House Bill hb0475e2

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                                       CS/HB 475, Second Engrossed



  1                      A bill to be entitled

  2         An act relating to public health; amending ss.

  3         39.201, 63.0423, 383.50, and 827.035, F.S.;

  4         expanding the type of personnel and facilities

  5         that may accept abandoned newborns; providing

  6         implied consent for treatment and transport and

  7         certain immunity from liability; amending s.

  8         154.02, F.S.; specifying purposes for which

  9         reserve amounts must be maintained in the

10         County Health Department Trust Fund; amending

11         s. 232.465, F.S.; expanding the type of

12         personnel that may supervise nonmedical school

13         district personnel; providing technical

14         corrections; amending s. 381.0056, F.S.;

15         providing requirements for school health

16         programs funded by health care districts or

17         certain health care entities; amending s.

18         381.0059, F.S.; revising background screening

19         requirements for school health service

20         personnel; amending s. 381.026, F.S., relating

21         to the Florida Patient's Bill of Rights and

22         Responsibilities; replacing references to the

23         term "physical handicap" with the term

24         "handicap"; amending ss. 382.003, 382.004,

25         382.013, 382.016, and 382.0255, F.S.; modifying

26         provisions relating to vital records; amending

27         s. 383.14, F.S.; requiring postnatal tests and

28         screenings for infant metabolic disorders to be

29         performed by the State Public Health

30         Laboratory; amending s. 383.402, F.S.;

31         modifying the annual report date for child


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                                       CS/HB 475, Second Engrossed



  1         abuse death reviews; creating s. 391.037, F.S.;

  2         providing that the furnishing of medical

  3         services by state employees under specified

  4         conditions does not constitute a conflict of

  5         interest; amending s. 401.113, F.S.; providing

  6         for use of funds in the Emergency Medical

  7         Services Trust Fund for injury prevention

  8         programs; amending s. 401.27, F.S.; authorizing

  9         the Department of Health to define by rule the

10         equivalent of cardiopulmonary resuscitation

11         courses for emergency medical technicians and

12         paramedics; exempting emergency medical

13         services examination questions and answers from

14         discovery; providing conditions for

15         introduction in administrative proceedings;

16         requiring the department to establish rules;

17         repealing s. 404.056(2), F.S., relating to the

18         Florida Coordinating Council on Radon

19         Protection; amending s. 404.056, F.S.; deleting

20         an obsolete environmental radiation

21         soil-testing requirement; clarifying rulemaking

22         authority; amending s. 499.012, F.S.; modifying

23         provisions relating to a retail pharmacy

24         wholesaler's permit to authorize transfer of

25         certain prescription drugs between the

26         permittee and a Modified Class II institutional

27         pharmacy; amending s. 509.049, F.S.; revising

28         provisions related to food service employee

29         training programs; providing for audits and

30         revocation of training program approval;

31         providing rulemaking authority; amending s.


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                                       CS/HB 475, Second Engrossed



  1         742.10, F.S.; requiring a voluntary

  2         acknowledgment of paternity for a child born

  3         out of wedlock to be notarized; amending s.

  4         743.0645, F.S., relating to consent to medical

  5         care or treatment of a minor; providing that a

  6         power of attorney to provide such consent

  7         includes the power to consent to surgical and

  8         general anesthesia services; providing

  9         effective dates.

10

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

12

13         Section 1.  Paragraph (f) of subsection (2) of section

14  39.201, Florida Statutes, is amended to read:

15         39.201  Mandatory reports of child abuse, abandonment,

16  or neglect; mandatory reports of death; central abuse

17  hotline.--

18         (2)

19         (f)  Reports involving abandoned newborn infants as

20  described in s. 383.50 shall be made and received by the

21  department.

22         1.  If the report is of an abandoned newborn infant as

23  described in s. 383.50 and there is no indication of abuse,

24  neglect, or abandonment of the infant other than that

25  necessarily entailed in the infant having been left at a fire

26  station or hospital, emergency medical services station, or

27  fire station, the department shall provide to the caller the

28  name of a licensed child-placing agency on a rotating basis

29  from a list of licensed child-placing agencies eligible and

30  required to accept physical custody of and to place newborn

31  infants left at a hospital, emergency medical services


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                                       CS/HB 475, Second Engrossed



  1  station, or a fire station. The report shall not be considered

  2  a report of abuse, neglect, or abandonment solely because the

  3  infant has been left at a hospital, emergency medical services

  4  station, or fire station pursuant to s. 383.50.

  5         2.  If the caller reports indications of abuse or

  6  neglect beyond that necessarily entailed in the infant having

  7  been left at a fire station or hospital, emergency medical

  8  services station, or fire station, the report shall be

  9  considered as a report of abuse, neglect, or abandonment and

10  shall be subject to the requirements of s. 39.395 and all

11  other relevant provisions of this chapter, notwithstanding any

12  provisions of chapter 383.

13         Section 2.  Subsections (1) and (4), paragraph (c) of

14  subsection (7), and subsection (10) of section 63.0423,

15  Florida Statutes, are amended to read:

16         63.0423  Procedures with respect to abandoned

17  newborns.--

18         (1)  A licensed child-placing agency that takes

19  physical custody of a newborn infant left at a hospital,

20  emergency medical services station, or a fire station pursuant

21  to s. 383.50, shall assume responsibility for all medical

22  costs and all other costs associated with the emergency

23  services and care of the newborn infant from the time the

24  licensed child-placing agency takes physical custody of the

25  newborn infant.

26         (4)  Within 7 days after accepting physical custody of

27  the newborn infant, the licensed child-placing agency shall

28  initiate a diligent search to notify and to obtain consent

29  from a parent whose identity or location is unknown, other

30  than the parent who has left a newborn infant at a fire

31  station or a hospital, emergency medical services station, or


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                                       CS/HB 475, Second Engrossed



  1  fire station in accordance with s. 383.50. The diligent search

  2  must include, at a minimum, inquiries of all known relatives

  3  of the parent, inquiries of all offices or program areas of

  4  the department likely to have information about the parent,

  5  inquiries of other state and federal agencies likely to have

  6  information about the parent, inquiries of appropriate utility

  7  and postal providers and inquiries of appropriate law

  8  enforcement agencies. Constructive notice must also be

  9  provided pursuant to chapter 49 in the county where the

10  newborn infant was left and in the county where the petition

11  to terminate parental rights will be filed. The constructive

12  notice must include at a minimum, available identifying

13  information, and information on whom a parent must contact in

14  order to assert a claim of parental rights of the newborn

15  infant and how to assert that claim. If a parent is identified

16  and located, notice of the adjudicatory hearing shall be

17  provided. If a parent can not be identified or located

18  subsequent to the diligent search and constructive notice, the

19  licensed child-placing agency shall file an affidavit of

20  diligent search at the same time that the petition to

21  terminate parental rights is filed.

22         (7)  If a claim of parental rights of a newborn infant

23  is made before the judgment to terminate parental rights is

24  entered, the circuit court shall hold the action for

25  termination of parental rights pending subsequent adoption in

26  abeyance for a period of time not to exceed 60 days.

27         (c)  The court may not terminate parental rights solely

28  on the basis that the parent left a newborn infant at a

29  hospital, emergency medical services station, or fire station

30  in accordance with s. 383.50.

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                                       CS/HB 475, Second Engrossed



  1         (10)  Except to the extent expressly provided in this

  2  section, proceedings initiated by a licensed child-placing

  3  agency for the termination of parental rights and subsequent

  4  adoption of a newborn left at a hospital, emergency medical

  5  services station, or a fire station in accordance with s.

  6  383.50 shall be conducted pursuant to this chapter 63.

  7         Section 3.  Subsection (5) is added to section 154.02,

  8  Florida Statutes, to read:

  9         154.02  County Health Department Trust Fund.--

10         (5)  At a minimum, the trust fund shall consist of:

11         (a)  An operating reserve, consisting of 8.5 percent of

12  the annual operating budget, maintained to ensure adequate

13  cash flow from nonstate revenue sources.

14         (b)  An emergency reserve of $500,000, derived from an

15  annual assessment on county health department funds based upon

16  their proportionate share of state general revenue, maintained

17  for county health departments to respond to public health

18  emergencies such as epidemics and natural disasters. The

19  emergency reserve shall be increased each July 1 by the

20  increase in the consumer price index that occurred during the

21  previous 12 months.

22         (c)  A fixed capital outlay reserve for nonrecurring

23  expenses that are needed for the renovation and expansion of

24  facilities, and for the construction of new and replacement

25  facilities identified by the Department of Health in

26  conjunction with the board of county commissioners in their

27  annual state-county contract and approved by the secretary of

28  the department. These funds may not be used for construction

29  projects unless there is a specific appropriation included in

30  the General Appropriations Act for this purpose.

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                                       CS/HB 475, Second Engrossed



  1         Section 4.  Subsections (2) and (3) of section 232.465,

  2  Florida Statutes, are amended to read:

  3         232.465  Provision of medical services; restrictions.--

  4         (2)  Nonmedical assistive personnel shall be allowed to

  5  perform health-related services upon successful completion of

  6  child-specific training by a registered nurse or advanced

  7  registered nurse practitioner licensed under chapter 464, a

  8  licensed practical nurse, a physician licensed pursuant to

  9  chapter 458 or chapter 459, or a physician assistant licensed

10  pursuant to chapter 458 or chapter 459.  All procedures shall

11  be monitored periodically by a the nurse, advanced registered

12  nurse practitioner, physician assistant, or physician.  Those

13  procedures include, but are not limited to:

14         (a)  Cleaning Intermittent clean catheterization.

15         (b)  Gastrostomy tube feeding.

16         (c)  Monitoring blood glucose.

17         (d)  Administering emergency injectable medication.

18         (3)  For all other invasive medical services not listed

19  in this section subsection (1) or subsection (2), a registered

20  nurse or advanced registered nurse practitioner licensed under

21  chapter 464, a licensed practical nurse, a physician licensed

22  pursuant to chapter 458 or chapter 459, or a physician

23  assistant licensed pursuant to chapter 458 or chapter 459

24  shall determine if nonmedical school district personnel shall

25  be allowed to perform such service.

26         Section 5.  Subsection (11) is added to section

27  381.0056, Florida Statutes, to read:

28         381.0056  School health services program.--

29         (11)  School health programs funded by health care

30  districts or entities defined in subsection (3) must be

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                                       CS/HB 475, Second Engrossed



  1  supplementary to and consistent with the requirements of this

  2  section and ss. 381.0057 and 381.0059.

  3         Section 6.  Section 381.0059, Florida Statutes, is

  4  amended to read:

  5         381.0059  Background screening requirements for school

  6  health services personnel.--

  7         (1)(a)  Pursuant to the provisions of chapter 435, any

  8  person who provides services under a school health services

  9  plan pursuant to s. 381.0056 must meet complete level 2

10  screening requirements as described in s. 435.04 as provided

11  in chapter 435. A person may satisfy the requirements of this

12  subsection by submitting proof of compliance with the

13  requirements of level 2 screening under s. 435.04, conducted

14  within 12 months before the date that person initially

15  provides services under a school health services plan pursuant

16  to s. 381.0056.

17         (2)  A person may provide Any person who provides

18  services under a school health services plan pursuant to s.

19  381.0056 prior to the completion of level 2 screening.

20  However, shall be on probationary status pending the results

21  of the level 2 screening, such person may not be alone with a

22  minor.

23         (b)  In order to conduct level 2 screening, any person

24  who provides services under a school health services plan

25  pursuant to s. 381.0056 must furnish to the Department of

26  Health a full set of fingerprints to enable the department to

27  conduct a criminal background investigation. Each person who

28  provides services under a school health services plan pursuant

29  to s. 381.0056 must file a complete set of fingerprints taken

30  by an authorized law enforcement officer and must provide

31  sufficient information for a statewide criminal records


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                                       CS/HB 475, Second Engrossed



  1  correspondence check through the Florida Department of Law

  2  Enforcement. The Department of Health shall submit the

  3  fingerprints to the Florida Department of Law Enforcement for

  4  a statewide criminal history check, and the Florida Department

  5  of Law Enforcement shall forward the fingerprints to the

  6  Federal Bureau of Investigation for a national criminal

  7  history check.

  8         (c)  The person subject to the required background

  9  screening or his or her employer must pay the fees required to

10  obtain the background screening. Payment for the screening

11  must be submitted to the Department of Health. The Florida

12  Department of Law Enforcement shall charge the Department of

13  Health for a level 2 screening at a rate sufficient to cover

14  the costs of such screening pursuant to s. 943.053(3). The

15  Department of Health shall establish a schedule of fees to

16  cover the costs of the level 2 screening. The applicant or his

17  or her employer who pays for the required screening may be

18  reimbursed by the Department of Health from funds designated

19  for this purpose.

20         (2)(a)  When the Department of Health has reasonable

21  cause to believe that grounds exist for the disqualification

22  of any person providing services under a school health

23  services plan pursuant to s. 381.0056, as a result of

24  background screening, it shall notify the person in writing,

25  stating the specific record that indicates noncompliance with

26  the level 2 screening standards. The Department of Health must

27  disqualify any person from providing services under a school

28  health services plan pursuant to s. 381.0056 if the department

29  finds that the person is not in compliance with the level 2

30  screening standards. A person who provides services under a

31  school health plan pursuant to s. 381.0056 on a probationary


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                                       CS/HB 475, Second Engrossed



  1  status and who is disqualified because of the results of his

  2  or her background screening may contest that disqualification.

  3         (3)(b)  As provided in s. 435.07, the Department of

  4  Health may grant an exemption from disqualification to provide

  5  a person providing services under a school health services

  6  plan pursuant to s. 381.0056 who has not received a

  7  professional license or certification from the Department of

  8  Health.

  9         (c)  As provided in s. 435.07, the Department of Health

10  may grant an exemption from disqualification to a person

11  providing services under a school health services plan

12  pursuant to s. 381.0056 who has received a professional

13  license or certification from the Department of Health.

14         (3)  Any person who is required to undergo the

15  background screening to provide services under a school health

16  plan pursuant to s. 381.0056 who refuses to cooperate in such

17  screening or refuses to submit the information necessary to

18  complete the screening, including fingerprints, shall be

19  disqualified for employment or volunteering in such position

20  or, if employed, shall be dismissed.

21         (4)  Under penalty of perjury, each person who provides

22  services under a school health plan pursuant to s. 381.0056

23  must attest to meeting the level 2 screening requirements for

24  participation under the plan and agree to inform his or her

25  employer the Department of Health immediately if convicted of

26  any disqualifying offense while providing services under a

27  school health services plan pursuant to s. 381.0056.

28         (5)  As used in this section, the term "person who

29  provides services under a school health services plan"

30  includes unpaid volunteers, except for does not include an

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                                       CS/HB 475, Second Engrossed



  1  unpaid volunteer who lectures students in group settings on

  2  health education topics.

  3         Section 7.  Paragraph (d) of subsection (4) and

  4  subsection (6) of section 381.026, Florida Statutes, are

  5  amended to read:

  6         381.026  Florida Patient's Bill of Rights and

  7  Responsibilities.--

  8         (4)  RIGHTS OF PATIENTS.--Each health care facility or

  9  provider shall observe the following standards:

10         (d)  Access to health care.--

11         1.  A patient has the right to impartial access to

12  medical treatment or accommodations, regardless of race,

13  national origin, religion, physical handicap, or source of

14  payment.

15         2.  A patient has the right to treatment for any

16  emergency medical condition that will deteriorate from failure

17  to provide such treatment.

18         (6)  SUMMARY OF RIGHTS AND RESPONSIBILITIES.--Any

19  health care provider who treats a patient in an office or any

20  health care facility licensed under chapter 395 that provides

21  emergency services and care or outpatient services and care to

22  a patient, or admits and treats a patient, shall adopt and

23  make available to the patient, in writing, a statement of the

24  rights and responsibilities of patients, including the

25  following:

26

27              SUMMARY OF THE FLORIDA PATIENT'S BILL

28                  OF RIGHTS AND RESPONSIBILITIES

29

30         Florida law requires that your health care provider or

31  health care facility recognize your rights while you are


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                                       CS/HB 475, Second Engrossed



  1  receiving medical care and that you respect the health care

  2  provider's or health care facility's right to expect certain

  3  behavior on the part of patients.  You may request a copy of

  4  the full text of this law from your health care provider or

  5  health care facility.  A summary of your rights and

  6  responsibilities follows:

  7         A patient has the right to be treated with courtesy and

  8  respect, with appreciation of his or her individual dignity,

  9  and with protection of his or her need for privacy.

10         A patient has the right to a prompt and reasonable

11  response to questions and requests.

12         A patient has the right to know who is providing

13  medical services and who is responsible for his or her care.

14         A patient has the right to know what patient support

15  services are available, including whether an interpreter is

16  available if he or she does not speak English.

17         A patient has the right to know what rules and

18  regulations apply to his or her conduct.

19         A patient has the right to be given by the health care

20  provider information concerning diagnosis, planned course of

21  treatment, alternatives, risks, and prognosis.

22         A patient has the right to refuse any treatment, except

23  as otherwise provided by law.

24         A patient has the right to be given, upon request, full

25  information and necessary counseling on the availability of

26  known financial resources for his or her care.

27         A patient who is eligible for Medicare has the right to

28  know, upon request and in advance of treatment, whether the

29  health care provider or health care facility accepts the

30  Medicare assignment rate.

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                                       CS/HB 475, Second Engrossed



  1         A patient has the right to receive, upon request, prior

  2  to treatment, a reasonable estimate of charges for medical

  3  care.

  4         A patient has the right to receive a copy of a

  5  reasonably clear and understandable, itemized bill and, upon

  6  request, to have the charges explained.

  7         A patient has the right to impartial access to medical

  8  treatment or accommodations, regardless of race, national

  9  origin, religion, physical handicap, or source of payment.

10         A patient has the right to treatment for any emergency

11  medical condition that will deteriorate from failure to

12  provide treatment.

13         A patient has the right to know if medical treatment is

14  for purposes of experimental research and to give his or her

15  consent or refusal to participate in such experimental

16  research.

17         A patient has the right to express grievances regarding

18  any violation of his or her rights, as stated in Florida law,

19  through the grievance procedure of the health care provider or

20  health care facility which served him or her and to the

21  appropriate state licensing agency.

22         A patient is responsible for providing to the health

23  care provider, to the best of his or her knowledge, accurate

24  and complete information about present complaints, past

25  illnesses, hospitalizations, medications, and other matters

26  relating to his or her health.

27         A patient is responsible for reporting unexpected

28  changes in his or her condition to the health care provider.

29         A patient is responsible for reporting to the health

30  care provider whether he or she comprehends a contemplated

31  course of action and what is expected of him or her.


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                                       CS/HB 475, Second Engrossed



  1         A patient is responsible for following the treatment

  2  plan recommended by the health care provider.

  3         A patient is responsible for keeping appointments and,

  4  when he or she is unable to do so for any reason, for

  5  notifying the health care provider or health care facility.

  6         A patient is responsible for his or her actions if he

  7  or she refuses treatment or does not follow the health care

  8  provider's instructions.

  9         A patient is responsible for assuring that the

10  financial obligations of his or her health care are fulfilled

11  as promptly as possible.

12         A patient is responsible for following health care

13  facility rules and regulations affecting patient care and

14  conduct.

15         Section 8.  Subsections (6) and (10) of section

16  382.003, Florida Statutes, are amended to read:

17         382.003  Powers and duties of the department.--The

18  department may:

19         (6)  Investigate cases of irregularity or violation of

20  law, and all local registrars of vital statistics shall aid

21  the department in such investigations.  When necessary, the

22  department shall report cases of violations of any of the

23  provisions of this chapter to the state attorney having charge

24  of the prosecution of misdemeanors in the registration

25  district in which the violation occurs.

26         (10)  Accept, use, and produce all records, reports,

27  and documents necessary for carrying out the provisions of

28  this chapter, in paper or electronic form, and adopt,

29  promulgate, and enforce all rules necessary for the

30  acceptance, use, production creation, issuance, recording,

31  maintenance, and processing of such vital records, reports,


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                                       CS/HB 475, Second Engrossed



  1  and documents, and for carrying out the provisions of ss.

  2  382.004-382.0135 and ss. 382.016-382.019.

  3         Section 9.  Subsections (1) and (2) of section 382.004,

  4  Florida Statutes, are amended to read:

  5         382.004  Reproduction and destruction of records.--

  6         (1)  The department is authorized to photograph,

  7  microphotograph, reproduce on film, or reproduce by electronic

  8  means vital records in such a manner that the data on each

  9  page are in exact conformity with the original record.

10         (2)  The department is authorized to destroy any of the

11  original vital records after they have been photographed or

12  reproduced in exact conformity with the original record and

13  after approval for destruction in accordance with chapter 257.

14         Section 10.  Paragraph (c) of subsection (2) of section

15  382.013, Florida Statutes, is amended to read:

16         382.013  Birth registration.--A certificate for each

17  live birth that occurs in this state shall be filed within 5

18  days after such birth with the local registrar of the district

19  in which the birth occurred and shall be registered by the

20  local registrar if the certificate has been completed and

21  filed in accordance with this chapter and adopted rules. The

22  information regarding registered births shall be used for

23  comparison with information in the state case registry, as

24  defined in chapter 61.

25         (2)  PATERNITY.--

26         (c)  If the mother is not married at the time of the

27  birth, the name of the father may not be entered on the birth

28  certificate without the execution of an a consenting affidavit

29  signed by both the mother and the person to be named as the

30  father.  The facility shall give After giving notice orally or

31  through the use of video or audio equipment, and in writing,


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                                       CS/HB 475, Second Engrossed



  1  of the alternatives to, the legal consequences of, and the

  2  rights, including, if one parent is a minor, any rights

  3  afforded due to minority status, and responsibilities that

  4  arise from signing an acknowledgment of paternity, the

  5  facility shall provide the mother and the person to be named

  6  as the father with the affidavit, as well as information

  7  provided by the Title IV-D agency established pursuant to s.

  8  409.2557, regarding the benefits of voluntary establishment of

  9  paternity. Upon request of the mother and the person to be

10  named as the father, the facility shall assist in the

11  execution of the affidavit or a notarized voluntary

12  acknowledgment of paternity.

13         Section 11.  Section 382.016, Florida Statutes, is

14  amended to read:

15         382.016  Amendment of records.--

16         (1)  The department, upon receipt of the fee prescribed

17  in s. 382.0255;, documentary evidence, as specified by rule,

18  of any misstatement, error, or omission occurring in any

19  birth, death, or fetal death record; as may be required by

20  department rule, and an affidavit setting forth the changes to

21  be made, shall amend or replace the original certificate as

22  necessary. However, except for a misspelling or an omission on

23  a death certificate with regard to the name of the surviving

24  spouse, the department may not change the name of the

25  surviving spouse on the certificate except by order of a court

26  of competent jurisdiction.

27         (1)(2)  CERTIFICATE OF LIVE BIRTH AMENDMENT.--

28         (a)  Until a child's first birthday, the child's given

29  name or surname may be amended upon receipt of the fees

30  prescribed in s. 382.0255 and an affidavit signed by each

31  parent named on the original birth certificate or by the


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                                       CS/HB 475, Second Engrossed



  1  registrant's guardian. If both parents are named on the

  2  certificate but both are not willing or available to sign the

  3  affidavit, the registrant's name may only be amended by court

  4  order.

  5         (b)(3)  Upon written request and receipt of an

  6  affidavit or notarized voluntary acknowledgment of paternity

  7  signed by the mother and father acknowledging the paternity of

  8  a registrant born out of wedlock, together with sufficient

  9  information to identify the original certificate of live

10  birth, the department shall prepare a new birth certificate,

11  which shall bear the same file number as the original birth

12  certificate. The names and identifying information of the

13  parents shall be entered as of the date of the registrant's

14  birth. The surname of the registrant may be changed from that

15  shown on the original birth certificate at the request of the

16  mother and father of the registrant, or the registrant if of

17  legal age. If the mother and father marry each other at any

18  time after the registrant's birth, the department shall, upon

19  the request of the mother and father or registrant if of legal

20  age and proof of the marriage, amend the certificate with

21  regard to the parents' marital status as though the parents

22  were married at the time of birth.

23         (4)  When a new certificate of birth is prepared

24  pursuant to subsection (3), The department shall substitute

25  the new certificate of birth for the original certificate on

26  file. All copies of the original certificate of live birth in

27  the custody of a local registrar or other state custodian of

28  vital records shall be forwarded to the State Registrar.

29  Thereafter, when a certified copy of the certificate of birth

30  or portion thereof is issued, it shall be a copy of the new

31  certificate of birth or portion thereof, except when a court


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                                       CS/HB 475, Second Engrossed



  1  order requires issuance of a certified copy of the original

  2  certificate of birth. The department shall place the original

  3  certificate of birth and all papers pertaining thereto under

  4  seal, not to be broken except by order of a court of competent

  5  jurisdiction or as otherwise provided by law.

  6         (c)(5)  If a father's name is listed on the birth

  7  certificate, the birth certificate may only be amended to

  8  remove the father's name or to add a different father's name

  9  upon court order. If a change in the registrant's surname is

10  also desired, such change must be included in the court order

11  or the name must be changed pursuant to s. 68.07.

12         (2)  CERTIFICATE OF DEATH AMENDMENTS.--Except for a

13  misspelling or an omission on a death certificate with regard

14  to the name of the surviving spouse, the department may not

15  change the name of a surviving spouse on the certificate

16  except by order of a court of competent jurisdiction.

17         Section 12.  Paragraph (h) of subsection (1) of section

18  382.0255, Florida Statutes, is amended to read:

19         382.0255  Fees.--

20         (1)  The department is entitled to fees, as follows:

21         (h)  Not less than 5 cents or more than 10 cents for

22  each data vital record listed on electronic media plus a

23  reasonable charge for the cost of preparation, as established

24  defined by department rule.

25         Section 13.  Paragraph (c) of subsection (3) of section

26  383.402, Florida Statutes, is amended to read:

27         383.402  Child abuse death review; State Child Abuse

28  Death Review Committee; local child abuse death review

29  committees.--

30         (3)  The State Child Abuse Death Review Committee

31  shall:


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                                       CS/HB 475, Second Engrossed



  1         (c)  Prepare an annual statistical report on the

  2  incidence and causes of death resulting from child abuse in

  3  the state during the prior calendar year. The state committee

  4  shall submit a copy of the report by December 31 September 30

  5  of each year to the Governor, the President of the Senate, and

  6  the Speaker of the House of Representatives, with the first

  7  annual report due on September 30, 2000. The report must

  8  include recommendations for state and local action, including

  9  specific policy, procedural, regulatory, or statutory changes,

10  and any other recommended preventive action.

11         Section 14.  Paragraph (b) of subsection (1) of section

12  383.14, Florida Statutes, is amended to read:

13         383.14  Screening for metabolic disorders, other

14  hereditary and congenital disorders, and environmental risk

15  factors.--

16         (1)  SCREENING REQUIREMENTS.--To help ensure access to

17  the maternal and child health care system, the Department of

18  Health shall promote the screening of all infants born in

19  Florida for phenylketonuria and other metabolic, hereditary,

20  and congenital disorders known to result in significant

21  impairment of health or intellect, as screening programs

22  accepted by current medical practice become available and

23  practical in the judgment of the department.  The department

24  shall also promote the identification and screening of all

25  infants born in this state and their families for

26  environmental risk factors such as low income, poor education,

27  maternal and family stress, emotional instability, substance

28  abuse, and other high-risk conditions associated with

29  increased risk of infant mortality and morbidity to provide

30  early intervention, remediation, and prevention services,

31  including, but not limited to, parent support and training


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                                       CS/HB 475, Second Engrossed



  1  programs, home visitation, and case management.

  2  Identification, perinatal screening, and intervention efforts

  3  shall begin prior to and immediately following the birth of

  4  the child by the attending health care provider.  Such efforts

  5  shall be conducted in hospitals, perinatal centers, county

  6  health departments, school health programs that provide

  7  prenatal care, and birthing centers, and reported to the

  8  Office of Vital Statistics.

  9         (b)  Postnatal screening.--A risk factor analysis using

10  the department's designated risk assessment instrument shall

11  also be conducted as part of the medical screening process

12  upon the birth of a child and submitted to the department's

13  Office of Vital Statistics for recording and other purposes

14  provided for in this chapter.  The department's screening

15  process for risk assessment shall include a scoring mechanism

16  and procedures that establish thresholds for notification,

17  further assessment, referral, and eligibility for services by

18  professionals or paraprofessionals consistent with the level

19  of risk. Procedures for developing and using the screening

20  instrument, notification, referral, and care coordination

21  services, reporting requirements, management information, and

22  maintenance of a computer-driven registry in the Office of

23  Vital Statistics which ensures privacy safeguards must be

24  consistent with the provisions and plans established under

25  chapter 411, Pub. L. No. 99-457, and this chapter.  Procedures

26  established for reporting information and maintaining a

27  confidential registry must include a mechanism for a

28  centralized information depository at the state and county

29  levels.  The department shall coordinate with existing risk

30  assessment systems and information registries.  The department

31  must ensure, to the maximum extent possible, that the


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                                       CS/HB 475, Second Engrossed



  1  screening information registry is integrated with the

  2  department's automated data systems, including the Florida

  3  On-line Recipient Integrated Data Access (FLORIDA) system.

  4  Tests and screenings must be performed by the State Public

  5  Health Laboratory, in coordination with Children's Medical

  6  Services, at such times and in such manner as is prescribed by

  7  the department after consultation with the Genetics and Infant

  8  Screening Advisory Council and the State Coordinating Council

  9  for School Readiness Programs.

10         Section 15.  Subsections (1), (3), (5), (6), and (9) of

11  section 383.50, Florida Statutes, are amended to read:

12         383.50  Treatment of abandoned newborn infant.--

13         (1)  As used in this section, the term "newborn infant"

14  means a child that a licensed physician reasonably believes to

15  be approximately 3 days old or younger at the time the child

16  is left at a hospital, emergency medical services station, or

17  a fire station.

18         (3)  Each emergency medical services station or fire

19  station staffed with full-time firefighters, or emergency

20  medical technicians, or paramedics shall accept any newborn

21  infant left with a firefighter, or emergency medical

22  technician, or paramedic. The firefighter, emergency medical

23  technician, or paramedic fire station shall consider these

24  actions as implied consent to and shall:

25         (a)  Provide emergency medical services to the newborn

26  infant to the extent he or she is trained to provide those

27  services, and

28         (b)  Arrange for the immediate transportation of the

29  newborn infant to the nearest hospital having with emergency

30  services.

31


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                                       CS/HB 475, Second Engrossed



  1  A licensee as defined in s. 401.23, a fire department, or an

  2  employee or agent of a licensee or fire department may treat

  3  and transport a newborn infant pursuant to this section. If a

  4  newborn infant is placed in the physical custody of an

  5  employee or agent of a licensee or fire department, such

  6  placement shall be considered implied consent for treatment

  7  and transport. A licensee, a fire department, or an employee

  8  or agent of a licensee or fire department Any firefighter or

  9  emergency medical technician accepting or providing emergency

10  medical services to a newborn infant pursuant to this

11  subsection is immune from criminal or civil liability for

12  acting in good faith pursuant to this section having performed

13  the act. Nothing in this subsection limits liability for

14  negligence.

15         (5)  Except where there is actual or suspected child

16  abuse or neglect, any parent who leaves a newborn infant with

17  a firefighter, or emergency medical technician, or paramedic

18  at a fire station or emergency medical services station, or

19  brings a newborn infant to an emergency room of a hospital and

20  expresses an intent to leave the newborn infant and not

21  return, has the absolute right to remain anonymous and to

22  leave at any time and may not be pursued or followed unless

23  the parent seeks to reclaim the newborn infant.

24         (6)  A parent of a newborn infant left at a hospital,

25  emergency medical services station, or a fire station under

26  this section may claim his or her newborn infant up until the

27  court enters a judgment terminating his or her parental

28  rights. A claim to of parental rights of the newborn infant

29  must be made to the entity having physical or legal custody of

30  the newborn infant or to the circuit court before whom

31  proceedings involving the newborn infant are pending.


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                                       CS/HB 475, Second Engrossed



  1         (9)  A newborn infant left at a fire station or a

  2  hospital, emergency medical services station, or fire station

  3  in accordance with this section shall not be deemed abandoned

  4  and subject to reporting and investigation requirements under

  5  s. 39.201 unless there is actual or suspected child abuse or

  6  until the department takes physical custody of the child.

  7         Section 16.  Section 391.037, Florida Statutes, is

  8  created to read:

  9         391.037  Physicians; private-sector services.--It is

10  not a violation of s. 112.313(7) for a physician licensed

11  under chapter 458 or chapter 459 who is providing

12  private-sector services to clients of the department or who is

13  employed by or has a contractual relationship with any

14  business entity or agency that is a contract provider for the

15  department to also be employed by the department to provide

16  services under this chapter or chapter 39 if:

17         (1)  The physician does not enter into contracts with

18  the department on behalf of any business entity or agency with

19  whom the physician is employed or has an employment or

20  contractual relationship.

21         (2)  The physician's private-sector employment or

22  contractual relationship does not create a conflict between

23  the physician's private-sector interests and public duties or

24  impede the full and faithful discharge of the physician's

25  public duties as an employee of the department.

26         (3)  The physician's employment with the department

27  does not compromise the ability of department clients to make

28  a voluntary choice among department-referred physicians and

29  private providers for their medical services.

30         Section 17.  Paragraph (b) of subsection (2) of section

31  401.113, Florida Statutes, is amended to read:


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                                       CS/HB 475, Second Engrossed



  1         401.113  Department; powers and duties.--

  2         (2)  The department shall annually dispense funds

  3  contained in the Emergency Medical Services Trust Fund as

  4  follows:

  5         (b)  Forty percent of such moneys must be used by the

  6  department for making matching grants to local agencies,

  7  municipalities, and emergency medical services organizations

  8  for the purpose of conducting research, increasing existing

  9  levels of emergency medical services, evaluation, community

10  education, injury prevention programs, and training in

11  cardiopulmonary resuscitation and other lifesaving and first

12  aid techniques.

13         1.  At least 90 percent of these moneys must be made

14  available on a cash matching basis.  A grant made under this

15  subparagraph must be contingent upon the recipient providing a

16  cash sum equal to 25 percent of the total department-approved

17  grant amount.

18         2.  No more than 10 percent of these moneys must be

19  made available to rural emergency medical services, and

20  notwithstanding the restrictions specified in subsection (1),

21  these moneys may be used for improvement, expansion, or

22  continuation of services provided.  A grant made under this

23  subparagraph must be contingent upon the recipient providing a

24  cash sum equal to no more than 10 percent of the total

25  department-approved grant amount.

26

27  The department shall develop procedures and standards for

28  grant disbursement under this paragraph based on the need for

29  emergency medical services, the requirements of the population

30  to be served, and the objectives of the state emergency

31  medical services plan.


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                                       CS/HB 475, Second Engrossed



  1         Section 18.  Subsections (4) and (5) of section 401.27,

  2  Florida Statutes, are amended to read:

  3         401.27  Personnel; standards and certification.--

  4         (4)  An applicant for certification or recertification

  5  as an emergency medical technician or paramedic must:

  6         (a)  Have completed an appropriate training course as

  7  follows:

  8         1.  For an emergency medical technician, an emergency

  9  medical technician training course equivalent to the most

10  recent emergency medical technician basic training course of

11  the United States Department of Transportation as approved by

12  the department;

13         2.  For a paramedic, a paramedic training program

14  equivalent to the most recent paramedic course of the United

15  States Department of Transportation as approved by the

16  department;

17         (b)  Certify under oath that he or she is not addicted

18  to alcohol or any controlled substance;

19         (c)  Certify under oath that he or she is free from any

20  physical or mental defect or disease that might impair the

21  applicant's ability to perform his or her duties;

22         (d)  Within 1 year after course completion have passed

23  an examination developed or required by the department;

24         (e)1.  For an emergency medical technician, hold either

25  a current American Heart Association cardiopulmonary

26  resuscitation course card or an American Red Cross

27  cardiopulmonary resuscitation course card or its equivalent as

28  defined by department rule;

29         2.  For a paramedic, hold a certificate of successful

30  course completion in advanced cardiac life support from the

31


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                                       CS/HB 475, Second Engrossed



  1  American Heart Association or its equivalent as defined by

  2  department rule;

  3         (f)  Submit the certification fee and the nonrefundable

  4  examination fee prescribed in s. 401.34, which examination fee

  5  will be required for each examination administered to an

  6  applicant; and

  7         (g)  Submit a completed application to the department,

  8  which application documents compliance with paragraphs (a),

  9  (b), (c), (e), (f), (g), and, if applicable, (d). The

10  application must be submitted so as to be received by the

11  department at least 30 calendar days before the next regularly

12  scheduled examination for which the applicant desires to be

13  scheduled.

14         (5)  The certification examination must be offered

15  monthly.  The department shall issue an examination admission

16  notice to the applicant advising him or her of the time and

17  place of the examination for which he or she is scheduled.

18  Individuals achieving a passing score on the certification

19  examination may be issued a temporary certificate with their

20  examination grade report.  The department must issue an

21  original certification within 45 days after the examination.

22  Examination questions and answers are not subject to discovery

23  but may be introduced into evidence and considered only in

24  camera in any administrative proceeding under chapter 120. If

25  an administrative hearing is held, the department shall

26  provide challenged examination questions and answers to the

27  administrative law judge. The department shall establish by

28  rule the procedure by which an applicant, and the applicant's

29  attorney, may review examination questions and answers in

30  accordance with s. 119.07(3)(a).

31


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                                       CS/HB 475, Second Engrossed



  1         Section 19.  Subsection (2) of section 404.056, Florida

  2  Statutes, is repealed, and present subsections (5) and (7) of

  3  said section are renumbered as subsections (4) and (6),

  4  respectively, and amended to read:

  5         404.056  Environmental radiation standards and

  6  programs; radon protection.--

  7         (4)(5)  MANDATORY TESTING.--All public and private

  8  school buildings or school sites housing students in

  9  kindergarten through grade 12; all state-owned,

10  state-operated, state-regulated, or state-licensed 24-hour

11  care facilities; and all state-licensed day care centers for

12  children or minors which are located in counties designated

13  within the Department of Community Affairs' Florida Radon

14  Protection Map Categories as "Intermediate" or "Elevated Radon

15  Potential" shall be measured to determine the level of indoor

16  radon, using measurement procedures established by the

17  department. Testing shall be completed within the first year

18  of construction in 20 percent of the habitable first floor

19  spaces within any of the regulated buildings. Initial

20  measurements shall be completed and reported to the department

21  by July 1 of the year the building is opened for occupancy.

22  Followup testing must be completed in 5 percent of the

23  habitable first floor spaces within any of the regulated

24  buildings after the building has been occupied for 5 years,

25  and results must be reported to the department by July 1 of

26  the 5th year of occupancy. After radon measurements have been

27  made twice, regulated buildings need not undergo further

28  testing unless significant structural changes occur. Where

29  fill soil is required for the construction of a regulated

30  building, initial testing of fill soil must be performed using

31  measurement procedures established by the department, and the


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                                       CS/HB 475, Second Engrossed



  1  results must be reported to the department prior to

  2  construction. No funds collected pursuant to s. 553.721 shall

  3  be used to carry out the provisions of this subsection.

  4         (6)(7)  RULES.--The department shall have the authority

  5  to promulgate rules necessary to carry out the provisions of

  6  this section, including the definition of terms.

  7         Section 20.  Paragraph (d) of subsection (2) of section

  8  499.012, Florida Statutes, is amended to read:

  9         499.012  Wholesale distribution; definitions; permits;

10  general requirements.--

11         (2)  The following types of wholesaler permits are

12  established:

13         (d)  A retail pharmacy wholesaler's permit.  A retail

14  pharmacy wholesaler is a retail pharmacy engaged in wholesale

15  distribution of prescription drugs within this state under the

16  following conditions:

17         1.  The pharmacy must obtain a retail pharmacy

18  wholesaler's permit pursuant to ss. 499.001-499.081 and the

19  rules adopted under those sections.

20         2.  The wholesale distribution activity does not exceed

21  30 percent of the total annual purchases of prescription

22  drugs.  If the wholesale distribution activity exceeds the

23  30-percent maximum, the pharmacy must obtain a prescription

24  drug wholesaler's permit.

25         3.  The transfer of prescription drugs that appear in

26  any schedule contained in chapter 893 is subject to chapter

27  893 and the federal Comprehensive Drug Abuse Prevention and

28  Control Act of 1970.

29         4.  The transfer is between a retail pharmacy and

30  another retail pharmacy, or a Modified Class II institutional

31  pharmacy, or a health care practitioner licensed in this state


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                                       CS/HB 475, Second Engrossed



  1  and authorized by law to dispense or prescribe prescription

  2  drugs.

  3         5.  All records of sales of prescription drugs subject

  4  to this section must be maintained separate and distinct from

  5  other records and comply with the recordkeeping requirements

  6  of ss. 499.001-499.081.

  7         Section 21.  Section 509.049, Florida Statutes, is

  8  amended to read:

  9         509.049  Food service employee training.--

10         (1)  The division shall adopt, by rule, minimum food

11  safety protection standards for the training of all food

12  service employees who are responsible for the storage,

13  preparation, display, or serving of foods to the public in

14  establishments regulated under this chapter.  These standards

15  shall not include an examination, but shall provide for a food

16  safety training certificate program for food service employees

17  to be administered by a private nonprofit provider chosen by

18  the division.

19         (2)  The division shall issue a request for competitive

20  sealed proposals which includes a statement of the contractual

21  services sought and all terms and conditions applicable to the

22  contract.  The division shall award the contract to the

23  provider whose proposal is determined in writing to be the

24  most advantageous to the state, taking into consideration the

25  price and the other criteria set forth in the request for

26  proposals.  The division shall contract with a provider on a

27  4-year basis and is authorized to promulgate by rule a per

28  employee fee to cover the contracted price for the program

29  administered by the provider.  In making its selection, the

30  division shall consider factors including, but not limited to,

31  the experience and history of the provider in representing the


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                                       CS/HB 475, Second Engrossed



  1  food service industry, the provider's demonstrated commitment

  2  to food safety, and its ability to provide a statewide program

  3  with industry support and participation.

  4         (3)  Any food safety training program established and

  5  administered to food handler employees utilized at a public

  6  food service establishment prior to July 1, 2000, may the

  7  effective date of this act shall be submitted by the operator

  8  or the provider to the division for its review and approval.

  9  If the food safety training program is found to be in

10  substantial compliance with the division's required criteria

11  and is approved by the division, nothing in this section shall

12  preclude any other operator of a food service establishment

13  from also utilizing the approved program or require the

14  employees of any operator to receive training from or pay a

15  fee to the division's contracted provider.  Review and

16  approval by the division of a program or programs under this

17  section shall include, but not be limited to, the minimum food

18  safety standards adopted by the division in accordance with

19  this section.

20         (4)  Approval of a program is subject to the provider's

21  continued compliance with the division's minimum program

22  standards. The division may conduct random audits of approved

23  programs to determine compliance and may audit any program if

24  it has reason to believe a program is not in compliance with

25  this section. The division may revoke a program's approval if

26  it finds a program is not in compliance with this section or

27  the rules adopted under this section.

28         (5)  It shall be the duty of the licensee of the public

29  food service establishment to provide training in accordance

30  with the described rule to all employees under the licensee's

31  supervision or control.  The licensee may designate a


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                                       CS/HB 475, Second Engrossed



  1  certified food service manager to perform this function as an

  2  agent of the licensee. Food service employees must receive

  3  certification pursuant to this section by January 1, 2001.

  4  Food service employees hired after November 1, 2000, must

  5  receive certification within 60 days after employment.

  6  Certification pursuant to this section shall remain valid for

  7  3 years.

  8         (6)  The division may adopt rules pursuant to ss.

  9  120.536(1) and 120.54 necessary to administer this section.

10  The rules may require:

11         (a)  The use of application forms, which may require,

12  but need not be limited to, the identification of training

13  components of the program and an applicant affidavit attesting

14  to the accuracy of the information provided in the

15  application;

16         (b)  Providers to maintain information concerning

17  establishments where they provide training pursuant to this

18  section;

19         (c)  Specific subject matter related to food safety for

20  use in training program components; and

21         (d)  The licensee to be responsible for providing proof

22  of employee training, and the division may request production

23  of such proof upon inspection of the establishment.

24         Section 22.  Subsections (1) and (3) of section 742.10,

25  Florida Statutes, are amended to read:

26         742.10  Establishment of paternity for children born

27  out of wedlock.--

28         (1)  This chapter provides the primary jurisdiction and

29  procedures for the determination of paternity for children

30  born out of wedlock. When the establishment of paternity has

31  been raised and determined within an adjudicatory hearing


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                                       CS/HB 475, Second Engrossed



  1  brought under the statutes governing inheritance, or

  2  dependency under workers' compensation or similar compensation

  3  programs, or when an affidavit acknowledging paternity or a

  4  stipulation of paternity is executed by both parties and filed

  5  with the clerk of the court, or when an a consenting affidavit

  6  or notarized voluntary acknowledgment of paternity as provided

  7  for in s. 382.013 or s. 382.016 is executed by both parties,

  8  it shall constitute the establishment of paternity for

  9  purposes of this chapter. If no adjudicatory proceeding was

10  held, a notarized voluntary acknowledgment of paternity shall

11  create a rebuttable presumption, as defined by s. 90.304, of

12  paternity and is subject to the right of any signatory to

13  rescind the acknowledgment within 60 days of the date the

14  acknowledgment was signed or the date of an administrative or

15  judicial proceeding relating to the child, including a

16  proceeding to establish a support order, in which the

17  signatory is a party, whichever is earlier.  Both parents are

18  required to provide their social security numbers on any

19  acknowledgment of paternity, consent affidavit, or stipulation

20  of paternity. Except for consenting affidavits under seal

21  pursuant to ss. 382.015 and 382.016, the Office of Vital

22  Statistics shall provide certified copies of affidavits to the

23  Title IV-D agency upon request.

24         (3)  The department shall adopt rules which establish

25  the information which must be provided to an individual prior

26  to execution of an a consenting affidavit or voluntary

27  acknowledgment of paternity. The information shall explain the

28  alternatives to, the legal consequences of, and the rights,

29  including, if one parent is a minor, any rights afforded due

30  to minority status, and responsibilities that arise from

31  acknowledging paternity.


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                                       CS/HB 475, Second Engrossed



  1         Section 23.  Paragraph (b) of subsection (1) and

  2  paragraph (a) of subsection (2) of section 743.0645, Florida

  3  Statutes, are amended to read:

  4         743.0645  Other persons who may consent to medical care

  5  or treatment of a minor.--

  6         (1)  As used in this section, the term:

  7         (b)  "Medical care and treatment" includes ordinary and

  8  necessary medical and dental examination and treatment,

  9  including blood testing, preventive care including ordinary

10  immunizations, tuberculin testing, and well-child care, but

11  does not include surgery, general anesthesia, provision of

12  psychotropic medications, or other extraordinary procedures

13  for which a separate court order, power of attorney, or

14  informed consent as provided by law is required.

15         (2)  Any of the following persons, in order of priority

16  listed, may consent to the medical care or treatment of a

17  minor who is not committed to the Department of Children and

18  Family Services or the Department of Juvenile Justice or in

19  their custody under chapter 39, chapter 984, or chapter 985

20  when, after a reasonable attempt, a person who has the power

21  to consent as otherwise provided by law cannot be contacted by

22  the treatment provider and actual notice to the contrary has

23  not been given to the provider by that person:

24         (a)  A person who possesses a power of attorney to

25  provide medical consent for the minor. A power of attorney

26  executed after July 1, 2001, to provide medical consent for a

27  minor includes the power to consent to medically necessary

28  surgical and general anesthesia services for the minor unless

29  such services are excluded by the individual executing the

30  power of attorney.

31


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                                       CS/HB 475, Second Engrossed



  1  There shall be maintained in the treatment provider's records

  2  of the minor documentation that a reasonable attempt was made

  3  to contact the person who has the power to consent.

  4         Section 24.  Section 827.035, Florida Statutes, is

  5  amended to read:

  6         827.035  Newborn infants.--It shall not constitute

  7  neglect of a child pursuant to s. 827.03 or contributing to

  8  the dependency of a child pursuant to s. 827.04, if a parent

  9  leaves a newborn infant, as defined in s. 383.50, at a

10  hospital, emergency medical services station, or fire station

11  or brings a newborn infant to an emergency room and expresses

12  an intent to leave the infant and not return, in compliance

13  with s. 383.50.

14         Section 25.  Effective June 1, 2001, subsection (1) of

15  section 71 of chapter 98-171, Laws of Florida, is repealed.

16         Section 26.  Except as otherwise provided herein, this

17  act shall take effect July 1, 2001.

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