fees may be

27  prorated on a quarterly basis when a facility will be in

28  operation for 6 months or less before the annual renewal date.

29  The department shall assess the minimum fees provided in this

30  subsection until a fee schedule is adopted promulgated by rule

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  of the department.  Facilities owned and operated by the state

  2  shall be exempt from the payment of any fees.

  3         (f)(g)  Fees collected by the department in accordance

  4  with provisions of this section and the rules adopted under

  5  this section shall be deposited into a trust fund administered

  6  by the department for the payment of costs incurred in the

  7  administration of this section.

  8         (g)(h)  Permits issued by the department shall be valid

  9  for no more than 5 years.  However, upon expiration, a new

10  permit may be issued by the department in accordance with this

11  section and the rules of the department.

12         (h)(i)  The department may is authorized to develop a

13  streamlined process for permitting biomedical waste storage

14  facilities that accept and store only sharps collected from

15  the public, which may include the issuance of a single permit

16  for each applicant that which develops or sponsors a sharps

17  collection program.

18         (5)  TRANSPORTERS.--Any person who transports

19  biomedical waste within the state must register with the

20  department prior to engaging in the transport of biomedical

21  waste in accordance with rules adopted promulgated by the

22  department.  A registration may not be transferred from one

23  biomedical waste transporter to another. If the ownership or

24  name of a biomedical waste transporter is changed and the

25  owner intends to continue operation of the transporter, the

26  owner must apply to the department on departmental forms

27  within the timeframes and in the manner prescribed by

28  department rule. The department may charge registration fees

29  in the same manner as is provided in paragraphs (4)(e) and (f)

30  (4)(f) and (g).  The department may exempt from this

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  requirement any person who, or facility that, transports less

  2  than 25 pounds of such waste on any single occasion.

  3         Section 14.  Subsection (5) of section 381.0101,

  4  Florida Statutes, is amended to read:

  5         381.0101  Environmental health professionals.--

  6         (5)  STANDARDS FOR CERTIFICATION.--The department shall

  7  adopt rules that establish definitions of terms and minimum

  8  standards of education, training, or experience for those

  9  persons subject to this section. The rules must shall also

10  address the process for application, examination, issuance,

11  expiration, and renewal of certification and ethical standards

12  of practice for the profession.

13         (a)  Persons employed as environmental health

14  professionals shall exhibit a knowledge of rules and

15  principles of environmental and public health law in Florida

16  through examination.  A person may not conduct environmental

17  health evaluations in a primary program area unless he or she

18  is currently certified in that program area or works under the

19  direct supervision of a certified environmental health

20  professional.

21         1.  All persons who begin employment in a primary

22  environmental health program on or after September 21, 1994,

23  must be certified in that program within 6 months after

24  employment.

25         2.  Persons employed in a primary environmental health

26  program prior to September 21, 1994, shall be considered

27  certified while employed in that position and shall be

28  required to adhere to any professional standards established

29  by the department pursuant to paragraph (b), complete any

30  continuing education requirements imposed under paragraph (d),

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  and pay the certificate renewal fee imposed under subsection

  2  (7).

  3         3.  Persons employed in a primary environmental health

  4  program prior to September 21, 1994, who change positions or

  5  program areas and transfer into another primary environmental

  6  health program area on or after September 21, 1994, must be

  7  certified in that program within 6 months after such transfer,

  8  except that they will not be required to possess the college

  9  degree required under paragraph (e).

10         4.  Registered sanitarians shall be considered

11  certified and shall be required to adhere to any professional

12  standards established by the department pursuant to paragraph

13  (b).

14         (b)  At a minimum, the department shall establish

15  standards for professionals in the areas of food hygiene and

16  onsite sewage treatment and disposal.

17         (c)  Those persons conducting primary environmental

18  health evaluations shall be certified by examination to be

19  knowledgeable in any primary area of environmental health in

20  which they are routinely assigned duties.

21         (d)  Persons who are certified shall renew their

22  certification biennially by completing not less than 24

23  contact hours of continuing education for each program area in

24  which they maintain certification.

25         (e)  Applicants for certification shall have graduated

26  from an accredited 4-year college or university with a degree

27  or major coursework in public health, environmental health,

28  environmental science, or a physical or biological science.

29         (f)  A certificateholder shall notify the department

30  within 60 days after any change of name or address from that

31  which appears on the current certificate.


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    CS for SB 2628                           First Engrossed (ntc)



  1         Section 15.  Subsection (1) of section 381.0203,

  2  Florida Statutes, is amended to read:

  3         381.0203  Pharmacy services.--

  4         (1)  The department may contract on a statewide basis

  5  for the purchase of drugs, as defined in s. 499.003, to be

  6  used by state agencies and political subdivisions, and may

  7  adopt rules to administer this section.

  8         Section 16.  Subsections (12) and (13) of section

  9  381.89, Florida Statutes, are amended to read:

10         381.89  Regulation of tanning facilities.--

11         (12)  The department may institute legal action for

12  injunctive or other relief to enforce this section. If a

13  tanning facility or other person violates this section or any

14  rule adopted under this section, the department may issue a

15  stop-use order, as prescribed by rule, to remove a tanning

16  device from service.

17         (13)  The department shall adopt rules to administer

18  implement this section. The rules may include, but need not be

19  limited to, requirements for training tanning facility

20  operators and employees; definitions of terms; the approval of

21  training courses; safety; plan review; and the design,

22  construction, operation, maintenance, and cleanliness of

23  tanning facilities and tanning devices.

24         Section 17.  Paragraph (a) of subsection (2) of section

25  383.011, Florida Statutes, is amended to read:

26         383.011  Administration of maternal and child health

27  programs.--

28         (2)  The Department of Health shall follow federal

29  requirements and may adopt any rules necessary for the

30  implementation of the maternal and child health care program,

31  the WIC program, and the Child Care Food Program.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (a)  The department may adopt rules that are necessary

  2  to administer the maternal and child health care program. The

  3  rules may include, but need not be limited to, requirements

  4  for client eligibility, program standards, service delivery,

  5  system responsibilities of county health departments and

  6  system assurance for healthy start coalitions, care

  7  coordination, enhanced services, quality assurance, and

  8  provider selection. The rules may also include provisions for

  9  the identification, screening, and intervention efforts by

10  health care providers prior to and following the birth of a

11  child and responsibilities for the interprogram coordination

12  of prenatal and infant care coalitions.

13         Section 18.  Subsection (2) of section 383.14, Florida

14  Statutes, is amended to read:

15         383.14  Screening for metabolic disorders, other

16  hereditary and congenital disorders, and environmental risk

17  factors.--

18         (2)  RULES.--After consultation with the Genetics and

19  Infant Screening Advisory Council, the department shall adopt

20  and enforce rules requiring that every infant born in this

21  state shall, prior to becoming 2 weeks of age, be subjected to

22  a test for phenylketonuria and, at the appropriate age, be

23  tested for such other metabolic diseases and hereditary or

24  congenital disorders as the department may deem necessary from

25  time to time. After consultation with the State Coordinating

26  Council for Early Childhood Services, the department shall

27  also adopt and enforce rules requiring every infant born in

28  this state to be screened for environmental risk factors that

29  place children and their families at risk for increased

30  morbidity, mortality, and other negative outcomes.  The

31  department shall adopt such additional rules as are found


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    CS for SB 2628                           First Engrossed (ntc)



  1  necessary for the administration of this section, including

  2  rules providing definitions of terms, rules relating to the

  3  methods used and time or times for testing as accepted medical

  4  practice indicates, rules relating to charging and collecting

  5  fees for screenings authorized by this section, and rules

  6  requiring mandatory reporting of the results of tests and

  7  screenings for these conditions to the department.

  8         Section 19.  Subsection (1) of section 383.19, Florida

  9  Statutes, is amended to read:

10         383.19  Standards; funding; ineligibility.--

11         (1)  The department shall adopt rules that specify

12  standards for development and operation of a center which

13  include, but are not limited to:

14         (a)  The need to provide services through a regional

15  perinatal intensive care center and the requirements of the

16  population to be served.

17         (b)  Equipment.

18         (c)  Facilities.

19         (d)  Staffing and qualifications of personnel.

20         (e)  Transportation services.

21         (f)  Data collection.

22         (g)  Definitions of terms.

23         Section 20.  Subsections (9) and (10) of section

24  383.216, Florida Statutes, are amended to read:

25         383.216  Community-based prenatal and infant health

26  care.--

27         (9)  Local prenatal and infant health care coalitions

28  shall incorporate as not-for-profit corporations for the

29  purpose of seeking and receiving grants from federal, state,

30  and local government and other contributors. However, a

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  coalition need not be designated as a tax-exempt organization

  2  under s. 501(c)(3) of the Internal Revenue Code.

  3         (10)  The Department of Health shall adopt rules as

  4  necessary to administer implement this section, including

  5  rules defining acceptable "in-kind" contributions and rules

  6  providing definitions of terms, coalition responsibilities,

  7  coalition operations and standards, and conditions for

  8  establishing and approving a coalition. A coalition may not be

  9  a direct provider of prenatal and infant-care services.

10         Section 21.  Section 384.33, Florida Statutes, is

11  amended to read:

12         384.33  Rules.--The department may adopt rules pursuant

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

14  this chapter. The rules may include requirements for methods

15  of contacting a physician to determine the need for followup

16  services related to sexually transmissible diseases; standards

17  for screening, treating, and performing contact investigations

18  to control the spread of sexually transmitted diseases; and

19  requirements for maintaining the security of confidential

20  information.

21         Section 22.  Subsection (4) of section 385.207, Florida

22  Statutes, is amended to read:

23         385.207  Care and assistance of persons with epilepsy;

24  establishment of programs in epilepsy control.--

25         (4)  The department shall adopt rules to administer

26  implement this section. The rules may include requirements for

27  the scope of service, criteria for eligibility, and

28  requirements for reports and forms.

29         Section 23.  Subsection (18) of section 391.026,

30  Florida Statutes, is amended to read:

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    CS for SB 2628                           First Engrossed (ntc)



  1         391.026  Powers and duties of the department.--The

  2  department shall have the following powers, duties, and

  3  responsibilities:

  4         (18)  To adopt rules pursuant to ss. 120.536(1) and

  5  120.54 to administer implement the Children's Medical Services

  6  provisions of this Act. The rules may include requirements for

  7  definitions of terms, program organization, and program

  8  description; a process for selecting an area medical director;

  9  responsibilities of applicants and clients; requirements for

10  service applications, including required medical and financial

11  information; eligibility requirements for initial treatment

12  and for continued eligibility, including financial and custody

13  issues; methodologies for resource development and allocation,

14  including medical and financial considerations; requirements

15  for reimbursement services rendered to a client; billing and

16  payment requirements for providers; requirements for

17  qualification, appointments, verification, and emergency

18  exceptions for health-professional consultants; general and

19  diagnostic-specific standards for diagnostic and treatment

20  facilities; and standards for the method of service delivery,

21  including consultant services, respect-for-privacy

22  considerations, examination requirements, family support

23  plans, and clinic design.

24         Section 24.  Section 392.66, Florida Statutes, is

25  amended to read:

26         392.66  Rules.--The department shall adopt rules

27  pursuant to ss. 120.536(1) and 120.54 to administer implement

28  the provisions of this chapter. The rules must include

29  requirements for tuberculosis treatment and provide

30  consequences if a person who has active tuberculosis fails to

31  comply with treatment requirements.


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    CS for SB 2628                           First Engrossed (ntc)



  1         Section 25.  Subsection (2) of section 395.401, Florida

  2  Statutes, is amended to read:

  3         395.401  Trauma services system plans; verification of

  4  trauma centers and pediatric trauma referral centers;

  5  procedures; renewal.--

  6         (2)(a)  The local and regional trauma agencies shall

  7  plan, implement, and evaluate trauma services systems, in

  8  accordance with this section and ss. 395.4015, 395.404, and

  9  395.4045, which consist of organized patterns of readiness and

10  response services based on public and private agreements and

11  operational procedures. The department shall establish, by

12  rule, processes and procedures for establishing a trauma

13  agency and obtaining its approval from the department.

14         (b)  The local and regional trauma agencies shall

15  develop and submit to the department plans for local and

16  regional trauma services systems. The plans must include, at a

17  minimum, the following components:

18         1.  The organizational structure of the trauma system.

19         2.  Prehospital care management guidelines for triage

20  and transportation of trauma cases.

21         3.  Flow patterns of trauma cases and transportation

22  system design and resources, including air transportation

23  services, and provision for interfacility transfer.

24         4.  The number and location of needed state-approved

25  trauma centers based on local needs, population, and location

26  and distribution of resources.

27         5.  Data collection regarding system operation and

28  patient outcome.

29         6.  Periodic performance evaluation of the trauma

30  system and its components.

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    CS for SB 2628                           First Engrossed (ntc)



  1         7.  The use of air transport services within the

  2  jurisdiction of the local trauma agency.

  3         8.  Public information and education about the trauma

  4  system.

  5         9.  Emergency medical services communication system

  6  usage and dispatching.

  7         10.  The coordination and integration between the

  8  verified trauma care facility and the nonverified health care

  9  facilities.

10         11.  Medical control and accountability.

11         12.  Quality control and system evaluation.

12         (c)  The department shall receive plans for the

13  implementation of inclusive trauma systems from trauma

14  agencies.  The department may approve or not approve trauma

15  agency plans based on the conformance of the plan with this

16  section and ss. 395.4015, 395.404, and 395.4045 and the rules

17  and definitions adopted by the department pursuant to those

18  sections.  The department shall approve or disapprove the

19  plans within 120 days after the date the plans are submitted

20  to the department. The department shall, by rule, provide an

21  application process for establishing a trauma agency. The

22  application must, at a minimum, provide requirements for the

23  trauma agency plan submitted for review, a process for

24  reviewing the application for a state-approved trauma agency,

25  a process for reviewing the trauma transport protocols for the

26  trauma agency, and a process for reviewing the staffing

27  requirements for the agency. The department shall, by rule,

28  establish minimum requirements for a trauma agency to conduct

29  an annual performance evaluation and submit the results to the

30  department.

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    CS for SB 2628                           First Engrossed (ntc)



  1         (d)  A trauma agency shall not operate unless the

  2  department has approved the local or regional trauma services

  3  system plan of the agency.

  4         (e)  The department may grant an exception to a portion

  5  of the rules adopted pursuant to this section or s. 395.4015

  6  if the local or regional trauma agency proves that, as defined

  7  in the rules, compliance with that requirement would not be in

  8  the best interest of the persons served within the affected

  9  local or regional trauma area.

10         (f)  A local or regional trauma agency may implement a

11  trauma care system only if the system meets the minimum

12  standards set forth in the rules for implementation

13  established by the department and if the plan has been

14  submitted to, and approved by, the department.  At least 60

15  days before the local or regional trauma agency submits the

16  plan for the trauma care system to the department, the local

17  or regional trauma agency shall hold a public hearing and give

18  adequate notice of the public hearing to all hospitals and

19  other interested parties in the area to be included in the

20  proposed system.

21         (g)  Local or regional trauma agencies may enter into

22  contracts for the purpose of implementing the local or

23  regional plan.  If local or regional agencies contract with

24  hospitals for trauma services, such agencies must contract

25  only with hospitals which are verified trauma centers.

26         (h)  Local or regional trauma agencies providing

27  service for more than one county shall, as part of their

28  formation, establish interlocal agreements between or among

29  the several counties in the regional system.

30

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (i)  This section does not restrict the authority of a

  2  health care facility to provide service for which it has

  3  received a license pursuant to this chapter.

  4         (j)  Any hospital which is verified as a trauma center

  5  shall accept all trauma victims that are appropriate for the

  6  facility regardless of race, sex, creed, or ability to pay.

  7         (k)  It is unlawful for any hospital or other facility

  8  to hold itself out as a trauma center unless it has been so

  9  verified.

10         (l)  A county, upon the recommendations of the local or

11  regional trauma agency, may adopt ordinances governing the

12  transport of a patient who is receiving care in the field from

13  prehospital emergency medical personnel when the patient meets

14  specific criteria for trauma, burn, or pediatric centers

15  adopted by the local or regional trauma agency.  These

16  ordinances must be consistent with s. 395.4045, ordinances

17  adopted under s. 401.25(6), and the local or regional trauma

18  system plan and, to the furthest possible extent, must ensure

19  that individual patients receive appropriate medical care

20  while protecting the interests of the community at large by

21  making maximum use of available emergency medical care

22  resources.

23         (m)  The local or regional trauma agency shall,

24  consistent with the regional trauma system plan, coordinate

25  and otherwise facilitate arrangements necessary to develop a

26  trauma services system.

27         (n)  After the submission of the initial trauma system

28  plan, each trauma agency shall, every 5th year, submit to the

29  department for approval an updated plan that identifies the

30  changes, if any, to be made in the regional trauma system.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (o)  This section does not preclude a local or regional

  2  trauma agency from adopting trauma care system standards.

  3         Section 26.  Paragraph (b) of subsection (3) of section

  4  395.402, Florida Statutes, is amended to read:

  5         395.402  Trauma service areas; number and location of

  6  trauma centers.--

  7         (3)  Trauma service areas are to be used. The

  8  department shall periodically review the assignment of the 67

  9  counties to trauma service areas. These assignments are made

10  for the purpose of developing a system of trauma centers.

11  Revisions made by the department should take into

12  consideration the recommendations made as part of the regional

13  trauma system plans approved by the department, as well as the

14  recommendations made as part of the state trauma system plan.

15  These areas must, at a minimum, be reviewed in the year 2000

16  and every 5 years thereafter. Until the department completes

17  its initial review, the assignment of counties shall remain as

18  established pursuant to chapter 90-284, Laws of Florida.

19         (b)  Each trauma service area should have at least one

20  Level I or Level II trauma center. The department shall

21  allocate, by rule, the number of trauma centers needed for

22  each trauma service area.

23         Section 27.  Section 401.35, Florida Statutes, is

24  amended to read:

25         401.35  Rules.--The department shall adopt rules,

26  including definitions of terms, necessary to carry out the

27  purposes of this part.

28         (1)  The rules must provide at least minimum standards

29  governing:

30         (a)  Sanitation, safety, and maintenance of basic life

31  support and advanced life support vehicles and air ambulances.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (b)  Emergency medical technician, paramedic, and

  2  driver training and qualifications.

  3         (c)  Ground ambulance and vehicle equipment and

  4  supplies at least as comprehensive as those published in the

  5  most current edition of the American College of Surgeons,

  6  Committee on Trauma, list of essential equipment for

  7  ambulances, as interpreted by rules of the department.

  8         (d)  Ground ambulance or vehicle design and

  9  construction at least equal to those most currently

10  recommended by the United States General Services

11  Administration as interpreted by rules of the department.

12         (e)  Staffing of basic life support and advanced life

13  support vehicles.

14         (f)  Two-way communications for basic life support

15  services and advanced life support services.

16         (g)  Advanced life support services equipment.

17         (h)  Programs of training for emergency medical

18  technicians and paramedics.

19         (i)  Vehicles, equipment, communications, and minimum

20  staffing qualifications for air ambulance services.

21         (j)  Ambulance driver qualifications, training, and

22  experience.

23         (k)  Optional use of telemetry by licensees.

24         (l)  Licensees' security and storage of controlled

25  substances, medications, and fluids, not inconsistent with the

26  provisions of chapter 499 or chapter 893.

27         (2)  The rules must establish application requirements

28  for licensure and certification.  Pursuant thereto, the

29  department must develop application forms for basic life

30  support services and advanced life support services.  An

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  application for each respective service license must include,

  2  but is not limited to:

  3         (a)  The name and business address of the operator and

  4  owner of the service or proposed service.

  5         (b)  The name under which the applicant will operate.

  6         (c)  A list of the names and addresses of all officers,

  7  directors, and shareholders of the applicant.

  8         (d)  A description of each vehicle to be used,

  9  including the make, model, year of manufacture, mileage, and

10  vehicle identification number (VIN); the state or federal

11  aviation or marine registration number, when applicable; and

12  the color scheme, insignia, name, monogram, or other

13  distinguishing characteristics to be used to designate the

14  applicant's vehicle or vehicles.

15         (e)  The service location from which the service will

16  operate.

17         (f)  A statement reasonably describing the geographic

18  area or areas to be served by the applicant.

19         (g)  A statement certifying that the applicant will

20  provide continuous service 24 hours a day, 7 days a week, if a

21  basic life support service license or an advanced life support

22  service license is sought.  Such service must be initiated

23  within 30 days after issuance of the license.

24         (h)  Such other information as the department

25  determines reasonable and necessary.

26         (i)  An oath, upon forms provided by the department

27  which shall contain such information as the department

28  reasonably requires, which may include affirmative evidence of

29  ability to comply with applicable laws and rules.

30         (3)  The rules must establish specifications regarding

31  insignia and other ambulance identification.  Any fire


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    CS for SB 2628                           First Engrossed (ntc)



  1  department may retain its fire department identity and may use

  2  such color scheme, insignia, name, monogram, or other

  3  distinguishing characteristic that is acceptable to the fire

  4  department for the purpose of designating its vehicles as

  5  advanced life support vehicles.  However, those advanced life

  6  support service/fire rescue vehicles or ambulances operated by

  7  fire departments which were purchased in whole or in part with

  8  federal funds must comply with federal regulations pertaining

  9  to color schemes, emblems, and markings.

10         (4)  The rules must establish circumstances and

11  procedures under which emergency medical technicians and

12  paramedics may honor orders by the patient's physician not to

13  resuscitate and the documentation and reporting requirements

14  for handling such requests.

15         (5)  The rules must establish requirements for

16  licensees and certificateholders with respect to providing

17  address information to the department; requirements for

18  examinations, grading, and passing scores for certification;

19  and requirements for determining whether a convicted felon

20  whose civil rights have not been restored is eligible for

21  certification or recertification.

22         Section 28.  Paragraph (f) of subsection (1) of section

23  403.862, Florida Statutes, is amended to read:

24         403.862  Department of Health; public water supply

25  duties and responsibilities; coordinated budget requests with

26  department.--

27         (1)  Recognizing that supervision and control of county

28  health departments of the Department of Health is retained by

29  the secretary of that agency, and that public health aspects

30  of the state public water supply program require joint

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  participation in the program by the Department of Health and

  2  its units and the department, the Department of Health shall:

  3         (f)  Have general supervision and control over all

  4  private water systems and all public water systems not

  5  otherwise covered or included in this part. This shall include

  6  the authority to adopt and enforce rules, including

  7  definitions of terms, to protect the health, safety, or

  8  welfare of persons being served by all private water systems

  9  and all public water systems not otherwise covered by this

10  part.

11         Section 29.  Subsection (3) of section 404.056, Florida

12  Statutes, is amended to read:

13         404.056  Environmental radiation standards and

14  programs; radon protection.--

15         (3)  CERTIFICATION.--

16         (a)  The department may is authorized to certify

17  persons who perform radon gas or radon progeny measurements,

18  including sample collection, analysis, or interpretation of

19  such measurements, and who perform mitigation of buildings for

20  radon gas or radon progeny, and shall collect a fee for such

21  certification. Before performing radon measurement or radon

22  mitigation services, including collecting samples, performing

23  analysis, or interpreting measurement results, a certified

24  individual must own, be employed by, or be retained as a

25  consultant to a certified radon measurement or certified radon

26  mitigation business. The department may establish criteria for

27  the application, certification, and annual renewal of basic

28  and advanced levels of certification for individuals, which

29  may include requirements for education and experience,

30  approved training, examinations, and reporting. The department

31  may approve training courses for certification and establish


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    CS for SB 2628                           First Engrossed (ntc)



  1  criteria for training courses and instructors. The department

  2  may observe and evaluate training sessions, instructors, and

  3  course material without charge.

  4         (b)  A person may not participate in performing radon

  5  gas or radon progeny measurements, including sample

  6  collection, analysis, or interpretation of such measurements,

  7  or perform mitigation of buildings for radon gas or radon

  8  progeny, and charge a fee or obtain other remuneration as

  9  benefit for such services or devices, unless that person is

10  certified by the department. A certification issued in

11  accordance with this section automatically expires at the end

12  of the certification period stated on the certificate. An

13  uncertified commercial business may subcontract radon

14  measurements to a certified radon business. The uncertified

15  commercial business must provide the complete radon report

16  from the certified radon business to the client and direct all

17  the client's questions about the measurements or radon report

18  to the certified radon business.

19         (c)  The results of measurements of radon gas or radon

20  progeny performed by persons certified under the provisions of

21  this subsection shall be reported to the department and

22  persons contracting for the service.  Upon request, the

23  results of measurements of radon gas or radon progeny which

24  are performed to evaluate the effectiveness of a radon

25  mitigation system shall be reported to the certified business

26  that installed the mitigation system. The report must include

27  the radon levels detected; the location, age, and description

28  of the building; the name and certification numbers of the

29  certified radon measurement business and individual who

30  performed the measurements; and other information determined

31  by the department to meet the requirements of the protocols


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    CS for SB 2628                           First Engrossed (ntc)



  1  and procedures for the type of measurement performed. Each

  2  installation of a radon mitigation system performed by a

  3  person certified under this section must be reported to the

  4  department according to the schedule set by the department.

  5  The report must include the premitigation and postmitigation

  6  radon levels; the type or types of systems installed; the

  7  location, age, and description of the building; and the name

  8  and certification number of the certified mitigation business

  9  that performed the mitigation.

10         (d)  Authorized representatives of the department may

11  have the authority to inspect the business and records of any

12  person certified under the provisions of this subsection, at

13  all reasonable times, to examine records and test procedures

14  to determine compliance with or violation of the provisions of

15  this section.

16         (e)  Any person who practices fraud, deception, or

17  misrepresentation in performing radon gas or radon progeny

18  measurements or in performing mitigation of buildings for

19  radon gas or radon progeny is subject to the penalties

20  provided in s. 404.161.

21         (f)  The department may is authorized to charge and

22  collect nonrefundable fees for the certification and annual

23  recertification of persons who perform radon gas or radon

24  progeny measurements or who perform mitigation of buildings

25  for radon gas or radon progeny. The amount of the initial

26  application fee and certification shall be not less than $200

27  or more than $900.  The amount of the annual recertification

28  fee shall be not less than $200 or more than $900. Effective

29  July 1, 1988, the fee amounts shall be the minimum fee

30  prescribed in this paragraph, and such fee amounts shall

31  remain in effect until the effective date of a fee schedule


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    CS for SB 2628                           First Engrossed (ntc)



  1  promulgated by rule by the department.  The fees collected

  2  shall be deposited in the Radiation Protection Trust Fund and

  3  shall be used only to implement the provisions of this

  4  section.  The surcharge established pursuant to subsection (3)

  5  may be used to supplement the fees established in this

  6  paragraph in carrying out the provisions of this subsection.

  7         (g)  The department may establish enforcement

  8  procedures; deny an application for initial or renewal

  9  certification; deny, suspend, or revoke a certification;, or

10  impose an administrative fine not to exceed $1,000 per

11  violation per day, for the violation of any provision of this

12  section or rule adopted under this section promulgated

13  pursuant thereto.

14         (h)  A certificateholder in good standing remains in

15  good standing when he or she becomes a member of the Armed

16  Forces of the United States on active duty without payment of

17  renewal fees as long as he or she is a member of the Armed

18  Forces on active duty and for a period of 6 months after his

19  or her discharge from active duty, if he or she is not engaged

20  in practicing radon measurement or radon mitigation in the

21  private sector for profit.  The certificateholder must pay a

22  renewal fee to renew the certificate.

23         (i)  A certificateholder who is in good standing

24  remains in good standing if he or she is absent from the state

25  because of his or her spouse's active duty with the Armed

26  Forces of the United States. The certificateholder remains in

27  good standing without payment of renewal fees as long as his

28  or her spouse is a member of the Armed Forces on active duty

29  and for a period of 6 months after the spouse's discharge from

30  active duty, if the certificateholder is not engaged in

31  practicing radon measurement or radon mitigation in the


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    CS for SB 2628                           First Engrossed (ntc)



  1  private sector for profit.  The certificateholder must pay a

  2  renewal fee to renew the certificate.

  3         (j)  The department may set criteria and requirements

  4  for the application, certification, and annual renewal of

  5  certification for radon measurement and mitigation businesses,

  6  which may include:

  7         1.  Requirements for measurement devices and

  8  measurement procedures, including the disclosure of mitigation

  9  materials, systems, and other mitigation services offered.

10         2.  The identification of certified specialists and

11  technicians employed by the business and requirements for

12  specialist staffing and duties.

13         3.  The analysis of measurement devices by proficient

14  analytical service providers.

15         4.  Requirements for a quality assurance and quality

16  control program.

17         5.  The disclosure of client measurement reporting

18  forms and warranties and operating instructions for mitigation

19  systems.

20         6.  Requirements for radon services publications and

21  the identification of the radon business certification number

22  in advertisements.

23         7.  Requirements for a worker health and safety

24  program.

25         8.  Requirements for maintaining radon records.

26         9.  The operation of branch office locations.

27         10.  Requirements for supervising subcontractors who

28  install mitigation systems.

29         11.  Requirements for building inspections and

30  evaluation and standards for the design and installation of

31  mitigation systems.


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    CS for SB 2628                           First Engrossed (ntc)



  1         12.  Prescribing conditions of premitigation and

  2  postmitigation mitigation measurements.

  3         13.  Requirements for renewals received after the

  4  automatic expiration date of certification.

  5         14.  Requirements for obtaining a duplicate or

  6  replacement certificate, including a fee not to exceed the

  7  cost of producing the duplicate or replacement certificate.

  8         15.  Requirements for reporting, including timeframes

  9  and content.

10         (k)  Any change in the information provided to the

11  department in the original business application to be reported

12  within 10 days after the change.

13         Section 30.  Subsection (1) of section 404.22, Florida

14  Statutes, is amended to read:

15         404.22  Radiation machines and components;

16  inspection.--

17         (1)  The department and its duly authorized agents may

18  inspect in a lawful manner at all reasonable hours any

19  hospital or other health care facility or other place in the

20  state in which a radiation machine is installed for the

21  purpose of determining whether the facility, the radiation

22  machine and its components, the film and film processing

23  equipment, the techniques and procedures, any mechanical

24  holding devices, the warning labels and signs, the written

25  safety procedures, and the resultant image produced meet the

26  standards of the department as set forth in this chapter and

27  rules adopted pursuant to this chapter thereto. Such rules may

28  include standards for radiation machine performance, surveys,

29  calibrations, and spot checks; requirements for quality

30  assurance programs and quality control programs; standards for

31  facility electrical systems, safety alarms,


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    CS for SB 2628                           First Engrossed (ntc)



  1  radiation-monitoring equipment, and dosimetry systems;

  2  requirements for visual and aural communication with patients;

  3  procedures for establishing radiation-safety committees for a

  4  facility; and qualifications of persons who cause a radiation

  5  machine to be used, who operate a radiation machine, and who

  6  ensure that a radiation machine complies with the requirements

  7  of this chapter and with rules of the department. If, in the

  8  opinion of the department, a radiation machine that which

  9  fails to meet such standards can be made to meet the standards

10  through an adjustment or limitation upon the stations or range

11  of the radiation machine or through the purchase of a

12  component meeting the standards, the department shall order

13  the owner of the radiation machine to make the necessary

14  adjustment or to purchase the necessary component within 90

15  days after of the date or receipt of the order. However, if

16  the radiation machine cannot be made to meet the standards,

17  the department shall order the owner to cease the use

18  utilization of the radiation machine.

19         Section 31.  Subsection (3) of section 489.553, Florida

20  Statutes, is amended to read:

21         489.553  Administration of part; registration

22  qualifications; examination.--

23         (3)  The department shall adopt reasonable rules,

24  including, but not limited to, rules that which establish

25  ethical standards of practice, requirements for registering as

26  a contractor, requirements for obtaining an initial or renewal

27  certificate of registration, disciplinary guidelines, and

28  requirements for the certification of partnerships and

29  corporations. The department and may amend or repeal the rules

30  same in accordance with the Administrative Procedure Act.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         Section 32.  Subsection (1) of section 491.006, Florida

  2  Statutes, is amended to read:

  3         491.006  Licensure or certification by endorsement.--

  4         (1)  The department shall license or grant a

  5  certificate to a person in a profession regulated by this

  6  chapter who, upon applying to the department and remitting the

  7  appropriate fee, demonstrates to the board that he or she:

  8         (a)  Has demonstrated, in a manner designated by rule

  9  of the board, knowledge of the laws and rules governing the

10  practice of clinical social work, marriage and family therapy,

11  and mental health counseling.

12         (b)1.  Holds an active valid license to practice and

13  has actively practiced the profession for which licensure is

14  applied in another state for 3 of the last 5 years immediately

15  preceding licensure.

16         2.  Meets the education requirements of this chapter

17  for the profession for which licensure is applied.

18         3.  Has passed a substantially equivalent licensing

19  examination in another state or has passed the licensure

20  examination in this state in the profession for which the

21  applicant seeks licensure.

22         4.  Holds a license in good standing, is not under

23  investigation for an act that which would constitute a

24  violation of this chapter, and has not been found to have

25  committed any act that which would constitute a violation of

26  this chapter. The fees paid by any applicant for certification

27  as a master social worker under this section are

28  nonrefundable.

29         Section 33.  Subsections (1) and (5) of section

30  491.0145, Florida Statutes, are amended to read:

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         491.0145  Certified master social worker.--The

  2  department may certify an applicant for a designation as a

  3  certified master social worker upon the following conditions:

  4         (1)  The applicant completes an application to be

  5  provided by the department and pays a nonrefundable fee not to

  6  exceed $250 to be established by rule of the department.  The

  7  completed application must be received by the department at

  8  least 60 days before the date of the examination in order for

  9  the applicant to qualify to take the scheduled exam.

10         (5)  The applicant has passed an examination required

11  by the department for this purpose.  The nonrefundable fee for

12  such examination may shall not exceed $250 as set by

13  department rule.

14         Section 34.  Present subsections (11) through (29) of

15  section 499.003, Florida Statutes, are redesignated as

16  subsections (12) through (30), respectively, and a new

17  subsection (11) is added to that section, to read:

18         499.003  Definitions of terms used in ss.

19  499.001-499.081.--As used in ss. 499.001-499.081, the term:

20         (11)  "Distribute or distribution" means to sell; offer

21  to sell; give away; transfer, whether by passage of title,

22  physical movement, or both; deliver; or offer to deliver. The

23  term does not mean to administer or dispense.

24         Section 35.  Subsections (25) and (26) are added to

25  section 499.005, Florida Statutes, to read:

26         499.005  Prohibited acts.--It is unlawful to perform or

27  cause the performance of any of the following acts in this

28  state:

29         (25)  Charging a dispensing fee for dispensing,

30  administering, or distributing a prescription drug sample.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (26)  Dispensing, administering, or distributing an

  2  investigational drug authorized under s. 499.018, except

  3  pursuant to a protocol approved by the department.

  4         Section 36.  Subsection (8) is added to section

  5  499.0054, Florida Statutes, to read:

  6         499.0054  Advertising and labeling of drugs, devices,

  7  and cosmetics.--It is a violation of the Florida Drug and

  8  Cosmetic Act to perform or cause the performance of any of the

  9  following acts:

10         (8)  The representation or suggestion in labeling or

11  advertising that an article is approved under ss.

12  499.001-499.081, when such is not the case.

13         Section 37.  Subsection (2) and paragraph (d) of

14  subsection (4) of section 499.01, Florida Statutes, are

15  amended to read:

16         499.01  Permits; applications; renewal; general

17  requirements.--

18         (2)  The department shall establish, by rule, the form

19  and content of the application to obtain or renew a permit.

20  The applicant must submit to the department with the

21  application a statement that swears or affirms that the

22  information is true and correct.

23         (a)  Information that an applicant must provide

24  includes, but need not be limited to:

25         1.  The name, full business address, and telephone

26  number of the applicant;

27         2.  All trade or business names used by the applicant;

28         3.  The address, telephone numbers, and the names of

29  contact persons for each facility used by the applicant for

30  the storage, handling, and distribution of prescription drugs;

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         4.  The type of ownership or operation, such as a

  2  partnership, corporation, or sole proprietorship; and

  3         5.  The names of the owner and the operator of the

  4  establishment, including:

  5         a.  If an individual, the name of the individual;

  6         b.  If a partnership, the name of each partner and the

  7  name of the partnership;

  8         c.  If a corporation, the name and title of each

  9  corporate officer and director, the corporate names, and the

10  name of the state of incorporation;

11         d.  If a sole proprietorship, the full name of the sole

12  proprietor and the name of the business entity; and

13         e.  Any other relevant information that the department

14  requires.

15         (b)  Upon approval of the application by the department

16  and payment of the required fee, the department shall issue a

17  permit to the applicant, if the applicant meets the

18  requirements of ss. 499.001-499.081 and rules adopted under

19  those sections.

20         (c)  Any change in information required under paragraph

21  (a) must be submitted to the department before the change

22  occurs.

23         (d)  The department shall consider, at a minimum, the

24  following factors in reviewing the qualifications of persons

25  to be permitted under ss. 499.001-499.081:

26         1.  The applicant's having been found guilty,

27  regardless of adjudication, in a court of this state or other

28  jurisdiction, of a violation of a law that directly relates to

29  a drug, device, or cosmetic.  A plea of nolo contendere

30  constitutes a finding of guilt for purposes of this

31  subparagraph.


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    CS for SB 2628                           First Engrossed (ntc)



  1         2.  The applicant's having been disciplined by a

  2  regulatory agency in any state for any offense that would

  3  constitute a violation of ss. 499.001-499.081.

  4         3.  Any felony conviction of the applicant under a

  5  federal, state, or local law;

  6         4.  The applicant's past experience in manufacturing or

  7  distributing drugs, devices, or cosmetics;

  8         5.  The furnishing by the applicant of false or

  9  fraudulent material in any application made in connection with

10  manufacturing or distributing drugs, devices, or cosmetics;

11         6.  Suspension or revocation by a federal, state, or

12  local government of any permit currently or previously held by

13  the applicant for the manufacture or distribution of any

14  drugs, devices, or cosmetics;

15         7.  Compliance with permitting requirements under any

16  previously granted permits;

17         8.  Compliance with requirements to maintain or make

18  available to the state permitting authority or to federal,

19  state, or local law enforcement officials those records

20  required under this section; and

21         9.  Any other factors or qualifications the department

22  considers relevant to and consistent with the public health

23  and safety.

24         (4)  A permit issued by the department is

25  nontransferable.  Each permit is valid only for the person or

26  governmental unit to which it is issued and is not subject to

27  sale, assignment, or other transfer, voluntarily or

28  involuntarily; nor is a permit valid for any establishment

29  other than the establishment for which it was originally

30  issued.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (d)  If an establishment permitted under ss.

  2  499.001-499.081 closes, the owner must notify the department

  3  in writing before the effective date of closure and must:

  4         1.  Return the permit to the department;

  5         2.  If the permittee is authorized to distribute legend

  6  drugs, indicate the disposition of such drugs, including the

  7  name, address, and inventory, and provide the name and address

  8  of a person to contact regarding access to records that are

  9  required to be maintained under ss. 499.001-499.081.  Transfer

10  of ownership of legend drugs may be made only to persons

11  authorized to possess legend drugs under ss. 499.001-499.081.

12         Section 38.  Paragraph (c) is added to subsection (2)

13  of section 499.0121, Florida Statutes, to read:

14         499.0121  Storage and handling of prescription

15  drugs.--The department shall adopt rules to implement this

16  section as necessary to protect the public health, safety, and

17  welfare.  Such rules shall include, but not be limited to,

18  requirements for the storage and handling of prescription

19  drugs and for the establishment and maintenance of

20  prescription drug distribution records.

21         (2)  SECURITY.--

22         (c)  Any vehicle that contains prescription drugs must

23  be secure from unauthorized access to the prescription drugs

24  in the vehicle.

25         Section 39.  Paragraph (b) of subsection (2) of section

26  499.0122, Florida Statutes, is amended to read:

27         499.0122  Medical oxygen and veterinary legend drug

28  retail establishments; definitions, permits, general

29  requirements.--

30         (2)

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (b)  The department shall adopt rules relating to

  2  information required from each retail establishment pursuant

  3  to s. 499.01(2), including requirements for prescriptions or

  4  orders.

  5         Section 40.  Paragraph (d) of subsection (2) of section

  6  499.013, Florida Statutes, is amended, and subsection (4) is

  7  added to that section, to read:

  8         499.013  Manufacturers of drugs, devices, and

  9  cosmetics; definitions, permits, and general requirements.--

10         (2)  Any person that engages in the manufacture of

11  drugs, devices, or cosmetics in this state must first obtain

12  one of the following permits and may engage only in the

13  activity allowed under that permit:

14         (d)  A device manufacturer's permit is required for any

15  person that engages in the manufacture or assembly of medical

16  devices for human use in this state, except that a permit is

17  not required if the person is engaged only in manufacturing or

18  assembling a medical device pursuant to a practitioner's order

19  for a specific patient.

20         1.  A manufacturer of medical devices in this state

21  must comply with all appropriate state and federal good

22  manufacturing practices.

23         2.  The department shall adopt rules related to

24  storage, handling, and recordkeeping requirements for

25  manufacturers of medical devices for human use.

26         (4)  Each manufacturer of medical devices,

27  over-the-counter drugs, or cosmetics must maintain records

28  that include the name and principal address of the seller or

29  transferor of the product, the address of the location from

30  which the product was shipped, the date of the transaction,

31


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    CS for SB 2628                           First Engrossed (ntc)



  1  the name and quantity of the product involved, and the name

  2  and principal address of the person who purchased the product.

  3         Section 41.  Subsections (1) and (3) of section

  4  499.015, Florida Statutes, are amended to read:

  5         499.015  Registration of drugs, devices, and cosmetics;

  6  issuance of certificates of free sale.--

  7         (1)(a)  Except for those persons exempted from the

  8  definition in s. 499.003(22) s. 499.003(21), any person who

  9  manufactures, packages, repackages, labels, or relabels a

10  drug, device, or cosmetic in this state must register such

11  drug, device, or cosmetic biennially with the department; pay

12  a fee in accordance with the fee schedule provided by s.

13  499.041; and comply with this section. The registrant must

14  list each separate and distinct drug, device, or cosmetic at

15  the time of registration.

16         (b)  The department may not register any product that

17  does not comply with the Federal Food, Drug, and Cosmetic Act,

18  as amended, or Title 21 C.F.R., or that is not an approved

19  investigational drug as provided for in s. 499.018.

20  Registration of a product by the department does not mean that

21  the product does in fact comply with all provisions of the

22  Federal Food, Drug, and Cosmetic Act, as amended.

23         (3)  Except for those persons exempted from the

24  definition in s. 499.003(22) s. 499.003(21), a person may not

25  sell any product that he or she has failed to register in

26  conformity with this section. Such failure to register

27  subjects such drug, device, or cosmetic product to seizure and

28  condemnation as provided in ss. 499.062-499.064, and subjects

29  such person to the penalties and remedies provided in ss.

30  499.001-499.081.

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         Section 42.  Subsection (4) of section 499.024, Florida

  2  Statutes, is amended to read:

  3         499.024  Drug product classification.--The secretary

  4  shall adopt rules to classify drug products intended for use

  5  by humans which the United States Food and Drug Administration

  6  has not classified in the federal act or the Code of Federal

  7  Regulations.

  8         (4)  Any product that falls under the drug definition,

  9  s. 499.003(12) s. 499.003(11), may be classified under the

10  authority of this section.  This section does not subject

11  portable emergency oxygen inhalators to classification;

12  however, this section does not exempt any person from ss.

13  499.01 and 499.015.

14         Section 43.  Subsection (1) of section 499.03, Florida

15  Statutes, is amended to read:

16         499.03  Possession of new drugs or legend drugs without

17  prescriptions unlawful; exemptions and exceptions.--

18         (1)  A person may not possess, or possess with intent

19  to sell, dispense, or deliver, any habit-forming, toxic,

20  harmful, or new drug subject to s. 499.003(23) s. 499.003(22),

21  or legend drug as defined in s. 499.003, unless the possession

22  of the drug has been obtained by a valid prescription of a

23  practitioner licensed by law to prescribe the drug.  However,

24  this section does not apply to the delivery of such drugs to

25  persons included in any of the classes named in this

26  subsection, or to the agents or employees of such persons, for

27  use in the usual course of their businesses or practices or in

28  the performance of their official duties, as the case may be;

29  nor does this section apply to the possession of such drugs by

30  those persons or their agents or employees for such use:

31


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    CS for SB 2628                           First Engrossed (ntc)



  1         (a)  A licensed pharmacist or any person under the

  2  licensed pharmacist's supervision while acting within the

  3  scope of the licensed pharmacist's practice;

  4         (b)  A licensed practitioner authorized by law to

  5  prescribe legend drugs or any person under the licensed

  6  practitioner's supervision while acting within the scope of

  7  the licensed practitioner's practice;

  8         (c)  A qualified person who uses legend drugs for

  9  lawful research, teaching, or testing, and not for resale;

10         (d)  A licensed hospital or other institution that

11  procures such drugs for lawful administration or dispensing by

12  practitioners;

13         (e)  An officer or employee of a federal, state, or

14  local government; or

15         (f)  A person that holds a valid permit issued by the

16  department pursuant to ss. 499.001-499.081 which authorizes

17  that person to possess prescription drugs.

18         Section 44.  Subsection (1) of section 499.05, Florida

19  Statutes, is amended to read:

20         499.05  Rules.--

21         (1)  The department shall adopt rules to implement and

22  enforce ss. 499.001-499.081 with respect to:.

23         (a)  The definition of terms used in ss.

24  499.001-499.081, and used in the rules adopted under ss.

25  499.001-499.081, when the use of the term is not its usual and

26  ordinary meaning.

27         (b)  Labeling requirements for drugs, devices, and

28  cosmetics.

29         (c)  Application requirements, protocols, reporting

30  requirements, and requirements for submitting other

31  information to the department and the Florida Drug Technical


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    CS for SB 2628                           First Engrossed (ntc)



  1  Review Panel, as required under the investigational drug

  2  program.

  3         (d)  The establishment of fees authorized in ss.

  4  499.001-499.081.

  5         (e)  The identification of permits that require an

  6  initial application and onsite inspection or other

  7  prerequisites for permitting which demonstrate that the

  8  establishment and person are in compliance with the

  9  requirements of ss. 499.001-499.081.

10         (f)  The application processes and forms for product

11  registration.

12         (g)  Procedures for requesting and issuing certificates

13  of free sale.

14         (h)  Inspections and investigations conducted under s.

15  499.051, and the identification of information claimed to be a

16  trade secret and exempt from the public records law as

17  provided in s. 499.051(5).

18         (i)  The establishment of a range of penalties, as

19  provided in s. 499.006; requirements for notifying persons of

20  the potential impact of a violation of ss. 499.001-499.081;

21  and a process for the uncontested settlement of alleged

22  violations.

23         (j)  Additional conditions that qualify as an emergency

24  medical reason under s. 499.012(1)(a)2.b.

25         Section 45.  Section 499.701, Florida Statutes, is

26  amended to read:

27         499.701  Adoption of rules by the department.--

28         (1)  The department shall adopt and enforce rules

29  necessary to the administration of its authority under this

30  part. The Said rules must shall be such as are reasonably

31  necessary for the protection of the health, welfare, and


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    CS for SB 2628                           First Engrossed (ntc)



  1  safety of the public and persons manufacturing, distributing,

  2  dealing, and possessing ether, and must provide for

  3  application forms and procedures, recordkeeping requirements,

  4  and security. The rules must and shall be in substantial

  5  conformity with generally accepted standards of safety

  6  concerning such subject matter.

  7         (2)  The department may adopt rules regarding

  8  recordkeeping and security for methyl ethyl ketone (MEK) or

  9  butyl acetate as needed.  These products and records are open

10  to inspection in the same manner as are ether products and

11  records.

12         Section 46.  Paragraph (d) of subsection (2) of section

13  501.122, Florida Statutes, is amended to read:

14         501.122  Control of nonionizing radiations; laser;

15  penalties.--

16         (2)  AUTHORITY TO ISSUE REGULATIONS.--Except for

17  electrical transmission and distribution lines and substation

18  facilities subject to regulation by the Department of

19  Environmental Protection pursuant to chapter 403, the

20  Department of Health shall adopt rules as necessary to protect

21  the health and safety of persons exposed to laser devices and

22  other nonionizing radiation, including the user or any others

23  who might come in contact with such radiation. The Department

24  of Health may:

25         (d)  Establish and prescribe performance standards for

26  lasers and other radiation control, including requirements for

27  radiation surveys and measurements and the methods and

28  instruments used to perform surveys; the qualifications,

29  duties, and training of users; the posting of warning signs

30  and labels for facilities and devices; recordkeeping; and

31  reports to the department, if it determines that such


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    CS for SB 2628                           First Engrossed (ntc)



  1  standards are necessary for the protection of the public

  2  health.

  3         Section 47.  Section 513.05, Florida Statutes, is

  4  amended to read:

  5         513.05  Rules.--The department may adopt rules

  6  pertaining to the location, construction, modification,

  7  equipment, and operation of mobile home parks, lodging parks,

  8  recreational vehicle parks, and recreational camps, except as

  9  provided in s. 633.022, as necessary to administer implement

10  this chapter. Such rules may include definitions of terms;

11  requirements for plan reviews of proposed and existing parks

12  and camps; plan reviews of parks that consolidate space or

13  change space size; water supply; sewage collection and

14  disposal; plumbing and backflow prevention; garbage and refuse

15  storage, collection, and disposal; insect and rodent control;

16  space requirements; heating facilities; food service;

17  lighting; sanitary facilities; bedding; an occupancy

18  equivalency to spaces for permits for recreational camps;

19  sanitary facilities in recreational vehicle parks; and the

20  owners' responsibilities at recreational vehicle parks and

21  recreational camps.

22         Section 48.  Section 514.021, Florida Statutes, is

23  amended to read:

24         514.021  Department authorization.--The department may

25  is authorized to adopt and enforce rules, which may include

26  definitions of terms, to protect the health, safety, or

27  welfare of persons using public swimming pools and bathing

28  places.  The department shall review and revise such rules as

29  necessary, but not less than biannually. Sanitation and safety

30  standards shall include, but not be limited to, matters

31  relating to structure; appurtenances; operation; source of


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    CS for SB 2628                           First Engrossed (ntc)



  1  water supply; bacteriological, chemical, and physical quality

  2  of water in the pool or bathing area; method of water

  3  purification, treatment, and disinfection; lifesaving

  4  apparatus; measures to ensure safety of bathers; and measures

  5  to ensure the personal cleanliness of bathers.

  6         Section 49.  Section 766.1115, Florida Statutes, is

  7  amended to read:

  8         766.1115  Health care providers; creation of agency

  9  relationship with governmental contractors.--

10         (1)  SHORT TITLE.--This section may be cited as the

11  "Access to Health Care Act."

12         (2)  FINDINGS AND INTENT.--The Legislature finds that a

13  significant proportion of the residents of this state who are

14  uninsured or Medicaid recipients are unable to access needed

15  health care because health care providers fear the increased

16  risk of medical malpractice liability.  It is the intent of

17  the Legislature that access to medical care for indigent

18  residents be improved by providing governmental protection to

19  health care providers who offer free quality medical services

20  to underserved populations of the state.  Therefore, it is the

21  intent of the Legislature to ensure that health care

22  professionals who contract to provide such services as agents

23  of the state are provided sovereign immunity.

24         (3)  DEFINITIONS.--As used in this section, the term:

25         (a)  "Contract" means an agreement executed in

26  compliance with this section between a health care provider

27  and a governmental contractor. This contract shall allow the

28  health care provider to deliver health care services to

29  low-income recipients as an agent of the governmental

30  contractor. The contract must be for volunteer, uncompensated

31  services.


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    CS for SB 2628                           First Engrossed (ntc)



  1         (b)  "Department" means the Department of Health.

  2         (c)  "Governmental contractor" means the department,

  3  county health departments, a special taxing district with

  4  health care responsibilities, or a hospital owned and operated

  5  by a governmental entity.

  6         (d)  "Health care provider" or "provider" means:

  7         1.  A birth center licensed under chapter 383.

  8         2.  An ambulatory surgical center licensed under

  9  chapter 395.

10         3.  A hospital licensed under chapter 395.

11         4.  A physician or physician assistant licensed under

12  chapter 458.

13         5.  An osteopathic physician or osteopathic physician

14  assistant licensed under chapter 459.

15         6.  A chiropractic physician licensed under chapter

16  460.

17         7.  A podiatric physician licensed under chapter 461.

18         8.  A registered nurse, nurse midwife, licensed

19  practical nurse, or advanced registered nurse practitioner

20  licensed or registered under chapter 464 or any facility which

21  employs nurses licensed or registered under chapter 464 to

22  supply all or part of the care delivered under this section.

23         9.  A midwife licensed under chapter 467.

24         10.  A health maintenance organization certificated

25  under part I of chapter 641.

26         11.  A health care professional association and its

27  employees or a corporate medical group and its employees.

28         12.  Any other medical facility the primary purpose of

29  which is to deliver human medical diagnostic services or which

30  delivers nonsurgical human medical treatment, and which

31  includes an office maintained by a provider.


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    CS for SB 2628                           First Engrossed (ntc)



  1         13.  A dentist or dental hygienist licensed under

  2  chapter 466.

  3         14.  Any other health care professional, practitioner,

  4  provider, or facility under contract with a governmental

  5  contractor, including a student enrolled in an accredited

  6  program that prepares the student for licensure as any one of

  7  the professionals listed in subparagraphs 4. through 9.

  8

  9  The term includes any nonprofit corporation qualified as

10  exempt from federal income taxation under s. 501(c) of the

11  Internal Revenue Code which delivers health care services

12  provided by licensed professionals listed in this paragraph,

13  any federally funded community health center, and any

14  volunteer corporation or volunteer health care provider that

15  delivers health care services.

16         (e)  "Low-income" means:

17         1.  A person who is Medicaid-eligible under Florida

18  law;

19         2.  A person who is without health insurance and whose

20  family income does not exceed 150 percent of the federal

21  poverty level as defined annually by the federal Office of

22  Management and Budget; or

23         3.  Any client of the department who voluntarily

24  chooses to participate in a program offered or approved by the

25  department and meets the program eligibility guidelines of the

26  department.

27         (4)  CONTRACT REQUIREMENTS.--A health care provider

28  that executes a contract with a governmental contractor to

29  deliver health care services on or after April 17, 1992, as an

30  agent of the governmental contractor is an agent for purposes

31  of s. 768.28(9), while acting within the scope of duties


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    CS for SB 2628                           First Engrossed (ntc)



  1  pursuant to the contract, if the contract complies with the

  2  requirements of this section and regardless of whether the

  3  individual treated is later found to be ineligible.  A health

  4  care provider under contract with the state may not be named

  5  as a defendant in any action arising out of the medical care

  6  or treatment provided on or after April 17, 1992, pursuant to

  7  contracts entered into under this section.  The contract must

  8  provide that:

  9         (a)  The right of dismissal or termination of any

10  health care provider delivering services pursuant to the

11  contract is retained by the governmental contractor.

12         (b)  The governmental contractor has access to the

13  patient records of any health care provider delivering

14  services pursuant to the contract.

15         (c)  Adverse incidents and information on treatment

16  outcomes must be reported by any health care provider to the

17  governmental contractor if such incidents and information

18  pertain to a patient treated pursuant to the contract. The

19  health care provider shall annually submit an adverse incident

20  report that includes all information required by s.

21  395.0197(6)(a), unless the adverse incident involves a result

22  described by s. 395.0197(8), in which case it shall be

23  reported within 15 days after the occurrence of such incident.

24  If an incident involves a professional licensed by the

25  Department of Health or a facility licensed by the Agency for

26  Health Care Administration, the governmental contractor shall

27  submit such incident reports to the appropriate department or

28  agency, which shall review each incident and determine whether

29  it involves conduct by the licensee that is subject to

30  disciplinary action. All patient medical records and any

31  identifying information contained in adverse incident reports


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    CS for SB 2628                           First Engrossed (ntc)



  1  and treatment outcomes which are obtained by governmental

  2  entities pursuant to this paragraph are confidential and

  3  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

  4  I of the State Constitution.

  5         (d)  Patient selection and initial referral must be

  6  made solely by the governmental contractor, and the provider

  7  must accept all referred patients. However, the number of

  8  patients that must be accepted may be limited by the contract,

  9  and patients may not be transferred to the provider based on a

10  violation of the antidumping provisions of the Omnibus Budget

11  Reconciliation Act of 1989, the Omnibus Budget Reconciliation

12  Act of 1990, or chapter 395.

13         (e)  If emergency care is required, the patient need

14  not be referred before receiving treatment, but must be

15  referred within 48 hours after treatment is commenced or

16  within 48 hours after the patient has the mental capacity to

17  consent to treatment, whichever occurs later.

18         (f)  Patient care, including any followup or hospital

19  care, is subject to approval by the governmental contractor.

20         (g)  The provider is subject to supervision and regular

21  inspection by the governmental contractor.

22

23  A governmental contractor that is also a health care provider

24  is not required to enter into a contract under this section

25  with respect to the health care services delivered by its

26  employees.

27         (5)  NOTICE OF AGENCY RELATIONSHIP.--The governmental

28  contractor must provide written notice to each patient, or the

29  patient's legal representative, receipt of which must be

30  acknowledged in writing, that the provider is an agent of the

31  governmental contractor and that the exclusive remedy for


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    CS for SB 2628                           First Engrossed (ntc)



  1  injury or damage suffered as the result of any act or omission

  2  of the provider or of any employee or agent thereof acting

  3  within the scope of duties pursuant to the contract is by

  4  commencement of an action pursuant to the provisions of s.

  5  768.28. With respect to any federally funded community health

  6  center, the notice requirements may be met by posting in a

  7  place conspicuous to all persons a notice that the federally

  8  funded community health center is an agent of the governmental

  9  contractor and that the exclusive remedy for injury or damage

10  suffered as the result of any act or omission of the provider

11  or of any employee or agent thereof acting within the scope of

12  duties pursuant to the contract is by commencement of an

13  action pursuant to the provisions of s. 768.28.

14         (6)  QUALITY ASSURANCE PROGRAM REQUIRED.--The

15  governmental contractor shall establish a quality assurance

16  program to monitor services delivered under any contract

17  between an agency and a health care provider pursuant to this

18  section.

19         (7)  RISK MANAGEMENT REPORT.--The Division of Risk

20  Management of the Department of Insurance shall annually

21  compile a report of all claims statistics for all entities

22  participating in the risk management program administered by

23  the division, which shall include the number and total of all

24  claims pending and paid, and defense and handling costs

25  associated with all claims brought against contract providers

26  under this section.  This report shall be forwarded to the

27  department and included in the annual report submitted to the

28  Legislature pursuant to this section.

29         (8)  REPORT TO THE LEGISLATURE.--Annually, the

30  department shall report to the President of the Senate, the

31  Speaker of the House of Representatives, and the minority


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    CS for SB 2628                           First Engrossed (ntc)



  1  leaders and relevant substantive committee chairpersons of

  2  both houses, summarizing the efficacy of access and treatment

  3  outcomes with respect to providing health care services for

  4  low-income persons pursuant to this section.

  5         (9)  MALPRACTICE LITIGATION COSTS.--Governmental

  6  contractors other than the department are responsible for

  7  their own costs and attorney's fees for malpractice litigation

  8  arising out of health care services delivered pursuant to this

  9  section.

10         (10)  RULES.--The department shall adopt rules designed

11  to administer implement this section in a manner consistent

12  with its purpose to provide and facilitate access to

13  appropriate, safe, and cost-effective health care services and

14  to maintain health care quality. The rules may include

15  services to be provided and authorized procedures.

16         (11)  APPLICABILITY.--This section applies to incidents

17  occurring on or after April 17, 1992.  This section does not

18  apply to any health care contract entered into by the

19  Department of Corrections which is subject to s.

20  768.28(10)(a). Nothing in this section in any way reduces or

21  limits the rights of the state or any of its agencies or

22  subdivisions to any benefit currently provided under s.

23  768.28.

24         Section 50.  This act shall take effect upon becoming a

25  law.

26

27

28

29

30

31


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