Senate Bill sb1558e1

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    CS for SB 1558                                 First Engrossed



  1                      A bill to be entitled

  2         An act relating to health care practitioner

  3         regulation; providing legislative intent and

  4         findings with respect to the Medical Quality

  5         Assurance Trust Fund and function administered

  6         by the Department of Health; requiring the

  7         Auditor General to do a followup Medical

  8         Quality Assurance audit and issue a report to

  9         the Legislature; requiring the Office of

10         Program Policy Analysis and Government

11         Accountability to study the feasibility of

12         maintaining the Medical Quality Assurance

13         function within a single department and issue a

14         report to the Legislature; requiring the

15         Department of Health to reimburse the Agency

16         for Health Care Administration for certain

17         costs; amending s. 456.004, F.S.; providing

18         requirements for rules relating to biennial

19         renewal of licenses; amending s. 456.025, F.S.;

20         revising requirements relating to the setting

21         and use of fees for the regulation of health

22         care professions and practitioners, including

23         continuing education fees; providing for an

24         electronic continuing-education tracking

25         system; amending ss. 457.107, 483.807, F.S.;

26         conforming provisions relating to fees;

27         repealing s. 458.31151, F.S., relating to

28         development of the examination for

29         foreign-trained physicians and the fees

30         therefor; amending s. 456.011, F.S.; requiring

31         board meetings to be conducted through


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    CS for SB 1558                                 First Engrossed



  1         teleconferencing or other technological means

  2         except under certain circumstances; amending s.

  3         456.013, F.S.; requiring the department to

  4         charge initial license fees; amending s.

  5         456.017, F.S.; providing for administration of

  6         national examinations and termination of

  7         state-administered written examinations;

  8         providing for administration of

  9         state-administered practical or clinical

10         examinations if paid for in advance by the

11         examination candidates; providing legislative

12         intent with respect to the use of national

13         examinations and the removal of

14         state-administered examinations as a barrier to

15         licensure; providing for electronic access to

16         and posting of examination scores under certain

17         conditions; providing for the sharing of

18         examinations or examination-item banks with

19         certain entities; providing for review of

20         questions by legal counsel under certain

21         circumstances; providing for electronic

22         administration of examinations; amending s.

23         456.035, F.S.; providing for electronic

24         notification of a licensee's current mailing

25         address and place of practice; amending s.

26         456.073, F.S.; prohibiting a letter of guidance

27         in lieu of a finding of probable cause under

28         certain conditions; amending s. 456.081, F.S.;

29         providing for publication of information;

30         amending s. 456.072, F.S.; revising and

31         providing grounds for discipline of licensees;


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  1         revising provisions governing and providing for

  2         disciplinary actions; amending s. 456.079,

  3         F.S.; requiring mitigating or aggravating

  4         circumstances to be in the final order to be

  5         considered in the imposition of penalties;

  6         amending ss. 457.109, 458.320, 458.331,

  7         459.0085, 459.015, 460.413, 461.013, 462.14,

  8         463.016, 464.018, 465.016, 466.028, 466.037,

  9         467.203, 468.1295, 468.1755, 468.217, 468.365,

10         468.518, 468.719, 468.811, 478.52, 480.046,

11         483.825, 483.901, 484.014, 484.056, 486.125,

12         490.009, 491.009, F.S.; conforming provisions

13         relating to disciplinary actions; repealing s.

14         483.827, F.S., relating to administrative

15         penalties applicable to clinical laboratory

16         personnel; amending s. 456.074, F.S.; providing

17         for immediate suspension of licenses for

18         violations relating to fraudulent practices;

19         amending s. 464.005, F.S.; providing for future

20         relocation of the headquarters of the Board of

21         Nursing; amending s. 456.003, F.S.; providing a

22         limitation on the duties of certain boards;

23         providing effective dates.

24

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

26

27         Section 1.  It is the intent of the Legislature that

28  the Medical Quality Assurance Trust Fund should be

29  administered in a fiscally responsible manner. It is also the

30  intent of the Legislature that the Department of Health reduce

31  expenses wherever possible to ensure that the cost of


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  1  regulation is reasonable and fair and does not serve as a

  2  barrier to licensure in this state. The Legislature adopts

  3  findings 1, 2, 4, 5, and 8 and all three recommendations of

  4  the Auditor General's Medical Quality Assurance Operational

  5  Audit Report Number 01-063. In addition, the Legislature

  6  adopts recommendations 1, 2, 4, 5, and 7 of the Florida Senate

  7  Committee on Fiscal Policy Interim Project Report 2001-016,

  8  except where such recommendations require the fees to be set

  9  by the boards.

10         Section 2.  The Auditor General shall conduct a

11  followup audit to the Medical Quality Assurance Operational

12  Audit Report Number 01-063 to determine if the Department of

13  Health has implemented the recommendations of that report. The

14  Auditor General shall complete the followup audit and issue a

15  report to the President of the Senate and the Speaker of the

16  House of Representatives no later than January 31, 2002.

17         Section 3.  The Office of Program Policy Analysis and

18  Government Accountability shall study the feasibility of

19  maintaining the entire Medical Quality Assurance function,

20  including enforcement, within a single department. The study

21  shall be completed and a report issued to the President of the

22  Senate and the Speaker of the House of Representatives no

23  later than November 30, 2001.

24         Section 4.  The contract between the Department of

25  Health and the Agency for Health Care Administration pursuant

26  to section 20.43(3), Florida Statutes, is not subject to the

27  provisions of section 216.346, Florida Statutes. The

28  Department of Health shall reimburse the Agency for Health

29  Care Administration for the agency's actual and direct costs

30  and the agency's appropriate share of indirect and

31


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  1  infrastructure costs applicable to the contract, subject to

  2  appropriated funds.

  3         Section 5.  Subsection (1) of section 456.004, Florida

  4  Statutes, is amended, and subsection (10) is added to that

  5  section, to read:

  6         456.004  Department; powers and duties.--The

  7  department, for the professions under its jurisdiction, shall:

  8         (1)  Adopt rules establishing a procedure for the

  9  biennial renewal of licenses; however, the department may

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

11  notwithstanding any other provisions of law to the contrary.

12  The rules shall specify the expiration dates of licenses and

13  the process for tracking compliance with continuing education

14  requirements, financial responsibility requirements, and any

15  other conditions of renewal set forth in statute or rule. Fees

16  for such renewal shall not exceed the fee caps for individual

17  professions on an annualized basis as authorized by law.

18         (10)  Set an examination fee that includes all costs to

19  develop, validate, administer, and defend the examination and

20  is an amount certain to cover all administrative costs plus

21  the actual per-applicant cost of the examination.

22         Section 6.  Section 456.025, Florida Statutes, is

23  amended to read:

24         456.025  Fees; receipts; disposition.--

25         (1)  It is the intent of the Legislature that all costs

26  of regulating health care professions and practitioners shall

27  be borne solely by licensees and licensure applicants. It is

28  also the intent of the Legislature that fees should be

29  reasonable and not serve as a barrier to licensure. Moreover,

30  it is the intent of the Legislature that the department

31  operate as efficiently as possible and regularly report to the


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    CS for SB 1558                                 First Engrossed



  1  Legislature additional methods to streamline operational

  2  costs. Therefore, the boards shall set fees in consultation

  3  with the department every 2 years for the professions

  4  regulated by the Division of Medical Quality Assurance. The

  5  fees shall be based on revenue projections prepared by the

  6  department using generally accepted accounting procedures and

  7  shall be adequate to cover all anticipated costs and to

  8  maintain a reasonable cash balance.

  9         (2)  The chairpersons of the boards and councils listed

10  in s. 20.043(3)(g) shall meet annually at the division

11  headquarters to review the long-range policy plan required by

12  s. 456.005 and current and proposed fee schedules. The

13  chairpersons, upon approval by the board, shall make

14  recommendations for any necessary statutory changes relating

15  to fees and fee caps. Such recommendations shall be compiled

16  by the Department of Health and be included in the annual

17  report to the Legislature required by s. 456.026 and be

18  included in the long-range policy plan required by s. 456.005.

19         (3)(1)  Each board within the jurisdiction of the

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

21  determine by rule the amount of license fees for the

22  profession it regulates, based upon long-range estimates

23  prepared by the department of the revenue required to

24  implement laws relating to the regulation of professions by

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

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

27  adequate to cover all anticipated costs and to maintain a

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

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

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

31  department that license fees are projected to be inadequate,


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    CS for SB 1558                                 First Engrossed



  1  the department shall set license fees on behalf of the

  2  applicable board to cover anticipated costs and to maintain

  3  the required cash balance. The department shall include

  4  recommended fee cap increases in its annual report to the

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

  6  regulated profession operate with a negative cash balance. The

  7  department may provide by rule for advancing sufficient funds

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

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

10  years, and the regulated profession must pay interest.

11  Interest shall be calculated at the current rate earned on

12  investments of a trust fund used by the department to

13  implement this chapter. Interest earned shall be allocated to

14  the various funds in accordance with the allocation of

15  investment earnings during the period of the advance.

16         (4)(2)  Each board, or the department if there is no

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

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

19  456.013(2) requested by a licensee who was licensed prior to

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

21  certificate requested by any licensee.

22         (5)(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 inactive status licensee

25  in an amount necessary to eliminate a cash deficit or, if

26  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.

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    CS for SB 1558                                 First Engrossed



  1         (6)  If the cash balance of the trust fund at the end

  2  of any fiscal year exceeds the total appropriation provided

  3  for the regulation of the health care professions in the prior

  4  fiscal year, the boards, in consultation with the department,

  5  may lower the fees imposed pursuant to this section.

  6         (7)(4)  Each board authorized to approve continuing

  7  education providers, or the department if there is no board,

  8  shall may establish, by rule, a fee not to exceed $250 for

  9  anyone seeking approval to provide continuing education

10  courses or programs and shall may establish by rule a biennial

11  renewal fee not to exceed $250 for the renewal of providership

12  of such courses. The fees collected from continuing education

13  providers shall be used for the purposes of reviewing course

14  provider applications, monitoring the integrity of the courses

15  provided, covering legal expenses incurred as a result of not

16  granting or renewing a providership, and developing and

17  maintaining an electronic continuing education tracking

18  system. The department shall implement an electronic

19  continuing education tracking system for each new biennial

20  renewal cycle for which electronic renewals are implemented

21  after the effective date of this act and shall integrate such

22  system into the licensure and renewal system. All approved

23  continuing education providers shall provide information on

24  course attendance to the department necessary to implement the

25  electronic tracking system. The department shall, by rule,

26  specify the form and procedures by which the information is to

27  be submitted. This subsection does not apply to continuing

28  education courses or providers approved by the board under

29  chapter 465.

30         (8)(5)  All moneys collected by the department from

31  fees or fines or from costs awarded to the agency by a court


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  1  shall be paid into a trust fund used by the department to

  2  implement this chapter. The Legislature shall appropriate

  3  funds from this trust fund sufficient to carry out this

  4  chapter and the provisions of law with respect to professions

  5  regulated by the Division of Medical Quality Assurance within

  6  the department and the boards. The department may contract

  7  with public and private entities to receive and deposit

  8  revenue pursuant to this section.  The department shall

  9  maintain separate accounts in the trust fund used by the

10  department to implement this chapter for every profession

11  within the department.  To the maximum extent possible, the

12  department shall directly charge all expenses to the account

13  of each regulated profession.  For the purpose of this

14  subsection, direct charge expenses include, but are not

15  limited to, costs for investigations, examinations, and legal

16  services.  For expenses that cannot be charged directly, the

17  department shall provide for the proportionate allocation

18  among the accounts of expenses incurred by the department in

19  the performance of its duties with respect to each regulated

20  profession. The regulation by the department of professions,

21  as defined in this chapter, shall be financed solely from

22  revenue collected by it from fees and other charges and

23  deposited in the Medical Quality Assurance Trust Fund, and all

24  such revenue is hereby appropriated to the department.

25  However, it is legislative intent that each profession shall

26  operate within its anticipated fees. The department may not

27  expend funds from the account of a profession to pay for the

28  expenses incurred on behalf of another profession, except that

29  the Board of Nursing must pay for any costs incurred in the

30  regulation of certified nursing assistants. The department

31  shall maintain adequate records to support its allocation of


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  1  agency expenses.  The department shall provide any board with

  2  reasonable access to these records upon request.  On or before

  3  October 1 of each year, the department shall provide each

  4  board an annual report of revenue and direct and allocated

  5  expenses related to the operation of that profession. The

  6  board shall use these reports and the department's adopted

  7  long-range plan to determine the amount of license fees. A

  8  condensed version of this information, with the department's

  9  recommendations, shall be included in the annual report to the

10  Legislature prepared under s. 456.026.

11         (9)(6)  The department shall provide a condensed

12  management report of budgets, finances, performance

13  statistics, and recommendations to each board at least once a

14  quarter.  The department shall identify and include in such

15  presentations any changes, or projected changes, made to the

16  board's budget since the last presentation.

17         (10)(7)  If a duplicate license is required or

18  requested by the licensee, the board or, if there is no board,

19  the department may charge a fee as determined by rule not to

20  exceed $25 before issuance of the duplicate license.

21         (11)(8)  The department or the appropriate board shall

22  charge a fee not to exceed $25 for the certification of a

23  public record. The fee shall be determined by rule of the

24  department. The department or the appropriate board shall

25  assess a fee for duplicating a public record as provided in s.

26  119.07(1)(a) and (b).

27         Section 7.  Subsections (1) of section 457.107, Florida

28  Statutes, is amended to read:

29         457.107  Renewal of licenses; continuing education.--

30

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    CS for SB 1558                                 First Engrossed



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

  2  of the renewal application and the required fee set by the

  3  board by rule, not to exceed $500.

  4         Section 8.  Section 458.31151, Florida Statutes, is

  5  repealed.

  6         Section 9.  Subsection (1) of section 483.807, Florida

  7  Statutes, is amended to read:

  8         483.807  Fees; establishment; disposition.--

  9         (1)  The board, by rule, shall establish fees to be

10  paid for application, examination, reexamination, licensing

11  and renewal, registration, laboratory training program

12  application, reinstatement, and recordmaking and

13  recordkeeping. The board may also establish, by rule, a

14  delinquency fee. The board shall establish fees that are

15  adequate to ensure the continued operation of the board and to

16  fund the proportionate expenses incurred by the department in

17  carrying out its licensure and other related responsibilities

18  under this part. Fees shall be based on departmental estimates

19  of the revenue required to implement this part and the

20  provisions of law with respect to the regulation of clinical

21  laboratory personnel.

22         Section 10.  Subsections (1), (3), and (4) of section

23  456.011, Florida Statutes, are amended to read:

24         456.011  Boards; organization; meetings; compensation

25  and travel expenses.--

26         (1)  Each board within the department shall comply with

27  the provisions of this chapter section.

28         (3)  The board shall meet at least once annually and

29  may meet as often as is necessary. Meetings shall be conducted

30  through teleconferencing or other technological means, unless

31  disciplinary hearings involving standard of care, sexual


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  1  misconduct, fraud, impairment, or felony convictions;

  2  licensure denial hearings; or controversial rule hearings are

  3  being conducted or unless otherwise approved in advance of the

  4  meeting by the director of the Division of Medical Quality

  5  Assurance. The chairperson or a quorum of the board shall have

  6  the authority to call other meetings, except as provided above

  7  relating to in-person meetings. A quorum shall be necessary

  8  for the conduct of official business by the board or any

  9  committee thereof. Unless otherwise provided by law, 51

10  percent or more of the appointed members of the board or any

11  committee, when applicable, shall constitute a quorum. The

12  membership of committees of the board, except as otherwise

13  authorized pursuant to this chapter or the applicable practice

14  act, shall be composed of currently appointed members of the

15  board. The vote of a majority of the members of the quorum

16  shall be necessary for any official action by the board or

17  committee. Three consecutive unexcused absences or absences

18  constituting 50 percent or more of the board's meetings within

19  any 12-month period shall cause the board membership of the

20  member in question to become void, and the position shall be

21  considered vacant. The board, or the department when there is

22  no board, shall, by rule, define unexcused absences.

23         (4)  Unless otherwise provided by law, a board member

24  or former board member serving on a probable cause panel shall

25  be compensated $50 for each day in attendance at an official

26  meeting of the board and for each day of participation in any

27  other business involving the board.  Each board shall adopt

28  rules defining the phrase "other business involving the

29  board," but the phrase may not routinely be defined to include

30  telephone conference calls that last less than 4 hours. A

31  board member also shall be entitled to reimbursement for


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    CS for SB 1558                                 First Engrossed



  1  expenses pursuant to s. 112.061.  Travel out of state shall

  2  require the prior approval of the secretary.

  3         Section 11.  Subsection (2) of section 456.013, Florida

  4  Statutes, is amended to read:

  5         456.013  Department; general licensing provisions.--

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

  7  shall may charge an initial license fee as determined by rule

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

  9  of the department.  Upon receipt of the appropriate license

10  fee, the department shall issue a license to any person

11  certified by the appropriate board, or its designee, as having

12  met the licensure requirements imposed by law or rule. The

13  license shall consist of a wallet-size identification card and

14  a wall card measuring 6 1/2  inches by 5 inches. In addition

15  to the two-part license, the department, at the time of

16  initial licensure, shall issue a wall certificate suitable for

17  conspicuous display, which shall be no smaller than 8 1/2

18  inches by 14 inches. The licensee shall surrender to the

19  department the wallet-size identification card, the wall card,

20  and the wall certificate, if one has been issued by the

21  department, if the licensee's license is revoked.

22         Section 12.  Section 456.017, Florida Statutes, is

23  amended to read:

24         456.017  Department of Health; examinations.--

25         (1)(a)  The department shall provide, contract, or

26  approve services for the development, preparation,

27  administration, scoring, score reporting, and evaluation of

28  all examinations, in consultation with the appropriate board.

29  The department shall certify that examinations developed and

30  approved by the department adequately and reliably measure an

31  applicant's ability to practice the profession regulated by


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  1  the department.  After an examination developed or approved by

  2  the department has been administered, the board, or the

  3  department when there is no board, may reject any question

  4  which does not reliably measure the general areas of

  5  competency specified in the rules of the board. The department

  6  may contract for the preparation, administration, scoring,

  7  score reporting, and evaluation of examinations, when such

  8  services are available and approved by the board.

  9         (b)  For each examination developed by the department

10  or contracted vendor, to the extent not otherwise specified by

11  statute, the board, or the department when there is no board,

12  shall by rule specify the general areas of competency to be

13  covered by each examination, the relative weight to be

14  assigned in grading each area tested, and the score necessary

15  to achieve a passing grade. The department shall assess, and

16  fees, where applicable, to cover the actual cost for any

17  purchase, development, validation, and administration, and

18  defense of required examinations.  This subsection does not

19  apply to national examinations approved and administered

20  pursuant to paragraph (c).  If a practical examination is

21  deemed to be necessary, the rules shall specify the criteria

22  by which examiners are to be selected, the grading criteria to

23  be used by the examiner, the relative weight to be assigned in

24  grading each criterion, and the score necessary to achieve a

25  passing grade. When a mandatory standardization exercise for a

26  practical examination is required by law, the board, or the

27  department when there is no board, may conduct such exercise.

28  Therefore, board members, or employees of the department when

29  there is no board, may serve as examiners at a practical

30  examination with the consent of the board or department, as

31  appropriate.


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  1         (c)1.  The board, or the department when there is no

  2  board, shall may approve by rule the use of one or more any

  3  national examinations examination which the department has

  4  certified as meeting requirements of national examinations and

  5  generally accepted testing standards pursuant to department

  6  rules.  Providers of examinations seeking certification by the

  7  department shall pay the actual costs incurred by the

  8  department in making a determination regarding the

  9  certification.  The name and number of a candidate may be

10  provided to a national contractor for the limited purpose of

11  preparing the grade tape and information to be returned to the

12  board or department; or, to the extent otherwise specified by

13  rule, the candidate may apply directly to the vendor of the

14  national examination and supply test score information to the

15  department.  The department may delegate to the board the duty

16  to provide and administer the examination.  Any national

17  examination approved by a board, or the department when there

18  is no board, prior to October 1, 1997, is deemed certified

19  under this paragraph.

20         2.  The board, or the department when there is no

21  board, shall approve and begin administering a national

22  examination no later than December 31, 2002. Neither the board

23  nor the department may administer a state-developed written

24  examination after December 31, 2002, notwithstanding any other

25  provision of law. The examination may be administered

26  electronically if adequate security measures are used, as

27  determined by rule of the department.

28         3.  The board, or the department when there is no

29  board, may administer a state-developed practical or clinical

30  examination, as required by the applicable practice act, if

31  all costs of development, validation, administration, review,


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  1  and defense are paid by the examination candidate prior to the

  2  administration of the examination. If a national practical or

  3  clinical examination is available and certified by the

  4  department pursuant to this section, the board, or the

  5  department when there is no board, may administer the national

  6  examination.

  7         4.  It is the intent of the Legislature to reduce the

  8  costs associated with state examinations and to encourage the

  9  use of national examinations whenever possible.

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

11  board, shall adopt rules regarding the security and monitoring

12  of examinations.  The department shall implement those rules

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

14  security of examinations, the department may employ the

15  procedures set forth in s. 456.065 to seek fines and

16  injunctive relief against an examinee who violates the

17  provisions of s. 456.018 or the rules adopted pursuant to this

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

19  purposes of investigation, confiscate any written,

20  photographic, or recording material or device in the

21  possession of the examinee at the examination site which the

22  department deems necessary to enforce such provisions or

23  rules. The scores of state-developed examinations taken by

24  candidates shall be provided to the candidates electronically

25  using a candidate identification number, and the department

26  shall post the aggregate scores on the department's website

27  without identifying the names of the candidates.

28         (e)  If the professional board with jurisdiction over

29  an examination concurs, the department may, for a fee, share

30  with any other state's licensing authority or a national

31  testing entity an examination or examination item bank


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    CS for SB 1558                                 First Engrossed



  1  developed by or for the department unless prohibited by a

  2  contract entered into by the department for development or

  3  purchase of the examination.  The department, with the

  4  concurrence of the appropriate board, shall establish

  5  guidelines that ensure security of a shared exam and shall

  6  require that any other state's licensing authority comply with

  7  those guidelines.  Those guidelines shall be approved by the

  8  appropriate professional board.  All fees paid by the user

  9  shall be applied to the department's examination and

10  development program for professions regulated by this chapter.

11         (f)  The department may adopt rules necessary to

12  administer this subsection.

13         (2)  For each examination developed by the department

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

15  there is no board, shall adopt rules providing for

16  reexamination of any applicants who failed an examination

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

18  written and a practical examination are given, an applicant

19  shall be required to retake only the portion of the

20  examination on which the applicant failed to achieve a passing

21  grade, if the applicant successfully passes that portion

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

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

24  portion. Except for national examinations approved and

25  administered pursuant to this section, the department shall

26  provide procedures for applicants who fail an examination

27  developed by the department or a contracted vendor to review

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

29  grading key for the questions the candidate answered

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

31  failed. Applicants shall bear the actual cost for the


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  1  department to provide examination review pursuant to this

  2  subsection. An applicant may waive in writing the

  3  confidentiality of the applicant's examination grades.

  4         (3)  For each examination developed or administered by

  5  the department or a contracted vendor, an accurate record of

  6  each applicant's examination questions, answers, papers,

  7  grades, and grading key shall be kept for a period of not less

  8  than 2 years immediately following the examination, and such

  9  record shall thereafter be maintained or destroyed as provided

10  in chapters 119 and 257.  This subsection does not apply to

11  national examinations approved and administered pursuant to

12  this section.

13         (4)  Meetings of any member of the department or of any

14  board within the department held for the exclusive purpose of

15  creating or reviewing licensure examination questions or

16  proposed examination questions are exempt from the provisions

17  of s. 286.011 and s. 24(b), Art. I of the State Constitution.

18  Any public records, such as tape recordings, minutes, or

19  notes, generated during or as a result of such meetings are

20  confidential and exempt from the provisions of s. 119.07(1)

21  and s. 24(a), Art. I of the State Constitution. However, these

22  exemptions shall not affect the right of any person to review

23  an examination as provided in subsection (2).

24         (5)  For examinations developed by the department or a

25  contracted vendor, each board, or the department when there is

26  no board, may provide licensure examinations in an applicant's

27  native language.  Notwithstanding any other provision of law,

28  applicants for examination or reexamination pursuant to this

29  subsection shall bear the full cost for the department's

30  development, preparation, validation, administration, grading,

31  and evaluation of any examination in a language other than


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  1  English prior to the examination being administered.  Requests

  2  for translated examinations must be on file in the board

  3  office at least 6 months prior to the scheduled examination.

  4  When determining whether it is in the public interest to allow

  5  the examination to be translated into a language other than

  6  English, the board shall consider the percentage of the

  7  population who speak the applicant's native language.

  8  Applicants must apply for translation to the applicable board

  9  at least 6 months prior to the scheduled examination.

10         (6)  In addition to meeting any other requirements for

11  licensure by examination or by endorsement, and

12  notwithstanding the provisions in paragraph (1)(c), an

13  applicant may be required by a board, or the department when

14  there is no board, to certify competency in state laws and

15  rules relating to the applicable practice act.

16         Section 13.  Subsection (1) of section 456.035, Florida

17  Statutes, is amended to read:

18         456.035  Address of record.--

19         (1)  Each licensee of the department is solely

20  responsible for notifying the department in writing of the

21  licensee's current mailing address and place of practice, as

22  defined by rule of the board or the department if there is no

23  board. Electronic notification shall be allowed by the

24  department; however, it shall be the responsibility of the

25  licensee to ensure that the electronic notification was

26  received by the department. A licensee's failure to notify the

27  department of a change of address constitutes a violation of

28  this section, and the licensee may be disciplined by the board

29  or the department if there is no board.

30         Section 14.  Subsections (2), (4), and (10) of section

31  456.073, Florida Statutes, are amended to read:


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  1         456.073  Disciplinary proceedings.--Disciplinary

  2  proceedings for each board shall be within the jurisdiction of

  3  the department.

  4         (2)  The department shall allocate sufficient and

  5  adequately trained staff to expeditiously and thoroughly

  6  determine legal sufficiency and investigate all legally

  7  sufficient complaints. For purposes of this section, it is the

  8  intent of the Legislature that the term "expeditiously" means

  9  that the department complete the report of its initial

10  investigative findings and recommendations concerning the

11  existence of probable cause within 6 months after its receipt

12  of the complaint. The failure of the department, for

13  disciplinary cases under its jurisdiction, to comply with the

14  time limits of this section while investigating a complaint

15  against a licensee constitutes harmless error in any

16  subsequent disciplinary action unless a court finds that

17  either the fairness of the proceeding or the correctness of

18  the action may have been impaired by a material error in

19  procedure or a failure to follow prescribed procedure.  When

20  its investigation is complete and legally sufficient, the

21  department shall prepare and submit to the probable cause

22  panel of the appropriate regulatory board the investigative

23  report of the department. The report shall contain the

24  investigative findings and the recommendations of the

25  department concerning the existence of probable cause. The

26  department shall not recommend a letter of guidance in lieu of

27  finding probable cause if the subject has already been issued

28  a letter of guidance for a related offense. At any time after

29  legal sufficiency is found, the department may dismiss any

30  case, or any part thereof, if the department determines that

31  there is insufficient evidence to support the prosecution of


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  1  allegations contained therein. The department shall provide a

  2  detailed report to the appropriate probable cause panel prior

  3  to dismissal of any case or part thereof, and to the subject

  4  of the complaint after dismissal of any case or part thereof,

  5  under this section. For cases dismissed prior to a finding of

  6  probable cause, such report is confidential and exempt from s.

  7  119.07(1). The probable cause panel shall have access, upon

  8  request, to the investigative files pertaining to a case prior

  9  to dismissal of such case. If the department dismisses a case,

10  the probable cause panel may retain independent legal counsel,

11  employ investigators, and continue the investigation and

12  prosecution of the case as it deems necessary.

13         (4)  The determination as to whether probable cause

14  exists shall be made by majority vote of a probable cause

15  panel of the board, or by the department, as appropriate. Each

16  regulatory board shall provide by rule that the determination

17  of probable cause shall be made by a panel of its members or

18  by the department. Each board may provide by rule for multiple

19  probable cause panels composed of at least two members. Each

20  board may provide by rule that one or more members of the

21  panel or panels may be a former board member. The length of

22  term or repetition of service of any such former board member

23  on a probable cause panel may vary according to the direction

24  of the board when authorized by board rule. Any probable cause

25  panel must include one of the board's former or present

26  consumer members, if one is available, is willing to serve,

27  and is authorized to do so by the board chair. Any probable

28  cause panel must include a present board member. Any probable

29  cause panel must include a former or present professional

30  board member. However, any former professional board member

31  serving on the probable cause panel must hold an active valid


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    CS for SB 1558                                 First Engrossed



  1  license for that profession. All proceedings of the panel are

  2  exempt from s. 286.011 until 10 days after probable cause has

  3  been found to exist by the panel or until the subject of the

  4  investigation waives his or her privilege of confidentiality.

  5  The probable cause panel may make a reasonable request, and

  6  upon such request the department shall provide such additional

  7  investigative information as is necessary to the determination

  8  of probable cause. A request for additional investigative

  9  information shall be made within 15 days from the date of

10  receipt by the probable cause panel of the investigative

11  report of the department or the agency. The probable cause

12  panel or the department, as may be appropriate, shall make its

13  determination of probable cause within 30 days after receipt

14  by it of the final investigative report of the department. The

15  secretary may grant extensions of the 15-day and the 30-day

16  time limits. In lieu of a finding of probable cause, the

17  probable cause panel, or the department if there is no board,

18  may issue a letter of guidance to the subject. If, within the

19  30-day time limit, as may be extended, the probable cause

20  panel does not make a determination regarding the existence of

21  probable cause or does not issue a letter of guidance in lieu

22  of a finding of probable cause, the department must make a

23  determination regarding the existence of probable cause within

24  10 days after the expiration of the time limit.  If the

25  probable cause panel finds that probable cause exists, it

26  shall direct the department to file a formal complaint against

27  the licensee. The department shall follow the directions of

28  the probable cause panel regarding the filing of a formal

29  complaint. If directed to do so, the department shall file a

30  formal complaint against the subject of the investigation and

31  prosecute that complaint pursuant to chapter 120. However, the


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    CS for SB 1558                                 First Engrossed



  1  department may decide not to prosecute the complaint if it

  2  finds that probable cause has been improvidently found by the

  3  panel. In such cases, the department shall refer the matter to

  4  the board. The board may then file a formal complaint and

  5  prosecute the complaint pursuant to chapter 120. The

  6  department shall also refer to the board any investigation or

  7  disciplinary proceeding not before the Division of

  8  Administrative Hearings pursuant to chapter 120 or otherwise

  9  completed by the department within 1 year after the filing of

10  a complaint. The department, for disciplinary cases under its

11  jurisdiction, must establish a uniform reporting system to

12  quarterly refer to each board the status of any investigation

13  or disciplinary proceeding that is not before the Division of

14  Administrative Hearings or otherwise completed by the

15  department within 1 year after the filing of the complaint.

16  Annually, the department if there is no board, or each board

17  must establish a plan to expedite reduce or otherwise close

18  any investigation or disciplinary proceeding that is not

19  before the Division of Administrative Hearings or otherwise

20  completed by the department within 1 year after the filing of

21  the complaint.  A probable cause panel or a board may retain

22  independent legal counsel, employ investigators, and continue

23  the investigation as it deems necessary; all costs thereof

24  shall be paid from a trust fund used by the department to

25  implement this chapter.  All proceedings of the probable cause

26  panel are exempt from s. 120.525.

27         (10)  The complaint and all information obtained

28  pursuant to the investigation by the department are

29  confidential and exempt from s. 119.07(1) until 10 days after

30  probable cause has been found to exist by the probable cause

31  panel or by the department, or until the regulated


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    CS for SB 1558                                 First Engrossed



  1  professional or subject of the investigation waives his or her

  2  privilege of confidentiality, whichever occurs first. Upon

  3  completion of the investigation and a recommendation by the

  4  department to find probable cause, and pursuant to a written

  5  request by the subject or the subject's attorney, the

  6  department shall provide the subject an opportunity to inspect

  7  the investigative file or, at the subject's expense, forward

  8  to the subject a copy of the investigative file.

  9  Notwithstanding s. 456.057, the subject may inspect or receive

10  a copy of any expert witness report or patient record

11  connected with the investigation if the subject agrees in

12  writing to maintain the confidentiality of any information

13  received under this subsection until 10 days after probable

14  cause is found and to maintain the confidentiality of patient

15  records pursuant to s. 456.057. The subject may file a written

16  response to the information contained in the investigative

17  file. Such response must be filed within 20 days of mailing by

18  the department, unless an extension of time has been granted

19  by the department. This subsection does not prohibit the

20  department from providing such information to any law

21  enforcement agency or to any other regulatory agency.

22         Section 15.  Section 456.081, Florida Statutes, is

23  amended to read:

24         456.081  Publication of information.--The department

25  and the boards shall have the authority to advise licensees

26  periodically, through the publication of a newsletter, about

27  information that the department or the board determines is of

28  interest to the industry. Unless otherwise prohibited by law,

29  the department and the boards shall publish a summary of final

30  orders resulting in disciplinary action fines, suspensions, or

31


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    CS for SB 1558                                 First Engrossed



  1  revocations, and any other information the department or the

  2  board determines is of interest to the public.

  3         Section 16.  Subsections (1), (2), and (4) of section

  4  456.072, Florida Statutes, are amended to read:

  5         456.072  Grounds for discipline; penalties;

  6  enforcement.--

  7         (1)  The following acts shall constitute grounds for

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

  9  be taken:

10         (a)  Making misleading, deceptive, or fraudulent

11  representations in or related to the practice of the

12  licensee's profession.

13         (b)  Intentionally violating any rule adopted by the

14  board or the department, as appropriate.

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

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

17  crime in any jurisdiction which relates to the practice of, or

18  the ability to practice, a licensee's profession.

19         (d)  Using a Class III or a Class IV laser device or

20  product, as defined by federal regulations, without having

21  complied with the rules adopted pursuant to s. 501.122(2)

22  governing the registration of such devices.

23         (e)  Failing to comply with the educational course

24  requirements for human immunodeficiency virus and acquired

25  immune deficiency syndrome.

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

27  regulated profession revoked, suspended, or otherwise acted

28  against, including the denial of licensure, by the licensing

29  authority of any jurisdiction, including its agencies or

30  subdivisions, for a violation that would constitute a

31  violation under Florida law. The licensing authority's


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    CS for SB 1558                                 First Engrossed



  1  acceptance of a relinquishment of licensure, stipulation,

  2  consent order, or other settlement, offered in response to or

  3  in anticipation of the filing of charges against the license,

  4  shall be construed as action against the license.

  5         (g)  Having been found liable in a civil proceeding for

  6  knowingly filing a false report or complaint with the

  7  department against another licensee.

  8         (h)  Attempting to obtain, obtaining, or renewing a

  9  license to practice a profession by bribery, by fraudulent

10  misrepresentation, or through an error of the department or

11  the board.

12         (i)  Except as provided in s. 465.016, failing to

13  report to the department any person who the licensee knows is

14  in violation of this chapter, the chapter regulating the

15  alleged violator, or the rules of the department or the board.

16         (j)  Aiding, assisting, procuring, employing, or

17  advising any unlicensed person or entity to practice a

18  profession contrary to this chapter, the chapter regulating

19  the profession, or the rules of the department or the board.

20         (k)  Failing to perform any statutory or legal

21  obligation placed upon a licensee.

22         (l)  Making or filing a report which the licensee knows

23  to be false, intentionally or negligently failing to file a

24  report or record required by state or federal law, or

25  willfully impeding or obstructing another person to do so.

26  Such reports or records shall include only those that are

27  signed in the capacity of a licensee.

28         (m)  Making deceptive, untrue, or fraudulent

29  representations in or related to the practice of a profession

30  or employing a trick or scheme in or related to the practice

31  of a profession.


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    CS for SB 1558                                 First Engrossed



  1         (n)  Exercising influence on the patient or client for

  2  the purpose of financial gain of the licensee or a third

  3  party.

  4         (o)  Practicing or offering to practice beyond the

  5  scope permitted by law or accepting and performing

  6  professional responsibilities the licensee knows, or has

  7  reason to know, the licensee is not competent to perform.

  8         (p)  Delegating or contracting for the performance of

  9  professional responsibilities by a person when the licensee

10  delegating or contracting for performance of such

11  responsibilities knows, or has reason to know, such person is

12  not qualified by training, experience, and authorization when

13  required to perform them.

14         (q)  Violating any provision of this chapter, the

15  applicable professional practice act, a rule of the department

16  or the board, or a lawful order of the department or the

17  board, or failing to comply with a lawfully issued subpoena of

18  the department.

19         (r)  Improperly interfering with an investigation or

20  inspection authorized by statute, or with any disciplinary

21  proceeding.

22         (s)  Failing to comply with the educational course

23  requirements for domestic violence.

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

25  381.026 and 381.0261 to provide patients with information

26  about their patient rights and how to file a patient

27  complaint.

28         (u)  Engaging or attempting to engage in sexual

29  misconduct as defined and prohibited in s. 456.063(1).

30         (v)  Failing to comply with the requirements for

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


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    CS for SB 1558                                 First Engrossed



  1  failing to provide initial information, failing to timely

  2  provide updated information, or making misleading, untrue,

  3  deceptive, or fraudulent representations on a profile,

  4  credentialing, or initial or renewal licensure application.

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

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

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

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

  9  crime in any jurisdiction. Convictions, findings,

10  adjudications, and pleas entered into prior to the enactment

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

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

13         (x)  Using information about people involved in motor

14  vehicle accidents which has been derived from accident reports

15  made by law enforcement officers or persons involved in

16  accidents pursuant to s. 316.066, or using information

17  published in a newspaper or other news publication or through

18  a radio or television broadcast that has used information

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

20  any other solicitation whatsoever of the people involved in

21  such accidents.

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

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

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

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

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

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

28  exists to believe that the licensee is unable to practice

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

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

31  or physical examination by physicians designated by the


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    CS for SB 1558                                 First Engrossed



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

  2  the department's order directing such examination may be

  3  enforced by filing a petition for enforcement in the circuit

  4  court where the licensee resides or does business. The

  5  department shall be entitled to the summary procedure provided

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

  7  this paragraph shall at reasonable intervals be afforded an

  8  opportunity to demonstrate that he or she can resume the

  9  competent practice of his or her profession with reasonable

10  skill and safety to patients.

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

12  112.0455, on any confirmed preemployment or employer-ordered

13  drug screening when the practitioner does not have a lawful

14  prescription and legitimate medical reason for using such

15  drug.

16         (aa)  Violating any provision of this chapter or any

17  rules adopted pursuant thereto.

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

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

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

21  practice act, including conduct constituting a substantial

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

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

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

25  penalties:

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

27  restrictions, an application for a license.

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

29         (c)  Restriction of practice or license, including, but

30  not limited to, restricting the licensee from practicing in

31  certain settings, restricting the licensee to work only under


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    CS for SB 1558                                 First Engrossed



  1  designated conditions or in certain settings, restricting the

  2  licensee from performing or providing designated clinical and

  3  administrative services, restricting the licensee from

  4  practicing more than a designated number of hours, or any

  5  other restriction found to be necessary for the protection of

  6  the public health, safety, and welfare.

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

  8  $10,000 for each count or separate offense.

  9         (e)  Issuance of a reprimand or letter of concern.

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

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

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

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

14  licensee to undergo treatment, attend continuing education

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

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

17  tailored to the violations found.

18         (g)  Corrective action.

19         (h)  Imposition of an administrative fine in accordance

20  with s. 381.0261 for violations regarding patient rights.

21         (i)  Refund of fees billed and collected from the

22  patient or a third party on behalf of the patient.

23         (j)  Requirement that the practitioner undergo remedial

24  education.

25

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

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

28  sanctions are necessary to protect the public or to compensate

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

30  the disciplining authority consider and include in the order

31  requirements designed to rehabilitate the practitioner. All


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    CS for SB 1558                                 First Engrossed



  1  costs associated with compliance with orders issued under this

  2  subsection are the obligation of the practitioner.

  3         (4)  In addition to any other discipline imposed

  4  pursuant to this section or discipline imposed for a violation

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

  6  is no board, shall may assess costs related to the

  7  investigation and prosecution of the case. In any case where

  8  the board or the department imposes a fine or assessment and

  9  the fine or assessment is not paid within a reasonable time,

10  such reasonable time to be prescribed in the rules of the

11  board, or the department when there is no board, or in the

12  order assessing such fines or costs, the department or the

13  Department of Legal Affairs may contract for the collection

14  of, or bring a civil action to recover, the fine or

15  assessment.

16         Section 17.  Subsection (3) of section 456.079, Florida

17  Statutes, is amended to read:

18         456.079  Disciplinary guidelines.--

19         (3)  A specific finding in the final order of

20  mitigating or aggravating circumstances shall allow the board

21  to impose a penalty other than that provided for in such

22  guidelines.  If applicable, the board, or the department if

23  there is no board, shall adopt by rule disciplinary guidelines

24  to designate possible mitigating and aggravating circumstances

25  and the variation and range of penalties permitted for such

26  circumstances.

27         Section 18.  Subsections (1) and (2) of section

28  457.109, Florida Statutes, are amended to read:

29         457.109  Disciplinary actions; grounds; action by the

30  board.--

31


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    CS for SB 1558                                 First Engrossed



  1         (1)  The following acts shall constitute grounds for

  2  denial of a license or disciplinary action, as specified in s.

  3  456.072(2) which the disciplinary actions specified in

  4  subsection (2) may be taken:

  5         (a)  Attempting to obtain, obtaining, or renewing a

  6  license to practice acupuncture by bribery, by fraudulent

  7  misrepresentations, or through an error of the department.

  8         (b)  Having a license to practice acupuncture revoked,

  9  suspended, or otherwise acted against, including the denial of

10  licensure, by the licensing authority of another state,

11  territory, or country.

12         (c)  Being convicted or found guilty, regardless of

13  adjudication, in any jurisdiction of a crime which directly

14  relates to the practice of acupuncture or to the ability to

15  practice acupuncture.  Any plea of nolo contendere shall be

16  considered a conviction for purposes of this chapter.

17         (d)  False, deceptive, or misleading advertising or

18  advertising which claims that acupuncture is useful in curing

19  any disease.

20         (e)  Advertising, practicing, or attempting to practice

21  under a name other than one's own.

22         (f)  Failing to report to the department any person who

23  the licensee knows is in violation of this chapter or of the

24  rules of the department.

25         (g)  Aiding, assisting, procuring, employing, or

26  advising any unlicensed person to practice acupuncture

27  contrary to this chapter or to a rule of the department.

28         (h)  Failing to perform any statutory or legal

29  obligation placed upon a licensed acupuncturist.

30         (i)  Making or filing a report which the licensee knows

31  to be false, intentionally or negligently failing to file a


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    CS for SB 1558                                 First Engrossed



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

  2  impeding or obstructing such filing or inducing another person

  3  to do so. Such reports or records shall include only those

  4  which are signed in the capacity as a licensed acupuncturist.

  5         (j)  Exercising influence within a

  6  patient-acupuncturist relationship for purposes of engaging a

  7  patient in sexual activity. A patient shall be presumed to be

  8  incapable of giving free, full, and informed consent to sexual

  9  activity with his or her acupuncturist.

10         (k)  Making deceptive, untrue, or fraudulent

11  representations in the practice of acupuncture or employing a

12  trick or scheme in the practice of acupuncture when such

13  scheme or trick fails to conform to the generally prevailing

14  standards of treatment in the community.

15         (l)  Soliciting patients, either personally or through

16  an agent, through the use of fraud, intimidation, undue

17  influence, or a form of overreaching or vexatious conduct. A

18  solicitation is any communication which directly or implicitly

19  requests an immediate oral response from the recipient.

20         (m)  Failing to keep written medical records justifying

21  the course of treatment of the patient.

22         (n)  Exercising influence on the patient to exploit the

23  patient for the financial gain of the licensee or of a third

24  party.

25         (o)  Being unable to practice acupuncture with

26  reasonable skill and safety to patients by reason of illness

27  or use of alcohol, drugs, narcotics, chemicals, or any other

28  type of material or as a result of any mental or physical

29  condition. In enforcing this paragraph, upon a finding of the

30  secretary or the secretary's designee that probable cause

31  exists to believe that the licensee is unable to serve as an


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    CS for SB 1558                                 First Engrossed



  1  acupuncturist due to the reasons stated in this paragraph, the

  2  department shall have the authority to issue an order to

  3  compel the licensee to submit to a mental or physical

  4  examination by a physician designated by the department. If

  5  the licensee refuses to comply with such order, the

  6  department's order directing such examination may be enforced

  7  by filing a petition for enforcement in the circuit court

  8  where the licensee resides or serves as an acupuncturist. The

  9  licensee against whom the petition is filed shall not be named

10  or identified by initials in any public court record or

11  document, and the proceedings shall be closed to the public.

12  The department shall be entitled to the summary procedure

13  provided in s. 51.011. An acupuncturist affected under this

14  paragraph shall at reasonable intervals be afforded an

15  opportunity to demonstrate that he or she can resume the

16  competent practice of acupuncture with reasonable skill and

17  safety to patients. In any proceeding under this paragraph,

18  neither the record of proceedings nor the orders entered by

19  the department shall be used against an acupuncturist in any

20  other proceeding.

21         (p)  Gross or repeated malpractice or the failure to

22  practice acupuncture with that level of care, skill, and

23  treatment which is recognized by a reasonably prudent similar

24  acupuncturist as being acceptable under similar conditions and

25  circumstances.

26         (q)  Practicing or offering to practice beyond the

27  scope permitted by law or accepting and performing

28  professional responsibilities which the licensee knows or has

29  reason to know that he or she is not competent to perform.

30         (r)  Delegating professional responsibilities to a

31  person when the licensee delegating such responsibilities


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    CS for SB 1558                                 First Engrossed



  1  knows or has reason to know that such person is not qualified

  2  by training, experience, or licensure to perform them.

  3         (s)  Violating any provision of this chapter, a rule of

  4  the department, or a lawful order of the board department

  5  previously entered in a disciplinary hearing or failing to

  6  comply with a lawfully issued subpoena of the department.

  7         (t)  Conspiring with another to commit an act, or

  8  committing an act, which would tend to coerce, intimidate, or

  9  preclude another licensee from lawfully advertising his or her

10  services.

11         (u)  Fraud or deceit or gross negligence, incompetence,

12  or misconduct in the operation of a course of study.

13         (v)  Failing to comply with state, county, or municipal

14  regulations or reporting requirements relating to public

15  health and the control of contagious and infectious diseases.

16         (w)  Failing to comply with any rule of the board

17  relating to health and safety, including, but not limited to,

18  the sterilization of needles and equipment and the disposal of

19  potentially infectious materials.

20         (x)  Violating any provision of this chapter or chapter

21  456, or any rules adopted pursuant thereto.

22         (2)  The board may enter an order denying licensure or

23  imposing any of the penalties in s. 456.072(2) against any

24  applicant for licensure or licensee who is found guilty of

25  violating any provision of subsection (1) of this section or

26  who is found guilty of violating any provision of s.

27  456.072(1). When the board finds any person guilty of any of

28  the acts set forth in subsection (1), it may enter an order

29  imposing one or more of the following penalties:

30         (a)  Refusal to certify to the department an

31  application for licensure.


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    CS for SB 1558                                 First Engrossed



  1         (b)  Revocation or suspension of a license.

  2         (c)  Restriction of practice.

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

  4  $1,000 for each count or separate offense.

  5         (e)  Issuance of a reprimand.

  6         (f)  Placement of the acupuncturist on probation for a

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

  8  specify.

  9         Section 19.  Subsection (6) of section 458.320, Florida

10  Statutes, is amended to read:

11         458.320  Financial responsibility.--

12         (6)  Any deceptive, untrue, or fraudulent

13  representation by the licensee with respect to any provision

14  of this section shall result in permanent disqualification

15  from any exemption to mandated financial responsibility as

16  provided in this section and shall constitute grounds for

17  disciplinary action under as specified in s. 458.331.

18         Section 20.  Subsections (1) and (2) of section

19  458.331, Florida Statutes, are amended to read:

20         458.331  Grounds for disciplinary action; action by the

21  board and department.--

22         (1)  The following acts shall constitute grounds for

23  denial of a license or disciplinary action, as specified in s.

24  456.072(2) which the disciplinary actions specified in

25  subsection (2) may be taken:

26         (a)  Attempting to obtain, obtaining, or renewing a

27  license to practice medicine by bribery, by fraudulent

28  misrepresentations, or through an error of the department or

29  the board.

30         (b)  Having a license or the authority to practice

31  medicine revoked, suspended, or otherwise acted against,


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    CS for SB 1558                                 First Engrossed



  1  including the denial of licensure, by the licensing authority

  2  of any jurisdiction, including its agencies or subdivisions.

  3  The licensing authority's acceptance of a physician's

  4  relinquishment of a license, stipulation, consent order, or

  5  other settlement, offered in response to or in anticipation of

  6  the filing of administrative charges against the physician's

  7  license, shall be construed as action against the physician's

  8  license.

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

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

11  crime in any jurisdiction which directly relates to the

12  practice of medicine or to the ability to practice medicine.

13         (d)  False, deceptive, or misleading advertising.

14         (e)  Failing to report to the department any person who

15  the licensee knows is in violation of this chapter or of the

16  rules of the department or the board. A treatment provider

17  approved pursuant to s. 456.076 shall provide the department

18  or consultant with information in accordance with the

19  requirements of s. 456.076(3), (4), (5), and (6).

20         (f)  Aiding, assisting, procuring, or advising any

21  unlicensed person to practice medicine contrary to this

22  chapter or to a rule of the department or the board.

23         (g)  Failing to perform any statutory or legal

24  obligation placed upon a licensed physician.

25         (h)  Making or filing a report which the licensee knows

26  to be false, intentionally or negligently failing to file a

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

28  impeding or obstructing such filing or inducing another person

29  to do so.  Such reports or records shall include only those

30  which are signed in the capacity as a licensed physician.

31


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    CS for SB 1558                                 First Engrossed



  1         (i)  Paying or receiving any commission, bonus,

  2  kickback, or rebate, or engaging in any split-fee arrangement

  3  in any form whatsoever with a physician, organization, agency,

  4  or person, either directly or indirectly, for patients

  5  referred to providers of health care goods and services,

  6  including, but not limited to, hospitals, nursing homes,

  7  clinical laboratories, ambulatory surgical centers, or

  8  pharmacies.  The provisions of this paragraph shall not be

  9  construed to prevent a physician from receiving a fee for

10  professional consultation services.

11         (j)  Exercising influence within a patient-physician

12  relationship for purposes of engaging a patient in sexual

13  activity. A patient shall be presumed to be incapable of

14  giving free, full, and informed consent to sexual activity

15  with his or her physician.

16         (k)  Making deceptive, untrue, or fraudulent

17  representations in or related to the practice of medicine or

18  employing a trick or scheme in the practice of medicine.

19         (l)  Soliciting patients, either personally or through

20  an agent, through the use of fraud, intimidation, undue

21  influence, or a form of overreaching or vexatious conduct.  A

22  solicitation is any communication which directly or implicitly

23  requests an immediate oral response from the recipient.

24         (m)  Failing to keep legible, as defined by department

25  rule in consultation with the board, medical records that

26  identify the licensed physician or the physician extender and

27  supervising physician by name and professional title who is or

28  are responsible for rendering, ordering, supervising, or

29  billing for each diagnostic or treatment procedure and that

30  justify the course of treatment of the patient, including, but

31  not limited to, patient histories; examination results; test


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    CS for SB 1558                                 First Engrossed



  1  results; records of drugs prescribed, dispensed, or

  2  administered; and reports of consultations and

  3  hospitalizations.

  4         (n)  Exercising influence on the patient or client in

  5  such a manner as to exploit the patient or client for

  6  financial gain of the licensee or of a third party, which

  7  shall include, but not be limited to, the promoting or selling

  8  of services, goods, appliances, or drugs.

  9         (o)  Promoting or advertising on any prescription form

10  of a community pharmacy unless the form shall also state "This

11  prescription may be filled at any pharmacy of your choice."

12         (p)  Performing professional services which have not

13  been duly authorized by the patient or client, or his or her

14  legal representative, except as provided in s. 743.064, s.

15  766.103, or s. 768.13.

16         (q)  Prescribing, dispensing, administering, mixing, or

17  otherwise preparing a legend drug, including any controlled

18  substance, other than in the course of the physician's

19  professional practice.  For the purposes of this paragraph, it

20  shall be legally presumed that prescribing, dispensing,

21  administering, mixing, or otherwise preparing legend drugs,

22  including all controlled substances, inappropriately or in

23  excessive or inappropriate quantities is not in the best

24  interest of the patient and is not in the course of the

25  physician's professional practice, without regard to his or

26  her intent.

27         (r)  Prescribing, dispensing, or administering any

28  medicinal drug appearing on any schedule set forth in chapter

29  893 by the physician to himself or herself, except one

30  prescribed, dispensed, or administered to the physician by

31


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    CS for SB 1558                                 First Engrossed



  1  another practitioner authorized to prescribe, dispense, or

  2  administer medicinal drugs.

  3         (s)  Being unable to practice medicine with reasonable

  4  skill and safety to patients by reason of illness or use of

  5  alcohol, drugs, narcotics, chemicals, or any other type of

  6  material or as a result of any mental or physical condition.

  7  In enforcing this paragraph, the department shall have, upon a

  8  finding of the secretary or the secretary's designee that

  9  probable cause exists to believe that the licensee is unable

10  to practice medicine because of the reasons stated in this

11  paragraph, the authority to issue an order to compel a

12  licensee to submit to a mental or physical examination by

13  physicians designated by the department. If the licensee

14  refuses to comply with such order, the department's order

15  directing such examination may be enforced by filing a

16  petition for enforcement in the circuit court where the

17  licensee resides or does business. The licensee against whom

18  the petition is filed may not be named or identified by

19  initials in any public court records or documents, and the

20  proceedings shall be closed to the public.  The department

21  shall be entitled to the summary procedure provided in s.

22  51.011. A licensee or certificateholder affected under this

23  paragraph shall at reasonable intervals be afforded an

24  opportunity to demonstrate that he or she can resume the

25  competent practice of medicine with reasonable skill and

26  safety to patients.

27         (t)  Gross or repeated malpractice or the failure to

28  practice medicine with that level of care, skill, and

29  treatment which is recognized by a reasonably prudent similar

30  physician as being acceptable under similar conditions and

31  circumstances.  The board shall give great weight to the


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    CS for SB 1558                                 First Engrossed



  1  provisions of s. 766.102 when enforcing this paragraph.  As

  2  used in this paragraph, "repeated malpractice" includes, but

  3  is not limited to, three or more claims for medical

  4  malpractice within the previous 5-year period resulting in

  5  indemnities being paid in excess of $25,000 each to the

  6  claimant in a judgment or settlement and which incidents

  7  involved negligent conduct by the physician.  As used in this

  8  paragraph, "gross malpractice" or "the failure to practice

  9  medicine with that level of care, skill, and treatment which

10  is recognized by a reasonably prudent similar physician as

11  being acceptable under similar conditions and circumstances,"

12  shall not be construed so as to require more than one

13  instance, event, or act.  Nothing in this paragraph shall be

14  construed to require that a physician be incompetent to

15  practice medicine in order to be disciplined pursuant to this

16  paragraph.

17         (u)  Performing any procedure or prescribing any

18  therapy which, by the prevailing standards of medical practice

19  in the community, would constitute experimentation on a human

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

21  consent.

22         (v)  Practicing or offering to practice beyond the

23  scope permitted by law or accepting and performing

24  professional responsibilities which the licensee knows or has

25  reason to know that he or she is not competent to perform. The

26  board may establish by rule standards of practice and

27  standards of care for particular practice settings, including,

28  but not limited to, education and training, equipment and

29  supplies, medications including anesthetics, assistance of and

30  delegation to other personnel, transfer agreements,

31  sterilization, records, performance of complex or multiple


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    CS for SB 1558                                 First Engrossed



  1  procedures, informed consent, and policy and procedure

  2  manuals.

  3         (w)  Delegating professional responsibilities to a

  4  person when the licensee delegating such responsibilities

  5  knows or has reason to know that such person is not qualified

  6  by training, experience, or licensure to perform them.

  7         (x)  Violating any provision of this chapter, a rule of

  8  the board or department, or 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         (y)  Conspiring with another licensee or with any other

13  person to commit an act, or committing an act, which would

14  tend to coerce, intimidate, or preclude another licensee from

15  lawfully advertising his or her services.

16         (z)  Procuring, or aiding or abetting in the procuring

17  of, an unlawful termination of pregnancy.

18         (aa)  Presigning blank prescription forms.

19         (bb)  Prescribing any medicinal drug appearing on

20  Schedule II in chapter 893 by the physician for office use.

21         (cc)  Prescribing, ordering, dispensing, administering,

22  supplying, selling, or giving any drug which is a Schedule II

23  amphetamine or a Schedule II sympathomimetic amine drug or any

24  compound thereof, pursuant to chapter 893, to or for any

25  person except for:

26         1.  The treatment of narcolepsy; hyperkinesis;

27  behavioral syndrome characterized by the developmentally

28  inappropriate symptoms of moderate to severe distractability,

29  short attention span, hyperactivity, emotional lability, and

30  impulsivity; or drug-induced brain dysfunction;

31


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    CS for SB 1558                                 First Engrossed



  1         2.  The differential diagnostic psychiatric evaluation

  2  of depression or the treatment of depression shown to be

  3  refractory to other therapeutic modalities; or

  4         3.  The clinical investigation of the effects of such

  5  drugs or compounds when an investigative protocol therefor is

  6  submitted to, reviewed, and approved by the board before such

  7  investigation is begun.

  8         (dd)  Failing to supervise adequately the activities of

  9  those physician assistants, paramedics, emergency medical

10  technicians, or advanced registered nurse practitioners acting

11  under the supervision of the physician.

12         (ee)  Prescribing, ordering, dispensing, administering,

13  supplying, selling, or giving growth hormones, testosterone or

14  its analogs, human chorionic gonadotropin (HCG), or other

15  hormones for the purpose of muscle building or to enhance

16  athletic performance. For the purposes of this subsection, the

17  term "muscle building" does not include the treatment of

18  injured muscle.  A prescription written for the drug products

19  listed above may be dispensed by the pharmacist with the

20  presumption that the prescription is for legitimate medical

21  use.

22         (ff)  Prescribing, ordering, dispensing, administering,

23  supplying, selling, or giving amygdalin (laetrile) to any

24  person.

25         (gg)  Misrepresenting or concealing a material fact at

26  any time during any phase of a licensing or disciplinary

27  process or procedure.

28         (hh)  Improperly interfering with an investigation or

29  with any disciplinary proceeding.

30         (ii)  Failing to report to the department any licensee

31  under this chapter or under chapter 459 who the physician or


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    CS for SB 1558                                 First Engrossed



  1  physician assistant knows has violated the grounds for

  2  disciplinary action set out in the law under which that person

  3  is licensed and who provides health care services in a

  4  facility licensed under chapter 395, or a health maintenance

  5  organization certificated under part I of chapter 641, in

  6  which the physician or physician assistant also provides

  7  services.

  8         (jj)  Being found by any court in this state to have

  9  provided corroborating written medical expert opinion attached

10  to any statutorily required notice of claim or intent or to

11  any statutorily required response rejecting a claim, without

12  reasonable investigation.

13         (kk)  Failing to report to the board, in writing,

14  within 30 days if action as defined in paragraph (b) has been

15  taken against one's license to practice medicine in another

16  state, territory, or country.

17         (ll)  Advertising or holding oneself out as a

18  board-certified specialist, if not qualified under s.

19  458.3312, in violation of this chapter.

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

21  381.026 and 381.0261 to provide patients with information

22  about their patient rights and how to file a patient

23  complaint.

24         (nn)  Violating any provision of this chapter or

25  chapter 456, or any rules adopted pursuant thereto.

26         (2)  The board may enter an order denying licensure or

27  imposing any of the penalties in s. 456.072(2) against any

28  applicant for licensure or licensee who is found guilty of

29  violating any provision of subsection (1) of this section or

30  who is found guilty of violating any provision of s.

31  456.072(1). When the board finds any person guilty of any of


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    CS for SB 1558                                 First Engrossed



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

  2  that would constitute a substantial violation of subsection

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

  4  imposing one or more of the following penalties:

  5         (a)  Refusal to certify, or certification with

  6  restrictions, to the department an application for licensure,

  7  certification, or registration.

  8         (b)  Revocation or suspension of a license.

  9         (c)  Restriction of practice.

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

11  $10,000 for each count or separate offense.

12         (e)  Issuance of a reprimand.

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

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

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

16  physician to submit to treatment, to attend continuing

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

18  under the supervision of another physician.

19         (g)  Issuance of a letter of concern.

20         (h)  Corrective action.

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

22  patient.

23         (j)  Imposition of an administrative fine in accordance

24  with s. 381.0261 for violations regarding patient rights.

25

26  In determining what action is appropriate, the board must

27  first consider what sanctions are necessary to protect the

28  public or to compensate the patient.  Only after those

29  sanctions have been imposed may the disciplining authority

30  consider and include in the order requirements designed to

31  rehabilitate the physician.  All costs associated with


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    CS for SB 1558                                 First Engrossed



  1  compliance with orders issued under this subsection are the

  2  obligation of the physician.

  3         Section 21.  Subsection (6) of section 459.0085,

  4  Florida Statutes, is amended to read:

  5         459.0085  Financial responsibility.--

  6         (6)  Any deceptive, untrue, or fraudulent

  7  representation by the licensee with respect to any provision

  8  of this section shall result in permanent disqualification

  9  from any exemption to mandated financial responsibility as

10  provided in this section and shall constitute grounds for

11  disciplinary action under as specified in s. 459.015.

12         Section 22.  Subsections (1) and (2) of section

13  459.015, Florida Statutes, are amended to read:

14         459.015  Grounds for disciplinary action; action by the

15  board and department.--

16         (1)  The following acts shall constitute grounds for

17  denial of a license or disciplinary action, as specified in s.

18  456.072(2) which the disciplinary actions specified in

19  subsection (2) may be taken:

20         (a)  Attempting to obtain, obtaining, or renewing a

21  license to practice osteopathic medicine or a certificate

22  issued under this chapter by bribery, by fraudulent

23  misrepresentations, or through an error of the department or

24  the board.

25         (b)  Having a license or the authority to practice

26  osteopathic medicine revoked, suspended, or otherwise acted

27  against, including the denial of licensure, by the licensing

28  authority of any jurisdiction, including its agencies or

29  subdivisions.  The licensing authority's acceptance of a

30  physician's relinquishment of license, stipulation, consent

31  order, or other settlement offered in response to or in


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    CS for SB 1558                                 First Engrossed



  1  anticipation of the filing of administrative charges against

  2  the physician shall be construed as action against the

  3  physician's license.

  4         (c)  Being convicted or found guilty, regardless of

  5  adjudication, of a crime in any jurisdiction which directly

  6  relates to the practice of osteopathic medicine or to the

  7  ability to practice osteopathic medicine.  A plea of nolo

  8  contendere shall create a rebuttable presumption of guilt to

  9  the underlying criminal charges.

10         (d)  False, deceptive, or misleading advertising.

11         (e)  Failing to report to the department or the

12  department's impaired professional consultant any person who

13  the licensee or certificateholder knows is in violation of

14  this chapter or of the rules of the department or the board.

15  A treatment provider, approved pursuant to s. 456.076, shall

16  provide the department or consultant with information in

17  accordance with the requirements of s. 456.076(3), (4), (5),

18  and (6).

19         (f)  Aiding, assisting, procuring, or advising any

20  unlicensed person to practice osteopathic medicine contrary to

21  this chapter or to a rule of the department or the board.

22         (g)  Failing to perform any statutory or legal

23  obligation placed upon a licensed osteopathic physician.

24         (h)  Giving false testimony in the course of any legal

25  or administrative proceedings relating to the practice of

26  medicine or the delivery of health care services.

27         (i)  Making or filing a report which the licensee knows

28  to be false, intentionally or negligently failing to file a

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

30  impeding or obstructing such filing, or inducing another

31  person to do so. Such reports or records shall include only


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    CS for SB 1558                                 First Engrossed



  1  those which are signed in the capacity as a licensed

  2  osteopathic physician.

  3         (j)  Paying or receiving any commission, bonus,

  4  kickback, or rebate, or engaging in any split-fee arrangement

  5  in any form whatsoever with a physician, organization, agency,

  6  person, partnership, firm, corporation, or other business

  7  entity, for patients referred to providers of health care

  8  goods and services, including, but not limited to, hospitals,

  9  nursing homes, clinical laboratories, ambulatory surgical

10  centers, or pharmacies.  The provisions of this paragraph

11  shall not be construed to prevent an osteopathic physician

12  from receiving a fee for professional consultation services.

13         (k)  Refusing to provide health care based on a

14  patient's participation in pending or past litigation or

15  participation in any disciplinary action conducted pursuant to

16  this chapter, unless such litigation or disciplinary action

17  directly involves the osteopathic physician requested to

18  provide services.

19         (l)  Exercising influence within a patient-physician

20  relationship for purposes of engaging a patient in sexual

21  activity. A patient shall be presumed to be incapable of

22  giving free, full, and informed consent to sexual activity

23  with his or her physician.

24         (m)  Making deceptive, untrue, or fraudulent

25  representations in or related to the practice of osteopathic

26  medicine or employing a trick or scheme in the practice of

27  osteopathic medicine.

28         (n)  Soliciting patients, either personally or through

29  an agent, through the use of fraud, intimidation, undue

30  influence, or forms of overreaching or vexatious conduct.  A

31


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    CS for SB 1558                                 First Engrossed



  1  solicitation is any communication which directly or implicitly

  2  requests an immediate oral response from the recipient.

  3         (o)  Failing to keep legible, as defined by department

  4  rule in consultation with the board, medical records that

  5  identify the licensed osteopathic physician or the osteopathic

  6  physician extender and supervising osteopathic physician by

  7  name and professional title who is or are responsible for

  8  rendering, ordering, supervising, or billing for each

  9  diagnostic or treatment procedure and that justify the course

10  of treatment of the patient, including, but not limited to,

11  patient histories; examination results; test results; records

12  of drugs prescribed, dispensed, or administered; and reports

13  of consultations and hospitalizations.

14         (p)  Fraudulently altering or destroying records

15  relating to patient care or treatment, including, but not

16  limited to, patient histories, examination results, and test

17  results.

18         (q)  Exercising influence on the patient or client in

19  such a manner as to exploit the patient or client for

20  financial gain of the licensee or of a third party which shall

21  include, but not be limited to, the promotion or sale of

22  services, goods, appliances, or drugs.

23         (r)  Promoting or advertising on any prescription form

24  of a community pharmacy, unless the form shall also state

25  "This prescription may be filled at any pharmacy of your

26  choice."

27         (s)  Performing professional services which have not

28  been duly authorized by the patient or client or his or her

29  legal representative except as provided in s. 743.064, s.

30  766.103, or s. 768.13.

31


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  1         (t)  Prescribing, dispensing, administering, supplying,

  2  selling, giving, mixing, or otherwise preparing a legend drug,

  3  including all controlled substances, other than in the course

  4  of the osteopathic physician's professional practice.  For the

  5  purposes of this paragraph, it shall be legally presumed that

  6  prescribing, dispensing, administering, supplying, selling,

  7  giving, mixing, or otherwise preparing legend drugs, including

  8  all controlled substances, inappropriately or in excessive or

  9  inappropriate quantities is not in the best interest of the

10  patient and is not in the course of the osteopathic

11  physician's professional practice, without regard to his or

12  her intent.

13         (u)  Prescribing or dispensing any medicinal drug

14  appearing on any schedule set forth in chapter 893 by the

15  osteopathic physician for himself or herself or administering

16  any such drug by the osteopathic physician to himself or

17  herself unless such drug is prescribed for the osteopathic

18  physician by another practitioner authorized to prescribe

19  medicinal drugs.

20         (v)  Prescribing, ordering, dispensing, administering,

21  supplying, selling, or giving amygdalin (laetrile) to any

22  person.

23         (w)  Being unable to practice osteopathic medicine with

24  reasonable skill and safety to patients by reason of illness

25  or use of alcohol, drugs, narcotics, chemicals, or any other

26  type of material or as a result of any mental or physical

27  condition.  In enforcing this paragraph, the department shall,

28  upon a finding of the secretary or the secretary's designee

29  that probable cause exists to believe that the licensee is

30  unable to practice medicine because of the reasons stated in

31  this paragraph, have the authority to issue an order to compel


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    CS for SB 1558                                 First Engrossed



  1  a licensee to submit to a mental or physical examination by

  2  physicians designated by the department.  If the licensee

  3  refuses to comply with such order, the department's order

  4  directing such examination may be enforced by filing a

  5  petition for enforcement in the circuit court where the

  6  licensee resides or does business.  The licensee against whom

  7  the petition is filed shall not be named or identified by

  8  initials in any public court records or documents, and the

  9  proceedings shall be closed to the public.  The department

10  shall be entitled to the summary procedure provided in s.

11  51.011.  A licensee or certificateholder affected under this

12  paragraph shall at reasonable intervals be afforded an

13  opportunity to demonstrate that he or she can resume the

14  competent practice of medicine with reasonable skill and

15  safety to patients.

16         (x)  Gross or repeated malpractice or the failure to

17  practice osteopathic medicine with that level of care, skill,

18  and treatment which is recognized by a reasonably prudent

19  similar osteopathic physician as being acceptable under

20  similar conditions and circumstances. The board shall give

21  great weight to the provisions of s. 766.102 when enforcing

22  this paragraph. As used in this paragraph, "repeated

23  malpractice" includes, but is not limited to, three or more

24  claims for medical malpractice within the previous 5-year

25  period resulting in indemnities being paid in excess of

26  $25,000 each to the claimant in a judgment or settlement and

27  which incidents involved negligent conduct by the osteopathic

28  physician. As used in this paragraph, "gross malpractice" or

29  "the failure to practice osteopathic medicine with that level

30  of care, skill, and treatment which is recognized by a

31  reasonably prudent similar osteopathic physician as being


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    CS for SB 1558                                 First Engrossed



  1  acceptable under similar conditions and circumstances" shall

  2  not be construed so as to require more than one instance,

  3  event, or act. Nothing in this paragraph shall be construed to

  4  require that an osteopathic physician be incompetent to

  5  practice osteopathic medicine in order to be disciplined

  6  pursuant to this paragraph.  A recommended order by an

  7  administrative law judge or a final order of the board finding

  8  a violation under this paragraph shall specify whether the

  9  licensee was found to have committed "gross malpractice,"

10  "repeated malpractice," or "failure to practice osteopathic

11  medicine with that level of care, skill, and treatment which

12  is recognized as being acceptable under similar conditions and

13  circumstances," or any combination thereof, and any

14  publication by the board shall so specify.

15         (y)  Performing any procedure or prescribing any

16  therapy which, by the prevailing standards of medical practice

17  in the community, would constitute experimentation on human

18  subjects, without first obtaining full, informed, and written

19  consent.

20         (z)  Practicing or offering to practice beyond the

21  scope permitted by law or accepting and performing

22  professional responsibilities which the licensee knows or has

23  reason to know that he or she is not competent to perform. The

24  board may establish by rule standards of practice and

25  standards of care for particular practice settings, including,

26  but not limited to, education and training, equipment and

27  supplies, medications including anesthetics, assistance of and

28  delegation to other personnel, transfer agreements,

29  sterilization, records, performance of complex or multiple

30  procedures, informed consent, and policy and procedure

31  manuals.


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    CS for SB 1558                                 First Engrossed



  1         (aa)  Delegating professional responsibilities to a

  2  person when the licensee delegating such responsibilities

  3  knows or has reason to know that such person is not qualified

  4  by training, experience, or licensure to perform them.

  5         (bb)  Violating any provision of this chapter, a rule

  6  of the board or department, or a lawful order of the board or

  7  department previously entered in a disciplinary hearing or

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

  9  or department.

10         (cc)  Conspiring with another licensee or with any

11  other person to commit an act, or committing an act, which

12  would tend to coerce, intimidate, or preclude another licensee

13  from lawfully advertising his or her services.

14         (dd)  Procuring, or aiding or abetting in the procuring

15  of, an unlawful termination of pregnancy.

16         (ee)  Presigning blank prescription forms.

17         (ff)  Prescribing any medicinal drug appearing on

18  Schedule II in chapter 893 by the osteopathic physician for

19  office use.

20         (gg)  Prescribing, ordering, dispensing, administering,

21  supplying, selling, or giving any drug which is a Schedule II

22  amphetamine or Schedule II sympathomimetic amine drug or any

23  compound thereof, pursuant to chapter 893, to or for any

24  person except for:

25         1.  The treatment of narcolepsy; hyperkinesis;

26  behavioral syndrome characterized by the developmentally

27  inappropriate symptoms of moderate to severe distractability,

28  short attention span, hyperactivity, emotional lability, and

29  impulsivity; or drug-induced brain dysfunction;

30

31


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    CS for SB 1558                                 First Engrossed



  1         2.  The differential diagnostic psychiatric evaluation

  2  of depression or the treatment of depression shown to be

  3  refractory to other therapeutic modalities; or

  4         3.  The clinical investigation of the effects of such

  5  drugs or compounds when an investigative protocol therefor is

  6  submitted to, reviewed, and approved by the board before such

  7  investigation is begun.

  8         (hh)  Failing to supervise adequately the activities of

  9  those physician assistants, paramedics, emergency medical

10  technicians, advanced registered nurse practitioners, or other

11  persons acting under the supervision of the osteopathic

12  physician.

13         (ii)  Prescribing, ordering, dispensing, administering,

14  supplying, selling, or giving growth hormones, testosterone or

15  its analogs, human chorionic gonadotropin (HCG), or other

16  hormones for the purpose of muscle building or to enhance

17  athletic performance. For the purposes of this subsection, the

18  term "muscle building" does not include the treatment of

19  injured muscle.  A prescription written for the drug products

20  listed above may be dispensed by the pharmacist with the

21  presumption that the prescription is for legitimate medical

22  use.

23         (jj)  Misrepresenting or concealing a material fact at

24  any time during any phase of a licensing or disciplinary

25  process or procedure.

26         (kk)  Improperly interfering with an investigation or

27  with any disciplinary proceeding.

28         (ll)  Failing to report to the department any licensee

29  under chapter 458 or under this chapter who the osteopathic

30  physician or physician assistant knows has violated the

31  grounds for disciplinary action set out in the law under which


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    CS for SB 1558                                 First Engrossed



  1  that person is licensed and who provides health care services

  2  in a facility licensed under chapter 395, or a health

  3  maintenance organization certificated under part I of chapter

  4  641, in which the osteopathic physician or physician assistant

  5  also provides services.

  6         (mm)  Being found by any court in this state to have

  7  provided corroborating written medical expert opinion attached

  8  to any statutorily required notice of claim or intent or to

  9  any statutorily required response rejecting a claim, without

10  reasonable investigation.

11         (nn)  Advertising or holding oneself out as a

12  board-certified specialist in violation of this chapter.

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

14  381.026 and 381.0261 to provide patients with information

15  about their patient rights and how to file a patient

16  complaint.

17         (pp)  Violating any provision of this chapter or

18  chapter 456, or any rules adopted pursuant thereto.

19         (2)  The board may enter an order denying licensure or

20  imposing any of the penalties in s. 456.072(2) against any

21  applicant for licensure or licensee who is found guilty of

22  violating any provision of subsection (1) of this section or

23  who is found guilty of violating any provision of s.

24  456.072(1). When the board finds any person guilty of any of

25  the grounds set forth in subsection (1), it may enter an order

26  imposing one or more of the following penalties:

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

28  to the department an application for certification, licensure,

29  renewal, or reactivation.

30         (b)  Revocation or suspension of a license or

31  certificate.


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    CS for SB 1558                                 First Engrossed



  1         (c)  Restriction of practice.

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

  3  $10,000 for each count or separate offense.

  4         (e)  Issuance of a reprimand.

  5         (f)  Issuance of a letter of concern.

  6         (g)  Placement of the osteopathic physician on

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

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

  9  requiring the osteopathic physician to submit to treatment,

10  attend continuing education courses, submit to reexamination,

11  or work under the supervision of another osteopathic

12  physician.

13         (h)  Corrective action.

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

15  patient.

16         (j)  Imposition of an administrative fine in accordance

17  with s. 381.0261 for violations regarding patient rights.

18

19  In determining what action is appropriate, the board must

20  first consider what sanctions are necessary to protect the

21  public or to compensate the patient.  Only after those

22  sanctions have been imposed may the disciplining authority

23  consider and include in the order requirements designed to

24  rehabilitate the physician.  All costs associated with

25  compliance with orders issued under this subsection are the

26  obligation of the physician.

27         Section 23.  Subsections (1) and (2) of section

28  460.413, Florida Statutes, are amended to read:

29         460.413  Grounds for disciplinary action; action by

30  board or department.--

31


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    CS for SB 1558                                 First Engrossed



  1         (1)  The following acts shall constitute grounds for

  2  denial of a license or disciplinary action, as specified in s.

  3  456.072(2) which the disciplinary actions specified in

  4  subsection (2) may be taken:

  5         (a)  Attempting to obtain, obtaining, or renewing a

  6  license to practice chiropractic medicine by bribery, by

  7  fraudulent misrepresentations, or through an error of the

  8  department or the board.

  9         (b)  Having a license to practice chiropractic medicine

10  revoked, suspended, or otherwise acted against, including the

11  denial of licensure, by the licensing authority of another

12  state, territory, or country.

13         (c)  Being convicted or found guilty, regardless of

14  adjudication, of a crime in any jurisdiction which directly

15  relates to the practice of chiropractic medicine or to the

16  ability to practice chiropractic medicine. Any plea of nolo

17  contendere shall be considered a conviction for purposes of

18  this chapter.

19         (d)  False, deceptive, or misleading advertising.

20         (e)  Causing to be advertised, by any means whatsoever,

21  any advertisement which does not contain an assertion or

22  statement which would identify herself or himself as a

23  chiropractic physician or identify such chiropractic clinic or

24  related institution in which she or he practices or in which

25  she or he is owner, in whole or in part, as a chiropractic

26  institution.

27         (f)  Advertising, practicing, or attempting to practice

28  under a name other than one's own.

29         (g)  Failing to report to the department any person who

30  the licensee knows is in violation of this chapter or of the

31  rules of the department or the board.


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    CS for SB 1558                                 First Engrossed



  1         (h)  Aiding, assisting, procuring, or advising any

  2  unlicensed person to practice chiropractic medicine contrary

  3  to this chapter or to a rule of the department or the board.

  4         (i)  Failing to perform any statutory or legal

  5  obligation placed upon a licensed chiropractic physician.

  6         (j)  Making or filing a report which the licensee knows

  7  to be false, intentionally or negligently failing to file a

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

  9  impeding or obstructing such filing or inducing another person

10  to do so.  Such reports or records shall include only those

11  which are signed in the capacity of a licensed chiropractic

12  physician.

13         (k)  Making misleading, deceptive, untrue, or

14  fraudulent representations in the practice of chiropractic

15  medicine or employing a trick or scheme in the practice of

16  chiropractic medicine when such trick or scheme fails to

17  conform to the generally prevailing standards of treatment in

18  the chiropractic medical community.

19         (l)  Soliciting patients either personally or through

20  an agent, unless such solicitation falls into a category of

21  solicitations approved by rule of the board.

22         (m)  Failing to keep legibly written chiropractic

23  medical records that identify clearly by name and credentials

24  the licensed chiropractic physician rendering, ordering,

25  supervising, or billing for each examination or treatment

26  procedure and that justify the course of treatment of the

27  patient, including, but not limited to, patient histories,

28  examination results, test results, X rays, and diagnosis of a

29  disease, condition, or injury.  X rays need not be retained

30  for more than 4 years.

31


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    CS for SB 1558                                 First Engrossed



  1         (n)  Exercising influence on the patient or client in

  2  such a manner as to exploit the patient or client for

  3  financial gain of the licensee or of a third party which shall

  4  include, but not be limited to, the promotion or sale of

  5  services, goods or appliances, or drugs.

  6         (o)  Performing professional services which have not

  7  been duly authorized by the patient or client or her or his

  8  legal representative except as provided in ss. 743.064,

  9  766.103, and 768.13.

10         (p)  Prescribing, dispensing, or administering any

11  medicinal drug except as authorized by s. 460.403(9)(c)2.,

12  performing any surgery, or practicing obstetrics.

13         (q)  Being unable to practice chiropractic medicine

14  with reasonable skill and safety to patients by reason of

15  illness or use of alcohol, drugs, narcotics, chemicals, or any

16  other type of material or as a result of any mental or

17  physical condition.  In enforcing this paragraph, upon a

18  finding by the secretary of the department, or his or her

19  designee, or the probable cause panel of the board that

20  probable cause exists to believe that the licensee is unable

21  to practice the profession because of reasons stated in this

22  paragraph, the department shall have the authority to compel a

23  licensee to submit to a mental or physical examination by a

24  physician designated by the department. If the licensee

25  refuses to comply with the department's order, the department

26  may file a petition for enforcement in the circuit court of

27  the circuit in which the licensee resides or does business.

28  The department shall be entitled to the summary procedure

29  provided in s. 51.011.  The record of proceedings to obtain a

30  compelled mental or physical examination shall not be used

31  against a licensee in any other proceedings.  A chiropractic


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    CS for SB 1558                                 First Engrossed



  1  physician affected under this paragraph shall at reasonable

  2  intervals be afforded an opportunity to demonstrate that she

  3  or he can resume the competent practice of chiropractic

  4  medicine with reasonable skill and safety to patients.

  5         (r)  Gross or repeated malpractice or the failure to

  6  practice chiropractic medicine at a level of care, skill, and

  7  treatment which is recognized by a reasonably prudent

  8  chiropractic physician as being acceptable under similar

  9  conditions and circumstances. The board shall give great

10  weight to the standards for malpractice in s. 766.102 in

11  interpreting this provision. A recommended order by an

12  administrative law judge, or a final order of the board

13  finding a violation under this section shall specify whether

14  the licensee was found to have committed "gross malpractice,"

15  "repeated malpractice," or "failure to practice chiropractic

16  medicine with that level of care, skill, and treatment which

17  is recognized as being acceptable under similar conditions and

18  circumstances" or any combination thereof, and any publication

19  by the board shall so specify.

20         (s)  Performing any procedure or prescribing any

21  therapy which, by the prevailing standards of chiropractic

22  medical practice in the community, would constitute

23  experimentation on human subjects, without first obtaining

24  full, informed, and written consent.

25         (t)  Practicing or offering to practice beyond the

26  scope permitted by law or accepting and performing

27  professional responsibilities which the licensee knows or has

28  reason to know that she or he is not competent to perform.

29         (u)  Delegating professional responsibilities to a

30  person when the licensee delegating such responsibilities

31


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    CS for SB 1558                                 First Engrossed



  1  knows or has reason to know that such person is not qualified

  2  by training, experience, or licensure to perform them.

  3         (v)  Violating any provision of this chapter, any rule

  4  of the board or department, or a lawful order of the board or

  5  department previously entered in a disciplinary hearing or

  6  failing to comply with a lawfully issued subpoena of the

  7  department.

  8         (w)  Conspiring with another licensee or with any other

  9  person to commit an act, or committing an act, which would

10  tend to coerce, intimidate, or preclude another licensee from

11  lawfully advertising her or his services.

12         (x)  Submitting to any third-party payor a claim for a

13  service or treatment which was not actually provided to a

14  patient.

15         (y)  Failing to preserve identity of funds and property

16  of a patient. As provided by rule of the board, money or other

17  property entrusted to a chiropractic physician for a specific

18  purpose, including advances for costs and expenses of

19  examination or treatment, is to be held in trust and must be

20  applied only to that purpose.  Money and other property of

21  patients coming into the hands of a chiropractic physician are

22  not subject to counterclaim or setoff for chiropractic

23  physician's fees, and a refusal to account for and deliver

24  over such money and property upon demand shall be deemed a

25  conversion. This is not to preclude the retention of money or

26  other property upon which the chiropractic physician has a

27  valid lien for services or to preclude the payment of agreed

28  fees from the proceeds of transactions for examinations or

29  treatments.  Controversies as to the amount of the fees are

30  not grounds for disciplinary proceedings unless the amount

31  demanded is clearly excessive or extortionate, or the demand


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    CS for SB 1558                                 First Engrossed



  1  is fraudulent. All funds of patients paid to a chiropractic

  2  physician, other than advances for costs and expenses, shall

  3  be deposited in one or more identifiable bank accounts

  4  maintained in the state in which the chiropractic physician's

  5  office is situated, and no funds belonging to the chiropractic

  6  physician shall be deposited therein except as follows:

  7         1.  Funds reasonably sufficient to pay bank charges may

  8  be deposited therein.

  9         2.  Funds belonging in part to a patient and in part

10  presently or potentially to the physician must be deposited

11  therein, but the portion belonging to the physician may be

12  withdrawn when due unless the right of the physician to

13  receive it is disputed by the patient, in which event the

14  disputed portion shall not be withdrawn until the dispute is

15  finally resolved.

16

17  Every chiropractic physician shall maintain complete records

18  of all funds, securities, and other properties of a patient

19  coming into the possession of the physician and render

20  appropriate accounts to the patient regarding them. In

21  addition, every chiropractic physician shall promptly pay or

22  deliver to the patient, as requested by the patient, the

23  funds, securities, or other properties in the possession of

24  the physician which the patient is entitled to receive.

25         (z)  Offering to accept or accepting payment for

26  services rendered by assignment from any third-party payor

27  after offering to accept or accepting whatever the third-party

28  payor covers as payment in full, if the effect of the offering

29  or acceptance is to eliminate or give the impression of

30  eliminating the need for payment by an insured of any required

31  deductions applicable in the policy of the insured.


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    CS for SB 1558                                 First Engrossed



  1         (aa)  Failing to provide, upon request of the insured,

  2  a copy of a claim submitted to any third-party payor for

  3  service or treatment of the insured.

  4         (bb)  Advertising a fee or charge for a service or

  5  treatment which is different from the fee or charge the

  6  licensee submits to third-party payors for that service or

  7  treatment.

  8         (cc)  Advertising any reduced or discounted fees for

  9  services or treatments, or advertising any free services or

10  treatments, without prominently stating in the advertisement

11  the usual fee of the licensee for the service or treatment

12  which is the subject of the discount, rebate, or free

13  offering.

14         (dd)  Using acupuncture without being certified

15  pursuant to s. 460.403(9)(f).

16         (ee)  Failing to report to the department any licensee

17  under chapter 458 or under chapter 459 who the chiropractic

18  physician or chiropractic physician's assistant knows has

19  violated the grounds for disciplinary action set out in the

20  law under which that person is licensed and who provides

21  health care services in a facility licensed under chapter 395,

22  or a health maintenance organization certificated under part I

23  of chapter 641, in which the chiropractic physician or

24  chiropractic physician's assistant also provides services.

25         (ff)  Violating any provision of this chapter or

26  chapter 456, or any rules adopted pursuant thereto.

27         (2)  The board may enter an order denying licensure or

28  imposing any of the penalties in s. 456.072(2) against any

29  applicant for licensure or licensee who is found guilty of

30  violating any provision of subsection (1) of this section or

31  who is found guilty of violating any provision of s.


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    CS for SB 1558                                 First Engrossed



  1  456.072(1). When the board finds any person guilty of any of

  2  the grounds set forth in subsection (1), it may enter an order

  3  imposing one or more of the following penalties:

  4         (a)  Refusal to certify to the department an

  5  application for licensure.

  6         (b)  Revocation or suspension of a license.

  7         (c)  Restriction of practice.

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

  9  $10,000 for each count or separate offense.

10         (e)  Issuance of a reprimand.

11         (f)  Placement of the chiropractic physician on

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

13  as the board may specify, including requiring the chiropractic

14  physician to submit to treatment, to attend continuing

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

16  under the supervision of another chiropractic physician.

17         (g)  Imposition of costs of the investigation and

18  prosecution.

19         (h)  Requirement that the chiropractic physician

20  undergo remedial education.

21         (i)  Issuance of a letter of concern.

22         (j)  Corrective action.

23         (k)  Refund of fees billed to and collected from the

24  patient or a third party.

25

26  In determining what action is appropriate, the board must

27  first consider what sanctions are necessary to protect the

28  public or to compensate the patient. Only after those

29  sanctions have been imposed may the disciplining authority

30  consider and include in the order requirements designed to

31  rehabilitate the chiropractic physician. All costs associated


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    CS for SB 1558                                 First Engrossed



  1  with compliance with orders issued under this subsection are

  2  the obligation of the chiropractic physician.

  3         Section 24.  Subsections (1) and (2) of section

  4  461.013, Florida Statutes, are amended to read:

  5         461.013  Grounds for disciplinary action; action by the

  6  board; investigations by department.--

  7         (1)  The following acts shall constitute grounds for

  8  denial of a license or disciplinary action, as specified in s.

  9  456.072(2) which the disciplinary actions specified in

10  subsection (2) may be taken:

11         (a)  Attempting to obtain, obtaining, or renewing a

12  license to practice podiatric medicine by bribery, by

13  fraudulent misrepresentations, or through an error of the

14  department or the board.

15         (b)  Having a license to practice podiatric medicine

16  revoked, suspended, or otherwise acted against, including the

17  denial of licensure, by the licensing authority of another

18  state, territory, or country.

19         (c)  Being convicted or found guilty, regardless of

20  adjudication, of a crime in any jurisdiction which directly

21  relates to the practice of podiatric medicine or to the

22  ability to practice podiatric medicine.  Any plea of nolo

23  contendere shall be considered a conviction for purposes of

24  this chapter.

25         (d)  False, deceptive, or misleading advertising.

26         (e)  Advertising, practicing, or attempting to practice

27  under a name other than one's own.

28         (f)  Failing to report to the department any person who

29  the licensee knows is in violation of this chapter or of the

30  rules of the department or the board.

31


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  1         (g)  Aiding, assisting, procuring, permitting, or

  2  advising any unlicensed person to practice podiatric medicine

  3  contrary to this chapter or to rule of the department or the

  4  board.

  5         (h)  Failing to perform any statutory or legal

  6  obligation placed upon a licensed podiatric physician.

  7         (i)  Making or filing a report which the licensee knows

  8  to be false, intentionally or negligently failing to file a

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

10  impeding or obstructing such filing or inducing another person

11  to do so.  Such report or records shall include only those

12  which are signed in the capacity of a licensed podiatric

13  physician.

14         (j)  Making misleading, deceptive, untrue, or

15  fraudulent representations in the practice of podiatric

16  medicine or employing a trick or scheme in the practice of

17  podiatric medicine when such scheme or trick fails to conform

18  to the generally prevailing standards of treatment in the

19  podiatric community.

20         (k)  Soliciting patients either personally or through

21  an agent, unless such solicitation falls into a category of

22  solicitations approved by rule of the board.

23         (l)  Failing to keep written medical records justifying

24  the course of treatment of the patient, including, but not

25  limited to, patient histories, examination results, and test

26  results.

27         (m)  Exercising influence on the patient or client in

28  such a manner as to exploit the patient or client for

29  financial gain of the licensee or of a third party which shall

30  include, but not be limited to, the promotion or sale of

31  services, goods, appliances, or drugs and the promoting or


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    CS for SB 1558                                 First Engrossed



  1  advertising on any prescription form of a community pharmacy

  2  unless the form shall also state "This prescription may be

  3  filled at any pharmacy of your choice."

  4         (n)  Performing professional services which have not

  5  been duly authorized by the patient or client or her or his

  6  legal representative except as provided in ss. 743.064,

  7  766.103, and 768.13.

  8         (o)  Prescribing, dispensing, administering, mixing, or

  9  otherwise preparing a legend drug, including all controlled

10  substances, other than in the course of the podiatric

11  physician's professional practice.  For the purposes of this

12  paragraph, it shall be legally presumed that prescribing,

13  dispensing, administering, mixing, or otherwise preparing

14  legend drugs, including all controlled substances,

15  inappropriately or in excessive or inappropriate quantities is

16  not in the best interest of the patient and is not in the

17  course of the podiatric physician's professional practice,

18  without regard to her or his intent.

19         (p)  Prescribing, dispensing, or administering any

20  medicinal drug appearing on any schedule set forth in chapter

21  893 by the podiatric physician to herself or himself except

22  those prescribed, dispensed, or administered to the podiatric

23  physician by another practitioner authorized to prescribe,

24  dispense, or administer them.

25         (q)  Prescribing, ordering, dispensing, administering,

26  supplying, selling, or giving any amphetamine or

27  sympathomimetic amine drug or compound designated as a

28  Schedule II controlled substance pursuant to chapter 893.

29         (r)  Being unable to practice podiatric medicine with

30  reasonable skill and safety to patients by reason of illness

31  or use of alcohol, drugs, narcotics, chemicals, or any other


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    CS for SB 1558                                 First Engrossed



  1  type of material or as a result of any mental or physical

  2  condition.  In enforcing this paragraph the department shall,

  3  upon probable cause, have authority to compel a podiatric

  4  physician to submit to a mental or physical examination by

  5  physicians designated by the department. Failure of a

  6  podiatric physician to submit to such examination when

  7  directed shall constitute an admission of the allegations

  8  against her or him, unless the failure was due to

  9  circumstances beyond her or his control, consequent upon which

10  a default and final order may be entered without the taking of

11  testimony or presentation of evidence.  A podiatric physician

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 podiatric medicine with

15  reasonable skill and safety to patients.

16         (s)  Gross or repeated malpractice or the failure to

17  practice podiatric medicine at a level of care, skill, and

18  treatment which is recognized by a reasonably prudent

19  podiatric physician as being acceptable under similar

20  conditions and circumstances.  The board shall give great

21  weight to the standards for malpractice in s. 766.102 in

22  interpreting this section. As used in this paragraph,

23  "repeated malpractice" includes, but is not limited to, three

24  or more claims for medical malpractice within the previous

25  5-year period resulting in indemnities being paid in excess of

26  $10,000 each to the claimant in a judgment or settlement and

27  which incidents involved negligent conduct by the podiatric

28  physicians. As used in this paragraph, "gross malpractice" or

29  "the failure to practice podiatric medicine with the level of

30  care, skill, and treatment which is recognized by a reasonably

31  prudent similar podiatric physician as being acceptable under


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    CS for SB 1558                                 First Engrossed



  1  similar conditions and circumstances" shall not be construed

  2  so as to require more than one instance, event, or act.

  3         (t)  Performing any procedure or prescribing any

  4  therapy which, by the prevailing standards of podiatric

  5  medical practice in the community, would constitute

  6  experimentation on human subjects without first obtaining

  7  full, informed, and written consent.

  8         (u)  Practicing or offering to practice beyond the

  9  scope permitted by law or accepting and performing

10  professional responsibilities which the licensee knows or has

11  reason to know that she or he is not competent to perform.

12         (v)  Delegating professional responsibilities to a

13  person when the licensee delegating such responsibilities

14  knows or has reason to know that such person is not qualified

15  by training, experience, or licensure to perform them.

16         (w)  Violating any provision of this chapter or chapter

17  456, any rule of the board or department, or a lawful order of

18  the board or department previously entered in a disciplinary

19  hearing or failing to comply with a lawfully issued subpoena

20  of the board or department.

21         (x)  Conspiring with another licensee or with any other

22  person to commit an act, or committing an act, which would

23  tend to coerce, intimidate, or preclude another licensee from

24  lawfully advertising her or his services.

25         (y)  Prescribing, ordering, dispensing, administering,

26  supplying, selling, or giving growth hormones, testosterone or

27  its analogs, human chorionic gonadotropin (HCG), or other

28  hormones for the purpose of muscle building or to enhance

29  athletic performance. For the purposes of this subsection, the

30  term "muscle building" does not include the treatment of

31  injured muscle.  A prescription written for any of the drug


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    CS for SB 1558                                 First Engrossed



  1  products listed above may be dispensed by the pharmacist with

  2  the presumption that the prescription is for legitimate

  3  medical use.

  4         (z)  Fraud, deceit, or misconduct in the practice of

  5  podiatric medicine.

  6         (aa)  Failing to report to the department any licensee

  7  under chapter 458 or chapter 459 who the podiatric physician

  8  knows has violated the grounds for disciplinary action set out

  9  in the law under which that person is licensed and who

10  provides health care services in a facility licensed under

11  chapter 395, or a health maintenance organization certificated

12  under part I of chapter 641, in which the podiatric physician

13  also provides services.

14         (bb)  Failing to comply with the requirements of ss.

15  381.026 and 381.0261 to provide patients with information

16  about their patient rights and how to file a patient

17  complaint.

18         (cc)  Violating any provision of this chapter or

19  chapter 456, or any rules adopted pursuant thereto.

20         (2)  The board may enter an order denying licensure or

21  imposing any of the penalties in s. 456.072(2) against any

22  applicant for licensure or licensee who is found guilty of

23  violating any provision of subsection (1) of this section or

24  who is found guilty of violating any provision of s.

25  456.072(1). When the board finds any person guilty of any of

26  the grounds set forth in subsection (1), it may enter an order

27  imposing one or more of the following penalties:

28         (a)  Refusal to certify to the department an

29  application for licensure.

30         (b)  Revocation or suspension of a license.

31         (c)  Restriction of practice.


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

  2  $10,000 for each count or separate offense.

  3         (e)  Issuance of a reprimand.

  4         (f)  Placing the podiatric physician on probation for a

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

  6  specify, including requiring the podiatric physician to submit

  7  to treatment, to attend continuing education courses, to

  8  submit to reexamination, and to work under the supervision of

  9  another podiatric physician.

10         (g)  Imposition of an administrative fine in accordance

11  with s. 381.0261 for violations regarding patient rights.

12         Section 25.  Subsections (1) and (2) of section 462.14,

13  Florida Statutes, are amended to read:

14         462.14  Grounds for disciplinary action; action by the

15  department.--

16         (1)  The following acts constitute grounds for denial

17  of a license or disciplinary action, as specified in s.

18  456.072(2) which the disciplinary actions specified in

19  subsection (2) may be taken:

20         (a)  Attempting to obtain, obtaining, or renewing a

21  license to practice naturopathic medicine by bribery, by

22  fraudulent misrepresentation, or through an error of the

23  department.

24         (b)  Having a license to practice naturopathic medicine

25  revoked, suspended, or otherwise acted against, including the

26  denial of licensure, by the licensing authority of another

27  state, territory, or country.

28         (c)  Being convicted or found guilty, regardless of

29  adjudication, of a crime in any jurisdiction which directly

30  relates to the practice of naturopathic medicine or to the

31  ability to practice naturopathic medicine. Any plea of nolo


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    CS for SB 1558                                 First Engrossed



  1  contendere shall be considered a conviction for purposes of

  2  this chapter.

  3         (d)  False, deceptive, or misleading advertising.

  4         (e)  Advertising, practicing, or attempting to practice

  5  under a name other than one's own.

  6         (f)  Failing to report to the department any person who

  7  the licensee knows is in violation of this chapter or of the

  8  rules of the department.

  9         (g)  Aiding, assisting, procuring, or advising any

10  unlicensed person to practice naturopathic medicine contrary

11  to this chapter or to a rule of the department.

12         (h)  Failing to perform any statutory or legal

13  obligation placed upon a licensed naturopathic physician.

14         (i)  Making or filing a report which the licensee knows

15  to be false, intentionally or negligently failing to file a

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

17  impeding or obstructing such filing or inducing another person

18  to do so.  Such reports or records shall include only those

19  which are signed in the capacity as a licensed naturopathic

20  physician.

21         (j)  Paying or receiving any commission, bonus,

22  kickback, or rebate, or engaging in any split-fee arrangement

23  in any form whatsoever with a physician, organization, agency,

24  or person, either directly or indirectly, for patients

25  referred to providers of health care goods and services,

26  including, but not limited to, hospitals, nursing homes,

27  clinical laboratories, ambulatory surgical centers, or

28  pharmacies.  The provisions of this paragraph shall not be

29  construed to prevent a naturopathic physician from receiving a

30  fee for professional consultation services.

31


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    CS for SB 1558                                 First Engrossed



  1         (k)  Exercising influence within a patient-physician

  2  relationship for purposes of engaging a patient in sexual

  3  activity. A patient shall be presumed to be incapable of

  4  giving free, full, and informed consent to sexual activity

  5  with her or his physician.

  6         (l)  Making deceptive, untrue, or fraudulent

  7  representations in the practice of naturopathic medicine or

  8  employing a trick or scheme in the practice of naturopathic

  9  medicine when such scheme or trick fails to conform to the

10  generally prevailing standards of treatment in the medical

11  community.

12         (m)  Soliciting patients, either personally or through

13  an agent, through the use of fraud, intimidation, undue

14  influence, or a form of overreaching or vexatious conduct.  A

15  "solicitation" is any communication which directly or

16  implicitly requests an immediate oral response from the

17  recipient.

18         (n)  Failing to keep written medical records justifying

19  the course of treatment of the patient, including, but not

20  limited to, patient histories, examination results, test

21  results, X rays, and records of the prescribing, dispensing

22  and administering of drugs.

23         (o)  Exercising influence on the patient or client in

24  such a manner as to exploit the patient or client for the

25  financial gain of the licensee or of a third party, which

26  shall include, but not be limited to, the promoting or selling

27  of services, goods, appliances, or drugs and the promoting or

28  advertising on any prescription form of a community pharmacy

29  unless the form also states "This prescription may be filled

30  at any pharmacy of your choice."

31


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    CS for SB 1558                                 First Engrossed



  1         (p)  Performing professional services which have not

  2  been duly authorized by the patient or client, or her or his

  3  legal representative, except as provided in s. 743.064, s.

  4  766.103, or s. 768.13.

  5         (q)  Prescribing, dispensing, administering, mixing, or

  6  otherwise preparing a legend drug, including any controlled

  7  substance, other than in the course of the naturopathic

  8  physician's professional practice.  For the purposes of this

  9  paragraph, it shall be legally presumed that prescribing,

10  dispensing, administering, mixing, or otherwise preparing

11  legend drugs, including all controlled substances,

12  inappropriately or in excessive or inappropriate quantities is

13  not in the best interest of the patient and is not in the

14  course of the naturopathic physician's professional practice,

15  without regard to her or his intent.

16         (r)  Prescribing, dispensing, or administering any

17  medicinal drug appearing on any schedule set forth in chapter

18  893 by the naturopathic physician to herself or himself,

19  except one prescribed, dispensed, or administered to the

20  naturopathic physician by another practitioner authorized to

21  prescribe, dispense, or administer medicinal drugs.

22         (s)  Being unable to practice naturopathic medicine

23  with reasonable skill and safety to patients by reason of

24  illness or use of alcohol, drugs, narcotics, chemicals, or any

25  other type of material or as a result of any mental or

26  physical condition.  In enforcing this paragraph, the

27  department shall have, upon probable cause, authority to

28  compel a naturopathic physician to submit to a mental or

29  physical examination by physicians designated by the

30  department.  The failure of a naturopathic physician to submit

31  to such an examination when so directed shall constitute an


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    CS for SB 1558                                 First Engrossed



  1  admission of the allegations against her or him upon which a

  2  default and final order may be entered without the taking of

  3  testimony or presentation of evidence, unless the failure was

  4  due to circumstances beyond the naturopathic physician's

  5  control.  A naturopathic physician affected under this

  6  paragraph shall at reasonable intervals be afforded an

  7  opportunity to demonstrate that she or he can resume the

  8  competent practice of naturopathic medicine with reasonable

  9  skill and safety to patients. In any proceeding under this

10  paragraph, neither the record of proceedings nor the orders

11  entered by the department may be used against a naturopathic

12  physician in any other proceeding.

13         (t)  Gross or repeated malpractice or the failure to

14  practice naturopathic medicine with that level of care, skill,

15  and treatment which is recognized by a reasonably prudent

16  similar physician as being acceptable under similar conditions

17  and circumstances.  The department shall give great weight to

18  the provisions of s. 766.102 when enforcing this paragraph.

19         (u)  Performing any procedure or prescribing any

20  therapy which, by the prevailing standards of medical practice

21  in the community, constitutes experimentation on a human

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

23  consent.

24         (v)  Practicing or offering to practice beyond the

25  scope permitted by law or accepting and performing

26  professional responsibilities which the licensee knows or has

27  reason to know that she or he is not competent to perform.

28         (w)  Delegating professional responsibilities to a

29  person when the licensee delegating such responsibilities

30  knows or has reason to know that such person is not qualified

31  by training, experience, or licensure to perform them.


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    CS for SB 1558                                 First Engrossed



  1         (x)  Violating any provision of this chapter, any rule

  2  of the department, or a lawful order of the department

  3  previously entered in a disciplinary hearing or failing to

  4  comply with a lawfully issued subpoena of the department.

  5         (y)  Conspiring with another licensee or with any other

  6  person to commit an act, or committing an act, which would

  7  tend to coerce, intimidate, or preclude another licensee from

  8  lawfully advertising her or his services.

  9         (z)  Procuring, or aiding or abetting in the procuring

10  of, an unlawful termination of pregnancy.

11         (aa)  Presigning blank prescription forms.

12         (bb)  Prescribing by the naturopathic physician for

13  office use any medicinal drug appearing on Schedule II in

14  chapter 893.

15         (cc)  Prescribing, ordering, dispensing, administering,

16  supplying, selling, or giving any drug which is an amphetamine

17  or sympathomimetic amine drug, or a compound designated

18  pursuant to chapter 893 as a Schedule II controlled substance

19  to or for any person except for:

20         1.  The treatment of narcolepsy; hyperkinesis;

21  behavioral syndrome in children characterized by the

22  developmentally inappropriate symptoms of moderate to severe

23  distractability, short attention span, hyperactivity,

24  emotional lability, and impulsivity; or drug-induced brain

25  dysfunction.

26         2.  The differential diagnostic psychiatric evaluation

27  of depression or the treatment of depression shown to be

28  refractory to other therapeutic modalities.

29         3.  The clinical investigation of the effects of such

30  drugs or compounds when an investigative protocol therefor is

31


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    CS for SB 1558                                 First Engrossed



  1  submitted to, reviewed, and approved by the department before

  2  such investigation is begun.

  3         (dd)  Prescribing, ordering, dispensing, administering,

  4  supplying, selling, or giving growth hormones, testosterone or

  5  its analogs, human chorionic gonadotropin (HCG), or other

  6  hormones for the purpose of muscle building or to enhance

  7  athletic performance. For the purposes of this subsection, the

  8  term "muscle building" does not include the treatment of

  9  injured muscle.  A prescription written for the drug products

10  listed above may be dispensed by the pharmacist with the

11  presumption that the prescription is for legitimate medical

12  use.

13         (ee)  Violating any provision of this chapter or

14  chapter 456, or any rules adopted pursuant thereto.

15         (2)  The department may enter an order denying

16  licensure or imposing any of the penalties in s. 456.072(2)

17  against any applicant for licensure or licensee who is found

18  guilty of violating any provision of subsection (1) of this

19  section or who is found guilty of violating any provision of

20  s. 456.072(1). When the department finds any person guilty of

21  any of the grounds set forth in subsection (1), it may enter

22  an order imposing one or more of the following penalties:

23         (a)  Refusal to certify to the department an

24  application for licensure.

25         (b)  Revocation or suspension of a license.

26         (c)  Restriction of practice.

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

28  $1,000 for each count or separate offense.

29         (e)  Issuance of a reprimand.

30         (f)  Placement of the naturopathic physician on

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


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    CS for SB 1558                                 First Engrossed



  1  as the department may specify, including, but not limited to,

  2  requiring the naturopathic physician to submit to treatment,

  3  to attend continuing education courses, to submit to

  4  reexamination, or to work under the supervision of another

  5  naturopathic physician.

  6         Section 26.  Subsections (1) and (2) of section

  7  463.016, Florida Statutes, are amended to read:

  8         463.016  Grounds for disciplinary action; action by the

  9  board.--

10         (1)  The following acts shall constitute grounds for

11  denial of a license or disciplinary action, as specified in s.

12  456.072(2) which the disciplinary actions specified in

13  subsection (2) may be taken:

14         (a)  Procuring or attempting to procure a license to

15  practice optometry by bribery, by fraudulent

16  misrepresentations, or through an error of the department or

17  board.

18         (b)  Procuring or attempting to procure a license for

19  any other person by making or causing to be made any false

20  representation.

21         (c)  Having a license to practice optometry revoked,

22  suspended, or otherwise acted against, including the denial of

23  licensure, by the licensing authority of another jurisdiction.

24         (d)  Being convicted or found guilty, regardless of

25  adjudication, of a crime in any jurisdiction which directly

26  relates to the practice of optometry or to the ability to

27  practice optometry.  Any plea of nolo contendere shall be

28  considered a conviction for the purposes of this chapter.

29         (e)  Making or filing a report or record which the

30  licensee knows to be false, intentionally or negligently

31  failing to file a report or record required by state or


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    CS for SB 1558                                 First Engrossed



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

  2  inducing another person to do so.  Such reports or records

  3  shall include only those which are signed by the licensee in

  4  her or his capacity as a licensed practitioner.

  5         (f)  Advertising goods or services in a manner which is

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

  7  content.

  8         (g)  Fraud or deceit, negligence or incompetency, or

  9  misconduct in the practice of optometry.

10         (h)  A violation or repeated violations of provisions

11  of this chapter, or of chapter 456, and any rules promulgated

12  pursuant thereto.

13         (i)  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         (j)  Willfully submitting to any third-party payor a

18  claim for services which were not provided to a patient.

19         (k)  Failing to keep written optometric records about

20  the examinations, treatments, and prescriptions for patients.

21         (l)  Willfully failing to report any person who the

22  licensee knows is in violation of this chapter or of rules of

23  the department or the board.

24         (m)  Gross or repeated malpractice.

25         (n)  Practicing with a revoked, suspended, inactive, or

26  delinquent license.

27         (o)  Being unable to practice optometry with reasonable

28  skill and safety to patients by reason of illness or use of

29  alcohol, drugs, narcotics, chemicals, or any other type of

30  material or as a result of any mental or physical condition.

31  A licensed practitioner affected under this paragraph shall at


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    CS for SB 1558                                 First Engrossed



  1  reasonable intervals be afforded an opportunity to demonstrate

  2  that she or he can resume the competent practice of optometry

  3  with reasonable skill and safety to patients.

  4         (p)  Having been disciplined by a regulatory agency in

  5  another state for any offense that would constitute a

  6  violation of Florida laws or rules regulating optometry.

  7         (q)  Violating any provision of s. 463.014 or s.

  8  463.015.

  9         (r)  Violating any lawful order of the board or

10  department, previously entered in a disciplinary hearing, or

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

12  or department.

13         (s)  Practicing or offering to practice beyond the

14  scope permitted by law or accepting and performing

15  professional responsibilities which the licensed practitioner

16  knows or has reason to know she or he is not competent to

17  perform.

18         (t)  Violating any provision of this chapter or chapter

19  456, or any rules adopted pursuant thereto.

20         (2)  The department may enter an order imposing any of

21  the penalties in s. 456.072(2) against any licensee who is

22  found guilty of violating any provision of subsection (1) of

23  this section or who is found guilty of violating any provision

24  of s. 456.072(1). When the board finds any person guilty of

25  any of the grounds set forth in subsection (1), it may enter

26  an order imposing one or more of the following penalties:

27         (a)  Refusal to certify to the department an

28  application for licensure.

29         (b)  Revocation or suspension of a license.

30         (c)  Imposition of an administrative fine not to exceed

31  $5,000 for each count or separate offense.


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    CS for SB 1558                                 First Engrossed



  1         (d)  Issuance of a reprimand.

  2         (e)  Placement of the licensed practitioner on

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

  4  as the board may specify, including requiring the licensed

  5  practitioner to submit to treatment, to attend continuing

  6  education courses, or to work under the supervision of another

  7  licensed practitioner.

  8         Section 27.  Subsections (1) and (2) of section

  9  464.018, Florida Statutes, are amended to read:

10         464.018  Disciplinary actions.--

11         (1)  The following acts constitute shall be grounds for

12  denial of a license or disciplinary action, as specified in s.

13  456.072(2) disciplinary action set forth in this section:

14         (a)  Procuring, attempting to procure, or renewing a

15  license to practice nursing by bribery, by knowing

16  misrepresentations, or through an error of the department or

17  the board.

18         (b)  Having a license to practice nursing revoked,

19  suspended, or otherwise acted against, including the denial of

20  licensure, by the licensing authority of another state,

21  territory, or country.

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

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

24  crime in any jurisdiction which directly relates to the

25  practice of nursing or to the ability to practice nursing.

26         (d)  Being found guilty, regardless of adjudication, of

27  any of the following offenses:

28         1.  A forcible felony as defined in chapter 776.

29         2.  A violation of chapter 812, relating to theft,

30  robbery, and related crimes.

31


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    CS for SB 1558                                 First Engrossed



  1         3.  A violation of chapter 817, relating to fraudulent

  2  practices.

  3         4.  A violation of chapter 800, relating to lewdness

  4  and indecent exposure.

  5         5.  A violation of chapter 784, relating to assault,

  6  battery, and culpable negligence.

  7         6.  A violation of chapter 827, relating to child

  8  abuse.

  9         7.  A violation of chapter 415, relating to protection

10  from abuse, neglect, and exploitation.

11         8.  A violation of chapter 39, relating to child abuse,

12  abandonment, and neglect.

13         (e)  Having been found guilty of, regardless of

14  adjudication, or entered a plea of nolo contendere or guilty

15  to, any offense prohibited under s. 435.03 or under any

16  similar statute of another jurisdiction; or having committed

17  an act which constitutes domestic violence as defined in s.

18  741.28.

19         (f)  Making or filing a false report or record, which

20  the licensee knows to be false, intentionally or negligently

21  failing to file a report or record required by state or

22  federal 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 are signed in the nurse's

25  capacity as a licensed nurse.

26         (g)  False, misleading, or deceptive advertising.

27         (h)  Unprofessional conduct, which shall include, but

28  not be limited to, any departure from, or the failure to

29  conform to, the minimal standards of acceptable and prevailing

30  nursing practice, in which case actual injury need not be

31  established.


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  1         (i)  Engaging or attempting to engage in the

  2  possession, sale, or distribution of controlled substances as

  3  set forth in chapter 893, for any other than legitimate

  4  purposes authorized by this part.

  5         (j)  Being unable to practice nursing with reasonable

  6  skill and safety to patients by reason of illness or use of

  7  alcohol, drugs, narcotics, or chemicals or any other type of

  8  material or as a result of any mental or physical condition.

  9  In enforcing this paragraph, the department shall have, upon a

10  finding of the secretary or the secretary's designee that

11  probable cause exists to believe that the licensee is unable

12  to practice nursing because of the reasons stated in this

13  paragraph, the authority to issue an order to compel a

14  licensee to submit to a mental or physical examination by

15  physicians designated by the department.  If the licensee

16  refuses to comply with such order, the department's order

17  directing such examination may be enforced by filing a

18  petition for enforcement in the circuit court where the

19  licensee resides or does business. The licensee against whom

20  the petition is filed shall not be named or identified by

21  initials in any public court records or documents, and the

22  proceedings shall be closed to the public. The department

23  shall be entitled to the summary procedure provided in s.

24  51.011. A nurse affected by the provisions of this paragraph

25  shall at reasonable intervals be afforded an opportunity to

26  demonstrate that she or he can resume the competent practice

27  of nursing with reasonable skill and safety to patients.

28         (k)  Failing to report to the department any person who

29  the licensee knows is in violation of this part or of the

30  rules of the department or the board; however, if the licensee

31  verifies that such person is actively participating in a


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    CS for SB 1558                                 First Engrossed



  1  board-approved program for the treatment of a physical or

  2  mental condition, the licensee is required to report such

  3  person only to an impaired professionals consultant.

  4         (l)  Knowingly violating any provision of this part, a

  5  rule of the board or the department, or a lawful order of the

  6  board or department previously entered in a disciplinary

  7  proceeding or failing to comply with a lawfully issued

  8  subpoena of the department.

  9         (m)  Failing to report to the department any licensee

10  under chapter 458 or under chapter 459 who the nurse knows has

11  violated the grounds for disciplinary action set out in the

12  law under which that person is licensed and who provides

13  health care services in a facility licensed under chapter 395,

14  or a health maintenance organization certificated under part I

15  of chapter 641, in which the nurse also provides services.

16         (n)  Violating any provision of this chapter or chapter

17  456, or any rules adopted pursuant thereto.

18         (2)  The board may enter an order denying licensure or

19  imposing any of the penalties in s. 456.072(2) against any

20  applicant for licensure or licensee who is found guilty of

21  violating any provision of subsection (1) of this section or

22  who is found guilty of violating any provision of s.

23  456.072(1). When the board finds any person guilty of any of

24  the grounds set forth in subsection (1), it may enter an order

25  imposing one or more of the following penalties:

26         (a)  Refusal to certify to the department an

27  application for licensure.

28         (b)  Revocation or suspension of a license with

29  reinstatement subject to the provisions of subsection (3).

30         (c)  Permanent revocation of a license.

31         (d)  Restriction of practice.


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  1         (e)  Imposition of an administrative fine not to exceed

  2  $1,000 for each count or separate offense.

  3         (f)  Issuance of a reprimand.

  4         (g)  Placement of the nurse on probation for a period

  5  of time and subject to such conditions as the board may

  6  specify, including requiring the nurse to submit to treatment,

  7  to attend continuing education courses, to take an

  8  examination, or to work under the supervision of another

  9  nurse.

10         Section 28.  Subsections (1) and (2) of section

11  465.016, Florida Statutes, are amended to read:

12         465.016  Disciplinary actions.--

13         (1)  The following acts constitute shall be grounds for

14  denial of a license or disciplinary action, as specified in s.

15  456.072(2) disciplinary action set forth in this section:

16         (a)  Obtaining a license by misrepresentation or fraud

17  or through an error of the department or the board.

18         (b)  Procuring or attempting to procure a license for

19  any other person by making or causing to be made any false

20  representation.

21         (c)  Permitting any person not licensed as a pharmacist

22  in this state or not registered as an intern in this state, or

23  permitting a registered intern who is not acting under the

24  direct and immediate personal supervision of a licensed

25  pharmacist, to fill, compound, or dispense any prescriptions

26  in a pharmacy owned and operated by such pharmacist or in a

27  pharmacy where such pharmacist is employed or on duty.

28         (d)  Being unfit or incompetent to practice pharmacy by

29  reason of:

30         1.  Habitual intoxication.

31


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    CS for SB 1558                                 First Engrossed



  1         2.  The misuse or abuse of any medicinal drug appearing

  2  in any schedule set forth in chapter 893.

  3         3.  Any abnormal physical or mental condition which

  4  threatens the safety of persons to whom she or he might sell

  5  or dispense prescriptions, drugs, or medical supplies or for

  6  whom she or he might manufacture, prepare, or package, or

  7  supervise the manufacturing, preparation, or packaging of,

  8  prescriptions, drugs, or medical supplies.

  9         (e)  Violating any of the requirements of this chapter;

10  or if licensed as a practitioner in this or any other state,

11  violating any of the requirements of their respective practice

12  act or violating chapter 499; 21 U.S.C. ss. 301-392, known as

13  the Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et

14  seq., known as the Comprehensive Drug Abuse Prevention and

15  Control Act; or chapter 893.

16         (f)  Having been convicted or found guilty, regardless

17  of adjudication, in a court of this state or other

18  jurisdiction, of a crime which directly relates to the ability

19  to practice pharmacy or to the practice of pharmacy.  A plea

20  of nolo contendere constitutes a conviction for purposes of

21  this provision.

22         (g)  Using in the compounding of a prescription, or

23  furnishing upon prescription, an ingredient or article

24  different in any manner from the ingredient or article

25  prescribed, except as authorized in s. 465.019(6) or s.

26  465.025.

27         (h)  Having been disciplined by a regulatory agency in

28  another state for any offense that would constitute a

29  violation of this chapter.

30         (i)  Compounding, dispensing, or distributing a legend

31  drug, including any controlled substance, other than in the


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    CS for SB 1558                                 First Engrossed



  1  course of the professional practice of pharmacy.  For purposes

  2  of this paragraph, it shall be legally presumed that the

  3  compounding, dispensing, or distributing of legend drugs in

  4  excessive or inappropriate quantities is not in the best

  5  interests of the patient and is not in the course of the

  6  professional practice of pharmacy.

  7         (j)  Making or filing a report or record which the

  8  licensee knows to be false, intentionally or negligently

  9  failing to file a report or record required by federal or

10  state law, willfully impeding or obstructing such filing, or

11  inducing another person to do so.  Such reports or records

12  include only those which the licensee is required to make or

13  file in her or his capacity as a licensed pharmacist.

14         (k)  Failing to make prescription fee or price

15  information readily available by failing to provide such

16  information upon request and upon the presentation of a

17  prescription for pricing or dispensing.  Nothing in this

18  section shall be construed to prohibit the quotation of price

19  information on a prescription drug to a potential consumer by

20  telephone.

21         (l)  Placing in the stock of any pharmacy any part of

22  any prescription compounded or dispensed which is returned by

23  a patient; however, in a hospital, nursing home, correctional

24  facility, or extended care facility in which unit-dose

25  medication is dispensed to inpatients, each dose being

26  individually sealed and the individual unit dose or unit-dose

27  system labeled with the name of the drug, dosage strength,

28  manufacturer's control number, and expiration date, if any,

29  the unused unit dose of medication may be returned to the

30  pharmacy for redispensing.  Each pharmacist shall maintain

31


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    CS for SB 1558                                 First Engrossed



  1  appropriate records for any unused or returned medicinal

  2  drugs.

  3         (m)  Being unable to practice pharmacy with reasonable

  4  skill and safety by reason of illness, use of drugs,

  5  narcotics, chemicals, or any other type of material or as a

  6  result of any mental or physical condition.  A pharmacist

  7  affected under this paragraph shall at reasonable intervals be

  8  afforded an opportunity to demonstrate that she or he can

  9  resume the competent practice of pharmacy with reasonable

10  skill and safety to her or his customers.

11         (n)  Violating a rule of the board or department or

12  violating an order of the board or department previously

13  entered in a disciplinary hearing.

14         (o)  Failing to report to the department any licensee

15  under chapter 458 or under chapter 459 who the pharmacist

16  knows has violated the grounds for disciplinary action set out

17  in the law under which that person is licensed and who

18  provides health care services in a facility licensed under

19  chapter 395, or a health maintenance organization certificated

20  under part I of chapter 641, in which the pharmacist also

21  provides services.

22         (p)  Failing to notify the Board of Pharmacy in writing

23  within 20 days of the commencement or cessation of the

24  practice of the profession of pharmacy in Florida when such

25  commencement or cessation of the practice of the profession of

26  pharmacy in Florida was a result of a pending or completed

27  disciplinary action or investigation in another jurisdiction.

28         (q)  Using or releasing a patient's records except as

29  authorized by this chapter and chapter 456.

30         (r)  Violating any provision of this chapter or chapter

31  456, or any rules adopted pursuant thereto.


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    CS for SB 1558                                 First Engrossed



  1         (2)  The board may enter an order denying licensure or

  2  imposing any of the penalties in s. 456.072(2) against any

  3  applicant for licensure or licensee who is found guilty of

  4  violating any provision of subsection (1) of this section or

  5  who is found guilty of violating any provision of s.

  6  456.072(1). When the board finds any person guilty of any of

  7  the grounds set forth in subsection (1), it may enter an order

  8  imposing one or more of the following penalties:

  9         (a)  Refusal to certify to the department an

10  application for licensure.

11         (b)  Revocation or suspension of a license.

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

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

14         (d)  Issuance of a reprimand.

15         (e)  Placement of the pharmacist on probation for a

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

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

18  pharmacist to submit to treatment, to attend continuing

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

20  under the supervision of another pharmacist.

21         Section 29.  Subsections (1) and (2) of section

22  466.028, Florida Statutes, are amended to read:

23         466.028  Grounds for disciplinary action; action by the

24  board.--

25         (1)  The following acts shall constitute grounds for

26  denial of a license or disciplinary action, as specified in s.

27  456.072(2) which the disciplinary actions specified in

28  subsection (2) may be taken:

29         (a)  Attempting to obtain, obtaining, or renewing a

30  license under this chapter by bribery, fraudulent

31


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    CS for SB 1558                                 First Engrossed



  1  misrepresentations, or through an error of the department or

  2  the board.

  3         (b)  Having a license to practice dentistry or dental

  4  hygiene revoked, suspended, or otherwise acted against,

  5  including the denial of licensure, by the licensing authority

  6  of another state, territory, or country.

  7         (c)  Being convicted or found guilty of or entering a

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

  9  crime in any jurisdiction which relates to the practice of

10  dentistry or dental hygiene.  A plea of nolo contendere shall

11  create a rebuttable presumption of guilt to the underlying

12  criminal charges.

13         (d)  Advertising goods or services in a manner which is

14  fraudulent, false, deceptive, or misleading in form or content

15  contrary to s. 466.019 or rules of the board adopted pursuant

16  thereto.

17         (e)  Advertising, practicing, or attempting to practice

18  under a name other than one's own.

19         (f)  Failing to report to the department any person who

20  the licensee knows, or has reason to believe, is clearly in

21  violation of this chapter or of the rules of the department or

22  the board.

23         (g)  Aiding, assisting, procuring, or advising any

24  unlicensed person to practice dentistry or dental hygiene

25  contrary to this chapter or to a rule of the department or the

26  board.

27         (h)  Being employed by any corporation, organization,

28  group, or person other than a dentist or a professional

29  corporation or limited liability company composed of dentists

30  to practice dentistry.

31


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    CS for SB 1558                                 First Engrossed



  1         (i)  Failing to perform any statutory or legal

  2  obligation placed upon a licensee.

  3         (j)  Making or filing a report which the licensee knows

  4  to be false, failing to file a report or record required by

  5  state or federal law, knowingly impeding or obstructing such

  6  filing or inducing another person to do so.  Such reports or

  7  records shall include only those which are signed in the

  8  capacity as a licensee.

  9         (k)  Committing any act which would constitute sexual

10  battery, as defined in chapter 794, upon a patient or

11  intentionally touching the sexual organ of a patient.

12         (l)  Making deceptive, untrue, or fraudulent

13  representations in or related to the practice of dentistry.

14         (m)  Failing to keep written dental records and medical

15  history records justifying the course of treatment of the

16  patient including, but not limited to, patient histories,

17  examination results, test results, and X rays, if taken.

18         (n)  Failing to make available to a patient or client,

19  or to her or his legal representative or to the department if

20  authorized in writing by the patient, copies of documents in

21  the possession or under control of the licensee which relate

22  to the patient or client.

23         (o)  Performing professional services which have not

24  been duly authorized by the patient or client, or her or his

25  legal representative, except as provided in ss. 766.103 and

26  768.13.

27         (p)  Prescribing, procuring, dispensing, administering,

28  mixing, or otherwise preparing a legend drug, including any

29  controlled substance, other than in the course of the

30  professional practice of the dentist.  For the purposes of

31  this paragraph, it shall be legally presumed that prescribing,


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    CS for SB 1558                                 First Engrossed



  1  procuring, dispensing, administering, mixing, or otherwise

  2  preparing legend drugs, including all controlled substances,

  3  in excessive or inappropriate quantities is not in the best

  4  interest of the patient and is not in the course of the

  5  professional practice of the dentist, without regard to her or

  6  his intent.

  7         (q)  Prescribing, procuring, dispensing, or

  8  administering any medicinal drug appearing on any schedule set

  9  forth in chapter 893, by a dentist to herself or himself,

10  except those prescribed, dispensed, or administered to the

11  dentist by another practitioner authorized to prescribe them.

12         (r)  Prescribing, procuring, ordering, dispensing,

13  administering, supplying, selling, or giving any drug which is

14  a Schedule II amphetamine or a Schedule II sympathomimetic

15  amine drug or a compound thereof, pursuant to chapter 893, to

16  or for any person except for the clinical investigation of the

17  effects of such drugs or compounds when an investigative

18  protocol therefor is submitted to, and reviewed and approved

19  by, the board before such investigation is begun.

20         (s)  Being unable to practice her or his profession

21  with reasonable skill and safety to patients by reason of

22  illness or use of alcohol, drugs, narcotics, chemicals, or any

23  other type of material or as a result of any mental or

24  physical condition.  In enforcing this paragraph, the

25  department shall have, upon a finding of the secretary or her

26  or his designee that probable cause exists to believe that the

27  licensee is unable to practice dentistry or dental hygiene

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

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

30  or physical examination by physicians designated by the

31  department.  If the licensee refuses to comply with such


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    CS for SB 1558                                 First Engrossed



  1  order, the department's order directing such examination may

  2  be enforced by filing a petition for enforcement in the

  3  circuit court where the licensee resides or does business.

  4  The licensee against whom the petition is filed shall not be

  5  named or identified by initials in any public court records or

  6  documents, and the proceedings shall be closed to the public.

  7  The department shall be entitled to the summary procedure

  8  provided in s. 51.011. A licensee affected under this

  9  paragraph shall at reasonable intervals be afforded an

10  opportunity to demonstrate that she or he can resume the

11  competent practice of her or his profession with reasonable

12  skill and safety to patients.

13         (t)  Fraud, deceit, or misconduct in the practice of

14  dentistry or dental hygiene.

15         (u)  Failure to provide and maintain reasonable

16  sanitary facilities and conditions.

17         (v)  Failure to provide adequate radiation safeguards.

18         (w)  Performing any procedure or prescribing any

19  therapy which, by the prevailing standards of dental practice

20  in the community, would constitute experimentation on human

21  subjects, without first obtaining full, informed, and written

22  consent.

23         (x)  Being guilty of incompetence or negligence by

24  failing to meet the minimum standards of performance in

25  diagnosis and treatment when measured against generally

26  prevailing peer performance, including, but not limited to,

27  the undertaking of diagnosis and treatment for which the

28  dentist is not qualified by training or experience or being

29  guilty of dental malpractice. For purposes of this paragraph,

30  it shall be legally presumed that a dentist is not guilty of

31  incompetence or negligence by declining to treat an individual


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    CS for SB 1558                                 First Engrossed



  1  if, in the dentist's professional judgment, the dentist or a

  2  member of her or his clinical staff is not qualified by

  3  training and experience, or the dentist's treatment facility

  4  is not clinically satisfactory or properly equipped to treat

  5  the unique characteristics and health status of the dental

  6  patient, provided the dentist refers the patient to a

  7  qualified dentist or facility for appropriate treatment.  As

  8  used in this paragraph, "dental malpractice" includes, but is

  9  not limited to, three or more claims within the previous

10  5-year period which resulted in indemnity being paid, or any

11  single indemnity paid in excess of $5,000 in a judgment or

12  settlement, as a result of negligent conduct on the part of

13  the dentist.

14         (y)  Practicing or offering to practice beyond the

15  scope permitted by law or accepting and performing

16  professional responsibilities which the licensee knows or has

17  reason to know that she or he is not competent to perform.

18         (z)  Delegating professional responsibilities to a

19  person who is not qualified by training, experience, or

20  licensure to perform them.

21         (aa)  The violation or the repeated violation of this

22  chapter, chapter 456, or any rule promulgated pursuant to

23  chapter 456 or this chapter; the violation of a lawful order

24  of the board or department previously entered in a

25  disciplinary hearing; or failure to comply with a lawfully

26  issued subpoena of the board or department.

27         (bb)  Conspiring with another licensee or with any

28  person to commit an act, or committing an act, which would

29  tend to coerce, intimidate, or preclude another licensee from

30  lawfully advertising her or his services.

31


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    CS for SB 1558                                 First Engrossed



  1         (cc)  Being adjudged mentally incompetent in this or

  2  any other state, the discipline for which shall last only so

  3  long as the adjudication.

  4         (dd)  Presigning blank prescription or laboratory work

  5  order forms.

  6         (ee)  Prescribing, ordering, dispensing, administering,

  7  supplying, selling, or giving growth hormones, testosterone or

  8  its analogs, human chorionic gonadotropin (HCG), or other

  9  hormones for the purpose of muscle building or to enhance

10  athletic performance. For the purposes of this subsection, the

11  term "muscle building" does not include the treatment of

12  injured muscle.  A prescription written for the drug products

13  listed above may be dispensed by the pharmacist with the

14  presumption that the prescription is for legitimate medical

15  use.

16         (ff)  Operating or causing to be operated a dental

17  office in such a manner as to result in dental treatment that

18  is below minimum acceptable standards of performance for the

19  community. This includes, but is not limited to, the use of

20  substandard materials or equipment, the imposition of time

21  limitations within which dental procedures are to be

22  performed, or the failure to maintain patient records as

23  required by this chapter.

24         (gg)  Administering anesthesia in a manner which

25  violates rules of the board adopted pursuant to s. 466.017.

26         (hh)  Failing to report to the department any licensee

27  under chapter 458 or chapter 459 who the dentist knows has

28  violated the grounds for disciplinary action set out in the

29  law under which that person is licensed and who provides

30  health care services in a facility licensed under chapter 395,

31


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    CS for SB 1558                                 First Engrossed



  1  or a health maintenance organization certificated under part I

  2  of chapter 641, in which the dentist also provides services.

  3         (ii)  Failing to report to the board, in writing,

  4  within 30 days if action has been taken against one's license

  5  to practice dentistry in another state, territory, or country.

  6         (jj)  Advertising specialty services in violation of

  7  this chapter.

  8         (kk)  Allowing any person other than another dentist or

  9  a professional corporation or limited liability company

10  composed of dentists to direct, control, or interfere with a

11  dentist's clinical judgment; however, this paragraph may not

12  be construed to limit a patient's right of informed consent.

13  To direct, control, or interfere with a dentist's clinical

14  judgment may not be interpreted to mean dental services

15  contractually excluded, the application of alternative

16  benefits that may be appropriate given the dentist's

17  prescribed course of treatment, or the application of

18  contractual provisions and scope of coverage determinations in

19  comparison with a dentist's prescribed treatment on behalf of

20  a covered person by an insurer, health maintenance

21  organization, or a prepaid limited health service

22  organization.

23         (ll)  Violating any provision of this chapter or

24  chapter 456, or any rules adopted pursuant thereto.

25         (2)  The board may enter an order denying licensure or

26  imposing any of the penalties in s. 456.072(2) against any

27  applicant for licensure or licensee who is found guilty of

28  violating any provision of subsection (1) of this section or

29  who is found guilty of violating any provision of s.

30  456.072(1). When the board finds any applicant or licensee

31  guilty of any of the grounds set forth in subsection (1), it


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    CS for SB 1558                                 First Engrossed



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

  2  penalties:

  3         (a)  Denial of an application for licensure.

  4         (b)  Revocation or suspension of a license.

  5         (c)  Imposition of an administrative fine not to exceed

  6  $3,000 for each count or separate offense.

  7         (d)  Issuance of a reprimand.

  8         (e)  Placement of the licensee on probation for a

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

10  specify, including requiring the licensee to attend continuing

11  education courses or demonstrate competency through a written

12  or practical examination or to work under the supervision of

13  another licensee.

14         (f)  Restricting the authorized scope of practice.

15         Section 30.  Section 466.037, Florida Statutes, is

16  amended to read:

17         466.037  Suspension and revocation; administrative

18  fine.--The department may suspend or revoke the certificate of

19  any dental laboratory registered under s. 466.032, for failing

20  to comply with the provisions of this chapter or rules adopted

21  by the department under this chapter.  The department may

22  impose an administrative fine not to exceed $500 for each

23  count or separate offense.

24         Section 31.  Subsections (1) and (2) of section

25  467.203, Florida Statutes, are amended to read:

26         467.203  Disciplinary actions; penalties.--

27         (1)  The following acts constitute shall be grounds for

28  denial of a license or disciplinary action, as specified in s.

29  456.072(2) disciplinary action as set forth in this section:

30

31


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  1         (a)  Procuring, attempting to procure, or renewing a

  2  license to practice midwifery by bribery, by fraudulent

  3  misrepresentation, or through an error of the department.

  4         (b)  Having a license to practice midwifery revoked,

  5  suspended, or otherwise acted against, including being denied

  6  licensure, by the licensing authority of another state,

  7  territory, or country.

  8         (c)  Being convicted or found guilty, regardless of

  9  adjudication, in any jurisdiction of a crime which directly

10  relates to the practice of midwifery or to the ability to

11  practice midwifery.  A plea of nolo contendere shall be

12  considered a conviction for purposes of this provision.

13         (d)  Making or filing a false report or record, which

14  the licensee knows to be false; intentionally or negligently

15  failing to file a report or record required by state or

16  federal law; or willfully impeding or obstructing such filing

17  or inducing another to do so.  Such reports or records shall

18  include only those which are signed in the midwife's capacity

19  as a licensed midwife.

20         (e)  Advertising falsely, misleadingly, or deceptively.

21         (f)  Engaging in unprofessional conduct, which

22  includes, but is not limited to, any departure from, or the

23  failure to conform to, the standards of practice of midwifery

24  as established by the department, in which case actual injury

25  need not be established.

26         (g)  Being unable to practice midwifery with reasonable

27  skill and safety to patients by reason of illness;

28  drunkenness; or use of drugs, narcotics, chemicals, or other

29  materials or as a result of any mental or physical condition.

30  A midwife affected under this paragraph shall, at reasonable

31  intervals, be afforded an opportunity to demonstrate that he


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  1  or she can resume the competent practice of midwifery with

  2  reasonable skill and safety.

  3         (h)  Failing to report to the department any person who

  4  the licensee knows is in violation of this chapter or of the

  5  rules of the department.

  6         (i)  Willfully or repeatedly Violating any provision of

  7  this chapter, any rule of the department, or any lawful order

  8  of the department previously entered in a disciplinary

  9  proceeding or failing to comply with a lawfully issued

10  subpoena of the department.

11         (j)  Violating any provision of this chapter or chapter

12  456, or any rules adopted pursuant thereto.

13         (2)  The department may enter an order denying

14  licensure or imposing any of the penalties in s. 456.072(2)

15  against any applicant for licensure or licensee who is found

16  guilty of violating any provision of subsection (1) of this

17  section or who is found guilty of violating any provision of

18  s. 456.072(1). When the department finds any person guilty of

19  any of the grounds set forth in subsection (1), it may enter

20  an order imposing one or more of the following penalties:

21         (a)  Refusal to approve an application for licensure.

22         (b)  Revocation or suspension of a license.

23         (c)  Imposition of an administrative fine not to exceed

24  $1,000 for each count or separate offense.

25         (d)  Issuance of a reprimand.

26         (e)  Placement of the midwife on probation for such

27  period of time and subject to such conditions as the

28  department may specify, including requiring the midwife to

29  submit to treatment; undertake further relevant education or

30  training; take an examination; or work under the supervision

31


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  1  of another licensed midwife, a physician, or a nurse midwife

  2  licensed under part I of chapter 464.

  3         Section 32.  Subsections (1) and (2) of section

  4  468.1295, Florida Statutes, are amended to read:

  5         468.1295  Disciplinary proceedings.--

  6         (1)  The following acts constitute grounds for denial

  7  of a license or disciplinary action, as specified in s.

  8  456.072(2) both disciplinary actions as set forth in

  9  subsection (2) and cease and desist or other related actions

10  by the department as set forth in s. 456.065:

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

12  bribery, by fraudulent misrepresentation, or through an error

13  of the department or the board.

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

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

16  authority of another state, territory, or country.

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

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

19  crime in any jurisdiction which directly relates to the

20  practice of speech-language pathology or audiology.

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

22  licensee knows to be false, intentionally or negligently

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

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

25  inducing another person to impede or obstruct such filing.

26  Such report or record shall include only those reports or

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

28  speech-language pathologist or audiologist.

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

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

31  content.


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

  2  negligence, incompetency, or misconduct in the practice of

  3  speech-language pathology or audiology.

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

  5  department previously entered in a disciplinary hearing, or

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

  7  or department.

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

  9  delinquent license.

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

11  advertising matter, promotional literature, testimonial,

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

13  representation, however disseminated or published, which is

14  misleading, deceiving, or untruthful.

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

16  delivery of a product unusable or impractical for the purpose

17  represented or implied by such action.

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

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

20  of testing and calibration of such equipment as designated by

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

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

23  advising any licensee or business entity to practice

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

25  chapter 456, or any rule adopted pursuant thereto.

26         (m)  Violating any provision of this part or chapter

27  456 or any rule adopted pursuant thereto.

28         (m)(n)  Misrepresenting the professional services

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

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

31


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  1  connote the availability of professional services when such

  2  use is not accurate.

  3         (n)(o)  Representing, advertising, or implying that a

  4  hearing aid or its repair is guaranteed without providing full

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

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

  7  conditions or limitations imposed upon the guarantee.

  8         (o)(p)  Representing, directly or by implication, that

  9  a hearing aid utilizing bone conduction has certain specified

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

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

12  and conspicuously that the instrument operates on the bone

13  conduction principle and that in many cases of hearing loss

14  this type of instrument may not be suitable.

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

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

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

18  similar or opposite effect.

19         (q)(r)  Making any statement regarding the cure of the

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

21         (r)(s)  Representing or implying that a hearing aid is

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

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

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

25         (s)(t)  Canvassing from house to house or by telephone,

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

27  hearing aid, except that contacting persons who have evidenced

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

29  of hearing aids, shall not be considered canvassing.

30

31


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  1         (t)(u)  Failing to notify the department in writing of

  2  a change in current mailing and place-of-practice address

  3  within 30 days after such change.

  4         (u)(v)  Failing to provide all information as described

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

  6         (v)(w)  Exercising influence on a client in such a

  7  manner as to exploit the client for financial gain of the

  8  licensee or of a third party.

  9         (w)(x)  Practicing or offering to practice beyond the

10  scope permitted by law or accepting and performing

11  professional responsibilities the licensee or

12  certificateholder knows, or has reason to know, the licensee

13  or certificateholder is not competent to perform.

14         (x)(y)  Aiding, assisting, procuring, or employing any

15  unlicensed person to practice speech-language pathology or

16  audiology.

17         (y)(z)  Delegating or contracting for the performance

18  of professional responsibilities by a person when the licensee

19  delegating or contracting for performance of such

20  responsibilities knows, or has reason to know, such person is

21  not qualified by training, experience, and authorization to

22  perform them.

23         (z)(aa)  Committing any act upon a patient or client

24  which would constitute sexual battery or which would

25  constitute sexual misconduct as defined pursuant to s.

26  468.1296.

27         (aa)(bb)  Being unable to practice the profession for

28  which he or she is licensed or certified under this chapter

29  with reasonable skill or competence as a result of any mental

30  or physical condition or by reason of illness, drunkenness, or

31  use of drugs, narcotics, chemicals, or any other substance. In


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    CS for SB 1558                                 First Engrossed



  1  enforcing this paragraph, upon a finding by the secretary, his

  2  or her designee, or the board that probable cause exists to

  3  believe that the licensee or certificateholder is unable to

  4  practice the profession because of the reasons stated in this

  5  paragraph, the department shall have the authority to compel a

  6  licensee or certificateholder to submit to a mental or

  7  physical examination by a physician, psychologist, clinical

  8  social worker, marriage and family therapist, or mental health

  9  counselor designated by the department or board.  If the

10  licensee or certificateholder refuses to comply with the

11  department's order directing the examination, such order may

12  be enforced by filing a petition for enforcement in the

13  circuit court in the circuit in which the licensee or

14  certificateholder resides or does business.  The department

15  shall be entitled to the summary procedure provided in s.

16  51.011.  A licensee or certificateholder affected under this

17  paragraph shall at reasonable intervals be afforded an

18  opportunity to demonstrate that he or she can resume the

19  competent practice for which he or she is licensed or

20  certified with reasonable skill and safety to patients.

21         (bb)  Violating any provision of this chapter or

22  chapter 456, or any rules adopted pursuant thereto.

23         (2)  The board may enter an order denying licensure or

24  imposing any of the penalties in s. 456.072(2) against any

25  applicant for licensure or licensee who is found guilty of

26  violating any provision of subsection (1) of this section or

27  who is found guilty of violating any provision of s.

28  456.072(1). When the board finds any person guilty of any of

29  the acts set forth in subsection (1), it may issue an order

30  imposing one or more of the following penalties:

31


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    CS for SB 1558                                 First Engrossed



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

  2  restrictions, an application for licensure.

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

  4         (c)  Issuance of a reprimand.

  5         (d)  Restriction of the authorized scope of practice.

  6         (e)  Imposition of an administrative fine not to exceed

  7  $1,000 for each count or separate offense.

  8         (f)  Placement of the licensee or certificateholder on

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

10  as the board may specify.  Those conditions may include, but

11  are not limited to, requiring the licensee or

12  certificateholder to undergo treatment, attend continuing

13  education courses, submit to be reexamined, work under the

14  supervision of another licensee, or satisfy any terms which

15  are reasonably tailored to the violation found.

16         (g)  Corrective action.

17         Section 33.  Subsections (1) and (2) of section

18  468.1755, Florida Statutes, are amended to read:

19         468.1755  Disciplinary proceedings.--

20         (1)  The following acts shall constitute grounds for

21  denial of a license or disciplinary action, as specified in s.

22  456.072(2) which the disciplinary actions in subsection (2)

23  may be taken:

24         (a)  Violation of any provision of s. 456.072(1) or s.

25  468.1745(1).

26         (b)  Attempting to procure a license to practice

27  nursing home administration by bribery, by fraudulent

28  misrepresentation, or through an error of the department or

29  the board.

30         (c)  Having a license to practice nursing home

31  administration revoked, suspended, or otherwise acted against,


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    CS for SB 1558                                 First Engrossed



  1  including the denial of licensure, by the licensing authority

  2  of another state, territory, or country.

  3         (d)  Being convicted or found guilty, regardless of

  4  adjudication, of a crime in any jurisdiction which relates to

  5  the practice of nursing home administration or the ability to

  6  practice nursing home administration.  Any plea of nolo

  7  contendere shall be considered a conviction for purposes of

  8  this part.

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

10  licensee knows to be false, intentionally failing to file a

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

12  impeding or obstructing such filing, or inducing another

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

14  records shall include only those which are signed in the

15  capacity of a licensed nursing home administrator.

16         (f)  Authorizing the discharge or transfer of a

17  resident for a reason other than those provided in ss. 400.022

18  and 400.0255.

19         (g)  Advertising goods or services in a manner which is

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

21  content.

22         (h)  Fraud or deceit, negligence, incompetence, or

23  misconduct in the practice of nursing home administration.

24         (i)  A violation or repeated violations of this part,

25  chapter 456, or any rules promulgated pursuant thereto.

26         (i)(j)  Violation of a lawful order of the board or

27  department previously entered in a disciplinary hearing or

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

29  or department.

30         (j)(k)  Practicing with a revoked, suspended, inactive,

31  or delinquent license.


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    CS for SB 1558                                 First Engrossed



  1         (k)(l)  Repeatedly acting in a manner inconsistent with

  2  the health, safety, or welfare of the patients of the facility

  3  in which he or she is the administrator.

  4         (l)(m)  Being unable to practice nursing home

  5  administration with reasonable skill and safety to patients by

  6  reason of illness, drunkenness, use of drugs, narcotics,

  7  chemicals, or any other material or substance or as a result

  8  of any mental or physical condition.  In enforcing this

  9  paragraph, upon a finding of the secretary or his or her

10  designee that probable cause exists to believe that the

11  licensee is unable to serve as a nursing home administrator

12  due to the reasons stated in this paragraph, the department

13  shall have the authority to issue an order to compel the

14  licensee to submit to a mental or physical examination by a

15  physician designated by the department. If the licensee

16  refuses to comply with such order, the department's order

17  directing such examination may be enforced by filing a

18  petition for enforcement in the circuit court where the

19  licensee resides or serves as a nursing home administrator.

20  The licensee against whom the petition is filed shall not be

21  named or identified by initials in any public court records or

22  documents, and the proceedings shall be closed to the public.

23  The department shall be entitled to the summary procedure

24  provided in s. 51.011.  A licensee affected under this

25  paragraph shall have the opportunity, at reasonable intervals,

26  to demonstrate that he or she can resume the competent

27  practice of nursing home administration with reasonable skill

28  and safety to patients.

29         (m)(n)  Willfully or repeatedly violating any of the

30  provisions of the law, code, or rules of the licensing or

31  supervising authority or agency of the state or political


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    CS for SB 1558                                 First Engrossed



  1  subdivision thereof having jurisdiction of the operation and

  2  licensing of nursing homes.

  3         (n)(o)  Paying, giving, causing to be paid or given, or

  4  offering to pay or to give to any person a commission or other

  5  valuable consideration for the solicitation or procurement,

  6  either directly or indirectly, of nursing home usage.

  7         (o)(p)  Willfully permitting unauthorized disclosure of

  8  information relating to a patient or his or her records.

  9         (p)(q)  Discriminating with respect to patients,

10  employees, or staff on account of race, religion, color, sex,

11  or national origin.

12         (q)  Violating any provision of this chapter or chapter

13  456, or any rules adopted pursuant thereto.

14         (2)  The board may enter an order denying licensure or

15  imposing any of the penalties in s. 456.072(2) against any

16  applicant for licensure or licensee who is found guilty of

17  violating any provision of subsection (1) of this section or

18  who is found guilty of violating any provision of s.

19  456.072(1). When the board finds any nursing home

20  administrator guilty of any of the grounds set forth in

21  subsection (1), it may enter an order imposing one or more of

22  the following penalties:

23         (a)  Denial of an application for licensure.

24         (b)  Revocation or suspension of a license.

25         (c)  Imposition of an administrative fine not to exceed

26  $1,000 for each count or separate offense.

27         (d)  Issuance of a reprimand.

28         (e)  Placement of the licensee on probation for a

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

30  specify, including requiring the licensee to attend continuing

31


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    CS for SB 1558                                 First Engrossed



  1  education courses or to work under the supervision of another

  2  licensee.

  3         (f)  Restriction of the authorized scope of practice.

  4         Section 34.  Section 468.217, Florida Statutes, is

  5  amended to read:

  6         468.217  Denial of or refusal to renew license;

  7  suspension and revocation of license and other disciplinary

  8  measures.--

  9         (1)  The following acts constitute grounds for denial

10  of a license or disciplinary action, as specified in s.

11  456.072(2) The board may deny or refuse to renew a license,

12  suspend or revoke a license, issue a reprimand, impose a fine,

13  or impose probationary conditions upon a licensee, when the

14  licensee or applicant for license has been guilty of

15  unprofessional conduct which has endangered, or is likely to

16  endanger, the health, welfare, or safety of the public.  Such

17  unprofessional conduct includes:

18         (a)  Attempting to obtain, obtaining, or renewing a

19  license to practice occupational therapy by bribery, by

20  fraudulent misrepresentation, or through an error of the

21  department or the board.

22         (b)  Having a license to practice occupational therapy

23  revoked, suspended, or otherwise acted against, including the

24  denial of licensure, by the licensing authority of another

25  state, territory, or country.

26         (c)  Being convicted or found guilty, regardless of

27  adjudication, of a crime in any jurisdiction which directly

28  relates to the practice of occupational therapy or to the

29  ability to practice occupational therapy.  A plea of nolo

30  contendere shall be considered a conviction for the purposes

31  of this part.


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    CS for SB 1558                                 First Engrossed



  1         (d)  False, deceptive, or misleading advertising.

  2         (e)  Advertising, practicing, or attempting to practice

  3  under a name other than one's own name.

  4         (f)  Failing to report to the department any person who

  5  the licensee knows is in violation of this part or of the

  6  rules of the department or of the board.

  7         (g)  Aiding, assisting, procuring, or advising any

  8  unlicensed person to practice occupational therapy contrary to

  9  this part or to a rule of the department or the board.

10         (h)  Failing to perform any statutory or legal

11  obligation placed upon a licensed occupational therapist or

12  occupational therapy assistant.

13         (i)  Making or filing a report which the licensee knows

14  to be 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 person

17  to do so.  Such reports or records include only those which

18  are signed in the capacity as a licensed occupational

19  therapist or occupational therapy assistant.

20         (j)  Paying or receiving any commission, bonus,

21  kickback, or rebate to or from, or engaging in any split-fee

22  arrangement in any form whatsoever with, a physician,

23  organization, agency, or person, either directly or

24  indirectly, for patients referred to providers of health care

25  goods and services, including, but not limited to, hospitals,

26  nursing homes, clinical laboratories, ambulatory surgical

27  centers, or pharmacies.  The provisions of this paragraph

28  shall not be construed to prevent an occupational therapist or

29  occupational therapy assistant from receiving a fee for

30  professional consultation services.

31


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  1         (k)  Exercising influence within a patient-therapist

  2  relationship for purposes of engaging a patient in sexual

  3  activity. A patient is presumed to be incapable of giving

  4  free, full, and informed consent to sexual activity with the

  5  patient's occupational therapist or occupational therapy

  6  assistant.

  7         (l)  Making deceptive, untrue, or fraudulent

  8  representations in the practice of occupational therapy or

  9  employing a trick or scheme in the practice of occupational

10  therapy if such scheme or trick fails to conform to the

11  generally prevailing standards of treatment in the

12  occupational therapy community.

13         (m)  Soliciting patients, either personally or through

14  an agent, through the use of fraud, intimidation, undue

15  influence, or a form of overreaching or vexatious conduct.  A

16  "solicitation" is any communication which directly or

17  implicitly requests an immediate oral response from the

18  recipient.

19         (n)  Failing to keep written records justifying the

20  course of treatment of the patient, including, but not limited

21  to, patient histories, examination results, and test results.

22         (o)  Exercising influence on the patient or client in

23  such a manner as to exploit the patient or client for

24  financial gain of the licensee or of a third party which

25  includes, but is not limited to, the promoting or selling of

26  services, goods, appliances, or drugs.

27         (p)  Performing professional services which have not

28  been duly authorized by the patient or client, or his or her

29  legal representative, except as provided in s. 768.13.

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

31  practice occupational therapy with that level of care, skill,


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    CS for SB 1558                                 First Engrossed



  1  and treatment which is recognized by a reasonably prudent

  2  similar occupational therapist or occupational therapy

  3  assistant as being acceptable under similar conditions and

  4  circumstances.

  5         (r)  Performing any procedure which, by the prevailing

  6  standards of occupational therapy practice in the community,

  7  would constitute experimentation on a human subject without

  8  first obtaining full, informed, and written consent.

  9         (s)  Practicing or offering to practice beyond the

10  scope permitted by law or accepting and performing

11  professional responsibilities which the licensee knows or has

12  reason to know that he or she is not competent to perform.

13         (t)  Being unable to practice occupational therapy with

14  reasonable skill and safety to patients by reason of illness

15  or use of alcohol, drugs, narcotics, chemicals, or any other

16  type of material or as a result of any mental or physical

17  condition.  In enforcing this paragraph, the department shall

18  have, upon probable cause, authority to compel an occupational

19  therapist or occupational therapy assistant to submit to a

20  mental or physical examination by physicians designated by the

21  department.  The failure of an occupational therapist or

22  occupational therapy assistant to submit to such examination

23  when so directed constitutes an admission of the allegations

24  against him or her, upon which a default and final order may

25  be entered without the taking of testimony or presentation of

26  evidence, unless the failure was due to circumstances beyond

27  his or her control.  An occupational therapist or occupational

28  therapy assistant affected under this paragraph shall at

29  reasonable intervals be afforded an opportunity to demonstrate

30  that he or she can resume the competent practice of

31  occupational therapy with reasonable skill and safety to


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    CS for SB 1558                                 First Engrossed



  1  patients. In any proceeding under this paragraph, neither the

  2  record of proceedings nor the orders entered by the board

  3  shall be used against an occupational therapist or

  4  occupational therapy assistant in any other proceeding.

  5         (u)  Delegating professional responsibilities to a

  6  person when the licensee who is delegating such

  7  responsibilities knows or has reason to know that such person

  8  is not qualified by training, experience, or licensure to

  9  perform them.

10         (v)  Violating any provision of this part, a rule of

11  the board or department, or a lawful order of the board or

12  department previously entered in a disciplinary hearing or

13  failing to comply with a lawfully issued subpoena of the

14  department.

15         (w)  Conspiring with another licensee or with any other

16  person to commit an act, or committing an act, which would

17  tend to coerce, intimidate, or preclude another licensee from

18  lawfully advertising his or her services.

19         (x)  Violating any provision of this chapter or chapter

20  456, or any rules adopted pursuant thereto.

21         (2)  The board may enter an order denying licensure or

22  imposing any of the penalties in s. 456.072(2) against any

23  applicant for licensure or licensee who is found guilty of

24  violating any provision of subsection (1) of this section or

25  who is found guilty of violating any provision of s.

26  456.072(1).

27         (3)(2)  The board may not reinstate the license of an

28  occupational therapist or occupational therapy assistant, or

29  cause a license to be issued to a person it has deemed

30  unqualified, until such time as the board is satisfied that

31  such person has complied with all the terms and conditions set


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  1  forth in the final order and is capable of safely engaging in

  2  the practice of occupational therapy.

  3         Section 35.  Subsections (1) and (2) of section

  4  468.365, Florida Statutes, are amended to read:

  5         468.365  Disciplinary grounds and actions.--

  6         (1)  The following acts constitute grounds for denial

  7  of a license or disciplinary action, as specified in s.

  8  456.072(2) which the disciplinary actions in subsection (2)

  9  may be taken:

10         (a)  Procuring, attempting to procure, or renewing a

11  license as provided by this part by bribery, by fraudulent

12  misrepresentation, or through an error of the department or

13  the board.

14         (b)  Having licensure, certification, registration, or

15  other authority, by whatever name known, to deliver

16  respiratory care services revoked, suspended, or otherwise

17  acted against, including the denial of licensure,

18  certification, registration, or other authority to deliver

19  respiratory care services by the licensing authority of

20  another state, territory, or country.

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

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

23  crime in any jurisdiction which directly relates to

24  respiratory care services or to the ability to deliver such

25  services.

26         (d)  Willfully making or filing a false report or

27  record, willfully failing to file a report or record required

28  by state or federal law, or willfully impeding or obstructing

29  such filing or inducing another person to do so.  Such reports

30  or records include only those reports or records which require

31


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  1  the signature of a respiratory care practitioner or

  2  respiratory therapist licensed pursuant to this part.

  3         (e)  Circulating false, misleading, or deceptive

  4  advertising.

  5         (f)  Unprofessional conduct, which includes, but is not

  6  limited to, any departure from, or failure to conform to,

  7  acceptable standards related to the delivery of respiratory

  8  care services, as set forth by the board in rules adopted

  9  pursuant to this part.

10         (g)  Engaging or attempting to engage in the

11  possession, sale, or distribution of controlled substances, as

12  set forth by law, for any purpose other than a legitimate

13  purpose.

14         (h)  Willfully failing to report any violation of this

15  part.

16         (i)  Willfully or repeatedly Violating a rule of the

17  board or the department or a lawful order of the board or

18  department previously entered in a disciplinary hearing.

19         (j)  Violation of any rule adopted pursuant to this

20  part or chapter 456.

21         (j)(k)  Engaging in the delivery of respiratory care

22  services with a revoked, suspended, or inactive license.

23         (k)(l)  Permitting, aiding, assisting, procuring, or

24  advising any person who is not licensed pursuant to this part,

25  contrary to this part or to any rule of the department or the

26  board.

27         (l)(m)  Failing to perform any statutory or legal

28  obligation placed upon a respiratory care practitioner or

29  respiratory therapist licensed pursuant to this part.

30

31


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  1         (m)(n)  Accepting and performing professional

  2  responsibilities which the licensee knows, or has reason to

  3  know, she or he is not competent to perform.

  4         (n)(o)  Delegating professional responsibilities to a

  5  person when the licensee delegating such responsibilities

  6  knows, or has reason to know, that such person is not

  7  qualified by training, experience, or licensure to perform

  8  them.

  9         (o)(p)  Gross or repeated malpractice or the failure to

10  deliver respiratory care services with that level of care,

11  skill, and treatment which is recognized by a reasonably

12  prudent respiratory care practitioner or respiratory therapist

13  with similar professional training as being acceptable under

14  similar conditions and circumstances.

15         (p)(q)  Paying or receiving any commission, bonus,

16  kickback, or rebate to or from, or engaging in any split-fee

17  arrangement in any form whatsoever with, a person,

18  organization, or agency, either directly or indirectly, for

19  goods or services rendered to patients referred by or to

20  providers of health care goods and services, including, but

21  not limited to, hospitals, nursing homes, clinical

22  laboratories, ambulatory surgical centers, or pharmacies.  The

23  provisions of this paragraph shall not be construed to prevent

24  the licensee from receiving a fee for professional

25  consultation services.

26         (q)(r)  Exercising influence within a respiratory care

27  relationship for the purpose of engaging a patient in sexual

28  activity.  A patient is presumed to be incapable of giving

29  free, full, and informed consent to sexual activity with the

30  patient's respiratory care practitioner or respiratory

31  therapist.


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  1         (r)(s)  Making deceptive, untrue, or fraudulent

  2  representations in the delivery of respiratory care services

  3  or employing a trick or scheme in the delivery of respiratory

  4  care services if such a scheme or trick fails to conform to

  5  the generally prevailing standards of other licensees within

  6  the community.

  7         (s)(t)  Soliciting patients, either personally or

  8  through an agent, through the use of fraud, deception, or

  9  otherwise misleading statements or through the exercise of

10  intimidation or undue influence.

11         (t)(u)  Failing to keep written respiratory care

12  records justifying the reason for the action taken by the

13  licensee.

14         (u)(v)  Exercising influence on the patient in such a

15  manner as to exploit the patient for the financial gain of the

16  licensee or a third party, which includes, but is not limited

17  to, the promoting or selling of services, goods, appliances,

18  or drugs.

19         (v)(w)  Performing professional services which have not

20  been duly ordered by a physician licensed pursuant to chapter

21  458 or chapter 459 and which are not in accordance with

22  protocols established by the hospital, other health care

23  provider, or the board, except as provided in ss. 743.064,

24  766.103, and 768.13.

25         (w)(x)  Being unable to deliver respiratory care

26  services with reasonable skill and safety to patients by

27  reason of illness or use of alcohol, drugs, narcotics,

28  chemicals, or any other type of material as a result of any

29  mental or physical condition.  In enforcing this paragraph,

30  the department shall, upon probable cause, have authority to

31  compel a respiratory care practitioner or respiratory


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  1  therapist to submit to a mental or physical examination by

  2  physicians designated by the department.  The cost of

  3  examination shall be borne by the licensee being examined.

  4  The failure of a respiratory care practitioner or respiratory

  5  therapist to submit to such an examination when so directed

  6  constitutes an admission of the allegations against her or

  7  him, upon which a default and a final order may be entered

  8  without the taking of testimony or presentation of evidence,

  9  unless the failure was due to circumstances beyond her or his

10  control.  A respiratory care practitioner or respiratory

11  therapist affected under this paragraph shall at reasonable

12  intervals be afforded an opportunity to demonstrate that she

13  or he can resume the competent delivery of respiratory care

14  services with reasonable skill and safety to her or his

15  patients.  In any proceeding under this paragraph, neither the

16  record of proceedings nor the orders entered by the board

17  shall be used against a respiratory care practitioner or

18  respiratory therapist in any other proceeding.

19         (x)  Violating any provision of this chapter or chapter

20  456, or any rules adopted pursuant thereto.

21         (2)  The board may enter an order denying licensure or

22  imposing any of the penalties in s. 456.072(2) against any

23  applicant for licensure or licensee who is found guilty of

24  violating any provision of subsection (1) of this section or

25  who is found guilty of violating any provision of s.

26  456.072(1). If the board finds any person guilty of any of the

27  grounds set forth in subsection (1), it may enter an order

28  imposing one or more of the following penalties:

29         (a)  Denial of an application for licensure.

30         (b)  Revocation or suspension of licensure.

31


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  1         (c)  Imposition of an administrative fine not to exceed

  2  $1,000 for each count or separate offense.

  3         (d)  Placement of the respiratory care practitioner or

  4  respiratory therapist on probation for such period of time and

  5  subject to such conditions as the board may specify,

  6  including, but not limited to, requiring the respiratory care

  7  practitioner or respiratory therapist to submit to treatment,

  8  to attend continuing education courses, or to work under the

  9  supervision of another respiratory care practitioner or

10  respiratory therapist.

11         (e)  Issuance of a reprimand.

12         Section 36.  Subsections (1) and (2) of section

13  468.518, Florida Statutes, are amended to read:

14         468.518  Grounds for disciplinary action.--

15         (1)  The following acts constitute grounds for denial

16  of a license or disciplinary action, as specified in s.

17  456.072(2) which the disciplinary actions in subsection (2)

18  may be taken:

19         (a)  Violating any provision of this part, any board or

20  agency rule adopted pursuant thereto, or any lawful order of

21  the board or agency previously entered in a disciplinary

22  hearing held pursuant to this part, or failing to comply with

23  a lawfully issued subpoena of the agency.  The provisions of

24  this paragraph also apply to any order or subpoena previously

25  issued by the Department of Health during its period of

26  regulatory control over this part.

27         (b)  Being unable to engage in dietetics and nutrition

28  practice or nutrition counseling with reasonable skill and

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

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

31  as a result of any mental or physical condition.


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  1         1.  A licensee whose license is suspended or revoked

  2  pursuant to this paragraph shall, at reasonable intervals, be

  3  given an opportunity to demonstrate that he or she can resume

  4  the competent practice of dietetics and nutrition or nutrition

  5  counseling with reasonable skill and safety to patients.

  6         2.  Neither the record of the proceeding nor the orders

  7  entered by the board in any proceeding under this paragraph

  8  may be used against a licensee in any other proceeding.

  9         (c)  Attempting to procure or procuring a license to

10  practice dietetics and nutrition or nutrition counseling by

11  fraud or material misrepresentation of material fact.

12         (d)  Having a license to practice dietetics and

13  nutrition or nutrition counseling revoked, suspended, or

14  otherwise acted against, including the denial of licensure by

15  the licensing authority of another state, district, territory,

16  or country.

17         (e)  Being convicted or found guilty of, or entering a

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

19  crime in any jurisdiction which directly relates to the

20  practice of dietetics and nutrition or nutrition counseling or

21  the ability to practice dietetics and nutrition or nutrition

22  counseling.

23         (f)  Making or filing a report or record that the

24  licensee knows to be false, willfully failing to file a report

25  or record required by state or federal law, willfully impeding

26  or obstructing such filing, or inducing another person to

27  impede or obstruct such filing. Such reports or records

28  include only those that are signed in the capacity of a

29  licensed dietitian/nutritionist or licensed nutrition

30  counselor.

31


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  1         (g)  Advertising goods or services in a manner that is

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

  3  content.

  4         (h)  Committing an act of fraud or deceit, or of

  5  negligence, incompetency, or misconduct in the practice of

  6  dietetics and nutrition or nutrition counseling.

  7         (i)  Practicing with a revoked, suspended, inactive, or

  8  delinquent license.

  9         (j)  Treating or undertaking to treat human ailments by

10  means other than by dietetics and nutrition practice or

11  nutrition counseling.

12         (k)  Failing to maintain acceptable standards of

13  practice as set forth by the board and the council in rules

14  adopted pursuant to this part.

15         (l)  Engaging directly or indirectly in the dividing,

16  transferring, assigning, rebating, or refunding of fees

17  received for professional services, or profiting by means of a

18  credit or other valuable consideration, such as an unearned

19  commission, discount, or gratuity, with any person referring a

20  patient or with any relative or business associate of the

21  referring person. Nothing in this part prohibits the members

22  of any regularly and properly organized business entity that

23  is composed of licensees under this part and recognized under

24  the laws of this state from making any division of their total

25  fees among themselves as they determine necessary.

26         (m)  Advertising, by or on behalf of a licensee under

27  this part, any method of assessment or treatment which is

28  experimental or without generally accepted scientific

29  validation.

30         (n)  Violating any provision of this chapter or chapter

31  456, or any rules adopted pursuant thereto.


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  1         (2)  The board may enter an order denying licensure or

  2  imposing any of the penalties in s. 456.072(2) against any

  3  applicant for licensure or licensee who is found guilty of

  4  violating any provision of subsection (1) of this section or

  5  who is found guilty of violating any provision of s.

  6  456.072(1). When the board finds any licensee guilty of any of

  7  the grounds set forth in subsection (1), it may enter an order

  8  imposing one or more of the following penalties:

  9         (a)  Denial of an application for licensure;

10         (b)  Revocation or suspension of a license;

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

12  $1,000 for each violation;

13         (d)  Issuance of a reprimand or letter of guidance;

14         (e)  Placement of the licensee on probation for a

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

16  specify, including requiring the licensee to attend continuing

17  education courses or to work under the supervision of a

18  licensed dietitian/nutritionist or licensed nutrition

19  counselor; or

20         (f)  Restriction of the authorized scope of practice of

21  the licensee.

22         Section 37.  Section 468.719, Florida Statutes, is

23  amended to read:

24         468.719  Disciplinary actions.--

25         (1)  The following acts constitute shall be grounds for

26  denial of a license or disciplinary action, as specified in s.

27  456.072(2) disciplinary actions provided for in subsection

28  (2):

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

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

31


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    CS for SB 1558                                 First Engrossed



  1  violation of this part, s. 456.072, or any rule adopted

  2  pursuant thereto.

  3         (a)(b)  Failing to include the athletic trainer's name

  4  and license number in any advertising, including, but not

  5  limited to, business cards and letterhead, related to the

  6  practice of athletic training.  Advertising shall not include

  7  clothing or other novelty items.

  8         (b)(c)  Committing incompetency or misconduct in the

  9  practice of athletic training.

10         (c)(d)  Committing fraud or deceit in the practice of

11  athletic training.

12         (d)(e)  Committing negligence, gross negligence, or

13  repeated negligence in the practice of athletic training.

14         (e)(f)  While practicing athletic training, being

15  unable to practice athletic training with reasonable skill and

16  safety to athletes by reason of illness or use of alcohol or

17  drugs or as a result of any mental or physical condition.

18         (f)  Violating any provision of this chapter or chapter

19  456, or any rules adopted pursuant thereto.

20         (2)  The board may enter an order denying licensure or

21  imposing any of the penalties in s. 456.072(2) against any

22  applicant for licensure or licensee who is found guilty of

23  violating any provision of subsection (1) of this section or

24  who is found guilty of violating any provision of s.

25  456.072(1). When the board finds any person guilty of any of

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

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

28  456.072.

29         Section 38.  Section 468.811, Florida Statutes, is

30  amended to read:

31         468.811  Disciplinary proceedings.--


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  1         (1)  The following acts constitute are grounds for

  2  denial of a license or disciplinary action, as specified in s.

  3  456.072(2): disciplinary action against a licensee and the

  4  issuance of cease and desist orders or other related action by

  5  the department, pursuant to s. 456.072, against any person who

  6  engages in or aids in a violation.

  7         (a)  Attempting to procure a license by fraudulent

  8  misrepresentation.

  9         (b)  Having a license to practice orthotics,

10  prosthetics, or pedorthics revoked, suspended, or otherwise

11  acted against, including the denial of licensure in another

12  jurisdiction.

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

14  nolo contendere to, regardless of adjudication, in any

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

16  orthotics, prosthetics, or pedorthics, including violations of

17  federal laws or regulations regarding orthotics, prosthetics,

18  or pedorthics.

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

20  is false, intentionally or negligently failing to file a

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

22  impeding or obstructing such filing, or inducing another

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

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

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

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

27  false, deceptive, or misleading manner.

28         (f)  Violation of this act or chapter 456, or any rules

29  adopted thereunder.

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

31  department previously entered in a disciplinary hearing or


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

  2  or department.

  3         (g)(h)  Practicing with a revoked, suspended, or

  4  inactive license.

  5         (h)(i)  Gross or repeated malpractice or the failure to

  6  deliver orthotic, prosthetic, or pedorthic services with that

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

  8  prudent licensed practitioner with similar professional

  9  training as being acceptable under similar conditions and

10  circumstances.

11         (i)(j)  Failing to provide written notice of any

12  applicable warranty for an orthosis, prosthesis, or pedorthic

13  device that is provided to a patient.

14         (j)  Violating any provision of this chapter or chapter

15  456, or any rules adopted pursuant thereto.

16         (2)  The board may enter an order denying licensure or

17  imposing any of the penalties in s. 456.072(2) against any

18  applicant for licensure or licensee who is found guilty of

19  violating any provision of subsection (1) of this section or

20  who is found guilty of violating any provision of s.

21  456.072(1). The board may enter an order imposing one or more

22  of the penalties in s. 456.072(2) against any person who

23  violates any provision of subsection (1).

24         Section 39.  Subsections (1) and (2) of section 478.52,

25  Florida Statutes, are amended to read:

26         478.52  Disciplinary proceedings.--

27         (1)  The following acts constitute are grounds for

28  denial of a license or disciplinary action, as specified in s.

29  456.072(2) which the disciplinary actions in subsection (2)

30  may be taken:

31


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  1         (a)  Obtaining or attempting to obtain a license by

  2  bribery, fraud, or knowing misrepresentation.

  3         (b)  Having a license or other authority to deliver

  4  electrolysis services revoked, suspended, or otherwise acted

  5  against, including denial of licensure, in another

  6  jurisdiction.

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

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

  9  crime, in any jurisdiction, which directly relates to the

10  practice of electrology.

11         (d)  Willfully making or filing a false report or

12  record, willfully failing to file a report or record required

13  for electrologists, or willfully impeding or obstructing the

14  filing of a report or record required by this act or inducing

15  another person to do so.

16         (e)  Circulating false, misleading, or deceptive

17  advertising.

18         (f)  Unprofessional conduct, including any departure

19  from, or failure to conform to, acceptable standards related

20  to the delivery of electrolysis services.

21         (g)  Engaging or attempting to engage in the illegal

22  possession, sale, or distribution of any illegal or controlled

23  substance.

24         (h)  Willfully failing to report any known violation of

25  this chapter.

26         (i)  Willfully or repeatedly violating a rule adopted

27  under this chapter, or an order of the board or department

28  previously entered in a disciplinary hearing.

29         (j)  Engaging in the delivery of electrolysis services

30  without an active license.

31


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  1         (k)  Employing an unlicensed person to practice

  2  electrology.

  3         (l)  Failing to perform any statutory or legal

  4  obligation placed upon an electrologist.

  5         (m)  Accepting and performing professional

  6  responsibilities which the licensee knows, or has reason to

  7  know, she or he is not competent to perform.

  8         (n)  Delegating professional responsibilities to a

  9  person the licensee knows, or has reason to know, is

10  unqualified by training, experience, or licensure to perform.

11         (o)  Gross or repeated malpractice or the inability to

12  practice electrology with reasonable skill and safety.

13         (p)  Judicially determined mental incompetency.

14         (q)  Practicing or attempting to practice electrology

15  under a name other than her or his own.

16         (r)  Being unable to practice electrology with

17  reasonable skill and safety because of a mental or physical

18  condition or illness, or the use of alcohol, controlled

19  substances, or any other substance which impairs one's ability

20  to practice.

21         1.  The department may, upon probable cause, compel a

22  licensee to submit to a mental or physical examination by

23  physicians designated by the department. The cost of an

24  examination shall be borne by the licensee, and her or his

25  failure to submit to such an examination constitutes an

26  admission of the allegations against her or him, consequent

27  upon which a default and a final order may be entered without

28  the taking of testimony or presentation of evidence, unless

29  the failure was due to circumstances beyond her or his

30  control.

31


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    CS for SB 1558                                 First Engrossed



  1         2.  A licensee who is disciplined under this paragraph

  2  shall, at reasonable intervals, be afforded an opportunity to

  3  demonstrate that she or he can resume the practice of

  4  electrology with reasonable skill and safety.

  5         3.  In any proceeding under this paragraph, the record

  6  of proceedings or the orders entered by the board may not be

  7  used against a licensee in any other proceeding.

  8         (s)  Disclosing the identity of or information about a

  9  patient without written permission, except for information

10  which does not identify a patient and which is used for

11  training purposes in an approved electrolysis training

12  program.

13         (t)  Practicing or attempting to practice any permanent

14  hair removal except as described in s. 478.42(5).

15         (u)  Operating any electrolysis facility unless it has

16  been duly licensed as provided in this chapter.

17         (v)  Violating any provision of this chapter or chapter

18  456, or any rules adopted pursuant thereto.

19         (2)  The board may enter an order denying licensure or

20  imposing any of the penalties in s. 456.072(2) against any

21  applicant for licensure or licensee who is found guilty of

22  violating any provision of subsection (1) of this section or

23  who is found guilty of violating any provision of s.

24  456.072(1). When the board finds any person guilty of any of

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

26  that would constitute a substantial violation of subsection

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

28  imposing one or more of the following penalties:

29         (a)  Deny the application for licensure.

30         (b)  Revoke or suspend the license.

31


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  1         (c)  Impose an administrative fine not to exceed $5,000

  2  for each count or separate offense.

  3         (d)  Place the licensee on probation for a specified

  4  time and subject the licensee to such conditions as the board

  5  determines necessary, including, but not limited to, requiring

  6  treatment, continuing education courses, reexamination, or

  7  working under the supervision of another licensee.

  8         (e)  Issue a reprimand to the licensee.

  9         (f)  Restriction of a licensee's practice.

10         Section 40.  Subsections (1) and (2) of section

11  480.046, Florida Statutes, are amended to read:

12         480.046  Grounds for disciplinary action by the

13  board.--

14         (1)  The following acts shall constitute grounds for

15  denial of a license or disciplinary action, as specified in s.

16  456.072(2) which disciplinary actions specified in subsection

17  (2) may be taken against a massage therapist or massage

18  establishment licensed under this act:

19         (a)  Attempting to procure a license to practice

20  massage by bribery or fraudulent misrepresentation.

21         (b)  Having a license to practice massage revoked,

22  suspended, or otherwise acted against, including the denial of

23  licensure, by the licensing authority of another state,

24  territory, or country.

25         (c)  Being convicted or found guilty, regardless of

26  adjudication, of a crime in any jurisdiction which directly

27  relates to the practice of massage or to the ability to

28  practice massage. Any plea of nolo contendere shall be

29  considered a conviction for purposes of this chapter.

30         (d)  False, deceptive, or misleading advertising.

31


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  1         (e)  Aiding, assisting, procuring, or advising any

  2  unlicensed person to practice massage contrary to the

  3  provisions of this chapter or to a rule of the department or

  4  the board.

  5         (f)  Making deceptive, untrue, or fraudulent

  6  representations in the practice of massage.

  7         (g)  Being unable to practice massage with reasonable

  8  skill and safety by reason of illness or use of alcohol,

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

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

11  this paragraph, the department shall have, upon probable

12  cause, authority to compel a massage therapist to submit to a

13  mental or physical examination by physicians designated by the

14  department.  Failure of a massage therapist to submit to such

15  examination when so directed, unless the failure was due to

16  circumstances beyond her or his control, shall constitute an

17  admission of the allegations against her or him, consequent

18  upon which a default and final order may be entered without

19  the taking of testimony or presentation of evidence.  A

20  massage therapist affected under this paragraph shall at

21  reasonable intervals be afforded an opportunity to demonstrate

22  that she or he can resume the competent practice of massage

23  with reasonable skill and safety to clients.

24         (h)  Gross or repeated malpractice or the failure to

25  practice massage with that level of care, skill, and treatment

26  which is recognized by a reasonably prudent massage therapist

27  as being acceptable under similar conditions and

28  circumstances.

29         (i)  Practicing or offering to practice beyond the

30  scope permitted by law or accepting and performing

31


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  1  professional responsibilities which the licensee knows or has

  2  reason to know that she or he is not competent to perform.

  3         (j)  Delegating professional responsibilities to a

  4  person when the licensee delegating such responsibilities

  5  knows or has reason to know that such person is not qualified

  6  by training, experience, or licensure to perform.

  7         (k)  Violating any provision of this chapter, a rule of

  8  the board or department, or 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         (l)  Refusing to permit the department to inspect the

13  business premises of the licensee during regular business

14  hours.

15         (m)  Failing to keep the equipment and premises of the

16  massage establishment in a clean and sanitary condition.

17         (n)  Practicing massage at a site, location, or place

18  which is not duly licensed as a massage establishment, except

19  that a massage therapist, as provided by rules adopted by the

20  board, may provide massage services, excluding colonic

21  irrigation, at the residence of a client, at the office of the

22  client, at a sports event, at a convention, or at a trade

23  show.

24         (o)  Violating any provision of this chapter or chapter

25  456, or any rules adopted pursuant thereto.

26         (2)  The board may enter an order denying licensure or

27  imposing any of the penalties in s. 456.072(2) against any

28  applicant for licensure or licensee who is found guilty of

29  violating any provision of subsection (1) of this section or

30  who is found guilty of violating any provision of s.

31  456.072(1). When the board finds any person guilty of any of


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  1  the grounds set forth in subsection (1), it may enter an order

  2  imposing one or more of the following penalties:

  3         (a)  Refusal to license an applicant.

  4         (b)  Revocation or suspension of a license.

  5         (c)  Issuance of a reprimand or censure.

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

  7  $1,000 for each count or separate offense.

  8         Section 41.  Section 483.825, Florida Statutes, is

  9  amended to read:

10         483.825  Grounds for disciplinary action.--

11         (1)  The following acts constitute grounds for denial

12  of a license or disciplinary action, as specified in s.

13  456.072(2) which disciplinary actions specified in s. 483.827

14  may be taken against applicants, registrants, and licensees

15  under this part:

16         (a)(1)  Attempting to obtain, obtaining, or renewing a

17  license or registration under this part by bribery, by

18  fraudulent misrepresentation, or through an error of the

19  department or the board.

20         (b)(2)  Engaging in or attempting to engage in, or

21  representing herself or himself as entitled to perform, any

22  clinical laboratory procedure or category of procedures not

23  authorized pursuant to her or his license.

24         (c)(3)  Demonstrating incompetence or making consistent

25  errors in the performance of clinical laboratory examinations

26  or procedures or erroneous reporting.

27         (d)(4)  Performing a test and rendering a report

28  thereon to a person not authorized by law to receive such

29  services.

30         (e)(5)  Has been convicted or found guilty of, or

31  entered a plea of nolo contendere to, regardless of


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  1  adjudication, a crime in any jurisdiction which directly

  2  relates to the activities of clinical laboratory personnel or

  3  involves moral turpitude or fraudulent or dishonest dealing.

  4  The record of a conviction certified or authenticated in such

  5  form as to be admissible in evidence under the laws of the

  6  state shall be admissible as prima facie evidence of such

  7  guilt.

  8         (f)(6)  Having been adjudged mentally or physically

  9  incompetent.

10         (g)(7)  Violating or Aiding and abetting in the

11  violation of any provision of this part or the rules adopted

12  hereunder.

13         (h)(8)  Reporting a test result when no laboratory test

14  was performed on a clinical specimen.

15         (i)(9)  Knowingly advertising false services or

16  credentials.

17         (j)(10)  Having a license revoked, suspended, or

18  otherwise acted against, including the denial of licensure, by

19  the licensing authority of another jurisdiction. The licensing

20  authority's acceptance of a relinquishment of a license,

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

22  response to or in anticipation of the filing of administrative

23  charges against the licensee, shall be construed as action

24  against the licensee.

25         (k)(11)  Failing to report to the board, in writing,

26  within 30 days that an action under subsection (5), subsection

27  (6), or subsection (10) has been taken against the licensee or

28  one's license to practice as clinical laboratory personnel in

29  another state, territory, country, or other jurisdiction.

30         (l)(12)  Being unable to perform or report clinical

31  laboratory examinations with reasonable skill and safety to


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  1  patients by reason of illness or use of alcohol, drugs,

  2  narcotics, chemicals, or any other type of material or as a

  3  result of any mental or physical condition.  In enforcing this

  4  subsection, the department shall have, upon a finding of the

  5  secretary or his or her designee that probable cause exists to

  6  believe that the licensee is unable to practice because of the

  7  reasons stated in this subsection, the authority to issue an

  8  order to compel a licensee to submit to a mental or physical

  9  examination by physicians designated by the department.  If

10  the licensee refuses to comply with such order, the

11  department's order directing such examination may be enforced

12  by filing a petition for enforcement in the circuit court

13  where the licensee resides or does business.  The department

14  shall be entitled to the summary procedure provided in s.

15  51.011.  A licensee affected under this subsection shall at

16  reasonable intervals be afforded an opportunity to demonstrate

17  that he or she can resume competent practice with reasonable

18  skill and safety to patients.

19         (m)(13)  Delegating professional responsibilities to a

20  person when the licensee delegating such responsibilities

21  knows, or has reason to know, that such person is not

22  qualified by training, experience, or licensure to perform

23  them.

24         (n)(14)  Violating a previous order of the board

25  entered in a disciplinary proceeding.

26         (o)(15)  Failing to report to the department a person

27  or other licensee who the licensee knows is in violation of

28  this chapter or the rules of the department or board adopted

29  hereunder.

30         (p)(16)  Making or filing a report which the licensee

31  knows to be false, intentionally or negligently failing to


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  1  file a report or record required by state or federal law,

  2  willfully impeding or obstructing such filing or inducing

  3  another person to do so, including, but not limited to,

  4  impeding an agent of the state from obtaining a report or

  5  record for investigative purposes. Such reports or records

  6  shall include only those generated in the capacity as a

  7  licensed clinical laboratory personnel.

  8         (q)(17)  Paying or receiving any commission, bonus,

  9  kickback, or rebate, or engaging in any split-fee arrangement

10  in any form whatsoever with a physician, organization, agency,

11  or person, either directly or indirectly for patients referred

12  to providers of health care goods and services including, but

13  not limited to, hospitals, nursing homes, clinical

14  laboratories, ambulatory surgical centers, or pharmacies. The

15  provisions of this subsection shall not be construed to

16  prevent a clinical laboratory professional from receiving a

17  fee for professional consultation services.

18         (r)(18)  Exercising influence on a patient or client in

19  such a manner as to exploit the patient or client for the

20  financial gain of the licensee or other third party, which

21  shall include, but not be limited to, the promoting, selling,

22  or withholding of services, goods, appliances, referrals, or

23  drugs.

24         (s)(19)  Practicing or offering to practice beyond the

25  scope permitted by law or rule, or accepting or performing

26  professional services or responsibilities which the licensee

27  knows or has reason to know that he or she is not competent to

28  perform.

29         (t)(20)  Misrepresenting or concealing a material fact

30  at any time during any phase of the licensing, investigative,

31  or disciplinary process, procedure, or proceeding.


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  1         (u)(21)  Improperly interfering with an investigation

  2  or any disciplinary proceeding.

  3         (v)(22)  Engaging in or attempting to engage in sexual

  4  misconduct, causing undue embarrassment or using disparaging

  5  language or language of a sexual nature towards a patient,

  6  exploiting superior/subordinate, professional/patient,

  7  instructor/student relationships for personal gain, sexual

  8  gratification, or advantage.

  9         (w)  Violating any provision of this chapter or chapter

10  456, or any rules adopted pursuant thereto.

11         (2)  The board may enter an order denying licensure or

12  imposing any of the penalties in s. 456.072(2) against any

13  applicant for licensure or licensee who is found guilty of

14  violating any provision of subsection (1) of this section or

15  who is found guilty of violating any provision of s.

16  456.072(1).

17         (3)  In determining the amount of the fine to be levied

18  for a violation, as provided in subsection (1), the following

19  factors shall be considered:

20         (a)  The severity of the violation, including the

21  probability that death or serious harm to the health or safety

22  of any person will result or has resulted, the severity of the

23  actual or potential harm, and the extent to which the

24  provisions of this part were violated.

25         (b)  Actions taken by the licensee to correct the

26  violation or to remedy complaints.

27         (c)  Any previous violation by the licensee.

28         (d)  The financial benefit to the licensee of

29  committing or continuing the violation.

30         Section 42.  Section 483.827, Florida Statutes, is

31  repealed.


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  1         Section 43.  Subsection (6) of section 483.901, Florida

  2  Statutes, is amended to read:

  3         483.901  Medical physicists; definitions; licensure.--

  4         (6)  LICENSE REQUIRED.--An individual may not engage in

  5  the practice of medical physics, including the specialties of

  6  diagnostic radiological physics, therapeutic radiological

  7  physics, medical nuclear radiological physics, or medical

  8  health physics, without a license issued by the department for

  9  the appropriate specialty.

10         (a)  The department shall adopt rules to administer

11  this section which specify license application and renewal

12  fees, continuing education requirements, and standards for

13  practicing medical physics.  The council shall recommend to

14  the department continuing education requirements that shall be

15  a condition of license renewal.  The department shall require

16  a minimum of 24 hours per biennium of continuing education

17  offered by an organization recommended by the council and

18  approved by the department.  The department, upon

19  recommendation of the council, may adopt rules to specify

20  continuing education requirements for persons who hold a

21  license in more than one specialty.

22         (b)  In order to apply for a medical physicist license

23  in one or more specialties, a person must file an individual

24  application for each specialty with the department.  The

25  application must be on a form prescribed by the department and

26  must be accompanied by a nonrefundable application fee for

27  each specialty.

28         (c)  The department may issue a license to an eligible

29  applicant if the applicant meets all license requirements.  At

30  any time before the department issues a license, the applicant

31  may request in writing that the application be withdrawn.  To


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  1  reapply, the applicant must submit a new application and an

  2  additional nonrefundable application fee and must meet all

  3  current licensure requirements.

  4         (d)  The department shall review each completed

  5  application for a license which the department receives.

  6         (e)  On receipt of an application and fee as specified

  7  in this section, the department may issue a license to

  8  practice medical physics in this state on or after October 1,

  9  1997, to a person who is board certified in the medical

10  physics specialty in which the applicant applies to practice

11  by the American Board of Radiology for diagnostic radiological

12  physics, therapeutic radiological physics, or medical nuclear

13  radiological physics; by the American Board of Medical Physics

14  for diagnostic radiological physics, therapeutic radiological

15  physics, or medical nuclear radiological physics; or by the

16  American Board of Health Physics or an equivalent certifying

17  body approved by the department.

18         (f)  A licensee shall:

19         1.  Display the license in a place accessible to the

20  public; and

21         2.  Report immediately any change in the licensee's

22  address or name to the department.

23         (g)  The following acts constitute are grounds for

24  denial of a license or disciplinary action, as specified in s.

25  456.072(2) which the disciplinary actions in paragraph (h) may

26  be taken:

27         1.  Obtaining or attempting to obtain a license by

28  bribery, fraud, knowing misrepresentation, or concealment of

29  material fact or through an error of the department.

30         2.  Having a license denied, revoked, suspended, or

31  otherwise acted against in another jurisdiction.


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  1         3.  Being convicted or found guilty of, or entering a

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

  3  crime in any jurisdiction which relates to the practice of, or

  4  the ability to practice, the profession of medical physics.

  5         4.  Willfully failing to file a report or record

  6  required for medical physics or willfully impeding or

  7  obstructing the filing of a report or record required by this

  8  section or inducing another person to do so.

  9         5.  Making misleading, deceptive, or fraudulent

10  representations in or related to the practice of medical

11  physics.

12         6.  Willfully failing to report any known violation of

13  this section or any rule adopted thereunder.

14         7.  Willfully or repeatedly violating a rule adopted

15  under this section or an order of the department.

16         7.8.  Failing to perform any statutory or legal

17  obligation placed upon a licensee.

18         8.9.  Aiding, assisting, procuring, employing, or

19  advising any unlicensed person to practice medical physics

20  contrary to this section or any rule adopted thereunder.

21         9.10.  Delegating or contracting for the performance of

22  professional responsibilities by a person when the licensee

23  delegating or contracting such responsibilities knows, or has

24  reason to know, such person is not qualified by training,

25  experience, and authorization to perform them.

26         10.11.  Practicing or offering to practice beyond the

27  scope permitted by law or accepting and performing

28  professional responsibilities the licensee knows, or has

29  reason to know, the licensee is not competent to perform.

30         11.12.  Gross or repeated malpractice or the inability

31  to practice medical physics with reasonable skill and safety.


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  1         12.13.  Judicially determined mental incompetency.

  2         13.14.  Being unable to practice medical physics with

  3  reasonable skill and safety because of a mental or physical

  4  condition or illness or the use of alcohol, controlled

  5  substances, or any other substance which impairs one's ability

  6  to practice.

  7         a.  The department may, upon probable cause, compel a

  8  licensee to submit to a mental or physical examination by

  9  physicians designated by the department.  The cost of an

10  examination shall be borne by the licensee, and the licensee's

11  failure to submit to such an examination constitutes an

12  admission of the allegations against the licensee, consequent

13  upon which a default and a final order may be entered without

14  the taking of testimony or presentation of evidence, unless

15  the failure was due to circumstances beyond the licensee's

16  control.

17         b.  A licensee who is disciplined under this

18  subparagraph shall, at reasonable intervals, be afforded an

19  opportunity to demonstrate that the licensee can resume the

20  practice of medical physics with reasonable skill and safety.

21         c.  With respect to any proceeding under this

22  subparagraph, the record of proceedings or the orders entered

23  by the department may not be used against a licensee in any

24  other proceeding.

25         14.  Violating any provision of this chapter or chapter

26  456, or any rules adopted pursuant thereto.

27         (h)  The board may enter an order denying licensure or

28  imposing any of the penalties in s. 456.072(2) against any

29  applicant for licensure or licensee who is found guilty of

30  violating any provision of subsection (1) of this section or

31  who is found guilty of violating any provision of s.


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  1  456.072(1). When the department finds any person guilty of any

  2  of the grounds set forth in paragraph (g), including conduct

  3  that would constitute a substantial violation of paragraph (g)

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

  5  imposing one or more of the following penalties:

  6         1.  Deny the application for licensure.

  7         2.  Revoke or suspend the license.

  8         3.  Impose an administrative fine for each count or

  9  separate offense.

10         4.  Place the licensee on probation for a specified

11  time and subject the licensee to such conditions as the

12  department determines necessary, including requiring

13  treatment, continuing education courses, or working under the

14  monitoring or supervision of another licensee.

15         5.  Restrict a licensee's practice.

16         6.  Issue a reprimand to the licensee.

17         (i)  The department may not issue or reinstate a

18  license to a person it has deemed unqualified until it is

19  satisfied that such person has complied with the terms and

20  conditions of the final order and that the licensee can safely

21  practice medical physics.

22         (j)  Upon receipt of a complete application and the fee

23  set forth by rule, the department may issue a

24  physicist-in-training certificate to a person qualified to

25  practice medical physics under direct supervision. The

26  department may establish by rule requirements for initial

27  certification and renewal of a physicist-in-training

28  certificate.

29         Section 44.  Subsections (1) and (2) of section

30  484.014, Florida Statutes, are amended to read:

31         484.014  Disciplinary actions.--


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  1         (1)  The following acts constitute relating to the

  2  practice of opticianry shall be grounds for denial of a

  3  license or disciplinary action, as specified in s. 456.072(2)

  4  both disciplinary action against an optician as set forth in

  5  this section and cease and desist or other related action by

  6  the department as set forth in s. 456.065 against any person

  7  operating an optical establishment who engages in, aids, or

  8  abets any such violation:

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

10  misrepresentation, bribery, or fraud or through an error of

11  the department or the board.

12         (b)  Procuring or attempting to procure a license for

13  any other person by making or causing to be made any false

14  representation.

15         (c)  Making or filing a report or record which the

16  licensee knows to be false, intentionally or negligently

17  failing to file a report or record required by federal or

18  state law, willfully impeding or obstructing such filing, or

19  inducing another person to do so. Such reports or records

20  shall include only those which the person is required to make

21  or file as an optician.

22         (d)  Failing to make fee or price information readily

23  available by providing such information upon request or upon

24  the presentation of a prescription.

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

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

27  content.

28         (f)  Fraud or deceit, or negligence, incompetency, or

29  misconduct, in the authorized practice of opticianry.

30         (g)  Violation or repeated violation of this part or of

31  chapter 456 or any rules promulgated pursuant thereto.


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  1         (g)(h)  Practicing with a revoked, suspended, inactive,

  2  or delinquent license.

  3         (h)(i)  Violation of a lawful order of the board or

  4  department previously entered in a disciplinary hearing or

  5  failing to comply with a lawfully issued subpoena of the

  6  department.

  7         (i)(j)  Violation of any provision of s. 484.012.

  8         (j)(k)  Conspiring with another licensee or with any

  9  person to commit an act, or committing an act, which would

10  coerce, intimidate, or preclude another licensee from lawfully

11  advertising her or his services.

12         (k)(l)  Willfully submitting to any third-party payor a

13  claim for services which were not provided to a patient.

14         (l)(m)  Failing to keep written prescription files.

15         (m)(n)  Willfully failing to report any person who the

16  licensee knows is in violation of this part or of rules of the

17  department or the board.

18         (n)(o)  Exercising influence on a client in such a

19  manner as to exploit the client for financial gain of the

20  licensee or of a third party.

21         (o)(p)  Gross or repeated malpractice.

22         (p)(q)  Permitting any person not licensed as an

23  optician in this state to fit or dispense any lenses,

24  spectacles, eyeglasses, or other optical devices which are

25  part of the practice of opticianry.

26         (q)(r)  Being convicted or found guilty of, or entering

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

28  court of this state or other jurisdiction, a crime which

29  relates to the ability to practice opticianry or to the

30  practice of opticianry.

31


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  1         (r)(s)  Having been disciplined by a regulatory agency

  2  in another state for any offense that would constitute a

  3  violation of Florida law or rules regulating opticianry.

  4         (s)(t)  Being unable to practice opticianry with

  5  reasonable skill and safety by reason of illness or use of

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

  7  as a result of any mental or physical condition. An optician

  8  affected under this paragraph shall at reasonable intervals be

  9  afforded an opportunity to demonstrate that she or he can

10  resume the competent practice of opticianry with reasonable

11  skill and safety to her or his customers.

12         (t)  Violating any provision of this chapter or chapter

13  456, or any rules adopted pursuant thereto.

14         (2)  The board may enter an order denying licensure or

15  imposing any of the penalties in s. 456.072(2) against any

16  applicant for licensure or licensee who is found guilty of

17  violating any provision of subsection (1) of this section or

18  who is found guilty of violating any provision of s.

19  456.072(1). When the board finds any person guilty of any of

20  the grounds set forth in subsection (1), it may enter an order

21  imposing one or more of the following penalties:

22         (a)  Refusal to certify to the department an

23  application for licensure.

24         (b)  Revocation or suspension of a license.

25         (c)  Imposition of an administrative fine not to exceed

26  $1,000 for each count or separate offense.

27         (d)  Issuance of a reprimand.

28         (e)  Placement of the optician on probation for a

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

30  specify, including requiring the optician to submit to

31


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  1  treatment or to work under the supervision of another

  2  optician.

  3         Section 45.  Subsections (1) and (2) of section

  4  484.056, Florida Statutes, are amended to read:

  5         484.056  Disciplinary proceedings.--

  6         (1)  The following acts constitute relating to the

  7  practice of dispensing hearing aids shall be grounds for

  8  denial of a license or disciplinary action, as specified in s.

  9  456.072(2) both disciplinary action against a hearing aid

10  specialist as set forth in this section and cease and desist

11  or other related action by the department as set forth in s.

12  456.065 against any person owning or operating a hearing aid

13  establishment who engages in, aids, or abets any such

14  violation:

15         (a)  Violation of any provision of s. 456.072(1), s.

16  484.0512, or s. 484.053.

17         (b)  Attempting to procure a license to dispense

18  hearing aids by bribery, by fraudulent misrepresentations, or

19  through an error of the department or the board.

20         (c)  Having a license to dispense hearing aids revoked,

21  suspended, or otherwise acted against, including the denial of

22  licensure, by the licensing authority of another state,

23  territory, or country.

24         (d)  Being convicted or found guilty of, or entering a

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

26  crime in any jurisdiction which directly relates to the

27  practice of dispensing hearing aids or the ability to practice

28  dispensing hearing aids, including violations of any federal

29  laws or regulations regarding hearing aids.

30         (e)  Making or filing a report or record which the

31  licensee knows to be false, intentionally or negligently


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  1  failing to file a report or record required by state or

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

  3  inducing another person to impede or obstruct such filing.

  4  Such reports or records shall include only those reports or

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

  6  hearing aid specialist.

  7         (f)  Advertising goods or services in a manner which is

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

  9  content.

10         (g)  Proof that the licensee is guilty of fraud or

11  deceit or of negligence, incompetency, or misconduct in the

12  practice of dispensing hearing aids.

13         (h)  Violation or repeated violation of this part or of

14  chapter 456, or any rules promulgated pursuant thereto.

15         (h)(i)  Violation of a lawful order of the board or

16  department previously entered in a disciplinary hearing or

17  failure to comply with a lawfully issued subpoena of the board

18  or department.

19         (i)(j)  Practicing with a revoked, suspended, inactive,

20  or delinquent license.

21         (j)(k)  Using, or causing or promoting the use of, any

22  advertising matter, promotional literature, testimonial,

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

24  representation, however disseminated or published, which is

25  misleading, deceiving, or untruthful.

26         (k)(l)  Showing or demonstrating, or, in the event of

27  sale, delivery of, a product unusable or impractical for the

28  purpose represented or implied by such action.

29         (l)(m)  Misrepresentation of professional services

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

31  of a hearing aid, or use of the terms "doctor," "clinic,"


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  1  "clinical," "medical audiologist," "clinical audiologist,"

  2  "research audiologist," or "audiologic" or any other term or

  3  title which might connote the availability of professional

  4  services when such use is not accurate.

  5         (m)(n)  Representation, advertisement, or implication

  6  that a hearing aid or its repair is guaranteed without

  7  providing full disclosure of the identity of the guarantor;

  8  the nature, extent, and duration of the guarantee; and the

  9  existence of conditions or limitations imposed upon the

10  guarantee.

11         (n)(o)  Representing, directly or by implication, that

12  a hearing aid utilizing bone conduction has certain specified

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

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

15  and conspicuously that the instrument operates on the bone

16  conduction principle and that in many cases of hearing loss

17  this type of instrument may not be suitable.

18         (o)(p)  Making any predictions or prognostications as

19  to the future course of a hearing impairment, either in

20  general terms or with reference to an individual person.

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

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

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

24  similar or opposite effect.

25         (q)(r)  Making any statement regarding the cure of the

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

27         (r)(s)  Representing or implying that a hearing aid is

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

29  "prescription-made" or in any other sense specially fabricated

30  for an individual person when such is not the case.

31


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  1         (s)(t)  Canvassing from house to house or by telephone

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

  3  hearing aid, except that contacting persons who have evidenced

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

  5  of hearing aids, shall not be considered canvassing.

  6         (t)(u)  Failure to submit to the board on an annual

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

  8  certification of testing and calibration of audiometric

  9  testing equipment on the form approved by the board.

10         (u)(v)  Failing to provide all information as described

11  in s. 484.051(1).

12         (v)(w)  Exercising influence on a client in such a

13  manner as to exploit the client for financial gain of the

14  licensee or of a third party.

15         (w)  Violating any provision of this chapter or chapter

16  456, or any rules adopted pursuant thereto.

17         (2)(a)  The board may enter an order denying licensure

18  or imposing any of the penalties in s. 456.072(2) against any

19  applicant for licensure or licensee who is found guilty of

20  violating any provision of subsection (1) of this section or

21  who is found guilty of violating any provision of s.

22  456.072(1). Except as provided in paragraph (b), when the

23  board finds any hearing aid specialist to be guilty of any of

24  the grounds set forth in subsection (1), it may enter an order

25  imposing one or more of the following penalties:

26         1.  Denial of an application for licensure.

27         2.  Revocation or suspension of a license.

28         3.  Imposition of an administrative fine not to exceed

29  $1,000 for each count or separate offense.

30         4.  Issuance of a reprimand.

31


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  1         5.  Placing the hearing aid specialist on probation for

  2  a period of time and subject to such conditions as the board

  3  may specify, including requiring the hearing aid specialist to

  4  attend continuing education courses or to work under the

  5  supervision of another hearing aid specialist.

  6         6.  Restricting the authorized scope of practice.

  7         (b)  The board shall revoke the license of any hearing

  8  aid specialist found guilty of canvassing as described in this

  9  section.

10         Section 46.  Subsections (1) and (2) of section

11  486.125, Florida Statutes, are amended to read:

12         486.125  Refusal, revocation, or suspension of license;

13  administrative fines and other disciplinary measures.--

14         (1)  The following acts shall constitute grounds for

15  denial of a license or disciplinary action, as specified in s.

16  456.072(2) which the disciplinary actions specified in

17  subsection (2) may be taken:

18         (a)  Being unable to practice physical therapy with

19  reasonable skill and safety to patients by reason of illness

20  or use of alcohol, drugs, narcotics, chemicals, or any other

21  type of material or as a result of any mental or physical

22  condition.

23         1.  In enforcing this paragraph, upon a finding of the

24  secretary or the secretary's designee that probable cause

25  exists to believe that the licensee is unable to practice

26  physical therapy due to the reasons stated in this paragraph,

27  the department shall have the authority to compel a physical

28  therapist or physical therapist assistant to submit to a

29  mental or physical examination by a physician designated by

30  the department.  If the licensee refuses to comply with such

31  order, the department's order directing such examination may


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  1  be enforced by filing a petition for enforcement in the

  2  circuit court where the licensee resides or serves as a

  3  physical therapy practitioner.  The licensee against whom the

  4  petition is filed shall not be named or identified by initials

  5  in any public court records or documents, and the proceedings

  6  shall be closed to the public.  The department shall be

  7  entitled to the summary procedure provided in s. 51.011.

  8         2.  A physical therapist or physical therapist

  9  assistant whose license is suspended or revoked pursuant to

10  this subsection shall, at reasonable intervals, be given an

11  opportunity to demonstrate that she or he can resume the

12  competent practice of physical therapy with reasonable skill

13  and safety to patients.

14         3.  Neither the record of proceeding nor the orders

15  entered by the board in any proceeding under this subsection

16  may be used against a physical therapist or physical therapist

17  assistant in any other proceeding.

18         (b)  Having committed fraud in the practice of physical

19  therapy or deceit in obtaining a license as a physical

20  therapist or as a physical therapist assistant.

21         (c)  Being convicted or found guilty regardless of

22  adjudication, of a crime in any jurisdiction which directly

23  relates to the practice of physical therapy or to the ability

24  to practice physical therapy. The entry of any plea of nolo

25  contendere shall be considered a conviction for purpose of

26  this chapter.

27         (d)  Having treated or undertaken to treat human

28  ailments by means other than by physical therapy, as defined

29  in this chapter.

30

31


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  1         (e)  Failing to maintain acceptable standards of

  2  physical therapy practice as set forth by the board in rules

  3  adopted pursuant to this chapter.

  4         (f)  Engaging directly or indirectly in the dividing,

  5  transferring, assigning, rebating, or refunding of fees

  6  received for professional services, or having been found to

  7  profit by means of a credit or other valuable consideration,

  8  such as an unearned commission, discount, or gratuity, with

  9  any person referring a patient or with any relative or

10  business associate of the referring person.  Nothing in this

11  chapter shall be construed to prohibit the members of any

12  regularly and properly organized business entity which is

13  comprised of physical therapists and which is recognized under

14  the laws of this state from making any division of their total

15  fees among themselves as they determine necessary.

16         (g)  Having a license revoked or suspended; having had

17  other disciplinary action taken against her or him; or having

18  had her or his application for a license refused, revoked, or

19  suspended by the licensing authority of another state,

20  territory, or country.

21         (h)  Violating any provision of this chapter, a rule of

22  the board or department, or a lawful order of the board or

23  department previously entered in a disciplinary hearing.

24         (i)  Making or filing a report or record which the

25  licensee knows to be false.  Such reports or records shall

26  include only those which are signed in the capacity of a

27  physical therapist.

28         (j)  Practicing or offering to practice beyond the

29  scope permitted by law or accepting and performing

30  professional responsibilities which the licensee knows or has

31


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    CS for SB 1558                                 First Engrossed



  1  reason to know that she or he is not competent to perform,

  2  including, but not limited to, specific spinal manipulation.

  3         (k)  Violating any provision of this chapter or chapter

  4  456, or any rules adopted pursuant thereto.

  5         (2)  The board may enter an order denying licensure or

  6  imposing any of the penalties in s. 456.072(2) against any

  7  applicant for licensure or licensee who is found guilty of

  8  violating any provision of subsection (1) of this section or

  9  who is found guilty of violating any provision of s.

10  456.072(1). When the board finds any person guilty of any of

11  the grounds set forth in subsection (1), it may enter an order

12  imposing one or more of the following penalties:

13         (a)  Refusal to certify to the department an

14  application for licensure.

15         (b)  Revocation or suspension of a license.

16         (c)  Restriction of practice.

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

18  $1,000 for each count or separate offense.

19         (e)  Issuance of a reprimand.

20         (f)  Placement of the physical therapist or physical

21  therapist assistant on probation for a period of time and

22  subject to such conditions as the board may specify,

23  including, but not limited to, requiring the physical

24  therapist or physical therapist assistant to submit to

25  treatment, to attend continuing education courses, to submit

26  to reexamination, or to work under the supervision of another

27  physical therapist.

28         (g)  Recovery of actual costs of investigation and

29  prosecution.

30         Section 47.  Section 490.009, Florida Statutes, is

31  amended to read:


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  1         490.009  Discipline.--

  2         (1)  When the department or, in the case of

  3  psychologists, the board finds that an applicant, provisional

  4  licensee, or licensee whom it regulates under this chapter has

  5  committed any of the acts set forth in subsection (2), it may

  6  issue an order imposing one or more of the following

  7  penalties:

  8         (a)  Denial of an application for licensure, either

  9  temporarily or permanently.

10         (b)  Revocation of an application for licensure, either

11  temporarily or permanently.

12         (c)  Suspension for a period of up to 5 years or

13  revocation of a license, after hearing.

14         (d)  Immediate suspension of a license pursuant to s.

15  120.60(6).

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

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

18         (f)  Issuance of a public reprimand.

19         (g)  Placement of an applicant or licensee on probation

20  for a period of time and subject to conditions specified by

21  the department or, in the case of psychologists, by the board,

22  including, but not limited to, requiring the applicant or

23  licensee to submit to treatment, to attend continuing

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

25  under the supervision of a designated licensee.

26         (h)  Restriction of practice.

27         (1)(2)  The following acts constitute of a licensee,

28  provisional licensee, or applicant are grounds for denial of a

29  license or disciplinary action, as specified in s. 456.072(2)

30  which the disciplinary actions listed in subsection (1) may be

31  taken:


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  1         (a)  Attempting to obtain, obtaining, or renewing a

  2  license under this chapter by bribery or fraudulent

  3  misrepresentation or through an error of the board or

  4  department.

  5         (b)  Having a license to practice a comparable

  6  profession revoked, suspended, or otherwise acted against,

  7  including the denial of certification or licensure by another

  8  state, territory, or country.

  9         (c)  Being convicted or found guilty, regardless of

10  adjudication, of a crime in any jurisdiction which directly

11  relates to the practice of his or her profession or the

12  ability to practice his or her profession.  A plea of nolo

13  contendere creates a rebuttable presumption of guilt of the

14  underlying criminal charges.  However, the board shall allow

15  the person who is the subject of the disciplinary proceeding

16  to present any evidence relevant to the underlying charges and

17  circumstances surrounding the plea.

18         (d)  False, deceptive, or misleading advertising or

19  obtaining a fee or other thing of value on the representation

20  that beneficial results from any treatment will be guaranteed.

21         (e)  Advertising, practicing, or attempting to practice

22  under a name other than one's own.

23         (f)  Maintaining a professional association with any

24  person who the applicant or licensee knows, or has reason to

25  believe, is in violation of this chapter or of a rule of the

26  department or, in the case of psychologists, of the department

27  or the board.

28         (g)  Knowingly aiding, assisting, procuring, or

29  advising any nonlicensed person to hold himself or herself out

30  as licensed under this chapter.

31


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  1         (h)  Failing to perform any statutory or legal

  2  obligation placed upon a person licensed under this chapter.

  3         (i)  Willfully making or filing a false report or

  4  record; failing to file a report or record required by state

  5  or federal law; willfully impeding or obstructing the filing

  6  of a report or record; or inducing another person to make or

  7  file a false report or record or to impede or obstruct the

  8  filing of a report or record.  Such report or record includes

  9  only a report or record which requires the signature of a

10  person licensed under this chapter.

11         (j)  Paying a kickback, rebate, bonus, or other

12  remuneration for receiving a patient or client, or receiving a

13  kickback, rebate, bonus, or other remuneration for referring a

14  patient or client to another provider of mental health care

15  services or to a provider of health care services or goods;

16  referring a patient or client to oneself for services on a

17  fee-paid basis when those services are already being paid for

18  by some other public or private entity; or entering into a

19  reciprocal referral agreement.

20         (k)  Committing any act upon a patient or client which

21  would constitute sexual battery or which would constitute

22  sexual misconduct as defined in s. 490.0111.

23         (l)  Making misleading, deceptive, untrue, or

24  fraudulent representations in the practice of any profession

25  licensed under this chapter.

26         (m)  Soliciting patients or clients personally, or

27  through an agent, through the use of fraud, intimidation,

28  undue influence, or a form of overreaching or vexatious

29  conduct.

30         (n)  Failing to make available to a patient or client,

31  upon written request, copies of test results, reports, or


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  1  documents in the possession or under the control of the

  2  licensee which have been prepared for and paid for by the

  3  patient or client.

  4         (o)  Failing to respond within 30 days to a written

  5  communication from the department concerning any investigation

  6  by the department or to make available any relevant records

  7  with respect to any investigation about the licensee's conduct

  8  or background.

  9         (p)  Being unable to practice the profession for which

10  he or she is licensed under this chapter with reasonable skill

11  or competence as a result of any mental or physical condition

12  or by reason of illness; drunkenness; or excessive use of

13  drugs, narcotics, chemicals, or any other substance.  In

14  enforcing this paragraph, upon a finding by the secretary, the

15  secretary's designee, or the board that probable cause exists

16  to believe that the licensee is unable to practice the

17  profession because of the reasons stated in this paragraph,

18  the department shall have the authority to compel a licensee

19  to submit to a mental or physical examination by psychologists

20  or physicians designated by the department or board.  If the

21  licensee refuses to comply with the department's order, the

22  department may file a petition for enforcement in the circuit

23  court of the circuit in which the licensee resides or does

24  business.  The licensee shall not be named or identified by

25  initials in the petition or in any other public court records

26  or documents, and the enforcement proceedings shall be closed

27  to the public.  The department shall be entitled to the

28  summary procedure provided in s. 51.011.  A licensee affected

29  under this paragraph shall be afforded an opportunity at

30  reasonable intervals to demonstrate that he or she can resume

31


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    CS for SB 1558                                 First Engrossed



  1  the competent practice for which he or she is licensed with

  2  reasonable skill and safety to patients.

  3         (q)  Violating provisions of this chapter, or of

  4  chapter 456, or any rules adopted pursuant thereto.

  5         (q)(r)  Performing any treatment or prescribing any

  6  therapy which, by the prevailing standards of the mental

  7  health professions in the community, would constitute

  8  experimentation on human subjects, without first obtaining

  9  full, informed, and written consent.

10         (r)(s)  Failing to meet the minimum standards of

11  performance in professional activities when measured against

12  generally prevailing peer performance, including the

13  undertaking of activities for which the licensee is not

14  qualified by training or experience.

15         (s)(t)  Delegating professional responsibilities to a

16  person whom the licensee knows or has reason to know is not

17  qualified by training or experience to perform such

18  responsibilities.

19         (t)(u)  Violating a rule relating to the regulation of

20  the profession or a lawful order of the department previously

21  entered in a disciplinary hearing.

22         (u)(v)  Failing to maintain in confidence a

23  communication made by a patient or client in the context of

24  such services, except as provided in s. 490.0147.

25         (v)(w)  Making public statements which are derived from

26  test data, client contacts, or behavioral research and which

27  identify or damage research subjects or clients.

28         (w)  Violating any provision of this chapter or chapter

29  456, or any rules adopted pursuant thereto.

30         (2)  The department or, in the case of psychologists,

31  the board may enter an order denying licensure or imposing any


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    CS for SB 1558                                 First Engrossed



  1  of the penalties in s. 456.072(2) against any applicant for

  2  licensure or licensee who is found guilty of violating any

  3  provision of subsection (1) of this section or who is found

  4  guilty of violating any provision of s. 456.072(1).

  5         Section 48.  Section 491.009, Florida Statutes, is

  6  amended to read:

  7         491.009  Discipline.--

  8         (1)  When the department or the board finds that an

  9  applicant, licensee, provisional licensee, registered intern,

10  or certificateholder whom it regulates under this chapter has

11  committed any of the acts set forth in subsection (2), it may

12  issue an order imposing one or more of the following

13  penalties:

14         (a)  Denial of an application for licensure,

15  registration, or certification, either temporarily or

16  permanently.

17         (b)  Revocation of an application for licensure,

18  registration, or certification, either temporarily or

19  permanently.

20         (c)  Suspension for a period of up to 5 years or

21  revocation of a license, registration, or certificate, after

22  hearing.

23         (d)  Immediate suspension of a license, registration,

24  or certificate pursuant to s. 120.60(6).

25         (e)  Imposition of an administrative fine not to exceed

26  $1,000 for each count or separate offense.

27         (f)  Issuance of a public reprimand.

28         (g)  Placement of an applicant, licensee, registered

29  intern, or certificateholder on probation for a period of time

30  and subject to such conditions as the board may specify,

31  including, but not limited to, requiring the applicant,


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    CS for SB 1558                                 First Engrossed



  1  licensee, registered intern, or certificateholder to submit to

  2  treatment, to attend continuing education courses, to submit

  3  to reexamination, or to work under the supervision of a

  4  designated licensee or certificateholder.

  5         (h)  Restriction of practice.

  6         (1)(2)  The following acts constitute of a licensee,

  7  provisional licensee, registered intern, certificateholder, or

  8  applicant are grounds for denial of a license or disciplinary

  9  action, as specified in s. 456.072(2) which the disciplinary

10  actions listed in subsection (1) may be taken:

11         (a)  Attempting to obtain, obtaining, or renewing a

12  license, registration, or certificate under this chapter by

13  bribery or fraudulent misrepresentation or through an error of

14  the board or the department.

15         (b)  Having a license, registration, or certificate to

16  practice a comparable profession revoked, suspended, or

17  otherwise acted against, including the denial of certification

18  or licensure by another state, territory, or country.

19         (c)  Being convicted or found guilty of, regardless of

20  adjudication, or having entered a plea of nolo contendere to,

21  a crime in any jurisdiction which directly relates to the

22  practice of his or her profession or the ability to practice

23  his or her profession.  However, in the case of a plea of nolo

24  contendere, the board shall allow the person who is the

25  subject of the disciplinary proceeding to present evidence in

26  mitigation relevant to the underlying charges and

27  circumstances surrounding the plea.

28         (d)  False, deceptive, or misleading advertising or

29  obtaining a fee or other thing of value on the representation

30  that beneficial results from any treatment will be guaranteed.

31


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  1         (e)  Advertising, practicing, or attempting to practice

  2  under a name other than one's own.

  3         (f)  Maintaining a professional association with any

  4  person who the applicant, licensee, registered intern, or

  5  certificateholder knows, or has reason to believe, is in

  6  violation of this chapter or of a rule of the department or

  7  the board.

  8         (g)  Knowingly aiding, assisting, procuring, or

  9  advising any nonlicensed, nonregistered, or noncertified

10  person to hold himself or herself out as licensed, registered,

11  or certified under this chapter.

12         (h)  Failing to perform any statutory or legal

13  obligation placed upon a person licensed, registered, or

14  certified under this chapter.

15         (i)  Willfully making or filing a false report or

16  record; failing to file a report or record required by state

17  or federal law; willfully impeding or obstructing the filing

18  of a report or record; or inducing another person to make or

19  file a false report or record or to impede or obstruct the

20  filing of a report or record.  Such report or record includes

21  only a report or record which requires the signature of a

22  person licensed, registered, or certified under this chapter.

23         (j)  Paying a kickback, rebate, bonus, or other

24  remuneration for receiving a patient or client, or receiving a

25  kickback, rebate, bonus, or other remuneration for referring a

26  patient or client to another provider of mental health care

27  services or to a provider of health care services or goods;

28  referring a patient or client to oneself for services on a

29  fee-paid basis when those services are already being paid for

30  by some other public or private entity; or entering into a

31  reciprocal referral agreement.


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  1         (k)  Committing any act upon a patient or client which

  2  would constitute sexual battery or which would constitute

  3  sexual misconduct as defined pursuant to s. 491.0111.

  4         (l)  Making misleading, deceptive, untrue, or

  5  fraudulent representations in the practice of any profession

  6  licensed, registered, or certified under this chapter.

  7         (m)  Soliciting patients or clients personally, or

  8  through an agent, through the use of fraud, intimidation,

  9  undue influence, or a form of overreaching or vexatious

10  conduct.

11         (n)  Failing to make available to a patient or client,

12  upon written request, copies of tests, reports, or documents

13  in the possession or under the control of the licensee,

14  registered intern, or certificateholder which have been

15  prepared for and paid for by the patient or client.

16         (o)  Failing to respond within 30 days to a written

17  communication from the department or the board concerning any

18  investigation by the department or the board, or failing to

19  make available any relevant records with respect to any

20  investigation about the licensee's, registered intern's, or

21  certificateholder's conduct or background.

22         (p)  Being unable to practice the profession for which

23  he or she is licensed, registered, or certified under this

24  chapter with reasonable skill or competence as a result of any

25  mental or physical condition or by reason of illness;

26  drunkenness; or excessive use of drugs, narcotics, chemicals,

27  or any other substance. In enforcing this paragraph, upon a

28  finding by the secretary, the secretary's designee, or the

29  board that probable cause exists to believe that the licensee,

30  registered intern, or certificateholder is unable to practice

31  the profession because of the reasons stated in this


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    CS for SB 1558                                 First Engrossed



  1  paragraph, the department shall have the authority to compel a

  2  licensee, registered intern, or certificateholder to submit to

  3  a mental or physical examination by psychologists, physicians,

  4  or other licensees under this chapter, designated by the

  5  department or board.  If the licensee, registered intern, or

  6  certificateholder refuses to comply with such order, the

  7  department's order directing the examination may be enforced

  8  by filing a petition for enforcement in the circuit court in

  9  the circuit in which the licensee, registered intern, or

10  certificateholder resides or does business.  The licensee,

11  registered intern, or certificateholder against whom the

12  petition is filed shall not be named or identified by initials

13  in any public court records or documents, and the proceedings

14  shall be closed to the public.  The department shall be

15  entitled to the summary procedure provided in s. 51.011. A

16  licensee, registered intern, or certificateholder affected

17  under this paragraph shall at reasonable intervals be afforded

18  an opportunity to demonstrate that he or she can resume the

19  competent practice for which he or she is licensed,

20  registered, or certified with reasonable skill and safety to

21  patients.

22         (q)  Violating provisions of this chapter, or of

23  chapter 456, or any rules adopted pursuant thereto.

24         (q)(r)  Performing any treatment or prescribing any

25  therapy which, by the prevailing standards of the mental

26  health professions in the community, would constitute

27  experimentation on human subjects, without first obtaining

28  full, informed, and written consent.

29         (r)(s)  Failing to meet the minimum standards of

30  performance in professional activities when measured against

31  generally prevailing peer performance, including the


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    CS for SB 1558                                 First Engrossed



  1  undertaking of activities for which the licensee, registered

  2  intern, or certificateholder is not qualified by training or

  3  experience.

  4         (s)(t)  Delegating professional responsibilities to a

  5  person whom the licensee, registered intern, or

  6  certificateholder knows or has reason to know is not qualified

  7  by training or experience to perform such responsibilities.

  8         (t)(u)  Violating a rule relating to the regulation of

  9  the profession or a lawful order of the department or the

10  board previously entered in a disciplinary hearing.

11         (u)(v)  Failure of the licensee, registered intern, or

12  certificateholder to maintain in confidence a communication

13  made by a patient or client in the context of such services,

14  except as provided in s. 491.0147.

15         (v)(w)  Making public statements which are derived from

16  test data, client contacts, or behavioral research and which

17  identify or damage research subjects or clients.

18         (w)  Violating any provision of this chapter or chapter

19  456, or any rules adopted pursuant thereto.

20         (2)  The board may enter an order denying licensure or

21  imposing any of the penalties in s. 456.072(2) against any

22  applicant for licensure or licensee who is found guilty of

23  violating any provision of subsection (1) of this section or

24  who is found guilty of violating any provision of s.

25  456.072(1).

26         Section 49.  Subsection (1) of section 456.074, Florida

27  Statutes, is amended to read:

28         456.074  Certain health care practitioners; immediate

29  suspension of license.--

30         (1)  The department shall issue an emergency order

31  suspending the license of any person licensed under chapter


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    CS for SB 1558                                 First Engrossed



  1  458, chapter 459, chapter 460, chapter 461, chapter 462,

  2  chapter 463, chapter 464, chapter 465, chapter 466, or chapter

  3  484 who pleads guilty to, is convicted or found guilty of, or

  4  who enters a plea of nolo contendere to, regardless of

  5  adjudication, a felony under chapter 409, chapter 817, or

  6  chapter 893 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C.

  7  ss. 1395-1396.

  8         Section 50.  Effective July 1, 2003, section 464.005,

  9  Florida Statutes, is amended to read:

10         464.005  Board headquarters.--The board shall maintain

11  its official headquarters in Tallahassee the city in which it

12  has been domiciled for the past 5 years.

13         Section 51.  Subsection (6) is added to section

14  456.003, Florida Statutes, to read:

15         456.003  Legislative intent; requirements.--

16         (6)  Unless expressly and specifically granted in

17  statute, the duties conferred on the boards do not include the

18  enlargement, modification, or contravention of the lawful

19  scope of practice of the profession regulated by the boards.

20  This subsection shall not prohibit the boards, or the

21  department when there is no board, from taking disciplinary

22  action or issuing a declaratory statement.

23         Section 52.  Except as otherwise expressly provided in

24  this act, this act shall take effect July 1, 2001.

25

26

27

28

29

30

31


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