Senate Bill sb1558e2

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    CS for SB 1558                                Second Engrossed



  1                      A bill to be entitled

  2         An act relating to health care; providing

  3         legislative intent and findings with respect to

  4         the Medical Quality Assurance Trust Fund and

  5         function administered by the Department of

  6         Health; requiring the Auditor General to do a

  7         followup Medical Quality Assurance audit and

  8         issue a report to the Legislature; requiring

  9         the Department of Health to reimburse the

10         Agency for Health Care Administration for

11         certain costs; requiring the Office of Program

12         Policy Analysis and Government Accountability

13         to study the feasibility of maintaining the

14         Medical Quality Assurance function within a

15         single department and issue a report to the

16         Legislature;  amending s. 456.004, F.S.;

17         providing requirements for rules relating to

18         biennial renewal of licenses; amending s.

19         456.025, F.S.; revising requirements relating

20         to the setting and use of fees for the

21         regulation of health care professions and

22         practitioners, including continuing education

23         fees; providing for an electronic continuing

24         education tracking system; repealing s.

25         458.31151, F.S.; repealing obsolete provisions;

26         amending s. 457.107, F.S.; for clarification of

27         acupuncture fees; amending s. 483.807, F.S.;

28         relating to clinical laboratory personnel fees;

29         amending s. 456.011, F.S.; requiring board

30         meetings to be conducted through

31         teleconferencing or other technological means


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    CS for SB 1558                                Second Engrossed



  1         except under certain circumstances; amending s.

  2         456.013, F.S.; requiring the department to

  3         charge initial license fees; amending s.

  4         456.017, F.S.; providing for administration of

  5         national examinations and termination of

  6         state-administered written examinations;

  7         providing for administration of

  8         state-administered practical or clinical

  9         examinations if paid for in advance by the

10         examination candidates; providing legislative

11         intent with respect to the use of national

12         examinations; providing for electronic access

13         to and posting of examination scores under

14         certain conditions; providing for the sharing

15         of examinations or examination item banks with

16         certain entities; clarifying circumstances

17         under which candidates may bring a challenge;

18         providing for electronic administration of

19         certain laws and rules examinations; amending

20         s. 456.035, F.S.; providing for electronic

21         notification of a licensee's current mailing

22         address and place of practice; amending s.

23         456.073, F.S.; authorizing a letter of guidance

24         in lieu of a finding of probable cause under

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

26         providing for the posting of newsletters on the

27         department's website; amending s. 456.072,

28         F.S.; revising and providing grounds for

29         discipline of licensees; revising and providing

30         disciplinary actions; amending s. 456.079,

31         F.S.; requiring mitigating or aggravating


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    CS for SB 1558                                Second Engrossed



  1         circumstances to be in the final order to be

  2         considered in the imposition of penalties;

  3         amending ss. 457.109, 458.320, 458.331,

  4         458.345, 458.347, 459.0085, 459.015, 459.022,

  5         460.413, 461.013, 462.14, 463.016, 464.018,

  6         465.008, 465.016, 466.028, 466.037, 467.203,

  7         468.1295, 468.1755, 468.217, 468.365, 468.518,

  8         468.719, 468.811, 478.52, 480.046, 483.825,

  9         483.901, 484.014, 484.056, 486.125, 490.009,

10         and 491.009, F.S.; revising and conforming

11         provisions relating to disciplinary grounds and

12         penalties; amending s. 458.315, F.S.; revising

13         the procedure for obtaining a temporary permit;

14         amending 459.0075, F.S.; revising the procedure

15         for obtaining a limited license; providing

16         requirements for the Board of Medicine in

17         issuing temporary certificates; amending s.

18         456.065, F.S.; requiring the unlicensed

19         activity fee to be in addition to all other

20         fees collected from each licensee; amending ss.

21         458.347 and 459.022, F.S.; allowing authorized

22         physician assistants to prescribe any

23         medication not listed on a formulary

24         established by the Council on Physician

25         Assistants; allowing authorized physician

26         assistants to dispense drug samples pursuant to

27         proper prescription; eliminating the formulary

28         committee and revising provisions relating to

29         creation and amendment of the formulary, to

30         conform; amending s. 456.003, F.S.; providing a

31         limitation on the duties of certain boards;


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    CS for SB 1558                                Second Engrossed



  1         providing for the Agency for Health Care

  2         Administration to create the Organ Transplant

  3         Task Force to study organ transplantation

  4         programs; requiring the task force to study and

  5         make recommendations on the necessity of the

  6         issuance of certificates of need for such

  7         programs and funding for organ transplantation;

  8         providing a date for the task force to report

  9         to the Governor and the Legislature; amending

10         s. 409.9205, F.S.; transferring positions in

11         the Medicaid Fraud Control Unit of the

12         Department of Legal Affairs to Career Services;

13         amending s. 483.245, F.S.; prohibiting rebate

14         or split-fee arrangements with dialysis

15         facilities for patient referrals to clinical

16         laboratories; providing penalties; amending s.

17         232.435, F.S.; providing training requirements

18         for a first responder and teacher athletic

19         trainer; amending s. 383.14, F.S.; amending

20         screening requirements for postnatal screening;

21         amending s. 395.0197, F.S.; revising provisions

22         relating to hospital and ambulatory surgical

23         center internal risk management programs;

24         modifying requirements for risk management and

25         prevention education and training; restricting

26         participation of unlicensed persons in surgical

27         procedures; requiring ongoing evaluation of

28         surgical procedures and protocols; eliminating

29         an annual report summarizing facility incident

30         reports and disciplinary actions; requiring the

31         Agency for Health Care Administration to


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    CS for SB 1558                                Second Engrossed



  1         publish website summaries of adverse incident

  2         reports; requiring facility reporting of

  3         allegations of sexual misconduct by health care

  4         practitioners; providing certain civil

  5         liability for licensed risk managers;

  6         prohibiting intimidation of a risk manager;

  7         providing a penalty; amending s. 395.10972,

  8         F.S.; increasing membership on the Health Care

  9         Risk Management Advisory Council; amending s.

10         395.701, F.S.; limiting the financial

11         information the agency may require to determine

12         the amount of hospital annual assessments;

13         amending s. 409.905, F.S.; providing that the

14         Agency for Health Care Administration may

15         restrict the provision of mandatory services by

16         mobile providers; amending s. 409.906, F.S.;

17         providing that the agency may restrict or

18         prohibit the provision of services by mobile

19         providers; providing that Medicaid will not

20         provide reimbursement for dental services

21         provided in mobile dental units, except for

22         certain units; amending s. 456.013, F.S.;

23         providing a professional continuing education

24         requirement relating to prevention of medical

25         errors; amending s. 456.057, F.S.; providing

26         for appointment of a records custodian under

27         certain circumstances; amending s. 456.063,

28         F.S.; requiring licensed health care

29         practitioners to report to the Department of

30         Health any allegations of sexual misconduct;

31         amending s. 456.072, F.S.; providing additional


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    CS for SB 1558                                Second Engrossed



  1         grounds for disciplinary actions; clarifying a

  2         penalty involving restriction of professional

  3         practice or license; providing additional

  4         penalties; requiring assessment of costs

  5         related to investigation and prosecution;

  6         amending s. 456.073, F.S.; requiring the

  7         Department of Health to notify the patient or

  8         legal representative of the status of a

  9         disciplinary case; requiring the department to

10         provide certain information to the complainant;

11         providing time limitations on the filing of

12         administrative complaints against licensees of

13         the department; amending s. 456.074, F.S.;

14         providing for an emergency order suspending the

15         license of a practitioner for fraud; amending

16         s. 456.077, F.S.; specifying violations for

17         which the Department of Health or a regulatory

18         board may issue citations; amending s. 456.081,

19         F.S.; requiring the Department of Health and

20         regulatory boards to maintain a website

21         containing specified information; amending ss.

22         458.331 and 459.015, F.S.; conforming language

23         and cross references to changes made by the

24         act; amending s. 641.51, F.S.; revising adverse

25         determination provisions; amending ss. 465.019

26         and 465.0196, F.S.; requiring institutional

27         pharmacies and special pharmacy permittees that

28         use pharmacy technicians to have a written

29         policy and procedures manual; directing the

30         Department of Health and the Agency for Health

31         Care Administration to review health care


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    CS for SB 1558                                Second Engrossed



  1         practitioner and facility reporting

  2         requirements; requiring a report to the

  3         Legislature; amending s. 468.1755, F.S.;

  4         providing an additional ground for disciplinary

  5         action against a nursing home administrator;

  6         reenacting ss. 468.1695(3) and 468.1735, F.S.,

  7         to incorporate said amendment in references;

  8         reenacting s. 484.056(1)(a), F.S., relating to

  9         disciplinary action against hearing aid

10         specialists, to incorporate the amendment to s.

11         456.072(1), in a reference; amending s.

12         766.101, F.S.; providing that a continuous

13         quality improvement committee of a licensed

14         pharmacy is a medical review committee for

15         purposes of immunity from liability, and

16         reenacting ss. 440.105(1)(a) and 626.989(6),

17         F.S., to incorporate said amendment in

18         references; amending s. 766.1115, F.S.;

19         conforming provisions and cross-references to

20         changes made by the act; amending s. 456.047,

21         F.S.; providing intent; revising and providing

22         definitions; revising duties of the Department

23         of Health relating to file maintenance;

24         providing that primary source data verified by

25         the department or its designee may be relied

26         upon to meet accreditation purposes; amending

27         s. 232.61, F.S.; requiring the Florida High

28         School Activities Association to adopt bylaws

29         which require students participating in

30         interscholastic athletic competition or who are

31         candidates for an interscholastic athletic team


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    CS for SB 1558                                Second Engrossed



  1         to satisfactorily pass a medical evaluation

  2         prior to participating in interscholastic

  3         athletic competition or engaging in practice

  4         with an interscholastic athletic team;

  5         providing requirements with respect to such

  6         evaluation; amending s. 240.4075, F.S.;

  7         transferring the Nursing Student Loan

  8         Forgiveness Program from the Department of

  9         Education to the Department of Health;

10         including public schools, family practice

11         teaching hospitals, and specialty hospitals for

12         children as eligible facilities under the

13         program; exempting such facilities from the

14         fund-matching requirements of the program;

15         amending s. 240.4076, F.S.; transferring the

16         nursing scholarship program from the Department

17         of Education to the Department of Health;

18         providing requirements under the program for

19         students seeking to qualify for a nursing

20         faculty position and receive credit for work in

21         such a position; including nursing homes,

22         hospitals, public schools, colleges of nursing,

23         and community college nursing programs as

24         eligible facilities under the program;

25         transferring powers, duties, functions, rules,

26         records, personnel, property, and

27         appropriations and other funds relating to the

28         Nursing Student Loan Forgiveness Program and

29         the nursing scholarship program from the

30         Department of Education to the Department of

31         Health; amending s. 464.005, F.S.; providing


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    CS for SB 1558                                Second Engrossed



  1         for future relocation of the headquarters of

  2         the Board of Nursing; amending s. 464.008,

  3         F.S.; revising education requirements for

  4         licensure by examination; amending s. 464.009,

  5         F.S.; revising requirements for licensure by

  6         endorsement; requiring submission of

  7         fingerprints for a criminal history check and a

  8         fee to cover the costs of such check; providing

  9         for an electronic applicant notification

10         process; creating s. 464.0195, F.S.; creating

11         the Florida Center for Nursing and providing

12         its goals; creating s. 464.0196, F.S.;

13         providing for a board of directors; providing

14         for appointment of board members; providing for

15         staggered terms; providing powers and duties;

16         authorizing per diem and travel expenses;

17         creating s. 464.0197, F.S.; declaring state

18         budget support for the center; prohibiting the

19         Board of Nursing from developing any rule

20         relating to faculty/student clinical ratios

21         until a specified time; requiring the Board of

22         Nursing and the Department of Education to

23         submit to the Legislature an implementation

24         plan detailing the impact and cost of any such

25         proposed rule change; amending s. 464.0205,

26         F.S.; deleting the application and processing

27         fee for applicants for a retired volunteer

28         nurse certificate; requiring study by Office of

29         Program Policy Analysis and Government

30         Accountability of the feasibility of

31         maintaining all of Medical Quality Assurance in


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    CS for SB 1558                                Second Engrossed



  1         one state agency; creating s. 456.0375, F.S.;

  2         requiring registration of certain clinics;

  3         providing requirements, including fees;

  4         providing rulemaking authority; requiring

  5         medical directors or clinic directors for such

  6         clinics and providing their duties and

  7         responsibilities; providing an appropriation;

  8         amending s. 456.031, F.S.; providing an

  9         alternative by which licensees under ch. 466,

10         F.S., relating to dentistry, may comply with a

11         general requirement that they take

12         domestic-violence education courses; amending

13         s. 456.033, F.S.; providing an alternative by

14         which such licensees may comply with a general

15         requirement that they take AIDS/HIV education

16         courses; amending s. 627.419, F.S.; providing

17         for appeals from certain adverse determinations

18         relating to dental service claims; providing

19         applicability; amending s. 468.302, F.S.;

20         revising a provision relating to exemption from

21         certification to use radiation on human beings;

22         providing training requirements; amending ss.

23         468.352, 468.355, 468.357, 468.358, and

24         468.359, F.S.; revising definitions and

25         provisions relating to licensure and use of

26         titles and abbreviations to correct and conform

27         terminology with respect to respiratory

28         therapists and respiratory care practitioners;

29         amending ss. 468.1155 and 468.1215, F.S.;

30         revising requirements for licensure to practice

31         speech-language pathology or audiology and for


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    CS for SB 1558                                Second Engrossed



  1         certification of speech-language pathology or

  2         audiology assistants; amending s. 480.033,

  3         F.S.; correcting terminology in the definition

  4         of "massage"; amending s. 484.002, F.S.;

  5         amending and creating definitions; amending ss.

  6         484.002, 484.006, 484.012, F.S.; replacing

  7         references to the term "medical doctor" with

  8         the term "allopathic or osteopathic physician";

  9         amending s. 484.013, F.S.; increasing the

10         penalty for certain acts involving preparation

11         or dispensing of optical devices; amending s.

12         921.0022, F.S.; providing for the ranking of

13         such offense on the offense severity ranking

14         chart; amending s. 484.015, F.S.; revising

15         inspection authority; amending s. 484.0445,

16         F.S.; removing certain provisions relating to

17         the training program for hearing aid

18         specialists; amending s. 484.045, F.S.;

19         revising requirements for licensure as a

20         hearing aid specialist by examination; amending

21         s. 490.012, F.S.; prohibiting the use of

22         certain titles or descriptions relating to the

23         practice of psychology or school psychology

24         unless properly licensed; providing penalties;

25         amending s. 490.014, F.S.; revising exemptions

26         from regulation under ch. 490, F.S., relating

27         to psychology; correcting a cross-reference;

28         amending s. 491.012, F.S.; revising

29         prohibitions against unlicensed practice of

30         clinical social work, marriage and family

31         therapy, and mental health counseling to


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    CS for SB 1558                                Second Engrossed



  1         provide that practice by registered interns is

  2         lawful; amending s. 491.014, F.S.; revising

  3         exemptions from licensure under ch. 491, F.S.,

  4         relating to clinical, counseling, and

  5         psychotherapy services, to prohibit the use by

  6         certain employees of titles, names, or

  7         descriptions protected by the chapter; amending

  8         ss. 458.319, 459.008, and 765.102, F.S.;

  9         conforming terminology relating to palliative

10         care; amending s. 765.101, F.S.; redefining the

11         term "end-stage condition" with respect to

12         health care advance directives; creating s.

13         765.1025, F.S.; prescribing the content and

14         suitability of palliative care; amending s.

15         765.1103, F.S.; revising provisions relating to

16         compliance with requests for pain management

17         and palliative care; amending s. 765.205, F.S.;

18         prescribing the standards of decisionmaking to

19         be used in certain circumstances by health care

20         surrogates, persons who have durable powers of

21         attorney for health care, and proxy

22         decisionmakers; amending s. 765.401, F.S.;

23         prescribing the standards of decisionmaking to

24         be used in certain circumstances by proxy

25         decisionmakers; requiring the Department of

26         Health to conduct an interim study on specialty

27         certification and provide a report to the

28         Legislature; amending s. 499.012, F.S.;

29         authorizing transfer of prescription drugs

30         between a retail pharmacy and a Modified Class

31         II institutional pharmacy under a retail


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    CS for SB 1558                                Second Engrossed



  1         pharmacy wholesaler's permit; providing

  2         legislative intent; amending ss. 395.3025,

  3         400.1415, and 456.057, F.S.; prohibiting the

  4         use of a patient's medical records for purposes

  5         of solicitation and marketing absent a specific

  6         written release or authorization; providing

  7         penalties; creating s. 626.9651, F.S.;

  8         requiring the Department of Insurance to adopt

  9         rules governing the use of a consumer's

10         nonpublic personal financial and health

11         information; providing standards for the rules;

12         amending s. 400.141, F.S.; prescribing duties

13         of nursing homes with respect to influenza and

14         pneumococcal polysaccharide vaccinations;

15         providing rulemaking authority; establishing

16         the Office of Community Partners within the

17         Department of Health to provide for delivery of

18         social services through eligible private

19         organizations and programs; providing procedure

20         for transfer of general revenue funds to match

21         federal funds received by the office; creating

22         s. 458.3147, F.S.; providing automatic

23         admission to any medical school in the State

24         University System for United States Military

25         Academy students or graduates; amending s.

26         409.91188, F.S.; requiring the Agency for

27         Health Care Administration to seek certain

28         waivers to allow certain Medicare beneficiaries

29         to participate in the Medipass HIV disease

30         management program; repealing s. 71(1) of ch.

31         98-171, Laws of Florida; abrogating the repeal


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    CS for SB 1558                                Second Engrossed



  1         of provisions of law which require background

  2         screening of certain applicants for licensure,

  3         certification, or registration; amending s.

  4         766.302, F.S.; clarifying the definition of the

  5         term "birth-related neurological injury";

  6         amending s. 766.31, F.S.; providing for payment

  7         of funeral expenses up to a specified amount;

  8         repealing s. 766.308, F.S., which provides for

  9         review by a medical advisory panel; amending s.

10         468.805, F.S.; revising grandfathering

11         requirements for licensure to practice

12         orthotics, prosthetics, or pedorthics without

13         meeting statutory educational requirements;

14         repealing s. 1, ch. 99-158, Laws of Florida,

15         relating to a deadline to apply for licensure

16         to practice orthotics, prosthetics, or

17         pedorthics without meeting statutory

18         educational requirements; providing effective

19         dates.

20  

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

22  

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

24  the Medical Quality Assurance Trust Fund should be

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

26  intent of the Legislature that the Department of Health reduce

27  expenses wherever possible to ensure that the cost of

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

29  barrier to licensure in this state. The Legislature adopts

30  findings 1, 2, 4, 5, and 8 and the recommendations of the

31  Auditor General's Medical Quality Assurance Operational Audit


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    CS for SB 1558                                Second Engrossed



  1  Report Number 01-063. In addition, the Legislature adopts

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

  3  Committee on Fiscal Policy Interim Project Report 2001-016.

  4         Section 2.  The Auditor General shall conduct a

  5  followup audit to the Medical Quality Assurance Operational

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

  7  Health has implemented the recommendations of that report. The

  8  Auditor General shall complete the followup audit and issue a

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

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

11         Section 3.  The contract between the Department of

12  Health and the Agency for Health Care Administration pursuant

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

14  provisions of section 216.346, Florida Statutes. The

15  Department of Health shall reimburse the Agency for Health

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

17  the agency's indirect costs incurred as a result of the

18  contract, subject to appropriated funds. The agency shall

19  provide to the department documentation, explanation, and

20  justification of all direct and indirect costs incurred, by

21  budget entity.

22         Section 4.  The Office of Program Policy Analysis and

23  Government Accountability shall study the feasibility of

24  maintaining the entire Medical Quality Assurance function,

25  including enforcement, within a single department. The study

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

27  Senate and the Speaker of the House of Representatives no

28  later than November 30, 2001.

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

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

31  section, to read:


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    CS for SB 1558                                Second Engrossed



  1         456.004  Department; powers and duties.--The

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

  3         (1)  Adopt rules establishing a procedure for the

  4  biennial renewal of licenses; however, the department may

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

  6  notwithstanding any other provisions of law to the contrary.

  7  The rules shall specify the expiration dates of licenses and

  8  the process for tracking compliance with continuing education

  9  requirements, financial responsibility requirements, and any

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

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

12  professions on an annualized basis as authorized by law.

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

14  develop, purchase, validate, administer, and defend the

15  examination and is an amount certain to cover all

16  administrative costs plus the actual per-applicant cost of the

17  examination.

18         Section 6.  Section 456.025, Florida Statutes, is

19  amended to read:

20         456.025  Fees; receipts; disposition.--

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

22  of regulating health care professions and practitioners shall

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

24  also the intent of the Legislature that fees should be

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

26  it is the intent of the Legislature that the department

27  operate as efficiently as possible and regularly report to the

28  Legislature additional methods to streamline operational

29  costs. Therefore, the boards in consultation with the

30  department, or the department if there is no board, shall, by

31  rule, set renewal fees which:


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    CS for SB 1558                                Second Engrossed



  1         (a)  Shall be based on revenue projections prepared

  2  using generally accepted accounting procedures;

  3         (b)  Shall be adequate to cover all expenses relating

  4  to that board identified in the department's long-range policy

  5  plan, as required by s. 456.005;

  6         (c)  Shall be reasonable, fair, and not serve as a

  7  barrier to licensure;

  8         (d)  Shall be based on potential earnings from working

  9  under the scope of the license;

10         (e)  Shall be similar to fees imposed on similar

11  licensure types;

12         (f)  Shall not be more than 10% greater than the fee

13  imposed for the previous biennium;

14         (g)  Shall not be more than 10% greater than the actual

15  cost to regulate that profession for the previous biennium;

16  and

17         (h)  Shall be subject to challenge pursuant to chapter

18  120.

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

20  in s. 20.43(3)(g), shall meet annually at division

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

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

23  chairpersons shall make recommendations for any necessary

24  statutory changes relating to fees and fee caps.  Such

25  recommendations shall be compiled by the Department of Health

26  and be included in the annual report to the Legislature

27  required by s. 456.026 as well as be included in the

28  long-range policy plan required by s. 456.005.

29         (2)(1)  Each board within the jurisdiction of the

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

31  determine by rule the amount of license fees for the


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    CS for SB 1558                                Second Engrossed



  1  profession it regulates, based upon long-range estimates

  2  prepared by the department of the revenue required to

  3  implement laws relating to the regulation of professions by

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

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

  6  adequate to cover all anticipated costs and to maintain a

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

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

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

10  department that license fees are projected to be inadequate,

11  the department shall set license fees on behalf of the

12  applicable board to cover anticipated costs and to maintain

13  the required cash balance. The department shall include

14  recommended fee cap increases in its annual report to the

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

16  regulated profession operate with a negative cash balance. The

17  department may provide by rule for advancing sufficient funds

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

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

20  years, and the regulated profession must pay interest.

21  Interest shall be calculated at the current rate earned on

22  investments of a trust fund used by the department to

23  implement this chapter. Interest earned shall be allocated to

24  the various funds in accordance with the allocation of

25  investment earnings during the period of the advance.

26         (3)(2)  Each board, or the department if there is no

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

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

29  456.013(2) requested by a licensee who was licensed prior to

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

31  certificate requested by any licensee.


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    CS for SB 1558                                Second Engrossed



  1         (4)(3)  Each board, or the department if there is no

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

  3  each active status licensee and each inactive status licensee

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

  5  there is not a cash deficit, in an amount sufficient to

  6  maintain the financial integrity of the professions as

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

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

  9  authorization.

10         (5)  If the cash balance of the trust fund at the end

11  of any fiscal year exceeds the total appropriation provided

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

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

14  may lower the license renewal fees.

15         (6)(4)  Each board authorized to approve continuing

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

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

18  anyone seeking approval to provide continuing education

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

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

21  of such courses. The fees collected from continuing education

22  providers shall be used for the purposes of reviewing course

23  provider applications, monitoring the integrity of the courses

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

25  granting or renewing a providership, and developing and

26  maintaining an electronic continuing education tracking

27  system. The department shall implement an electronic

28  continuing education tracking system for each new biennial

29  renewal cycle for which electronic renewals are implemented

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

31  system into the licensure and renewal system. All approved


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    CS for SB 1558                                Second Engrossed



  1  continuing education providers shall provide information on

  2  course attendance to the department necessary to implement the

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

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

  5  be submitted. This subsection does not apply to continuing

  6  education courses or providers approved by the board under

  7  chapter 465.

  8         (7)(5)  All moneys collected by the department from

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

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

11  implement this chapter. The Legislature shall appropriate

12  funds from this trust fund sufficient to carry out this

13  chapter and the provisions of law with respect to professions

14  regulated by the Division of Medical Quality Assurance within

15  the department and the boards. The department may contract

16  with public and private entities to receive and deposit

17  revenue pursuant to this section.  The department shall

18  maintain separate accounts in the trust fund used by the

19  department to implement this chapter for every profession

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

21  department shall directly charge all expenses to the account

22  of each regulated profession.  For the purpose of this

23  subsection, direct charge expenses include, but are not

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

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

26  department shall provide for the proportionate allocation

27  among the accounts of expenses incurred by the department in

28  the performance of its duties with respect to each regulated

29  profession. The regulation by the department of professions,

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

31  revenue collected by it from fees and other charges and


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    CS for SB 1558                                Second Engrossed



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

  2  such revenue is hereby appropriated to the department.

  3  However, it is legislative intent that each profession shall

  4  operate within its anticipated fees. The department may not

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

  6  expenses incurred on behalf of another profession, except that

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

  8  regulation of certified nursing assistants. The department

  9  shall maintain adequate records to support its allocation of

10  agency expenses.  The department shall provide any board with

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

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

13  board an annual report of revenue and direct and allocated

14  expenses related to the operation of that profession. The

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

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

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

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

19  Legislature prepared under s. 456.026.

20         (8)(6)  The department shall provide a condensed

21  management report of budgets, finances, performance

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

23  quarter.  The department shall identify and include in such

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

25  board's budget since the last presentation.

26         (9)(7)  If a duplicate license is required or requested

27  by the licensee, the board or, if there is no board, the

28  department may charge a fee as determined by rule not to

29  exceed $25 before issuance of the duplicate license.

30         (10)(8)  The department or the appropriate board shall

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


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    CS for SB 1558                                Second Engrossed



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

  2  department. The department or the appropriate board shall

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

  4  119.07(1)(a) and (b).

  5         Section 7.  Subsection (1) of section 457.107, Florida

  6  Statutes, is amended to read:

  7         457.107  Renewal of licenses; continuing education.--

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

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

10  board by rule, not to exceed $500.

11         Section 8.  Section 458.31151, Florida Statutes, is

12  repealed.

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

14  Statutes, is amended to read:

15         483.807  Fees; establishment; disposition.--

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

17  paid for application, examination, reexamination, licensing

18  and renewal, registration, laboratory training program

19  application, reinstatement, and recordmaking and

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

21  delinquency fee. The board shall establish fees that are

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

23  fund the proportionate expenses incurred by the department in

24  carrying out its licensure and other related responsibilities

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

26  of the revenue required to implement this part and the

27  provisions of law with respect to the regulation of clinical

28  laboratory personnel.

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

30  456.011, Florida Statutes, are amended to read:

31  


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    CS for SB 1558                                Second Engrossed



  1         456.011  Boards; organization; meetings; compensation

  2  and travel expenses.--

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

  4  the provisions of this chapter section.

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

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

  7  through teleconferencing or other technological means, unless

  8  disciplinary hearings involving standard of care, sexual

  9  misconduct, fraud, impairment, or felony convictions;

10  licensure denial hearings; or controversial rule hearings are

11  being conducted; or unless otherwise approved in advance of

12  the meeting by the director of the Division of Medical Quality

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

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

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

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

17  committee thereof. Unless otherwise provided by law, 51

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

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

20  membership of committees of the board, except as otherwise

21  authorized pursuant to this chapter or the applicable practice

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

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

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

25  committee. Three consecutive unexcused absences or absences

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

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

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

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

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

31  


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    CS for SB 1558                                Second Engrossed



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

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

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

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

  5  other business involving the board.  Each board shall adopt

  6  rules defining the phrase "other business involving the

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

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

  9  board member also shall be entitled to reimbursement for

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

11  require the prior approval of the secretary.

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

13  Statutes, is amended to read:

14         456.013  Department; general licensing provisions.--

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

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

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

18  of the department.  Upon receipt of the appropriate license

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

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

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

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

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

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

25  initial licensure, shall issue a wall certificate suitable for

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

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

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

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

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

31  


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    CS for SB 1558                                Second Engrossed



  1         Section 12.  Section 456.017, Florida Statutes, is

  2  amended to read:

  3         456.017  Department of Health; examinations.--

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

  5  approve services for the development, preparation,

  6  administration, scoring, score reporting, and evaluation of

  7  all examinations, in consultation with the appropriate board.

  8  The department shall certify that examinations developed and

  9  approved by the department adequately and reliably measure an

10  applicant's ability to practice the profession regulated by

11  the department.  After an examination developed or approved by

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

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

14  which does not reliably measure the general areas of

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

16  may contract for the preparation, administration, scoring,

17  score reporting, and evaluation of examinations, when such

18  services are available and approved by the board.

19         (b)  For each examination developed by the department

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

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

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

23  covered by each examination, the relative weight to be

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

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

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

27  purchase, development, validation, and administration, and

28  defense of required examinations.  This subsection does not

29  apply to national examinations approved and administered

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

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


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    CS for SB 1558                                Second Engrossed



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

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

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

  4  passing grade. When a mandatory standardization exercise for a

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

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

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

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

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

10  appropriate.

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

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

13  national examinations examination which the department has

14  certified as meeting requirements of national examinations and

15  generally accepted testing standards pursuant to department

16  rules.  Providers of examinations seeking certification by the

17  department shall pay the actual costs incurred by the

18  department in making a determination regarding the

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

20  provided to a national contractor for the limited purpose of

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

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

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

24  national examination and supply test score information to the

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

26  to provide and administer the examination.  Any national

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

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

29  under this paragraph.

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

31  board, shall approve and begin administering a national


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    CS for SB 1558                                Second Engrossed



  1  examination no later than December 31, 2001. Neither the board

  2  nor the department may administer a state-developed written

  3  examination after December 31, 2001, notwithstanding any other

  4  provision of law. The examination may be administered

  5  electronically if adequate security measures are used, as

  6  determined by rule of the department.

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

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

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

10  all costs of development, purchase, validation,

11  administration, review, and defense are paid by the

12  examination candidate prior to the administration of the

13  examination. If a national practical or clinical examination

14  is available and certified by the department pursuant to this

15  section, the board, or the department when there is no board,

16  may administer the national examination.

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

18  costs associated with state examinations and to encourage the

19  use of national examinations whenever possible.

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

21  board, shall adopt rules regarding the security and monitoring

22  of examinations.  The department shall implement those rules

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

24  security of examinations, the department may employ the

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

26  injunctive relief against an examinee who violates the

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

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

29  purposes of investigation, confiscate any written,

30  photographic, or recording material or device in the

31  possession of the examinee at the examination site which the


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    CS for SB 1558                                Second Engrossed



  1  department deems necessary to enforce such provisions or

  2  rules. The scores of candidates who have taken state-developed

  3  examinations shall be provided to the candidates

  4  electronically using a candidate identification number, and

  5  the department shall post the aggregate scores on the

  6  department's website without identifying the names of the

  7  candidates.

  8         (e)  If the professional board with jurisdiction over

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

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

11  testing entity an examination or examination item bank

12  developed by or for the department unless prohibited by a

13  contract entered into by the department for development or

14  purchase of the examination.  The department, with the

15  concurrence of the appropriate board, shall establish

16  guidelines that ensure security of a shared exam and shall

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

18  those guidelines.  Those guidelines shall be approved by the

19  appropriate professional board.  All fees paid by the user

20  shall be applied to the department's examination and

21  development program for professions regulated by this chapter.

22         (f)  The department may adopt rules necessary to

23  administer this subsection.

24         (2)  For each examination developed by the department

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

26  there is no board, shall adopt rules providing for

27  reexamination of any applicants who failed an examination

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

29  written and a practical examination are given, an applicant

30  shall be required to retake only the portion of the

31  examination on which the applicant failed to achieve a passing


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    CS for SB 1558                                Second Engrossed



  1  grade, if the applicant successfully passes that portion

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

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

  4  portion. Except for national examinations approved and

  5  administered pursuant to this section, the department shall

  6  provide procedures for applicants who fail an examination

  7  developed by the department or a contracted vendor to review

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

  9  grading key for the questions the candidate answered

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

11  failed. Applicants shall bear the actual cost for the

12  department to provide examination review pursuant to this

13  subsection. An applicant may waive in writing the

14  confidentiality of the applicant's examination grades.

15  Notwithstanding any other provisions, only candidates who fail

16  an examination by less than ten percent shall be entitled to

17  challenge the validity of the examination at hearing.

18         (3)  For each examination developed or administered by

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

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

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

22  than 2 years immediately following the examination, and such

23  record shall thereafter be maintained or destroyed as provided

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

25  national examinations approved and administered pursuant to

26  this section.

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

28  board within the department held for the exclusive purpose of

29  creating or reviewing licensure examination questions or

30  proposed examination questions are exempt from the provisions

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


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    CS for SB 1558                                Second Engrossed



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

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

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

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

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

  6  an examination as provided in subsection (2).

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

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

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

10  native language.  Notwithstanding any other provision of law,

11  applicants for examination or reexamination pursuant to this

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

13  development, preparation, validation, administration, grading,

14  and evaluation of any examination in a language other than

15  English prior to the examination being administered.  Requests

16  for translated examinations must be on file in the board

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

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

19  the examination to be translated into a language other than

20  English, the board shall consider the percentage of the

21  population who speak the applicant's native language.

22  Applicants must apply for translation to the applicable board

23  at least 6 months prior to the scheduled examination.

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

25  licensure by examination or by endorsement, and

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

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

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

29  rules relating to the applicable practice act. Beginning

30  October 1, 2001, all laws and rules examinations shall be

31  administered electronically unless the laws and rules


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    CS for SB 1558                                Second Engrossed



  1  examination is administered concurrently with another written

  2  examination for that profession or unless the electronic

  3  administration would be substantially more expensive.

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

  5  Statutes, is amended to read:

  6         456.035  Address of record.--

  7         (1)  Each licensee of the department is solely

  8  responsible for notifying the department in writing of the

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

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

11  board. Electronic notification shall be allowed by the

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

13  licensee to ensure that the electronic notification was

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

15  department of a change of address constitutes a violation of

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

17  or the department if there is no board.

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

19  456.073, Florida Statutes, are amended to read:

20         456.073  Disciplinary proceedings.--Disciplinary

21  proceedings for each board shall be within the jurisdiction of

22  the department.

23         (2)  The department shall allocate sufficient and

24  adequately trained staff to expeditiously and thoroughly

25  determine legal sufficiency and investigate all legally

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

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

28  that the department complete the report of its initial

29  investigative findings and recommendations concerning the

30  existence of probable cause within 6 months after its receipt

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


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    CS for SB 1558                                Second Engrossed



  1  disciplinary cases under its jurisdiction, to comply with the

  2  time limits of this section while investigating a complaint

  3  against a licensee constitutes harmless error in any

  4  subsequent disciplinary action unless a court finds that

  5  either the fairness of the proceeding or the correctness of

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

  7  procedure or a failure to follow prescribed procedure.  When

  8  its investigation is complete and legally sufficient, the

  9  department shall prepare and submit to the probable cause

10  panel of the appropriate regulatory board the investigative

11  report of the department. The report shall contain the

12  investigative findings and the recommendations of the

13  department concerning the existence of probable cause. The

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

15  finding probable cause if the subject has already been issued

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

17  legal sufficiency is found, the department may dismiss any

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

19  there is insufficient evidence to support the prosecution of

20  allegations contained therein. The department shall provide a

21  detailed report to the appropriate probable cause panel prior

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

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

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

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

26  119.07(1). The probable cause panel shall have access, upon

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

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

29  the probable cause panel may retain independent legal counsel,

30  employ investigators, and continue the investigation and

31  prosecution of the case as it deems necessary.


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    CS for SB 1558                                Second Engrossed



  1         (4)  The determination as to whether probable cause

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

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

  4  regulatory board shall provide by rule that the determination

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

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

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

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

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

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

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

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

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

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

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

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

17  cause panel must include a former or present professional

18  board member. However, any former professional board member

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

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

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

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

23  investigation waives his or her privilege of confidentiality.

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

25  upon such request the department shall provide such additional

26  investigative information as is necessary to the determination

27  of probable cause. A request for additional investigative

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

29  receipt by the probable cause panel of the investigative

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

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


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    CS for SB 1558                                Second Engrossed



  1  determination of probable cause within 30 days after receipt

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

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

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

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

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

  7  30-day time limit, as may be extended, the probable cause

  8  panel does not make a determination regarding the existence of

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

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

11  determination regarding the existence of probable cause within

12  10 days after the expiration of the time limit.  If the

13  probable cause panel finds that probable cause exists, it

14  shall direct the department to file a formal complaint against

15  the licensee. The department shall follow the directions of

16  the probable cause panel regarding the filing of a formal

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

18  formal complaint against the subject of the investigation and

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

20  department may decide not to prosecute the complaint if it

21  finds that probable cause has been improvidently found by the

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

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

24  prosecute the complaint pursuant to chapter 120. The

25  department shall also refer to the board any investigation or

26  disciplinary proceeding not before the Division of

27  Administrative Hearings pursuant to chapter 120 or otherwise

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

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

30  jurisdiction, must establish a uniform reporting system to

31  quarterly refer to each board the status of any investigation


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    CS for SB 1558                                Second Engrossed



  1  or disciplinary proceeding that is not before the Division of

  2  Administrative Hearings or otherwise completed by the

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

  4  Annually, the department, in consultation with the applicable

  5  probable cause panel, if there is no board, or each board must

  6  establish a plan to expedite reduce or otherwise close any

  7  investigation or disciplinary proceeding that is not before

  8  the Division of Administrative Hearings or otherwise completed

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

10  complaint.  A probable cause panel or a board may retain

11  independent legal counsel, employ investigators, and continue

12  the investigation as it deems necessary; all costs thereof

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

14  implement this chapter.  All proceedings of the probable cause

15  panel are exempt from s. 120.525.

16         (10)  The complaint and all information obtained

17  pursuant to the investigation by the department are

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

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

20  panel or by the department, or until the regulated

21  professional or subject of the investigation waives his or her

22  privilege of confidentiality, whichever occurs first. Upon

23  completion of the investigation and a recommendation by the

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

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

26  department shall provide the subject an opportunity to inspect

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

28  to the subject a copy of the investigative file.

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

30  a copy of any expert witness report or patient record

31  connected with the investigation if the subject agrees in


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    CS for SB 1558                                Second Engrossed



  1  writing to maintain the confidentiality of any information

  2  received under this subsection until 10 days after probable

  3  cause is found and to maintain the confidentiality of patient

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

  5  response to the information contained in the investigative

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

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

  8  by the department. This subsection does not prohibit the

  9  department from providing such information to any law

10  enforcement agency or to any other regulatory agency.

11         Section 15.  Section 456.081, Florida Statutes, is

12  amended to read:

13         456.081  Publication of information.--The department

14  and the boards shall have the authority to advise licensees

15  periodically, through the publication of a newsletter on the

16  department's website, about information that the department or

17  the board determines is of interest to the industry. Unless

18  otherwise prohibited by law, the department and the boards

19  shall publish a summary of final orders resulting in

20  disciplinary action fines, suspensions, or revocations, and

21  any other information the department or the board determines

22  is of interest to the public.

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

24  Statutes, is amended to read:

25         456.079  Disciplinary guidelines.--

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

27  mitigating or aggravating circumstances shall allow the board

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

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

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

31  to designate possible mitigating and aggravating circumstances


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    CS for SB 1558                                Second Engrossed



  1  and the variation and range of penalties permitted for such

  2  circumstances.

  3         Section 17.  Subsections (1) and (2) of section

  4  457.109, Florida Statutes, are amended to read:

  5         457.109  Disciplinary actions; grounds; action by the

  6  board.--

  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 acupuncture by bribery, by fraudulent

13  misrepresentations, or through an error of the department.

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

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

16  licensure, by the licensing authority of another state,

17  territory, or country.

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

19  adjudication, in any jurisdiction of a crime which directly

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

21  practice acupuncture.  Any plea of nolo contendere shall be

22  considered a conviction for purposes of this chapter.

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

24  advertising which claims that acupuncture is useful in curing

25  any disease.

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.

31  


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    CS for SB 1558                                Second Engrossed



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

  2  advising any unlicensed person to practice acupuncture

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

  4         (h)  Failing to perform any statutory or legal

  5  obligation placed upon a licensed acupuncturist.

  6         (i)  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 as a licensed acupuncturist.

12         (j)  Exercising influence within a

13  patient-acupuncturist relationship for purposes of engaging a

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

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

16  activity with his or her acupuncturist.

17         (k)  Making deceptive, untrue, or fraudulent

18  representations in the practice of acupuncture or employing a

19  trick or scheme in the practice of acupuncture when such

20  scheme or trick fails to conform to the generally prevailing

21  standards of treatment in the community.

22         (l)  Soliciting patients, either personally or through

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

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

25  solicitation is any communication which directly or implicitly

26  requests an immediate oral response from the recipient.

27         (m)  Failing to keep written medical records justifying

28  the course of treatment of the patient.

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

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

31  party.


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    CS for SB 1558                                Second Engrossed



  1         (o)  Being unable to practice acupuncture with

  2  reasonable skill and safety to patients by reason of illness

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

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

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

  6  secretary or the secretary's designee that probable cause

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

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

  9  department shall have the authority to issue an order to

10  compel the licensee to submit to a mental or physical

11  examination by a physician designated by the department. If

12  the licensee refuses to comply with such order, the

13  department's order directing such examination may be enforced

14  by filing a petition for enforcement in the circuit court

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

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

17  or identified by initials in any public court record or

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

19  The department shall be entitled to the summary procedure

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

21  paragraph shall at reasonable intervals be afforded an

22  opportunity to demonstrate that he or she can resume the

23  competent practice of acupuncture with reasonable skill and

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

25  neither the record of proceedings nor the orders entered by

26  the department shall be used against an acupuncturist in any

27  other proceeding.

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

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

30  treatment which is recognized by a reasonably prudent similar

31  


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    CS for SB 1558                                Second Engrossed



  1  acupuncturist as being acceptable under similar conditions and

  2  circumstances.

  3         (q)  Practicing or offering to practice beyond the

  4  scope permitted by law or accepting and performing

  5  professional responsibilities which the licensee knows or has

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

  7         (r)  Delegating professional responsibilities to a

  8  person when the licensee delegating such responsibilities

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

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

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

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

13  previously entered in a disciplinary hearing or failing to

14  comply with a lawfully issued subpoena of the department.

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

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

17  preclude another licensee from lawfully advertising his or her

18  services.

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

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

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

22  regulations or reporting requirements relating to public

23  health and the control of contagious and infectious diseases.

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

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

26  the sterilization of needles and equipment and the disposal of

27  potentially infectious materials.

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

29  456, or any rules adopted pursuant thereto.

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

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


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    CS for SB 1558                                Second Engrossed



  1  applicant for licensure or licensee who is found guilty of

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

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

  4  456.072(1). When the board finds any person guilty of any of

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

  6  imposing one or more of the following penalties:

  7         (a)  Refusal to certify to the department an

  8  application for licensure.

  9         (b)  Revocation or suspension of a license.

10         (c)  Restriction of practice.

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

12  $1,000 for each count or separate offense.

13         (e)  Issuance of a reprimand.

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

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

16  specify.

17         Section 18.  Subsection (2) of section 458.315, Florida

18  Statutes, is amended to read:

19         458.315  Temporary certificate for practice in areas of

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

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

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

23  certificate to practice in communities of Florida where there

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

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

26  department, correctional facility, community health center

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

28  Public Health Services Act, or other entity that provides

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

30  Health Officer.  The Board of Medicine may issue this

31  temporary certificate with the following restrictions:


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    CS for SB 1558                                Second Engrossed



  1         (2)  The board may administer an abbreviated oral

  2  examination to determine the physician's competency, but no

  3  written regular examination is necessary. Within 60 days after

  4  receipt of an application for a temporary certificate, the

  5  board shall review the application and issue the temporary

  6  certificate or notify the applicant of denial.

  7         Section 19.  Paragraph (d) is added to subsection (1)

  8  of section 459.0075, Florida Statutes, to read:

  9         459.0075  Limited licenses.--

10         (1)  Any person desiring to obtain a limited license

11  shall:

12         (d)  Within 60 days after receipt of an application for

13  a limited license, the board shall review the application and

14  issue the limited license or notify the applicant of denial.

15         Section 20.  Subsection (6) of section 458.320, Florida

16  Statutes, is amended to read:

17         458.320  Financial responsibility.--

18         (6)  Any deceptive, untrue, or fraudulent

19  representation by the licensee with respect to any provision

20  of this section shall result in permanent disqualification

21  from any exemption to mandated financial responsibility as

22  provided in this section and shall constitute grounds for

23  disciplinary action under as specified in s. 458.331.

24         Section 21.  Subsections (1) and (2) of section

25  458.331, Florida Statutes, are amended to read:

26         458.331  Grounds for disciplinary action; action by the

27  board and department.--

28         (1)  The following acts shall constitute grounds for

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

30  456.072(2) which the disciplinary actions specified in

31  subsection (2) may be taken:


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    CS for SB 1558                                Second Engrossed



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

  2  license to practice medicine by bribery, by fraudulent

  3  misrepresentations, or through an error of the department or

  4  the board.

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

  6  medicine revoked, suspended, or otherwise acted against,

  7  including the denial of licensure, by the licensing authority

  8  of any jurisdiction, including its agencies or subdivisions.

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

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

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

12  the filing of administrative charges against the physician's

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

14  license.

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 directly relates to the

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

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

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

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

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

23  approved pursuant to s. 456.076 shall provide the department

24  or consultant with information in accordance with the

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

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

27  unlicensed person to practice medicine contrary to this

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

29         (g)  Failing to perform any statutory or legal

30  obligation placed upon a licensed physician.

31  


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    CS for SB 1558                                Second Engrossed



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

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

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

  4  impeding or obstructing such filing or inducing another person

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

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

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

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

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

10  or person, either directly or indirectly, for patients

11  referred to providers of health care goods and services,

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

13  clinical laboratories, ambulatory surgical centers, or

14  pharmacies.  The provisions of this paragraph shall not be

15  construed to prevent a physician from receiving a fee for

16  professional consultation services.

17         (j)  Exercising influence within a patient-physician

18  relationship for purposes of engaging a patient in sexual

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

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

21  with his or her physician.

22         (k)  Making deceptive, untrue, or fraudulent

23  representations in or related to the practice of medicine or

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

25         (l)  Soliciting patients, either personally or through

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

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

28  solicitation is any communication which directly or implicitly

29  requests an immediate oral response from the recipient.

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

31  rule in consultation with the board, medical records that


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    CS for SB 1558                                Second Engrossed



  1  identify the licensed physician or the physician extender and

  2  supervising physician by name and professional title who is or

  3  are responsible for rendering, ordering, supervising, or

  4  billing for each diagnostic or treatment procedure and that

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

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

  7  results; records of drugs prescribed, dispensed, or

  8  administered; and reports of consultations and

  9  hospitalizations.

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

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

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

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

14  of services, goods, appliances, or drugs.

15         (o)  Promoting or advertising on any prescription form

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

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

18         (p)  Performing professional services which have not

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

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

21  766.103, or s. 768.13.

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

23  otherwise preparing a legend drug, including any controlled

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

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

26  shall be legally presumed that prescribing, dispensing,

27  administering, mixing, or otherwise preparing legend drugs,

28  including all controlled substances, inappropriately or in

29  excessive or inappropriate quantities is not in the best

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

31  


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    CS for SB 1558                                Second Engrossed



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

  2  her intent.

  3         (r)  Prescribing, dispensing, or administering any

  4  medicinal drug appearing on any schedule set forth in chapter

  5  893 by the physician to himself or herself, except one

  6  prescribed, dispensed, or administered to the physician by

  7  another practitioner authorized to prescribe, dispense, or

  8  administer medicinal drugs.

  9         (s)  Being unable to practice medicine with reasonable

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

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

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

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

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

15  probable cause exists to believe that the licensee is unable

16  to practice medicine because of the reasons stated in this

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

18  licensee to submit to a mental or physical examination by

19  physicians designated by the department. If the licensee

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

21  directing such examination may be enforced by filing a

22  petition for enforcement in the circuit court where the

23  licensee resides or does business. The licensee against whom

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

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

26  proceedings shall be closed to the public.  The department

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

28  51.011. A licensee or certificateholder affected under this

29  paragraph shall at reasonable intervals be afforded an

30  opportunity to demonstrate that he or she can resume the

31  


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    CS for SB 1558                                Second Engrossed



  1  competent practice of medicine with reasonable skill and

  2  safety to patients.

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

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

  5  treatment which is recognized by a reasonably prudent similar

  6  physician as being acceptable under similar conditions and

  7  circumstances.  The board shall give great weight to the

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

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

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

11  malpractice within the previous 5-year period resulting in

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

13  claimant in a judgment or settlement and which incidents

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

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

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

17  is recognized by a reasonably prudent similar physician as

18  being acceptable under similar conditions and circumstances,"

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

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

21  construed to require that a physician be incompetent to

22  practice medicine in order to be disciplined pursuant to this

23  paragraph.

24         (u)  Performing any procedure or prescribing any

25  therapy which, by the prevailing standards of medical practice

26  in the community, would constitute experimentation on a human

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

28  consent.

29         (v)  Practicing or offering to practice beyond the

30  scope permitted by law or accepting and performing

31  professional responsibilities which the licensee knows or has


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    CS for SB 1558                                Second Engrossed



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

  2  board may establish by rule standards of practice and

  3  standards of care for particular practice settings, including,

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

  5  supplies, medications including anesthetics, assistance of and

  6  delegation to other personnel, transfer agreements,

  7  sterilization, records, performance of complex or multiple

  8  procedures, informed consent, and policy and procedure

  9  manuals.

10         (w)  Delegating professional responsibilities to a

11  person when the licensee delegating such responsibilities

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

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

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

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

16  department previously entered in a disciplinary hearing or

17  failing to comply with a lawfully issued subpoena of the

18  department.

19         (y)  Conspiring with another licensee or with any other

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

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

22  lawfully advertising his or her services.

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

24  of, an unlawful termination of pregnancy.

25         (aa)  Presigning blank prescription forms.

26         (bb)  Prescribing any medicinal drug appearing on

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

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

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

30  amphetamine or a Schedule II sympathomimetic amine drug or any

31  


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    CS for SB 1558                                Second Engrossed



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

  2  person except for:

  3         1.  The treatment of narcolepsy; hyperkinesis;

  4  behavioral syndrome characterized by the developmentally

  5  inappropriate symptoms of moderate to severe distractability,

  6  short attention span, hyperactivity, emotional lability, and

  7  impulsivity; or drug-induced brain dysfunction;

  8         2.  The differential diagnostic psychiatric evaluation

  9  of depression or the treatment of depression shown to be

10  refractory to other therapeutic modalities; or

11         3.  The clinical investigation of the effects of such

12  drugs or compounds when an investigative protocol therefor is

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

14  investigation is begun.

15         (dd)  Failing to supervise adequately the activities of

16  those physician assistants, paramedics, emergency medical

17  technicians, or advanced registered nurse practitioners acting

18  under the supervision of the physician.

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

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

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

22  hormones for the purpose of muscle building or to enhance

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

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

25  injured muscle.  A prescription written for the drug products

26  listed above may be dispensed by the pharmacist with the

27  presumption that the prescription is for legitimate medical

28  use.

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

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

31  person.


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    CS for SB 1558                                Second Engrossed



  1         (gg)  Misrepresenting or concealing a material fact at

  2  any time during any phase of a licensing or disciplinary

  3  process or procedure.

  4         (hh)  Improperly interfering with an investigation or

  5  with any disciplinary proceeding.

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

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

  8  physician assistant knows has violated the grounds for

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

10  is licensed and who provides health care services in a

11  facility licensed under chapter 395, or a health maintenance

12  organization certificated under part I of chapter 641, in

13  which the physician or physician assistant also provides

14  services.

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

16  provided corroborating written medical expert opinion attached

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

18  any statutorily required response rejecting a claim, without

19  reasonable investigation.

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

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

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

23  state, territory, or country.

24         (ll)  Advertising or holding oneself out as a

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

26  458.3312, in violation of this chapter.

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

28  381.026 and 381.0261 to provide patients with information

29  about their patient rights and how to file a patient

30  complaint.

31  


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    CS for SB 1558                                Second Engrossed



  1         (nn)  Violating any provision of this chapter or

  2  chapter 456, or any rules adopted pursuant thereto.

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

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

  5  applicant for licensure or licensee who is found guilty of

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

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

  8  456.072(1). When the board finds any person guilty of any of

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

10  that would constitute a substantial violation of subsection

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

12  imposing one or more of the following penalties:

13         (a)  Refusal to certify, or certification with

14  restrictions, to the department an application for licensure,

15  certification, or registration.

16         (b)  Revocation or suspension of a license.

17         (c)  Restriction of practice.

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

19  $10,000 for each count or separate offense.

20         (e)  Issuance of a reprimand.

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

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

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

24  physician to submit to treatment, to attend continuing

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

26  under the supervision of another physician.

27         (g)  Issuance of a letter of concern.

28         (h)  Corrective action.

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

30  patient.

31  


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    CS for SB 1558                                Second Engrossed



  1         (j)  Imposition of an administrative fine in accordance

  2  with s. 381.0261 for violations regarding patient rights.

  3  

  4  In determining what action is appropriate, the board must

  5  first consider what sanctions are necessary to protect the

  6  public or to compensate the patient.  Only after those

  7  sanctions have been imposed may the disciplining authority

  8  consider and include in the order requirements designed to

  9  rehabilitate the physician.  All costs associated with

10  compliance with orders issued under this subsection are the

11  obligation of the physician.

12         Section 22.  Subsection (2) of section 458.345, Florida

13  Statutes, is amended to read:

14         458.345  Registration of resident physicians, interns,

15  and fellows; list of hospital employees; prescribing of

16  medicinal drugs; penalty.--

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

18  registration any applicant who is under investigation in any

19  state or jurisdiction for an act which would constitute

20  grounds the basis for imposing a disciplinary action under

21  penalty specified in s. 458.331(2)(b) until such time as the

22  investigation is completed, at which time the provisions of s.

23  458.331 shall apply.

24         Section 23.  Subsection (7) of section 458.347, Florida

25  Statutes, is amended to read:

26         458.347  Physician assistants.--

27         (7)  PHYSICIAN ASSISTANT LICENSURE.--

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

29  penalties authorized under specified in ss. 456.072 and

30  458.331(2) upon a physician assistant if the physician

31  assistant or the supervising physician has been found guilty


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    CS for SB 1558                                Second Engrossed



  1  of or is being investigated for any act that constitutes a

  2  violation of this chapter or chapter 456.

  3         Section 24.  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 25.  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                                Second 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                                Second 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                                Second 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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    CS for SB 1558                                Second Engrossed



  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                                Second 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                                Second 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                                Second 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                                Second 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                                Second 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                                Second 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 26.  Paragraph (f) of subsection (7) of section

28  459.022, Florida Statutes, is amended to read:

29         459.022  Physician assistants.--

30         (7)  PHYSICIAN ASSISTANT LICENSURE.--

31  


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    CS for SB 1558                                Second Engrossed



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

  2  of the penalties authorized under specified in ss. 456.072 and

  3  459.015(2) upon a physician assistant if the physician

  4  assistant or the supervising physician has been found guilty

  5  of or is being investigated for any act that constitutes a

  6  violation of this chapter or chapter 456.

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

  8  460.413, Florida Statutes, are amended to read:

  9         460.413  Grounds for disciplinary action; action by

10  board or department.--

11         (1)  The following acts shall constitute grounds for

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

13  456.072(2) which the disciplinary actions specified in

14  subsection (2) may be taken:

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

16  license to practice chiropractic medicine by bribery, by

17  fraudulent misrepresentations, or through an error of the

18  department or the board.

19         (b)  Having a license to practice chiropractic medicine

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

21  denial of licensure, by the licensing authority of another

22  state, territory, or country.

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

24  adjudication, of a crime in any jurisdiction which directly

25  relates to the practice of chiropractic medicine or to the

26  ability to practice chiropractic medicine. Any plea of nolo

27  contendere shall be considered a conviction for purposes of

28  this chapter.

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

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

31  any advertisement which does not contain an assertion or


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    CS for SB 1558                                Second Engrossed



  1  statement which would identify herself or himself as a

  2  chiropractic physician or identify such chiropractic clinic or

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

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

  5  institution.

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

  7  under a name other than one's own.

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

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

10  rules of the department or the board.

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

12  unlicensed person to practice chiropractic medicine contrary

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

14         (i)  Failing to perform any statutory or legal

15  obligation placed upon a licensed chiropractic physician.

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

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

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

19  impeding or obstructing such filing or inducing another person

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

21  which are signed in the capacity of a licensed chiropractic

22  physician.

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

24  fraudulent representations in the practice of chiropractic

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

26  chiropractic medicine when such trick or scheme fails to

27  conform to the generally prevailing standards of treatment in

28  the chiropractic medical community.

29         (l)  Soliciting patients either personally or through

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

31  solicitations approved by rule of the board.


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    CS for SB 1558                                Second Engrossed



  1         (m)  Failing to keep legibly written chiropractic

  2  medical records that identify clearly by name and credentials

  3  the licensed chiropractic physician rendering, ordering,

  4  supervising, or billing for each examination or treatment

  5  procedure and that justify the course of treatment of the

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

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

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

  9  for more than 4 years.

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

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

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

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

14  services, goods or appliances, or drugs.

15         (o)  Performing professional services which have not

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

17  legal representative except as provided in ss. 743.064,

18  766.103, and 768.13.

19         (p)  Prescribing, dispensing, or administering any

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

21  performing any surgery, or practicing obstetrics.

22         (q)  Being unable to practice chiropractic 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, upon a

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

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

29  probable cause exists to believe that the licensee is unable

30  to practice the profession because of reasons stated in this

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


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    CS for SB 1558                                Second Engrossed



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

  2  physician designated by the department. If the licensee

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

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

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

  6  The department shall be entitled to the summary procedure

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

  8  compelled mental or physical examination shall not be used

  9  against a licensee in any other proceedings.  A chiropractic

10  physician affected under this paragraph shall at reasonable

11  intervals be afforded an opportunity to demonstrate that she

12  or he can resume the competent practice of chiropractic

13  medicine with reasonable skill and safety to patients.

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

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

16  treatment which is recognized by a reasonably prudent

17  chiropractic physician as being acceptable under similar

18  conditions and circumstances. The board shall give great

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

20  interpreting this provision. A recommended order by an

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

22  finding a violation under this section shall specify whether

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

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

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

26  is recognized as being acceptable under similar conditions and

27  circumstances" or any combination thereof, and any publication

28  by the board shall so specify.

29         (s)  Performing any procedure or prescribing any

30  therapy which, by the prevailing standards of chiropractic

31  medical practice in the community, would constitute


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    CS for SB 1558                                Second Engrossed



  1  experimentation on human subjects, without first obtaining

  2  full, informed, and written consent.

  3         (t)  Practicing or offering to practice beyond the

  4  scope permitted by law or accepting and performing

  5  professional responsibilities which the licensee knows or has

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

  7         (u)  Delegating professional responsibilities to a

  8  person when the licensee delegating such responsibilities

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

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

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

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

13  department previously entered in a disciplinary hearing or

14  failing to comply with a lawfully issued subpoena of the

15  department.

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

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

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

19  lawfully advertising her or his services.

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

21  service or treatment which was not actually provided to a

22  patient.

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

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

25  property entrusted to a chiropractic physician for a specific

26  purpose, including advances for costs and expenses of

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

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

29  patients coming into the hands of a chiropractic physician are

30  not subject to counterclaim or setoff for chiropractic

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


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    CS for SB 1558                                Second Engrossed



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

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

  3  other property upon which the chiropractic physician has a

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

  5  fees from the proceeds of transactions for examinations or

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

  7  not grounds for disciplinary proceedings unless the amount

  8  demanded is clearly excessive or extortionate, or the demand

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

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

11  be deposited in one or more identifiable bank accounts

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

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

14  physician shall be deposited therein except as follows:

15         1.  Funds reasonably sufficient to pay bank charges may

16  be deposited therein.

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

18  presently or potentially to the physician must be deposited

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

20  withdrawn when due unless the right of the physician to

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

22  disputed portion shall not be withdrawn until the dispute is

23  finally resolved.

24  

25  Every chiropractic physician shall maintain complete records

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

27  coming into the possession of the physician and render

28  appropriate accounts to the patient regarding them. In

29  addition, every chiropractic physician shall promptly pay or

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

31  


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    CS for SB 1558                                Second Engrossed



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

  2  the physician which the patient is entitled to receive.

  3         (z)  Offering to accept or accepting payment for

  4  services rendered by assignment from any third-party payor

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

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

  7  or acceptance is to eliminate or give the impression of

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

  9  deductions applicable in the policy of the insured.

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

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

12  service or treatment of the insured.

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

14  treatment which is different from the fee or charge the

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

16  treatment.

17         (cc)  Advertising any reduced or discounted fees for

18  services or treatments, or advertising any free services or

19  treatments, without prominently stating in the advertisement

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

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

22  offering.

23         (dd)  Using acupuncture without being certified

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

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

26  under chapter 458 or under chapter 459 who the chiropractic

27  physician or chiropractic physician's assistant 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  or a health maintenance organization certificated under part I


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    CS for SB 1558                                Second Engrossed



  1  of chapter 641, in which the chiropractic physician or

  2  chiropractic physician's assistant also provides services.

  3         (ff)  Violating any provision of this chapter or

  4  chapter 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  $10,000 for each count or separate offense.

19         (e)  Issuance of a reprimand.

20         (f)  Placement of the chiropractic physician on

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

22  as the board may specify, including requiring the chiropractic

23  physician to submit to treatment, to attend continuing

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

25  under the supervision of another chiropractic physician.

26         (g)  Imposition of costs of the investigation and

27  prosecution.

28         (h)  Requirement that the chiropractic physician

29  undergo remedial education.

30         (i)  Issuance of a letter of concern.

31         (j)  Corrective action.


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    CS for SB 1558                                Second Engrossed



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

  2  patient or a third party.

  3  

  4  In determining what action is appropriate, the board must

  5  first consider what sanctions are necessary to protect the

  6  public or to compensate the patient. Only after those

  7  sanctions have been imposed may the disciplining authority

  8  consider and include in the order requirements designed to

  9  rehabilitate the chiropractic physician. All costs associated

10  with compliance with orders issued under this subsection are

11  the obligation of the chiropractic physician.

12         Section 28.  Subsections (1) and (2) of section

13  461.013, Florida Statutes, are amended to read:

14         461.013  Grounds for disciplinary action; action by the

15  board; investigations by 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 podiatric medicine by bribery, by

22  fraudulent misrepresentations, or through an error of the

23  department or the board.

24         (b)  Having a license to practice podiatric 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 podiatric medicine or to the

31  ability to practice podiatric medicine.  Any plea of nolo


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    CS for SB 1558                                Second 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 or the board.

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

10  advising any unlicensed person to practice podiatric medicine

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

12  board.

13         (h)  Failing to perform any statutory or legal

14  obligation placed upon a licensed podiatric physician.

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

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

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

18  impeding or obstructing such filing or inducing another person

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

20  which are signed in the capacity of a licensed podiatric

21  physician.

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

23  fraudulent representations in the practice of podiatric

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

25  podiatric medicine when such scheme or trick fails to conform

26  to the generally prevailing standards of treatment in the

27  podiatric community.

28         (k)  Soliciting patients either personally or through

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

30  solicitations approved by rule of the board.

31  


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    CS for SB 1558                                Second Engrossed



  1         (l)  Failing to keep written medical records justifying

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

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

  4  results.

  5         (m)  Exercising influence on the patient or client in

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

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

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

  9  services, goods, appliances, or drugs and the promoting or

10  advertising on any prescription form of a community pharmacy

11  unless the form shall also state "This prescription may be

12  filled at any pharmacy of your choice."

13         (n)  Performing professional services which have not

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

15  legal representative except as provided in ss. 743.064,

16  766.103, and 768.13.

17         (o)  Prescribing, dispensing, administering, mixing, or

18  otherwise preparing a legend drug, including all controlled

19  substances, other than in the course of the podiatric

20  physician's professional practice.  For the purposes of this

21  paragraph, it shall be legally presumed that prescribing,

22  dispensing, administering, mixing, or otherwise preparing

23  legend drugs, including all controlled substances,

24  inappropriately or in excessive or inappropriate quantities is

25  not in the best interest of the patient and is not in the

26  course of the podiatric physician's professional practice,

27  without regard to her or his intent.

28         (p)  Prescribing, dispensing, or administering any

29  medicinal drug appearing on any schedule set forth in chapter

30  893 by the podiatric physician to herself or himself except

31  those prescribed, dispensed, or administered to the podiatric


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    CS for SB 1558                                Second Engrossed



  1  physician by another practitioner authorized to prescribe,

  2  dispense, or administer them.

  3         (q)  Prescribing, ordering, dispensing, administering,

  4  supplying, selling, or giving any amphetamine or

  5  sympathomimetic amine drug or compound designated as a

  6  Schedule II controlled substance pursuant to chapter 893.

  7         (r)  Being unable to practice podiatric medicine with

  8  reasonable skill and safety to patients by reason of illness

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

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

11  condition.  In enforcing this paragraph the department shall,

12  upon probable cause, have authority to compel a podiatric

13  physician to submit to a mental or physical examination by

14  physicians designated by the department. Failure of a

15  podiatric physician to submit to such examination when

16  directed shall constitute an admission of the allegations

17  against her or him, unless the failure was due to

18  circumstances beyond her or his control, consequent upon which

19  a default and final order may be entered without the taking of

20  testimony or presentation of evidence.  A podiatric physician

21  affected under this paragraph shall at reasonable intervals be

22  afforded an opportunity to demonstrate that she or he can

23  resume the competent practice of podiatric medicine with

24  reasonable skill and safety to patients.

25         (s)  Gross or repeated malpractice or the failure to

26  practice podiatric medicine at a level of care, skill, and

27  treatment which is recognized by a reasonably prudent

28  podiatric physician as being acceptable under similar

29  conditions and circumstances.  The board shall give great

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

31  interpreting this section. As used in this paragraph,


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    CS for SB 1558                                Second Engrossed



  1  "repeated malpractice" includes, but is not limited to, three

  2  or more claims for medical malpractice within the previous

  3  5-year period resulting in indemnities being paid in excess of

  4  $10,000 each to the claimant in a judgment or settlement and

  5  which incidents involved negligent conduct by the podiatric

  6  physicians. As used in this paragraph, "gross malpractice" or

  7  "the failure to practice podiatric medicine with the level of

  8  care, skill, and treatment which is recognized by a reasonably

  9  prudent similar podiatric physician as being acceptable under

10  similar conditions and circumstances" shall not be construed

11  so as to require more than one instance, event, or act.

12         (t)  Performing any procedure or prescribing any

13  therapy which, by the prevailing standards of podiatric

14  medical practice in the community, would constitute

15  experimentation on human subjects without first obtaining

16  full, informed, and written consent.

17         (u)  Practicing or offering to practice beyond the

18  scope permitted by law or accepting and performing

19  professional responsibilities which the licensee knows or has

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

21         (v)  Delegating professional responsibilities to a

22  person when the licensee delegating such responsibilities

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

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

25         (w)  Violating any provision of this chapter or chapter

26  456, any rule of the board or department, or a lawful order of

27  the board or department previously entered in a disciplinary

28  hearing or failing to comply with a lawfully issued subpoena

29  of the board or department.

30         (x)  Conspiring with another licensee or with any other

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


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    CS for SB 1558                                Second Engrossed



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

  2  lawfully advertising her or his services.

  3         (y)  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 any of the drug

10  products listed above may be dispensed by the pharmacist with

11  the presumption that the prescription is for legitimate

12  medical use.

13         (z)  Fraud, deceit, or misconduct in the practice of

14  podiatric medicine.

15         (aa)  Failing to report to the department any licensee

16  under chapter 458 or chapter 459 who the podiatric physician

17  knows has violated the grounds for disciplinary action set out

18  in the law under which that person is licensed and who

19  provides health care services in a facility licensed under

20  chapter 395, or a health maintenance organization certificated

21  under part I of chapter 641, in which the podiatric physician

22  also provides services.

23         (bb)  Failing to comply with the requirements of ss.

24  381.026 and 381.0261 to provide patients with information

25  about their patient rights and how to file a patient

26  complaint.

27         (cc)  Violating any provision of this chapter or

28  chapter 456, or any rules adopted pursuant thereto.

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

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

31  applicant for licensure or licensee who is found guilty of


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    CS for SB 1558                                Second Engrossed



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

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

  3  456.072(1). When the board finds any person guilty of any of

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

  5  imposing one or more of the following penalties:

  6         (a)  Refusal to certify to the department an

  7  application for licensure.

  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)  Placing the podiatric physician on probation for a

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

15  specify, including requiring the podiatric physician to submit

16  to treatment, to attend continuing education courses, to

17  submit to reexamination, and to work under the supervision of

18  another podiatric physician.

19         (g)  Imposition of an administrative fine in accordance

20  with s. 381.0261 for violations regarding patient rights.

21         Section 29.  Subsections (1) and (2) of section 462.14,

22  Florida Statutes, are amended to read:

23         462.14  Grounds for disciplinary action; action by the

24  department.--

25         (1)  The following acts constitute grounds for denial

26  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 to practice naturopathic medicine by bribery, by

31  


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    CS for SB 1558                                Second Engrossed



  1  fraudulent misrepresentation, or through an error of the

  2  department.

  3         (b)  Having a license to practice naturopathic medicine

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

  5  denial of licensure, by the licensing authority of another

  6  state, territory, or country.

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

  8  adjudication, of a crime in any jurisdiction which directly

  9  relates to the practice of naturopathic medicine or to the

10  ability to practice naturopathic medicine. Any plea of nolo

11  contendere shall be considered a conviction for purposes of

12  this chapter.

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

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

15  under a name other than one's own.

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

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

18  rules of the department.

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

20  unlicensed person to practice naturopathic medicine contrary

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

22         (h)  Failing to perform any statutory or legal

23  obligation placed upon a licensed naturopathic physician.

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

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

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

27  impeding or obstructing such filing or inducing another person

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

29  which are signed in the capacity as a licensed naturopathic

30  physician.

31  


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    CS for SB 1558                                Second Engrossed



  1         (j)  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 naturopathic physician from receiving a

10  fee for professional consultation services.

11         (k)  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 her or his physician.

16         (l)  Making deceptive, untrue, or fraudulent

17  representations in the practice of naturopathic medicine or

18  employing a trick or scheme in the practice of naturopathic

19  medicine when such scheme or trick fails to conform to the

20  generally prevailing standards of treatment in the medical

21  community.

22         (m)  Soliciting patients, either personally or through

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

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

25  "solicitation" is any communication which directly or

26  implicitly requests an immediate oral response from the

27  recipient.

28         (n)  Failing to keep written medical records justifying

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

30  limited to, patient histories, examination results, test

31  


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    CS for SB 1558                                Second Engrossed



  1  results, X rays, and records of the prescribing, dispensing

  2  and administering of drugs.

  3         (o)  Exercising influence on the patient or client in

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

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

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

  7  of services, goods, appliances, or drugs and the promoting or

  8  advertising on any prescription form of a community pharmacy

  9  unless the form also states "This prescription may be filled

10  at any pharmacy of your choice."

11         (p)  Performing professional services which have not

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

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

14  766.103, or s. 768.13.

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

16  otherwise preparing a legend drug, including any controlled

17  substance, other than in the course of the naturopathic

18  physician's professional practice.  For the purposes of this

19  paragraph, it shall be legally presumed that prescribing,

20  dispensing, administering, mixing, or otherwise preparing

21  legend drugs, including all controlled substances,

22  inappropriately or in excessive or inappropriate quantities is

23  not in the best interest of the patient and is not in the

24  course of the naturopathic physician's professional practice,

25  without regard to her or his intent.

26         (r)  Prescribing, dispensing, or administering any

27  medicinal drug appearing on any schedule set forth in chapter

28  893 by the naturopathic physician to herself or himself,

29  except one prescribed, dispensed, or administered to the

30  naturopathic physician by another practitioner authorized to

31  prescribe, dispense, or administer medicinal drugs.


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    CS for SB 1558                                Second Engrossed



  1         (s)  Being unable to practice naturopathic medicine

  2  with reasonable skill and safety to patients by reason of

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

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

  5  physical condition.  In enforcing this paragraph, the

  6  department shall have, upon probable cause, authority to

  7  compel a naturopathic physician to submit to a mental or

  8  physical examination by physicians designated by the

  9  department.  The failure of a naturopathic physician to submit

10  to such an examination when so directed shall constitute an

11  admission of the allegations against her or him upon which a

12  default and final order may be entered without the taking of

13  testimony or presentation of evidence, unless the failure was

14  due to circumstances beyond the naturopathic physician's

15  control.  A naturopathic physician affected under this

16  paragraph shall at reasonable intervals be afforded an

17  opportunity to demonstrate that she or he can resume the

18  competent practice of naturopathic medicine with reasonable

19  skill and safety to patients. In any proceeding under this

20  paragraph, neither the record of proceedings nor the orders

21  entered by the department may be used against a naturopathic

22  physician in any other proceeding.

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

24  practice naturopathic medicine with that level of care, skill,

25  and treatment which is recognized by a reasonably prudent

26  similar physician as being acceptable under similar conditions

27  and circumstances.  The department shall give great weight to

28  the provisions of s. 766.102 when enforcing this paragraph.

29         (u)  Performing any procedure or prescribing any

30  therapy which, by the prevailing standards of medical practice

31  in the community, constitutes experimentation on a human


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    CS for SB 1558                                Second Engrossed



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

  2  consent.

  3         (v)  Practicing or offering to practice beyond the

  4  scope permitted by law or accepting and performing

  5  professional responsibilities which the licensee knows or has

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

  7         (w)  Delegating professional responsibilities to a

  8  person when the licensee delegating such responsibilities

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

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

11         (x)  Violating any provision of this chapter, any rule

12  of the department, or a lawful order of the department

13  previously entered in a disciplinary hearing or failing to

14  comply with a lawfully issued subpoena of the department.

15         (y)  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 her or his services.

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

20  of, an unlawful termination of pregnancy.

21         (aa)  Presigning blank prescription forms.

22         (bb)  Prescribing by the naturopathic physician for

23  office use any medicinal drug appearing on Schedule II in

24  chapter 893.

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

26  supplying, selling, or giving any drug which is an amphetamine

27  or sympathomimetic amine drug, or a compound designated

28  pursuant to chapter 893 as a Schedule II controlled substance

29  to or for any person except for:

30         1.  The treatment of narcolepsy; hyperkinesis;

31  behavioral syndrome in children characterized by the


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    CS for SB 1558                                Second Engrossed



  1  developmentally inappropriate symptoms of moderate to severe

  2  distractability, short attention span, hyperactivity,

  3  emotional lability, and impulsivity; or drug-induced brain

  4  dysfunction.

  5         2.  The differential diagnostic psychiatric evaluation

  6  of depression or the treatment of depression shown to be

  7  refractory to other therapeutic modalities.

  8         3.  The clinical investigation of the effects of such

  9  drugs or compounds when an investigative protocol therefor is

10  submitted to, reviewed, and approved by the department before

11  such investigation is begun.

12         (dd)  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         (ee)  Violating any provision of this chapter or

23  chapter 456, or any rules adopted pursuant thereto.

24         (2)  The department may enter an order denying

25  licensure or imposing any of the penalties in s. 456.072(2)

26  against any applicant for licensure or licensee who is found

27  guilty of violating any provision of subsection (1) of this

28  section or who is found guilty of violating any provision of

29  s. 456.072(1). When the department finds any person guilty of

30  any of the grounds set forth in subsection (1), it may enter

31  an order imposing one or more of the following penalties:


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    CS for SB 1558                                Second Engrossed



  1         (a)  Refusal to certify to the department an

  2  application for licensure.

  3         (b)  Revocation or suspension of a license.

  4         (c)  Restriction of practice.

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

  6  $1,000 for each count or separate offense.

  7         (e)  Issuance of a reprimand.

  8         (f)  Placement of the naturopathic physician on

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

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

11  requiring the naturopathic physician to submit to treatment,

12  to attend continuing education courses, to submit to

13  reexamination, or to work under the supervision of another

14  naturopathic physician.

15         Section 30.  Subsections (1) and (2) of section

16  463.016, Florida Statutes, are amended to read:

17         463.016  Grounds for disciplinary action; action by the

18  board.--

19         (1)  The following acts shall constitute grounds for

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

21  456.072(2) which the disciplinary actions specified in

22  subsection (2) may be taken:

23         (a)  Procuring or attempting to procure a license to

24  practice optometry by bribery, by fraudulent

25  misrepresentations, or through an error of the department or

26  board.

27         (b)  Procuring or attempting to procure a license for

28  any other person by making or causing to be made any false

29  representation.

30  

31  


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    CS for SB 1558                                Second Engrossed



  1         (c)  Having a license to practice optometry revoked,

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

  3  licensure, by the licensing authority of another jurisdiction.

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

  5  adjudication, of a crime in any jurisdiction which directly

  6  relates to the practice of optometry or to the ability to

  7  practice optometry.  Any plea of nolo contendere shall be

  8  considered a conviction for the purposes of this chapter.

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

10  licensee knows to be false, intentionally or negligently

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

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

13  inducing another person to do so.  Such reports or records

14  shall include only those which are signed by the licensee in

15  her or his capacity as a licensed practitioner.

16         (f)  Advertising goods or services in a manner which is

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

18  content.

19         (g)  Fraud or deceit, negligence or incompetency, or

20  misconduct in the practice of optometry.

21         (h)  A violation or repeated violations of provisions

22  of this chapter, or of chapter 456, and any rules promulgated

23  pursuant thereto.

24         (i)  Conspiring with another licensee or with any

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

26  coerce, intimidate, or preclude another licensee from lawfully

27  advertising her or his services.

28         (j)  Willfully submitting to any third-party payor a

29  claim for services which were not provided to a patient.

30         (k)  Failing to keep written optometric records about

31  the examinations, treatments, and prescriptions for patients.


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    CS for SB 1558                                Second Engrossed



  1         (l)  Willfully failing to report any person who the

  2  licensee knows is in violation of this chapter or of rules of

  3  the department or the board.

  4         (m)  Gross or repeated malpractice.

  5         (n)  Practicing with a revoked, suspended, inactive, or

  6  delinquent license.

  7         (o)  Being unable to practice optometry with reasonable

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

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

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

11  A licensed practitioner affected under this paragraph shall at

12  reasonable intervals be afforded an opportunity to demonstrate

13  that she or he can resume the competent practice of optometry

14  with reasonable skill and safety to patients.

15         (p)  Having been disciplined by a regulatory agency in

16  another state for any offense that would constitute a

17  violation of Florida laws or rules regulating optometry.

18         (q)  Violating any provision of s. 463.014 or s.

19  463.015.

20         (r)  Violating any lawful order of the board or

21  department, previously entered in a disciplinary hearing, or

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

23  or department.

24         (s)  Practicing or offering to practice beyond the

25  scope permitted by law or accepting and performing

26  professional responsibilities which the licensed practitioner

27  knows or has reason to know she or he is not competent to

28  perform.

29         (t)  Violating any provision of this chapter or chapter

30  456, or any rules adopted pursuant thereto.

31  


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    CS for SB 1558                                Second Engrossed



  1         (2)  The department may enter an order imposing any of

  2  the penalties in s. 456.072(2) against any licensee who is

  3  found guilty of violating any provision of subsection (1) of

  4  this section or who is found guilty of violating any provision

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

  6  any of the grounds set forth in subsection (1), it may enter

  7  an order imposing one or more of the following penalties:

  8         (a)  Refusal to certify to the department an

  9  application for licensure.

10         (b)  Revocation or suspension of a license.

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

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

13         (d)  Issuance of a reprimand.

14         (e)  Placement of the licensed practitioner on

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

16  as the board may specify, including requiring the licensed

17  practitioner to submit to treatment, to attend continuing

18  education courses, or to work under the supervision of another

19  licensed practitioner.

20         Section 31.  Subsections (1) and (2) of section

21  464.018, Florida Statutes, are amended to read:

22         464.018  Disciplinary actions.--

23         (1)  The following acts constitute shall be grounds for

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

25  456.072(2) disciplinary action set forth in this section:

26         (a)  Procuring, attempting to procure, or renewing a

27  license to practice nursing by bribery, by knowing

28  misrepresentations, or through an error of the department or

29  the board.

30         (b)  Having a license to practice nursing revoked,

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


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    CS for SB 1558                                Second Engrossed



  1  licensure, by the licensing authority of another state,

  2  territory, or country.

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

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

  5  crime in any jurisdiction which directly relates to the

  6  practice of nursing or to the ability to practice nursing.

  7         (d)  Being found guilty, regardless of adjudication, of

  8  any of the following offenses:

  9         1.  A forcible felony as defined in chapter 776.

10         2.  A violation of chapter 812, relating to theft,

11  robbery, and related crimes.

12         3.  A violation of chapter 817, relating to fraudulent

13  practices.

14         4.  A violation of chapter 800, relating to lewdness

15  and indecent exposure.

16         5.  A violation of chapter 784, relating to assault,

17  battery, and culpable negligence.

18         6.  A violation of chapter 827, relating to child

19  abuse.

20         7.  A violation of chapter 415, relating to protection

21  from abuse, neglect, and exploitation.

22         8.  A violation of chapter 39, relating to child abuse,

23  abandonment, and neglect.

24         (e)  Having been found guilty of, regardless of

25  adjudication, or entered a plea of nolo contendere or guilty

26  to, any offense prohibited under s. 435.03 or under any

27  similar statute of another jurisdiction; or having committed

28  an act which constitutes domestic violence as defined in s.

29  741.28.

30         (f)  Making or filing a false report or record, which

31  the licensee knows to be false, intentionally or negligently


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    CS for SB 1558                                Second Engrossed



  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 do so.  Such reports or records

  4  shall include only those which are signed in the nurse's

  5  capacity as a licensed nurse.

  6         (g)  False, misleading, or deceptive advertising.

  7         (h)  Unprofessional conduct, which shall include, but

  8  not be limited to, any departure from, or the failure to

  9  conform to, the minimal standards of acceptable and prevailing

10  nursing practice, in which case actual injury need not be

11  established.

12         (i)  Engaging or attempting to engage in the

13  possession, sale, or distribution of controlled substances as

14  set forth in chapter 893, for any other than legitimate

15  purposes authorized by this part.

16         (j)  Being unable to practice nursing with reasonable

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

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

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

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

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

22  probable cause exists to believe that the licensee is unable

23  to practice nursing because of the reasons stated in this

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

25  licensee to submit to a mental or physical examination by

26  physicians designated by the department.  If the licensee

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

28  directing such examination may be enforced by filing a

29  petition for enforcement in the circuit court where the

30  licensee resides or does business. The licensee against whom

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


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    CS for SB 1558                                Second Engrossed



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

  2  proceedings shall be closed to the public. The department

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

  4  51.011. A nurse affected by the provisions of this paragraph

  5  shall at reasonable intervals be afforded an opportunity to

  6  demonstrate that she or he can resume the competent practice

  7  of nursing with reasonable skill and safety to patients.

  8         (k)  Failing to report to the department any person who

  9  the licensee knows is in violation of this part or of the

10  rules of the department or the board; however, if the licensee

11  verifies that such person is actively participating in a

12  board-approved program for the treatment of a physical or

13  mental condition, the licensee is required to report such

14  person only to an impaired professionals consultant.

15         (l)  Knowingly violating any provision of this part, a

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

17  board or department previously entered in a disciplinary

18  proceeding or failing to comply with a lawfully issued

19  subpoena of the department.

20         (m)  Failing to report to the department any licensee

21  under chapter 458 or under chapter 459 who the nurse knows has

22  violated the grounds for disciplinary action set out in the

23  law under which that person is licensed and who provides

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

25  or a health maintenance organization certificated under part I

26  of chapter 641, in which the nurse also provides services.

27         (n)  Violating any provision of this chapter or chapter

28  456, or any rules adopted pursuant thereto.

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

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

31  applicant for licensure or licensee who is found guilty of


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    CS for SB 1558                                Second Engrossed



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

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

  3  456.072(1). When the board finds any person guilty of any of

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

  5  imposing one or more of the following penalties:

  6         (a)  Refusal to certify to the department an

  7  application for licensure.

  8         (b)  Revocation or suspension of a license with

  9  reinstatement subject to the provisions of subsection (3).

10         (c)  Permanent revocation of a license.

11         (d)  Restriction of practice.

12         (e)  Imposition of an administrative fine not to exceed

13  $1,000 for each count or separate offense.

14         (f)  Issuance of a reprimand.

15         (g)  Placement of the nurse on probation for a period

16  of time and subject to such conditions as the board may

17  specify, including requiring the nurse to submit to treatment,

18  to attend continuing education courses, to take an

19  examination, or to work under the supervision of another

20  nurse.

21         Section 32.  Subsection (3) of section 465.008, Florida

22  Statutes, is amended to read:

23         465.008  Renewal of license.--

24         (3)  Sixty days prior to the end of the biennium the

25  department shall mail a notice of renewal to the last known

26  address of the licensee.

27         Section 33.  Subsections (1) and (2) of section

28  465.016, Florida Statutes, are amended to read:

29         465.016  Disciplinary actions.--

30  

31  


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    CS for SB 1558                                Second Engrossed



  1         (1)  The following acts constitute shall be grounds for

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

  3  456.072(2) disciplinary action set forth in this section:

  4         (a)  Obtaining a license by misrepresentation or fraud

  5  or through an error of the department or the board.

  6         (b)  Procuring or attempting to procure a license for

  7  any other person by making or causing to be made any false

  8  representation.

  9         (c)  Permitting any person not licensed as a pharmacist

10  in this state or not registered as an intern in this state, or

11  permitting a registered intern who is not acting under the

12  direct and immediate personal supervision of a licensed

13  pharmacist, to fill, compound, or dispense any prescriptions

14  in a pharmacy owned and operated by such pharmacist or in a

15  pharmacy where such pharmacist is employed or on duty.

16         (d)  Being unfit or incompetent to practice pharmacy by

17  reason of:

18         1.  Habitual intoxication.

19         2.  The misuse or abuse of any medicinal drug appearing

20  in any schedule set forth in chapter 893.

21         3.  Any abnormal physical or mental condition which

22  threatens the safety of persons to whom she or he might sell

23  or dispense prescriptions, drugs, or medical supplies or for

24  whom she or he might manufacture, prepare, or package, or

25  supervise the manufacturing, preparation, or packaging of,

26  prescriptions, drugs, or medical supplies.

27         (e)  Violating any of the requirements of this chapter;

28  or if licensed as a practitioner in this or any other state,

29  violating any of the requirements of their respective practice

30  act or violating chapter 499; 21 U.S.C. ss. 301-392, known as

31  the Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et


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    CS for SB 1558                                Second Engrossed



  1  seq., known as the Comprehensive Drug Abuse Prevention and

  2  Control Act; or chapter 893.

  3         (f)  Having been convicted or found guilty, regardless

  4  of adjudication, in a court of this state or other

  5  jurisdiction, of a crime which directly relates to the ability

  6  to practice pharmacy or to the practice of pharmacy.  A plea

  7  of nolo contendere constitutes a conviction for purposes of

  8  this provision.

  9         (g)  Using in the compounding of a prescription, or

10  furnishing upon prescription, an ingredient or article

11  different in any manner from the ingredient or article

12  prescribed, except as authorized in s. 465.019(6) or s.

13  465.025.

14         (h)  Having been disciplined by a regulatory agency in

15  another state for any offense that would constitute a

16  violation of this chapter.

17         (i)  Compounding, dispensing, or distributing a legend

18  drug, including any controlled substance, other than in the

19  course of the professional practice of pharmacy.  For purposes

20  of this paragraph, it shall be legally presumed that the

21  compounding, dispensing, or distributing of legend drugs in

22  excessive or inappropriate quantities is not in the best

23  interests of the patient and is not in the course of the

24  professional practice of pharmacy.

25         (j)  Making or filing a report or record which the

26  licensee knows to be false, intentionally or negligently

27  failing to file a report or record required by federal or

28  state law, willfully impeding or obstructing such filing, or

29  inducing another person to do so.  Such reports or records

30  include only those which the licensee is required to make or

31  file in her or his capacity as a licensed pharmacist.


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    CS for SB 1558                                Second Engrossed



  1         (k)  Failing to make prescription fee or price

  2  information readily available by failing to provide such

  3  information upon request and upon the presentation of a

  4  prescription for pricing or dispensing.  Nothing in this

  5  section shall be construed to prohibit the quotation of price

  6  information on a prescription drug to a potential consumer by

  7  telephone.

  8         (l)  Placing in the stock of any pharmacy any part of

  9  any prescription compounded or dispensed which is returned by

10  a patient; however, in a hospital, nursing home, correctional

11  facility, or extended care facility in which unit-dose

12  medication is dispensed to inpatients, each dose being

13  individually sealed and the individual unit dose or unit-dose

14  system labeled with the name of the drug, dosage strength,

15  manufacturer's control number, and expiration date, if any,

16  the unused unit dose of medication may be returned to the

17  pharmacy for redispensing.  Each pharmacist shall maintain

18  appropriate records for any unused or returned medicinal

19  drugs.

20         (m)  Being unable to practice pharmacy with reasonable

21  skill and safety by reason of illness, use of drugs,

22  narcotics, chemicals, or any other type of material or as a

23  result of any mental or physical condition.  A pharmacist

24  affected under this paragraph shall at reasonable intervals be

25  afforded an opportunity to demonstrate that she or he can

26  resume the competent practice of pharmacy with reasonable

27  skill and safety to her or his customers.

28         (n)  Violating a rule of the board or department or

29  violating an order of the board or department previously

30  entered in a disciplinary hearing.

31  


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    CS for SB 1558                                Second Engrossed



  1         (o)  Failing to report to the department any licensee

  2  under chapter 458 or under chapter 459 who the pharmacist

  3  knows has violated the grounds for disciplinary action set out

  4  in the law under which that person is licensed and who

  5  provides health care services in a facility licensed under

  6  chapter 395, or a health maintenance organization certificated

  7  under part I of chapter 641, in which the pharmacist also

  8  provides services.

  9         (p)  Failing to notify the Board of Pharmacy in writing

10  within 20 days of the commencement or cessation of the

11  practice of the profession of pharmacy in Florida when such

12  commencement or cessation of the practice of the profession of

13  pharmacy in Florida was a result of a pending or completed

14  disciplinary action or investigation in another jurisdiction.

15         (q)  Using or releasing a patient's records except as

16  authorized by this chapter and chapter 456.

17         (r)  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), it may enter an order

26  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                                Second Engrossed



  1         (d)  Issuance of a reprimand.

  2         (e)  Placement of the pharmacist on probation for a

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

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

  5  pharmacist to submit to treatment, to attend continuing

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

  7  under the supervision of another pharmacist.

  8         Section 34.  Subsections (1) and (2) of section

  9  466.028, Florida Statutes, are amended to read:

10         466.028  Grounds for disciplinary action; action by the

11  board.--

12         (1)  The following acts shall constitute grounds for

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

14  456.072(2) which the disciplinary actions specified in

15  subsection (2) may be taken:

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

17  license under this chapter by bribery, fraudulent

18  misrepresentations, or through an error of the department or

19  the board.

20         (b)  Having a license to practice dentistry or dental

21  hygiene revoked, suspended, or otherwise acted against,

22  including the denial of licensure, by the licensing authority

23  of another state, territory, or country.

24         (c)  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 relates to the practice of

27  dentistry or dental hygiene.  A plea of nolo contendere shall

28  create a rebuttable presumption of guilt to the underlying

29  criminal charges.

30         (d)  Advertising goods or services in a manner which is

31  fraudulent, false, deceptive, or misleading in form or content


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    CS for SB 1558                                Second Engrossed



  1  contrary to s. 466.019 or rules of the board adopted pursuant

  2  thereto.

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

  4  under a name other than one's own.

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

  6  the licensee knows, or has reason to believe, is clearly in

  7  violation of this chapter or of the rules of the department or

  8  the board.

  9         (g)  Aiding, assisting, procuring, or advising any

10  unlicensed person to practice dentistry or dental hygiene

11  contrary to this chapter or to a rule of the department or the

12  board.

13         (h)  Being employed by any corporation, organization,

14  group, or person other than a dentist or a professional

15  corporation or limited liability company composed of dentists

16  to practice dentistry.

17         (i)  Failing to perform any statutory or legal

18  obligation placed upon a licensee.

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

20  to be false, failing to file a report or record required by

21  state or federal law, knowingly impeding or obstructing such

22  filing or inducing another person to do so.  Such reports or

23  records shall include only those which are signed in the

24  capacity as a licensee.

25         (k)  Committing any act which would constitute sexual

26  battery, as defined in chapter 794, upon a patient or

27  intentionally touching the sexual organ of a patient.

28         (l)  Making deceptive, untrue, or fraudulent

29  representations in or related to the practice of dentistry.

30         (m)  Failing to keep written dental records and medical

31  history records justifying the course of treatment of the


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

  2  examination results, test results, and X rays, if taken.

  3         (n)  Failing to make available to a patient or client,

  4  or to her or his legal representative or to the department if

  5  authorized in writing by the patient, copies of documents in

  6  the possession or under control of the licensee which relate

  7  to the patient or client.

  8         (o)  Performing professional services which have not

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

10  legal representative, except as provided in ss. 766.103 and

11  768.13.

12         (p)  Prescribing, procuring, dispensing, administering,

13  mixing, or otherwise preparing a legend drug, including any

14  controlled substance, other than in the course of the

15  professional practice of the dentist.  For the purposes of

16  this paragraph, it shall be legally presumed that prescribing,

17  procuring, dispensing, administering, mixing, or otherwise

18  preparing legend drugs, including all controlled substances,

19  in excessive or inappropriate quantities is not in the best

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

21  professional practice of the dentist, without regard to her or

22  his intent.

23         (q)  Prescribing, procuring, dispensing, or

24  administering any medicinal drug appearing on any schedule set

25  forth in chapter 893, by a dentist to herself or himself,

26  except those prescribed, dispensed, or administered to the

27  dentist by another practitioner authorized to prescribe them.

28         (r)  Prescribing, procuring, ordering, dispensing,

29  administering, supplying, selling, or giving any drug which is

30  a Schedule II amphetamine or a Schedule II sympathomimetic

31  amine drug or a compound thereof, pursuant to chapter 893, to


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    CS for SB 1558                                Second Engrossed



  1  or for any person except for the clinical investigation of the

  2  effects of such drugs or compounds when an investigative

  3  protocol therefor is submitted to, and reviewed and approved

  4  by, the board before such investigation is begun.

  5         (s)  Being unable to practice her or his profession

  6  with reasonable skill and safety to patients by reason of

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

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

  9  physical condition.  In enforcing this paragraph, the

10  department shall have, upon a finding of the secretary or her

11  or his designee that probable cause exists to believe that the

12  licensee is unable to practice dentistry or dental hygiene

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

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

15  or physical examination by physicians designated by the

16  department.  If the licensee refuses to comply with such

17  order, the department's order directing such examination may

18  be enforced by filing a petition for enforcement in the

19  circuit court where the licensee resides or does business.

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 at reasonable intervals be afforded an

26  opportunity to demonstrate that she or he can resume the

27  competent practice of her or his profession with reasonable

28  skill and safety to patients.

29         (t)  Fraud, deceit, or misconduct in the practice of

30  dentistry or dental hygiene.

31  


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    CS for SB 1558                                Second Engrossed



  1         (u)  Failure to provide and maintain reasonable

  2  sanitary facilities and conditions.

  3         (v)  Failure to provide adequate radiation safeguards.

  4         (w)  Performing any procedure or prescribing any

  5  therapy which, by the prevailing standards of dental practice

  6  in the community, would constitute experimentation on human

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

  8  consent.

  9         (x)  Being guilty of incompetence or negligence by

10  failing to meet the minimum standards of performance in

11  diagnosis and treatment when measured against generally

12  prevailing peer performance, including, but not limited to,

13  the undertaking of diagnosis and treatment for which the

14  dentist is not qualified by training or experience or being

15  guilty of dental malpractice. For purposes of this paragraph,

16  it shall be legally presumed that a dentist is not guilty of

17  incompetence or negligence by declining to treat an individual

18  if, in the dentist's professional judgment, the dentist or a

19  member of her or his clinical staff is not qualified by

20  training and experience, or the dentist's treatment facility

21  is not clinically satisfactory or properly equipped to treat

22  the unique characteristics and health status of the dental

23  patient, provided the dentist refers the patient to a

24  qualified dentist or facility for appropriate treatment.  As

25  used in this paragraph, "dental malpractice" includes, but is

26  not limited to, three or more claims within the previous

27  5-year period which resulted in indemnity being paid, or any

28  single indemnity paid in excess of $5,000 in a judgment or

29  settlement, as a result of negligent conduct on the part of

30  the dentist.

31  


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    CS for SB 1558                                Second Engrossed



  1         (y)  Practicing or offering to practice beyond the

  2  scope permitted by law or accepting and performing

  3  professional responsibilities which the licensee knows or has

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

  5         (z)  Delegating professional responsibilities to a

  6  person who is not qualified by training, experience, or

  7  licensure to perform them.

  8         (aa)  The violation or the repeated violation of this

  9  chapter, chapter 456, or any rule promulgated pursuant to

10  chapter 456 or this chapter; the violation of a lawful order

11  of the board or department previously entered in a

12  disciplinary hearing; or failure to comply with a lawfully

13  issued subpoena of the board or department.

14         (bb)  Conspiring with another licensee or with any

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

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

17  lawfully advertising her or his services.

18         (cc)  Being adjudged mentally incompetent in this or

19  any other state, the discipline for which shall last only so

20  long as the adjudication.

21         (dd)  Presigning blank prescription or laboratory work

22  order forms.

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

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

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

26  hormones for the purpose of muscle building or to enhance

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

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

29  injured muscle.  A prescription written for the drug products

30  listed above may be dispensed by the pharmacist with the

31  


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    CS for SB 1558                                Second Engrossed



  1  presumption that the prescription is for legitimate medical

  2  use.

  3         (ff)  Operating or causing to be operated a dental

  4  office in such a manner as to result in dental treatment that

  5  is below minimum acceptable standards of performance for the

  6  community. This includes, but is not limited to, the use of

  7  substandard materials or equipment, the imposition of time

  8  limitations within which dental procedures are to be

  9  performed, or the failure to maintain patient records as

10  required by this chapter.

11         (gg)  Administering anesthesia in a manner which

12  violates rules of the board adopted pursuant to s. 466.017.

13         (hh)  Failing to report to the department any licensee

14  under chapter 458 or chapter 459 who the dentist knows has

15  violated the grounds for disciplinary action set out in the

16  law under which that person is licensed and who provides

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

18  or a health maintenance organization certificated under part I

19  of chapter 641, in which the dentist also provides services.

20         (ii)  Failing to report to the board, in writing,

21  within 30 days if action has been taken against one's license

22  to practice dentistry in another state, territory, or country.

23         (jj)  Advertising specialty services in violation of

24  this chapter.

25         (kk)  Allowing any person other than another dentist or

26  a professional corporation or limited liability company

27  composed of dentists to direct, control, or interfere with a

28  dentist's clinical judgment; however, this paragraph may not

29  be construed to limit a patient's right of informed consent.

30  To direct, control, or interfere with a dentist's clinical

31  judgment may not be interpreted to mean dental services


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    CS for SB 1558                                Second Engrossed



  1  contractually excluded, the application of alternative

  2  benefits that may be appropriate given the dentist's

  3  prescribed course of treatment, or the application of

  4  contractual provisions and scope of coverage determinations in

  5  comparison with a dentist's prescribed treatment on behalf of

  6  a covered person by an insurer, health maintenance

  7  organization, or a prepaid limited health service

  8  organization.

  9         (ll)  Violating any provision of this chapter or

10  chapter 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). When the board finds any applicant or licensee

17  guilty of any of the grounds set forth in subsection (1), it

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

19  penalties:

20         (a)  Denial of an application for licensure.

21         (b)  Revocation or suspension of a license.

22         (c)  Imposition of an administrative fine not to exceed

23  $3,000 for each count or separate offense.

24         (d)  Issuance of a reprimand.

25         (e)  Placement of the licensee on probation for a

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

27  specify, including requiring the licensee to attend continuing

28  education courses or demonstrate competency through a written

29  or practical examination or to work under the supervision of

30  another licensee.

31         (f)  Restricting the authorized scope of practice.


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    CS for SB 1558                                Second Engrossed



  1         Section 35.  Section 466.037, Florida Statutes, is

  2  amended to read:

  3         466.037  Suspension and revocation; administrative

  4  fine.--The department may suspend or revoke the certificate of

  5  any dental laboratory registered under s. 466.032, for failing

  6  to comply with the provisions of this chapter or rules adopted

  7  by the department under this chapter.  The department may

  8  impose an administrative fine not to exceed $500 for each

  9  count or separate offense.

10         Section 36.  Subsections (1) and (2) of section

11  467.203, Florida Statutes, are amended to read:

12         467.203  Disciplinary actions; penalties.--

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 as set forth in this section:

16         (a)  Procuring, attempting to procure, or renewing a

17  license to practice midwifery by bribery, by fraudulent

18  misrepresentation, or through an error of the department.

19         (b)  Having a license to practice midwifery revoked,

20  suspended, or otherwise acted against, including being denied

21  licensure, by the licensing authority of another state,

22  territory, or country.

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

24  adjudication, in any jurisdiction of a crime which directly

25  relates to the practice of midwifery or to the ability to

26  practice midwifery.  A plea of nolo contendere shall be

27  considered a conviction for purposes of this provision.

28         (d)  Making or filing a false report or record, which

29  the licensee knows to be false; intentionally or negligently

30  failing to file a report or record required by state or

31  federal law; or willfully impeding or obstructing such filing


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    CS for SB 1558                                Second Engrossed



  1  or inducing another to do so.  Such reports or records shall

  2  include only those which are signed in the midwife's capacity

  3  as a licensed midwife.

  4         (e)  Advertising falsely, misleadingly, or deceptively.

  5         (f)  Engaging in unprofessional conduct, which

  6  includes, but is not limited to, any departure from, or the

  7  failure to conform to, the standards of practice of midwifery

  8  as established by the department, in which case actual injury

  9  need not be established.

10         (g)  Being unable to practice midwifery with reasonable

11  skill and safety to patients by reason of illness;

12  drunkenness; or use of drugs, narcotics, chemicals, or other

13  materials or as a result of any mental or physical condition.

14  A midwife affected under this paragraph shall, at reasonable

15  intervals, be afforded an opportunity to demonstrate that he

16  or she can resume the competent practice of midwifery with

17  reasonable skill and safety.

18         (h)  Failing to report to the department any person who

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

20  rules of the department.

21         (i)  Willfully or repeatedly Violating any provision of

22  this chapter, any rule of the department, or any lawful order

23  of the department previously entered in a disciplinary

24  proceeding or failing to comply with a lawfully issued

25  subpoena of the department.

26         (j)  Violating any provision of this chapter or chapter

27  456, or any rules adopted pursuant thereto.

28         (2)  The department may enter an order denying

29  licensure or imposing any of the penalties in s. 456.072(2)

30  against any applicant for licensure or licensee who is found

31  guilty of violating any provision of subsection (1) of this


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    CS for SB 1558                                Second Engrossed



  1  section or who is found guilty of violating any provision of

  2  s. 456.072(1). When the department finds any person guilty of

  3  any of the grounds set forth in subsection (1), it may enter

  4  an order imposing one or more of the following penalties:

  5         (a)  Refusal to approve an application for licensure.

  6         (b)  Revocation or suspension of a license.

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

  8  $1,000 for each count or separate offense.

  9         (d)  Issuance of a reprimand.

10         (e)  Placement of the midwife on probation for such

11  period of time and subject to such conditions as the

12  department may specify, including requiring the midwife to

13  submit to treatment; undertake further relevant education or

14  training; take an examination; or work under the supervision

15  of another licensed midwife, a physician, or a nurse midwife

16  licensed under part I of chapter 464.

17         Section 37.  Subsections (1) and (2) of section

18  468.1295, Florida Statutes, are amended to read:

19         468.1295  Disciplinary proceedings.--

20         (1)  The following acts constitute grounds for denial

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

22  456.072(2) both disciplinary actions as set forth in

23  subsection (2) and cease and desist or other related actions

24  by the department as set forth in s. 456.065:

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

26  bribery, by fraudulent misrepresentation, or through an error

27  of the department or the board.

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

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

30  authority of another state, territory, or country.

31  


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    CS for SB 1558                                Second Engrossed



  1         (c)  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 directly relates to the

  4  practice of speech-language pathology or audiology.

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

  6  licensee knows to be false, intentionally or negligently

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

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

  9  inducing another person to impede or obstruct such filing.

10  Such report or record shall include only those reports or

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

12  speech-language pathologist or audiologist.

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

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

15  content.

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

17  negligence, incompetency, or misconduct in the practice of

18  speech-language pathology or audiology.

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

20  department previously entered in a disciplinary hearing, or

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

22  or department.

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

24  delinquent license.

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

26  advertising matter, promotional literature, testimonial,

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

28  representation, however disseminated or published, which is

29  misleading, deceiving, or untruthful.

30  

31  


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    CS for SB 1558                                Second Engrossed



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

  2  delivery of a product unusable or impractical for the purpose

  3  represented or implied by such action.

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

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

  6  of testing and calibration of such equipment as designated by

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

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

  9  advising any licensee or business entity to practice

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

11  chapter 456, or any rule adopted pursuant thereto.

12         (m)  Violating any provision of this part or chapter

13  456 or any rule adopted pursuant thereto.

14         (m)(n)  Misrepresenting the professional services

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

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

17  connote the availability of professional services when such

18  use is not accurate.

19         (n)(o)  Representing, advertising, or implying that a

20  hearing aid or its repair is guaranteed without providing full

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

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

23  conditions or limitations imposed upon the guarantee.

24         (o)(p)  Representing, directly or by implication, that

25  a hearing aid utilizing bone conduction has certain specified

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

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

28  and conspicuously that the instrument operates on the bone

29  conduction principle and that in many cases of hearing loss

30  this type of instrument may not be suitable.

31  


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    CS for SB 1558                                Second Engrossed



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

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

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

  4  similar or opposite effect.

  5         (q)(r)  Making any statement regarding the cure of the

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

  7         (r)(s)  Representing or implying that a hearing aid is

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

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

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

11         (s)(t)  Canvassing from house to house or by telephone,

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

13  hearing aid, except that contacting persons who have evidenced

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

15  of hearing aids, shall not be considered canvassing.

16         (t)(u)  Failing to notify the department in writing of

17  a change in current mailing and place-of-practice address

18  within 30 days after such change.

19         (u)(v)  Failing to provide all information as described

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

21         (v)(w)  Exercising influence on a client in such a

22  manner as to exploit the client for financial gain of the

23  licensee or of a third party.

24         (w)(x)  Practicing or offering to practice beyond the

25  scope permitted by law or accepting and performing

26  professional responsibilities the licensee or

27  certificateholder knows, or has reason to know, the licensee

28  or certificateholder is not competent to perform.

29         (x)(y)  Aiding, assisting, procuring, or employing any

30  unlicensed person to practice speech-language pathology or

31  audiology.


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    CS for SB 1558                                Second Engrossed



  1         (y)(z)  Delegating or contracting for the performance

  2  of professional responsibilities by a person when the licensee

  3  delegating or contracting for performance of such

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

  5  not qualified by training, experience, and authorization to

  6  perform them.

  7         (z)(aa)  Committing any act upon a patient or client

  8  which would constitute sexual battery or which would

  9  constitute sexual misconduct as defined pursuant to s.

10  468.1296.

11         (aa)(bb)  Being unable to practice the profession for

12  which he or she is licensed or certified under this chapter

13  with reasonable skill or competence as a result of any mental

14  or physical condition or by reason of illness, drunkenness, or

15  use of drugs, narcotics, chemicals, or any other substance. In

16  enforcing this paragraph, upon a finding by the secretary, his

17  or her designee, or the board that probable cause exists to

18  believe that the licensee or certificateholder is unable to

19  practice the profession because of the reasons stated in this

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

21  licensee or certificateholder to submit to a mental or

22  physical examination by a physician, psychologist, clinical

23  social worker, marriage and family therapist, or mental health

24  counselor designated by the department or board.  If the

25  licensee or certificateholder refuses to comply with the

26  department's order directing the examination, such order may

27  be enforced by filing a petition for enforcement in the

28  circuit court in the circuit in which the licensee or

29  certificateholder resides or does business.  The department

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

31  51.011.  A licensee or certificateholder affected under this


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    CS for SB 1558                                Second Engrossed



  1  paragraph shall at reasonable intervals be afforded an

  2  opportunity to demonstrate that he or she can resume the

  3  competent practice for which he or she is licensed or

  4  certified with reasonable skill and safety to patients.

  5         (bb)  Violating any provision of this chapter or

  6  chapter 456, or any rules adopted pursuant thereto.

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

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

  9  applicant for licensure or licensee who is found guilty of

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

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

12  456.072(1). When the board finds any person guilty of any of

13  the acts set forth in subsection (1), it may issue an order

14  imposing one or more of the following penalties:

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

16  restrictions, an application for licensure.

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

18         (c)  Issuance of a reprimand.

19         (d)  Restriction of the authorized scope of practice.

20         (e)  Imposition of an administrative fine not to exceed

21  $1,000 for each count or separate offense.

22         (f)  Placement of the licensee or certificateholder on

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

24  as the board may specify.  Those conditions may include, but

25  are not limited to, requiring the licensee or

26  certificateholder to undergo treatment, attend continuing

27  education courses, submit to be reexamined, work under the

28  supervision of another licensee, or satisfy any terms which

29  are reasonably tailored to the violation found.

30         (g)  Corrective action.

31  


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    CS for SB 1558                                Second Engrossed



  1         Section 38.  Subsections (1) and (2) of section

  2  468.1755, Florida Statutes, are amended to read:

  3         468.1755  Disciplinary proceedings.--

  4         (1)  The following acts shall constitute grounds for

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

  6  456.072(2) which the disciplinary actions in subsection (2)

  7  may be taken:

  8         (a)  Violation of any provision of s. 456.072(1) or s.

  9  468.1745(1).

10         (b)  Attempting to procure a license to practice

11  nursing home administration by bribery, by fraudulent

12  misrepresentation, or through an error of the department or

13  the board.

14         (c)  Having a license to practice nursing home

15  administration revoked, suspended, or otherwise acted against,

16  including the denial of licensure, by the licensing authority

17  of another state, territory, or country.

18         (d)  Being convicted or found guilty, regardless of

19  adjudication, of a crime in any jurisdiction which relates to

20  the practice of nursing home administration or the ability to

21  practice nursing home administration.  Any plea of nolo

22  contendere shall be considered a conviction for purposes of

23  this part.

24         (e)  Making or filing a report or record which the

25  licensee knows to be false, intentionally failing to file a

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

27  impeding or obstructing such filing, or inducing another

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

29  records shall include only those which are signed in the

30  capacity of a licensed nursing home administrator.

31  


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    CS for SB 1558                                Second Engrossed



  1         (f)  Authorizing the discharge or transfer of a

  2  resident for a reason other than those provided in ss. 400.022

  3  and 400.0255.

  4         (g)  Advertising goods or services in a manner which is

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

  6  content.

  7         (h)  Fraud or deceit, negligence, incompetence, or

  8  misconduct in the practice of nursing home administration.

  9         (i)  A violation or repeated violations of this part,

10  chapter 456, or any rules promulgated pursuant thereto.

11         (i)(j)  Violation of 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 board

14  or department.

15         (j)(k)  Practicing with a revoked, suspended, inactive,

16  or delinquent license.

17         (k)(l)  Repeatedly acting in a manner inconsistent with

18  the health, safety, or welfare of the patients of the facility

19  in which he or she is the administrator.

20         (l)(m)  Being unable to practice nursing home

21  administration with reasonable skill and safety to patients by

22  reason of illness, drunkenness, use of drugs, narcotics,

23  chemicals, or any other material or substance or as a result

24  of any mental or physical condition.  In enforcing this

25  paragraph, upon a finding of the secretary or his or her

26  designee that probable cause exists to believe that the

27  licensee is unable to serve as a nursing home administrator

28  due to the reasons stated in this paragraph, the department

29  shall have the authority to issue an order to compel the

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

31  physician designated by the department. If the licensee


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

  2  directing such examination may be enforced by filing a

  3  petition for enforcement in the circuit court where the

  4  licensee resides or serves as a nursing home administrator.

  5  The licensee against whom the petition is filed shall not be

  6  named or identified by initials in any public court records or

  7  documents, and the proceedings shall be closed to the public.

  8  The department shall be entitled to the summary procedure

  9  provided in s. 51.011.  A licensee affected under this

10  paragraph shall have the opportunity, at reasonable intervals,

11  to demonstrate that he or she can resume the competent

12  practice of nursing home administration with reasonable skill

13  and safety to patients.

14         (m)(n)  Willfully or repeatedly violating any of the

15  provisions of the law, code, or rules of the licensing or

16  supervising authority or agency of the state or political

17  subdivision thereof having jurisdiction of the operation and

18  licensing of nursing homes.

19         (n)(o)  Paying, giving, causing to be paid or given, or

20  offering to pay or to give to any person a commission or other

21  valuable consideration for the solicitation or procurement,

22  either directly or indirectly, of nursing home usage.

23         (o)(p)  Willfully permitting unauthorized disclosure of

24  information relating to a patient or his or her records.

25         (p)(q)  Discriminating with respect to patients,

26  employees, or staff on account of race, religion, color, sex,

27  or national origin.

28         (q)  Violating any provision of this chapter or chapter

29  456, or any rules adopted pursuant thereto.

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

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


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  1  applicant for licensure or licensee who is found guilty of

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

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

  4  456.072(1). When the board finds any nursing home

  5  administrator guilty of any of the grounds set forth in

  6  subsection (1), it may enter an order imposing one or more of

  7  the following penalties:

  8         (a)  Denial of an application for licensure.

  9         (b)  Revocation or suspension of a license.

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

11  $1,000 for each count or separate offense.

12         (d)  Issuance of a reprimand.

13         (e)  Placement of the licensee on probation for a

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

15  specify, including requiring the licensee to attend continuing

16  education courses or to work under the supervision of another

17  licensee.

18         (f)  Restriction of the authorized scope of practice.

19         Section 39.  Section 468.217, Florida Statutes, is

20  amended to read:

21         468.217  Denial of or refusal to renew license;

22  suspension and revocation of license and other disciplinary

23  measures.--

24         (1)  The following acts constitute grounds for denial

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

26  456.072(2) The board may deny or refuse to renew a license,

27  suspend or revoke a license, issue a reprimand, impose a fine,

28  or impose probationary conditions upon a licensee, when the

29  licensee or applicant for license has been guilty of

30  unprofessional conduct which has endangered, or is likely to

31  


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  1  endanger, the health, welfare, or safety of the public.  Such

  2  unprofessional conduct includes:

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

  4  license to practice occupational therapy by bribery, by

  5  fraudulent misrepresentation, or through an error of the

  6  department or the board.

  7         (b)  Having a license to practice occupational therapy

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

  9  denial of licensure, by the licensing authority of another

10  state, territory, or country.

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

12  adjudication, of a crime in any jurisdiction which directly

13  relates to the practice of occupational therapy or to the

14  ability to practice occupational therapy.  A plea of nolo

15  contendere shall be considered a conviction for the purposes

16  of this part.

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

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

19  under a name other than one's own name.

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

21  the licensee knows is in violation of this part or of the

22  rules of the department or of the board.

23         (g)  Aiding, assisting, procuring, or advising any

24  unlicensed person to practice occupational therapy contrary to

25  this part or to a rule of the department or the board.

26         (h)  Failing to perform any statutory or legal

27  obligation placed upon a licensed occupational therapist or

28  occupational therapy assistant.

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

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

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


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  1  impeding or obstructing such filing or inducing another person

  2  to do so.  Such reports or records include only those which

  3  are signed in the capacity as a licensed occupational

  4  therapist or occupational therapy assistant.

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

  6  kickback, or rebate to or from, or engaging in any split-fee

  7  arrangement in any form whatsoever with, a physician,

  8  organization, agency, or person, either directly or

  9  indirectly, for patients referred to providers of health care

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

11  nursing homes, clinical laboratories, ambulatory surgical

12  centers, or pharmacies.  The provisions of this paragraph

13  shall not be construed to prevent an occupational therapist or

14  occupational therapy assistant from receiving a fee for

15  professional consultation services.

16         (k)  Exercising influence within a patient-therapist

17  relationship for purposes of engaging a patient in sexual

18  activity. A patient is presumed to be incapable of giving

19  free, full, and informed consent to sexual activity with the

20  patient's occupational therapist or occupational therapy

21  assistant.

22         (l)  Making deceptive, untrue, or fraudulent

23  representations in the practice of occupational therapy or

24  employing a trick or scheme in the practice of occupational

25  therapy if such scheme or trick fails to conform to the

26  generally prevailing standards of treatment in the

27  occupational therapy community.

28         (m)  Soliciting patients, either personally or through

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

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

31  "solicitation" is any communication which directly or


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  1  implicitly requests an immediate oral response from the

  2  recipient.

  3         (n)  Failing to keep written records justifying the

  4  course of treatment of the patient, including, but not limited

  5  to, patient histories, examination results, and test results.

  6         (o)  Exercising influence on the patient or client in

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

  8  financial gain of the licensee or of a third party which

  9  includes, but is not limited to, the promoting or selling of

10  services, goods, appliances, or drugs.

11         (p)  Performing professional services which have not

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

13  legal representative, except as provided in s. 768.13.

14         (q)  Gross or repeated malpractice or the failure to

15  practice occupational therapy with that level of care, skill,

16  and treatment which is recognized by a reasonably prudent

17  similar occupational therapist or occupational therapy

18  assistant as being acceptable under similar conditions and

19  circumstances.

20         (r)  Performing any procedure which, by the prevailing

21  standards of occupational therapy practice in the community,

22  would constitute experimentation on a human subject without

23  first obtaining full, informed, and written consent.

24         (s)  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 he or she is not competent to perform.

28         (t)  Being unable to practice occupational therapy with

29  reasonable skill and safety to patients by reason of illness

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

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


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  1  condition.  In enforcing this paragraph, the department shall

  2  have, upon probable cause, authority to compel an occupational

  3  therapist or occupational therapy assistant to submit to a

  4  mental or physical examination by physicians designated by the

  5  department.  The failure of an occupational therapist or

  6  occupational therapy assistant to submit to such examination

  7  when so directed constitutes an admission of the allegations

  8  against him or her, upon which a default and final order may

  9  be entered without the taking of testimony or presentation of

10  evidence, unless the failure was due to circumstances beyond

11  his or her control.  An occupational therapist or occupational

12  therapy assistant affected under this paragraph shall at

13  reasonable intervals be afforded an opportunity to demonstrate

14  that he or she can resume the competent practice of

15  occupational therapy with reasonable skill and safety to

16  patients. In any proceeding under this paragraph, neither the

17  record of proceedings nor the orders entered by the board

18  shall be used against an occupational therapist or

19  occupational therapy assistant in any other proceeding.

20         (u)  Delegating professional responsibilities to a

21  person when the licensee who is delegating such

22  responsibilities knows or has reason to know that such person

23  is not qualified by training, experience, or licensure to

24  perform them.

25         (v)  Violating any provision of this part, a rule of

26  the board or department, or 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

29  department.

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

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


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

  2  lawfully advertising his or her services.

  3         (x)  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).

11         (3)(2)  The board may not reinstate the license of an

12  occupational therapist or occupational therapy assistant, or

13  cause a license to be issued to a person it has deemed

14  unqualified, until such time as the board is satisfied that

15  such person has complied with all the terms and conditions set

16  forth in the final order and is capable of safely engaging in

17  the practice of occupational therapy.

18         Section 40.  Subsections (1) and (2) of section

19  468.365, Florida Statutes, are amended to read:

20         468.365  Disciplinary grounds and actions.--

21         (1)  The following acts constitute grounds for denial

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

23  456.072(2) which the disciplinary actions in subsection (2)

24  may be taken:

25         (a)  Procuring, attempting to procure, or renewing a

26  license as provided by this part by bribery, by fraudulent

27  misrepresentation, or through an error of the department or

28  the board.

29         (b)  Having licensure, certification, registration, or

30  other authority, by whatever name known, to deliver

31  respiratory care services revoked, suspended, or otherwise


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  1  acted against, including the denial of licensure,

  2  certification, registration, or other authority to deliver

  3  respiratory care services by the licensing authority of

  4  another state, territory, or country.

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

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

  7  crime in any jurisdiction which directly relates to

  8  respiratory care services or to the ability to deliver such

  9  services.

10         (d)  Willfully making or filing a false report or

11  record, willfully failing to file a report or record required

12  by state or federal law, or willfully impeding or obstructing

13  such filing or inducing another person to do so.  Such reports

14  or records include only those reports or records which require

15  the signature of a respiratory care practitioner or

16  respiratory therapist licensed pursuant to this part.

17         (e)  Circulating false, misleading, or deceptive

18  advertising.

19         (f)  Unprofessional conduct, which includes, but is not

20  limited to, any departure from, or failure to conform to,

21  acceptable standards related to the delivery of respiratory

22  care services, as set forth by the board in rules adopted

23  pursuant to this part.

24         (g)  Engaging or attempting to engage in the

25  possession, sale, or distribution of controlled substances, as

26  set forth by law, for any purpose other than a legitimate

27  purpose.

28         (h)  Willfully failing to report any violation of this

29  part.

30  

31  


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  1         (i)  Willfully or repeatedly Violating a rule of the

  2  board or the department or a lawful order of the board or

  3  department previously entered in a disciplinary hearing.

  4         (j)  Violation of any rule adopted pursuant to this

  5  part or chapter 456.

  6         (j)(k)  Engaging in the delivery of respiratory care

  7  services with a revoked, suspended, or inactive license.

  8         (k)(l)  Permitting, aiding, assisting, procuring, or

  9  advising any person who is not licensed pursuant to this part,

10  contrary to this part or to any rule of the department or the

11  board.

12         (l)(m)  Failing to perform any statutory or legal

13  obligation placed upon a respiratory care practitioner or

14  respiratory therapist licensed pursuant to this part.

15         (m)(n)  Accepting and performing professional

16  responsibilities which the licensee knows, or has reason to

17  know, she or he is not competent to perform.

18         (n)(o)  Delegating professional responsibilities to a

19  person when the licensee delegating such responsibilities

20  knows, or has reason to know, that such person is not

21  qualified by training, experience, or licensure to perform

22  them.

23         (o)(p)  Gross or repeated malpractice or the failure to

24  deliver respiratory care services with that level of care,

25  skill, and treatment which is recognized by a reasonably

26  prudent respiratory care practitioner or respiratory therapist

27  with similar professional training as being acceptable under

28  similar conditions and circumstances.

29         (p)(q)  Paying or receiving any commission, bonus,

30  kickback, or rebate to or from, or engaging in any split-fee

31  arrangement in any form whatsoever with, a person,


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  1  organization, or agency, either directly or indirectly, for

  2  goods or services rendered to patients referred by or to

  3  providers of health care goods and services, including, but

  4  not limited to, hospitals, nursing homes, clinical

  5  laboratories, ambulatory surgical centers, or pharmacies.  The

  6  provisions of this paragraph shall not be construed to prevent

  7  the licensee from receiving a fee for professional

  8  consultation services.

  9         (q)(r)  Exercising influence within a respiratory care

10  relationship for the purpose of engaging a patient in sexual

11  activity.  A patient is presumed to be incapable of giving

12  free, full, and informed consent to sexual activity with the

13  patient's respiratory care practitioner or respiratory

14  therapist.

15         (r)(s)  Making deceptive, untrue, or fraudulent

16  representations in the delivery of respiratory care services

17  or employing a trick or scheme in the delivery of respiratory

18  care services if such a scheme or trick fails to conform to

19  the generally prevailing standards of other licensees within

20  the community.

21         (s)(t)  Soliciting patients, either personally or

22  through an agent, through the use of fraud, deception, or

23  otherwise misleading statements or through the exercise of

24  intimidation or undue influence.

25         (t)(u)  Failing to keep written respiratory care

26  records justifying the reason for the action taken by the

27  licensee.

28         (u)(v)  Exercising influence on the patient in such a

29  manner as to exploit the patient for the financial gain of the

30  licensee or a third party, which includes, but is not limited

31  


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  1  to, the promoting or selling of services, goods, appliances,

  2  or drugs.

  3         (v)(w)  Performing professional services which have not

  4  been duly ordered by a physician licensed pursuant to chapter

  5  458 or chapter 459 and which are not in accordance with

  6  protocols established by the hospital, other health care

  7  provider, or the board, except as provided in ss. 743.064,

  8  766.103, and 768.13.

  9         (w)(x)  Being unable to deliver respiratory care

10  services with reasonable skill and safety to patients by

11  reason of illness or use of alcohol, drugs, narcotics,

12  chemicals, or any other type of material as a result of any

13  mental or physical condition.  In enforcing this paragraph,

14  the department shall, upon probable cause, have authority to

15  compel a respiratory care practitioner or respiratory

16  therapist to submit to a mental or physical examination by

17  physicians designated by the department.  The cost of

18  examination shall be borne by the licensee being examined.

19  The failure of a respiratory care practitioner or respiratory

20  therapist to submit to such an examination when so directed

21  constitutes an admission of the allegations against her or

22  him, upon which a default and a final order may be entered

23  without the taking of testimony or presentation of evidence,

24  unless the failure was due to circumstances beyond her or his

25  control.  A respiratory care practitioner or respiratory

26  therapist affected under this paragraph shall at reasonable

27  intervals be afforded an opportunity to demonstrate that she

28  or he can resume the competent delivery of respiratory care

29  services with reasonable skill and safety to her or his

30  patients.  In any proceeding under this paragraph, neither the

31  record of proceedings nor the orders entered by the board


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  1  shall be used against a respiratory care practitioner or

  2  respiratory therapist in any other proceeding.

  3         (x)  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). If the board finds any person guilty of any of the

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

12  imposing one or more of the following penalties:

13         (a)  Denial of an application for licensure.

14         (b)  Revocation or suspension of licensure.

15         (c)  Imposition of an administrative fine not to exceed

16  $1,000 for each count or separate offense.

17         (d)  Placement of the respiratory care practitioner or

18  respiratory therapist on probation for such period of time and

19  subject to such conditions as the board may specify,

20  including, but not limited to, requiring the respiratory care

21  practitioner or respiratory therapist to submit to treatment,

22  to attend continuing education courses, or to work under the

23  supervision of another respiratory care practitioner or

24  respiratory therapist.

25         (e)  Issuance of a reprimand.

26         Section 41.  Subsections (1) and (2) of section

27  468.518, Florida Statutes, are amended to read:

28         468.518  Grounds for disciplinary action.--

29         (1)  The following acts constitute grounds for denial

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

31  


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  1  456.072(2) which the disciplinary actions in subsection (2)

  2  may be taken:

  3         (a)  Violating any provision of this part, any board or

  4  agency rule adopted pursuant thereto, or any lawful order of

  5  the board or agency previously entered in a disciplinary

  6  hearing held pursuant to this part, or failing to comply with

  7  a lawfully issued subpoena of the agency.  The provisions of

  8  this paragraph also apply to any order or subpoena previously

  9  issued by the Department of Health during its period of

10  regulatory control over this part.

11         (b)  Being unable to engage in dietetics and nutrition

12  practice or nutrition counseling with reasonable skill and

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

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

15  as a result of any mental or physical condition.

16         1.  A licensee whose license is suspended or revoked

17  pursuant to this paragraph shall, at reasonable intervals, be

18  given an opportunity to demonstrate that he or she can resume

19  the competent practice of dietetics and nutrition or nutrition

20  counseling with reasonable skill and safety to patients.

21         2.  Neither the record of the proceeding nor the orders

22  entered by the board in any proceeding under this paragraph

23  may be used against a licensee in any other proceeding.

24         (c)  Attempting to procure or procuring a license to

25  practice dietetics and nutrition or nutrition counseling by

26  fraud or material misrepresentation of material fact.

27         (d)  Having a license to practice dietetics and

28  nutrition or nutrition counseling revoked, suspended, or

29  otherwise acted against, including the denial of licensure by

30  the licensing authority of another state, district, territory,

31  or country.


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  1         (e)  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 directly relates to the

  4  practice of dietetics and nutrition or nutrition counseling or

  5  the ability to practice dietetics and nutrition or nutrition

  6  counseling.

  7         (f)  Making or filing a report or record that the

  8  licensee knows to be false, willfully failing to file a report

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

10  or obstructing such filing, or inducing another person to

11  impede or obstruct such filing. Such reports or records

12  include only those that are signed in the capacity of a

13  licensed dietitian/nutritionist or licensed nutrition

14  counselor.

15         (g)  Advertising goods or services in a manner that is

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

17  content.

18         (h)  Committing an act of fraud or deceit, or of

19  negligence, incompetency, or misconduct in the practice of

20  dietetics and nutrition or nutrition counseling.

21         (i)  Practicing with a revoked, suspended, inactive, or

22  delinquent license.

23         (j)  Treating or undertaking to treat human ailments by

24  means other than by dietetics and nutrition practice or

25  nutrition counseling.

26         (k)  Failing to maintain acceptable standards of

27  practice as set forth by the board and the council in rules

28  adopted pursuant to this part.

29         (l)  Engaging directly or indirectly in the dividing,

30  transferring, assigning, rebating, or refunding of fees

31  received for professional services, or profiting by means of a


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  1  credit or other valuable consideration, such as an unearned

  2  commission, discount, or gratuity, with any person referring a

  3  patient or with any relative or business associate of the

  4  referring person. Nothing in this part prohibits the members

  5  of any regularly and properly organized business entity that

  6  is composed of licensees under this part and recognized under

  7  the laws of this state from making any division of their total

  8  fees among themselves as they determine necessary.

  9         (m)  Advertising, by or on behalf of a licensee under

10  this part, any method of assessment or treatment which is

11  experimental or without generally accepted scientific

12  validation.

13         (n)  Violating any provision of this chapter or chapter

14  456, or any rules adopted pursuant thereto.

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

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

17  applicant for licensure or licensee who is found guilty of

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

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

20  456.072(1). When the board finds any licensee guilty of any of

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

22  imposing one or more of the following penalties:

23         (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 violation;

27         (d)  Issuance of a reprimand or letter of guidance;

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  education courses or to work under the supervision of a


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  1  licensed dietitian/nutritionist or licensed nutrition

  2  counselor; or

  3         (f)  Restriction of the authorized scope of practice of

  4  the licensee.

  5         Section 42.  Section 468.719, Florida Statutes, is

  6  amended to read:

  7         468.719  Disciplinary actions.--

  8         (1)  The following acts constitute shall be grounds for

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

10  456.072(2) disciplinary actions provided for in subsection

11  (2):

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

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

14  violation of this part, s. 456.072, or any rule adopted

15  pursuant thereto.

16         (a)(b)  Failing to include the athletic trainer's name

17  and license number in any advertising, including, but not

18  limited to, business cards and letterhead, related to the

19  practice of athletic training.  Advertising shall not include

20  clothing or other novelty items.

21         (b)(c)  Committing incompetency or misconduct in the

22  practice of athletic training.

23         (c)(d)  Committing fraud or deceit in the practice of

24  athletic training.

25         (d)(e)  Committing negligence, gross negligence, or

26  repeated negligence in the practice of athletic training.

27         (e)(f)  While practicing athletic training, being

28  unable to practice athletic training with reasonable skill and

29  safety to athletes by reason of illness or use of alcohol or

30  drugs or as a result of any mental or physical condition.

31  


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  1         (f)  Violating any provision of this chapter or chapter

  2  456, or any rules adopted pursuant thereto.

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

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

  5  applicant for licensure or licensee who is found guilty of

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

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

  8  456.072(1). When the board finds any person guilty of any of

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

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

11  456.072.

12         Section 43.  Section 468.811, Florida Statutes, is

13  amended to read:

14         468.811  Disciplinary proceedings.--

15         (1)  The following acts constitute are grounds for

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

17  456.072(2): disciplinary action against a licensee and the

18  issuance of cease and desist orders or other related action by

19  the department, pursuant to s. 456.072, against any person who

20  engages in or aids in a violation.

21         (a)  Attempting to procure a license by fraudulent

22  misrepresentation.

23         (b)  Having a license to practice orthotics,

24  prosthetics, or pedorthics revoked, suspended, or otherwise

25  acted against, including the denial of licensure in another

26  jurisdiction.

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

28  nolo contendere to, regardless of adjudication, in any

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

30  orthotics, prosthetics, or pedorthics, including violations of

31  


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  1  federal laws or regulations regarding orthotics, prosthetics,

  2  or pedorthics.

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

  4  is false, intentionally or negligently failing to file a

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

  6  impeding or obstructing such filing, or inducing another

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

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

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

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

11  false, deceptive, or misleading manner.

12         (f)  Violation of this act or chapter 456, or any rules

13  adopted thereunder.

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

15  department previously entered in a disciplinary hearing or

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

17  or department.

18         (g)(h)  Practicing with a revoked, suspended, or

19  inactive license.

20         (h)(i)  Gross or repeated malpractice or the failure to

21  deliver orthotic, prosthetic, or pedorthic services with that

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

23  prudent licensed practitioner with similar professional

24  training as being acceptable under similar conditions and

25  circumstances.

26         (i)(j)  Failing to provide written notice of any

27  applicable warranty for an orthosis, prosthesis, or pedorthic

28  device that is provided to a patient.

29         (j)  Violating any provision of this chapter or chapter

30  456, or any rules adopted pursuant thereto.

31  


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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). The board may enter an order imposing one or more

  7  of the penalties in s. 456.072(2) against any person who

  8  violates any provision of subsection (1).

  9         Section 44.  Subsections (1) and (2) of section 478.52,

10  Florida Statutes, are amended to read:

11         478.52  Disciplinary proceedings.--

12         (1)  The following acts constitute are grounds for

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

14  456.072(2) which the disciplinary actions in subsection (2)

15  may be taken:

16         (a)  Obtaining or attempting to obtain a license by

17  bribery, fraud, or knowing misrepresentation.

18         (b)  Having a license or other authority to deliver

19  electrolysis services revoked, suspended, or otherwise acted

20  against, including denial of licensure, in another

21  jurisdiction.

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 electrology.

26         (d)  Willfully making or filing a false report or

27  record, willfully failing to file a report or record required

28  for electrologists, or willfully impeding or obstructing the

29  filing of a report or record required by this act or inducing

30  another person to do so.

31  


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  1         (e)  Circulating false, misleading, or deceptive

  2  advertising.

  3         (f)  Unprofessional conduct, including any departure

  4  from, or failure to conform to, acceptable standards related

  5  to the delivery of electrolysis services.

  6         (g)  Engaging or attempting to engage in the illegal

  7  possession, sale, or distribution of any illegal or controlled

  8  substance.

  9         (h)  Willfully failing to report any known violation of

10  this chapter.

11         (i)  Willfully or repeatedly violating a rule adopted

12  under this chapter, or an order of the board or department

13  previously entered in a disciplinary hearing.

14         (j)  Engaging in the delivery of electrolysis services

15  without an active license.

16         (k)  Employing an unlicensed person to practice

17  electrology.

18         (l)  Failing to perform any statutory or legal

19  obligation placed upon an electrologist.

20         (m)  Accepting and performing professional

21  responsibilities which the licensee knows, or has reason to

22  know, she or he is not competent to perform.

23         (n)  Delegating professional responsibilities to a

24  person the licensee knows, or has reason to know, is

25  unqualified by training, experience, or licensure to perform.

26         (o)  Gross or repeated malpractice or the inability to

27  practice electrology with reasonable skill and safety.

28         (p)  Judicially determined mental incompetency.

29         (q)  Practicing or attempting to practice electrology

30  under a name other than her or his own.

31  


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  1         (r)  Being unable to practice electrology with

  2  reasonable skill and safety because of a mental or physical

  3  condition or illness, or the use of alcohol, controlled

  4  substances, or any other substance which impairs one's ability

  5  to practice.

  6         1.  The department may, upon probable cause, compel a

  7  licensee to submit to a mental or physical examination by

  8  physicians designated by the department. The cost of an

  9  examination shall be borne by the licensee, and her or his

10  failure to submit to such an examination constitutes an

11  admission of the allegations against her or him, consequent

12  upon which a default and a final order may be entered without

13  the taking of testimony or presentation of evidence, unless

14  the failure was due to circumstances beyond her or his

15  control.

16         2.  A licensee who is disciplined under this paragraph

17  shall, at reasonable intervals, be afforded an opportunity to

18  demonstrate that she or he can resume the practice of

19  electrology with reasonable skill and safety.

20         3.  In any proceeding under this paragraph, the record

21  of proceedings or the orders entered by the board may not be

22  used against a licensee in any other proceeding.

23         (s)  Disclosing the identity of or information about a

24  patient without written permission, except for information

25  which does not identify a patient and which is used for

26  training purposes in an approved electrolysis training

27  program.

28         (t)  Practicing or attempting to practice any permanent

29  hair removal except as described in s. 478.42(5).

30         (u)  Operating any electrolysis facility unless it has

31  been duly licensed as provided in this chapter.


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  1         (v)  Violating any provision of this chapter or chapter

  2  456, or any rules adopted pursuant thereto.

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

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

  5  applicant for licensure or licensee who is found guilty of

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

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

  8  456.072(1). When the board finds any person guilty of any of

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

10  that would constitute a substantial violation of subsection

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

12  imposing one or more of the following penalties:

13         (a)  Deny the application for licensure.

14         (b)  Revoke or suspend the license.

15         (c)  Impose an administrative fine not to exceed $5,000

16  for each count or separate offense.

17         (d)  Place the licensee on probation for a specified

18  time and subject the licensee to such conditions as the board

19  determines necessary, including, but not limited to, requiring

20  treatment, continuing education courses, reexamination, or

21  working under the supervision of another licensee.

22         (e)  Issue a reprimand to the licensee.

23         (f)  Restriction of a licensee's practice.

24         Section 45.  Subsections (1) and (2) of section

25  480.046, Florida Statutes, are amended to read:

26         480.046  Grounds for disciplinary action by the

27  board.--

28         (1)  The following acts shall constitute grounds for

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

30  456.072(2) which disciplinary actions specified in subsection

31  


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  1  (2) may be taken against a massage therapist or massage

  2  establishment licensed under this act:

  3         (a)  Attempting to procure a license to practice

  4  massage by bribery or fraudulent misrepresentation.

  5         (b)  Having a license to practice massage revoked,

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

  7  licensure, by the licensing authority of another state,

  8  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 massage or to the ability to

12  practice massage. Any plea of nolo contendere shall be

13  considered a conviction for purposes of this chapter.

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

15         (e)  Aiding, assisting, procuring, or advising any

16  unlicensed person to practice massage contrary to the

17  provisions of this chapter or to a rule of the department or

18  the board.

19         (f)  Making deceptive, untrue, or fraudulent

20  representations in the practice of massage.

21         (g)  Being unable to practice massage with reasonable

22  skill and safety by reason of illness or use of alcohol,

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

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

25  this paragraph, the department shall have, upon probable

26  cause, authority to compel a massage therapist to submit to a

27  mental or physical examination by physicians designated by the

28  department.  Failure of a massage therapist to submit to such

29  examination when so directed, unless the failure was due to

30  circumstances beyond her or his control, shall constitute an

31  admission of the allegations against her or him, consequent


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  1  upon which a default and final order may be entered without

  2  the taking of testimony or presentation of evidence.  A

  3  massage therapist affected under this paragraph shall at

  4  reasonable intervals be afforded an opportunity to demonstrate

  5  that she or he can resume the competent practice of massage

  6  with reasonable skill and safety to clients.

  7         (h)  Gross or repeated malpractice or the failure to

  8  practice massage with that level of care, skill, and treatment

  9  which is recognized by a reasonably prudent massage therapist

10  as being acceptable under similar conditions and

11  circumstances.

12         (i)  Practicing or offering to practice beyond the

13  scope permitted by law or accepting and performing

14  professional responsibilities which the licensee knows or has

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

16         (j)  Delegating professional responsibilities to a

17  person when the licensee delegating such responsibilities

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

19  by training, experience, or licensure to perform.

20         (k)  Violating any provision of this chapter, a rule of

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

22  department previously entered in a disciplinary hearing, or

23  failing to comply with a lawfully issued subpoena of the

24  department.

25         (l)  Refusing to permit the department to inspect the

26  business premises of the licensee during regular business

27  hours.

28         (m)  Failing to keep the equipment and premises of the

29  massage establishment in a clean and sanitary condition.

30         (n)  Practicing massage at a site, location, or place

31  which is not duly licensed as a massage establishment, except


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  1  that a massage therapist, as provided by rules adopted by the

  2  board, may provide massage services, excluding colonic

  3  irrigation, at the residence of a client, at the office of the

  4  client, at a sports event, at a convention, or at a trade

  5  show.

  6         (o)  Violating any provision of this chapter or chapter

  7  456, or any rules adopted pursuant thereto.

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

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

10  applicant for licensure or licensee who is found guilty of

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

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

13  456.072(1). When the board finds any person guilty of any of

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

15  imposing one or more of the following penalties:

16         (a)  Refusal to license an applicant.

17         (b)  Revocation or suspension of a license.

18         (c)  Issuance of a reprimand or censure.

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

20  $1,000 for each count or separate offense.

21         Section 46.  Section 483.825, Florida Statutes, is

22  amended to read:

23         483.825  Grounds for disciplinary action.--

24         (1)  The following acts constitute grounds for denial

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

26  456.072(2) which disciplinary actions specified in s. 483.827

27  may be taken against applicants, registrants, and licensees

28  under this part:

29         (a)(1)  Attempting to obtain, obtaining, or renewing a

30  license or registration under this part by bribery, by

31  


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  1  fraudulent misrepresentation, or through an error of the

  2  department or the board.

  3         (b)(2)  Engaging in or attempting to engage in, or

  4  representing herself or himself as entitled to perform, any

  5  clinical laboratory procedure or category of procedures not

  6  authorized pursuant to her or his license.

  7         (c)(3)  Demonstrating incompetence or making consistent

  8  errors in the performance of clinical laboratory examinations

  9  or procedures or erroneous reporting.

10         (d)(4)  Performing a test and rendering a report

11  thereon to a person not authorized by law to receive such

12  services.

13         (e)(5)  Has been convicted or found guilty of, or

14  entered a plea of nolo contendere to, regardless of

15  adjudication, a crime in any jurisdiction which directly

16  relates to the activities of clinical laboratory personnel or

17  involves moral turpitude or fraudulent or dishonest dealing.

18  The record of a conviction certified or authenticated in such

19  form as to be admissible in evidence under the laws of the

20  state shall be admissible as prima facie evidence of such

21  guilt.

22         (f)(6)  Having been adjudged mentally or physically

23  incompetent.

24         (g)(7)  Violating or Aiding and abetting in the

25  violation of any provision of this part or the rules adopted

26  hereunder.

27         (h)(8)  Reporting a test result when no laboratory test

28  was performed on a clinical specimen.

29         (i)(9)  Knowingly advertising false services or

30  credentials.

31  


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  1         (j)(10)  Having a license revoked, suspended, or

  2  otherwise acted against, including the denial of licensure, by

  3  the licensing authority of another jurisdiction. The licensing

  4  authority's acceptance of a relinquishment of a license,

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

  6  response to or in anticipation of the filing of administrative

  7  charges against the licensee, shall be construed as action

  8  against the licensee.

  9         (k)(11)  Failing to report to the board, in writing,

10  within 30 days that an action under subsection (5), subsection

11  (6), or subsection (10) has been taken against the licensee or

12  one's license to practice as clinical laboratory personnel in

13  another state, territory, country, or other jurisdiction.

14         (l)(12)  Being unable to perform or report clinical

15  laboratory examinations with reasonable skill and safety to

16  patients by reason of illness or use of alcohol, drugs,

17  narcotics, chemicals, or any other type of material or as a

18  result of any mental or physical condition.  In enforcing this

19  subsection, the department shall have, upon a finding of the

20  secretary or his or her designee that probable cause exists to

21  believe that the licensee is unable to practice because of the

22  reasons stated in this subsection, the authority to issue an

23  order to compel a licensee to submit to a mental or physical

24  examination by physicians designated by the department.  If

25  the licensee refuses to comply with such order, the

26  department's order directing such examination may be enforced

27  by filing a petition for enforcement in the circuit court

28  where the licensee resides or does business.  The department

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

30  51.011.  A licensee affected under this subsection shall at

31  reasonable intervals be afforded an opportunity to demonstrate


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  1  that he or she can resume competent practice with reasonable

  2  skill and safety to patients.

  3         (m)(13)  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

  6  qualified by training, experience, or licensure to perform

  7  them.

  8         (n)(14)  Violating a previous order of the board

  9  entered in a disciplinary proceeding.

10         (o)(15)  Failing to report to the department a person

11  or other licensee who the licensee knows is in violation of

12  this chapter or the rules of the department or board adopted

13  hereunder.

14         (p)(16)  Making or filing a report which the licensee

15  knows to be false, intentionally or negligently failing to

16  file a report or record required by state or federal law,

17  willfully impeding or obstructing such filing or inducing

18  another person to do so, including, but not limited to,

19  impeding an agent of the state from obtaining a report or

20  record for investigative purposes. Such reports or records

21  shall include only those generated in the capacity as a

22  licensed clinical laboratory personnel.

23         (q)(17)  Paying or receiving any commission, bonus,

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

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

26  or person, either directly or indirectly for patients referred

27  to providers of health care goods and services including, but

28  not limited to, hospitals, nursing homes, clinical

29  laboratories, ambulatory surgical centers, or pharmacies. The

30  provisions of this subsection shall not be construed to

31  


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  1  prevent a clinical laboratory professional from receiving a

  2  fee for professional consultation services.

  3         (r)(18)  Exercising influence on a patient or client in

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

  5  financial gain of the licensee or other third party, which

  6  shall include, but not be limited to, the promoting, selling,

  7  or withholding of services, goods, appliances, referrals, or

  8  drugs.

  9         (s)(19)  Practicing or offering to practice beyond the

10  scope permitted by law or rule, or accepting or performing

11  professional services or responsibilities which the licensee

12  knows or has reason to know that he or she is not competent to

13  perform.

14         (t)(20)  Misrepresenting or concealing a material fact

15  at any time during any phase of the licensing, investigative,

16  or disciplinary process, procedure, or proceeding.

17         (u)(21)  Improperly interfering with an investigation

18  or any disciplinary proceeding.

19         (v)(22)  Engaging in or attempting to engage in sexual

20  misconduct, causing undue embarrassment or using disparaging

21  language or language of a sexual nature towards a patient,

22  exploiting superior/subordinate, professional/patient,

23  instructor/student relationships for personal gain, sexual

24  gratification, or advantage.

25         (w)  Violating any provision of this chapter or chapter

26  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  


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

  2  456.072(1).

  3         (3)  In determining the amount of the fine to be levied

  4  for a violation, as provided in subsection (1), the following

  5  factors shall be considered:

  6         (a)  The severity of the violation, including the

  7  probability that death or serious harm to the health or safety

  8  of any person will result or has resulted, the severity of the

  9  actual or potential harm, and the extent to which the

10  provisions of this part were violated.

11         (b)  Actions taken by the licensee to correct the

12  violation or to remedy complaints.

13         (c)  Any previous violation by the licensee.

14         (d)  The financial benefit to the licensee of

15  committing or continuing the violation.

16         Section 47.  Section 483.827, Florida Statutes, is

17  repealed.

18         Section 48.  Subsection (6) of section 483.901, Florida

19  Statutes, is amended to read:

20         483.901  Medical physicists; definitions; licensure.--

21         (6)  LICENSE REQUIRED.--An individual may not engage in

22  the practice of medical physics, including the specialties of

23  diagnostic radiological physics, therapeutic radiological

24  physics, medical nuclear radiological physics, or medical

25  health physics, without a license issued by the department for

26  the appropriate specialty.

27         (a)  The department shall adopt rules to administer

28  this section which specify license application and renewal

29  fees, continuing education requirements, and standards for

30  practicing medical physics.  The council shall recommend to

31  the department continuing education requirements that shall be


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  1  a condition of license renewal.  The department shall require

  2  a minimum of 24 hours per biennium of continuing education

  3  offered by an organization recommended by the council and

  4  approved by the department.  The department, upon

  5  recommendation of the council, may adopt rules to specify

  6  continuing education requirements for persons who hold a

  7  license in more than one specialty.

  8         (b)  In order to apply for a medical physicist license

  9  in one or more specialties, a person must file an individual

10  application for each specialty with the department.  The

11  application must be on a form prescribed by the department and

12  must be accompanied by a nonrefundable application fee for

13  each specialty.

14         (c)  The department may issue a license to an eligible

15  applicant if the applicant meets all license requirements.  At

16  any time before the department issues a license, the applicant

17  may request in writing that the application be withdrawn.  To

18  reapply, the applicant must submit a new application and an

19  additional nonrefundable application fee and must meet all

20  current licensure requirements.

21         (d)  The department shall review each completed

22  application for a license which the department receives.

23         (e)  On receipt of an application and fee as specified

24  in this section, the department may issue a license to

25  practice medical physics in this state on or after October 1,

26  1997, to a person who is board certified in the medical

27  physics specialty in which the applicant applies to practice

28  by the American Board of Radiology for diagnostic radiological

29  physics, therapeutic radiological physics, or medical nuclear

30  radiological physics; by the American Board of Medical Physics

31  for diagnostic radiological physics, therapeutic radiological


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  1  physics, or medical nuclear radiological physics; or by the

  2  American Board of Health Physics or an equivalent certifying

  3  body approved by the department.

  4         (f)  A licensee shall:

  5         1.  Display the license in a place accessible to the

  6  public; and

  7         2.  Report immediately any change in the licensee's

  8  address or name to the department.

  9         (g)  The following acts constitute are grounds for

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

11  456.072(2) which the disciplinary actions in paragraph (h) may

12  be taken:

13         1.  Obtaining or attempting to obtain a license by

14  bribery, fraud, knowing misrepresentation, or concealment of

15  material fact or through an error of the department.

16         2.  Having a license denied, revoked, suspended, or

17  otherwise acted against in another jurisdiction.

18         3.  Being convicted or found guilty of, or entering a

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

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

21  the ability to practice, the profession of medical physics.

22         4.  Willfully failing to file a report or record

23  required for medical physics or willfully impeding or

24  obstructing the filing of a report or record required by this

25  section or inducing another person to do so.

26         5.  Making misleading, deceptive, or fraudulent

27  representations in or related to the practice of medical

28  physics.

29         6.  Willfully failing to report any known violation of

30  this section or any rule adopted thereunder.

31  


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    CS for SB 1558                                Second Engrossed



  1         7.  Willfully or repeatedly violating a rule adopted

  2  under this section or an order of the department.

  3         7.8.  Failing to perform any statutory or legal

  4  obligation placed upon a licensee.

  5         8.9.  Aiding, assisting, procuring, employing, or

  6  advising any unlicensed person to practice medical physics

  7  contrary to this section or any rule adopted thereunder.

  8         9.10.  Delegating or contracting for the performance of

  9  professional responsibilities by a person when the licensee

10  delegating or contracting such responsibilities knows, or has

11  reason to know, such person is not qualified by training,

12  experience, and authorization to perform them.

13         10.11.  Practicing or offering to practice beyond the

14  scope permitted by law or accepting and performing

15  professional responsibilities the licensee knows, or has

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

17         11.12.  Gross or repeated malpractice or the inability

18  to practice medical physics with reasonable skill and safety.

19         12.13.  Judicially determined mental incompetency.

20         13.14.  Being unable to practice medical physics with

21  reasonable skill and safety because of a mental or physical

22  condition or illness or the use of alcohol, controlled

23  substances, or any other substance which impairs one's ability

24  to practice.

25         a.  The department may, upon probable cause, compel a

26  licensee to submit to a mental or physical examination by

27  physicians designated by the department.  The cost of an

28  examination shall be borne by the licensee, and the licensee's

29  failure to submit to such an examination constitutes an

30  admission of the allegations against the licensee, consequent

31  upon which a default and a final order may be entered without


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    CS for SB 1558                                Second Engrossed



  1  the taking of testimony or presentation of evidence, unless

  2  the failure was due to circumstances beyond the licensee's

  3  control.

  4         b.  A licensee who is disciplined under this

  5  subparagraph shall, at reasonable intervals, be afforded an

  6  opportunity to demonstrate that the licensee can resume the

  7  practice of medical physics with reasonable skill and safety.

  8         c.  With respect to any proceeding under this

  9  subparagraph, the record of proceedings or the orders entered

10  by the department may not be used against a licensee in any

11  other proceeding.

12         14.  Violating any provision of this chapter or chapter

13  456, or any rules adopted pursuant thereto.

14         (h)  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 department finds any person guilty of any

20  of the grounds set forth in paragraph (g), including conduct

21  that would constitute a substantial violation of paragraph (g)

22  which occurred prior to licensure, it may enter an order

23  imposing one or more of the following penalties:

24         1.  Deny the application for licensure.

25         2.  Revoke or suspend the license.

26         3.  Impose an administrative fine for each count or

27  separate offense.

28         4.  Place the licensee on probation for a specified

29  time and subject the licensee to such conditions as the

30  department determines necessary, including requiring

31  


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    CS for SB 1558                                Second Engrossed



  1  treatment, continuing education courses, or working under the

  2  monitoring or supervision of another licensee.

  3         5.  Restrict a licensee's practice.

  4         6.  Issue a reprimand to the licensee.

  5         (i)  The department may not issue or reinstate a

  6  license to a person it has deemed unqualified until it is

  7  satisfied that such person has complied with the terms and

  8  conditions of the final order and that the licensee can safely

  9  practice medical physics.

10         (j)  Upon receipt of a complete application and the fee

11  set forth by rule, the department may issue a

12  physicist-in-training certificate to a person qualified to

13  practice medical physics under direct supervision. The

14  department may establish by rule requirements for initial

15  certification and renewal of a physicist-in-training

16  certificate.

17         Section 49.  Subsections (1) and (2) of section

18  484.014, Florida Statutes, are amended to read:

19         484.014  Disciplinary actions.--

20         (1)  The following acts constitute relating to the

21  practice of opticianry shall be grounds for denial of a

22  license or disciplinary action, as specified in s. 456.072(2)

23  both disciplinary action against an optician as set forth in

24  this section and cease and desist or other related action by

25  the department as set forth in s. 456.065 against any person

26  operating an optical establishment who engages in, aids, or

27  abets any such violation:

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

29  misrepresentation, bribery, or fraud or through an error of

30  the department or the board.

31  


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    CS for SB 1558                                Second Engrossed



  1         (b)  Procuring or attempting to procure a license for

  2  any other person by making or causing to be made any false

  3  representation.

  4         (c)  Making or filing a report or record which the

  5  licensee knows to be false, intentionally or negligently

  6  failing to file a report or record required by federal or

  7  state law, willfully impeding or obstructing such filing, or

  8  inducing another person to do so. Such reports or records

  9  shall include only those which the person is required to make

10  or file as an optician.

11         (d)  Failing to make fee or price information readily

12  available by providing such information upon request or upon

13  the presentation of a prescription.

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

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

16  content.

17         (f)  Fraud or deceit, or negligence, incompetency, or

18  misconduct, in the authorized practice of opticianry.

19         (g)  Violation or repeated violation of this part or of

20  chapter 456 or any rules promulgated pursuant thereto.

21         (g)(h)  Practicing with a revoked, suspended, inactive,

22  or delinquent license.

23         (h)(i)  Violation of a lawful order of the board or

24  department previously entered in a disciplinary hearing or

25  failing to comply with a lawfully issued subpoena of the

26  department.

27         (i)(j)  Violation of any provision of s. 484.012.

28         (j)(k)  Conspiring with another licensee or with any

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

30  coerce, intimidate, or preclude another licensee from lawfully

31  advertising her or his services.


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    CS for SB 1558                                Second Engrossed



  1         (k)(l)  Willfully submitting to any third-party payor a

  2  claim for services which were not provided to a patient.

  3         (l)(m)  Failing to keep written prescription files.

  4         (m)(n)  Willfully failing to report any person who the

  5  licensee knows is in violation of this part or of rules of the

  6  department or the board.

  7         (n)(o)  Exercising influence on a client in such a

  8  manner as to exploit the client for financial gain of the

  9  licensee or of a third party.

10         (o)(p)  Gross or repeated malpractice.

11         (p)(q)  Permitting any person not licensed as an

12  optician in this state to fit or dispense any lenses,

13  spectacles, eyeglasses, or other optical devices which are

14  part of the practice of opticianry.

15         (q)(r)  Being convicted or found guilty of, or entering

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

17  court of this state or other jurisdiction, a crime which

18  relates to the ability to practice opticianry or to the

19  practice of opticianry.

20         (r)(s)  Having been disciplined by a regulatory agency

21  in another state for any offense that would constitute a

22  violation of Florida law or rules regulating opticianry.

23         (s)(t)  Being unable to practice opticianry with

24  reasonable skill and safety by reason of illness or use of

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

26  as a result of any mental or physical condition. An optician

27  affected under this paragraph shall at reasonable intervals be

28  afforded an opportunity to demonstrate that she or he can

29  resume the competent practice of opticianry with reasonable

30  skill and safety to her or his customers.

31  


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    CS for SB 1558                                Second Engrossed



  1         (t)  Violating any provision of this chapter or chapter

  2  456, or any rules adopted pursuant thereto.

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

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

  5  applicant for licensure or licensee who is found guilty of

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

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

  8  456.072(1). When the board finds any person guilty of any of

  9  the grounds set forth in subsection (1), it may enter an order

10  imposing one or more of the following penalties:

11         (a)  Refusal to certify to the department an

12  application for licensure.

13         (b)  Revocation or suspension of a license.

14         (c)  Imposition of an administrative fine not to exceed

15  $1,000 for each count or separate offense.

16         (d)  Issuance of a reprimand.

17         (e)  Placement of the optician on probation for a

18  period of time and subject to such conditions as the board may

19  specify, including requiring the optician to submit to

20  treatment or to work under the supervision of another

21  optician.

22         Section 50.  Subsections (1) and (2) of section

23  484.056, Florida Statutes, are amended to read:

24         484.056  Disciplinary proceedings.--

25         (1)  The following acts constitute relating to the

26  practice of dispensing hearing aids shall be grounds for

27  denial of a license or disciplinary action, as specified in s.

28  456.072(2) both disciplinary action against a hearing aid

29  specialist as set forth in this section and cease and desist

30  or other related action by the department as set forth in s.

31  456.065 against any person owning or operating a hearing aid


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    CS for SB 1558                                Second Engrossed



  1  establishment who engages in, aids, or abets any such

  2  violation:

  3         (a)  Violation of any provision of s. 456.072(1), s.

  4  484.0512, or s. 484.053.

  5         (b)  Attempting to procure a license to dispense

  6  hearing aids by bribery, by fraudulent misrepresentations, or

  7  through an error of the department or the board.

  8         (c)  Having a license to dispense hearing aids 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         (d)  Being convicted or found guilty of, or entering a

13  plea of nolo contendere to, regardless of adjudication, a

14  crime in any jurisdiction which directly relates to the

15  practice of dispensing hearing aids or the ability to practice

16  dispensing hearing aids, including violations of any federal

17  laws or regulations regarding hearing aids.

18         (e)  Making or filing a report or record which the

19  licensee knows to be false, intentionally or negligently

20  failing to file a report or record required by state or

21  federal law, willfully impeding or obstructing such filing, or

22  inducing another person to impede or obstruct such filing.

23  Such reports or records shall include only those reports or

24  records which are signed in one's capacity as a licensed

25  hearing aid specialist.

26         (f)  Advertising goods or services in a manner which is

27  fraudulent, false, deceptive, or misleading in form or

28  content.

29         (g)  Proof that the licensee is guilty of fraud or

30  deceit or of negligence, incompetency, or misconduct in the

31  practice of dispensing hearing aids.


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    CS for SB 1558                                Second Engrossed



  1         (h)  Violation or repeated violation of this part or of

  2  chapter 456, or any rules promulgated pursuant thereto.

  3         (h)(i)  Violation of a lawful order of the board or

  4  department previously entered in a disciplinary hearing or

  5  failure to comply with a lawfully issued subpoena of the board

  6  or department.

  7         (i)(j)  Practicing with a revoked, suspended, inactive,

  8  or delinquent license.

  9         (j)(k)  Using, or causing or promoting the use of, any

10  advertising matter, promotional literature, testimonial,

11  guarantee, warranty, label, brand, insignia, or other

12  representation, however disseminated or published, which is

13  misleading, deceiving, or untruthful.

14         (k)(l)  Showing or demonstrating, or, in the event of

15  sale, delivery of, a product unusable or impractical for the

16  purpose represented or implied by such action.

17         (l)(m)  Misrepresentation of professional services

18  available in the fitting, sale, adjustment, service, or repair

19  of a hearing aid, or use of the terms "doctor," "clinic,"

20  "clinical," "medical audiologist," "clinical audiologist,"

21  "research audiologist," or "audiologic" or any other term or

22  title which might connote the availability of professional

23  services when such use is not accurate.

24         (m)(n)  Representation, advertisement, or implication

25  that a hearing aid or its repair is guaranteed without

26  providing full disclosure of the identity of the guarantor;

27  the nature, extent, and duration of the guarantee; and the

28  existence of conditions or limitations imposed upon the

29  guarantee.

30         (n)(o)  Representing, directly or by implication, that

31  a hearing aid utilizing bone conduction has certain specified


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    CS for SB 1558                                Second Engrossed



  1  features, such as the absence of anything in the ear or

  2  leading to the ear, or the like, without disclosing clearly

  3  and conspicuously that the instrument operates on the bone

  4  conduction principle and that in many cases of hearing loss

  5  this type of instrument may not be suitable.

  6         (o)(p)  Making any predictions or prognostications as

  7  to the future course of a hearing impairment, either in

  8  general terms or with reference to an individual person.

  9         (p)(q)  Stating or implying that the use of any hearing

10  aid will improve or preserve hearing or prevent or retard the

11  progression of a hearing impairment or that it will have any

12  similar or opposite effect.

13         (q)(r)  Making any statement regarding the cure of the

14  cause of a hearing impairment by the use of a hearing aid.

15         (r)(s)  Representing or implying that a hearing aid is

16  or will be "custom-made," "made to order," or

17  "prescription-made" or in any other sense specially fabricated

18  for an individual person when such is not the case.

19         (s)(t)  Canvassing from house to house or by telephone

20  either in person or by an agent for the purpose of selling a

21  hearing aid, except that contacting persons who have evidenced

22  an interest in hearing aids, or have been referred as in need

23  of hearing aids, shall not be considered canvassing.

24         (t)(u)  Failure to submit to the board on an annual

25  basis, or such other basis as may be provided by rule,

26  certification of testing and calibration of audiometric

27  testing equipment on the form approved by the board.

28         (u)(v)  Failing to provide all information as described

29  in s. 484.051(1).

30  

31  


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    CS for SB 1558                                Second Engrossed



  1         (v)(w)  Exercising influence on a client in such a

  2  manner as to exploit the client for financial gain of the

  3  licensee or of a third party.

  4         (w)  Violating any provision of this chapter or chapter

  5  456, or any rules adopted pursuant thereto.

  6         (2)(a)  The board may enter an order denying licensure

  7  or imposing any of the penalties in s. 456.072(2) against any

  8  applicant for licensure or licensee who is found guilty of

  9  violating any provision of subsection (1) of this section or

10  who is found guilty of violating any provision of s.

11  456.072(1). Except as provided in paragraph (b), when the

12  board finds any hearing aid specialist to be guilty of any of

13  the grounds set forth in subsection (1), it may enter an order

14  imposing one or more of the following penalties:

15         1.  Denial of an application for licensure.

16         2.  Revocation or suspension of a license.

17         3.  Imposition of an administrative fine not to exceed

18  $1,000 for each count or separate offense.

19         4.  Issuance of a reprimand.

20         5.  Placing the hearing aid specialist on probation for

21  a period of time and subject to such conditions as the board

22  may specify, including requiring the hearing aid specialist to

23  attend continuing education courses or to work under the

24  supervision of another hearing aid specialist.

25         6.  Restricting the authorized scope of practice.

26         (b)  The board shall revoke the license of any hearing

27  aid specialist found guilty of canvassing as described in this

28  section.

29         Section 51.  Subsections (1) and (2) of section

30  486.125, Florida Statutes, are amended to read:

31  


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    CS for SB 1558                                Second Engrossed



  1         486.125  Refusal, revocation, or suspension of license;

  2  administrative fines and other disciplinary measures.--

  3         (1)  The following acts shall constitute grounds for

  4  denial of a license or disciplinary action, as specified in s.

  5  456.072(2) which the disciplinary actions specified in

  6  subsection (2) may be taken:

  7         (a)  Being unable to practice physical therapy with

  8  reasonable skill and safety to patients by reason of illness

  9  or use of alcohol, drugs, narcotics, chemicals, or any other

10  type of material or as a result of any mental or physical

11  condition.

12         1.  In enforcing this paragraph, upon a finding of the

13  secretary or the secretary's designee that probable cause

14  exists to believe that the licensee is unable to practice

15  physical therapy due to the reasons stated in this paragraph,

16  the department shall have the authority to compel a physical

17  therapist or physical therapist assistant to submit to a

18  mental or physical examination by a physician designated by

19  the department.  If the licensee refuses to comply with such

20  order, the department's order directing such examination may

21  be enforced by filing a petition for enforcement in the

22  circuit court where the licensee resides or serves as a

23  physical therapy practitioner.  The licensee against whom the

24  petition is filed shall not be named or identified by initials

25  in any public court records or documents, and the proceedings

26  shall be closed to the public.  The department shall be

27  entitled to the summary procedure provided in s. 51.011.

28         2.  A physical therapist or physical therapist

29  assistant whose license is suspended or revoked pursuant to

30  this subsection shall, at reasonable intervals, be given an

31  opportunity to demonstrate that she or he can resume the


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    CS for SB 1558                                Second Engrossed



  1  competent practice of physical therapy with reasonable skill

  2  and safety to patients.

  3         3.  Neither the record of proceeding nor the orders

  4  entered by the board in any proceeding under this subsection

  5  may be used against a physical therapist or physical therapist

  6  assistant in any other proceeding.

  7         (b)  Having committed fraud in the practice of physical

  8  therapy or deceit in obtaining a license as a physical

  9  therapist or as a physical therapist assistant.

10         (c)  Being convicted or found guilty regardless of

11  adjudication, of a crime in any jurisdiction which directly

12  relates to the practice of physical therapy or to the ability

13  to practice physical therapy. The entry of any plea of nolo

14  contendere shall be considered a conviction for purpose of

15  this chapter.

16         (d)  Having treated or undertaken to treat human

17  ailments by means other than by physical therapy, as defined

18  in this chapter.

19         (e)  Failing to maintain acceptable standards of

20  physical therapy practice as set forth by the board in rules

21  adopted pursuant to this chapter.

22         (f)  Engaging directly or indirectly in the dividing,

23  transferring, assigning, rebating, or refunding of fees

24  received for professional services, or having been found to

25  profit by means of a credit or other valuable consideration,

26  such as an unearned commission, discount, or gratuity, with

27  any person referring a patient or with any relative or

28  business associate of the referring person.  Nothing in this

29  chapter shall be construed to prohibit the members of any

30  regularly and properly organized business entity which is

31  comprised of physical therapists and which is recognized under


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    CS for SB 1558                                Second Engrossed



  1  the laws of this state from making any division of their total

  2  fees among themselves as they determine necessary.

  3         (g)  Having a license revoked or suspended; having had

  4  other disciplinary action taken against her or him; or having

  5  had her or his application for a license refused, revoked, or

  6  suspended by the licensing authority of another state,

  7  territory, or country.

  8         (h)  Violating any provision of this chapter, a rule of

  9  the board or department, or a lawful order of the board or

10  department previously entered in a disciplinary hearing.

11         (i)  Making or filing a report or record which the

12  licensee knows to be false.  Such reports or records shall

13  include only those which are signed in the capacity of a

14  physical therapist.

15         (j)  Practicing or offering to practice beyond the

16  scope permitted by law or accepting and performing

17  professional responsibilities which the licensee knows or has

18  reason to know that she or he is not competent to perform,

19  including, but not limited to, specific spinal manipulation.

20         (k)  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 grounds 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                                Second 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 physical therapist or physical

  7  therapist assistant on probation for a period of time and

  8  subject to such conditions as the board may specify,

  9  including, but not limited to, requiring the physical

10  therapist or physical therapist assistant to submit to

11  treatment, to attend continuing education courses, to submit

12  to reexamination, or to work under the supervision of another

13  physical therapist.

14         (g)  Recovery of actual costs of investigation and

15  prosecution.

16         Section 52.  Section 490.009, Florida Statutes, is

17  amended to read:

18         490.009  Discipline.--

19         (1)  When the department or, in the case of

20  psychologists, the board finds that an applicant, provisional

21  licensee, or licensee whom it regulates under this chapter has

22  committed any of the acts set forth in subsection (2), it may

23  issue an order imposing one or more of the following

24  penalties:

25         (a)  Denial of an application for licensure, either

26  temporarily or permanently.

27         (b)  Revocation of an application for licensure, either

28  temporarily or permanently.

29         (c)  Suspension for a period of up to 5 years or

30  revocation of a license, after hearing.

31  


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    CS for SB 1558                                Second Engrossed



  1         (d)  Immediate suspension of a license pursuant to s.

  2  120.60(6).

  3         (e)  Imposition of an administrative fine not to exceed

  4  $5,000 for each count or separate offense.

  5         (f)  Issuance of a public reprimand.

  6         (g)  Placement of an applicant or licensee on probation

  7  for a period of time and subject to conditions specified by

  8  the department or, in the case of psychologists, by the board,

  9  including, but not limited to, requiring the applicant or

10  licensee to submit to treatment, to attend continuing

11  education courses, to submit to reexamination, or to work

12  under the supervision of a designated licensee.

13         (h)  Restriction of practice.

14         (1)(2)  The following acts constitute of a licensee,

15  provisional licensee, or applicant are grounds for denial of a

16  license or disciplinary action, as specified in s. 456.072(2)

17  which the disciplinary actions listed in subsection (1) may be

18  taken:

19         (a)  Attempting to obtain, obtaining, or renewing a

20  license under this chapter by bribery or fraudulent

21  misrepresentation or through an error of the board or

22  department.

23         (b)  Having a license to practice a comparable

24  profession revoked, suspended, or otherwise acted against,

25  including the denial of certification or licensure by another

26  state, territory, or country.

27         (c)  Being convicted or found guilty, regardless of

28  adjudication, of a crime in any jurisdiction which directly

29  relates to the practice of his or her profession or the

30  ability to practice his or her profession.  A plea of nolo

31  contendere creates a rebuttable presumption of guilt of the


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    CS for SB 1558                                Second Engrossed



  1  underlying criminal charges.  However, the board shall allow

  2  the person who is the subject of the disciplinary proceeding

  3  to present any evidence relevant to the underlying charges and

  4  circumstances surrounding the plea.

  5         (d)  False, deceptive, or misleading advertising or

  6  obtaining a fee or other thing of value on the representation

  7  that beneficial results from any treatment will be guaranteed.

  8         (e)  Advertising, practicing, or attempting to practice

  9  under a name other than one's own.

10         (f)  Maintaining a professional association with any

11  person who the applicant or licensee knows, or has reason to

12  believe, is in violation of this chapter or of a rule of the

13  department or, in the case of psychologists, of the department

14  or the board.

15         (g)  Knowingly aiding, assisting, procuring, or

16  advising any nonlicensed person to hold himself or herself out

17  as licensed under this chapter.

18         (h)  Failing to perform any statutory or legal

19  obligation placed upon a person licensed under this chapter.

20         (i)  Willfully making or filing a false report or

21  record; failing to file a report or record required by state

22  or federal law; willfully impeding or obstructing the filing

23  of a report or record; or inducing another person to make or

24  file a false report or record or to impede or obstruct the

25  filing of a report or record.  Such report or record includes

26  only a report or record which requires the signature of a

27  person licensed under this chapter.

28         (j)  Paying a kickback, rebate, bonus, or other

29  remuneration for receiving a patient or client, or receiving a

30  kickback, rebate, bonus, or other remuneration for referring a

31  patient or client to another provider of mental health care


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  1  services or to a provider of health care services or goods;

  2  referring a patient or client to oneself for services on a

  3  fee-paid basis when those services are already being paid for

  4  by some other public or private entity; or entering into a

  5  reciprocal referral agreement.

  6         (k)  Committing any act upon a patient or client which

  7  would constitute sexual battery or which would constitute

  8  sexual misconduct as defined in s. 490.0111.

  9         (l)  Making misleading, deceptive, untrue, or

10  fraudulent representations in the practice of any profession

11  licensed under this chapter.

12         (m)  Soliciting patients or clients personally, or

13  through an agent, through the use of fraud, intimidation,

14  undue influence, or a form of overreaching or vexatious

15  conduct.

16         (n)  Failing to make available to a patient or client,

17  upon written request, copies of test results, reports, or

18  documents in the possession or under the control of the

19  licensee which have been prepared for and paid for by the

20  patient or client.

21         (o)  Failing to respond within 30 days to a written

22  communication from the department concerning any investigation

23  by the department or to make available any relevant records

24  with respect to any investigation about the licensee's conduct

25  or background.

26         (p)  Being unable to practice the profession for which

27  he or she is licensed under this chapter with reasonable skill

28  or competence as a result of any mental or physical condition

29  or by reason of illness; drunkenness; or excessive use of

30  drugs, narcotics, chemicals, or any other substance.  In

31  enforcing this paragraph, upon a finding by the secretary, the


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  1  secretary's designee, or the board that probable cause exists

  2  to believe that the licensee is unable to practice the

  3  profession because of the reasons stated in this paragraph,

  4  the department shall have the authority to compel a licensee

  5  to submit to a mental or physical examination by psychologists

  6  or physicians designated by the department or board.  If the

  7  licensee refuses to comply with the department's order, the

  8  department may file a petition for enforcement in the circuit

  9  court of the circuit in which the licensee resides or does

10  business.  The licensee shall not be named or identified by

11  initials in the petition or in any other public court records

12  or documents, and the enforcement proceedings shall be closed

13  to the public.  The department shall be entitled to the

14  summary procedure provided in s. 51.011.  A licensee affected

15  under this paragraph shall be afforded an opportunity at

16  reasonable intervals to demonstrate that he or she can resume

17  the competent practice for which he or she is licensed with

18  reasonable skill and safety to patients.

19         (q)  Violating provisions of this chapter, or of

20  chapter 456, or any rules adopted pursuant thereto.

21         (q)(r)  Performing any treatment or prescribing any

22  therapy which, by the prevailing standards of the mental

23  health professions in the community, would constitute

24  experimentation on human subjects, without first obtaining

25  full, informed, and written consent.

26         (r)(s)  Failing to meet the minimum standards of

27  performance in professional activities when measured against

28  generally prevailing peer performance, including the

29  undertaking of activities for which the licensee is not

30  qualified by training or experience.

31  


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  1         (s)(t)  Delegating professional responsibilities to a

  2  person whom the licensee knows or has reason to know is not

  3  qualified by training or experience to perform such

  4  responsibilities.

  5         (t)(u)  Violating a rule relating to the regulation of

  6  the profession or a lawful order of the department previously

  7  entered in a disciplinary hearing.

  8         (u)(v)  Failing to maintain in confidence a

  9  communication made by a patient or client in the context of

10  such services, except as provided in s. 490.0147.

11         (v)(w)  Making public statements which are derived from

12  test data, client contacts, or behavioral research and which

13  identify or damage research subjects or clients.

14         (w)  Violating any provision of this chapter or chapter

15  456, or any rules adopted pursuant thereto.

16         (2)  The department, or in the case of psychologists,

17  the board, may enter an order denying licensure or imposing

18  any of the penalties in s. 456.072(2) against any applicant

19  for licensure or licensee who is found guilty of violating any

20  provision of subsection (1) of this section or who is found

21  guilty of violating any provision of s. 456.072(1).

22         Section 53.  Section 491.009, Florida Statutes, is

23  amended to read:

24         491.009  Discipline.--

25         (1)  When the department or the board finds that an

26  applicant, licensee, provisional licensee, registered intern,

27  or certificateholder whom it regulates under this chapter has

28  committed any of the acts set forth in subsection (2), it may

29  issue an order imposing one or more of the following

30  penalties:

31  


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  1         (a)  Denial of an application for licensure,

  2  registration, or certification, either temporarily or

  3  permanently.

  4         (b)  Revocation of an application for licensure,

  5  registration, or certification, either temporarily or

  6  permanently.

  7         (c)  Suspension for a period of up to 5 years or

  8  revocation of a license, registration, or certificate, after

  9  hearing.

10         (d)  Immediate suspension of a license, registration,

11  or certificate pursuant to s. 120.60(6).

12         (e)  Imposition of an administrative fine not to exceed

13  $1,000 for each count or separate offense.

14         (f)  Issuance of a public reprimand.

15         (g)  Placement of an applicant, licensee, registered

16  intern, or certificateholder on probation for a period of time

17  and subject to such conditions as the board may specify,

18  including, but not limited to, requiring the applicant,

19  licensee, registered intern, or certificateholder to submit to

20  treatment, to attend continuing education courses, to submit

21  to reexamination, or to work under the supervision of a

22  designated licensee or certificateholder.

23         (h)  Restriction of practice.

24         (1)(2)  The following acts constitute of a licensee,

25  provisional licensee, registered intern, certificateholder, or

26  applicant are grounds for denial of a license or disciplinary

27  action, as specified in s. 456.072(2) which the disciplinary

28  actions listed in subsection (1) may be taken:

29         (a)  Attempting to obtain, obtaining, or renewing a

30  license, registration, or certificate under this chapter by

31  


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    CS for SB 1558                                Second Engrossed



  1  bribery or fraudulent misrepresentation or through an error of

  2  the board or the department.

  3         (b)  Having a license, registration, or certificate to

  4  practice a comparable profession revoked, suspended, or

  5  otherwise acted against, including the denial of certification

  6  or licensure by another state, territory, or country.

  7         (c)  Being convicted or found guilty of, regardless of

  8  adjudication, or having entered a plea of nolo contendere to,

  9  a crime in any jurisdiction which directly relates to the

10  practice of his or her profession or the ability to practice

11  his or her profession.  However, in the case of a plea of nolo

12  contendere, the board shall allow the person who is the

13  subject of the disciplinary proceeding to present evidence in

14  mitigation relevant to the underlying charges and

15  circumstances surrounding the plea.

16         (d)  False, deceptive, or misleading advertising or

17  obtaining a fee or other thing of value on the representation

18  that beneficial results from any treatment will be guaranteed.

19         (e)  Advertising, practicing, or attempting to practice

20  under a name other than one's own.

21         (f)  Maintaining a professional association with any

22  person who the applicant, licensee, registered intern, or

23  certificateholder knows, or has reason to believe, is in

24  violation of this chapter or of a rule of the department or

25  the board.

26         (g)  Knowingly aiding, assisting, procuring, or

27  advising any nonlicensed, nonregistered, or noncertified

28  person to hold himself or herself out as licensed, registered,

29  or certified under this chapter.

30  

31  


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    CS for SB 1558                                Second Engrossed



  1         (h)  Failing to perform any statutory or legal

  2  obligation placed upon a person licensed, registered, or

  3  certified under this chapter.

  4         (i)  Willfully making or filing a false report or

  5  record; failing to file a report or record required by state

  6  or federal law; willfully impeding or obstructing the filing

  7  of a report or record; or inducing another person to make or

  8  file a false report or record or to impede or obstruct the

  9  filing of a report or record.  Such report or record includes

10  only a report or record which requires the signature of a

11  person licensed, registered, or certified under this chapter.

12         (j)  Paying a kickback, rebate, bonus, or other

13  remuneration for receiving a patient or client, or receiving a

14  kickback, rebate, bonus, or other remuneration for referring a

15  patient or client to another provider of mental health care

16  services or to a provider of health care services or goods;

17  referring a patient or client to oneself for services on a

18  fee-paid basis when those services are already being paid for

19  by some other public or private entity; or entering into a

20  reciprocal referral agreement.

21         (k)  Committing any act upon a patient or client which

22  would constitute sexual battery or which would constitute

23  sexual misconduct as defined pursuant to s. 491.0111.

24         (l)  Making misleading, deceptive, untrue, or

25  fraudulent representations in the practice of any profession

26  licensed, registered, or certified under this chapter.

27         (m)  Soliciting patients or clients personally, or

28  through an agent, through the use of fraud, intimidation,

29  undue influence, or a form of overreaching or vexatious

30  conduct.

31  


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    CS for SB 1558                                Second Engrossed



  1         (n)  Failing to make available to a patient or client,

  2  upon written request, copies of tests, reports, or documents

  3  in the possession or under the control of the licensee,

  4  registered intern, or certificateholder which have been

  5  prepared for and paid for by the patient or client.

  6         (o)  Failing to respond within 30 days to a written

  7  communication from the department or the board concerning any

  8  investigation by the department or the board, or failing to

  9  make available any relevant records with respect to any

10  investigation about the licensee's, registered intern's, or

11  certificateholder's conduct or background.

12         (p)  Being unable to practice the profession for which

13  he or she is licensed, registered, or certified under this

14  chapter with reasonable skill or competence as a result of any

15  mental or physical condition or by reason of illness;

16  drunkenness; or excessive use of drugs, narcotics, chemicals,

17  or any other substance. In enforcing this paragraph, upon a

18  finding by the secretary, the secretary's designee, or the

19  board that probable cause exists to believe that the licensee,

20  registered intern, or certificateholder is unable to practice

21  the profession because of the reasons stated in this

22  paragraph, the department shall have the authority to compel a

23  licensee, registered intern, or certificateholder to submit to

24  a mental or physical examination by psychologists, physicians,

25  or other licensees under this chapter, designated by the

26  department or board.  If the licensee, registered intern, or

27  certificateholder refuses to comply with such order, the

28  department's order directing the examination may be enforced

29  by filing a petition for enforcement in the circuit court in

30  the circuit in which the licensee, registered intern, or

31  certificateholder resides or does business.  The licensee,


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    CS for SB 1558                                Second Engrossed



  1  registered intern, or certificateholder against whom the

  2  petition is filed shall not be named or identified by initials

  3  in any public court records or documents, and the proceedings

  4  shall be closed to the public.  The department shall be

  5  entitled to the summary procedure provided in s. 51.011. A

  6  licensee, registered intern, or certificateholder affected

  7  under this paragraph shall at reasonable intervals be afforded

  8  an opportunity to demonstrate that he or she can resume the

  9  competent practice for which he or she is licensed,

10  registered, or certified with reasonable skill and safety to

11  patients.

12         (q)  Violating provisions of this chapter, or of

13  chapter 456, or any rules adopted pursuant thereto.

14         (q)(r)  Performing any treatment or prescribing any

15  therapy which, by the prevailing standards of the mental

16  health professions in the community, would constitute

17  experimentation on human subjects, without first obtaining

18  full, informed, and written consent.

19         (r)(s)  Failing to meet the minimum standards of

20  performance in professional activities when measured against

21  generally prevailing peer performance, including the

22  undertaking of activities for which the licensee, registered

23  intern, or certificateholder is not qualified by training or

24  experience.

25         (s)(t)  Delegating professional responsibilities to a

26  person whom the licensee, registered intern, or

27  certificateholder knows or has reason to know is not qualified

28  by training or experience to perform such responsibilities.

29         (t)(u)  Violating a rule relating to the regulation of

30  the profession or a lawful order of the department or the

31  board previously entered in a disciplinary hearing.


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    CS for SB 1558                                Second Engrossed



  1         (u)(v)  Failure of the licensee, registered intern, or

  2  certificateholder to maintain in confidence a communication

  3  made by a patient or client in the context of such services,

  4  except as provided in s. 491.0147.

  5         (v)(w)  Making public statements which are derived from

  6  test data, client contacts, or behavioral research and which

  7  identify or damage research subjects or clients.

  8         (w)  Violating any provision of this chapter or chapter

  9  456, or any rules adopted pursuant thereto.

10         (2)  The department, or in the case of psychologists,

11  the board, may enter an order denying licensure or imposing

12  any of the penalties in s. 456.072(2) against any applicant

13  for licensure or licensee who is found guilty of violating any

14  provision of subsection (1) of this section or who is found

15  guilty of violating any provision of s. 456.072(1).

16         Section 54.  Subsection (3) of section 456.065, Florida

17  Statutes, is amended to read:

18         456.065  Unlicensed practice of a health care

19  profession; intent; cease and desist notice; penalties;

20  enforcement; citations; fees; allocation and disposition of

21  moneys collected.--

22         (3)  Because all enforcement costs should be covered by

23  professions regulated by the department, the department shall

24  impose, upon initial licensure and each licensure renewal, a

25  special fee of $5 per licensee to fund efforts to combat

26  unlicensed activity. Such fee shall be in addition to all

27  other fees collected from each licensee. The board, with

28  concurrence of the department, or the department when there is

29  no board, may earmark $5 of the current licensure fee for this

30  purpose, if such board, or profession regulated by the

31  department, is not in a deficit and has a reasonable cash


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    CS for SB 1558                                Second Engrossed



  1  balance. The department shall make direct charges to the

  2  Medical Quality Assurance Trust Fund by profession. The

  3  department shall seek board advice regarding enforcement

  4  methods and strategies. The department shall directly credit

  5  the Medical Quality Assurance Trust Fund, by profession, with

  6  the revenues received from the department's efforts to enforce

  7  licensure provisions. The department shall include all

  8  financial and statistical data resulting from unlicensed

  9  activity enforcement as a separate category in the quarterly

10  management report provided for in s. 456.025. For an

11  unlicensed activity account, a balance which remains at the

12  end of a renewal cycle may, with concurrence of the applicable

13  board and the department, be transferred to the operating fund

14  account of that profession. The department shall also use

15  these funds to inform and educate consumers generally on the

16  importance of using licensed health care practitioners.

17         Section 55.  Effective October 1, 2001, paragraphs (e)

18  and (f) of subsection (4) of section 458.347, Florida

19  Statutes, are amended to read:

20         458.347  Physician assistants.--

21         (4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--

22         (e)  A supervisory physician may delegate to a fully

23  licensed physician assistant the authority to prescribe any

24  medication used in the supervisory physician's practice unless

25  if such medication is listed on the formulary created pursuant

26  to paragraph (f).  A fully licensed physician assistant may

27  only prescribe such medication under the following

28  circumstances:

29         1.  A physician assistant must clearly identify to the

30  patient that he or she is a physician assistant.  Furthermore,

31  the physician assistant must inform the patient that the


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  1  patient has the right to see the physician prior to any

  2  prescription being prescribed by the physician assistant.

  3         2.  The supervisory physician must notify the

  4  department of his or her intent to delegate, on a

  5  department-approved form, before delegating such authority and

  6  notify the department of any change in prescriptive privileges

  7  of the physician assistant.

  8         3.  The physician assistant must file with the

  9  department, before commencing to prescribe, evidence that he

10  or she has completed a continuing medical education course of

11  at least 3 classroom hours in prescriptive practice, conducted

12  by an accredited program approved by the boards, which course

13  covers the limitations, responsibilities, and privileges

14  involved in prescribing medicinal drugs, or evidence that he

15  or she has received education comparable to the continuing

16  education course as part of an accredited physician assistant

17  training program.

18         4.  The physician assistant must file with the

19  department, before commencing to prescribe, evidence that the

20  physician assistant has a minimum of 3 months of clinical

21  experience in the specialty area of the supervising physician.

22         5.  The physician assistant must file with the

23  department a signed affidavit that he or she has completed a

24  minimum of 10 continuing medical education hours in the

25  specialty practice in which the physician assistant has

26  prescriptive privileges with each licensure renewal

27  application.

28         6.  The department shall issue a license and a

29  prescriber number to the physician assistant granting

30  authority for the prescribing of medicinal drugs authorized

31  


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    CS for SB 1558                                Second Engrossed



  1  within this paragraph upon completion of the foregoing

  2  requirements.

  3         7.  The prescription must be written in a form that

  4  complies with chapter 499 and must contain, in addition to the

  5  supervisory physician's name, address, and telephone number,

  6  the physician assistant's prescriber number. Unless it is a

  7  drug sample dispensed by the physician assistant, the

  8  prescription must be filled in a pharmacy permitted under

  9  chapter 465 and must be dispensed in that pharmacy by a

10  pharmacist licensed under chapter 465. The appearance of the

11  prescriber number creates a presumption that the physician

12  assistant is authorized to prescribe the medicinal drug and

13  the prescription is valid.

14         8.  The physician assistant must note the prescription

15  in the appropriate medical record, and the supervisory

16  physician must review and sign each notation.  For dispensing

17  purposes only, the failure of the supervisory physician to

18  comply with these requirements does not affect the validity of

19  the prescription.

20         9.  This paragraph does not prohibit a supervisory

21  physician from delegating to a physician assistant the

22  authority to order medication for a hospitalized patient of

23  the supervisory physician.

24  

25  This paragraph does not apply to facilities licensed pursuant

26  to chapter 395.

27         (f)1.  There is created a five-member committee

28  appointed by the Secretary of Health.  The committee must be

29  composed of one fully licensed physician assistant licensed

30  pursuant to this section or s. 459.022, two physicians

31  licensed pursuant to this chapter, one of whom supervises a


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    CS for SB 1558                                Second Engrossed



  1  fully licensed physician assistant, one osteopathic physician

  2  licensed pursuant to chapter 459, and one pharmacist licensed

  3  pursuant to chapter 465 who is not licensed pursuant to this

  4  chapter or chapter 459.  The council committee shall establish

  5  a formulary of medicinal drugs that for which a fully licensed

  6  physician assistant, licensed under this section or s.

  7  459.022, may not prescribe. The formulary must may not include

  8  controlled substances as defined in chapter 893,

  9  antineoplastics, antipsychotics, radiopharmaceuticals, general

10  anesthetics and or radiographic contrast materials, and all or

11  any parenteral preparations except insulin and epinephrine.

12         2.  In establishing the formulary, the council shall

13  consult with a pharmacist licensed under chapter 465, but not

14  licensed under this chapter or chapter 459, who shall be

15  selected by the Secretary of Health.

16         3.2.  Only the council committee shall add to, delete

17  from, or modify the formulary.  Any person who requests an

18  addition, deletion, or modification of a medicinal drug listed

19  on such formulary has the burden of proof to show cause why

20  such addition, deletion, or modification should be made.

21         4.3.  The boards shall adopt the formulary required by

22  this paragraph, and each addition, deletion, or modification

23  to the formulary, by rule. Notwithstanding any provision of

24  chapter 120 to the contrary, the formulary rule shall be

25  effective 60 days after the date it is filed with the

26  Secretary of State.  Upon adoption of the formulary, the

27  department shall mail a copy of such formulary to each fully

28  licensed physician assistant, licensed under this section or

29  s. 459.022, and to each pharmacy licensed by the state.  The

30  boards shall establish, by rule, a fee not to exceed $200 to

31  fund the provisions of this paragraph and paragraph (e).


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    CS for SB 1558                                Second Engrossed



  1         Section 56.  Effective October 1, 2001, subsection (4)

  2  and paragraph (c) of subsection (9) of section 459.022,

  3  Florida Statutes, are amended to read:

  4         459.022  Physician assistants.--

  5         (4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--

  6         (a)  The boards shall adopt, by rule, the general

  7  principles that supervising physicians must use in developing

  8  the scope of practice of a physician assistant under direct

  9  supervision and under indirect supervision. These principles

10  shall recognize the diversity of both specialty and practice

11  settings in which physician assistants are used.

12         (b)  This chapter does not prevent third-party payors

13  from reimbursing employers of physician assistants for covered

14  services rendered by licensed physician assistants.

15         (c)  Licensed physician assistants may not be denied

16  clinical hospital privileges, except for cause, so long as the

17  supervising physician is a staff member in good standing.

18         (d)  A supervisory physician may delegate to a licensed

19  physician assistant, pursuant to a written protocol, the

20  authority to act according to s. 154.04(1)(c).  Such delegated

21  authority is limited to the supervising physician's practice

22  in connection with a county health department as defined and

23  established pursuant to chapter 154.  The boards shall adopt

24  rules governing the supervision of physician assistants by

25  physicians in county health departments.

26         (e)  A supervisory physician may delegate to a fully

27  licensed physician assistant the authority to prescribe any

28  medication used in the supervisory physician's practice unless

29  if such medication is listed on the formulary created pursuant

30  to s. 458.347.  A fully licensed physician assistant may only

31  prescribe such medication under the following circumstances:


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    CS for SB 1558                                Second Engrossed



  1         1.  A physician assistant must clearly identify to the

  2  patient that she or he is a physician assistant. Furthermore,

  3  the physician assistant must inform the patient that the

  4  patient has the right to see the physician prior to any

  5  prescription being prescribed by the physician assistant.

  6         2.  The supervisory physician must notify the

  7  department of her or his intent to delegate, on a

  8  department-approved form, before delegating such authority and

  9  notify the department of any change in prescriptive privileges

10  of the physician assistant.

11         3.  The physician assistant must file with the

12  department, before commencing to prescribe, evidence that she

13  or he has completed a continuing medical education course of

14  at least 3 classroom hours in prescriptive practice, conducted

15  by an accredited program approved by the boards, which course

16  covers the limitations, responsibilities, and privileges

17  involved in prescribing medicinal drugs, or evidence that she

18  or he has received education comparable to the continuing

19  education course as part of an accredited physician assistant

20  training program.

21         4.  The physician assistant must file with the

22  department, before commencing to prescribe, evidence that the

23  physician assistant has a minimum of 3 months of clinical

24  experience in the specialty area of the supervising physician.

25         5.  The physician assistant must file with the

26  department a signed affidavit that she or he has completed a

27  minimum of 10 continuing medical education hours in the

28  specialty practice in which the physician assistant has

29  prescriptive privileges with each licensure renewal

30  application.

31  


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  1         6.  The department shall issue a license and a

  2  prescriber number to the physician assistant granting

  3  authority for the prescribing of medicinal drugs authorized

  4  within this paragraph upon completion of the foregoing

  5  requirements.

  6         7.  The prescription must be written in a form that

  7  complies with chapter 499 and must contain, in addition to the

  8  supervisory physician's name, address, and telephone number,

  9  the physician assistant's prescriber number. Unless it is a

10  drug sample dispensed by the physician assistant, the

11  prescription must be filled in a pharmacy permitted under

12  chapter 465, and must be dispensed in that pharmacy by a

13  pharmacist licensed under chapter 465. The appearance of the

14  prescriber number creates a presumption that the physician

15  assistant is authorized to prescribe the medicinal drug and

16  the prescription is valid.

17         8.  The physician assistant must note the prescription

18  in the appropriate medical record, and the supervisory

19  physician must review and sign each notation.  For dispensing

20  purposes only, the failure of the supervisory physician to

21  comply with these requirements does not affect the validity of

22  the prescription.

23         9.  This paragraph does not prohibit a supervisory

24  physician from delegating to a physician assistant the

25  authority to order medication for a hospitalized patient of

26  the supervisory physician.

27  

28  This paragraph does not apply to facilities licensed pursuant

29  to chapter 395.

30         (f)1.  There is created a five-member committee

31  appointed by the Secretary of Health.  The committee must be


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    CS for SB 1558                                Second Engrossed



  1  composed of one fully licensed physician assistant licensed

  2  pursuant to this section or s. 458.347, two physicians

  3  licensed pursuant to chapter 458, one of whom supervises a

  4  fully licensed physician assistant, one osteopathic physician

  5  licensed pursuant to this chapter, and one pharmacist licensed

  6  pursuant to chapter 465 who is not licensed pursuant to this

  7  chapter or chapter 458.  The committee shall establish a

  8  formulary of medicinal drugs for which a fully licensed

  9  physician assistant may prescribe. The formulary may not

10  include controlled substances as defined in chapter 893,

11  antineoplastics, antipsychotics, radiopharmaceuticals, general

12  anesthetics or radiographic contrast materials, or any

13  parenteral preparations except insulin and epinephrine.

14         2.  Only the committee shall add to, delete from, or

15  modify the formulary.  Any person who requests an addition,

16  deletion, or modification of a medicinal drug listed on such

17  formulary has the burden of proof to show cause why such

18  addition, deletion, or modification should be made.

19         3.  The boards shall adopt the formulary required by

20  this paragraph, and each addition, deletion, or modification

21  to the formulary, by rule. Notwithstanding any provision of

22  chapter 120 to the contrary, the formulary rule shall be

23  effective 60 days after the date it is filed with the

24  Secretary of State.  Upon adoption of the formulary, the

25  department shall mail a copy of such formulary to each fully

26  licensed physician assistant and to each pharmacy licensed by

27  the state.  The boards shall establish, by rule, a fee not to

28  exceed $200 to fund the provisions of this paragraph and

29  paragraph (e).

30         (9)  COUNCIL ON PHYSICIAN ASSISTANTS.--The Council on

31  Physician Assistants is created within the department.


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  1         (c)  The council shall:

  2         1.  Recommend to the department the licensure of

  3  physician assistants.

  4         2.  Develop all rules regulating the use of physician

  5  assistants by physicians under chapter 458 and this chapter,

  6  except for rules relating to the formulary developed under s.

  7  458.347(4)(f). The council shall also develop rules to ensure

  8  that the continuity of supervision is maintained in each

  9  practice setting. The boards shall consider adopting a

10  proposed rule developed by the council at the regularly

11  scheduled meeting immediately following the submission of the

12  proposed rule by the council.  A proposed rule submitted by

13  the council may not be adopted by either board unless both

14  boards have accepted and approved the identical language

15  contained in the proposed rule. The language of all proposed

16  rules submitted by the council must be approved by both boards

17  pursuant to each respective board's guidelines and standards

18  regarding the adoption of proposed rules.  If either board

19  rejects the council's proposed rule, that board must specify

20  its objection to the council with particularity and include

21  any recommendations it may have for the modification of the

22  proposed rule.

23         3.  Make recommendations to the boards regarding all

24  matters relating to physician assistants.

25         4.  Address concerns and problems of practicing

26  physician assistants in order to improve safety in the

27  clinical practices of licensed physician assistants.

28         Section 57.  Subsections (6) is added to section

29  456.003, Florida Statutes, to read:

30         456.003  Legislative intent; requirements.--

31  


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  1         (6)  Unless expressly and specifically granted in

  2  statute, the duties conferred on the boards do not include the

  3  enlargement, modification, or contravention of the lawful

  4  scope of practice of the profession regulated by the boards.

  5  This subsection shall not prohibit the boards, or the

  6  department when there is no board, from taking disciplinary

  7  action or issuing a declaratory statement.

  8         Section 58.  (1)(a)  The Agency for Health Care

  9  Administration shall create an Organ Transplant Task Force

10  within the Agency for Health Care Administration, which task

11  force must be funded by existing agency funds.

12         (b)  Task force participants shall be responsible for

13  only the expenses that they generate individually through

14  participation. The agency shall be responsible for expenses

15  incidental to the production of any required data or reports.

16         (2)  The task force shall consist of up to 15 members.

17  The task force chairperson shall be selected by majority vote

18  of a quorum present. Eight members shall constitute a quorum.

19  The membership shall include, but not be limited to, a balance

20  of members representing the Agency for Health Care

21  Administration, health care facilities that have existing

22  organ transplantation programs, individual organ transplant

23  health care practitioners, pediatric organ transplantation

24  programs, organ procurement agencies, and organ transplant

25  recipients or family members.

26         (3)  The task force shall meet for the purpose of

27  studying and making recommendations regarding current and

28  future supply of organs in relation to the number of existing

29  organ transplantation programs and the future necessity of the

30  issuance of a certificate of need for proposed organ

31  transplantation programs. At a minimum, the task force shall


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  1  submit a report to the Legislature which includes a summary of

  2  the method of allocation and distribution of organs; a list of

  3  facilities performing multiple organ transplants and the

  4  number being performed; the number of Medicaid and charity

  5  care patients who have received organ transplants by existing

  6  organ transplant programs; suggested mechanisms for funding

  7  organ transplants, which shall include, but need not limited

  8  to, an organ transplant trust fund for the treatment of

  9  Medicaid and charity patients; the impact of trends in health

10  care delivery and financing on organ transplantation; and the

11  number of certificates of need applications reviewed by the

12  Agency for Health Care Administration in the last 5 years,

13  including the number approved or denied and the number

14  litigated.

15         (4)  The task force shall meet at the call of the

16  chairperson. The task force shall submit a report to the

17  Governor, the President of the Senate, and the Speaker of the

18  House of Representatives by January 15, 2002. The task force

19  is abolished effective December 31, 2002.

20         Section 59.  Section 409.9205, Florida Statutes, is

21  amended to read:

22         409.9205  Medicaid Fraud Control Unit; law enforcement

23  officers.--

24         (1)  Except as provided in s. 110.205, all positions in

25  the Medicaid Fraud Control Unit of the Department of Legal

26  Affairs are hereby transferred to the Career Service System.

27         (2)  All investigators employed by the Medicaid Fraud

28  Control Unit who have been certified under s. 943.1395 are law

29  enforcement officers of the state.  Such investigators have

30  the authority to conduct criminal investigations, bear arms,

31  make arrests, and apply for, serve, and execute search


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  1  warrants, arrest warrants, capias, and other process

  2  throughout the state pertaining to Medicaid fraud as described

  3  in this chapter.  The Attorney General shall provide

  4  reasonable notice of criminal investigations conducted by the

  5  Medicaid Fraud Control Unit to, and coordinate those

  6  investigations with, the sheriffs of the respective counties.

  7  Investigators employed by the Medicaid Fraud Control Unit are

  8  not eligible for membership in the Special Risk Class of the

  9  Florida Retirement System under s. 121.0515.

10         Section 60.  Subsection (1) of section 483.245, Florida

11  Statutes, is amended to read:

12         483.245  Rebates prohibited; penalties.--

13         (1)  It is unlawful for any person to pay or receive

14  any commission, bonus, kickback, or rebate or engage in any

15  split-fee arrangement in any form whatsoever with any dialysis

16  facility, physician, surgeon, organization, agency, or person,

17  either directly or indirectly, for patients referred to a

18  clinical laboratory licensed under this part.

19         Section 61.  Subsection (3) of section 232.435, Florida

20  Statutes, is amended to read:

21         232.435  Extracurricular athletic activities; athletic

22  trainers.--

23         (3)(a)  To the extent practicable, a school district

24  program should include the following employment classification

25  and advancement scheme:

26         1.  First responder.--To qualify as a first responder,

27  a person must possess a professional, temporary, part-time,

28  adjunct, or substitute certificate pursuant to s. 231.17, be

29  certified in cardiopulmonary resuscitation, first aid, and

30  have 15 semester hours in courses such as care and prevention

31  of athletic injuries, anatomy, physiology, nutrition,


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    CS for SB 1558                                Second Engrossed



  1  counseling, and other similar courses approved by the

  2  Commissioner of Education.  This person may only administer

  3  first aid and similar care. Teacher apprentice trainer I.--To

  4  qualify as a teacher apprentice trainer I, a person must

  5  possess a professional, temporary, part-time, adjunct, or

  6  substitute certificate pursuant to s. 231.17, be certified in

  7  first aid and cardiopulmonary resuscitation, and have earned a

  8  minimum of 6 semester hours or the equivalent number of

  9  inservice education points in the basic prevention and care of

10  athletic injuries.

11         2.  Teacher apprentice trainer II.--To qualify as a

12  teacher apprentice trainer II, a person must meet the

13  requirements of teacher apprentice trainer I and also have

14  earned a minimum of 15 additional semester hours or the

15  equivalent number of inservice education points in such

16  courses as anatomy, physiology, use of modalities, nutrition,

17  counseling, and other courses approved by the Commissioner of

18  Education.

19         2.3.  Teacher athletic trainer.--To qualify as a

20  teacher athletic trainer, a person must possess a

21  professional, temporary, part-time, adjunct, or substitute

22  certificate pursuant to s. 232.17, and be licensed as required

23  by part XIII of chapter 468 meet the requirements of teacher

24  apprentice trainer II, be certified by the Department of

25  Education or a nationally recognized athletic trainer

26  association, and perform one or more of the following

27  functions:  preventing athletic injuries; recognizing,

28  evaluating, managing, treating, and rehabilitating athletic

29  injuries; administering an athletic training program; and

30  educating and counseling athletes.

31  


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    CS for SB 1558                                Second Engrossed



  1         (b)  If a school district uses the services of an

  2  athletic trainer who is not a teacher athletic trainer or a

  3  teacher apprentice trainer within the requirements of this

  4  section, such athletic trainer must be licensed as required by

  5  part XIII of chapter 468.

  6         Section 62.  Paragraph (b) of subsection (1) of section

  7  383.14, Florida Statutes, is amended to read:

  8         383.14  Screening for metabolic disorders, other

  9  hereditary and congenital disorders, and environmental risk

10  factors.--

11         (1)  SCREENING REQUIREMENTS.--To help ensure access to

12  the maternal and child health care system, the Department of

13  Health shall promote the screening of all infants born in

14  Florida for phenylketonuria and other metabolic, hereditary,

15  and congenital disorders known to result in significant

16  impairment of health or intellect, as screening programs

17  accepted by current medical practice become available and

18  practical in the judgment of the department.  The department

19  shall also promote the identification and screening of all

20  infants born in this state and their families for

21  environmental risk factors such as low income, poor education,

22  maternal and family stress, emotional instability, substance

23  abuse, and other high-risk conditions associated with

24  increased risk of infant mortality and morbidity to provide

25  early intervention, remediation, and prevention services,

26  including, but not limited to, parent support and training

27  programs, home visitation, and case management.

28  Identification, perinatal screening, and intervention efforts

29  shall begin prior to and immediately following the birth of

30  the child by the attending health care provider.  Such efforts

31  shall be conducted in hospitals, perinatal centers, county


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    CS for SB 1558                                Second Engrossed



  1  health departments, school health programs that provide

  2  prenatal care, and birthing centers, and reported to the

  3  Office of Vital Statistics.

  4         (b)  Postnatal screening.--A risk factor analysis using

  5  the department's designated risk assessment instrument shall

  6  also be conducted as part of the medical screening process

  7  upon the birth of a child and submitted to the department's

  8  Office of Vital Statistics for recording and other purposes

  9  provided for in this chapter.  The department's screening

10  process for risk assessment shall include a scoring mechanism

11  and procedures that establish thresholds for notification,

12  further assessment, referral, and eligibility for services by

13  professionals or paraprofessionals consistent with the level

14  of risk. Procedures for developing and using the screening

15  instrument, notification, referral, and care coordination

16  services, reporting requirements, management information, and

17  maintenance of a computer-driven registry in the Office of

18  Vital Statistics which ensures privacy safeguards must be

19  consistent with the provisions and plans established under

20  chapter 411, Pub. L. No. 99-457, and this chapter.  Procedures

21  established for reporting information and maintaining a

22  confidential registry must include a mechanism for a

23  centralized information depository at the state and county

24  levels.  The department shall coordinate with existing risk

25  assessment systems and information registries.  The department

26  must ensure, to the maximum extent possible, that the

27  screening information registry is integrated with the

28  department's automated data systems, including the Florida

29  On-line Recipient Integrated Data Access (FLORIDA) system.

30  Tests and screenings must be performed by the State Public

31  Health Laboratory, in coordination with Children's Medical


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    CS for SB 1558                                Second Engrossed



  1  Services, at such times and in such manner as is prescribed by

  2  the department after consultation with the Genetics and Infant

  3  Screening Advisory Council and the State Coordinating Council

  4  for School Readiness Programs.

  5         Section 63.  Section 395.0197, Florida Statutes, is

  6  amended to read:

  7         395.0197  Internal risk management program.--

  8         (1)  Every licensed facility shall, as a part of its

  9  administrative functions, establish an internal risk

10  management program that includes all of the following

11  components:

12         (a)  The investigation and analysis of the frequency

13  and causes of general categories and specific types of adverse

14  incidents to patients.

15         (b)  The development of appropriate measures to

16  minimize the risk of adverse incidents to patients, including,

17  but not limited to:

18         1.  Risk management and risk prevention education and

19  training of all nonphysician personnel as follows:

20         a.  Such education and training of all nonphysician

21  personnel as part of their initial orientation; and

22         b.  At least 1 hour of such education and training

23  annually for all nonphysician personnel of the licensed

24  facility working in clinical areas and providing patient care,

25  except those persons licensed as health care practitioners who

26  are required to complete continuing education coursework

27  pursuant to chapter 456 or the respective practice act.

28         2.  A prohibition, except when emergency circumstances

29  require otherwise, against a staff member of the licensed

30  facility attending a patient in the recovery room, unless the

31  staff member is authorized to attend the patient in the


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    CS for SB 1558                                Second Engrossed



  1  recovery room and is in the company of at least one other

  2  person.  However, a licensed facility is exempt from the

  3  two-person requirement if it has:

  4         a.  Live visual observation;

  5         b.  Electronic observation; or

  6         c.  Any other reasonable measure taken to ensure

  7  patient protection and privacy.

  8         3.  A prohibition against an unlicensed person from

  9  assisting or participating in any surgical procedure unless

10  the facility has authorized the person to do so following a

11  competency assessment, and such assistance or participation is

12  done under the direct and immediate supervision of a licensed

13  physician and is not otherwise an activity that may only be

14  performed by a licensed health care practitioner.

15         4.  Development, implementation, and ongoing evaluation

16  of procedures, protocols, and systems to accurately identify

17  patients, planned procedures, and the correct site of the

18  planned procedure so as to minimize the performance of a

19  surgical procedure on the wrong patient, a wrong surgical

20  procedure, a wrong-site surgical procedure, or a surgical

21  procedure otherwise unrelated to the patient's diagnosis or

22  medical condition.

23         (c)  The analysis of patient grievances that relate to

24  patient care and the quality of medical services.

25         (d)  The development and implementation of an incident

26  reporting system based upon the affirmative duty of all health

27  care providers and all agents and employees of the licensed

28  health care facility to report adverse incidents to the risk

29  manager, or to his or her designee, within 3 business days

30  after their occurrence.

31  


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  1         (2)  The internal risk management program is the

  2  responsibility of the governing board of the health care

  3  facility. Each licensed facility shall hire a risk manager,

  4  licensed under s. 395.10974 part IX of chapter 626, who is

  5  responsible for implementation and oversight of such

  6  facility's internal risk management program as required by

  7  this section.  A risk manager must not be made responsible for

  8  more than four internal risk management programs in separate

  9  licensed facilities, unless the facilities are under one

10  corporate ownership or the risk management programs are in

11  rural hospitals.

12         (3)  In addition to the programs mandated by this

13  section, other innovative approaches intended to reduce the

14  frequency and severity of medical malpractice and patient

15  injury claims shall be encouraged and their implementation and

16  operation facilitated. Such additional approaches may include

17  extending internal risk management programs to health care

18  providers' offices and the assuming of provider liability by a

19  licensed health care facility for acts or omissions occurring

20  within the licensed facility.

21         (4)  The agency shall, after consulting with the

22  Department of Insurance, adopt rules governing the

23  establishment of internal risk management programs to meet the

24  needs of individual licensed facilities.  Each internal risk

25  management program shall include the use of incident reports

26  to be filed with an individual of responsibility who is

27  competent in risk management techniques in the employ of each

28  licensed facility, such as an insurance coordinator, or who is

29  retained by the licensed facility as a consultant.  The

30  individual responsible for the risk management program shall

31  have free access to all medical records of the licensed


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    CS for SB 1558                                Second Engrossed



  1  facility.  The incident reports are part of the workpapers of

  2  the attorney defending the licensed facility in litigation

  3  relating to the licensed facility and are subject to

  4  discovery, but are not admissible as evidence in court.  A

  5  person filing an incident report is not subject to civil suit

  6  by virtue of such incident report.  As a part of each internal

  7  risk management program, the incident reports shall be used to

  8  develop categories of incidents which identify problem areas.

  9  Once identified, procedures shall be adjusted to correct the

10  problem areas.

11         (5)  For purposes of reporting to the agency pursuant

12  to this section, the term "adverse incident" means an event

13  over which health care personnel could exercise control and

14  which is associated in whole or in part with medical

15  intervention, rather than the condition for which such

16  intervention occurred, and which:

17         (a)  Results in one of the following injuries:

18         1.  Death;

19         2.  Brain or spinal damage;

20         3.  Permanent disfigurement;

21         4.  Fracture or dislocation of bones or joints;

22         5.  A resulting limitation of neurological, physical,

23  or sensory function which continues after discharge from the

24  facility;

25         6.  Any condition that required specialized medical

26  attention or surgical intervention resulting from nonemergency

27  medical intervention, other than an emergency medical

28  condition, to which the patient has not given his or her

29  informed consent; or

30         7.  Any condition that required the transfer of the

31  patient, within or outside the facility, to a unit providing a


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    CS for SB 1558                                Second Engrossed



  1  more acute level of care due to the adverse incident, rather

  2  than the patient's condition prior to the adverse incident;

  3         (b)  Was the performance of a surgical procedure on the

  4  wrong patient, a wrong surgical procedure, a wrong-site

  5  surgical procedure, or a surgical procedure otherwise

  6  unrelated to the patient's diagnosis or medical condition;

  7         (c)  Required the surgical repair of damage resulting

  8  to a patient from a planned surgical procedure, where the

  9  damage was not a recognized specific risk, as disclosed to the

10  patient and documented through the informed-consent process;

11  or

12         (d)  Was a procedure to remove unplanned foreign

13  objects remaining from a surgical procedure.

14         (6)(a)  Each licensed facility subject to this section

15  shall submit an annual report to the agency summarizing the

16  incident reports that have been filed in the facility for that

17  year. The report shall include:

18         1.  The total number of adverse incidents.

19         2.  A listing, by category, of the types of operations,

20  diagnostic or treatment procedures, or other actions causing

21  the injuries, and the number of incidents occurring within

22  each category.

23         3.  A listing, by category, of the types of injuries

24  caused and the number of incidents occurring within each

25  category.

26         4.  A code number using the health care professional's

27  licensure number and a separate code number identifying all

28  other individuals directly involved in adverse incidents to

29  patients, the relationship of the individual to the licensed

30  facility, and the number of incidents in which each individual

31  has been directly involved.  Each licensed facility shall


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    CS for SB 1558                                Second Engrossed



  1  maintain names of the health care professionals and

  2  individuals identified by code numbers for purposes of this

  3  section.

  4         5.  A description of all malpractice claims filed

  5  against the licensed facility, including the total number of

  6  pending and closed claims and the nature of the incident which

  7  led to, the persons involved in, and the status and

  8  disposition of each claim. Each report shall update status and

  9  disposition for all prior reports.

10         (b)  The information reported to the agency pursuant to

11  paragraph (a) which relates to persons licensed under chapter

12  458, chapter 459, chapter 461, or chapter 466 shall be

13  reviewed by the agency.  The agency shall determine whether

14  any of the incidents potentially involved conduct by a health

15  care professional who is subject to disciplinary action, in

16  which case the provisions of s. 456.073 shall apply.

17         (c)  The report submitted to the agency shall also

18  contain the name and license number of the risk manager of the

19  licensed facility, a copy of its policy and procedures which

20  govern the measures taken by the facility and its risk manager

21  to reduce the risk of injuries and adverse incidents, and the

22  results of such measures.  The annual report is confidential

23  and is not available to the public pursuant to s. 119.07(1) or

24  any other law providing access to public records. The annual

25  report is not discoverable or admissible in any civil or

26  administrative action, except in disciplinary proceedings by

27  the agency or the appropriate regulatory board. The annual

28  report is not available to the public as part of the record of

29  investigation for and prosecution in disciplinary proceedings

30  made available to the public by the agency or the appropriate

31  regulatory board.  However, the agency or the appropriate


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    CS for SB 1558                                Second Engrossed



  1  regulatory board shall make available, upon written request by

  2  a health care professional against whom probable cause has

  3  been found, any such records which form the basis of the

  4  determination of probable cause.

  5         (7)  The licensed facility shall notify the agency no

  6  later than 1 business day after the risk manager or his or her

  7  designee has received a report pursuant to paragraph (1)(d)

  8  and can determine within 1 business day that any of the

  9  following adverse incidents has occurred, whether occurring in

10  the licensed facility or arising from health care prior to

11  admission in the licensed facility:

12         (a)  The death of a patient;

13         (b)  Brain or spinal damage to a patient;

14         (c)  The performance of a surgical procedure on the

15  wrong patient;

16         (d)  The performance of a wrong-site surgical

17  procedure; or

18         (e)  The performance of a wrong surgical procedure.

19  

20  The notification must be made in writing and be provided by

21  facsimile device or overnight mail delivery. The notification

22  must include information regarding the identity of the

23  affected patient, the type of adverse incident, the initiation

24  of an investigation by the facility, and whether the events

25  causing or resulting in the adverse incident represent a

26  potential risk to other patients.

27         (8)  Any of the following adverse incidents, whether

28  occurring in the licensed facility or arising from health care

29  prior to admission in the licensed facility, shall be reported

30  by the facility to the agency within 15 calendar days after

31  its occurrence:


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    CS for SB 1558                                Second Engrossed



  1         (a)  The death of a patient;

  2         (b)  Brain or spinal damage to a patient;

  3         (c)  The performance of a surgical procedure on the

  4  wrong patient;

  5         (d)  The performance of a wrong-site surgical

  6  procedure;

  7         (e)  The performance of a wrong surgical procedure;

  8         (f)  The performance of a surgical procedure that is

  9  medically unnecessary or otherwise unrelated to the patient's

10  diagnosis or medical condition;

11         (g)  The surgical repair of damage resulting to a

12  patient from a planned surgical procedure, where the damage is

13  not a recognized specific risk, as disclosed to the patient

14  and documented through the informed-consent process; or

15         (h)  The performance of procedures to remove unplanned

16  foreign objects remaining from a surgical procedure.

17  

18  The agency may grant extensions to this reporting requirement

19  for more than 15 days upon justification submitted in writing

20  by the facility administrator to the agency. The agency may

21  require an additional, final report.  These reports shall not

22  be available to the public pursuant to s. 119.07(1) or any

23  other law providing access to public records, nor be

24  discoverable or admissible in any civil or administrative

25  action, except in disciplinary proceedings by the agency or

26  the appropriate regulatory board, nor shall they be available

27  to the public as part of the record of investigation for and

28  prosecution in disciplinary proceedings made available to the

29  public by the agency or the appropriate regulatory board.

30  However, the agency or the appropriate regulatory board shall

31  make available, upon written request by a health care


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    CS for SB 1558                                Second Engrossed



  1  professional against whom probable cause has been found, any

  2  such records which form the basis of the determination of

  3  probable cause.  The agency may investigate, as it deems

  4  appropriate, any such incident and prescribe measures that

  5  must or may be taken in response to the incident. The agency

  6  shall review each incident and determine whether it

  7  potentially involved conduct by the health care professional

  8  who is subject to disciplinary action, in which case the

  9  provisions of s. 456.073 shall apply.

10         (9)  The agency shall publish on the agency's website,

11  no less than quarterly, a summary and trend analysis of

12  adverse incident reports received pursuant to this section,

13  which shall not include information that would identify the

14  patient, the reporting facility, or the health care

15  practitioners involved. The agency shall publish on the

16  agency's website an annual summary and trend analysis of all

17  adverse incident reports and malpractice claims information

18  provided by facilities in their annual reports, which shall

19  not include information that would identify the patient, the

20  reporting facility, or the practitioners involved.  The

21  purpose of the publication of the summary and trend analysis

22  is to promote the rapid dissemination of information relating

23  to adverse incidents and malpractice claims to assist in

24  avoidance of similar incidents and reduce morbidity and

25  mortality.

26         (10)(9)  The internal risk manager of each licensed

27  facility shall:

28         (a)  Investigate every allegation of sexual misconduct

29  which is made against a member of the facility's personnel who

30  has direct patient contact, when the allegation is that the

31  


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    CS for SB 1558                                Second Engrossed



  1  sexual misconduct occurred at the facility or on the grounds

  2  of the facility.; and

  3         (b)  Report every allegation of sexual misconduct to

  4  the administrator of the licensed facility.

  5         (c)  Notify the family or guardian of the victim, if a

  6  minor, that an allegation of sexual misconduct has been made

  7  and that an investigation is being conducted.;

  8         (d)  Report to the Department of Health every

  9  allegation of sexual misconduct, as defined in chapter 456 and

10  the respective practice act, by a licensed health care

11  practitioner that involves a patient.

12         (11)(10)  Any witness who witnessed or who possesses

13  actual knowledge of the act that is the basis of an allegation

14  of sexual abuse shall:

15         (a)  Notify the local police; and

16         (b)  Notify the hospital risk manager and the

17  administrator.

18  

19  For purposes of this subsection, "sexual abuse" means acts of

20  a sexual nature committed for the sexual gratification of

21  anyone upon, or in the presence of, a vulnerable adult,

22  without the vulnerable adult's informed consent, or a minor.

23  "Sexual abuse" includes, but is not limited to, the acts

24  defined in s. 794.011(1)(h), fondling, exposure of a

25  vulnerable adult's or minor's sexual organs, or the use of the

26  vulnerable adult or minor to solicit for or engage in

27  prostitution or sexual performance. "Sexual abuse" does not

28  include any act intended for a valid medical purpose or any

29  act which may reasonably be construed to be a normal

30  caregiving action.

31  


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    CS for SB 1558                                Second Engrossed



  1         (12)(11)  A person who, with malice or with intent to

  2  discredit or harm a licensed facility or any person, makes a

  3  false allegation of sexual misconduct against a member of a

  4  licensed facility's personnel is guilty of a misdemeanor of

  5  the second degree, punishable as provided in s. 775.082 or s.

  6  775.083.

  7         (13)(12)  In addition to any penalty imposed pursuant

  8  to this section, the agency shall require a written plan of

  9  correction from the facility.  For a single incident or series

10  of isolated incidents that are nonwillful violations of the

11  reporting requirements of this section, the agency shall first

12  seek to obtain corrective action by the facility.  If the

13  correction is not demonstrated within the timeframe

14  established by the agency or if there is a pattern of

15  nonwillful violations of this section, the agency may impose

16  an administrative fine, not to exceed $5,000 for any violation

17  of the reporting requirements of this section.  The

18  administrative fine for repeated nonwillful violations shall

19  not exceed $10,000 for any violation.  The administrative fine

20  for each intentional and willful violation may not exceed

21  $25,000 per violation, per day.  The fine for an intentional

22  and willful violation of this section may not exceed $250,000.

23  In determining the amount of fine to be levied, the agency

24  shall be guided by s. 395.1065(2)(b). This subsection does not

25  apply to the notice requirements under subsection (7).

26         (14)(13)  The agency shall have access to all licensed

27  facility records necessary to carry out the provisions of this

28  section.  The records obtained by the agency under subsection

29  (6), subsection (8), or subsection (10) (9) are not available

30  to the public under s. 119.07(1), nor shall they be

31  discoverable or admissible in any civil or administrative


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    CS for SB 1558                                Second Engrossed



  1  action, except in disciplinary proceedings by the agency or

  2  the appropriate regulatory board, nor shall records obtained

  3  pursuant to s. 456.071 be available to the public as part of

  4  the record of investigation for and prosecution in

  5  disciplinary proceedings made available to the public by the

  6  agency or the appropriate regulatory board. However, the

  7  agency or the appropriate regulatory board shall make

  8  available, upon written request by a health care professional

  9  against whom probable cause has been found, any such records

10  which form the basis of the determination of probable cause,

11  except that, with respect to medical review committee records,

12  s. 766.101 controls.

13         (15)(14)  The meetings of the committees and governing

14  board of a licensed facility held solely for the purpose of

15  achieving the objectives of risk management as provided by

16  this section shall not be open to the public under the

17  provisions of chapter 286. The records of such meetings are

18  confidential and exempt from s. 119.07(1), except as provided

19  in subsection (14) (13).

20         (16)(15)  The agency shall review, as part of its

21  licensure inspection process, the internal risk management

22  program at each licensed facility regulated by this section to

23  determine whether the program meets standards established in

24  statutes and rules, whether the program is being conducted in

25  a manner designed to reduce adverse incidents, and whether the

26  program is appropriately reporting incidents under this

27  section subsections (5), (6), (7), and (8).

28         (17)(16)  There shall be no monetary liability on the

29  part of, and no cause of action for damages shall arise

30  against, any risk manager, licensed under s. 395.10974 part IX

31  of chapter 626, for the implementation and oversight of the


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    CS for SB 1558                                Second Engrossed



  1  internal risk management program in a facility licensed under

  2  this chapter or chapter 390 as required by this section, for

  3  any act or proceeding undertaken or performed within the scope

  4  of the functions of such internal risk management program if

  5  the risk manager acts without intentional fraud.

  6         (18)  A privilege against civil liability is hereby

  7  granted to any licensed risk manager or licensed facility with

  8  regard to information furnished pursuant to this chapter,

  9  unless the licensed risk manager or facility acted in bad

10  faith or with malice in providing such information.

11         (19)(17)  If the agency, through its receipt of any

12  reports required under this section the annual reports

13  prescribed in subsection (6) or through any investigation, has

14  a reasonable belief that conduct by a staff member or employee

15  of a licensed facility is grounds for disciplinary action by

16  the appropriate regulatory board, the agency shall report this

17  fact to such regulatory board.

18         (18)  The agency shall annually publish a report

19  summarizing the information contained in the annual incident

20  reports submitted by licensed facilities pursuant to

21  subsection (6) and disciplinary actions reported to the agency

22  pursuant to s. 395.0193. The report must, at a minimum,

23  summarize:

24         (a)  Adverse incidents, by category of reported

25  incident, and by type of professional involved.

26         (b)  Types of malpractice claims filed, by type of

27  professional involved.

28         (c)  Disciplinary actions taken against professionals,

29  by type of professional involved.

30         (20)  It shall be unlawful for any person to coerce,

31  intimidate, or preclude a risk manager from lawfully executing


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    CS for SB 1558                                Second Engrossed



  1  his or her reporting obligations pursuant to this chapter.

  2  Such unlawful action shall be subject to civil monetary

  3  penalties not to exceed $10,000 per violation.

  4         Section 64.  Section 395.10972, Florida Statutes, is

  5  amended to read:

  6         395.10972  Health Care Risk Manager Advisory

  7  Council.--The Secretary of Health Care Administration may

  8  appoint a seven-member five-member advisory council to advise

  9  the agency on matters pertaining to health care risk managers.

10  The members of the council shall serve at the pleasure of the

11  secretary. The council shall designate a chair. The council

12  shall meet at the call of the secretary or at those times as

13  may be required by rule of the agency.  The members of the

14  advisory council shall receive no compensation for their

15  services, but shall be reimbursed for travel expenses as

16  provided in s. 112.061. The council shall consist of

17  individuals representing the following areas:

18         (1)  Two shall be active health care risk managers,

19  including one risk manager who is recommended by and a member

20  of the Florida Society of Healthcare Risk Management.

21         (2)  One shall be an active hospital administrator.

22         (3)  One shall be an employee of an insurer or

23  self-insurer of medical malpractice coverage.

24         (4)  One shall be a representative of the

25  health-care-consuming public.

26         (5)  Two shall be licensed health care practitioners,

27  one of whom shall be licensed as a physician under chapter 458

28  or chapter 459.

29         Section 65.  Paragraph (b) of subsection (2) of section

30  395.701, Florida Statutes, is amended to read:

31  


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    CS for SB 1558                                Second Engrossed



  1         395.701  Annual assessments on net operating revenues

  2  for inpatient and outpatient services to fund public medical

  3  assistance; administrative fines for failure to pay

  4  assessments when due; exemption.--

  5         (2)

  6         (b)  There is imposed upon each hospital an assessment

  7  in an amount equal to 1 percent of the annual net operating

  8  revenue for outpatient services for each hospital, such

  9  revenue to be determined by the agency, based on the actual

10  experience of the hospital as reported to the agency. While

11  prior year report worksheets may be reconciled to the

12  hospital's audited financial statements, no additional audited

13  financial components may be required for the purposes of

14  determining the amount of the assessment imposed pursuant to

15  this section other than those in effect on July 1, 2000.

16  Within 6 months after the end of each hospital fiscal year,

17  the agency shall certify the amount of the assessment for each

18  hospital. The assessment shall be payable to and collected by

19  the agency in equal quarterly amounts, on or before the first

20  day of each calendar quarter, beginning with the first full

21  calendar quarter that occurs after the agency certifies the

22  amount of the assessment for each hospital. All moneys

23  collected pursuant to this subsection shall be deposited into

24  the Public Medical Assistance Trust Fund.

25         Section 66.  Section 409.905, Florida Statutes, is

26  amended to read:

27         409.905  Mandatory Medicaid services.--The agency may

28  make payments for the following services, which are required

29  of the state by Title XIX of the Social Security Act,

30  furnished by Medicaid providers to recipients who are

31  determined to be eligible on the dates on which the services


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    CS for SB 1558                                Second Engrossed



  1  were provided.  Any service under this section shall be

  2  provided only when medically necessary and in accordance with

  3  state and federal law. Mandatory services rendered by

  4  providers in mobile units to Medicaid recipients may be

  5  restricted by the agency. Nothing in this section shall be

  6  construed to prevent or limit the agency from adjusting fees,

  7  reimbursement rates, lengths of stay, number of visits, number

  8  of services, or any other adjustments necessary to comply with

  9  the availability of moneys and any limitations or directions

10  provided for in the General Appropriations Act or chapter 216.

11         (1)  ADVANCED REGISTERED NURSE PRACTITIONER

12  SERVICES.--The agency shall pay for services provided to a

13  recipient by a licensed advanced registered nurse practitioner

14  who has a valid collaboration agreement with a licensed

15  physician on file with the Department of Health or who

16  provides anesthesia services in accordance with established

17  protocol required by state law and approved by the medical

18  staff of the facility in which the anesthetic service is

19  performed. Reimbursement for such services must be provided in

20  an amount that equals not less than 80 percent of the

21  reimbursement to a physician who provides the same services,

22  unless otherwise provided for in the General Appropriations

23  Act.

24         (2)  EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND

25  TREATMENT SERVICES.--The agency shall pay for early and

26  periodic screening and diagnosis of a recipient under age 21

27  to ascertain physical and mental problems and conditions and

28  provide treatment to correct or ameliorate these problems and

29  conditions.  These services include all services determined by

30  the agency to be medically necessary for the treatment,

31  correction, or amelioration of these problems, including


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    CS for SB 1558                                Second Engrossed



  1  personal care, private duty nursing, durable medical

  2  equipment, physical therapy, occupational therapy, speech

  3  therapy, respiratory therapy, and immunizations.

  4         (3)  FAMILY PLANNING SERVICES.--The agency shall pay

  5  for services necessary to enable a recipient voluntarily to

  6  plan family size or to space children. These services include

  7  information; education; counseling regarding the availability,

  8  benefits, and risks of each method of pregnancy prevention;

  9  drugs and supplies; and necessary medical care and followup.

10  Each recipient participating in the family planning portion of

11  the Medicaid program must be provided freedom to choose any

12  alternative method of family planning, as required by federal

13  law.

14         (4)  HOME HEALTH CARE SERVICES.--The agency shall pay

15  for nursing and home health aide services, supplies,

16  appliances, and durable medical equipment, necessary to assist

17  a recipient living at home. An entity that provides services

18  pursuant to this subsection shall be licensed under part IV of

19  chapter 400 or part II of chapter 499, if appropriate.  These

20  services, equipment, and supplies, or reimbursement therefor,

21  may be limited as provided in the General Appropriations Act

22  and do not include services, equipment, or supplies provided

23  to a person residing in a hospital or nursing facility. In

24  providing home health care services, the agency may require

25  prior authorization of care based on diagnosis.

26         (5)  HOSPITAL INPATIENT SERVICES.--The agency shall pay

27  for all covered services provided for the medical care and

28  treatment of a recipient who is admitted as an inpatient by a

29  licensed physician or dentist to a hospital licensed under

30  part I of chapter 395.  However, the agency shall limit the

31  payment for inpatient hospital services for a Medicaid


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    CS for SB 1558                                Second Engrossed



  1  recipient 21 years of age or older to 45 days or the number of

  2  days necessary to comply with the General Appropriations Act.

  3         (a)  The agency is authorized to implement

  4  reimbursement and utilization management reforms in order to

  5  comply with any limitations or directions in the General

  6  Appropriations Act, which may include, but are not limited to:

  7  prior authorization for inpatient psychiatric days; enhanced

  8  utilization and concurrent review programs for highly utilized

  9  services; reduction or elimination of covered days of service;

10  adjusting reimbursement ceilings for variable costs; adjusting

11  reimbursement ceilings for fixed and property costs; and

12  implementing target rates of increase.

13         (b)  A licensed hospital maintained primarily for the

14  care and treatment of patients having mental disorders or

15  mental diseases is not eligible to participate in the hospital

16  inpatient portion of the Medicaid program except as provided

17  in federal law.  However, the department shall apply for a

18  waiver, within 9 months after June 5, 1991, designed to

19  provide hospitalization services for mental health reasons to

20  children and adults in the most cost-effective and lowest cost

21  setting possible.  Such waiver shall include a request for the

22  opportunity to pay for care in hospitals known under federal

23  law as "institutions for mental disease" or "IMD's."  The

24  waiver proposal shall propose no additional aggregate cost to

25  the state or Federal Government, and shall be conducted in

26  Hillsborough County, Highlands County, Hardee County, Manatee

27  County, and Polk County.  The waiver proposal may incorporate

28  competitive bidding for hospital services, comprehensive

29  brokering, prepaid capitated arrangements, or other mechanisms

30  deemed by the department to show promise in reducing the cost

31  of acute care and increasing the effectiveness of preventive


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    CS for SB 1558                                Second Engrossed



  1  care.  When developing the waiver proposal, the department

  2  shall take into account price, quality, accessibility,

  3  linkages of the hospital to community services and family

  4  support programs, plans of the hospital to ensure the earliest

  5  discharge possible, and the comprehensiveness of the mental

  6  health and other health care services offered by participating

  7  providers.

  8         (c)  Agency for Health Care Administration shall adjust

  9  a hospital's current inpatient per diem rate to reflect the

10  cost of serving the Medicaid population at that institution

11  if:

12         1.  The hospital experiences an increase in Medicaid

13  caseload by more than 25 percent in any year, primarily

14  resulting from the closure of a hospital in the same service

15  area occurring after July 1, 1995; or

16         2.  The hospital's Medicaid per diem rate is at least

17  25 percent below the Medicaid per patient cost for that year.

18  

19  No later than November 1, 2000, the agency must provide

20  estimated costs for any adjustment in a hospital inpatient per

21  diem pursuant to this paragraph to the Executive Office of the

22  Governor, the House of Representatives General Appropriations

23  Committee, and the Senate Budget Committee. Before the agency

24  implements a change in a hospital's inpatient per diem rate

25  pursuant to this paragraph, the Legislature must have

26  specifically appropriated sufficient funds in the 2001-2002

27  General Appropriations Act to support the increase in cost as

28  estimated by the agency. This paragraph is repealed on July 1,

29  2001.

30         (6)  HOSPITAL OUTPATIENT SERVICES.--The agency shall

31  pay for preventive, diagnostic, therapeutic, or palliative


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    CS for SB 1558                                Second Engrossed



  1  care and other services provided to a recipient in the

  2  outpatient portion of a hospital licensed under part I of

  3  chapter 395, and provided under the direction of a licensed

  4  physician or licensed dentist, except that payment for such

  5  care and services is limited to $1,500 per state fiscal year

  6  per recipient, unless an exception has been made by the

  7  agency, and with the exception of a Medicaid recipient under

  8  age 21, in which case the only limitation is medical

  9  necessity.

10         (7)  INDEPENDENT LABORATORY SERVICES.--The agency shall

11  pay for medically necessary diagnostic laboratory procedures

12  ordered by a licensed physician or other licensed practitioner

13  of the healing arts which are provided for a recipient in a

14  laboratory that meets the requirements for Medicare

15  participation and is licensed under chapter 483, if required.

16         (8)  NURSING FACILITY SERVICES.--The agency shall pay

17  for 24-hour-a-day nursing and rehabilitative services for a

18  recipient in a nursing facility licensed under part II of

19  chapter 400 or in a rural hospital, as defined in s. 395.602,

20  or in a Medicare certified skilled nursing facility operated

21  by a hospital, as defined by s. 395.002(11), that is licensed

22  under part I of chapter 395, and in accordance with provisions

23  set forth in s. 409.908(2)(a), which services are ordered by

24  and provided under the direction of a licensed physician.

25  However, if a nursing facility has been destroyed or otherwise

26  made uninhabitable by natural disaster or other emergency and

27  another nursing facility is not available, the agency must pay

28  for similar services temporarily in a hospital licensed under

29  part I of chapter 395 provided federal funding is approved and

30  available.

31  


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    CS for SB 1558                                Second Engrossed



  1         (9)  PHYSICIAN SERVICES.--The agency shall pay for

  2  covered services and procedures rendered to a recipient by, or

  3  under the personal supervision of, a person licensed under

  4  state law to practice medicine or osteopathic medicine.  These

  5  services may be furnished in the physician's office, the

  6  Medicaid recipient's home, a hospital, a nursing facility, or

  7  elsewhere, but shall be medically necessary for the treatment

  8  of an injury, illness, or disease within the scope of the

  9  practice of medicine or osteopathic medicine as defined by

10  state law.  The agency shall not pay for services that are

11  clinically unproven, experimental, or for purely cosmetic

12  purposes.

13         (10)  PORTABLE X-RAY SERVICES.--The agency shall pay

14  for professional and technical portable radiological services

15  ordered by a licensed physician or other licensed practitioner

16  of the healing arts which are provided by a licensed

17  professional in a setting other than a hospital, clinic, or

18  office of a physician or practitioner of the healing arts, on

19  behalf of a recipient.

20         (11)  RURAL HEALTH CLINIC SERVICES.--The agency shall

21  pay for outpatient primary health care services for a

22  recipient provided by a clinic certified by and participating

23  in the Medicare program which is located in a federally

24  designated, rural, medically underserved area and has on its

25  staff one or more licensed primary care nurse practitioners or

26  physician assistants, and a licensed staff supervising

27  physician or a consulting supervising physician.

28         (12)  TRANSPORTATION SERVICES.--The agency shall ensure

29  that appropriate transportation services are available for a

30  Medicaid recipient in need of transport to a qualified

31  Medicaid provider for medically necessary and


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    CS for SB 1558                                Second Engrossed



  1  Medicaid-compensable services, provided a client's ability to

  2  choose a specific transportation provider shall be limited to

  3  those options resulting from policies established by the

  4  agency to meet the fiscal limitations of the General

  5  Appropriations Act.  The agency may pay for transportation and

  6  other related travel expenses as necessary only if these

  7  services are not otherwise available.

  8         Section 67.  Section 409.906, Florida Statutes, is

  9  amended to read:

10         409.906  Optional Medicaid services.--Subject to

11  specific appropriations, the agency may make payments for

12  services which are optional to the state under Title XIX of

13  the Social Security Act and are furnished by Medicaid

14  providers to recipients who are determined to be eligible on

15  the dates on which the services were provided.  Any optional

16  service that is provided shall be provided only when medically

17  necessary and in accordance with state and federal law.

18  Optional services rendered by providers in mobile units to

19  Medicaid recipients may be restricted or prohibited by the

20  agency. Nothing in this section shall be construed to prevent

21  or limit the agency from adjusting fees, reimbursement rates,

22  lengths of stay, number of visits, or number of services, or

23  making any other adjustments necessary to comply with the

24  availability of moneys and any limitations or directions

25  provided for in the General Appropriations Act or chapter 216.

26  If necessary to safeguard the state's systems of providing

27  services to elderly and disabled persons and subject to the

28  notice and review provisions of s. 216.177, the Governor may

29  direct the Agency for Health Care Administration to amend the

30  Medicaid state plan to delete the optional Medicaid service

31  


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    CS for SB 1558                                Second Engrossed



  1  known as "Intermediate Care Facilities for the Developmentally

  2  Disabled."  Optional services may include:

  3         (1)  ADULT DENTURE SERVICES.--The agency may pay for

  4  dentures, the procedures required to seat dentures, and the

  5  repair and reline of dentures, provided by or under the

  6  direction of a licensed dentist, for a recipient who is age 21

  7  or older. However, Medicaid will not provide reimbursement for

  8  dental services provided in a mobile dental unit, except for a

  9  mobile dental unit:

10         (a)  Owned by, operated by, or having a contractual

11  agreement with the Department of Health and complying with

12  Medicaid's county health department clinic services program

13  specifications as a county health department clinic services

14  provider.

15         (b)  Owned by, operated by, or having a contractual

16  arrangement with a federally qualified health center and

17  complying with Medicaid's federally qualified health center

18  specifications as a federally qualified health center

19  provider.

20         (c)  Rendering dental services to Medicaid recipients,

21  21 years of age and older, at nursing facilities.

22         (d)  Owned by, operated by, or having a contractual

23  agreement with a state-approved dental educational

24  institution.

25         (2)  ADULT HEALTH SCREENING SERVICES.--The agency may

26  pay for an annual routine physical examination, conducted by

27  or under the direction of a licensed physician, for a

28  recipient age 21 or older, without regard to medical

29  necessity, in order to detect and prevent disease, disability,

30  or other health condition or its progression.

31  


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    CS for SB 1558                                Second Engrossed



  1         (3)  AMBULATORY SURGICAL CENTER SERVICES.--The agency

  2  may pay for services provided to a recipient in an ambulatory

  3  surgical center licensed under part I of chapter 395, by or

  4  under the direction of a licensed physician or dentist.

  5         (4)  BIRTH CENTER SERVICES.--The agency may pay for

  6  examinations and delivery, recovery, and newborn assessment,

  7  and related services, provided in a licensed birth center

  8  staffed with licensed physicians, certified nurse midwives,

  9  and midwives licensed in accordance with chapter 467, to a

10  recipient expected to experience a low-risk pregnancy and

11  delivery.

12         (5)  CASE MANAGEMENT SERVICES.--The agency may pay for

13  primary care case management services rendered to a recipient

14  pursuant to a federally approved waiver, and targeted case

15  management services for specific groups of targeted

16  recipients, for which funding has been provided and which are

17  rendered pursuant to federal guidelines. The agency is

18  authorized to limit reimbursement for targeted case management

19  services in order to comply with any limitations or directions

20  provided for in the General Appropriations Act.

21  Notwithstanding s. 216.292, the Department of Children and

22  Family Services may transfer general funds to the Agency for

23  Health Care Administration to fund state match requirements

24  exceeding the amount specified in the General Appropriations

25  Act for targeted case management services.

26         (6)  CHILDREN'S DENTAL SERVICES.--The agency may pay

27  for diagnostic, preventive, or corrective procedures,

28  including orthodontia in severe cases, provided to a recipient

29  under age 21, by or under the supervision of a licensed

30  dentist.  Services provided under this program include

31  treatment of the teeth and associated structures of the oral


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    CS for SB 1558                                Second Engrossed



  1  cavity, as well as treatment of disease, injury, or impairment

  2  that may affect the oral or general health of the individual.

  3  However, Medicaid will not provide reimbursement for dental

  4  services provided in a mobile dental unit, except for a mobile

  5  dental unit:

  6         (a)  Owned by, operated by, or having a contractual

  7  agreement with the Department of Health and complying with

  8  Medicaid's county health department clinic services program

  9  specifications as a county health department clinic services

10  provider.

11         (b)  Owned by, operated by, or having a contractual

12  arrangement with a federally qualified health center and

13  complying with Medicaid's federally qualified health center

14  specifications as a federally qualified health center

15  provider.

16         (c)  Rendering dental services to Medicaid recipients,

17  21 years of age and older, at nursing facilities.

18         (d)  Owned by, operated by, or having a contractual

19  agreement with a state-approved dental educational

20  institution.

21         (7)  CHIROPRACTIC SERVICES.--The agency may pay for

22  manual manipulation of the spine and initial services,

23  screening, and X rays provided to a recipient by a licensed

24  chiropractic physician.

25         (8)  COMMUNITY MENTAL HEALTH SERVICES.--The agency may

26  pay for rehabilitative services provided to a recipient by a

27  mental health or substance abuse provider licensed by the

28  agency and under contract with the agency or the Department of

29  Children and Family Services to provide such services.  Those

30  services which are psychiatric in nature shall be rendered or

31  recommended by a psychiatrist, and those services which are


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    CS for SB 1558                                Second Engrossed



  1  medical in nature shall be rendered or recommended by a

  2  physician or psychiatrist. The agency must develop a provider

  3  enrollment process for community mental health providers which

  4  bases provider enrollment on an assessment of service need.

  5  The provider enrollment process shall be designed to control

  6  costs, prevent fraud and abuse, consider provider expertise

  7  and capacity, and assess provider success in managing

  8  utilization of care and measuring treatment outcomes.

  9  Providers will be selected through a competitive procurement

10  or selective contracting process. In addition to other

11  community mental health providers, the agency shall consider

12  for enrollment mental health programs licensed under chapter

13  395 and group practices licensed under chapter 458, chapter

14  459, chapter 490, or chapter 491. The agency is also

15  authorized to continue operation of its behavioral health

16  utilization management program and may develop new services if

17  these actions are necessary to ensure savings from the

18  implementation of the utilization management system. The

19  agency shall coordinate the implementation of this enrollment

20  process with the Department of Children and Family Services

21  and the Department of Juvenile Justice. The agency is

22  authorized to utilize diagnostic criteria in setting

23  reimbursement rates, to preauthorize certain high-cost or

24  highly utilized services, to limit or eliminate coverage for

25  certain services, or to make any other adjustments necessary

26  to comply with any limitations or directions provided for in

27  the General Appropriations Act.

28         (9)  DIALYSIS FACILITY SERVICES.--Subject to specific

29  appropriations being provided for this purpose, the agency may

30  pay a dialysis facility that is approved as a dialysis

31  facility in accordance with Title XVIII of the Social Security


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  1  Act, for dialysis services that are provided to a Medicaid

  2  recipient under the direction of a physician licensed to

  3  practice medicine or osteopathic medicine in this state,

  4  including dialysis services provided in the recipient's home

  5  by a hospital-based or freestanding dialysis facility.

  6         (10)  DURABLE MEDICAL EQUIPMENT.--The agency may

  7  authorize and pay for certain durable medical equipment and

  8  supplies provided to a Medicaid recipient as medically

  9  necessary.

10         (11)  HEALTHY START SERVICES.--The agency may pay for a

11  continuum of risk-appropriate medical and psychosocial

12  services for the Healthy Start program in accordance with a

13  federal waiver. The agency may not implement the federal

14  waiver unless the waiver permits the state to limit enrollment

15  or the amount, duration, and scope of services to ensure that

16  expenditures will not exceed funds appropriated by the

17  Legislature or available from local sources. If the Health

18  Care Financing Administration does not approve a federal

19  waiver for Healthy Start services, the agency, in consultation

20  with the Department of Health and the Florida Association of

21  Healthy Start Coalitions, is authorized to establish a

22  Medicaid certified-match program for Healthy Start services.

23  Participation in the Healthy Start certified-match program

24  shall be voluntary, and reimbursement shall be limited to the

25  federal Medicaid share to Medicaid-enrolled Healthy Start

26  coalitions for services provided to Medicaid recipients. The

27  agency shall take no action to implement a certified-match

28  program without ensuring that the amendment and review

29  requirements of ss. 216.177 and 216.181 have been met.

30         (12)  HEARING SERVICES.--The agency may pay for hearing

31  and related services, including hearing evaluations, hearing


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  1  aid devices, dispensing of the hearing aid, and related

  2  repairs, if provided to a recipient by a licensed hearing aid

  3  specialist, otolaryngologist, otologist, audiologist, or

  4  physician.

  5         (13)  HOME AND COMMUNITY-BASED SERVICES.--The agency

  6  may pay for home-based or community-based services that are

  7  rendered to a recipient in accordance with a federally

  8  approved waiver program.

  9         (14)  HOSPICE CARE SERVICES.--The agency may pay for

10  all reasonable and necessary services for the palliation or

11  management of a recipient's terminal illness, if the services

12  are provided by a hospice that is licensed under part VI of

13  chapter 400 and meets Medicare certification requirements.

14         (15)  INTERMEDIATE CARE FACILITY FOR THE

15  DEVELOPMENTALLY DISABLED SERVICES.--The agency may pay for

16  health-related care and services provided on a 24-hour-a-day

17  basis by a facility licensed and certified as a Medicaid

18  Intermediate Care Facility for the Developmentally Disabled,

19  for a recipient who needs such care because of a developmental

20  disability.

21         (16)  INTERMEDIATE CARE SERVICES.--The agency may pay

22  for 24-hour-a-day intermediate care nursing and rehabilitation

23  services rendered to a recipient in a nursing facility

24  licensed under part II of chapter 400, if the services are

25  ordered by and provided under the direction of a physician.

26         (17)  OPTOMETRIC SERVICES.--The agency may pay for

27  services provided to a recipient, including examination,

28  diagnosis, treatment, and management, related to ocular

29  pathology, if the services are provided by a licensed

30  optometrist or physician.

31  


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  1         (18)  PHYSICIAN ASSISTANT SERVICES.--The agency may pay

  2  for all services provided to a recipient by a physician

  3  assistant licensed under s. 458.347 or s. 459.022.

  4  Reimbursement for such services must be not less than 80

  5  percent of the reimbursement that would be paid to a physician

  6  who provided the same services.

  7         (19)  PODIATRIC SERVICES.--The agency may pay for

  8  services, including diagnosis and medical, surgical,

  9  palliative, and mechanical treatment, related to ailments of

10  the human foot and lower leg, if provided to a recipient by a

11  podiatric physician licensed under state law.

12         (20)  PRESCRIBED DRUG SERVICES.--The agency may pay for

13  medications that are prescribed for a recipient by a physician

14  or other licensed practitioner of the healing arts authorized

15  to prescribe medications and that are dispensed to the

16  recipient by a licensed pharmacist or physician in accordance

17  with applicable state and federal law.

18         (21)  REGISTERED NURSE FIRST ASSISTANT SERVICES.--The

19  agency may pay for all services provided to a recipient by a

20  registered nurse first assistant as described in s. 464.027.

21  Reimbursement for such services may not be less than 80

22  percent of the reimbursement that would be paid to a physician

23  providing the same services.

24         (22)  STATE HOSPITAL SERVICES.--The agency may pay for

25  all-inclusive psychiatric inpatient hospital care provided to

26  a recipient age 65 or older in a state mental hospital.

27         (23)  VISUAL SERVICES.--The agency may pay for visual

28  examinations, eyeglasses, and eyeglass repairs for a

29  recipient, if they are prescribed by a licensed physician

30  specializing in diseases of the eye or by a licensed

31  optometrist.


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  1         (24)  CHILD-WELFARE-TARGETED CASE MANAGEMENT.--The

  2  Agency for Health Care Administration, in consultation with

  3  the Department of Children and Family Services, may establish

  4  a targeted case-management pilot project in those counties

  5  identified by the Department of Children and Family Services

  6  and for the community-based child welfare project in Sarasota

  7  and Manatee counties, as authorized under s. 409.1671. These

  8  projects shall be established for the purpose of determining

  9  the impact of targeted case management on the child welfare

10  program and the earnings from the child welfare program.

11  Results of the pilot projects shall be reported to the Child

12  Welfare Estimating Conference and the Social Services

13  Estimating Conference established under s. 216.136. The number

14  of projects may not be increased until requested by the

15  Department of Children and Family Services, recommended by the

16  Child Welfare Estimating Conference and the Social Services

17  Estimating Conference, and approved by the Legislature. The

18  covered group of individuals who are eligible to receive

19  targeted case management include children who are eligible for

20  Medicaid; who are between the ages of birth through 21; and

21  who are under protective supervision or postplacement

22  supervision, under foster-care supervision, or in shelter care

23  or foster care. The number of individuals who are eligible to

24  receive targeted case management shall be limited to the

25  number for whom the Department of Children and Family Services

26  has available matching funds to cover the costs. The general

27  revenue funds required to match the funds for services

28  provided by the community-based child welfare projects are

29  limited to funds available for services described under s.

30  409.1671. The Department of Children and Family Services may

31  


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    CS for SB 1558                                Second Engrossed



  1  transfer the general revenue matching funds as billed by the

  2  Agency for Health Care Administration.

  3         Section 68.  Present subsections (7) through (11) of

  4  section 456.013, Florida Statutes, are renumbered as

  5  subsections (8) through (12), respectively, and a new

  6  subsection (7) is added to that section to read:

  7         456.013  Department; general licensing provisions.--

  8         (7)  The boards, or the department when there is no

  9  board, shall require the completion of a 2-hour course

10  relating to prevention of medical errors as part of the

11  licensure and renewal process. The 2-hour course shall count

12  towards the total number of continuing education hours

13  required for the profession. The course shall be approved by

14  the board or department, as appropriate, and shall include a

15  study of root-cause analysis, error reduction and prevention,

16  and patient safety. If the course is being offered by a

17  facility licensed pursuant to chapter 395 for its employees,

18  the board may approve up to 1 hour of the 2-hour course to be

19  specifically related to error reduction and prevention methods

20  used in that facility.

21         Section 69.  Subsection (19) is added to section

22  456.057, Florida Statutes, to read:

23         456.057  Ownership and control of patient records;

24  report or copies of records to be furnished.--

25         (19)  The board, or department when there is no board,

26  may temporarily or permanently appoint a person or entity as a

27  custodian of medical records in the event of the death of a

28  practitioner, the mental or physical incapacitation of the

29  practitioner, or the abandonment of medical records by a

30  practitioner. The custodian appointed shall comply with all

31  


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    CS for SB 1558                                Second Engrossed



  1  provisions of this section, including the release of patient

  2  records.

  3         Section 70.  Subsection (3) is added to section

  4  456.063, Florida Statutes, to read:

  5         456.063  Sexual misconduct; disqualification for

  6  license, certificate, or registration.--

  7         (3)  Licensed health care practitioners shall report

  8  allegations of sexual misconduct to the department, regardless

  9  of the practice setting in which the alleged sexual misconduct

10  occurred.

11         Section 71.  Paragraphs (c) and (q) of subsection (1)

12  of section 456.072, Florida Statutes, are amended, paragraphs

13  (aa), (bb), and (cc) are added to that subsection, paragraphs

14  (c), (d), and (e) of subsection (2) and subsection (4) are

15  amended, and paragraphs (i) and (j) are added to subsection

16  (2) of that section, to read:

17         456.072  Grounds for discipline; penalties;

18  enforcement.--

19         (1)  The following acts shall constitute grounds for

20  which the disciplinary actions specified in subsection (2) may

21  be taken:

22         (c)  Being convicted or found guilty of, or entering a

23  plea of guilty or nolo contendere to, regardless of

24  adjudication, a crime in any jurisdiction which relates to the

25  practice of, or the ability to practice, a licensee's

26  profession.

27         (q)  Violating any provision of this chapter, the

28  applicable professional practice act, a rule of the department

29  or the board, or a lawful order of the department or the

30  board, or failing to comply with a lawfully issued subpoena of

31  the department.


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  1         (aa)  Performing or attempting to perform health care

  2  services on the wrong patient, a wrong-site procedure, a wrong

  3  procedure, or an unauthorized procedure or a procedure that is

  4  medically unnecessary or otherwise unrelated to the patient's

  5  diagnosis or medical condition. For the purposes of this

  6  paragraph, performing or attempting to perform health care

  7  services includes the preparation of the patient.

  8         (bb)  Leaving a foreign body in a patient, such as a

  9  sponge, clamp, forceps, surgical needle, or other

10  paraphernalia commonly used in surgical, examination, or other

11  diagnostic procedures. For the purposes of this paragraph, it

12  shall be legally presumed that retention of a foreign body is

13  not in the best interest of the patient and is not within the

14  standard of care of the profession, regardless of the intent

15  of the professional.

16         (cc)  Violating any provision of this chapter, the

17  applicable practice act, or any rules adopted pursuant

18  thereto.

19         (2)  When the board, or the department when there is no

20  board, finds any person guilty of the grounds set forth in

21  subsection (1) or of any grounds set forth in the applicable

22  practice act, including conduct constituting a substantial

23  violation of subsection (1) or a violation of the applicable

24  practice act which occurred prior to obtaining a license, it

25  may enter an order imposing one or more of the following

26  penalties:

27         (c)  Restriction of practice or license, including, but

28  not limited to, restricting the licensee from practicing in

29  certain settings, restricting the licensee to work only under

30  designated conditions or in certain settings, restricting the

31  licensee from performing or providing designated clinical and


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    CS for SB 1558                                Second Engrossed



  1  administrative services, restricting the licensee from

  2  practicing more than a designated number of hours, or any

  3  other restriction found to be necessary for the protection of

  4  the public health, safety, and welfare.

  5         (d)  Imposition of an administrative fine not to exceed

  6  $10,000 for each count or separate offense. If the violation

  7  is for fraud or making a false or fraudulent representation,

  8  the board, or the department if there is no board, must impose

  9  a fine of $10,000 per count or offense.

10         (e)  Issuance of a reprimand or letter of concern.

11         (i)  Refund of fees billed and collected from the

12  patient or a third party on behalf of the patient.

13         (j)  Requirement that the practitioner undergo remedial

14  education.

15  

16  In determining what action is appropriate, the board, or

17  department when there is no board, must first consider what

18  sanctions are necessary to protect the public or to compensate

19  the patient. Only after those sanctions have been imposed may

20  the disciplining authority consider and include in the order

21  requirements designed to rehabilitate the practitioner. All

22  costs associated with compliance with orders issued under this

23  subsection are the obligation of the practitioner.

24         (4)  In addition to any other discipline imposed

25  through final order, or citation, entered on or after July 1,

26  2001, pursuant to this section or discipline imposed through

27  final order, or citation, entered on or after July 1, 2001,

28  for a violation of any practice act, the board, or the

29  department when there is no board, shall may assess costs

30  related to the investigation and prosecution of the case. In

31  any case where the board or the department imposes a fine or


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    CS for SB 1558                                Second Engrossed



  1  assessment and the fine or assessment is not paid within a

  2  reasonable time, such reasonable time to be prescribed in the

  3  rules of the board, or the department when there is no board,

  4  or in the order assessing such fines or costs, the department

  5  or the Department of Legal Affairs may contract for the

  6  collection of, or bring a civil action to recover, the fine or

  7  assessment.

  8         Section 72.  Paragraphs (a) and (c) of subsection (9)

  9  of section 456.073, Florida Statutes, are amended, and,

10  effective upon this act becoming a law, subsection (13) is

11  added to that section, to read:

12         456.073  Disciplinary proceedings.--Disciplinary

13  proceedings for each board shall be within the jurisdiction of

14  the department.

15         (9)(a)  The department shall periodically notify the

16  person who filed the complaint, as well as the patient or the

17  patient's legal representative, of the status of the

18  investigation, indicating whether probable cause has been

19  found and the status of any civil action or administrative

20  proceeding or appeal.

21         (c)  In any disciplinary case for which probable cause

22  is not found, the department shall so inform the person who

23  filed the complaint and notify that person that he or she may,

24  within 60 days, provide any additional information to the

25  department probable cause panel which may be relevant to the

26  decision. To facilitate the provision of additional

27  information, the person who filed the complaint may receive,

28  upon request, a copy of the department's expert report that

29  supported the recommendation for closure, if such a report was

30  relied upon by the department. In no way does this require the

31  department to procure an expert opinion or report if none was


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  1  used. Additionally, the identity of the expert shall remain

  2  confidential. In any administrative proceeding under s.

  3  120.57, the person who filed the disciplinary complaint shall

  4  have the right to present oral or written communication

  5  relating to the alleged disciplinary violations or to the

  6  appropriate penalty.

  7         (13)  Notwithstanding any provision of law to the

  8  contrary, an administrative complaint against a licensee shall

  9  be filed within 6 years after the time of the incident or

10  occurrence giving rise to the complaint against the licensee.

11  If such incident or occurrence involved criminal actions,

12  diversion of controlled substances, sexual misconduct, or

13  impairment by the licensee, this subsection does not apply to

14  bar initiation of an investigation or filing of an

15  administrative complaint beyond the 6-year timeframe. In those

16  cases covered by this subsection in which it can be shown that

17  fraud, concealment, or intentional misrepresentation of fact

18  prevented the discovery of the violation of law, the period of

19  limitations is extended forward, but in no event to exceed 12

20  years after the time of the incident or occurrence.

21         Section 73.  Subsection (1) of section 456.074, Florida

22  Statutes, is amended to read:

23         456.074  Certain health care practitioners; immediate

24  suspension of license.--

25         (1)  The department shall issue an emergency order

26  suspending the license of any person licensed under chapter

27  458, chapter 459, chapter 460, chapter 461, chapter 462,

28  chapter 463, chapter 464, chapter 465, chapter 466, or chapter

29  484 who pleads guilty to, is convicted or found guilty of, or

30  who enters a plea of nolo contendere to, regardless of

31  adjudication, a felony under chapter 409, chapter 817, or


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    CS for SB 1558                                Second Engrossed



  1  chapter 893 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C.

  2  ss. 1395-1396.

  3         Section 74.  Subsections (2) and (6) of section

  4  456.077, Florida Statutes, are amended to read:

  5         456.077  Authority to issue citations.--

  6         (2)  The board, or the department if there is no board,

  7  shall adopt rules designating violations for which a citation

  8  may be issued.  Such rules shall designate as citation

  9  violations those violations for which there is no substantial

10  threat to the public health, safety, and welfare. Violations

11  for which a citation may be issued shall include violations of

12  continuing education requirements, failure to timely pay

13  required fees and fines, failure to comply with the

14  requirements of ss. 381.026 and 381.0261 regarding the

15  dissemination of information regarding patient rights, failure

16  to comply with advertising requirements, failure to timely

17  update practitioner profile and credentialing files, failure

18  to display signs, licenses, and permits, failure to have

19  required reference books available, and all other violations

20  that do not pose a direct and serious threat to the health and

21  safety of the patient.

22         (6)  A board created on or after January 1, 1992, has 6

23  months in which to enact rules designating violations and

24  penalties appropriate for citation offenses. Failure to enact

25  such rules gives the department exclusive authority to adopt

26  rules as required for implementing this section. A board has

27  continuous authority to amend its rules adopted pursuant to

28  this section.

29         Section 75.  Section 456.081, Florida Statutes, is

30  amended to read:

31  


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  1         456.081  Publication of information.--The department

  2  and the boards shall have the authority to advise licensees

  3  periodically, through the publication of a newsletter, about

  4  information that the department or the board determines is of

  5  interest to the industry. The department and the boards shall

  6  maintain a website which contains copies of the newsletter;

  7  information relating to adverse incident reports without

  8  identifying the patient, practitioner, or facility in which

  9  the adverse incident occurred until 10 days after probable

10  cause is found, at which time the name of the practitioner and

11  facility shall become public as part of the investigative

12  file; information about error prevention and safety

13  strategies; and information concerning best practices. Unless

14  otherwise prohibited by law, the department and the boards

15  shall publish on the website a summary of final orders entered

16  after July 1, 2001, resulting in disciplinary action fines,

17  suspensions, or revocations, and any other information the

18  department or the board determines is of interest to the

19  public. In order to provide useful and timely information at

20  minimal cost, the department and boards may consult with, and

21  include information provided by, professional associations and

22  national organizations.

23         Section 76.  Subsection (9) of section 458.331, Florida

24  Statutes, is amended to read:

25         458.331  Grounds for disciplinary action; action by the

26  board and department.--

27         (9)  When an investigation of a physician is

28  undertaken, the department shall promptly furnish to the

29  physician or the physician's attorney a copy of the complaint

30  or document which resulted in the initiation of the

31  investigation.  For purposes of this subsection, such


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    CS for SB 1558                                Second Engrossed



  1  documents include, but are not limited to: the pertinent

  2  portions of an annual report submitted to the department

  3  pursuant to s. 395.0197(6); a report of an adverse incident

  4  which is provided to the department pursuant to s.

  5  395.0197(8); a report of peer review disciplinary action

  6  submitted to the department pursuant to s. 395.0193(4) or s.

  7  458.337, providing that the investigations, proceedings, and

  8  records relating to such peer review disciplinary action shall

  9  continue to retain their privileged status even as to the

10  licensee who is the subject of the investigation, as provided

11  by ss. 395.0193(8) and 458.337(3); a report of a closed claim

12  submitted pursuant to s. 627.912; a presuit notice submitted

13  pursuant to s. 766.106(2); and a petition brought under the

14  Florida Birth-Related Neurological Injury Compensation Plan,

15  pursuant to s. 766.305(2).  The physician may submit a written

16  response to the information contained in the complaint or

17  document which resulted in the initiation of the investigation

18  within 45 days after service to the physician of the complaint

19  or document. The physician's written response shall be

20  considered by the probable cause panel.

21         Section 77.  Subsection (9) of section 459.015, Florida

22  Statutes, is amended to read:

23         459.015  Grounds for disciplinary action; action by the

24  board and department.--

25         (9)  When an investigation of an osteopathic physician

26  is undertaken, the department shall promptly furnish to the

27  osteopathic physician or his or her attorney a copy of the

28  complaint or document which resulted in the initiation of the

29  investigation. For purposes of this subsection, such documents

30  include, but are not limited to: the pertinent portions of an

31  annual report submitted to the department pursuant to s.


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    CS for SB 1558                                Second Engrossed



  1  395.0197(6); a report of an adverse incident which is provided

  2  to the department pursuant to s. 395.0197(8); a report of peer

  3  review disciplinary action submitted to the department

  4  pursuant to s. 395.0193(4) or s. 459.016, provided that the

  5  investigations, proceedings, and records relating to such peer

  6  review disciplinary action shall continue to retain their

  7  privileged status even as to the licensee who is the subject

  8  of the investigation, as provided by ss. 395.0193(8) and

  9  459.016(3); a report of a closed claim submitted pursuant to

10  s. 627.912; a presuit notice submitted pursuant to s.

11  766.106(2); and a petition brought under the Florida

12  Birth-Related Neurological Injury Compensation Plan, pursuant

13  to s. 766.305(2).  The osteopathic physician may submit a

14  written response to the information contained in the complaint

15  or document which resulted in the initiation of the

16  investigation within 45 days after service to the osteopathic

17  physician of the complaint or document. The osteopathic

18  physician's written response shall be considered by the

19  probable cause panel.

20         Section 78.  Effective January 1, 2002, subsection (4)

21  of section 641.51, Florida Statutes, is amended to read:

22         641.51  Quality assurance program; second medical

23  opinion requirement.--

24         (4)  The organization shall ensure that only a

25  physician with an active, unencumbered license licensed under

26  chapter 458 or chapter 459, or an allopathic or osteopathic

27  physician with an active, unencumbered license in another

28  state with similar licensing requirements may render an

29  adverse determination regarding a service provided by a

30  physician licensed in this state. The organization shall

31  submit to the treating provider and the subscriber written


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    CS for SB 1558                                Second Engrossed



  1  notification regarding the organization's adverse

  2  determination within 2 working days after the subscriber or

  3  provider is notified of the adverse determination. The written

  4  notification must include the utilization review criteria or

  5  benefits provisions used in the adverse determination,

  6  identify the physician who rendered the adverse determination,

  7  and be signed by an authorized representative of the

  8  organization or the physician who rendered the adverse

  9  determination. The organization must include with the

10  notification of an adverse determination information

11  concerning the appeal process for adverse determinations. This

12  provision does not create authority for the Board of Medicine

13  or Board of Osteopathic Medicine to regulate the organization;

14  however, the Board of Medicine and the Board of Osteopathic

15  Medicine continue to have jurisdiction over licensees of their

16  respective boards.

17         Section 79.  Subsection (5) of section 465.019, Florida

18  Statutes, is amended to read:

19         465.019  Institutional pharmacies; permits.--

20         (5)  All institutional pharmacies shall be under the

21  professional supervision of a consultant pharmacist, and the

22  compounding and dispensing of medicinal drugs shall be done

23  only by a licensed pharmacist. Every institutional pharmacy

24  that employs or otherwise utilizes pharmacy technicians shall

25  have a written policy and procedures manual specifying those

26  duties, tasks, and functions which a pharmacy technician is

27  allowed to perform.

28         Section 80.  Section 465.0196, Florida Statutes, is

29  amended to read:

30         465.0196  Special pharmacy permits.--Any person

31  desiring a permit to operate a pharmacy which does not fall


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  1  within the definitions set forth in s. 465.003(11)(a)1., 2.,

  2  and 3. shall apply to the department for a special pharmacy

  3  permit.  If the board certifies that the application complies

  4  with the applicable laws and rules of the board governing the

  5  practice of the profession of pharmacy, the department shall

  6  issue the permit.  No permit shall be issued unless a licensed

  7  pharmacist is designated to undertake the professional

  8  supervision of the compounding and dispensing of all drugs

  9  dispensed by the pharmacy.  The licensed pharmacist shall be

10  responsible for maintaining all drug records and for providing

11  for the security of the area in the facility in which the

12  compounding, storing, and dispensing of medicinal drugs

13  occurs.  The permittee shall notify the department within 10

14  days of any change of the licensed pharmacist responsible for

15  such duties. Every permittee that employs or otherwise

16  utilizes pharmacy technicians shall have a written policy and

17  procedures manual specifying those duties, tasks, and

18  functions which a pharmacy technician is allowed to perform.

19         Section 81.  Effective upon this act becoming a law and

20  operating retroactively to July 1, 2000, section 22 of Chapter

21  2000-256, Laws of Florida, is amended to read:

22         Section 22.  The amendments to ss. 395.701 and

23  395.7015, Florida Statutes, by this act shall take effect July

24  1, 2000 only upon the Agency for Health Care Administration

25  receiving written confirmation from the federal Health Care

26  Financing Administration that the changes contained in such

27  amendments will not adversely affect the use of the remaining

28  assessments as state match for the state's Medicaid program.

29         Section 82.  The Department of Health and the Agency

30  for Health Care Administration shall conduct a review of all

31  statutorily imposed reporting requirements for health care


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  1  practitioners and health facilities. The department and the

  2  agency shall report back to the Legislature on or before

  3  November 1, 2001, with recommendations and suggested statutory

  4  changes to streamline reporting requirements to avoid

  5  duplicative, overlapping, and unnecessary reports or data

  6  elements.

  7         Section 83.  Paragraph (r) is added to subsection (1)

  8  of section 468.1755, Florida Statutes, and, for the purpose of

  9  incorporating the amendment to section 456.072(1), Florida

10  Statutes, in a reference thereto, paragraph (a) of subsection

11  (1) of that section is reenacted, to read:

12         468.1755  Disciplinary proceedings.--

13         (1)  The following acts shall constitute grounds for

14  which the disciplinary actions in subsection (2) may be taken:

15         (a)  Violation of any provision of s. 456.072(1) or s.

16  468.1745(1).

17         (r)  Failing to implement an ongoing quality assurance

18  program directed by an interdisciplinary team that meets at

19  least every other month.

20         (2)  When the board finds any nursing home

21  administrator guilty of any of the grounds set forth in

22  subsection (1), it may enter an order imposing one or more of

23  the following penalties:

24         (a)  Denial of an application for licensure.

25         (b)  Revocation or suspension of a license.

26         (c)  Imposition of an administrative fine not to exceed

27  $1,000 for each count or separate offense.

28         (d)  Issuance of a reprimand.

29         (e)  Placement of the licensee on probation for a

30  period of time and subject to such conditions as the board may

31  specify, including requiring the licensee to attend continuing


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  1  education courses or to work under the supervision of another

  2  licensee.

  3         (f)  Restriction of the authorized scope of practice.

  4         Section 84.  For the purpose of incorporating the

  5  amendment to section 468.1755(1), Florida Statutes, in

  6  reference thereto, subsection (3) of section 468.1695, Florida

  7  Statutes, and section 468.1735, Florida Statutes, are

  8  reenacted to read:

  9         468.1695  Licensure by examination.--

10         (3)  The department shall issue a license to practice

11  nursing home administration to any applicant who successfully

12  completes the examination in accordance with this section and

13  otherwise meets the requirements of this part.  The department

14  shall not issue a license to any applicant who is under

15  investigation in this state or another jurisdiction for an

16  offense which would constitute a violation of s. 468.1745 or

17  s. 468.1755. Upon completion of the investigation, the

18  provisions of s. 468.1755 shall apply.

19         468.1735  Provisional license.--The board may establish

20  by rule requirements for issuance of a provisional license.  A

21  provisional license shall be issued only to fill a position of

22  nursing home administrator that unexpectedly becomes vacant

23  due to illness, sudden death of the administrator, or

24  abandonment of position and shall be issued for one single

25  period as provided by rule not to exceed 6 months.  The

26  department shall not issue a provisional license to any

27  applicant who is under investigation in this state or another

28  jurisdiction for an offense which would constitute a violation

29  of s. 468.1745 or s. 468.1755. Upon completion of the

30  investigation, the provisions of s. 468.1755 shall apply.  The

31  provisional license may be issued to a person who does not


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  1  meet all of the licensing requirements established by this

  2  part, but the board shall by rule establish minimal

  3  requirements to ensure protection of the public health,

  4  safety, and welfare.  The provisional license shall be issued

  5  to the person who is designated as the responsible person next

  6  in command in the event of the administrator's departure.  The

  7  board may set an application fee not to exceed $500 for a

  8  provisional license.

  9         Section 85.  For the purpose of incorporating the

10  amendment to section 456.072(1), Florida Statutes, in a

11  reference thereto, paragraph (a) of subsection (1) of section

12  484.056, Florida Statutes, is reenacted to read:

13         484.056  Disciplinary proceedings.--

14         (1)  The following acts relating to the practice of

15  dispensing hearing aids shall be grounds for both disciplinary

16  action against a hearing aid specialist as set forth in this

17  section and cease and desist or other related action by the

18  department as set forth in s. 456.065 against any person

19  owning or operating a hearing aid establishment who engages

20  in, aids, or abets any such violation:

21         (a)  Violation of any provision of s. 456.072(1), s.

22  484.0512, or s. 484.053.

23         Section 86.  Paragraph (a) of subsection (1), paragraph

24  (a) of subsection (7), and subsection (8) of section 766.101,

25  Florida Statutes, are amended to read:

26         766.101  Medical review committee, immunity from

27  liability.--

28         (1)  As used in this section:

29         (a)  The term "medical review committee" or "committee"

30  means:

31  


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  1         1.a.  A committee of a hospital or ambulatory surgical

  2  center licensed under chapter 395 or a health maintenance

  3  organization certificated under part I of chapter 641,

  4         b.  A committee of a physician-hospital organization, a

  5  provider-sponsored organization, or an integrated delivery

  6  system,

  7         c.  A committee of a state or local professional

  8  society of health care providers,

  9         d.  A committee of a medical staff of a licensed

10  hospital or nursing home, provided the medical staff operates

11  pursuant to written bylaws that have been approved by the

12  governing board of the hospital or nursing home,

13         e.  A committee of the Department of Corrections or the

14  Correctional Medical Authority as created under s. 945.602, or

15  employees, agents, or consultants of either the department or

16  the authority or both,

17         f.  A committee of a professional service corporation

18  formed under chapter 621 or a corporation organized under

19  chapter 607 or chapter 617, which is formed and operated for

20  the practice of medicine as defined in s. 458.305(3), and

21  which has at least 25 health care providers who routinely

22  provide health care services directly to patients,

23         g.  A committee of a mental health treatment facility

24  licensed under chapter 394 or a community mental health center

25  as defined in s. 394.907, provided the quality assurance

26  program operates pursuant to the guidelines which have been

27  approved by the governing board of the agency,

28         h.  A committee of a substance abuse treatment and

29  education prevention program licensed under chapter 397

30  provided the quality assurance program operates pursuant to

31  


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  1  the guidelines which have been approved by the governing board

  2  of the agency,

  3         i.  A peer review or utilization review committee

  4  organized under chapter 440, or

  5         j.  A committee of the Department of Health, a county

  6  health department, healthy start coalition, or certified rural

  7  health network, when reviewing quality of care, or employees

  8  of these entities when reviewing mortality records, or

  9         k.  A continuous quality improvement committee of a

10  pharmacy licensed pursuant to chapter 465,

11  

12  which committee is formed to evaluate and improve the quality

13  of health care rendered by providers of health service or to

14  determine that health services rendered were professionally

15  indicated or were performed in compliance with the applicable

16  standard of care or that the cost of health care rendered was

17  considered reasonable by the providers of professional health

18  services in the area; or

19         2.  A committee of an insurer, self-insurer, or joint

20  underwriting association of medical malpractice insurance, or

21  other persons conducting review under s. 766.106.

22         (7)(a)  It is the intent of the Legislature to

23  encourage medical review committees to contribute further to

24  the quality of health care in this state by reviewing

25  complaints against physicians in the manner described in this

26  paragraph. Accordingly, the Department of Health Business and

27  Professional Regulation may enter into a letter of agreement

28  with a professional society of physicians licensed under

29  chapter 458 or chapter 459, under which agreement the medical

30  or peer review committees of the professional society will

31  conduct a review of any complaint or case referred to the


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  1  society by the department which involves a question as to

  2  whether a physician's actions represented a breach of the

  3  prevailing professional standard of care. The prevailing

  4  professional standard of care is that level of care, skill,

  5  and treatment which, in light of all relevant surrounding

  6  circumstances, is recognized as acceptable and appropriate by

  7  reasonably prudent similar health care providers. The letter

  8  of agreement must specify that the professional society will

  9  submit an advisory report to the department within a

10  reasonable time following the department's written and

11  appropriately supported request to the professional society.

12  The advisory report, which is not binding upon the department,

13  constitutes the professional opinion of the medical review

14  committee and must include:

15         1.  A statement of relevant factual findings.

16         2.  The judgment of the committee as to whether the

17  physician's actions represented a breach of the prevailing

18  professional standard of care.

19         (8)  No cause of action of any nature by a person

20  licensed pursuant to chapter 458, chapter 459, chapter 461,

21  chapter 463, part I of chapter 464, chapter 465, or chapter

22  466 shall arise against another person licensed pursuant to

23  chapter 458, chapter 459, chapter 461, chapter 463, part I of

24  chapter 464, chapter 465, or chapter 466 for furnishing

25  information to a duly appointed medical review committee, to

26  an internal risk management program established under s.

27  395.0197, to the Department of Health or the Agency for Health

28  Care Administration Business and Professional Regulation, or

29  to the appropriate regulatory board if the information

30  furnished concerns patient care at a facility licensed

31  pursuant to part I of chapter 395 where both persons provide


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  1  health care services, if the information is not intentionally

  2  fraudulent, and if the information is within the scope of the

  3  functions of the committee, department, or board. However, if

  4  such information is otherwise available from original sources,

  5  it is not immune from discovery or use in a civil action

  6  merely because it was presented during a proceeding of the

  7  committee, department, or board.

  8         Section 87.  For the purpose of incorporating the

  9  amendment to section 766.101(1)(a), Florida Statutes, in

10  references thereto, paragraph (a) of subsection (1) of section

11  440.105, Florida Statutes, and subsection (6) of section

12  626.989, Florida Statutes, are reenacted to read:

13         440.105  Prohibited activities; reports; penalties;

14  limitations.--

15         (1)(a)  Any insurance carrier, any individual

16  self-insured, any commercial or group self-insurance fund, any

17  professional practitioner licensed or regulated by the

18  Department of Business and Professional Regulation, except as

19  otherwise provided by law, any medical review committee as

20  defined in s. 766.101, any private medical review committee,

21  and any insurer, agent, or other person licensed under the

22  insurance code, or any employee thereof, having knowledge or

23  who believes that a fraudulent act or any other act or

24  practice which, upon conviction, constitutes a felony or

25  misdemeanor under this chapter is being or has been committed

26  shall send to the Division of Insurance Fraud, Bureau of

27  Workers' Compensation Fraud, a report or information pertinent

28  to such knowledge or belief and such additional information

29  relative thereto as the bureau may require. The bureau shall

30  review such information or reports and select such information

31  or reports as, in its judgment, may require further


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  1  investigation. It shall then cause an independent examination

  2  of the facts surrounding such information or report to be made

  3  to determine the extent, if any, to which a fraudulent act or

  4  any other act or practice which, upon conviction, constitutes

  5  a felony or a misdemeanor under this chapter is being

  6  committed. The bureau shall report any alleged violations of

  7  law which its investigations disclose to the appropriate

  8  licensing agency and state attorney or other prosecuting

  9  agency having jurisdiction with respect to any such violations

10  of this chapter. If prosecution by the state attorney or other

11  prosecuting agency having jurisdiction with respect to such

12  violation is not begun within 60 days of the bureau's report,

13  the state attorney or other prosecuting agency having

14  jurisdiction with respect to such violation shall inform the

15  bureau of the reasons for the lack of prosecution.

16         626.989  Investigation by department or Division of

17  Insurance Fraud; compliance; immunity; confidential

18  information; reports to division; division investigator's

19  power of arrest.--

20         (6)  Any person, other than an insurer, agent, or other

21  person licensed under the code, or an employee thereof, having

22  knowledge or who believes that a fraudulent insurance act or

23  any other act or practice which, upon conviction, constitutes

24  a felony or a misdemeanor under the code, or under s. 817.234,

25  is being or has been committed may send to the Division of

26  Insurance Fraud a report or information pertinent to such

27  knowledge or belief and such additional information relative

28  thereto as the department may request. Any professional

29  practitioner licensed or regulated by the Department of

30  Business and Professional Regulation, except as otherwise

31  provided by law, any medical review committee as defined in s.


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    CS for SB 1558                                Second Engrossed



  1  766.101, any private medical review committee, and any

  2  insurer, agent, or other person licensed under the code, or an

  3  employee thereof, having knowledge or who believes that a

  4  fraudulent insurance act or any other act or practice which,

  5  upon conviction, constitutes a felony or a misdemeanor under

  6  the code, or under s. 817.234, is being or has been committed

  7  shall send to the Division of Insurance Fraud a report or

  8  information pertinent to such knowledge or belief and such

  9  additional information relative thereto as the department may

10  require. The Division of Insurance Fraud shall review such

11  information or reports and select such information or reports

12  as, in its judgment, may require further investigation. It

13  shall then cause an independent examination of the facts

14  surrounding such information or report to be made to determine

15  the extent, if any, to which a fraudulent insurance act or any

16  other act or practice which, upon conviction, constitutes a

17  felony or a misdemeanor under the code, or under s. 817.234,

18  is being committed. The Division of Insurance Fraud shall

19  report any alleged violations of law which its investigations

20  disclose to the appropriate licensing agency and state

21  attorney or other prosecuting agency having jurisdiction with

22  respect to any such violation, as provided in s. 624.310. If

23  prosecution by the state attorney or other prosecuting agency

24  having jurisdiction with respect to such violation is not

25  begun within 60 days of the division's report, the state

26  attorney or other prosecuting agency having jurisdiction with

27  respect to such violation shall inform the division of the

28  reasons for the lack of prosecution.

29         Section 88.  Paragraph (c) of subsection (4) of section

30  766.1115, Florida Statutes, is amended to read:

31  


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  1         766.1115  Health care providers; creation of agency

  2  relationship with governmental contractors.--

  3         (4)  CONTRACT REQUIREMENTS.--A health care provider

  4  that executes a contract with a governmental contractor to

  5  deliver health care services on or after April 17, 1992, as an

  6  agent of the governmental contractor is an agent for purposes

  7  of s. 768.28(9), while acting within the scope of duties

  8  pursuant to the contract, if the contract complies with the

  9  requirements of this section and regardless of whether the

10  individual treated is later found to be ineligible.  A health

11  care provider under contract with the state may not be named

12  as a defendant in any action arising out of the medical care

13  or treatment provided on or after April 17, 1992, pursuant to

14  contracts entered into under this section.  The contract must

15  provide that:

16         (c)  Adverse incidents and information on treatment

17  outcomes must be reported by any health care provider to the

18  governmental contractor if such incidents and information

19  pertain to a patient treated pursuant to the contract. The

20  health care provider shall submit the reports required by s.

21  395.0197 annually submit an adverse incident report that

22  includes all information required by s. 395.0197(6)(a), unless

23  the adverse incident involves a result described by s.

24  395.0197(8), in which case it shall be reported within 15 days

25  after the occurrence of such incident. If an incident involves

26  a professional licensed by the Department of Health or a

27  facility licensed by the Agency for Health Care

28  Administration, the governmental contractor shall submit such

29  incident reports to the appropriate department or agency,

30  which shall review each incident and determine whether it

31  involves conduct by the licensee that is subject to


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  1  disciplinary action. All patient medical records and any

  2  identifying information contained in adverse incident reports

  3  and treatment outcomes which are obtained by governmental

  4  entities pursuant to this paragraph are confidential and

  5  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

  6  I of the State Constitution.

  7         Section 89.  Section 456.047, Florida Statutes, is

  8  amended to read:

  9         456.047  Standardized credentialing for health care

10  practitioners.--

11         (1)  INTENT.--The Legislature recognizes that an

12  efficient and effective health care practitioner credentialing

13  program helps to ensure access to quality health care and also

14  recognizes that health care practitioner credentialing

15  activities have increased significantly as a result of health

16  care reform and recent changes in health care delivery and

17  reimbursement systems. Moreover, the resulting duplication of

18  health care practitioner credentialing activities is

19  unnecessarily costly and cumbersome for both the practitioner

20  and the entity granting practice privileges. Therefore, it is

21  the intent of this section that a credentials collection

22  program be established which provides that, once a health care

23  practitioner's core credentials data are collected, they need

24  not be collected again, except for corrections, updates, and

25  modifications thereto. Furthermore, it is the intent of the

26  Legislature that the department and all entities and

27  practitioners work cooperatively to ensure the integrity and

28  accuracy of the program. Participation under this section

29  shall include those individuals licensed under chapter 458,

30  chapter 459, chapter 460, chapter 461, or s. 464.012. However,

31  the department shall, with the approval of the applicable


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  1  board, include other professions under the jurisdiction of the

  2  Division of Medical Quality Assurance in this program,

  3  provided they meet the requirements of s. 456.039 or s.

  4  456.0391.

  5         (2)  DEFINITIONS.--As used in this section, the term:

  6         (a)  "Certified" or "accredited," as applicable, means

  7  approved by a quality assessment program, from the National

  8  Committee for Quality Assurance, the Joint Commission on

  9  Accreditation of Healthcare Organizations, the American

10  Accreditation HealthCare Commission/URAC, or any such other

11  nationally recognized and accepted organization authorized by

12  the department, used to assess and certify any credentials

13  verification program, entity, or organization that verifies

14  the credentials of any health care practitioner.

15         (b)  "Core credentials data" means data that is primary

16  source verified and includes the following data: current name,

17  any former name, and any alias, any professional education,

18  professional training, licensure, current Drug Enforcement

19  Administration certification, social security number,

20  specialty board certification, Educational Commission for

21  Foreign Medical Graduates certification, and hospital or other

22  institutional affiliations, evidence of professional liability

23  coverage or evidence of financial responsibility as required

24  by s. 458.320, s. 459.0085, or s. 456.048, history of claims,

25  suits, judgments, or settlements, final disciplinary action

26  reported pursuant to s. 456.039(1)(a)8. or s. 456.0391(1)(a)8.

27  The department may by rule designate additional core

28  credentials data elements, and Medicare or Medicaid sanctions.

29         (c)  "Credential" or "credentialing" means the process

30  of assessing and verifying the qualifications of a licensed

31  


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  1  health care practitioner or applicant for licensure as a

  2  health care practitioner.

  3         (d)  "Credentials verification organization" means any

  4  organization certified or accredited as a credentials

  5  verification organization.

  6         (e)  "Department" means the Department of Health,

  7  Division of Medical Quality Assurance.

  8         (f)  "Designated credentials verification organization"

  9  means the credentials verification organization which is

10  selected by the health care practitioner, if the health care

11  practitioner chooses to make such a designation.

12         (g)  "Drug Enforcement Administration certification"

13  means certification issued by the Drug Enforcement

14  Administration for purposes of administration or prescription

15  of controlled substances. Submission of such certification

16  under this section must include evidence that the

17  certification is current and must also include all current

18  addresses to which the certificate is issued.

19         (h)  "Health care entity" means:

20         1.  Any health care facility or other health care

21  organization licensed or certified to provide approved medical

22  and allied health services in this state;

23         2.  Any entity licensed by the Department of Insurance

24  as a prepaid health care plan or health maintenance

25  organization or as an insurer to provide coverage for health

26  care services through a network of providers or similar

27  organization licensed under chapter 627, chapter 636, chapter

28  641, or chapter 651; or

29         3.  Any accredited medical school in this state.

30         (i)  "Health care practitioner" means any person

31  licensed, or, for credentialing purposes only, any person


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  1  applying for licensure, under chapter 458, chapter 459,

  2  chapter 460, chapter 461, or s. 464.012 or any person licensed

  3  or applying for licensure under a chapter subsequently made

  4  subject to this section by the department with the approval of

  5  the applicable board, except a person registered or applying

  6  for registration pursuant to s. 458.345 or s. 459.021.

  7         (j)  "Hospital or other institutional affiliations"

  8  means each hospital or other institution for which the health

  9  care practitioner or applicant has provided medical services.

10  Submission of such information under this section must

11  include, for each hospital or other institution, the name and

12  address of the hospital or institution, the staff status of

13  the health care practitioner or applicant at that hospital or

14  institution, and the dates of affiliation with that hospital

15  or institution.

16         (j)(k)  "National accrediting organization" means an

17  organization that awards accreditation or certification to

18  hospitals, managed care organizations, credentials

19  verification organizations, or other health care

20  organizations, including, but not limited to, the Joint

21  Commission on Accreditation of Healthcare Organizations, the

22  American Accreditation HealthCare Commission/URAC, and the

23  National Committee for Quality Assurance.

24         (k)  "Primary source verification" means verification

25  of professional qualifications based on evidence obtained

26  directly from the issuing source of the applicable

27  qualification or from any other source deemed as a primary

28  source for such verification by the department or an

29  accrediting body approved by the department.

30  

31  


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  1         (l)  "Professional training" means any internship,

  2  residency, or fellowship relating to the profession for which

  3  the health care practitioner is licensed or seeking licensure.

  4         (m)  "Specialty board certification" means

  5  certification in a specialty issued by a specialty board

  6  recognized by the board in this state that regulates the

  7  profession for which the health care practitioner is licensed

  8  or seeking licensure.

  9         (3)  STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.--

10         (a)  Every health care practitioner shall:

11         1.  Report all core credentials data to the department

12  which is not already on file with the department, either by

13  designating a credentials verification organization to submit

14  the data or by submitting the data directly.

15         2.  Notify the department within 45 days of any

16  corrections, updates, or modifications to the core credentials

17  data either through his or her designated credentials

18  verification organization or by submitting the data directly.

19  Corrections, updates, and modifications to the core

20  credentials data provided the department under this section

21  shall comply with the updating requirements of s. 456.039(3)

22  or s. 456.0391(3) related to profiling.

23         (b)  The department shall:

24         1.  Maintain a complete, current file of applicable

25  core credentials data on each health care practitioner, which

26  shall include data provided in accordance with subparagraph

27  (a)1. and all updates provided in accordance with subparagraph

28  (a)2.

29         2.  Release the core credentials data that is otherwise

30  confidential or exempt from the provisions of chapter 119 and

31  s. 24(a), Art. I of the State Constitution and any


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  1  corrections, updates, and modifications thereto, if authorized

  2  by the health care practitioner.

  3         3.  Charge a fee to access the core credentials data,

  4  which may not exceed the actual cost, including prorated setup

  5  and operating costs, pursuant to the requirements of chapter

  6  119.

  7         4.  Develop standardized forms to be used by the health

  8  care practitioner or designated credentials verification

  9  organization for the initial reporting of core credentials

10  data, for the health care practitioner to authorize the

11  release of core credentials data, and for the subsequent

12  reporting of corrections, updates, and modifications thereto.

13         (c)  A registered credentials verification organization

14  may be designated by a health care practitioner to assist the

15  health care practitioner to comply with the requirements of

16  subparagraph (a)2. A designated credentials verification

17  organization shall:

18         1.  Timely comply with the requirements of subparagraph

19  (a)2., pursuant to rules adopted by the department.

20         2.  Not provide the health care practitioner's core

21  credentials data, including all corrections, updates, and

22  modifications, without the authorization of the practitioner.

23         (d)  This section shall not be construed to restrict in

24  any way the authority of the health care entity to credential

25  and to approve or deny an application for hospital staff

26  membership, clinical privileges, or managed care network

27  participation.

28         (4)  DUPLICATION OF DATA PROHIBITED.--

29         (a)  A health care entity or credentials verification

30  organization is prohibited from collecting or attempting to

31  collect duplicate core credentials data from any health care


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  1  practitioner if the information is available from the

  2  department. This section shall not be construed to restrict

  3  the right of any health care entity or credentials

  4  verification organization to collect additional information

  5  from the health care practitioner which is not included in the

  6  core credentials data file. This section shall not be

  7  construed to prohibit a health care entity or credentials

  8  verification organization from obtaining all necessary

  9  attestation and release form signatures and dates.

10         (b)  Effective July 1, 2002, a state agency in this

11  state which credentials health care practitioners may not

12  collect or attempt to collect duplicate core credentials data

13  from any individual health care practitioner if the

14  information is already available from the department. This

15  section shall not be construed to restrict the right of any

16  such state agency to request additional information not

17  included in the core credentials credential data file, but

18  which is deemed necessary for the agency's specific

19  credentialing purposes.

20         (5)  STANDARDS AND REGISTRATION.--Any credentials

21  verification organization that does business in this state

22  must be fully accredited or certified as a credentials

23  verification organization by a national accrediting

24  organization as specified in paragraph (2)(a) and must

25  register with the department. The department may charge a

26  reasonable registration fee, not to exceed an amount

27  sufficient to cover its actual expenses in providing and

28  enforcing such registration. The department shall establish by

29  rule for biennial renewal of such registration. Failure by a

30  registered credentials verification organization to maintain

31  full accreditation or certification, to provide data as


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  1  authorized by the health care practitioner, to report to the

  2  department changes, updates, and modifications to a health

  3  care practitioner's records within the time period specified

  4  in subparagraph (3)(a)2., or to comply with the prohibition

  5  against collection of duplicate core credentials data from a

  6  practitioner may result in denial of an application for

  7  renewal of registration or in revocation or suspension of a

  8  registration.

  9         (6)  PRIMARY SOURCE VERIFIED DATA.--Health care

10  entities and credentials verification organizations may rely

11  upon any data that has been primary source verified by the

12  department or its designee to meet primary source verification

13  requirements of national accrediting organizations.

14         (7)(6)  LIABILITY.--No civil, criminal, or

15  administrative action may be instituted, and there shall be no

16  liability, against any registered credentials verification

17  organization or health care entity on account of its reliance

18  on any data obtained directly from the department.

19         (8)(7)  LIABILITY INSURANCE REQUIREMENTS.--Each

20  credentials verification organization doing business in this

21  state shall maintain liability insurance appropriate to meet

22  the certification or accreditation requirements established in

23  this section.

24         (9)(8)  RULES.--The department shall adopt rules

25  necessary to develop and implement the standardized core

26  credentials data collection program established by this

27  section.

28         Section 90.  Section 232.61, Florida Statutes, is

29  amended to read:

30         232.61  Governing organization for athletics; adoption

31  of bylaws.--


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  1         (1)  The organization shall adopt bylaws that, unless

  2  specifically provided by statute, establish eligibility

  3  requirements for all students who participate in high school

  4  athletic competition in its member schools. The bylaws

  5  governing residence and transfer shall allow the student to be

  6  eligible in the school in which he or she first enrolls each

  7  school year, or makes himself or herself a candidate for an

  8  athletic team by engaging in a practice prior to enrolling in

  9  any member school. The student shall be eligible in that

10  school so long as he or she remains enrolled in that school.

11  Subsequent eligibility shall be determined and enforced

12  through the organization's bylaws.

13         (2)  The organization shall also adopt bylaws that

14  specifically prohibit the recruiting of students for athletic

15  purposes. The bylaws shall prescribe penalties and an appeals

16  process for athletic recruiting violations.

17         (3)  The organization shall adopt bylaws that require

18  all students participating in interscholastic athletic

19  competition or who are candidates for an interscholastic

20  athletic team to satisfactorily pass a medical evaluation each

21  year prior to participating in interscholastic athletic

22  competition or engaging in any practice, tryout, workout, or

23  other physical activity associated with the student's

24  candidacy for an interscholastic athletic team. Such medical

25  evaluation can only be administered by a practitioner licensed

26  under the provisions of chapter 458, chapter 459, chapter 460,

27  or s. 464.012, and in good standing with the practitioner's

28  regulatory board. The bylaws shall establish requirements for

29  eliciting a student's medical history and performing the

30  medical evaluation required under this subsection, which shall

31  include minimum standards for the physical capabilities


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  1  necessary for participation in interscholastic athletic

  2  competition as contained in a uniform preparticipation

  3  physical evaluation form. The evaluation form shall provide

  4  place for the signature of the practitioner performing the

  5  evaluation with an attestation that each examination procedure

  6  listed on the form was performed by the practitioner or by

  7  someone under the direct supervision of the practitioner. The

  8  form shall also contain a place for the practitioner to

  9  indicate if a referral to another practitioner was made in

10  lieu of completion of a certain examination procedure. The

11  form shall provide a place for the practitioner to whom the

12  student was referred to complete the remaining sections and

13  attest to that portion of the examination. Practitioners

14  administering medical evaluations pursuant to this section

15  must know the minimum standards established by the

16  organization and certify that the student meets the standards.

17  If the practitioner determines that there are any abnormal

18  findings in the cardiovascular system, the student may not

19  participate unless a subsequent EKG or other cardiovascular

20  assessment indicates that the abnormality will not place the

21  student at risk during such participation. Results of such

22  medical evaluation must be provided to the school. No student

23  shall be eligible to participate in any interscholastic

24  athletic competition or engage in any practice, tryout,

25  workout, or other physical activity associated with the

26  student's candidacy for an interscholastic athletic team until

27  the results of the medical evaluation verifying that the

28  student has satisfactorily passed the evaluation have been

29  received and approved by the school.

30         (4)  Notwithstanding the provisions of subsection (3),

31  a student may participate in interscholastic athletic


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  1  competition or be a candidate for an interscholastic athletic

  2  team if the parent or guardian of the student objects in

  3  writing to the student undergoing a medical evaluation because

  4  such evaluation is contrary to his or her religious tenets or

  5  practices, provided that no person or entity shall be held

  6  liable for any injury or other damages suffered by such

  7  student.

  8         Section 91.  Section 240.4075, Florida Statutes, is

  9  amended to read:

10         240.4075  Nursing Student Loan Forgiveness Program.--

11         (1)  To encourage qualified personnel to seek

12  employment in areas of this state in which critical nursing

13  shortages exist, there is established the Nursing Student Loan

14  Forgiveness Program.  The primary function of the program is

15  to increase employment and retention of registered nurses and

16  licensed practical nurses in nursing homes and hospitals in

17  the state and in state-operated medical and health care

18  facilities, public schools, birth centers, and federally

19  sponsored community health centers and teaching hospitals by

20  making repayments toward loans received by students from

21  federal or state programs or commercial lending institutions

22  for the support of postsecondary study in accredited or

23  approved nursing programs.

24         (2)  To be eligible, a candidate must have graduated

25  from an accredited or approved nursing program and have

26  received a Florida license as a licensed practical nurse or a

27  registered nurse or a Florida certificate as an advanced

28  registered nurse practitioner.

29         (3)  Only loans to pay the costs of tuition, books, and

30  living expenses shall be covered, at an amount not to exceed

31  $4,000 for each year of education towards the degree obtained.


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  1         (4)  Receipt of funds pursuant to this program shall be

  2  contingent upon continued proof of employment in the

  3  designated facilities in this state. Loan principal payments

  4  shall be made by the Department of Health Education directly

  5  to the federal or state programs or commercial lending

  6  institutions holding the loan as follows:

  7         (a)  Twenty-five percent of the loan principal and

  8  accrued interest shall be retired after the first year of

  9  nursing;

10         (b)  Fifty percent of the loan principal and accrued

11  interest shall be retired after the second year of nursing;

12         (c)  Seventy-five percent of the loan principal and

13  accrued interest shall be retired after the third year of

14  nursing; and

15         (d)  The remaining loan principal and accrued interest

16  shall be retired after the fourth year of nursing.

17  

18  In no case may payment for any nurse exceed $4,000 in any

19  12-month period.

20         (5)  There is created the Nursing Student Loan

21  Forgiveness Trust Fund to be administered by the Department of

22  Health Education pursuant to this section and s. 240.4076 and

23  department rules.  The Comptroller shall authorize

24  expenditures from the trust fund upon receipt of vouchers

25  approved by the Department of Health Education. All moneys

26  collected from the private health care industry and other

27  private sources for the purposes of this section shall be

28  deposited into the Nursing Student Loan Forgiveness Trust

29  Fund. Any balance in the trust fund at the end of any fiscal

30  year shall remain therein and shall be available for carrying

31  out the purposes of this section and s. 240.4076.


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  1         (6)  In addition to licensing fees imposed under part I

  2  of chapter 464, there is hereby levied and imposed an

  3  additional fee of $5, which fee shall be paid upon licensure

  4  or renewal of nursing licensure. Revenues collected from the

  5  fee imposed in this subsection shall be deposited in the

  6  Nursing Student Loan Forgiveness Trust Fund of the Department

  7  of Health Education and will be used solely for the purpose of

  8  carrying out the provisions of this section and s. 240.4076.

  9  Up to 50 percent of the revenues appropriated to implement

10  this subsection may be used for the nursing scholarship

11  program established pursuant to s. 240.4076.

12         (7)(a)  Funds contained in the Nursing Student Loan

13  Forgiveness Trust Fund which are to be used for loan

14  forgiveness for those nurses employed by hospitals, birth

15  centers, and nursing homes must be matched on a

16  dollar-for-dollar basis by contributions from the employing

17  institutions, except that this provision shall not apply to

18  state-operated medical and health care facilities, public

19  schools, county health departments, federally sponsored

20  community health centers, or teaching hospitals as defined in

21  s. 408.07, family practice teaching hospitals as defined in s.

22  395.805, or specialty hospitals for children as used in s.

23  409.9119. If in any given fiscal quarter there are

24  insufficient funds in the trust fund to grant all eligible

25  applicant requests, awards shall be based on the following

26  priority of employer:  county health departments; federally

27  sponsored community health centers; state-operated medical and

28  health care facilities; public schools; teaching hospitals as

29  defined in s. 408.07; family practice teaching hospitals as

30  defined in s. 395.805; specialty hospitals for children as

31  


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  1  used in s. 409.9119; and other hospitals, birth centers, and

  2  nursing homes.

  3         (b)  All Nursing Student Loan Forgiveness Trust Fund

  4  moneys shall be invested pursuant to s. 18.125.  Interest

  5  income accruing to that portion of the trust fund not matched

  6  shall increase the total funds available for loan forgiveness

  7  and scholarships. Pledged contributions shall not be eligible

  8  for matching prior to the actual collection of the total

  9  private contribution for the year.

10         (8)  The Department of Health Education may solicit

11  technical assistance relating to the conduct of this program

12  from the Department of Education Health.

13         (9)  The Department of Health Education is authorized

14  to recover from the Nursing Student Loan Forgiveness Trust

15  Fund its costs for administering the Nursing Student Loan

16  Forgiveness Program.

17         (10)  The Department of Health Education may adopt

18  rules necessary to administer this program.

19         (11)  This section shall be implemented only as

20  specifically funded.

21         Section 92.  Section 240.4076, Florida Statutes, is

22  amended to read:

23         240.4076  Nursing scholarship program.--

24         (1)  There is established within the Department of

25  Health Education a scholarship program for the purpose of

26  attracting capable and promising students to the nursing

27  profession.

28         (2)  A scholarship applicant shall be enrolled as a

29  full-time or part-time student in the upper division of an

30  approved nursing program leading to the award of a

31  baccalaureate degree or graduate degree to qualify for a


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    CS for SB 1558                                Second Engrossed



  1  nursing faculty position or as an or any advanced registered

  2  nurse practitioner degree or be enrolled as a full-time or

  3  part-time student in an approved program leading to the award

  4  of an associate degree in nursing or a diploma in nursing.

  5         (3)  A scholarship may be awarded for no more than 2

  6  years, in an amount not to exceed $8,000 per year.  However,

  7  registered nurses pursuing a graduate degree for a faculty

  8  position or to practice as an advanced registered nurse

  9  practitioner degree may receive up to $12,000 per year.

10  Beginning July 1, 1998, these amounts shall be adjusted by the

11  amount of increase or decrease in the consumer price index for

12  urban consumers published by the United States Department of

13  Commerce.

14         (4)  Credit for repayment of a scholarship shall be as

15  follows:

16         (a)  For each full year of scholarship assistance, the

17  recipient agrees to work for 12 months in a faculty position

18  in a college of nursing or community college nursing program

19  in this state or at a health care facility in a medically

20  underserved area as approved by the Department of Health

21  Education. Scholarship recipients who attend school on a

22  part-time basis shall have their employment service obligation

23  prorated in proportion to the amount of scholarship payments

24  received.

25         (b)  Eligible health care facilities include nursing

26  homes and hospitals in this state, state-operated medical or

27  health care facilities, public schools, county health

28  departments, federally sponsored community health centers,

29  colleges of nursing in universities in this state, and

30  community college nursing programs in this state or teaching

31  hospitals as defined in s. 408.07. The recipient shall be


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  1  encouraged to complete the service obligation at a single

  2  employment site.  If continuous employment at the same site is

  3  not feasible, the recipient may apply to the department for a

  4  transfer to another approved health care facility.

  5         (c)  Any recipient who does not complete an appropriate

  6  program of studies or who does not become licensed shall repay

  7  to the Department of Health Education, on a schedule to be

  8  determined by the department, the entire amount of the

  9  scholarship plus 18 percent interest accruing from the date of

10  the scholarship payment. Moneys repaid shall be deposited into

11  the Nursing Student Loan Forgiveness Trust Fund established in

12  s. 240.4075.  However, the department may provide additional

13  time for repayment if the department finds that circumstances

14  beyond the control of the recipient caused or contributed to

15  the default.

16         (d)  Any recipient who does not accept employment as a

17  nurse at an approved health care facility or who does not

18  complete 12 months of approved employment for each year of

19  scholarship assistance received shall repay to the Department

20  of Health Education an amount equal to two times the entire

21  amount of the scholarship plus interest accruing from the date

22  of the scholarship payment at the maximum allowable interest

23  rate permitted by law.  Repayment shall be made within 1 year

24  of notice that the recipient is considered to be in default.

25  However, the department may provide additional time for

26  repayment if the department finds that circumstances beyond

27  the control of the recipient caused or contributed to the

28  default.

29         (5)  Scholarship payments shall be transmitted to the

30  recipient upon receipt of documentation that the recipient is

31  enrolled in an approved nursing program. The Department of


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  1  Health Education shall develop a formula to prorate payments

  2  to scholarship recipients so as not to exceed the maximum

  3  amount per academic year.

  4         (6)  The Department of Health Education shall adopt

  5  rules, including rules to address extraordinary circumstances

  6  that may cause a recipient to default on either the school

  7  enrollment or employment contractual agreement, to implement

  8  this section and may solicit technical assistance relating to

  9  the conduct of this program from the Department of Health.

10         (7)  The Department of Health Education is authorized

11  to recover from the Nursing Student Loan Forgiveness Trust

12  Fund its costs for administering the nursing scholarship

13  program.

14         Section 93.  All powers, duties, and functions, rules,

15  records, personnel, property, and unexpended balances of

16  appropriations, allocations, or other funds of the Department

17  of Education relating to the Nursing Student Loan Forgiveness

18  Program and the nursing scholarship program are transferred by

19  a type two transfer, as defined in s. 20.06(2), Florida

20  Statutes, to the Department of Health.

21         Section 94.  Effective July 1, 2003, section 464.005,

22  Florida Statutes, is amended to read:

23         464.005  Board headquarters.--The board shall maintain

24  its official headquarters in Tallahassee the city in which it

25  has been domiciled for the past 5 years.

26         Section 95.  Subsections (1) and (2) of section

27  464.008, Florida Statutes, are amended to read:

28         464.008  Licensure by examination.--

29         (1)  Any person desiring to be licensed as a registered

30  nurse or licensed practical nurse shall apply to the

31  


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  1  department to take the licensure examination.  The department

  2  shall examine each applicant who:

  3         (a)  Has completed the application form and remitted a

  4  fee set by the board not to exceed $150 and has remitted an

  5  examination fee set by the board not to exceed $75 plus the

  6  actual per applicant cost to the department for purchase of

  7  the examination from the National Council of State Boards of

  8  Nursing or a similar national organization.

  9         (b)  Has provided sufficient information on or after

10  October 1, 1989, which must be submitted by the department for

11  a statewide criminal records correspondence check through the

12  Department of Law Enforcement.

13         (c)  Is in good mental and physical health, is a

14  recipient of a high school diploma or the equivalent, and has

15  completed the requirements for graduation from an approved

16  program, or its equivalent as determined by the board, for the

17  preparation of registered nurses or licensed practical nurses,

18  whichever is applicable.  Courses successfully completed in a

19  professional nursing program which are at least equivalent to

20  a practical nursing program may be used to satisfy the

21  education requirements for licensure as a licensed practical

22  nurse.

23         (d)  Has the ability to communicate in the English

24  language, which may be determined by an examination given by

25  the department.

26         (2)  Each applicant who passes the examination and

27  provides proof of meeting the educational requirements

28  specified in subsection (1) graduation from an approved

29  nursing program shall, unless denied pursuant to s. 464.018,

30  be entitled to licensure as a registered professional nurse or

31  a licensed practical nurse, whichever is applicable.


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  1         Section 96.  Section 464.009, Florida Statutes, is

  2  amended to read:

  3         464.009  Licensure by endorsement.--

  4         (1)  The department shall issue the appropriate license

  5  by endorsement to practice professional or practical nursing

  6  to an applicant who, upon applying to the department and

  7  remitting a fee set by the board not to exceed $100,

  8  demonstrates to the board that he or she:

  9         (a)  Holds a valid license to practice professional or

10  practical nursing in another state of the United States,

11  provided that, when the applicant secured his or her original

12  license, the requirements for licensure were substantially

13  equivalent to or more stringent than those existing in Florida

14  at that time; or

15         (b)  Meets the qualifications for licensure in s.

16  464.008 and has successfully completed a state, regional, or

17  national examination which is substantially equivalent to or

18  more stringent than the examination given by the department.

19         (2)  Such examinations and requirements from other

20  states shall be presumed to be substantially equivalent to or

21  more stringent than those in this state.  Such presumption

22  shall not arise until January 1, 1980. However, the board may,

23  by rule, specify states the examinations and requirements of

24  which shall not be presumed to be substantially equivalent to

25  those of this state.

26         (3)  The applicant must submit to the department a set

27  of fingerprints on a form and under procedures specified by

28  the department, along with a payment in an amount equal to the

29  costs incurred by the Department of Health for the criminal

30  background check of the applicant. The Department of Health

31  shall submit the fingerprints provided by the applicant to the


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    CS for SB 1558                                Second Engrossed



  1  Florida Department of Law Enforcement for a statewide criminal

  2  history check, and the Florida Department of Law Enforcement

  3  shall forward the fingerprints to the Federal Bureau of

  4  Investigation for a national criminal history check of the

  5  applicant. The Department of Health shall review the results

  6  of the criminal history check, issue a license to an applicant

  7  who has met all of the other requirements for licensure and

  8  has no criminal history, and shall refer all applicants with

  9  criminal histories back to the board for determination as to

10  whether a license should be issued and under what conditions.

11         (4)(3)  The department shall not issue a license by

12  endorsement to any applicant who is under investigation in

13  another state for an act which would constitute a violation of

14  this part or chapter 456 until such time as the investigation

15  is complete, at which time the provisions of s. 464.018 shall

16  apply.

17         (5)  The department shall develop an electronic

18  applicant notification process and provide electronic

19  notification when the application has been received and when

20  background screenings have been completed, and shall issue a

21  license within 30 days after completion of all required data

22  collection and verification. This 30-day period to issue a

23  license shall be tolled if the applicant must appear before

24  the board due to information provided on the application or

25  obtained through screening and data collection and

26  verification procedures.

27         Section 97.  Section 464.0195, Florida Statutes, is

28  created to read:

29         464.0195  Florida Center for Nursing; goals.--There is

30  established the Florida Center for Nursing to address issues

31  of supply and demand for nursing, including issues of


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  1  recruitment, retention, and utilization of nurse workforce

  2  resources. The Legislature finds that the center will repay

  3  the state's investment by providing an ongoing strategy for

  4  the allocation of the state's resources directed towards

  5  nursing. The primary goals for the center shall be to:

  6         (1)  Develop a strategic statewide plan for nursing

  7  manpower in this state by:

  8         (a)  Establishing and maintaining a database on nursing

  9  supply and demand in the state, to include current supply and

10  demand, and future projections; and

11         (b)  Selecting from the plan priorities to be

12  addressed.

13         (2)  Convene various groups representative of nurses,

14  other health care providers, business and industry, consumers,

15  legislators, and educators to:

16         (a)  Review and comment on data analysis prepared for

17  the center;

18         (b)  Recommend systemic changes, including strategies

19  for implementation of recommended changes; and

20         (c)  Evaluate and report the results of these efforts

21  to the Legislature and others.

22         (3)  Enhance and promote recognition, reward, and

23  renewal activities for nurses in the state by:

24         (a)  Promoting nursing excellence programs such as

25  magnet recognition by the American Nurses Credentialing

26  Center;

27         (b)  Proposing and creating additional reward,

28  recognition, and renewal activities for nurses; and

29         (c)  Promoting media and positive image-building

30  efforts for nursing.

31  


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  1         Section 98.  Section 464.0196, Florida Statutes, is

  2  created to read:

  3         464.0196  Florida Center for Nursing; board of

  4  directors.--

  5         (1)  The Florida Center for Nursing shall be governed

  6  by a policy-setting board of directors. The board shall

  7  consist of 16 members, with a simple majority of the board

  8  being nurses representative of various practice areas. Other

  9  members shall include representatives of other health care

10  professions, business and industry, health care providers, and

11  consumers. The members of the board shall be appointed by the

12  Governor as follows:

13         (a)  Four members recommended by the President of the

14  Senate, at least one of whom shall be a registered nurse

15  recommended by the Florida Organization of Nurse Executives

16  and at least one other representative of the hospital industry

17  recommended by the Florida Hospital Association;

18         (b)  Four members recommended by the Speaker of the

19  House of Representatives, at least one of whom shall be a

20  registered nurse recommended by the Florida Nurses Association

21  and at least one other representative of the long-term care

22  industry;

23         (c)  Four members recommended by the Governor, two of

24  whom shall be registered nurses; and

25         (d)  Four nurse educators recommended by the State

26  Board of Education, one of whom shall be a dean of a College

27  of Nursing at a state university, one other shall be a

28  director of a nursing program in a state community college.

29         (2)  The initial terms of the members shall be as

30  follows:

31  


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  1         (a)  Of the members appointed pursuant to paragraph

  2  (1)(a), two shall be appointed for terms expiring June 30,

  3  2005, one for a term expiring June 30, 2004, and one for a

  4  term expiring June 30, 2003.

  5         (b)  Of the members appointed pursuant to paragraph

  6  (1)(b), one shall be appointed for a term expiring June 30,

  7  2005, two for terms expiring June 30, 2004, and one for a term

  8  expiring June 20, 2003.

  9         (c)  Of the members appointed pursuant to paragraph

10  (1)(c), one shall be appointed for a term expiring June 30,

11  2005, one for a term expiring June 30, 2004, and two for terms

12  expiring June 30, 2003.

13         (d)  Of the members appointed pursuant to paragraph

14  (1)(d), the terms of two members recommended by the State

15  Board of Education shall expire June 30, 2005; the term of the

16  member who is a dean of a College of Nursing at a state

17  university shall expire June 30, 2004; and the term of the

18  member who is a director of a state community college nursing

19  program shall expire June 30, 2003.

20  

21  After the initial appointments expire, the terms of all the

22  members shall be for 3 years, with no member serving more than

23  two consecutive terms.

24         (3)  The board shall have the following powers and

25  duties:

26         (a)  To employ an executive director.

27         (b)  To determine operational policy.

28         (c)  To elect a chair and officers, to serve 2-year

29  terms. The chair and officers may not succeed themselves.

30         (d)  To establish committees of the board as needed.

31  


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  1         (e)  To appoint a multidisciplinary advisory council

  2  for input and advice on policy matters.

  3         (f)  To implement the major functions of the center as

  4  established in the goals set out in s. 464.0195.

  5         (g)  To seek and accept nonstate funds for sustaining

  6  the center and carrying out center policy.

  7         (4)  The members of the board are entitled to receive

  8  per diem and allowances prescribed by law for state boards and

  9  commissions.

10         Section 99.  Section 464.0197, Florida Statutes, is

11  created to read:

12         464.0197  Florida Center for Nursing; state budget

13  support.--The Legislature finds that it is imperative that the

14  state protect its investment and progress made in nursing

15  efforts to date. The Legislature finds that the Florida Center

16  for Nursing is the appropriate means to do so. The center

17  shall have state budget support for its operations so that it

18  may have adequate resources for the tasks the Legislature has

19  set out in s. 464.0195.

20         Section 100.  The Board of Nursing within the

21  Department of Health shall hold in abeyance until July 1,

22  2002, the development of any rule pursuant to s. 464.019(2),

23  Florida Statutes, which relates to the establishment of

24  faculty/student clinical ratios. The Board of Nursing and the

25  Department of Education shall submit to the President of the

26  Senate and the Speaker of the House of Representatives by

27  December 31, 2001, an implementation plan that details both

28  the impact and the cost of any such proposed rule change.

29         Section 101.  Subsection (1) of section 464.0205,

30  Florida Statutes, is amended to read:

31         464.0205  Retired volunteer nurse certificate.--


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  1         (1)  Any retired practical or registered nurse desiring

  2  to serve indigent, underserved, or critical need populations

  3  in this state may apply to the department for a retired

  4  volunteer nurse certificate by providing:

  5         (a)  A complete application.

  6         (b)  An application and processing fee of $25.

  7         (b)(c)  Verification that the applicant had been

  8  licensed to practice nursing in any jurisdiction in the United

  9  States for at least 10 years, had retired or plans to retire,

10  intends to practice nursing only pursuant to the limitations

11  provided by the retired volunteer nurse certificate, and has

12  not committed any act that would constitute a violation under

13  s. 464.018(1).

14         (c)(d)  Proof that the applicant meets the requirements

15  for licensure under s. 464.008 or s. 464.009.

16         Section 102.  The Florida Legislature's Office of

17  Program Policy Analysis and Government Accountability shall

18  study the feasibility of maintaining the entire Medical

19  Quality Assurance function, including enforcement, within one

20  department, as recommended by the Auditor General in

21  Operational Report Number 01-063. The study shall be completed

22  and a report issued to the Legislature on or before November

23  30, 2001.

24         Section 103.  Effective October 1, 2001, section

25  456.0375, Florida Statutes, is created to read:

26         456.0375  Registration of certain clinics;

27  requirements; discipline; exemptions.--

28         (1)(a)  As used in this section, the term "clinic"

29  means a business operating in a single structure or facility,

30  or in a group of adjacent structures or facilities operating

31  under the same business name or management, at which health


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  1  care services are provided to individuals and which tender

  2  charges for reimbursement for such services.

  3         (b)  For purposes of this section, the term "clinic"

  4  does not include and the registration requirements herein do

  5  not apply to:

  6         1.  Entities licensed or registered by the state

  7  pursuant to chapter 390, chapter 394, chapter 395, chapter

  8  397, chapter 400, chapter 463, chapter 465, chapter 466,

  9  chapter 478, chapter 480, or chapter 484.

10         2.  Entities exempt from federal taxation under 26

11  U.S.C. s. 501(c)(3).

12         3.  Sole proprietorships, group practices,

13  partnerships, or corporations that provide health care

14  services by licensed health care practitioners pursuant to

15  chapters 457, 458, 459, 460, 461, 462, 463, 466, 467, 484,

16  486, 490, 491, or parts I, III, X, XIII, or XIV of chapter

17  468, or s. 464.012, which are wholly owned by licensed health

18  care practitioners or the licensed health care practitioner

19  and the spouse, parent, or child of a licensed health care

20  practitioner, so long as one of the owners who is a licensed

21  health care practitioner is supervising the services performed

22  therein and is legally responsible for the entity's compliance

23  with all federal and state laws.  However, no health care

24  practitioner may supervise services beyond the scope of the

25  practitioner's license.

26         (2)(a)  Every clinic, as defined in paragraph (1)(a),

27  must register, and must at all times maintain a valid

28  registration, with the Department of Health.  Each clinic

29  location shall be registered separately even though operated

30  under the same business name or management, and each clinic

31  shall appoint a medical director or clinical director.


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  1         (b)  The department shall adopt rules necessary to

  2  implement the registration program, including rules

  3  establishing the specific registration procedures, forms, and

  4  fees.  Registration fees must be reasonably calculated to

  5  cover the cost of registration and must be of such amount that

  6  the total fees collected do not exceed the cost of

  7  administering and enforcing compliance with this section.

  8  Registration may be conducted electronically. The registration

  9  program must require:

10         1.  The clinic to file the registration form with the

11  department within 60 days after the effective date of this

12  section or prior to the inception of operation.  The

13  registration expires automatically 2 years after its date of

14  issuance and must be renewed biennially.

15         2.  The registration form to contain the name,

16  residence and business address, phone number, and license

17  number of the medical director or clinical director for the

18  clinic.

19         3.  The clinic to display the registration certificate

20  in a conspicuous location within the clinic readily visible to

21  all patients.

22         (3)(a)  Each clinic must employ or contract with a

23  physician maintaining a full and unencumbered physician

24  license in accordance with chapter 458, chapter 459, chapter

25  460, or chapter 461 to serve as the medical director.

26  However, if the clinic is limited to providing health care

27  services pursuant to chapter 457, chapter 484, chapter 486,

28  chapter 490, or chapter 491 or part I, part III, part X, part

29  XIII, or part XIV of chapter 468, the clinic may appoint a

30  health care practitioner licensed under that chapter to serve

31  as a clinical director who is responsible for the clinic's


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  1  activities.  A health care practitioner may not serve as the

  2  clinical director if the services provided at the clinic are

  3  beyond the scope of that practitioner's license.

  4         (b)  The medical director or clinical director shall

  5  agree in writing to accept legal responsibility for the

  6  following activities on behalf of the clinic. The medical

  7  director or the clinical director shall:

  8         1.  Have signs identifying the medical director or

  9  clinical director posted in a conspicuous location within the

10  clinic readily visible to all patients.

11         2.  Ensure that all practitioners providing health care

12  services or supplies to patients maintain a current active and

13  unencumbered Florida license.

14         3.  Review any patient referral contracts or agreements

15  executed by the clinic.

16         4.  Ensure that all health care practitioners at the

17  clinic have active appropriate certification or licensure for

18  the level of care being provided.

19         5.  Serve as the clinic records holder as defined in s.

20  456.057.

21         6.  Ensure compliance with the recordkeeping, office

22  surgery, and adverse incident reporting requirements of

23  chapter 456, the respective practice acts, and rules adopted

24  thereunder.

25         7.  Conduct systematic reviews of clinic billings to

26  ensure that the billings are not fraudulent or unlawful.  Upon

27  discovery of an unlawful charge, the medical director shall

28  take immediate corrective action.

29         (c)  Any contract to serve as a medical director or a

30  clinical director entered into or renewed by a physician or a

31  licensed health care practitioner in violation of this section


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  1  is void as contrary to public policy.  This section shall

  2  apply to contracts entered into or renewed on or after October

  3  1, 2001.

  4         (d)  The department, in consultation with the boards,

  5  shall adopt rules specifying limitations on the number of

  6  registered clinics and licensees for which a medical director

  7  or a clinical director may assume responsibility for purposes

  8  of this section. In determining the quality of supervision a

  9  medical director or a clinical director can provide, the

10  department shall consider the number of clinic employees,

11  clinic location, and services provided by the clinic.

12         (4)(a)  All charges or reimbursement claims made by or

13  on behalf of a clinic that is required to be registered under

14  this section, but that is not so registered, are unlawful

15  charges and therefore are noncompensable and unenforceable.

16         (b)  Any person establishing, operating, or managing an

17  unregistered clinic otherwise required to be registered under

18  this section commits a felony of the third degree, punishable

19  as provided in s. 775.082, s. 775.083, or s. 775.084.

20         (c)  Any licensed health care practitioner who violates

21  this section is subject to discipline in accordance with

22  chapter 456 and the respective practice act.

23         (d)  The department shall revoke the registration of

24  any clinic registered under this section for operating in

25  violation of the requirements of this section or the rules

26  adopted by the department.

27         (e)  The department shall investigate allegations of

28  noncompliance with this section and the rules adopted pursuant

29  to this section.

30         Section 104.  The sum of $100,000 is appropriated from

31  the registration fees collected from clinics pursuant to s.


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  1  456.0375, Florida Statutes, and one-half of one full-time

  2  equivalent position is authorized, to the Department of Health

  3  for the purposes of regulating medical clinics pursuant to s.

  4  456.0375, Florida Statutes. The appropriated funds shall be

  5  deposited into the Medical Quality Assurance Trust Fund.

  6         Section 105.  Subsection (3) of section 456.031,

  7  Florida Statutes, is amended to read:

  8         456.031  Requirement for instruction on domestic

  9  violence.--

10         (3)(a)  In lieu of completing a course as required in

11  subsection (1), a licensee or certificateholder may complete a

12  course in end-of-life care and palliative health care, if the

13  licensee or certificateholder has completed an approved

14  domestic violence course in the immediately preceding

15  biennium.

16         (b)  In lieu of completing a course as required by

17  subsection (1), a person licensed under chapter 466 who has

18  completed an approved domestic-violence education course in

19  the immediately preceding 2 years may complete a course

20  approved by the Board of Dentistry.

21         Section 106.  Subsection (9) of section 456.033,

22  Florida Statutes, is amended to read:

23         456.033  Requirement for instruction for certain

24  licensees on human immunodeficiency virus and acquired immune

25  deficiency syndrome.--

26         (9)(a)  In lieu of completing a course as required in

27  subsection (1), the licensee may complete a course in

28  end-of-life care and palliative health care, so long as the

29  licensee completed an approved AIDS/HIV course in the

30  immediately preceding biennium.

31  


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  1         (b)  In lieu of completing a course as required by

  2  subsection (1), a person licensed under chapter 466 who has

  3  completed an approved AIDS/HIV course in the immediately

  4  preceding 2 years may complete a course approved by the Board

  5  of Dentistry.

  6         Section 107.  (1)  Subsection (9) is added to section

  7  627.419, Florida Statutes, to read:

  8         627.419  Construction of policies.--

  9         (9)  With respect to any group or individual insurer

10  covering dental services, each claimant, or dentist acting for

11  a claimant, who has had a claim denied as not medically or

12  dentally necessary or who has had a claim payment based on an

13  alternate dental service in accordance with accepted dental

14  standards for adequate and appropriate care must be provided

15  an opportunity for an appeal to the insurer's licensed dentist

16  who is responsible for the medical necessity reviews under the

17  plan or is a member of the plan's peer review group. The

18  appeal may be by telephone, and the insurer's dentist must

19  respond within a reasonable time, not to exceed 15 business

20  days.

21         (2)  This section shall apply to policies issued or

22  renewed on or after July 1, 2001.

23         Section 108.  Paragraph (d) of subsection (3) of

24  section 468.302, Florida Statutes, is amended to read:

25         468.302  Use of radiation; identification of certified

26  persons; limitations; exceptions.--

27         (3)

28         (d)  A person holding a certificate as a general

29  radiographer may not perform nuclear medicine and radiation

30  therapy procedures, except as provided in this paragraph. A

31  person who is a general radiographer certified pursuant to


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  1  this part who receives additional training and skills in

  2  radiation therapy technology procedures as referenced in this

  3  paragraph may assist with managing patients undergoing

  4  radiation therapy treatments if that assistance is provided to

  5  a person registered with the American Registry of Radiologic

  6  Technologists in radiation therapy who is also certified

  7  pursuant to this part as a radiation therapy technologist.

  8  Both the general radiographer and the radiation therapy

  9  technologist must perform these radiation therapy services

10  under the general supervision of a physician licensed under

11  chapter 458 or chapter 459 who is trained and skilled in

12  performing radiation therapy treatments. The radiation therapy

13  technologist identified under this paragraph may not delegate

14  any function to the general radiographer which could

15  reasonably be expected to create an unnecessary danger to a

16  patient's life, health, or safety. The general radiographer

17  identified under this section may not, however, perform the

18  following services while assisting the radiation therapy

19  technologist: radiation treatment planning, calculation of

20  radiation therapy doses, or any of the duties of a medical

21  physicist. The general radiographer identified under this

22  section must successfully complete a training program in the

23  following areas before assisting with radiation therapy

24  technology duties:

25         1.  Principles of radiation therapy treatment;

26         2.  Biological effects of radiation;

27         3.  Radiation exposure and monitoring;

28         4.  Radiation safety and protection;

29         5.  Evaluation and handling of radiographic treatment

30  equipment and accessories; and

31  


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  1         6.  Patient positioning for radiation therapy

  2  treatment.

  3  

  4  In addition, a general radiographer may participate in

  5  additional approved programs as provided by rule of the

  6  department.

  7         Section 109.  Subsections (8) and (9) of section

  8  468.352, Florida Statutes, are amended to read:

  9         468.352  Definitions.--As used in this part, unless the

10  context otherwise requires, the term:

11         (8)  "Registered respiratory therapist" means any

12  person licensed pursuant to this part who is employed to

13  deliver respiratory care services under the order of a

14  physician licensed pursuant to chapter 458 or chapter 459, and

15  in accordance with protocols established by a hospital, other

16  health care provider, or the board, and who functions in

17  situations of unsupervised patient contact requiring

18  individual judgment.

19         (9)  "Certified respiratory therapist" or "respiratory

20  care practitioner" means any person licensed pursuant to this

21  part who is employed to deliver respiratory care services

22  under the order of a physician licensed pursuant to chapter

23  458 or chapter 459, and in accordance with protocols

24  established by a hospital, other health care provider, or the

25  board.

26         Section 110.  Subsections (1) and (2) of section

27  468.355, Florida Statutes, are amended to read:

28         468.355  Eligibility for licensure; temporary

29  licensure.--

30  

31  


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  1         (1)  To be eligible for licensure by the board as a

  2  certified respiratory therapist respiratory care practitioner,

  3  an applicant must:

  4         (a)  Be at least 18 years old.

  5         (b)  Possess a high school diploma or a graduate

  6  equivalency diploma.

  7         (c)  Meet at least one of the following criteria:

  8         1.  The applicant has successfully completed a training

  9  program for respiratory therapy technicians or respiratory

10  therapists approved by the Commission on Accreditation of

11  Allied Health Education Programs, or the equivalent thereof,

12  as accepted by the board.

13         2.  The applicant is currently a "Certified Respiratory

14  Therapist Therapy Technician" certified by the National Board

15  for Respiratory Care, or the equivalent thereof, as accepted

16  by the board.

17         3.  The applicant is currently a "Registered

18  Respiratory Therapist" registered by the National Board for

19  Respiratory Care, or the equivalent thereof, as accepted by

20  the board.

21  

22  The criteria set forth in subparagraphs 2. and 3.

23  notwithstanding, the board shall periodically review the

24  examinations and standards of the National Board for

25  Respiratory Care and may reject those examinations and

26  standards if they are deemed inappropriate.

27         (2)  To be eligible for licensure by the board as a

28  registered respiratory therapist, an applicant must:

29         (a)  Be at least 18 years old.

30         (b)  Possess a high school diploma or a graduate

31  equivalency diploma.


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  1         (c)  Meet at least one of the following criteria:

  2         1.  The applicant has successfully completed a training

  3  program for registered respiratory therapists approved by the

  4  Commission on Accreditation of Allied Health Education

  5  Programs, or the equivalent thereof, as accepted by the board.

  6         2.  The applicant is currently a "Registered

  7  Respiratory Therapist" registered by the National Board for

  8  Respiratory Care, or the equivalent thereof, as accepted by

  9  the board.

10  

11  The criteria set forth in subparagraphs 1. and 2.

12  notwithstanding, the board shall periodically review the

13  examinations and standards of the National Board for

14  Respiratory Care and may reject those examinations and

15  standards if they are deemed inappropriate.

16         Section 111.  Section 468.357, Florida Statutes, is

17  amended to read:

18         468.357  Licensure by examination.--

19         (1)  A person who desires to be licensed as a certified

20  respiratory therapist respiratory care practitioner may submit

21  an application to take the examination, in accordance with

22  board rule.

23         (a)  Each applicant may take the examination who is

24  determined by the board to have:

25         1.  Completed the application form and remitted the

26  applicable fee set by the board;

27         2.  Submitted required documentation as required in s.

28  468.355; and

29         3.  Remitted an examination fee set by the examination

30  provider.

31  


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  1         (b)  Examinations for licensure of certified

  2  respiratory therapist respiratory care practitioners must be

  3  conducted no less than two times a year in such geographical

  4  locations or by such methods as are deemed advantageous to the

  5  majority of the applicants.

  6         (c)  The examination given for certified respiratory

  7  therapist respiratory care practitioners shall be the same as

  8  that given by the National Board for Respiratory Care for

  9  entry-level certification of respiratory therapists therapy

10  technicians.  However, an equivalent examination may be

11  accepted by the board in lieu of that examination.

12         (2)  Each applicant who passes the examination shall be

13  entitled to licensure as a certified respiratory therapist

14  respiratory care practitioner, and the department shall issue

15  a license pursuant to this part to any applicant who

16  successfully completes the examination in accordance with this

17  section.  However, the department shall not issue a license to

18  any applicant who is under investigation in another

19  jurisdiction for an offense which would constitute a violation

20  of this part. Upon completion of such an investigation, if the

21  applicant is found guilty of such an offense, the applicable

22  provisions of s. 468.365 will apply.

23         Section 112.  Subsections (1) and (2) of section

24  468.358, Florida Statutes, are amended to read:

25         468.358  Licensure by endorsement.--

26         (1)  Licensure as a certified respiratory therapist

27  respiratory care practitioner shall be granted by endorsement

28  to an individual who holds the "Certified Respiratory

29  Therapist Therapy Technician" credential issued by the

30  National Board for Respiratory Care or an equivalent

31  credential acceptable to the board. Licensure by this


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  1  mechanism requires verification by oath and submission of

  2  evidence satisfactory to the board that such credential is

  3  held.

  4         (2)  Licensure as a registered respiratory therapist

  5  shall be granted by endorsement to an individual who holds the

  6  "Registered Respiratory Therapist" credential issued by the

  7  National Board for Respiratory Care or an equivalent

  8  credential acceptable to the board. Licensure by this

  9  mechanism requires verification by oath and submission of

10  evidence satisfactory to the board that such credential is

11  held.

12         Section 113.  Section 468.359, Florida Statutes, is

13  amended to read:

14         468.359  Assumption of title and use of

15  abbreviations.--

16         (1)  Only persons who are licensed pursuant to this

17  part as respiratory care practitioners have the right to use

18  the title "Respiratory Care Practitioner" and the abbreviation

19  "RCP."

20         (2)  Only persons who are licensed pursuant to this

21  part as registered respiratory therapists have the right to

22  use the title "Registered Respiratory Therapist" and the

23  abbreviation "RRT," when delivering services pursuant to this

24  part provided such persons have passed the Registry

25  Examination for Respiratory Therapists given by the National

26  Board for Respiratory Care.

27         (3)  Only persons who are licensed pursuant to this

28  part as certified respiratory therapists have the right to use

29  the title "Certified Respiratory Therapist" and the

30  abbreviation "CRT" when delivering services pursuant to this

31  part. graduates of board-approved programs for respiratory


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  1  care practitioners may use the term "Graduate Respiratory

  2  Therapy Technician" and the abbreviation "GRTT."

  3         (4)  Only persons who are graduates of board-approved

  4  programs for respiratory therapists may use the term "Graduate

  5  Respiratory Therapist" and the abbreviation "GRT."

  6         (4)(5)  No person in this state shall deliver

  7  respiratory care services; advertise as, or assume the title

  8  of, respiratory care practitioner, certified respiratory

  9  therapist, or registered respiratory therapist; or use the

10  abbreviation "RCP," "CRT," or "RRT" that would lead the public

11  to believe that such person is licensed pursuant to this part

12  unless such person is so licensed; or take any other action

13  that would lead the public to believe that such person is

14  licensed pursuant to this part unless such person is so

15  licensed.

16         Section 114.  Subsections (2), (3), and (4) of section

17  468.1155, Florida Statutes, are amended to read:

18         468.1155  Provisional license; requirements.--

19         (2)  The department shall issue a provisional license

20  to practice speech-language pathology to each applicant who

21  the board certifies has:

22         (a)  Completed the application form and remitted the

23  required fees, including a nonrefundable application fee.

24         (b)  Received a master's degree or is currently

25  enrolled in a doctoral degree program with a major emphasis in

26  speech-language pathology from an institution of higher

27  learning which is, or at the time the applicant was enrolled

28  and graduated, was, accredited by an accrediting agency

29  recognized by the Council for Higher Education Commission on

30  Recognition of Postsecondary Accreditation or from an

31  institution which is publicly recognized as a member in good


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  1  standing with the Association of Universities and Colleges of

  2  Canada.  An applicant who graduated from or is currently

  3  enrolled in a program at a university or college outside the

  4  United States or Canada must present documentation of the

  5  determination of equivalency to standards established by the

  6  Council for Higher Education Commission on Recognition of

  7  Postsecondary Accreditation in order to qualify.  The

  8  applicant must have completed 60 semester hours that include:

  9         1.  Fundamental information applicable to the normal

10  development and use of speech, hearing, and language;

11  information about training in management of speech, hearing,

12  and language disorders; and information supplementary to these

13  fields.

14         2.  Six semester hours in audiology.

15         3.  Thirty of the required 60 semester hours in courses

16  acceptable toward a graduate degree by the college or

17  university in which these courses were taken, of which 24

18  semester hours must be in speech-language pathology.

19         (c)  Completed 300 supervised clinical clock hours with

20  200 clock hours in the area of speech-language pathology or

21  completed the number of clock hours required by an accredited

22  institution meeting national certification standards.  The

23  supervised clinical clock hours shall be completed within the

24  training institution or one of its cooperating programs.

25         (3)  The department shall issue a provisional license

26  to practice audiology to each applicant who the board

27  certifies has:

28         (a)  Completed the application form and remitted the

29  required fees, including a nonrefundable application fee.

30         (b)  Received a master's degree or is currently

31  enrolled in a doctoral degree program with a major emphasis in


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  1  audiology from an institution of higher learning which is, or

  2  at the time the applicant was enrolled and graduated was,

  3  accredited by an accrediting agency recognized by the Council

  4  for Higher Education Commission on Recognition of

  5  Postsecondary Accreditation or from an institution which is

  6  publicly recognized as a member in good standing with the

  7  Association of Universities and Colleges of Canada. An

  8  applicant who graduated from or is currently enrolled in a

  9  program at a university or college outside the United States

10  or Canada must present documentation of the determination of

11  equivalency to standards established by the Council for Higher

12  Education Commission on Recognition of Postsecondary

13  Accreditation in order to qualify.  The applicant must have

14  completed 60 semester hours that include:

15         1.  Fundamental information applicable to the normal

16  development and use of speech, hearing, and language;

17  information about training in management of speech, hearing,

18  and language disorders; and information supplementary to these

19  fields.

20         2.  Six semester hours in speech-language pathology.

21         3.  Thirty of the required 60 semester hours in courses

22  acceptable toward a graduate degree by the college or

23  university in which these courses were taken, of which 24

24  semester hours must be in audiology.

25         (c)  Completed 300 supervised clinical clock hours with

26  200 clock hours in the area of audiology or completed the

27  number of clock hours required by an accredited institution

28  meeting national certification standards.  The supervised

29  clinical clock hours shall be completed within the training

30  institution or one of its cooperating programs.

31  


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  1         (4)  An applicant for a provisional license who has

  2  received a master's degree or is currently enrolled in a

  3  doctoral degree program with a major emphasis in

  4  speech-language pathology as provided in subsection (2), or

  5  audiology as provided in subsection (3), and who seeks

  6  licensure in the area in which the applicant is not currently

  7  licensed, must have completed 30 semester hours in courses

  8  acceptable toward a graduate degree and 200 supervised

  9  clinical clock hours in the second discipline from an

10  accredited institution.

11         Section 115.  Paragraph (b) of subsection (1) and

12  paragraph (b) of subsection (2) of section 468.1215, Florida

13  Statutes, are amended to read:

14         468.1215  Speech-language pathology assistant and

15  audiology assistant; certification.--

16         (1)  The department shall issue a certificate as a

17  speech-language pathology assistant to each applicant who the

18  board certifies has:

19         (b)  Earned a bachelor's degree from a college or

20  university accredited by a regional association of colleges

21  and schools recognized by the Department of Education which

22  includes at least 24 semester hours of coursework as approved

23  by the board at an institution accredited by an accrediting

24  agency recognized by the Council for Higher Education

25  Commission on Recognition of Postsecondary Accreditation.

26         (2)  The department shall issue a certificate as an

27  audiology assistant to each applicant who the board certifies

28  has:

29         (b)  Completed at least 24 semester hours of coursework

30  as approved by the board at an institution accredited by an

31  accrediting agency recognized by the Council for Higher


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  1  Education Commission on Recognition of Postsecondary

  2  Accreditation.

  3         Section 116.  Subsection (3) of section 480.033,

  4  Florida Statutes, is amended to read:

  5         480.033  Definitions.--As used in this act:

  6         (3)  "Massage" means the manipulation of the soft

  7  superficial tissues of the human body with the hand, foot,

  8  arm, or elbow, whether or not such manipulation is aided by

  9  hydrotherapy, including colonic irrigation, or thermal

10  therapy; any electrical or mechanical device; or the

11  application to the human body of a chemical or herbal

12  preparation.

13         Section 117.  Subsection (3) of section 484.002,

14  Florida Statutes, is amended, and subsection (8) is added to

15  that section, to read:

16         484.002  Definitions.--As used in this part:

17         (3)  "Opticianry" means the preparation and dispensing

18  of lenses, spectacles, eyeglasses, contact lenses, and other

19  optical devices to the intended user or agent thereof, upon

20  the written prescription of a licensed allopathic or

21  osteopathic physician medical doctor or optometrist who is

22  duly licensed to practice or upon presentation of a duplicate

23  prescription.  The selection of frame designs, the actual

24  sales transaction, and the transfer of physical possession of

25  lenses, spectacles, eyeglasses, contact lenses, and other

26  optical devices subsequent to performance of all services of

27  the optician shall not be considered the practice of

28  opticianry; however, such physical possession shall not be

29  transferred until the optician has completed the fitting of

30  the optical device upon the customer.  The practice of

31  opticianry also includes the duplication of lenses accurately


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  1  as to power, without prescription.  A board-certified optician

  2  qualified and operating under rules established by the board

  3  may fill, fit, adapt, or dispense any soft contact lens

  4  prescription.  Such optician may fill, fit, adapt, or dispense

  5  any extended wear or hard contact lens prescription to the

  6  extent authorized to do so by the prescribing allopathic or

  7  osteopathic physician medical doctor or optometrist.

  8         (8)  "Contact lenses" means a prescribed medical device

  9  intended to be worn directly against the cornea of the eye to

10  correct vision conditions, act as a therapeutic device, or

11  provide a cosmetic effect.

12         (9)  "Optical Dispensing" means interpreting but not

13  altering a prescription of a licensed physician or optometrist

14  and designing, adapting, fitting, or replacing the prescribed

15  optical aids, pursuant to such prescription, to or for the

16  intended wearer, duplicating lenses, accurately as to power

17  without a prescription and duplicating nonprescription eyewear

18  and parts of eyewear. "Optical Dispensing" does not include

19  selecting frames, transferring an optical aid to the wearer

20  after an optician has completed fitting it, or providing

21  instruction in the general care and use of an optical aid,

22  including placement, removal, hygiene, or cleaning.

23         Section 118.  Subsection (2) of section 484.006,

24  Florida Statutes, is amended to read:

25         484.006  Certain rules prohibited.--

26         (2)  No rule or policy of the board shall prohibit any

27  optician from practicing jointly with optometrists or

28  allopathic or osteopathic physicians medical doctors licensed

29  in this state.

30         Section 119.  Subsections (1) and (2) of section

31  484.012, Florida Statutes, are amended to read:


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  1         484.012  Prescriptions; filing; duplication of

  2  prescriptions; duplication of lenses.--

  3         (1)  Any prescription written by a duly licensed

  4  allopathic or osteopathic physician medical doctor or

  5  optometrist for any lenses, spectacles, eyeglasses, contact

  6  lenses, or other optical devices shall be kept on file for a

  7  period of 2 years with the optical establishment that fills

  8  such prescription.  However, the licensed optician may

  9  maintain a copy of the prescription.

10         (2)  Upon request by the intended user of the

11  prescribed lenses, spectacles, eyeglasses, contact lenses, or

12  other optical devices, or by an agent of the intended user,

13  the optician who fills the original prescription shall

14  duplicate, on a form prescribed by rule of the board, the

15  original prescription. However, for medical reasons only, the

16  prescribing allopathic or osteopathic physician medical doctor

17  or optometrist may, upon the original prescription, prohibit

18  its duplication.  Any duplication shall be considered a valid

19  prescription to be filled for a period of 5 years from the

20  date of the original prescription, except that a contact lens

21  prescription shall be considered a valid prescription to be

22  filled for a period of 2 years from the date of the original

23  prescription.

24         Section 120.  Section 484.013, Florida Statutes, is

25  amended to read:

26         484.013  Violations and penalties.--

27         (1)  It is unlawful for any person:

28         (a)  To make a false or fraudulent statement, either

29  for herself or himself or for another person, in any

30  application, affidavit, or statement presented to the board or

31  in any proceeding before the board.


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  1         (b)  To prepare or dispense lenses, spectacles,

  2  eyeglasses, contact lenses, or other optical devices when such

  3  person is not licensed as an optician in this state.

  4         (c)  To prepare or dispense lenses, spectacles,

  5  eyeglasses, contact lenses, or other optical devices without

  6  first being furnished with a prescription as provided for in

  7  s. 484.012.

  8         (2)  It is unlawful for any person other than an

  9  optician licensed under this part to use the title "optician"

10  or otherwise lead the public to believe that she or he is

11  engaged in the practice of opticianry.

12         (3)  It is unlawful for any optician to engage in the

13  diagnosis of the human eyes, attempt to determine the

14  refractive powers of the human eyes, or, in any manner,

15  attempt to prescribe for or treat diseases or ailments of

16  human beings.

17         (4)  It is unlawful for any person to open or operate,

18  either alone or with any other person or persons, an optical

19  establishment which does not have the permit required by this

20  part.

21         (5)(a)  Except as otherwise provided in paragraph (b),

22  a Any person who violates any a provision of this section

23  commits a misdemeanor of the second degree, punishable as

24  provided in s. 775.082 or s. 775.083.

25         (b)  A person who knowingly violates paragraph (1)(c)

26  commits a felony of the third degree, punishable as provided

27  in s. 775.082, s. 775.083, or s. 775.084.

28         Section 121.  Paragraph (g) of subsection (3) of

29  section 921.0022, Florida Statutes, is amended to read:

30         921.0022  Criminal Punishment Code; offense severity

31  ranking chart.--


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    CS for SB 1558                                Second Engrossed



  1         (3)  OFFENSE SEVERITY RANKING CHART

  2  

  3  Florida           Felony

  4  Statute           Degree             Description

  5  

  6                     

  7                              (g)  LEVEL 7

  8  316.193(3)(c)2.    3rd      DUI resulting in serious bodily

  9                              injury.

10  327.35(3)(c)2.     3rd      Vessel BUI resulting in serious

11                              bodily injury.

12  402.319(2)         2nd      Misrepresentation and negligence

13                              or intentional act resulting in

14                              great bodily harm, permanent

15                              disfiguration, permanent

16                              disability, or death.

17  409.920(2)         3rd      Medicaid provider fraud.

18  456.065(2)         3rd      Practicing a health care

19                              profession without a license.

20  456.065(2)         2nd      Practicing a health care

21                              profession without a license

22                              which results in serious bodily

23                              injury.

24  458.327(1)         3rd      Practicing medicine without a

25                              license.

26  459.013(1)         3rd      Practicing osteopathic medicine

27                              without a license.

28  460.411(1)         3rd      Practicing chiropractic medicine

29                              without a license.

30  461.012(1)         3rd      Practicing podiatric medicine

31                              without a license.


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  1  462.17             3rd      Practicing naturopathy without a

  2                              license.

  3  463.015(1)         3rd      Practicing optometry without a

  4                              license.

  5  464.016(1)         3rd      Practicing nursing without a

  6                              license.

  7  465.015(2)         3rd      Practicing pharmacy without a

  8                              license.

  9  466.026(1)         3rd      Practicing dentistry or dental

10                              hygiene without a license.

11  467.201            3rd      Practicing midwifery without a

12                              license.

13  468.366            3rd      Delivering respiratory care

14                              services without a license.

15  483.828(1)         3rd      Practicing as clinical laboratory

16                              personnel without a license.

17  483.901(9)         3rd      Practicing medical physics

18                              without a license.

19  484.013(1)(c)      3rd      Preparing or dispensing optical

20                              devices without a prescription.

21  484.053            3rd      Dispensing hearing aids without a

22                              license.

23  494.0018(2)        1st      Conviction of any violation of

24                              ss. 494.001-494.0077 in which the

25                              total money and property

26                              unlawfully obtained exceeded

27                              $50,000 and there were five or

28                              more victims.

29  

30  

31  


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  1  560.123(8)(b)1.    3rd      Failure to report currency or

  2                              payment instruments exceeding

  3                              $300 but less than $20,000 by

  4                              money transmitter.

  5  560.125(5)(a)      3rd      Money transmitter business by

  6                              unauthorized person, currency or

  7                              payment instruments exceeding

  8                              $300 but less than $20,000.

  9  655.50(10)(b)1.    3rd      Failure to report financial

10                              transactions exceeding $300 but

11                              less than $20,000 by financial

12                              institution.

13  782.051(3)         2nd      Attempted felony murder of a

14                              person by a person other than the

15                              perpetrator or the perpetrator of

16                              an attempted felony.

17  782.07(1)          2nd      Killing of a human being by the

18                              act, procurement, or culpable

19                              negligence of another

20                              (manslaughter).

21  782.071            2nd      Killing of human being or viable

22                              fetus by the operation of a motor

23                              vehicle in a reckless manner

24                              (vehicular homicide).

25  782.072            2nd      Killing of a human being by the

26                              operation of a vessel in a

27                              reckless manner (vessel

28                              homicide).

29  784.045(1)(a)1.    2nd      Aggravated battery; intentionally

30                              causing great bodily harm or

31                              disfigurement.


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  1  784.045(1)(a)2.    2nd      Aggravated battery; using deadly

  2                              weapon.

  3  784.045(1)(b)      2nd      Aggravated battery; perpetrator

  4                              aware victim pregnant.

  5  784.048(4)         3rd      Aggravated stalking; violation of

  6                              injunction or court order.

  7  784.07(2)(d)       1st      Aggravated battery on law

  8                              enforcement officer.

  9  784.08(2)(a)       1st      Aggravated battery on a person 65

10                              years of age or older.

11  784.081(1)         1st      Aggravated battery on specified

12                              official or employee.

13  784.082(1)         1st      Aggravated battery by detained

14                              person on visitor or other

15                              detainee.

16  784.083(1)         1st      Aggravated battery on code

17                              inspector.

18  790.07(4)          1st      Specified weapons violation

19                              subsequent to previous conviction

20                              of s. 790.07(1) or (2).

21  790.16(1)          1st      Discharge of a machine gun under

22                              specified circumstances.

23  790.166(3)         2nd      Possessing, selling, using, or

24                              attempting to use a hoax weapon

25                              of mass destruction.

26  796.03             2nd      Procuring any person under 16

27                              years for prostitution.

28  800.04(5)(c)1.     2nd      Lewd or lascivious molestation;

29                              victim less than 12 years of age;

30                              offender less than 18 years.

31  


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  1  800.04(5)(c)2.     2nd      Lewd or lascivious molestation;

  2                              victim 12 years of age or older

  3                              but less than 16 years; offender

  4                              18 years or older.

  5  806.01(2)          2nd      Maliciously damage structure by

  6                              fire or explosive.

  7  810.02(3)(a)       2nd      Burglary of occupied dwelling;

  8                              unarmed; no assault or battery.

  9  810.02(3)(b)       2nd      Burglary of unoccupied dwelling;

10                              unarmed; no assault or battery.

11  810.02(3)(d)       2nd      Burglary of occupied conveyance;

12                              unarmed; no assault or battery.

13  812.014(2)(a)      1st      Property stolen, valued at

14                              $100,000 or more; property stolen

15                              while causing other property

16                              damage; 1st degree grand theft.

17  812.019(2)         1st      Stolen property; initiates,

18                              organizes, plans, etc., the theft

19                              of property and traffics in

20                              stolen property.

21  812.131(2)(a)      2nd      Robbery by sudden snatching.

22  812.133(2)(b)      1st      Carjacking; no firearm, deadly

23                              weapon, or other weapon.

24  825.102(3)(b)      2nd      Neglecting an elderly person or

25                              disabled adult causing great

26                              bodily harm, disability, or

27                              disfigurement.

28  825.1025(2)        2nd      Lewd or lascivious battery upon

29                              an elderly person or disabled

30                              adult.

31  


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  1  825.103(2)(b)      2nd      Exploiting an elderly person or

  2                              disabled adult and property is

  3                              valued at $20,000 or more, but

  4                              less than $100,000.

  5  827.03(3)(b)       2nd      Neglect of a child causing great

  6                              bodily harm, disability, or

  7                              disfigurement.

  8  827.04(3)          3rd      Impregnation of a child under 16

  9                              years of age by person 21 years

10                              of age or older.

11  837.05(2)          3rd      Giving false information about

12                              alleged capital felony to a law

13                              enforcement officer.

14  872.06             2nd      Abuse of a dead human body.

15  893.13(1)(c)1.     1st      Sell, manufacture, or deliver

16                              cocaine (or other drug prohibited

17                              under s. 893.03(1)(a), (1)(b),

18                              (1)(d), (2)(a), (2)(b), or

19                              (2)(c)4.) within 1,000 feet of a

20                              child care facility or school.

21  893.13(1)(e)1.     1st      Sell, manufacture, or deliver

22                              cocaine or other drug prohibited

23                              under s. 893.03(1)(a), (1)(b),

24                              (1)(d), (2)(a), (2)(b), or

25                              (2)(c)4., within 1,000 feet of

26                              property used for religious

27                              services or a specified business

28                              site.

29  

30  

31  


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  1  893.13(4)(a)       1st      Deliver to minor cocaine (or

  2                              other s. 893.03(1)(a), (1)(b),

  3                              (1)(d), (2)(a), (2)(b), or

  4                              (2)(c)4. drugs).

  5  893.135(1)(a)1.    1st      Trafficking in cannabis, more

  6                              than 50 lbs., less than 2,000

  7                              lbs.

  8  893.135

  9   (1)(b)1.a.        1st      Trafficking in cocaine, more than

10                              28 grams, less than 200 grams.

11  893.135

12   (1)(c)1.a.        1st      Trafficking in illegal drugs,

13                              more than 4 grams, less than 14

14                              grams.

15  893.135

16   (1)(d)1.          1st      Trafficking in phencyclidine,

17                              more than 28 grams, less than 200

18                              grams.

19  893.135(1)(e)1.    1st      Trafficking in methaqualone, more

20                              than 200 grams, less than 5

21                              kilograms.

22  893.135(1)(f)1.    1st      Trafficking in amphetamine, more

23                              than 14 grams, less than 28

24                              grams.

25  893.135

26   (1)(g)1.a.        1st      Trafficking in flunitrazepam, 4

27                              grams or more, less than 14

28                              grams.

29  

30  

31  


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  1  893.135

  2   (1)(h)1.a.        1st      Trafficking in

  3                              gamma-hydroxybutyric acid (GHB),

  4                              1 kilogram or more, less than 5

  5                              kilograms.

  6  893.135

  7   (1)(i)1.a.        1st      Trafficking in 1,4-Butanediol, 1

  8                              kilogram or more, less then 5

  9                              kilograms.

10  893.135

11   (1)(j)2.a.        1st      Trafficking in Phenethylamines,

12                              10 grams or more, less than 200

13                              grams.

14  896.101(5)(a)      3rd      Money laundering, financial

15                              transactions exceeding $300 but

16                              less than $20,000.

17  896.104(4)(a)1.    3rd      Structuring transactions to evade

18                              reporting or registration

19                              requirements, financial

20                              transactions exceeding $300 but

21                              less than $20,000.

22         Section 122.  Section 484.015, Florida Statutes, is

23  amended to read:

24         484.015  Authority to inspect.--Duly authorized agents

25  and employees of the department shall have the power to

26  inspect in a lawful manner at all reasonable hours an any

27  establishment of any kind in the state in which lenses,

28  spectacles, eyeglasses, contact lenses, and any other optical

29  devices are prepared or and dispensed, for the purposes of:

30         (1)  Determining if any provision of this part, or any

31  rule promulgated under its authority, is being violated;


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  1         (2)  Securing samples or specimens of any lenses,

  2  spectacles, eyeglasses, contact lenses, or other optical

  3  devices, after paying or offering to pay for such sample or

  4  specimen; or

  5         (3)  Securing such other evidence as may be needed for

  6  prosecution under this part.

  7         Section 123.  Subsection (1) of section 484.0445,

  8  Florida Statutes, is amended to read:

  9         484.0445  Training program.--

10         (1)  The board shall establish by rule a training

11  program for a minimum not to exceed 6 months in length, which

12  may include a board-approved home study course.  Upon

13  submitting to the department the registration fee, the

14  applicant may register and enter the training program.  Upon

15  completion of the training program, the trainee shall take the

16  first available written and practical examinations offered by

17  the department.  The department shall administer the written

18  and practical examinations as prescribed by board rule.  If

19  the trainee fails either the written or the practical

20  examination, she or he may repeat the training program one

21  time and retake the failed examination, provided she or he

22  takes the next available examination.  No person may remain in

23  trainee status or further perform any services authorized for

24  a trainee if she or he fails either the written or the

25  practical examination twice; but, a trainee may continue to

26  function as a trainee until she or he has received the results

27  of the examinations.  Any applicant who has failed an

28  examination twice and is no longer functioning as a trainee

29  shall be eligible for reexamination as provided in s.

30  484.045(2).

31  


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  1         Section 124.  Section 484.045, Florida Statutes, is

  2  amended to read:

  3         484.045  Licensure by examination.--

  4         (1)  Any person desiring to be licensed as a hearing

  5  aid specialist shall apply to the department on a form

  6  approved by the department to take the licensure examination,

  7  which shall include a clinical practical component.

  8         (2)  The department shall license examine each

  9  applicant who the board certifies:

10         (a)  Has completed the application form and remitted

11  the required fees applicable fee to the board and has paid the

12  examination fee;

13         (b)  Is of good moral character;

14         (c)  Is 18 years of age or older;

15         (d)  Is a graduate of an accredited high school or its

16  equivalent; and

17         (e)1.  Has met the requirements of the training program

18  set forth in s. 484.0445; or

19         2.a.  Has a valid, current license as a hearing aid

20  specialist or its equivalent from another state and has been

21  actively practicing in such capacity for at least 12 months;

22  or

23         b.  Is currently certified by the National Board for

24  Certification in Hearing Instrument Sciences and has been

25  actively practicing for at least 12 months. Persons qualifying

26  under this sub-subparagraph need not take the written or

27  practical examination, but must take and pass a test on

28  Florida laws and rules relating to the fitting and dispensing

29  of hearing aids.

30         (f)  Has passed an examination, as prescribed by board

31  rule; and


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  1         (g)  Has demonstrated, in a manner designated by rule

  2  of the board, knowledge of state laws and rules relating to

  3  the fitting and dispensing of hearing aids.

  4         (3)  A person who fails the examination may make

  5  application for reexamination to the appropriate examining

  6  entity, as prescribed by board rule.

  7         (2)  On or after October 1, 1990, every applicant who

  8  is qualified to take the examination shall be allowed to take

  9  the examination three times. If, after October 1, 1990, an

10  applicant fails the examination three times, the applicant

11  shall no longer be eligible to take the examination.

12         (3)  The department shall issue a license to practice

13  dispensing hearing aids to any applicant who successfully

14  completes the examination in accordance with this section.

15         Section 125.  Effective January 1, 2002, subsection (1)

16  of section 490.012, Florida Statutes, is amended to read:

17         490.012  Violations; penalties; injunction.--

18         (1)(a)  No person shall hold herself or himself out by

19  any professional title, name, or description incorporating the

20  word "psychologist" unless such person holds a valid, active

21  license as a psychologist under this chapter.

22         (b)  No person shall hold herself or himself out by any

23  professional title, name, or description incorporating the

24  words "school psychologist" unless such person holds a valid,

25  active license as a school psychologist under this chapter or

26  is certified as a school psychologist by the Department of

27  Education.

28         (c)(1)(a)  No person shall hold herself or himself out

29  by any title or description incorporating the words, or

30  permutations of them, "psychologist," "psychology,"

31  "psychological," "psychodiagnostic," or "school psychologist,"


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  1  or describe any test or report as psychological, unless such

  2  person holds a valid, active license under this chapter or is

  3  exempt from the provisions of this chapter.

  4         (d)(b)  No person shall hold herself or himself out by

  5  any title or description incorporating the word, or a

  6  permutation of the word, "psychotherapy" unless such person

  7  holds a valid, active license under chapter 458, chapter 459,

  8  chapter 490, or chapter 491, or such person is certified as an

  9  advanced registered nurse practitioner, pursuant to s.

10  464.012, who has been determined by the Board of Nursing as a

11  specialist in psychiatric mental health.

12         (e)(c)  No person licensed or provisionally licensed

13  pursuant to this chapter shall hold herself or himself out by

14  any title or description which indicates licensure other than

15  that which has been granted to her or him.

16         Section 126.  Effective January 1, 2002, Florida

17  Statutes, is amended to read:

18         490.014  Exemptions.--

19         (1)(a)  No provision of this chapter shall be construed

20  to limit the practice of physicians licensed pursuant to

21  chapter 458 or chapter 459 so long as they do not hold

22  themselves out to the public as psychologists or use a

23  professional title protected by this chapter.

24         (b)  No provision of this chapter shall be construed to

25  limit the practice of nursing, clinical social work, marriage

26  and family therapy, mental health counseling, or other

27  recognized businesses or professions, or to prevent qualified

28  members of other professions from doing work of a nature

29  consistent with their training, so long as they do not hold

30  themselves out to the public as psychologists or use a title

31  or description protected by this chapter.  Nothing in this


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  1  subsection shall be construed to exempt any person from the

  2  provisions of s. 490.012.

  3         (2)  No person shall be required to be licensed or

  4  provisionally licensed under this chapter who:

  5         (a)  Is a salaried employee of a government agency;

  6  developmental services program, mental health, alcohol, or

  7  drug abuse facility operating pursuant to chapter 393, chapter

  8  394, or chapter 397; subsidized child care program, subsidized

  9  child care case management program, or child care resource and

10  referral program operating pursuant to chapter 402;

11  child-placing or child-caring agency licensed pursuant to

12  chapter 409; domestic violence center certified pursuant to

13  chapter 39; accredited academic institution; or research

14  institution, if such employee is performing duties for which

15  he or she was trained and hired solely within the confines of

16  such agency, facility, or institution, so long as the employee

17  is not held out to the public as a psychologist pursuant to s.

18  490.012(1)(a) .

19         (b)  Is a salaried employee of a private, nonprofit

20  organization providing counseling services to children, youth,

21  and families, if such services are provided for no charge, if

22  such employee is performing duties for which he or she was

23  trained and hired, so long as the employee is not held out to

24  the public as a psychologist pursuant to s. 490.012(1)(a).

25         (c)  Is a student who is pursuing a course of study

26  which leads to a degree in medicine or a profession regulated

27  by this chapter who is providing services in a training

28  setting, provided such activities or services constitute part

29  of a supervised course of study, or is a graduate accumulating

30  the experience required for any licensure under this chapter,

31  provided such graduate or student is designated by a title


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  1  such as "intern" or "trainee" which clearly indicates the

  2  in-training status of the student.

  3         (d)  Is certified in school psychology by the

  4  Department of Education and is performing psychological

  5  services as an employee of a public or private educational

  6  institution.  Such exemption shall not be construed to

  7  authorize any unlicensed practice which is not performed as a

  8  direct employee of an educational institution.

  9         (e)  Is not a resident of the state but offers services

10  in this state, provided:

11         1.  Such services are performed for no more than 5 days

12  in any month and no more than 15 days in any calendar year;

13  and

14         2.  Such nonresident is licensed or certified by a

15  state or territory of the United States, or by a foreign

16  country or province, the standards of which were, at the date

17  of his or her licensure or certification, equivalent to or

18  higher than the requirements of this chapter in the opinion of

19  the department or, in the case of psychologists, in the

20  opinion of the board.

21         (f)  Is a rabbi, priest, minister, or member of the

22  clergy of any religious denomination or sect when engaging in

23  activities which are within the scope of the performance of

24  his or her regular or specialized ministerial duties and for

25  which no separate charge is made, or when such activities are

26  performed, with or without charge, for or under the auspices

27  or sponsorship, individually or in conjunction with others, of

28  an established and legally cognizable church, denomination, or

29  sect, and when the person rendering service remains

30  accountable to the established authority thereof.

31  


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  1         (3)  No provision of this chapter shall be construed to

  2  limit the practice of any individual who solely engages in

  3  behavior analysis so long as he or she does not hold himself

  4  or herself out to the public as possessing a license issued

  5  pursuant to this chapter or use a title or description

  6  protected by this chapter.

  7         (4)  Nothing in this section shall exempt any person

  8  from the provisions provision of s. 490.012(1)(a)-(b) (a)-(b).

  9         (5)  Except as stipulated by the board, the exemptions

10  contained in this section do not apply to any person licensed

11  under this chapter whose license has been suspended or revoked

12  by the board or another jurisdiction.

13         Section 127.  Effective January 1, 2002, paragraphs

14  (i), (j), and (k) of subsection (1) of section 491.012,

15  Florida Statutes, are amended to read:

16         491.012  Violations; penalty; injunction.--

17         (1)  It is unlawful and a violation of this chapter for

18  any person to:

19         (i)  Practice clinical social work in this state, as

20  the practice is defined in s. 491.003(7), for compensation,

21  unless the person holds a valid, active license to practice

22  clinical social work issued pursuant to this chapter or is an

23  intern registered pursuant to s. 491.0045.

24         (j)  Practice marriage and family therapy in this

25  state, as the practice is defined in s. 491.003(8), for

26  compensation, unless the person holds a valid, active license

27  to practice marriage and family therapy issued pursuant to

28  this chapter or is an intern registered pursuant to s.

29  491.0045.

30         (k)  Practice mental health counseling in this state,

31  as the practice is defined in s. 491.003(9), for compensation,


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  1  unless the person holds a valid, active license to practice

  2  mental health counseling issued pursuant to this chapter or is

  3  an intern registered pursuant to s. 491.0045.

  4         Section 128.  Effective January 1, 2002, paragraphs (a)

  5  and (b) of subsection (4) of section 491.014, Florida

  6  Statutes, are amended to read:

  7         491.014  Exemptions.--

  8         (4)  No person shall be required to be licensed,

  9  provisionally licensed, registered, or certified under this

10  chapter who:

11         (a)  Is a salaried employee of a government agency;

12  developmental services program, mental health, alcohol, or

13  drug abuse facility operating pursuant to chapter 393, chapter

14  394, or chapter 397; subsidized child care program, subsidized

15  child care case management program, or child care resource and

16  referral program operating pursuant to chapter 402;

17  child-placing or child-caring agency licensed pursuant to

18  chapter 409; domestic violence center certified pursuant to

19  chapter 39; accredited academic institution; or research

20  institution, if such employee is performing duties for which

21  he or she was trained and hired solely within the confines of

22  such agency, facility, or institution, so long as the employee

23  is not held out to the public as a clinical social worker,

24  mental health counselor, or marriage and family therapist.

25         (b)  Is a salaried employee of a private, nonprofit

26  organization providing counseling services to children, youth,

27  and families, if such services are provided for no charge, if

28  such employee is performing duties for which he or she was

29  trained and hired, so long as the employee is not held out to

30  the public as a clinical social worker, mental health

31  counselor, or marriage and family therapist.


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  1         Section 129.  Subsection (4) of section 458.319,

  2  Florida Statutes, is amended to read:

  3         458.319  Renewal of license.--

  4         (4)  Notwithstanding the provisions of s. 456.033, a

  5  physician may complete continuing education on end-of-life

  6  care and palliative health care in lieu of continuing

  7  education in AIDS/HIV, if that physician has completed the

  8  AIDS/HIV continuing education in the immediately preceding

  9  biennium.

10         Section 130.  Subsection (5) of section 459.008,

11  Florida Statutes, is amended to read:

12         459.008  Renewal of licenses and certificates.--

13         (5)  Notwithstanding the provisions of s. 456.033, an

14  osteopathic physician may complete continuing education on

15  end-of-life and palliative health care in lieu of continuing

16  education in AIDS/HIV, if that physician has completed the

17  AIDS/HIV continuing education in the immediately preceding

18  biennium.

19         Section 131.  Subsection (4) of section 765.101,

20  Florida Statutes, is amended to read:

21         765.101  Definitions.--As used in this chapter:

22         (4)  "End-stage condition" means an irreversible a

23  condition that is caused by injury, disease, or illness which

24  has resulted in progressively severe and permanent

25  deterioration, indicated by incapacity and complete physical

26  dependency and for which, to a reasonable degree of medical

27  probability certainty, treatment of the irreversible condition

28  would be medically ineffective.

29         Section 132.  Subsection (4) of section 765.102,

30  Florida Statutes, is amended to read:

31         765.102  Legislative findings and intent.--


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  1         (4)  The Legislature recognizes the need for all health

  2  care professionals to rapidly increase their understanding of

  3  end-of-life and palliative health care. Therefore, the

  4  Legislature encourages the professional regulatory boards to

  5  adopt appropriate standards and guidelines regarding

  6  end-of-life care and pain management and encourages

  7  educational institutions established to train health care

  8  professionals and allied health professionals to implement

  9  curricula to train such professionals to provide end-of-life

10  care, including pain management and palliative care.

11         Section 133.  Section 765.1025, Florida Statutes, is

12  created to read:

13         765.1025  Palliative care.--For purposes of this

14  chapter:

15         (1)  Palliative care is the comprehensive management of

16  the physical, psychological, social, spiritual, and

17  existential needs of patients. Palliative care is especially

18  suited to the care of persons who have incurable, progressive

19  illness.

20         (2)  Palliative care must include:

21         (a)  An opportunity to discuss and plan for end-of-life

22  care.

23         (b)  Assurance that physical and mental suffering will

24  be carefully attended to.

25         (c)  Assurance that preferences for withholding and

26  withdrawing life-sustaining interventions will be honored.

27         (d)  Assurance that the personal goals of the dying

28  person will be addressed.

29         (e)  Assurance that the dignity of the dying person

30  will be a priority.

31  


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  1         (f)  Assurance that health care providers will not

  2  abandon the dying person.

  3         (g)  Assurance that the burden to family and others

  4  will be addressed.

  5         (h)  Assurance that advance directives for care will be

  6  respected regardless of the location of care.

  7         (i)  Assurance that organizational mechanisms are in

  8  place to evaluate the availability and quality of end-of-life,

  9  palliative, and hospice care services, including the

10  evaluation of administrative and regulatory barriers.

11         (j)  Assurance that necessary health care services will

12  be provided and that relevant reimbursement policies are

13  available.

14         (k)  Assurance that the goals expressed in paragraphs

15  (a)-(j) will be accomplished in a culturally appropriate

16  manner.

17         Section 134.  Subsection (2) of section 765.1103,

18  Florida Statutes, is amended to read:

19         765.1103  Pain management and palliative care.--

20         (2)  Health care providers and practitioners regulated

21  under chapter 458, chapter 459, or chapter 464 must, as

22  appropriate, comply with a request for pain management or

23  palliative care from a patient under their care or, for an

24  incapacitated patient under their care, from a surrogate,

25  proxy, guardian, or other representative permitted to make

26  health care decisions for the incapacitated patient.

27  Facilities regulated under chapter 400 or chapter 395 must

28  comply with the pain management or palliative care measures

29  ordered by the patient's physician. When the patient is

30  receiving care as an admitted patient of a facility or a

31  provider or is a subscriber of a health care facility, health


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  1  care provider, or health care practitioner regulated under

  2  chapter 395, chapter 400, chapter 458, chapter 459, chapter

  3  464, or chapter 641, such facility, provider, or practitioner

  4  must, when appropriate, comply with a request for pain

  5  management or palliative care from a capacitated patient or an

  6  incapacitated patient's health care surrogate or proxy,

  7  court-appointed guardian as provided in chapter 744, or

  8  attorney in fact as provided in chapter 709. The

  9  court-appointed guardian or attorney in fact must have been

10  delegated authority to make health care decisions on behalf of

11  the patient.

12         Section 135.  Paragraph (b) of subsection (1) of

13  section 765.205, Florida Statutes, is amended to read:

14         765.205  Responsibility of the surrogate.--

15         (1)  The surrogate, in accordance with the principal's

16  instructions, unless such authority has been expressly limited

17  by the principal, shall:

18         (b)  Consult expeditiously with appropriate health care

19  providers to provide informed consent, and make only health

20  care decisions for the principal which he or she believes the

21  principal would have made under the circumstances if the

22  principal were capable of making such decisions. If there is

23  no indication of what the principal would have chosen, the

24  surrogate may consider the patient's best interest in deciding

25  that proposed treatments are to be withheld or that treatments

26  currently in effect are to be withdrawn.

27         Section 136.  Subsections (2) and (3) of section

28  765.401, Florida Statutes, are amended to read:

29         765.401  The proxy.--

30         (2)  Any health care decision made under this part must

31  be based on the proxy's informed consent and on the decision


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  1  the proxy reasonably believes the patient would have made

  2  under the circumstances. If there is no indication of what the

  3  patient would have chosen, the proxy may consider the

  4  patient's best interest in deciding that proposed treatments

  5  are to be withheld or that treatments currently in effect are

  6  to be withdrawn.

  7         (3)  Before exercising the incapacitated patient's

  8  rights to select or decline health care, the proxy must comply

  9  with the provisions of ss. 765.205 and 765.305, except that a

10  proxy's decision to withhold or withdraw life-prolonging

11  procedures must be supported by clear and convincing evidence

12  that the decision would have been the one the patient would

13  have chosen had the patient been competent or, if there is no

14  indication of what the patient would have chosen, that the

15  decision is in the patient's best interest.

16         Section 137.  The Legislature finds that the area of

17  specialty training is of great importance to the citizens of

18  this state and that specialty training and certification

19  creates a higher level of proficiency for the practitioner and

20  improves the delivery of health care to Floridians. Because

21  much confusion exists among the patient population and

22  practitioners as to the requirements for board certification,

23  the Legislature directs the Department of Health to conduct a

24  study of the area of specialty certification relating to the

25  Board of Medicine, the Board of Osteopathic Medicine, and the

26  Board of Dentistry. The study should review current statutes

27  and rules to determine if any barriers exist in board

28  recognition of certifying organizations and if restrictions

29  placed on a licensee's speech both target an identifiable harm

30  and mitigate against such harm in a direct and effective

31  manner. A final report shall be provided no later than January


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  1  1, 2002, to the President of the Senate and the Speaker of the

  2  House of Representatives for distribution to the chairs of the

  3  health-care-related committees.

  4         Section 138.  Paragraph (d) of subsection (2) of

  5  section 499.012, Florida Statutes, is amended to read:

  6         499.012  Wholesale distribution; definitions; permits;

  7  general requirements.--

  8         (2)  The following types of wholesaler permits are

  9  established:

10         (d)  A retail pharmacy wholesaler's permit.  A retail

11  pharmacy wholesaler is a retail pharmacy engaged in wholesale

12  distribution of prescription drugs within this state under the

13  following conditions:

14         1.  The pharmacy must obtain a retail pharmacy

15  wholesaler's permit pursuant to ss. 499.001-499.081 and the

16  rules adopted under those sections.

17         2.  The wholesale distribution activity does not exceed

18  30 percent of the total annual purchases of prescription

19  drugs.  If the wholesale distribution activity exceeds the

20  30-percent maximum, the pharmacy must obtain a prescription

21  drug wholesaler's permit.

22         3.  The transfer of prescription drugs that appear in

23  any schedule contained in chapter 893 is subject to chapter

24  893 and the federal Comprehensive Drug Abuse Prevention and

25  Control Act of 1970.

26         4.  The transfer is between a retail pharmacy and

27  another retail pharmacy, a Modified Class II institutional

28  pharmacy, or a health care practitioner licensed in this state

29  and authorized by law to dispense or prescribe prescription

30  drugs.

31  


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  1         5.  All records of sales of prescription drugs subject

  2  to this section must be maintained separate and distinct from

  3  other records and comply with the recordkeeping requirements

  4  of ss. 499.001-499.081.

  5         Section 139.  The Legislature finds that personal

  6  identifying information, name, age, diagnosis, address, bank

  7  account numbers, and debit and credit card numbers contained

  8  in the records relating to an individual's personal health or

  9  eligibility for health-related services made or received by

10  the individual's physician and public or private health

11  facility should be held confidential.  Furthermore, the

12  Legislature finds that every person has an expectation of and

13  a right to privacy in all matters concerning her or his

14  personal health when medical services are provided. Matters of

15  personal health are traditionally private and confidential

16  concerns between the patient and the health care provider. The

17  private and confidential nature of personal health matters

18  pervades both the public and private sectors. For these

19  reasons, it is the express intent of the Legislature to

20  protect confidential information and the individual's

21  expectations of the right to privacy in all matters regarding

22  her or his personal health and not to have such information

23  exploited for purposes of solicitation or marketing the sale

24  of goods and services.

25         Section 140.  Subsection (5) of section 456.057,

26  Florida Statutes, is amended to read:

27         456.057  Ownership and control of patient records;

28  report or copies of records to be furnished.--

29         (5)(a)  Except as otherwise provided in this section

30  and in s. 440.13(4)(c), such records may not be furnished to,

31  and the medical condition of a patient may not be discussed


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  1  with, any person other than the patient or the patient's legal

  2  representative or other health care practitioners and

  3  providers involved in the care or treatment of the patient,

  4  except upon written authorization of the patient. However,

  5  such records may be furnished without written authorization

  6  under the following circumstances:

  7         1.(a)  To any person, firm, or corporation that has

  8  procured or furnished such examination or treatment with the

  9  patient's consent.

10         2.(b)  When compulsory physical examination is made

11  pursuant to Rule 1.360, Florida Rules of Civil Procedure, in

12  which case copies of the medical records shall be furnished to

13  both the defendant and the plaintiff.

14         3.(c)  In any civil or criminal action, unless

15  otherwise prohibited by law, upon the issuance of a subpoena

16  from a court of competent jurisdiction and proper notice to

17  the patient or the patient's legal representative by the party

18  seeking such records.

19         4.(d)  For statistical and scientific research,

20  provided the information is abstracted in such a way as to

21  protect the identity of the patient or provided written

22  permission is received from the patient or the patient's legal

23  representative.

24         (b)  Absent a specific written release or authorization

25  permitting utilization of patient information for solicitation

26  or marketing the sale of goods or services, any use of that

27  information for those purposes is prohibited.

28         Section 141.  Subsection (7) of section 395.3025,

29  Florida Statutes is amended to read:

30         395.3025  Patient and personnel records; copies;

31  examination.--


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  1         (7)(a)  If the content of any record of patient

  2  treatment is provided under this section, the recipient, if

  3  other than the patient or the patient's representative, may

  4  use such information only for the purpose provided and may not

  5  further disclose any information to any other person or

  6  entity, unless expressly permitted by the written consent of

  7  the patient.  A general authorization for the release of

  8  medical information is not sufficient for this purpose.  The

  9  content of such patient treatment record is confidential and

10  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

11  I of the State Constitution.

12         (b)  Absent a specific written release or authorization

13  permitting utilization of patient information for solicitation

14  or marketing the sale of goods or services, any use of that

15  information for those purposes is prohibited.

16         Section 142.  Subsection (1) of section 400.1415,

17  Florida Statutes, is amended to read:

18         400.1415  Patient records; penalties for alteration.--

19         (1)  Any person who fraudulently alters, defaces, or

20  falsifies any medical record or releases medical records for

21  the purposes of solicitation or marketing the sale of goods or

22  services absent a specific written release or authorization

23  permitting utilization of patient information, or other

24  nursing home record, or causes or procures any of these

25  offenses to be committed, commits a misdemeanor of the second

26  degree, punishable as provided in s. 775.082 or s. 775.083.

27         Section 143.  Section 626.9651, Florida Statutes, is

28  created to read:

29         626.9651  Privacy.--The department shall adopt rules

30  consistent with other provisions of the Florida Insurance Code

31  to govern the use of a consumer's nonpublic personal financial


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  1  and health information. These rules must be based on,

  2  consistent with, and not more restrictive than the Privacy of

  3  Consumer Financial and Health Information Regulation, adopted

  4  September 26, 2000, by the National Association of Insurance

  5  Commissioners; however, the rules must permit the use and

  6  disclosure of nonpublic personal health information for

  7  scientific, medical, or public policy research, in accordance

  8  with federal law. In addition, these rules must be consistent

  9  with, and not more restrictive than, the standards contained

10  in Title V of the Gramm-Leach-Bliley Act of 1999, Pub. L. No.

11  106-102. If the department determines that a health insurer or

12  health maintenance organization is in compliance with, or is

13  actively undertaking compliance with, the consumer privacy

14  protection rules adopted by the United States Department of

15  Health and Human Services, in conformance with the Health

16  Insurance Portability and Affordability Act, that health

17  insurer or health maintenance organization is in compliance

18  with this section.

19         Section 144.  Effective upon becoming law, subsections

20  (14), (15), and (16) are added to section 400.141, Florida

21  Statutes, to read:

22         400.141  Administration and management of nursing home

23  facilities.--Every licensed facility shall comply with all

24  applicable standards and rules of the agency and shall:

25         (14)  Before November 30 of each year, subject to the

26  availability of an adequate supply of the necessary vaccine,

27  provide for immunizations against influenza viruses to all its

28  consenting residents in accordance with the recommendations of

29  the U.S. Centers for Disease Control and Prevention, subject

30  to exemptions for medical contraindications and religious or

31  personal beliefs. Subject to these exemptions, any consenting


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  1  person who becomes a resident of the facility after November

  2  30 but before March 31 of the following year must be immunized

  3  within 5 working days after becoming a resident. Immunization

  4  shall not be provided to any resident who provides

  5  documentation that he or she has been immunized as required by

  6  this subsection. This subsection does not prohibit a resident

  7  from receiving the immunization from his or her personal

  8  physician if he or she so chooses. A resident who chooses to

  9  receive the immunization from his or her personal physician

10  shall provide proof of immunization to the facility. The

11  agency may adopt and enforce any rules necessary to comply

12  with or implement this subsection.

13         (15)  Assess all residents for eligibility for

14  pneumococcal polysaccharide vaccination (PPV) and vaccinate

15  residents when indicated within 60 days after the effective

16  date of this act in accordance with the recommendations of the

17  U.S. Centers for Disease Control and Prevention, subject to

18  exemptions for medical contraindications and religious or

19  personal beliefs. Residents admitted after the effective date

20  of this act shall be assessed within 5 working days of

21  admission and, when indicated, vaccinated within 60 days in

22  accordance with the recommendations of the United States

23  Centers for Disease Control and Prevention, subject to

24  exemptions for medical contradictions and religious or

25  personal beliefs. Immunization shall not be provided to any

26  resident who provides documentation that he or she has been

27  immunized as required by this subsection. This subsection does

28  not prohibit a resident from receiving the immunization from

29  his or her personal physician if he or she so chooses. A

30  resident who chooses to receive the immunization from his or

31  her personal physician shall provide proof of immunization to


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  1  the facility. The agency may adopt and enforce any rules

  2  necessary to comply with or implement this subsection.

  3         (16)  Annually encourage and promote to its employees

  4  the benefits associated with immunizations against influenza

  5  viruses in accordance with the recommendations of the U.S.

  6  Centers for Disease Control and Prevention. The agency may

  7  adopt and enforce any rules necessary to comply with or

  8  implement this subsection.

  9  

10  Facilities that have been awarded a Gold Seal under the

11  program established in s. 400.235 may develop a plan to

12  provide certified nursing assistant training as prescribed by

13  federal regulations and state rules and may apply to the

14  agency for approval of its program.

15         Section 145.  There is established the Office of

16  Community Partners within the Department of Health for the

17  purpose of receiving, coordinating, and dispensing federal

18  funds set aside to expand the delivery of social services

19  through eligible private community organizations and programs.

20  The office shall provide policy direction and promote civic

21  initiatives which seek to preserve and strengthen families and

22  communities. The Department of Health, the Department of

23  Children and Family Services, the Department of Juvenile

24  Justice, and the Department of Corrections may request

25  transfer of general revenue funds between agencies, as

26  approved by the Legislative Budget Commission, as necessary to

27  match federal funds received by the Office of Community

28  Partners for these initiatives.

29         Section 146.  Section 458.3147, Florida Statutes, is

30  created to read:

31  


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  1         458.3147  Medical school eligibility of military

  2  academy students or graduates.--Any Florida resident who is a

  3  student at or a graduate of any of the United States military

  4  academies who has command approval to apply to medical school

  5  prior to assignment to the medical corps of the United States

  6  military shall be admitted to any medical school in the State

  7  University System. Each medical school in the State University

  8  System shall admit two such applicants each academic year.

  9         Section 147.  Section 409.91188, Florida Statutes, is

10  amended to read:

11         409.91188  Specialty prepaid health plans for Medicaid

12  recipients with HIV or AIDS.--The Agency for Health Care

13  Administration is authorized to contract with specialty

14  prepaid health plans and pay them on a prepaid capitated basis

15  to provide Medicaid benefits to Medicaid-eligible recipients

16  who have human immunodeficiency syndrome (HIV) or acquired

17  immunodeficiency syndrome (AIDS). The agency shall apply for

18  and is authorized to implement federal waivers or other

19  necessary federal authorization to implement the prepaid

20  health plans authorized by this section. The agency shall

21  procure the specialty prepaid health plans through a

22  competitive procurement. In awarding a contract to a managed

23  care plan, the agency shall take into account price, quality,

24  accessibility, linkages to community-based organizations, and

25  the comprehensiveness of the benefit package offered by the

26  plan. The agency may bid the HIV/AIDS specialty plans on a

27  county, regional, or statewide basis. Qualified plans must be

28  licensed under chapter 641. The agency shall monitor and

29  evaluate the implementation of this waiver program if it is

30  approved by the Federal Government and shall report on its

31  status to the President of the Senate and the Speaker of the


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  1  House of Representatives by February 1, 2001. To improve

  2  coordination of medical care delivery and to increase

  3  cost-efficiency for the Medicaid program in treating HIV

  4  disease, the Agency for Healthcare Administration shall seek

  5  all necessary federal waivers to allow participation in the

  6  Medipass HIV disease management program for Medicare

  7  beneficiaries who test positive for HIV infection and who also

  8  qualify for Medicaid benefits such as prescription medications

  9  not covered by Medicare.

10         Section 148.  Effective June 1, 2001, subsection (1) of

11  section 71 of chapter 98-171, Laws of Florida, is repealed.

12         Section 149.  Effective July 1, 2001, and applicable to

13  births occurring on or after that date, subsection (2) of

14  section 766.302, Florida Statutes, is amended to read:

15         766.302  Definitions; ss. 766.301-766.316.--As used in

16  ss. 766.301-766.316, the term:

17         (2)  "Birth-related neurological injury" means injury

18  to the brain or spinal cord of a live infant weighing at least

19  2,500 grams for a single gestation or, in the case of a

20  multiple gestation, a live infant weighing at least 2,000

21  grams at birth caused by oxygen deprivation or mechanical

22  injury occurring in the course of labor, delivery, or

23  resuscitation in the immediate postdelivery period in a

24  hospital, which renders the infant permanently and

25  substantially mentally and physically impaired.  This

26  definition shall apply to live births only and shall not

27  include disability or death caused by genetic or congenital

28  abnormality.

29         Section 150.  Effective July 1, 2001, and applicable to

30  births occurring on or after that date, paragraph (b) of

31  


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  1  subsection (1) of section 766.31, Florida Statutes, is amended

  2  to read:

  3         766.31  Administrative law judge awards for

  4  birth-related neurological injuries; notice of award.--

  5         (1)  Upon determining that an infant has sustained a

  6  birth-related neurological injury and that obstetrical

  7  services were delivered by a participating physician at the

  8  birth, the administrative law judge shall make an award

  9  providing compensation for the following items relative to

10  such injury:

11         (b)1.  Periodic payments of an award to the parents or

12  legal guardians of the infant found to have sustained a

13  birth-related neurological injury, which award shall not

14  exceed $100,000. However, at the discretion of the

15  administrative law judge, such award may be made in a lump

16  sum.

17         2.  Payment for funeral expenses not to exceed $1,500.

18         Section 151.  Section 766.308, Florida Statutes, is

19  repealed.

20         Section 152.  Section 468.805, Florida Statutes, is

21  amended to read:

22         468.805  Grandfathering.--

23         (1)(a)  A person who has practiced orthotics,

24  prosthetics, or pedorthics in this state for the required

25  period between since July 1, 1990, and March 1, 1998, who,

26  before March 1, 1998, applied applies to the department for a

27  license to practice orthotics, prosthetics, or pedorthics, and

28  who received certification in orthotics, prosthetics, or

29  pedorthics from a national certifying body and had his or her

30  application fully approved by the board before October 1,

31  2000, may be licensed as a prosthetist, an orthotist, a


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    CS for SB 1558                                Second Engrossed



  1  prosthetist-orthotist, an orthotic fitter, an orthotic fitter

  2  assistant, or a pedorthist, as applicable determined from the

  3  person's experience, certification, and educational

  4  preparation, without meeting the educational requirements set

  5  forth in s. 468.803, upon receipt of the application fee and

  6  licensing fee and after the board has completed an

  7  investigation into the applicant's background and experience.

  8  The board shall require an application fee not to exceed $500,

  9  which shall be nonrefundable. The board shall complete its

10  investigation within 6 months after receipt of the completed

11  application.

12         (b)  The period of experience required for licensure

13  under this subsection section is 5 years for a prosthetist or

14  an orthotist and; 2 years for an orthotic fitter, an orthotic

15  fitter assistant, or a pedorthist. Each applicant shall

16  document experience in the; and 5 years for an orthotist whose

17  scope of practice for the profession applied for as is defined

18  under s. 468.80(7).

19         (2)(a)  An applicant for licensure as an orthotist, a

20  prosthetist, or a prosthetist-orthotist who cannot demonstrate

21  5 years of experience as required by subsection (1), but who

22  has practiced as an orthotist, a prosthetist, or a

23  prosthetist-orthotist in this state for at least 2 years

24  between July 1, 1990, and March 1, 1998, and A person who has

25  received certification as an orthotist, a prosthetist, or a

26  prosthetist-orthotist from a national certifying body before

27  July 1, 1998, and who has practiced orthotics or prosthetics

28  in this state for at least 2 years but less than 5 years is

29  eligible for a provisional license.

30         (b)  An applicant for provisional licensure shall

31  submit proof that he or she has been actively practicing as a


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    CS for SB 1558                                Second Engrossed



  1  nationally certified orthotist, prosthetist, or

  2  prosthetist-orthotist, an application fee, and a provisional

  3  license fee.

  4         (b)(c)  A provisional licensee is required to practice

  5  under supervision of a fully licensed orthotist, prosthetist,

  6  or prosthetist-orthotist for up to 3 years in order to meet

  7  the 5-year experience requirement of subsection (1) to be

  8  licensed as an orthotist, a prosthetist, or a

  9  prosthetist-orthotist. The provisional licensee must

10  demonstrate that the supervised practice includes experience

11  in the scope of practice of the profession as defined under s.

12  468.80.

13         (d)  After appropriate investigation, the board shall

14  license as an orthotist, prosthetist, or prosthetist-orthotist

15  the provisional licensee who has successfully completed the

16  period of experience required and otherwise meets the

17  requirements of subsection (1).

18         (e)  The board shall require an application fee, not to

19  exceed $500, which is nonrefundable, and a provisional

20  licensure fee, not to exceed $500.

21         (3)  Upon receipt of the nonrefundable application fee

22  and the appropriate licensing fee, the board shall complete an

23  investigation into the applicant's background and experience.

24  The board shall complete its investigation within 6 months

25  after receipt of the completed application. The 90-day period

26  for approval or denial of a license required under s. 120.60

27  does not apply to applications for licensure or provisional

28  licensure under this section.

29         (4)  The board by rule shall establish the following

30  fees not to exceed $500 each:

31  


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  1         (a)  Application fee for licensure under subsection

  2  (1).

  3         (b)  Application fee for provisional licensure under

  4  subsection (2).

  5         (c)  Application fee for licensure following

  6  provisional licensure under subsection (2).

  7         (d)  Initial licensure fee.

  8         (e)  Provisional licensure fee.

  9         (5)(3)  An applicant who has received certification as

10  an orthotist, a prosthetist, a prosthetist-orthotist, or a

11  pedorthist from a national certifying body which requires the

12  successful completion of an examination, may be licensed under

13  this section without taking an additional examination. An

14  applicant who has not received certification from a national

15  certifying body which requires the successful completion of an

16  examination shall be required to take an examination as

17  determined by the board. This examination shall be designed to

18  determine if the applicant has the minimum qualifications

19  needed to be licensed under this section. The board may charge

20  an examination fee and the actual per applicant cost to the

21  department for purchase or development of the examination.

22         (6)(4)  An applicant who successfully completed prior

23  to March 1, 1998, at least one-half of the examination

24  required for national certification and successfully completed

25  the remaining portion of the examination and became certified

26  prior to October 1, 2000 July 1, 1998, shall be considered as

27  nationally certified by March 1, 1998, for purposes of this

28  section.

29         (7)(5)  This section is repealed July 1, 2002.

30         Section 153.  Section 1 of chapter 99-158, Laws of

31  Florida, is repealed.


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  1         Section 154.  Except as otherwise provided herein, this

  2  act shall take effect July 1, 2001.

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