House Bill hb0507c1

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    Florida House of Representatives - 2002              CS/HB 507

        By the Council for Healthy Communities and Representatives
    Fasano, Fiorentino and Sobel





  1                      A bill to be entitled

  2         An act relating to responsiveness to

  3         emergencies and disasters; providing

  4         legislative findings; amending s. 381.0011,

  5         F.S.; revising duties of the Department of

  6         Health; authorizing the State Health Officer to

  7         take specified emergency actions to protect the

  8         public health; amending s. 381.0034, F.S.;

  9         providing a requirement for instruction of

10         certain health care licensees on conditions

11         caused by nuclear, biological, and chemical

12         terrorism, as a condition of initial licensure,

13         and, in lieu of the requirement for instruction

14         on HIV and AIDS, as a condition of relicensure;

15         amending s. 381.0035, F.S.; providing a

16         requirement for instruction of employees at

17         certain health care facilities on conditions

18         caused by nuclear, biological, and chemical

19         terrorism, upon initial employment, and, in

20         lieu of the requirement of instruction on HIV

21         and AIDS, as biennial continuing education;

22         providing an exception; creating s. 381.0421,

23         F.S.; requiring postsecondary education

24         institutions to provide information on

25         hepatitis B; requiring individuals residing in

26         on-campus housing to document vaccinations

27         against hepatitis B or sign a waiver; amending

28         ss. 395.1027 and 401.245, F.S.; correcting

29         cross references; amending s. 401.23, F.S.;

30         revising definitions of "advanced life support"

31         and "basic life support" and defining

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  1         "emergency medical condition"; amending s.

  2         401.252, F.S.; authorizing physician assistants

  3         to conduct interfacility transfers in a

  4         permitted ambulance under certain

  5         circumstances; amending s. 401.27, F.S.;

  6         providing that the course on conditions caused

  7         by nuclear, biological, and chemical terrorism

  8         shall count toward the total required hours for

  9         biennial recertification of emergency medical

10         technicians and paramedics; amending s.

11         456.033, F.S.; providing a requirement for

12         instruction of certain health care

13         practitioners on conditions caused by nuclear,

14         biological, and chemical terrorism, as a

15         condition of initial licensure, and, in lieu of

16         the requirement for instruction on HIV and

17         AIDS, as part of biennial relicensure; creating

18         s. 456.0345, F.S.; providing continuing

19         education credits to health care practitioners

20         for certain life support training; amending s.

21         456.072, F.S.; conforming provisions relating

22         to grounds for disciplinary actions to changes

23         in health care practitioners' course

24         requirements; amending s. 456.38, F.S.;

25         revising provisions relating to the health care

26         practitioner registry for disasters and

27         emergencies; prohibiting certain termination of

28         or discrimination against a practitioner

29         providing disaster medical assistance; amending

30         ss. 458.319 and 459.008, F.S.; conforming

31         provisions relating to exceptions to continuing

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  1         education requirements for physicians and

  2         osteopathic physicians; providing an effective

  3         date.

  4

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

  6

  7         Section 1.  Legislative findings.--The Legislature

  8  finds that it is critical that Florida be prepared to respond

  9  appropriately to a health crisis and injuries in the event of

10  an emergency or disaster. The Legislature finds that there is

11  a need to better educate health care practitioners on diseases

12  and conditions that might be caused by nuclear, biological,

13  and chemical terrorism so that health care practitioners can

14  more effectively care for patients and better educate patients

15  as to prevention and treatment. Additionally, the Legislature

16  finds that not all health care practitioners have been

17  recently trained in life support and first aid and that all

18  health care practitioners should be encouraged to obtain such

19  training. The Legislature finds that health care practitioners

20  who are willing to respond in emergencies or disasters should

21  not be penalized for providing their assistance.

22         Section 2.  Section 381.0011, Florida Statutes, is

23  amended to read:

24         381.0011  Duties and powers of the Department of

25  Health; authority of State Health Officer.--

26         (1)  It is the duty of the Department of Health to:

27         (a)(1)  Assess the public health status and needs of

28  the state through statewide data collection and other

29  appropriate means, with special attention to future needs that

30  may result from population growth, technological advancements,

31  new societal priorities, or other changes.

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  1         (b)(2)  Formulate general policies affecting the public

  2  health of the state.

  3         (c)(3)  Include in the department's strategic plan

  4  developed under s. 186.021 a summary of all aspects of the

  5  public health mission and health status objectives to direct

  6  the use of public health resources with an emphasis on

  7  prevention.

  8         (d)(4)  Administer and enforce laws and rules relating

  9  to sanitation, control of communicable diseases, illnesses and

10  hazards to health among humans and from animals to humans, and

11  the general health of the people of the state.

12         (e)(5)  Cooperate with and accept assistance from

13  federal, state, and local officials for the prevention and

14  suppression of communicable and other diseases, illnesses,

15  injuries, and hazards to human health.

16         (f)(6)  Declare, enforce, modify, and abolish

17  quarantine of persons, animals, and premises as the

18  circumstances indicate for controlling communicable diseases

19  or providing protection from unsafe conditions that pose a

20  threat to public health, except as provided in ss. 384.28 and

21  392.545-392.60.

22         1.(a)  The department shall adopt rules to specify the

23  conditions and procedures for imposing and releasing a

24  quarantine. The rules must include provisions related to:

25         a.1.  The closure of premises.

26         b.2.  The movement of persons or animals exposed to or

27  infected with a communicable disease.

28         c.3.  The tests or prophylactic treatment, including

29  vaccination, for communicable disease required prior to

30  employment or admission to the premises or to comply with a

31  quarantine.

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  1         d.4.  Testing or destruction of animals with or

  2  suspected of having a disease transmissible to humans.

  3         e.5.  Access by the department to quarantined premises.

  4         f.6.  The disinfection of quarantined animals, persons,

  5  or premises.

  6         g.  Methods of quarantine.

  7         2.(b)  Any health regulation that restricts travel or

  8  trade within the state may not be adopted or enforced in this

  9  state except by authority of the department.

10         (g)(7)  Provide for a thorough investigation and study

11  of the incidence, causes, modes of propagation and

12  transmission, and means of prevention, control, and cure of

13  diseases, illnesses, and hazards to human health.

14         (h)(8)  Provide for the dissemination of information to

15  the public relative to the prevention, control, and cure of

16  diseases, illnesses, and hazards to human health.  The

17  department shall conduct a workshop before issuing any health

18  alert or advisory relating to food-borne illness or

19  communicable disease in public lodging or food service

20  establishments in order to inform persons, trade associations,

21  and businesses of the risk to public health and to seek the

22  input of affected persons, trade associations, and businesses

23  on the best methods of informing and protecting the public,

24  except in an emergency, in which case the workshop must be

25  held within 14 days after the issuance of the emergency alert

26  or advisory.

27         (i)(9)  Act as registrar of vital statistics.

28         (j)(10)  Cooperate with and assist federal health

29  officials in enforcing public health laws and regulations.

30

31

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  1         (k)(11)  Cooperate with other departments, local

  2  officials, and private boards and organizations for the

  3  improvement and preservation of the public health.

  4         (l)(12)  Cooperate with other departments, local

  5  officials, and private organizations in developing and

  6  implementing a statewide injury control program.

  7         (m)(13)  Adopt rules pursuant to ss. 120.536(1) and

  8  120.54 to implement the provisions of law conferring duties

  9  upon it.  This paragraph subsection does not authorize the

10  department to require a permit or license unless such

11  requirement is specifically provided by law.

12         (n)(14)  Perform any other duties prescribed by law.

13         (2)  The State Health Officer is authorized to take the

14  following actions to protect the public health:

15         (a)  Notwithstanding chapters 465 and 499 and rules

16  adopted thereunder, the State Health Officer may direct

17  pharmacists employed by the department to compound bulk

18  prescription drugs and provide these bulk prescription drugs

19  to county health department physicians, physician assistants,

20  and nurses for administration to persons as part of a

21  prophylactic or treatment regimen when there is a significant

22  risk to the public health from a disease, an environmental

23  contaminant, or a suspected act of nuclear, biological, or

24  chemical terrorism.

25         (b)  The State Health Officer, upon declaration of a

26  public health emergency pursuant to s. 381.00315, may take

27  such actions as are necessary to protect the public health.

28  Such actions shall include, but are not limited to:

29         1.  Directing Florida manufacturers and wholesalers of

30  prescription and over-the-counter drugs permitted under

31  chapter 499 to give priority to shipping such drugs to

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  1  pharmacies and health care providers located in geographic

  2  areas identified by the State Health Officer. Florida

  3  manufacturers and wholesalers must respond to the State Health

  4  Officer's priority shipping directive before shipping the

  5  specified drugs to other pharmacies or health care providers

  6  in Florida.

  7         2.  Notwithstanding s. 456.036, temporarily

  8  reactivating the inactive licenses of physicians licensed

  9  under chapter 458 or chapter 459; physician assistants

10  licensed under chapter 458 or chapter 459; licensed practical

11  nurses, registered nurses, and advanced registered nurse

12  practitioners licensed under chapter 464; respiratory

13  therapists licensed under part V of chapter 468; and emergency

14  medical technicians and paramedics licensed under chapter 401

15  when such practitioners are needed to respond to the public

16  health emergency. Only those licensees referenced in this

17  subparagraph who request reactivation and have unencumbered

18  inactive licenses are eligible for reactivation.  Any inactive

19  license reactivated pursuant to this subparagraph shall return

20  to inactive status when the public health emergency ends or

21  prior to the end of the public health emergency if the State

22  Health Officer determines that the health care practitioner is

23  no longer needed to provide services during the emergency. The

24  license may only be reactivated for a period not to exceed 90

25  days without meeting the requirements of s. 456.036 or chapter

26  401. If a physician assistant or advanced registered nurse

27  practitioner requests reactivation and volunteers during the

28  declared public health emergency, the county health department

29  medical director, if appropriate, shall serve as the

30  supervising physician for the physician assistant and shall be

31

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  1  authorized to delegate acts of medical diagnosis and treatment

  2  to the advanced registered nurse practitioner.

  3         3.  Notwithstanding any law to the contrary, compelling

  4  an individual to be examined, tested, vaccinated, treated, or

  5  quarantined for communicable diseases that have significant

  6  morbidity or mortality and present a severe danger to public

  7  health. Prior to taking action under this subparagraph, the

  8  State Health Officer shall, to the extent possible, consult

  9  with the Governor.

10         a.  Examination, testing, or treatment may be performed

11  by any qualified person authorized by the State Health

12  Officer.

13         b.  If the individual poses a danger to public health,

14  the State Health Officer may subject the individual to

15  quarantine. If there is no practicable method to quarantine

16  the individual, the State Health Officer may use any means

17  necessary to vaccinate or treat the individual.

18         c.  Any order of the State Health Officer given to

19  effectuate this subparagraph shall be immediately enforceable

20  by law enforcement.

21

22  Individuals who assist the State Health Officer at his or her

23  request on a volunteer basis during a public health emergency

24  declared pursuant to s. 381.00315 shall be entitled to the

25  benefits in s. 110.504(2), (3), (4), and (5).

26         Section 3.  Section 381.0034, Florida Statutes, is

27  amended to read:

28         381.0034  Requirement for instruction on conditions

29  caused by nuclear, biological, and chemical terrorism and on

30  human immunodeficiency virus and acquired immune deficiency

31  syndrome.--

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  1         (1)  As of July 1, 1991, The Department of Health shall

  2  require each person licensed or certified under chapter 401,

  3  chapter 467, part IV of chapter 468, or chapter 483, as a

  4  condition of biennial relicensure, to complete an educational

  5  course approved by the department on conditions caused by

  6  nuclear, biological, and chemical terrorism. The course shall

  7  consist of education on diagnosis and treatment, the modes of

  8  transmission, infection control procedures, and clinical

  9  management. Such course shall also include information on

10  reporting suspected cases of conditions caused by nuclear,

11  biological, or chemical terrorism to the appropriate health

12  and law enforcement authorities, and prevention of human

13  immunodeficiency virus and acquired immune deficiency

14  syndrome. Such course shall include information on current

15  Florida law on acquired immune deficiency syndrome and its

16  impact on testing, confidentiality of test results, and

17  treatment of patients. Each such licensee or certificateholder

18  shall submit confirmation of having completed said course, on

19  a form provided by the department, when submitting fees or

20  application for each biennial renewal.

21         (2)  Failure to complete the requirements of this

22  section shall be grounds for disciplinary action contained in

23  the chapters specified in subsection (1).  In addition to

24  discipline by the department, the licensee or

25  certificateholder shall be required to complete the required

26  said course or courses.

27         (3)  The department shall require, as a condition of

28  granting a license under the chapters specified in subsection

29  (1), that an applicant making initial application for

30  licensure complete respective an educational courses course

31  acceptable to the department on conditions caused by nuclear,

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  1  biological, and chemical terrorism and on human

  2  immunodeficiency virus and acquired immune deficiency

  3  syndrome.  An applicant who has not taken such courses a

  4  course at the time of licensure shall, upon an affidavit

  5  showing good cause, be allowed 6 months to complete this

  6  requirement.

  7         (4)  The department shall have the authority to adopt

  8  rules to carry out the provisions of this section.

  9         (5)  Any professional holding two or more licenses or

10  certificates subject to the provisions of this section shall

11  be permitted to show proof of having taken one

12  department-approved course on conditions caused by nuclear,

13  biological, and chemical terrorism human immunodeficiency

14  virus and acquired immune deficiency syndrome, for purposes of

15  relicensure or recertification for the additional licenses.

16         Section 4.  Section 381.0035, Florida Statutes, is

17  amended to read:

18         381.0035  Educational courses course on human

19  immunodeficiency virus and acquired immune deficiency syndrome

20  and on conditions caused by nuclear, biological, and chemical

21  terrorism; employees and clients of certain health care

22  facilities.--

23         (1)(a)  The Department of Health shall require all

24  employees and clients of facilities licensed under chapters

25  393, 394, and 397 and employees of facilities licensed under

26  chapter 395 and parts II, III, IV, and VI of chapter 400 to

27  complete, biennially, a continuing educational course on the

28  modes of transmission, infection control procedures, clinical

29  management, and prevention of human immunodeficiency virus and

30  acquired immune deficiency syndrome with an emphasis on

31  appropriate behavior and attitude change. Such instruction

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  1  shall include information on current Florida law and its

  2  impact on testing, confidentiality of test results, and

  3  treatment of patients and any protocols and procedures

  4  applicable to human immunodeficiency counseling and testing,

  5  reporting, the offering of HIV testing to pregnant women, and

  6  partner notification issues pursuant to ss. 381.004 and

  7  384.25.

  8         (b)  The department shall require all employees of

  9  facilities licensed under chapters 393, 394, 395, and 397 and

10  parts II, III, IV, and VI of chapter 400 to complete,

11  biennially, a continuing educational course on conditions

12  caused by nuclear, biological, and chemical terrorism. The

13  course shall consist of education on diagnosis and treatment,

14  modes of transmission, infection control procedures, and

15  clinical management. Such course shall also include

16  information on reporting suspected cases of conditions caused

17  by nuclear, biological, or chemical terrorism to the

18  appropriate health and law enforcement authorities.

19         (2)  New employees of facilities licensed under

20  chapters 393, 394, 395, and 397 and parts II, III, IV, and VI

21  of chapter 400 shall be required to complete a course on human

22  immunodeficiency virus and acquired immune deficiency

23  syndrome, with instruction to include information on current

24  Florida law and its impact on testing, confidentiality of test

25  results, and treatment of patients. New employees of such

26  facilities shall also be required to complete a course on

27  conditions caused by nuclear, biological, and chemical

28  terrorism, with instruction to include information on

29  reporting suspected cases to the appropriate health and law

30  enforcement authorities.

31

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  1         (3)  Facilities licensed under chapters 393, 394, 395,

  2  and 397, and parts II, III, IV, and VI of chapter 400 shall

  3  maintain a record of employees and dates of attendance at

  4  human immunodeficiency virus and acquired immune deficiency

  5  syndrome educational courses on human immunodeficiency virus

  6  and acquired immune deficiency syndrome and on conditions

  7  caused by nuclear, biological, and chemical terrorism.

  8         (4)  The department shall have the authority to review

  9  the records of each facility to determine compliance with the

10  requirements of this section.  The department may adopt rules

11  to carry out the provisions of this section.

12         (5)  In lieu of completing a course as required in

13  paragraph (1)(b), the employee may complete a course on

14  end-of-life care and palliative health care or a course on

15  HIV/AIDS so long as the employee completed an approved course

16  on conditions caused by nuclear, biological, and chemical

17  terrorism in the immediately preceding biennium.

18         Section 5.  Section 381.0421, Florida Statutes, is

19  created to read:

20         381.0421  Vaccination against hepatitis B.--

21         (1)  A postsecondary education institution shall

22  provide detailed information concerning the risks associated

23  with hepatitis B and the availability, effectiveness, and

24  known contraindications of any required or recommended vaccine

25  against hepatitis B to every student, or to the student's

26  parent or guardian if the student is a minor, who has been

27  accepted for admission.

28         (2)  An individual enrolled in a postsecondary

29  education institution who will be residing in on-campus

30  housing shall provide documentation of vaccinations against

31  hepatitis B unless the individual, if the individual is 18

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  1  years of age or older, or the individual's parent or guardian,

  2  if the individual is a minor, declines the vaccinations and

  3  the individual, parent, or guardian signs a waiver provided by

  4  the institution acknowledging receipt and review of the

  5  information provided.

  6         (3)  This section does not require any postsecondary

  7  education institution to provide or pay for vaccinations

  8  against hepatitis B.

  9         Section 6.  Subsection (4) of section 395.1027, Florida

10  Statutes, is amended to read:

11         395.1027  Regional poison control centers.--

12         (4)  By October 1, 1999, each regional poison control

13  center shall develop a prehospital emergency dispatch protocol

14  with each licensee defined by s. 401.23(14)(13) in the

15  geographic area covered by the regional poison control center.

16  The prehospital emergency dispatch protocol shall be developed

17  by each licensee's medical director in conjunction with the

18  designated regional poison control center responsible for the

19  geographic area in which the licensee operates. The protocol

20  shall define toxic substances and describe the procedure by

21  which the designated regional poison control center may be

22  consulted by the licensee. If a call is transferred to the

23  designated regional poison control center in accordance with

24  the protocol established under this section and s. 401.268,

25  the designated regional poison control center shall assume

26  responsibility and liability for the call.

27         Section 7.  Section 401.23, Florida Statutes, is

28  amended to read:

29         401.23  Definitions.--As used in this part, the term:

30         (1)  "Advanced life support" means the use of skills

31  and techniques described in the most recent United States

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  1  Department of Transportation National Standard Paramedic

  2  Curriculum by a paramedic under the supervision of a

  3  licensee's medical director as required by rules of the

  4  department. The term "advanced life support" also includes

  5  other techniques that have been approved and are performed

  6  under conditions specified by rules of the department. The

  7  term "advanced life support" also includes provision of care

  8  by a paramedic under the supervision of a licensee's medical

  9  director to a person experiencing an emergency medical

10  condition as defined in subsection (11) treatment of

11  life-threatening medical emergencies through the use of

12  techniques such as endotracheal intubation, the administration

13  of drugs or intravenous fluids, telemetry, cardiac monitoring,

14  and cardiac defibrillation by a qualified person, pursuant to

15  rules of the department.

16         (2)  "Advanced life support service" means any

17  emergency medical transport or nontransport service which uses

18  advanced life support techniques.

19         (3)  "Air ambulance" means any fixed-wing or

20  rotary-wing aircraft used for, or intended to be used for, air

21  transportation of sick or injured persons requiring or likely

22  to require medical attention during transport.

23         (4)  "Air ambulance service" means any publicly or

24  privately owned service, licensed in accordance with the

25  provisions of this part, which operates air ambulances to

26  transport persons requiring or likely to require medical

27  attention during transport.

28         (5)  "Ambulance" or "emergency medical services

29  vehicle" means any privately or publicly owned land or water

30  vehicle that is designed, constructed, reconstructed,

31  maintained, equipped, or operated for, and is used for, or

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  1  intended to be used for, land or water transportation of sick

  2  or injured persons requiring or likely to require medical

  3  attention during transport.

  4         (6)  "Ambulance driver" means any person who meets the

  5  requirements of s. 401.281.

  6         (7)  "Basic life support" means the use of skills and

  7  techniques described in the most recent United States

  8  Department of Transportation National Standard EMT-Basic

  9  Curriculum by an emergency medical technician or paramedic

10  under the supervision of a licensee's medical director as

11  required by rules of the department. The term "basic life

12  support" also includes other techniques that have been

13  approved and are performed under conditions specified by rules

14  of the department. The term "basic life support" also includes

15  provision of care by a paramedic or emergency medical

16  technician under the supervision of a licensee's medical

17  director to a person experiencing an emergency medical

18  condition as defined in subsection (11) treatment of medical

19  emergencies by a qualified person through the use of

20  techniques such as patient assessment, cardiopulmonary

21  resuscitation (CPR), splinting, obstetrical assistance,

22  bandaging, administration of oxygen, application of medical

23  antishock trousers, administration of a subcutaneous injection

24  using a premeasured autoinjector of epinephrine to a person

25  suffering an anaphylactic reaction, and other techniques

26  described in the Emergency Medical Technician Basic Training

27  Course Curriculum of the United States Department of

28  Transportation.  The term "basic life support" also includes

29  other techniques which have been approved and are performed

30  under conditions specified by rules of the department.

31

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  1         (8)  "Basic life support service" means any emergency

  2  medical service which uses only basic life support techniques.

  3         (9)  "Certification" means any authorization issued

  4  pursuant to this part to a person to act as an emergency

  5  medical technician or a paramedic.

  6         (10)  "Department" means the Department of Health.

  7         (11)  "Emergency medical condition" means:

  8         (a)  A medical condition manifesting itself by acute

  9  symptoms of sufficient severity, which may include severe

10  pain, psychiatric disturbances, symptoms of substance abuse,

11  or other acute symptoms, such that the absence of immediate

12  medical attention could reasonably be expected to result in

13  any of the following:

14         1.  Serious jeopardy to the health of a patient,

15  including a pregnant woman or fetus.

16         2.  Serious impairment to bodily functions.

17         3.  Serious dysfunction of any bodily organ or part.

18         (b)  With respect to a pregnant woman, that there is

19  evidence of the onset and persistence of uterine contractions

20  or rupture of the membranes.

21         (c)  With respect to a person exhibiting acute

22  psychiatric disturbance or substance abuse, that the absence

23  of immediate medical attention could reasonably be expected to

24  result in:

25         1.  Serious jeopardy to the health of a patient; or

26         2.  Serious jeopardy to the health of others.

27         (12)(11)  "Emergency medical technician" means a person

28  who is certified by the department to perform basic life

29  support pursuant to this part.

30         (13)(12)  "Interfacility transfer" means the

31  transportation by ambulance of a patient between two

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  1  facilities licensed under chapter 393, chapter 395, or chapter

  2  400, pursuant to this part.

  3         (14)(13)  "Licensee" means any basic life support

  4  service, advanced life support service, or air ambulance

  5  service licensed pursuant to this part.

  6         (15)(14)  "Medical direction" means direct supervision

  7  by a physician through two-way voice communication or, when

  8  such voice communication is unavailable, through established

  9  standing orders, pursuant to rules of the department.

10         (16)(15)  "Medical director" means a physician who is

11  employed or contracted by a licensee and who provides medical

12  supervision, including appropriate quality assurance but not

13  including administrative and managerial functions, for daily

14  operations and training pursuant to this part.

15         (17)(16)  "Mutual aid agreement" means a written

16  agreement between two or more entities whereby the signing

17  parties agree to lend aid to one another under conditions

18  specified in the agreement and as sanctioned by the governing

19  body of each affected county.

20         (18)(17)  "Paramedic" means a person who is certified

21  by the department to perform basic and advanced life support

22  pursuant to this part.

23         (19)(18)  "Permit" means any authorization issued

24  pursuant to this part for a vehicle to be operated as a basic

25  life support or advanced life support transport vehicle or an

26  advanced life support nontransport vehicle providing basic or

27  advanced life support.

28         (20)(19)  "Physician" means a practitioner who is

29  licensed under the provisions of chapter 458 or chapter 459.

30  For the purpose of providing "medical direction" as defined in

31  subsection (14) for the treatment of patients immediately

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  1  prior to or during transportation to a United States

  2  Department of Veterans Affairs medical facility, "physician"

  3  also means a practitioner employed by the United States

  4  Department of Veterans Affairs.

  5         (21)(20)  "Registered nurse" means a practitioner who

  6  is licensed to practice professional nursing pursuant to part

  7  I of chapter 464.

  8         (22)(21)  "Secretary" means the Secretary of Health.

  9         (23)(22)  "Service location" means any permanent

10  location in or from which a licensee solicits, accepts, or

11  conducts business under this part.

12         Section 8.  Paragraph (b) of subsection (2) of section

13  401.245, Florida Statutes, is amended to read:

14         401.245  Emergency Medical Services Advisory Council.--

15         (2)

16         (b)  Representation on the Emergency Medical Services

17  Advisory Council shall include:  two licensed physicians who

18  are "medical directors" as defined in s. 401.23(16)(15) or

19  whose medical practice is closely related to emergency medical

20  services; two emergency medical service administrators, one of

21  whom is employed by a fire service; two certified paramedics,

22  one of whom is employed by a fire service; two certified

23  emergency medical technicians, one of whom is employed by a

24  fire service; one emergency medical services educator; one

25  emergency nurse; one hospital administrator; one

26  representative of air ambulance services; one representative

27  of a commercial ambulance operator; and two laypersons who are

28  in no way connected with emergency medical services, one of

29  whom is a representative of the elderly. Ex officio members of

30  the advisory council from state agencies shall include, but

31  shall not be limited to, representatives from the Department

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  1  of Education, the Department of Management Services, the

  2  Department of Insurance, the Department of Highway Safety and

  3  Motor Vehicles, the Department of Transportation, and the

  4  Department of Community Affairs.

  5         Section 9.  Subsection (1) of section 401.252, Florida

  6  Statutes, is amended to read:

  7         401.252  Interfacility transfer.--

  8         (1)  A licensed basic or advanced life support

  9  ambulance service may conduct interfacility transfers in a

10  permitted ambulance, using a registered nurse or physician

11  assistant in place of an emergency medical technician or

12  paramedic, if:

13         (a)  The registered nurse or physician assistant holds

14  a current certificate of successful course completion in

15  advanced cardiac life support;

16         (b)  The physician in charge has granted permission for

17  such a transfer, has designated the level of service required

18  for such transfer, and has deemed the patient to be in such a

19  condition appropriate to this type of ambulance staffing; and

20         (c)  The registered nurse operates within the scope of

21  part I of chapter 464 or the physician assistant operates

22  within the physician assistant's scope of practice under

23  chapter 458 or chapter 459.

24         Section 10.  Subsection (6) of section 401.27, Florida

25  Statutes, is amended to read:

26         401.27  Personnel; standards and certification.--

27         (6)(a)  The department shall establish by rule a

28  procedure for biennial renewal certification of emergency

29  medical technicians. Such rules must require a United States

30  Department of Transportation refresher training program of at

31  least 30 hours as approved by the department every 2 years.

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  1  Completion of the course required by s. 381.0034(1) shall

  2  count toward the 30 hours. The refresher program may be

  3  offered in multiple presentations spread over the 2-year

  4  period.  The rules must also provide that the refresher course

  5  requirement may be satisfied by passing a challenge

  6  examination.

  7         (b)  The department shall establish by rule a procedure

  8  for biennial renewal certification of paramedics.  Such rules

  9  must require candidates for renewal to have taken at least 30

10  hours of continuing education units during the 2-year period.

11  Completion of the course required by s. 381.0034(1) shall

12  count toward the 30 hours. The rules must provide that the

13  continuing education requirement may be satisfied by passing a

14  challenge examination.

15         Section 11.  Section 456.033, Florida Statutes, is

16  amended to read:

17         456.033  Requirement for instruction for certain

18  licensees on conditions caused by nuclear, biological, and

19  chemical terrorism and on HIV and AIDS.--

20         (1)  The appropriate board shall require each person

21  licensed or certified under chapter 457; chapter 458; chapter

22  459; chapter 460; chapter 461; chapter 463; part I of chapter

23  464; chapter 465; chapter 466; part II, part III, part V, or

24  part X of chapter 468; or chapter 486 to complete a continuing

25  educational course, approved by the board, on conditions

26  caused by nuclear, biological, and chemical terrorism human

27  immunodeficiency virus and acquired immune deficiency syndrome

28  as part of biennial relicensure or recertification. The course

29  shall consist of education on diagnosis and treatment, the

30  modes of transmission, infection control procedures, and

31  clinical management. Such course shall also include

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  1  information on reporting suspected cases of conditions caused

  2  by nuclear, biological, or chemical terrorism to the

  3  appropriate health and law enforcement authorities, and

  4  prevention of human immunodeficiency virus and acquired immune

  5  deficiency syndrome. Such course shall include information on

  6  current Florida law on acquired immune deficiency syndrome and

  7  its impact on testing, confidentiality of test results,

  8  treatment of patients, and any protocols and procedures

  9  applicable to human immunodeficiency virus counseling and

10  testing, reporting, the offering of HIV testing to pregnant

11  women, and partner notification issues pursuant to ss. 381.004

12  and 384.25.

13         (2)  Each such licensee or certificateholder shall

14  submit confirmation of having completed said course, on a form

15  as provided by the board, when submitting fees for each

16  biennial renewal.

17         (3)  The board shall have the authority to approve

18  additional equivalent courses that may be used to satisfy the

19  requirements in subsection (1).  Each licensing board that

20  requires a licensee to complete an educational course pursuant

21  to this section may count the hours required for completion of

22  the course included in the total continuing educational

23  requirements as required by law.

24         (4)  Any person holding two or more licenses subject to

25  the provisions of this section shall be permitted to show

26  proof of having taken one board-approved course on conditions

27  caused by nuclear, biological, and chemical terrorism human

28  immunodeficiency virus and acquired immune deficiency

29  syndrome, for purposes of relicensure or recertification for

30  additional licenses.

31

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  1         (5)  Failure to comply with the above requirements of

  2  this section shall constitute grounds for disciplinary action

  3  under each respective licensing chapter and s. 456.072(1)(e).

  4  In addition to discipline by the board, the licensee shall be

  5  required to complete the required course or courses.

  6         (6)  The board shall require as a condition of granting

  7  a license under the chapters and parts specified in subsection

  8  (1) that an applicant making initial application for licensure

  9  complete respective an educational courses course acceptable

10  to the board on conditions caused by nuclear, biological, and

11  chemical terrorism and on human immunodeficiency virus and

12  acquired immune deficiency syndrome. An applicant who has not

13  taken such courses a course at the time of licensure shall,

14  upon an affidavit showing good cause, be allowed 6 months to

15  complete this requirement.

16         (7)  The board shall have the authority to adopt rules

17  to carry out the provisions of this section.

18         (8)  The board shall report to the Legislature by March

19  1 of each year as to the implementation and compliance with

20  the requirements of this section.

21         (9)(a)  In lieu of completing a course as required in

22  subsection (1), the licensee may complete a course on in

23  end-of-life care and palliative health care or a course on

24  HIV/AIDS, so long as the licensee completed an approved

25  AIDS/HIV course on conditions caused by nuclear, biological,

26  and chemical terrorism in the 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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  1         Section 12.  Section 456.0345, Florida Statutes, is

  2  created to read:

  3         456.0345  Life support training.--Health care

  4  practitioners who obtain training in advanced cardiac life

  5  support, cardiopulmonary resuscitation, or emergency first aid

  6  shall receive an equivalent number of continuing education

  7  course credits which may be applied toward licensure renewal

  8  requirements.

  9         Section 13.  Paragraph (e) of subsection (1) of section

10  456.072, Florida Statutes, is amended to read:

11         456.072  Grounds for discipline; penalties;

12  enforcement.--

13         (1)  The following acts shall constitute grounds for

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

15  be taken:

16         (e)  Failing to comply with the educational course

17  requirements for conditions caused by nuclear, biological, and

18  chemical terrorism or for human immunodeficiency virus and

19  acquired immune deficiency syndrome.

20         Section 14.  Section 456.38, Florida Statutes, is

21  amended to read:

22         456.38  Practitioner registry for disasters and

23  emergencies.--The Department of Health shall may include on

24  its application and renewal forms for the licensure or

25  certification of health care practitioners licensed pursuant

26  to chapter 458, chapter 459, chapter 464, or part V of chapter

27  468, as defined in s. 456.001, who could assist the department

28  in the event of a disaster a question asking if the

29  practitioner would be available to provide health care

30  services in special needs shelters or to help staff disaster

31  medical assistance teams during times of emergency or major

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  1  disaster. The names of practitioners who answer affirmatively

  2  shall be maintained by the department as a health care

  3  practitioner registry for disasters and emergencies. A health

  4  care practitioner who volunteers his or her services in a

  5  special needs shelter or as part of a disaster medical

  6  assistance team during a time of emergency or disaster shall

  7  not be terminated or discriminated against by his or her

  8  employer for such volunteer work, provided that the health

  9  care practitioner returns to his or her regular employment

10  within 2 weeks or within a longer period that has been

11  previously approved by the employer in writing.

12         Section 15.  Subsection (4) of section 458.319, Florida

13  Statutes, is amended to read:

14         458.319  Renewal of license.--

15         (4)  Notwithstanding the provisions of s. 456.033, a

16  physician may complete continuing education on end-of-life

17  care and palliative care in lieu of continuing education in

18  conditions caused by nuclear, biological, and chemical

19  terrorism AIDS/HIV, if that physician has completed the

20  AIDS/HIV continuing education in conditions caused by nuclear,

21  biological, and chemical terrorism in the immediately

22  preceding biennium.

23         Section 16.  Subsection (5) of section 459.008, Florida

24  Statutes, is amended to read:

25         459.008  Renewal of licenses and certificates.--

26         (5)  Notwithstanding the provisions of s. 456.033, an

27  osteopathic physician may complete continuing education on

28  end-of-life and palliative care in lieu of continuing

29  education in conditions caused by nuclear, biological, and

30  chemical terrorism AIDS/HIV, if that physician has completed

31  the AIDS/HIV continuing education in conditions caused by

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  1  nuclear, biological, and chemical terrorism in the immediately

  2  preceding biennium.

  3         Section 17.  This act shall take effect upon becoming a

  4  law.

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