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



                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___

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

  5

  6

  7

  8

  9

10  ______________________________________________________________

11  Senator Campbell moved the following amendment:

12

13         Senate Amendment (with title amendment) 

14         On page 38, between lines 25 and 26,

15

16  insert:

17         Section 17.  Pursuant to section 187 of chapter 99-397,

18  Laws of Florida, the Agency for Health Care Administration was

19  directed to conduct a detailed study and analysis of clinical

20  laboratory services for kidney dialysis patients in the State

21  of Florida and to report back to the Legislature no later than

22  February 1, 2000. The agency reported that additional time and

23  investigative resources were necessary to adequately respond

24  to the legislative directives. Therefore, the sum of $230,000

25  from the Agency for Health Care Administration Tobacco

26  Settlement Trust Fund is appropriated to the Agency for Health

27  Care Administration to contract with the University of South

28  Florida to conduct a review of laboratory test utilization,

29  any self-referral to clinical laboratories, financial

30  arrangements among kidney dialysis centers, their medical

31  directors, referring physicians, and any business

                                  1
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  relationships and affiliations with clinical laboratories, and

  2  the quality and effectiveness of kidney dialysis treatment in

  3  this state. A report on the findings from such review shall be

  4  presented to the President of the Senate, the Speaker of the

  5  House of Representatives, and the chairs of the appropriate

  6  substantive committees of the Legislature no later than

  7  February 1, 2001.

  8         Section 18.  Florida Commission on Excellence in Health

  9  Care.--

10         (1)  LEGISLATIVE FINDINGS AND INTENT.--The Legislature

11  finds that the health care delivery industry is one of the

12  largest and most complex industries in Florida. The

13  Legislature finds that the current system of regulating health

14  care practitioners and health care providers is one of blame

15  and punishment and does not encourage voluntary admission of

16  errors and immediate corrective action on a large scale. The

17  Legislature finds that previous attempts to identify and

18  address areas which impact the quality of care provided by the

19  health care industry have suffered from a lack of coordination

20  among the industry's stakeholders and regulators. The

21  Legislature finds that additional focus on strengthening

22  health care delivery systems by eliminating avoidable mistakes

23  in the diagnosis and treatment of Floridians holds tremendous

24  promise to increase the quality of health care services

25  available to Floridians, thereby reducing the costs associated

26  with medical mistakes and malpractice and in turn increasing

27  access to health care in the state. To achieve this enhanced

28  focus, it is the intent of the Legislature to create the

29  Florida Commission on Excellence in Health Care to facilitate

30  the development of a comprehensive statewide strategy for

31  improving health care delivery systems through meaningful

                                  2
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  reporting standards, data collection and review, and quality

  2  measurement.

  3         (2)  DEFINITIONS.--As used in this act, the term:

  4         (a)  "Agency" means the Agency for Health Care

  5  Administration.

  6         (b)  "Commission" means the Florida Commission on

  7  Excellence in Health Care.

  8         (c)  "Department" means the Department of Health.

  9         (d)  "Error," with respect to health care, means an

10  unintended act, by omission or commission.

11         (e)  "Health care practitioner" means any person

12  licensed under chapter 457; chapter 458; chapter 459; chapter

13  460; chapter 461; chapter 462; chapter 463; chapter 464;

14  chapter 465; chapter 466; chapter 467; part I, part II, part

15  III, part V, part X, part XIII, or part XIV of chapter 468;

16  chapter 478; chapter 480; part III or part IV of chapter 483;

17  chapter 484; chapter 486; chapter 490; or chapter 491, Florida

18  Statutes.

19         (f)  "Health care provider" means any health care

20  facility or other health care organization licensed or

21  certified to provide approved medical and allied health

22  services in this state.

23         (3)  COMMISSION; DUTIES AND RESPONSIBILITIES.--There is

24  hereby created the Florida Commission on Excellence in Health

25  Care. The commission shall:

26         (a)  Identify existing data sources that evaluate

27  quality of care in Florida and collect, analyze, and evaluate

28  this data.

29         (b)  Establish guidelines for data sharing and

30  coordination.

31         (c)  Identify core sets of quality measures for

                                  3
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  standardized reporting by appropriate components of the health

  2  care continuum.

  3         (d)  Recommend a framework for quality measurement and

  4  outcome reporting.

  5         (e)  Develop quality measures that enhance and improve

  6  the ability to evaluate and improve care.

  7         (f)  Make recommendations regarding research and

  8  development needed to advance quality measurement and

  9  reporting.

10         (g)  Evaluate regulatory issues relating to the

11  pharmacy profession and recommend changes necessary to

12  optimize patient safety.

13         (h)  Facilitate open discussion of a process to ensure

14  that comparative information on health care quality is valid,

15  reliable, comprehensive, understandable, and widely available

16  in the public domain.

17         (i)  Sponsor public hearings to share information and

18  expertise, identify "best practices," and recommend methods to

19  promote their acceptance.

20         (j)  Evaluate current regulatory programs to determine

21  what changes, if any, need to be made to facilitate patient

22  safety.

23         (k)  Review public and private health care purchasing

24  systems to determine if there are sufficient mandates and

25  incentives to facilitate continuous improvement in patient

26  safety.

27         (l)  Analyze how effective existing regulatory systems

28  are in ensuring continuous competence and knowledge of

29  effective safety practices.

30         (m)  Develop a framework for organizations that

31  license, accredit, or credential health care practitioners and

                                  4
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  health care providers to more quickly and effectively identify

  2  unsafe providers and practitioners and to take action

  3  necessary to remove the unsafe provider or practitioner from

  4  practice or operation until such time as the practitioner or

  5  provider has proven safe to practice or operate.

  6         (n)  Recommend procedures for development of a

  7  curriculum on patient safety and methods of incorporating such

  8  curriculum into training, licensure, and certification

  9  requirements.

10         (o)  Develop a framework for regulatory bodies to

11  disseminate information on patient safety to health care

12  practitioners, health care providers, and consumers through

13  conferences, journal articles and editorials, newsletters,

14  publications, and Internet websites.

15         (p)  Recommend procedures to incorporate recognized

16  patient safety considerations into practice guidelines and

17  into standards related to the introduction and diffusion of

18  new technologies, therapies, and drugs.

19         (q)  Recommend a framework for development of

20  community-based collaborative initiatives for error reporting

21  and analysis and implementation of patient safety

22  improvements.

23         (r)  Evaluate the role of advertising in promoting or

24  adversely affecting patient safety.

25         (s)  Evaluate and make recommendations regarding the

26  need for licensure of additional persons who participate in

27  the delivery of health care to Floridians, including, but not

28  limited to, surgical technologists and pharmacy technicians.

29         (t)  Evaluate the benefits and problems of the current

30  disciplinary systems and make recommendations regarding

31  alternatives and improvements.

                                  5
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (4)  MEMBERSHIP, ORGANIZATION, MEETINGS, PROCEDURES,

  2  STAFF.--

  3         (a)  The commission shall consist of:

  4         1.  The Secretary of Health and the Executive Director

  5  of the Agency for Health Care Administration.

  6         2.  One representative each from the following agencies

  7  or organizations:  the Board of Medicine, the Board of

  8  Osteopathic Medicine, the Board of Pharmacy, the Board of

  9  Nursing, the Board of Dentistry, the Florida Dental

10  Association, the Florida Medical Association, the Florida

11  Osteopathic Medical Association, the Florida Academy of

12  Physician Assistants, the Florida Chiropractic Society, the

13  Florida Chiropractic Association, the Florida Podiatric

14  Medical Association, the Florida Society of Ambulatory

15  Surgical Centers, the Florida Statutory Teaching Hospital

16  Council, Inc., the Florida Statutory Rural Hospital Council,

17  the Florida Nurses Association, the Florida Organization of

18  Nursing Executives, the Florida Pharmacy Association, the

19  Florida Society of Health System Pharmacists, Inc., the

20  Florida Retail Federation, the Florida Hospital Association,

21  the Association of Community Hospitals and Health Systems of

22  Florida, Inc., the Florida League of Health Care Systems, the

23  Florida Health Care Risk Management Advisory Council, the

24  Florida Health Care Association, and the Florida Association

25  of Homes for the Aging;

26         3.  One licensed clinical laboratory director,

27  appointed by the Secretary of Health;

28         4.  Two health lawyers, appointed by the Secretary of

29  Health, one of whom shall be a member of The Florida Bar

30  Health Law Section who defends physicians and one of whom

31  shall be a member of the Florida Academy of Trial Lawyers;

                                  6
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         5.  One representative of the medical malpractice

  2  professional liability insurance industry, appointed by the

  3  Secretary of Health;

  4         6.  One representative of a Florida medical school

  5  appointed by the Secretary of Health;

  6         7.  Two representatives of the health insurance

  7  industry, appointed by the Executive Director of the Agency

  8  for Health Care Administration, one of whom shall represent

  9  indemnity plans and one of whom shall represent managed care;

10         8.  Four consumer advocates, consisting of one from the

11  Association for Responsible Medicine, one appointed by the

12  Governor, one appointed by the President of the Senate, and

13  one appointed by the Speaker of the House of Representatives;

14  and

15         9.  Two legislators, one appointed by the President of

16  the Senate and one appointed by the Speaker of the House of

17  Representatives.

18

19  Commission membership shall reflect the geographic and

20  demographic diversity of the state.

21         (b)  The Secretary of Health and the Executive Director

22  of the Agency for Health Care Administration shall jointly

23  chair the commission. Subcommittees shall be formed by the

24  joint chairs, as needed, to make recommendations to the full

25  commission on the subjects assigned. However, all votes on

26  work products of the commission shall be at the full

27  commission level, and all recommendations to the Governor, the

28  President of the Senate, and the Speaker of the House of

29  Representatives must pass by a two-thirds vote of the full

30  commission. Sponsoring agencies and organizations may

31  designate an alternative member who may attend and vote on

                                  7
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  behalf of the sponsoring agency or organization in the event

  2  the appointed member is unable to attend a meeting of the

  3  commission or any subcommittee. The commission shall be

  4  staffed by employees of the Department of Health and the

  5  Agency for Health Care Administration. Sponsoring agencies or

  6  organizations must fund the travel and related expenses of

  7  their appointed members on the commission. Travel and related

  8  expenses for the consumer members of the commission shall be

  9  reimbursed by the state pursuant to s. 112.061, Florida

10  Statutes. The commission shall hold its first meeting no later

11  than July 15, 2000.

12         (5)  EVIDENTIARY PROHIBITIONS.--

13         (a)  The findings, recommendations, evaluations,

14  opinions, investigations, proceedings, records, reports,

15  minutes, testimony, correspondence, work product, and actions

16  of the commission shall be available to the public, but may

17  not be introduced into evidence at any civil, criminal,

18  special, or administrative proceeding against a health care

19  practitioner or health care provider arising out of the

20  matters which are the subject of the findings of the

21  commission. Moreover, no member of the commission shall be

22  examined in any civil, criminal, special, or administrative

23  proceeding against a health care practitioner or health care

24  provider as to any evidence or other matters produced or

25  presented during the proceedings of this commission or as to

26  any findings, recommendations, evaluations, opinions,

27  investigations, proceedings, records, reports, minutes,

28  testimony, correspondence, work product, or other actions of

29  the commission or any members thereof. However, nothing in

30  this section shall be construed to mean that information,

31  documents, or records otherwise available and obtained from

                                  8
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  original sources are immune from discovery or use in any

  2  civil, criminal, special, or administrative proceeding merely

  3  because they were presented during proceedings of the

  4  commission. Nor shall any person who testifies before the

  5  commission or who is a member of the commission be prevented

  6  from testifying as to matters within his or her knowledge in a

  7  subsequent civil, criminal, special, or administrative

  8  proceeding merely because such person testified in front of

  9  the commission.

10         (b)  The findings, recommendations, evaluations,

11  opinions, investigations, proceedings, records, reports,

12  minutes, testimony, correspondence, work product, and actions

13  of the commission shall be used as a guide and resource and

14  shall not be construed as establishing or advocating the

15  standard of care for health care practitioners or health care

16  providers unless subsequently enacted into law or adopted in

17  rule. Nor shall any findings, recommendations, evaluations,

18  opinions, investigations, proceedings, records, reports,

19  minutes, testimony, correspondence, work product, or actions

20  of the commission be admissible as evidence in any way,

21  directly or indirectly, by introduction of documents or as a

22  basis of an expert opinion as to the standard of care

23  applicable to health care practitioners or health care

24  providers in any civil, criminal, special, or administrative

25  proceeding unless subsequently enacted into law or adopted in

26  rule.

27         (c)  No person who testifies before the commission or

28  who is a member of the commission may specifically identify

29  any patient, health care practitioner, or health care provider

30  by name. Moreover, the findings, recommendations, evaluations,

31  opinions, investigations, proceedings, records, reports,

                                  9
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  minutes, testimony, correspondence, work product, and actions

  2  of the commission may not specifically identify any patient,

  3  health care practitioner, or health care provider by name.

  4         (6)  REPORT; TERMINATION.--The commission shall provide

  5  a report of its findings and recommendations to the Governor,

  6  the President of the Senate, and the Speaker of the House of

  7  Representatives no later than February 1, 2001. After

  8  submission of the report, the commission shall continue to

  9  exist for the purpose of assisting the Department of Health,

10  the Agency for Health Care Administration, and the regulatory

11  boards in their drafting of proposed legislation and rules to

12  implement its recommendations and for the purpose of providing

13  information to the health care industry on its

14  recommendations. The commission shall be terminated June 1,

15  2001.

16         Section 19.  The sum of $91,000 in nonrecurring general

17  revenue is hereby appropriated from the General Revenue Fund

18  to the Department of Health to cover costs of the Florida

19  Commission on Excellence in Health Care relating to the travel

20  and related expenses of staff, consumer members, and members

21  appointed by the department or agency; the hiring of

22  consultants, if necessary; and the reproduction and

23  dissemination of documents; however, no portion of this

24  appropriation shall be effective that duplicates a similar

25  appropriation for the same purpose contained in other

26  legislation from the 2000 legislative session that becomes

27  law.

28         Section 20.  The sum of $200,000 is appropriated from

29  the Insurance Commissioner's Regulatory Trust Fund to the

30  Office of Legislative Services for the purpose of implementing

31  the legislative intent expressed in s. 624.215(1), Florida

                                  10
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Statutes, for a systematic review of current mandated health

  2  coverages. The review must be conducted by certified actuaries

  3  and other appropriate professionals and shall consist of an

  4  assessment of the impact, including, but not limited to, the

  5  costs and benefits, of current mandated health coverages using

  6  the guidelines provided in s. 624.215(2), Florida Statutes.

  7  This assessment shall establish the aggregate cost of mandated

  8  health coverages.

  9         Section 21.  Subsections (1) and (3) of section

10  455.564, Florida Statutes, are amended to read:

11         455.564  Department; general licensing provisions.--

12         (1)(a)  Any person desiring to be licensed in a

13  profession within the jurisdiction of the department shall

14  apply to the department in writing to take the licensure

15  examination.  The application shall be made on a form prepared

16  and furnished by the department. The application form must be

17  available on the World Wide Web and the department may accept

18  electronically submitted applications beginning July 1, 2001.

19  The application and shall require the social security number

20  of the applicant, except as provided in paragraph (b). The

21  form shall be supplemented as needed to reflect any material

22  change in any circumstance or condition stated in the

23  application which takes place between the initial filing of

24  the application and the final grant or denial of the license

25  and which might affect the decision of the department. If an

26  application is submitted electronically, the department may

27  require supplemental materials, including an original

28  signature of the applicant and verification of credentials, to

29  be submitted in a non-electronic format. An incomplete

30  application shall expire 1 year after initial filing. In order

31  to further the economic development goals of the state, and

                                  11
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  notwithstanding any law to the contrary, the department may

  2  enter into an agreement with the county tax collector for the

  3  purpose of appointing the county tax collector as the

  4  department's agent to accept applications for licenses and

  5  applications for renewals of licenses. The agreement must

  6  specify the time within which the tax collector must forward

  7  any applications and accompanying application fees to the

  8  department.

  9         (b)  If an applicant has not been issued a social

10  security number by the Federal Government at the time of

11  application because the applicant is not a citizen or resident

12  of this country, the department may process the application

13  using a unique personal identification number. If such an

14  applicant is otherwise eligible for licensure, the board, or

15  the department when there is no board, may issue a temporary

16  license to the applicant, which shall expire 30 days after

17  issuance unless a social security number is obtained and

18  submitted in writing to the department. Upon receipt of the

19  applicant's social security number, the department shall issue

20  a new license, which shall expire at the end of the current

21  biennium.

22         (3)(a)  The board, or the department when there is no

23  board, may refuse to issue an initial license to any applicant

24  who is under investigation or prosecution in any jurisdiction

25  for an action that would constitute a violation of this part

26  or the professional practice acts administered by the

27  department and the boards, until such time as the

28  investigation or prosecution is complete, and the time period

29  in which the licensure application must be granted or denied

30  shall be tolled until 15 days after the receipt of the final

31  results of the investigation or prosecution.

                                  12
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (b)  If an applicant has been convicted of a felony

  2  related to the practice or ability to practice any health care

  3  profession, the board, or the department when there is no

  4  board, may require the applicant to prove that his or her

  5  civil rights have been restored.

  6         (c)  In considering applications for licensure, the

  7  board, or the department when there is no board, may require a

  8  personal appearance of the applicant. If the applicant is

  9  required to appear, the time period in which a licensure

10  application must be granted or denied shall be tolled until

11  such time as the applicant appears. However, if the applicant

12  fails to appear before the board at either of the next two

13  regularly scheduled board meetings, or fails to appear before

14  the department within 30 days if there is no board, the

15  application for licensure shall be denied.

16         Section 22.  Paragraph (d) is added to subsection (4)

17  of section 455.565, Florida Statutes, to read:

18         455.565  Designated health care professionals;

19  information required for licensure.--

20         (4)

21         (d)  Any applicant for initial licensure or renewal of

22  licensure as a health care practitioner who submits to the

23  Department of Health a set of fingerprints or information

24  required for the criminal history check required under this

25  section shall not be required to provide a subsequent set of

26  fingerprints or other duplicate information required for a

27  criminal history check to the Agency for Health Care

28  Administration, the Department of Juvenile Justice, or the

29  Department of Children and Family Services for employment or

30  licensure with such agency or department if the applicant has

31  undergone a criminal history check as a condition of initial

                                  13
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  licensure or licensure renewal as a health care practitioner

  2  with the Department of Health or any of its regulatory boards,

  3  notwithstanding any other provision of law to the contrary. In

  4  lieu of such duplicate submission, the Agency for Health Care

  5  Administration, the Department of Juvenile Justice, and the

  6  Department of Children and Family Services shall obtain

  7  criminal history information for employment or licensure of

  8  health care practitioners by such agency and departments from

  9  the Department of Health's health care practitioner

10  credentialing system.

11         Section 23.  Section 455.5651, Florida Statutes, is

12  amended to read:

13         455.5651  Practitioner profile; creation.--

14         (1)  Beginning July 1, 1999, the Department of Health

15  shall compile the information submitted pursuant to s. 455.565

16  into a practitioner profile of the applicant submitting the

17  information, except that the Department of Health may develop

18  a format to compile uniformly any information submitted under

19  s. 455.565(4)(b).

20         (2)  On the profile published required under subsection

21  (1), the department shall indicate if the information provided

22  under s. 455.565(1)(a)7. is not corroborated by a criminal

23  history check conducted according to this subsection. If the

24  information provided under s. 455.565(1)(a)7. is corroborated

25  by the criminal history check, the fact that the criminal

26  history check was performed need not be indicated on the

27  profile. The department, or the board having regulatory

28  authority over the practitioner acting on behalf of the

29  department, shall investigate any information received by the

30  department or the board when it has reasonable grounds to

31  believe that the practitioner has violated any law that

                                  14
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  relates to the practitioner's practice.

  2         (3)  The Department of Health may include in each

  3  practitioner's practitioner profile that criminal information

  4  that directly relates to the practitioner's ability to

  5  competently practice his or her profession.  The department

  6  must include in each practitioner's practitioner profile the

  7  following statement:  "The criminal history information, if

  8  any exists, may be incomplete; federal criminal history

  9  information is not available to the public."

10         (4)  The Department of Health shall include, with

11  respect to a practitioner licensed under chapter 458 or

12  chapter 459, a statement of how the practitioner has elected

13  to comply with the financial responsibility requirements of s.

14  458.320 or s. 459.0085. The department shall include, with

15  respect to practitioners subject to s. 455.694, a statement of

16  how the practitioner has elected to comply with the financial

17  responsibility requirements of that section. The department

18  shall include, with respect to practitioners licensed under

19  chapter 458, chapter 459, or chapter 461, information relating

20  to liability actions which has been reported under s. 455.697

21  or s. 627.912 within the previous 10 years for any paid claim

22  that exceeds $5,000. Such claims information shall be reported

23  in the context of comparing an individual practitioner's

24  claims to the experience of other practitioners physicians

25  within the same specialty, or profession if the practitioner

26  is not a specialist, to the extent such information is

27  available to the Department of Health. If information relating

28  to a liability action is included in a practitioner's

29  practitioner profile, the profile must also include the

30  following statement:  "Settlement of a claim may occur for a

31  variety of reasons that do not necessarily reflect negatively

                                  15
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  on the professional competence or conduct of the practitioner

  2  physician.  A payment in settlement of a medical malpractice

  3  action or claim should not be construed as creating a

  4  presumption that medical malpractice has occurred."

  5         (5)  The Department of Health may not include

  6  disciplinary action taken by a licensed hospital or an

  7  ambulatory surgical center in the practitioner profile.

  8         (6)  The Department of Health may include in the

  9  practitioner's practitioner profile any other information that

10  is a public record of any governmental entity and that relates

11  to a practitioner's ability to competently practice his or her

12  profession.  However, the department must consult with the

13  board having regulatory authority over the practitioner before

14  such information is included in his or her profile.

15         (7)  Upon the completion of a practitioner profile

16  under this section, the Department of Health shall furnish the

17  practitioner who is the subject of the profile a copy of it.

18  The practitioner has a period of 30 days in which to review

19  the profile and to correct any factual inaccuracies in it. The

20  Department of Health shall make the profile available to the

21  public at the end of the 30-day period. The department shall

22  make the profiles available to the public through the World

23  Wide Web and other commonly used means of distribution.

24         (8)  Making a practitioner profile available to the

25  public under this section does not constitute agency action

26  for which a hearing under s. 120.57 may be sought.

27         Section 24.  Section 455.5653, Florida Statutes, is

28  amended to read:

29         455.5653  Practitioner profiles; data

30  storage.--Effective upon this act becoming a law, the

31  Department of Health must develop or contract for a computer

                                  16
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  system to accommodate the new data collection and storage

  2  requirements under this act pending the development and

  3  operation of a computer system by the Department of Health for

  4  handling the collection, input, revision, and update of data

  5  submitted by physicians as a part of their initial licensure

  6  or renewal to be compiled into individual practitioner

  7  profiles. The Department of Health must incorporate any data

  8  required by this act into the computer system used in

  9  conjunction with the regulation of health care professions

10  under its jurisdiction. The department must develop, by the

11  year 2000, a schedule and procedures for each practitioner

12  within a health care profession regulated within the Division

13  of Medical Quality Assurance to submit relevant information to

14  be compiled into a profile to be made available to the public.

15  The Department of Health is authorized to contract with and

16  negotiate any interagency agreement necessary to develop and

17  implement the practitioner profiles. The Department of Health

18  shall have access to any information or record maintained by

19  the Agency for Health Care Administration, including any

20  information or record that is otherwise confidential and

21  exempt from the provisions of chapter 119 and s. 24(a), Art. I

22  of the State Constitution, so that the Department of Health

23  may corroborate any information that practitioners physicians

24  are required to report under s. 455.565.

25         Section 25.  Section 455.5654, Florida Statutes, is

26  amended to read:

27         455.5654  Practitioner profiles; rules;

28  workshops.--Effective upon this act becoming a law, the

29  Department of Health shall adopt rules for the form of a

30  practitioner profile that the agency is required to prepare.

31  The Department of Health, pursuant to chapter 120, must hold

                                  17
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  public workshops for purposes of rule development to implement

  2  this section. An agency to which information is to be

  3  submitted under this act may adopt by rule a form for the

  4  submission of the information required under s. 455.565.

  5         Section 26.  Subsection (1) of section 455.567, Florida

  6  Statutes, is amended to read:

  7         455.567  Sexual misconduct; disqualification for

  8  license, certificate, or registration.--

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

10  profession means violation of the professional relationship

11  through which the health care practitioner uses such

12  relationship to engage or attempt to engage the patient or

13  client, or an immediate family member, guardian, or

14  representative of the patient or client in, or to induce or

15  attempt to induce such person to engage in, verbal or physical

16  sexual activity outside the scope of the professional practice

17  of such health care profession. Sexual misconduct in the

18  practice of a health care profession is prohibited.

19         Section 27.  Paragraphs (f) and (u) of subsection (1),

20  paragraph (c) of subsection (2), and subsection (3) of section

21  455.624, Florida Statutes, are amended, and paragraphs (y) and

22  (z) are added to subsection (1) of said section, to read:

23         455.624  Grounds for discipline; penalties;

24  enforcement.--

25         (1)  The following acts shall constitute grounds for

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

27  be taken:

28         (f)  Having a license or the authority to practice any

29  the regulated profession revoked, suspended, or otherwise

30  acted against, including the denial of licensure, by the

31  licensing authority of any jurisdiction, including its

                                  18
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  agencies or subdivisions, for a violation that would

  2  constitute a violation under Florida law. The licensing

  3  authority's acceptance of a relinquishment of licensure,

  4  stipulation, consent order, or other settlement, offered in

  5  response to or in anticipation of the filing of charges

  6  against the license, shall be construed as action against the

  7  license.

  8         (u)  Engaging or attempting to engage in sexual

  9  misconduct as defined and prohibited in s. 455.567(1) a

10  patient or client in verbal or physical sexual activity. For

11  the purposes of this section, a patient or client shall be

12  presumed to be incapable of giving free, full, and informed

13  consent to verbal or physical sexual activity.

14         (y)  Being unable to practice with reasonable skill and

15  safety to patients by reason of illness or use of alcohol,

16  drugs, narcotics, chemicals, or any other type of material or

17  as a result of any mental or physical condition. In enforcing

18  this paragraph, the department shall have, upon a finding of

19  the secretary or the secretary's designee that probable cause

20  exists to believe that the licensee is unable to practice

21  because of the reasons stated in this paragraph, the authority

22  to issue an order to compel a licensee to submit to a mental

23  or physical examination by physicians designated by the

24  department. If the licensee refuses to comply with such order,

25  the department's order directing such examination may be

26  enforced by filing a petition for enforcement in the circuit

27  court where the licensee resides or does business. The

28  department shall be entitled to the summary procedure provided

29  in s. 51.011. A licensee or certificateholder affected under

30  this paragraph shall at reasonable intervals be afforded an

31  opportunity to demonstrate that he or she can resume the

                                  19
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  competent practice of his or her profession with reasonable

  2  skill and safety to patients.

  3         (z)  Testing positive for any drug, as defined in s.

  4  112.0455, on any confirmed preemployment or employer-ordered

  5  drug screening when the practitioner does not have a lawful

  6  prescription and legitimate medical reason for using such

  7  drug.

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

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

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

11  practice act, including conduct constituting a substantial

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

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

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

15  penalties:

16         (c)  Restriction of practice or license.

17

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

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

20  sanctions are necessary to protect the public or to compensate

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

22  the disciplining authority consider and include in the order

23  requirements designed to rehabilitate the practitioner. All

24  costs associated with compliance with orders issued under this

25  subsection are the obligation of the practitioner.

26         (3)(a)  Notwithstanding subsection (2), if the ground

27  for disciplinary action is the first-time failure of the

28  licensee to satisfy continuing education requirements

29  established by the board, or by the department if there is no

30  board, the board or department, as applicable, shall issue a

31  citation in accordance with s. 455.617 and assess a fine, as

                                  20
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  determined by the board or department by rule. In addition,

  2  for each hour of continuing education not completed or

  3  completed late, the board or department, as applicable, may

  4  require the licensee to take 1 additional hour of continuing

  5  education for each hour not completed or completed late.

  6         (b)  Notwithstanding subsection (2), if the ground for

  7  disciplinary action is the first-time violation of a practice

  8  act for unprofessional conduct, as used in ss. 464.018(1)(h),

  9  467.203(1)(f), 468.365(1)(f), and 478.52(1)(f), and no actual

10  harm to the patient occurred, the board or department, as

11  applicable, shall issue a citation in accordance with s.

12  455.617 and assess a penalty as determined by rule of the

13  board or department.

14         Section 28.  For the purpose of incorporating the

15  amendment to section 455.624, Florida Statutes, in references

16  thereto, the sections or subdivisions of Florida Statutes set

17  forth below are reenacted to read:

18         455.577  Penalty for theft or reproduction of an

19  examination.--In addition to, or in lieu of, any other

20  discipline imposed pursuant to s. 455.624, the theft of an

21  examination in whole or in part or the act of reproducing or

22  copying any examination administered by the department,

23  whether such examination is reproduced or copied in part or in

24  whole and by any means, constitutes a felony of the third

25  degree, punishable as provided in s. 775.082, s. 775.083, or

26  s. 775.084.

27         455.631  Penalty for giving false information.--In

28  addition to, or in lieu of, any other discipline imposed

29  pursuant to s. 455.624, the act of knowingly giving false

30  information in the course of applying for or obtaining a

31  license from the department, or any board thereunder, with

                                  21
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  intent to mislead a public servant in the performance of his

  2  or her official duties, or the act of attempting to obtain or

  3  obtaining a license from the department, or any board

  4  thereunder, to practice a profession by knowingly misleading

  5  statements or knowing misrepresentations constitutes a felony

  6  of the third degree, punishable as provided in s. 775.082, s.

  7  775.083, or s. 775.084.

  8         455.651  Disclosure of confidential information.--

  9         (2)  Any person who willfully violates any provision of

10  this section is guilty of a misdemeanor of the first degree,

11  punishable as provided in s. 775.082 or s. 775.083, and may be

12  subject to discipline pursuant to s. 455.624, and, if

13  applicable, shall be removed from office, employment, or the

14  contractual relationship.

15         455.712  Business establishments; requirements for

16  active status licenses.--

17         (1)  A business establishment regulated by the Division

18  of Medical Quality Assurance pursuant to this part may provide

19  regulated services only if the business establishment has an

20  active status license. A business establishment that provides

21  regulated services without an active status license is in

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

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

24  the business establishment.

25         458.347  Physician assistants.--

26         (7)  PHYSICIAN ASSISTANT LICENSURE.--

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

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

29  physician assistant if the physician assistant or the

30  supervising physician has been found guilty of or is being

31  investigated for any act that constitutes a violation of this

                                  22
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  chapter or part II of chapter 455.

  2         459.022  Physician assistants.--

  3         (7)  PHYSICIAN ASSISTANT LICENSURE.--

  4         (f)  The Board of Osteopathic Medicine may impose any

  5  of the penalties specified in ss. 455.624 and 459.015(2) upon

  6  a physician assistant if the physician assistant or the

  7  supervising physician has been found guilty of or is being

  8  investigated for any act that constitutes a violation of this

  9  chapter or part II of chapter 455.

10         468.1755  Disciplinary proceedings.--

11         (1)  The following acts shall constitute grounds for

12  which the disciplinary actions in subsection (2) may be taken:

13         (a)  Violation of any provision of s. 455.624(1) or s.

14  468.1745(1).

15         468.719  Disciplinary actions.--

16         (1)  The following acts shall be grounds for

17  disciplinary actions provided for in subsection (2):

18         (a)  A violation of any law relating to the practice of

19  athletic training, including, but not limited to, any

20  violation of this part, s. 455.624, or any rule adopted

21  pursuant thereto.

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

23  the acts set forth in subsection (1), the board may enter an

24  order imposing one or more of the penalties provided in s.

25  455.624.

26         468.811  Disciplinary proceedings.--

27         (1)  The following acts are grounds for disciplinary

28  action against a licensee and the issuance of cease and desist

29  orders or other related action by the department, pursuant to

30  s. 455.624, against any person who engages in or aids in a

31  violation.

                                  23
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (a)  Attempting to procure a license by fraudulent

  2  misrepresentation.

  3         (b)  Having a license to practice orthotics,

  4  prosthetics, or pedorthics revoked, suspended, or otherwise

  5  acted against, including the denial of licensure in another

  6  jurisdiction.

  7         (c)  Being convicted or found guilty of or pleading

  8  nolo contendere to, regardless of adjudication, in any

  9  jurisdiction, a crime that directly relates to the practice of

10  orthotics, prosthetics, or pedorthics, including violations of

11  federal laws or regulations regarding orthotics, prosthetics,

12  or pedorthics.

13         (d)  Filing a report or record that the licensee knows

14  is false, intentionally or negligently failing to file a

15  report or record required by state or federal law, willfully

16  impeding or obstructing such filing, or inducing another

17  person to impede or obstruct such filing. Such reports or

18  records include only reports or records that are signed in a

19  person's capacity as a licensee under this act.

20         (e)  Advertising goods or services in a fraudulent,

21  false, deceptive, or misleading manner.

22         (f)  Violation of this act or part II of chapter 455,

23  or any rules adopted thereunder.

24         (g)  Violation of an order of the board, agency, or

25  department previously entered in a disciplinary hearing or

26  failure to comply with a subpoena issued by the board, agency,

27  or department.

28         (h)  Practicing with a revoked, suspended, or inactive

29  license.

30         (i)  Gross or repeated malpractice or the failure to

31  deliver orthotic, prosthetic, or pedorthic services with that

                                  24
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  level of care and skill which is recognized by a reasonably

  2  prudent licensed practitioner with similar professional

  3  training as being acceptable under similar conditions and

  4  circumstances.

  5         (j)  Failing to provide written notice of any

  6  applicable warranty for an orthosis, prosthesis, or pedorthic

  7  device that is provided to a patient.

  8         (2)  The board may enter an order imposing one or more

  9  of the penalties in s. 455.624(2) against any person who

10  violates any provision of subsection (1).

11         484.056  Disciplinary proceedings.--

12         (1)  The following acts relating to the practice of

13  dispensing hearing aids shall be grounds for both disciplinary

14  action against a hearing aid specialist as set forth in this

15  section and cease and desist or other related action by the

16  department as set forth in s. 455.637 against any person

17  owning or operating a hearing aid establishment who engages

18  in, aids, or abets any such violation:

19         (a)  Violation of any provision of s. 455.624(1), s.

20  484.0512, or s. 484.053.

21         Section 29.  Section 455.704, Florida Statutes, is

22  repealed.

23         Section 30.  Subsections (1), (2), and (3) of section

24  455.707, Florida Statutes, are amended to read:

25         455.707  Treatment programs for impaired

26  practitioners.--

27         (1)  For professions that do not have impaired

28  practitioner programs provided for in their practice acts, the

29  department shall, by rule, designate approved impaired

30  practitioner treatment programs under this section. The

31  department may adopt rules setting forth appropriate criteria

                                  25
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  for approval of treatment providers based on the policies and

  2  guidelines established by the Impaired Practitioners

  3  Committee.  The rules may must specify the manner in which the

  4  consultant, retained as set forth in subsection (2), works

  5  with the department in intervention, requirements for

  6  evaluating and treating a professional, and requirements for

  7  the continued care and monitoring of a professional by the

  8  consultant by an approved at a department-approved treatment

  9  provider.  The department shall not compel any impaired

10  practitioner program in existence on October 1, 1992, to serve

11  additional professions.

12         (2)  The department shall retain one or more impaired

13  practitioner consultants as recommended by the committee.  A

14  consultant shall be a licensee or recovered licensee under the

15  jurisdiction of the Division of Medical Quality Assurance

16  within the department, and at least one consultant must be a

17  practitioner or recovered practitioner licensed under chapter

18  458, chapter 459, or chapter 464.  The consultant shall assist

19  the probable cause panel and department in carrying out the

20  responsibilities of this section.  This shall include working

21  with department investigators to determine whether a

22  practitioner is, in fact, impaired.

23         (3)(a)  Whenever the department receives a written or

24  oral legally sufficient complaint alleging that a licensee

25  under the jurisdiction of the Division of Medical Quality

26  Assurance within the department is impaired as a result of the

27  misuse or abuse of alcohol or drugs, or both, or due to a

28  mental or physical condition which could affect the licensee's

29  ability to practice with skill and safety, and no complaint

30  against the licensee other than impairment exists, the

31  reporting of such information shall not constitute grounds for

                                  26
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  discipline pursuant to s. 455.624 or the corresponding grounds

  2  for discipline within the applicable practice act a complaint

  3  within the meaning of s. 455.621 if the probable cause panel

  4  of the appropriate board, or the department when there is no

  5  board, finds:

  6         1.  The licensee has acknowledged the impairment

  7  problem.

  8         2.  The licensee has voluntarily enrolled in an

  9  appropriate, approved treatment program.

10         3.  The licensee has voluntarily withdrawn from

11  practice or limited the scope of practice as required by the

12  consultant determined by the panel, or the department when

13  there is no board, in each case, until such time as the panel,

14  or the department when there is no board, is satisfied the

15  licensee has successfully completed an approved treatment

16  program.

17         4.  The licensee has executed releases for medical

18  records, authorizing the release of all records of

19  evaluations, diagnoses, and treatment of the licensee,

20  including records of treatment for emotional or mental

21  conditions, to the consultant. The consultant shall make no

22  copies or reports of records that do not regard the issue of

23  the licensee's impairment and his or her participation in a

24  treatment program.

25         (b)  If, however, the department has not received a

26  legally sufficient complaint and the licensee agrees to

27  withdraw from practice until such time as the consultant

28  determines the licensee has satisfactorily completed an

29  approved treatment program or evaluation, the probable cause

30  panel, or the department when there is no board, shall not

31  become involved in the licensee's case.

                                  27
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (c)  Inquiries related to impairment treatment programs

  2  designed to provide information to the licensee and others and

  3  which do not indicate that the licensee presents a danger to

  4  the public shall not constitute a complaint within the meaning

  5  of s. 455.621 and shall be exempt from the provisions of this

  6  subsection.

  7         (d)  Whenever the department receives a legally

  8  sufficient complaint alleging that a licensee is impaired as

  9  described in paragraph (a) and no complaint against the

10  licensee other than impairment exists, the department shall

11  forward all information in its possession regarding the

12  impaired licensee to the consultant. For the purposes of this

13  section, a suspension from hospital staff privileges due to

14  the impairment does not constitute a complaint.

15         (e)  The probable cause panel, or the department when

16  there is no board, shall work directly with the consultant,

17  and all information concerning a practitioner obtained from

18  the consultant by the panel, or the department when there is

19  no board, shall remain confidential and exempt from the

20  provisions of s. 119.07(1), subject to the provisions of

21  subsections (5) and (6).

22         (f)  A finding of probable cause shall not be made as

23  long as the panel, or the department when there is no board,

24  is satisfied, based upon information it receives from the

25  consultant and the department, that the licensee is

26  progressing satisfactorily in an approved impaired

27  practitioner treatment program and no other complaint against

28  the licensee exists.

29         Section 31.  Subsection (1) of section 310.102, Florida

30  Statutes, is amended to read:

31         310.102  Treatment programs for impaired pilots and

                                  28
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  deputy pilots.--

  2         (1)  The department shall, by rule, designate approved

  3  treatment programs for impaired pilots and deputy pilots under

  4  this section. The department may adopt rules setting forth

  5  appropriate criteria for approval of treatment providers based

  6  on the policies and guidelines established by the Impaired

  7  Practitioners Committee under s. 455.704.

  8         Section 32.  Section 455.711, Florida Statutes, is

  9  amended to read:

10         455.711  Licenses; active and inactive and delinquent

11  status; delinquency.--

12         (1)  A licensee may practice a profession only if the

13  licensee has an active status license. A licensee who

14  practices a profession without an active status license is in

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

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

17  the licensee.

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

19  board, shall permit a licensee to choose, at the time of

20  licensure renewal, an active or inactive status. However, a

21  licensee who changes from inactive to active status is not

22  eligible to return to inactive status until the licensee

23  thereafter completes a licensure cycle on active status.

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

25  board, shall by rule impose a fee for renewal of an active or

26  inactive status license. The renewal fee for an inactive

27  status license may not exceed which is no greater than the fee

28  for an active status license.

29         (4)  Notwithstanding any other provision of law to the

30  contrary, a licensee may change licensure status at any time.

31         (a)  Active status licensees choosing inactive status

                                  29
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  at the time of license renewal must pay the inactive status

  2  renewal fee, and, if applicable, the delinquency fee and the

  3  fee to change licensure status. Active status licensees

  4  choosing inactive status at any other time than at the time of

  5  license renewal must pay the fee to change licensure status.

  6         (b)  An inactive status licensee may change to active

  7  status at any time, if the licensee meets all requirements for

  8  active status, pays any additional licensure fees necessary to

  9  equal those imposed on an active status licensee, pays any

10  applicable reactivation fees as set by the board, or the

11  department if there is no board, and meets all continuing

12  education requirements as specified in this section. Inactive

13  status licensees choosing active status at the time of license

14  renewal must pay the active status renewal fee, any applicable

15  reactivation fees as set by the board, or the department if

16  there is no board, and, if applicable, the delinquency fee and

17  the fee to change licensure status. Inactive status licensees

18  choosing active status at any other time than at the time of

19  license renewal must pay the difference between the inactive

20  status renewal fee and the active status renewal fee, if any

21  exists, any applicable reactivation fees as set by the board,

22  or the department if there is no board, and the fee to change

23  licensure status.

24         (5)  A licensee must apply with a complete application,

25  as defined by rule of the board, or the department if there is

26  no board, to renew an active status or inactive status license

27  before the license expires. If a licensee fails to renew

28  before the license expires, the license becomes delinquent in

29  the license cycle following expiration.

30         (6)  A delinquent status licensee must affirmatively

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

                                  30
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  inactive status during the licensure cycle in which a licensee

  3  becomes delinquent. Failure by a delinquent status licensee to

  4  become active or inactive before the expiration of the current

  5  licensure cycle renders the license null without any further

  6  action by the board or the department. Any subsequent

  7  licensure shall be as a result of applying for and meeting all

  8  requirements imposed on an applicant for new licensure.

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

10  board, shall by rule impose an additional delinquency fee, not

11  to exceed the biennial renewal fee for an active status

12  license, on a delinquent status licensee when such licensee

13  applies for active or inactive status.

14         (8)  Each board, or the department if there is no

15  board, shall by rule impose an additional fee, not to exceed

16  the biennial renewal fee for an active status license, for

17  processing a licensee's request to change licensure status at

18  any time other than at the beginning of a licensure cycle.

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

20  board, may by rule impose reasonable conditions, excluding

21  full reexamination but including part of a national

22  examination or a special purpose examination to assess current

23  competency, necessary to ensure that a licensee who has been

24  on inactive status for more than two consecutive biennial

25  licensure cycles and who applies for active status can

26  practice with the care and skill sufficient to protect the

27  health, safety, and welfare of the public. Reactivation

28  requirements may differ depending on the length of time

29  licensees are inactive. The costs to meet reactivation

30  requirements shall be borne by licensees requesting

31  reactivation.

                                  31
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (10)  Before reactivation, an inactive status licensee

  2  or a delinquent licensee who was inactive prior to becoming

  3  delinquent must meet the same continuing education

  4  requirements, if any, imposed on an active status licensee for

  5  all biennial licensure periods in which the licensee was

  6  inactive or delinquent.

  7         (11)  The status or a change in status of a licensee

  8  does not alter in any way the right of the board, or of the

  9  department if there is no board, to impose discipline or to

10  enforce discipline previously imposed on a licensee for acts

11  or omissions committed by the licensee while holding a

12  license, whether active, inactive, or delinquent.

13         (12)  This section does not apply to a business

14  establishment registered, permitted, or licensed by the

15  department to do business.

16         (13)  The board, or the department when there is no

17  board, may adopt rules pursuant to ss. 120.536(1) and 120.54

18  as necessary to implement this section.

19         Section 33.  Subsection (3) of section 455.587, Florida

20  Statutes, is amended to read:

21         455.587  Fees; receipts; disposition.--

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

23  board, may, by rule, assess and collect a one-time fee from

24  each active status licensee and each voluntary inactive status

25  licensee in an amount necessary to eliminate a cash deficit

26  or, if there is not a cash deficit, in an amount sufficient to

27  maintain the financial integrity of the professions as

28  required in this section. Not more than one such assessment

29  may be made in any 4-year period without specific legislative

30  authorization.

31         Section 34.  Subsection (1) of section 455.714, Florida

                                  32
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Statutes, is amended to read:

  2         455.714  Renewal and cancellation notices.--

  3         (1)  At least 90 days before the end of a licensure

  4  cycle, the department shall:

  5         (a)  Forward a licensure renewal notification to an

  6  active or inactive status licensee at the licensee's last

  7  known address of record with the department.

  8         (b)  Forward a notice of pending cancellation of

  9  licensure to a delinquent status licensee at the licensee's

10  last known address of record with the department.

11         Section 35.  Section 455.719, Florida Statutes, is

12  created to read:

13         455.719  Health care professionals; exemption from

14  disqualification from employment or contracting.--Any other

15  provision of law to the contrary notwithstanding, only the

16  appropriate regulatory board, or the department when there is

17  no board, may grant an exemption from disqualification from

18  employment or contracting as provided in s. 435.07 to a person

19  under the licensing jurisdiction of that board or the

20  department, as applicable.

21         Section 36.  Section 455.637, Florida Statutes, is

22  amended to read:

23         455.637  Unlicensed practice of a health care

24  profession; intent; cease and desist notice; penalties civil

25  penalty; enforcement; citations; fees; allocation and

26  disposition of moneys collected.--

27         (1)  It is the intent of the Legislature that vigorous

28  enforcement of licensure regulation for all health care

29  professions is a state priority in order to protect Florida

30  residents and visitors from the potentially serious and

31  dangerous consequences of receiving medical and health care

                                  33
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  services from unlicensed persons whose professional education

  2  and training and other relevant qualifications have not been

  3  approved through the issuance of a license by the appropriate

  4  regulatory board or the department when there is no board. The

  5  unlicensed practice of a health care profession or the

  6  performance or delivery of medical or health care services to

  7  patients in this state without a valid, active license to

  8  practice that profession, regardless of the means of the

  9  performance or delivery of such services, is strictly

10  prohibited.

11         (2)  The penalties for unlicensed practice of a health

12  care profession shall include the following:

13         (a)(1)  When the department has probable cause to

14  believe that any person not licensed by the department, or the

15  appropriate regulatory board within the department, has

16  violated any provision of this part or any statute that

17  relates to the practice of a profession regulated by the

18  department, or any rule adopted pursuant thereto, the

19  department may issue and deliver to such person a notice to

20  cease and desist from such violation. In addition, the

21  department may issue and deliver a notice to cease and desist

22  to any person who aids and abets the unlicensed practice of a

23  profession by employing such unlicensed person. The issuance

24  of a notice to cease and desist shall not constitute agency

25  action for which a hearing under ss. 120.569 and 120.57 may be

26  sought. For the purpose of enforcing a cease and desist order,

27  the department may file a proceeding in the name of the state

28  seeking issuance of an injunction or a writ of mandamus

29  against any person who violates any provisions of such order.

30         (b)  In addition to the foregoing remedies under

31  paragraph (a), the department may impose by citation an

                                  34
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  administrative penalty not to exceed $5,000 per incident

  2  pursuant to the provisions of chapter 120 or may issue a

  3  citation pursuant to the provisions of subsection (3). The

  4  citation shall be issued to the subject and shall contain the

  5  subject's name and any other information the department

  6  determines to be necessary to identify the subject, a brief

  7  factual statement, the sections of the law allegedly violated,

  8  and the penalty imposed. If the subject does not dispute the

  9  matter in the citation with the department within 30 days

10  after the citation is served, the citation shall become a

11  final order of the department. The department may adopt rules

12  to implement this section. The penalty shall be a fine of not

13  less than $500 nor more than $5,000 as established by rule of

14  the department. Each day that the unlicensed practice

15  continues after issuance of a notice to cease and desist

16  constitutes a separate violation. The department shall be

17  entitled to recover the costs of investigation and prosecution

18  in addition to the fine levied pursuant to the citation.

19  Service of a citation may be made by personal service or by

20  mail to the subject at the subject's last known address or

21  place of practice. If the department is required to seek

22  enforcement of the cease and desist or agency order for a

23  penalty pursuant to s. 120.569, it shall be entitled to

24  collect its attorney's fees and costs, together with any cost

25  of collection.

26         (c)(2)  In addition to or in lieu of any other

27  administrative remedy provided in subsection (1), the

28  department may seek the imposition of a civil penalty through

29  the circuit court for any violation for which the department

30  may issue a notice to cease and desist under subsection (1).

31  The civil penalty shall be no less than $500 and no more than

                                  35
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  $5,000 for each offense. The court may also award to the

  2  prevailing party court costs and reasonable attorney fees and,

  3  in the event the department prevails, may also award

  4  reasonable costs of investigation and prosecution.

  5         (d)  In addition to the administrative and civil

  6  remedies under paragraphs (b) and (c) and in addition to the

  7  criminal violations and penalties listed in the individual

  8  health care practice acts:

  9         1.  It is a felony of the third degree, punishable as

10  provided in s. 775.082, s. 775.083, or s. 775.084, to

11  practice, attempt to practice, or offer to practice a health

12  care profession without an active, valid Florida license to

13  practice that profession. Practicing without an active, valid

14  license also includes practicing on a suspended, revoked, or

15  void license, but does not include practicing, attempting to

16  practice, or offering to practice with an inactive or

17  delinquent license for a period of up to 12 months which is

18  addressed in subparagraph 3. Applying for employment for a

19  position that requires a license without notifying the

20  employer that the person does not currently possess a valid,

21  active license to practice that profession shall be deemed to

22  be an attempt or offer to practice that health care profession

23  without a license. Holding oneself out, regardless of the

24  means of communication, as able to practice a health care

25  profession or as able to provide services that require a

26  health care license shall be deemed to be an attempt or offer

27  to practice such profession without a license. The minimum

28  penalty for violating this subparagraph shall be a fine of

29  $1,000 and a minimum mandatory period of incarceration of 1

30  year.

31         2.  It is a felony of the second degree, punishable as

                                  36
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  provided in s. 775.082, s. 775.083, or s. 775.084, to practice

  2  a health care profession without an active, valid Florida

  3  license to practice that profession when such practice results

  4  in serious bodily injury. For purposes of this section,

  5  "serious bodily injury" means death; brain or spinal damage;

  6  disfigurement; fracture or dislocation of bones or joints;

  7  limitation of neurological, physical, or sensory function; or

  8  any condition that required subsequent surgical repair. The

  9  minimum penalty for violating this subparagraph shall be a

10  fine of $1,000 and a minimum mandatory period of incarceration

11  of 1 year.

12         3.  It is a misdemeanor of the first degree, punishable

13  as provided in s. 775.082 or s. 775.083, to practice, attempt

14  to practice, or offer to practice a health care profession

15  with an inactive or delinquent license for any period of time

16  up to 12 months. However, practicing, attempting to practice,

17  or offering to practice a health care profession when that

18  person's license has been inactive or delinquent for a period

19  of time of 12 months or more shall be a felony of the third

20  degree, punishable as provided in s. 775.082, s. 775.083, or

21  s. 775.084. The minimum penalty for violating this

22  subparagraph shall be a term of imprisonment of 30 days and a

23  fine of $500.

24         (3)  Because all enforcement costs should be covered by

25  professions regulated by the department, the department shall

26  impose, upon initial licensure and each licensure renewal, a

27  special fee of $5 per licensee to fund efforts to combat

28  unlicensed activity. Such fee shall be in addition to all

29  other fees collected from each licensee. The board with

30  concurrence of the department, or the department when there is

31  no board, may earmark $5 of the current licensure fee for this

                                  37
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  purpose, if such board, or profession regulated by the

  2  department, is not in a deficit and has a reasonable cash

  3  balance. The department shall make direct charges to the

  4  Medical Quality Assurance Trust Fund by profession. The

  5  department shall seek board advice regarding enforcement

  6  methods and strategies. The department shall directly credit

  7  the Medical Quality Assurance Trust Fund, by profession, with

  8  the revenues received from the department's efforts to enforce

  9  licensure provisions. The department shall include all

10  financial and statistical data resulting from unlicensed

11  activity enforcement as a separate category in the quarterly

12  management report provided for in s. 455.587. For an

13  unlicensed activity account, a balance which remains at the

14  end of a renewal cycle may, with concurrence of the applicable

15  board and the department, be transferred to the operating fund

16  account of that profession. The department shall also use

17  these funds to inform and educate consumers generally on the

18  importance of using licensed health care practitioners.

19         (3)(a)  Notwithstanding the provisions of s. 455.621,

20  the department shall adopt rules to permit the issuance of

21  citations for unlicensed practice of a profession. The

22  citation shall be issued to the subject and shall contain the

23  subject's name and any other information the department

24  determines to be necessary to identify the subject, a brief

25  factual statement, the sections of the law allegedly violated,

26  and the penalty imposed. The citation must clearly state that

27  the subject may choose, in lieu of accepting the citation, to

28  follow the procedure under s. 455.621. If the subject disputes

29  the matter in the citation, the procedures set forth in s.

30  455.621 must be followed. However, if the subject does not

31  dispute the matter in the citation with the department within

                                  38
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  30 days after the citation is served, the citation shall

  2  become a final order of the department. The penalty shall be a

  3  fine of not less than $500 or more than $5,000 or other

  4  conditions as established by rule.

  5         (b)  Each day that the unlicensed practice continues

  6  after issuance of a citation constitutes a separate violation.

  7         (c)  The department shall be entitled to recover the

  8  costs of investigation, in addition to any penalty provided

  9  according to department rule as part of the penalty levied

10  pursuant to the citation.

11         (d)  Service of a citation may be made by personal

12  service or certified mail, restricted delivery, to the subject

13  at the subject's last known address.

14         (4)  All fines, fees, and costs collected through the

15  procedures set forth in this section shall be allocated to the

16  professions in the manner provided for in s. 455.641 for the

17  allocation of the fees assessed and collected to combat

18  unlicensed practice of a profession.

19         (4)(5)  The provisions of this section apply only to

20  health care the professional practice acts administered by the

21  department.

22         (5)  Nothing herein shall be construed to limit or

23  restrict the sale, use, or recommendation of the use of a

24  dietary supplement, as defined by the Food, Drug, and Cosmetic

25  Act, Title 21, s. 321, so long as the person selling, using,

26  or recommending the dietary supplement does so in compliance

27  with federal and state law.

28         Section 37.  Section 458.3135, Florida Statutes, is

29  created to read:

30         458.3135  Temporary certificate for visiting physicians

31  to practice in approved cancer centers.--

                                  39
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

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

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

  4  be issued a temporary certificate to practice in a

  5  board-approved cancer center under the International Cancer

  6  Center Visiting Physician Program. A certificate may be issued

  7  to a physician who will be training under the direct

  8  supervision of a physician employed by or under contract with

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

10  The purpose of the International Cancer Center Visiting

11  Physician Program is to provide to internationally respected

12  and highly qualified physicians advanced education and

13  training on cancer treatment techniques developed at an

14  approved cancer center. The board may issue this temporary

15  certificate in accordance with the restrictions set forth in

16  this section.

17         (2)  A temporary certificate for practice in an

18  approved cancer center may be issued without examination to an

19  individual who:

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

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

22  listed with the World Health Organization;

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

24  medicine in another country;

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

26  board and remitted a nonrefundable application fee not to

27  exceed $300;

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

29  jurisdiction which would constitute the basis for disciplining

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

31         (e)  Meets the financial responsibility requirements of

                                  40
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  s. 458.320; and

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

  3  cancer center approved by the board.

  4         (3)  The board shall by rule establish qualifications

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

  6  minimum shall require the cancer center to be licensed under

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

  8  National Cancer Institute-designated cancer center. The board

  9  shall review the cancer centers approved under this section

10  not less than annually to ascertain that the minimum

11  requirements of this chapter and the rules adopted thereunder

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

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

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

15  no temporary certificate for that cancer center shall be valid

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

17  cancer center.

18         (4)  A recipient of a temporary certificate for

19  practice in an approved cancer center may use the certificate

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

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

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

23  longer approved by the board, the temporary certificate shall

24  expire and the recipient shall no longer be authorized to

25  practice in this state.

26         (5)  A recipient of a temporary certificate for

27  practice in an approved cancer center is limited to practicing

28  in facilities owned or operated by that approved cancer center

29  and is limited to only practicing under the direct supervision

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

31  license to practice medicine in this state issued under this

                                  41
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  chapter or chapter 459.

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

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

  4  is under investigation in another jurisdiction for an act that

  5  would constitute a violation of this chapter or chapter 455

  6  until such time as the investigation is complete and the

  7  physician is found innocent of all charges.

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

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

10  provisions of chapters 455 and 458 apply.

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

12  certificates that may be issued by the board under this

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

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

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

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

17  authorize a physician who is not licensed to practice medicine

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

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

20  section.

21         Section 38.  Paragraph (i) of subsection (1), and

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

23  amended to read:

24           458.3145  Medical faculty certificate.--

25         (1)  A medical faculty certificate may be issued

26  without examination to an individual who:

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

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

29  listed with the World Health Organization;

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

31  medicine in another jurisdiction;

                                  42
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  nonrefundable application fee not to exceed $500;

  3         (d)  Has completed an approved residency or fellowship

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

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

  6  residency requirement;

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

  8         (f)  Is of good moral character;

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

10  jurisdiction which would constitute the basis for disciplining

11  a physician under s. 458.331;

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

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

14  medical school, the equivalent of 2 academic years of

15  preprofessional, postsecondary education, as determined by

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

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

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

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

20         1.  The University of Florida,

21         2.  The University of Miami,

22         3.  The University of South Florida, or

23         4.  The Florida State University, or

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

25  Jacksonville, Florida.

26         (2)  The certificate authorizes the holder to practice

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

28  accredited medical school and its affiliated clinical

29  facilities or teaching hospitals that are registered with the

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

31  certificates will be practicing.  Such certificate

                                  43
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  automatically expires when the holder's relationship with the

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

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

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

  5  board and provides certification by the dean of the medical

  6  school that the holder is a distinguished medical scholar and

  7  an outstanding practicing physician.

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

  9  under this section has all rights and responsibilities

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

11  458.311, except as specifically provided otherwise by law.

12  Such responsibilities include compliance with continuing

13  medical education requirements as set forth by rule of the

14  board. A hospital or ambulatory surgical center licensed under

15  chapter 395, health maintenance organization certified under

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

17  multiple-employer welfare arrangement as defined in s.

18  624.437, or any other entity in this state, in considering and

19  acting upon an application for staff membership, clinical

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

21  may not deny the application of an otherwise qualified

22  physician for such staff membership, clinical privileges, or

23  other credentials solely because the applicant is a holder of

24  a medical faculty certificate under this section.

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

26  medical faculty certificateholders as provided in subsection

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

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

29  240.512 and may not exceed 5 persons at the institution named

30  in subparagraph (1)(i)54.

31         5.  Annual review of all such certificate recipients

                                  44
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  schools within this state and reported to the Board of

  3  Medicine.

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

  5  when providing medical care or treatment in connection with

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

  7  request of the dean of an accredited medical school within

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

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

10  upon registration with the board and demonstration of

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

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

13  performance of such medical care or treatment must be limited

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

15  consecutive days, and must be rendered within a facility

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

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

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

19  physician registered under this subsection. However, no more

20  than three physicians per year per institution may be

21  registered under this subsection, and an exemption under this

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

23  any given 5-year period.

24         Section 39.  Subsection (5) is added to section

25  458.315, Florida Statutes, to read:

26         458.315  Temporary certificate for practice in areas of

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

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

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

30  certificate to practice in communities of Florida where there

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

                                  45
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  department, correctional facility, community health center

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

  4  Public Health Services Act, or other entity that provides

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

  6  Health Officer.  The Board of Medicine may issue this

  7  temporary certificate with the following restrictions:

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

  9  including neurological injury compensation assessments, shall

10  be waived for those persons obtaining a temporary certificate

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

12  providing volunteer, uncompensated care for low-income

13  Floridians. The applicant must submit an affidavit from the

14  employing agency or institution stating that the physician

15  will not receive any compensation for any service involving

16  the practice of medicine.

17         Section 40.  Section 458.345, Florida Statutes, is

18  amended to read:

19         458.345  Registration of resident physicians, interns,

20  and fellows; list of hospital employees; prescribing of

21  medicinal drugs; penalty.--

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

23  physician, assistant resident physician, house physician,

24  intern, or fellow in fellowship training which leads to

25  subspecialty board certification in this state, or any person

26  desiring to practice as a resident physician, assistant

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

28  fellowship training in a teaching hospital in this state as

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

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

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

                                  46
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  register any applicant the board certifies has met the

  3  following requirements:

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

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

  6  without the state which would constitute the basis for refusal

  7  to certify an application for licensure pursuant to s.

  8  458.331.

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

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

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

12  registration any applicant who is under investigation in any

13  state or jurisdiction for an act which would constitute the

14  basis for imposing a disciplinary penalty specified in s.

15  458.331(2)(b) until such time as the investigation is

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

17  apply.

18         (3)  Every hospital or teaching hospital employing or

19  utilizing the services of a resident physician, assistant

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

21  fellowship training registered under this section which leads

22  to subspecialty board certification shall designate a person

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

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

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

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

27  such hospital shall provide the executive director of the

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

29  responsible for furnishing such reports.

30         (4)  Registration under this section shall

31  automatically expire after 2 years without further action by

                                  47
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  the board or the department unless an application for renewal

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

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

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

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

  6  subspecialty board certification in a hospital or teaching

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

  8  active license or renewal of registration under this section.

  9  Requirements for renewal of registration shall be established

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

11  as set by the board shall accompany the application for

12  renewal, except that resident physicians, assistant resident

13  physicians, interns, and fellows in fellowship training

14  registered under this section which leads to subspecialty

15  board certification shall be exempt from payment of any

16  renewal fees.

17         (5)  Notwithstanding any provision of this section or

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

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

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

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

22  prescribe medicinal drugs described in schedules set out in

23  chapter 893 when:

24         (a)  The person prescribes such medicinal drugs through

25  use of a Drug Enforcement Administration number issued to the

26  hospital or teaching hospital by which the person is employed

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

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

29  the identification number issued to such the hospital; and

30         (c)  The use of the institutional identification number

31  and individual suffixes conforms to the requirements of the

                                  48
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  federal Drug Enforcement Administration.

  2         (7)  Any person willfully violating this section

  3  commits a misdemeanor of the first degree, punishable as

  4  provided in s. 775.082 or s. 775.083.

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

  6  120.536(1) and 120.54 as necessary to implement this section.

  7         Section 41.  Subsection (3) of section 458.348, Florida

  8  Statutes, is created to read:

  9         458.348  Formal supervisory relationships, standing

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

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

12  protocols relating to electrolysis or electrology using laser

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

14  physicians licensed under this chapter or chapter 459 shall

15  require the person performing such service to be appropriately

16  trained and work only under the direct supervision and

17  responsibility of a physician licensed under this chapter or

18  chapter 459. All protocols relating to electrolysis or

19  electrology using needle-type epilation devices by persons

20  other than physicians licensed under this chapter or chapter

21  459 shall require the person performing such service to be

22  appropriately trained and work only under the general

23  supervision of a physician licensed under this chapter or

24  chapter 459.

25         Section 42.  Section 459.021, Florida Statutes, is

26  amended to read:

27         459.021  Registration of resident physicians, interns,

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

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

30  Osteopathic Medicine from a college of osteopathic medicine

31  recognized and approved by the American Osteopathic

                                  49
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Association who desires to practice as a resident physician,

  2  assistant resident physician, house physician, intern, or

  3  fellow in fellowship training which leads to subspecialty

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

  5  practice as a resident physician, assistant resident

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

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

  8  408.07(44) or s. 395.805(2), who does not hold an active

  9  license issued under this chapter shall apply to the

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

11  department, within 30 days of commencing such a training

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

13  board.

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

15  section shall renew such registration annually.  Such

16  registration shall be terminated upon the registrant's receipt

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

18  shall be registered under this section for an aggregate of

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

20  board.

21         (3)  Every hospital or teaching hospital having

22  employed or contracted with or utilized the services of a

23  person who holds a degree of Doctor of Osteopathic Medicine

24  from a college of osteopathic medicine recognized and approved

25  by the American Osteopathic Association as a resident

26  physician, assistant resident physician, house physician,

27  intern, or fellow in fellowship training registered under this

28  section which leads to subspecialty board certification shall

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

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

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

                                  50
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  executive officer of each such hospital shall provide the

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

  4  address of the person responsible for filing such reports.

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

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

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

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

  9  grounds:

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

11  physician, assistant resident physician, house physician, or

12  fellow in fellowship training from the list of employees

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

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

15         (b)  Practicing osteopathic medicine outside of a bona

16  fide hospital training program.

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

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

19  hospital or teaching hospital, and also for the

20  superintendent, administrator, and other person or persons

21  having administrative authority in such a hospital:

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

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

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

25  a license to practice osteopathic medicine under this chapter.

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

27  information required by subsection (3).

28         (6)  Any person desiring registration pursuant to this

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

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

31  120.536(1) and 120.54 as necessary to implement this section.

                                  51
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (8)  Notwithstanding any provision of this section or

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

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

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

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

  6  prescribe medicinal drugs described in schedules set out in

  7  chapter 893 when:

  8         (a)  The person prescribes such medicinal drugs through

  9  use of a Drug Enforcement Administration number issued to the

10  hospital or teaching hospital by which the person is employed

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

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

13  the identification number issued to such the hospital; and

14         (c)  The use of the institutional identification number

15  and individual suffixes conforms to the requirements of the

16  federal Drug Enforcement Administration.

17         Section 43.  Paragraph (d) is added to subsection (9)

18  of section 458.347, Florida Statutes, to read:

19         458.347  Physician assistants.--

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

21  Physician Assistants is created within the department.

22         (a)  The council shall consist of five members

23  appointed as follows:

24         1.  The chairperson of the Board of Medicine shall

25  appoint three members who are physicians and members of the

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

27  physician assistant in the physician's practice.

28         2.  The chairperson of the Board of Osteopathic

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

30  member of the Board of Osteopathic Medicine.

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

                                  52
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  designee shall appoint a fully licensed physician assistant

  2  licensed under this chapter or chapter 459.

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

  4  be physicians who supervise physician assistants in their

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

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

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

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

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

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

11  The council shall annually elect a chairperson from among its

12  members.

13         (c)  The council shall:

14         1.  Recommend to the department the licensure of

15  physician assistants.

16         2.  Develop all rules regulating the use of physician

17  assistants by physicians under this chapter and chapter 459,

18  except for rules relating to the formulary developed under

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

20  ensure that the continuity of supervision is maintained in

21  each practice setting.  The boards shall consider adopting a

22  proposed rule developed by the council at the regularly

23  scheduled meeting immediately following the submission of the

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

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

26  boards have accepted and approved the identical language

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

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

29  pursuant to each respective board's guidelines and standards

30  regarding the adoption of proposed rules. If either board

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

                                  53
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  its objection to the council with particularity and include

  2  any recommendations it may have for the modification of the

  3  proposed rule.

  4         3.  Make recommendations to the boards regarding all

  5  matters relating to physician assistants.

  6         4.  Address concerns and problems of practicing

  7  physician assistants in order to improve safety in the

  8  clinical practices of licensed physician assistants.

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

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

11  each of the requirements for licensure set forth in this

12  section, the Council may enter an order to:

13         1.  Refuse to certify the applicant for licensure;

14         2.  Approve the applicant for licensure with

15  restrictions on the scope of practice or license; or

16         3.  Approve the applicant for conditional licensure.

17  Such conditions may include placement of the licensee on

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

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

20  requiring the licensee to undergo treatment, to attend

21  continuing education courses, to work under the direct

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

23  corrective action.

24         Section 44.  Paragraph (d) is added to subsection (9)

25  of section 459.022, Florida Statutes, to read:

26         459.022  Physician assistants.--

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

28  Physician Assistants is created within the department.

29         (a)  The council shall consist of five members

30  appointed as follows:

31         1.  The chairperson of the Board of Medicine shall

                                  54
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  appoint three members who are physicians and members of the

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

  3  physician assistant in the physician's practice.

  4         2.  The chairperson of the Board of Osteopathic

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

  6  member of the Board of Osteopathic Medicine.

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

  8  designee shall appoint a fully licensed physician assistant

  9  licensed under chapter 458 or this chapter.

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

11  be physicians who supervise physician assistants in their

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

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

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

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

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

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

18  The council shall annually elect a chairperson from among its

19  members.

20         (c)  The council shall:

21         1.  Recommend to the department the licensure of

22  physician assistants.

23         2.  Develop all rules regulating the use of physician

24  assistants by physicians under chapter 458 and this chapter,

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

26  458.347(4)(f). The council shall also develop rules to ensure

27  that the continuity of supervision is maintained in each

28  practice setting. The boards shall consider adopting a

29  proposed rule developed by the council at the regularly

30  scheduled meeting immediately following the submission of the

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

                                  55
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  boards have accepted and approved the identical language

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

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

  5  pursuant to each respective board's guidelines and standards

  6  regarding the adoption of proposed rules.  If either board

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

  8  its objection to the council with particularity and include

  9  any recommendations it may have for the modification of the

10  proposed rule.

11         3.  Make recommendations to the boards regarding all

12  matters relating to physician assistants.

13         4.  Address concerns and problems of practicing

14  physician assistants in order to improve safety in the

15  clinical practices of licensed physician assistants.

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

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

18  each of the requirements for licensure set forth in this

19  section, the Council may enter an order to:

20         1.  Refuse to certify the applicant for licensure;

21         2.  Approve the applicant for licensure with

22  restrictions on the scope of practice or license; or

23         3.  Approve the applicant for conditional licensure.

24  Such conditions may include placement of the licensee on

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

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

27  requiring the licensee to undergo treatment, to attend

28  continuing education courses, to work under the direct

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

30  corrective action.

31         Section 45.  The amendment of s. 455.637, Florida

                                  56
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Statutes, by this act applies to offenses committed on or

  2  after the effective date of such section.

  3         Section 46.  Section 455.641, Florida Statutes, is

  4  repealed.

  5         Section 47.  For the purpose of incorporating the

  6  amendment to section 455.637, Florida Statutes, in references

  7  thereto, the sections or subdivisions of Florida Statutes set

  8  forth below are reenacted to read:

  9         455.574  Department of Health; examinations.--

10         (1)

11         (d)  Each board, or the department when there is no

12  board, shall adopt rules regarding the security and monitoring

13  of examinations.  The department shall implement those rules

14  adopted by the respective boards.  In order to maintain the

15  security of examinations, the department may employ the

16  procedures set forth in s. 455.637 to seek fines and

17  injunctive relief against an examinee who violates the

18  provisions of s. 455.577 or the rules adopted pursuant to this

19  paragraph.  The department, or any agent thereof, may, for the

20  purposes of investigation, confiscate any written,

21  photographic, or recording material or device in the

22  possession of the examinee at the examination site which the

23  department deems necessary to enforce such provisions or

24  rules.

25         468.1295  Disciplinary proceedings.--

26         (1)  The following acts constitute grounds for both

27  disciplinary actions as set forth in subsection (2) and cease

28  and desist or other related actions by the department as set

29  forth in s. 455.637:

30         (a)  Procuring or attempting to procure a license by

31  bribery, by fraudulent misrepresentation, or through an error

                                  57
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  of the department or the board.

  2         (b)  Having a license revoked, suspended, or otherwise

  3  acted against, including denial of licensure, by the licensing

  4  authority of another state, territory, or country.

  5         (c)  Being convicted or found guilty of, or entering a

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

  7  crime in any jurisdiction which directly relates to the

  8  practice of speech-language pathology or audiology.

  9         (d)  Making or filing a report or record which the

10  licensee knows to be false, intentionally or negligently

11  failing to file a report or records required by state or

12  federal law, willfully impeding or obstructing such filing, or

13  inducing another person to impede or obstruct such filing.

14  Such report or record shall include only those reports or

15  records which are signed in one's capacity as a licensed

16  speech-language pathologist or audiologist.

17         (e)  Advertising goods or services in a manner which is

18  fraudulent, false, deceptive, or misleading in form or

19  content.

20         (f)  Being proven guilty of fraud or deceit or of

21  negligence, incompetency, or misconduct in the practice of

22  speech-language pathology or audiology.

23         (g)  Violating a lawful order of the board or

24  department previously entered in a disciplinary hearing, or

25  failing to comply with a lawfully issued subpoena of the board

26  or department.

27         (h)  Practicing with a revoked, suspended, inactive, or

28  delinquent license.

29         (i)  Using, or causing or promoting the use of, any

30  advertising matter, promotional literature, testimonial,

31  guarantee, warranty, label, brand, insignia, or other

                                  58
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  representation, however disseminated or published, which is

  2  misleading, deceiving, or untruthful.

  3         (j)  Showing or demonstrating or, in the event of sale,

  4  delivery of a product unusable or impractical for the purpose

  5  represented or implied by such action.

  6         (k)  Failing to submit to the board on an annual basis,

  7  or such other basis as may be provided by rule, certification

  8  of testing and calibration of such equipment as designated by

  9  the board and on the form approved by the board.

10         (l)  Aiding, assisting, procuring, employing, or

11  advising any licensee or business entity to practice

12  speech-language pathology or audiology contrary to this part,

13  part II of chapter 455, or any rule adopted pursuant thereto.

14         (m)  Violating any provision of this part or part II of

15  chapter 455 or any rule adopted pursuant thereto.

16         (n)  Misrepresenting the professional services

17  available in the fitting, sale, adjustment, service, or repair

18  of a hearing aid, or using any other term or title which might

19  connote the availability of professional services when such

20  use is not accurate.

21         (o)  Representing, advertising, or implying that a

22  hearing aid or its repair is guaranteed without providing full

23  disclosure of the identity of the guarantor; the nature,

24  extent, and duration of the guarantee; and the existence of

25  conditions or limitations imposed upon the guarantee.

26         (p)  Representing, directly or by implication, that a

27  hearing aid utilizing bone conduction has certain specified

28  features, such as the absence of anything in the ear or

29  leading to the ear, or the like, without disclosing clearly

30  and conspicuously that the instrument operates on the bone

31  conduction principle and that in many cases of hearing loss

                                  59
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  this type of instrument may not be suitable.

  2         (q)  Stating or implying that the use of any hearing

  3  aid will improve or preserve hearing or prevent or retard the

  4  progression of a hearing impairment or that it will have any

  5  similar or opposite effect.

  6         (r)  Making any statement regarding the cure of the

  7  cause of a hearing impairment by the use of a hearing aid.

  8         (s)  Representing or implying that a hearing aid is or

  9  will be "custom-made," "made to order," or

10  "prescription-made," or in any other sense specially

11  fabricated for an individual, when such is not the case.

12         (t)  Canvassing from house to house or by telephone,

13  either in person or by an agent, for the purpose of selling a

14  hearing aid, except that contacting persons who have evidenced

15  an interest in hearing aids, or have been referred as in need

16  of hearing aids, shall not be considered canvassing.

17         (u)  Failing to notify the department in writing of a

18  change in current mailing and place-of-practice address within

19  30 days after such change.

20         (v)  Failing to provide all information as described in

21  ss. 468.1225(5)(b), 468.1245(1), and 468.1246.

22         (w)  Exercising influence on a client in such a manner

23  as to exploit the client for financial gain of the licensee or

24  of a third party.

25         (x)  Practicing or offering to practice beyond the

26  scope permitted by law or accepting and performing

27  professional responsibilities the licensee or

28  certificateholder knows, or has reason to know, the licensee

29  or certificateholder is not competent to perform.

30         (y)  Aiding, assisting, procuring, or employing any

31  unlicensed person to practice speech-language pathology or

                                  60
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  audiology.

  2         (z)  Delegating or contracting for the performance of

  3  professional responsibilities by a person when the licensee

  4  delegating or contracting for performance of such

  5  responsibilities knows, or has reason to know, such person is

  6  not qualified by training, experience, and authorization to

  7  perform them.

  8         (aa)  Committing any act upon a patient or client which

  9  would constitute sexual battery or which would constitute

10  sexual misconduct as defined pursuant to s. 468.1296.

11         (bb)  Being unable to practice the profession for which

12  he or she is licensed or certified under this chapter with

13  reasonable skill or competence as a result of any mental or

14  physical condition or by reason of illness, drunkenness, or

15  use of drugs, narcotics, chemicals, or any other substance. In

16  enforcing this paragraph, upon a finding by the secretary, his

17  or her designee, or the board that probable cause exists to

18  believe that the licensee or certificateholder is unable to

19  practice the profession because of the reasons stated in this

20  paragraph, the department shall have the authority to compel a

21  licensee or certificateholder to submit to a mental or

22  physical examination by a physician, psychologist, clinical

23  social worker, marriage and family therapist, or mental health

24  counselor designated by the department or board.  If the

25  licensee or certificateholder refuses to comply with the

26  department's order directing the examination, such order may

27  be enforced by filing a petition for enforcement in the

28  circuit court in the circuit in which the licensee or

29  certificateholder resides or does business.  The department

30  shall be entitled to the summary procedure provided in s.

31  51.011.  A licensee or certificateholder affected under this

                                  61
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  paragraph shall at reasonable intervals be afforded an

  2  opportunity to demonstrate that he or she can resume the

  3  competent practice for which he or she is licensed or

  4  certified with reasonable skill and safety to patients.

  5         484.014  Disciplinary actions.--

  6         (1)  The following acts relating to the practice of

  7  opticianry shall be grounds for both disciplinary action

  8  against an optician as set forth in this section and cease and

  9  desist or other related action by the department as set forth

10  in s. 455.637 against any person operating an optical

11  establishment who engages in, aids, or abets any such

12  violation:

13         (a)  Procuring or attempting to procure a license by

14  misrepresentation, bribery, or fraud or through an error of

15  the department or the board.

16         (b)  Procuring or attempting to procure a license for

17  any other person by making or causing to be made any false

18  representation.

19         (c)  Making or filing a report or record which the

20  licensee knows to be false, intentionally or negligently

21  failing to file a report or record required by federal or

22  state law, willfully impeding or obstructing such filing, or

23  inducing another person to do so. Such reports or records

24  shall include only those which the person is required to make

25  or file as an optician.

26         (d)  Failing to make fee or price information readily

27  available by providing such information upon request or upon

28  the presentation of a prescription.

29         (e)  Advertising goods or services in a manner which is

30  fraudulent, false, deceptive, or misleading in form or

31  content.

                                  62
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (f)  Fraud or deceit, or negligence, incompetency, or

  2  misconduct, in the authorized practice of opticianry.

  3         (g)  Violation or repeated violation of this part or of

  4  part II of chapter 455 or any rules promulgated pursuant

  5  thereto.

  6         (h)  Practicing with a revoked, suspended, inactive, or

  7  delinquent license.

  8         (i)  Violation of a lawful order of the board or

  9  department previously entered in a disciplinary hearing or

10  failing to comply with a lawfully issued subpoena of the

11  department.

12         (j)  Violation of any provision of s. 484.012.

13         (k)  Conspiring with another licensee or with any

14  person to commit an act, or committing an act, which would

15  coerce, intimidate, or preclude another licensee from lawfully

16  advertising her or his services.

17         (l)  Willfully submitting to any third-party payor a

18  claim for services which were not provided to a patient.

19         (m)  Failing to keep written prescription files.

20         (n)  Willfully failing to report any person who the

21  licensee knows is in violation of this part or of rules of the

22  department or the board.

23         (o)  Exercising influence on a client in such a manner

24  as to exploit the client for financial gain of the licensee or

25  of a third party.

26         (p)  Gross or repeated malpractice.

27         (q)  Permitting any person not licensed as an optician

28  in this state to fit or dispense any lenses, spectacles,

29  eyeglasses, or other optical devices which are part of the

30  practice of opticianry.

31         (r)  Being convicted or found guilty of, or entering a

                                  63
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  plea of nolo contendere to, regardless of adjudication, in a

  2  court of this state or other jurisdiction, a crime which

  3  relates to the ability to practice opticianry or to the

  4  practice of opticianry.

  5         (s)  Having been disciplined by a regulatory agency in

  6  another state for any offense that would constitute a

  7  violation of Florida law or rules regulating opticianry.

  8         (t)  Being unable to practice opticianry with

  9  reasonable skill and safety by reason of illness or use of

10  drugs, narcotics, chemicals, or any other type of material or

11  as a result of any mental or physical condition. An optician

12  affected under this paragraph shall at reasonable intervals be

13  afforded an opportunity to demonstrate that she or he can

14  resume the competent practice of opticianry with reasonable

15  skill and safety to her or his customers.

16         484.056  Disciplinary proceedings.--

17         (1)  The following acts relating to the practice of

18  dispensing hearing aids shall be grounds for both disciplinary

19  action against a hearing aid specialist as set forth in this

20  section and cease and desist or other related action by the

21  department as set forth in s. 455.637 against any person

22  owning or operating a hearing aid establishment who engages

23  in, aids, or abets any such violation:

24         (a)  Violation of any provision of s. 455.624(1), s.

25  484.0512, or s. 484.053.

26         (b)  Attempting to procure a license to dispense

27  hearing aids by bribery, by fraudulent misrepresentations, or

28  through an error of the department or the board.

29         (c)  Having a license to dispense hearing aids revoked,

30  suspended, or otherwise acted against, including the denial of

31  licensure, by the licensing authority of another state,

                                  64
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  territory, or country.

  2         (d)  Being convicted or found guilty of, or entering a

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

  4  crime in any jurisdiction which directly relates to the

  5  practice of dispensing hearing aids or the ability to practice

  6  dispensing hearing aids, including violations of any federal

  7  laws or regulations regarding hearing aids.

  8         (e)  Making or filing a report or record which the

  9  licensee knows to be false, intentionally or negligently

10  failing to file a report or record required by state or

11  federal law, willfully impeding or obstructing such filing, or

12  inducing another person to impede or obstruct such filing.

13  Such reports or records shall include only those reports or

14  records which are signed in one's capacity as a licensed

15  hearing aid specialist.

16         (f)  Advertising goods or services in a manner which is

17  fraudulent, false, deceptive, or misleading in form or

18  content.

19         (g)  Proof that the licensee is guilty of fraud or

20  deceit or of negligence, incompetency, or misconduct in the

21  practice of dispensing hearing aids.

22         (h)  Violation or repeated violation of this part or of

23  part II of chapter 455, or any rules promulgated pursuant

24  thereto.

25         (i)  Violation of a lawful order of the board or

26  department previously entered in a disciplinary hearing or

27  failure to comply with a lawfully issued subpoena of the board

28  or department.

29         (j)  Practicing with a revoked, suspended, inactive, or

30  delinquent license.

31         (k)  Using, or causing or promoting the use of, any

                                  65
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  advertising matter, promotional literature, testimonial,

  2  guarantee, warranty, label, brand, insignia, or other

  3  representation, however disseminated or published, which is

  4  misleading, deceiving, or untruthful.

  5         (l)  Showing or demonstrating, or, in the event of

  6  sale, delivery of, a product unusable or impractical for the

  7  purpose represented or implied by such action.

  8         (m)  Misrepresentation of professional services

  9  available in the fitting, sale, adjustment, service, or repair

10  of a hearing aid, or use of the terms "doctor," "clinic,"

11  "clinical," "medical audiologist," "clinical audiologist,"

12  "research audiologist," or "audiologic" or any other term or

13  title which might connote the availability of professional

14  services when such use is not accurate.

15         (n)  Representation, advertisement, or implication that

16  a hearing aid or its repair is guaranteed without providing

17  full disclosure of the identity of the guarantor; the nature,

18  extent, and duration of the guarantee; and the existence of

19  conditions or limitations imposed upon the guarantee.

20         (o)  Representing, directly or by implication, that a

21  hearing aid utilizing bone conduction has certain specified

22  features, such as the absence of anything in the ear or

23  leading to the ear, or the like, without disclosing clearly

24  and conspicuously that the instrument operates on the bone

25  conduction principle and that in many cases of hearing loss

26  this type of instrument may not be suitable.

27         (p)  Making any predictions or prognostications as to

28  the future course of a hearing impairment, either in general

29  terms or with reference to an individual person.

30         (q)  Stating or implying that the use of any hearing

31  aid will improve or preserve hearing or prevent or retard the

                                  66
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  progression of a hearing impairment or that it will have any

  2  similar or opposite effect.

  3         (r)  Making any statement regarding the cure of the

  4  cause of a hearing impairment by the use of a hearing aid.

  5         (s)  Representing or implying that a hearing aid is or

  6  will be "custom-made," "made to order," or "prescription-made"

  7  or in any other sense specially fabricated for an individual

  8  person when such is not the case.

  9         (t)  Canvassing from house to house or by telephone

10  either in person or by an agent for the purpose of selling a

11  hearing aid, except that contacting persons who have evidenced

12  an interest in hearing aids, or have been referred as in need

13  of hearing aids, shall not be considered canvassing.

14         (u)  Failure to submit to the board on an annual basis,

15  or such other basis as may be provided by rule, certification

16  of testing and calibration of audiometric testing equipment on

17  the form approved by the board.

18         (v)  Failing to provide all information as described in

19  s. 484.051(1).

20         (w)  Exercising influence on a client in such a manner

21  as to exploit the client for financial gain of the licensee or

22  of a third party.

23         Section 48.  Paragraphs (a) and (g) of subsection (3)

24  of section 921.0022, Florida Statutes, are amended to read:

25         921.0022  Criminal Punishment Code; offense severity

26  ranking chart.--

27         (3)  OFFENSE SEVERITY RANKING CHART

28

29  Florida           Felony

30  Statute           Degree             Description

31

                                  67
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1                              (a)  LEVEL 1

  2  24.118(3)(a)       3rd      Counterfeit or altered state

  3                              lottery ticket.

  4  212.054(2)(b)      3rd      Discretionary sales surtax;

  5                              limitations, administration, and

  6                              collection.

  7  212.15(2)(b)       3rd      Failure to remit sales taxes,

  8                              amount greater than $300 but less

  9                              than $20,000.

10  319.30(5)          3rd      Sell, exchange, give away

11                              certificate of title or

12                              identification number plate.

13  319.35(1)(a)       3rd      Tamper, adjust, change, etc., an

14                              odometer.

15  320.26(1)(a)       3rd      Counterfeit, manufacture, or sell

16                              registration license plates or

17                              validation stickers.

18  322.212(1)         3rd      Possession of forged, stolen,

19                              counterfeit, or unlawfully issued

20                              driver's license; possession of

21                              simulated identification.

22  322.212(4)         3rd      Supply or aid in supplying

23                              unauthorized driver's license or

24                              identification card.

25  322.212(5)(a)      3rd      False application for driver's

26                              license or identification card.

27  370.13(3)(a)       3rd      Molest any stone crab trap, line,

28                              or buoy which is property of

29                              licenseholder.

30  370.135(1)         3rd      Molest any blue crab trap, line,

31                              or buoy which is property of

                                  68
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1                              licenseholder.

  2  372.663(1)         3rd      Poach any alligator or

  3                              crocodilia.

  4  414.39(2)          3rd      Unauthorized use, possession,

  5                              forgery, or alteration of food

  6                              stamps, Medicaid ID, value

  7                              greater than $200.

  8  414.39(3)(a)       3rd      Fraudulent misappropriation of

  9                              public assistance funds by

10                              employee/official, value more

11                              than $200.

12  443.071(1)         3rd      False statement or representation

13                              to obtain or increase

14                              unemployment compensation

15                              benefits.

16  458.327(1)(a)      3rd      Unlicensed practice of medicine.

17  466.026(1)(a)      3rd      Unlicensed practice of dentistry

18                              or dental hygiene.

19  509.151(1)         3rd      Defraud an innkeeper, food or

20                              lodging value greater than $300.

21  517.302(1)         3rd      Violation of the Florida

22                              Securities and Investor

23                              Protection Act.

24  562.27(1)          3rd      Possess still or still apparatus.

25  713.69             3rd      Tenant removes property upon

26                              which lien has accrued, value

27                              more than $50.

28  812.014(3)(c)      3rd      Petit theft (3rd conviction);

29                              theft of any property not

30                              specified in subsection (2).

31

                                  69
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  812.081(2)         3rd      Unlawfully makes or causes to be

  2                              made a reproduction of a trade

  3                              secret.

  4  815.04(4)(a)       3rd      Offense against intellectual

  5                              property (i.e., computer

  6                              programs, data).

  7  817.52(2)          3rd      Hiring with intent to defraud,

  8                              motor vehicle services.

  9  826.01             3rd      Bigamy.

10  828.122(3)         3rd      Fighting or baiting animals.

11  831.04(1)          3rd      Any erasure, alteration, etc., of

12                              any replacement deed, map, plat,

13                              or other document listed in s.

14                              92.28.

15  831.31(1)(a)       3rd      Sell, deliver, or possess

16                              counterfeit controlled

17                              substances, all but s. 893.03(5)

18                              drugs.

19  832.041(1)         3rd      Stopping payment with intent to

20                              defraud $150 or more.

21  832.05

22   (2)(b)&(4)(c)     3rd      Knowing, making, issuing

23                              worthless checks $150 or more or

24                              obtaining property in return for

25                              worthless check $150 or more.

26  838.015(3)         3rd      Bribery.

27  838.016(1)         3rd      Public servant receiving unlawful

28                              compensation.

29  838.15(2)          3rd      Commercial bribe receiving.

30  838.16             3rd      Commercial bribery.

31

                                  70
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  843.18             3rd      Fleeing by boat to elude a law

  2                              enforcement officer.

  3  847.011(1)(a)      3rd      Sell, distribute, etc., obscene,

  4                              lewd, etc., material (2nd

  5                              conviction).

  6  849.01             3rd      Keeping gambling house.

  7  849.09(1)(a)-(d)   3rd      Lottery; set up, promote, etc.,

  8                              or assist therein, conduct or

  9                              advertise drawing for prizes, or

10                              dispose of property or money by

11                              means of lottery.

12  849.23             3rd      Gambling-related machines;

13                              "common offender" as to property

14                              rights.

15  849.25(2)          3rd      Engaging in bookmaking.

16  860.08             3rd      Interfere with a railroad signal.

17  860.13(1)(a)       3rd      Operate aircraft while under the

18                              influence.

19  893.13(2)(a)2.     3rd      Purchase of cannabis.

20  893.13(6)(a)       3rd      Possession of cannabis (more than

21                              20 grams).

22  893.13(7)(a)10.    3rd      Affix false or forged label to

23                              package of controlled substance.

24  934.03(1)(a)       3rd      Intercepts, or procures any other

25                              person to intercept, any wire or

26                              oral communication.

27                              (g)  LEVEL 7

28  316.193(3)(c)2.    3rd      DUI resulting in serious bodily

29                              injury.

30  327.35(3)(c)2.     3rd      Vessel BUI resulting in serious

31                              bodily injury.

                                  71
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  402.319(2)         2nd      Misrepresentation and negligence

  2                              or intentional act resulting in

  3                              great bodily harm, permanent

  4                              disfiguration, permanent

  5                              disability, or death.

  6  409.920(2)         3rd      Medicaid provider fraud.

  7  455.637(2)         3rd      Practicing a health care

  8                              profession without a license.

  9  455.637(2)         2nd      Practicing a health care

10                              profession without a license

11                              which results in serious bodily

12                              injury.

13  458.327(1)         3rd      Practicing medicine without a

14                              license.

15  459.013(1)         3rd      Practicing osteopathic medicine

16                              without a license.

17  460.411(1)         3rd      Practicing chiropractic medicine

18                              without a license.

19  461.012(1)         3rd      Practicing podiatric medicine

20                              without a license.

21  462.17             3rd      Practicing naturopathy without a

22                              license.

23  463.015(1)         3rd      Practicing optometry without a

24                              license.

25  464.016(1)         3rd      Practicing nursing without a

26                              license.

27  465.015(2)         3rd      Practicing pharmacy without a

28                              license.

29  466.026(1)         3rd      Practicing dentistry or dental

30                              hygiene without a license.

31

                                  72
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  467.201            3rd      Practicing midwifery without a

  2                              license.

  3  468.366            3rd      Delivering respiratory care

  4                              services without a license.

  5  483.828(1)         3rd      Practicing as clinical laboratory

  6                              personnel without a license.

  7  483.901(9)         3rd      Practicing medical physics

  8                              without a license.

  9  484.053            3rd      Dispensing hearing aids without a

10                              license.

11  494.0018(2)        1st      Conviction of any violation of

12                              ss. 494.001-494.0077 in which the

13                              total money and property

14                              unlawfully obtained exceeded

15                              $50,000 and there were five or

16                              more victims.

17  782.051(3)         2nd      Attempted felony murder of a

18                              person by a person other than the

19                              perpetrator or the perpetrator of

20                              an attempted felony.

21  782.07(1)          2nd      Killing of a human being by the

22                              act, procurement, or culpable

23                              negligence of another

24                              (manslaughter).

25  782.071            2nd      Killing of human being or viable

26                              fetus by the operation of a motor

27                              vehicle in a reckless manner

28                              (vehicular homicide).

29  782.072            2nd      Killing of a human being by the

30                              operation of a vessel in a

31                              reckless manner (vessel

                                  73
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1                              homicide).

  2  784.045(1)(a)1.    2nd      Aggravated battery; intentionally

  3                              causing great bodily harm or

  4                              disfigurement.

  5  784.045(1)(a)2.    2nd      Aggravated battery; using deadly

  6                              weapon.

  7  784.045(1)(b)      2nd      Aggravated battery; perpetrator

  8                              aware victim pregnant.

  9  784.048(4)         3rd      Aggravated stalking; violation of

10                              injunction or court order.

11  784.07(2)(d)       1st      Aggravated battery on law

12                              enforcement officer.

13  784.08(2)(a)       1st      Aggravated battery on a person 65

14                              years of age or older.

15  784.081(1)         1st      Aggravated battery on specified

16                              official or employee.

17  784.082(1)         1st      Aggravated battery by detained

18                              person on visitor or other

19                              detainee.

20  784.083(1)         1st      Aggravated battery on code

21                              inspector.

22  790.07(4)          1st      Specified weapons violation

23                              subsequent to previous conviction

24                              of s. 790.07(1) or (2).

25  790.16(1)          1st      Discharge of a machine gun under

26                              specified circumstances.

27  796.03             2nd      Procuring any person under 16

28                              years for prostitution.

29  800.04(5)(c)1.     2nd      Lewd or lascivious molestation;

30                              victim less than 12 years of age;

31                              offender less than 18 years.

                                  74
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  800.04(5)(c)2.     2nd      Lewd or lascivious molestation;

  2                              victim 12 years of age or older

  3                              but less than 16 years; offender

  4                              18 years or older.

  5  806.01(2)          2nd      Maliciously damage structure by

  6                              fire or explosive.

  7  810.02(3)(a)       2nd      Burglary of occupied dwelling;

  8                              unarmed; no assault or battery.

  9  810.02(3)(b)       2nd      Burglary of unoccupied dwelling;

10                              unarmed; no assault or battery.

11  810.02(3)(d)       2nd      Burglary of occupied conveyance;

12                              unarmed; no assault or battery.

13  812.014(2)(a)      1st      Property stolen, valued at

14                              $100,000 or more; property stolen

15                              while causing other property

16                              damage; 1st degree grand theft.

17  812.019(2)         1st      Stolen property; initiates,

18                              organizes, plans, etc., the theft

19                              of property and traffics in

20                              stolen property.

21  812.131(2)(a)      2nd      Robbery by sudden snatching.

22  812.133(2)(b)      1st      Carjacking; no firearm, deadly

23                              weapon, or other weapon.

24  825.102(3)(b)      2nd      Neglecting an elderly person or

25                              disabled adult causing great

26                              bodily harm, disability, or

27                              disfigurement.

28  825.1025(2)        2nd      Lewd or lascivious battery upon

29                              an elderly person or disabled

30                              adult.

31

                                  75
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  825.103(2)(b)      2nd      Exploiting an elderly person or

  2                              disabled adult and property is

  3                              valued at $20,000 or more, but

  4                              less than $100,000.

  5  827.03(3)(b)       2nd      Neglect of a child causing great

  6                              bodily harm, disability, or

  7                              disfigurement.

  8  827.04(3)          3rd      Impregnation of a child under 16

  9                              years of age by person 21 years

10                              of age or older.

11  837.05(2)          3rd      Giving false information about

12                              alleged capital felony to a law

13                              enforcement officer.

14  872.06             2nd      Abuse of a dead human body.

15  893.13(1)(c)1.     1st      Sell, manufacture, or deliver

16                              cocaine (or other drug prohibited

17                              under s. 893.03(1)(a), (1)(b),

18                              (1)(d), (2)(a), or (2)(b)) within

19                              1,000 feet of a child care

20                              facility or school.

21  893.13(1)(e)       1st      Sell, manufacture, or deliver

22                              cocaine or other drug prohibited

23                              under s. 893.03(1)(a), (1)(b),

24                              (1)(d), (2)(a), or (2)(b), within

25                              1,000 feet of property used for

26                              religious services or a specified

27                              business site.

28  893.13(4)(a)       1st      Deliver to minor cocaine (or

29                              other s. 893.03(1)(a), (1)(b),

30                              (1)(d), (2)(a), or (2)(b) drugs).

31

                                  76
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  893.135(1)(a)1.    1st      Trafficking in cannabis, more

  2                              than 50 lbs., less than 2,000

  3                              lbs.

  4  893.135

  5   (1)(b)1.a.        1st      Trafficking in cocaine, more than

  6                              28 grams, less than 200 grams.

  7  893.135

  8   (1)(c)1.a.        1st      Trafficking in illegal drugs,

  9                              more than 4 grams, less than 14

10                              grams.

11  893.135

12   (1)(d)1.          1st      Trafficking in phencyclidine,

13                              more than 28 grams, less than 200

14                              grams.

15  893.135(1)(e)1.    1st      Trafficking in methaqualone, more

16                              than 200 grams, less than 5

17                              kilograms.

18  893.135(1)(f)1.    1st      Trafficking in amphetamine, more

19                              than 14 grams, less than 28

20                              grams.

21  893.135

22   (1)(g)1.a.        1st      Trafficking in flunitrazepam, 4

23                              grams or more, less than 14

24                              grams.

25         Section 49.  Subsection (1) of section 458.327, Florida

26  Statutes, reads:

27         458.327  Penalty for violations.--

28         (1)  Each of the following acts constitutes a felony of

29  the third degree, punishable as provided in s. 775.082, s.

30  775.083, or s. 775.084:

31         (a)  The practice of medicine or an attempt to practice

                                  77
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  medicine without a license to practice in Florida.

  2         (b)  The use or attempted use of a license which is

  3  suspended or revoked to practice medicine.

  4         (c)  Attempting to obtain or obtaining a license to

  5  practice medicine by knowing misrepresentation.

  6         (d)  Attempting to obtain or obtaining a position as a

  7  medical practitioner or medical resident in a clinic or

  8  hospital through knowing misrepresentation of education,

  9  training, or experience.

10         Section 50.  Subsection (1) of section 459.013, Florida

11  Statutes, reads:

12         459.013  Penalty for violations.--

13         (1)  Each of the following acts constitutes a felony of

14  the third degree, punishable as provided in s. 775.082, s.

15  775.083, or s. 775.084:

16         (a)  The practice of osteopathic medicine, or an

17  attempt to practice osteopathic medicine, without an active

18  license or certificate issued pursuant to this chapter.

19         (b)  The practice of osteopathic medicine by a person

20  holding a limited license, osteopathic faculty certificate, or

21  other certificate issued under this chapter beyond the scope

22  of practice authorized for such licensee or certificateholder.

23         (c)  Attempting to obtain or obtaining a license to

24  practice osteopathic medicine by knowing misrepresentation.

25         (d)  Attempting to obtain or obtaining a position as an

26  osteopathic medical practitioner or osteopathic medical

27  resident in a clinic or hospital through knowing

28  misrepresentation of education, training, or experience.

29         Section 51.  Subsection (1) of section 460.411, Florida

30  Statutes, reads:

31         460.411  Violations and penalties.--

                                  78
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (1)  Each of the following acts constitutes a violation

  2  of this chapter and is a felony of the third degree,

  3  punishable as provided in s. 775.082, s. 775.083, or s.

  4  775.084:

  5         (a)  Practicing or attempting to practice chiropractic

  6  medicine without an active license or with a license

  7  fraudulently obtained.

  8         (b)  Using or attempting to use a license to practice

  9  chiropractic medicine which has been suspended or revoked.

10         Section 52.  Subsection (1) of section 461.012, Florida

11  Statutes, reads:

12         461.012  Violations and penalties.--

13         (1)  Each of the following acts constitutes a violation

14  of this chapter and is a felony of the third degree,

15  punishable as provided in s. 775.082, s. 775.083, or s.

16  775.084:

17         (a)  Practicing or attempting to practice podiatric

18  medicine without an active license or with a license

19  fraudulently obtained.

20         (b)  Advertising podiatric services without an active

21  license obtained pursuant to this chapter or with a license

22  fraudulently obtained.

23         (c)  Using or attempting to use a license to practice

24  podiatric medicine which has been suspended or revoked.

25         Section 53.  Section 462.17, Florida Statutes, reads:

26         462.17  Penalty for offenses relating to

27  naturopathy.--Any person who shall:

28         (1)  Sell, fraudulently obtain, or furnish any

29  naturopathic diploma, license, record, or registration or aid

30  or abet in the same;

31         (2)  Practice naturopathy under the cover of any

                                  79
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  diploma, license, record, or registration illegally or

  2  fraudulently obtained or secured or issued unlawfully or upon

  3  fraudulent representations;

  4         (3)  Advertise to practice naturopathy under a name

  5  other than her or his own or under an assumed name;

  6         (4)  Falsely impersonate another practitioner of a like

  7  or different name;

  8         (5)  Practice or advertise to practice naturopathy or

  9  use in connection with her or his name any designation tending

10  to imply or to designate the person as a practitioner of

11  naturopathy without then being lawfully licensed and

12  authorized to practice naturopathy in this state; or

13         (6)  Practice naturopathy during the time her or his

14  license is suspended or revoked

15

16  shall be guilty of a felony of the third degree, punishable as

17  provided in s. 775.082, s. 775.083, or s. 775.084.

18         Section 54.  Subsection (1) of section 463.015, Florida

19  Statutes, reads:

20         463.015  Violations and penalties.--

21         (1)  Each of the following acts constitutes a felony of

22  the third degree, punishable as provided in s. 775.082, s.

23  775.083, or s. 775.084:

24         (a)  Practicing or attempting to practice optometry

25  without a valid active license issued pursuant to this

26  chapter.

27         (b)  Attempting to obtain or obtaining a license to

28  practice optometry by fraudulent misrepresentation.

29         (c)  Using or attempting to use a license to practice

30  optometry which has been suspended or revoked.

31         Section 55.  Subsection (1) of section 464.016, Florida

                                  80
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Statutes, reads:

  2         464.016  Violations and penalties.--

  3         (1)  Each of the following acts constitutes a felony of

  4  the third degree, punishable as provided in s. 775.082, s.

  5  775.083, or s. 775.084:

  6         (a)  Practicing advanced or specialized, professional

  7  or practical nursing, as defined in this chapter, unless

  8  holding an active license or certificate to do so.

  9         (b)  Using or attempting to use a license or

10  certificate which has been suspended or revoked.

11         (c)  Knowingly employing unlicensed persons in the

12  practice of nursing.

13         (d)  Obtaining or attempting to obtain a license or

14  certificate under this chapter by misleading statements or

15  knowing misrepresentation.

16         Section 56.  Subsection (2) of section 465.015, Florida

17  Statutes, reads:

18         465.015  Violations and penalties.--

19         (2)  It is unlawful for any person:

20         (a)  To make a false or fraudulent statement, either

21  for herself or himself or for another person, in any

22  application, affidavit, or statement presented to the board or

23  in any proceeding before the board.

24         (b)  To fill, compound, or dispense prescriptions or to

25  dispense medicinal drugs if such person does not hold an

26  active license as a pharmacist in this state, is not

27  registered as an intern in this state, or is an intern not

28  acting under the direct and immediate personal supervision of

29  a licensed pharmacist.

30         (c)  To sell or dispense drugs as defined in s.

31  465.003(8) without first being furnished with a prescription.

                                  81
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (d)  To sell samples or complimentary packages of drug

  2  products.

  3         Section 57.  Subsection (1) of section 466.026, Florida

  4  Statutes, reads:

  5         466.026  Prohibitions; penalties.--

  6         (1)  Each of the following acts constitutes a felony of

  7  the third degree, punishable as provided in s. 775.082, s.

  8  775.083, or s. 775.084:

  9         (a)  Practicing dentistry or dental hygiene unless the

10  person has an appropriate, active license issued by the

11  department pursuant to this chapter.

12         (b)  Using or attempting to use a license issued

13  pursuant to this chapter which license has been suspended or

14  revoked.

15         (c)  Knowingly employing any person to perform duties

16  outside the scope allowed such person under this chapter or

17  the rules of the board.

18         (d)  Giving false or forged evidence to the department

19  or board for the purpose of obtaining a license.

20         (e)  Selling or offering to sell a diploma conferring a

21  degree from a dental college or dental hygiene school or

22  college, or a license issued pursuant to this chapter, or

23  procuring such diploma or license with intent that it shall be

24  used as evidence of that which the document stands for, by a

25  person other than the one upon whom it was conferred or to

26  whom it was granted.

27         Section 58.  Section 467.201, Florida Statutes, reads:

28         467.201  Violations and penalties.--Each of the

29  following acts constitutes a felony of the third degree,

30  punishable as provided in s. 775.082, s. 775.083, or s.

31  775.084:

                                  82
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (1)  Practicing midwifery, unless holding an active

  2  license to do so.

  3         (2)  Using or attempting to use a license which has

  4  been suspended or revoked.

  5         (3)  The willful practice of midwifery by a student

  6  midwife without a preceptor present, except in an emergency.

  7         (4)  Knowingly allowing a student midwife to practice

  8  midwifery without a preceptor present, except in an emergency.

  9         (5)  Obtaining or attempting to obtain a license under

10  this chapter through bribery or fraudulent misrepresentation.

11         (6)  Using the name or title "midwife" or "licensed

12  midwife" or any other name or title which implies that a

13  person is licensed to practice midwifery, unless such person

14  is duly licensed as provided in this chapter.

15         (7)  Knowingly concealing information relating to the

16  enforcement of this chapter or rules adopted pursuant thereto.

17         Section 59.  Section 468.366, Florida Statutes, reads:

18         468.366  Penalties for violations.--

19         (1)  It is a violation of law for any person, including

20  any firm, association, or corporation, to:

21         (a)  Sell or fraudulently obtain, attempt to obtain, or

22  furnish to any person a diploma, license, or record, or aid or

23  abet in the sale, procurement, or attempted procurement

24  thereof.

25         (b)  Deliver respiratory care services, as defined by

26  this part or by rule of the board, under cover of any diploma,

27  license, or record that was illegally or fraudulently obtained

28  or signed or issued unlawfully or under fraudulent

29  representation.

30         (c)  Deliver respiratory care services, as defined by

31  this part or by rule of the board, unless such person is duly

                                  83
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  licensed to do so under the provisions of this part or unless

  2  such person is exempted pursuant to s. 468.368.

  3         (d)  Use, in connection with his or her name, any

  4  designation tending to imply that he or she is a respiratory

  5  care practitioner or a respiratory therapist, duly licensed

  6  under the provisions of this part, unless he or she is so

  7  licensed.

  8         (e)  Advertise an educational program as meeting the

  9  requirements of this part, or conduct an educational program

10  for the preparation of respiratory care practitioners or

11  respiratory therapists, unless such program has been approved

12  by the board.

13         (f)  Knowingly employ unlicensed persons in the

14  delivery of respiratory care services, unless exempted by this

15  part.

16         (g)  Knowingly conceal information relative to any

17  violation of this part.

18         (2)  Any violation of this section is a felony of the

19  third degree, punishable as provided in s. 775.082, s.

20  775.083, or s. 775.084.

21         Section 60.  Subsection (1) of section 483.828, Florida

22  Statutes, reads:

23         483.828  Penalties for violations.--

24         (1)  Each of the following acts constitutes a felony of

25  the third degree, punishable as provided in s. 775.082, s.

26  775.083, or s. 775.084:

27         (a)  Practicing as clinical laboratory personnel

28  without an active license.

29         (b)  Using or attempting to use a license to practice

30  as clinical laboratory personnel which is suspended or

31  revoked.

                                  84
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (c)  Attempting to obtain or obtaining a license to

  2  practice as clinical laboratory personnel by knowing

  3  misrepresentation.

  4         Section 61.  Subsection (9) of section 483.901, Florida

  5  Statutes, reads:

  6         483.901  Medical physicists; definitions; licensure.--

  7         (9)  PENALTY FOR VIOLATIONS.--It is a felony of the

  8  third degree, punishable as provided in s. 775.082, s.

  9  775.083, or s. 775.084, to:

10         (a)  Practice or attempt to practice medical physics or

11  hold oneself out to be a licensed medical physicist without

12  holding an active license.

13         (b)  Practice or attempt to practice medical physics

14  under a name other than one's own.

15         (c)  Use or attempt to use a revoked or suspended

16  license or the license of another.

17         Section 62.  Section 484.053, Florida Statutes, reads:

18         484.053  Prohibitions; penalties.--

19         (1)  A person may not:

20         (a)  Practice dispensing hearing aids unless the person

21  is a licensed hearing aid specialist;

22         (b)  Use the name or title "hearing aid specialist"

23  when the person has not been licensed under this part;

24         (c)  Present as her or his own the license of another;

25         (d)  Give false, incomplete, or forged evidence to the

26  board or a member thereof for the purposes of obtaining a

27  license;

28         (e)  Use or attempt to use a hearing aid specialist

29  license that is delinquent or has been suspended, revoked, or

30  placed on inactive status;

31         (f)  Knowingly employ unlicensed persons in the

                                  85
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  practice of dispensing hearing aids; or

  2         (g)  Knowingly conceal information relative to

  3  violations of this part.

  4         (2)  Any person who violates any of the provisions of

  5  this section is guilty of a felony of the third degree,

  6  punishable as provided in s. 775.082 or s. 775.083.

  7         (3)  If a person licensed under this part allows the

  8  sale of a hearing aid by an unlicensed person not registered

  9  as a trainee or fails to comply with the requirements of s.

10  484.0445(2) relating to supervision of trainees, the board

11  shall, upon determination of that violation, order the full

12  refund of moneys paid by the purchaser upon return of the

13  hearing aid to the seller's place of business.

14         Section 63.  Subsection (1) of section 457.102, Florida

15  Statutes, is amended to read:

16         457.102  Definitions.--As used in this chapter:

17         (1)  "Acupuncture" means a form of primary health care,

18  based on traditional Chinese medical concepts and modern

19  oriental medical techniques, that employs acupuncture

20  diagnosis and treatment, as well as adjunctive therapies and

21  diagnostic techniques, for the promotion, maintenance, and

22  restoration of health and the prevention of disease.

23  Acupuncture shall include, but not be limited to, the

24  insertion of acupuncture needles and the application of

25  moxibustion to specific areas of the human body and the use of

26  electroacupuncture, Qi Gong, oriental massage, herbal therapy,

27  dietary guidelines, and other adjunctive therapies, as defined

28  by board rule.

29         Section 64.  Section 457.105, Florida Statutes, is

30  amended to read:

31         457.105  Licensure qualifications and fees.--

                                  86
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (1)  It is unlawful for any person to practice

  2  acupuncture in this state unless such person has been licensed

  3  by the board, is in a board-approved course of study, or is

  4  otherwise exempted by this chapter.

  5         (2)  A person may become licensed to practice

  6  acupuncture if the person applies to the department and:

  7         (a)  Is 21 18 years of age or older, has good moral

  8  character, and has the ability to communicate in English,

  9  which is demonstrated by having passed the national written

10  examination in English or, if such examination was passed in a

11  foreign language, by also having passed a nationally

12  recognized English proficiency examination;

13         (b)  Has completed 60 college credits from an

14  accredited postsecondary institution as a prerequisite to

15  enrollment in an authorized 3-year course of study in

16  acupuncture and oriental medicine, and has completed a 3-year

17  course of study in acupuncture and oriental medicine, and

18  effective July 31, 2001, a 4-year course of study in

19  acupuncture and oriental medicine, which meets standards

20  established by the board by rule, which standards include, but

21  are not limited to, successful completion of academic courses

22  in western anatomy, western physiology, western pathology,

23  western biomedical terminology, first aid, and cardiopulmonary

24  resuscitation (CPR). However, any person who enrolled in an

25  authorized course of study in acupuncture before August 1,

26  1997, must have completed only a 2-year course of study which

27  meets standards established by the board by rule, which

28  standards must include, but are not limited to, successful

29  completion of academic courses in western anatomy, western

30  physiology, and western pathology;

31         (c)  Has successfully completed a board-approved

                                  87
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  national certification process, is actively licensed in a

  2  state that has examination requirements that are substantially

  3  equivalent to or more stringent than those of this state, or

  4  passes an examination administered by the department, which

  5  examination tests the applicant's competency and knowledge of

  6  the practice of acupuncture and oriental medicine. At the

  7  request of any applicant, oriental nomenclature for the points

  8  shall be used in the examination. The examination shall

  9  include a practical examination of the knowledge and skills

10  required to practice modern and traditional acupuncture and

11  oriental medicine, covering diagnostic and treatment

12  techniques and procedures; and

13         (d)  Pays the required fees set by the board by rule

14  not to exceed the following amounts:

15         1.  Examination fee: $500 plus the actual per applicant

16  cost to the department for purchase of the written and

17  practical portions of the examination from a national

18  organization approved by the board.

19         2.  Application fee: $300.

20         3.  Reexamination fee: $500 plus the actual per

21  applicant cost to the department for purchase of the written

22  and practical portions of the examination from a national

23  organization approved by the board.

24         4.  Initial biennial licensure fee: $400, if licensed

25  in the first half of the biennium, and $200, if licensed in

26  the second half of the biennium.

27         Section 65.  Subsection (1) of section 457.107, Florida

28  Statutes, is amended to read:

29         457.107  Renewal of licenses; continuing education.--

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

31  of the renewal application and the fee set by the board by

                                  88
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  rule, not to exceed $500 $700.

  2         Section 66.  Section 483.824, Florida Statutes, is

  3  amended to read:

  4         483.824  Qualifications of clinical laboratory

  5  director.--A clinical laboratory director must have 4 years of

  6  clinical laboratory experience with 2 years of experience in

  7  the specialty to be directed or be nationally board certified

  8  in the specialty to be directed, and must meet one of the

  9  following requirements:

10         (1)  Be a physician licensed under chapter 458 or

11  chapter 459;

12         (2)  Hold an earned doctoral degree in a chemical,

13  physical, or biological science from a regionally accredited

14  institution and maintain national certification requirements

15  equal to those required by the federal Health Care Financing

16  Administration be nationally certified; or

17         (3)  For the subspecialty of oral pathology, be a

18  physician licensed under chapter 458 or chapter 459 or a

19  dentist licensed under chapter 466.

20         Section 67.  Subsection (11) of section 641.51, Florida

21  Statutes, is created to read:

22         641.51  Quality assurance program; second medical

23  opinion requirement.--

24         (11)  If a contracted primary care physician, licensed

25  under Chapter 458 or Chapter 459, and the organization

26  determine that a subscriber requires examination by a licensed

27  ophthalmologist for medically necessary, contractually covered

28  services, then the organization shall authorize the contracted

29  primary care physician to send the subscriber to a contracted

30  licensed ophthalmologist,

31         Section 68.  February 6th of each year is designated

                                  89
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1  Florida Alzheimer's Disease Day.

  2         Section 69.  Subsections (4) through (10) of section

  3  641.51, Florida Statutes, are redesignated as subsections (5)

  4  through (11), respectively, and a new subsection (4) is added

  5  to said section to read:

  6         641.51  Quality assurance program; second medical

  7  opinion requirement.--

  8         (4)  The organization shall ensure that only a

  9  physician licensed under chapter 458 or chapter 459 or an

10  allopathic or osteopathic physician with an active,

11  unencumbered license in another state with similar licensing

12  requirements may render an adverse determination regarding a

13  service provided by a physician licensed in this state. The

14  organization shall submit to the treating provider and the

15  subscriber written notification regarding the organization's

16  adverse determination within 2 working days after the

17  subscriber or provider is notified of the adverse

18  determination. The written notification must include the

19  utilization review criteria or benefits provisions used in the

20  adverse determination, identify the physician who rendered the

21  adverse determination, and be signed by an authorized

22  representative of the organization or the physician who

23  rendered the adverse determination. The organization must

24  include with the notification of an adverse determination

25  information concerning the appeal process for adverse

26  determinations.

27         Section 70.  Subsection (2) of section 766.106, Florida

28  Statutes, is amended to read:

29         766.106  Notice before filing action for medical

30  malpractice; presuit screening period; offers for admission of

31  liability and for arbitration; informal discovery; review.--

                                  90
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         (2)  After completion of presuit investigation pursuant

  2  to s. 766.203 and prior to filing a claim for medical

  3  malpractice, a claimant shall notify each prospective

  4  defendant and, if any prospective defendant is a health care

  5  provider licensed under chapter 458, chapter 459, chapter 460,

  6  chapter 461, or chapter 466, the Department of Health by

  7  certified mail, return receipt requested, of intent to

  8  initiate litigation for medical malpractice. Following the

  9  initiation of a suit alleging medical malpractice with a court

10  of competent jurisdiction, and service of the complaint upon a

11  defendant, the claimant shall provide a copy of the complaint

12  to the Department of Health. Notice to the Department of

13  Health must include the full name and address of the claimant;

14  the full names and any known addresses of any health care

15  providers licensed under chapter 458, chapter 459, chapter

16  460, chapter 461, or chapter 466 who are prospective

17  defendants identified at the time; the date and a summary of

18  the occurrence giving rise to the claim; and a description of

19  the injury to the claimant. The requirement of providing the

20  complaint for notice to the Department of Health does not

21  impair the claimant's legal rights or ability to seek relief

22  for his or her claim, and the fact of providing the complaint

23  notice provided to the department is not discoverable or

24  admissible in any civil or administrative action. The

25  Department of Health shall review each incident and determine

26  whether it involved conduct by a licensee which is potentially

27  subject to disciplinary action, in which case the provisions

28  of s. 455.621 apply.

29

30  (Redesignate subsequent sections.)

31

                                  91
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





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

  2  And the title is amended as follows:

  3         On page 3, line 1, after the semicolon,

  4

  5  insert:

  6         providing an appropriation for continued review

  7         of clinical laboratory services for kidney

  8         dialysis patients and requiring a report

  9         thereon; creating the Florida Commission on

10         Excellence in Health Care; providing

11         legislative findings and intent; providing

12         definitions; providing duties and

13         responsibilities; providing for membership,

14         organization, meetings, procedures, and staff;

15         providing for reimbursement of travel and

16         related expenses of certain members; providing

17         certain evidentiary prohibitions; requiring a

18         report to the Governor, the President of the

19         Senate, and the Speaker of the House of

20         Representatives; providing for termination of

21         the commission; providing appropriations;

22         amending s. 455.564, F.S.; revising general

23         licensing provisions for professions under the

24         jurisdiction of the Department of Health;

25         providing for processing of applications from

26         foreign or nonresident applicants not yet

27         having a social security number; providing for

28         temporary licensure of such applicants;

29         revising provisions relating to ongoing

30         criminal investigations or prosecutions;

31         requiring proof of restoration of civil rights

                                  92
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         under certain circumstances; authorizing

  2         requirement for personal appearance prior to

  3         grant or denial of a license; providing for

  4         tolling of application decision deadlines under

  5         certain circumstances; amending s. 455.565,

  6         F.S.; eliminating duplicative submission of

  7         fingerprints and other information required for

  8         criminal history checks; providing for certain

  9         access to criminal history information through

10         the department's health care practitioner

11         credentialing system; amending s. 455.5651,

12         F.S.; authorizing the department to publish

13         certain information in practitioner profiles;

14         amending s. 455.5653, F.S.; deleting obsolete

15         language relating to scheduling and development

16         of practitioner profiles for additional health

17         care practitioners; providing the department

18         access to information on health care

19         practitioners maintained by the Agency for

20         Health Care Administration for corroboration

21         purposes; amending s. 455.5654, F.S.; providing

22         for adoption by rule of a form for submission

23         of profiling information; amending s. 455.567,

24         F.S.; expanding the prohibition against sexual

25         misconduct to cover violations against

26         guardians and representatives of patients or

27         clients; providing penalties; amending s.

28         455.624, F.S.; revising and providing grounds

29         for disciplinary action relating to having a

30         license to practice a regulated health care

31         profession acted against, sexual misconduct,

                                  93
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         inability to practice properly due to alcohol

  2         or substance abuse or a mental or physical

  3         condition, and testing positive for a drug

  4         without a lawful prescription therefor;

  5         providing for restriction of license as a

  6         disciplinary action; providing for issuance of

  7         a citation and assessment of a fine for certain

  8         first-time violations; reenacting ss. 455.577,

  9         455.631, 455.651(2), 455.712(1), 458.347(7)(g),

10         459.022(7)(f), 468.1755(1)(a), 468.719(1)(a)

11         and (2), 468.811, and 484.056(1)(a), F.S.,

12         relating to theft or reproduction of an

13         examination, giving false information,

14         disclosure of confidential information,

15         business establishments providing regulated

16         services without an active status license, and

17         practice violations by physician assistants,

18         nursing home administrators, athletic trainers,

19         orthotists, prosthetists, pedorthists, and

20         hearing aid specialists, to incorporate the

21         amendment to s. 455.624, F.S., in references

22         thereto; repealing s. 455.704, F.S., relating

23         to the Impaired Practitioners Committee;

24         amending s. 455.707, F.S., relating to impaired

25         practitioners, to conform; clarifying

26         provisions relating to complaints against

27         impaired practitioners; amending s. 310.102,

28         F.S.; revising and removing references, to

29         conform; amending s. 455.711, F.S.; revising

30         provisions relating to active and inactive

31         status licensure; eliminating reference to

                                  94
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         delinquency as a licensure status; providing

  2         rulemaking authority; amending ss. 455.587 and

  3         455.714, F.S.; revising references, to conform;

  4         creating s. 455.719, F.S.; providing that the

  5         appropriate medical regulatory board, or the

  6         department when there is no board, has

  7         exclusive authority to grant exemptions from

  8         disqualification from employment or contracting

  9         with respect to persons under the licensing

10         jurisdiction of that board or the department,

11         as applicable; amending s. 455.637, F.S.;

12         revising provisions relating to sanctions

13         against the unlicensed practice of a health

14         care profession; providing legislative intent;

15         revising and expanding provisions relating to

16         civil and administrative remedies; providing

17         criminal penalties; incorporating and modifying

18         the substance of current provisions that impose

19         a fee to combat unlicensed activity and provide

20         for disposition of the proceeds thereof;

21         providing statutory construction relating to

22         dietary supplements; creating s. 458.3135,

23         F.S.; providing for temporary certification for

24         visiting physicians to practice in approved

25         cancer centers; providing certification

26         requirements; providing fees; providing for

27         approval of cancer centers and annual review of

28         such approval; providing practice limitations

29         and conditions; limiting the number of

30         certificates that may be issued; providing

31         rulemaking authority; amending s. 458.3145,

                                  95
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         F.S.; adding medical schools to list of

  2         programs at which medical faculty

  3         certificateholders may practice; amending s.

  4         458.315, F.S.; waiving application and

  5         licensure fees for physicians obtaining a

  6         temporary certificate to practice in areas of

  7         critical need when such practice is limited to

  8         volunteer, uncompensated care for low-income

  9         persons; amending ss. 458.345 and 459.021,

10         F.S.; providing for registration of persons

11         desiring to practice as a resident physician,

12         assistant resident physician, house physician,

13         intern, or fellow in fellowship training in a

14         statutory teaching hospital; providing

15         requirements; providing fees; providing

16         penalties; providing rulemaking authority;

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

18         to contain specified requirements; amending s.

19         458.347, F.S.; providing authority to the

20         Council on Physician Assistants to refuse to

21         certify an applicant for licensure or place

22         restrictions or conditions on license; amending

23         s. 459.022, F.S.; providing authority to the

24         Council on Physician Assistants to refuse to

25         certify an applicant for licensure or place

26         restrictions or conditions on license;

27         providing applicability; repealing s. 455.641,

28         F.S., relating to unlicensed activity fees, to

29         conform; reenacting ss. 455.574(1)(d),

30         468.1295(1), 484.014(1), and 484.056(1), F.S.,

31         relating to violation of security provisions

                                  96
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         for examinations and violations involving

  2         speech-language pathology, audiology,

  3         opticianry, and the dispensing of hearing aids,

  4         to incorporate the amendment to s. 455.637,

  5         F.S., in references thereto; amending s.

  6         921.0022, F.S.; modifying the criminal offense

  7         severity ranking chart to add or increase the

  8         level of various offenses relating to the

  9         practice of a health care profession, the

10         practice of medicine, osteopathic medicine,

11         chiropractic medicine, podiatric medicine,

12         naturopathy, optometry, nursing, pharmacy,

13         dentistry, dental hygiene, midwifery,

14         respiratory therapy, and medical physics,

15         practicing as clinical laboratory personnel,

16         and the dispensing of hearing aids; reading ss.

17         458.327, 459.013, 460.411, 461.012, 462.17,

18         463.015, 464.016, 465.015, 466.026, 467.201,

19         468.366, 483.828, 483.901, 484.053, F.S.;

20         providing penalties; amending s. 457.102, F.S.;

21         revising the definition of "acupuncture";

22         amending s. 457.105, F.S.; revising licensure

23         qualifications to practice acupuncture;

24         amending s. 457.107, F.S.; modifying the fee

25         for renewal of a license to practice

26         acupuncture; amending s. 483.824, F.S.;

27         revising qualifications of clinical laboratory

28         directors; amending s. 641.51, F.S.; providing

29         for referral to ophthalmologist under certain

30         circumstances; designating Florida Alzheimer's

31         Disease Day; amending s. 766.106, F.S.;

                                  97
    4:21 PM   05/04/00                              s0420c1c-3317t




                                                  SENATE AMENDMENT

    Bill No. CS for SB 420

    Amendment No. ___





  1         providing that following the initiation of a

  2         suit alleging medical malpractice the claimant

  3         must provide notice to the Department of Health

  4         along with a copy of the service of process;

  5         amending s. 641.51, F.S., relating to quality

  6         assurance program requirements for certain

  7         managed care organizations; allowing the

  8         rendering of adverse determinations by

  9         physicians licensed in Florida or states with

10         similar requirements; requiring the submission

11         of facts and documentation pertaining to

12         rendered adverse determinations; providing

13         timeframe for organizations to submit facts and

14         documentation to providers and subscribers in

15         writing; requiring an authorized representative

16         to sign the notification;

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

                                  98
    4:21 PM   05/04/00                              s0420c1c-3317t