Senate Bill sb1950

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    Florida Senate - 2002                                  SB 1950

    By Senator Sullivan





    22-1431-02                                              See HB

  1                      A bill to be entitled

  2         An act relating to health regulation;

  3         transferring to the Department of Health the

  4         powers, duties, functions, and assets that

  5         relate to the consumer complaint services,

  6         investigations, and prosecutorial services

  7         performed by the Agency for Health Care

  8         Administration under contract with the

  9         department; amending s. 20.43, F.S.; deleting a

10         provision authorizing the department to enter

11         into such contract with the agency, to conform;

12         updating a reference to provide the name of a

13         regulatory board under the Division of Medical

14         Quality Assurance; amending s. 456.073, F.S.;

15         revising procedures and timeframes for formal

16         hearings of health care practitioner

17         disciplinary cases; revising the charges and

18         manner of charging for disciplinary hearings;

19         providing fees; requiring a joint audit of

20         hearings and their billing formulas and a

21         report to the Legislature; amending s. 456.076,

22         F.S.; requiring each impaired practitioner to

23         pay a portion of the cost of a consultant and

24         impaired practitioner program and the full cost

25         of the required treatment program or plan;

26         providing certain exceptions; repealing s.

27         456.047, F.S., to terminate the standardized

28         credentialing program for health care

29         practitioners; prohibiting the refund of moneys

30         collected through the credentialing program;

31         amending ss. 456.039, 456.0391, 456.072, and

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         456.077, F.S.; removing references, to conform;

  2         amending s. 458.309, F.S.; requiring

  3         accreditation of physician offices in which

  4         surgery is performed; amending s. 459.005,

  5         F.S.; requiring accreditation of osteopathic

  6         physician offices in which surgery is

  7         performed; amending s. 456.004, F.S., relating

  8         to powers and duties of the department;

  9         requiring performance measures for certain

10         entities; providing procedures for considering

11         board requests to privatize regulatory

12         functions; amending s. 456.009, F.S.; requiring

13         performance measures for certain legal and

14         investigative services and annual review of

15         such services to determine whether such

16         performance measures are being met; amending s.

17         456.011, F.S.; requiring regulatory board

18         committee meetings, including probable cause

19         panels, to be held electronically unless

20         certain conditions are met; amending s.

21         456.026, F.S.; requiring inclusion of

22         performance measures for certain entities in

23         the department's annual report to the

24         Legislature; creating s. 458.3093, F.S.;

25         requiring submission of credentials for initial

26         physician licensure to a national licensure

27         verification service; requiring verification of

28         such credentials by that service or an

29         equivalent program; creating s. 459.0053, F.S.;

30         requiring submission of credentials for initial

31         osteopathic physician licensure to a national

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         licensure verification service; requiring

  2         verification of such credentials by that

  3         service, a specified association, or an

  4         equivalent program; amending ss. 458.331,

  5         459.015, and 627.912, F.S.; raising the

  6         malpractice closed claims reporting requirement

  7         amount; amending s. 456.073, F.S.; requiring

  8         health care practitioner licensees to pay the

  9         actual costs of investigation and prosecution

10         under certain circumstances; requiring cases in

11         which no probable cause has been found to be

12         closed within a specified period of time;

13         requiring a study of the field office structure

14         and organization of the Agency for Health Care

15         Administration and a report to the Legislature;

16         amending s. 456.025, F.S.; eliminating certain

17         restrictions on the setting of licensure

18         renewal fees for health care practitioners;

19         creating s. 456.0165, F.S.; restricting the

20         costs that may be charged by educational

21         institutions hosting health care practitioner

22         licensure examinations; requiring that health

23         care practitioner licensure and licensure

24         renewal fees be set at the statutory fee cap or

25         at the level of actual regulatory costs,

26         whichever is less; amending s. 468.301, F.S.;

27         revising the definition of "direct supervision"

28         applicable to the regulation of radiologic

29         technology; amending s. 468.302, F.S.;

30         authorizing certified nuclear medicine

31         technologists to administer X radiation from

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         certain devices under certain circumstances;

  2         exempting certain persons from radiologic

  3         technologist certification and providing

  4         certain training requirements for such

  5         exemption; amending s. 468.352, F.S.; revising

  6         and providing definitions applicable to the

  7         regulation of respiratory therapy; amending s.

  8         468.355, F.S.; revising provisions relating to

  9         respiratory therapy licensure and testing

10         requirements; amending s. 468.368, F.S.;

11         revising exemptions from respiratory therapy

12         licensure requirements; repealing s. 468.356,

13         F.S., relating to the approval of educational

14         programs; repealing s. 468.357, F.S., relating

15         to licensure by examination; requiring that

16         applications for health care practitioner

17         licensure and licensure renewal be submitted

18         electronically beginning July 1, 2003;

19         directing the Division of Statutory Revision to

20         annually submit reviser's bills to adjust the

21         statutory fee caps applicable to regulation of

22         health care practitioners; renumbering ss.

23         381.0602, 381.6021, 381.6022, 381.6023,

24         381.6024, and 381.6026, F.S., and renumbering

25         and amending ss. 381.60225 and 381.6025, F.S.,

26         to move provisions relating to organ and tissue

27         procurement, donation, and transplantation to

28         part V, ch. 765, F.S., relating to anatomical

29         gifts; conforming cross-references; amending

30         ss. 395.2050, 409.815, 765.5216, and 765.522,

31         F.S.; conforming cross-references; creating s.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         765.539, F.S.; prohibiting cadaveric organ and

  2         tissue procurement organizations from pooling

  3         human cells or tissues; providing effective

  4         dates.

  5

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

  7

  8         Section 1.  (1)  Effective July 1, 2002, all powers,

  9  duties, functions, records, personnel, property, and

10  unexpended balances of appropriations, allocations, and other

11  funds of the Agency for Health Care Administration which

12  relate to consumer complaint services, investigations, and

13  prosecutorial services currently provided by the Agency for

14  Health Care Administration under a contract with the

15  Department of Health are transferred to the Department of

16  Health by a type two transfer, as defined in section 20.06(2),

17  Florida Statutes.  This transfer of funds shall include all

18  advance payments made from the Medical Quality Assurance Trust

19  Fund to the Agency for Health Care Administration.

20         (2)(a)  Effective July 1, 2002, 281 full-time

21  equivalent positions are eliminated from the Agency for Health

22  Care Administration's total number of authorized positions.

23  Effective July 1, 2002, 273 full-time equivalent positions are

24  authorized for the Department of Health, to be added to the

25  department's total number of authorized positions.  Any such

26  position transferred to the Department of Health which remains

27  unfilled 90 days after the transfer shall be eliminated.

28         (b)  All records, personnel, and funds of the consumer

29  complaint and investigative services units of the agency are

30  transferred and assigned to the Division of Medical Quality

31  Assurance of the Department of Health.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         (c)  All records, personnel, and funds of the health

  2  care practitioner prosecutorial unit of the agency are

  3  transferred and assigned to the Office of the General Counsel

  4  of the Department of Health.

  5         (3)  The Department of Health is deemed the successor

  6  in interest in all legal proceedings and contracts currently

  7  involving the Agency for Health Care Administration and

  8  relating to health care practitioner regulation.  Except as

  9  provided in this section, no legal proceeding shall be

10  dismissed, nor any contract terminated, on the basis of this

11  type two transfer.  The interagency agreement between the

12  Department of Health and the Agency for Health Care

13  Administration shall terminate on June 30, 2002.

14         Section 2.  Paragraph (g) of subsection (3) of section

15  20.43, Florida Statutes, is amended to read:

16         20.43  Department of Health.--There is created a

17  Department of Health.

18         (3)  The following divisions of the Department of

19  Health are established:

20         (g)  Division of Medical Quality Assurance, which is

21  responsible for the following boards and professions

22  established within the division:

23         1.  The Board of Acupuncture, created under chapter

24  457.

25         2.  The Board of Medicine, created under chapter 458.

26         3.  The Board of Osteopathic Medicine, created under

27  chapter 459.

28         4.  The Board of Chiropractic Medicine, created under

29  chapter 460.

30         5.  The Board of Podiatric Medicine, created under

31  chapter 461.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         6.  Naturopathy, as provided under chapter 462.

  2         7.  The Board of Optometry, created under chapter 463.

  3         8.  The Board of Nursing, created under part I of

  4  chapter 464.

  5         9.  Nursing assistants, as provided under part II of

  6  chapter 464.

  7         10.  The Board of Pharmacy, created under chapter 465.

  8         11.  The Board of Dentistry, created under chapter 466.

  9         12.  Midwifery, as provided under chapter 467.

10         13.  The Board of Speech-Language Pathology and

11  Audiology, created under part I of chapter 468.

12         14.  The Board of Nursing Home Administrators, created

13  under part II of chapter 468.

14         15.  The Board of Occupational Therapy, created under

15  part III of chapter 468.

16         16.  The Board of Respiratory Care therapy, as created

17  provided under part V of chapter 468.

18         17.  Dietetics and nutrition practice, as provided

19  under part X of chapter 468.

20         18.  The Board of Athletic Training, created under part

21  XIII of chapter 468.

22         19.  The Board of Orthotists and Prosthetists, created

23  under part XIV of chapter 468.

24         20.  Electrolysis, as provided under chapter 478.

25         21.  The Board of Massage Therapy, created under

26  chapter 480.

27         22.  The Board of Clinical Laboratory Personnel,

28  created under part III of chapter 483.

29         23.  Medical physicists, as provided under part IV of

30  chapter 483.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         24.  The Board of Opticianry, created under part I of

  2  chapter 484.

  3         25.  The Board of Hearing Aid Specialists, created

  4  under part II of chapter 484.

  5         26.  The Board of Physical Therapy Practice, created

  6  under chapter 486.

  7         27.  The Board of Psychology, created under chapter

  8  490.

  9         28.  School psychologists, as provided under chapter

10  490.

11         29.  The Board of Clinical Social Work, Marriage and

12  Family Therapy, and Mental Health Counseling, created under

13  chapter 491.

14

15  The department may contract with the Agency for Health Care

16  Administration who shall provide consumer complaint,

17  investigative, and prosecutorial services required by the

18  Division of Medical Quality Assurance, councils, or boards, as

19  appropriate.

20         Section 3.  Subsection (5) of section 456.073, Florida

21  Statutes, is amended to read:

22         456.073  Disciplinary proceedings.--Disciplinary

23  proceedings for each board shall be within the jurisdiction of

24  the department.

25         (5)(a)  A formal hearing before an administrative law

26  judge from the Division of Administrative Hearings shall be

27  held pursuant to chapter 120 if there are any disputed issues

28  of material fact raised within 45 days after service of the

29  administrative complaint.  The administrative law judge shall

30  issue a recommended order pursuant to chapter 120.  If any

31  party raises an issue of disputed fact during an informal

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  hearing, the hearing shall be terminated and a formal hearing

  2  pursuant to chapter 120 shall be held.

  3         (b)  Notwithstanding s. 120.569(2), the department

  4  shall notify the division within 45 days after receipt of a

  5  petition or request for a hearing which the department has

  6  determined requires a formal hearing before an administrative

  7  law judge.

  8         (c)  The division shall maintain time records for each

  9  case it receives. The division shall charge its expenses to

10  the Medical Quality Assurance Trust Fund based on an hourly

11  rate set forth in this paragraph.  The costs charged shall

12  include actual travel and copying expenses plus a $100 hourly

13  fee for the actual time spent on the case by the

14  administrative law judge or hearing officer. There shall be a

15  one-time filing fee per case of $50. There shall be no charge

16  for hearings cancelled more than 21 days in advance. Hearings

17  cancelled between 3 and 21 days in advance shall be billed for

18  actual expenses incurred, including travel cancellation fees

19  actually incurred. For any formal hearing cancelled less than

20  72 hours before the start of the hearing, actual expenses

21  incurred and a cancellation fee of $250 shall be billed.

22         Section 4.  All payments made after July 1, 2002, by

23  the Department of Health to the Division of Administrative

24  Hearings which are based on a formula in effect prior to that

25  date shall revert to the Department of Health. Effective July

26  1, 2002, the Division of Administrative Hearings shall bill

27  the Department of Health in accordance with section

28  456.073(5), Florida Statutes.

29         Section 5.  The Office of Program Policy Analysis and

30  Government Accountability and the Auditor General shall

31  conduct a joint audit of all hearings and billings therefor

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  conducted by the Division of Administrative Hearings for all

  2  state agencies and nonstate agencies and shall present a

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

  4  House of Representatives on or before January 1, 2003, which

  5  contains findings and recommendations regarding the manner in

  6  which the division charges for its services.  The report shall

  7  recommend alternative billing formulas.

  8         Section 6.  Subsection (7) is added to section 456.076,

  9  Florida Statutes, to read:

10         456.076  Treatment programs for impaired

11  practitioners.--

12         (7)  Each licensee participating in an impaired

13  practitioner program pursuant to this section shall pay a

14  minimum of 40 percent of the costs of the consultant and

15  impaired practitioner program incurred as a result of that

16  licensee, unless the consultant finds the licensee to be

17  financially unable to pay.  Payment of these costs shall be a

18  condition of the contract between the impaired practitioner

19  program and the impaired practitioner.  Failure to pay the

20  required costs shall be a violation of the contract, unless

21  prior arrangements have been made with the impaired

22  practitioner program.  If the licensee has entered the

23  impaired practitioner program as a result of a disciplinary

24  investigation, such payment shall be included in the final

25  order imposing discipline.  The remaining costs shall be paid

26  out of the Medical Quality Assurance Trust Fund or other

27  federal, state, or private program funds.  Each licensee shall

28  pay the full cost of the approved treatment program or other

29  treatment plan required by the impaired practitioner program,

30  unless private funds are available to assist with such

31  payment.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         Section 7.  Section 456.047, Florida Statutes, is

  2  repealed.

  3         Section 8.  All revenues associated with section

  4  456.047, Florida Statutes, and collected by the Department of

  5  Health on or before July 1, 2002, shall remain in the Medical

  6  Quality Assurance Trust Fund, and no refunds shall be given.

  7         Section 9.  Paragraph (d) of subsection (4) of section

  8  456.039, Florida Statutes, is amended to read:

  9         456.039  Designated health care professionals;

10  information required for licensure.--

11         (4)

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

13  licensure as a health care practitioner who submits to the

14  Department of Health a set of fingerprints or information

15  required for the criminal history check required under this

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

17  fingerprints or other duplicate information required for a

18  criminal history check to the Agency for Health Care

19  Administration, the Department of Juvenile Justice, or the

20  Department of Children and Family Services for employment or

21  licensure with such agency or department if the applicant has

22  undergone a criminal history check as a condition of initial

23  licensure or licensure renewal as a health care practitioner

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

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

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

27  Administration, the Department of Juvenile Justice, and the

28  Department of Children and Family Services shall obtain

29  criminal history information for employment or licensure of

30  health care practitioners by such agency and departments from

31

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  the Department of Health Health's health care practitioner

  2  credentialing system.

  3         Section 10.  Paragraph (d) of subsection (4) of section

  4  456.0391, Florida Statutes, is amended to read:

  5         456.0391  Advanced registered nurse practitioners;

  6  information required for certification.--

  7         (4)

  8         (d)  Any applicant for initial certification or renewal

  9  of certification as an advanced registered nurse practitioner

10  who submits to the Department of Health a set of fingerprints

11  and information required for the criminal history check

12  required under this section shall not be required to provide a

13  subsequent set of fingerprints or other duplicate information

14  required for a criminal history check to the Agency for Health

15  Care Administration, the Department of Juvenile Justice, or

16  the Department of Children and Family Services for employment

17  or licensure with such agency or department, if the applicant

18  has undergone a criminal history check as a condition of

19  initial certification or renewal of certification as an

20  advanced registered nurse practitioner with the Department of

21  Health, notwithstanding any other provision of law to the

22  contrary. In lieu of such duplicate submission, the Agency for

23  Health Care Administration, the Department of Juvenile

24  Justice, and the Department of Children and Family Services

25  shall obtain criminal history information for employment or

26  licensure of persons certified under s. 464.012 by such agency

27  or department from the Department of Health Health's health

28  care practitioner credentialing system.

29         Section 11.  Paragraph (v) of subsection (1) of section

30  456.072, Florida Statutes, is amended to read:

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         456.072  Grounds for discipline; penalties;

  2  enforcement.--

  3         (1)  The following acts shall constitute grounds for

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

  5  be taken:

  6         (v)  Failing to comply with the requirements for

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

  8  failing to provide initial information, failing to timely

  9  provide updated information, or making misleading, untrue,

10  deceptive, or fraudulent representations on a profile,

11  credentialing, or initial or renewal licensure application.

12         Section 12.  Subsection (2) of section 456.077, Florida

13  Statutes, is amended to read:

14         456.077  Authority to issue citations.--

15         (2)  The board, or the department if there is no board,

16  shall adopt rules designating violations for which a citation

17  may be issued. Such rules shall designate as citation

18  violations those violations for which there is no substantial

19  threat to the public health, safety, and welfare. Violations

20  for which a citation may be issued shall include violations of

21  continuing education requirements; failure to timely pay

22  required fees and fines; failure to comply with the

23  requirements of ss. 381.026 and 381.0261 regarding the

24  dissemination of information regarding patient rights; failure

25  to comply with advertising requirements; failure to timely

26  update practitioner profile and credentialing files; failure

27  to display signs, licenses, and permits; failure to have

28  required reference books available; and all other violations

29  that do not pose a direct and serious threat to the health and

30  safety of the patient.

31

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         Section 13.  Subsection (3) of section 458.309, Florida

  2  Statutes, is amended to read:

  3         458.309  Authority to make rules.--

  4         (3)  All physicians who perform level 2 procedures

  5  lasting more than 5 minutes and all level 3 surgical

  6  procedures in an office setting must register the office with

  7  the department unless that office is licensed as a facility

  8  pursuant to chapter 395. Each office that is required under

  9  this subsection to be registered must be The department shall

10  inspect the physician's office annually unless the office is

11  accredited by a nationally recognized accrediting agency

12  approved by the Board of Medicine by rule or an accrediting

13  organization subsequently approved by the Board of Medicine by

14  rule.  Each office registered but not accredited as required

15  by this subsection must achieve full and unconditional

16  accreditation no later than July 1, 2003, and must maintain

17  unconditional accreditation as long as procedures described in

18  this subsection which require the office to be registered and

19  accredited are performed.  Accreditation reports shall be

20  submitted to the department. The actual costs for registration

21  and inspection or accreditation shall be paid by the person

22  seeking to register and operate the office setting in which

23  office surgery is performed.  The board may adopt rules

24  pursuant to ss. 120.536(1) and 120.54 to implement this

25  subsection.

26         Section 14.  Subsection (2) of section 459.005, Florida

27  Statutes, is amended to read:

28         459.005  Rulemaking authority.--

29         (2)  All osteopathic physicians who perform level 2

30  procedures lasting more than 5 minutes and all level 3

31  surgical procedures in an office setting must register the

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  office with the department unless that office is licensed as a

  2  facility pursuant to chapter 395.  Each office that is

  3  required under this subsection to be registered must be The

  4  department shall inspect the physician's office annually

  5  unless the office is accredited by a nationally recognized

  6  accrediting agency approved by the Board of Medicine or the

  7  Board of Osteopathic Medicine by rule or an accrediting

  8  organization subsequently approved by the Board of Medicine or

  9  the Board of Osteopathic Medicine by rule.  Each office

10  registered but not accredited as required by this subsection

11  must achieve full and unconditional accreditation no later

12  than July 1, 2003, and must maintain unconditional

13  accreditation as long as procedures described in this

14  subsection which require the office to be registered and

15  accredited are performed. Accreditation reports shall be

16  submitted to the department. The actual costs for registration

17  and inspection or accreditation shall be paid by the person

18  seeking to register and operate the office setting in which

19  office surgery is performed.  The Board of Osteopathic

20  Medicine may adopt rules pursuant to ss. 120.536(1) and 120.54

21  to implement this subsection.

22         Section 15.  Subsections (11) and (12) are added to

23  section 456.004, Florida Statutes, to read:

24         456.004  Department; powers and duties.--The

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

26         (11)  Require objective performance measures for all

27  bureaus, units, boards, contracted entities, and board

28  executive directors which reflect the expected quality and

29  quantity of services.

30         (12)  Consider all board requests to use private

31  vendors for particular regulatory functions.  In considering a

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  board request, the department shall conduct a cost-benefit

  2  analysis to determine if the function could be appropriately

  3  and successfully performed by a private entity at a lower cost

  4  or with improved efficiency.  If after reviewing the

  5  department's cost-benefit analysis the board desires to

  6  contract with a vendor for a particular regulatory function

  7  and the board has a positive cash balance, the department

  8  shall enter into a contract for the service.  The contract

  9  shall include objective performance measures that reflect the

10  expected quality and quantity of the service and shall include

11  a provision that terminates the contract if the service falls

12  below expected levels.  For purposes of this subsection, a

13  "regulatory function" shall be defined to include licensure,

14  licensure renewal, examination, complaint analysis,

15  investigation, or prosecution.

16         Section 16.  Subsection (1) of section 456.009, Florida

17  Statutes, is amended to read:

18         456.009  Legal and investigative services.--

19         (1)  The department shall provide board counsel for

20  boards within the department by contracting with the

21  Department of Legal Affairs, by retaining private counsel

22  pursuant to s. 287.059, or by providing department staff

23  counsel. The primary responsibility of board counsel shall be

24  to represent the interests of the citizens of the state. A

25  board shall provide for the periodic review and evaluation of

26  the services provided by its board counsel. Fees and costs of

27  such counsel shall be paid from a trust fund used by the

28  department to implement this chapter, subject to the

29  provisions of s. 456.025. All contracts for independent

30  counsel shall provide for periodic review and evaluation by

31  the board and the department of services provided. All legal

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  and investigative services shall be reviewed by the department

  2  annually to determine if such services are meeting the

  3  performance measures specified in law and in the contract. All

  4  contracts for legal and investigative services must include

  5  objective performance measures that reflect the expected

  6  quality and quantity of the contracted services.

  7         Section 17.  Subsection (6) is added to section

  8  456.011, Florida Statutes, to read:

  9         456.011  Boards; organization; meetings; compensation

10  and travel expenses.--

11         (6)  Meetings of board committees, including probable

12  cause panels, shall be conducted electronically unless held

13  concurrently with, or on the day immediately before or after,

14  a regularly scheduled in-person board meeting.  However, if a

15  particular committee meeting is expected to last more than 5

16  hours and cannot be held before or after the in-person board

17  meeting, the chair of the committee may request special

18  permission from the director of the Division of Medical

19  Quality Assurance to hold an in-person committee meeting in

20  Tallahassee.

21         Section 18.  Subsection (11) is added to section

22  456.026, Florida Statutes, to read:

23         456.026  Annual report concerning finances,

24  administrative complaints, disciplinary actions, and

25  recommendations.--The department is directed to prepare and

26  submit a report to the President of the Senate and the Speaker

27  of the House of Representatives by November 1 of each year. In

28  addition to finances and any other information the Legislature

29  may require, the report shall include statistics and relevant

30  information, profession by profession, detailing:

31

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  1         (11)  The performance measures for all bureaus, units,

  2  boards, and contracted entities required by the department to

  3  reflect the expected quality and quantity of services, and a

  4  description of any effort to improve the performance of such

  5  services.

  6         Section 19.  Section 458.3093, Florida Statutes, is

  7  created to read:

  8         458.3093  Licensure credentials verification.--All

  9  applicants for initial physician licensure pursuant to this

10  chapter must submit their credentials to the Federation of

11  State Medical Boards.  Effective January 1, 2003, the board

12  and the department shall only consider applications for

13  initial physician licensure pursuant to this chapter which

14  have been verified by the Federation of State Medical Boards

15  Credentials Verification Service or an equivalent program

16  approved by the board.

17         Section 20.  Section 459.0053, Florida Statutes, is

18  created to read:

19         459.0053  Licensure credentials verification.--All

20  applicants for initial osteopathic physician licensure

21  pursuant to this chapter must submit their credentials to the

22  Federation of State Medical Boards.  Effective January 1,

23  2003, the board and the department shall only consider

24  applications for initial osteopathic physician licensure

25  pursuant to this chapter which have been verified by the

26  Federation of State Medical Boards Credentials Verification

27  Service, the American Osteopathic Association, or an

28  equivalent program approved by the board.

29         Section 21.  Paragraph (t) of subsection (1) of section

30  458.331, Florida Statutes, is amended to read:

31

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  1         458.331  Grounds for disciplinary action; action by the

  2  board and department.--

  3         (1)  The following acts constitute grounds for denial

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

  5  456.072(2):

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

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

  8  treatment which is recognized by a reasonably prudent similar

  9  physician as being acceptable under similar conditions and

10  circumstances.  The board shall give great weight to the

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

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

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

14  malpractice within the previous 5-year period resulting in

15  indemnities being paid in excess of $50,000 $25,000 each to

16  the claimant in a judgment or settlement and which incidents

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

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

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

20  is recognized by a reasonably prudent similar physician as

21  being acceptable under similar conditions and circumstances,"

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

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

24  construed to require that a physician be incompetent to

25  practice medicine in order to be disciplined pursuant to this

26  paragraph.

27         Section 22.  Paragraph (x) of subsection (1) of section

28  459.015, Florida Statutes, is amended to read:

29         459.015  Grounds for disciplinary action; action by the

30  board and department.--

31

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  1         (1)  The following acts constitute grounds for denial

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

  3  456.072(2):

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

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

  6  and treatment which is recognized by a reasonably prudent

  7  similar osteopathic physician as being acceptable under

  8  similar conditions and circumstances. The board shall give

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

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

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

12  claims for medical malpractice within the previous 5-year

13  period resulting in indemnities being paid in excess of

14  $50,000 $25,000 each to the claimant in a judgment or

15  settlement and which incidents involved negligent conduct by

16  the osteopathic physician. As used in this paragraph, "gross

17  malpractice" or "the failure to practice osteopathic medicine

18  with that level of care, skill, and treatment which is

19  recognized by a reasonably prudent similar osteopathic

20  physician as being acceptable under similar conditions and

21  circumstances" shall not be construed so as to require more

22  than one instance, event, or act. Nothing in this paragraph

23  shall be construed to require that an osteopathic physician be

24  incompetent to practice osteopathic medicine in order to be

25  disciplined pursuant to this paragraph.  A recommended order

26  by an administrative law judge or a final order of the board

27  finding a violation under this paragraph shall specify whether

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

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

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

31  is recognized as being acceptable under similar conditions and

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  1  circumstances," or any combination thereof, and any

  2  publication by the board shall so specify.

  3         Section 23.  Subsection (1) of section 627.912, Florida

  4  Statutes, is amended to read:

  5         627.912  Professional liability claims and actions;

  6  reports by insurers.--

  7         (1)  Each self-insurer authorized under s. 627.357 and

  8  each insurer or joint underwriting association providing

  9  professional liability insurance to a practitioner of medicine

10  licensed under chapter 458, to a practitioner of osteopathic

11  medicine licensed under chapter 459, to a podiatric physician

12  licensed under chapter 461, to a dentist licensed under

13  chapter 466, to a hospital licensed under chapter 395, to a

14  crisis stabilization unit licensed under part IV of chapter

15  394, to a health maintenance organization certificated under

16  part I of chapter 641, to clinics included in chapter 390, to

17  an ambulatory surgical center as defined in s. 395.002, or to

18  a member of The Florida Bar shall report in duplicate to the

19  Department of Insurance any claim or action for damages for

20  personal injuries claimed to have been caused by error,

21  omission, or negligence in the performance of such insured's

22  professional services or based on a claimed performance of

23  professional services without consent, if the claim resulted

24  in:

25         (a)  A final judgment in any amount.

26         (b)  A settlement in any amount.

27

28  Reports shall be filed with the Department of Insurance. and,

29  If the insured party is licensed under chapter 458, chapter

30  459, chapter 461, or chapter 466, with the Department of

31  Health, and the final judgment or settlement was in an amount

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  1  exceeding $50,000, the report shall also be filed with the

  2  Department of Health. Reports must be filed no later than 30

  3  days following the occurrence of any event listed in this

  4  subsection paragraph (a) or paragraph (b). The Department of

  5  Health shall review each report and determine whether any of

  6  the incidents that resulted in the claim potentially involved

  7  conduct by the licensee that is subject to disciplinary

  8  action, in which case the provisions of s. 456.073 shall

  9  apply. The Department of Health, as part of the annual report

10  required by s. 456.026, shall publish annual statistics,

11  without identifying licensees, on the reports it receives,

12  including final action taken on such reports by the Department

13  of Health or the appropriate regulatory board.

14         Section 24.  Subsections (14) and (15) are added to

15  section 456.073, Florida Statutes, to read:

16         456.073  Disciplinary proceedings.--Disciplinary

17  proceedings for each board shall be within the jurisdiction of

18  the department.

19         (14)  When the probable cause panel determines that

20  probable cause exists that a violation of law occurred but

21  decides to issue a letter of guidance in lieu of finding

22  probable cause as a result of mitigating circumstances, the

23  subject shall be required to pay the actual costs of the

24  investigation and prosecution of the case within 30 days after

25  the execution of the closing order.  If the subject fails to

26  pay the costs within 30 days, the case shall be reopened and

27  the department shall file an administrative complaint against

28  the subject based on the underlying case.  No additional

29  charges may be added as a result of the subject failing to pay

30  the costs.  The issuance of a letter of guidance and the

31  assessment of costs under this subsection shall not be

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  1  considered discipline, nor shall it be considered a final

  2  order of discipline.

  3         (15)  All cases in which no probable cause is found

  4  shall be closed within 14 days following the probable cause

  5  panel meeting at which such determination was made.  The

  6  department shall mail a copy of the closing order to the

  7  subject within 14 days after such probable cause panel

  8  meeting.

  9         Section 25.  The Office of Program Policy Analysis and

10  Governmental Accountability shall review the investigative

11  field office structure and organization of the Agency for

12  Health Care Administration to determine the feasibility of

13  eliminating all or some field offices, the feasibility of

14  combining field offices, and the feasibility of requiring

15  field inspectors and investigators to telecommute from home in

16  lieu of paying for office space. The review shall include all

17  agency programs that have field offices including health

18  practitioner regulation, even if health practitioner

19  regulation is transferred to the Department of Health. The

20  review shall be completed and a report issued to the President

21  of the Senate and the Speaker of the House of Representatives

22  no later than January 1, 2003.

23         Section 26.  Subsection (1) of section 456.025, Florida

24  Statutes, is amended to read:

25         456.025  Fees; receipts; disposition.--

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

27  of regulating health care professions and practitioners shall

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

29  also the intent of the Legislature that fees should be

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

31  it is the intent of the Legislature that the department

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  1  operate as efficiently as possible and regularly report to the

  2  Legislature additional methods to streamline operational

  3  costs. Therefore, the boards in consultation with the

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

  5  rule, set renewal fees which:

  6         (a)  Shall be based on revenue projections prepared

  7  using generally accepted accounting procedures;

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

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

10  plan, as required by s. 456.005;

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

12  barrier to licensure;

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

14  under the scope of the license;

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

16  licensure types; and

17         (f)  Shall not be more than 10 percent greater than the

18  fee imposed for the previous biennium;

19         (g)  Shall not be more than 10 percent greater than the

20  actual cost to regulate that profession for the previous

21  biennium; and

22         (f)(h)  Shall be subject to challenge pursuant to

23  chapter 120.

24         Section 27.  Section 456.0165, Florida Statutes, is

25  created to read:

26         456.0165  Examination location.--A college, university,

27  or vocational school in this state may serve as the host

28  school for a health care practitioner licensure examination.

29  However, the college, university, or vocational school may not

30  charge the department for rent, space, reusable equipment,

31  utilities, or janitorial services.  The college, university,

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  1  or vocational school may charge the department only the actual

  2  cost of nonreusable supplies provided by the school at the

  3  request of the department.

  4         Section 28.  Effective July 1, 2002, all licensure and

  5  licensure renewal fees for professions within the Division of

  6  Medical Quality Assurance shall be set at the profession's

  7  statutory fee cap or at a level equal to the actual

  8  per-licensee cost to regulate that profession, whichever is

  9  less.

10         Section 29.  Subsection (6) of section 468.301, Florida

11  Statutes, is amended to read:

12         468.301  Definitions.--As used in this part, the term:

13         (6)  "Direct supervision" means supervision and control

14  by a licensed practitioner who assumes legal liability for the

15  services rendered. by the basic X-ray machine operator or

16  basic X-ray machine operator-podiatric medicine, which

17  Supervision requires the physical presence of the licensed

18  practitioner for consultation and direction of the actions of

19  the basic X-ray machine operator or basic X-ray machine

20  operator-podiatric medicine.

21         Section 30.  Paragraph (g) of subsection (3) and

22  paragraph (c) of subsection (6) of section 468.302, Florida

23  Statutes, are amended to read:

24         468.302  Use of radiation; identification of certified

25  persons; limitations; exceptions.--

26         (3)

27         (g)  A person holding a certificate as a nuclear

28  medicine technologist may only:

29         1.  Conduct in vivo and in vitro measurements of

30  radioactivity and administer radiopharmaceuticals to human

31  beings for diagnostic and therapeutic purposes.

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  1         2.  Administer X radiation from a combination nuclear

  2  medicine-computed tomography device if that radiation is

  3  administered as an integral part of a nuclear medicine

  4  procedure that uses an automated computed tomography protocol

  5  and the person has received device-specific training on the

  6  combination device.

  7

  8  However, the authority of a nuclear medicine technologist

  9  under this paragraph excludes radioimmunoassay and other

10  clinical laboratory testing regulated pursuant to chapter 483.

11         (6)  Requirement for certification does not apply to:

12         (c)  A person who is a registered nurse licensed under

13  part I of chapter 464, a respiratory therapist licensed under

14  part V of chapter 468, or a cardiovascular technologist or

15  cardiopulmonary technologist with active certification as a

16  registered cardiovascular invasive specialist from a

17  nationally recognized credentialing organization, or future

18  equivalent should such credentialing be subsequently modified,

19  each of whom is trained and skilled in invasive cardiovascular

20  cardiopulmonary technology, including the radiologic

21  technology duties associated with such procedures, and who

22  provides invasive cardiovascular cardiopulmonary technology

23  services at the direction, and under the direct supervision,

24  of a licensed practitioner. A person requesting this exemption

25  must have successfully completed a didactic and clinical

26  training program in the following areas before performing

27  radiologic technology duties under the direct supervision of a

28  licensed practitioner:

29         1.  Principles of X-ray production and equipment

30  operation.

31         2.  Biological effects of radiation.

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  1         3.  Radiation exposure and monitoring.

  2         4.  Radiation safety and protection.

  3         5.  Evaluation of radiographic equipment and

  4  accessories.

  5         6.  Radiographic exposure and technique factors.

  6         7.  Film processing.

  7         8.  Image quality assurance.

  8         9.  Patient positioning.

  9         10.  Administration and complications of contrast

10  media.

11         11.  Specific fluoroscopic and digital X-ray imaging

12  procedures related to invasive cardiovascular technology.

13         Section 31.  Section 468.352, Florida Statutes, is

14  amended to read:

15         (Substantial rewording of section. See

16         s. 468.352, F.S., for present text.)

17         468.352  Definitions.--As used in this part the term:

18         (1)  "Board" means the Board of Respiratory Care.

19         (2)  "Certified respiratory therapist" means any person

20  licensed pursuant to this part who is certified by the

21  National Board for Respiratory Care or its successor; who is

22  employed to deliver respiratory care services, under the order

23  of a physician licensed pursuant to chapter 458 or chapter

24  459, in accordance with protocols established by a hospital or

25  other health care provider or the board; and who functions in

26  situations of unsupervised patient contact requiring

27  individual judgment.

28         (3)  "Critical care" means care given to a patient in

29  any setting involving a life-threatening emergency.

30         (4)  "Department" means the Department of Health.

31

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  1         (5)  "Direct supervision" means practicing under the

  2  direction of a licensed, registered, or certified respiratory

  3  therapist who is physically on the premises and readily

  4  available, as defined by the board.

  5         (6)  "Physician supervision" means supervision and

  6  control by a physician licensed under chapter 458 or chapter

  7  459 who assumes the legal liability for the services rendered

  8  by the personnel employed in his or her office. Except in the

  9  case of an emergency, physician supervision requires the easy

10  availability of the physician within the office or the

11  physical presence of the physician for consultation and

12  direction of the actions of the persons who deliver

13  respiratory care services.

14         (7)  "Practice of respiratory care" or "respiratory

15  therapy" means the allied health specialty associated with the

16  cardiopulmonary system that is practiced under the orders of a

17  physician licensed under chapter 458 or chapter 459 and in

18  accordance with protocols, policies, and procedures

19  established by a hospital or other health care provider or the

20  board, including the assessment, diagnostic evaluation,

21  treatment, management, control, rehabilitation, education, and

22  care of patients.

23         (8)  "Registered respiratory therapist" means any

24  person licensed under this part who is registered by the

25  National Board for Respiratory Care or its successor, and who

26  is employed to deliver respiratory care services under the

27  order of a physician licensed under chapter 458 or chapter

28  459, in accordance with protocols established by a hospital or

29  other health care provider or the board, and who functions in

30  situations of unsupervised patient contact requiring

31  individual judgment.

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  1         (9)  "Respiratory care practitioner" means any person

  2  licensed under this part who is employed to deliver

  3  respiratory care services, under direct supervision, pursuant

  4  to the order of a physician licensed under chapter 458 or

  5  chapter 459.

  6         (10)  "Respiratory care services" includes:

  7         (a)  Evaluation and disease management.

  8         (b)  Diagnostic and therapeutic use of respiratory

  9  equipment, devices, or medical gas.

10         (c)  Administration of drugs, as duly ordered or

11  prescribed by a physician licensed under chapter 458 or

12  chapter 459 and in accordance with protocols, policies, and

13  procedures established by a hospital or other health care

14  provider or the board.

15         (d)  Initiation, management, and maintenance of

16  equipment to assist and support ventilation and respiration.

17         (e)  Diagnostic procedures, research, and therapeutic

18  treatment and procedures, including measurement of ventilatory

19  volumes, pressures, and flows; specimen collection and

20  analysis of blood for gas transport and acid/base

21  determinations; pulmonary-function testing; and other related

22  physiological monitoring of cardiopulmonary systems.

23         (f)  Cardiopulmonary rehabilitation.

24         (g)  Cardiopulmonary resuscitation, advanced cardiac

25  life support, neonatal resuscitation, and pediatric advanced

26  life support, or equivalent functions.

27         (h)  Insertion and maintenance of artificial airways

28  and intravascular catheters.

29         (i)  Performing sleep-disorder studies.

30         (j)  Education of patients, families, the public, or

31  other health care providers, including disease process and

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  1  management programs and smoking prevention and cessation

  2  programs.

  3         (k)  Initiation and management of hyperbaric oxygen.

  4         Section 32.  Section 468.355, Florida Statutes, is

  5  amended to read:

  6         (Substantial rewording of section. See

  7         s. 468.355, F.S., for present text.)

  8         468.355  Licensure requirements.--To be eligible for

  9  licensure by the board, an applicant must be certified as a

10  "Certified Respiratory Therapist" or be registered as a

11  "Registered Respiratory Therapist" by the National Board for

12  Respiratory Care, or its successor.

13         Section 33.  Section 468.368, Florida Statutes, is

14  amended to read:

15         (Substantial rewording of section. See

16         s. 468.368, F.S., for present text.)

17         468.368  Exemptions.--This part may not be construed to

18  prevent or restrict the practice, service, or activities of:

19         (1)  Any person licensed in this state by any other law

20  from engaging in the profession or occupation for which he or

21  she is licensed.

22         (2)  Any legally qualified person in the state or

23  another state or territory who is employed by the United

24  States Government or any agency thereof while such person is

25  discharging his or her official duties.

26         (3)  A friend or family member who is providing

27  respiratory care services to an ill person and who does not

28  represent himself or herself to be a respiratory care

29  practitioner or respiratory therapist.

30

31

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  1         (4)  An individual providing respiratory care services

  2  in an emergency who does not represent himself or herself as a

  3  respiratory care practitioner or respiratory therapist.

  4         (5)  Any individual employed to deliver, assemble, set

  5  up, or test equipment for use in a home, upon the order of a

  6  physician licensed pursuant to chapter 458 or chapter 459.

  7  This subsection does not, however, authorize the practice of

  8  respiratory care without a license.

  9         (6)  Any individual credentialed by the Board of

10  Registered Polysomnographic Technologists as a registered

11  polysomnographic technologist, as related to the diagnosis and

12  evaluation of treatment for sleep disorders.

13         (7)  Any individual certified or registered as a

14  pulmonary function technologist who is credentialed by the

15  National Board for Respiratory Care for performing

16  cardiopulmonary diagnostic studies.

17         (8)  Any student who is enrolled in an accredited

18  respiratory care program approved by the board, while

19  performing respiratory care as an integral part of a required

20  course.

21         (9)  The delivery of incidental respiratory care to

22  noninstitutionalized persons by surrogate family members who

23  do not represent themselves as registered or certified

24  respiratory care therapists.

25         (10)  Any individual credentialed by the Underseas

26  Hyperbaric Society in hyperbaric medicine or its equivalent as

27  determined by the board, while performing related duties. This

28  subsection does not, however, authorize the practice of

29  respiratory care without a license.

30         Section 34.  Sections 468.356 and 468.357, Florida

31  Statutes, are repealed.

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  1         Section 35.  Beginning July 1, 2003, application forms

  2  for initial licensure and licensure renewal for the

  3  professions regulated by the Department of Health, Division of

  4  Medical Quality Assurance, shall be submitted electronically

  5  through the World Wide Web.  The department shall issue the

  6  license or renew a license if the licensee provides

  7  satisfactory evidence that all conditions and requirements of

  8  licensure or renewal have been met, including, but not limited

  9  to, the payment of fees, the completion of required continuing

10  education coursework, and, if applicable, the maintenance of

11  financial responsibility.  This section shall not be construed

12  to reduce or eliminate any requirement set forth in chapter

13  456, Florida Statutes, or the applicable practice act.

14         Section 36.  Beginning with the 2004 Regular Session of

15  the Legislature, the Division of Statutory Revision shall

16  prepare a reviser's bill for each regular legislative session

17  that proposes to increase by 2.5 percent the statutory fee

18  caps set forth in sections 456.025, 457.105, 457.107, 458.313,

19  458.3135, 458.3145, 458.317, 458.319, 458.347, 459.0092,

20  459.022, 460.406, 460.407, 460.4165, 460.4166, 461.006,

21  461.007, 462.16, 462.19, 463.0057, 463.006, 463.007, 464.008,

22  464.009, 464.012, 464.019, 465.007, 465.0075, 465.008,

23  465.0125, 465.0126, 465.022, 465.0276, 466.006, 466.007,

24  466.008, 466.013, 466.032, 467.0125, 467.0135, 468.1145,

25  468.1695, 468.1705, 468.1715, 468.1735, 468.221, 468.364,

26  468.508, 468.709, 468.803, 468.806, 478.55, 480.043, 480.044,

27  483.807, 483.901, 484.002, 484.007, 484.008, 484.009,

28  484.0447, 486.041, 486.061, 486.081, 486.085, 486.103,

29  486.106, 486.107, 486.108, 490.005, 490.0051, 490.007,

30  491.0045, 491.0046, 491.005, 491.007, 491.008, 491.0085, and

31

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  1  491.0145, Florida Statutes, to be effective July 1 of the year

  2  in which proposed.

  3         Section 37.  Sections 381.0602, 381.6021, 381.6022,

  4  381.6023, 381.6024, and 381.6026, Florida Statutes, are

  5  renumbered as sections 765.53, 765.541, 765.542, 765.544,

  6  765.545, and 765.547, Florida Statutes, respectively.

  7         Section 38.  Section 381.60225, Florida Statutes, is

  8  renumbered as section 765.543, Florida Statutes, and is

  9  amended to read:

10         765.543 381.60225  Background screening.--

11         (1)  Each applicant for certification must comply with

12  the following requirements:

13         (a)  Upon receipt of a completed, signed, and dated

14  application, the Agency for Health Care Administration shall

15  require background screening, in accordance with the level 2

16  standards for screening set forth in chapter 435, of the

17  managing employee, or other similarly titled individual

18  responsible for the daily operation of the organization,

19  agency, or entity, and financial officer, or other similarly

20  titled individual who is responsible for the financial

21  operation of the organization, agency, or entity, including

22  billings for services.  The applicant must comply with the

23  procedures for level 2 background screening as set forth in

24  chapter 435, as well as the requirements of s. 435.03(3).

25         (b)  The Agency for Health Care Administration may

26  require background screening of any other individual who is an

27  applicant if the Agency for Health Care Administration has

28  probable cause to believe that he or she has been convicted of

29  a crime or has committed any other offense prohibited under

30  the level 2 standards for screening set forth in chapter 435.

31

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         (c)  Proof of compliance with the level 2 background

  2  screening requirements of chapter 435 which has been submitted

  3  within the previous 5 years in compliance with any other

  4  health care licensure requirements of this state is acceptable

  5  in fulfillment of the requirements of paragraph (a).

  6         (d)  A provisional certification may be granted to the

  7  organization, agency, or entity when each individual required

  8  by this section to undergo background screening has met the

  9  standards for the Department of Law Enforcement background

10  check, but the agency has not yet received background

11  screening results from the Federal Bureau of Investigation, or

12  a request for a disqualification exemption has been submitted

13  to the agency as set forth in chapter 435, but a response has

14  not yet been issued. A standard certification may be granted

15  to the organization, agency, or entity upon the agency's

16  receipt of a report of the results of the Federal Bureau of

17  Investigation background screening for each individual

18  required by this section to undergo background screening which

19  confirms that all standards have been met, or upon the

20  granting of a disqualification exemption by the agency as set

21  forth in chapter 435. Any other person who is required to

22  undergo level 2 background screening may serve in his or her

23  capacity pending the agency's receipt of the report from the

24  Federal Bureau of Investigation. However, the person may not

25  continue to serve if the report indicates any violation of

26  background screening standards and a disqualification

27  exemption has not been requested of and granted by the agency

28  as set forth in chapter 435.

29         (e)  Each applicant must submit to the agency, with its

30  application, a description and explanation of any exclusions,

31  permanent suspensions, or terminations of the applicant from

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  the Medicare or Medicaid programs. Proof of compliance with

  2  the requirements for disclosure of ownership and control

  3  interests under the Medicaid or Medicare programs shall be

  4  accepted in lieu of this submission.

  5         (f)  Each applicant must submit to the agency a

  6  description and explanation of any conviction of an offense

  7  prohibited under the level 2 standards of chapter 435 by a

  8  member of the board of directors of the applicant, its

  9  officers, or any individual owning 5 percent or more of the

10  applicant. This requirement does not apply to a director of a

11  not-for-profit corporation or organization if the director

12  serves solely in a voluntary capacity for the corporation or

13  organization, does not regularly take part in the day-to-day

14  operational decisions of the corporation or organization,

15  receives no remuneration for his or her services on the

16  corporation or organization's board of directors, and has no

17  financial interest and has no family members with a financial

18  interest in the corporation or organization, provided that the

19  director and the not-for-profit corporation or organization

20  include in the application a statement affirming that the

21  director's relationship to the corporation satisfies the

22  requirements of this paragraph.

23         (g)  The agency may not certify any organization,

24  agency, or entity if any applicant or managing employee has

25  been found guilty of, regardless of adjudication, or has

26  entered a plea of nolo contendere or guilty to, any offense

27  prohibited under the level 2 standards for screening set forth

28  in chapter 435, unless an exemption from disqualification has

29  been granted by the agency as set forth in chapter 435.

30         (h)  The agency may deny or revoke certification of any

31  organization, agency, or entity if the applicant:

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         1.  Has falsely represented a material fact in the

  2  application required by paragraph (e) or paragraph (f), or has

  3  omitted any material fact from the application required by

  4  paragraph (e) or paragraph (f); or

  5         2.  Has had prior action taken against the applicant

  6  under the Medicaid or Medicare program as set forth in

  7  paragraph (e).

  8         (i)  An application for renewal of certification must

  9  contain the information required under paragraphs (e) and (f).

10         (2)  An organ procurement organization, tissue bank, or

11  eye bank certified by the Agency for Health Care

12  Administration in accordance with ss. 381.6021 and 765.542

13  381.6022 is not subject to the requirements of this section if

14  the entity has no direct patient care responsibilities and

15  does not bill patients or insurers directly for services under

16  the Medicare or Medicaid programs, or for privately insured

17  services.

18         Section 39.  Section 381.6025, Florida Statutes, is

19  renumbered as section 765.546, Florida Statutes, and amended

20  to read:

21         765.546 381.6025  Physician supervision of cadaveric

22  organ and tissue procurement coordinators.--Organ procurement

23  organizations, tissue banks, and eye banks may employ

24  coordinators, who are registered nurses, physician's

25  assistants, or other medically trained personnel who meet the

26  relevant standards for organ procurement organizations, tissue

27  banks, or eye banks as adopted by the Agency for Health Care

28  Administration under s. 765.541 381.6021, to assist in the

29  medical management of organ donors or in the surgical

30  procurement of cadaveric organs, tissues, or eyes for

31  transplantation or research. A coordinator who assists in the

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  medical management of organ donors or in the surgical

  2  procurement of cadaveric organs, tissues, or eyes for

  3  transplantation or research must do so under the direction and

  4  supervision of a licensed physician medical director pursuant

  5  to rules and guidelines to be adopted by the Agency for Health

  6  Care Administration. With the exception of organ procurement

  7  surgery, this supervision may be indirect supervision. For

  8  purposes of this section, the term "indirect supervision"

  9  means that the medical director is responsible for the medical

10  actions of the coordinator, that the coordinator is operating

11  under protocols expressly approved by the medical director,

12  and that the medical director or his or her physician designee

13  is always available, in person or by telephone, to provide

14  medical direction, consultation, and advice in cases of organ,

15  tissue, and eye donation and procurement. Although indirect

16  supervision is authorized under this section, direct physician

17  supervision is to be encouraged when appropriate.

18         Section 40.  Subsection (2) of section 395.2050,

19  Florida Statutes, is amended to read:

20         395.2050  Routine inquiry for organ and tissue

21  donation; certification for procurement activities.--

22         (2)  Every hospital licensed under this chapter that is

23  engaged in the procurement of organs, tissues, or eyes shall

24  comply with the certification requirements of ss.

25  765.541-765.547 381.6021-381.6026.

26         Section 41.  Paragraph (e) of subsection (2) of section

27  409.815, Florida Statutes, is amended to read:

28         409.815  Health benefits coverage; limitations.--

29         (2)  BENCHMARK BENEFITS.--In order for health benefits

30  coverage to qualify for premium assistance payments for an

31  eligible child under ss. 409.810-409.820, the health benefits

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  coverage, except for coverage under Medicaid and Medikids,

  2  must include the following minimum benefits, as medically

  3  necessary.

  4         (e)  Organ transplantation services.--Covered services

  5  include pretransplant, transplant, and postdischarge services

  6  and treatment of complications after transplantation for

  7  transplants deemed necessary and appropriate within the

  8  guidelines set by the Organ Transplant Advisory Council under

  9  s. 765.53 381.0602 or the Bone Marrow Transplant Advisory

10  Panel under s. 627.4236.

11         Section 42.  Subsection (2) of section 765.5216,

12  Florida Statutes, is amended to read:

13         765.5216  Organ and tissue donor education panel.--

14         (2)  There is created within the Agency for Health Care

15  Administration a statewide organ and tissue donor education

16  panel, consisting of 12 members, to represent the interests of

17  the public with regard to increasing the number of organ and

18  tissue donors within the state.  The panel and the Organ and

19  Tissue Procurement and Transplantation Advisory Board

20  established in s. 765.544 381.6023 shall jointly develop,

21  subject to the approval of the Agency for Health Care

22  Administration, education initiatives pursuant to s. 732.9215,

23  which the agency shall implement.  The membership must be

24  balanced with respect to gender, ethnicity, and other

25  demographic characteristics so that the appointees reflect the

26  diversity of the population of this state.  The panel members

27  must include:

28         (a)  A representative from the Agency for Health Care

29  Administration, who shall serve as chairperson of the panel.

30         (b)  A representative from a Florida licensed organ

31  procurement organization.

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1         (c)  A representative from a Florida licensed tissue

  2  bank.

  3         (d)  A representative from a Florida licensed eye bank.

  4         (e)  A representative from a Florida licensed hospital.

  5         (f)  A representative from the Division of Driver

  6  Licenses of the Department of Highway Safety and Motor

  7  Vehicles, who possesses experience and knowledge in dealing

  8  with the public.

  9         (g)  A representative from the family of an organ,

10  tissue, or eye donor.

11         (h)  A representative who has been the recipient of a

12  transplanted organ, tissue, or eye, or is a family member of a

13  recipient.

14         (i)  A representative who is a minority person as

15  defined in s. 381.81.

16         (j)  A representative from a professional association

17  or public relations or advertising organization.

18         (k)  A representative from a community service club or

19  organization.

20         (l)  A representative from the Department of Education.

21         Section 43.  Subsection (5) of section 765.522, Florida

22  Statutes, is amended to read:

23         765.522  Duty of certain hospital administrators;

24  liability of hospital administrators, organ procurement

25  organizations, eye banks, and tissue banks.--

26         (5)  There shall be no civil or criminal liability

27  against any organ procurement organization, eye bank, or

28  tissue bank certified under s. 765.542 381.6022, or against

29  any hospital or hospital administrator or designee, when

30  complying with the provisions of this part and the rules of

31  the Agency for Health Care Administration or when, in the

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1  exercise of reasonable care, a request for organ donation is

  2  inappropriate and the gift is not made according to this part

  3  and the rules of the Agency for Health Care Administration.

  4         Section 44.  Section 765.539, Florida Statutes, is

  5  created to read:

  6         765.539  Organizations engaged in the practice of

  7  cadaveric organ and tissue procurement; pooling of cells or

  8  tissues prohibited.--Organizations engaged in the practice of

  9  cadaveric organ and tissue procurement in this state are

10  prohibited from allowing human cells or tissues from two or

11  more donors to be pooled during retrieval, processing,

12  preservation, or storage.  For purposes of this section,

13  "pooled" means placed in physical contact or processed in any

14  way which allows any fluids, cells, or tissues to be

15  commingled in any way between two or more donors.

16         Section 45.  Except as otherwise provided in this act,

17  this act shall take effect July 1, 2002.

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19

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22

23

24

25

26

27

28

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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1            *****************************************

  2                       LEGISLATIVE SUMMARY

  3    Transfers to the Department of Health the powers, duties,
      functions, and assets that relate to the consumer
  4    complaint services, investigations, and prosecutorial
      services performed by the Agency for Health Care
  5    Administration under contract with the department.

  6
      Revises procedures and timeframes for formal hearings of
  7    health care practitioner disciplinary cases. Revises the
      charges and manner of charging for disciplinary hearings.
  8    Provides fees.  Requires a joint audit of hearings and
      their billing formulas and a report to the Legislature.
  9

10    Requires each impaired practitioner to pay a portion of
      the cost of the consultant and impaired practitioner
11    program and the full cost of the required treatment
      program or plan.  Provides certain exceptions.
12

13    Terminates the standardized credentialing program for
      health care practitioners and prohibits the refund of
14    moneys collected through the program.

15
      Requires accreditation of physician offices and
16    osteopathic physician offices in which surgery is
      performed.
17

18    Expands powers and duties of the Department of Health to
      require performance measures for certain entities and to
19    provide procedures for considering board requests to
      privatize regulatory functions.  Requires performance
20    measures for certain legal and investigative services and
      annual review of such services to determine whether such
21    performance measures are being met.  Requires regulatory
      board committee meetings, including probable cause
22    panels, to be held electronically unless certain
      conditions are met.  Requires inclusion of performance
23    measures for certain entities in the department's annual
      report to the Legislature.
24

25    Requires submission of credentials for initial physician
      or osteopathic physician licensure to a national
26    licensure verification service.  Requires verification of
      such credentials by that service, a specified
27    association, or an equivalent program.

28
      Raises the malpractice closed claims reporting
29    requirement amount.

30
      Requires health care practitioner licensees to pay the
31    actual costs of investigation and prosecution under
      certain circumstances.  Requires cases in which no
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    Florida Senate - 2002                                  SB 1950
    22-1431-02                                              See HB




  1    probable cause has been found to be closed within a
      specified period of time.
  2

  3    Requires a study of the field office structure and
      organization of the Agency for Health Care Administration
  4    and a report to the Legislature.

  5
      Eliminates certain restrictions on the setting of
  6    licensure renewal fees for health care practitioners.
      Restricts the costs that may be charged by educational
  7    institutions hosting health care practitioner licensure
      examinations.  Requires health care practitioner
  8    licensure and licensure renewal fees to be set at the
      statutory fee cap or at the level of actual regulatory
  9    costs, whichever is less.

10
      Revises the definition of "direct supervision" applicable
11    to the regulation of radiologic technology.  Authorizes
      certified nuclear medicine technologists to administer X
12    radiation from certain devices under certain
      circumstances.  Exempts certain persons from radiologic
13    technologist certification and provides certain training
      requirements for such exemption.
14

15    Revises and provides definitions applicable to the
      regulation of respiratory therapy.  Revises provisions
16    relating to respiratory therapy licensure and testing
      requirements.  Revises exemptions from respiratory
17    therapy licensure requirements.  Repeals provisions
      relating to the approval of educational programs and
18    licensure by examination.

19
      Requires applications for health care practitioner
20    licensure and licensure renewal to be submitted
      electronically beginning July 1, 2003.  Directs the
21    Division of Statutory Revision to annually submit
      reviser's bills to adjust the statutory fee caps
22    applicable to regulation of health care practitioners.

23
      Moves provisions relating to organ and tissue
24    procurement, donation, and transplantation from ch. 381,
      F.S., relating to public health, to part V, ch. 765,
25    F.S., relating to anatomical gifts.  Prohibits cadaveric
      organ and tissue procurement organizations from pooling
26    human cells or tissues.

27

28

29

30

31

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