HB 1925, Engrossed 1 2003
1	A bill to be entitled
2	An act relating to health; amending s. 17.41, F.S.;
3	providing for funds from the tobacco settlement to be
4	transferred to the Biomedical Research Trust Fund within
5	the Department of Health; amending s. 20.43, F.S.;
6	renaming certain divisions within the Department of
7	Health; establishing the Division of Disability
8	Determinations within the department; establishing the
9	Office of Minority Health within the department; amending
10	s. 154.01, F.S.; providing for environmental health
11	services to include investigations of elevated blood lead
12	levels; authorizing the expenditure of funds for such
13	investigations; creating s. 216.342, F.S.; authorizing the
14	expenditure of funds of the United States Trust Fund for
15	the operation of the Division of Disability
16	Determinations; amending s. 381.0011, F.S.; revising
17	duties of the Department of Health with respect to injury
18	prevention and control; amending s. 381.004, F.S.;
19	revising requirements for the release of HIV test results;
20	amending s. 381.0065, F.S., relating to onsite sewage
21	treatment and disposal systems; clarifying a definition;
22	deleting obsolete provisions; amending s. 381.0072, F.S.;
23	clarifying provisions governing the authority of the
24	Department of Health to adopt and enforce sanitation
25	rules; revising exemptions; creating s. 381.104, F.S.;
26	authorizing state agencies to establish employee health
27	and wellness programs; providing requirements for the
28	programs; requiring the use of an employee health and
29	wellness activity agreement form; requiring an evaluation
30	and improvement process for the program; requiring the
31	Department of Health to provide model program guidelines;
32	amending ss. 381.7353 and 381.7355, F.S.; including oral
33	health care in the Closing the Gap grant program; creating
34	s. 381.86, F.S.; creating the Review Council for Human
35	Subjects within the Department of Health; providing duties
36	and membership; providing for reimbursement for per diem
37	and travel expenses; requiring the department to charge
38	for costs incurred by the council for research oversight;
39	providing an exception; amending s. 381.89, F.S.; revising
40	the fees imposed for the licensure of tanning facilities;
41	amending s. 381.90, F.S.; revising the membership of the
42	Health Information Systems Council; revising the date for
43	submitting an annual plan; amending s. 383.14, F.S.;
44	clarifying provisions with respect to the screening of
45	newborns; amending s. 384.25, F.S.; revising requirements
46	for the reporting of sexually transmissible diseases;
47	requiring the Department of Health to adopt rules relating
48	to newborns or infants exposed to HIV; amending s.
49	385.204, F.S.; revising requirements for the purchase and
50	distribution of insulin by the Department of Health;
51	amending s. 391.021, F.S.; redefining the term "children
52	with special health care needs" for purposes of the
53	Children's Medical Services Act; amending s. 391.025,
54	F.S.; revising applicability and scope of the act;
55	amending s. 391.029, F.S.; revising requirements for
56	program eligibility; amending s. 391.055, F.S.; requiring
57	the referral to the Children's Medical Services network of
58	a newborn having a certain abnormal screening result;
59	creating s. 391.309, F.S.; establishing the Florida
60	Infants and Toddlers Early Intervention Program; providing
61	requirements for the Department of Health under the
62	program; requiring certain federal waivers; amending s.
63	393.064, F.S.; transferring to the Department of Health
64	authority for the supervision and management of the
65	Raymond C. Philips Research and Education Unit; amending
66	s. 394.4615, F.S.; limiting a patient's access to his or
67	her records where the patient's life or safety is
68	endangered; amending s. 394.9151, F.S.; authorizing the
69	Department of Children and Family Services to contract
70	with the Correctional Medical Authority to conduct surveys
71	of medical services and to provide medical quality
72	assurance and improvement assistance at secure confinement
73	and treatment facilities for certain persons; amending s.
74	395.3025, F.S.; clarifying access to patient records for
75	professional disciplinary purposes and for research
76	purposes; amending s. 395.404, F.S.; revising requirements
77	for reports to the Department of Health concerning certain
78	brain or spinal cord injuries; amending s. 395.7015, F.S.;
79	conforming cross references; amending s. 400.141, F.S.;
80	requiring copies of records to be provided to the
81	Department of Health upon subpoena; amending s. 400.145,
82	F.S.; requiring certification of copies of records
83	requested pursuant to subpoena or patient release;
84	amending s. 400.211, F.S.; reducing inservice training
85	hours for nursing assistants; creating s. 400.455, F.S.;
86	requiring a certified copy of subpoenaed records under
87	certain circumstances; amending s. 401.113, F.S.;
88	providing for the use of funds generated from interest on
89	certain grant moneys dispensed from the Emergency Medical
90	Services Trust Fund; amending s. 401.211, F.S.; providing
91	legislative intent with respect to a comprehensive
92	statewide injury prevention and control program; creating
93	s. 401.243, F.S.; providing duties of the Department of
94	Health in operating the program; amending s. 401.27, F.S.;
95	authorizing electronically submitted applications for
96	certification or recertification as an emergency medical
97	technician or a paramedic; removing a provision
98	authorizing a temporary certificate; revising requirements
99	for an insignia identifying such person; requiring
100	submission of information and fingerprints for a criminal
101	history check; requiring fees; providing additional
102	grounds for denial of certification or recertification;
103	providing for certain exemptions; amending s. 401.2701,
104	F.S.; requiring emergency medical services training
105	programs to advise students of certification and
106	regulatory requirements; amending s. 401.2715, F.S.;
107	requiring recognition, upon application, of entities
108	approved by the Continuing Education Coordinating Board
109	for Emergency Medical Services for recertification
110	training; amending s. 401.272, F.S.; providing that
111	paramedics may provide life support services in hospital
112	emergency departments under certain circumstances;
113	amending s. 404.056, F.S.; revising requirements for
114	mandatory testing of certain buildings and facilities for
115	radon; amending s. 409.814, F.S.; authorizing certain
116	children to participate in the Florida Healthy Kids
117	program or the Medikids program; amending s. 455.227,
118	F.S.; conforming a cross reference; amending s. 456.017,
119	F.S.; providing for electronic posting of examination
120	scores; amending s. 456.025, F.S.; deleting the
121	requirement for the Department of Health to develop and
122	maintain a continuing education tracking system; amending
123	s. 456.0375, F.S.; providing exemption from registration
124	for community college and university clinics; providing
125	distinction between supervision of administrative services
126	and supervision of health care delivery services;
127	providing exemption from registration for clinical
128	facilities where training is provided by certain medical
129	schools; amending s. 456.039, F.S.; deleting a cross
130	reference; amending s. 456.049, F.S.; specifying amount of
131	final professional liability claims to be reported for
132	physicians and dentists; amending s. 456.063, F.S.;
133	providing professional regulatory boards, or the
134	Department of Health if there is no board, rulemaking
135	authority for reporting allegations of sexual misconduct;
136	amending s. 456.072, F.S.; clarifying grounds for
137	discipline for performing or attempting to perform health
138	care services on the wrong patient or that are otherwise
139	wrong or unnecessary or leaving a foreign body in the
140	patient; providing for discipline for prescribing,
141	administering, dispensing, or distributing certain
142	medications without a valid professional relationship;
143	providing for additional costs to be assessed as part of
144	any penalty or other form of discipline; requiring clear
145	and convincing evidence to revoke or suspend a license and
146	the greater weight of the evidence for other forms of
147	discipline; conforming a cross reference; amending s.
148	456.073, F.S.; extending the time within which the subject
149	of an investigation may submit a written response to the
150	information in the complaint or other documentation;
151	requiring the Department of Health to give 45 days' notice
152	to the Division of Administrative Hearings when a hearing
153	is needed; requiring the division to charge its expenses
154	to the Medical Quality Assurance Trust Fund; providing for
155	certain fees and charges; amending s. 456.077, F.S.;
156	providing that citations for first offenses do not
157	constitute discipline; deleting the required period for
158	issuing a citation; amending s. 456.078, F.S.; requiring
159	designation of certain violations as appropriate for
160	mediation; excluding certain violations from mediation;
161	requiring successful mediation to include a statement of
162	whether of not the resolution constitutes discipline;
163	requiring payment for the administrative costs of
164	mediation; prohibiting mediation more than once involving
165	a breach of the standard of care for health care
166	professionals; providing rulemaking authority; amending s.
167	458.303, F.S.; conforming cross references; amending s.
168	458.311, F.S.; consolidating and revising provisions
169	relating to requirements for licensure of physicians;
170	amending s. 458.3124, F.S.; conforming a cross reference;
171	amending s. 458.315, F.S.; consolidating and revising
172	provisions relating to requirements for limited licensure
173	of physicians; amending s. 458.319, F.S.; deleting a cross
174	reference; amending s. 458.320, F.S.; conforming a cross
175	reference; creating s. 458.3215, F.S.; providing for
176	reactivation of a physician's license for clinical
177	research purposes; providing for fees and continuing
178	education; amending s. 458.331, F.S.; increasing the
179	threshold amount of claims against a physician that
180	represent repeated malpractice; revising a reporting
181	requirement to conform; reducing the time period for a
182	physician to respond to information contained in a
183	complaint or other documentation; amending ss. 458.345 and
184	458.347, F.S.; conforming cross references; amending s.
185	459.008, F.S.; deleting a cross reference; creating s.
186	459.0091, F.S.; providing for reactivation of an
187	osteopathic physician's license for clinical research
188	purposes; providing for fees and continuing education;
189	amending s. 459.015, F.S.; increasing the threshold amount
190	of claims against an osteopathic physician that represent
191	repeated malpractice; revising a reporting requirement to
192	conform; reducing the time period for an osteopathic
193	physician to respond to information contained in a
194	complaint or other documentation; amending s. 460.406,
195	F.S.; revising an accrediting agency for chiropractic
196	education; amending s. 460.413, F.S.; reducing the time
197	period for a chiropractic physician to respond to
198	information contained in a complaint or other
199	documentation; amending s. 461.013, F.S.; increasing the
200	threshold amount of claims against a podiatric physician
201	that represent repeated malpractice; revising a reporting
202	requirement to conform; reducing the time period for a
203	podiatric physician to respond to information contained in
204	a complaint or other documentation; amending s. 463.006,
205	F.S.; revising an accrediting agency for optometry
206	education; amending s. 464.0205, F.S.; conforming a cross
207	reference; amending s. 464.203, F.S.; clarifying
208	requirements for criminal history checks of certified
209	nursing assistants; reducing the hours of inservice
210	training required each year; providing for biennial
211	renewal of certification, including fees; amending s.
212	464.204, F.S.; revising a ground for disciplinary action
213	for specificity and removal of the requirement of
214	intentionality; amending s. 465.016, F.S.; providing for
215	disciplinary action against a pharmacist for compounding,
216	dispensing, or distributing legend drugs not prescribed in
217	the course of a valid professional relationship; amending
218	s. 467.009, F.S.; revising an accrediting agency for
219	midwifery education and the licensing agency for midwives;
220	amending s. 467.013, F.S.; providing for inactive
221	licensure status for midwives pursuant to rule of the
222	Department of Health and deleting statutory provisions to
223	conform; amending s. 467.0135, F.S.; clarifying language
224	for licensure status and fees for midwives; amending s.
225	467.017, F.S.; requiring a midwife's emergency care plan
226	to be available upon request of the Department of Health;
227	amending s. 468.302, F.S.; authorizing a nuclear medicine
228	technologist to administer certain X radiation; excluding
229	such technologist from creating or modifying certain
230	tomography protocols and operating certain tomography
231	devices; amending s. 468.352, F.S.; revising definitions
232	applicable to regulation of respiratory therapy; amending
233	s. 468.355, F.S.; revising licensure requirements to
234	practice respiratory therapy; amending s. 468.368, F.S.;
235	revising requirements for exemptions from respiratory care
236	regulation; amending s. 468.509, F.S.; revising an
237	accrediting agency for education of dietitians and
238	nutritionists; amending s. 468.707, F.S.; revising an
239	accrediting agency for education of athletic trainers;
240	deleting a provision relating to a continuing education
241	course on HIV/AIDS for initial licensure as an athletic
242	trainer; amending ss. 486.031 and 486.102, F.S.; revising
243	an accrediting agency for education of physical therapists
244	and physical therapist assistants; amending s. 489.553,
245	F.S.; revising registration requirements for master septic
246	tank contractors; amending s. 489.554, F.S.; revising
247	registration renewal requirements for such contractors;
248	providing for inactive status and reactivation of
249	registration; amending ss. 490.005 and 491.005, F.S.;
250	revising an accrediting agency for education of
251	psychologists and psychotherapists; revising requirements
252	for licensure as a clinical social worker; amending s.
253	491.0145, F.S.; prohibiting the licensure of a certified
254	master social worker if not licensed before a certain
255	date; creating s. 491.0146, F.S.; providing a saving
256	clause for a certified master social worker licensed from
257	a certain date; amending s. 491.0147, F.S.; providing
258	exemption from liability for disclosure of confidential
259	information under certain circumstances; amending s.
260	499.003, F.S.; redefining the term "compressed medical
261	gas" for purposes of the Florida Drug and Cosmetic Act;
262	amending s. 499.007, F.S.; revising requirements for
263	labeling medicinal drugs; amending s. 499.01, F.S.;
264	authorizing the department to issue a prescription drug
265	manufacturer permit to a nuclear pharmacy that is a health
266	care entity; amending s. 499.0121, F.S.; providing
267	requirements for retaining inventories and records;
268	transferring and renumbering s. 501.122, F.S., relating to
269	the control of nonionizing radiations; amending s.
270	627.912, F.S.; requiring insurers to report to the
271	Department of Health final claims in certain amounts for
272	physicians, osteopathic physicians, podiatric physicians,
273	and dentists; amending s. 766.101, F.S.; including certain
274	university committees as medical review committees;
275	amending s. 766.314, F.S.; exempting children born in
276	certain family practice teaching hospitals from fee
277	assessments used to finance the Florida Birth-Related
278	Neurological Injury Compensation Plan; conforming a cross
279	reference; amending s. 784.081, F.S.; providing for the
280	reclassification of the offense of assault or battery if
281	committed on an employee of the Department of Health or
282	upon a direct service contract provider of the department;
283	amending s. 817.567, F.S.; revising an accrediting agency
284	for institutions awarding academic degrees and titles;
285	creating s. 945.6038, F.S.; authorizing the Correctional
286	Medical Authority to contract with other agencies to
287	provide medical quality improvement services; amending s.
288	1009.992, F.S.; revising the definition of the term
289	"institution" to update a reference to an accrediting
290	agency; amending s. 1012.46, F.S.; revising provisions
291	relating to athletic trainers in school districts;
292	removing a legislative goal; clarifying a cross reference;
293	providing for payments by the Department of Health and the
294	Division of Administrative Hearings with respect to
295	billings for hearings; requiring a joint audit of hearings
296	and billings of the Division of Administrative Hearings;
297	requiring a report to the Legislature on billing practices
298	of the Division of Administrative Hearings; requiring the
299	Department of Health, in consultation with specified
300	educational institutions, to conduct a study with respect
301	to using skills of foreign-trained physicians to practice
302	as physician assistants in this state and to report the
303	results and recommendations to the Governor and
304	Legislature; repealing s. 381.0098(9), F.S., relating to
305	obsolete transition provisions concerning biomedical
306	waste; repealing s. 381.85, F.S., relating to biomedical
307	and social research; repealing s. 385.103(2)(f), F.S.,
308	relating to rulemaking authority of the department with
309	respect to the operation of community intervention
310	programs; repealing s. 385.205, F.S., relating to programs
311	in kidney disease control; repealing s. 385.209, F.S.,
312	relating to dissemination of information on cholesterol
313	health risks; repealing s. 445.033(7), F.S., relating to
314	an exemption from biomedical and social research
315	requirements for evaluations of TANF-funded programs
316	conducted by Workforce Florida, Inc.; repealing s.
317	456.031, F.S., relating to a requirement for instruction
318	on domestic violence; repealing s. 456.033, F.S., relating
319	to requirement for instruction on HIV and AIDS for certain
320	licensees; repealing s. 456.034, F.S., relating to
321	requirement for instruction on HIV and AIDS for athletic
322	trainers and massage therapists; repealing s. 458.313,
323	F.S., relating to physician licensure by endorsement;
324	repealing s. 458.316, F.S., relating to public health
325	certificates; repealing s. 458.3165, F.S., relating to
326	public psychiatry certificates; repealing s. 458.317,
327	F.S., relating to limited licenses for physicians;
328	repealing s. 468.356, F.S., relating to approval of
329	educational programs for respiratory therapy licensure;
330	repealing s. 468.357, F.S., relating to respiratory
331	therapy licensure by examination; repealing s. 468.711(3),
332	F.S., relating to a continuing education course on
333	HIV/AIDS for athletic trainers seeking relicensure;
334	providing an effective date.
335
336	Be It Enacted by the Legislature of the State of Florida:
337
338	Section 1. Subsection (5) of section 17.41, Florida
339	Statutes, is amended to read:
340	17.41 Department of Banking and Finance Tobacco Settlement
341	Clearing Trust Fund.--
342	(5) The department shall disburse funds, by nonoperating
343	transfer, from the Tobacco Settlement Clearing Trust Fund to the
344	tobacco settlement trust funds of the various agencies or the
345	Biomedical Research Trust Fund within the Department of Health,
346	as appropriate,in amounts equal to the annual appropriations
347	made from those agencies' trust funds in the General
348	Appropriations Act.
349	Section 2. Paragraphs (f) and (j) of subsection (3) of
350	section 20.43, Florida Statutes, are amended, paragraph (k) is
351	added to said subsection, subsections (4) through (8) are
352	renumbered as subsections (5) through (9), respectively, and a
353	new subsection (4) is added to said section, to read:
354	20.43 Department of Health.--There is created a Department
355	of Health.
356	(3) The following divisions of the Department of Health
357	are established:
358	(f) Division of Emergency Medical OperationsServices and
359	Community Health Resources.
360	(j) Division of Health AccessAwarenessand Tobacco.
361	(k) Division of Disability Determinations.
362	(4) There is established within the Department of Health
363	the Office of Minority Health.
364	Section 3. Paragraph (a) of subsection (2) and subsection
365	(3) of section 154.01, Florida Statutes, are amended to read:
366	154.01 County health department delivery system.--
367	(2) A functional system of county health department
368	services shall be established which shall include the following
369	three levels of service and be funded as follows:
370	(a) "Environmental health services" are those services
371	which are organized and operated to protect the health of the
372	general public by monitoring and regulating activities in the
373	environment which may contribute to the occurrence or
374	transmission of disease. Environmental health services shall be
375	supported by available federal, state, and local funds and shall
376	include those services mandated on a state or federal level.
377	Examples of environmental health services include, but are not
378	limited to, food hygiene, investigations of elevated blood lead
379	levels,safe drinking water supply, sewage and solid waste
380	disposal, swimming pools, group care facilities, migrant labor
381	camps, toxic material control, radiological health, occupational
382	health, and entomology.
383	(3) The Department of Health shall enter into contracts
384	with the several counties for the purposes of this part. All
385	contracts shall be negotiated and approved by the appropriate
386	local governing bodies and the appropriate district
387	administrators on behalf of the department. In accordance with
388	federal guidelines, the state may utilize federal funds for
389	county health department services. A standard contract format
390	shall be developed and used by the department in contract
391	negotiations. The contract shall include the three levels of
392	county health department services outlined in subsection (2)
393	above and shall contain a section which stipulates, for the
394	contract year:
395	(a) All revenue sources, including federal, state, and
396	local general revenue, fees, and other cash contributions, which
397	shall be used by the county health department for county health
398	department services.;
399	(b) The types of services to be provided in each level of
400	service. Each participating county may expend funds for
401	federally mandated certification or recertification fees related
402	to investigations of elevated blood lead levels as provided
403	under paragraph (2)(a).;
404	(c) The estimated number of clients, where applicable, who
405	will be served, by type of service.;
406	(d) The estimated number of services, where applicable,
407	that will be provided, by type of service.;
408	(e) The estimated number of staff positions (full-time
409	equivalent positions) who will work in each type of service
410	area.; and
411	(f) The estimated expenditures for each type of service
412	and for each level of service.
413
414	The contract shall also provide for financial and service
415	reporting for each type of service according to standard service
416	and reporting procedures established by the department.
417	Section 4. Section 216.342, Florida Statutes, is created
418	to read:
419	216.342 Disbursement of funds of the United States Trust
420	Fund.--Funds of the United States Trust Fund may be expended by
421	the Department of Health in accordance with the budget and plans
422	agreed upon by the Social Security Administration and the
423	Department of Health for the operation of the Division of
424	Disability Determinations. The limitations on appropriations
425	provided in s. 216.262(1) do not apply to the United States
426	Trust Fund.
427	Section 5. Subsection (12) of section 381.0011, Florida
428	Statutes, is amended to read:
429	381.0011 Duties and powers of the Department of
430	Health.--It is the duty of the Department of Health to:
431	(12) MaintainCooperate with other departments, local
432	officials, and private organizations in developing and
433	implementing a statewide injury prevention andcontrol program.
434	Section 6. Paragraph (d) of subsection (3) of section
435	381.004, Florida Statutes, is amended to read:
436	381.004 HIV testing.--
437	(3) HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED
438	CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--
439	(d) No test result shall be determined as positive, and no
440	positive test result shall be revealed to any person, without
441	corroborating or confirmatory tests being conducted except in
442	the following situations:
443	1. Preliminary test results may be released to licensed
444	physicians or the medical or nonmedical personnel subject to the
445	significant exposure for purposes of subparagraphs (h)10., 11.,
446	and 12.
447	2. Preliminary test results may be released to health care
448	providers and to the person tested when decisions about medical
449	care or treatment of, or recommendation to, the person tested
450	and, in the case of an intrapartum or postpartum woman, when
451	care, treatment, or recommendations regarding her newborn,
452	cannot await the results of confirmatory testing. Positive
453	preliminary HIV test results shall not be characterized to the
454	patient as a diagnosis of HIV infection. Justification for the
455	use of preliminary test results must be documented in the
456	medical record by the health care provider who ordered the test.
457	This subparagraph does not authorize the release of preliminary
458	test results for the purpose of routine identification of HIV-
459	infected individuals or when HIV testing is incidental to the
460	preliminary diagnosis or care of a patient. Corroborating or
461	confirmatory testing must be conducted as followup to a positive
462	preliminary test.
463	3. Positive rapid test results are considered preliminary
464	and may be released in accordance with the manufacturer's
465	instructions as approved by the United States Food and Drug
466	Administration. Positive rapid test results require confirmatory
467	testing for diagnosis and reporting of HIV infection.
468
469	Results shall be communicated to the patient according to
470	statute regardless of the outcome. Except as provided in this
471	section, test results are confidential and exempt from the
472	provisions of s. 119.07(1).
473	Section 7. Paragraph (k) of subsection (2) and paragraph
474	(j) of subsection (4) of section 381.0065, Florida Statutes, are
475	amended to read:
476	381.0065 Onsite sewage treatment and disposal systems;
477	regulation.--
478	(2) DEFINITIONS.--As used in ss. 381.0065-381.0067, the
479	term:
480	(k) "Permanent nontidal surface water body" means a
481	perennial stream, a perennial river, an intermittent stream, a
482	perennial lake, a submerged marsh or swamp, a submerged wooded
483	marsh or swamp, a spring, or a seep, as identified on the most
484	recent quadrangle map, 7.5 minute series (topographic), produced
485	by the United States Geological Survey, or products derived from
486	that series. "Permanent nontidal surface water body" shall also
487	mean an artificial surface water body that does not have an
488	impermeable bottom and side and that is designed to hold, or
489	does hold, visible standing water for at least 180 days of the
490	year. However, a nontidal surface water body that is drained,
491	either naturally or artificially, where the intent or the result
492	is that such drainage be temporary, shall be considered a
493	permanent nontidal surface water body. A nontidal surface water
494	body that is drained of all visible surface water, where the
495	lawful intent or the result of such drainage is that such
496	drainage will be permanent, shall not be considered a permanent
497	nontidal surface water body. The boundary of a permanent
498	nontidal surface water body shall be the mean annual flood line.
499	(4) PERMITS; INSTALLATION; AND CONDITIONS.--A person may
500	not construct, repair, modify, abandon, or operate an onsite
501	sewage treatment and disposal system without first obtaining a
502	permit approved by the department. The department may issue
503	permits to carry out this section, but shall not make the
504	issuance of such permits contingent upon prior approval by the
505	Department of Environmental Protection. A construction permit is
506	valid for 18 months from the issuance date and may be extended
507	by the department for one 90-day period under rules adopted by
508	the department. A repair permit is valid for 90 days from the
509	date of issuance. An operating permit must be obtained prior to
510	the use of any aerobic treatment unit or if the establishment
511	generates commercial waste. Buildings or establishments that use
512	an aerobic treatment unit or generate commercial waste shall be
513	inspected by the department at least annually to assure
514	compliance with the terms of the operating permit. The operating
515	permit for a commercial wastewater system is valid for 1 year
516	from the date of issuance and must be renewed annually. The
517	operating permit for an aerobic treatment unit is valid for 2
518	years from the date of issuance and must be renewed every 2
519	years. If all information pertaining to the siting, location,
520	and installation conditions or repair of an onsite sewage
521	treatment and disposal system remains the same, a construction
522	or repair permit for the onsite sewage treatment and disposal
523	system may be transferred to another person, if the transferee
524	files, within 60 days after the transfer of ownership, an
525	amended application providing all corrected information and
526	proof of ownership of the property. There is no fee associated
527	with the processing of this supplemental information. A person
528	may not contract to construct, modify, alter, repair, service,
529	abandon, or maintain any portion of an onsite sewage treatment
530	and disposal system without being registered under part III of
531	chapter 489. A property owner who personally performs
532	construction, maintenance, or repairs to a system serving his or
533	her own owner-occupied single-family residence is exempt from
534	registration requirements for performing such construction,
535	maintenance, or repairs on that residence, but is subject to all
536	permitting requirements. A municipality or political subdivision
537	of the state may not issue a building or plumbing permit for any
538	building that requires the use of an onsite sewage treatment and
539	disposal system unless the owner or builder has received a
540	construction permit for such system from the department. A
541	building or structure may not be occupied and a municipality,
542	political subdivision, or any state or federal agency may not
543	authorize occupancy until the department approves the final
544	installation of the onsite sewage treatment and disposal system.
545	A municipality or political subdivision of the state may not
546	approve any change in occupancy or tenancy of a building that
547	uses an onsite sewage treatment and disposal system until the
548	department has reviewed the use of the system with the proposed
549	change, approved the change, and amended the operating permit.
550	(j) An onsite sewage treatment and disposal system for a
551	single-family residence that is designed by a professional
552	engineer registered in the state and certified by such engineer
553	as complying with performance criteria adopted by the department
554	must be approved by the department subject to the following:
555	1. The performance criteria applicable to engineer-
556	designed systems must be limited to those necessary to ensure
557	that such systems do not adversely affect the public health or
558	significantly degrade the groundwater or surface water. Such
559	performance criteria shall include consideration of the quality
560	of system effluent, the proposed total sewage flow per acre,
561	wastewater treatment capabilities of the natural or replaced
562	soil, water quality classification of the potential surface-
563	water-receiving body, and the structural and maintenance
564	viability of the system for the treatment of domestic
565	wastewater. However, performance criteria shall address only
566	the performance of a system and not a system's design.
567	2. The technical review and advisory panel shall assist
568	the department in the development of performance criteria
569	applicable to engineer-designed systems. Workshops on the
570	development of the rules delineating such criteria shall
571	commence not later than September 1, 1996, and the department
572	shall advertise such rules for public hearing no later than
573	October 1, 1997.
574	3. A person electing to utilize an engineer-designed
575	system shall, upon completion of the system design, submit such
576	design, certified by a registered professional engineer, to the
577	county health department. The county health department may
578	utilize an outside consultant to review the engineer-designed
579	system, with the actual cost of such review to be borne by the
580	applicant. Within 5 working days after receiving an engineer-
581	designed system permit application, the county health department
582	shall request additional information if the application is not
583	complete. Within 15 working days after receiving a complete
584	application for an engineer-designed system, the county health
585	department either shall issue the permit or, if it determines
586	that the system does not comply with the performance criteria,
587	shall notify the applicant of that determination and refer the
588	application to the department for a determination as to whether
589	the system should be approved, disapproved, or approved with
590	modification. The department engineer's determination shall
591	prevail over the action of the county health department. The
592	applicant shall be notified in writing of the department's
593	determination and of the applicant's rights to pursue a variance
594	or seek review under the provisions of chapter 120.
595	4. The owner of an engineer-designed performance-based
596	system must maintain a current maintenance service agreement
597	with a maintenance entity permitted by the department. The
598	maintenance entity shall obtain a biennial system operating
599	permit from the department for each system under service
600	contract. The department shall inspect the system at least
601	annually, or on such periodic basis as the fee collected
602	permits, and may collect system-effluent samples if appropriate
603	to determine compliance with the performance criteria. The fee
604	for the biennial operating permit shall be collected beginning
605	with the second year of system operation. The maintenance entity
606	shall inspect each system at least twice each year and shall
607	report quarterly to the department on the number of systems
608	inspected and serviced.
609	5. If an engineer-designed system fails to properly
610	function or fails to meet performance standards, the system
611	shall be re-engineered, if necessary, to bring the system into
612	compliance with the provisions of this section.
613	Section 8. Paragraph (a) of subsection (2) of section
614	381.0072, Florida Statutes, is amended to read:
615	381.0072 Food service protection.--It shall be the duty of
616	the Department of Health to adopt and enforce sanitation rules
617	consistent with law to ensure the protection of the public from
618	food-borne illness. These rules shall provide the standards and
619	requirements for the storage, preparation, serving, or display
620	of food in food service establishments as defined in this
621	section and which are not permitted or licensed under chapter
622	500 or chapter 509.
623	(2) DUTIES.--
624	(a) The department shall adopt rules, including
625	definitions of terms which are consistent with law prescribing
626	minimum sanitation standards and manager certification
627	requirements as prescribed in s. 509.039, and which shall be
628	enforced in food service establishments as defined in this
629	section. The sanitation standards must address the construction,
630	operation, and maintenance of the establishment; lighting,
631	ventilation, laundry rooms, lockers, use and storage of toxic
632	materials and cleaning compounds, and first-aid supplies; plan
633	review; design, construction, installation, location,
634	maintenance, sanitation, and storage of food equipment and
635	utensils; employee training, health, hygiene, and work
636	practices; food supplies, preparation, storage, transportation,
637	and service, including access to the areas where food is stored
638	or prepared; and sanitary facilities and controls, including
639	water supply and sewage disposal; plumbing and toilet
640	facilities; garbage and refuse collection, storage, and
641	disposal; and vermin control. Public and private schools if the
642	food service is operated by school employees, hospitals licensed
643	under chapter 395, nursing homes licensed under part II of
644	chapter 400, child care facilities as defined in s. 402.301, and
645	residential facilities colocated with a nursing home or hospital
646	if all food is prepared in a central kitchen that complies with
647	nursing or hospital regulations, and bars and loungesshall be
648	exempt from the rules developed for manager certification. The
649	department shall administer a comprehensive inspection,
650	monitoring, and sampling program to ensure such standards are
651	maintained. With respect to food service establishments
652	permitted or licensed under chapter 500 or chapter 509, the
653	department shall assist the Division of Hotels and Restaurants
654	of the Department of Business and Professional Regulation and
655	the Department of Agriculture and Consumer Services with
656	rulemaking by providing technical information.
657	Section 9. Section 381.104, Florida Statutes, is created
658	to read:
659	381.104 Employee health and wellness program.--
660	(1) Each state agency may allocate, from existing
661	resources, the necessary funding and facilities for the
662	development and maintenance of an employee health and wellness
663	program and may seek additional funding from other sources to
664	support the program for the benefit of the agency's employees.
665	(2) Each state agency may dedicate resources to develop
666	and coordinate an employee health and wellness program or
667	arrange to cooperate with other agencies in their geographic
668	proximity for program coordination, including providers of state
669	employee benefits.
670	(3) Each state agency may establish an employee health and
671	wellness coordinator and an advisory committee to guide the
672	development of an operational plan, including the collection of
673	data, to plan events and activities, and to oversee program
674	evaluation and the allocation of funds.
675	(4) Each state agency may conduct and dedicate resources
676	toward an employee needs assessment to ascertain the health-and-
677	wellness-related needs of its employees.
678	(5) Each state agency may establish policies that allow
679	employees no longer than 30 minutes of work time three times
680	each week, as individual workloads allow, which may be used for
681	the purpose of engaging in health and wellness activities,
682	including physical activity, stress-reduction programs, tobacco
683	cessation, personal training, nutrition counseling, or weight
684	reduction and control.
685	(6) Each state agency participating in the program must
686	use an employee health and wellness activity agreement form,
687	which must be completed and signed by the employee, signed by
688	the employee's immediate supervisor, and kept in the employee's
689	personnel file prior to participating in any activity. This form
690	shall be developed by the Department of Health. It is the
691	responsibility of the employee to complete the form, including
692	the time of the workday the health and wellness activity will be
693	observed and on which days of the week, obtain the signature of
694	his or her supervisor, and submit the form to the personnel
695	office. The employee must submit a revised employee health and
696	wellness activity agreement form prior to any change in the
697	employee's activities.
698	(7) Each state agency may designate up to 1 hour each
699	month for the purpose of providing health and wellness training
700	for its employees.
701	(8) Each state agency may use e-mail and other
702	communication systems to promote the agency's employee health
703	and wellness activities.
704	(9) Each state agency may, and is encouraged to:
705	(a) Enter into an agreement or contract with other state
706	agencies, including a state-supported college or university, or
707	with a local or federal department, institution, commission,
708	agency, or private enterprise to present, collaborate, or
709	participate jointly in health or wellness education or activity
710	programs.
711	(b) Implement as a part of the employee health and
712	wellness program health education activities that focus on skill
713	development and lifestyle behavior change, along with
714	information dissemination and awareness building, preferably
715	tailored to an employee's interests and needs.
716	(c) Review and offer recommendations on environmental and
717	social support policies that pertain to improving the health of
718	employees.
719	(d) Link the employee health and wellness program to
720	programs such as the employee assistance program and other
721	related programs to help employees balance work and family.
722	(e) Offer free, low-cost, or employee-fee-based employee
723	health and wellness programs.
724	(10) Each agency that develops and implements an employee
725	health and wellness program shall include and document an
726	evaluation and improvement process to help enhance the program's
727	efficiency and effectiveness over time.
728	(11) The Department of Health shall provide model program
729	guidelines for the employee health and wellness program and
730	shall provide ongoing technical assistance to other state
731	agencies to assist in developing the agency's employee health
732	and wellness program.
733	Section 10. Paragraph (e) of subsection (2) of section
734	381.7353, Florida Statutes, is amended to read:
735	381.7353 Reducing Racial and Ethnic Health Disparities:
736	Closing the Gap grant program; administration; department
737	duties.--
738	(2) The department shall:
739	(e) Coordinate with existing community-based programs,
740	such as chronic disease community intervention programs, cancer
741	prevention and control programs, diabetes control programs, oral
742	health care programs,the Healthy Start program, the Florida
743	KidCare Program, the HIV/AIDS program, immunization programs,
744	and other related programs at the state and local levels, to
745	avoid duplication of effort and promote consistency.
746	Section 11. Paragraph (a) of subsection (2) of section
747	381.7355, Florida Statutes, is amended to read:
748	381.7355 Project requirements; review criteria.--
749	(2) A proposal must include each of the following
750	elements:
751	(a) The purpose and objectives of the proposal, including
752	identification of the particular racial or ethnic disparity the
753	project will address. The proposal must address one or more of
754	the following priority areas:
755	1. Decreasing racial and ethnic disparities in maternal
756	and infant mortality rates.
757	2. Decreasing racial and ethnic disparities in morbidity
758	and mortality rates relating to cancer.
759	3. Decreasing racial and ethnic disparities in morbidity
760	and mortality rates relating to HIV/AIDS.
761	4. Decreasing racial and ethnic disparities in morbidity
762	and mortality rates relating to cardiovascular disease.
763	5. Decreasing racial and ethnic disparities in morbidity
764	and mortality rates relating to diabetes.
765	6. Increasing adult and child immunization rates in
766	certain racial and ethnic populations.
767	7. Decreasing racial and ethnic disparities in oral health
768	care.
769	Section 12. Section 381.86, Florida Statutes, is created
770	to read:
771	381.86 Review Council for Human Subjects.--
772	(1) The Review Council for Human Subjects is created
773	within the Department of Health to comply with federal
774	requirements under 45 C.F.R. part 46 and 21 C.F.R. parts 50 and
775	56 for an institutional review board to review all biomedical
776	and behavioral research on human subjects which is funded by the
777	department or supported by the department in any manner,
778	including the permitting of access to department data or
779	department resources.
780	(2) Consistent with federal requirements, the Secretary of
781	Health shall determine and appoint the membership on the council
782	and designate the chair.
783	(3) The council may serve as an institutional review board
784	for other agencies at the discretion of the secretary.
785	(4) Each council member is entitled to reimbursement for
786	per diem and travel expenses as provided in s. 112.061 while
787	carrying out the official business of the council.
788	(5) The department shall charge for costs incurred by the
789	council for research oversight according to a fee schedule,
790	except that fees shall be waived for any student who is a
791	candidate for a degree at a university located in this state.
792	The fee schedule shall provide for fees for initial review,
793	amendments, and continuing review. The department shall adopt
794	rules necessary to comply with federal requirements and this
795	section. Such rules shall also prescribe procedures for
796	requesting council review.
797	(6) Fees collected pursuant to this section shall be
798	deposited into the department's Administrative Trust Fund and
799	used solely for the purpose of administering the program
800	authorized by this section.
801	Section 13. Paragraphs (b) and (c) of subsection (3) of
802	section 381.89, Florida Statutes, are amended to read:
803	381.89 Regulation of tanning facilities.--
804	(3)
805	(b) The department shall establish procedures for the
806	issuance and annual renewal of licenses and shall establish
807	annual license and renewal fees and late payment feesin an
808	amount necessary to cover the expenses of administering this
809	section. Annual license and renewal fees may notshall be not
810	less than $125 nor more than $250 per tanning device and a
811	maximum total fee per individual tanning facility may be set by
812	rule. Effective October 1, 1991, the fee amount shall be the
813	minimum fee proscribed in this paragraph and such fee amount
814	shall remain in effect until the effective date of a fee
815	schedule adopted by the department.
816	(c) The department may adopt a system under which licenses
817	expire on staggered dates and the annual renewal fees are
818	prorated quarterlymonthlyto reflect the actual number of
819	months the license is valid.
820	Section 14. Subsection (3) and paragraph (a) of subsection
821	(7) of section 381.90, Florida Statutes, are amended to read:
822	381.90 Health Information Systems Council; legislative
823	intent; creation, appointment, duties.--
824	(3) The council shall be composed of the following members
825	or their senior executive-level designees:
826	(a) The Secretary of the Department of Health.;
827	(b) The Executive Directorsecretary of the Department of
828	Veterans' Affairs.Business and Professional Regulation;
829	(c) The Secretary of the Department ofChildren and Family
830	Services.;
831	(d) The Secretary of Health Care Administration.;
832	(e) The Secretary of the Department of Corrections.;
833	(f) The Attorney General.;
834	(g) The Executive Director of the Correctional Medical
835	Authority.;
836	(h) Two members representing county health departments,
837	one from a small county and one from a large county, appointed
838	by the Governor.;
839	(i) A representative from the Florida Association of
840	Counties.;
841	(j) The Chief Financial Officer.State Treasurer and
842	Insurance Commissioner;
843	(k) A representative from the Florida Healthy Kids
844	Corporation.;
845	(l) A representative from a school of public health chosen
846	by the Commissioner of Education.Board of Regents;
847	(m) The Commissioner of Education.;
848	(n) The Secretary of the Department of Elderly Affairs.;
849	and
850	(o) The Secretary of the Department ofJuvenile Justice.
851
852	Representatives of the Federal Government may serve without
853	voting rights.
854	(7) The council's duties and responsibilities include, but
855	are not limited to, the following:
856	(a) By JuneMarch1 of each year, to develop and approve a
857	strategic plan pursuant to the requirements set forth in s.
858	186.022(9). Copies of the plan shall be transmitted
859	electronically or in writing to the Executive Office of the
860	Governor, the Speaker of the House of Representatives, and the
861	President of the Senate.
862	Section 15. Subsections (1) and (2), paragraphs (f) and
863	(g) of subsection (3), and subsection (5) of section 383.14,
864	Florida Statutes, are amended to read:
865	383.14 Screening for metabolic disorders, other hereditary
866	and congenital disorders, and environmental risk factors.--
867	(1) SCREENING REQUIREMENTS.--To help ensure access to the
868	maternal and child health care system, the Department of Health
869	shall promote the screening of all newbornsinfantsborn in
870	Florida for phenylketonuria and other metabolic, hereditary, and
871	congenital disorders known to result in significant impairment
872	of health or intellect, as screening programs accepted by
873	current medical practice become available and practical in the
874	judgment of the department. The department shall also promote
875	the identification and screening of all newbornsinfantsborn in
876	this state and their families for environmental risk factors
877	such as low income, poor education, maternal and family stress,
878	emotional instability, substance abuse, and other high-risk
879	conditions associated with increased risk of infant mortality
880	and morbidity to provide early intervention, remediation, and
881	prevention services, including, but not limited to, parent
882	support and training programs, home visitation, and case
883	management. Identification, perinatal screening, and
884	intervention efforts shall begin prior to and immediately
885	following the birth of the child by the attending health care
886	provider. Such efforts shall be conducted in hospitals,
887	perinatal centers, county health departments, school health
888	programs that provide prenatal care, and birthing centers, and
889	reported to the Office of Vital Statistics.
890	(a) Prenatal screening.--The department shall develop a
891	multilevel screening process that includes a risk assessment
892	instrument to identify women at risk for a preterm birth or
893	other high-risk condition. The primary health care provider
894	shall complete the risk assessment instrument and report the
895	results to the Office of Vital Statistics so that the woman may
896	immediately be notified and referred to appropriate health,
897	education, and social services.
898	(b) Postnatal screening.--A risk factor analysis using the
899	department's designated risk assessment instrument shall also be
900	conducted as part of the medical screening process upon the
901	birth of a child and submitted to the department's Office of
902	Vital Statistics for recording and other purposes provided for
903	in this chapter. The department's screening process for risk
904	assessment shall include a scoring mechanism and procedures that
905	establish thresholds for notification, further assessment,
906	referral, and eligibility for services by professionals or
907	paraprofessionals consistent with the level of risk. Procedures
908	for developing and using the screening instrument, notification,
909	referral, and care coordination services, reporting
910	requirements, management information, and maintenance of a
911	computer-driven registry in the Office of Vital Statistics which
912	ensures privacy safeguards must be consistent with the
913	provisions and plans established under chapter 411, Pub. L. No.
914	99-457, and this chapter. Procedures established for reporting
915	information and maintaining a confidential registry must include
916	a mechanism for a centralized information depository at the
917	state and county levels. The department shall coordinate with
918	existing risk assessment systems and information registries.
919	The department must ensure, to the maximum extent possible, that
920	the screening information registry is integrated with the
921	department's automated data systems, including the Florida On-
922	line Recipient Integrated Data Access (FLORIDA) system. Tests
923	and screenings must be performed by the State Public Health
924	Laboratory, in coordination with Children's Medical Services, at
925	such times and in such manner as is prescribed by the department
926	after consultation with the Genetics and NewbornInfant
927	Screening Advisory Council and the State Coordinating Council
928	for School Readiness Programs.
929	(2) RULES.--After consultation with the Genetics and
930	NewbornInfantScreening Advisory Council, the department shall
931	adopt and enforce rules requiring that every newborninfantborn
932	in this state shall, prior to becoming 2 weeks of age, be
933	subjected to a test for phenylketonuria and, at the appropriate
934	age, be tested for such other metabolic diseases and hereditary
935	or congenital disorders as the department may deem necessary
936	from time to time. After consultation with the State
937	Coordinating Council for School Readiness Programs, the
938	department shall also adopt and enforce rules requiring every
939	newborninfantborn in this state to be screened for
940	environmental risk factors that place children and their
941	families at risk for increased morbidity, mortality, and other
942	negative outcomes. The department shall adopt such additional
943	rules as are found necessary for the administration of this
944	section, including rules providing definitions of terms, rules
945	relating to the methods used and time or times for testing as
946	accepted medical practice indicates, rules relating to charging
947	and collecting fees for screenings authorized by this section,
948	and rules requiring mandatory reporting of the results of tests
949	and screenings for these conditions to the department.
950	(3) DEPARTMENT OF HEALTH; POWERS AND DUTIES.--The
951	department shall administer and provide certain services to
952	implement the provisions of this section and shall:
953	(f) Promote the availability of genetic studies and
954	counseling in order that the parents, siblings, and affected
955	newbornsinfantsmay benefit from available knowledge of the
956	condition.
957	(g) Have the authority to charge and collect fees for
958	screenings authorized in this section, as follows:
959	1. A fee of $20 will be charged for each live birth, as
960	recorded by the Office of Vital Statistics, occurring in a
961	hospital licensed under part I of chapter 395 or a birth center
962	licensed under s. 383.305, up to 3,000 live births per licensed
963	hospital per year or over 60 births per birth center per year.
964	The department shall calculate the annual assessment for each
965	hospital and birth center, and this assessment must be paid in
966	equal amounts quarterly. Quarterly, the department shall
967	generate and mail to each hospital and birth center a statement
968	of the amount due.
969	2. As part of the department's legislative budget request
970	prepared pursuant to chapter 216, the department shall submit a
971	certification by the department's inspector general, or the
972	director of auditing within the inspector general's office, of
973	the annual costs of the uniform testing and reporting procedures
974	of the newborninfantscreening program. In certifying the
975	annual costs, the department's inspector general or the director
976	of auditing within the inspector general's office shall
977	calculate the direct costs of the uniform testing and reporting
978	procedures, including applicable administrative costs.
979	Administrative costs shall be limited to those department costs
980	which are reasonably and directly associated with the
981	administration of the uniform testing and reporting procedures
982	of the newborninfantscreening program.
983
984	All provisions of this subsection must be coordinated with the
985	provisions and plans established under this chapter, chapter
986	411, and Pub. L. No. 99-457.
987	(5) ADVISORY COUNCIL.--There is established a Genetics and
988	NewbornInfantScreening Advisory Council made up of 12 members
989	appointed by the Secretary of Health. The council shall be
990	composed of two consumer members, three practicing
991	pediatricians, at least one of whom must be a pediatric
992	hematologist, one representative from each of the four medical
993	schools in the state, the Secretary of Health or his or her
994	designee, one representative from the Department of Health
995	representing Children's Medical Services, and one representative
996	from the Developmental Disabilities Program Office of the
997	Department of Children and Family Services. All appointments
998	shall be for a term of 4 years. The chairperson of the council
999	shall be elected from the membership of the council and shall
1000	serve for a period of 2 years. The council shall meet at least
1001	semiannually or upon the call of the chairperson. The council
1002	may establish ad hoc or temporary technical advisory groups to
1003	assist the council with specific topics which come before the
1004	council. Council members shall serve without pay. Pursuant to
1005	the provisions of s. 112.061, the council members are entitled
1006	to be reimbursed for per diem and travel expenses. It is the
1007	purpose of the council to advise the department about:
1008	(a) Conditions for which testing should be included under
1009	the screening program and the genetics program.;
1010	(b) Procedures for collection and transmission of
1011	specimens and recording of results.; and
1012	(c) Methods whereby screening programs and genetics
1013	services for children now provided or proposed to be offered in
1014	the state may be more effectively evaluated, coordinated, and
1015	consolidated.
1016	Section 16. Section 384.25, Florida Statutes, is amended
1017	to read:
1018	384.25 Reporting required.--
1019	(1) Each person who makes a diagnosis of or treats a
1020	person with a sexually transmissible disease and each laboratory
1021	that performs a test for a sexually transmissible disease which
1022	concludes with a positive result shall report such facts as may
1023	be required by the department by rule, within a time period as
1024	specified by rule of the department, but in no case to exceed 2
1025	weeks.
1026	(a)(2)The department shall adopt rules specifying the
1027	information required in and a minimum time period for reporting
1028	a sexually transmissible disease. In adopting such rules, the
1029	department shall consider the need for information, protections
1030	for the privacy and confidentiality of the patient, and the
1031	practical ability of persons and laboratories to report in a
1032	reasonable fashion. To ensure the confidentiality of persons
1033	infected with the human immunodeficiency virus (HIV), reporting
1034	of HIV infection and acquired immune deficiency syndrome (AIDS)
1035	must be conducted using a systemthe HIV/AIDS Reporting System
1036	(HARS)developed by the Centers for Disease Control and
1037	Prevention of the United States Public Health Service or an
1038	equivalent system.
1039	(b)(3) The department shall require reporting of physician
1040	diagnosed cases of AIDS and HIV infection consistent withbased
1041	upon diagnostic criteria for surveillance-case definition for
1042	HIV/AIDS reportingfrom the Centers for Disease Control and
1043	Prevention.
1044	(c)(4) The department shallmayrequire physician and
1045	laboratory reporting of HIV infection. However, only reports of
1046	HIV infection identified on or after the effective date of the
1047	rule developed by the department pursuant to this subsection
1048	shall be accepted. TheReporting may not affect or relate to
1049	anonymous HIV testing programs conducted pursuant to s.
1050	381.004(4) or to university-based medical research protocols as
1051	determined by the department.
1052	(2)(5) After notification of the test subject under
1053	subsection (4), the department may, with the consent of the test
1054	subject, notify school superintendents of students and school
1055	personnel whose HIV tests are positive.
1056	(3) The department shall adopt rules requiring each
1057	physician and laboratory to report any newborn or infant up to
1058	18 months of age who has been exposed to HIV. The rules may
1059	include the method and time period for reporting, information to
1060	be included in the report, requirements for enforcement, and
1061	followup activities by the department.
1062	(4)(6)The department shall by February 1 of each year
1063	submit to the Legislature an annual report relating to all
1064	information obtained pursuant to this section.
1065	(5)(7)Each person who violates the provisions of this
1066	section or the rules adopted hereunder may be fined by the
1067	department up to $500 for each offense. The department shall
1068	report each violation of this section to the regulatory agency
1069	responsible for licensing each health care professional and each
1070	laboratory to which these provisions apply.
1071	Section 17. Subsection (1) of section 385.204, Florida
1072	Statutes, is amended to read:
1073	385.204 Insulin; purchase, distribution; penalty for
1074	fraudulent application for and obtaining of insulin.--
1075	(1) The Department of Health, to the extent funds are
1076	available,shall purchase and distribute insulin through its
1077	agents or other appropriate agent of the state or Federal
1078	Government in any county or municipality in the state to any
1079	bona fide resident of this state suffering from diabetes or a
1080	kindred diseaserequiring insulin in its treatment who makes
1081	application for insulin and furnishes proof of his or her
1082	financial inability to purchase in accordance with the rules
1083	adoptedpromulgatedby the department concerning the
1084	distribution of insulin.
1085	Section 18. Subsection (2) of section 391.021, Florida
1086	Statutes, is amended to read:
1087	391.021 Definitions.--When used in this act, unless the
1088	context clearly indicates otherwise:
1089	(2) "Children with special health care needs" means those
1090	children under the age of 21 years who have, or are at increased
1091	risk for, chronic physical, developmental, behavioral, or
1092	emotional conditions and who also require health care and
1093	related services of a type or amount beyond that which is
1094	generally required by childrenwhose serious or chronic physical
1095	or developmental conditions require extensive preventive and
1096	maintenance care beyond that required by typically healthy
1097	children. Health care utilization by these children exceeds the
1098	statistically expected usage of the normal child adjusted for
1099	chronological age. These children often need complex care
1100	requiring multiple providers, rehabilitation services, and
1101	specialized equipment in a number of different settings.
1102	Section 19. Section 391.025, Florida Statutes, is amended
1103	to read:
1104	391.025 Applicability and scope.--
1105	(1) This act applies to health services provided to
1106	eligible individuals who are:
1107	(a) Enrolled in the Medicaid program;
1108	(b) Enrolled in the Florida Kidcare program; and
1109	(c) Uninsured or underinsured, provided that they meet the
1110	financial eligibility requirements established in this act, and
1111	to the extent that resources are appropriated for their care.
1112	(1)(2)The Children's Medical Services program consists of
1113	the following components:
1114	(a) The newborninfant metabolicscreening program
1115	established in s. 383.14.
1116	(b) The regional perinatal intensive care centers program
1117	established in ss. 383.15-383.21.
1118	(c) A federal or state program authorized by the
1119	Legislature.
1120	(d) The developmental evaluation and intervention program,
1121	including the Florida Infants and Toddlers Early Intervention
1122	Program.
1123	(e) The Children's Medical Services network.
1124	(2)(3)The Children's Medical Services program shall not
1125	be deemed an insurer and is not subject to the licensing
1126	requirements of the Florida Insurance Code or the rules of the
1127	Department of Insurance, when providing services to children who
1128	receive Medicaid benefits, other Medicaid-eligible children with
1129	special health care needs, and children participating in the
1130	Florida Kidcare program.
1131	Section 20. Section 391.029, Florida Statutes, is amended
1132	to read:
1133	391.029 Program eligibility.--
1134	(1) The department shall establish the medical criteria to
1135	determine if an applicant for the Children's Medical Services
1136	program is an eligible individual.
1137	(2) The following individuals are financially eligible to
1138	receive services throughforthe program:
1139	(a) A high-risk pregnant female who is eligible for
1140	Medicaid.
1141	(b) ChildrenA childwith special health care needs from
1142	birth to age 21 years of age who areiseligible for Medicaid.
1143	(c) ChildrenA childwith special health care needs from
1144	birth to age 19 years of age who areiseligible for a program
1145	under Title XXI of the Social Security Act.
1146	(3) Subject to the availability of funds, the following
1147	individuals may receive services through the program:
1148	(a)(d)ChildrenA childwith special health care needs
1149	from birth to age 21 years of age whose family income is above
1150	financial eligibility requirements under Title XXI of the Social
1151	Security Act and whoseprojected annual cost of care adjusts the
1152	family income to Medicaid financial criteria. In cases where
1153	the family income is adjusted based on a projected annual cost
1154	of care, the family shall participate financially in the cost of
1155	care based on criteria established by the department.
1156	(b)(e)ChildrenA child with special health care needs
1157	from birth to 21 years of age, as provideddefinedin Title V of
1158	the Social Security Act relating to children with special health
1159	care needs.
1160
1161	The department may continue to serve certain children with
1162	special health care needs who are 21 years of age or older and
1163	who were receiving services from the program prior to April 1,
1164	1998. Such children may be served by the department until July
1165	1, 2000.
1166	(4)(3)The department shall determine the financial and
1167	medical eligibility of children for the program. The department
1168	shall also determine the financial ability of the parents, or
1169	persons or other agencies having legal custody over such
1170	individuals, to pay the costs of health services under the
1171	program. The department may pay reasonable travel expenses
1172	related to the determination of eligibility for or the provision
1173	of health services.
1174	(5)(4)Any child who has been provided with surgical or
1175	medical care or treatment under this act prior to being adopted
1176	shall continue to be eligible to be provided with such care or
1177	treatment after his or her adoption, regardless of the financial
1178	ability of the persons adopting the child.
1179	Section 21. Subsection (4) is added to section 391.055,
1180	Florida Statutes, to read:
1181	391.055 Service delivery systems.--
1182	(4) If a newborn has a presumptively abnormal screening
1183	result for metabolic or other hereditary and congenital
1184	disorders which is identified through the newborn screening
1185	program pursuant to s. 383.14, the newborn shall be referred to
1186	the Children's Medical Services network for confirmatory
1187	testing, medical management, or medical referral.
1188	Section 22. Section 391.309, Florida Statutes, is created
1189	to read:
1190	391.309 Florida Infants and Toddlers Early Intervention
1191	Program.--The Department of Health may implement and administer
1192	Part C of the federal Individuals with Disabilities Education
1193	Act (IDEA), which shall be known as the Florida Infants and
1194	Toddlers Early Intervention Program.
1195	(1) The department, jointly with the Department of
1196	Education, shall annually prepare a grant application to the
1197	United States Department of Education for funding early
1198	intervention services for infants and toddlers with
1199	disabilities, ages birth through 36 months, and their families
1200	pursuant to Part C of the federal Individuals with Disabilities
1201	Education Act.
1202	(2) The department shall ensure that no early intervention
1203	provider participating in the program provides both core and
1204	required services without a waiver from the Deputy Secretary for
1205	Children's Medical Services, or his or her designee, as
1206	expressed in the contract between the department and the
1207	provider. For purposes of this section, core services are
1208	limited to child find and referral services, family support
1209	planning, service coordination, and multidisciplinary
1210	evaluation.
1211	Section 23. Subsection (5) of section 393.064, Florida
1212	Statutes, is amended to read:
1213	393.064 Prevention.--
1214	(5) The Department of HealthChildren and Family Services
1215	shall have the authority, within available resources, to
1216	contract for the supervision and management of the Raymond C.
1217	Philips Research and Education Unit, and such contract shall
1218	include specific program objectives.
1219	Section 24. Subsection (10) of section 394.4615, Florida
1220	Statutes, is amended to read:
1221	394.4615 Clinical records; confidentiality.--
1222	(10) Patients shall have reasonable access to their
1223	clinical records, unless such access is determined by the
1224	patient's physician to be a danger to the patient's life or
1225	safetyharmful to the patient. If the patient's right to inspect
1226	his or her clinical record is restricted by the facility,
1227	written notice of such restriction shall be given to the patient
1228	and the patient's guardian, guardian advocate, attorney, and
1229	representative. In addition, the restriction shall be recorded
1230	in the clinical record, together with the reasons for it. The
1231	restriction of a patient's right to inspect his or her clinical
1232	record shall expire after 7 days but may be renewed, after
1233	review, for subsequent 7-day periods.
1234	Section 25. Section 394.9151, Florida Statutes, is amended
1235	to read:
1236	394.9151 Contract authority.--The Department of Children
1237	and Family Services may contract with a private entity or state
1238	agency for use of and operation of facilities to comply with the
1239	requirements of this act. The department of Children and Family
1240	Servicesmay also contract with the Correctional Privatization
1241	Commission as defined in chapter 957 to issue a request for
1242	proposals and monitor contract compliance for these services.
1243	The department may enter an agreement or may contract with the
1244	Correctional Medical Authority as defined in chapter 945 to
1245	conduct surveys of medical services and to provide medical
1246	quality assurance and improvement assistance at secure
1247	confinement and treatment facilities for persons confined under
1248	this part.
1249	Section 26. Paragraphs (a) and (e) of subsection (4) and
1250	paragraph (b) of subsection (7) of section 395.3025, Florida
1251	Statutes, are amended, and a new paragraph (l) is added to
1252	subsection (4) of said section, to read:
1253	395.3025 Patient and personnel records; copies;
1254	examination.--
1255	(4) Patient records are confidential and must not be
1256	disclosed without the consent of the person to whom they
1257	pertain, but appropriate disclosure may be made without such
1258	consent to:
1259	(a) Licensed Facility personnel and all other licensed
1260	health care practitionersattending physiciansfor use in
1261	connection with the treatment of the patient.
1262	(e) The Department of Healthagencyupon subpoena issued
1263	pursuant to s. 456.071, but the records obtained thereby must be
1264	used solely for the purpose of the departmentagencyand the
1265	appropriate professional board in its investigation,
1266	prosecution, and appeal of disciplinary proceedings. The
1267	administrator or records custodian in a facility licensed under
1268	this chapter shall certify that a true and complete copy of the
1269	records requested pursuant to a subpoena or patient release have
1270	been provided to the department or otherwise identify those
1271	documents that have not been provided. If the departmentagency
1272	requests copies of the records, the facility shall charge no
1273	more than its actual copying costs, including reasonable staff
1274	time. The records must be sealed and must not be available to
1275	the public pursuant to s. 119.07(1) or any other statute
1276	providing access to records, nor may they be available to the
1277	public as part of the record of investigation for and
1278	prosecution in disciplinary proceedings made available to the
1279	public by the departmentagencyor the appropriate regulatory
1280	board. However, the departmentagencymust make available, upon
1281	written request by a practitioner against whom probable cause
1282	has been found, any such records that form the basis of the
1283	determination of probable cause.
1284	(l) Researchers or facility personnel for research
1285	purposes, provided that the researchers or facility personnel
1286	demonstrate compliance with the requirements of 45 C.F.R. s.
1287	164.512(i).
1288	(7)
1289	(b) Absent a specific written release or authorization
1290	permitting utilization of patient information for solicitation
1291	or marketing the sale of goods or services, any use of suchthat
1292	information for that purposethose purposes is prohibited. For
1293	purposes of this paragraph, the term "marketing" is defined as
1294	set forth in 45 C.F.R. s. 164.501.
1295	Section 27. Subsection (2) of section 395.404, Florida
1296	Statutes, is amended to read:
1297	395.404 Review of trauma registry data; confidentiality
1298	and limited release.--
1299	(2) Notwithstanding the provisions of s. 381.74, each
1300	trauma center and acute care hospital shall submit severe
1301	disability and head-injury registry data to the department as
1302	provided by rule. Each trauma center and acute care hospital
1303	shall continue to provide initial notification of any person who
1304	has a moderate-to-severe brain or spinal cord injurypersons who
1305	have severe disabilities and head injuries to the brain and
1306	spinal cord injury central registry ofthe Department of Health
1307	within timeframes provided in s. 381.74chapter 413. Such
1308	initial notification shall be made in the manner prescribed by
1309	the Department of Health for the purpose of providing timely
1310	vocational rehabilitation and transitional services to an
1311	individual who sustains traumatic moderate-to-severe brain or
1312	spinal cord injury to enable such individual to return to his or
1313	her communityservices to the severely disabled or head-injured
1314	person.
1315	Section 28. Paragraph (b) of subsection (2) of section
1316	395.7015, Florida Statutes, is amended to read:
1317	395.7015 Annual assessment on health care entities.--
1318	(2) There is imposed an annual assessment against certain
1319	health care entities as described in this section:
1320	(b) For the purpose of this section, "health care
1321	entities" include the following:
1322	1. Ambulatory surgical centers and mobile surgical
1323	facilities licensed under s. 395.003. This subsection shall only
1324	apply to mobile surgical facilities operating under contracts
1325	entered into on or after July 1, 1998.
1326	2. Clinical laboratories licensed under s. 483.091,
1327	excluding any hospital laboratory defined under s. 483.041(6),
1328	any clinical laboratory operated by the state or a political
1329	subdivision of the state, any clinical laboratory which
1330	qualifies as an exempt organization under s. 501(c)(3) of the
1331	Internal Revenue Code of 1986, as amended, and which receives 70
1332	percent or more of its gross revenues from services to charity
1333	patients or Medicaid patients, and any blood, plasma, or tissue
1334	bank procuring, storing, or distributing blood, plasma, or
1335	tissue either for future manufacture or research or distributed
1336	on a nonprofit basis, and further excluding any clinical
1337	laboratory which is wholly owned and operated by 6 or fewer
1338	physicians who are licensed pursuant to chapter 458 or chapter
1339	459 and who practice in the same group practice, and at which no
1340	clinical laboratory work is performed for patients referred by
1341	any health care provider who is not a member of the same group.
1342	3. Diagnostic-imaging centers that are freestanding
1343	outpatient facilities that provide specialized services for the
1344	identification or determination of a disease through examination
1345	and also provide sophisticated radiological services, and in
1346	which services are rendered by a physician licensed by the Board
1347	of Medicine under s. 458.311, s. 458.313, or s. 458.315458.317,
1348	or by an osteopathic physician licensed by the Board of
1349	Osteopathic Medicine under s. 459.006, s. 459.007, or s.
1350	459.0075. For purposes of this paragraph, "sophisticated
1351	radiological services" means the following: magnetic resonance
1352	imaging; nuclear medicine; angiography; arteriography; computed
1353	tomography; positron emission tomography; digital vascular
1354	imaging; bronchography; lymphangiography; splenography;
1355	ultrasound, excluding ultrasound providers that are part of a
1356	private physician's office practice or when ultrasound is
1357	provided by two or more physicians licensed under chapter 458 or
1358	chapter 459 who are members of the same professional association
1359	and who practice in the same medical specialties; and such other
1360	sophisticated radiological services, excluding mammography, as
1361	adopted in rule by the board.
1362	Section 29. Subsection (10) of section 400.141, Florida
1363	Statutes, is amended to read:
1364	400.141 Administration and management of nursing home
1365	facilities.--Every licensed facility shall comply with all
1366	applicable standards and rules of the agency and shall:
1367	(10) Keep full records of resident admissions and
1368	discharges; medical and general health status, including medical
1369	records, personal and social history, and identity and address
1370	of next of kin or other persons who may have responsibility for
1371	the affairs of the residents; and individual resident care plans
1372	including, but not limited to, prescribed services, service
1373	frequency and duration, and service goals. The records shall be
1374	open to inspection by the agency. A certified complete copy of
1375	the records shall be provided to the Department of Health upon
1376	subpoena issued pursuant to ss. 456.057 and 456.071. The
1377	provisions of chapter 456 shall apply to the records obtained
1378	pursuant to this section.
1379	Section 30. Subsection (3) is added to section 400.145,
1380	Florida Statutes, to read:
1381	400.145 Records of care and treatment of resident; copies
1382	to be furnished.--
1383	(3) The administrator or records custodian in a facility
1384	licensed under this chapter shall certify that a true and
1385	complete copy of the records requested pursuant to a subpoena or
1386	patient release have been provided to the department or
1387	otherwise identify those documents that have not been provided.
1388	Section 31. Paragraph (a) of subsection (4) of section
1389	400.211, Florida Statutes, is amended to read:
1390	400.211 Persons employed as nursing assistants;
1391	certification requirement.--
1392	(4) When employed by a nursing home facility for a 12-
1393	month period or longer, a nursing assistant, to maintain
1394	certification, shall submit to a performance review every 12
1395	months and must receive regular inservice education based on the
1396	outcome of such reviews. The inservice training must:
1397	(a) Be sufficient to ensure the continuing competence of
1398	nursing assistants, must be at least 1218hours per year, and
1399	may include hours accrued under s. 464.203(7)(8);
1400
1401	Costs associated with this training may not be reimbursed from
1402	additional Medicaid funding through interim rate adjustments.
1403	Section 32. Section 400.455, Florida Statutes, is created
1404	to read:
1405	400.455 Certified copy of subpoenaed records.--Upon a
1406	subpoena issued by the Department of Health pursuant to s.
1407	456.057 or s. 456.071, a certified complete copy of the
1408	requested records shall be provided. The provisions of chapter
1409	456 shall apply to the records obtained pursuant to this
1410	section.
1411	Section 33. Subsection (2) of section 401.113, Florida
1412	Statutes, is amended to read:
1413	401.113 Department; powers and duties.--
1414	(2)(a)The department shall annually dispense funds
1415	contained in the Emergency Medical Services Trust Fund as
1416	follows:
1417	1.(a)Forty-five percent of such moneys must be divided
1418	among the counties according to the proportion of the combined
1419	amount deposited in the trust fund from the county. These funds
1420	may not be used to match grant funds as identified in
1421	subparagraph 2.paragraph(b).An individual board of county
1422	commissioners may distribute these funds to emergency medical
1423	service organizations within the county, as it deems
1424	appropriate.
1425	2.(b)Forty percent of such moneys must be used by the
1426	department for making matching grants to local agencies,
1427	municipalities, and emergency medical services organizations for
1428	the purpose of conducting research, increasing existing levels
1429	of emergency medical services, evaluation, community education,
1430	injury prevention programs, and training in cardiopulmonary
1431	resuscitation and other lifesaving and first aid techniques.
1432	a.1.At least 90 percent of these moneys must be made
1433	available on a cash matching basis. A grant made under this
1434	sub-subparagraphsubparagraphmust be contingent upon the
1435	recipient providing a cash sum equal to 25 percent of the total
1436	department-approved grant amount.
1437	b.2.No more than 10 percent of these moneys must be made
1438	available to rural emergency medical services, and
1439	notwithstanding the restrictions specified in subsection (1),
1440	these moneys may be used for improvement, expansion, or
1441	continuation of services provided. A grant made under this sub-
1442	subparagraphsubparagraphmust be contingent upon the recipient
1443	providing a cash sum equal to no more than 10 percent of the
1444	total department-approved grant amount.
1445
1446	The department shall develop procedures and standards for grant
1447	disbursement under this subparagraphparagraphbased on the need
1448	for emergency medical services, the requirements of the
1449	population to be served, and the objectives of the state
1450	emergency medical services plan.
1451	3.(c)Fifteen percent of such moneys must be used by the
1452	department for capital equipment outlay, personnel, community
1453	education, evaluation, and other costs associated with the
1454	administration of this chapter. Any moneys not annually used for
1455	this purpose must be used for making additional rural grant
1456	funds available.
1457	(b) Notwithstanding any other provision of law to the
1458	contrary, any interest generated from grant funds may be
1459	expended by the grantee on the budget items approved by the
1460	department. Grantees receiving funds that require a match may
1461	not expend interest funds until all match requirements have been
1462	satisfied. Such grantees shall return to the department any
1463	interest and grant funds not expended at the conclusion of the
1464	grant period. All such returned funds shall be used by the
1465	department for additional matching grant awards.
1466	Section 34. Section 401.211, Florida Statutes, is amended
1467	to read:
1468	401.211 Legislative intent.--The Legislature recognizes
1469	that the systematic provision of emergency medical services
1470	saves lives and reduces disability associated with illness and
1471	injury. In addition, that system of care must be equally capable
1472	of assessing, treating, and transporting children, adults, and
1473	frail elderly persons. Further, it is the intent of the
1474	Legislature to encourage the development and maintenance of
1475	emergency medical services because such services are essential
1476	to the health and well-being of all citizens of the state. The
1477	Legislature also recognizes that the establishment of a
1478	comprehensive statewide injury prevention and control program
1479	supports state and community health systems by further enhancing
1480	the total delivery system of emergency medical services and
1481	reduces injuries for all persons.The purpose of this part is to
1482	protect and enhance the public health, welfare, and safety
1483	through the establishment of an emergency medical services state
1484	plan, an advisory council, a comprehensive statewide injury
1485	prevention and control program,minimum standards for emergency
1486	medical services personnel, vehicles, services and medical
1487	direction, and the establishment of a statewide inspection
1488	program created to monitor the quality of patient care delivered
1489	by each licensed service and appropriately certified personnel.
1490	Section 35. Section 401.243, Florida Statutes, is created
1491	to read:
1492	401.243 Injury prevention and control.--The injury
1493	prevention and control program is responsible for the statewide
1494	coordination and expansion of injury prevention and control
1495	activities. The duties of the department may include, but are
1496	not limited to, data collection, surveillance, education, and
1497	the promotion of interventions. The department may:
1498	(1) Assist county health departments and community and
1499	other state agencies by serving as a focal point for injury
1500	prevention expertise and guidance.
1501	(2) Seek, receive, and expend any funds received through
1502	appropriations, grants, donations, or contributions from public
1503	or private sources for program purposes.
1504	(3) Adopt rules related to the activities of the program,
1505	including, but not limited to, those needed for implementation
1506	of injury prevention and control activities, data collection,
1507	surveillance, education, promotion of interventions, and
1508	assistance to other entities.
1509	(4) Develop, and revise as necessary, a comprehensive
1510	state plan for injury prevention and control.
1511	Section 36. Subsections (3), (4), (5), and (13) of section
1512	401.27, Florida Statutes, are amended, and subsection (14) is
1513	added to said section, to read:
1514	401.27 Personnel; standards and certification.--
1515	(3) Any person who desires to be certified or recertified
1516	as an emergency medical technician or paramedic must apply to
1517	the department under oath on forms provided by the department
1518	which shall contain such information as the department
1519	reasonably requires, which may include affirmative evidence of
1520	ability to comply with applicable laws and rules. The department
1521	may accept electronically submitted applications. If an
1522	application is submitted electronically, the department may
1523	require supplemental materials, including an original signature
1524	of the applicant and documentation verifying eligibility for
1525	certification to be submitted in a nonelectronic format.The
1526	department shall determine whether the applicant meets the
1527	requirements specified in this section and in rules of the
1528	department and shall issue a certificate to any person who meets
1529	such requirements.
1530	(4) An applicant for certification or recertification as
1531	an emergency medical technician or paramedic must:
1532	(a) Have completed an appropriate training course as
1533	follows:
1534	1. For an emergency medical technician, an emergency
1535	medical technician training course equivalent to the most recent
1536	emergency medical technician basic training course of the United
1537	States Department of Transportation as approved by the
1538	department.;
1539	2. For a paramedic, a paramedic training program
1540	equivalent to the most recent paramedic course of the United
1541	States Department of Transportation as approved by the
1542	department.;
1543	(b) Certify under oaththat he or she is not addicted to
1544	alcohol or any controlled substance.;
1545	(c) Certify under oaththat he or she is free from any
1546	physical or mental defect or disease that might impair the
1547	applicant's ability to perform his or her duties.;
1548	(d) Within 1 year after course completion have passed an
1549	examination developed or required by the department.;
1550	(e)1. For an emergency medical technician, hold either a
1551	current American Heart Association cardiopulmonary resuscitation
1552	course card or an American Red Cross cardiopulmonary
1553	resuscitation course card or its equivalent as defined by
1554	department rule.;
1555	2. For a paramedic, hold a certificate of successful
1556	course completion in advanced cardiac life support from the
1557	American Heart Association or its equivalent as defined by
1558	department rule.;
1559	(f) Submit the certification fee and the nonrefundable
1560	examination fee prescribed in s. 401.34, which examination fee
1561	will be required for each examination administered to an
1562	applicant.; and
1563	(g) Submit a completed application to the department,
1564	which application documents compliance with paragraphs (a), (b),
1565	(c), (e), (f), (g), and, if applicable, (d). The application
1566	must be submitted so as to be received by the department at
1567	least 30 calendar days before the next regularly scheduled
1568	examination for which the applicant desires to be scheduled.
1569	(5) The certification examination must be offered monthly.
1570	The department shall issue an examination admission notice to
1571	the applicant advising him or her of the time and place of the
1572	examination for which he or she is scheduled. Individuals
1573	achieving a passing score on the certification examination may
1574	be issued a temporary certificate with their examination grade
1575	report. The department must issue an original certification
1576	within 45 days after the examination.Examination questions and
1577	answers are not subject to discovery but may be introduced into
1578	evidence and considered only in camera in any administrative
1579	proceeding under chapter 120. If an administrative hearing is
1580	held, the department shall provide challenged examination
1581	questions and answers to the administrative law judge. The
1582	department shall establish by rule the procedure by which an
1583	applicant, and the applicant's attorney, may review examination
1584	questions and answers in accordance with s. 119.07(3)(a).
1585	(13) The department shall adopt a standard state insignia
1586	for emergency medical technicians and paramedics. The department
1587	shall establish by rule the requirements to display the state
1588	emergency medical technician and paramedic insignia. The rules
1589	may not require a person to wear the standard insignia but must
1590	require thatIf a person wears any insignia that identifies the
1591	person as a certified emergency medical technician or paramedic
1592	in this state, the insignia must be the standard state insignia
1593	adopted under this section. The insignia mustdenote the
1594	individual's level of certification at which he or she is
1595	functioning.
1596	(14)(a) An applicant for initial certification under this
1597	section must submit information and a set of fingerprints to the
1598	department on a form and under procedures specified by the
1599	department, along with payment in an amount equal to the costs
1600	incurred by the department for a statewide and a national
1601	criminal history check of the applicant.
1602	(b) An applicant for renewal of certification who has not
1603	previously submitted a set of fingerprints to the department
1604	must submit information required to perform a statewide and a
1605	national criminal history check and a set of fingerprints to the
1606	department as a condition of the initial renewal of his or her
1607	certificate after the effective date of this section. The
1608	applicant must submit the fingerprints on a form and under
1609	procedures specified by the department, along with payment in an
1610	amount equal to the costs incurred by the department. For
1611	subsequent renewals, the department shall, by rule, adopt an
1612	application form that includes a sworn oath or affirmation
1613	attesting to the existence of any criminal convictions,
1614	regardless of plea or adjudication, which have occurred since
1615	the previous certification. If there has been a criminal
1616	conviction, the provisions of this subsection shall apply. The
1617	department shall notify current certificateholders of their
1618	requirement to undergo a criminal history check sufficiently in
1619	advance of the 2004 biennial expiration for the
1620	certificateholder to provide the required information prior to
1621	submission of the renewal certification application. Eligibility
1622	for renewal may not be denied by the department for the first
1623	renewal application subsequent to enactment of this subsection
1624	for delays created in obtaining the criminal history from the
1625	Department of Law Enforcement, the Federal Bureau of
1626	Investigation, or the Division of State Fire Marshal if the
1627	applicant has submitted the required criminal history screening
1628	information or affidavit and fees with the renewal certification
1629	application.
1630	(c) Pursuant to the requirements of s. 120.60,
1631	applications for certification must be processed within 90 days
1632	after receipt of a completed application. Applications for
1633	certification shall not be complete until the criminal history
1634	information and certified copies of all court documents for
1635	those applications with prior criminal convictions, pursuant to
1636	this section, have been received by the department.
1637	(d) The department shall submit the fingerprints and
1638	information required for a statewide criminal history check to
1639	the Department of Law Enforcement for such check, and the
1640	Department of Law Enforcement shall forward the fingerprints and
1641	information to the Federal Bureau of Investigation for a
1642	national criminal history check of the applicant.
1643	(e) If an applicant has undergone a criminal history check
1644	as a condition of employment or certification as a firefighter
1645	under s. 633.34, the Division of State Fire Marshal of the
1646	Department of Financial Services shall provide the criminal
1647	history information regarding the applicant seeking
1648	certification or renewal of certification under this section to
1649	the department. Any applicant for initial certification or
1650	renewal of certification who has already submitted a set of
1651	fingerprints and information to the Division of State Fire
1652	Marshal of the Department of Financial Services for the criminal
1653	history check required for employment and certification of
1654	firefighters under s. 633.34 within 2 years prior to application
1655	under this section is not required to provide to the department
1656	a subsequent set of fingerprints or other duplicate information
1657	required for a criminal history check if the applicant submits
1658	an affidavit in a form prescribed by the department attesting
1659	that he or she has been a state resident for the previous 2
1660	years.
1661	(f) Notwithstanding the grounds for certification denial
1662	outlined in s. 401.411, an applicant must not have:
1663	1. Been found guilty of, regardless of plea or
1664	adjudication, any offense prohibited under any of the following
1665	provisions of the Florida Statutes or under any similar statute
1666	of another jurisdiction:
1667	a. Section 415.111, relating to abuse, neglect, or
1668	exploitation of a vulnerable adult.
1669	b. Section 782.04, relating to murder.
1670	c. Section 782.07, relating to manslaughter, aggravated
1671	manslaughter of an elderly person or disabled adult, aggravated
1672	manslaughter of a child, or aggravated manslaughter of an
1673	officer, a firefighter, an emergency medical technician, or a
1674	paramedic.
1675	d. Section 782.071, relating to vehicular homicide.
1676	e. Section 782.09, relating to killing of an unborn child
1677	by injury to the mother.
1678	f. Section 784.011, relating to assault, if the victim of
1679	the offense was a minor.
1680	g. Section 784.021, relating to aggravated assault.
1681	h. Section 784.03, relating to battery, if the victim of
1682	the offense was a minor.
1683	i. Section 784.045, relating to aggravated battery.
1684	j. Section 787.01, relating to kidnapping.
1685	k. Section 787.02, relating to false imprisonment.
1686	l. Section 794.011, relating to sexual battery.
1687	m. Former s. 794.041, relating to prohibited acts of
1688	persons in familial or custodial authority.
1689	n. Chapter 796, relating to prostitution.
1690	o. Section 798.02, relating to lewd and lascivious
1691	behavior.
1692	p. Chapter 800, relating to lewdness and indecent
1693	exposure.
1694	q. Section 806.01, relating to arson.
1695	r. Chapter 812, relating to theft, robbery, and related
1696	crimes, if the offense was a felony.
1697	s. Section 817.563, relating to fraudulent sale of
1698	controlled substances, only if the offense was a felony.
1699	t. Section 825.102, relating to abuse, aggravated abuse,
1700	or neglect of an elderly person or disabled adult.
1701	u. Section 825.1025, relating to lewd or lascivious
1702	offenses committed upon or in the presence of an elderly person
1703	or disabled person.
1704	v. Section 825.103, relating to exploitation of an elderly
1705	person or disabled adult, if the offense was a felony.
1706	w. Section 826.04, relating to incest.
1707	x. Section 827.03, relating to child abuse, aggravated
1708	child abuse, or neglect of a child.
1709	y. Section 827.04, relating to contributing to the
1710	delinquency or dependency of a child.
1711	z. Former s. 827.05, relating to negligent treatment of
1712	children.
1713	aa. Section 827.071, relating to sexual performance by a
1714	child.
1715	bb. Chapter 847, relating to obscenity.
1716	cc. Chapter 893, relating to drug abuse prevention and
1717	control, only if the offense was a felony or if any other person
1718	involved in the offense was a minor.
1719	2. Committed an act that constitutes domestic violence as
1720	defined in s. 741.28.
1721	(g) The department may grant to any applicant who would
1722	otherwise be denied certification or recertification under this
1723	subsection an exemption from that denial for:
1724	1. Felonies committed more than 3 years prior to the date
1725	of disqualification;
1726	2. Misdemeanors prohibited under any of the Florida
1727	Statutes cited in this subsection or under similar statutes of
1728	other jurisdictions;
1729	3. Offenses that were felonies when committed but are now
1730	misdemeanors;
1731	4. Findings of delinquency; or
1732	5. Commissions of acts of domestic violence as defined in
1733	s. 741.28.
1734	(h) For the department to grant an exemption to any
1735	applicant under this section, the applicant must demonstrate by
1736	clear and convincing evidence that the applicant should not be
1737	disqualified from certification or renewal of certification.
1738	Applicants seeking an exemption have the burden of setting forth
1739	sufficient evidence of rehabilitation, including, but not
1740	limited to, the circumstances surrounding the criminal incident
1741	for which an exemption is sought, the time period that has
1742	elapsed since the incident, the nature of the harm caused to the
1743	victim, and the history of the applicant since the incident, or
1744	any other evidence or circumstances indicating that the
1745	applicant will not present a danger if certification or renewal
1746	of certification is granted. To do so the applicant must request
1747	an exemption and submit the required information supporting that
1748	request at the time of application so that the department may
1749	make a determination in accordance with this section.
1750	(i) Denial of certification or renewal of certification
1751	under paragraph (f) may not be removed from, nor may an
1752	exemption be granted to, any applicant who is found guilty of,
1753	regardless of plea or adjudication, any felony covered by
1754	paragraph (f) solely by reason of any pardon, executive
1755	clemency, or restoration of civil rights.
1756	(j) If an applicant has undergone a criminal history check
1757	as a condition of employment or licensing under any Florida
1758	Statute within 2 years prior to application under this section,
1759	the applicant may submit a copy of the official Florida Criminal
1760	History Record or National Criminal History Record produced
1761	under that requirement in lieu of the fingerprint card required
1762	in paragraph (a) or paragraph (b). The department shall
1763	determine if the submission meets its requirements and, if not,
1764	the applicant shall be required to comply with the provisions of
1765	this subsection. The department is authorized to share criminal
1766	history information with local, state, and federal agencies for
1767	purposes of licensing or employment background checks.
1768	Section 37. Subsection (6) is added to section 401.2701,
1769	Florida Statutes, to read:
1770	401.2701 Emergency medical services training programs.--
1771	(6) Training programs approved by the department shall at
1772	initiation of an emergency medical technician or paramedic
1773	course advise students of the certification and regulatory
1774	requirements of this chapter, including, but not limited to, the
1775	criminal history screening requirement for initial and renewal
1776	certification under s. 401.27. The department shall prescribe,
1777	by rule, the required content of this component of the course.
1778	Section 38. Subsection (2) of section 401.2715, Florida
1779	Statutes, is amended to read:
1780	401.2715 Recertification training of emergency medical
1781	technicians and paramedics.--
1782	(2) Any individual, institution, school, corporation, or
1783	governmental entity may conduct emergency medical technician or
1784	paramedic recertification training upon application to the
1785	department and payment of a nonrefundable fee to be deposited
1786	into the Emergency Medical Services Trust Fund. Institutions
1787	conducting department-approved educational programs as provided
1788	in this chapter and licensed ambulance services are exempt from
1789	the application process and payment of fees. Upon application,
1790	the department shall recognize any entity in this state that has
1791	approval from the Continuing Education Coordinating Board for
1792	Emergency Medical Services for courses in cardiopulmonary
1793	resuscitation or advanced life support for equivalency.The
1794	department shall adopt rules for the application and payment of
1795	a fee not to exceed the actual cost of administering this
1796	approval process.
1797	Section 39. Section 401.272, Florida Statutes, is amended
1798	to read:
1799	401.272 Emergency medical services community health
1800	care.--
1801	(1)(a)The purpose of this section is to encourage more
1802	effective utilization of the skills of emergency medical
1803	technicians and paramedics by enabling them to perform, in
1804	partnership with local county health departments, specific
1805	additional health care tasks that are consistent with the public
1806	health and welfare.
1807	(b)(2)Notwithstanding any other provision of law to the
1808	contrary:
1809	1.(a)Paramedics or emergency medical technicians may
1810	perform health promotion and wellness activities and blood
1811	pressure screenings in a nonemergency environment, within the
1812	scope of their training, and under the direction of a medical
1813	director. As used in this subparagraphparagraph, the term
1814	"health promotion and wellness" means the provision of public
1815	health programs pertaining to the prevention of illness and
1816	injury.
1817	2.(b)Paramedics may administer immunizations in a
1818	nonemergency environment, within the scope of their training,
1819	and under the direction of a medical director. There must be a
1820	written agreement between the paramedic's medical director and
1821	the county health department located in each county in which the
1822	paramedic administers immunizations. This agreement must
1823	establish the protocols, policies, and procedures under which
1824	the paramedic must operate.
1825	(c)(3)Each medical director under whose direction a
1826	paramedic administers immunizations must verify and document
1827	that the paramedic has received sufficient training and
1828	experience to administer immunizations. The verification must be
1829	documented on forms developed by the department, and the
1830	completed forms must be maintained at the service location of
1831	the licensee and made available to the department upon request.
1832	(d)(4)The department may adopt and enforce all rules
1833	necessary to enforce the provisions relating to a paramedic's
1834	administration of immunizations and the performance of health
1835	promotion and wellness activities and blood pressure screenings
1836	by a paramedic or emergency medical technician in a nonemergency
1837	environment.
1838	(2) Notwithstanding any other provision of law to the
1839	contrary, paramedics may provide basic life support and advanced
1840	life support in a hospital emergency department. Such services
1841	provided by paramedics must be under the direction of the
1842	manager or nursing director of the emergency department. Where
1843	the management and provision of emergency medical services is
1844	contracted by the hospital, paramedics providing services in the
1845	emergency department must be employees of the medical group
1846	contracted to provide emergency medical services to the hospital
1847	and the services provided by paramedics must be under the direct
1848	supervision of a physician.
1849	Section 40. Subsection (4) of section 404.056, Florida
1850	Statutes, is amended to read:
1851	404.056 Environmental radiation standards and projects;
1852	certification of persons performing measurement or mitigation
1853	services; mandatory testing; notification on real estate
1854	documents; rules.--
1855	(4) MANDATORY TESTING.--All public and private school
1856	buildings or school sites housing students in kindergarten
1857	through grade 12; all state-owned, state-operated, state-
1858	regulated, or state-licensed 24-hour care facilities; and all
1859	state-licensed day care centers for children or minors which are
1860	located in counties designated within the Department of
1861	Community Affairs' Florida Radon Protection Map Categories as
1862	"Intermediate" or "Elevated Radon Potential" shall be measured
1863	to determine the level of indoor radon, using measurement
1864	procedures established by the department. Initial measurements
1865	Testing shall be performedcompleted within the first year of
1866	constructionin 20 percent of the habitable first floor spaces
1867	within any of the regulated buildings. Initial measurements
1868	shall be completed and reported to the department within 1by
1869	July 1 of the year after the datethe building is opened for
1870	occupancy or within 1 year after license approval for an entity
1871	residing in an existing building. Followup testing must be
1872	completed in 5 percent of the habitable first floor spaces
1873	within any of the regulated buildings after the building has
1874	been occupied for 5 years, and results must be reported to the
1875	department by the first dayJuly 1 of the 6th5thyear of
1876	occupancy. After radon measurements have been made twice,
1877	regulated buildings need not undergo further testing unless
1878	significant structural changes occur. No funds collected
1879	pursuant to s. 553.721 shall be used to carry out the provisions
1880	of this subsection.
1881	Section 41. Subsection (5) of section 409.814, Florida
1882	Statutes, is amended to read:
1883	409.814 Eligibility.--A child whose family income is equal
1884	to or below 200 percent of the federal poverty level is eligible
1885	for the Florida Kidcare program as provided in this section. In
1886	determining the eligibility of such a child, an assets test is
1887	not required. An applicant under 19 years of age who, based on a
1888	complete application, appears to be eligible for the Medicaid
1889	component of the Florida Kidcare program is presumed eligible
1890	for coverage under Medicaid, subject to federal rules. A child
1891	who has been deemed presumptively eligible for Medicaid shall
1892	not be enrolled in a managed care plan until the child's full
1893	eligibility determination for Medicaid has been completed. The
1894	Florida Healthy Kids Corporation may, subject to compliance with
1895	applicable requirements of the Agency for Health Care
1896	Administration and the Department of Children and Family
1897	Services, be designated as an entity to conduct presumptive
1898	eligibility determinations. An applicant under 19 years of age
1899	who, based on a complete application, appears to be eligible for
1900	the Medikids, Florida Healthy Kids, or Children's Medical
1901	Services network program component, who is screened as
1902	ineligible for Medicaid and prior to the monthly verification of
1903	the applicant's enrollment in Medicaid or of eligibility for
1904	coverage under the state employee health benefit plan, may be
1905	enrolled in and begin receiving coverage from the appropriate
1906	program component on the first day of the month following the
1907	receipt of a completed application. For enrollment in the
1908	Children's Medical Services network, a complete application
1909	includes the medical or behavioral health screening. If, after
1910	verification, an individual is determined to be ineligible for
1911	coverage, he or she must be disenrolled from the respective
1912	Title XXI-funded Kidcare program component.
1913	(5) A child whose family income is above 200 percent of
1914	the federal poverty level or a child who is excluded under the
1915	provisions of subsection (4) may participate in the Florida
1916	Healthy Kids program or the Medikids program,Kidcare program,
1917	excluding the Medicaid program, but issubject to the following
1918	provisions:
1919	(a) The family is not eligible for premium assistance
1920	payments and must pay the full cost of the premium, including
1921	any administrative costs.
1922	(b) The agency is authorized to place limits on enrollment
1923	in Medikids by these children in order to avoid adverse
1924	selection. The number of children participating in Medikids
1925	whose family income exceeds 200 percent of the federal poverty
1926	level must not exceed 10 percent of total enrollees in the
1927	Medikids program.
1928	(c) The board of directors of the Florida Healthy Kids
1929	Corporation is authorized to place limits on enrollment of these
1930	children in order to avoid adverse selection. In addition, the
1931	board is authorized to offer a reduced benefit package to these
1932	children in order to limit program costs for such families. The
1933	number of children participating in the Florida Healthy Kids
1934	program whose family income exceeds 200 percent of the federal
1935	poverty level must not exceed 10 percent of total enrollees in
1936	the Florida Healthy Kids program.
1937	(d) Children described in this subsection are not counted
1938	in the annual enrollment ceiling for the Florida Kidcare
1939	program.
1940	Section 42. Paragraph (d) of subsection (1) of section
1941	455.227, Florida Statutes, is amended to read:
1942	455.227 Grounds for discipline; penalties; enforcement.--
1943	(1) The following acts shall constitute grounds for which
1944	the disciplinary actions specified in subsection (2) may be
1945	taken:
1946	(d) Using a Class III or a Class IV laser device or
1947	product, as defined by federal regulations, without having
1948	complied with the rules adopted pursuant to s. 404.24(2)
1949	501.122(2)governing the registration of such devices.
1950	Section 43. Subsection (7) is added to section 456.017,
1951	Florida Statutes, to read:
1952	456.017 Examinations.--
1953	(7) The department may post examination scores
1954	electronically on the Internet in lieu of mailing the scores to
1955	each applicant. Such electronic posting of the examination
1956	scores meets the requirements of chapter 120 if the department
1957	also posts with the examination scores a notification of rights
1958	as set forth in chapter 120. The date of receipt for purposes of
1959	chapter 120 shall be the date the examination scores are posted
1960	electronically. The department shall also notify the examinee
1961	when scores are posted electronically of the availability of a
1962	postexamination review, if applicable.
1963	Section 44. Subsection (7) of section 456.025, Florida
1964	Statutes, is amended to read:
1965	456.025 Fees; receipts; disposition.--
1966	(7) Each board, or the department if there is no board,
1967	shall establish, by rule, a fee not to exceed $250 for anyone
1968	seeking approval to provide continuing education courses or
1969	programs and shall establish by rule a biennial renewal fee not
1970	to exceed $250 for the renewal of providership of such courses.
1971	The fees collected from continuing education providers shall be
1972	used for the purposes of reviewing course provider applications,
1973	monitoring the integrity of the courses provided, andcovering
1974	legal expenses incurred as a result of not granting or renewing
1975	a providership, and developing and maintaining an electronic
1976	continuing education tracking system. The department shall
1977	implement an electronic continuing education tracking system for
1978	each new biennial renewal cycle for which electronic renewals
1979	are implemented after the effective date of this act and shall
1980	integrate such system into the licensure and renewal system. All
1981	approved continuing education providers shall provide
1982	information on course attendance to the department necessary to
1983	implement the electronic tracking system. The department shall,
1984	by rule, specify the form and procedures by which the
1985	information is to be submitted.
1986	Section 45. Paragraph (b) of subsection (1) of section
1987	456.0375, Florida Statutes, is amended to read:
1988	456.0375 Registration of certain clinics; requirements;
1989	discipline; exemptions.--
1990	(1)
1991	(b) For purposes of this section, the term "clinic" does
1992	not include and the registration requirements herein do not
1993	apply to:
1994	1. Entities licensed or registered by the state pursuant
1995	to chapter 390, chapter 394, chapter 395, chapter 397, chapter
1996	400, chapter 463, chapter 465, chapter 466, chapter 478, chapter
1997	480, or chapter 484.
1998	2. Entities exempt from federal taxation under 26 U.S.C.
1999	s. 501(c)(3) and community college and university clinics.
2000	3. Sole proprietorships, group practices, partnerships, or
2001	corporations that provide health care services by licensed
2002	health care practitioners pursuant to chapters 457, 458, 459,
2003	460, 461, 462, 463, 466, 467, 484, 486, 490, 491, or part I,
2004	part III, part X, part XIII, or part XIV of chapter 468, or s.
2005	464.012, which are wholly owned by licensed health care
2006	practitioners or the licensed health care practitioner and the
2007	spouse, parent, or child of a licensed health care practitioner,
2008	so long as one of the owners who is a licensed health care
2009	practitioner is supervising the administrativeservices
2010	performed therein and is legally responsible for the entity's
2011	compliance with all federal and state laws. However, no health
2012	care practitioner may supervise the health care delivery
2013	services beyond the scope of the practitioner's license.
2014	Supervision of the administrative services for compliance with
2015	federal and state laws is different and distinct from
2016	supervision of the delivery of health care services. Health care
2017	delivery is the sole responsibility of the physician delivering
2018	health care services.
2019	4. Clinical facilities affiliated with an accredited
2020	medical school at which training is provided for medical
2021	students, residents, or fellows.
2022	Section 46. Paragraph (a) of subsection (4) of section
2023	456.039, Florida Statutes, is amended to read:
2024	456.039 Designated health care professionals; information
2025	required for licensure.--
2026	(4)(a) An applicant for initial licensure must submit a
2027	set of fingerprints to the Department of Health in accordance
2028	with s. 458.311, s. 458.3115, s. 458.3124, s. 458.313,s.
2029	459.0055, s. 460.406, or s. 461.006.
2030	Section 47. Subsection (1) of section 456.049, Florida
2031	Statutes, is amended to read:
2032	456.049 Health care practitioners; reports on professional
2033	liability claims and actions.--
2034	(1) Any practitioner of medicine licensed pursuant to the
2035	provisions of chapter 458, practitioner of osteopathic medicine
2036	licensed pursuant to the provisions of chapter 459, podiatric
2037	physician licensed pursuant to the provisions of chapter 461, or
2038	dentist licensed pursuant to the provisions of chapter 466 shall
2039	report to the department any claim or action for damages for
2040	personal injury alleged to have been caused by error, omission,
2041	or negligence in the performance of such licensee's professional
2042	services or based on a claimed performance of professional
2043	services without consent if the claim was not covered by an
2044	insurer required to report under s. 627.912 and the claim
2045	resulted in:
2046	(a) A final judgment of $50,000 or more, or of $25,000 or
2047	more for a dentist licensed pursuant to the provisions of
2048	chapter 466in any amount.
2049	(b) A settlement of $50,000 or more, or of $25,000 or more
2050	for a dentist licensed pursuant to the provisions of chapter 466
2051	in any amount.
2052	(c) A final disposition not resulting in payment on behalf
2053	of the licensee.
2054
2055	Reports shall be filed with the department no later than 60 days
2056	following the occurrence of any event listed in paragraph (a),
2057	paragraph (b), or paragraph (c).
2058	Section 48. Subsection (3) of section 456.063, Florida
2059	Statutes, is amended to read:
2060	456.063 Sexual misconduct; disqualification for license,
2061	certificate, or registration.--
2062	(3) Licensed health care practitioners shall report
2063	allegations of sexual misconduct to the department, regardless
2064	of the practice setting in which the alleged sexual misconduct
2065	occurred. Each board, or the department if there is no board,
2066	may adopt rules to implement the requirements for reporting
2067	allegations of sexual misconduct, including rules to determine
2068	the sufficiency of the allegations.
2069	Section 49. Paragraphs (d), (aa), and (bb) of subsection
2070	(1) and subsection (4) of section 456.072, Florida Statutes, are
2071	amended, paragraph (dd) is added to subsection (1), and
2072	subsection (7) is added to said section, to read:
2073	456.072 Grounds for discipline; penalties; enforcement.--
2074	(1) The following acts shall constitute grounds for which
2075	the disciplinary actions specified in subsection (2) may be
2076	taken:
2077	(d) Using a Class III or a Class IV laser device or
2078	product, as defined by federal regulations, without having
2079	complied with the rules adopted pursuant to s. 404.24(2)
2080	501.122(2)governing the registration of such devices.
2081	(aa) Performing or attempting to perform health care
2082	services on the wrong patient, a wrong-site procedure, a wrong
2083	procedure, or an unauthorized procedure or a procedure that is
2084	medically unnecessary or otherwise unrelated to the patient's
2085	diagnosis or medical condition. For the purposes of this
2086	paragraph, performing or attempting to perform health care
2087	services includes invasive actions taken in furtherance ofthe
2088	preparation of the patient, but does not include those
2089	preparations that are noninvasive.
2090	(bb) Leaving a foreign body in a patient, such as a
2091	sponge, clamp, forceps, surgical needle, or other paraphernalia
2092	commonly used in surgical, examination, or other diagnostic
2093	procedures, unless leaving the foreign body is medically
2094	indicated and documented in the patient record. For the purposes
2095	of this paragraph, it shall be legally presumed that retention
2096	of a foreign body is not in the best interest of the patient and
2097	is not within the standard of care of the profession, unless
2098	medically indicated and documented in the patient record
2099	regardless of the intent of the professional.
2100	(dd) Prescribing, administering, dispensing, or
2101	distributing a legend drug, including a controlled substance,
2102	when the practitioner knows or reasonably should know that the
2103	receiving patient has not established a valid professional
2104	relationship with the prescribing practitioner. A medical
2105	questionnaire completed by Internet, telephone, electronic
2106	transfer, or mail does not establish a valid professional
2107	relationship.
2108	(4) In anyaddition to any other discipline imposed
2109	through final order, or citation,entered on or after July 1,
2110	2001, that imposes a penalty or other form of discipline
2111	pursuant to this section or discipline imposed through final
2112	order, or citation, entered on or after July 1, 2001,for a
2113	violation of any practice act, the board, or the department when
2114	there is no board, shall assess costs related to the
2115	investigation and prosecution of the case, including costs
2116	associated with an attorney's time. The amount of costs to be
2117	assessed shall be determined by the board, or the department
2118	when there is no board, following its consideration of an
2119	affidavit of itemized costs and any written objections thereto.
2120	In any case where the board or the department imposesa fine or
2121	assessment of costs imposed by the board or departmentand the
2122	fine or assessmentis not paid within a reasonable time, such
2123	reasonable time to be prescribed in the rules of the board, or
2124	the department when there is no board, or in the order assessing
2125	such fines or costs, the department or the Department of Legal
2126	Affairs may contract for the collection of, or bring a civil
2127	action to recover, the fine or assessment.
2128	(7) In any formal administrative hearing conducted under
2129	s. 120.57(1), the department shall establish grounds for
2130	revocation or suspension of a license by clear and convincing
2131	evidence. Any other forms of discipline shall be established by
2132	the greater weight of the evidence.
2133	Section 50. Subsections (1) and (5) of section 456.073,
2134	Florida Statutes, are amended to read:
2135	456.073 Disciplinary proceedings.--Disciplinary
2136	proceedings for each board shall be within the jurisdiction of
2137	the department.
2138	(1) The department, for the boards under its jurisdiction,
2139	shall cause to be investigated any complaint that is filed
2140	before it if the complaint is in writing, signed by the
2141	complainant, and legally sufficient. A complaint is legally
2142	sufficient if it contains ultimate facts that show that a
2143	violation of this chapter, of any of the practice acts relating
2144	to the professions regulated by the department, or of any rule
2145	adopted by the department or a regulatory board in the
2146	department has occurred. In order to determine legal
2147	sufficiency, the department may require supporting information
2148	or documentation. The department may investigate, and the
2149	department or the appropriate board may take appropriate final
2150	action on, a complaint even though the original complainant
2151	withdraws it or otherwise indicates a desire not to cause the
2152	complaint to be investigated or prosecuted to completion. The
2153	department may investigate an anonymous complaint if the
2154	complaint is in writing and is legally sufficient, if the
2155	alleged violation of law or rules is substantial, and if the
2156	department has reason to believe, after preliminary inquiry,
2157	that the violations alleged in the complaint are true. The
2158	department may investigate a complaint made by a confidential
2159	informant if the complaint is legally sufficient, if the alleged
2160	violation of law or rule is substantial, and if the department
2161	has reason to believe, after preliminary inquiry, that the
2162	allegations of the complainant are true. The department may
2163	initiate an investigation if it has reasonable cause to believe
2164	that a licensee or a group of licensees has violated a Florida
2165	statute, a rule of the department, or a rule of a board. Except
2166	as provided in ss. 458.331(9), 459.015(9), 460.413(5), and
2167	461.013(6),When an investigation of any subject is undertaken,
2168	the department shall promptly furnish to the subject or the
2169	subject's attorney a copy of the complaint or document that
2170	resulted in the initiation of the investigation. The subject may
2171	submit a written response to the information contained in such
2172	complaint or document within 3020days after service to the
2173	subject of the complaint or document. The subject's written
2174	response shall be considered by the probable cause panel. The
2175	right to respond does not prohibit the issuance of a summary
2176	emergency order if necessary to protect the public. However, if
2177	the secretary, or the secretary's designee, and the chair of the
2178	respective board or the chair of its probable cause panel agree
2179	in writing that such notification would be detrimental to the
2180	investigation, the department may withhold notification. The
2181	department may conduct an investigation without notification to
2182	any subject if the act under investigation is a criminal
2183	offense.
2184	(5)(a)A formal hearing before an administrative law judge
2185	from the Division of Administrative Hearings shall be requested
2186	heldpursuant to chapter 120 if there are any disputed issues of
2187	material fact raised within 45 days after service of the
2188	administrative complaint. The administrative law judge shall
2189	issue a recommended order pursuant to chapter 120. If any party
2190	raises an issue of disputed fact during an informal hearing, the
2191	hearing shall be terminated and a formal hearing pursuant to
2192	chapter 120 shall be held.
2193	(b) Notwithstanding s. 120.569(2), the department shall
2194	notify the division within 45 days after receipt of a petition
2195	or request for a hearing which the department has determined
2196	requires a formal hearing before an administrative law judge.
2197	(c) The division shall maintain time records for each case
2198	it receives. The division shall charge its expenses to the
2199	Medical Quality Assurance Trust Fund based on an hourly rate set
2200	forth in this paragraph. The costs charged shall include actual
2201	travel and copying expenses plus a $100 hourly fee for the
2202	actual time spent on the case by the administrative law judge or
2203	hearing officer. There shall be a one-time filing fee per case
2204	of $50. There shall be no charge for hearings canceled more than
2205	21 days in advance. Hearings canceled between 3 and 21 days in
2206	advance shall be billed for actual expenses incurred. For any
2207	formal hearing canceled less than 72 hours before the start of
2208	the hearing, actual expenses incurred and a cancellation fee of
2209	$250 shall be billed.
2210	Section 51. Section 456.077, Florida Statutes, is amended
2211	to read:
2212	456.077 Authority to issue citations.--
2213	(1) Notwithstanding s. 456.073, the board, or the
2214	department if there is no board, shall adopt rules to permit the
2215	issuance of citations. The citation shall be issued to the
2216	subject and shall contain the subject's name and address, the
2217	subject's license number if applicable, a brief factual
2218	statement, the sections of the law allegedly violated, and the
2219	penalty imposed. The citation must clearly state that the
2220	subject may choose, in lieu of accepting the citation, to follow
2221	the procedure under s. 456.073. If the subject disputes the
2222	matter in the citation, the procedures set forth in s. 456.073
2223	must be followed. However, if the subject does not dispute the
2224	matter in the citation with the department within 30 days after
2225	the citation is served, the citation becomes a publicfinal
2226	order and does not constituteconstitutes discipline for a first
2227	offense. The penalty shall be a fine or other conditions as
2228	established by rule.
2229	(2) The board, or the department if there is no board,
2230	shall adopt rules designating violations for which a citation
2231	may be issued. Such rules shall designate as citation violations
2232	those violations for which there is no substantial threat to the
2233	public health, safety, and welfare. Violations for which a
2234	citation may be issued shall include violations of continuing
2235	education requirements; failure to timely pay required fees and
2236	fines; failure to comply with the requirements of ss. 381.026
2237	and 381.0261 regarding the dissemination of information
2238	regarding patient rights; failure to comply with advertising
2239	requirements; failure to timely update practitioner profile and
2240	credentialing files; failure to display signs, licenses, and
2241	permits; failure to have required reference books available; and
2242	all other violations that do not pose a direct and serious
2243	threat to the health and safety of the patient.
2244	(3) The department shall be entitled to recover the costs
2245	of investigation, in addition to any penalty provided according
2246	to board or department rule, as part of the penalty levied
2247	pursuant to the citation.
2248	(4) A citation must be issued within 6 months after the
2249	filing of the complaint that is the basis for the citation.
2250	(4)(5)Service of a citation may be made by personal
2251	service or certified mail, restricted delivery, to the subject
2252	at the subject's last known address.
2253	(5)(6)A board has 6 months in which to enact rules
2254	designating violations and penalties appropriate for citation
2255	offenses. Failure to enact such rules gives the department
2256	exclusive authority to adopt rules as required for implementing
2257	this section. A board has continuous authority to amend its
2258	rules adopted pursuant to this section.
2259	Section 52. Section 456.078, Florida Statutes, is amended
2260	to read:
2261	456.078 Mediation.--
2262	(1) Notwithstanding the provisions of s. 456.073, the
2263	board, or the department when there is no board, shall adopt
2264	rules to designate which violations of the applicable
2265	professional practice act are appropriate for mediation. The
2266	board, or the department when there is no board, shallmay
2267	designate as mediation offenses those complaints where harm
2268	caused by the licensee is economic in nature, except complaints
2269	involving fraud,or can be remedied by the licensee, or does not
2270	result in an adverse incident. For the purposes of this section,
2271	an adverse incident is defined as an event that results in:
2272	(a) The death of a patient;
2273	(b) Brain or spinal damage to a patient;
2274	(c) The performance of a surgical procedure on the wrong
2275	patient;
2276	(d) The performance of a wrong-site surgical procedure;
2277	(e) The performance of a wrong surgical procedure;
2278	(f) The performance of a surgical procedure that is
2279	medically unnecessary or otherwise unrelated to the patient's
2280	diagnosis or medical condition;
2281	(g) The surgical repair of damage resulting to a patient
2282	from a planned surgical procedure, where the damage is not a
2283	recognized specific risk, as disclosed to the patient and
2284	documented through the informed-consent process; or
2285	(h) The performance of procedures to remove unplanned
2286	foreign objects remaining from a surgical procedure.
2287	(2) After the department determines a complaint is legally
2288	sufficient and the alleged violations are defined as mediation
2289	offenses, the department or any agent of the department may
2290	conduct informal mediation to resolve the complaint. If the
2291	complainant and the subject of the complaint agree to a
2292	resolution of a complaint within 14 days after contact by the
2293	mediator, the mediator shall notify the department of the terms
2294	of the resolution. The department or board shall take no further
2295	action unless the complainant and the subject each fail to
2296	record with the department an acknowledgment of satisfaction of
2297	the terms of mediation within 60 days of the mediator's
2298	notification to the department. A successful mediation shall
2299	include a statement of whether or not the resolution constitutes
2300	discipline. However,in the event the complainant and subject
2301	fail to reach settlement terms or to record the required
2302	acknowledgment, the department shall process the complaint
2303	according to the provisions of s. 456.073.
2304	(3) Conduct or statements made during mediation are
2305	inadmissible in any proceeding pursuant to s. 456.073. Further,
2306	any information relating to the mediation of a case shall be
2307	subject to the confidentiality provisions of s. 456.073.
2308	(4) Any licensee who completes a successful mediation
2309	shall pay the department's administrative costs for the
2310	mediation. No licensee shall go through the mediation process
2311	more than once if the allegation relates to the breach of the
2312	standard of care for that health care professional. In any
2313	event,no licensee shall go through the mediation process more
2314	than three times without approval of the department. The
2315	department may consider the subject and dates of the earlier
2316	complaints in rendering its decision. Such decision shall not be
2317	considered a final agency action for purposes of chapter 120.
2318	(5) A board has 6 months in which to adopt rules
2319	designating violations appropriate for mediation. Failure to
2320	adopt such rules gives the department exclusive authority to
2321	adopt rules as required for implementing this sectionAny board
2322	created on or after January 1, 1995, shall have 6 months to
2323	adopt rules designating which violations are appropriate for
2324	mediation, after which time the department shall have exclusive
2325	authority to adopt rules pursuant to this section. A board shall
2326	have continuing authority to amend its rules adopted pursuant to
2327	this section.
2328	Section 53. Section 458.303, Florida Statutes, is amended
2329	to read:
2330	458.303 Provisions not applicable to other practitioners;
2331	exceptions, etc.--
2332	(1) The provisions of ss. 458.301, 458.303, 458.305,
2333	458.307, 458.309, 458.311, 458.313, 458.315, 458.317,458.319,
2334	458.321, 458.327, 458.329, 458.331, 458.337, 458.339, 458.341,
2335	458.343, 458.345, and 458.347 shall have no application to:
2336	(a) Other duly licensed health care practitioners acting
2337	within their scope of practice authorized by statute.
2338	(b) Any physician lawfully licensed in another state or
2339	territory or foreign country, when meeting duly licensed
2340	physicians of this state in consultation.
2341	(c) Commissioned medical officers of the Armed Forces of
2342	the United States and of the Public Health Service of the United
2343	States while on active duty and while acting within the scope of
2344	their military or public health responsibilities.
2345	(d) Any person while actually serving without salary or
2346	professional fees on the resident medical staff of a hospital in
2347	this state, subject to the provisions of s. 458.321.
2348	(e) Any person furnishing medical assistance in case of an
2349	emergency.
2350	(f) The domestic administration of recognized family
2351	remedies.
2352	(g) The practice of the religious tenets of any church in
2353	this state.
2354	(h) Any person or manufacturer who, without the use of
2355	drugs or medicine, mechanically fits or sells lenses, artificial
2356	eyes or limbs, or other apparatus or appliances or is engaged in
2357	the mechanical examination of eyes for the purpose of
2358	constructing or adjusting spectacles, eyeglasses, or lenses.
2359	(2) Nothing in s. 458.301, s. 458.303, s. 458.305, s.
2360	458.307, s. 458.309, s. 458.311, s. 458.313,s. 458.319, s.
2361	458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.
2362	458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347 shall
2363	be construed to prohibit any service rendered by a registered
2364	nurse or a licensed practical nurse, if such service is rendered
2365	under the direct supervision and control of a licensed physician
2366	who provides specific direction for any service to be performed
2367	and gives final approval to all services performed. Further,
2368	nothing in this or any other chapter shall be construed to
2369	prohibit any service rendered by a medical assistant in
2370	accordance with the provisions of s. 458.3485.
2371	Section 54. Section 458.311, Florida Statutes, is amended
2372	to read:
2373	(Substantial rewording of section. See
2374	s. 458.311, F.S., for present text.)
2375	458.311 Licensure; requirements; fees.--
2376	(1) Any person desiring to be licensed as a physician
2377	shall apply to the department on forms furnished by the
2378	department. The department shall license each applicant who the
2379	board certifies has met the provisions of this section.
2380	(2) Each applicant must demonstrate compliance with the
2381	following:
2382	(a) Has completed the application form and remitted a
2383	nonrefundable application fee not to exceed $500.
2384	(b) Is at least 21 years of age.
2385	(c) Is of good moral character.
2386	(d) Has not committed any act or offense in this or any
2387	other jurisdiction which would constitute the basis for
2388	disciplining a physician pursuant to s. 458.331.
2389	(e) Has submitted to the department a set of fingerprints
2390	on a form and under procedures specified by the department,
2391	along with a payment in an amount equal to the costs incurred by
2392	the department for the criminal history check of the applicant.
2393	(f) Has caused to be submitted to the department core
2394	credentials verified by the Federation Credentials Verification
2395	Service of the Federation of State Medical Boards.
2396	(g) For an applicant holding a valid active license in
2397	another state, has submitted evidence of the active licensed
2398	practice of medicine in another jurisdiction for at least 2 of
2399	the immediately preceding 4 years or evidence of successful
2400	completion of either a board-approved postgraduate training
2401	program within 2 years preceding filing of an application or a
2402	board-approved clinical competency examination within the year
2403	preceding the filing of an application for licensure. For
2404	purposes of this paragraph, the term "active licensed practice
2405	of medicine" means that practice of medicine by physicians,
2406	including those employed by any governmental entity in community
2407	or public health, as defined by this chapter, those designated
2408	as medical directors under s. 641.495(11) who are practicing
2409	medicine, and those on the active teaching faculty of an
2410	accredited medical school. If the applicant fails to meet the
2411	requirements of this paragraph, the board may impose conditions
2412	on the license, including, but not limited to, supervision of
2413	practice.
2414	(3) Each applicant must demonstrate that he or she has
2415	complied with one of the following:
2416	(a) Is a graduate of an allopathic medical school or
2417	allopathic college recognized and approved by an accrediting
2418	agency recognized by the United States Department of Education
2419	or is a graduate of an allopathic medical school or allopathic
2420	college within a territorial jurisdiction of the United States
2421	recognized by the accrediting agency of the governmental body of
2422	that jurisdiction; or
2423	(b) Is a graduate of an allopathic international medical
2424	school registered with the World Health Organization and has had
2425	his or her medical credentials evaluated by the Educational
2426	Commission for Foreign Medical Graduates, holds an active, valid
2427	certificate issued by that commission, and has passed the
2428	examination utilized by that commission. However, a graduate of
2429	an international medical school need not present the certificate
2430	issued by the Educational Commission for Foreign Medical
2431	Graduates or pass the examination utilized by that commission if
2432	the graduate has:
2433	1. Received a bachelor's degree from an accredited United
2434	States college or university.
2435	2. Studied at a medical school which is recognized by the
2436	World Health Organization.
2437	3. Completed all of the formal requirements of the
2438	international medical school, except the internship or social
2439	service requirements, and passed part I of the National Board of
2440	Medical Examiners examination or the Educational Commission for
2441	Foreign Medical Graduates examination equivalent.
2442	4. Completed an academic year of supervised clinical
2443	training in a hospital affiliated with a medical school approved
2444	by the Council on Medical Education of the American Medical
2445	Association and, upon completion, passed part II of the National
2446	Board of Medical Examiners examination or the Educational
2447	Commission for Foreign Medical Graduates examination equivalent.
2448	(4) Each applicant must demonstrate that he or she has
2449	completed an Accreditation Council for Graduate Medical
2450	Education (ACGME) approved residency, as defined by board rule,
2451	of at least 2 years, or a fellowship of at least 2 years in one
2452	specialty area which is counted toward regular or subspecialty
2453	certification by a board recognized and certified by the
2454	American Board of Medical Specialties. However, applicants who
2455	meet the requirements of paragraph (3)(a) who completed their
2456	training prior to October 1, 2003, must demonstrate completion
2457	of at least 1 year of an approved residency.
2458	(5)(a) Each applicant must demonstrate that he or she has
2459	complied with one of the following examination requirements:
2460	1. Prior to January 1, 2000, has obtained a passing score,
2461	as established by rule of the board, on the licensure
2462	examination of the National Board of Medical Examiners (NBME),
2463	the licensure examination of the Federation of State Medical
2464	Boards of the United States, Inc. (FLEX), the United States
2465	Medical Licensing Examination (USMLE), or a combination thereof;
2466	2. On or after January 1, 2000, has obtained a passing
2467	score on all three steps of the United States Medical Licensing
2468	Examination (USMLE); or
2469	3. Has obtained a passing score on a state board
2470	examination or the Canadian licensing examination (LLMCC) if the
2471	applicant has a current active license in at least one other
2472	jurisdiction of the United States or Canada and has practiced
2473	pursuant to such licensure continuously for the immediately
2474	preceeding 10 years without encumbrance on the license.
2475	(b) As prescribed by board rule, the board may require an
2476	applicant who does not pass any step of the national licensing
2477	examination after five attempts to complete additional remedial
2478	education or training.
2479	(c) As prescribed by board rule, the board may require an
2480	applicant who does not pass all steps of the United States
2481	Medical Licensing Examination (USMLE) within 7 years to complete
2482	additional remedial education or training or to retake the step
2483	of the examination which the applicant passed first.
2484	(6) The department and the board shall ensure that
2485	applicants for licensure meet the criteria of this section
2486	through an investigative process.
2487	(7) The board may not certify to the department for
2488	licensure any applicant who is under investigation in another
2489	jurisdiction for an offense which would constitute a violation
2490	of this chapter until such investigation is completed. Upon
2491	completion of the investigation, the provisions of s. 458.331
2492	shall apply. Furthermore, the department may not issue an
2493	unrestricted license to any individual who has committed any act
2494	or offense in any jurisdiction which would constitute the basis
2495	for disciplining a physician pursuant to s. 458.331. When the
2496	board finds that an individual has committed an act or offense
2497	in any jurisdiction which would constitute the basis for
2498	disciplining a physician pursuant to s. 458.331, the board may
2499	enter an order imposing one or more of the terms set forth in s.
2500	456.072(2).
2501	(8) The board may adopt rules pursuant to ss. 120.536(1)
2502	and 120.54 necessary to carry out the provisions of this
2503	section, which shall be applied on a uniform and consistent
2504	basis.
2505	(9) When the board determines that any applicant for
2506	licensure has failed to meet, to the board's satisfaction, each
2507	of the appropriate requirements set forth in this section, it
2508	may enter an order requiring one or more of the following terms:
2509	(a) Refusal to certify to the department an application
2510	for licensure, certification, or registration;
2511	(b) Certification to the department of an application for
2512	licensure, certification, or registration with restrictions on
2513	the scope of practice of the licensee; or
2514	(c) Certification to the department of an application for
2515	licensure, certification, or registration with placement of the
2516	physician on probation for a period of time and subject to such
2517	conditions as the board may specify, including, but not limited
2518	to, requiring the physician to submit to treatment, attend
2519	continuing education courses, submit to reexamination, or work
2520	under the supervision of another physician.
2521	Section 55. Subsection (5) of section 458.3124, Florida
2522	Statutes, is amended to read:
2523	458.3124 Restricted license; certain experienced foreign-
2524	trained physicians.--
2525	(5) Notwithstanding s. 458.311(3) and (4)(1)(f), a person
2526	who successfully meets the requirements of this section and who
2527	successfully passes Step III of the United States Medical
2528	Licensing Examination is eligible for full licensure as a
2529	physician.
2530	Section 56. Section 458.315, Florida Statutes, is amended
2531	to read:
2532	(Substantial rewording of section. See
2533	s. 458.315, F.S., for present text.)
2534	458.315 Limited licenses.--
2535	(1) Any person desiring to obtain a limited license shall
2536	apply to the department on forms furnished by the department.
2537	The department shall license each applicant who the board
2538	certifies:
2539	(a) Has submitted to the department, with an application
2540	and fee not to exceed $300, a statement stating that he or she
2541	has been licensed to practice medicine in any jurisdiction or
2542	territory of the United States or Canada for at least 2 years
2543	and intends to practice only pursuant to the restrictions of a
2544	limited license granted pursuant to this section. However, if
2545	the physician will only use the limited license for
2546	noncompensated practice, and submits a statement from the
2547	employing agency or institution stating that he or she will not
2548	receive compensation for any service involving the practice of
2549	medicine, the application fee and all licensure fees shall be
2550	waived.
2551	(b) Has submitted evidence of the active licensed practice
2552	of medicine in any jurisdiction or territory of the United
2553	States or Canada for at least 2 of the immediately preceding 4
2554	years. For purposes of this paragraph, the term "active licensed
2555	practice of medicine" means that practice of medicine by
2556	physicians, including those employed by any government entity in
2557	community or public health, as defined by this chapter, those
2558	designated as medical directors under s. 641.495(11) who are
2559	practicing medicine, and those on the active teaching faculty of
2560	an accredited medical school. If it has been more than 3 years
2561	since active practice was conducted by the applicant, a licensed
2562	physician approved by the board shall supervise the applicant
2563	for a period of 6 months after he or she is granted a limited
2564	license for practice, unless the board determines that a shorter
2565	period of supervision will be sufficient to ensure that the
2566	applicant is qualified for licensure. Procedures for such
2567	supervision shall be established by the board.
2568	(c) Has submitted to the department a set of fingerprints
2569	on a form and under procedures by the department for the
2570	criminal history check of the applicant.
2571	(d) Has not committed any act or offense in this or any
2572	other jurisdiction which would constitute the basis for
2573	disciplining a physician pursuant to s. 458.331.
2574	(2) After approval of an application under this section, a
2575	limited license may not be issued until the applicant provides
2576	to the board an affidavit that there have been no substantial
2577	changes in his or her status since initial application.
2578	(3) The recipient of a limited license used for
2579	noncompensated practice shall only practice in the employ of
2580	programs or facilities that provide uncompensated health care
2581	services by volunteer licensed health care professionals to low-
2582	income persons whose family income does not exceed 120 percent
2583	of the federal poverty level or to uninsured persons. These
2584	facilities shall include, but not be limited to, the department,
2585	community and migrant health centers funded under s. 330 of the
2586	Public Health Service Act, and volunteer health care provider
2587	programs contracted with the department to provide uncompensated
2588	care under the provisions of s. 766.1115.
2589	(4) The recipient of a limited license used for
2590	compensated practice shall only practice in the employ of
2591	certain programs and facilities that provide health care
2592	services and are located within federally designated primary
2593	care health professional shortage areas, unless otherwise
2594	approved by the Secretary of Health. These programs and
2595	facilities shall include, but not be limited to, the department,
2596	the Department of Corrections, county or municipal correctional
2597	facilities, the Department of Juvenile Justice, the Department
2598	of Children and Family Services, and those programs and
2599	facilities funded under s. 330 of the Public Health Service Act.
2600	(5) The recipient of a limited license shall, within 30
2601	days after accepting employment, notify the board of all
2602	approved institutions in which the licensee practices and all
2603	approved institutions in which the licensee's practice
2604	privileges have been denied. Evidence of noncompensated
2605	employment shall be required for the fee waiver under paragraph
2606	(1)(a).
2607	(6) Upon renewal, a limited licenseholder shall, in
2608	addition to complying with other applicable provisions of this
2609	chapter, document compliance with the restrictions prescribed in
2610	this section.
2611	(7) Any person holding an active or inactive license to
2612	practice medicine in the state may convert that license to a
2613	limited license for the purpose of providing volunteer,
2614	uncompensated care for low-income Floridians. The licensee must
2615	submit a statement from the employing agency or institution
2616	stating that he or she will not receive compensation for any
2617	service involving the practice of medicine. All licensure fees,
2618	including neurological injury compensation assessments, shall be
2619	waived.
2620	(8) Nothing in this section limits in any way any policy
2621	by the board otherwise authorized by law to grant licenses to
2622	physicians duly licensed in other states under conditions less
2623	restrictive than the requirements of this section.
2624	Notwithstanding any other provision of this section, the board
2625	may refuse to authorize a physician otherwise qualified to
2626	practice in the employ of any agency or institution otherwise
2627	qualified if the agency or institution has caused or permitted
2628	violations of the provisions of this chapter which it knew or
2629	should have known were occurring.
2630	Section 57. Subsection (4) of section 458.319, Florida
2631	Statutes, is amended to read:
2632	458.319 Renewal of license.--
2633	(4) Notwithstanding the provisions of s. 456.033,A
2634	physician may complete continuing education on end-of-life care
2635	and palliative care in lieu of continuing education in AIDS/HIV,
2636	if that physician has completed the AIDS/HIV continuing
2637	education in the immediately preceding biennium.
2638	Section 58. Paragraph (c) of subsection (5) of section
2639	458.320, Florida Statutes, is amended to read:
2640	458.320 Financial responsibility.--
2641	(5) The requirements of subsections (1), (2), and (3)
2642	shall not apply to:
2643	(c) Any person holding a limited license pursuant to s.
2644	458.315458.317and practicing under the scope of such limited
2645	license.
2646	Section 59. Section 458.3215, Florida Statutes, is created
2647	to read:
2648	458.3215 Reactivation of license for clinical research
2649	purposes.--
2650	(1) Any person who left the practice of medicine for
2651	purposes of retirement and who, at the time of retirement, was
2652	in good standing with the board may apply to the board to have
2653	his or her license reactivated, without examination, for
2654	purposes of seeing patients solely in a clinical research
2655	setting. Such person may not have been out of the practice of
2656	medicine for more than 10 years at the time of applying for
2657	reactivation of a license under this section.
2658	(2) The board shall by rule set the reactivation fee, not
2659	to exceed $300, and develop criteria for reactivation of a
2660	license under this section, including appropriate continuing
2661	education requirements, not to exceed those prescribed in s.
2662	458.321 for reactivation of a license.
2663	Section 60. Paragraph (t) of subsection (1) and
2664	subsections (6) and (9) of section 458.331, Florida Statutes,
2665	are amended to read:
2666	458.331 Grounds for disciplinary action; action by the
2667	board and department.--
2668	(1) The following acts constitute grounds for denial of a
2669	license or disciplinary action, as specified in s. 456.072(2):
2670	(t) Gross or repeated malpractice or the failure to
2671	practice medicine with that level of care, skill, and treatment
2672	which is recognized by a reasonably prudent similar physician as
2673	being acceptable under similar conditions and circumstances. The
2674	board shall give great weight to the provisions of s. 766.102
2675	when enforcing this paragraph. As used in this paragraph,
2676	"repeated malpractice" includes, but is not limited to, three or
2677	more claims for medical malpractice within the previous 5-year
2678	period resulting in indemnities being paid in excess of $50,000
2679	$25,000each to the claimant in a judgment or settlement and
2680	which incidents involved negligent conduct by the physician. As
2681	used in this paragraph, "gross malpractice" or "the failure to
2682	practice medicine with that level of care, skill, and treatment
2683	which is recognized by a reasonably prudent similar physician as
2684	being acceptable under similar conditions and circumstances,"
2685	shall not be construed so as to require more than one instance,
2686	event, or act. Nothing in this paragraph shall be construed to
2687	require that a physician be incompetent to practice medicine in
2688	order to be disciplined pursuant to this paragraph.
2689	(6) Upon the department's receipt from an insurer or self-
2690	insurer of a report of a closed claim against a physician
2691	pursuant to s. 627.912 or from a health care practitioner of a
2692	report pursuant to s. 456.049, or upon the receipt from a
2693	claimant of a presuit notice against a physician pursuant to s.
2694	766.106, the department shall review each report and determine
2695	whether it potentially involved conduct by a licensee that is
2696	subject to disciplinary action, in which case the provisions of
2697	s. 456.073 shall apply. However, if it is reported that a
2698	physician has had three or more claims with indemnities
2699	exceeding $50,000$25,000each within the previous 5-year
2700	period, the department shall investigate the occurrences upon
2701	which the claims were based and determine if action by the
2702	department against the physician is warranted.
2703	(9) When an investigation of a physician is undertaken,
2704	the department shall promptly furnish to the physician or the
2705	physician's attorney a copy of the complaint or document which
2706	resulted in the initiation of the investigation. For purposes of
2707	this subsection, such documents include, but are not limited to:
2708	the pertinent portions of an annual report submitted to the
2709	department pursuant to s. 395.0197(6); a report of an adverse
2710	incident which is provided to the department pursuant to s.
2711	395.0197; a report of peer review disciplinary action submitted
2712	to the department pursuant to s. 395.0193(4) or s. 458.337,
2713	providing that the investigations, proceedings, and records
2714	relating to such peer review disciplinary action shall continue
2715	to retain their privileged status even as to the licensee who is
2716	the subject of the investigation, as provided by ss. 395.0193(8)
2717	and 458.337(3); a report of a closed claim submitted pursuant to
2718	s. 627.912; a presuit notice submitted pursuant to s.
2719	766.106(2); and a petition brought under the Florida Birth-
2720	Related Neurological Injury Compensation Plan, pursuant to s.
2721	766.305(2). The physician may submit a written response to the
2722	information contained in the complaint or document which
2723	resulted in the initiation of the investigation within 3045
2724	days after service to the physician of the complaint or
2725	document. The physician's written response shall be considered
2726	by the probable cause panel.
2727	Section 61. Paragraph (c) of subsection (1) of section
2728	458.345, Florida Statutes, is amended to read:
2729	458.345 Registration of resident physicians, interns, and
2730	fellows; list of hospital employees; prescribing of medicinal
2731	drugs; penalty.--
2732	(1) Any person desiring to practice as a resident
2733	physician, assistant resident physician, house physician,
2734	intern, or fellow in fellowship training which leads to
2735	subspecialty board certification in this state, or any person
2736	desiring to practice as a resident physician, assistant resident
2737	physician, house physician, intern, or fellow in fellowship
2738	training in a teaching hospital in this state as defined in s.
2739	408.07(44) or s. 395.805(2), who does not hold a valid, active
2740	license issued under this chapter shall apply to the department
2741	to be registered and shall remit a fee not to exceed $300 as set
2742	by the board. The department shall register any applicant the
2743	board certifies has met the following requirements:
2744	(c) Is a graduate of a medical school or college as
2745	specified in s. 458.311(3)(1)(f).
2746	Section 62. Paragraph (b) of subsection (7) of section
2747	458.347, Florida Statutes, is amended to read:
2748	458.347 Physician assistants.--
2749	(7) PHYSICIAN ASSISTANT LICENSURE.--
2750	(b)1. Notwithstanding subparagraph (a)2. and sub-
2751	subparagraph (a)3.a., the department shall examine each
2752	applicant who the Board of Medicine certifies:
2753	a. Has completed the application form and remitted a
2754	nonrefundable application fee not to exceed $500 and an
2755	examination fee not to exceed $300, plus the actual cost to the
2756	department to provide the examination. The examination fee is
2757	refundable if the applicant is found to be ineligible to take
2758	the examination. The department shall not require the applicant
2759	to pass a separate practical component of the examination. For
2760	examinations given after July 1, 1998, competencies measured
2761	through practical examinations shall be incorporated into the
2762	written examination through a multiple-choice format. The
2763	department shall translate the examination into the native
2764	language of any applicant who requests and agrees to pay all
2765	costs of such translation, provided that the translation request
2766	is filed with the board office no later than 9 months before the
2767	scheduled examination and the applicant remits translation fees
2768	as specified by the department no later than 6 months before the
2769	scheduled examination, and provided that the applicant
2770	demonstrates to the department the ability to communicate orally
2771	in basic English. If the applicant is unable to pay translation
2772	costs, the applicant may take the next available examination in
2773	English if the applicant submits a request in writing by the
2774	application deadline and if the applicant is otherwise eligible
2775	under this section. To demonstrate the ability to communicate
2776	orally in basic English, a passing score or grade is required,
2777	as determined by the department or organization that developed
2778	it, on the test for spoken English (TSE) by the Educational
2779	Testing Service (ETS), the test of English as a foreign language
2780	(TOEFL) by ETS, a high school or college level English course,
2781	or the English examination for citizenship, Immigration and
2782	Naturalization Service. A notarized copy of an Educational
2783	Commission for Foreign Medical Graduates (ECFMG) certificate may
2784	also be used to demonstrate the ability to communicate in basic
2785	English; and
2786	b.(I) Is an unlicensed physician who graduated from a
2787	foreign medical school listed with the World Health Organization
2788	who has not previously taken and failed the examination of the
2789	National Commission on Certification of Physician Assistants and
2790	who has been certified by the Board of Medicine as having met
2791	the requirements for licensure as a medical doctor by
2792	examination as set forth in s. 458.311(2)-(7)(1), (3), (4), and
2793	(5), with the exception that the applicant is not required to
2794	have completed an approved residency of at least 1 year and the
2795	applicant is not required to have passed the licensing
2796	examination specified under s. 458.311 or hold a valid, active
2797	certificate issued by the Educational Commission for Foreign
2798	Medical Graduates; was eligible and made initial application for
2799	certification as a physician assistant in this state between
2800	July 1, 1990, and June 30, 1991; and was a resident of this
2801	state on July 1, 1990, or was licensed or certified in any state
2802	in the United States as a physician assistant on July 1, 1990;
2803	or
2804	(II) Completed all coursework requirements of the Master
2805	of Medical Science Physician Assistant Program offered through
2806	the Florida College of Physician's Assistants prior to its
2807	closure in August of 1996. Prior to taking the examination, such
2808	applicant must successfully complete any clinical rotations that
2809	were not completed under such program prior to its termination
2810	and any additional clinical rotations with an appropriate
2811	physician assistant preceptor, not to exceed 6 months, that are
2812	determined necessary by the council. The boards shall determine,
2813	based on recommendations from the council, the facilities under
2814	which such incomplete or additional clinical rotations may be
2815	completed and shall also determine what constitutes successful
2816	completion thereof, provided such requirements are comparable to
2817	those established by accredited physician assistant programs.
2818	This sub-sub-subparagraph is repealed July 1, 2001.
2819	2. The department may grant temporary licensure to an
2820	applicant who meets the requirements of subparagraph 1. Between
2821	meetings of the council, the department may grant temporary
2822	licensure to practice based on the completion of all temporary
2823	licensure requirements. All such administratively issued
2824	licenses shall be reviewed and acted on at the next regular
2825	meeting of the council. A temporary license expires 30 days
2826	after receipt and notice of scores to the licenseholder from the
2827	first available examination specified in subparagraph 1.
2828	following licensure by the department. An applicant who fails
2829	the proficiency examination is no longer temporarily licensed,
2830	but may apply for a one-time extension of temporary licensure
2831	after reapplying for the next available examination. Extended
2832	licensure shall expire upon failure of the licenseholder to sit
2833	for the next available examination or upon receipt and notice of
2834	scores to the licenseholder from such examination.
2835	3. Notwithstanding any other provision of law, the
2836	examination specified pursuant to subparagraph 1. shall be
2837	administered by the department only five times. Applicants
2838	certified by the board for examination shall receive at least 6
2839	months' notice of eligibility prior to the administration of the
2840	initial examination. Subsequent examinations shall be
2841	administered at 1-year intervals following the reporting of the
2842	scores of the first and subsequent examinations. For the
2843	purposes of this paragraph, the department may develop, contract
2844	for the development of, purchase, or approve an examination that
2845	adequately measures an applicant's ability to practice with
2846	reasonable skill and safety. The minimum passing score on the
2847	examination shall be established by the department, with the
2848	advice of the board. Those applicants failing to pass that
2849	examination or any subsequent examination shall receive notice
2850	of the administration of the next examination with the notice of
2851	scores following such examination. Any applicant who passes the
2852	examination and meets the requirements of this section shall be
2853	licensed as a physician assistant with all rights defined
2854	thereby.
2855	Section 63. Subsection (5) of section 459.008, Florida
2856	Statutes, is amended to read:
2857	459.008 Renewal of licenses and certificates.--
2858	(5) Notwithstanding the provisions of s. 456.033,An
2859	osteopathic physician may complete continuing education on end-
2860	of-life and palliative care in lieu of continuing education in
2861	AIDS/HIV, if that physician has completed the AIDS/HIV
2862	continuing education in the immediately preceding biennium.
2863	Section 64. Section 459.0091, Florida Statutes, is created
2864	to read:
2865	459.0091 Reactivation of license for clinical research
2866	purposes.--
2867	(1) Any person who left the practice of osteopathic
2868	medicine for purposes of retirement and who, at the time of
2869	retirement, was in good standing with the board may apply to the
2870	board to have his or her license reactivated, without
2871	examination, for purposes of seeing patients solely in a
2872	clinical research setting. Such person may not have been out of
2873	the practice of medicine for more than 10 years at the time of
2874	applying for reactivation of a license under this section.
2875	(2) The board shall by rule set the reactivation fee, not
2876	to exceed $300, and develop criteria for reactivation of a
2877	license under this section, including appropriate continuing
2878	education requirements, not to exceed those prescribed in s.
2879	459.009 for reactivation of a license.
2880	Section 65. Paragraph (x) of subsection (1) and
2881	subsections (6) and (9) of section 459.015, Florida Statutes,
2882	are amended to read:
2883	459.015 Grounds for disciplinary action; action by the
2884	board and department.--
2885	(1) The following acts constitute grounds for denial of a
2886	license or disciplinary action, as specified in s. 456.072(2):
2887	(x) Gross or repeated malpractice or the failure to
2888	practice osteopathic medicine with that level of care, skill,
2889	and treatment which is recognized by a reasonably prudent
2890	similar osteopathic physician as being acceptable under similar
2891	conditions and circumstances. The board shall give great weight
2892	to the provisions of s. 766.102 when enforcing this paragraph.
2893	As used in this paragraph, "repeated malpractice" includes, but
2894	is not limited to, three or more claims for medical malpractice
2895	within the previous 5-year period resulting in indemnities being
2896	paid in excess of $50,000$25,000each to the claimant in a
2897	judgment or settlement and which incidents involved negligent
2898	conduct by the osteopathic physician. As used in this paragraph,
2899	"gross malpractice" or "the failure to practice osteopathic
2900	medicine with that level of care, skill, and treatment which is
2901	recognized by a reasonably prudent similar osteopathic physician
2902	as being acceptable under similar conditions and circumstances"
2903	shall not be construed so as to require more than one instance,
2904	event, or act. Nothing in this paragraph shall be construed to
2905	require that an osteopathic physician be incompetent to practice
2906	osteopathic medicine in order to be disciplined pursuant to this
2907	paragraph. A recommended order by an administrative law judge or
2908	a final order of the board finding a violation under this
2909	paragraph shall specify whether the licensee was found to have
2910	committed "gross malpractice," "repeated malpractice," or
2911	"failure to practice osteopathic medicine with that level of
2912	care, skill, and treatment which is recognized as being
2913	acceptable under similar conditions and circumstances," or any
2914	combination thereof, and any publication by the board shall so
2915	specify.
2916	(6) Upon the department's receipt from an insurer or self-
2917	insurer of a report of a closed claim against an osteopathic
2918	physician pursuant to s. 627.912 or from a health care
2919	practitioner of a report pursuant to s. 456.049, or upon the
2920	receipt from a claimant of a presuit notice against an
2921	osteopathic physician pursuant to s. 766.106, the department
2922	shall review each report and determine whether it potentially
2923	involved conduct by a licensee that is subject to disciplinary
2924	action, in which case the provisions of s. 456.073 shall apply.
2925	However, if it is reported that an osteopathic physician has had
2926	three or more claims with indemnities exceeding $50,000$25,000
2927	each within the previous 5-year period, the department shall
2928	investigate the occurrences upon which the claims were based and
2929	determine if action by the department against the osteopathic
2930	physician is warranted.
2931	(9) When an investigation of an osteopathic physician is
2932	undertaken, the department shall promptly furnish to the
2933	osteopathic physician or his or her attorney a copy of the
2934	complaint or document which resulted in the initiation of the
2935	investigation. For purposes of this subsection, such documents
2936	include, but are not limited to: the pertinent portions of an
2937	annual report submitted to the department pursuant to s.
2938	395.0197(6); a report of an adverse incident which is provided
2939	to the department pursuant to s. 395.0197; a report of peer
2940	review disciplinary action submitted to the department pursuant
2941	to s. 395.0193(4) or s. 459.016, provided that the
2942	investigations, proceedings, and records relating to such peer
2943	review disciplinary action shall continue to retain their
2944	privileged status even as to the licensee who is the subject of
2945	the investigation, as provided by ss. 395.0193(8) and
2946	459.016(3); a report of a closed claim submitted pursuant to s.
2947	627.912; a presuit notice submitted pursuant to s. 766.106(2);
2948	and a petition brought under the Florida Birth-Related
2949	Neurological Injury Compensation Plan, pursuant to s.
2950	766.305(2). The osteopathic physician may submit a written
2951	response to the information contained in the complaint or
2952	document which resulted in the initiation of the investigation
2953	within 3045days after service to the osteopathic physician of
2954	the complaint or document. The osteopathic physician's written
2955	response shall be considered by the probable cause panel.
2956	Section 66. Paragraph (d) of subsection (1) of section
2957	460.406, Florida Statutes, is amended to read:
2958	460.406 Licensure by examination.--
2959	(1) Any person desiring to be licensed as a chiropractic
2960	physician shall apply to the department to take the licensure
2961	examination. There shall be an application fee set by the board
2962	not to exceed $100 which shall be nonrefundable. There shall
2963	also be an examination fee not to exceed $500 plus the actual
2964	per applicant cost to the department for purchase of portions of
2965	the examination from the National Board of Chiropractic
2966	Examiners or a similar national organization, which may be
2967	refundable if the applicant is found ineligible to take the
2968	examination. The department shall examine each applicant who
2969	the board certifies has:
2970	(d)1. For an applicant who has matriculated in a
2971	chiropractic college prior to July 2, 1990, completed at least 2
2972	years of residence college work, consisting of a minimum of one-
2973	half the work acceptable for a bachelor's degree granted on the
2974	basis of a 4-year period of study, in a college or university
2975	accredited by an accrediting agency recognized and approved by
2976	the United States Department of Education. However, prior to
2977	being certified by the board to sit for the examination, each
2978	applicant who has matriculated in a chiropractic college after
2979	July 1, 1990, shall have been granted a bachelor's degree, based
2980	upon 4 academic years of study, by a college or university
2981	accredited by a regional accrediting agency which is a member of
2982	the Council for Higher Education Accreditation or the United
2983	States Department of EducationCommission on Recognition of
2984	Postsecondary Accreditation.
2985	2. Effective July 1, 2000, completed, prior to
2986	matriculation in a chiropractic college, at least 3 years of
2987	residence college work, consisting of a minimum of 90 semester
2988	hours leading to a bachelor's degree in a liberal arts college
2989	or university accredited by an accrediting agency recognized and
2990	approved by the United States Department of Education. However,
2991	prior to being certified by the board to sit for the
2992	examination, each applicant who has matriculated in a
2993	chiropractic college after July 1, 2000, shall have been granted
2994	a bachelor's degree from an institution holding accreditation
2995	for that degree from a regional accrediting agency which is
2996	recognized by the United States Department of Education. The
2997	applicant's chiropractic degree must consist of credits earned
2998	in the chiropractic program and may not include academic credit
2999	for courses from the bachelor's degree.
3000	Section 67. Subsection (5) of section 460.413, Florida
3001	Statutes, is amended to read:
3002	460.413 Grounds for disciplinary action; action by board
3003	or department.--
3004	(5) When an investigation of a chiropractic physician is
3005	undertaken, the department shall promptly furnish to the
3006	chiropractic physician or her or his attorney a copy of the
3007	complaint or document which resulted in the initiation of the
3008	investigation. The chiropractic physician may submit a written
3009	response to the information contained in such complaint or
3010	document within 3045days after service to the chiropractic
3011	physician of the complaint or document. The chiropractic
3012	physician's written response shall be considered by the probable
3013	cause panel.
3014	Section 68. Paragraph (s) of subsection (1), paragraph (a)
3015	of subsection (5), and subsection (6) of section 461.013,
3016	Florida Statutes, are amended to read:
3017	461.013 Grounds for disciplinary action; action by the
3018	board; investigations by department.--
3019	(1) The following acts constitute grounds for denial of a
3020	license or disciplinary action, as specified in s. 456.072(2):
3021	(s) Gross or repeated malpractice or the failure to
3022	practice podiatric medicine at a level of care, skill, and
3023	treatment which is recognized by a reasonably prudent podiatric
3024	physician as being acceptable under similar conditions and
3025	circumstances. The board shall give great weight to the
3026	standards for malpractice in s. 766.102 in interpreting this
3027	section. As used in this paragraph, "repeated malpractice"
3028	includes, but is not limited to, three or more claims for
3029	medical malpractice within the previous 5-year period resulting
3030	in indemnities being paid in excess of $50,000$10,000each to
3031	the claimant in a judgment or settlement and which incidents
3032	involved negligent conduct by the podiatric physicians. As used
3033	in this paragraph, "gross malpractice" or "the failure to
3034	practice podiatric medicine with the level of care, skill, and
3035	treatment which is recognized by a reasonably prudent similar
3036	podiatric physician as being acceptable under similar conditions
3037	and circumstances" shall not be construed so as to require more
3038	than one instance, event, or act.
3039	(5)(a) Upon the department's receipt from an insurer or
3040	self-insurer of a report of a closed claim against a podiatric
3041	physician pursuant to s. 627.912, or upon the receipt from a
3042	claimant of a presuit notice against a podiatric physician
3043	pursuant to s. 766.106, the department shall review each report
3044	and determine whether it potentially involved conduct by a
3045	licensee that is subject to disciplinary action, in which case
3046	the provisions of s. 456.073 shall apply. However, if it is
3047	reported that a podiatric physician has had three or more claims
3048	with indemnities exceeding $50,000$25,000each within the
3049	previous 5-year period, the department shall investigate the
3050	occurrences upon which the claims were based and determine if
3051	action by the department against the podiatric physician is
3052	warranted.
3053	(6) When an investigation of a podiatric physician is
3054	undertaken, the department shall promptly furnish to the
3055	podiatric physician or her or his attorney a copy of the
3056	complaint or document which resulted in the initiation of the
3057	investigation. The podiatric physician may submit a written
3058	response to the information contained in such complaint or
3059	document within 3045days after service to the podiatric
3060	physician of the complaint or document. The podiatric
3061	physician's written response shall be considered by the probable
3062	cause panel.
3063	Section 69. Paragraph (b) of subsection (1) of section
3064	463.006, Florida Statutes, is amended to read:
3065	463.006 Licensure and certification by examination.--
3066	(1) Any person desiring to be a licensed practitioner
3067	pursuant to this chapter shall apply to the department to take
3068	the licensure and certification examinations. The department
3069	shall examine each applicant who the board determines has:
3070	(b) Submitted proof satisfactory to the department that
3071	she or he:
3072	1. Is at least 18 years of age.
3073	2. Has graduated from an accredited school or college of
3074	optometry approved by rule of the board.
3075	3. Is of good moral character.
3076	4. Has successfully completed at least 110 hours of
3077	transcript-quality coursework and clinical training in general
3078	and ocular pharmacology as determined by the board, at an
3079	institution that:
3080	a. Has facilities for both didactic and clinical
3081	instructions in pharmacology.; and
3082	b. Is accredited by a regional or professional accrediting
3083	organization that is recognized and approved by the Council for
3084	Higher EducationCommission on Recognition of Postsecondary
3085	Accreditation or the United States Department of Education.
3086	5. Has completed at least 1 year of supervised experience
3087	in differential diagnosis of eye disease or disorders as part of
3088	the optometric training or in a clinical setting as part of the
3089	optometric experience.
3090	Section 70. Paragraph (a) of subsection (4) of section
3091	464.0205, Florida Statutes, is amended to read:
3092	464.0205 Retired volunteer nurse certificate.--
3093	(4) A retired volunteer nurse receiving certification from
3094	the board shall:
3095	(a) Work under the direct supervision of the director of a
3096	county health department, a physician working under a limited
3097	license issued pursuant to s. 458.315458.317or s. 459.0075, a
3098	physician licensed under chapter 458 or chapter 459, an advanced
3099	registered nurse practitioner certified under s. 464.012, or a
3100	registered nurse licensed under s. 464.008 or s. 464.009.
3101	Section 71. Subsections (1), (5), and (7) of section
3102	464.203, Florida Statutes, are amended, and subsection (8) is
3103	added to said section, to read:
3104	464.203 Certified nursing assistants; certification
3105	requirement.--
3106	(1) The board shall issue a certificate to practice as a
3107	certified nursing assistant to any person who demonstrates a
3108	minimum competency to read and write and successfully passes the
3109	required statewide criminal history check through the Department
3110	of Law Enforcement or, if the applicant has not maintained
3111	continuous residency within the state for the 5 years
3112	immediately preceding the date of application, a federal
3113	criminal history check through the Federal Bureau of
3114	InvestigationLevel I or Level II screening pursuant to s.
3115	400.215and meets one of the following requirements:
3116	(a) Has successfully completed an approved training
3117	program and achieved a minimum score, established by rule of the
3118	board, on the nursing assistant competency examination, which
3119	consists of a written portion and skills-demonstration portion
3120	approved by the board and administered at a site and by
3121	personnel approved by the department.
3122	(b) Has achieved a minimum score, established by rule of
3123	the board, on the nursing assistant competency examination,
3124	which consists of a written portion and skills-demonstration
3125	portion, approved by the board and administered at a site and by
3126	personnel approved by the department and:
3127	1. Has a high school diploma, or its equivalent; or
3128	2. Is at least 18 years of age.
3129	(c) Is currently certified in another state; is listed on
3130	that state's certified nursing assistant registry; and has not
3131	been found to have committed abuse, neglect, or exploitation in
3132	that state.
3133	(d) Has completed the curriculum developed under the
3134	Enterprise Florida Jobs and Education Partnership Grant and
3135	achieved a minimum score, established by rule of the board, on
3136	the nursing assistant competency examination, which consists of
3137	a written portion and skills-demonstration portion, approved by
3138	the board and administered at a site and by personnel approved
3139	by the department.
3140	(5) Certification as a nursing assistant, in accordance
3141	with this part, may be renewedcontinues in effectuntil such
3142	time as the nursing assistant allows a period of 24 consecutive
3143	months to pass during which period the nursing assistant fails
3144	to perform any nursing-related services for monetary
3145	compensation. When a nursing assistant fails to perform any
3146	nursing-related services for monetary compensation for a period
3147	of 24 consecutive months, the nursing assistant must complete a
3148	new training and competency evaluation program or a new
3149	competency evaluation program.
3150	(7) A certified nursing assistant shall complete 1218
3151	hours of inservice training during each calendar year. The
3152	certified nursing assistant shall be responsible for maintaining
3153	documentation demonstrating compliance with these provisions.
3154	The Council on Certified Nursing Assistants, in accordance with
3155	s. 464.2085(2)(b), shall propose rules to implement this
3156	subsection.
3157	(8) The department shall renew a certificate upon receipt
3158	of the renewal application and a fee not to exceed $50
3159	biennially. The department shall adopt rules establishing a
3160	procedure for the biennial renewal of certificates. Any
3161	certificate not renewed by July 1, 2005, shall be void.
3162	Section 72. Paragraph (b) of subsection (1) of section
3163	464.204, Florida Statutes, is amended to read:
3164	464.204 Denial, suspension, or revocation of
3165	certification; disciplinary actions.--
3166	(1) The following acts constitute grounds for which the
3167	board may impose disciplinary sanctions as specified in
3168	subsection (2):
3169	(b) Intentionally Violating any provision of parts I and
3170	II ofthis chapter, chapter 456, or the rules adopted by the
3171	board.
3172	Section 73. Paragraph (i) of subsection (1) of section
3173	465.016, Florida Statutes, is amended to read:
3174	465.016 Disciplinary actions.--
3175	(1) The following acts constitute grounds for denial of a
3176	license or disciplinary action, as specified in s. 456.072(2):
3177	(i) Compounding, dispensing, or distributing a legend
3178	drug, including any controlled substance, other than in the
3179	course of the professional practice of pharmacy. For purposes of
3180	this paragraph, it shall be legally presumed that the
3181	compounding, dispensing, or distributing of legend drugs in
3182	excessive or inappropriate quantities is not in the best
3183	interests of the patient and is not in the course of the
3184	professional practice of pharmacy. A quantity of legend drug
3185	which the licensee knows or reasonably should know was not
3186	prescribed in the course of a valid professional relationship is
3187	presumed to be an excessive or inappropriate quantity. A medical
3188	questionnaire completed by Internet, telephone, electronic
3189	transfer, or mail does not establish a valid professional
3190	relationship.
3191	Section 74. Subsection (8) of section 467.009, Florida
3192	Statutes, is amended to read:
3193	467.009 Midwifery programs; education and training
3194	requirements.--
3195	(8) Nonpublic educational institutions that conduct
3196	approved midwifery programs shall be accredited by an
3197	accrediting agency recognized and approved by the Council for
3198	Higher Education Accreditation or the United States Department
3199	of Educationa member of the Commission on Recognition of
3200	Postsecondary Accreditation and shall be licensed by the
3201	Commission for IndependentState Board of Nonpublic Career
3202	Education.
3203	Section 75. Section 467.013, Florida Statutes, is amended
3204	to read:
3205	467.013 Inactive status.--A licensee may request that his
3206	or her license be placed in an inactive status by making
3207	application to the department pursuant to department ruleand
3208	paying a fee.
3209	(1) An inactive license may be renewed for one additional
3210	biennium upon application to the department and payment of the
3211	applicable biennium renewal fee. The department shall establish
3212	by rule procedures and fees for applying to place a license on
3213	inactive status, renewing an inactive license, and reactivating
3214	an inactive license. The fee for any of these procedures may not
3215	exceed the biennial renewal fee established by the department.
3216	(2) Any license that is not renewed by the end of the
3217	biennium established by the department automatically reverts to
3218	involuntary inactive status unless the licensee has applied for
3219	voluntary inactive status. Such license may be reactivated only
3220	if the licensee meets the requirements for reactivating the
3221	license established by department rule.
3222	(3) A midwife who desires to reactivate an inactive
3223	license shall apply to the department, complete the reactivation
3224	application, remit the applicable fees, and submit proof of
3225	compliance with the requirements for continuing education
3226	established by department rule.
3227	(4) Each licensed midwife whose license has been placed on
3228	inactive status for more than 1 year must complete continuing
3229	education hours as a condition of reactivating the inactive
3230	license.
3231	(5) The licensee shall submit to the department evidence
3232	of participation in 10 hours of continuing education, approved
3233	by the department and clinically related to the practice of
3234	midwifery, for each year of the biennium in which the license
3235	was inactive. This requirement is in addition to submitting
3236	evidence of completing the continuing education required for the
3237	most recent biennium in which the licensee held an active
3238	license.
3239	Section 76. Section 467.0135, Florida Statutes, is amended
3240	to read:
3241	467.0135 Fees.--The department shall establish fees for
3242	application, examination, initial licensure, renewal of active
3243	statuslicensure, licensure by endorsement, inactive status,
3244	delinquent status, and reactivation of an inactive status
3245	license. The appropriate fee must be paid at the time of
3246	application and is payable to the Department of Health, in
3247	accordance with rules adopted by the department. A fee is
3248	nonrefundable, unless otherwise provided by rule. A fee may not
3249	exceed:
3250	(1) Five hundred dollars for examination.
3251	(1)(2)Five hundred dollars for initial licensure.
3252	(2)(3) Five hundred dollars for renewal of an active
3253	status licenselicensure.
3254	(3)(4) Two hundred dollars for application, which fee is
3255	nonrefundable.
3256	(4)(5) Five hundred dollars for renewalreactivationof an
3257	inactive statuslicense.
3258	(5)(6)Five hundred dollars for licensure by endorsement.
3259
3260	A fee for inactive status, reactivation of an inactive status
3261	license, or delinquency may not exceed the fee established by
3262	the department for biennial renewal of an active statuslicense.
3263	All fees collected under this section shall be deposited in the
3264	Medical Quality Assurance Trust Fund.
3265	Section 77. Subsection (1) of section 467.017, Florida
3266	Statutes, is amended to read:
3267	467.017 Emergency care plan; immunity.--
3268	(1) Every licensed midwife shall develop a written plan
3269	for the appropriate delivery of emergency care. A copy of the
3270	plan shall accompany any application for license issuance and
3271	must be made available upon request of the departmentor
3272	renewal. The plan shall address the following:
3273	(a) Consultation with other health care providers.
3274	(b) Emergency transfer.
3275	(c) Access to neonatal intensive care units and
3276	obstetrical units or other patient care areas.
3277	Section 78. Paragraph (g) of subsection (3) of section
3278	468.302, Florida Statutes, is amended to read:
3279	468.302 Use of radiation; identification of certified
3280	persons; limitations; exceptions.--
3281	(3)
3282	(g)1.A person holding a certificate as a nuclear medicine
3283	technologist may only:
3284	a.Conduct in vivo and in vitro measurements of
3285	radioactivity and administer radiopharmaceuticals to human
3286	beings for diagnostic and therapeutic purposes.
3287	b. Administer X radiation from a combination nuclear
3288	medicine-computed tomography device if that radiation is
3289	administered as an integral part of a nuclear medicine procedure
3290	that uses an automated computed tomography protocol for the
3291	purposes of attenuation correction and anatomical localization
3292	and the person has received device-specific training on the
3293	combination device.
3294	2.However,The authority of a nuclear medicine
3295	technologist under this paragraph excludes:
3296	a.Radioimmunoassay and other clinical laboratory testing
3297	regulated pursuant to chapter 483.
3298	b. Creating or modifying automated computed tomography
3299	protocols.
3300	c. Any other operation of a computed tomography device,
3301	especially for the purposes of stand-alone diagnostic imaging
3302	which is regulated pursuant to the general radiographic scope in
3303	this part.
3304	Section 79. Section 468.352, Florida Statutes, is amended
3305	to read:
3306	(Substantial rewording of section. See
3307	s. 468.352, F.S., for present text.)
3308	468.352 Definitions.--As used in this part, the term:
3309	(1) "Board" means the Board of Respiratory Care.
3310	(2) "Certified respiratory therapist" means any person
3311	licensed under this part who is certified by the National Board
3312	for Respiratory Care, or its successor, who is employed to
3313	deliver respiratory care services under the order of a physician
3314	licensed pursuant to chapter 458 or chapter 459 in accordance
3315	with protocols established by a hospital or other health care
3316	provider or the board and who functions in situations of
3317	unsupervised contact requiring individual judgment.
3318	(3) "Critical care" means care given to a patient in any
3319	setting involving a life-threatening emergency.
3320	(4) "Department" means the Department of Health.
3321	(5) "Direct supervision" means practicing under the
3322	direction of a licensed, registered, or certified respiratory
3323	therapist who is physically on the premises and readily
3324	available, as defined by the board.
3325	(6) "Physician supervision" means supervision and control
3326	by a physician licensed under chapter 458 or chapter 459 who
3327	assumes the legal liability for the services rendered by the
3328	personnel employed in his or her office. Except in the case of
3329	an emergency, physician supervision requires the easy
3330	availability of the physician within the office or the physical
3331	presence of the physician for consultation and direction of the
3332	actions of the persons who deliver respiratory care services.
3333	(7) "Practice of respiratory care" or "respiratory
3334	therapy" means the allied health specialty associated with the
3335	cardiopulmonary system that is practiced under the orders of a
3336	physician licensed under chapter 458 or chapter 459 and in
3337	accordance with protocols, policies, and procedures established
3338	by a hospital or other health care provider or the board,
3339	including the assessment, diagnostic evaluation, treatment,
3340	management, control, rehabilitation, education, and care of
3341	patients in all health care settings.
3342	(8) "Registered respiratory therapist" means any person
3343	licensed under this part who is registered by the National Board
3344	for Respiratory Care, or its successor, who is employed to
3345	deliver respiratory care services under the order of a physician
3346	licensed under chapter 458 or chapter 459 in accordance with
3347	protocols established by a hospital or other health care
3348	provider or the board, and who functions in situations of
3349	unsupervised contact requiring individual judgment.
3350	(9) "Respiratory care practitioner" means any person
3351	licensed under this part who is employed to deliver respiratory
3352	care services under direct supervision pursuant to the order of
3353	a physician licensed under chapter 458 or chapter 459.
3354	(10) "Respiratory care services" includes:
3355	(a) Evaluation and disease management.
3356	(b) Diagnostic and therapeutic use of respiratory
3357	equipment, devices, or medical gas.
3358	(c) Administration of drugs, as duly ordered or prescribed
3359	by a physician licensed under chapter 458 or chapter 459 and in
3360	accordance with protocols, policies, and procedures established
3361	by a hospital, another health care provider, or the board.
3362	(d) Initiation, management, and maintenance of equipment
3363	to assist and support ventilation and respiration.
3364	(e) Diagnostic procedures, research, and therapeutic
3365	treatment and procedures, including measurement of ventilatory
3366	volumes, pressures, and flows; specimen collection and analysis
3367	of blood for gas transport and acid/base determinations;
3368	pulmonary-function testing; and other related physiological
3369	monitoring of cardiopulmonary systems.
3370	(f) Cardiopulmonary rehabilitation.
3371	(g) Cardiopulmonary resuscitation, advanced cardiac life
3372	support, neonatal resuscitation, and pediatric advanced life
3373	support, or equivalent functions.
3374	(h) Insertion and maintenance of artificial airways and
3375	intravascular catheters.
3376	(i) Performing sleep disorder studies.
3377	(j) Education of patients, families, the public, or other
3378	health care providers, including disease process and management
3379	programs and smoking prevention and cessation programs.
3380	(k) Initiation and management of hyperbaric oxygen.
3381	Section 80. Section 468.355, Florida Statutes, is amended
3382	to read:
3383	(Substantial rewording of section. See
3384	s. 468.355, F.S., for present text.)
3385	468.355 Licensure requirements.--To be eligible for
3386	licensure by the board, an applicant must be an active certified
3387	respiratory therapist or an active registered respiratory
3388	therapist credentialed by the National Board for Respiratory
3389	Care or its successor.
3390	Section 81. Section 468.368, Florida Statutes, is amended
3391	to read:
3392	(Substantial rewording of section. See
3393	s. 468.368, F.S., for present text.)
3394	468.368 Exemptions.--This part may not be construed to
3395	prevent or restrict the practice, services, or activities of:
3396	(1) Any person licensed in this state by any other
3397	provision of law when engaging in the profession or occupation
3398	for which he or she is licensed.
3399	(2) Any legally qualified person in the state or another
3400	state or territory who is employed by the United States
3401	Government or any agency thereof while such person is
3402	discharging his or her official duties.
3403	(3) A friend or family member who is providing respiratory
3404	care services to an ill person and who does not represent
3405	himself or herself as a respiratory care practitioner or
3406	respiratory therapist.
3407	(4) An individual providing respiratory care services in
3408	an emergency who does not represent himself or herself as a
3409	respiratory care practitioner or respiratory therapist.
3410	(5) Any individual employed to deliver, assemble, set up,
3411	or test equipment for use in a home, upon the order of a
3412	physician licensed pursuant to chapter 458 or chapter 459. This
3413	subsection does not, however, authorize the practice of
3414	respiratory care without a license.
3415	(6) Any individual performing polysomnography under
3416	medical direction, as related to the diagnosis and evaluation of
3417	treatment for sleep disorders.
3418	(7) Any individual certified or registered as a pulmonary
3419	function technologist who is credentialed by the National Board
3420	for Respiratory Care or its successor for performing
3421	cardiopulmonary diagnostic studies.
3422	(8) Any student who is enrolled in an accredited
3423	respiratory care program approved by the board while performing
3424	respiratory care as an integral part of a required course.
3425	(9) The delivery of incidental respiratory care to
3426	noninstitutionalized persons by surrogate family members who do
3427	not represent themselves as registered or certified respiratory
3428	care therapists.
3429	(10) Any individual credentialed by the Underseas
3430	Hyperbaric Society in hyperbaric medicine, or its equivalent as
3431	determined by the board, while performing related duties. This
3432	subsection does not, however, authorize the practice of
3433	respiratory care without a license.
3434	Section 82. Subsection (2) of section 468.509, Florida
3435	Statutes, is amended to read:
3436	468.509 Dietitian/nutritionist; requirements for
3437	licensure.--
3438	(2) The agency shall examine any applicant who the board
3439	certifies has completed the application form and remitted the
3440	application and examination fees specified in s. 468.508 and
3441	who:
3442	(a)1. Possesses a baccalaureate or postbaccalaureate
3443	degree with a major course of study in human nutrition, food and
3444	nutrition, dietetics, or food management, or an equivalent major
3445	course of study, from a school or program accredited, at the
3446	time of the applicant's graduation, by the appropriate
3447	accrediting agency recognized by the Council for Higher
3448	Education Accreditation orCommission on Recognition of
3449	Postsecondary Accreditation andthe United States Department of
3450	Education; and
3451	2. Has completed a preprofessional experience component of
3452	not less than 900 hours or has education or experience
3453	determined to be equivalent by the board; or
3454	(b)1. Has an academic degree, from a foreign country, that
3455	has been validated by an accrediting agency approved by the
3456	United States Department of Education as equivalent to the
3457	baccalaureate or postbaccalaureate degree conferred by a
3458	regionally accredited college or university in the United
3459	States;
3460	2. Has completed a major course of study in human
3461	nutrition, food and nutrition, dietetics, or food management;
3462	and
3463	3. Has completed a preprofessional experience component of
3464	not less than 900 hours or has education or experience
3465	determined to be equivalent by the board.
3466	Section 83. Section 468.707, Florida Statutes, is amended
3467	to read:
3468	468.707 Licensure by examination; requirements.--
3469	(1)Any person desiring to be licensed as an athletic
3470	trainer shall apply to the department on a form approved by the
3471	department.
3472	(1)(a)The department shall license each applicant who:
3473	(a)1.Has completed the application form and remitted the
3474	required fees.
3475	(b)2.Is at least 21 years of age.
3476	(c)3.Has obtained a baccalaureate degree from a college
3477	or university accredited by an accrediting agency recognized and
3478	approved by the United States Department of Education or the
3479	Council for Higher EducationCommission on Recognition of
3480	PostsecondaryAccreditation, or approved by the board.
3481	(d)4.Has completed coursework from a college or
3482	university accredited by an accrediting agency recognized and
3483	approved by the United States Department of Education or the
3484	Council for Higher EducationCommission on Recognition of
3485	Postsecondary Accreditation, or approved by the board, in each
3486	of the following areas, as provided by rule: health, human
3487	anatomy, kinesiology/biomechanics, human physiology, physiology
3488	of exercise, basic athletic training, and advanced athletic
3489	training.
3490	(e)5.Has current certification in standard first aid and
3491	cardiovascular pulmonary resuscitation from the American Red
3492	Cross or an equivalent certification as determined by the board.
3493	(f)6.Has, within 2 of the preceding 5 years, attained a
3494	minimum of 800 hours of athletic training experience under the
3495	direct supervision of a licensed athletic trainer or an athletic
3496	trainer certified by the National Athletic Trainers' Association
3497	or a comparable national athletic standards organization.
3498	(g)7.Has passed an examination administered or approved
3499	by the board.
3500	(2)(b)The department shall also license each applicant
3501	who:
3502	(a)1.Has completed the application form and remitted the
3503	required fees no later than October 1, 1996.
3504	(b)2.Is at least 21 years of age.
3505	(c)3.Has current certification in standard first aid and
3506	cardiovascular pulmonary resuscitation from the American Red
3507	Cross or an equivalent certification as determined by the board.
3508	(d)1.4.a.Has practiced athletic training for at least 3
3509	of the 5 years preceding application; or
3510	2.b.Is currently certified by the National Athletic
3511	Trainers' Association or a comparable national athletic
3512	standards organization.
3513	(2) Pursuant to the requirements of s. 456.034, each
3514	applicant shall complete a continuing education course on human
3515	immunodeficiency virus and acquired immune deficiency syndrome
3516	as part of initial licensure.
3517	Section 84. Section 486.031, Florida Statutes, is amended
3518	to read:
3519	486.031 Physical therapist; licensing requirements.--To be
3520	eligible for licensing as a physical therapist, an applicant
3521	must:
3522	(1) Be at least 18 years old.;
3523	(2) Be of good moral character.; and
3524	(3)(a) Have been graduated from a school of physical
3525	therapy which has been approved for the educational preparation
3526	of physical therapists by the appropriate accrediting agency
3527	recognized by the Council for Higher EducationCommission on
3528	Recognition of PostsecondaryAccreditation or the United States
3529	Department of Education at the time of her or his graduation and
3530	have passed, to the satisfaction of the board, the American
3531	Registry Examination prior to 1971 or a national examination
3532	approved by the board to determine her or his fitness for
3533	practice as a physical therapist as hereinafter provided;
3534	(b) Have received a diploma from a program in physical
3535	therapy in a foreign country and have educational credentials
3536	deemed equivalent to those required for the educational
3537	preparation of physical therapists in this country, as
3538	recognized by the appropriate agency as identified by the board,
3539	and have passed to the satisfaction of the board an examination
3540	to determine her or his fitness for practice as a physical
3541	therapist as hereinafter provided; or
3542	(c) Be entitled to licensure without examination as
3543	provided in s. 486.081.
3544	Section 85. Section 486.102, Florida Statutes, is amended
3545	to read:
3546	486.102 Physical therapist assistant; licensing
3547	requirements.--To be eligible for licensing by the board as a
3548	physical therapist assistant, an applicant must:
3549	(1) Be at least 18 years old.;
3550	(2) Be of good moral character.; and
3551	(3)(a) Have been graduated from a school giving a course
3552	of not less than 2 years for physical therapist assistants,
3553	which has been approved for the educational preparation of
3554	physical therapist assistants by the appropriate accrediting
3555	agency recognized by the Council for Higher EducationCommission
3556	on Recognition of PostsecondaryAccreditation or the United
3557	States Department of Education at the time of her or his
3558	graduation and have passed to the satisfaction of the board an
3559	examination to determine her or his fitness for practice as a
3560	physical therapist assistant as hereinafter provided;
3561	(b) Have been graduated from a school giving a course for
3562	physical therapist assistants in a foreign country and have
3563	educational credentials deemed equivalent to those required for
3564	the educational preparation of physical therapist assistants in
3565	this country, as recognized by the appropriate agency as
3566	identified by the board, and passed to the satisfaction of the
3567	board an examination to determine her or his fitness for
3568	practice as a physical therapist assistant as hereinafter
3569	provided; or
3570	(c) Be entitled to licensure without examination as
3571	provided in s. 486.107.
3572	Section 86. Paragraph (a) of subsection (5) of section
3573	489.553, Florida Statutes, is amended to read:
3574	489.553 Administration of part; registration
3575	qualifications; examination.--
3576	(5) To be eligible for registration by the department as a
3577	master septic tank contractor, the applicant must:
3578	(a) Have been a registered septic tank contractor in
3579	Florida for at least 3 years or a plumbing contractor certified
3580	under part I of this chapter who has provided septic tank
3581	contracting services for at least 3 years. The 3 years must
3582	immediately precede the date of application and may not be
3583	interrupted by any probation, suspension, or revocation imposed
3584	by the licensing agency.
3585	Section 87. Section 489.554, Florida Statutes, is amended
3586	to read:
3587	489.554 Registration renewal.--
3588	(1)The department shall prescribe by rule the method for
3589	approval of continuing education courses,and forrenewal of
3590	annual registration, inactive status for late filing of a
3591	renewal application, allowing a contractor to hold his or her
3592	registration in inactive status for a specified period, and
3593	reactivating a license.
3594	(2)At a minimum, annual renewal shall include continuing
3595	education requirements of not less than 6 classroom hours
3596	annually for septic tank contractors and not less than 12
3597	classroom hours annually for master septic tank contractors. The
3598	12 classroom hours of continuing education required for master
3599	septic tank contractors may include the 6 classroom hours
3600	required for septic tank contractors, but at a minimum must
3601	include 6 classroom hours of approved master septic tank
3602	contractor coursework.
3603	(3) A certificate of registration shall become inactive if
3604	a renewal application is not filed in a timely manner. A
3605	certificate that has become inactive may be reactivated under
3606	this section by application to the department. A registered
3607	contractor may apply to the department for voluntary inactive
3608	status at any time during the period of registration.
3609	(4) A master septic tank contractor may elect to revert to
3610	registered septic tank contractor status at any time during the
3611	period of registration. The department shall prescribe by rule
3612	the method for a master septic tank contractor whose
3613	registration has reverted to registered septic tank contractor
3614	status to apply for master septic tank contractor status.
3615	(5) The department shall deny an application for renewal
3616	if there is any outstanding administrative penalty against the
3617	applicant which is final agency action and all judicial reviews
3618	are exhausted.
3619	Section 88. Paragraph (b) of subsection (2) of section
3620	490.005, Florida Statutes, is amended to read:
3621	490.005 Licensure by examination.--
3622	(2) Any person desiring to be licensed as a school
3623	psychologist shall apply to the department to take the licensure
3624	examination. The department shall license each applicant who
3625	the department certifies has:
3626	(b) Submitted satisfactory proof to the department that
3627	the applicant:
3628	1. Has received a doctorate, specialist, or equivalent
3629	degree from a program primarily psychological in nature and has
3630	completed 60 semester hours or 90 quarter hours of graduate
3631	study, in areas related to school psychology as defined by rule
3632	of the department, from a college or university which at the
3633	time the applicant was enrolled and graduated was accredited by
3634	an accrediting agency recognized and approved by the Council for
3635	Higher Education Accreditation or the United States Department
3636	of EducationCommission on Recognition of Postsecondary
3637	Accreditation or froman institution which is publicly
3638	recognized as a member in good standing with the Association of
3639	Universities and Colleges of Canada.
3640	2. Has had a minimum of 3 years of experience in school
3641	psychology, 2 years of which must be supervised by an individual
3642	who is a licensed school psychologist or who has otherwise
3643	qualified as a school psychologist supervisor, by education and
3644	experience, as set forth by rule of the department. A doctoral
3645	internship may be applied toward the supervision requirement.
3646	3. Has passed an examination provided by the department.
3647	Section 89. Paragraph (d) of subsection (1), paragraph (b)
3648	of subsection (3), and paragraph (b) of subsection (4) of
3649	section 491.005, Florida Statutes, are amended, and paragraph
3650	(f) is added to subsection (1) of said section, to read:
3651	491.005 Licensure by examination.--
3652	(1) CLINICAL SOCIAL WORK.--Upon verification of
3653	documentation and payment of a fee not to exceed $200, as set by
3654	board rule, plus the actual per applicant cost to the department
3655	for purchase of the examination from the American Association of
3656	State Social Worker's Boards or a similar national organization,
3657	the department shall issue a license as a clinical social worker
3658	to an applicant who the board certifies:
3659	(d) Has passed a theory and practice examination approved
3660	provided by the boarddepartment for this purpose, which shall
3661	only be taken following completion of the clinical experience
3662	requirement.
3663	(f) Has satisfied all coursework requirements in this
3664	section by successfully completing the required course as a
3665	student or by teaching the required graduate course as an
3666	instructor or professor in an accredited institution.
3667	(3) MARRIAGE AND FAMILY THERAPY.--Upon verification of
3668	documentation and payment of a fee not to exceed $200, as set by
3669	board rule, plus the actual cost to the department for the
3670	purchase of the examination from the Association of Marital and
3671	Family Therapy Regulatory Board, or similar national
3672	organization, the department shall issue a license as a marriage
3673	and family therapist to an applicant who the board certifies:
3674	(b)1. Has a minimum of a master's degree with major
3675	emphasis in marriage and family therapy, or a closely related
3676	field, and has completed all of the following requirements:
3677	a. Thirty-six semester hours or 48 quarter hours of
3678	graduate coursework, which must include a minimum of 3 semester
3679	hours or 4 quarter hours of graduate-level course credits in
3680	each of the following nine areas: dynamics of marriage and
3681	family systems; marriage therapy and counseling theory and
3682	techniques; family therapy and counseling theory and techniques;
3683	individual human development theories throughout the life cycle;
3684	personality theory or general counseling theory and techniques;
3685	psychopathology; human sexuality theory and counseling
3686	techniques; psychosocial theory; and substance abuse theory and
3687	counseling techniques. Courses in research, evaluation,
3688	appraisal, assessment, or testing theories and procedures;
3689	thesis or dissertation work; or practicums, internships, or
3690	fieldwork may not be applied toward this requirement.
3691	b. A minimum of one graduate-level course of 3 semester
3692	hours or 4 quarter hours in legal, ethical, and professional
3693	standards issues in the practice of marriage and family therapy
3694	or a course determined by the board to be equivalent.
3695	c. A minimum of one graduate-level course of 3 semester
3696	hours or 4 quarter hours in diagnosis, appraisal, assessment,
3697	and testing for individual or interpersonal disorder or
3698	dysfunction; and a minimum of one 3-semester-hour or 4-quarter-
3699	hour graduate-level course in behavioral research which focuses
3700	on the interpretation and application of research data as it
3701	applies to clinical practice. Credit for thesis or dissertation
3702	work, practicums, internships, or fieldwork may not be applied
3703	toward this requirement.
3704	d. A minimum of one supervised clinical practicum,
3705	internship, or field experience in a marriage and family
3706	counseling setting, during which the student provided 180 direct
3707	client contact hours of marriage and family therapy services
3708	under the supervision of an individual who met the requirements
3709	for supervision under paragraph (c). This requirement may be met
3710	by a supervised practice experience which took place outside the
3711	academic arena, but which is certified as equivalent to a
3712	graduate-level practicum or internship program which required a
3713	minimum of 180 direct client contact hours of marriage and
3714	family therapy services currently offered within an academic
3715	program of a college or university accredited by an accrediting
3716	agency approved by the United States Department of Education, or
3717	an institution which is publicly recognized as a member in good
3718	standing with the Association of Universities and Colleges of
3719	Canada or a training institution accredited by the Commission on
3720	Accreditation for Marriage and Family Therapy Education
3721	recognized by the United States Department of Education.
3722	Certification shall be required from an official of such
3723	college, university, or training institution.
3724	2. If the course title which appears on the applicant's
3725	transcript does not clearly identify the content of the
3726	coursework, the applicant shall be required to provide
3727	additional documentation, including, but not limited to, a
3728	syllabus or catalog description published for the course.
3729
3730	The required master's degree must have been received in an
3731	institution of higher education which at the time the applicant
3732	graduated was: fully accredited by a regional accrediting body
3733	recognized by the Council for Higher Education Accreditation or
3734	the United States Department of EducationCommission on
3735	Recognition of Postsecondary Accreditation; publicly recognized
3736	as a member in good standing with the Association of
3737	Universities and Colleges of Canada; or an institution of higher
3738	education located outside the United States and Canada, which at
3739	the time the applicant was enrolled and at the time the
3740	applicant graduated maintained a standard of training
3741	substantially equivalent to the standards of training of those
3742	institutions in the United States which are accredited by a
3743	regional accrediting body recognized by the Council for Higher
3744	Education Accreditation or the United States Department of
3745	EducationCommission on Recognition of Postsecondary
3746	Accreditation. Such foreign education and training must have
3747	been received in an institution or program of higher education
3748	officially recognized by the government of the country in which
3749	it is located as an institution or program to train students to
3750	practice as professional marriage and family therapists or
3751	psychotherapists. The burden of establishing that the
3752	requirements of this provision have been met shall be upon the
3753	applicant, and the board shall require documentation, such as,
3754	but not limited to, an evaluation by a foreign equivalency
3755	determination service, as evidence that the applicant's graduate
3756	degree program and education were equivalent to an accredited
3757	program in this country. An applicant with a master's degree
3758	from a program which did not emphasize marriage and family
3759	therapy may complete the coursework requirement in a training
3760	institution fully accredited by the Commission on Accreditation
3761	for Marriage and Family Therapy Education recognized by the
3762	United States Department of Education.
3763	(4) MENTAL HEALTH COUNSELING.--Upon verification of
3764	documentation and payment of a fee not to exceed $200, as set by
3765	board rule, plus the actual per applicant cost to the department
3766	for purchase of the examination from the Professional
3767	Examination Service for the National Academy of Certified
3768	Clinical Mental Health Counselors or a similar national
3769	organization, the department shall issue a license as a mental
3770	health counselor to an applicant who the board certifies:
3771	(b)1. Has a minimum of an earned master's degree from a
3772	mental health counseling program accredited by the Council for
3773	the Accreditation of Counseling and Related Educational Programs
3774	that consists of at least 60 semester hours or 80 quarter hours
3775	of clinical and didactic instruction, including a course in
3776	human sexuality and a course in substance abuse. If the master's
3777	degree is earned from a program related to the practice of
3778	mental health counseling that is not accredited by the Council
3779	for the Accreditation of Counseling and Related Educational
3780	Programs, then the coursework and practicum, internship, or
3781	fieldwork must consist of at least 60 semester hours or 80
3782	quarter hours and meet the following requirements:
3783	a. Thirty-three semester hours or 44 quarter hours of
3784	graduate coursework, which must include a minimum of 3 semester
3785	hours or 4 quarter hours of graduate-level coursework in each of
3786	the following 11 content areas: counseling theories and
3787	practice; human growth and development; diagnosis and treatment
3788	of psychopathology; human sexuality; group theories and
3789	practice; individual evaluation and assessment; career and
3790	lifestyle assessment; research and program evaluation; social
3791	and cultural foundations; counseling in community settings; and
3792	substance abuse. Courses in research, thesis or dissertation
3793	work, practicums, internships, or fieldwork may not be applied
3794	toward this requirement.
3795	b. A minimum of 3 semester hours or 4 quarter hours of
3796	graduate-level coursework in legal, ethical, and professional
3797	standards issues in the practice of mental health counseling,
3798	which includes goals, objectives, and practices of professional
3799	counseling organizations, codes of ethics, legal considerations,
3800	standards of preparation, certifications and licensing, and the
3801	role identity and professional obligations of mental health
3802	counselors. Courses in research, thesis or dissertation work,
3803	practicums, internships, or fieldwork may not be applied toward
3804	this requirement.
3805	c. The equivalent, as determined by the board, of at least
3806	1,000 hours of university-sponsored supervised clinical
3807	practicum, internship, or field experience as required in the
3808	accrediting standards of the Council for Accreditation of
3809	Counseling and Related Educational Programs for mental health
3810	counseling programs. This experience may not be used to satisfy
3811	the post-master's clinical experience requirement.
3812	2. If the course title which appears on the applicant's
3813	transcript does not clearly identify the content of the
3814	coursework, the applicant shall be required to provide
3815	additional documentation, including, but not limited to, a
3816	syllabus or catalog description published for the course.
3817
3818	Education and training in mental health counseling must have
3819	been received in an institution of higher education which at the
3820	time the applicant graduated was: fully accredited by a regional
3821	accrediting body recognized by the Council for Higher Education
3822	Accreditation or the United States Department of Education
3823	Commission on Recognition of Postsecondary Accreditation;
3824	publicly recognized as a member in good standing with the
3825	Association of Universities and Colleges of Canada; or an
3826	institution of higher education located outside the United
3827	States and Canada, which at the time the applicant was enrolled
3828	and at the time the applicant graduated maintained a standard of
3829	training substantially equivalent to the standards of training
3830	of those institutions in the United States which are accredited
3831	by a regional accrediting body recognized by the Council for
3832	Higher Education Accreditation or the United States Department
3833	of EducationCommission on Recognition of Postsecondary
3834	Accreditation. Such foreign education and training must have
3835	been received in an institution or program of higher education
3836	officially recognized by the government of the country in which
3837	it is located as an institution or program to train students to
3838	practice as mental health counselors. The burden of establishing
3839	that the requirements of this provision have been met shall be
3840	upon the applicant, and the board shall require documentation,
3841	such as, but not limited to, an evaluation by a foreign
3842	equivalency determination service, as evidence that the
3843	applicant's graduate degree program and education were
3844	equivalent to an accredited program in this country.
3845	Section 90. Section 491.0145, Florida Statutes, is amended
3846	to read:
3847	491.0145 Certified master social worker.--The department
3848	may not adopt any rules that would cause any person who was not
3849	licensed as a certified master social worker in accordance with
3850	this chapter on January 1, 1990, to become licensed.The
3851	department may certify an applicant for a designation as a
3852	certified master social worker upon the following conditions:
3853	(1) The applicant completes an application to be provided
3854	by the department and pays a nonrefundable fee not to exceed
3855	$250 to be established by rule of the department. The completed
3856	application must be received by the department at least 60 days
3857	before the date of the examination in order for the applicant to
3858	qualify to take the scheduled exam.
3859	(2) The applicant submits proof satisfactory to the
3860	department that the applicant has received a doctoral degree in
3861	social work, or a master's degree with a major emphasis or
3862	specialty in clinical practice or administration, including, but
3863	not limited to, agency administration and supervision, program
3864	planning and evaluation, staff development, research, community
3865	organization, community services, social planning, and human
3866	service advocacy. Doctoral degrees must have been received from
3867	a graduate school of social work which at the time the applicant
3868	was enrolled and graduated was accredited by an accrediting
3869	agency approved by the United States Department of Education.
3870	Master's degrees must have been received from a graduate school
3871	of social work which at the time the applicant was enrolled and
3872	graduated was accredited by the Council on Social Work Education
3873	or the Canadian Association of Schools of Social Work or by one
3874	that meets comparable standards.
3875	(3) The applicant has had at least 3 years' experience, as
3876	defined by rule, including, but not limited to, clinical
3877	services or administrative activities as defined in subsection
3878	(2), 2 years of which must be at the post-master's level under
3879	the supervision of a person who meets the education and
3880	experience requirements for certification as a certified master
3881	social worker, as defined by rule, or licensure as a clinical
3882	social worker under this chapter. A doctoral internship may be
3883	applied toward the supervision requirement.
3884	(4) Any person who holds a master's degree in social work
3885	from institutions outside the United States may apply to the
3886	department for certification if the academic training in social
3887	work has been evaluated as equivalent to a degree from a school
3888	accredited by the Council on Social Work Education. Any such
3889	person shall submit a copy of the academic training from the
3890	Foreign Equivalency Determination Service of the Council on
3891	Social Work Education.
3892	(5) The applicant has passed an examination required by
3893	the department for this purpose. The nonrefundable fee for such
3894	examination may not exceed $250 as set by department rule.
3895	(6) Nothing in this chapter shall be construed to
3896	authorize a certified master social worker to provide clinical
3897	social work services.
3898	Section 91. Section 491.0146, Florida Statutes, is created
3899	to read:
3900	491.0146 Saving clause.--All licenses to practice as a
3901	certified master social worker issued pursuant to this chapter
3902	and valid on October 1, 2002, shall remain in full force and
3903	effect.
3904	Section 92. Subsection (3) of section 491.0147, Florida
3905	Statutes, is amended to read:
3906	491.0147 Confidentiality and privileged
3907	communications.--Any communication between any person licensed
3908	or certified under this chapter and her or his patient or client
3909	shall be confidential. This secrecy may be waived under the
3910	following conditions:
3911	(3)(a)When there is a clear and immediate probability of
3912	physical harm to the patient or client, to other individuals, or
3913	to society and the person licensed or certified under this
3914	chapter communicates the information only to the potential
3915	victim, appropriate family member, or law enforcement or other
3916	appropriate authorities.
3917	(b) There shall be no civil or criminal liability arising
3918	from the disclosure of otherwise confidential communications by
3919	a person licensed or certified under this chapter when the
3920	disclosure is made pursuant to paragraph (a).
3921	Section 93. Subsection (6) of section 499.003, Florida
3922	Statutes, is amended to read:
3923	499.003 Definitions of terms used in ss. 499.001-
3924	499.081.--As used in ss. 499.001-499.081, the term:
3925	(6) "Compressed medical gas" means any liquefied or
3926	vaporized gas that is classified as a prescription drug or
3927	medical device, whether it is alone or in combination with other
3928	gases.
3929	Section 94. Subsection (2) of section 499.007, Florida
3930	Statutes, is amended to read:
3931	499.007 Misbranded drug or device.--A drug or device is
3932	misbranded:
3933	(2) Unless, if in package form, it bears a label
3934	containing:
3935	(a) The name and place of business of the manufacturer or
3936	distributor; in addition, for a medicinal drug, as defined in s.
3937	499.003, the label must contain the name and place of business
3938	of the manufacturerof the finished dosage form of the drug.
3939	For the purpose of this paragraph, the finished dosage form of a
3940	medicinal drug is that form of the drug which is, or is intended
3941	to be, dispensed or administered to the patient and requires no
3942	further manufacturing or processing other than packaging,
3943	reconstitution, and labeling.; and
3944	(b) An accurate statement of the quantity of the contents
3945	in terms of weight, measure, or numerical count; however, under
3946	this section, reasonable variations are permitted, and the
3947	department shall establish by rule exemptions for small
3948	packages.
3949
3950	A drug dispensed by filling or refilling a written or oral
3951	prescription of a practitioner licensed by law to prescribe such
3952	drug is exempt from the requirements of this section, except
3953	subsections (1), (8), (10), and (11) and the packaging
3954	requirements of subsections (6) and (7), if the drug bears a
3955	label that contains the name and address of the dispenser or
3956	seller, the prescription number and the date the prescription
3957	was written or filled, the name of the prescriber and the name
3958	of the patient, and the directions for use and cautionary
3959	statements. This exemption does not apply to any drug dispensed
3960	in the course of the conduct of a business of dispensing drugs
3961	pursuant to diagnosis by mail or to any drug dispensed in
3962	violation of subsection (12). The department may, by rule,
3963	exempt drugs subject to ss. 499.062-499.064 from subsection (12)
3964	if compliance with that subsection is not necessary to protect
3965	the public health, safety, and welfare.
3966	Section 95. Paragraph (e) of subsection (1) of section
3967	499.01, Florida Statutes, is amended to read:
3968	499.01 Permits; applications; renewal; general
3969	requirements.--
3970	(1) Any person that is required under ss. 499.001-499.081
3971	to have a permit must apply to the department on forms furnished
3972	by the department.
3973	(e) The department may not issuea permit for a
3974	prescription drug manufacturer, prescription drug wholesaler, or
3975	retail pharmacy wholesaler may not be issuedto the address of a
3976	health care entity, except as provided in this paragraph. The
3977	department may issue a prescription drug manufacturer permit to
3978	an applicant at the same address as a licensed nuclear pharmacy
3979	that is a health care entity for the purpose of manufacturing
3980	prescription drugs used in positron emission tomography or other
3981	radiopharmaceuticals, as listed in a rule adopted by the
3982	department pursuant to this paragraph. The purpose of this
3983	exemption is to ensure availability of state-of-the-art
3984	pharmaceuticals that would pose a significant danger to the
3985	public health if manufactured at a separate establishment
3986	address other than the nuclear pharmacy from which the
3987	prescription drugs are dispensed.
3988	Section 96. Paragraph (b) of subsection (6) of section
3989	499.0121, Florida Statutes, is amended to read:
3990	499.0121 Storage and handling of prescription drugs;
3991	recordkeeping.--The department shall adopt rules to implement
3992	this section as necessary to protect the public health, safety,
3993	and welfare. Such rules shall include, but not be limited to,
3994	requirements for the storage and handling of prescription drugs
3995	and for the establishment and maintenance of prescription drug
3996	distribution records.
3997	(6) RECORDKEEPING.--The department shall adopt rules that
3998	require keeping such records of prescription drugs as are
3999	necessary for the protection of the public health.
4000	(b) Inventories and records must be made available for
4001	inspection and photocopying by authorized federal, state, or
4002	local officials for a period of 2 years following disposition of
4003	the drugs or 3 years after the date the inventory or record was
4004	created, whichever is longer.
4005
4006	For the purposes of this subsection, the term "authorized
4007	distributors of record" means those distributors with whom a
4008	manufacturer has established an ongoing relationship to
4009	distribute the manufacturer's products.
4010	Section 97. Section 501.122, Florida Statutes, is
4011	transferred and renumbered as section 404.24, Florida Statutes.
4012	Section 98. Subsection (1) of section 627.912, Florida
4013	Statutes, is amended to read:
4014	627.912 Professional liability claims and actions; reports
4015	by insurers.--
4016	(1) Each self-insurer authorized under s. 627.357 and each
4017	insurer or joint underwriting association providing professional
4018	liability insurance to a practitioner of medicine licensed under
4019	chapter 458, to a practitioner of osteopathic medicine licensed
4020	under chapter 459, to a podiatric physician licensed under
4021	chapter 461, to a dentist licensed under chapter 466, to a
4022	hospital licensed under chapter 395, to a crisis stabilization
4023	unit licensed under part IV of chapter 394, to a health
4024	maintenance organization certificated under part I of chapter
4025	641, to clinics included in chapter 390, to an ambulatory
4026	surgical center as defined in s. 395.002, or to a member of The
4027	Florida Bar shall report in duplicate to the Department of
4028	Insurance any claim or action for damages for personal injuries
4029	claimed to have been caused by error, omission, or negligence in
4030	the performance of such insured's professional services or based
4031	on a claimed performance of professional services without
4032	consent, if the claim resulted in:
4033	(a) A final judgment in any amount.
4034	(b) A settlement in any amount.
4035
4036	Reports shall be filed with the department and, if the insured
4037	party is licensed under chapter 458, chapter 459, or chapter 461
4038	and the final judgment or settlement amount was $50,000 or more,
4039	or if the insured party is licensed under chapter 466 and the
4040	final judgment or settlement amount was $25,000 or more, or
4041	chapter 466,with the Department of Health, no later than 30
4042	days following the occurrence of any event listed in paragraph
4043	(a) or paragraph (b). The Department of Health shall review each
4044	report and determine whether any of the incidents that resulted
4045	in the claim potentially involved conduct by the licensee that
4046	is subject to disciplinary action, in which case the provisions
4047	of s. 456.073 shall apply. The Department of Health, as part of
4048	the annual report required by s. 456.026, shall publish annual
4049	statistics, without identifying licensees, on the reports it
4050	receives, including final action taken on such reports by the
4051	Department of Health or the appropriate regulatory board.
4052	Section 99. Paragraph (a) of subsection (1) of section
4053	766.101, Florida Statutes, is amended to read:
4054	766.101 Medical review committee, immunity from
4055	liability.--
4056	(1) As used in this section:
4057	(a) The term "medical review committee" or "committee"
4058	means:
4059	1.a. A committee of a hospital or ambulatory surgical
4060	center licensed under chapter 395 or a health maintenance
4061	organization certificated under part I of chapter 641,
4062	b. A committee of a physician-hospital organization, a
4063	provider-sponsored organization, or an integrated delivery
4064	system,
4065	c. A committee of a state or local professional society of
4066	health care providers,
4067	d. A committee of a medical staff of a licensed hospital
4068	or nursing home, provided the medical staff operates pursuant to
4069	written bylaws that have been approved by the governing board of
4070	the hospital or nursing home,
4071	e. A committee of the Department of Corrections or the
4072	Correctional Medical Authority as created under s. 945.602, or
4073	employees, agents, or consultants of either the department or
4074	the authority or both,
4075	f. A committee of a professional service corporation
4076	formed under chapter 621 or a corporation organized under
4077	chapter 607 or chapter 617, which is formed and operated for the
4078	practice of medicine as defined in s. 458.305(3), and which has
4079	at least 25 health care providers who routinely provide health
4080	care services directly to patients,
4081	g. A committee of a mental health treatment facility
4082	licensed under chapter 394 or a community mental health center
4083	as defined in s. 394.907, provided the quality assurance program
4084	operates pursuant to the guidelines which have been approved by
4085	the governing board of the agency,
4086	h. A committee of a substance abuse treatment and
4087	education prevention program licensed under chapter 397 provided
4088	the quality assurance program operates pursuant to the
4089	guidelines which have been approved by the governing board of
4090	the agency,
4091	i. A peer review or utilization review committee organized
4092	under chapter 440,
4093	j. A committee of the Department of Health, a county
4094	health department, healthy start coalition, or certified rural
4095	health network, when reviewing quality of care, or employees of
4096	these entities when reviewing mortality records, or
4097	k. A continuous quality improvement committee of a
4098	pharmacy licensed pursuant to chapter 465,
4099	l. A committee established by a university board of
4100	trustees, or
4101	m. A committee comprised of faculty, residents, students,
4102	and administrators of an accredited college of medicine,
4103	nursing, or other health care discipline,
4104
4105	which committee is formed to evaluate and improve the quality of
4106	health care rendered by providers of health service or to
4107	determine that health services rendered were professionally
4108	indicated or were performed in compliance with the applicable
4109	standard of care or that the cost of health care rendered was
4110	considered reasonable by the providers of professional health
4111	services in the area; or
4112	2. A committee of an insurer, self-insurer, or joint
4113	underwriting association of medical malpractice insurance, or
4114	other persons conducting review under s. 766.106.
4115	Section 100. Paragraphs (a) and (b) of subsection (4) of
4116	section 766.314, Florida Statutes, are amended to read:
4117	766.314 Assessments; plan of operation.--
4118	(4) The following persons and entities shall pay into the
4119	association an initial assessment in accordance with the plan of
4120	operation:
4121	(a) On or before October 1, 1988, each hospital licensed
4122	under chapter 395 shall pay an initial assessment of $50 per
4123	infant delivered in the hospital during the prior calendar year,
4124	as reported to the Agency for Health Care Administration;
4125	provided, however, that a hospital owned or operated by the
4126	state or a county, special taxing district, or other political
4127	subdivision of the state shall not be required to pay the
4128	initial assessment or any assessment required by subsection (5).
4129	The term "infant delivered" includes live births and not
4130	stillbirths, but the term does not include infants delivered by
4131	employees or agents of the Board of Regents,orthose born in a
4132	teaching hospital as defined in s. 408.07, or those born in a
4133	family practice teaching hospital designated pursuant to s.
4134	395.806 that had been deemed by the association as being exempt
4135	from assessments for fiscal years 1997-1998 through 2001-2002.
4136	The initial assessment and any assessment imposed pursuant to
4137	subsection (5) may not include any infant born to a charity
4138	patient (as defined by rule of the Agency for Health Care
4139	Administration) or born to a patient for whom the hospital
4140	receives Medicaid reimbursement, if the sum of the annual
4141	charges for charity patients plus the annual Medicaid
4142	contractuals of the hospital exceeds 10 percent of the total
4143	annual gross operating revenues of the hospital. The hospital is
4144	responsible for documenting, to the satisfaction of the
4145	association, the exclusion of any birth from the computation of
4146	the assessment. Upon demonstration of financial need by a
4147	hospital, the association may provide for installment payments
4148	of assessments.
4149	(b)1. On or before October 15, 1988, all physicians
4150	licensed pursuant to chapter 458 or chapter 459 as of October 1,
4151	1988, other than participating physicians, shall be assessed an
4152	initial assessment of $250, which must be paid no later than
4153	December 1, 1988.
4154	2. Any such physician who becomes licensed after September
4155	30, 1988, and before January 1, 1989, shall pay into the
4156	association an initial assessment of $250 upon licensure.
4157	3. Any such physician who becomes licensed on or after
4158	January 1, 1989, shall pay an initial assessment equal to the
4159	most recent assessment made pursuant to this paragraph,
4160	paragraph (5)(a), or paragraph (7)(b).
4161	4. However, if the physician is a physician specified in
4162	this subparagraph, the assessment is not applicable:
4163	a. A resident physician, assistant resident physician, or
4164	intern in an approved postgraduate training program, as defined
4165	by the Board of Medicine or the Board of Osteopathic Medicine by
4166	rule;
4167	b. A retired physician who has withdrawn from the practice
4168	of medicine but who maintains an active license as evidenced by
4169	an affidavit filed with the Department of Health. Prior to
4170	reentering the practice of medicine in this state, a retired
4171	physician as herein defined must notify the Board of Medicine or
4172	the Board of Osteopathic Medicine and pay the appropriate
4173	assessments pursuant to this section;
4174	c. A physician who holds a limited license pursuant to s.
4175	458.315458.317and who is not being compensated for medical
4176	services;
4177	d. A physician who is employed full time by the United
4178	States Department of Veterans Affairs and whose practice is
4179	confined to United States Department of Veterans Affairs
4180	hospitals; or
4181	e. A physician who is a member of the Armed Forces of the
4182	United States and who meets the requirements of s. 456.024.
4183	f. A physician who is employed full time by the State of
4184	Florida and whose practice is confined to state-owned
4185	correctional institutions, a county health department, or state-
4186	owned mental health or developmental services facilities, or who
4187	is employed full time by the Department of Health.
4188	Section 101. Section 784.081, Florida Statutes, is amended
4189	to read:
4190	784.081 Assault or battery on specified officials or
4191	employees; reclassification of offenses.--Whenever a person is
4192	charged with committing an assault or aggravated assault or a
4193	battery or aggravated battery upon any elected official or
4194	employee of: a school district; a private school; the Florida
4195	School for the Deaf and the Blind; a university developmental
4196	research school; a state university or any other entity of the
4197	state system of public education, as defined in s. 1000.04; an
4198	employee or protective investigator of the Department of
4199	Children and Family Services; oran employee of a lead
4200	community-based provider and its direct service contract
4201	providers; or an employee of the Department of Health or its
4202	direct service contract providers, when the person committing
4203	the offense knows or has reason to know the identity or position
4204	or employment of the victim, the offense for which the person is
4205	charged shall be reclassified as follows:
4206	(1) In the case of aggravated battery, from a felony of
4207	the second degree to a felony of the first degree.
4208	(2) In the case of aggravated assault, from a felony of
4209	the third degree to a felony of the second degree.
4210	(3) In the case of battery, from a misdemeanor of the
4211	first degree to a felony of the third degree.
4212	(4) In the case of assault, from a misdemeanor of the
4213	second degree to a misdemeanor of the first degree.
4214	Section 102. Paragraph (a) of subsection (1) of section
4215	817.567, Florida Statutes, is amended to read:
4216	817.567 Making false claims of academic degree or title.--
4217	(1) No person in the state may claim, either orally or in
4218	writing, to possess an academic degree, as defined in s.
4219	1005.02, or the title associated with said degree, unless the
4220	person has, in fact, been awarded said degree from an
4221	institution that is:
4222	(a) Accredited by a regional or professional accrediting
4223	agency recognized by the United States Department of Education
4224	or the Council for Higher EducationCommission on Recognition of
4225	PostsecondaryAccreditation;
4226	Section 103. Section 945.6038, Florida Statutes, is
4227	created to read:
4228	945.6038 Additional services.--The authority is authorized
4229	to enter into an agreement or contract with the Department of
4230	Children and Family Services, subject to the availability of
4231	funding, to conduct surveys of medical services and to provide
4232	medical quality assurance and improvement assistance at secure
4233	confinement and treatment facilities for persons confined under
4234	part V of chapter 394. The authority is authorized to enter into
4235	similar agreements with other state agencies, subject to the
4236	availability of funds. The authority may not enter any such
4237	agreement if it would impair the authority's ability to fulfill
4238	its obligations with regard to the Department of Corrections as
4239	set forth in this chapter.
4240	Section 104. Subsection (13) of section 1009.992, Florida
4241	Statutes, is amended to read:
4242	1009.992 Definitions.--As used in this act:
4243	(13) "Institution" means any college or university which,
4244	by virtue of law or charter, is accredited by and holds
4245	membership in the Council for Higher EducationCommission on
4246	Recognition of PostsecondaryAccreditation; which grants
4247	baccalaureate or associate degrees; which is not a pervasively
4248	sectarian institution; and which does not discriminate in the
4249	admission of students on the basis of race, color, religion,
4250	sex, or creed.
4251	Section 105. Section 1012.46, Florida Statutes, is amended
4252	to read:
4253	1012.46 Athletic trainers.--
4254	(1) School districts may establish and implement an
4255	athletic injuries prevention and treatment program. Central to
4256	this program should be the employment and availability of
4257	persons trained in the prevention and treatment of physical
4258	injuries which may occur during athletic activities. The program
4259	should reflect opportunities for progressive advancement and
4260	compensation in employment as provided in subsection (2) and
4261	meet certain other minimum standards developed by the Department
4262	of Education. The goal of the Legislature is to have school
4263	districts employ and have available a full-time teacher athletic
4264	trainer in each high school in the state.
4265	(2) To the extent practicable, a school district program
4266	should include the following employment classification and
4267	advancement scheme:
4268	(a) First responder.--To qualify as a first responder, a
4269	person must possess a professional, temporary, part-time,
4270	adjunct, or substitute certificate pursuant to s. 1012.56, be
4271	certified in cardiopulmonary resuscitation, first aid, and have
4272	15 semester hours in courses such as care and prevention of
4273	athletic injuries, anatomy, physiology, nutrition, counseling,
4274	and other similar courses approved by the Commissioner of
4275	Education. This person may only administer first aid and similar
4276	care, and shall not hold himself or herself out to the school
4277	district or public as an athletic trainer pursuant to part XIII
4278	of chapter 468.
4279	(b) Teacher Athletic trainer.--To qualify as ana teacher
4280	athletic trainer, a person must be licensed as required by part
4281	XIII of chapter 468 and may be utilized by the school district
4282	as possessa professional, temporary, part-time, adjunct, or
4283	substitute teachercertificatepursuant to s. 1012.35, s.
4284	1012.56, or s. 1012.57, and be licensed as required by part XIII
4285	of chapter 468.
4286	Section 106. (1) All payments made after July 1, 2003, by
4287	the Department of Health to the Division of Administrative
4288	Hearings which are based on a formula in effect prior to that
4289	date shall revert to the Department of Health. Effective July 1,
4290	2004, the Division of Administrative Hearings shall bill the
4291	Department of Health in accordance with s. 456.073(5), Florida
4292	Statutes.
4293	(2) The Office of Program Policy Analysis and Government
4294	Accountability and the Auditor General shall conduct a joint
4295	audit of all hearings and billings therefor conducted by the
4296	Division of Administrative Hearings for all state agencies and
4297	nonstate agencies and shall present a report to the President of
4298	the Senate and the Speaker of the House of Representatives on or
4299	before January 1, 2004, which contains findings and
4300	recommendations regarding the manner in which the division
4301	charges for its services. The report shall recommend alternative
4302	billing formulas.
4303	Section 107. (1) The Department of Health, in
4304	consultation with the Miami-Dade Community College Physician
4305	Assistant Program, the University of Florida Physician Assistant
4306	Program, the Nova Southeastern University Physician Assistant
4307	Program, the Florida Academy of Physician Assistants, and the
4308	Barry University Physician Assistant Program, shall conduct a
4309	study to establish the most advantageous methods to utilize the
4310	medical skills of foreign-trained physicians to practice as
4311	physician assistants in this state. Such study shall indicate:
4312	(a) The existing pathways or methods for a foreign-trained
4313	physician to receive a license to practice as a physician
4314	assistant in Florida.
4315	(b) National standards, national examinations, and
4316	credentialing requirements for a foreign-trained physician to be
4317	licensed to practice as a physician assistant in other states in
4318	the United States.
4319	(c) Training, education requirements, remedial courses,
4320	and supervisory needs of a foreign-trained physician desiring to
4321	become eligible to practice as a physician assistant.
4322	(d) The scope of practice of a foreign-trained physician
4323	assistant.
4324	(e) Any other areas of study that the department and
4325	educational institutions deem appropriate to further the intent
4326	of this section.
4327	(2) A copy of the study, including results and
4328	recommendations, shall be presented to the Governor, the
4329	President of the Senate, and the Speaker of the House of
4330	Representatives no later than January 1, 2004.
4331	Section 108. Subsection (9) of section 381.0098, section
4332	381.85, paragraph (f) of subsection (2) of section 385.103,
4333	sections 385.205 and 385.209, subsection (7) of section 445.033,
4334	sections 456.031, 456.033, 456.034, 458.313, 458.316, 458.3165,
4335	458.317, 468.356, and 468.357, and subsection (3) of section
4336	468.711, Florida Statutes, are repealed.
4337	Section 109. Except as otherwise provided herein, this act
4338	shall take effect July 1, 2003.