HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
CHAMBER ACTION
Senate House
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11 Representative(s) Farkas offered the following:
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13 Amendment (with title amendment)
14 Remove from the bill: Everything after the enacting clause
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16 and insert in lieu thereof:
17 Section 1. Subsection (1) of section 483.245, Florida
18 Statutes, is amended to read:
19 483.245 Rebates prohibited; penalties.--
20 (1) It is unlawful for any person to pay or receive
21 any commission, bonus, kickback, or rebate or engage in any
22 split-fee arrangement in any form whatsoever with any dialysis
23 facility, physician, surgeon, organization, agency, or person,
24 either directly or indirectly, for patients referred to a
25 clinical laboratory licensed under this part.
26 Section 2. Subsection (3) of section 232.435, Florida
27 Statutes, is amended to read:
28 232.435 Extracurricular athletic activities; athletic
29 trainers.--
30 (3)(a) To the extent practicable, a school district
31 program should include the following employment classification
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 and advancement scheme:
2 1. First responder - To qualify as a first responder,
3 a person must possess a professional, temporary, part-time,
4 adjunct, or substitute certificate pursuant to s. 231.17, be
5 certified in cardiopulmonary resuscitation, first aid, and
6 have 15 semester hours in courses such as care and prevention
7 of athletic injuries, anatomy, physiology, nutrition,
8 counseling, and other similar courses approved by the
9 Commissioner of Education. This person may only administer
10 first aid and similar care.
11 1. Teacher apprentice trainer I.--To qualify as a
12 teacher apprentice trainer I, a person must possess a
13 professional, temporary, part-time, adjunct, or substitute
14 certificate pursuant to s. 231.17, be certified in first aid
15 and cardiopulmonary resuscitation, and have earned a minimum
16 of 6 semester hours or the equivalent number of inservice
17 education points in the basic prevention and care of athletic
18 injuries.
19 2. Teacher apprentice trainer II.--To qualify as a
20 teacher apprentice trainer II, a person must meet the
21 requirements of teacher apprentice trainer I and also have
22 earned a minimum of 15 additional semester hours or the
23 equivalent number of inservice education points in such
24 courses as anatomy, physiology, use of modalities, nutrition,
25 counseling, and other courses approved by the Commissioner of
26 Education.
27 2.3. Teacher athletic trainer.--To qualify as a
28 teacher athletic trainer, a person must possess a
29 professional, temporary, part-time, adjunct, or substitute
30 certificate pursuant to s. 232.17, and be licensed as required
31 by part XIII of chapter 468 meet the requirements of teacher
2
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 apprentice trainer II, be certified by the Department of
2 Education or a nationally recognized athletic trainer
3 association, and perform one or more of the following
4 functions: preventing athletic injuries; recognizing,
5 evaluating, managing, treating, and rehabilitating athletic
6 injuries; administering an athletic training program; and
7 educating and counseling athletes.
8 (b) If a school district uses the services of an
9 athletic trainer who is not a teacher athletic trainer or a
10 teacher apprentice trainer within the requirements of this
11 section, such athletic trainer must be licensed as required by
12 part XIII of chapter 468.
13 Section 3. Section 381.6021, Florida Statutes, is
14 amended to read:
15 381.6021 Certification of organizations engaged in the
16 practice of cadaveric organ and tissue procurement.--The
17 Agency for Health Care Administration shall:
18 (1) Establish a program for the certification of
19 organizations, agencies, or other entities engaged in the
20 procurement of organs, tissues, and eyes for transplantation;
21 (2) Adopt rules that set forth appropriate standards
22 and guidelines for the program. These standards and guidelines
23 must be substantially based on the existing laws of the
24 Federal Government and this state and the existing standards
25 and guidelines of the federal Food and Drug Administration
26 (FDA), the United Network for Organ Sharing (UNOS), the
27 American Association of Tissue Banks (AATB), the South-Eastern
28 Organ Procurement Foundation (SEOPF), the North American
29 Transplant Coordinators Organization (NATCO), and the Eye Bank
30 Association of America (EBAA). In addition, the Agency for
31 Health Care Administration shall, before adopting these
3
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 standards and guidelines, seek input from all organ
2 procurement organizations, tissue banks, and eye banks based
3 in this state. However, notwithstanding any other provision of
4 law to the contrary, rules adopted under this subsection shall
5 not allow human cells or tissue from two or more donors to be
6 pooled during retrieval, processing, preservation, or storage.
7 For purposes of this subsection, "pooled" means placed in
8 physical contact or mixed in a single receptacle;
9 (3) Collect, keep, and make available to the Governor
10 and the Legislature information regarding the numbers and
11 disposition of organs and tissues procured by each certified
12 entity;
13 (4) Monitor participating facilities and agencies for
14 program compliance; and
15 (5) Provide for the administration of the Organ and
16 Tissue Procurement and Transplantation Advisory Board.
17 Section 4. Paragraph (b) of subsection (1) of section
18 383.14, Florida Statutes, is amended to read:
19 383.14 Screening for metabolic disorders, other
20 hereditary and congenital disorders, and environmental risk
21 factors.--
22 (1) SCREENING REQUIREMENTS.--To help ensure access to
23 the maternal and child health care system, the Department of
24 Health shall promote the screening of all infants born in
25 Florida for phenylketonuria and other metabolic, hereditary,
26 and congenital disorders known to result in significant
27 impairment of health or intellect, as screening programs
28 accepted by current medical practice become available and
29 practical in the judgment of the department. The department
30 shall also promote the identification and screening of all
31 infants born in this state and their families for
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 environmental risk factors such as low income, poor education,
2 maternal and family stress, emotional instability, substance
3 abuse, and other high-risk conditions associated with
4 increased risk of infant mortality and morbidity to provide
5 early intervention, remediation, and prevention services,
6 including, but not limited to, parent support and training
7 programs, home visitation, and case management.
8 Identification, perinatal screening, and intervention efforts
9 shall begin prior to and immediately following the birth of
10 the child by the attending health care provider. Such efforts
11 shall be conducted in hospitals, perinatal centers, county
12 health departments, school health programs that provide
13 prenatal care, and birthing centers, and reported to the
14 Office of Vital Statistics.
15 (b) Postnatal screening.--A risk factor analysis using
16 the department's designated risk assessment instrument shall
17 also be conducted as part of the medical screening process
18 upon the birth of a child and submitted to the department's
19 Office of Vital Statistics for recording and other purposes
20 provided for in this chapter. The department's screening
21 process for risk assessment shall include a scoring mechanism
22 and procedures that establish thresholds for notification,
23 further assessment, referral, and eligibility for services by
24 professionals or paraprofessionals consistent with the level
25 of risk. Procedures for developing and using the screening
26 instrument, notification, referral, and care coordination
27 services, reporting requirements, management information, and
28 maintenance of a computer-driven registry in the Office of
29 Vital Statistics which ensures privacy safeguards must be
30 consistent with the provisions and plans established under
31 chapter 411, Pub. L. No. 99-457, and this chapter. Procedures
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 established for reporting information and maintaining a
2 confidential registry must include a mechanism for a
3 centralized information depository at the state and county
4 levels. The department shall coordinate with existing risk
5 assessment systems and information registries. The department
6 must ensure, to the maximum extent possible, that the
7 screening information registry is integrated with the
8 department's automated data systems, including the Florida
9 On-line Recipient Integrated Data Access (FLORIDA) system.
10 Tests and screenings must be performed by the State Public
11 Health Laboratory, in coordination with Children's Medical
12 Services, at such times and in such manner as is prescribed by
13 the department after consultation with the Genetics and Infant
14 Screening Advisory Council and the State Coordinating Council
15 for School Readiness Programs.
16 Section 5. Section 395.0197, Florida Statutes, is
17 amended to read:
18 395.0197 Internal risk management program.--
19 (1) Every licensed facility shall, as a part of its
20 administrative functions, establish an internal risk
21 management program that includes all of the following
22 components:
23 (a) The investigation and analysis of the frequency
24 and causes of general categories and specific types of adverse
25 incidents to patients.
26 (b) The development of appropriate measures to
27 minimize the risk of adverse incidents to patients, including,
28 but not limited to:
29 1. Risk management and risk prevention education and
30 training of all nonphysician personnel as follows:
31 a. Such education and training of all nonphysician
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 personnel as part of their initial orientation; and
2 b. At least 1 hour of such education and training
3 annually for all nonphysician personnel of the licensed
4 facility working in clinical areas and providing patient care,
5 except those persons licensed as health care practitioners who
6 are required to complete continuing education coursework
7 pursuant to chapter 456 or the respective practice act.
8 2. A prohibition, except when emergency circumstances
9 require otherwise, against a staff member of the licensed
10 facility attending a patient in the recovery room, unless the
11 staff member is authorized to attend the patient in the
12 recovery room and is in the company of at least one other
13 person. However, a licensed facility is exempt from the
14 two-person requirement if it has:
15 a. Live visual observation;
16 b. Electronic observation; or
17 c. Any other reasonable measure taken to ensure
18 patient protection and privacy.
19 3. A prohibition against an unlicensed person from
20 assisting or participating in any surgical procedure unless
21 the facility has authorized the person to do so following a
22 competency assessment, and such assistance or participation is
23 done under the direct and immediate supervision of a licensed
24 physician and is not otherwise an activity that may only be
25 performed by a licensed health care practitioner.
26 4. Development, implementation, and ongoing evaluation
27 of procedures, protocols, and systems to accurately identify
28 patients, planned procedures, and the correct site of the
29 planned procedure so as to minimize the performance of a
30 surgical procedure on the wrong patient, a wrong surgical
31 procedure, a wrong-site surgical procedure, or a surgical
7
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 procedure otherwise unrelated to the patient's diagnosis or
2 medical condition.
3 (c) The analysis of patient grievances that relate to
4 patient care and the quality of medical services.
5 (d) The development and implementation of an incident
6 reporting system based upon the affirmative duty of all health
7 care providers and all agents and employees of the licensed
8 health care facility to report adverse incidents to the risk
9 manager, or to his or her designee, within 3 business days
10 after their occurrence.
11 (2) The internal risk management program is the
12 responsibility of the governing board of the health care
13 facility. Each licensed facility shall hire a risk manager,
14 licensed under s. 395.10974 part IX of chapter 626, who is
15 responsible for implementation and oversight of such
16 facility's internal risk management program as required by
17 this section. A risk manager must not be made responsible for
18 more than four internal risk management programs in separate
19 licensed facilities, unless the facilities are under one
20 corporate ownership or the risk management programs are in
21 rural hospitals.
22 (3) In addition to the programs mandated by this
23 section, other innovative approaches intended to reduce the
24 frequency and severity of medical malpractice and patient
25 injury claims shall be encouraged and their implementation and
26 operation facilitated. Such additional approaches may include
27 extending internal risk management programs to health care
28 providers' offices and the assuming of provider liability by a
29 licensed health care facility for acts or omissions occurring
30 within the licensed facility.
31 (4) The agency shall, after consulting with the
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Department of Insurance, adopt rules governing the
2 establishment of internal risk management programs to meet the
3 needs of individual licensed facilities. Each internal risk
4 management program shall include the use of incident reports
5 to be filed with an individual of responsibility who is
6 competent in risk management techniques in the employ of each
7 licensed facility, such as an insurance coordinator, or who is
8 retained by the licensed facility as a consultant. The
9 individual responsible for the risk management program shall
10 have free access to all medical records of the licensed
11 facility. The incident reports are part of the workpapers of
12 the attorney defending the licensed facility in litigation
13 relating to the licensed facility and are subject to
14 discovery, but are not admissible as evidence in court. A
15 person filing an incident report is not subject to civil suit
16 by virtue of such incident report. As a part of each internal
17 risk management program, the incident reports shall be used to
18 develop categories of incidents which identify problem areas.
19 Once identified, procedures shall be adjusted to correct the
20 problem areas.
21 (5) For purposes of reporting to the agency pursuant
22 to this section, the term "adverse incident" means an event
23 over which health care personnel could exercise control and
24 which is associated in whole or in part with medical
25 intervention, rather than the condition for which such
26 intervention occurred, and which:
27 (a) Results in one of the following injuries:
28 1. Death;
29 2. Brain or spinal damage;
30 3. Permanent disfigurement;
31 4. Fracture or dislocation of bones or joints;
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 5. A resulting limitation of neurological, physical,
2 or sensory function which continues after discharge from the
3 facility;
4 6. Any condition that required specialized medical
5 attention or surgical intervention resulting from nonemergency
6 medical intervention, other than an emergency medical
7 condition, to which the patient has not given his or her
8 informed consent; or
9 7. Any condition that required the transfer of the
10 patient, within or outside the facility, to a unit providing a
11 more acute level of care due to the adverse incident, rather
12 than the patient's condition prior to the adverse incident;
13 (b) Was the performance of a surgical procedure on the
14 wrong patient, a wrong surgical procedure, a wrong-site
15 surgical procedure, or a surgical procedure otherwise
16 unrelated to the patient's diagnosis or medical condition;
17 (c) Required the surgical repair of damage resulting
18 to a patient from a planned surgical procedure, where the
19 damage was not a recognized specific risk, as disclosed to the
20 patient and documented through the informed-consent process;
21 or
22 (d) Was a procedure to remove unplanned foreign
23 objects remaining from a surgical procedure.
24 (6)(a) Each licensed facility subject to this section
25 shall submit an annual report to the agency summarizing the
26 incident reports that have been filed in the facility for that
27 year. The report shall include:
28 1. The total number of adverse incidents.
29 2. A listing, by category, of the types of operations,
30 diagnostic or treatment procedures, or other actions causing
31 the injuries, and the number of incidents occurring within
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 each category.
2 3. A listing, by category, of the types of injuries
3 caused and the number of incidents occurring within each
4 category.
5 4. A code number using the health care professional's
6 licensure number and a separate code number identifying all
7 other individuals directly involved in adverse incidents to
8 patients, the relationship of the individual to the licensed
9 facility, and the number of incidents in which each individual
10 has been directly involved. Each licensed facility shall
11 maintain names of the health care professionals and
12 individuals identified by code numbers for purposes of this
13 section.
14 5. A description of all malpractice claims filed
15 against the licensed facility, including the total number of
16 pending and closed claims and the nature of the incident which
17 led to, the persons involved in, and the status and
18 disposition of each claim. Each report shall update status and
19 disposition for all prior reports.
20 (b) The information reported to the agency pursuant to
21 paragraph (a) which relates to persons licensed under chapter
22 458, chapter 459, chapter 461, or chapter 466 shall be
23 reviewed by the agency. The agency shall determine whether
24 any of the incidents potentially involved conduct by a health
25 care professional who is subject to disciplinary action, in
26 which case the provisions of s. 456.073 shall apply.
27 (c) The report submitted to the agency shall also
28 contain the name and license number of the risk manager of the
29 licensed facility, a copy of its policy and procedures which
30 govern the measures taken by the facility and its risk manager
31 to reduce the risk of injuries and adverse incidents, and the
11
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 results of such measures. The annual report is confidential
2 and is not available to the public pursuant to s. 119.07(1) or
3 any other law providing access to public records. The annual
4 report is not discoverable or admissible in any civil or
5 administrative action, except in disciplinary proceedings by
6 the agency or the appropriate regulatory board. The annual
7 report is not available to the public as part of the record of
8 investigation for and prosecution in disciplinary proceedings
9 made available to the public by the agency or the appropriate
10 regulatory board. However, the agency or the appropriate
11 regulatory board shall make available, upon written request by
12 a health care professional against whom probable cause has
13 been found, any such records which form the basis of the
14 determination of probable cause.
15 (7) The licensed facility shall notify the agency no
16 later than 1 business day after the risk manager or his or her
17 designee has received a report pursuant to paragraph (1)(d)
18 and can determine within 1 business day that any of the
19 following adverse incidents has occurred, whether occurring in
20 the licensed facility or arising from health care prior to
21 admission in the licensed facility:
22 (a) The death of a patient;
23 (b) Brain or spinal damage to a patient;
24 (c) The performance of a surgical procedure on the
25 wrong patient;
26 (d) The performance of a wrong-site surgical
27 procedure; or
28 (e) The performance of a wrong surgical procedure.
29
30 The notification must be made in writing and be provided by
31 facsimile device or overnight mail delivery. The notification
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 must include information regarding the identity of the
2 affected patient, the type of adverse incident, the initiation
3 of an investigation by the facility, and whether the events
4 causing or resulting in the adverse incident represent a
5 potential risk to other patients.
6 (8) Any of the following adverse incidents, whether
7 occurring in the licensed facility or arising from health care
8 prior to admission in the licensed facility, shall be reported
9 by the facility to the agency within 15 calendar days after
10 its occurrence:
11 (a) The death of a patient;
12 (b) Brain or spinal damage to a patient;
13 (c) The performance of a surgical procedure on the
14 wrong patient;
15 (d) The performance of a wrong-site surgical
16 procedure;
17 (e) The performance of a wrong surgical procedure;
18 (f) The performance of a surgical procedure that is
19 medically unnecessary or otherwise unrelated to the patient's
20 diagnosis or medical condition;
21 (g) The surgical repair of damage resulting to a
22 patient from a planned surgical procedure, where the damage is
23 not a recognized specific risk, as disclosed to the patient
24 and documented through the informed-consent process; or
25 (h) The performance of procedures to remove unplanned
26 foreign objects remaining from a surgical procedure.
27
28 The agency may grant extensions to this reporting requirement
29 for more than 15 days upon justification submitted in writing
30 by the facility administrator to the agency. The agency may
31 require an additional, final report. These reports shall not
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 be available to the public pursuant to s. 119.07(1) or any
2 other law providing access to public records, nor be
3 discoverable or admissible in any civil or administrative
4 action, except in disciplinary proceedings by the agency or
5 the appropriate regulatory board, nor shall they be available
6 to the public as part of the record of investigation for and
7 prosecution in disciplinary proceedings made available to the
8 public by the agency or the appropriate regulatory board.
9 However, the agency or the appropriate regulatory board shall
10 make available, upon written request by a health care
11 professional against whom probable cause has been found, any
12 such records which form the basis of the determination of
13 probable cause. The agency may investigate, as it deems
14 appropriate, any such incident and prescribe measures that
15 must or may be taken in response to the incident. The agency
16 shall review each incident and determine whether it
17 potentially involved conduct by the health care professional
18 who is subject to disciplinary action, in which case the
19 provisions of s. 456.073 shall apply.
20 (9) The agency shall publish on the agency's website,
21 no less than quarterly, a summary and trend analysis of
22 adverse incident reports received pursuant to this section,
23 which shall not include information that would identify the
24 patient, the reporting facility, or the health care
25 practitioners involved. The agency shall publish on the
26 agency's website an annual summary and trend analysis of all
27 adverse incident reports and malpractice claims information
28 provided by facilities in their annual reports, which shall
29 not include information that would identify the patient, the
30 reporting facility, or the practitioners involved. The
31 purpose of the publication of the summary and trend analysis
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 is to promote the rapid dissemination of information relating
2 to adverse incidents and malpractice claims to assist in
3 avoidance of similar incidents and reduce morbidity and
4 mortality.
5 (10)(9) The internal risk manager of each licensed
6 facility shall:
7 (a) Investigate every allegation of sexual misconduct
8 which is made against a member of the facility's personnel who
9 has direct patient contact, when the allegation is that the
10 sexual misconduct occurred at the facility or on the grounds
11 of the facility.; and
12 (b) Report every allegation of sexual misconduct to
13 the administrator of the licensed facility.
14 (c) Notify the family or guardian of the victim, if a
15 minor, that an allegation of sexual misconduct has been made
16 and that an investigation is being conducted.;
17 (d) Report to the Department of Health every
18 allegation of sexual misconduct, as defined in chapter 456 and
19 the respective practice act, by a licensed health care
20 practitioner that involves a patient.
21 (11)(10) Any witness who witnessed or who possesses
22 actual knowledge of the act that is the basis of an allegation
23 of sexual abuse shall:
24 (a) Notify the local police; and
25 (b) Notify the hospital risk manager and the
26 administrator.
27
28 For purposes of this subsection, "sexual abuse" means acts of
29 a sexual nature committed for the sexual gratification of
30 anyone upon, or in the presence of, a vulnerable adult,
31 without the vulnerable adult's informed consent, or a minor.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 "Sexual abuse" includes, but is not limited to, the acts
2 defined in s. 794.011(1)(h), fondling, exposure of a
3 vulnerable adult's or minor's sexual organs, or the use of the
4 vulnerable adult or minor to solicit for or engage in
5 prostitution or sexual performance. "Sexual abuse" does not
6 include any act intended for a valid medical purpose or any
7 act which may reasonably be construed to be a normal
8 caregiving action.
9 (12)(11) A person who, with malice or with intent to
10 discredit or harm a licensed facility or any person, makes a
11 false allegation of sexual misconduct against a member of a
12 licensed facility's personnel is guilty of a misdemeanor of
13 the second degree, punishable as provided in s. 775.082 or s.
14 775.083.
15 (13)(12) In addition to any penalty imposed pursuant
16 to this section, the agency shall require a written plan of
17 correction from the facility. For a single incident or series
18 of isolated incidents that are nonwillful violations of the
19 reporting requirements of this section, the agency shall first
20 seek to obtain corrective action by the facility. If the
21 correction is not demonstrated within the timeframe
22 established by the agency or if there is a pattern of
23 nonwillful violations of this section, the agency may impose
24 an administrative fine, not to exceed $5,000 for any violation
25 of the reporting requirements of this section. The
26 administrative fine for repeated nonwillful violations shall
27 not exceed $10,000 for any violation. The administrative fine
28 for each intentional and willful violation may not exceed
29 $25,000 per violation, per day. The fine for an intentional
30 and willful violation of this section may not exceed $250,000.
31 In determining the amount of fine to be levied, the agency
16
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 shall be guided by s. 395.1065(2)(b). This subsection does not
2 apply to the notice requirements under subsection (7).
3 (14)(13) The agency shall have access to all licensed
4 facility records necessary to carry out the provisions of this
5 section. The records obtained by the agency under subsection
6 (6), subsection (8), or subsection (10) (9) are not available
7 to the public under s. 119.07(1), nor shall they be
8 discoverable or admissible in any civil or administrative
9 action, except in disciplinary proceedings by the agency or
10 the appropriate regulatory board, nor shall records obtained
11 pursuant to s. 456.071 be available to the public as part of
12 the record of investigation for and prosecution in
13 disciplinary proceedings made available to the public by the
14 agency or the appropriate regulatory board. However, the
15 agency or the appropriate regulatory board shall make
16 available, upon written request by a health care professional
17 against whom probable cause has been found, any such records
18 which form the basis of the determination of probable cause,
19 except that, with respect to medical review committee records,
20 s. 766.101 controls.
21 (15)(14) The meetings of the committees and governing
22 board of a licensed facility held solely for the purpose of
23 achieving the objectives of risk management as provided by
24 this section shall not be open to the public under the
25 provisions of chapter 286. The records of such meetings are
26 confidential and exempt from s. 119.07(1), except as provided
27 in subsection (14) (13).
28 (16)(15) The agency shall review, as part of its
29 licensure inspection process, the internal risk management
30 program at each licensed facility regulated by this section to
31 determine whether the program meets standards established in
17
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 statutes and rules, whether the program is being conducted in
2 a manner designed to reduce adverse incidents, and whether the
3 program is appropriately reporting incidents under this
4 section subsections (5), (6), (7), and (8).
5 (17)(16) There shall be no monetary liability on the
6 part of, and no cause of action for damages shall arise
7 against, any risk manager, licensed under s. 395.10974 part IX
8 of chapter 626, for the implementation and oversight of the
9 internal risk management program in a facility licensed under
10 this chapter or chapter 390 as required by this section, for
11 any act or proceeding undertaken or performed within the scope
12 of the functions of such internal risk management program if
13 the risk manager acts without intentional fraud.
14 (18) A privilege against civil liability is hereby
15 granted to any licensed risk manager or licensed facility with
16 regard to information furnished pursuant to this chapter,
17 unless the licensed risk manager or facility acted in bad
18 faith or with malice in providing such information.
19 (19)(17) If the agency, through its receipt of any
20 reports required under this section the annual reports
21 prescribed in subsection (6) or through any investigation, has
22 a reasonable belief that conduct by a staff member or employee
23 of a licensed facility is grounds for disciplinary action by
24 the appropriate regulatory board, the agency shall report this
25 fact to such regulatory board.
26 (18) The agency shall annually publish a report
27 summarizing the information contained in the annual incident
28 reports submitted by licensed facilities pursuant to
29 subsection (6) and disciplinary actions reported to the agency
30 pursuant to s. 395.0193. The report must, at a minimum,
31 summarize:
18
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (a) Adverse incidents, by category of reported
2 incident, and by type of professional involved.
3 (b) Types of malpractice claims filed, by type of
4 professional involved.
5 (c) Disciplinary actions taken against professionals,
6 by type of professional involved.
7 (20) It shall be unlawful for any person to coerce,
8 intimidate, or preclude a risk manager from lawfully executing
9 his or her reporting obligations pursuant to this chapter.
10 Such unlawful action shall be subject to civil monetary
11 penalties not to exceed $10,000 per violation.
12 Section 6. Section 395.10972, Florida Statutes, is
13 amended to read:
14 395.10972 Health Care Risk Manager Advisory
15 Council.--The Secretary of Health Care Administration may
16 appoint a seven-member five-member advisory council to advise
17 the agency on matters pertaining to health care risk managers.
18 The members of the council shall serve at the pleasure of the
19 secretary. The council shall designate a chair. The council
20 shall meet at the call of the secretary or at those times as
21 may be required by rule of the agency. The members of the
22 advisory council shall receive no compensation for their
23 services, but shall be reimbursed for travel expenses as
24 provided in s. 112.061. The council shall consist of
25 individuals representing the following areas:
26 (1) Two shall be active health care risk managers,
27 including one risk manager who is recommended by and a member
28 of the Florida Society of Healthcare Risk Management.
29 (2) One shall be an active hospital administrator.
30 (3) One shall be an employee of an insurer or
31 self-insurer of medical malpractice coverage.
19
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (4) One shall be a representative of the
2 health-care-consuming public.
3 (5) Two shall be licensed health care practitioners,
4 one of whom shall be licensed as a physician under chapter 458
5 or chapter 459.
6 Section 7. Paragraph (b) of subsection (2) of section
7 395.701, Florida Statutes, is amended to read:
8 395.701 Annual assessments on net operating revenues
9 for inpatient and outpatient services to fund public medical
10 assistance; administrative fines for failure to pay
11 assessments when due; exemption.--
12 (2)
13 (b) There is imposed upon each hospital an assessment
14 in an amount equal to 1 percent of the annual net operating
15 revenue for outpatient services for each hospital, such
16 revenue to be determined by the agency, based on the actual
17 experience of the hospital as reported to the agency. While
18 prior year report worksheets may be reconciled to the
19 hospital's audited financial statements, no additional audited
20 financial components may be required for the purposes of
21 determining the amount of the assessment imposed pursuant to
22 this section other than those in effect on July 1, 2000.
23 Within 6 months after the end of each hospital fiscal year,
24 the agency shall certify the amount of the assessment for each
25 hospital. The assessment shall be payable to and collected by
26 the agency in equal quarterly amounts, on or before the first
27 day of each calendar quarter, beginning with the first full
28 calendar quarter that occurs after the agency certifies the
29 amount of the assessment for each hospital. All moneys
30 collected pursuant to this subsection shall be deposited into
31 the Public Medical Assistance Trust Fund.
20
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Section 8. Section 409.905, Florida Statutes, is
2 amended to read:
3 409.905 Mandatory Medicaid services.--The agency may
4 make payments for the following services, which are required
5 of the state by Title XIX of the Social Security Act,
6 furnished by Medicaid providers to recipients who are
7 determined to be eligible on the dates on which the services
8 were provided. Any service under this section shall be
9 provided only when medically necessary and in accordance with
10 state and federal law. Mandatory services rendered by
11 providers in mobile units to Medicaid recipients may be
12 restricted by the agency. Nothing in this section shall be
13 construed to prevent or limit the agency from adjusting fees,
14 reimbursement rates, lengths of stay, number of visits, number
15 of services, or any other adjustments necessary to comply with
16 the availability of moneys and any limitations or directions
17 provided for in the General Appropriations Act or chapter 216.
18 (1) ADVANCED REGISTERED NURSE PRACTITIONER
19 SERVICES.--The agency shall pay for services provided to a
20 recipient by a licensed advanced registered nurse practitioner
21 who has a valid collaboration agreement with a licensed
22 physician on file with the Department of Health or who
23 provides anesthesia services in accordance with established
24 protocol required by state law and approved by the medical
25 staff of the facility in which the anesthetic service is
26 performed. Reimbursement for such services must be provided in
27 an amount that equals not less than 80 percent of the
28 reimbursement to a physician who provides the same services,
29 unless otherwise provided for in the General Appropriations
30 Act.
31 (2) EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND
21
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 TREATMENT SERVICES.--The agency shall pay for early and
2 periodic screening and diagnosis of a recipient under age 21
3 to ascertain physical and mental problems and conditions and
4 provide treatment to correct or ameliorate these problems and
5 conditions. These services include all services determined by
6 the agency to be medically necessary for the treatment,
7 correction, or amelioration of these problems, including
8 personal care, private duty nursing, durable medical
9 equipment, physical therapy, occupational therapy, speech
10 therapy, respiratory therapy, and immunizations.
11 (3) FAMILY PLANNING SERVICES.--The agency shall pay
12 for services necessary to enable a recipient voluntarily to
13 plan family size or to space children. These services include
14 information; education; counseling regarding the availability,
15 benefits, and risks of each method of pregnancy prevention;
16 drugs and supplies; and necessary medical care and followup.
17 Each recipient participating in the family planning portion of
18 the Medicaid program must be provided freedom to choose any
19 alternative method of family planning, as required by federal
20 law.
21 (4) HOME HEALTH CARE SERVICES.--The agency shall pay
22 for nursing and home health aide services, supplies,
23 appliances, and durable medical equipment, necessary to assist
24 a recipient living at home. An entity that provides services
25 pursuant to this subsection shall be licensed under part IV of
26 chapter 400 or part II of chapter 499, if appropriate. These
27 services, equipment, and supplies, or reimbursement therefor,
28 may be limited as provided in the General Appropriations Act
29 and do not include services, equipment, or supplies provided
30 to a person residing in a hospital or nursing facility. In
31 providing home health care services, the agency may require
22
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 prior authorization of care based on diagnosis.
2 (5) HOSPITAL INPATIENT SERVICES.--The agency shall pay
3 for all covered services provided for the medical care and
4 treatment of a recipient who is admitted as an inpatient by a
5 licensed physician or dentist to a hospital licensed under
6 part I of chapter 395. However, the agency shall limit the
7 payment for inpatient hospital services for a Medicaid
8 recipient 21 years of age or older to 45 days or the number of
9 days necessary to comply with the General Appropriations Act.
10 (a) The agency is authorized to implement
11 reimbursement and utilization management reforms in order to
12 comply with any limitations or directions in the General
13 Appropriations Act, which may include, but are not limited to:
14 prior authorization for inpatient psychiatric days; enhanced
15 utilization and concurrent review programs for highly utilized
16 services; reduction or elimination of covered days of service;
17 adjusting reimbursement ceilings for variable costs; adjusting
18 reimbursement ceilings for fixed and property costs; and
19 implementing target rates of increase.
20 (b) A licensed hospital maintained primarily for the
21 care and treatment of patients having mental disorders or
22 mental diseases is not eligible to participate in the hospital
23 inpatient portion of the Medicaid program except as provided
24 in federal law. However, the department shall apply for a
25 waiver, within 9 months after June 5, 1991, designed to
26 provide hospitalization services for mental health reasons to
27 children and adults in the most cost-effective and lowest cost
28 setting possible. Such waiver shall include a request for the
29 opportunity to pay for care in hospitals known under federal
30 law as "institutions for mental disease" or "IMD's." The
31 waiver proposal shall propose no additional aggregate cost to
23
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 the state or Federal Government, and shall be conducted in
2 Hillsborough County, Highlands County, Hardee County, Manatee
3 County, and Polk County. The waiver proposal may incorporate
4 competitive bidding for hospital services, comprehensive
5 brokering, prepaid capitated arrangements, or other mechanisms
6 deemed by the department to show promise in reducing the cost
7 of acute care and increasing the effectiveness of preventive
8 care. When developing the waiver proposal, the department
9 shall take into account price, quality, accessibility,
10 linkages of the hospital to community services and family
11 support programs, plans of the hospital to ensure the earliest
12 discharge possible, and the comprehensiveness of the mental
13 health and other health care services offered by participating
14 providers.
15 (c) Agency for Health Care Administration shall adjust
16 a hospital's current inpatient per diem rate to reflect the
17 cost of serving the Medicaid population at that institution
18 if:
19 1. The hospital experiences an increase in Medicaid
20 caseload by more than 25 percent in any year, primarily
21 resulting from the closure of a hospital in the same service
22 area occurring after July 1, 1995; or
23 2. The hospital's Medicaid per diem rate is at least
24 25 percent below the Medicaid per patient cost for that year.
25
26 No later than November 1, 2000, the agency must provide
27 estimated costs for any adjustment in a hospital inpatient per
28 diem pursuant to this paragraph to the Executive Office of the
29 Governor, the House of Representatives General Appropriations
30 Committee, and the Senate Budget Committee. Before the agency
31 implements a change in a hospital's inpatient per diem rate
24
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 pursuant to this paragraph, the Legislature must have
2 specifically appropriated sufficient funds in the 2001-2002
3 General Appropriations Act to support the increase in cost as
4 estimated by the agency. This paragraph is repealed on July 1,
5 2001.
6 (6) HOSPITAL OUTPATIENT SERVICES.--The agency shall
7 pay for preventive, diagnostic, therapeutic, or palliative
8 care and other services provided to a recipient in the
9 outpatient portion of a hospital licensed under part I of
10 chapter 395, and provided under the direction of a licensed
11 physician or licensed dentist, except that payment for such
12 care and services is limited to $1,500 per state fiscal year
13 per recipient, unless an exception has been made by the
14 agency, and with the exception of a Medicaid recipient under
15 age 21, in which case the only limitation is medical
16 necessity.
17 (7) INDEPENDENT LABORATORY SERVICES.--The agency shall
18 pay for medically necessary diagnostic laboratory procedures
19 ordered by a licensed physician or other licensed practitioner
20 of the healing arts which are provided for a recipient in a
21 laboratory that meets the requirements for Medicare
22 participation and is licensed under chapter 483, if required.
23 (8) NURSING FACILITY SERVICES.--The agency shall pay
24 for 24-hour-a-day nursing and rehabilitative services for a
25 recipient in a nursing facility licensed under part II of
26 chapter 400 or in a rural hospital, as defined in s. 395.602,
27 or in a Medicare certified skilled nursing facility operated
28 by a hospital, as defined by s. 395.002(11), that is licensed
29 under part I of chapter 395, and in accordance with provisions
30 set forth in s. 409.908(2)(a), which services are ordered by
31 and provided under the direction of a licensed physician.
25
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 However, if a nursing facility has been destroyed or otherwise
2 made uninhabitable by natural disaster or other emergency and
3 another nursing facility is not available, the agency must pay
4 for similar services temporarily in a hospital licensed under
5 part I of chapter 395 provided federal funding is approved and
6 available.
7 (9) PHYSICIAN SERVICES.--The agency shall pay for
8 covered services and procedures rendered to a recipient by, or
9 under the personal supervision of, a person licensed under
10 state law to practice medicine or osteopathic medicine. These
11 services may be furnished in the physician's office, the
12 Medicaid recipient's home, a hospital, a nursing facility, or
13 elsewhere, but shall be medically necessary for the treatment
14 of an injury, illness, or disease within the scope of the
15 practice of medicine or osteopathic medicine as defined by
16 state law. The agency shall not pay for services that are
17 clinically unproven, experimental, or for purely cosmetic
18 purposes.
19 (10) PORTABLE X-RAY SERVICES.--The agency shall pay
20 for professional and technical portable radiological services
21 ordered by a licensed physician or other licensed practitioner
22 of the healing arts which are provided by a licensed
23 professional in a setting other than a hospital, clinic, or
24 office of a physician or practitioner of the healing arts, on
25 behalf of a recipient.
26 (11) RURAL HEALTH CLINIC SERVICES.--The agency shall
27 pay for outpatient primary health care services for a
28 recipient provided by a clinic certified by and participating
29 in the Medicare program which is located in a federally
30 designated, rural, medically underserved area and has on its
31 staff one or more licensed primary care nurse practitioners or
26
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 physician assistants, and a licensed staff supervising
2 physician or a consulting supervising physician.
3 (12) TRANSPORTATION SERVICES.--The agency shall ensure
4 that appropriate transportation services are available for a
5 Medicaid recipient in need of transport to a qualified
6 Medicaid provider for medically necessary and
7 Medicaid-compensable services, provided a client's ability to
8 choose a specific transportation provider shall be limited to
9 those options resulting from policies established by the
10 agency to meet the fiscal limitations of the General
11 Appropriations Act. The agency may pay for transportation and
12 other related travel expenses as necessary only if these
13 services are not otherwise available.
14 Section 9. Section 409.906, Florida Statutes, is
15 amended to read:
16 409.906 Optional Medicaid services.--Subject to
17 specific appropriations, the agency may make payments for
18 services which are optional to the state under Title XIX of
19 the Social Security Act and are furnished by Medicaid
20 providers to recipients who are determined to be eligible on
21 the dates on which the services were provided. Any optional
22 service that is provided shall be provided only when medically
23 necessary and in accordance with state and federal law.
24 Optional services rendered by providers in mobile units to
25 Medicaid recipients may be restricted or prohibited by the
26 agency. Nothing in this section shall be construed to prevent
27 or limit the agency from adjusting fees, reimbursement rates,
28 lengths of stay, number of visits, or number of services, or
29 making any other adjustments necessary to comply with the
30 availability of moneys and any limitations or directions
31 provided for in the General Appropriations Act or chapter 216.
27
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 If necessary to safeguard the state's systems of providing
2 services to elderly and disabled persons and subject to the
3 notice and review provisions of s. 216.177, the Governor may
4 direct the Agency for Health Care Administration to amend the
5 Medicaid state plan to delete the optional Medicaid service
6 known as "Intermediate Care Facilities for the Developmentally
7 Disabled." Optional services may include:
8 (1) ADULT DENTURE SERVICES.--The agency may pay for
9 dentures, the procedures required to seat dentures, and the
10 repair and reline of dentures, provided by or under the
11 direction of a licensed dentist, for a recipient who is age 21
12 or older. However, Medicaid will not provide reimbursement for
13 dental services provided in a mobile dental unit, except for a
14 mobile dental unit:
15 (a) Owned by, operated by, or having a contractual
16 agreement with the Department of Health and complying with
17 Medicaid's county health department clinic services program
18 specifications as a county health department clinic services
19 provider.
20 (b) Owned by, operated by, or having a contractual
21 arrangement with a federally qualified health center and
22 complying with Medicaid's federally qualified health center
23 specifications as a federally qualified health center
24 provider.
25 (c) Rendering dental services to Medicaid recipients,
26 21 years of age and older, at nursing facilities.
27 (d) Owned by, operated by, or having a contractual
28 agreement with a state-approved dental educational
29 institution.
30 (2) ADULT HEALTH SCREENING SERVICES.--The agency may
31 pay for an annual routine physical examination, conducted by
28
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 or under the direction of a licensed physician, for a
2 recipient age 21 or older, without regard to medical
3 necessity, in order to detect and prevent disease, disability,
4 or other health condition or its progression.
5 (3) AMBULATORY SURGICAL CENTER SERVICES.--The agency
6 may pay for services provided to a recipient in an ambulatory
7 surgical center licensed under part I of chapter 395, by or
8 under the direction of a licensed physician or dentist.
9 (4) BIRTH CENTER SERVICES.--The agency may pay for
10 examinations and delivery, recovery, and newborn assessment,
11 and related services, provided in a licensed birth center
12 staffed with licensed physicians, certified nurse midwives,
13 and midwives licensed in accordance with chapter 467, to a
14 recipient expected to experience a low-risk pregnancy and
15 delivery.
16 (5) CASE MANAGEMENT SERVICES.--The agency may pay for
17 primary care case management services rendered to a recipient
18 pursuant to a federally approved waiver, and targeted case
19 management services for specific groups of targeted
20 recipients, for which funding has been provided and which are
21 rendered pursuant to federal guidelines. The agency is
22 authorized to limit reimbursement for targeted case management
23 services in order to comply with any limitations or directions
24 provided for in the General Appropriations Act.
25 Notwithstanding s. 216.292, the Department of Children and
26 Family Services may transfer general funds to the Agency for
27 Health Care Administration to fund state match requirements
28 exceeding the amount specified in the General Appropriations
29 Act for targeted case management services.
30 (6) CHILDREN'S DENTAL SERVICES.--The agency may pay
31 for diagnostic, preventive, or corrective procedures,
29
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 including orthodontia in severe cases, provided to a recipient
2 under age 21, by or under the supervision of a licensed
3 dentist. Services provided under this program include
4 treatment of the teeth and associated structures of the oral
5 cavity, as well as treatment of disease, injury, or impairment
6 that may affect the oral or general health of the individual.
7 However, Medicaid will not provide reimbursement for dental
8 services provided in a mobile dental unit, except for a mobile
9 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 (7) CHIROPRACTIC SERVICES.--The agency may pay for
26 manual manipulation of the spine and initial services,
27 screening, and X rays provided to a recipient by a licensed
28 chiropractic physician.
29 (8) COMMUNITY MENTAL HEALTH SERVICES.--The agency may
30 pay for rehabilitative services provided to a recipient by a
31 mental health or substance abuse provider licensed by the
30
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 agency and under contract with the agency or the Department of
2 Children and Family Services to provide such services. Those
3 services which are psychiatric in nature shall be rendered or
4 recommended by a psychiatrist, and those services which are
5 medical in nature shall be rendered or recommended by a
6 physician or psychiatrist. The agency must develop a provider
7 enrollment process for community mental health providers which
8 bases provider enrollment on an assessment of service need.
9 The provider enrollment process shall be designed to control
10 costs, prevent fraud and abuse, consider provider expertise
11 and capacity, and assess provider success in managing
12 utilization of care and measuring treatment outcomes.
13 Providers will be selected through a competitive procurement
14 or selective contracting process. In addition to other
15 community mental health providers, the agency shall consider
16 for enrollment mental health programs licensed under chapter
17 395 and group practices licensed under chapter 458, chapter
18 459, chapter 490, or chapter 491. The agency is also
19 authorized to continue operation of its behavioral health
20 utilization management program and may develop new services if
21 these actions are necessary to ensure savings from the
22 implementation of the utilization management system. The
23 agency shall coordinate the implementation of this enrollment
24 process with the Department of Children and Family Services
25 and the Department of Juvenile Justice. The agency is
26 authorized to utilize diagnostic criteria in setting
27 reimbursement rates, to preauthorize certain high-cost or
28 highly utilized services, to limit or eliminate coverage for
29 certain services, or to make any other adjustments necessary
30 to comply with any limitations or directions provided for in
31 the General Appropriations Act.
31
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (9) DIALYSIS FACILITY SERVICES.--Subject to specific
2 appropriations being provided for this purpose, the agency may
3 pay a dialysis facility that is approved as a dialysis
4 facility in accordance with Title XVIII of the Social Security
5 Act, for dialysis services that are provided to a Medicaid
6 recipient under the direction of a physician licensed to
7 practice medicine or osteopathic medicine in this state,
8 including dialysis services provided in the recipient's home
9 by a hospital-based or freestanding dialysis facility.
10 (10) DURABLE MEDICAL EQUIPMENT.--The agency may
11 authorize and pay for certain durable medical equipment and
12 supplies provided to a Medicaid recipient as medically
13 necessary.
14 (11) HEALTHY START SERVICES.--The agency may pay for a
15 continuum of risk-appropriate medical and psychosocial
16 services for the Healthy Start program in accordance with a
17 federal waiver. The agency may not implement the federal
18 waiver unless the waiver permits the state to limit enrollment
19 or the amount, duration, and scope of services to ensure that
20 expenditures will not exceed funds appropriated by the
21 Legislature or available from local sources. If the Health
22 Care Financing Administration does not approve a federal
23 waiver for Healthy Start services, the agency, in consultation
24 with the Department of Health and the Florida Association of
25 Healthy Start Coalitions, is authorized to establish a
26 Medicaid certified-match program for Healthy Start services.
27 Participation in the Healthy Start certified-match program
28 shall be voluntary, and reimbursement shall be limited to the
29 federal Medicaid share to Medicaid-enrolled Healthy Start
30 coalitions for services provided to Medicaid recipients. The
31 agency shall take no action to implement a certified-match
32
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 program without ensuring that the amendment and review
2 requirements of ss. 216.177 and 216.181 have been met.
3 (12) HEARING SERVICES.--The agency may pay for hearing
4 and related services, including hearing evaluations, hearing
5 aid devices, dispensing of the hearing aid, and related
6 repairs, if provided to a recipient by a licensed hearing aid
7 specialist, otolaryngologist, otologist, audiologist, or
8 physician.
9 (13) HOME AND COMMUNITY-BASED SERVICES.--The agency
10 may pay for home-based or community-based services that are
11 rendered to a recipient in accordance with a federally
12 approved waiver program.
13 (14) HOSPICE CARE SERVICES.--The agency may pay for
14 all reasonable and necessary services for the palliation or
15 management of a recipient's terminal illness, if the services
16 are provided by a hospice that is licensed under part VI of
17 chapter 400 and meets Medicare certification requirements.
18 (15) INTERMEDIATE CARE FACILITY FOR THE
19 DEVELOPMENTALLY DISABLED SERVICES.--The agency may pay for
20 health-related care and services provided on a 24-hour-a-day
21 basis by a facility licensed and certified as a Medicaid
22 Intermediate Care Facility for the Developmentally Disabled,
23 for a recipient who needs such care because of a developmental
24 disability.
25 (16) INTERMEDIATE CARE SERVICES.--The agency may pay
26 for 24-hour-a-day intermediate care nursing and rehabilitation
27 services rendered to a recipient in a nursing facility
28 licensed under part II of chapter 400, if the services are
29 ordered by and provided under the direction of a physician.
30 (17) OPTOMETRIC SERVICES.--The agency may pay for
31 services provided to a recipient, including examination,
33
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 diagnosis, treatment, and management, related to ocular
2 pathology, if the services are provided by a licensed
3 optometrist or physician.
4 (18) PHYSICIAN ASSISTANT SERVICES.--The agency may pay
5 for all services provided to a recipient by a physician
6 assistant licensed under s. 458.347 or s. 459.022.
7 Reimbursement for such services must be not less than 80
8 percent of the reimbursement that would be paid to a physician
9 who provided the same services.
10 (19) PODIATRIC SERVICES.--The agency may pay for
11 services, including diagnosis and medical, surgical,
12 palliative, and mechanical treatment, related to ailments of
13 the human foot and lower leg, if provided to a recipient by a
14 podiatric physician licensed under state law.
15 (20) PRESCRIBED DRUG SERVICES.--The agency may pay for
16 medications that are prescribed for a recipient by a physician
17 or other licensed practitioner of the healing arts authorized
18 to prescribe medications and that are dispensed to the
19 recipient by a licensed pharmacist or physician in accordance
20 with applicable state and federal law.
21 (21) REGISTERED NURSE FIRST ASSISTANT SERVICES.--The
22 agency may pay for all services provided to a recipient by a
23 registered nurse first assistant as described in s. 464.027.
24 Reimbursement for such services may not be less than 80
25 percent of the reimbursement that would be paid to a physician
26 providing the same services.
27 (22) STATE HOSPITAL SERVICES.--The agency may pay for
28 all-inclusive psychiatric inpatient hospital care provided to
29 a recipient age 65 or older in a state mental hospital.
30 (23) VISUAL SERVICES.--The agency may pay for visual
31 examinations, eyeglasses, and eyeglass repairs for a
34
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 recipient, if they are prescribed by a licensed physician
2 specializing in diseases of the eye or by a licensed
3 optometrist.
4 (24) CHILD-WELFARE-TARGETED CASE MANAGEMENT.--The
5 Agency for Health Care Administration, in consultation with
6 the Department of Children and Family Services, may establish
7 a targeted case-management pilot project in those counties
8 identified by the Department of Children and Family Services
9 and for the community-based child welfare project in Sarasota
10 and Manatee counties, as authorized under s. 409.1671. These
11 projects shall be established for the purpose of determining
12 the impact of targeted case management on the child welfare
13 program and the earnings from the child welfare program.
14 Results of the pilot projects shall be reported to the Child
15 Welfare Estimating Conference and the Social Services
16 Estimating Conference established under s. 216.136. The number
17 of projects may not be increased until requested by the
18 Department of Children and Family Services, recommended by the
19 Child Welfare Estimating Conference and the Social Services
20 Estimating Conference, and approved by the Legislature. The
21 covered group of individuals who are eligible to receive
22 targeted case management include children who are eligible for
23 Medicaid; who are between the ages of birth through 21; and
24 who are under protective supervision or postplacement
25 supervision, under foster-care supervision, or in shelter care
26 or foster care. The number of individuals who are eligible to
27 receive targeted case management shall be limited to the
28 number for whom the Department of Children and Family Services
29 has available matching funds to cover the costs. The general
30 revenue funds required to match the funds for services
31 provided by the community-based child welfare projects are
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 limited to funds available for services described under s.
2 409.1671. The Department of Children and Family Services may
3 transfer the general revenue matching funds as billed by the
4 Agency for Health Care Administration.
5 Section 10. Subsections (7) through (11) of section
6 456.013, Florida Statutes, are renumbered as subsections (8)
7 through (12), respectively, and a new subsection (7) is added
8 to said section to read:
9 456.013 Department; general licensing provisions.--
10 (7) The boards, or the department when there is no
11 board, shall require the completion of a 2-hour course
12 relating to prevention of medical errors as part of the
13 licensure and renewal process. The 2-hour course shall count
14 towards the total number of continuing education hours
15 required for the profession. The course shall be approved by
16 the board or department, as appropriate, and shall include a
17 study of root-cause analysis, error reduction and prevention,
18 and patient safety. If the course is being offered by a
19 facility licensed pursuant to chapter 395 for its employees,
20 the board may approve up to 1 hour of the 2-hour course to be
21 specifically related to error reduction and prevention methods
22 used in that facility.
23 Section 11. Subsection (19) is added to section
24 456.057, Florida Statutes, to read:
25 456.057 Ownership and control of patient records;
26 report or copies of records to be furnished.--
27 (19) The board, or department when there is no board,
28 may temporarily or permanently appoint a person or entity as a
29 custodian of medical records in the event of the death of a
30 practitioner, the mental or physical incapacitation of the
31 practitioner, or the abandonment of medical records by a
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 practitioner. The custodian appointed shall comply with all
2 provisions of this section, including the release of patient
3 records.
4 Section 12. Subsection (3) is added to section
5 456.063, Florida Statutes, to read:
6 456.063 Sexual misconduct; disqualification for
7 license, certificate, or registration; reports of allegation
8 of sexual misconduct.--
9 (3) Licensed health care practitioners shall report
10 allegations of sexual misconduct to the department, regardless
11 of the practice setting in which the alleged sexual misconduct
12 occurred.
13 Section 13. Paragraph (c) of subsection (1) of section
14 456.072, Florida Statutes, is amended, paragraphs (aa) and
15 (bb) are added to said subsection, paragraphs (c) and (d) of
16 subsection (2) and subsection (4) are amended, and paragraphs
17 (i) and (j) are added to subsection (2) of said section, to
18 read:
19 456.072 Grounds for discipline; penalties;
20 enforcement.--
21 (1) The following acts shall constitute grounds for
22 which the disciplinary actions specified in subsection (2) may
23 be taken:
24 (c) Being convicted or found guilty of, or entering a
25 plea of guilty or nolo contendere to, regardless of
26 adjudication, a crime in any jurisdiction which relates to the
27 practice of, or the ability to practice, a licensee's
28 profession.
29 (aa) Performing or attempting to perform health care
30 services on the wrong patient, a wrong-site procedure, a wrong
31 procedure, or an unauthorized procedure or a procedure that is
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 medically unnecessary or otherwise unrelated to the patient's
2 diagnosis or medical condition. For the purposes of this
3 paragraph, performing or attempting to perform health care
4 services includes the preparation of the patient.
5 (bb) Leaving a foreign body in a patient, such as a
6 sponge, clamp, forceps, surgical needle, or other
7 paraphernalia commonly used in surgical, examination, or other
8 diagnostic procedures. For the purposes of this paragraph, it
9 shall be legally presumed that retention of a foreign body is
10 not in the best interest of the patient and is not within the
11 standard of care of the profession, regardless of the intent
12 of the professional.
13 (2) When the board, or the department when there is no
14 board, finds any person guilty of the grounds set forth in
15 subsection (1) or of any grounds set forth in the applicable
16 practice act, including conduct constituting a substantial
17 violation of subsection (1) or a violation of the applicable
18 practice act which occurred prior to obtaining a license, it
19 may enter an order imposing one or more of the following
20 penalties:
21 (c) Restriction of practice or license, including, but
22 not limited to, restricting the licensee from practicing in
23 certain settings, restricting the licensee to work only under
24 designated conditions or in certain settings, restricting the
25 licensee from performing or providing designated clinical and
26 administrative services, restricting the licensee from
27 practicing more than a designated number of hours, or any
28 other restriction found to be necessary for the protection of
29 the public health, safety, and welfare.
30 (d) Imposition of an administrative fine not to exceed
31 $10,000 for each count or separate offense. If the violation
38
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 is for fraud or making a false or fraudulent representation,
2 the board, or the department if there is no board, must impose
3 a fine of $10,000 per count or offense.
4 (i) Refund of fees billed and collected from the
5 patient or a third party on behalf of the patient.
6 (j) Requirement that the practitioner undergo remedial
7 education.
8
9 In determining what action is appropriate, the board, or
10 department when there is no board, must first consider what
11 sanctions are necessary to protect the public or to compensate
12 the patient. Only after those sanctions have been imposed may
13 the disciplining authority consider and include in the order
14 requirements designed to rehabilitate the practitioner. All
15 costs associated with compliance with orders issued under this
16 subsection are the obligation of the practitioner.
17 (4) In addition to any other discipline imposed
18 pursuant to this section or discipline imposed for a violation
19 of any practice act, the board, or the department when there
20 is no board, shall may assess costs related to the
21 investigation and prosecution of the case. In any case where
22 the board or the department imposes a fine or assessment and
23 the fine or assessment is not paid within a reasonable time,
24 such reasonable time to be prescribed in the rules of the
25 board, or the department when there is no board, or in the
26 order assessing such fines or costs, the department or the
27 Department of Legal Affairs may contract for the collection
28 of, or bring a civil action to recover, the fine or
29 assessment.
30 Section 14. Paragraphs (a) and (c) of subsection (9)
31 of section 456.073, Florida Statutes, are amended, and,
39
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 effective upon this act becoming a law, subsection (13) is
2 added to said section, to read:
3 456.073 Disciplinary proceedings.--Disciplinary
4 proceedings for each board shall be within the jurisdiction of
5 the department.
6 (9)(a) The department shall periodically notify the
7 person who filed the complaint, as well as the patient or the
8 patient's legal representative, of the status of the
9 investigation, indicating whether probable cause has been
10 found and the status of any civil action or administrative
11 proceeding or appeal.
12 (c) In any disciplinary case for which probable cause
13 is not found, the department shall so inform the person who
14 filed the complaint and notify that person that he or she may,
15 within 60 days, provide any additional information to the
16 department probable cause panel which may be relevant to the
17 decision. To facilitate the provision of additional
18 information, the person who filed the complaint may receive,
19 upon request, a copy of the department's expert report that
20 supported the recommendation for closure, if such a report was
21 relied upon by the department. In no way does this require the
22 department to procure an expert opinion or report if none was
23 used. Additionally, the identity of the expert shall remain
24 confidential. In any administrative proceeding under s.
25 120.57, the person who filed the disciplinary complaint shall
26 have the right to present oral or written communication
27 relating to the alleged disciplinary violations or to the
28 appropriate penalty.
29 (13) Notwithstanding any provision of law to the
30 contrary, an administrative complaint against a licensee shall
31 be filed within 6 years after the time of the incident or
40
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 occurrence giving rise to the complaint against the licensee.
2 If such incident or occurrence involved criminal actions,
3 diversion of controlled substances, sexual misconduct, or
4 impairment by the licensee, this subsection does not apply to
5 bar initiation of an investigation or filing of an
6 administrative complaint beyond the 6-year timeframe. In those
7 cases covered by this subsection in which it can be shown that
8 fraud, concealment, or intentional misrepresentation of fact
9 prevented the discovery of the violation of law, the period of
10 limitations is extended forward, but in no event to exceed 12
11 years after the time of the incident or occurrence.
12 Section 15. Subsection (1) of section 456.074, Florida
13 Statutes, is amended to read:
14 456.074 Certain health care practitioners; immediate
15 suspension of license.--
16 (1) The department shall issue an emergency order
17 suspending the license of any person licensed under chapter
18 458, chapter 459, chapter 460, chapter 461, chapter 462,
19 chapter 463, chapter 464, chapter 465, chapter 466, or chapter
20 484 who pleads guilty to, is convicted or found guilty of, or
21 who enters a plea of nolo contendere to, regardless of
22 adjudication, a felony under chapter 409, chapter 817, or
23 chapter 893 or under 21 U.S.C. ss. 801-970 or under 42 U.S.C.
24 ss. 1395-1396.
25 Section 16. Subsections (2) and (6) of section
26 456.077, Florida Statutes, are amended to read:
27 456.077 Authority to issue citations.--
28 (2) The board, or the department if there is no board,
29 shall adopt rules designating violations for which a citation
30 may be issued. Such rules shall designate as citation
31 violations those violations for which there is no substantial
41
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 threat to the public health, safety, and welfare. Violations
2 for which a citation may be issued shall include violations of
3 continuing education requirements, failure to timely pay
4 required fees and fines, failure to comply with the
5 requirements of ss. 381.026 and 381.0261 regarding the
6 dissemination of information regarding patient rights, failure
7 to comply with advertising requirements, failure to timely
8 update practitioner profile and credentialing files, failure
9 to display signs, licenses, and permits, failure to have
10 required reference books available, and all other violations
11 that do not pose a direct and serious threat to the health and
12 safety of the patient.
13 (6) A board created on or after January 1, 1992, has 6
14 months in which to enact rules designating violations and
15 penalties appropriate for citation offenses. Failure to enact
16 such rules gives the department exclusive authority to adopt
17 rules as required for implementing this section. A board has
18 continuous authority to amend its rules adopted pursuant to
19 this section.
20 Section 17. Section 456.081, Florida Statutes, is
21 amended to read:
22 456.081 Publication of information.--The department
23 and the boards shall have the authority to advise licensees
24 periodically, through the publication of a newsletter, about
25 information that the department or the board determines is of
26 interest to the industry. The department and the boards shall
27 maintain a website which contains copies of the newsletter;
28 information relating to adverse incident reports without
29 identifying the patient, practitioner, or facility in which
30 the adverse incident occurred until 10 days after probable
31 cause is found, at which time the name of the practitioner and
42
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 facility shall become public as part of the investigative
2 file; information about error prevention and safety
3 strategies; and information concerning best practices. Unless
4 otherwise prohibited by law, the department and the boards
5 shall publish on the website a summary of final orders entered
6 after July 1, 2001, resulting in disciplinary action fines,
7 suspensions, or revocations, and any other information the
8 department or the board determines is of interest to the
9 public. In order to provide useful and timely information at
10 minimal cost, the department and boards may consult with, and
11 include information provided by, professional associations and
12 national organizations.
13 Section 18. Section 458.3147, Florida Statutes, is
14 created to read:
15 458.3147 Medical school eligibility of military
16 academy students or graduates.--Any Florida resident who is a
17 student at or a graduate of any of the United States military
18 academies who qualifies for assignment to the Medical Corps of
19 the United States military shall be considered eligible for
20 admission to any medical school in the State University
21 System. All application fees shall be waived or refunded.
22 Section 19. Subsection (9) of section 458.331, Florida
23 Statutes, is amended to read:
24 458.331 Grounds for disciplinary action; action by the
25 board and department.--
26 (9) When an investigation of a physician is
27 undertaken, the department shall promptly furnish to the
28 physician or the physician's attorney a copy of the complaint
29 or document which resulted in the initiation of the
30 investigation. For purposes of this subsection, such
31 documents include, but are not limited to: the pertinent
43
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 portions of an annual report submitted to the department
2 pursuant to s. 395.0197(6); a report of an adverse incident
3 which is provided to the department pursuant to s.
4 395.0197(8); a report of peer review disciplinary action
5 submitted to the department pursuant to s. 395.0193(4) or s.
6 458.337, providing that the investigations, proceedings, and
7 records relating to such peer review disciplinary action shall
8 continue to retain their privileged status even as to the
9 licensee who is the subject of the investigation, as provided
10 by ss. 395.0193(8) and 458.337(3); a report of a closed claim
11 submitted pursuant to s. 627.912; a presuit notice submitted
12 pursuant to s. 766.106(2); and a petition brought under the
13 Florida Birth-Related Neurological Injury Compensation Plan,
14 pursuant to s. 766.305(2). The physician may submit a written
15 response to the information contained in the complaint or
16 document which resulted in the initiation of the investigation
17 within 45 days after service to the physician of the complaint
18 or document. The physician's written response shall be
19 considered by the probable cause panel.
20 Section 20. Subsection (9) of section 459.015, Florida
21 Statutes, is amended to read:
22 459.015 Grounds for disciplinary action; action by the
23 board and department.--
24 (9) When an investigation of an osteopathic physician
25 is undertaken, the department shall promptly furnish to the
26 osteopathic physician or his or her attorney a copy of the
27 complaint or document which resulted in the initiation of the
28 investigation. For purposes of this subsection, such documents
29 include, but are not limited to: the pertinent portions of an
30 annual report submitted to the department pursuant to s.
31 395.0197(6); a report of an adverse incident which is provided
44
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 to the department pursuant to s. 395.0197(8); a report of peer
2 review disciplinary action submitted to the department
3 pursuant to s. 395.0193(4) or s. 459.016, provided that the
4 investigations, proceedings, and records relating to such peer
5 review disciplinary action shall continue to retain their
6 privileged status even as to the licensee who is the subject
7 of the investigation, as provided by ss. 395.0193(8) and
8 459.016(3); a report of a closed claim submitted pursuant to
9 s. 627.912; a presuit notice submitted pursuant to s.
10 766.106(2); and a petition brought under the Florida
11 Birth-Related Neurological Injury Compensation Plan, pursuant
12 to s. 766.305(2). The osteopathic physician may submit a
13 written response to the information contained in the complaint
14 or document which resulted in the initiation of the
15 investigation within 45 days after service to the osteopathic
16 physician of the complaint or document. The osteopathic
17 physician's written response shall be considered by the
18 probable cause panel.
19 Section 21. Effective January 1, 2002, subsection (4)
20 of section 641.51, Florida Statutes, is amended to read:
21 641.51 Quality assurance program; second medical
22 opinion requirement.--
23 (4) The organization shall ensure that only a
24 physician with an active, unencumbered license licensed under
25 chapter 458 or chapter 459, or an allopathic or osteopathic
26 physician with an active, unencumbered license in another
27 state with similar licensing requirements may render an
28 adverse determination regarding a service provided by a
29 physician licensed in this state. The organization shall
30 submit to the treating provider and the subscriber written
31 notification regarding the organization's adverse
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 determination within 2 working days after the subscriber or
2 provider is notified of the adverse determination. The written
3 notification must include the utilization review criteria or
4 benefits provisions used in the adverse determination,
5 identify the physician who rendered the adverse determination,
6 and be signed by an authorized representative of the
7 organization or the physician who rendered the adverse
8 determination. The organization must include with the
9 notification of an adverse determination information
10 concerning the appeal process for adverse determinations. This
11 provision does not create authority for the Board of Medicine
12 or Board of Osteopathic Medicine to regulate the organization;
13 however, the Board of Medicine and the Board of Osteopathic
14 Medicine continue to have jurisdiction over licensees of their
15 respective boards.
16 Section 22. Subsection (5) of section 465.019, Florida
17 Statutes, is amended to read:
18 465.019 Institutional pharmacies; permits.--
19 (5) All institutional pharmacies shall be under the
20 professional supervision of a consultant pharmacist, and the
21 compounding and dispensing of medicinal drugs shall be done
22 only by a licensed pharmacist. Every institutional pharmacy
23 that employs or otherwise utilizes pharmacy technicians shall
24 have a written policy and procedures manual specifying those
25 duties, tasks, and functions which a pharmacy technician is
26 allowed to perform.
27 Section 23. Section 465.0196, Florida Statutes, is
28 amended to read:
29 465.0196 Special pharmacy permits.--Any person
30 desiring a permit to operate a pharmacy which does not fall
31 within the definitions set forth in s. 465.003(11)(a)1., 2.,
46
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 and 3. shall apply to the department for a special pharmacy
2 permit. If the board certifies that the application complies
3 with the applicable laws and rules of the board governing the
4 practice of the profession of pharmacy, the department shall
5 issue the permit. No permit shall be issued unless a licensed
6 pharmacist is designated to undertake the professional
7 supervision of the compounding and dispensing of all drugs
8 dispensed by the pharmacy. The licensed pharmacist shall be
9 responsible for maintaining all drug records and for providing
10 for the security of the area in the facility in which the
11 compounding, storing, and dispensing of medicinal drugs
12 occurs. The permittee shall notify the department within 10
13 days of any change of the licensed pharmacist responsible for
14 such duties. Every permittee that employs or otherwise
15 utilizes pharmacy technicians shall have a written policy and
16 procedures manual specifying those duties, tasks, and
17 functions which a pharmacy technician is allowed to perform.
18 Section 24. The Department of Health and the Agency
19 for Health Care Administration shall conduct a review of all
20 statutorily imposed reporting requirements for health care
21 practitioners and health facilities. The department and the
22 agency shall report back to the Legislature on or before
23 November 1, 2001, with recommendations and suggested statutory
24 changes to streamline reporting requirements to avoid
25 duplicative, overlapping, and unnecessary reports or data
26 elements.
27 Section 25. Paragraph (r) is added to subsection (1)
28 of section 468.1755, Florida Statutes, and, for the purpose of
29 incorporating the amendment to section 456.072(1), Florida
30 Statutes, in a reference thereto, paragraph (a) of subsection
31 (1) of said section is reenacted, to read:
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 468.1755 Disciplinary proceedings.--
2 (1) The following acts shall constitute grounds for
3 which the disciplinary actions in subsection (2) may be taken:
4 (a) Violation of any provision of s. 456.072(1) or s.
5 468.1745(1).
6 (r) Failing to implement an ongoing quality assurance
7 program directed by an interdisciplinary team that meets at
8 least every other month.
9 (2) When the board finds any nursing home
10 administrator guilty of any of the grounds set forth in
11 subsection (1), it may enter an order imposing one or more of
12 the following penalties:
13 (a) Denial of an application for licensure.
14 (b) Revocation or suspension of a license.
15 (c) Imposition of an administrative fine not to exceed
16 $1,000 for each count or separate offense.
17 (d) Issuance of a reprimand.
18 (e) Placement of the licensee on probation for a
19 period of time and subject to such conditions as the board may
20 specify, including requiring the licensee to attend continuing
21 education courses or to work under the supervision of another
22 licensee.
23 (f) Restriction of the authorized scope of practice.
24 Section 26. For the purpose of incorporating the
25 amendment to section 468.1755(1), Florida Statutes, in
26 reference thereto, subsection (3) of section 468.1695, Florida
27 Statutes, and section 468.1735, Florida Statutes, are
28 reenacted to read:
29 468.1695 Licensure by examination.--
30 (3) The department shall issue a license to practice
31 nursing home administration to any applicant who successfully
48
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 completes the examination in accordance with this section and
2 otherwise meets the requirements of this part. The department
3 shall not issue a license to any applicant who is under
4 investigation in this state or another jurisdiction for an
5 offense which would constitute a violation of s. 468.1745 or
6 s. 468.1755. Upon completion of the investigation, the
7 provisions of s. 468.1755 shall apply.
8 468.1735 Provisional license.--The board may establish
9 by rule requirements for issuance of a provisional license. A
10 provisional license shall be issued only to fill a position of
11 nursing home administrator that unexpectedly becomes vacant
12 due to illness, sudden death of the administrator, or
13 abandonment of position and shall be issued for one single
14 period as provided by rule not to exceed 6 months. The
15 department shall not issue a provisional license to any
16 applicant who is under investigation in this state or another
17 jurisdiction for an offense which would constitute a violation
18 of s. 468.1745 or s. 468.1755. Upon completion of the
19 investigation, the provisions of s. 468.1755 shall apply. The
20 provisional license may be issued to a person who does not
21 meet all of the licensing requirements established by this
22 part, but the board shall by rule establish minimal
23 requirements to ensure protection of the public health,
24 safety, and welfare. The provisional license shall be issued
25 to the person who is designated as the responsible person next
26 in command in the event of the administrator's departure. The
27 board may set an application fee not to exceed $500 for a
28 provisional license.
29 Section 27. For the purpose of incorporating the
30 amendment to section 456.072(1), Florida Statutes, in a
31 reference thereto, paragraph (a) of subsection (1) of section
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 484.056, Florida Statutes, is reenacted to read:
2 484.056 Disciplinary proceedings.--
3 (1) The following acts relating to the practice of
4 dispensing hearing aids shall be grounds for both disciplinary
5 action against a hearing aid specialist as set forth in this
6 section and cease and desist or other related action by the
7 department as set forth in s. 456.065 against any person
8 owning or operating a hearing aid establishment who engages
9 in, aids, or abets any such violation:
10 (a) Violation of any provision of s. 456.072(1), s.
11 484.0512, or s. 484.053.
12 Section 28. Paragraph (a) of subsection (1), paragraph
13 (a) of subsection (7), and subsection (8) of section 766.101,
14 Florida Statutes, are amended to read:
15 766.101 Medical review committee, immunity from
16 liability.--
17 (1) As used in this section:
18 (a) The term "medical review committee" or "committee"
19 means:
20 1.a. A committee of a hospital or ambulatory surgical
21 center licensed under chapter 395 or a health maintenance
22 organization certificated under part I of chapter 641,
23 b. A committee of a physician-hospital organization, a
24 provider-sponsored organization, or an integrated delivery
25 system,
26 c. A committee of a state or local professional
27 society of health care providers,
28 d. A committee of a medical staff of a licensed
29 hospital or nursing home, provided the medical staff operates
30 pursuant to written bylaws that have been approved by the
31 governing board of the hospital or nursing home,
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 e. A committee of the Department of Corrections or the
2 Correctional Medical Authority as created under s. 945.602, or
3 employees, agents, or consultants of either the department or
4 the authority or both,
5 f. A committee of a professional service corporation
6 formed under chapter 621 or a corporation organized under
7 chapter 607 or chapter 617, which is formed and operated for
8 the practice of medicine as defined in s. 458.305(3), and
9 which has at least 25 health care providers who routinely
10 provide health care services directly to patients,
11 g. A committee of a mental health treatment facility
12 licensed under chapter 394 or a community mental health center
13 as defined in s. 394.907, provided the quality assurance
14 program operates pursuant to the guidelines which have been
15 approved by the governing board of the agency,
16 h. A committee of a substance abuse treatment and
17 education prevention program licensed under chapter 397
18 provided the quality assurance program operates pursuant to
19 the guidelines which have been approved by the governing board
20 of the agency,
21 i. A peer review or utilization review committee
22 organized under chapter 440, or
23 j. A committee of the Department of Health, a county
24 health department, healthy start coalition, or certified rural
25 health network, when reviewing quality of care, or employees
26 of these entities when reviewing mortality records, or
27 k. A continuous quality improvement committee of a
28 pharmacy licensed pursuant to chapter 465,
29
30 which committee is formed to evaluate and improve the quality
31 of health care rendered by providers of health service or to
51
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 determine that health services rendered were professionally
2 indicated or were performed in compliance with the applicable
3 standard of care or that the cost of health care rendered was
4 considered reasonable by the providers of professional health
5 services in the area; or
6 2. A committee of an insurer, self-insurer, or joint
7 underwriting association of medical malpractice insurance, or
8 other persons conducting review under s. 766.106.
9 (7)(a) It is the intent of the Legislature to
10 encourage medical review committees to contribute further to
11 the quality of health care in this state by reviewing
12 complaints against physicians in the manner described in this
13 paragraph. Accordingly, the Department of Health Business and
14 Professional Regulation may enter into a letter of agreement
15 with a professional society of physicians licensed under
16 chapter 458 or chapter 459, under which agreement the medical
17 or peer review committees of the professional society will
18 conduct a review of any complaint or case referred to the
19 society by the department which involves a question as to
20 whether a physician's actions represented a breach of the
21 prevailing professional standard of care. The prevailing
22 professional standard of care is that level of care, skill,
23 and treatment which, in light of all relevant surrounding
24 circumstances, is recognized as acceptable and appropriate by
25 reasonably prudent similar health care providers. The letter
26 of agreement must specify that the professional society will
27 submit an advisory report to the department within a
28 reasonable time following the department's written and
29 appropriately supported request to the professional society.
30 The advisory report, which is not binding upon the department,
31 constitutes the professional opinion of the medical review
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 committee and must include:
2 1. A statement of relevant factual findings.
3 2. The judgment of the committee as to whether the
4 physician's actions represented a breach of the prevailing
5 professional standard of care.
6 (8) No cause of action of any nature by a person
7 licensed pursuant to chapter 458, chapter 459, chapter 461,
8 chapter 463, part I of chapter 464, chapter 465, or chapter
9 466 shall arise against another person licensed pursuant to
10 chapter 458, chapter 459, chapter 461, chapter 463, part I of
11 chapter 464, chapter 465, or chapter 466 for furnishing
12 information to a duly appointed medical review committee, to
13 an internal risk management program established under s.
14 395.0197, to the Department of Health or the Agency for Health
15 Care Administration Business and Professional Regulation, or
16 to the appropriate regulatory board if the information
17 furnished concerns patient care at a facility licensed
18 pursuant to part I of chapter 395 where both persons provide
19 health care services, if the information is not intentionally
20 fraudulent, and if the information is within the scope of the
21 functions of the committee, department, or board. However, if
22 such information is otherwise available from original sources,
23 it is not immune from discovery or use in a civil action
24 merely because it was presented during a proceeding of the
25 committee, department, or board.
26 Section 29. For the purpose of incorporating the
27 amendment to section 766.101(1)(a), Florida Statutes, in
28 references thereto, paragraph (a) of subsection (1) of section
29 440.105, Florida Statutes, and subsection (6) of section
30 626.989, Florida Statutes, are reenacted to read:
31 440.105 Prohibited activities; reports; penalties;
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 limitations.--
2 (1)(a) Any insurance carrier, any individual
3 self-insured, any commercial or group self-insurance fund, any
4 professional practitioner licensed or regulated by the
5 Department of Business and Professional Regulation, except as
6 otherwise provided by law, any medical review committee as
7 defined in s. 766.101, any private medical review committee,
8 and any insurer, agent, or other person licensed under the
9 insurance code, or any employee thereof, having knowledge or
10 who believes that a fraudulent act or any other act or
11 practice which, upon conviction, constitutes a felony or
12 misdemeanor under this chapter is being or has been committed
13 shall send to the Division of Insurance Fraud, Bureau of
14 Workers' Compensation Fraud, a report or information pertinent
15 to such knowledge or belief and such additional information
16 relative thereto as the bureau may require. The bureau shall
17 review such information or reports and select such information
18 or reports as, in its judgment, may require further
19 investigation. It shall then cause an independent examination
20 of the facts surrounding such information or report to be made
21 to determine the extent, if any, to which a fraudulent act or
22 any other act or practice which, upon conviction, constitutes
23 a felony or a misdemeanor under this chapter is being
24 committed. The bureau shall report any alleged violations of
25 law which its investigations disclose to the appropriate
26 licensing agency and state attorney or other prosecuting
27 agency having jurisdiction with respect to any such violations
28 of this chapter. If prosecution by the state attorney or other
29 prosecuting agency having jurisdiction with respect to such
30 violation is not begun within 60 days of the bureau's report,
31 the state attorney or other prosecuting agency having
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 jurisdiction with respect to such violation shall inform the
2 bureau of the reasons for the lack of prosecution.
3 626.989 Investigation by department or Division of
4 Insurance Fraud; compliance; immunity; confidential
5 information; reports to division; division investigator's
6 power of arrest.--
7 (6) Any person, other than an insurer, agent, or other
8 person licensed under the code, or an employee thereof, having
9 knowledge or who believes that a fraudulent insurance act or
10 any other act or practice which, upon conviction, constitutes
11 a felony or a misdemeanor under the code, or under s. 817.234,
12 is being or has been committed may send to the Division of
13 Insurance Fraud a report or information pertinent to such
14 knowledge or belief and such additional information relative
15 thereto as the department may request. Any professional
16 practitioner licensed or regulated by the Department of
17 Business and Professional Regulation, except as otherwise
18 provided by law, any medical review committee as defined in s.
19 766.101, any private medical review committee, and any
20 insurer, agent, or other person licensed under the code, or an
21 employee thereof, having knowledge or who believes that a
22 fraudulent insurance act or any other act or practice which,
23 upon conviction, constitutes a felony or a misdemeanor under
24 the code, or under s. 817.234, is being or has been committed
25 shall send to the Division of Insurance Fraud a report or
26 information pertinent to such knowledge or belief and such
27 additional information relative thereto as the department may
28 require. The Division of Insurance Fraud shall review such
29 information or reports and select such information or reports
30 as, in its judgment, may require further investigation. It
31 shall then cause an independent examination of the facts
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 surrounding such information or report to be made to determine
2 the extent, if any, to which a fraudulent insurance act or any
3 other act or practice which, upon conviction, constitutes a
4 felony or a misdemeanor under the code, or under s. 817.234,
5 is being committed. The Division of Insurance Fraud shall
6 report any alleged violations of law which its investigations
7 disclose to the appropriate licensing agency and state
8 attorney or other prosecuting agency having jurisdiction with
9 respect to any such violation, as provided in s. 624.310. If
10 prosecution by the state attorney or other prosecuting agency
11 having jurisdiction with respect to such violation is not
12 begun within 60 days of the division's report, the state
13 attorney or other prosecuting agency having jurisdiction with
14 respect to such violation shall inform the division of the
15 reasons for the lack of prosecution.
16 Section 30. Effective on July 1, 2001 and applicable
17 to all contracts entered into or renewed on or after July 1,
18 2001, section 627.6474, Florida Statutes, is created to read:
19 627.6474 Provider contracts.--A health insurer shall
20 not require a contracted health care practitioner as defined
21 in s. 456.001(4) to accept the terms of other health care
22 practitioner contracts with the insurer or any other insurer,
23 or health maintenance organization, under common management
24 and control with the insurer, including Medicare and Medicaid
25 practitioner contracts and those authorized by s. 627.6471, s.
26 627.6472, or s. 641.315, except for a practitioner in a group
27 practice as defined in s. 456.053 who must accept the terms of
28 a contract negotiated for the practitioner by the group, as a
29 condition of continuation or renewal of the contract. Any
30 contract provision that violates this section is void. A
31 violation of this section is not subject to the criminal
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 penalty specified in s. 624.15.
2 Section 31. Effective on July 1, 2001 and applicable
3 to all contracts entered into or renewed on or after July 1,
4 2001, subsection (11) is added to section 627.662, Florida
5 Statutes, to read:
6 627.662 Other provisions applicable.--The following
7 provisions apply to group health insurance, blanket health
8 insurance, and franchise health insurance:
9 (11) Section 627.6474, relating to provider contracts.
10 Section 32. Effective on July 1, 2001 and applicable
11 to all contracts entered into or renewed on or after July 1,
12 2001, subsection (10) is added to section 641.315, Florida
13 Statutes, to read:
14 641.315 Provider contracts.--
15 (10) A health maintenance organization shall not
16 require a contracted health care practitioner as defined in s.
17 456.001(4) to accept the terms of other health care
18 practitioner contracts with the health maintenance
19 organization or any insurer, or other health maintenance
20 organization, under common management and control with the
21 health maintenance organization, including Medicare and
22 Medicaid practitioner contracts and those authorized by s.
23 627.6471, s. 627.6472, or s. 641.315, except for a
24 practitioner in a group practice as defined in s. 456.053 who
25 must accept the terms of a contract negotiated for the
26 practitioner by the group, as a condition of continuation or
27 renewal of the contract. Any contract provision that violates
28 this section is void. A violation of this section is not
29 subject to the criminal penalty specified in s. 624.15.
30 Section 33. Paragraph (c) of subsection (4) of section
31 766.1115, Florida Statutes, is amended to read:
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
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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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
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 34. 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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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
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 health care practitioner or applicant for licensure as a
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 health care practitioner.
2 (d) "Credentials verification organization" means any
3 organization certified or accredited as a credentials
4 verification organization.
5 (e) "Department" means the Department of Health,
6 Division of Medical Quality Assurance.
7 (f) "Designated credentials verification organization"
8 means the credentials verification organization which is
9 selected by the health care practitioner, if the health care
10 practitioner chooses to make such a designation.
11 (g) "Drug Enforcement Administration certification"
12 means certification issued by the Drug Enforcement
13 Administration for purposes of administration or prescription
14 of controlled substances. Submission of such certification
15 under this section must include evidence that the
16 certification is current and must also include all current
17 addresses to which the certificate is issued.
18 (h) "Health care entity" means:
19 1. Any health care facility or other health care
20 organization licensed or certified to provide approved medical
21 and allied health services in this state;
22 2. Any entity licensed by the Department of Insurance
23 as a prepaid health care plan or health maintenance
24 organization or as an insurer to provide coverage for health
25 care services through a network of providers or similar
26 organization licensed under chapter 627, chapter 636, chapter
27 641, or chapter 651; or
28 3. Any accredited medical school in this state.
29 (i) "Health care practitioner" means any person
30 licensed, or, for credentialing purposes only, any person
31 applying for licensure, under chapter 458, chapter 459,
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 chapter 460, chapter 461, or s. 464.012 or any person licensed
2 or applying for licensure under a chapter subsequently made
3 subject to this section by the department with the approval of
4 the applicable board, except a person registered or applying
5 for registration pursuant to s. 458.345 or s. 459.021.
6 (j) "Hospital or other institutional affiliations"
7 means each hospital or other institution for which the health
8 care practitioner or applicant has provided medical services.
9 Submission of such information under this section must
10 include, for each hospital or other institution, the name and
11 address of the hospital or institution, the staff status of
12 the health care practitioner or applicant at that hospital or
13 institution, and the dates of affiliation with that hospital
14 or institution.
15 (j)(k) "National accrediting organization" means an
16 organization that awards accreditation or certification to
17 hospitals, managed care organizations, credentials
18 verification organizations, or other health care
19 organizations, including, but not limited to, the Joint
20 Commission on Accreditation of Healthcare Organizations, the
21 American Accreditation HealthCare Commission/URAC, and the
22 National Committee for Quality Assurance.
23 (k) "Primary source verification" means verification
24 of professional qualifications based on evidence obtained
25 directly from the issuing source of the applicable
26 qualification or from any other source deemed as a primary
27 source for such verification by the department or an
28 accrediting body approved by the department.
29 (l) "Professional training" means any internship,
30 residency, or fellowship relating to the profession for which
31 the health care practitioner is licensed or seeking licensure.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (m) "Specialty board certification" means
2 certification in a specialty issued by a specialty board
3 recognized by the board in this state that regulates the
4 profession for which the health care practitioner is licensed
5 or seeking licensure.
6 (3) STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.--
7 (a) Every health care practitioner shall:
8 1. Report all core credentials data to the department
9 which is not already on file with the department, either by
10 designating a credentials verification organization to submit
11 the data or by submitting the data directly.
12 2. Notify the department within 45 days of any
13 corrections, updates, or modifications to the core credentials
14 data either through his or her designated credentials
15 verification organization or by submitting the data directly.
16 Corrections, updates, and modifications to the core
17 credentials data provided the department under this section
18 shall comply with the updating requirements of s. 456.039(3)
19 or s. 456.0391(3) related to profiling.
20 (b) The department shall:
21 1. Maintain a complete, current file of applicable
22 core credentials data on each health care practitioner, which
23 shall include data provided in accordance with subparagraph
24 (a)1. and all updates provided in accordance with subparagraph
25 (a)2.
26 2. Release the core credentials data that is otherwise
27 confidential or exempt from the provisions of chapter 119 and
28 s. 24(a), Art. I of the State Constitution and any
29 corrections, updates, and modifications thereto, if authorized
30 by the health care practitioner.
31 3. Charge a fee to access the core credentials data,
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 which may not exceed the actual cost, including prorated setup
2 and operating costs, pursuant to the requirements of chapter
3 119.
4 4. Develop standardized forms to be used by the health
5 care practitioner or designated credentials verification
6 organization for the initial reporting of core credentials
7 data, for the health care practitioner to authorize the
8 release of core credentials data, and for the subsequent
9 reporting of corrections, updates, and modifications thereto.
10 (c) A registered credentials verification organization
11 may be designated by a health care practitioner to assist the
12 health care practitioner to comply with the requirements of
13 subparagraph (a)2. A designated credentials verification
14 organization shall:
15 1. Timely comply with the requirements of subparagraph
16 (a)2., pursuant to rules adopted by the department.
17 2. Not provide the health care practitioner's core
18 credentials data, including all corrections, updates, and
19 modifications, without the authorization of the practitioner.
20 (d) This section shall not be construed to restrict in
21 any way the authority of the health care entity to credential
22 and to approve or deny an application for hospital staff
23 membership, clinical privileges, or managed care network
24 participation.
25 (4) DUPLICATION OF DATA PROHIBITED.--
26 (a) A health care entity or credentials verification
27 organization is prohibited from collecting or attempting to
28 collect duplicate core credentials data from any health care
29 practitioner if the information is available from the
30 department. This section shall not be construed to restrict
31 the right of any health care entity or credentials
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 verification organization to collect additional information
2 from the health care practitioner which is not included in the
3 core credentials data file. This section shall not be
4 construed to prohibit a health care entity or credentials
5 verification organization from obtaining all necessary
6 attestation and release form signatures and dates.
7 (b) Effective July 1, 2002, a state agency in this
8 state which credentials health care practitioners may not
9 collect or attempt to collect duplicate core credentials data
10 from any individual health care practitioner if the
11 information is already available from the department. This
12 section shall not be construed to restrict the right of any
13 such state agency to request additional information not
14 included in the core credentials credential data file, but
15 which is deemed necessary for the agency's specific
16 credentialing purposes.
17 (5) STANDARDS AND REGISTRATION.--Any credentials
18 verification organization that does business in this state
19 must be fully accredited or certified as a credentials
20 verification organization by a national accrediting
21 organization as specified in paragraph (2)(a) and must
22 register with the department. The department may charge a
23 reasonable registration fee, not to exceed an amount
24 sufficient to cover its actual expenses in providing and
25 enforcing such registration. The department shall establish by
26 rule for biennial renewal of such registration. Failure by a
27 registered credentials verification organization to maintain
28 full accreditation or certification, to provide data as
29 authorized by the health care practitioner, to report to the
30 department changes, updates, and modifications to a health
31 care practitioner's records within the time period specified
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 in subparagraph (3)(a)2., or to comply with the prohibition
2 against collection of duplicate core credentials data from a
3 practitioner may result in denial of an application for
4 renewal of registration or in revocation or suspension of a
5 registration.
6 (6) PRIMARY SOURCE VERIFIED DATA.--Health care
7 entities and credentials verification organizations may rely
8 upon any data that has been primary source verified by the
9 department or its designee to meet primary source verification
10 requirements of national accrediting organizations.
11 (7)(6) LIABILITY.--No civil, criminal, or
12 administrative action may be instituted, and there shall be no
13 liability, against any registered credentials verification
14 organization or health care entity on account of its reliance
15 on any data obtained directly from the department.
16 (8)(7) LIABILITY INSURANCE REQUIREMENTS.--Each
17 credentials verification organization doing business in this
18 state shall maintain liability insurance appropriate to meet
19 the certification or accreditation requirements established in
20 this section.
21 (9)(8) RULES.--The department shall adopt rules
22 necessary to develop and implement the standardized core
23 credentials data collection program established by this
24 section.
25 Section 35. Section 232.61, Florida Statutes, is
26 amended to read:
27 232.61 Governing organization for athletics; adoption
28 of bylaws.--
29 (1) The organization shall adopt bylaws that, unless
30 specifically provided by statute, establish eligibility
31 requirements for all students who participate in high school
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 athletic competition in its member schools. The bylaws
2 governing residence and transfer shall allow the student to be
3 eligible in the school in which he or she first enrolls each
4 school year, or makes himself or herself a candidate for an
5 athletic team by engaging in a practice prior to enrolling in
6 any member school. The student shall be eligible in that
7 school so long as he or she remains enrolled in that school.
8 Subsequent eligibility shall be determined and enforced
9 through the organization's bylaws.
10 (2) The organization shall also adopt bylaws that
11 specifically prohibit the recruiting of students for athletic
12 purposes. The bylaws shall prescribe penalties and an appeals
13 process for athletic recruiting violations.
14 (3) The organization shall adopt bylaws that require
15 all students participating in interscholastic athletic
16 competition or who are candidates for an interscholastic
17 athletic team to satisfactorily pass a medical evaluation each
18 year prior to participating in interscholastic athletic
19 competition or engaging in any practice, tryout, workout, or
20 other physical activity associated with the student's
21 candidacy for an interscholastic athletic team. Such medical
22 evaluation can only be administered by a physician licensed
23 under the provisions of chapter 458, chapter 459, or chapter
24 460, and in good standing with the physician's regulatory
25 board. The bylaws shall establish requirements for eliciting a
26 student's medical history and performing the medical
27 evaluation required under this subsection, which shall include
28 minimum standards for the physical capabilities necessary for
29 participation in interscholastic athletic competition as
30 contained in a uniform preparticipation physical evaluation
31 form. The evaluation form shall provide place for the
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 signature of the physician performing the evaluation with an
2 attestation that each examination procedure listed on the form
3 was performed by the physician or by someone under the direct
4 supervision of the physician. The form shall also contain a
5 place for the physician to indicate if a referral to another
6 physician was made in lieu of completion of a certain
7 examination procedure. The form shall provide a place for the
8 physician to whom the student was referred to complete the
9 remaining sections and attest to that portion of the
10 examination. Physicians administering medical evaluations
11 pursuant to this section must know the minimum standards
12 established by the organization and certify that the student
13 meets the standards. If the physician determines that there
14 are any abnormal findings in the cardiovascular system, the
15 student may not participate unless a subsequent EKG or other
16 cardiovascular assessment indicates that the abnormality will
17 not place the student at risk during such participation.
18 Results of such medical evaluation must be provided to the
19 school. No student shall be eligible to participate in any
20 interscholastic athletic competition or engage in any
21 practice, tryout, workout, or other physical activity
22 associated with the student's candidacy for an interscholastic
23 athletic team until the results of the medical evaluation
24 verifying that the student has satisfactorily passed the
25 evaluation have been received and approved by the school.
26 (4) Notwithstanding the provisions of subsection (3),
27 a student may participate in interscholastic athletic
28 competition or be a candidate for an interscholastic athletic
29 team if the parent or guardian of the student objects in
30 writing to the student undergoing a medical evaluation because
31 such evaluation is contrary to his or her religious tenets or
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 practices, provided that no person shall be held liable for
2 any injury or other damages suffered by such student resulting
3 from his or her participation in interscholastic athletic
4 competition or in any practice, tryout, workout, or other
5 physical activity associated with his or her candidacy for an
6 interscholastic athletic team.
7 Section 36. Section 240.4075, Florida Statutes, is
8 amended to read:
9 240.4075 Nursing Student Loan Forgiveness Program.--
10 (1) To encourage qualified personnel to seek
11 employment in areas of this state in which critical nursing
12 shortages exist, there is established the Nursing Student Loan
13 Forgiveness Program. The primary function of the program is
14 to increase employment and retention of registered nurses and
15 licensed practical nurses in nursing homes and hospitals in
16 the state and in state-operated medical and health care
17 facilities, public schools, birth centers, and federally
18 sponsored community health centers and teaching hospitals by
19 making repayments toward loans received by students from
20 federal or state programs or commercial lending institutions
21 for the support of postsecondary study in accredited or
22 approved nursing programs.
23 (2) To be eligible, a candidate must have graduated
24 from an accredited or approved nursing program and have
25 received a Florida license as a licensed practical nurse or a
26 registered nurse or a Florida certificate as an advanced
27 registered nurse practitioner.
28 (3) Only loans to pay the costs of tuition, books, and
29 living expenses shall be covered, at an amount not to exceed
30 $4,000 for each year of education towards the degree obtained.
31 (4) Receipt of funds pursuant to this program shall be
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 contingent upon continued proof of employment in the
2 designated facilities in this state. Loan principal payments
3 shall be made by the Department of Health Education directly
4 to the federal or state programs or commercial lending
5 institutions holding the loan as follows:
6 (a) Twenty-five percent of the loan principal and
7 accrued interest shall be retired after the first year of
8 nursing;
9 (b) Fifty percent of the loan principal and accrued
10 interest shall be retired after the second year of nursing;
11 (c) Seventy-five percent of the loan principal and
12 accrued interest shall be retired after the third year of
13 nursing; and
14 (d) The remaining loan principal and accrued interest
15 shall be retired after the fourth year of nursing.
16
17 In no case may payment for any nurse exceed $4,000 in any
18 12-month period.
19 (5) There is created the Nursing Student Loan
20 Forgiveness Trust Fund to be administered by the Department of
21 Health Education pursuant to this section and s. 240.4076 and
22 department rules. The Comptroller shall authorize
23 expenditures from the trust fund upon receipt of vouchers
24 approved by the Department of Health Education. All moneys
25 collected from the private health care industry and other
26 private sources for the purposes of this section shall be
27 deposited into the Nursing Student Loan Forgiveness Trust
28 Fund. Any balance in the trust fund at the end of any fiscal
29 year shall remain therein and shall be available for carrying
30 out the purposes of this section and s. 240.4076.
31 (6) In addition to licensing fees imposed under part I
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 of chapter 464, there is hereby levied and imposed an
2 additional fee of $5, which fee shall be paid upon licensure
3 or renewal of nursing licensure. Revenues collected from the
4 fee imposed in this subsection shall be deposited in the
5 Nursing Student Loan Forgiveness Trust Fund of the Department
6 of Health Education and will be used solely for the purpose of
7 carrying out the provisions of this section and s. 240.4076.
8 Up to 50 percent of the revenues appropriated to implement
9 this subsection may be used for the nursing scholarship
10 program established pursuant to s. 240.4076.
11 (7)(a) Funds contained in the Nursing Student Loan
12 Forgiveness Trust Fund which are to be used for loan
13 forgiveness for those nurses employed by hospitals, birth
14 centers, and nursing homes must be matched on a
15 dollar-for-dollar basis by contributions from the employing
16 institutions, except that this provision shall not apply to
17 state-operated medical and health care facilities, public
18 schools, county health departments, federally sponsored
19 community health centers, or teaching hospitals as defined in
20 s. 408.07, family practice teaching hospitals as defined in s.
21 395.805, or specialty hospitals for children as used in s.
22 409.9119. If in any given fiscal quarter there are
23 insufficient funds in the trust fund to grant all eligible
24 applicant requests, awards shall be based on the following
25 priority of employer: county health departments; federally
26 sponsored community health centers; state-operated medical and
27 health care facilities; public schools; teaching hospitals as
28 defined in s. 408.07; family practice teaching hospitals as
29 defined in s. 395.805; specialty hospitals for children as
30 used in s. 409.9119; and other hospitals, birth centers, and
31 nursing homes.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (b) All Nursing Student Loan Forgiveness Trust Fund
2 moneys shall be invested pursuant to s. 18.125. Interest
3 income accruing to that portion of the trust fund not matched
4 shall increase the total funds available for loan forgiveness
5 and scholarships. Pledged contributions shall not be eligible
6 for matching prior to the actual collection of the total
7 private contribution for the year.
8 (8) The Department of Health Education may solicit
9 technical assistance relating to the conduct of this program
10 from the Department of Education Health.
11 (9) The Department of Health Education is authorized
12 to recover from the Nursing Student Loan Forgiveness Trust
13 Fund its costs for administering the Nursing Student Loan
14 Forgiveness Program.
15 (10) The Department of Health Education may adopt
16 rules necessary to administer this program.
17 (11) This section shall be implemented only as
18 specifically funded.
19 Section 37. Section 240.4076, Florida Statutes, is
20 amended to read:
21 240.4076 Nursing scholarship program.--
22 (1) There is established within the Department of
23 Health Education a scholarship program for the purpose of
24 attracting capable and promising students to the nursing
25 profession.
26 (2) A scholarship applicant shall be enrolled as a
27 full-time or part-time student in the upper division of an
28 approved nursing program leading to the award of a
29 baccalaureate degree or graduate degree to qualify for a
30 nursing faculty position or as an or any advanced registered
31 nurse practitioner degree or be enrolled as a full-time or
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 part-time student in an approved program leading to the award
2 of an associate degree in nursing or a diploma in nursing.
3 (3) A scholarship may be awarded for no more than 2
4 years, in an amount not to exceed $8,000 per year. However,
5 registered nurses pursuing a graduate degree for a faculty
6 position or to practice as an advanced registered nurse
7 practitioner degree may receive up to $12,000 per year.
8 Beginning July 1, 1998, these amounts shall be adjusted by the
9 amount of increase or decrease in the consumer price index for
10 urban consumers published by the United States Department of
11 Commerce.
12 (4) Credit for repayment of a scholarship shall be as
13 follows:
14 (a) For each full year of scholarship assistance, the
15 recipient agrees to work for 12 months in a faculty position
16 in a college of nursing or community college nursing program
17 in this state or at a health care facility in a medically
18 underserved area as approved by the Department of Health
19 Education. Scholarship recipients who attend school on a
20 part-time basis shall have their employment service obligation
21 prorated in proportion to the amount of scholarship payments
22 received.
23 (b) Eligible health care facilities include nursing
24 homes and hospitals in this state, state-operated medical or
25 health care facilities, public schools, county health
26 departments, federally sponsored community health centers,
27 colleges of nursing in universities in this state, and
28 community college nursing programs in this state or teaching
29 hospitals as defined in s. 408.07. The recipient shall be
30 encouraged to complete the service obligation at a single
31 employment site. If continuous employment at the same site is
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 not feasible, the recipient may apply to the department for a
2 transfer to another approved health care facility.
3 (c) Any recipient who does not complete an appropriate
4 program of studies or who does not become licensed shall repay
5 to the Department of Health Education, on a schedule to be
6 determined by the department, the entire amount of the
7 scholarship plus 18 percent interest accruing from the date of
8 the scholarship payment. Moneys repaid shall be deposited into
9 the Nursing Student Loan Forgiveness Trust Fund established in
10 s. 240.4075. However, the department may provide additional
11 time for repayment if the department finds that circumstances
12 beyond the control of the recipient caused or contributed to
13 the default.
14 (d) Any recipient who does not accept employment as a
15 nurse at an approved health care facility or who does not
16 complete 12 months of approved employment for each year of
17 scholarship assistance received shall repay to the Department
18 of Health Education an amount equal to two times the entire
19 amount of the scholarship plus interest accruing from the date
20 of the scholarship payment at the maximum allowable interest
21 rate permitted by law. Repayment shall be made within 1 year
22 of notice that the recipient is considered to be in default.
23 However, the department may provide additional time for
24 repayment if the department finds that circumstances beyond
25 the control of the recipient caused or contributed to the
26 default.
27 (5) Scholarship payments shall be transmitted to the
28 recipient upon receipt of documentation that the recipient is
29 enrolled in an approved nursing program. The Department of
30 Health Education shall develop a formula to prorate payments
31 to scholarship recipients so as not to exceed the maximum
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 amount per academic year.
2 (6) The Department of Health Education shall adopt
3 rules, including rules to address extraordinary circumstances
4 that may cause a recipient to default on either the school
5 enrollment or employment contractual agreement, to implement
6 this section and may solicit technical assistance relating to
7 the conduct of this program from the Department of Health.
8 (7) The Department of Health Education is authorized
9 to recover from the Nursing Student Loan Forgiveness Trust
10 Fund its costs for administering the nursing scholarship
11 program.
12 Section 38. All powers, duties, and functions, rules,
13 records, personnel, property, and unexpended balances of
14 appropriations, allocations, or other funds of the Department
15 of Education relating to the Nursing Student Loan Forgiveness
16 Program and the nursing scholarship program are transferred by
17 a type two transfer, as defined in s. 20.06(2), Florida
18 Statutes, to the Department of Health.
19 Section 39. Effective July 1, 2003, section 464.005,
20 Florida Statutes, is amended to read:
21 464.005 Board headquarters.--The board shall maintain
22 its official headquarters in Tallahassee the city in which it
23 has been domiciled for the past 5 years.
24 Section 40. Subsections (1) and (2) of section
25 464.008, Florida Statutes, are amended to read:
26 464.008 Licensure by examination.--
27 (1) Any person desiring to be licensed as a registered
28 nurse or licensed practical nurse shall apply to the
29 department to take the licensure examination. The department
30 shall examine each applicant who:
31 (a) Has completed the application form and remitted a
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 fee set by the board not to exceed $150 and has remitted an
2 examination fee set by the board not to exceed $75 plus the
3 actual per applicant cost to the department for purchase of
4 the examination from the National Council of State Boards of
5 Nursing or a similar national organization.
6 (b) Has provided sufficient information on or after
7 October 1, 1989, which must be submitted by the department for
8 a statewide criminal records correspondence check through the
9 Department of Law Enforcement.
10 (c) Is in good mental and physical health, is a
11 recipient of a high school diploma or the equivalent, and has
12 completed the requirements for graduation from an approved
13 program, or its equivalent as determined by the board, for the
14 preparation of registered nurses or licensed practical nurses,
15 whichever is applicable. Courses successfully completed in a
16 professional nursing program which are at least equivalent to
17 a practical nursing program may be used to satisfy the
18 education requirements for licensure as a licensed practical
19 nurse.
20 (d) Has the ability to communicate in the English
21 language, which may be determined by an examination given by
22 the department.
23 (2) Each applicant who passes the examination and
24 provides proof of meeting the educational requirements
25 specified in subsection (1) graduation from an approved
26 nursing program shall, unless denied pursuant to s. 464.018,
27 be entitled to licensure as a registered professional nurse or
28 a licensed practical nurse, whichever is applicable.
29 Section 41. Section 464.009, Florida Statutes, is
30 amended to read:
31 464.009 Licensure by endorsement.--
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (1) The department shall issue the appropriate license
2 by endorsement to practice professional or practical nursing
3 to an applicant who, upon applying to the department and
4 remitting a fee set by the board not to exceed $100,
5 demonstrates to the board that he or she:
6 (a) Holds a valid license to practice professional or
7 practical nursing in another state of the United States,
8 provided that, when the applicant secured his or her original
9 license, the requirements for licensure were substantially
10 equivalent to or more stringent than those existing in Florida
11 at that time; or
12 (b) Meets the qualifications for licensure in s.
13 464.008 and has successfully completed a state, regional, or
14 national examination which is substantially equivalent to or
15 more stringent than the examination given by the department.
16 (2) Such examinations and requirements from other
17 states shall be presumed to be substantially equivalent to or
18 more stringent than those in this state. Such presumption
19 shall not arise until January 1, 1980. However, the board may,
20 by rule, specify states the examinations and requirements of
21 which shall not be presumed to be substantially equivalent to
22 those of this state.
23 (3) The applicant must submit to the department a set
24 of fingerprints on a form and under procedures specified by
25 the department, along with a payment in an amount equal to the
26 costs incurred by the Department of Health for the criminal
27 background check of the applicant. The Department of Health
28 shall submit the fingerprints provided by the applicant to the
29 Florida Department of Law Enforcement for a statewide criminal
30 history check, and the Florida Department of Law Enforcement
31 shall forward the fingerprints to the Federal Bureau of
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Investigation for a national criminal history check of the
2 applicant. The Department of Health shall review the results
3 of the criminal history check, issue a license to an applicant
4 who has met all of the other requirements for licensure and
5 has no criminal history, and shall refer all applicants with
6 criminal histories back to the board for determination as to
7 whether a license should be issued and under what conditions.
8 (4)(3) The department shall not issue a license by
9 endorsement to any applicant who is under investigation in
10 another state for an act which would constitute a violation of
11 this part or chapter 456 until such time as the investigation
12 is complete, at which time the provisions of s. 464.018 shall
13 apply.
14 (5) The department shall develop an electronic
15 applicant notification process and provide electronic
16 notification when the application has been received and when
17 background screenings have been completed, and shall issue a
18 license within 30 days after completion of all required data
19 collection and verification. This 30-day period to issue a
20 license shall be tolled if the applicant must appear before
21 the board due to information provided on the application or
22 obtained through screening and data collection and
23 verification procedures.
24 Section 42. Section 464.0195, Florida Statutes, is
25 created to read:
26 464.0195 Florida Center for Nursing; goals.--There is
27 established the Florida Center for Nursing to address issues
28 of supply and demand for nursing, including issues of
29 recruitment, retention, and utilization of nurse workforce
30 resources. The Legislature finds that the center will repay
31 the state's investment by providing an ongoing strategy for
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 the allocation of the state's resources directed towards
2 nursing. The primary goals for the center shall be to:
3 (1) Develop a strategic statewide plan for nursing
4 manpower in this state by:
5 (a) Establishing and maintaining a database on nursing
6 supply and demand in the state, to include current supply and
7 demand, and future projections; and
8 (b) Selecting from the plan priorities to be
9 addressed.
10 (2) Convene various groups representative of nurses,
11 other health care providers, business and industry, consumers,
12 legislators, and educators to:
13 (a) Review and comment on data analysis prepared for
14 the center;
15 (b) Recommend systemic changes, including strategies
16 for implementation of recommended changes; and
17 (c) Evaluate and report the results of these efforts
18 to the Legislature and others.
19 (3) Enhance and promote recognition, reward, and
20 renewal activities for nurses in the state by:
21 (a) Promoting nursing excellence programs such as
22 magnet recognition by the American Nurses Credentialing
23 Center;
24 (b) Proposing and creating additional reward,
25 recognition, and renewal activities for nurses; and
26 (c) Promoting media and positive image-building
27 efforts for nursing.
28 Section 43. Section 464.0196, Florida Statutes, is
29 created to read:
30 464.0196 Florida Center for Nursing; board of
31 directors.--
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (1) The Florida Center for Nursing shall be governed
2 by a policy-setting board of directors. The board shall
3 consist of 16 members, with a simple majority of the board
4 being nurses representative of various practice areas. Other
5 members shall include representatives of other health care
6 professions, business and industry, health care providers, and
7 consumers. The members of the board shall be appointed by the
8 Governor as follows:
9 (a) Four members recommended by the President of the
10 Senate, at least one of whom shall be a registered nurse
11 recommended by the Florida Organization of Nurse Executives
12 and at least one other representative of the hospital industry
13 recommended by the Florida Hospital Association;
14 (b) Four members recommended by the Speaker of the
15 House of Representatives, at least one of whom shall be a
16 registered nurse recommended by the Florida Nurses Association
17 and at least one other representative of the long-term care
18 industry;
19 (c) Four members recommended by the Governor, two of
20 whom shall be registered nurses; and
21 (d) Four nurse educators recommended by the State
22 Board of Education, one of whom shall be a dean of a College
23 of Nursing at a state university, one other shall be a
24 director of a nursing program in a state community college.
25 (2) The initial terms of the members shall be as
26 follows:
27 (a) Of the members appointed pursuant to paragraph
28 (1)(a), two shall be appointed for terms expiring June 30,
29 2005, one for a term expiring June 30, 2004, and one for a
30 term expiring June 30, 2003.
31 (b) Of the members appointed pursuant to paragraph
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (1)(b), one shall be appointed for a term expiring June 30,
2 2005, two for terms expiring June 30, 2004, and one for a term
3 expiring June 20, 2003.
4 (c) Of the members appointed pursuant to paragraph
5 (1)(c), one shall be appointed for a term expiring June 30,
6 2005, one for a term expiring June 30, 2004, and two for terms
7 expiring June 30, 2003.
8 (d) Of the members appointed pursuant to paragraph
9 (1)(d), the terms of two members recommended by the State
10 Board of Education shall expire June 30, 2005; the term of the
11 member who is a dean of a College of Nursing at a state
12 university shall expire June 30, 2004; and the term of the
13 member who is a director of a state community college nursing
14 program shall expire June 30, 2003.
15
16 After the initial appointments expire, the terms of all the
17 members shall be for 3 years, with no member serving more than
18 two consecutive terms.
19 (3) The board shall have the following powers and
20 duties:
21 (a) To employ an executive director.
22 (b) To determine operational policy.
23 (c) To elect a chair and officers, to serve 2-year
24 terms. The chair and officers may not succeed themselves.
25 (d) To establish committees of the board as needed.
26 (e) To appoint a multidisciplinary advisory council
27 for input and advice on policy matters.
28 (f) To implement the major functions of the center as
29 established in the goals set out in s. 464.0195.
30 (g) To seek and accept nonstate funds for sustaining
31 the center and carrying out center policy.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (4) The members of the board are entitled to receive
2 per diem and allowances prescribed by law for state boards and
3 commissions.
4 Section 44. Section 464.0197, Florida Statutes, is
5 created to read:
6 464.0197 Florida Center for Nursing; state budget
7 support.--The Legislature finds that it is imperative that the
8 state protect its investment and progress made in nursing
9 efforts to date. The Legislature finds that the Florida Center
10 for Nursing is the appropriate means to do so. The center
11 shall have state budget support for its operations so that it
12 may have adequate resources for the tasks the Legislature has
13 set out in s. 464.0195.
14 Section 45. The Board of Nursing within the Department
15 of Health shall hold in abeyance until July 1, 2002, the
16 development of any rule pursuant to s. 464.019(2), Florida
17 Statutes, which relates to the establishment of
18 faculty/student clinical ratios. The Board of Nursing and the
19 Department of Education shall submit to the President of the
20 Senate and the Speaker of the House of Representatives by
21 December 31, 2001, an implementation plan that details both
22 the impact and the cost of any such proposed rule change.
23 Section 46. Subsection (1) of section 464.0205,
24 Florida Statutes, is amended to read:
25 464.0205 Retired volunteer nurse certificate.--
26 (1) Any retired practical or registered nurse desiring
27 to serve indigent, underserved, or critical need populations
28 in this state may apply to the department for a retired
29 volunteer nurse certificate by providing:
30 (a) A complete application.
31 (b) An application and processing fee of $25.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (b)(c) Verification that the applicant had been
2 licensed to practice nursing in any jurisdiction in the United
3 States for at least 10 years, had retired or plans to retire,
4 intends to practice nursing only pursuant to the limitations
5 provided by the retired volunteer nurse certificate, and has
6 not committed any act that would constitute a violation under
7 s. 464.018(1).
8 (c)(d) Proof that the applicant meets the requirements
9 for licensure under s. 464.008 or s. 464.009.
10 Section 47. The Florida Legislature's Office of
11 Program Policy Analysis and Government Accountability shall
12 study the feasibility of maintaining the entire Medical
13 Quality Assurance function, including enforcement, within one
14 department, as recommended by the Auditor General in
15 Operational Report Number 01-063. The study shall be completed
16 and a report issued to the Legislature on or before November
17 30, 2001.
18 Section 48. Effective October 1, 2001, section
19 456.0375, Florida Statutes, is created to read:
20 456.0375 Registration of certain clinics;
21 requirements; discipline; exemptions.--
22 (1)(a) As used in this section, the term "clinic"
23 means a business operating in a single structure or facility
24 or group of adjacent structures or facilities operating under
25 the same business name or management at which health care
26 services are provided to individuals and which tenders charges
27 for reimbursement for such services.
28 (b) For purposes of this section, the term "clinic"
29 does not include and the registration requirements in this
30 section do not apply to:
31 1. Entities licensed or registered by the state
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 pursuant to chapter 390, chapter 394, chapter 395, chapter
2 397, chapter 400, chapter 463, chapter 465, chapter 466,
3 chapter 478, chapter 480, or chapter 484.
4 2. Entities exempt from federal taxation under 26
5 U.S.C. s. 501(c)(3).
6 3. Sole proprietorships, group practices,
7 partnerships, or corporations which provide health care
8 services by licensed health care practitioners pursuant to
9 chapter 457, chapter 458, chapter 459, chapter 460, chapter
10 461, chapter 462, chapter 463, chapter 466, chapter 467,
11 chapter 484, chapter 486, chapter 490, or chapter 491; part I,
12 part III, part X, part XIII, or part XIV of chapter 468; or s.
13 464.012, which are wholly owned by licensed health care
14 practitioners or wholly owned by licensed health care
15 practitioners and the spouse, parent, or child of a licensed
16 health care practitioner, so long as one of the owners who is
17 a licensed health care practitioner is supervising the
18 services performed therein and is legally responsible for the
19 entity's compliance with all federal and state laws. However,
20 no health care practitioner may supervise services beyond the
21 scope of the practitioner's license.
22 (2)(a) Every clinic, as defined in paragraph (1)(a),
23 must register, and at all times maintain a valid registration,
24 with the department. Each clinic location must be registered
25 separately even though operated under the same business name
26 or management, and each clinic must appoint a medical director
27 or clinic director.
28 (b) The department shall adopt rules necessary to
29 administer the registration program, including rules
30 establishing the specific registration procedures, forms, and
31 fees. Registration may be conducted electronically.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Registration fees must be calculated to reasonably cover the
2 cost of registration and must be of such amount that the total
3 fees collected do not exceed the cost of administering and
4 enforcing compliance with this section. The registration
5 program must require:
6 1. The clinic to file the registration form with the
7 department within 60 days after the effective date of this
8 section or prior to the inception of operation. The
9 registration expires automatically 2 years after its date of
10 issuance and must be renewed biennially thereafter.
11 2. The registration form to contain the name,
12 residence, and business address, phone number, and license
13 number of the medical director or clinic director for the
14 clinic.
15 3. The clinic to display the registration certificate
16 in a conspicuous location within the clinic which is readily
17 visible to all patients.
18 (3)(a) Each clinic must employ or contract with a
19 physician maintaining a full and unencumbered physician
20 license in accordance with chapter 458, chapter 459, chapter
21 460, or chapter 461 to serve as the medical director. However,
22 if the clinic is limited to providing health care services
23 pursuant to chapter 457, chapter 484, chapter 486, chapter
24 490, or chapter 491 or part I, part III, part X, part XIII, or
25 part XIV of chapter 468, the clinic may appoint a health care
26 practitioner licensed under that chapter to serve as the
27 clinic director who is responsible for the clinic's
28 activities. A health care practitioner may not serve as the
29 clinic director if the services provided at the clinic are
30 beyond the scope of that practitioner's license.
31 (b) The medical director or clinic director must agree
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 in writing to accept responsibility for the following
2 activities on behalf of the clinic. The medical director or
3 the clinic director shall:
4 1. Have signs identifying the medical director or
5 clinic director posted in a conspicuous location within the
6 clinic which is readily visible to all patients.
7 2. Ensure that all practitioners providing health care
8 services or supplies to patients maintain a current, active,
9 and unencumbered Florida license.
10 3. Review any patient-referral contracts or agreements
11 executed by the clinic.
12 4. Ensure that all health care practitioners at the
13 clinic have active appropriate certification or licensure for
14 the level of care being provided.
15 5. Serve as the clinic records owner as defined in s.
16 456.057.
17 6. Ensure compliance with the recordkeeping, office
18 surgery, and adverse incident reporting requirements of
19 chapter 456, the respective practice acts, and the rules
20 adopted thereunder.
21 7. Conduct systematic reviews of clinic billings to
22 ensure that the billings are not fraudulent or unlawful. Upon
23 discovery of an unlawful charge, the medical director or
24 clinic director must take immediate corrective action.
25 (c) Any contract to serve as a medical director or
26 clinic director entered into or renewed by a physician or
27 licensed health care practitioner in violation of this section
28 is void as contrary to public policy. This section applies to
29 contracts entered into or renewed on or after the effective
30 date of this section.
31 (d) The department, in consultation with the boards,
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 shall adopt rules specifying limitations on the number of
2 registered clinics and licensees for which a medical director
3 or clinic director may assume responsibility for purposes of
4 this section. In determining the quality of supervision a
5 medical director or clinic director can provide, the
6 department shall consider the number of clinic employees, the
7 clinic location, and the services provided by the clinic.
8 (4)(a) All charges or reimbursement claims made by or
9 on behalf of a clinic that is required to be registered under
10 this section but that is not so registered are unlawful
11 charges and therefore are noncompensable and unenforceable.
12 (b) Any person establishing, operating, or managing an
13 unregistered clinic otherwise required to be registered under
14 this section commits a felony of the third degree, punishable
15 as provided in s. 775.082, s. 775.083, or s. 775.084.
16 (c) Any licensed health care practitioner who violates
17 this section is subject to discipline in accordance with this
18 chapter and the respective practice act.
19 (d) The department shall revoke the registration of
20 any clinic registered under this section for operating in
21 violation of the requirements of this section or the rules
22 adopted pursuant to this section.
23 (e) The department shall investigate allegations of
24 noncompliance with this section and the rules adopted pursuant
25 to this section.
26 Section 49. The sum of $100,000 is appropriated from
27 the registration fees collected from clinics pursuant to s.
28 456.0375, Florida Statutes, and one-half of one full-time
29 equivalent position is authorized, to the Department of Health
30 for the purposes of regulating medical clinics pursuant to s.
31 456.0375, Florida Statutes. The appropriated funds shall be
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 deposited into the Medical Quality Assurance Trust Fund.
2 Section 50. Subsection (3) of section 456.031, Florida
3 Statutes, is amended to read:
4 456.031 Requirement for instruction on domestic
5 violence.--
6 (3)(a) In lieu of completing a course as required in
7 subsection (1), a licensee or certificateholder may complete a
8 course in end-of-life care and palliative health care, if the
9 licensee or certificateholder has completed an approved
10 domestic violence course in the immediately preceding
11 biennium.
12 (b) In lieu of completing a course as required by
13 subsection (1), a person licensed under chapter 466 who has
14 completed an approved domestic-violence education course in
15 the immediately preceding 2 years may complete a course
16 approved by the Board of Dentistry.
17 Section 51. Subsection (9) of section 456.033, Florida
18 Statutes, is amended to read:
19 456.033 Requirement for instruction for certain
20 licensees on human immunodeficiency virus and acquired immune
21 deficiency syndrome.--
22 (9)(a) In lieu of completing a course as required in
23 subsection (1), the licensee may complete a course in
24 end-of-life care and palliative health care, so long as the
25 licensee completed an approved AIDS/HIV course in the
26 immediately preceding biennium.
27 (b) In lieu of completing a course as required by
28 subsection (1), a person licensed under chapter 466 who has
29 completed an approved AIDS/HIV course in the immediately
30 preceding 2 years may complete a course approved by the Board
31 of Dentistry.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Section 52. (1) Subsection (9) is added to section
2 627.419, Florida Statutes, to read:
3 627.419 Construction of policies.--
4 (9) With respect to any group or individual insurer
5 covering dental services, each claimant, or dentist acting for
6 a claimant, who has had a claim denied as not medically or
7 dentally necessary or who has had a claim payment based on an
8 alternate dental service in accordance with accepted dental
9 standards for adequate and appropriate care must be provided
10 an opportunity for an appeal to the insurer's licensed dentist
11 who is responsible for the medical necessity reviews under the
12 plan or is a member of the plan's peer review group. The
13 appeal may be by telephone, and the insurer's dentist must
14 respond within a reasonable time, not to exceed 15 business
15 days.
16 (2) This section shall apply to policies issued or
17 renewed on or after July 1, 2001.
18 Section 53. Paragraph (c) of subsection (6) of section
19 468.302, Florida Statutes, is amended to read:
20 468.302 Use of radiation; identification of certified
21 persons; limitations; exceptions.--
22 (6) Requirement for certification does not apply to:
23 (c) A person who is trained and skilled in invasive
24 cardiovascular cardiopulmonary technology, including the
25 radiologic technology duties associated with these procedures,
26 and who provides invasive cardiovascular cardiopulmonary
27 technology services at the direction, and under the direct
28 supervision, of a licensed practitioner who is trained and
29 skilled in performing invasive cardiovascular procedures. Such
30 persons must have successfully completed a didactic and
31 clinical training program in the following areas before
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 performing radiologic technology duties:
2 1. Principles of X-ray production and equipment
3 operation.
4 2. Biological effects of radiation.
5 3. Radiation exposure and monitoring.
6 4. Radiation safety and protection.
7 5. Evaluation of radiographic equipment and
8 accessories.
9 6. Radiographic exposure and technique factors.
10 7. Film processing.
11 8. Image quality assurance.
12 9. Patient positioning.
13 10. Administration and complications of contrast
14 media.
15 11. Specific fluoroscopic and digital X-ray imaging
16 procedures related to invasive cardiovascular technology.
17 Section 54. Subsections (8) and (9) of section
18 468.352, Florida Statutes, are amended to read:
19 468.352 Definitions.--As used in this part, unless the
20 context otherwise requires, the term:
21 (8) "Registered respiratory therapist" means any
22 person licensed pursuant to this part who is employed to
23 deliver respiratory care services under the order of a
24 physician licensed pursuant to chapter 458 or chapter 459, and
25 in accordance with protocols established by a hospital, other
26 health care provider, or the board, and who functions in
27 situations of unsupervised patient contact requiring
28 individual judgment.
29 (9) "Certified respiratory therapist" or "respiratory
30 care practitioner" means any person licensed pursuant to this
31 part who is employed to deliver respiratory care services
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 under the order of a physician licensed pursuant to chapter
2 458 or chapter 459, and in accordance with protocols
3 established by a hospital, other health care provider, or the
4 board.
5 Section 55. Subsections (1) and (2) of section
6 468.355, Florida Statutes, are amended to read:
7 468.355 Eligibility for licensure; temporary
8 licensure.--
9 (1) To be eligible for licensure by the board as a
10 certified respiratory therapist respiratory care practitioner,
11 an applicant must:
12 (a) Be at least 18 years old.
13 (b) Possess a high school diploma or a graduate
14 equivalency diploma.
15 (c) Meet at least one of the following criteria:
16 1. The applicant has successfully completed a training
17 program for respiratory therapy technicians or respiratory
18 therapists approved by the Commission on Accreditation of
19 Allied Health Education Programs, or the equivalent thereof,
20 as accepted by the board.
21 2. The applicant is currently a "Certified Respiratory
22 Therapist Therapy Technician" certified by the National Board
23 for Respiratory Care, or the equivalent thereof, as accepted
24 by the board.
25 3. The applicant is currently a "Registered
26 Respiratory Therapist" registered by the National Board for
27 Respiratory Care, or the equivalent thereof, as accepted by
28 the board.
29
30 The criteria set forth in subparagraphs 2. and 3.
31 notwithstanding, the board shall periodically review the
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 examinations and standards of the National Board for
2 Respiratory Care and may reject those examinations and
3 standards if they are deemed inappropriate.
4 (2) To be eligible for licensure by the board as a
5 registered respiratory therapist, an applicant must:
6 (a) Be at least 18 years old.
7 (b) Possess a high school diploma or a graduate
8 equivalency diploma.
9 (c) Meet at least one of the following criteria:
10 1. The applicant has successfully completed a training
11 program for registered respiratory therapists approved by the
12 Commission on Accreditation of Allied Health Education
13 Programs, or the equivalent thereof, as accepted by the board.
14 2. The applicant is currently a "Registered
15 Respiratory Therapist" registered by the National Board for
16 Respiratory Care, or the equivalent thereof, as accepted by
17 the board.
18
19 The criteria set forth in subparagraphs 1. and 2.
20 notwithstanding, the board shall periodically review the
21 examinations and standards of the National Board for
22 Respiratory Care and may reject those examinations and
23 standards if they are deemed inappropriate.
24 Section 56. Section 468.357, Florida Statutes, is
25 amended to read:
26 468.357 Licensure by examination.--
27 (1) A person who desires to be licensed as a certified
28 respiratory therapist respiratory care practitioner may submit
29 an application to take the examination, in accordance with
30 board rule.
31 (a) Each applicant may take the examination who is
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 determined by the board to have:
2 1. Completed the application form and remitted the
3 applicable fee set by the board;
4 2. Submitted required documentation as required in s.
5 468.355; and
6 3. Remitted an examination fee set by the examination
7 provider.
8 (b) Examinations for licensure of certified
9 respiratory therapist respiratory care practitioners must be
10 conducted no less than two times a year in such geographical
11 locations or by such methods as are deemed advantageous to the
12 majority of the applicants.
13 (c) The examination given for certified respiratory
14 therapist respiratory care practitioners shall be the same as
15 that given by the National Board for Respiratory Care for
16 entry-level certification of respiratory therapists therapy
17 technicians. However, an equivalent examination may be
18 accepted by the board in lieu of that examination.
19 (2) Each applicant who passes the examination shall be
20 entitled to licensure as a certified respiratory therapist
21 respiratory care practitioner, and the department shall issue
22 a license pursuant to this part to any applicant who
23 successfully completes the examination in accordance with this
24 section. However, the department shall not issue a license to
25 any applicant who is under investigation in another
26 jurisdiction for an offense which would constitute a violation
27 of this part. Upon completion of such an investigation, if the
28 applicant is found guilty of such an offense, the applicable
29 provisions of s. 468.365 will apply.
30 Section 57. Subsections (1) and (2) of section
31 468.358, Florida Statutes, are amended to read:
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 468.358 Licensure by endorsement.--
2 (1) Licensure as a certified respiratory therapist
3 respiratory care practitioner shall be granted by endorsement
4 to an individual who holds the "Certified Respiratory
5 Therapist Therapy Technician" credential issued by the
6 National Board for Respiratory Care or an equivalent
7 credential acceptable to the board. Licensure by this
8 mechanism requires verification by oath and submission of
9 evidence satisfactory to the board that such credential is
10 held.
11 (2) Licensure as a registered respiratory therapist
12 shall be granted by endorsement to an individual who holds the
13 "Registered Respiratory Therapist" credential issued by the
14 National Board for Respiratory Care or an equivalent
15 credential acceptable to the board. Licensure by this
16 mechanism requires verification by oath and submission of
17 evidence satisfactory to the board that such credential is
18 held.
19 Section 58. Section 468.359, Florida Statutes, is
20 amended to read:
21 468.359 Assumption of title and use of
22 abbreviations.--
23 (1) Only persons who are licensed pursuant to this
24 part as respiratory care practitioners have the right to use
25 the title "Respiratory Care Practitioner" and the abbreviation
26 "RCP."
27 (2) Only persons who are licensed pursuant to this
28 part as registered respiratory therapists have the right to
29 use the title "Registered Respiratory Therapist" and the
30 abbreviation "RRT," when delivering services pursuant to this
31 part provided such persons have passed the Registry
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Examination for Respiratory Therapists given by the National
2 Board for Respiratory Care.
3 (3) Only persons who are licensed pursuant to this
4 part as certified respiratory therapists have the right to use
5 the title "Certified Respiratory Therapist" and the
6 abbreviation "CRT" when delivering services pursuant to this
7 part. graduates of board-approved programs for respiratory
8 care practitioners may use the term "Graduate Respiratory
9 Therapy Technician" and the abbreviation "GRTT."
10 (4) Only persons who are graduates of board-approved
11 programs for respiratory therapists may use the term "Graduate
12 Respiratory Therapist" and the abbreviation "GRT."
13 (4)(5) No person in this state shall deliver
14 respiratory care services; advertise as, or assume the title
15 of, respiratory care practitioner, certified respiratory
16 therapist, or registered respiratory therapist; or use the
17 abbreviation "RCP," "CRT," or "RRT" that would lead the public
18 to believe that such person is licensed pursuant to this part
19 unless such person is so licensed; or take any other action
20 that would lead the public to believe that such person is
21 licensed pursuant to this part unless such person is so
22 licensed.
23 Section 59. Subsections (2), (3), and (4) of section
24 468.1155, Florida Statutes, are amended to read:
25 468.1155 Provisional license; requirements.--
26 (2) The department shall issue a provisional license
27 to practice speech-language pathology to each applicant who
28 the board certifies has:
29 (a) Completed the application form and remitted the
30 required fees, including a nonrefundable application fee.
31 (b) Received a master's degree or is currently
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 enrolled in a doctoral degree program with a major emphasis in
2 speech-language pathology from an institution of higher
3 learning which is, or at the time the applicant was enrolled
4 and graduated, was, accredited by an accrediting agency
5 recognized by the Council for Higher Education Commission on
6 Recognition of Postsecondary Accreditation or from an
7 institution which is publicly recognized as a member in good
8 standing with the Association of Universities and Colleges of
9 Canada. An applicant who graduated from or is currently
10 enrolled in a program at a university or college outside the
11 United States or Canada must present documentation of the
12 determination of equivalency to standards established by the
13 Council for Higher Education Commission on Recognition of
14 Postsecondary Accreditation in order to qualify. The
15 applicant must have completed 60 semester hours that include:
16 1. Fundamental information applicable to the normal
17 development and use of speech, hearing, and language;
18 information about training in management of speech, hearing,
19 and language disorders; and information supplementary to these
20 fields.
21 2. Six semester hours in audiology.
22 3. Thirty of the required 60 semester hours in courses
23 acceptable toward a graduate degree by the college or
24 university in which these courses were taken, of which 24
25 semester hours must be in speech-language pathology.
26 (c) Completed 300 supervised clinical clock hours with
27 200 clock hours in the area of speech-language pathology or
28 completed the number of clock hours required by an accredited
29 institution meeting national certification standards. The
30 supervised clinical clock hours shall be completed within the
31 training institution or one of its cooperating programs.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (3) The department shall issue a provisional license
2 to practice audiology to each applicant who the board
3 certifies has:
4 (a) Completed the application form and remitted the
5 required fees, including a nonrefundable application fee.
6 (b) Received a master's degree or is currently
7 enrolled in a doctoral degree program with a major emphasis in
8 audiology from an institution of higher learning which is, or
9 at the time the applicant was enrolled and graduated was,
10 accredited by an accrediting agency recognized by the Council
11 for Higher Education Commission on Recognition of
12 Postsecondary Accreditation or from an institution which is
13 publicly recognized as a member in good standing with the
14 Association of Universities and Colleges of Canada. An
15 applicant who graduated from or is currently enrolled in a
16 program at a university or college outside the United States
17 or Canada must present documentation of the determination of
18 equivalency to standards established by the Council for Higher
19 Education Commission on Recognition of Postsecondary
20 Accreditation in order to qualify. The applicant must have
21 completed 60 semester hours that include:
22 1. Fundamental information applicable to the normal
23 development and use of speech, hearing, and language;
24 information about training in management of speech, hearing,
25 and language disorders; and information supplementary to these
26 fields.
27 2. Six semester hours in speech-language pathology.
28 3. Thirty of the required 60 semester hours in courses
29 acceptable toward a graduate degree by the college or
30 university in which these courses were taken, of which 24
31 semester hours must be in audiology.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (c) Completed 300 supervised clinical clock hours with
2 200 clock hours in the area of audiology or completed the
3 number of clock hours required by an accredited institution
4 meeting national certification standards. The supervised
5 clinical clock hours shall be completed within the training
6 institution or one of its cooperating programs.
7 (4) An applicant for a provisional license who has
8 received a master's degree or is currently enrolled in a
9 doctoral degree program with a major emphasis in
10 speech-language pathology as provided in subsection (2), or
11 audiology as provided in subsection (3), and who seeks
12 licensure in the area in which the applicant is not currently
13 licensed, must have completed 30 semester hours in courses
14 acceptable toward a graduate degree and 200 supervised
15 clinical clock hours in the second discipline from an
16 accredited institution.
17 Section 60. Paragraph (b) of subsection (1) and
18 paragraph (b) of subsection (2) of section 468.1215, Florida
19 Statutes, are amended to read:
20 468.1215 Speech-language pathology assistant and
21 audiology assistant; certification.--
22 (1) The department shall issue a certificate as a
23 speech-language pathology assistant to each applicant who the
24 board certifies has:
25 (b) Earned a bachelor's degree from a college or
26 university accredited by a regional association of colleges
27 and schools recognized by the Department of Education which
28 includes at least 24 semester hours of coursework as approved
29 by the board at an institution accredited by an accrediting
30 agency recognized by the Council for Higher Education
31 Commission on Recognition of Postsecondary Accreditation.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (2) The department shall issue a certificate as an
2 audiology assistant to each applicant who the board certifies
3 has:
4 (b) Completed at least 24 semester hours of coursework
5 as approved by the board at an institution accredited by an
6 accrediting agency recognized by the Council for Higher
7 Education Commission on Recognition of Postsecondary
8 Accreditation.
9 Section 61. Subsection (3) of section 480.033, Florida
10 Statutes, is amended to read:
11 480.033 Definitions.--As used in this act:
12 (3) "Massage" means the manipulation of the soft
13 superficial tissues of the human body with the hand, foot,
14 arm, or elbow, whether or not such manipulation is aided by
15 hydrotherapy, including colonic irrigation, or thermal
16 therapy; any electrical or mechanical device; or the
17 application to the human body of a chemical or herbal
18 preparation.
19 Section 62. Subsection (3) of section 484.002, Florida
20 Statutes, is amended, and subsection (8) is added to that
21 section, to read:
22 484.002 Definitions.--As used in this part:
23 (3) "Opticianry" means the preparation and dispensing
24 of lenses, spectacles, eyeglasses, contact lenses, and other
25 optical devices to the intended user or agent thereof, upon
26 the written prescription of a licensed allopathic or
27 osteopathic physician medical doctor or optometrist who is
28 duly licensed to practice or upon presentation of a duplicate
29 prescription. The selection of frame designs, the actual
30 sales transaction, and the transfer of physical possession of
31 lenses, spectacles, eyeglasses, contact lenses, and other
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 optical devices subsequent to performance of all services of
2 the optician shall not be considered the practice of
3 opticianry; however, such physical possession shall not be
4 transferred until the optician has completed the fitting of
5 the optical device upon the customer. The practice of
6 opticianry also includes the duplication of lenses accurately
7 as to power, without prescription. A board-certified optician
8 qualified and operating under rules established by the board
9 may fill, fit, adapt, or dispense any soft contact lens
10 prescription. Such optician may fill, fit, adapt, or dispense
11 any extended wear or hard contact lens prescription to the
12 extent authorized to do so by the prescribing allopathic or
13 osteopathic physician medical doctor or optometrist.
14 (8) "Contact lenses" means a prescribed medical device
15 intended to be worn directly against the cornea of the eye to
16 correct vision conditions, act as a therapeutic device, or
17 provide a cosmetic effect.
18 (9) "Optical Dispensing" means interpreting but not
19 altering a prescription of a licensed physician or optometrist
20 and designing, adapting, fitting, or replacing the prescribed
21 optical aids, pursuant to such prescription, to or for the
22 intended wearer, duplicating lenses, accurately as to power
23 without a prescription and duplicating nonprescription eyewear
24 and parts of eyewear. "Optical Dispensing" does not include
25 selecting frames, transferring an optical aid to the wearer
26 after an optician has completed fitting it, or providing
27 instruction in the general care and use of an optical aid,
28 including placement, removal, hygiene, or cleaning.
29 Section 63. Subsection (2) of section 484.006, Florida
30 Statutes, is amended to read:
31 484.006 Certain rules prohibited.--
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (2) No rule or policy of the board shall prohibit any
2 optician from practicing jointly with optometrists or
3 allopathic or osteopathic physicians medical doctors licensed
4 in this state.
5 Section 64. Subsections (1) and (2) of section
6 484.012, Florida Statutes, are amended to read:
7 484.012 Prescriptions; filing; duplication of
8 prescriptions; duplication of lenses.--
9 (1) Any prescription written by a duly licensed
10 allopathic or osteopathic physician medical doctor or
11 optometrist for any lenses, spectacles, eyeglasses, contact
12 lenses, or other optical devices shall be kept on file for a
13 period of 2 years with the optical establishment that fills
14 such prescription. However, the licensed optician may
15 maintain a copy of the prescription.
16 (2) Upon request by the intended user of the
17 prescribed lenses, spectacles, eyeglasses, contact lenses, or
18 other optical devices, or by an agent of the intended user,
19 the optician who fills the original prescription shall
20 duplicate, on a form prescribed by rule of the board, the
21 original prescription. However, for medical reasons only, the
22 prescribing allopathic or osteopathic physician medical doctor
23 or optometrist may, upon the original prescription, prohibit
24 its duplication. Any duplication shall be considered a valid
25 prescription to be filled for a period of 5 years from the
26 date of the original prescription, except that a contact lens
27 prescription shall be considered a valid prescription to be
28 filled for a period of 2 years from the date of the original
29 prescription.
30 Section 65. Section 484.013, Florida Statutes, is
31 amended to read:
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 484.013 Violations and penalties.--
2 (1) It is unlawful for any person:
3 (a) To intentionally make a false or fraudulent
4 statement, either for herself or himself or for another
5 person, in any application, affidavit, or statement presented
6 to the board or in any proceeding before the board.
7 (b) To prepare or dispense lenses, spectacles,
8 eyeglasses, contact lenses, or other optical devices when such
9 person is not licensed as an optician in this state.
10 (c) To prepare or dispense lenses, spectacles,
11 eyeglasses, contact lenses, or other optical devices without
12 first being furnished with a prescription as provided for in
13 s. 484.012.
14 (2) It is unlawful for any person other than an
15 optician licensed under this part to use the title "optician"
16 or otherwise lead the public to believe that she or he is
17 engaged in the practice of opticianry.
18 (3) It is unlawful for any optician to engage in the
19 diagnosis of the human eyes, attempt to determine the
20 refractive powers of the human eyes, or, in any manner,
21 attempt to prescribe for or treat diseases or ailments of
22 human beings.
23 (4) It is unlawful for any person to open or operate,
24 either alone or with any other person or persons, an optical
25 establishment which does not have the permit required by this
26 part.
27 (5) A Any person who knowingly violates any a
28 provision of this section commits a felony misdemeanor of the
29 third second degree, punishable as provided in s. 775.082, or
30 s. 775.083, or s. 775.084.
31 Section 66. Section 484.015, Florida Statutes, is
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 amended to read:
2 484.015 Authority to inspect.--Duly authorized agents
3 and employees of the department shall have the power to
4 inspect in a lawful manner at all reasonable hours an any
5 establishment of any kind in the state in which lenses,
6 spectacles, eyeglasses, contact lenses, and any other optical
7 devices are prepared or and dispensed, for the purposes of:
8 (1) Determining if any provision of this part, or any
9 rule promulgated under its authority, is being violated;
10 (2) Securing samples or specimens of any lenses,
11 spectacles, eyeglasses, contact lenses, or other optical
12 devices, after paying or offering to pay for such sample or
13 specimen; or
14 (3) Securing such other evidence as may be needed for
15 prosecution under this part.
16 Section 67. Paragraph (g) of subsection (3) of section
17 921.0022, Florida Statutes, is amended to read:
18 921.0022 Criminal Punishment Code; offense severity
19 ranking chart.--
20 (3) OFFENSE SEVERITY RANKING CHART
21
22 Florida Felony
23 Statute Degree Description
24
25 (g) LEVEL 7
26 316.193(3)(c)2. 3rd DUI resulting in serious bodily
27 injury.
28 327.35(3)(c)2. 3rd Vessel BUI resulting in serious
29 bodily injury.
30 402.319(2) 2nd Misrepresentation and negligence
31 or intentional act resulting in
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 great bodily harm, permanent
2 disfiguration, permanent
3 disability, or death.
4 409.920(2) 3rd Medicaid provider fraud.
5 456.065(2) 3rd Practicing a health care
6 profession without a license.
7 456.065(2) 2nd Practicing a health care
8 profession without a license
9 which results in serious bodily
10 injury.
11 458.327(1) 3rd Practicing medicine without a
12 license.
13 459.013(1) 3rd Practicing osteopathic medicine
14 without a license.
15 460.411(1) 3rd Practicing chiropractic medicine
16 without a license.
17 461.012(1) 3rd Practicing podiatric medicine
18 without a license.
19 462.17 3rd Practicing naturopathy without a
20 license.
21 463.015(1) 3rd Practicing optometry without a
22 license.
23 464.016(1) 3rd Practicing nursing without a
24 license.
25 465.015(2) 3rd Practicing pharmacy without a
26 license.
27 466.026(1) 3rd Practicing dentistry or dental
28 hygiene without a license.
29 467.201 3rd Practicing midwifery without a
30 license.
31
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 468.366 3rd Delivering respiratory care
2 services without a license.
3 483.828(1) 3rd Practicing as clinical laboratory
4 personnel without a license.
5 483.901(9) 3rd Practicing medical physics
6 without a license.
7 484.013 3rd Practicing opticianry without a
8 license.
9 484.053 3rd Dispensing hearing aids without a
10 license.
11 494.0018(2) 1st Conviction of any violation of
12 ss. 494.001-494.0077 in which the
13 total money and property
14 unlawfully obtained exceeded
15 $50,000 and there were five or
16 more victims.
17 560.123(8)(b)1. 3rd Failure to report currency or
18 payment instruments exceeding
19 $300 but less than $20,000 by
20 money transmitter.
21 560.125(5)(a) 3rd Money transmitter business by
22 unauthorized person, currency or
23 payment instruments exceeding
24 $300 but less than $20,000.
25 655.50(10)(b)1. 3rd Failure to report financial
26 transactions exceeding $300 but
27 less than $20,000 by financial
28 institution.
29 782.051(3) 2nd Attempted felony murder of a
30 person by a person other than the
31 perpetrator or the perpetrator of
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 an attempted felony.
2 782.07(1) 2nd Killing of a human being by the
3 act, procurement, or culpable
4 negligence of another
5 (manslaughter).
6 782.071 2nd Killing of human being or viable
7 fetus by the operation of a motor
8 vehicle in a reckless manner
9 (vehicular homicide).
10 782.072 2nd Killing of a human being by the
11 operation of a vessel in a
12 reckless manner (vessel
13 homicide).
14 784.045(1)(a)1. 2nd Aggravated battery; intentionally
15 causing great bodily harm or
16 disfigurement.
17 784.045(1)(a)2. 2nd Aggravated battery; using deadly
18 weapon.
19 784.045(1)(b) 2nd Aggravated battery; perpetrator
20 aware victim pregnant.
21 784.048(4) 3rd Aggravated stalking; violation of
22 injunction or court order.
23 784.07(2)(d) 1st Aggravated battery on law
24 enforcement officer.
25 784.08(2)(a) 1st Aggravated battery on a person 65
26 years of age or older.
27 784.081(1) 1st Aggravated battery on specified
28 official or employee.
29 784.082(1) 1st Aggravated battery by detained
30 person on visitor or other
31 detainee.
106
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 784.083(1) 1st Aggravated battery on code
2 inspector.
3 790.07(4) 1st Specified weapons violation
4 subsequent to previous conviction
5 of s. 790.07(1) or (2).
6 790.16(1) 1st Discharge of a machine gun under
7 specified circumstances.
8 790.166(3) 2nd Possessing, selling, using, or
9 attempting to use a hoax weapon
10 of mass destruction.
11 796.03 2nd Procuring any person under 16
12 years for prostitution.
13 800.04(5)(c)1. 2nd Lewd or lascivious molestation;
14 victim less than 12 years of age;
15 offender less than 18 years.
16 800.04(5)(c)2. 2nd Lewd or lascivious molestation;
17 victim 12 years of age or older
18 but less than 16 years; offender
19 18 years or older.
20 806.01(2) 2nd Maliciously damage structure by
21 fire or explosive.
22 810.02(3)(a) 2nd Burglary of occupied dwelling;
23 unarmed; no assault or battery.
24 810.02(3)(b) 2nd Burglary of unoccupied dwelling;
25 unarmed; no assault or battery.
26 810.02(3)(d) 2nd Burglary of occupied conveyance;
27 unarmed; no assault or battery.
28 812.014(2)(a) 1st Property stolen, valued at
29 $100,000 or more; property stolen
30 while causing other property
31 damage; 1st degree grand theft.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 812.019(2) 1st Stolen property; initiates,
2 organizes, plans, etc., the theft
3 of property and traffics in
4 stolen property.
5 812.131(2)(a) 2nd Robbery by sudden snatching.
6 812.133(2)(b) 1st Carjacking; no firearm, deadly
7 weapon, or other weapon.
8 825.102(3)(b) 2nd Neglecting an elderly person or
9 disabled adult causing great
10 bodily harm, disability, or
11 disfigurement.
12 825.1025(2) 2nd Lewd or lascivious battery upon
13 an elderly person or disabled
14 adult.
15 825.103(2)(b) 2nd Exploiting an elderly person or
16 disabled adult and property is
17 valued at $20,000 or more, but
18 less than $100,000.
19 827.03(3)(b) 2nd Neglect of a child causing great
20 bodily harm, disability, or
21 disfigurement.
22 827.04(3) 3rd Impregnation of a child under 16
23 years of age by person 21 years
24 of age or older.
25 837.05(2) 3rd Giving false information about
26 alleged capital felony to a law
27 enforcement officer.
28 872.06 2nd Abuse of a dead human body.
29 893.13(1)(c)1. 1st Sell, manufacture, or deliver
30 cocaine (or other drug prohibited
31 under s. 893.03(1)(a), (1)(b),
108
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (1)(d), (2)(a), (2)(b), or
2 (2)(c)4.) within 1,000 feet of a
3 child care facility or school.
4 893.13(1)(e)1. 1st Sell, manufacture, or deliver
5 cocaine or other drug prohibited
6 under s. 893.03(1)(a), (1)(b),
7 (1)(d), (2)(a), (2)(b), or
8 (2)(c)4., within 1,000 feet of
9 property used for religious
10 services or a specified business
11 site.
12 893.13(4)(a) 1st Deliver to minor cocaine (or
13 other s. 893.03(1)(a), (1)(b),
14 (1)(d), (2)(a), (2)(b), or
15 (2)(c)4. drugs).
16 893.135(1)(a)1. 1st Trafficking in cannabis, more
17 than 50 lbs., less than 2,000
18 lbs.
19 893.135
20 (1)(b)1.a. 1st Trafficking in cocaine, more than
21 28 grams, less than 200 grams.
22 893.135
23 (1)(c)1.a. 1st Trafficking in illegal drugs,
24 more than 4 grams, less than 14
25 grams.
26 893.135
27 (1)(d)1. 1st Trafficking in phencyclidine,
28 more than 28 grams, less than 200
29 grams.
30 893.135(1)(e)1. 1st Trafficking in methaqualone, more
31 than 200 grams, less than 5
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 kilograms.
2 893.135(1)(f)1. 1st Trafficking in amphetamine, more
3 than 14 grams, less than 28
4 grams.
5 893.135
6 (1)(g)1.a. 1st Trafficking in flunitrazepam, 4
7 grams or more, less than 14
8 grams.
9 893.135
10 (1)(h)1.a. 1st Trafficking in
11 gamma-hydroxybutyric acid (GHB),
12 1 kilogram or more, less than 5
13 kilograms.
14 893.135
15 (1)(i)1.a. 1st Trafficking in 1,4-Butanediol, 1
16 kilogram or more, less then 5
17 kilograms.
18 893.135
19 (1)(j)2.a. 1st Trafficking in Phenethylamines,
20 10 grams or more, less than 200
21 grams.
22 896.101(5)(a) 3rd Money laundering, financial
23 transactions exceeding $300 but
24 less than $20,000.
25 896.104(4)(a)1. 3rd Structuring transactions to evade
26 reporting or registration
27 requirements, financial
28 transactions exceeding $300 but
29 less than $20,000.
30 Section 68. Subsection (1) of section 484.0445,
31 Florida Statutes, is amended to read:
110
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 484.0445 Training program.--
2 (1) The board shall establish by rule a training
3 program for a minimum not to exceed 6 months in length, which
4 may include a board-approved home study course. Upon
5 submitting to the department the registration fee, the
6 applicant may register and enter the training program. Upon
7 completion of the training program, the trainee shall take the
8 first available written and practical examinations offered by
9 the department. The department shall administer the written
10 and practical examinations as prescribed by board rule. If
11 the trainee fails either the written or the practical
12 examination, she or he may repeat the training program one
13 time and retake the failed examination, provided she or he
14 takes the next available examination. No person may remain in
15 trainee status or further perform any services authorized for
16 a trainee if she or he fails either the written or the
17 practical examination twice; but, a trainee may continue to
18 function as a trainee until she or he has received the results
19 of the examinations. Any applicant who has failed an
20 examination twice and is no longer functioning as a trainee
21 shall be eligible for reexamination as provided in s.
22 484.045(2).
23 Section 69. Section 484.045, Florida Statutes, is
24 amended to read:
25 484.045 Licensure by examination.--
26 (1) Any person desiring to be licensed as a hearing
27 aid specialist shall apply to the department on a form
28 approved by the department to take the licensure examination,
29 which shall include a clinical practical component.
30 (2) The department shall license examine each
31 applicant who the board certifies:
111
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (a) Has completed the application form and remitted
2 the required fees applicable fee to the board and has paid the
3 examination fee;
4 (b) Is of good moral character;
5 (c) Is 18 years of age or older;
6 (d) Is a graduate of an accredited high school or its
7 equivalent; and
8 (e)1. Has met the requirements of the training program
9 set forth in s. 484.0445; or
10 2.a. Has a valid, current license as a hearing aid
11 specialist or its equivalent from another state and has been
12 actively practicing in such capacity for at least 12 months;
13 or
14 b. Is currently certified by the National Board for
15 Certification in Hearing Instrument Sciences and has been
16 actively practicing for at least 12 months. Persons qualifying
17 under this sub-subparagraph need not take the written or
18 practical examination, but must take and pass a test on
19 Florida laws and rules relating to the fitting and dispensing
20 of hearing aids.
21 (f) Has passed an examination, as prescribed by board
22 rule; and
23 (g) Has demonstrated, in a manner designated by rule
24 of the board, knowledge of state laws and rules relating to
25 the fitting and dispensing of hearing aids.
26 (3) A person who fails the examination may make
27 application for reexamination to the appropriate examining
28 entity, as prescribed by board rule.
29 (2) On or after October 1, 1990, every applicant who
30 is qualified to take the examination shall be allowed to take
31 the examination three times. If, after October 1, 1990, an
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 applicant fails the examination three times, the applicant
2 shall no longer be eligible to take the examination.
3 (3) The department shall issue a license to practice
4 dispensing hearing aids to any applicant who successfully
5 completes the examination in accordance with this section.
6 Section 70. Effective January 1, 2002, subsection (1)
7 of section 490.012, Florida Statutes, is amended to read:
8 490.012 Violations; penalties; injunction.--
9 (1)(a) No person shall hold herself or himself out by
10 any professional title, name, or description incorporating the
11 word "psychologist" unless such person holds a valid, active
12 license as a psychologist under this chapter.
13 (b) No person shall hold herself or himself out by any
14 professional title, name, or description incorporating the
15 words "school psychologist" unless such person holds a valid,
16 active license as a school psychologist under this chapter or
17 is certified as a school psychologist by the Department of
18 Education.
19 (c)(1)(a) No person shall hold herself or himself out
20 by any title or description incorporating the words, or
21 permutations of them, "psychologist," "psychology,"
22 "psychological," "psychodiagnostic," or "school psychologist,"
23 or describe any test or report as psychological, unless such
24 person holds a valid, active license under this chapter or is
25 exempt from the provisions of this chapter.
26 (d)(b) No person shall hold herself or himself out by
27 any title or description incorporating the word, or a
28 permutation of the word, "psychotherapy" unless such person
29 holds a valid, active license under chapter 458, chapter 459,
30 chapter 490, or chapter 491, or such person is certified as an
31 advanced registered nurse practitioner, pursuant to s.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 464.012, who has been determined by the Board of Nursing as a
2 specialist in psychiatric mental health.
3 (e)(c) No person licensed or provisionally licensed
4 pursuant to this chapter shall hold herself or himself out by
5 any title or description which indicates licensure other than
6 that which has been granted to her or him.
7 Section 71. Effective January 1, 2002, Florida
8 Statutes, is amended to read:
9 490.014 Exemptions.--
10 (1)(a) No provision of this chapter shall be construed
11 to limit the practice of physicians licensed pursuant to
12 chapter 458 or chapter 459 so long as they do not hold
13 themselves out to the public as psychologists or use a
14 professional title protected by this chapter.
15 (b) No provision of this chapter shall be construed to
16 limit the practice of nursing, clinical social work, marriage
17 and family therapy, mental health counseling, or other
18 recognized businesses or professions, or to prevent qualified
19 members of other professions from doing work of a nature
20 consistent with their training, so long as they do not hold
21 themselves out to the public as psychologists or use a title
22 or description protected by this chapter. Nothing in this
23 subsection shall be construed to exempt any person from the
24 provisions of s. 490.012.
25 (2) No person shall be required to be licensed or
26 provisionally licensed under this chapter who:
27 (a) Is a salaried employee of a government agency;
28 developmental services program, mental health, alcohol, or
29 drug abuse facility operating pursuant to chapter 393, chapter
30 394, or chapter 397; subsidized child care program, subsidized
31 child care case management program, or child care resource and
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 referral program operating pursuant to chapter 402;
2 child-placing or child-caring agency licensed pursuant to
3 chapter 409; domestic violence center certified pursuant to
4 chapter 39; accredited academic institution; or research
5 institution, if such employee is performing duties for which
6 he or she was trained and hired solely within the confines of
7 such agency, facility, or institution, so long as the employee
8 is not held out to the public as a psychologist pursuant to s.
9 490.012(1)(a) .
10 (b) Is a salaried employee of a private, nonprofit
11 organization providing counseling services to children, youth,
12 and families, if such services are provided for no charge, if
13 such employee is performing duties for which he or she was
14 trained and hired, so long as the employee is not held out to
15 the public as a psychologist pursuant to s. 490.012(1)(a).
16 (c) Is a student who is pursuing a course of study
17 which leads to a degree in medicine or a profession regulated
18 by this chapter who is providing services in a training
19 setting, provided such activities or services constitute part
20 of a supervised course of study, or is a graduate accumulating
21 the experience required for any licensure under this chapter,
22 provided such graduate or student is designated by a title
23 such as "intern" or "trainee" which clearly indicates the
24 in-training status of the student.
25 (d) Is certified in school psychology by the
26 Department of Education and is performing psychological
27 services as an employee of a public or private educational
28 institution. Such exemption shall not be construed to
29 authorize any unlicensed practice which is not performed as a
30 direct employee of an educational institution.
31 (e) Is not a resident of the state but offers services
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 in this state, provided:
2 1. Such services are performed for no more than 5 days
3 in any month and no more than 15 days in any calendar year;
4 and
5 2. Such nonresident is licensed or certified by a
6 state or territory of the United States, or by a foreign
7 country or province, the standards of which were, at the date
8 of his or her licensure or certification, equivalent to or
9 higher than the requirements of this chapter in the opinion of
10 the department or, in the case of psychologists, in the
11 opinion of the board.
12 (f) Is a rabbi, priest, minister, or member of the
13 clergy of any religious denomination or sect when engaging in
14 activities which are within the scope of the performance of
15 his or her regular or specialized ministerial duties and for
16 which no separate charge is made, or when such activities are
17 performed, with or without charge, for or under the auspices
18 or sponsorship, individually or in conjunction with others, of
19 an established and legally cognizable church, denomination, or
20 sect, and when the person rendering service remains
21 accountable to the established authority thereof.
22 (3) No provision of this chapter shall be construed to
23 limit the practice of any individual who solely engages in
24 behavior analysis so long as he or she does not hold himself
25 or herself out to the public as possessing a license issued
26 pursuant to this chapter or use a title or description
27 protected by this chapter.
28 (4) Nothing in this section shall exempt any person
29 from the provisions provision of s. 490.012(1)(a)-(d) (a)-(b).
30 (5) Except as stipulated by the board, the exemptions
31 contained in this section do not apply to any person licensed
116
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 under this chapter whose license has been suspended or revoked
2 by the board or another jurisdiction.
3 Section 72. Effective January 1, 2002, paragraphs (i),
4 (j), and (k) of subsection (1) of section 491.012, Florida
5 Statutes, are amended to read:
6 491.012 Violations; penalty; injunction.--
7 (1) It is unlawful and a violation of this chapter for
8 any person to:
9 (i) Practice clinical social work in this state, as
10 the practice is defined in s. 491.003(7), for compensation,
11 unless the person holds a valid, active license to practice
12 clinical social work issued pursuant to this chapter or is an
13 intern registered pursuant to s. 491.0045.
14 (j) Practice marriage and family therapy in this
15 state, as the practice is defined in s. 491.003(8), for
16 compensation, unless the person holds a valid, active license
17 to practice marriage and family therapy issued pursuant to
18 this chapter or is an intern registered pursuant to s.
19 491.0045.
20 (k) Practice mental health counseling in this state,
21 as the practice is defined in s. 491.003(9), for compensation,
22 unless the person holds a valid, active license to practice
23 mental health counseling issued pursuant to this chapter or is
24 an intern registered pursuant to s. 491.0045.
25 Section 73. Effective January 1, 2002, paragraphs (a)
26 and (b) of subsection (4) of section 491.014, Florida
27 Statutes, are amended to read:
28 491.014 Exemptions.--
29 (4) No person shall be required to be licensed,
30 provisionally licensed, registered, or certified under this
31 chapter who:
117
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (a) Is a salaried employee of a government agency;
2 developmental services program, mental health, alcohol, or
3 drug abuse facility operating pursuant to chapter 393, chapter
4 394, or chapter 397; subsidized child care program, subsidized
5 child care case management program, or child care resource and
6 referral program operating pursuant to chapter 402;
7 child-placing or child-caring agency licensed pursuant to
8 chapter 409; domestic violence center certified pursuant to
9 chapter 39; accredited academic institution; or research
10 institution, if such employee is performing duties for which
11 he or she was trained and hired solely within the confines of
12 such agency, facility, or institution, so long as the employee
13 is not held out to the public as a clinical social worker,
14 mental health counselor, or marriage and family therapist.
15 (b) Is a salaried employee of a private, nonprofit
16 organization providing counseling services to children, youth,
17 and families, if such services are provided for no charge, if
18 such employee is performing duties for which he or she was
19 trained and hired, so long as the employee is not held out to
20 the public as a clinical social worker, mental health
21 counselor, or marriage and family therapist.
22 Section 74. Subsection (4) of section 458.319, Florida
23 Statutes, is amended to read:
24 458.319 Renewal of license.--
25 (4) Notwithstanding the provisions of s. 456.033, a
26 physician may complete continuing education on end-of-life
27 care and palliative health care in lieu of continuing
28 education in AIDS/HIV, if that physician has completed the
29 AIDS/HIV continuing education in the immediately preceding
30 biennium.
31 Section 75. Subsection (5) of section 459.008, Florida
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Statutes, is amended to read:
2 459.008 Renewal of licenses and certificates.--
3 (5) Notwithstanding the provisions of s. 456.033, an
4 osteopathic physician may complete continuing education on
5 end-of-life and palliative health care in lieu of continuing
6 education in AIDS/HIV, if that physician has completed the
7 AIDS/HIV continuing education in the immediately preceding
8 biennium.
9 Section 76. Subsection (4) of section 765.101, Florida
10 Statutes, is amended to read:
11 765.101 Definitions.--As used in this chapter:
12 (4) "End-stage condition" means an irreversible a
13 condition that is caused by injury, disease, or illness which
14 has resulted in progressively severe and permanent
15 deterioration, indicated by incapacity and complete physical
16 dependency and for which, to a reasonable degree of medical
17 probability certainty, treatment of the irreversible condition
18 would be medically ineffective.
19 Section 77. Subsection (4) of section 765.102, Florida
20 Statutes, is amended to read:
21 765.102 Legislative findings and intent.--
22 (4) The Legislature recognizes the need for all health
23 care professionals to rapidly increase their understanding of
24 end-of-life and palliative health care. Therefore, the
25 Legislature encourages the professional regulatory boards to
26 adopt appropriate standards and guidelines regarding
27 end-of-life care and pain management and encourages
28 educational institutions established to train health care
29 professionals and allied health professionals to implement
30 curricula to train such professionals to provide end-of-life
31 care, including pain management and palliative care.
119
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Section 78. Section 765.1025, Florida Statutes, is
2 created to read:
3 765.1025 Palliative care.--For purposes of this
4 chapter:
5 (1) Palliative care is the comprehensive management of
6 the physical, psychological, social, spiritual, and
7 existential needs of patients. Palliative care is especially
8 suited to the care of persons who have incurable, progressive
9 illness.
10 (2) Palliative care must include:
11 (a) An opportunity to discuss and plan for end-of-life
12 care.
13 (b) Assurance that physical and mental suffering will
14 be carefully attended to.
15 (c) Assurance that preferences for withholding and
16 withdrawing life-sustaining interventions will be honored.
17 (d) Assurance that the personal goals of the dying
18 person will be addressed.
19 (e) Assurance that the dignity of the dying person
20 will be a priority.
21 (f) Assurance that health care providers will not
22 abandon the dying person.
23 (g) Assurance that the burden to family and others
24 will be addressed.
25 (h) Assurance that advance directives for care will be
26 respected regardless of the location of care.
27 (i) Assurance that organizational mechanisms are in
28 place to evaluate the availability and quality of end-of-life
29 and palliative care services, including the removal of
30 administrative and regulatory barriers.
31 (j) Assurance that necessary health care services will
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 be provided and that relevant reimbursement policies are
2 available.
3 (k) Assurance that the goals expressed in paragraphs
4 (a)-(j) will be accomplished in a culturally appropriate
5 manner.
6 Section 79. Subsection (2) of section 765.1103,
7 Florida Statutes, is amended to read:
8 765.1103 Pain management and palliative care.--
9 (2) Health care providers and practitioners regulated
10 under chapter 458, chapter 459, or chapter 464 must, as
11 appropriate, comply with a request for pain management or
12 palliative care from a patient under their care or, for an
13 incapacitated patient under their care, from a surrogate,
14 proxy, guardian, or other representative permitted to make
15 health care decisions for the incapacitated patient.
16 Facilities regulated under chapter 400 or chapter 395 must
17 comply with the pain management or palliative care measures
18 ordered by the patient's physician. When the patient is
19 receiving care as an admitted patient of a facility or a
20 provider or is a subscriber of a health care facility, health
21 care provider, or health care practitioner regulated under
22 chapter 395, chapter 400, chapter 458, chapter 459, chapter
23 464, or chapter 641, such facility, provider, or practitioner
24 must, when appropriate, comply with a request for pain
25 management or palliative care from a capacitated patient or an
26 incapacitated patient's health care surrogate or proxy,
27 court-appointed guardian as provided in chapter 744, or
28 attorney in fact as provided in chapter 709. The
29 court-appointed guardian or attorney in fact must have been
30 delegated authority to make health care decisions on behalf of
31 the patient.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 Section 80. Paragraph (b) of subsection (1) of section
2 765.205, Florida Statutes, is amended to read:
3 765.205 Responsibility of the surrogate.--
4 (1) The surrogate, in accordance with the principal's
5 instructions, unless such authority has been expressly limited
6 by the principal, shall:
7 (b) Consult expeditiously with appropriate health care
8 providers to provide informed consent, and make only health
9 care decisions for the principal which he or she believes the
10 principal would have made under the circumstances if the
11 principal were capable of making such decisions. This
12 substituted-judgment standard is the preferred standard of
13 decisionmaking to be used by health care surrogates, persons
14 who have durable powers of attorney for health care, and proxy
15 decisionmakers. However, if there is no indication of what the
16 principal would have chosen, the surrogate may consider the
17 patient's best interest in deciding that proposed treatments
18 are to be withheld or that treatments currently in effect are
19 to be withdrawn.
20 Section 81. Subsections (2) and (3) of section
21 765.401, Florida Statutes, are amended to read:
22 765.401 The proxy.--
23 (2) Any health care decision made under this part must
24 be based on the proxy's informed consent and on the decision
25 the proxy reasonably believes the patient would have made
26 under the circumstances. This substituted-judgment standard is
27 the preferred standard of decisionmaking to be used by a
28 proxy. However, if there is no indication of what the patient
29 would have chosen, the proxy may consider the patient's best
30 interest in deciding that proposed treatments are to be
31 withheld or that treatments currently in effect are to be
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 withdrawn.
2 (3) Before exercising the incapacitated patient's
3 rights to select or decline health care, the proxy must comply
4 with the provisions of ss. 765.205 and 765.305, except that a
5 proxy's decision to withhold or withdraw life-prolonging
6 procedures must be supported by clear and convincing evidence
7 that the decision would have been the one the patient would
8 have chosen had the patient been competent or, if there is no
9 indication of what the patient would have chosen, that the
10 decision is in the patient's best interest.
11 Section 82. The Legislature finds that the area of
12 physician specialty training is of great importance to the
13 citizens of this state and that specialty training and
14 certification creates a higher level of proficiency for the
15 physician and improves the delivery of health care to
16 Floridians. Because much confusion exists among the patient
17 population and physicians as to the requirements for board
18 certification, the Legislature directs the Department of
19 Health to conduct an interim study of the area of specialty
20 certification for the Board of Medicine and the Board of
21 Osteopathic Medicine. The study should review current Florida
22 Statutes and board rules to determine if any barriers exist in
23 board recognition of certifying and physician-certifying
24 organizations and if restrictions placed on a licensee's
25 speech both target an identifiable harm and mitigate against
26 such harm in a direct and effective manner. A final report
27 shall be provided no later than January 1, 2002, to the
28 President of the Senate and the Speaker of the House of
29 Representatives for distribution to the chairs of the
30 health-care-related committees.
31 Section 83. Paragraph (d) of subsection (2) of section
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 499.012, Florida Statutes, is amended to read:
2 499.012 Wholesale distribution; definitions; permits;
3 general requirements.--
4 (2) The following types of wholesaler permits are
5 established:
6 (d) A retail pharmacy wholesaler's permit. A retail
7 pharmacy wholesaler is a retail pharmacy engaged in wholesale
8 distribution of prescription drugs within this state under the
9 following conditions:
10 1. The pharmacy must obtain a retail pharmacy
11 wholesaler's permit pursuant to ss. 499.001-499.081 and the
12 rules adopted under those sections.
13 2. The wholesale distribution activity does not exceed
14 30 percent of the total annual purchases of prescription
15 drugs. If the wholesale distribution activity exceeds the
16 30-percent maximum, the pharmacy must obtain a prescription
17 drug wholesaler's permit.
18 3. The transfer of prescription drugs that appear in
19 any schedule contained in chapter 893 is subject to chapter
20 893 and the federal Comprehensive Drug Abuse Prevention and
21 Control Act of 1970.
22 4. The transfer is between a retail pharmacy and
23 another retail pharmacy, a Modified Class II institutional
24 pharmacy, or a health care practitioner licensed in this state
25 and authorized by law to dispense or prescribe prescription
26 drugs.
27 5. All records of sales of prescription drugs subject
28 to this section must be maintained separate and distinct from
29 other records and comply with the recordkeeping requirements
30 of ss. 499.001-499.081.
31 Section 84. Section 627.613, Florida Statutes, is
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 amended to read:
2 627.613 Time of payment of claims.--
3 (1) The contract shall include the following
4 provision:
5
6 "Time of Payment of Claims: After receiving written
7 proof of loss, the insurer will pay monthly all benefits then
8 due for ...(type of benefit).... Benefits for any other loss
9 covered by this policy will be paid as soon as the insurer
10 receives proper written proof."
11
12 (2)(a) As used in this section, the term "clean claim"
13 for a noninstitutional provider means a claim submitted on a
14 HCFA 1500 form which has no defect or impropriety, including
15 lack of required substantialing documentation for
16 noncontracted providers and suppliers, or particular
17 circumstances requiring special treatment which prevent timely
18 payment from being made on the claim. A claim may not be
19 considered not clean solely because a health insurer refers
20 the claim to a medical specialist within the insurer for
21 examination. If additional substantialing documentation, such
22 as the medical record or encounter data, is required from a
23 source outside the insurer, the claim is considered not clean.
24 This definition of "clean claim" is repealed on the effective
25 date of rules adopted by the department which define the term
26 "clean claim."
27 (b) Absent a written definition that is agreed upon
28 through contract, the term "clean claim" for an institutional
29 claim is a properly and accurately completed paper or
30 electronic billing instrument that consists of the UB-92 data
31 set or its successor with entries stated as mandatory by the
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 National Uniform Billing Committee.
2 (3)(a) A health insurer shall pay any clean claim or
3 any portion of a clean claim made by a contract provider for
4 services or goods provided under a contract with the health
5 insurer, or a clean claim made by a noncontracted provider
6 which the insurer does not contest or deny, within 45 days
7 after receipt of the claim by the health insurer which is
8 mailed or electronically transferred by the provider.
9 (b) A health insurer that denies or contests a
10 provider's claim or any portion of a claim must notify the
11 provider, in writing, within 45 days after the health insurer
12 receives the claim that the claim is contested or denied. The
13 notice that the claim is denied or contested must identify the
14 contested portion of the claim and the specific reason for
15 contesting or denying the claim, and, if contested, must
16 include a request for additional medical information. If the
17 provider submits additional information, the provider must,
18 within 30 days after receipt of the request, mail or
19 electronically transfer the information to the health insurer.
20 The health insurer shall pay or deny the claim or portion of
21 the claim within 45 days after receipt of the information.
22 (4) Payment of a claim is considered made on the date
23 the payment was received, electronically transferred, or
24 otherwise delivered. An overdue payment of a claim bears
25 simple interest at the rate of 10 percent per year. Interest
26 on an overdue payment for a clean claim, or for any
27 uncontested portion of a clean claim, begins to accrue on the
28 46th day after the date the claim is received. The interest is
29 payable with the payment of the claim.
30 (5) A health insurer must pay or deny a claim not
31 later than 120 days after receiving the claim. Failure to do
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 so creates an uncontestable obligation for the health insurer
2 to pay the claim to the provider.
3 (6) If the claim has been electronically transmitted
4 to the health insurer, a provider's claim for payment shall be
5 considered received by the health insurer on the date receipt
6 is verified electronically or, if the claim is mailed to the
7 address provided by the insurer, on the date indicated on the
8 return receipt. A provider may not submit a duplicate claim
9 until 45 days following submission of the original claim.
10 (7) A provider, or the provider's designee, who bills
11 electronically must be provided with an electronic
12 acknowledgment of the receipt of a claim within 72 hours.
13 (8) A health insurer may not retroactively deny a
14 claim because of an insured's ineligibility more than 1 year
15 after the date of payment of a clean claim.
16 (9) The department shall adopt rules to establish
17 claim-filing standards that are consistent with federal
18 claim-filing standards required by the United States Secretary
19 of Health and Human Services. The department shall adopt rules
20 to require the code sets that are consistent with those
21 adopted by the United States Secretary of Health and Human
22 Services. These code sets shall apply to both electronic and
23 paper claims. A code set, as defined by the Secretary,
24 includes both the codes and the descriptors of the codes.
25 (10) Contracted and noncontracted health care
26 providers who have a claims dispute that is not resolved by
27 the health insurer and provider may submit the claims dispute
28 to statewide provider and managed care organization claim
29 dispute resolution program created by s. 408.7057 to have the
30 claims dispute reviewed and considered by the resolution
31 organization.
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 (2) Health insurers shall reimburse all claims or any
2 portion of any claim from an insured or an insured's
3 assignees, for payment under a health insurance policy, within
4 45 days after receipt of the claim by the health insurer. If
5 a claim or a portion of a claim is contested by the health
6 insurer, the insured or the insured's assignees shall be
7 notified, in writing, that the claim is contested or denied,
8 within 45 days after receipt of the claim by the health
9 insurer. The notice that a claim is contested shall identify
10 the contested portion of the claim and the reasons for
11 contesting the claim.
12 (3) A health insurer, upon receipt of the additional
13 information requested from the insured or the insured's
14 assignees shall pay or deny the contested claim or portion of
15 the contested claim, within 60 days.
16 (4) An insurer shall pay or deny any claim no later
17 than 120 days after receiving the claim.
18 (5) Payment shall be treated as being made on the date
19 a draft or other valid instrument which is equivalent to
20 payment was placed in the United States mail in a properly
21 addressed, postpaid envelope or, if not so posted, on the date
22 of delivery.
23 (6) All overdue payments shall bear simple interest at
24 the rate of 10 percent per year.
25 (11)(7) Upon written notification by an insured, an
26 insurer shall investigate any claim of improper billing by a
27 physician, hospital, or other health care provider. The
28 insurer shall determine if the insured was properly billed for
29 only those procedures and services that the insured actually
30 received. If the insurer determines that the insured has been
31 improperly billed, the insurer shall notify the insured and
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 the provider of its findings and shall reduce the amount of
2 payment to the provider by the amount determined to be
3 improperly billed. If a reduction is made due to such
4 notification by the insured, the insurer shall pay to the
5 insured 20 percent of the amount of the reduction up to $500.
6 Section 85. Except as otherwise provided herein, this
7 act shall take effect July 1, 2001.
8
9
10 ================ T I T L E A M E N D M E N T ===============
11 And the title is amended as follows:
12 On page 1, lines 2 through 10,
13 remove from the title of the bill: all of said lines
14
15 and insert in lieu thereof:
16 An act relating to health care regulation;
17 amending s. 483.245, F.S.; prohibiting rebate
18 or split-fee arrangements with dialysis
19 facilities for patient referrals to clinical
20 laboratories; providing penalties; amending s.
21 232.435, F.S.; providing training requirements
22 for a first responder and teacher athletic
23 trainer; amending s. 381.6021, F.S.;
24 prohibiting rules that establish standards and
25 guidelines for organ and tissue procurement
26 from allowing the pooling of human cells or
27 tissue; amending s. 383.14, F.S.; amending
28 screening requirements for postnatal screening;
29 amending s. 395.0197, F.S.; revising provisions
30 relating to hospital and ambulatory surgical
31 center internal risk management programs;
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 modifying requirements for risk management and
2 prevention education and training; restricting
3 participation of unlicensed persons in surgical
4 procedures; requiring ongoing evaluation of
5 surgical procedures and protocols; eliminating
6 an annual report summarizing facility incident
7 reports and disciplinary actions; requiring the
8 Agency for Health Care Administration to
9 publish website summaries of adverse incident
10 reports; requiring facility reporting of
11 allegations of sexual misconduct by health care
12 practitioners; providing certain civil
13 liability for licensed risk managers;
14 prohibiting intimidation of a risk manager;
15 providing a penalty; amending s. 395.10972,
16 F.S.; increasing membership on the Health Care
17 Risk Management Advisory Council; amending s.
18 395.701, F.S.; limiting the financial
19 information the agency may require to determine
20 the amount of hospital annual assessments;
21 amending s. 409.905, F.S.; providing that the
22 Agency for Health Care Administration may
23 restrict the provision of mandatory services by
24 mobile providers; amending s. 409.906, F.S.;
25 providing that the agency may restrict or
26 prohibit the provision of services by mobile
27 providers; providing that Medicaid will not
28 provide reimbursement for dental services
29 provided in mobile dental units, except for
30 certain units; amending s. 456.013, F.S.;
31 providing a professional continuing education
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 requirement relating to prevention of medical
2 errors; amending s. 456.057, F.S.; providing
3 for appointment of a records custodian under
4 certain circumstances; amending s. 456.063,
5 F.S.; requiring licensed health care
6 practitioners to report to the Department of
7 Health any allegations of sexual misconduct;
8 amending s. 456.072, F.S.; providing additional
9 grounds for disciplinary actions; clarifying a
10 penalty involving restriction of professional
11 practice or license; providing additional
12 penalties; requiring assessment of costs
13 related to investigation and prosecution;
14 amending s. 456.073, F.S.; requiring the
15 Department of Health to notify the patient or
16 legal representative of the status of a
17 disciplinary case; requiring the department to
18 provide certain information to the complainant;
19 providing time limitations on the filing of
20 administrative complaints against licensees of
21 the department; amending s. 456.074, F.S.;
22 providing for an emergency order suspending the
23 license of any practitioner for fraud; amending
24 s. 456.077, F.S.; specifying violations for
25 which the Department of Health or a regulatory
26 board may issue citations; amending s. 456.081,
27 F.S.; requiring the Department of Health and
28 regulatory boards to maintain a website
29 containing specified information; creating s.
30 458.3147, F.S.; providing automatic eligibility
31 for admission to any medical school in the
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 State University System for military academy
2 students or graduates who qualify for the
3 Medical Corps of the United States military;
4 providing for waiver or refund of application
5 fees; amending ss. 458.331 and 459.015, F.S.;
6 conforming language and cross references to
7 changes made by the act; amending s. 641.51,
8 F.S.; revising adverse determination
9 provisions; amending ss. 465.019 and 465.0196,
10 F.S.; requiring institutional pharmacies and
11 special pharmacy permittees that use pharmacy
12 technicians to have a written policy and
13 procedures manual; directing the Department of
14 Health and the Agency for Health Care
15 Administration to review health care
16 practitioner and facility reporting
17 requirements; requiring a report to the
18 Legislature; amending s. 468.1755, F.S.;
19 providing an additional ground for disciplinary
20 action against a nursing home administrator;
21 reenacting ss. 468.1695(3) and 468.1735, F.S.,
22 to incorporate said amendment in references;
23 reenacting s. 484.056(1)(a), F.S., relating to
24 disciplinary action against hearing aid
25 specialists, to incorporate the amendment to s.
26 456.072(1), in a reference; amending s.
27 766.101, F.S.; providing that a continuous
28 quality improvement committee of a licensed
29 pharmacy is a medical review committee for
30 purposes of immunity from liability, and
31 reenacting ss. 440.105(1)(a) and 626.989(6),
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 F.S., to incorporate said amendment in
2 references; creating s. 627.6474, F.S.;
3 prohibiting health insurers from requiring
4 certain contracted health care practitioners to
5 accept the terms of other health care
6 contractsas a condition of continuation or
7 renewal; providing exceptions; amending s.
8 627.662, F.S.; applying this prohibition to
9 group health insurance, blanket health
10 insurance, and franchise health insurance;
11 amending s. 641.315, F.S.; applying this
12 prohibition to health maintenance
13 organizations; amending s. 766.1115, F.S.;
14 conforming language and cross references to
15 changes made by the act; amending s. 456.047,
16 F.S.; providing intent; revising and providing
17 definitions; revising duties of the Department
18 of Health relating to file maintenance;
19 providing that primary source data verified by
20 the department or its designee may be relied
21 upon to meet accreditation purposes; amending
22 s. 232.61, F.S.; requiring the Florida High
23 School Activities Association to adopt bylaws
24 which require students participating in
25 interscholastic athletic competition or who are
26 candidates for an interscholastic athletic team
27 to satisfactorily pass a medical evaluation
28 prior to participating in interscholastic
29 athletic competition or engaging in practice
30 with an interscholastic athletic team;
31 providing requirements with respect to such
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 evaluation; amending s. 240.4075, F.S.;
2 transferring the Nursing Student Loan
3 Forgiveness Program from the Department of
4 Education to the Department of Health;
5 including public schools, family practice
6 teaching hospitals, and specialty hospitals for
7 children as eligible facilities under the
8 program; exempting such facilities from the
9 fund-matching requirements of the program;
10 amending s. 240.4076, F.S.; transferring the
11 nursing scholarship program from the Department
12 of Education to the Department of Health;
13 providing requirements under the program for
14 students seeking to qualify for a nursing
15 faculty position and receive credit for work in
16 such a position; including nursing homes,
17 hospitals, public schools, colleges of nursing,
18 and community college nursing programs as
19 eligible facilities under the program;
20 transferring powers, duties, functions, rules,
21 records, personnel, property, and
22 appropriations and other funds relating to the
23 Nursing Student Loan Forgiveness Program and
24 the nursing scholarship program from the
25 Department of Education to the Department of
26 Health; amending s. 464.005, F.S.; providing
27 for future relocation of the headquarters of
28 the Board of Nursing; amending s. 464.008,
29 F.S.; revising education requirements for
30 licensure by examination; amending s. 464.009,
31 F.S.; revising requirements for licensure by
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 endorsement; requiring submission of
2 fingerprints for a criminal history check and a
3 fee to cover the costs of such check; providing
4 for an electronic applicant notification
5 process; creating s. 464.0195, F.S.; creating
6 the Florida Center for Nursing and providing
7 its goals; creating s. 464.0196, F.S.;
8 providing for a board of directors; providing
9 for appointment of board members; providing for
10 staggered terms; providing powers and duties;
11 authorizing per diem and travel expenses;
12 creating s. 464.0197, F.S.; declaring state
13 budget support for the center; prohibiting the
14 Board of Nursing from developing any rule
15 relating to faculty/student clinical ratios
16 until a specified time; requiring the Board of
17 Nursing and the Department of Education to
18 submit to the Legislature an implementation
19 plan detailing the impact and cost of any such
20 proposed rule change; amending s. 464.0205,
21 F.S.; deleting the application and processing
22 fee for applicants for a retired volunteer
23 nurse certificate; requiring study by Office of
24 Program Policy Analysis and Government
25 Accountability of the feasibility of
26 maintaining all of Medical Quality Assurance in
27 one state agency; creating s. 456.0375, F.S.;
28 requiring registration of certain clinics;
29 providing requirements, including fees;
30 providing rulemaking authority; requiring
31 medical directors or clinic directors for such
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 clinics and providing their duties and
2 responsibilities; providing an appropriation;
3 amending s. 456.031, F.S.; providing an
4 alternative by which licensees under ch. 466,
5 F.S., relating to dentistry, may comply with a
6 general requirement that they take
7 domestic-violence education courses; amending
8 s. 456.033, F.S.; providing an alternative by
9 which such licensees may comply with a general
10 requirement that they take AIDS/HIV education
11 courses; amending s. 627.419, F.S.; providing
12 for appeals from certain adverse determinations
13 relating to dental service claims; providing
14 applicability; amending s. 468.302, F.S.;
15 revising a provision relating to exemption from
16 certification to use radiation on human beings;
17 amending ss. 468.352, 468.355, 468.357,
18 468.358, and 468.359, F.S.; revising
19 definitions and provisions relating to
20 licensure and use of titles and abbreviations
21 to correct and conform terminology with respect
22 to respiratory therapists and respiratory care
23 practitioners; amending ss. 468.1155 and
24 468.1215, F.S.; revising requirements for
25 licensure to practice speech-language pathology
26 or audiology and for certification of
27 speech-language pathology or audiology
28 assistants; amending s. 480.033, F.S.;
29 correcting terminology in the definition of
30 "massage"; amending s. 484.002, F.S.; amending
31 and creating definitions; amending ss. 484.002,
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 484.006, 484.012, F.S.; replacing references to
2 the term "medical doctor" with the term
3 "allopathic or osteopathic physician"; amending
4 s. 484.013, F.S.; revising provisions
5 prescribing violations and penalties applicable
6 to the practice of opticianry; amending s.
7 484.015, F.S.; revising inspection authority;
8 amending s. 921.0022, F.S., relating to the
9 Criminal Punishment Code; providing an offense
10 severity ranking for the offense of practicing
11 opticianry without a license; amending s.
12 484.0445, F.S.; removing certain provisions
13 relating to the training program for hearing
14 aid specialists; amending s. 484.045, F.S.;
15 revising requirements for licensure as a
16 hearing aid specialist by examination; amending
17 s. 490.012, F.S.; prohibiting the use of
18 certain titles or descriptions relating to the
19 practice of psychology or school psychology
20 unless properly licensed; providing penalties;
21 amending s. 490.014, F.S.; revising exemptions
22 from regulation under ch. 490, F.S., relating
23 to psychology; correcting a cross reference;
24 amending s. 491.012, F.S.; revising
25 prohibitions against unlicensed practice of
26 clinical social work, marriage and family
27 therapy, and mental health counseling to
28 provide that practice by registered interns is
29 lawful; amending s. 491.014, F.S.; revising
30 exemptions from licensure under ch. 491, F.S.,
31 relating to clinical, counseling, and
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HOUSE AMENDMENT
Bill No. SB 782, 1st Eng.
Amendment No. 1 (for drafter's use only)
1 psychotherapy services, to prohibit the use by
2 certain employees of titles, names, or
3 descriptions protected by the chapter; amending
4 ss. 458.319, 459.008, and 765.102, F.S.;
5 conforming terminology relating to palliative
6 care; amending s. 765.101, F.S.; redefining the
7 term "end-stage condition" with respect to
8 health care advance directives; creating s.
9 765.1025, F.S.; prescribing the content and
10 suitability of palliative care; amending s.
11 765.1103, F.S.; revising provisions relating to
12 compliance with requests for pain management
13 and palliative care; amending s. 765.205, F.S.;
14 prescribing the standards of decisionmaking to
15 be used in certain circumstances by health care
16 surrogates, persons who have durable powers of
17 attorney for health care, and proxy
18 decisionmakers; amending s. 765.401, F.S.;
19 prescribing the standards of decisionmaking to
20 be used in certain circumstances by proxy
21 decisionmakers; requiring the Department of
22 Health to conduct an interim study on specialty
23 certification and provide a report to the
24 Legislature; amending s. 499.012, F.S.;
25 authorizing transfer of prescription drugs
26 between a retail pharmacy and a Modified Class
27 II institutional pharmacy under a retail
28 pharmacy wholesaler's permit; amending s.
29 627.613, F.S.; amending time of payment of
30 claims; providing effective dates.
31
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