HB 1583 2003
1	A bill to be entitled
2	An act relating to the practice of psychology; amending s.
3	490.003, F.S.; revising a definition; creating s.
4	490.0146, F.S.; providing requirements for and conditions
5	on the prescription and administration of drugs, including
6	controlled substances, by psychologists; providing
7	definitions; requiring certification; providing
8	requirements for application for and renewal of
9	prescriptive authority; providing prescribing practices;
10	requiring transmission of certain information to the Board
11	of Pharmacy; providing rulemaking authority to establish
12	grounds for discipline and for suspension or revocation of
13	prescriptive authority; amending s. 464.003, F.S.;
14	revising certain definitions; amending s. 464.012, F.S.;
15	including psychological treatment under supervision of a
16	licensed psychologist certified to prescribe drugs among
17	those functions an advanced registered nurse practitioner
18	may perform within the framework of an established
19	protocol; amending s. 458.348, F.S.; revising references,
20	to conform; amending s. 893.02, F.S.; revising a
21	definition; reenacting s. 775.051, F.S., relating to
22	voluntary intoxication as a defense, to incorporate the
23	amendment to s. 893.02, F.S., in a reference thereto;
24	providing an effective date.
25
26	Be It Enacted by the Legislature of the State of Florida:
27
28	Section 1. Subsection (4) of section 490.003, Florida
29	Statutes, is amended to read:
30	490.003 Definitions.--As used in this chapter:
31	(4) "Practice of psychology" means the observations,
32	description, evaluation, interpretation, and modification of
33	human behavior, by the use of scientific and applied
34	psychological principles, methods, and procedures, for the
35	purpose of describing, preventing, alleviating, or eliminating
36	symptomatic, maladaptive, or undesired behavior and of enhancing
37	interpersonal behavioral health and mental or psychological
38	health. The practice of psychology includes the prescription and
39	administration of drugs, including, but not limited to,
40	controlled substances, when the licensee is certified to
41	prescribe drugs pursuant to s. 490.0146.The ethical practice of
42	psychology includes, but is not limited to, psychological
43	testing and the evaluation or assessment of personal
44	characteristics such as intelligence, personality, abilities,
45	interests, aptitudes, and neuropsychological functioning,
46	including evaluation of mental competency to manage one's
47	affairs and to participate in legal proceedings; counseling,
48	psychoanalysis, all forms of psychotherapy, sex therapy,
49	hypnosis, biofeedback, and behavioral analysis and therapy;
50	psychoeducational evaluation, therapy, remediation, and
51	consultation; and use of psychological methods to diagnose and
52	treat mental, nervous, psychological, marital, or emotional
53	disorders, illness, or disability, alcoholism and substance
54	abuse, and disorders of habit or conduct, as well as the
55	psychological aspects of physical illness, accident, injury, or
56	disability, including neuropsychological evaluation, diagnosis,
57	prognosis, etiology, and treatment.
58	(a) Psychological services may be rendered to individuals,
59	couples, families, groups, and the public without regard to
60	place of service.
61	(b) The use of specific modalities within the practice of
62	psychology is restricted to psychologists appropriately trained
63	in the use of such modalities.
64	(c) The practice of psychology shall be construed within
65	the meaning of this definition without regard to whether payment
66	is requested or received for services rendered.
67	Section 2. Section 490.0146, Florida Statutes, is created
68	to read:
69	490.0146 Prescription of drugs.--
70	(1) DEFINITIONS.--As used in this section:
71	(a) “Prescriptive authority" means the authority to
72	prescribe, administer, and dispense drugs, including controlled
73	substances, and other treatment procedures within the scope of
74	practice of psychology in accordance with rules adopted by the
75	board.
76	(b) “Psychologist certified to prescribe" means a
77	licensed, doctoral-level psychologist who has undergone
78	specialized training, has passed an examination accepted by the
79	board, and has received from the board a certificate granting
80	prescriptive authority, which is current and has not been revoked
81	or suspended.
82	(c) “Prescription" means an order for a drug, a laboratory
83	test, or any medicine, device, or treatment, including, but not
84	limited to, a controlled substance.
85	(2) CERTIFICATION OF PRESCRIPTIVE AUTHORITY.--
86	(a) The board shall certify licensed, doctoral-level
87	psychologists to prescribe, administer, and dispense drugs,
88	including controlled substances, in accordance with applicable
89	state and federal laws.
90	(b) The board shall adopt rules for reviewing educational
91	and training credentials for the certification process in
92	accordance with current standards of professional practice.
93	(c) The board may seek the advice of other state agencies
94	with relevant experience in devising the certification procedures
95	and criteria.
96	(3) APPLICATION FOR INITIAL PRESCRIPTIVE AUTHORITY.--A
97	psychologist may apply to the board for prescriptive authority
98	and shall demonstrate, by official transcript or other official
99	evidence satisfactory to the board, the following:
100	(a) Completion of a doctoral degree in psychology pursuant
101	to s. 490.003(3).
102	(b) Holding a current license to practice psychology in
103	this state.
104	(c) Completion of a program of education in an organized
105	program of intensive didactic instruction, as defined by the
106	board, consisting of the following core areas of instruction:
107	neuroscience, pharmacology, psychopharmacology, physiology,
108	pathophysiology, appropriate and relevant physical and laboratory
109	assessment, and clinical pharmacotherapeutics.
110	(d) Having obtained supervised and relevant clinical
111	experience sufficient to attain competency in the treatment of a
112	patient population under the direction of qualified
113	practitioners, as determined by the board.
114	(e) Passage of a certification examination administered by
115	the board and developed by a nationally recognized body approved
116	by the board.
117	(4) RENEWAL OF PRESCRIPTIVE AUTHORITY.--
118	(a) The board shall establish by rule a method for the
119	renewal of prescriptive authority at the time of or in
120	conjunction with the renewal of licenses.
121	(b) Each applicant for renewal of prescriptive authority
122	shall present evidence satisfactory to the board which
123	demonstrates the completion of 10 hours of continuing education
124	relevant to prescriptive authority during a biennium and which
125	may be part of the biennial continuing education requirement for
126	licensure renewal.
127	(5) PRESCRIBING PRACTICES.--
128	(a) Every prescription issued by a psychologist certified
129	to prescribe shall comply with all applicable state and federal
130	laws.
131	(b) Records of all prescriptions issued by a psychologist
132	certified to prescribe shall be maintained in patient records.
133	(6) SUBSTANCE PRESCRIPTIVE AUTHORITY.--
134	(a) Each psychologist certified to prescribe controlled
135	substances shall file with the board, in a timely manner, all
136	applicable individual Drug Enforcement Administration
137	registrations and numbers.
138	(b) The board shall maintain current records of every
139	psychologist certified to prescribe, including Drug Enforcement
140	Administration registrations and numbers.
141	(7) INTERACTION WITH THE BOARD OF PHARMACY.--
142	(a) The board shall transmit annually to the Board of
143	Pharmacy a list of psychologists certified to prescribe that
144	contains the following information:
145	1. The name of the psychologist.
146	2. The psychologist's identification number assigned by
147	the board.
148	3. The effective date of the psychologist's prescriptive
149	authority.
150	(b) The board shall promptly forward to the Board of
151	Pharmacy the names and titles of psychologists added to or
152	deleted from the annual list of psychologists certified to
153	prescribe.
154	(c) The board shall notify the Board of Pharmacy in a
155	timely manner upon termination, suspension, or reinstatement of a
156	psychologist's prescriptive authority.
157	(8) DISCIPLINE; SUSPENSION OR REVOCATION OF PRESCRIPTIVE
158	AUTHORITY.--The board shall establish by rule criteria for
159	disciplining, or suspending or revoking the prescriptive
160	authority of, a psychologist certified to prescribe. The board
161	may require any of the following: education, training,
162	rehabilitation, fines, reprimand, restriction of practice, or
163	suspension or revocation of prescriptive authority.
164	Section 3. Paragraphs (b) and (c) of subsection (3) of
165	section 464.003, Florida Statutes, are amended to read:
166	464.003 Definitions.--As used in this part:
167	(3)
168	(b) "Practice of practical nursing" means the performance
169	of selected acts, including the administration of treatments and
170	medications, in the care of the ill, injured, or infirm and the
171	promotion of wellness, maintenance of health, and prevention of
172	illness of others under the direction of a registered nurse, a
173	licensed physician, a licensed osteopathic physician, a licensed
174	podiatric physician, or a licensed dentist, or a licensed
175	psychologist certified to prescribe drugs pursuant to s.
176	490.0146.
177
178	The professional nurse and the practical nurse shall be
179	responsible and accountable for making decisions that are based
180	upon the individual's educational preparation and experience in
181	nursing.
182	(c) "Advanced or specialized nursing practice" means, in
183	addition to the practice of professional nursing, the
184	performance of advanced-level nursing acts approved by the board
185	which, by virtue of postbasic specialized education, training,
186	and experience, are proper to be performed by an advanced
187	registered nurse practitioner. Within the context of advanced or
188	specialized nursing practice, the advanced registered nurse
189	practitioner may perform acts of nursing diagnosis and nursing
190	treatment of alterations of the health status. The advanced
191	registered nurse practitioner may also perform acts of medical
192	diagnosis and treatment, prescription, and operation which are
193	identified and approved by a joint committee composed of three
194	members appointed by the Board of Nursing, two of whom shall be
195	advanced registered nurse practitioners; three members appointed
196	by the Board of Medicine, two of whom shall have had work
197	experience with advanced registered nurse practitioners; and the
198	secretary of the department or the secretary's designee. Each
199	committee member appointed by a board shall be appointed to a
200	term of 4 years unless a shorter term is required to establish
201	or maintain staggered terms. The Board of Nursing shall adopt
202	rules authorizing the performance of any such acts approved by
203	the joint committee. Unless otherwise specified by the joint
204	committee, such acts shall be performed under the general
205	supervision of a practitioner licensed under chapter 458,
206	chapter 459, or chapter 466, or a practitioner licensed under
207	chapter 490 who is certified to prescribe drugs pursuant to s.
208	490.0146,within the framework of standing protocols which
209	identify the medical or psychologicalacts to be performed and
210	the conditions for their performance. The department may, by
211	rule, require that a copy of the protocol be filed with the
212	department along with the notice required by s. 458.348.
213	Section 4. Subsection (3) of section 464.012, Florida
214	Statutes, is amended to read:
215	464.012 Certification of advanced registered nurse
216	practitioners; fees.--
217	(3) An advanced registered nurse practitioner shall
218	perform those functions authorized in this section within the
219	framework of an established protocol. A practitioner currently
220	licensed under chapter 458, chapter 459, or chapter 466 or a
221	practitioner currently licensed under chapter 490 who is
222	certified to prescribe drugs pursuant to s. 490.0146shall
223	maintain supervision for directing the specific course of
224	medical or psychologicaltreatment. Within the established
225	framework, an advanced registered nurse practitioner may:
226	(a) Monitor and alter drug therapies.
227	(b) Initiate appropriate therapies for certain conditions.
228	(c) Perform additional functions as may be determined by
229	rule in accordance with s. 464.003(3)(c).
230	(d) Order diagnostic tests and physical and occupational
231	therapy.
232	Section 5. Paragraph (a) of subsection (1) and subsection
233	(2) of section 458.348, Florida Statutes, are amended to read:
234	458.348 Formal supervisory relationships, standing orders,
235	and established protocols; notice; standards.--
236	(1) NOTICE.--
237	(a) When a physician enters into a formal supervisory
238	relationship or standing orders with an emergency medical
239	technician or paramedic licensed pursuant to s. 401.27, which
240	relationship or orders contemplate the performance of medical
241	acts, or when a physician enters into an established protocol
242	with an advanced registered nurse practitioner, which protocol
243	contemplates the performance of medical or psychologicalacts
244	identified and approved by the joint committee pursuant to s.
245	464.003(3)(c) or acts set forth in s. 464.012(3) and (4), the
246	physician shall submit notice to the board. The notice shall
247	contain a statement in substantially the following form:
248
249	I, ... (name and professional license number of physician)
250	..., of ... (address of physician) ... have hereby entered
251	into a formal supervisory relationship, standing orders, or an
252	established protocol with ... (number of persons) ...
253	emergency medical technician(s), ... (number of persons) ...
254	paramedic(s), or ... (number of persons) ... advanced
255	registered nurse practitioner(s).
256
257	(2) ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.--The
258	joint committee created by s. 464.003(3)(c) shall determine
259	minimum standards for the content of established protocols
260	pursuant to which an advanced registered nurse practitioner may
261	perform medical or psychologicalacts identified and approved by
262	the joint committee pursuant to s. 464.003(3)(c) or acts set
263	forth in s. 464.012(3) and (4) and shall determine minimum
264	standards for supervision of such acts by the physician, unless
265	the joint committee determines that any act set forth in s.
266	464.012(3) or (4) is not a medical or psychologicalact. Such
267	standards shall be based on risk to the patient and acceptable
268	standards of medical or psychologicalcare and shall take into
269	account the special problems of medically underserved areas. The
270	standards developed by the joint committee shall be adopted as
271	rules by the Board of Nursing and the Board of Medicine for
272	purposes of carrying out their responsibilities pursuant to part
273	I of chapter 464 and this chapter, respectively, but neither
274	board shall have disciplinary powers over the licensees of the
275	other board.
276	Section 6. Subsection (19) of section 893.02, Florida
277	Statutes, is amended to read:
278	893.02 Definitions.--The following words and phrases as
279	used in this chapter shall have the following meanings, unless
280	the context otherwise requires:
281	(19) "Practitioner" means a physician licensed pursuant to
282	chapter 458, a dentist licensed pursuant to chapter 466, a
283	veterinarian licensed pursuant to chapter 474, an osteopathic
284	physician licensed pursuant to chapter 459, a naturopath
285	licensed pursuant to chapter 462, ora podiatric physician
286	licensed pursuant to chapter 461, or a psychologist licensed
287	pursuant to chapter 490 and certified to prescribe drugs
288	pursuant to s. 490.0146,provided such practitioner holds a
289	valid federal controlled substance registry number.
290	Section 7. For purposes of incorporating the amendment to
291	section 893.02, Florida Statutes, in a reference thereto,
292	section 775.051, Florida Statutes, is reenacted to read:
293	775.051 Voluntary intoxication; not a defense; evidence
294	not admissible for certain purposes; exception.--Voluntary
295	intoxication resulting from the consumption, injection, or other
296	use of alcohol or other controlled substance as described in
297	chapter 893 is not a defense to any offense proscribed by law.
298	Evidence of a defendant's voluntary intoxication is not
299	admissible to show that the defendant lacked the specific intent
300	to commit an offense and is not admissible to show that the
301	defendant was insane at the time of the offense, except when the
302	consumption, injection, or use of a controlled substance under
303	chapter 893 was pursuant to a lawful prescription issued to the
304	defendant by a practitioner as defined in s. 893.02.
305	Section 8. This act shall take effect July 1, 2003.