Senate Bill sb0572e1

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    CS for CS for SB 572                           First Engrossed



  1                      A bill to be entitled

  2         An act relating to health care; amending s.

  3         408.036, F.S.; providing an exemption from

  4         certificate-of-need requirements for certain

  5         open-heart-surgery programs; providing criteria

  6         for qualifying for the exemption; requiring the

  7         Agency for Health Care Administration to report

  8         to the Legislature; amending s. 466.006, F.S.;

  9         amending s. 466.004, F.S.; requiring the

10         Council on Dental Hygiene to meet at least

11         twice a year; providing for consideration by

12         the Board of Dentistry of rule and policy

13         recommendations of the council; creating s.

14         466.055, F.S.; providing for the appointment of

15         an executive director; providing for duties,

16         and board oversight; requiring director to

17         oversee staff; requiring the department to

18         contract for a dental intake officer and

19         providing qualifications; requiring certain

20         responsibilities of the officer; requiring the

21         board to establish certain performance

22         parameters for departmental handling of

23         disciplinary cases, and consequences; requiring

24         testing services to report to the board if

25         requested; requiring a board spending plan and

26         its content; requiring board spending authority

27         over discretionary budget items; requiring a

28         department report of certain information;

29         providing for a board response; amending s.

30         466.006, F.S.; providing a short title;

31         requiring the Agency for Workforce Innovation


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    CS for CS for SB 572                           First Engrossed



 1         to establish a pilot program for delivery of

 2         certified geriatric specialty nursing

 3         education; specifying eligibility requirements

 4         for certified nursing assistants to obtain

 5         certified geriatric specialty nursing

 6         education; specifying requirements for the

 7         education of certified nursing assistants to

 8         prepare for certification as a certified

 9         geriatric specialist; creating a Certified

10         Geriatric Specialty Nursing Initiative Steering

11         Committee; providing for the composition of and

12         manner of appointment to the Certified

13         Geriatric Specialty Nursing Initiative Steering

14         Committee; providing responsibilities of the

15         steering committee; providing for reimbursement

16         for per diem and travel expenses; requiring the

17         Agency for Workforce Innovation to conduct or

18         contract for an evaluation of the pilot program

19         for delivery of certified geriatric specialty

20         nursing education; requiring the evaluation to

21         include recommendations regarding the expansion

22         of the delivery of certified geriatric

23         specialty nursing education in nursing homes;

24         requiring the Agency for Workforce Innovation

25         to report to the Governor and Legislature

26         regarding the status and evaluation of the

27         pilot program; creating s. 464.0125, F.S.;

28         providing definitions; providing requirements

29         for persons to become certified geriatric

30         specialists; specifying fees; providing for

31         articulation of geriatric specialty nursing


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    CS for CS for SB 572                           First Engrossed



 1         coursework and practical nursing coursework;

 2         providing practice standards and grounds for

 3         which certified geriatric specialists may be

 4         subject to discipline by the Board of Nursing;

 5         creating restrictions on the use of

 6         professional nursing titles; prohibiting the

 7         use of certain professional titles; providing

 8         penalties; authorizing approved nursing

 9         programs to provide education for the

10         preparation of certified geriatric specialists

11         without further board approval; authorizing

12         certified geriatric specialists to supervise

13         the activities of others in nursing home

14         facilities according to rules by the Board of

15         Nursing; revising terminology relating to

16         nursing to conform to the certification of

17         geriatric specialists; amending s. 381.00315,

18         F.S.; revising requirements for the

19         reactivation of the licenses of specified

20         health care practitioners in the event of

21         public health emergency to include certified

22         geriatric specialists; amending s. 400.021,

23         F.S.; including services provided by a

24         certified geriatric specialist within the

25         definition of nursing service; amending s.

26         400.211, F.S.; revising requirements for

27         persons employed as nursing assistants to

28         conform to the certification of certified

29         geriatric specialists; amending s. 400.23,

30         F.S.; specifying that certified geriatric

31         specialists shall be considered licensed


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    CS for CS for SB 572                           First Engrossed



 1         nursing staff; authorizing licensed practical

 2         nurses to supervise the activities of certified

 3         geriatric specialists in nursing home

 4         facilities according to rules adopted by the

 5         Board of Nursing; amending s. 409.908, F.S.;

 6         revising the methodology for reimbursement of

 7         Medicaid program providers to include services

 8         of certified geriatric specialists; amending s.

 9         458.303, F.S.; revising exceptions to the

10         practice of medicine to include services

11         delegated to a certified geriatric specialist

12         under specified circumstances; amending s.

13         1009.65, F.S.; revising eligibility for the

14         Medical Education Reimbursement and Loan

15         Repayment Program to include certified

16         geriatric specialists; amending s. 1009.66,

17         F.S.; revising eligibility requirements for the

18         Nursing Student Loan Forgiveness Program to

19         include certified geriatric specialists;

20         providing an appropriation; amending s.

21         464.201, F.S.; defining terms; amending s.

22         464.202, F.S.; authorizing the Board of Nursing

23         to adopt rules regarding the practice and

24         supervision of certified nursing assistants;

25         creating the James and Esther King Center for

26         Universal Research to Eradicate Disease;

27         providing intent and duties; creating an

28         advisory council; amending s. 215.5602, F.S.;

29         expanding the long-term goals and funding of

30         the Florida Biomedical Research Program to

31         include the cure of specified diseases;


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    CS for CS for SB 572                           First Engrossed



 1         creating the Florida Cancer Research

 2         Cooperative; providing for a board of

 3         directors; providing the cooperative's mission

 4         and duties; amending s. 484.0512, F.S.;

 5         providing a criminal penalty for failure of a

 6         seller to refund within a specified time moneys

 7         required to be refunded to a purchaser for the

 8         return or attempted return of a hearing aid;

 9         providing a definition; amending s. 456.073,

10         F.S.; providing that a state prisoner must

11         exhaust all available administrative remedies

12         before filing a complaint with the Department

13         of Health against a health care practitioner

14         who is providing health care services within

15         the Department of Corrections, unless the

16         practitioner poses a serious threat to the

17         health or safety of a person who is not a state

18         prisoner; requiring the Department of Health to

19         be notified if a health care practitioner is

20         disciplined or allowed to resign for a

21         practice-related offense; requiring the

22         Division of Medical Quality Assurance of the

23         Department of Health to conduct a study of

24         clinical and academic training requirements of

25         certified optometric practitioners; providing

26         for appointment of members; requiring a report

27         to be submitted to the Governor and

28         Legislature; amending s. 465.0265, F.S.;

29         providing requirements for the filing of

30         prescriptions by pharmacies that are under

31         common ownership or that have a contractual


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    CS for CS for SB 572                           First Engrossed



 1         relationship with one another; specifying

 2         requirements for exceptions to prescription

 3         transfers between certain pharmacies; amending

 4         s. 466.006, F.S.; allowing certain dental

 5         students to take the examinations required to

 6         practice dentistry in this state under

 7         specified conditions; providing a prerequisite

 8         to licensure of such students; creating s.

 9         466.0065, F.S.; allowing certain dental

10         students to take regional licensure

11         examinations under specified conditions;

12         restricting the applicability of examination

13         results to licensing in other jurisdictions;

14         requiring approval by the Board of Dentistry

15         and providing prerequisites to such approval;

16         creating the "Nick Oelrich Gift of Life Act";

17         amending s. 765.512, F.S., relating to

18         anatomical gifts; prohibiting modification of a

19         donor's intent; providing that a donor document

20         is legally binding; authorizing specified

21         persons to furnish a donor's medical records

22         upon request; amending s. 765.516, F.S.;

23         revising procedures by which the terms of an

24         anatomical gift may be amended or the gift may

25         be revoked; amending s. 765.401, F.S.;

26         providing additional persons who may be given a

27         proxy for the making of health care decisions;

28         requiring review by the facility's bioethics

29         committee of decisions to withhold or withdraw

30         life-prolonging procedures; requiring

31         documentation of efforts to locate certain


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    CS for CS for SB 572                           First Engrossed



 1         proxies; amending s. 641.19, F.S.; providing

 2         that the term "specialty" does not include the

 3         services of a licensed chiropractic physician

 4         for purposes of the regulation of managed care;

 5         creating s. 466.0065, F.S.; amending s.

 6         466.006, F.S.; allowing certain dental students

 7         to take the examination required for practicing

 8         dentistry in this state; creating s. 466.0065,

 9         F.S.; allowing certain dental students to take

10         regional licensure examinations under specified

11         conditions; restricting the applicability of

12         examination results; requiring approval by the

13         Board of Dentistry and providing prerequisites

14         to such approval; providing an appropriation

15         and authorizing a position; creating s.

16         768.1335, F.S.; providing a short title;

17         providing definitions; providing a presumption

18         of non-negligence in the use of emergency

19         medical dispatch protocols by an emergency

20         medical dispatcher or the emergency medical

21         dispatch agency, its agents, or employees;

22         amending s. 401.111, F.S.; authorizing grants

23         by the Department of Health to emergency

24         medical dispatch agencies; allowing certain

25         dental students to take the examination

26         required for practicing dentistry in this

27         state; creating s. 466.0065, F.S.; allowing

28         certain dental students to take regional

29         licensure examinations under specified

30         conditions; restricting the applicability of

31         examination results; requiring approval by the


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    CS for CS for SB 572                           First Engrossed



 1         Board of Dentistry and providing prerequisites

 2         to such approval; providing an appropriation

 3         and authorizing a position; amending ss.

 4         381.7353, 381.7355, F.S.; including oral health

 5         care in the Closing the Gap grant program;

 6         providing effective dates.

 7  

 8         WHEREAS, emergency medical dispatch programs promote

 9  appropriate standards that result in more effective dispatch

10  of emergency services and the saving of lives, and

11         WHEREAS, the dispatcher is the first responder to a

12  medical emergency when someone dials 911 or calls a medical

13  dispatch agency directly, and dispatchers are being recognized

14  nationally as the true first responders to the emergency

15  scene, and

16         WHEREAS, an emergency medical dispatcher has an

17  immediate response time during which to offer basic

18  instructions to the caller regardless of the emergency medical

19  services response time and is crucial for the delivery and

20  receipt of information to EMS units, and

21         WHEREAS, an emergency medical dispatch program is a key

22  component of a quality EMS system, and

23         WHEREAS, organizations such as the American Heart

24  Association (AHA), the American College of Emergency

25  Physicians (ACEP), the National Association of Emergency

26  Medical Services Physicians (NAEMSP), the National Institute

27  of Health (NIH), the National Highway Traffic Safety

28  Administration (NHTSA), and the American Society of Testing

29  and Materials (ASTM) have endorsed the development and

30  adoption of standards for emergency medical dispatch, and

31  


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    CS for CS for SB 572                           First Engrossed



 1         WHEREAS, a properly trained emergency medical

 2  dispatcher significantly improves the quality of care provided

 3  by an EMS system because the dispatcher is able to identify

 4  the level of need of the caller, including resource

 5  allocations and response modes, thus enabling more effective

 6  and efficient dispatch of limited response resources; identify

 7  situations that might require prearrival instructions; gather

 8  information to be relayed to the responding crews to help them

 9  better manage and respond to the emergency medical situation

10  upon arrival; and obtain information regarding emergency

11  medical scene safety for the patient, bystanders, and

12  responding personnel, and

13         WHEREAS, many states are now adopting a standard

14  emergency medical dispatch program, and

15         WHEREAS, the most successful EMS systems are those that

16  have strong field response times coupled with well-trained

17  emergency medical dispatchers, NOW, THEREFORE,

18  

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

20  

21         Section 1.  Paragraph (t) is added to subsection (3) of

22  section 408.036, Florida Statutes, to read:

23         408.036  Projects subject to review.--

24         (3)  EXEMPTIONS.--Upon request, the following projects

25  are subject to exemption from the provisions of subsection

26  (1):

27         (t)1.  For the provision of adult open-heart services

28  in a hospital located within the boundaries of Palm Beach,

29  Polk, Martin, St. Lucie, and Indian River Counties if the

30  following conditions are met: The exemption must be based upon

31  objective criteria and address and solve the twin problems of


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    CS for CS for SB 572                           First Engrossed



 1  geographic and temporal access. A hospital shall be exempt

 2  from the certificate-of-need review for the establishment of

 3  an open-heart-surgery program when the application for

 4  exemption submitted under this paragraph complies with the

 5  following criteria:

 6         a.  The applicant must certify that it will meet and

 7  continuously maintain the minimum licensure requirements

 8  adopted by the agency governing adult open-heart programs,

 9  including the most current guidelines of the American College

10  of Cardiology and American Heart Association Guidelines for

11  Adult Open Heart Programs.

12         b.  The applicant must certify that it will maintain

13  sufficient appropriate equipment and health personnel to

14  ensure quality and safety.

15         c.  The applicant must certify that it will maintain

16  appropriate times of operation and protocols to ensure

17  availability and appropriate referrals in the event of

18  emergencies.

19         d.  The applicant can demonstrate that it is referring

20  300 or more patients per year from the hospital, including the

21  emergency room, for cardiac services at a hospital with

22  cardiac services, or that the average wait for transfer for 50

23  percent or more of the cardiac patients exceeds 4 hours.

24         e.  The applicant is a general acute care hospital that

25  is in operation for 3 years or more.

26         f.  The applicant is performing more than 300

27  diagnostic cardiac catheterization procedures per year,

28  combined inpatient and outpatient.

29         g.  The applicant's payor mix at a minimum reflects the

30  community average for Medicaid, charity care, and self-pay

31  patients or the applicant must certify that it will provide a


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    CS for CS for SB 572                           First Engrossed



 1  minimum of 5 percent of Medicaid, charity care, and self-pay

 2  to open-heart-surgery patients.

 3         h.  If the applicant fails to meet the established

 4  criteria for open-heart programs or fails to reach 300

 5  surgeries per year by the end of its third year of operation,

 6  it must show cause why its exemption should not be revoked.

 7         2.  By December 31, 2004, and annually thereafter, the

 8  Agency for Health Care Administration shall submit a report to

 9  the Legislature providing information concerning the number of

10  requests for exemption received under this paragraph and the

11  number of exemptions granted or denied.

12         Section 2.  Paragraph (a) of subsection (2) of section

13  466.004, Florida Statutes, is amended to read:

14         466.004  Board of Dentistry.--

15         (2)  To advise the board, it is the intent of the

16  Legislature that councils be appointed as specified in

17  paragraphs (a), (b), and (c).  The department shall provide

18  administrative support to the councils and shall provide

19  public notice of meetings and agenda of the councils. Councils

20  shall include at least one board member who shall chair the

21  council and shall include nonboard members. All council

22  members shall be appointed by the board chair.  Council

23  members shall be appointed for 4-year terms, and all members

24  shall be eligible for reimbursement of expenses in the manner

25  of board members.

26         (a)  A Council on Dental Hygiene shall be appointed by

27  the board chair and shall include one dental hygienist member

28  of the board, who shall chair the council, one dental member

29  of the board, and three dental hygienists who are actively

30  engaged in the practice of dental hygiene in this state. The

31  council shall meet at the request of the board chair, a


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    CS for CS for SB 572                           First Engrossed



 1  majority of the members of the board, or the council chair, if

 2  the council meets at least twice each year.  The council is

 3  charged with the responsibility of and shall meet for the

 4  purpose of developing rules and policies for recommendation to

 5  the board, which the board shall consider, on matters

 6  pertaining to that part of dentistry consisting of

 7  educational, preventive, or therapeutic dental hygiene

 8  services; dental hygiene licensure, discipline, or regulation;

 9  and dental hygiene education. Rule and policy recommendations

10  of the council shall be considered by the board at its next

11  regularly scheduled meeting in the same manner it considers

12  rule and policy recommendations from designated subcommittees

13  of the board. Any rule or policy proposed by the board

14  pertaining to the specified part of dentistry defined by this

15  paragraph shall be referred to the council for a

16  recommendation prior to final action by the board.

17         Section 3.  Section 466.055, Florida Statutes, is

18  created to read:

19         466.055  Board of Dentistry Empowerment Act.--

20         (1)  If requested by the Board of Dentistry, it shall

21  direct the department whom to appoint as executive director

22  pursuant to the rules of the state personnel system. The

23  committee conducting interviews of candidates for executive

24  director shall consist of the board chairman or his designee

25  and the secretary or his or her designee. A list of final

26  candidates shall be submitted to the board, which shall

27  approve the candidate to be hired. The approval process shall

28  include the right of the board to interview the list of

29  submitted candidates. The board may reject all the candidates

30  on the submitted list and request that a new list be submitted

31  by the interview committee. The executive director shall


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    CS for CS for SB 572                           First Engrossed



 1  perform those duties and responsibilities specific to the

 2  Board of Dentistry and shall exclusively serve the Board of

 3  Dentistry. The board shall monitor the performance of the

 4  executive director, based on established performance standards

 5  and should the board determine, by a majority vote, that the

 6  performance of the executive director is consistently below

 7  the performance standards of the board and thus unacceptable,

 8  the board shall promptly notify the department of its

 9  findings, in writing, and the department shall take

10  appropriate action to replace the executive director, pursuant

11  to the state personnel rules.

12         (2)  The executive director shall be responsible for

13  overseeing the hiring of all other staff members who work

14  directly for the executive director and who perform services

15  for the board.

16         (3)  The department shall contract for a dental intake

17  officer when requested by the Board of Dentistry in accordance

18  with the state personnel system and qualifications established

19  for such position by the Board of Dentistry. The

20  qualifications for the position shall include a requirement

21  that the candidate be a licensed Florida dentist in good

22  standing.

23         (4)  The dental intake officer shall be responsible for

24  determining the legal sufficiency of all dental complaints

25  received by the department within 5 working days after the

26  complaint is filed; advising the board regarding dental health

27  regulation issues; and advising field investigators on dental

28  issues related to the complaints to assure that complaints are

29  properly investigated in a timely and efficacious manner.

30         (5)  The Board of Dentistry, in consultation with the

31  department, shall establish reasonable and comprehensive


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    CS for CS for SB 572                           First Engrossed



 1  performance parameters for the prosecution of disciplinary

 2  cases by the department. Such parameters shall reflect the

 3  quality and quantity of services to be provided to the board,

 4  including, but not limited to, the proportion of cases that

 5  are successfully prosecuted through final hearing and appeal

 6  if such cases involve irremediable harm or injury or the

 7  immediate threat of irremediable harm or injury to the

 8  patient. The board shall conduct an annual evaluation to

 9  determine if the department has met the established

10  performance parameters. A finding by the board that the

11  department has failed to meet established parameters shall

12  enable the board, by a majority vote, to instruct the

13  department to retain sufficient outside contractual

14  prosecutorial services pursuant to s. 287.057(3), to fulfill

15  the immediate and forseeable prosecutorial needs of the board.

16  Contract negotiations and vendor selection shall be conducted

17  in consultation with the chairman of the board or his

18  designee. Each contract for prosecutorial services shall

19  include, at a minimum, the performance parameters developed by

20  the board for its assessment of the department.

21         (6)  If requested, a representative of testing services

22  of the Department of Health shall appear before the board, or

23  a committee of the board, following the completion of each

24  examination cycle to discuss examination issues. If the board

25  identifies issues to be addressed, testing services shall

26  report to the board, as requested at the next board meeting,

27  on its progress in addressing the issues identified by the

28  board.

29         (7)(a)  In conjunction with each fiscal year budgetary

30  cycle, the department, in consultation with the board, shall

31  develop a Board of Dentistry spending plan encompassing


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    CS for CS for SB 572                           First Engrossed



 1  anticipated revenue of all types along with all anticipated

 2  operating expenses of the board and associated support

 3  services of the department, which shall include all direct and

 4  allocated expenses necessary to enable the board to fulfill

 5  its responsibilities. All expenditure detail as provided

 6  herein shall reflect the methodology and calculations of the

 7  department in allocating common expenses among all regulatory

 8  boards.

 9         (b)  The Board of Dentistry shall have spending

10  authority over discretionary budgetary items, as determined by

11  the department and the board jointly. Discretionary budgetary

12  items shall include the selection of board meeting venue,

13  hotel facilities, and accommodations; travel of board members

14  and necessary staff to all meetings of the board; attendance

15  by board members at meetings and conferences deemed to be

16  important by the board in fulfilling its responsibilities,

17  monitoring performance, and confirming the accuracy of

18  information provided to the board or others which relates to

19  the duties and responsibilities of the board; and an

20  operational contingency. Operational contingency is that

21  portion of cash on hand that exceeds that required for the

22  5-year spending plan as described in s. 456.005. The

23  operational contingency may be used for a special project by

24  the board in fulfilling its responsibilities if a deficit does

25  not or would not exist for the profession. In exercising its

26  spending authority over discretionary budget items, the board

27  must adhere to all applicable state laws and directives;

28  assure that all meeting locations are accessible to the public

29  and licensees; assure that board meetings are conducted in an

30  effective and efficient manner for the public and licensees;

31  assure that the minimal number of board members or staff


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    CS for CS for SB 572                           First Engrossed



 1  attend any meeting or conference; and assure the maximum use

 2  of technology. When requested by the board, the department

 3  shall provide timely procurement assistance to facilitate all

 4  discretionary expenditures of the board.

 5         (8)(a)  The department shall submit a report to the

 6  Governor, the President of the Senate, and the Speaker of the

 7  House of Representatives by November 1 of each year on the

 8  effectiveness and efficiency of this section, including:

 9         1.  The revenues, expenditures, and cash balances for

10  the prior year, and a review of the adequacy of existing

11  revenues;

12         2.  The nature and extent of all services provided to

13  the board by the department;

14         3.  The total cost allocated by the department for each

15  service provided by the department to the board and the amount

16  and percent by which each cost is appropriate to dentistry's

17  pro-rata share of the total cost of such services provided by

18  the department to all affected boards, councils, and

19  professions;

20         4.  The number of licensure examinations taken, the

21  fees collected for licensure examination, and the time from

22  which a candidate for licensure completed the required

23  examination to the time in which the candidate received the

24  results;

25         5.  The number of licenses issued, revoked, or

26  suspended;

27         6.  The number of disciplinary complaints received,

28  determined to be legally sufficient, investigated, referred to

29  the board's probable cause panel, prosecuted, subject to final

30  board action, and appealed; the number, maximum, and average

31  duration of licenses suspended; the number of licenses


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    CS for CS for SB 572                           First Engrossed



 1  revoked; the number of cases spanning more than 180,270, and

 2  365 days from receipt of complaints to submission to the

 3  board's probable cause panel; the proportion of cases which

 4  were eligible for and the number of cases actually resolved by

 5  citation; the proportion of cases where probable cause was

 6  found; the number of cases were probable cause was found that

 7  were not prosecuted or that did not result in stipulated

 8  agreements; the number of cases involving stipulated

 9  agreements; the number of cases involving stipulated

10  agreements which were changed by the board and the number of

11  cases involving stipulated agreements that were rejected

12  without modification by the board; the number of cases taking

13  in excess of 1 year from the date of receipt of a complaint to

14  final board action; the number of cases involving formal

15  hearings; the status of all cases appealed; the number of

16  cases where licensure suspension or revocation was stayed

17  pending appeal; the number of emergency suspension orders

18  issued; the average and maximum range of costs of complaint

19  investigations and prosecutions; and the amount of fines and

20  expenses collected by type of cases prosecuted;

21         7.  The status of the development and implementation of

22  rules providing for disciplinary guidelines pursuant to s.

23  456.079; and

24         8.  Such recommendations for administrative and

25  statutory changes necessary to facilitate efficient and

26  cost-effective operation of the board and the department.

27         (b)  The department shall include in the report any

28  statement, comment, suggestion, recommendation, or objection

29  made by the board in response to the report.

30         Section 4.  This act may be cited as the "Clara Ramsey

31  Care of the Elderly Act."


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    CS for CS for SB 572                           First Engrossed



 1         Section 5.  Certified Geriatric Specialist Preparation

 2  Pilot Program.--

 3         (1)  The Agency for Workforce Innovation shall

 4  establish a pilot program for delivery of geriatric nursing

 5  education to certified nursing assistants who wish to become

 6  certified geriatric specialists. The agency shall select two

 7  pilot sites in nursing homes that have received the Gold Seal

 8  designation under section 400.235, Florida Statutes; have been

 9  designated as a teaching nursing home under section 430.80,

10  Florida Statutes; or have not received a class I or class II

11  deficiency within the 30 months preceding application for this

12  program.

13         (2)  To be eligible to receive geriatric nursing

14  education, a certified nursing assistant must have been

15  employed by a participating nursing home for at least 1 year

16  and have received a high school diploma or its equivalent.

17         (3)  The education shall be provided at the worksite

18  and in coordination with the certified nursing assistant's

19  work schedule.

20         (4)  Faculty shall provide the instruction under an

21  approved nursing program pursuant to section 464.019, Florida

22  Statutes.

23         (5)  The education shall prepare the certified nursing

24  assistant to meet the requirements for certification as a

25  geriatric specialist. The didactic and clinical education

26  shall include all portions of the practical nursing curriculum

27  pursuant to section 464.019, Florida Statutes, except for

28  pediatric and obstetric/maternal-child education, and shall

29  include additional education in the care of ill, injured, or

30  infirm geriatric patients and the maintenance of health, the

31  


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 1  prevention of injury, and the provision of palliative care for

 2  geriatric patients.

 3         Section 6.  Certified Geriatric Specialty Nursing

 4  Initiative Steering Committee.--

 5         (1)  In order to guide the implementation of the

 6  Certified Geriatric Specialist Preparation Pilot Program,

 7  there is created a Certified Geriatric Specialty Nursing

 8  Initiative Steering Committee. The steering committee shall be

 9  composed of the following members:

10         (a)  The chair of the Board of Nursing or his or her

11  designee;

12         (b)  A representative of the Agency for Workforce

13  Innovation, appointed by the Director of Workforce Innovation;

14         (c)  A representative of Workforce Florida, Inc.,

15  appointed by the chair of the Board of Directors of Workforce

16  Florida, Inc.;

17         (d)  A representative of the Department of Education,

18  appointed by the Secretary of Education;

19         (e)  A representative of the Agency for Health Care

20  Administration, appointed by the Secretary of Health Care

21  Administration;

22         (f)  The Director of the Florida Center for Nursing;

23  and

24         (g)  A representative of a Gold Seal nursing home that

25  is not one of the pilot program sites, appointed by the

26  Secretary of Health Care Administration.

27         (2)  The steering committee shall:

28         (a)  Provide consultation and guidance to the Agency

29  for Workforce Innovation on matters of policy during the

30  implementation of the pilot program; and

31  


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 1         (b)  Provide oversight to the evaluation of the pilot

 2  program.

 3         (3)  Members of the steering committee are entitled to

 4  reimbursement for per diem and travel expenses under section

 5  112.061, Florida Statutes.

 6         (4)  The steering committee shall complete its

 7  activities by June 30, 2006, and the authorization for the

 8  steering committee ends on that date.

 9         Section 7.  Evaluation of the Certified Geriatric

10  Specialist Preparation Pilot Program.--The Agency for

11  Workforce Innovation, in consultation with the Certified

12  Geriatric Specialty Nursing Initiative Steering Committee,

13  shall conduct, or contract for an evaluation of the pilot

14  program. The agency shall ensure that an evaluation report is

15  submitted to the Governor, the President of the Senate, and

16  the Speaker of the House of Representatives by January 1,

17  2006. The evaluation must address the experience and success

18  of the certified nursing assistants in the pilot program and

19  must contain recommendations regarding the expansion of the

20  delivery of geriatric nursing education in nursing homes.

21         Section 8.  Reports.--The Agency for Workforce

22  Innovation shall submit status reports and recommendations

23  regarding legislation necessary to further the implementation

24  of the pilot program to the Governor, the President of the

25  Senate, and the Speaker of the House of Representatives on

26  January 1, 2004, January 1, 2005, and January 1, 2006.

27         Section 9.  Section 464.0125, Florida Statutes, is

28  created to read:

29         464.0125  Certified geriatric specialists;

30  certification requirements.--

31         (1)  DEFINITIONS; RESPONSIBILITIES.--


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 1         (a)  As used in this section, the term:

 2         1.  "Certified geriatric specialist" means a person who

 3  meets the qualifications specified in this section and who is

 4  certified by the board to practice as a certified geriatric

 5  specialist.

 6         2.  "Geriatric patient" means any patient who is 60

 7  years of age or older.

 8         3.  "Practice of certified geriatric specialty nursing"

 9  means the performance of selected acts in facilities licensed

10  under part II or part III of chapter 400, including the

11  administration of treatments and medications, in the care of

12  ill, injured, or infirm geriatric patients and the promotion

13  of wellness, maintenance of health, and prevention of illness

14  of geriatric patients under the direction of a registered

15  nurse, a licensed physician, a licensed osteopathic physician,

16  a licensed podiatric physician, or a licensed dentist. The

17  scope of practice of a certified geriatric specialist includes

18  the practice of practical nursing as defined in s. 464.003 for

19  geriatric patients only, except for any act in which

20  instruction and clinical knowledge of pediatric nursing or

21  obstetric/maternal-child nursing is required. A certified

22  geriatric specialist, while providing nursing services in

23  facilities licensed under part II or part III of chapter 400,

24  may supervise the activities of certified nursing assistants

25  and other unlicensed personnel providing services in such

26  facilities in accordance with rules adopted by the board.

27         (b)  The certified geriatric specialist shall be

28  responsible and accountable for making decisions that are

29  based upon the individual's educational preparation and

30  experience in performing certified geriatric specialty

31  nursing.


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 1         (2)  CERTIFICATION.--

 2         (a)  Any certified nursing assistant desiring to be

 3  certified as a certified geriatric specialist shall apply to

 4  the department and submit proof that he or she holds a current

 5  certificate as a certified nursing assistant under this part

 6  and has satisfactorily completed the following requirements:

 7         1.  Is in good mental and physical health, is a

 8  recipient of a high school diploma or its equivalent and has

 9  completed the requirements for graduation from an approved

10  program for nursing or its equivalent, as determined by the

11  board, for the preparation of licensed practical nurses,

12  except for instruction and clinical knowledge of pediatric

13  nursing or obstetric/maternal-child nursing. Any program that

14  is approved on July 1, 2003, by the board for the preparation

15  of registered nurses or licensed practical nurses may provide

16  education for the preparation of certified geriatric

17  specialists without further board approval.

18         2.  Has the ability to communicate in the English

19  language, which may be determined by an examination given by

20  the department.

21         3.  Has provided sufficient information, which must be

22  submitted by the department for a statewide criminal records

23  correspondence check through the Department of Law

24  Enforcement.

25         (b)  Each applicant who meets the requirements of this

26  subsection shall, unless denied pursuant to s. 464.018, be

27  entitled to certification as a certified geriatric specialist.

28  The board shall certify, and the department shall issue a

29  certificate to practice as a certified geriatric specialist

30  to, any certified nursing assistant meeting the qualifications

31  in this section. The board shall establish an application fee


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 1  not to exceed $100 and a biennial renewal fee not to exceed

 2  $50. The board may adopt rules to administer this section.

 3         (c)  A person receiving certification under this

 4  section shall:

 5         1.  Work only within the confines of a facility

 6  licensed under part II or part III of chapter 400.

 7         2.  Care for geriatric patients only.

 8         3.  Comply with the minimum standards of practice for

 9  nurses and be subject to disciplinary action for violations of

10  s. 464.018.

11         (3)  ARTICULATION.--Any certified geriatric specialist

12  who completes the additional instruction and coursework in an

13  approved nursing program pursuant to s. 464.019 for the

14  preparation of practical nursing in the areas of pediatric

15  nursing and obstetric/maternal-child nursing shall, unless

16  denied pursuant to s. 464.018, be entitled to licensure as a

17  licensed practical nurse if the applicant otherwise meets the

18  requirements of s. 464.008.

19         (4)  TITLES AND ABBREVIATIONS; RESTRICTIONS;

20  PENALTIES.--

21         (a)  Only persons who hold certificates to practice as

22  certified geriatric specialists in this state or who are

23  performing services within the practice of certified geriatric

24  specialty nursing pursuant to the exception set forth in s.

25  464.022(8) shall have the right to use the title "Certified

26  Geriatric Specialist" and the abbreviation "C.G.S."

27         (b)  No person shall practice or advertise as, or

28  assume the title of, certified geriatric specialist or use the

29  abbreviation "C.G.S." or take any other action that would lead

30  the public to believe that person was certified as such or is

31  performing services within the practice of certified geriatric


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 1  specialty nursing pursuant to the exception set forth in s.

 2  464.022(8), unless that person is certified to practice as

 3  such.

 4         (c)  A violation of this subsection is a misdemeanor of

 5  the first degree, punishable as provided in s. 775.082 or s.

 6  775.083.

 7         (5)  VIOLATIONS AND PENALTIES.--Practicing certified

 8  geriatric specialty nursing, as defined in this section,

 9  without holding an active certificate to do so constitutes a

10  felony of the third degree, punishable as provided in s.

11  775.082, s. 775.083, or s. 775.084.

12         Section 10.  Paragraph (b) of subsection (1) of section

13  381.00315, Florida Statutes, is amended to read:

14         381.00315  Public health advisories; public health

15  emergencies.--The State Health Officer is responsible for

16  declaring public health emergencies and issuing public health

17  advisories.

18         (1)  As used in this section, the term:

19         (b)  "Public health emergency" means any occurrence, or

20  threat thereof, whether natural or man made, which results or

21  may result in substantial injury or harm to the public health

22  from infectious disease, chemical agents, nuclear agents,

23  biological toxins, or situations involving mass casualties or

24  natural disasters. Prior to declaring a public health

25  emergency, the State Health Officer shall, to the extent

26  possible, consult with the Governor and shall notify the Chief

27  of Domestic Security Initiatives as created in s. 943.03. The

28  declaration of a public health emergency shall continue until

29  the State Health Officer finds that the threat or danger has

30  been dealt with to the extent that the emergency conditions no

31  longer exist and he or she terminates the declaration.


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 1  However, a declaration of a public health emergency may not

 2  continue for longer than 60 days unless the Governor concurs

 3  in the renewal of the declaration. The State Health Officer,

 4  upon declaration of a public health emergency, may take

 5  actions that are necessary to protect the public health. Such

 6  actions include, but are not limited to:

 7         1.  Directing manufacturers of prescription drugs or

 8  over-the-counter drugs who are permitted under chapter 499 and

 9  wholesalers of prescription drugs located in this state who

10  are permitted under chapter 499 to give priority to the

11  shipping of specified drugs to pharmacies and health care

12  providers within geographic areas that have been identified by

13  the State Health Officer. The State Health Officer must

14  identify the drugs to be shipped. Manufacturers and

15  wholesalers located in the state must respond to the State

16  Health Officer's priority shipping directive before shipping

17  the specified drugs.

18         2.  Notwithstanding chapters 465 and 499 and rules

19  adopted thereunder, directing pharmacists employed by the

20  department to compound bulk prescription drugs and provide

21  these bulk prescription drugs to physicians and nurses of

22  county health departments or any qualified person authorized

23  by the State Health Officer for administration to persons as

24  part of a prophylactic or treatment regimen.

25         3.  Notwithstanding s. 456.036, temporarily

26  reactivating the inactive license of the following health care

27  practitioners, when such practitioners are needed to respond

28  to the public health emergency: physicians licensed under

29  chapter 458 or chapter 459; physician assistants licensed

30  under chapter 458 or chapter 459; certified geriatric

31  specialists certified under part I of chapter 464; licensed


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 1  practical nurses, registered nurses, and advanced registered

 2  nurse practitioners licensed under part I of chapter 464;

 3  respiratory therapists licensed under part V of chapter 468;

 4  and emergency medical technicians and paramedics certified

 5  under part III of chapter 401. Only those health care

 6  practitioners specified in this paragraph who possess an

 7  unencumbered inactive license and who request that such

 8  license be reactivated are eligible for reactivation. An

 9  inactive license that is reactivated under this paragraph

10  shall return to inactive status when the public health

11  emergency ends or prior to the end of the public health

12  emergency if the State Health Officer determines that the

13  health care practitioner is no longer needed to provide

14  services during the public health emergency. Such licenses may

15  only be reactivated for a period not to exceed 90 days without

16  meeting the requirements of s. 456.036 or chapter 401, as

17  applicable.

18         4.  Ordering an individual to be examined, tested,

19  vaccinated, treated, or quarantined for communicable diseases

20  that have significant morbidity or mortality and present a

21  severe danger to public health. Individuals who are unable or

22  unwilling to be examined, tested, vaccinated, or treated for

23  reasons of health, religion, or conscience may be subjected to

24  quarantine.

25         a.  Examination, testing, vaccination, or treatment may

26  be performed by any qualified person authorized by the State

27  Health Officer.

28         b.  If the individual poses a danger to the public

29  health, the State Health Officer may subject the individual to

30  quarantine. If there is no practical method to quarantine the

31  


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 1  individual, the State Health Officer may use any means

 2  necessary to vaccinate or treat the individual.

 3  

 4  Any order of the State Health Officer given to effectuate this

 5  paragraph shall be immediately enforceable by a law

 6  enforcement officer under s. 381.0012.

 7         Section 11.  Subsection (14) of section 400.021,

 8  Florida Statutes, is amended to read:

 9         400.021  Definitions.--When used in this part, unless

10  the context otherwise requires, the term:

11         (14)  "Nursing service" means such services or acts as

12  may be rendered, directly or indirectly, to and in behalf of a

13  person by individuals as defined in ss. s. 464.003 and

14  464.0125.

15         Section 12.  Subsection (1) of section 400.211, Florida

16  Statutes, is amended to read:

17         400.211  Persons employed as nursing assistants;

18  certification requirement.--

19         (1)  To serve as a nursing assistant in any nursing

20  home, a person must be certified as a nursing assistant under

21  part II of chapter 464, unless the person is a registered

22  nurse, a or practical nurse, or a certified geriatric

23  specialist certified or licensed in accordance with part I of

24  chapter 464 or an applicant for such licensure who is

25  permitted to practice nursing in accordance with rules adopted

26  by the Board of Nursing pursuant to part I of chapter 464.

27         Section 13.  Paragraphs (a) and (c) of subsection (3)

28  of section 400.23, Florida Statutes, are amended to read:

29         400.23  Rules; evaluation and deficiencies; licensure

30  status.--

31  


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 1         (3)(a)  The agency shall adopt rules providing for the

 2  minimum staffing requirements for nursing homes. These

 3  requirements shall include, for each nursing home facility, a

 4  minimum certified nursing assistant staffing of 2.3 hours of

 5  direct care per resident per day beginning January 1, 2002,

 6  increasing to 2.6 hours of direct care per resident per day

 7  beginning January 1, 2003, and increasing to 2.9 hours of

 8  direct care per resident per day beginning January 1, 2004.

 9  Beginning January 1, 2002, no facility shall staff below one

10  certified nursing assistant per 20 residents, and a minimum

11  licensed nursing staffing of 1.0 hour of direct resident care

12  per resident per day but never below one licensed nurse per 40

13  residents. For purposes of computing nursing staffing minimums

14  and ratios, certified geriatric specialists shall be

15  considered licensed nursing staff. Nursing assistants employed

16  under s. 400.211(2) may be included in computing the staffing

17  ratio for certified nursing assistants only if they provide

18  nursing assistance services to residents on a full-time basis.

19  Each nursing home must document compliance with staffing

20  standards as required under this paragraph and post daily the

21  names of staff on duty for the benefit of facility residents

22  and the public. The agency shall recognize the use of licensed

23  nurses for compliance with minimum staffing requirements for

24  certified nursing assistants, provided that the facility

25  otherwise meets the minimum staffing requirements for licensed

26  nurses and that the licensed nurses so recognized are

27  performing the duties of a certified nursing assistant. Unless

28  otherwise approved by the agency, licensed nurses counted

29  towards the minimum staffing requirements for certified

30  nursing assistants must exclusively perform the duties of a

31  certified nursing assistant for the entire shift and shall not


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 1  also be counted towards the minimum staffing requirements for

 2  licensed nurses. If the agency approved a facility's request

 3  to use a licensed nurse to perform both licensed nursing and

 4  certified nursing assistant duties, the facility must allocate

 5  the amount of staff time specifically spent on certified

 6  nursing assistant duties for the purpose of documenting

 7  compliance with minimum staffing requirements for certified

 8  and licensed nursing staff. In no event may the hours of a

 9  licensed nurse with dual job responsibilities be counted

10  twice.

11         (c)  Licensed practical nurses licensed under chapter

12  464 who are providing nursing services in nursing home

13  facilities under this part may supervise the activities of

14  other licensed practical nurses, certified geriatric

15  specialists, certified nursing assistants, and other

16  unlicensed personnel providing services in such facilities in

17  accordance with rules adopted by the Board of Nursing.

18         Section 14.  Paragraph (b) of subsection (2) of section

19  409.908, Florida Statutes, is amended to read:

20         409.908  Reimbursement of Medicaid providers.--Subject

21  to specific appropriations, the agency shall reimburse

22  Medicaid providers, in accordance with state and federal law,

23  according to methodologies set forth in the rules of the

24  agency and in policy manuals and handbooks incorporated by

25  reference therein.  These methodologies may include fee

26  schedules, reimbursement methods based on cost reporting,

27  negotiated fees, competitive bidding pursuant to s. 287.057,

28  and other mechanisms the agency considers efficient and

29  effective for purchasing services or goods on behalf of

30  recipients. If a provider is reimbursed based on cost

31  reporting and submits a cost report late and that cost report


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 1  would have been used to set a lower reimbursement rate for a

 2  rate semester, then the provider's rate for that semester

 3  shall be retroactively calculated using the new cost report,

 4  and full payment at the recalculated rate shall be affected

 5  retroactively. Medicare-granted extensions for filing cost

 6  reports, if applicable, shall also apply to Medicaid cost

 7  reports. Payment for Medicaid compensable services made on

 8  behalf of Medicaid eligible persons is subject to the

 9  availability of moneys and any limitations or directions

10  provided for in the General Appropriations Act or chapter 216.

11  Further, nothing in this section shall be construed to prevent

12  or limit the agency from adjusting fees, reimbursement rates,

13  lengths of stay, number of visits, or number of services, or

14  making any other adjustments necessary to comply with the

15  availability of moneys and any limitations or directions

16  provided for in the General Appropriations Act, provided the

17  adjustment is consistent with legislative intent.

18         (2)

19         (b)  Subject to any limitations or directions provided

20  for in the General Appropriations Act, the agency shall

21  establish and implement a Florida Title XIX Long-Term Care

22  Reimbursement Plan (Medicaid) for nursing home care in order

23  to provide care and services in conformance with the

24  applicable state and federal laws, rules, regulations, and

25  quality and safety standards and to ensure that individuals

26  eligible for medical assistance have reasonable geographic

27  access to such care.

28         1.  Changes of ownership or of licensed operator do not

29  qualify for increases in reimbursement rates associated with

30  the change of ownership or of licensed operator. The agency

31  shall amend the Title XIX Long Term Care Reimbursement Plan to


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 1  provide that the initial nursing home reimbursement rates, for

 2  the operating, patient care, and MAR components, associated

 3  with related and unrelated party changes of ownership or

 4  licensed operator filed on or after September 1, 2001, are

 5  equivalent to the previous owner's reimbursement rate.

 6         2.  The agency shall amend the long-term care

 7  reimbursement plan and cost reporting system to create direct

 8  care and indirect care subcomponents of the patient care

 9  component of the per diem rate. These two subcomponents

10  together shall equal the patient care component of the per

11  diem rate. Separate cost-based ceilings shall be calculated

12  for each patient care subcomponent. The direct care

13  subcomponent of the per diem rate shall be limited by the

14  cost-based class ceiling, and the indirect care subcomponent

15  shall be limited by the lower of the cost-based class ceiling,

16  by the target rate class ceiling, or by the individual

17  provider target. The agency shall adjust the patient care

18  component effective January 1, 2002. The cost to adjust the

19  direct care subcomponent shall be net of the total funds

20  previously allocated for the case mix add-on. The agency shall

21  make the required changes to the nursing home cost reporting

22  forms to implement this requirement effective January 1, 2002.

23         3.  The direct care subcomponent shall include salaries

24  and benefits of direct care staff providing nursing services

25  including registered nurses, licensed practical nurses,

26  certified geriatric specialists, certified under part I of

27  chapter 464, and certified nursing assistants who deliver care

28  directly to residents in the nursing home facility. This

29  excludes nursing administration, MDS, and care plan

30  coordinators, staff development, and staffing coordinator.

31  


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 1         4.  All other patient care costs shall be included in

 2  the indirect care cost subcomponent of the patient care per

 3  diem rate. There shall be no costs directly or indirectly

 4  allocated to the direct care subcomponent from a home office

 5  or management company.

 6         5.  On July 1 of each year, the agency shall report to

 7  the Legislature direct and indirect care costs, including

 8  average direct and indirect care costs per resident per

 9  facility and direct care and indirect care salaries and

10  benefits per category of staff member per facility.

11         6.  In order to offset the cost of general and

12  professional liability insurance, the agency shall amend the

13  plan to allow for interim rate adjustments to reflect

14  increases in the cost of general or professional liability

15  insurance for nursing homes. This provision shall be

16  implemented to the extent existing appropriations are

17  available.

18  

19  It is the intent of the Legislature that the reimbursement

20  plan achieve the goal of providing access to health care for

21  nursing home residents who require large amounts of care while

22  encouraging diversion services as an alternative to nursing

23  home care for residents who can be served within the

24  community. The agency shall base the establishment of any

25  maximum rate of payment, whether overall or component, on the

26  available moneys as provided for in the General Appropriations

27  Act. The agency may base the maximum rate of payment on the

28  results of scientifically valid analysis and conclusions

29  derived from objective statistical data pertinent to the

30  particular maximum rate of payment.

31  


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 1         Section 15.  Subsection (2) of section 458.303, Florida

 2  Statutes, is amended to read:

 3         458.303  Provisions not applicable to other

 4  practitioners; exceptions, etc.--

 5         (2)  Nothing in s. 458.301, s. 458.303, s. 458.305, s.

 6  458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.

 7  458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.

 8  458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347

 9  shall be construed to prohibit any service rendered by a

10  registered nurse, or a licensed practical nurse, or a

11  certified geriatric specialist certified under part I of

12  chapter 464, if such service is rendered under the direct

13  supervision and control of a licensed physician who provides

14  specific direction for any service to be performed and gives

15  final approval to all services performed.  Further, nothing in

16  this or any other chapter shall be construed to prohibit any

17  service rendered by a medical assistant in accordance with the

18  provisions of s. 458.3485.

19         Section 16.  Subsection (1) and paragraph (a) of

20  subsection (2) of section 1009.65, Florida Statutes, are

21  amended to read:

22         1009.65  Medical Education Reimbursement and Loan

23  Repayment Program.--

24         (1)  To encourage qualified medical professionals to

25  practice in underserved locations where there are shortages of

26  such personnel, there is established the Medical Education

27  Reimbursement and Loan Repayment Program. The function of the

28  program is to make payments that offset loans and educational

29  expenses incurred by students for studies leading to a medical

30  or nursing degree, medical or nursing licensure, or advanced

31  registered nurse practitioner certification or physician


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 1  assistant licensure. The following licensed or certified

 2  health care professionals are eligible to participate in this

 3  program: medical doctors with primary care specialties,

 4  doctors of osteopathic medicine with primary care specialties,

 5  physician's assistants, certified geriatric specialists

 6  certified under part I of chapter 464, licensed practical

 7  nurses and registered nurses, and advanced registered nurse

 8  practitioners with primary care specialties such as certified

 9  nurse midwives. Primary care medical specialties for

10  physicians include obstetrics, gynecology, general and family

11  practice, internal medicine, pediatrics, and other specialties

12  which may be identified by the Department of Health.

13         (2)  From the funds available, the Department of Health

14  shall make payments to selected medical professionals as

15  follows:

16         (a)  Up to $4,000 per year for certified geriatric

17  specialists certified under part I of chapter 464, licensed

18  practical nurses, and registered nurses, up to $10,000 per

19  year for advanced registered nurse practitioners and

20  physician's assistants, and up to $20,000 per year for

21  physicians.  Penalties for noncompliance shall be the same as

22  those in the National Health Services Corps Loan Repayment

23  Program. Educational expenses include costs for tuition,

24  matriculation, registration, books, laboratory and other fees,

25  other educational costs, and reasonable living expenses as

26  determined by the Department of Health.

27         Section 17.  Subsection (2) of section 1009.66, Florida

28  Statutes, is amended to read:

29         1009.66  Nursing Student Loan Forgiveness Program.--

30         (2)  To be eligible, a candidate must have graduated

31  from an accredited or approved nursing program and have


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 1  received a Florida license as a licensed practical nurse, a

 2  certified geriatric specialist certified under part I of

 3  chapter 464, or a registered nurse or a Florida certificate as

 4  an advanced registered nurse practitioner.

 5         Section 18.  The sum of $157,017 is appropriated from

 6  the General Revenue Fund to the Agency for Workforce

 7  Innovation to support the work of the Certified Geriatric

 8  Specialty Nursing Initiative Steering Committee, to administer

 9  the pilot sites, contract for an evaluation, and to provide,

10  if necessary, nursing faculty, substitute certified nursing

11  assistants for those who are in clinical education, and

12  technical support to the pilot sites during the 2003-2004

13  fiscal year.

14         Section 19.  Subsection (6) is added to section

15  464.201, Florida Statutes, to read:

16         464.201  Definitions.--As used in this part, the term:

17         (6)  "Practice of a certified nursing assistant" means

18  providing care and assisting persons with tasks relating to

19  the activities of daily living. Such tasks are those

20  associated with personal care, maintaining mobility, nutrition

21  and hydration, toileting and elimination, assistive devices,

22  safety and cleanliness, data gathering, reporting abnormal

23  signs and symptoms, post mortem care, patient socialization

24  and reality orientation, end-of-life care, CPR and emergency

25  care, residents' or patients' rights, documentation of nursing

26  assistant services, and other tasks that a certified nurse

27  assistant may perform after training beyond that required for

28  initial certification and upon validation of competence in

29  that skill by a registered nurse. This section does not

30  restrict the ability of any person who is otherwise trained

31  and educated from performing such tasks.


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    CS for CS for SB 572                           First Engrossed



 1         Section 20.  Section 464.202, Florida Statutes, is

 2  amended to read:

 3         464.202  Duties and powers of the board.--The board

 4  shall maintain, or contract with or approve another entity to

 5  maintain, a state registry of certified nursing assistants.

 6  The registry must consist of the name of each certified

 7  nursing assistant in this state; other identifying information

 8  defined by board rule; certification status; the effective

 9  date of certification; other information required by state or

10  federal law; information regarding any crime or any abuse,

11  neglect, or exploitation as provided under chapter 435; and

12  any disciplinary action taken against the certified nursing

13  assistant. The registry shall be accessible to the public, the

14  certificateholder, employers, and other state agencies. The

15  board shall adopt by rule testing procedures for use in

16  certifying nursing assistants and shall adopt rules regulating

17  the practice of certified nursing assistants which specify the

18  scope of practice authorized and level of supervision required

19  for the practice of certified nursing assistants to enforce

20  this part. The board may contract with or approve another

21  entity or organization to provide the examination services,

22  including the development and administration of examinations.

23  The board shall require that the contract provider offer

24  certified nursing assistant applications via the Internet, and

25  may require the contract provider to accept certified nursing

26  assistant applications for processing via the Internet.  The

27  board shall require the contract provider to provide the

28  preliminary results of the certified nursing examination on

29  the date the test is administered. The provider shall pay all

30  reasonable costs and expenses incurred by the board in

31  evaluating the provider's application and performance during


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    CS for CS for SB 572                           First Engrossed



 1  the delivery of services, including examination services and

 2  procedures for maintaining the certified nursing assistant

 3  registry.

 4         Section 21.  James and Esther King Center for Universal

 5  Research to Eradicate Disease.--

 6         (1)  The Legislature finds that an estimated 128

 7  million Americans suffer from acute, chronic, and degenerative

 8  diseases and that biomedical research is the key to finding

 9  cures for these diseases that negatively affect all

10  Floridians. The Legislature further finds that, while there is

11  much research being conducted throughout this state and

12  throughout the world, there is a lack of coordination of

13  efforts among researchers. The Legislature, therefore, finds

14  that there is a significant need for a coordinated effort if

15  the goal of curing disease is to be achieved. Moreover, the

16  Legislature finds that the biomedical technology sector meets

17  the criteria of a high-impact sector, pursuant to section

18  288.108, Florida Statutes, having a high importance to this

19  state's economy with a significant potential for growth and

20  contribution to our universities and quality of life.

21         (2)  It is the intent of the Legislature that Florida

22  strive to become the nation's leader in biomedical research

23  and commit itself to being the state to find cures for the

24  most deadly and widespread diseases. It is further the intent

25  of the Legislature that there be a coordinated effort among

26  the state's public and private universities and the biomedical

27  industry to discover such cures. Moreover, it is the intent of

28  the Legislature to expand the state economy by attracting

29  biomedical researchers and research companies to this state.

30  

31  


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    CS for CS for SB 572                           First Engrossed



 1         (3)  There is established the James and Esther King

 2  Center for Universal Research to Eradicate Disease, which

 3  shall be known as the "CURED."

 4         (a)  The purpose of the center is to coordinate,

 5  improve, expand, and monitor all biomedical research programs

 6  within the state, facilitate funding opportunities, and foster

 7  improved technology transfer of research findings into

 8  clinical trials and widespread public use.

 9         (b)  The goal of the center is to find cures for

10  diseases such as cancer, heart disease, lung disease,

11  diabetes, and neurological disorders, including Alzheimer's

12  disease, epilepsy, and Parkinson's disease.

13         (c)  The center shall hold an annual biomedical

14  technology summit in Florida to which biomedical researchers,

15  biomedical technology companies, business incubators,

16  pharmaceutical manufacturers, and others around the nation and

17  world are invited to share biomedical research findings in

18  order to expedite the discovery of cures.  Summit attendees

19  will be required to cover the costs of such attendance or

20  obtain sponsorship for such attendance.

21         (d)  The center shall encourage clinical trials in this

22  state on research that holds promise of curing a disease or

23  condition. The center shall facilitate partnerships between

24  researchers, treating physicians, and community hospitals for

25  the purpose of sharing new techniques and new research

26  findings, as well as coordinating voluntary donations to

27  ensure an adequate supply of adult stem cells or cord blood.

28         (e)  The center shall also encourage the discovery and

29  production in Florida of vaccines that prevent disease.

30         (f)  The center shall monitor the supply and demand

31  needs of researchers relating to stem cell research and other


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    CS for CS for SB 572                           First Engrossed



 1  types of human tissue research. If the center determines that

 2  there is a need for increased donation of human tissue, it

 3  shall notify hospitals licensed pursuant to chapter 395,

 4  Florida Statutes, that have entered into partnership

 5  agreements with research institutes conducting stem cell

 6  research located in the same geographic region as the

 7  researchers demanding the stem cells or other tissues. Such

 8  hospitals shall then implement programs that encourage

 9  voluntary donations of cord blood or other needed adult

10  tissue.

11         (g)  The center shall be funded through private, state,

12  and federal sources.

13         (h)  The center shall serve as a registry of all known

14  biomedical grant opportunities and may assist any public or

15  private biomedical research program in this state in preparing

16  grant requests.

17         (i)  The center shall maintain a website with links to

18  peer-reviewed biomedical research. The website shall also

19  contain a list of all known biomedical research being

20  conducted in Florida and shall facilitate communication among

21  researchers and other interested parties.

22         (j)  The center shall submit an annual report to the

23  Governor, the President of the Senate, and the Speaker of the

24  House of Representatives no later than January 15 which

25  contains recommendations for legislative change necessary to

26  foster a positive climate for biomedical research in this

27  state.

28         (k)  The duties of the center may be outsourced by the

29  Department of Health to a private entity or state university.

30         (4)  There is established within the center an advisory

31  council which shall meet at least annually.


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    CS for CS for SB 572                           First Engrossed



 1         (a)  The council shall consist of the members of the

 2  board of directors of the Florida Research Consortium and at

 3  least one representative from:

 4         1.  The Emerging Technology Commission.

 5         2.  Enterprise Florida, Inc.

 6         3.  BioFlorida.

 7         4.  The Florida Biomedical Research Advisory Council.

 8         5.  The Florida Medical Foundation.

 9         6.  Pharmaceutical Research and Manufacturers of

10  America.

11         (b)  Members of the council shall serve without

12  compensation and each organization represented shall cover all

13  expenses of its representative.

14         Section 22.  Paragraphs (a) and (b) of subsection (1),

15  subsection (2), and paragraph (f) of subsection (10) of

16  section 215.5602, Florida Statutes, are amended to read:

17         215.5602  Florida Biomedical Research Program.--

18         (1)  There is established within the Department of

19  Health the Florida Biomedical Research Program funded by the

20  proceeds of the Lawton Chiles Endowment Fund pursuant to s.

21  215.5601. The purpose of the Florida Biomedical Research

22  Program is to provide an annual and perpetual source of

23  funding in order to support research initiatives that address

24  the health care problems of Floridians in the areas of

25  tobacco-related cancer, cardiovascular disease, stroke, and

26  pulmonary disease. The long-term goals of the program are to:

27         (a)  Improve the health of Floridians by researching

28  better prevention, diagnoses, and treatments, and cures for

29  cancer, cardiovascular disease, stroke, and pulmonary disease.

30         (b)  Expand the foundation of biomedical knowledge

31  relating to the prevention, diagnosis, and treatment, and cure


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    CS for CS for SB 572                           First Engrossed



 1  of diseases related to tobacco use, including cancer,

 2  cardiovascular disease, stroke, and pulmonary disease.

 3         (2)  Funds appropriated for the Florida Biomedical

 4  Research Program shall be used exclusively for the award of

 5  grants and fellowships as established in this section; for

 6  research relating to the prevention, diagnosis, and treatment,

 7  and cure of diseases related to tobacco use, including cancer,

 8  cardiovascular disease, stroke, and pulmonary disease; and for

 9  expenses incurred in the administration of this section.

10  Priority shall be granted to research designed to prevent or

11  cure disease.

12         (10)  The council shall submit an annual progress

13  report on the state of biomedical research in this state to

14  the Governor, the Secretary of Health, the President of the

15  Senate, and the Speaker of the House of Representatives by

16  February 1. The report must include:

17         (f)  Progress in the prevention, diagnosis, and

18  treatment, and cure of diseases related to tobacco use,

19  including cancer, cardiovascular disease, stroke, and

20  pulmonary disease.

21         Section 23.  Florida Cancer Research Cooperative.--

22         (1)  Effective July 1, 2003, the Florida Cancer

23  Research Cooperative is established for the purpose of making

24  the State of Florida a world class center for cancer research.

25         (2)(a)  A not-for-profit corporation, acting as an

26  instrumentality of the Florida Dialogue on Cancer, shall be

27  organized for the purpose of governing the affairs of the

28  cooperative.

29         (b)  The Florida Cancer Research Cooperative, Inc., may

30  create not-for-profit corporate subsidiaries to fulfill its

31  mission. The not-for-profit corporation and its subsidiaries


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    CS for CS for SB 572                           First Engrossed



 1  are authorized to receive, hold, invest, and administer

 2  property and any moneys acquired from private, local, state,

 3  and federal sources, as well as technical and professional

 4  income generated or derived from the mission-related

 5  activities of the cooperative.

 6         (c)  The affairs of the not-for-profit corporation

 7  shall be managed by a board of directors which shall consist

 8  of:

 9         1.  The Secretary of the Department of Health or his or

10  her designee;

11         2.  The Chief Executive Officer of the H. Lee Moffitt

12  Cancer Center or his or her designee;

13         3.  The President of the University of Florida Shands

14  Cancer Center or his or her designee;

15         4.  The Chief Executive Officer of the University of

16  Miami Sylvester Comprehensive Cancer Center or his or her

17  designee;

18         5.  The Chief Executive Officer of the Mayo Clinic,

19  Jacksonville or his or her designee;

20         6.  The Chief Executive Officer of the American Cancer

21  Society, Florida Division or his or her designee;

22         7.  The President of the American Cancer Society,

23  Florida Division Board of Directors or his or her designee;

24         8.  The President of the Florida Society of Clinical

25  Oncology or his or her designee;

26         9.  The Chief Executive Officer of Enterprise Florida,

27  Inc., or his or her designee;

28         10.  Three representatives from large Florida hospitals

29  or institutions, not delineated in subparagraphs 1. through

30  6., that treat a large volume of cancer patients. One shall be

31  appointed by the Governor, one shall be appointed by the


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    CS for CS for SB 572                           First Engrossed



 1  Speaker of the House of Representatives, and one shall be

 2  appointed by the President of the Senate;

 3         11.  Three representatives from community-based,

 4  statewide organizations serving populations that experience

 5  cancer disparities, one of whom shall be appointed by the

 6  Governor, one of whom shall be appointed by the Speaker of the

 7  House of Representatives, and one of whom shall be appointed

 8  by the President of the Senate;

 9         12.  One member of the Florida House of

10  Representatives, to be appointed by the Speaker of the House

11  of Representatives;

12         13.  One member of the Florida Senate, to be appointed

13  by the President of the Senate;

14         14.  Three university presidents, one of whom shall be

15  appointed by the Governor, one of whom shall be appointed by

16  the Speaker of the House of Representatives, and one of whom

17  shall be appointed by the President of the Senate; and

18         15.  Five representatives from other statewide public

19  health organizations whose missions include public education

20  and the eradication of cancer, three of whom shall be

21  appointed by the Governor, one of whom shall be appointed by

22  the Speaker of the House of Representatives, and one of whom

23  shall be appointed by the President of the Senate.

24         (d)  Appointments made by the Speaker of the House of

25  Representatives and the President of the Senate pursuant to

26  paragraph (c) shall be for 2-year terms, concurrent with the

27  bienniums in which they serve as presiding officers.

28         (e)  Appointments made by the Governor pursuant to

29  paragraph (c) shall be for 2-year terms, although the Governor

30  may reappoint directors.

31  


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    CS for CS for SB 572                           First Engrossed



 1         (f)  Members of the board of directors of the

 2  not-for-profit corporation or any subsidiaries shall serve

 3  without compensation.

 4         (3)  The cooperative shall issue an annual report to

 5  the Governor, the Speaker of the House of Representatives, and

 6  the President of the Senate, by December 15 of each year, with

 7  policy and funding recommendations regarding cancer research

 8  capacity in Florida and related issues.

 9         Section 24.  Florida Cancer Research Cooperative;

10  mission and duties.--

11         (1)  The cooperative shall develop and centralize the

12  processes and shared services for expanding cancer research in

13  Florida through:

14         (a)  Support through bioinformatics, in order to create

15  a cancer informatics infrastructure that enhances information

16  and resource exchange and integration through researchers

17  working in diverse disciplines to facilitate the full spectrum

18  of cancer investigations;

19         (b)  Technical coordination, business development, and

20  support of intellectual property;

21         (c)  Development of a statewide cancer clinical trials

22  network as contemplated in section 1; and

23         (d)  Other multidisciplinary research support

24  activities.

25         (2)  The cooperative shall work in concert with the

26  Center for Universal Research to Eradicate Disease created in

27  section 1 to ensure that the goals of the center are advanced.

28         Section 25.  Section 484.0512, Florida Statutes, is

29  amended to read:

30  

31  


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    CS for CS for SB 572                           First Engrossed



 1         484.0512  Thirty-day trial period; purchaser's right to

 2  cancel; notice; refund; cancellation fee; criminal penalty

 3  procedures.--

 4         (1)  A person selling a hearing aid in this state must

 5  provide the buyer with written notice of a 30-day trial period

 6  and money-back guarantee. The guarantee must permit the

 7  purchaser to cancel the purchase for a valid reason as defined

 8  by rule of the board within 30 days after receiving the

 9  hearing aid, by returning the hearing aid or mailing written

10  notice of cancellation to the seller. If the hearing aid must

11  be repaired, remade, or adjusted during the 30-day trial

12  period, the running of the 30-day trial period is suspended 1

13  day for each 24-hour period that the hearing aid is not in the

14  purchaser's possession. A repaired, remade, or adjusted

15  hearing aid must be claimed by the purchaser within 3 working

16  days after notification of availability. The running of the

17  30-day trial period resumes on the day the purchaser reclaims

18  the repaired, remade, or adjusted hearing aid or on the fourth

19  day after notification of availability.

20         (2)  The board, in consultation with the Board of

21  Speech-Language Pathology and Audiology, shall prescribe by

22  rule the terms and conditions to be contained in the

23  money-back guarantee and any exceptions thereto. Such rule

24  shall provide, at a minimum, that the charges for earmolds and

25  service provided to fit the hearing aid may be retained by the

26  licensee. The rules shall also set forth any reasonable

27  charges to be held by the licensee as a cancellation fee. Such

28  rule shall be effective on or before December 1, 1994. Should

29  the board fail to adopt such rule, a licensee may not charge a

30  cancellation fee which exceeds 5 percent of the total charge

31  for a hearing aid alone. The terms and conditions of the


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    CS for CS for SB 572                           First Engrossed



 1  guarantee, including the total amount available for refund,

 2  shall be provided in writing to the purchaser prior to the

 3  signing of the contract.

 4         (3)  Within 30 days after the return or attempted

 5  return of the hearing aid, the seller shall refund all moneys

 6  that must be refunded to a purchaser pursuant to this section.

 7  A violation of this subsection is a misdemeanor of the first

 8  degree, punishable as provided in s. 775.082 or s. 775.083.

 9         (4)  For purposes of this section, the term "seller" or

10  "person selling a hearing aid" includes:

11         (a)  Any natural person licensed under this part or any

12  other natural person who signs a sales receipt required by s.

13  484.051(2) or s. 468.1245(2) or who otherwise fits, delivers,

14  or dispenses a hearing aid.

15         (b)  Any business organization, whether a sole

16  proprietorship, partnership, corporation, professional

17  association, joint venture, business trust, or other legal

18  entity, which dispenses a hearing aid or enters into an

19  agreement to dispense a hearing aid.

20         (c)  Any person who controls, manages, or operates an

21  establishment or business that dispenses a hearing aid or

22  enters into an agreement to dispense a hearing aid.

23         Section 26.  Effective upon this act becoming a law,

24  subsection (1) of section 456.073, Florida Statutes, is

25  amended to read:

26         456.073  Disciplinary proceedings.--Disciplinary

27  proceedings for each board shall be within the jurisdiction of

28  the department.

29         (1)  The department, for the boards under its

30  jurisdiction, shall cause to be investigated any complaint

31  that is filed before it if the complaint is in writing, signed


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    CS for CS for SB 572                           First Engrossed



 1  by the complainant, and legally sufficient. A complaint filed

 2  by a state prisoner against a health care practitioner

 3  employed by or otherwise providing health care services within

 4  a facility of the Department of Corrections is not legally

 5  sufficient unless there is a showing that the prisoner

 6  complainant has exhausted all available administrative

 7  remedies within the state correctional system before filing

 8  the complaint. However, if the department determines after a

 9  preliminary inquiry of a state prisoner's complaint, that the

10  practitioner may present a serious threat to the health and

11  safety of any individual who is not a state prisoner, the

12  department may determine legal sufficiency and proceed with

13  discipline. The Department of Health shall be notified within

14  15 days whenever the Department of Corrections disciplines or

15  allows a health care practitioner to resign for an offense

16  related to the practice of his or her profession. A complaint

17  is legally sufficient if it contains ultimate facts that show

18  that a violation of this chapter, of any of the practice acts

19  relating to the professions regulated by the department, or of

20  any rule adopted by the department or a regulatory board in

21  the department has occurred. In order to determine legal

22  sufficiency, the department may require supporting information

23  or documentation. The department may investigate, and the

24  department or the appropriate board may take appropriate final

25  action on, a complaint even though the original complainant

26  withdraws it or otherwise indicates a desire not to cause the

27  complaint to be investigated or prosecuted to completion. The

28  department may investigate an anonymous complaint if the

29  complaint is in writing and is legally sufficient, if the

30  alleged violation of law or rules is substantial, and if the

31  department has reason to believe, after preliminary inquiry,


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    CS for CS for SB 572                           First Engrossed



 1  that the violations alleged in the complaint are true. The

 2  department may investigate a complaint made by a confidential

 3  informant if the complaint is legally sufficient, if the

 4  alleged violation of law or rule is substantial, and if the

 5  department has reason to believe, after preliminary inquiry,

 6  that the allegations of the complainant are true. The

 7  department may initiate an investigation if it has reasonable

 8  cause to believe that a licensee or a group of licensees has

 9  violated a Florida statute, a rule of the department, or a

10  rule of a board. Except as provided in ss. 458.331(9),

11  459.015(9), 460.413(5), and 461.013(6), when an investigation

12  of any subject is undertaken, the department shall promptly

13  furnish to the subject or the subject's attorney a copy of the

14  complaint or document that resulted in the initiation of the

15  investigation. The subject may submit a written response to

16  the information contained in such complaint or document within

17  20 days after service to the subject of the complaint or

18  document. The subject's written response shall be considered

19  by the probable cause panel. The right to respond does not

20  prohibit the issuance of a summary emergency order if

21  necessary to protect the public. However, if the secretary, or

22  the secretary's designee, and the chair of the respective

23  board or the chair of its probable cause panel agree in

24  writing that such notification would be detrimental to the

25  investigation, the department may withhold notification. The

26  department may conduct an investigation without notification

27  to any subject if the act under investigation is a criminal

28  offense.

29         Section 27.  (1)  The Division of Medical Quality

30  Assurance of the Department of Health shall conduct a study of

31  clinical and academic training requirements of certified


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    CS for CS for SB 572                           First Engrossed



 1  optometric practitioners, licensed pursuant to chapter 463,

 2  Florida Statutes, to determine the extent to which prescribing

 3  authority may be expanded. The study group shall be composed

 4  of the following members:

 5         (a)  One pharmacologist representing the University of

 6  Florida;

 7         (b)  One pharmacologist representing Nova Southeastern

 8  University;

 9         (c)  One pharmacologist representing Florida

10  Agricultural and Mechanical University;

11         (d)  One ophthalmologist representing Mayo Clinic

12  Jacksonville;

13         (e)  One ophthalmologist representing Bascom Palmer Eye

14  Institute;

15         (f)  One board-certified internist appointed by the

16  University of South Florida;

17         (g)  One optometrist representing the Florida Board of

18  Optometry;

19         (h)  One certified optometric practitioner representing

20  the Florida Optometric Association; and

21         (i)  One certified optometric practitioner appointed by

22  the Nova Southeastern University College of Optometry.

23         (2)  The study group shall be chaired by the Secretary

24  of Health or his or her designee. The study shall be completed

25  and a final report presented to the Governor, the President of

26  the Senate, and the Speaker of the House of Representatives by

27  January 15, 2004. If applicable, a minority report shall be

28  completed and presented to the Governor, the President of the

29  Senate, and the Speaker of the House of Representatives by

30  January 31, 2004.

31  


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 1         (3)  This section shall take effect upon becoming a

 2  law.

 3         Section 28.  Present subsection (4) of section

 4  465.0265, Florida Statutes, is redesignated as subsection (5),

 5  and a new subsection (4) is added to that section, to read:

 6         465.0265  Centralized prescription filling.--

 7         (4)  Pharmacies accessing the same prescription records

 8  in a centralized database or pharmacy computers linked in any

 9  other manner may refill or dispense prescriptions at the

10  request of another pharmacy so linked if the pharmacies have

11  the same owner or have a written contract specifying the

12  services to be provided by each pharmacy, the responsibilities

13  of each pharmacy, and the manner in which the pharmacies will

14  comply with federal and state laws and rules. Prescriptions

15  refilled or dispensed using such a system shall not be

16  considered prescription transfers or copies if the computer

17  system registers a complete and full audit trail of all

18  activities and includes the identification of the pharmacies

19  and pharmacists accessing the centralized database and if the

20  system restricts access to the computerized prescription

21  records to pharmacies or other authorized personnel.

22         Section 29.  Subsection (2) of section 466.006, Florida

23  Statutes, is amended to read:

24         466.006  Examination of dentists.--

25         (2)  An applicant shall be entitled to take the

26  examinations required in this section to practice dentistry in

27  this state if the applicant:

28         (a)  Is 18 years of age or older.

29         (b)1.  Is a graduate of a dental school accredited by

30  the Commission on Accreditation of the American Dental

31  


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    CS for CS for SB 572                           First Engrossed



 1  Association or its successor agency, if any, or any other

 2  nationally recognized accrediting agency; or.

 3         2.  Is a dental student in the final year of a program

 4  at such an accredited school who has completed all the

 5  coursework necessary to prepare the student to perform the

 6  clinical and diagnostic procedures required to pass the

 7  examinations. With respect to a dental student in the final

 8  year of a program at a dental school, a passing score on the

 9  examinations is valid for 180 days after the date the

10  examinations were completed. A dental school student who takes

11  the licensure examinations during the student's final year of

12  an approved dental school must have graduated before being

13  certified for licensure pursuant to s. 466.011.

14         (c)  Has successfully completed the National Board of

15  Dental Examiners dental examination within 10 years of the

16  date of application.

17         Section 30.  Section 466.0065, Florida Statutes, is

18  created to read:

19         466.0065  Regional licensure examinations.--

20         (1)  It is the intent of the Legislature that schools

21  of dentistry be allowed to offer regional licensure

22  examinations to dental students who are in the final year of a

23  program at an approved dental school for the sole purpose of

24  facilitating the student's licensing in other jurisdictions.

25  This section does not allow a person to be licensed as a

26  dentist in this state without taking the examinations as set

27  forth in s. 466.006, nor does this section mean that regional

28  examinations administered under this section may be

29  substituted for complying with testing requirements under s.

30  466.006.

31  


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 1         (2)  Each school of dentistry in this state which is

 2  accredited by the Commission on Accreditation of the American

 3  Dental Association or its successor agency may, upon written

 4  approval by the Board of Dentistry, offer regional licensure

 5  examinations only to dental students in the final year of a

 6  program at an approved dental school, if the board has

 7  approved the hosting school's written plan to comply with the

 8  following conditions:

 9         (a)  The examining body must be a member of the

10  American Association of Dental Examiners.

11         (b)  The student must have successfully completed parts

12  I and II of the National Board of Dental Examiners examination

13  within 2 years before taking the regional examination.

14         (c)  The student must possess medical malpractice

15  insurance in amounts that the board determines to be

16  sufficient to cover any reasonably forseeable incident of harm

17  to a patient during the clinical portion of the regional

18  examination.

19         (d)  At least one of the examination monitors must be a

20  dentist licensed in this state who has completed all necessary

21  standardization exercises required by the regional examination

22  body.

23         (e)  Adequate arrangements must be made, when

24  necessary, for patients who require followup care as a result

25  of procedures performed during the clinical portion of the

26  regional examination.

27         (f)  The board chair or the chair's designee must be

28  allowed to observe testing while it is in progress.

29         (g)  Each student, upon applying to take the regional

30  examination, must receive written disclosure in at least

31  12-point boldface type which states: "This examination does


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    CS for CS for SB 572                           First Engrossed



 1  not meet the licensure requirements of chapter 466, Florida

 2  Statutes, for licensure in the State of Florida. Persons

 3  wishing to practice dentistry in Florida must pass the Florida

 4  licensure examinations. For more information on Florida's

 5  licensure examination procedures, please contact the Florida

 6  Board of Dentistry."

 7         (h)  The student must be enrolled as a dental student

 8  in the student's final year of a program at an approved dental

 9  school that is accredited by the Commission on Accreditation

10  of the American Dental Association or its successor agency.

11         (i)  The student must have completed all the coursework

12  necessary to prepare the student to perform all clinical and

13  diagnostic procedures required to pass the regional

14  examination.

15         (j)  The student's academic record must not include any

16  evidence suggesting that the student poses an unreasonable

17  risk to any live patients who are required for the clinical

18  portion of the regional examination. In order to protect the

19  health and safety of the public, the board may request

20  additional information and documents pertaining to the

21  candidate's mental and physical health in order to fully

22  assess the candidate's fitness to engage in exercises

23  involving a live patient.

24         (3)  A student who takes the examination pursuant to

25  this section, a dental school that submits a plan pursuant to

26  this section, or a regional examination body that a dental

27  school proposes to host under this section does not have

28  standing to assert that a state agency has taken action for

29  which a hearing may be sought under ss. 120.569 and 120.57.

30         Section 31.  This act may be cited as the "Nick Oelrich

31  Gift of Life Act."


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 1         Section 32.  Subsections (1), (2), and (6) of section

 2  765.512, Florida Statutes, are amended to read:

 3         765.512  Persons who may make an anatomical gift.--

 4         (1)  Any person who may make a will may give all or

 5  part of his or her body for any purpose specified in s.

 6  765.510, the gift to take effect upon death.  An anatomical

 7  gift made by an adult donor and not revoked by the donor as

 8  provided in s. 765.516 is irrevocable and does not require the

 9  consent or concurrence of any person after the donor's death.

10  A family member, guardian, representative ad litem, or health

11  care surrogate of an adult donor who has made an anatomical

12  gift pursuant to subsection (2) may not modify, deny or

13  prevent a donor's wish or intent to make an anatomical gift

14  from being made after the donor's death.

15         (2)  If the decedent has executed an agreement

16  concerning an anatomical gift, by including signing an organ

17  and tissue donor card, by expressing his or her wish to donate

18  in a living will or advance directive, or by signifying his or

19  her intent to donate on his or her driver's license or in some

20  other written form has indicated his or her wish to make an

21  anatomical gift, and in the absence of actual notice of

22  contrary indications by the decedent, the document is evidence

23  of legally sufficient informed consent to donate an anatomical

24  gift and is legally binding. Any surrogate designated by the

25  decedent pursuant to part II of this chapter may give all or

26  any part of the decedent's body for any purpose specified in

27  s. 765.510.

28         (6)  A gift of all or part of a body authorizes:

29         (a)  Any examination necessary to assure medical

30  acceptability of the gift for the purposes intended.

31  


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 1         (b)  The decedent's medical provider, family, or a

 2  third party to furnish medical records requested concerning

 3  the decedent's medical and social history.

 4         Section 33.  Section 765.516, Florida Statutes, is

 5  amended to read:

 6         765.516  Amendment of the terms of or the revocation of

 7  the gift.--

 8         (1)  A donor may amend the terms of or revoke an

 9  anatomical gift by:

10         (a)  The execution and delivery to the donee of a

11  signed statement.

12         (b)  An oral statement that is:

13         1.  Made to the donor's spouse; or

14         2. made in the presence of two persons, one of whom

15  must not be a family member, and communicated to the donor's

16  family or attorney or to the donee.

17         (c)  A statement during a terminal illness or injury

18  addressed to an attending physician, who must communicate the

19  revocation of the gift to the procurement organization that is

20  certified by the state.

21         (d)  A signed document found on or about the donor's

22  person or in the donor's effects.

23         (2)  Any gift made by a will may also be amended or

24  revoked in the manner provided for amendment or revocation of

25  wills or as provided in subsection (1).

26         Section 34.  Subsection (1) of section 765.401, Florida

27  Statutes, is amended to read:

28         765.401  The proxy.--

29         (1)  If an incapacitated or developmentally disabled

30  patient has not executed an advance directive, or designated a

31  surrogate to execute an advance directive, or the designated


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    CS for CS for SB 572                           First Engrossed



 1  or alternate surrogate is no longer available to make health

 2  care decisions, health care decisions may be made for the

 3  patient by any of the following individuals, in the following

 4  order of priority, if no individual in a prior class is

 5  reasonably available, willing, or competent to act:

 6         (a)  The judicially appointed guardian of the patient

 7  or the guardian advocate of the person having a developmental

 8  disability as defined in s. 393.063, who has been authorized

 9  to consent to medical treatment, if such guardian has

10  previously been appointed; however, this paragraph shall not

11  be construed to require such appointment before a treatment

12  decision can be made under this subsection;

13         (b)  The patient's spouse;

14         (c)  An adult child of the patient, or if the patient

15  has more than one adult child, a majority of the adult

16  children who are reasonably available for consultation;

17         (d)  A parent of the patient;

18         (e)  The adult sibling of the patient or, if the

19  patient has more than one sibling, a majority of the adult

20  siblings who are reasonably available for consultation;

21         (f)  An adult relative of the patient who has exhibited

22  special care and concern for the patient and who has

23  maintained regular contact with the patient and who is

24  familiar with the patient's activities, health, and religious

25  or moral beliefs; or

26         (g)  A close friend of the patient; or.

27         (h)  A clinical social worker licensed pursuant to

28  chapter 491, or a graduate of a court-approved guardianship

29  program. Such a proxy must be selected by the provider's

30  bioethics committee and must not be employed by the provider.

31  If the provider does not have a bioethics committee, then such


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 1  a proxy may be chosen through an arrangement with the

 2  bioethics committee of another provider. The proxy must be

 3  notified that upon request the provider shall make available a

 4  second physician, not involved in the patient's care, to

 5  assist the proxy in evaluating treatment. Decisions to

 6  withhold or withdraw life-prolonging procedures must be

 7  reviewed by the facility's bioethics committee. Documentation

 8  of efforts to locate proxies from prior classes must be

 9  recorded in the patient record.

10         Section 35.  Subsection (22) is added to section

11  641.19, Florida Statutes, to read:

12         641.19  Definitions.--As used in this part, the term:

13         (22)  "Specialty" does not include services performed

14  by a chiropractic physician licensed under chapter 460.

15         Section 36.  Section 466.0065, Florida Statutes, is

16  created to read:

17         466.0065  Regional licensure examinations.--

18         (1)  It is the intent of the Legislature that schools

19  of dentistry be allowed to offer regional licensure

20  examinations to dental students who are in the final year of

21  an approved dental school for the sole purpose of facilitating

22  the student's licensing in other jurisdictions. This section

23  does not allow a person to be licensed as a dentist in this

24  state without taking the examination as set forth in s.

25  466.006 nor does this section mean that regional examinations

26  administered under this section may be substituted for

27  complying with testing requirements under s. 466.006.

28         (2)  Each school of dentistry in this state which is

29  accredited by the Commission on Accreditation of the American

30  Dental Association or its successor agency may, upon written

31  approval by the Board of Dentistry, offer regional licensure


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    CS for CS for SB 572                           First Engrossed



 1  examinations only to dental students in the final year of an

 2  approved dental school, if the board has approved the hosting

 3  school's submitted written plan to comply with the following

 4  conditions:

 5         (a)  The examining body must be a member of the

 6  American Association of Dental Examiners.

 7         (b)  The student must have successfully completed parts

 8  I and II of the National Board of Dental Examiners

 9  examination within 2 years before taking the regional

10  examination.

11         (c)  The student must possess medical malpractice

12  insurance in amounts that the board determines to be

13  sufficient to cover any reasonably forseeable incident of harm

14  to a patient during the clinical portion of the examination.

15         (d)  The examination must be monitored by dentists

16  licensed in this state who are approved by the board and who

17  have completed a mandatory standardization exercise before

18  each practical or clinical examination.

19         (e)  Adequate arrangements must be made, when

20  necessary, for patients who require followup care as a result

21  of procedures performed during the clinical portion of the

22  examination.

23         (f)  The board chairman or the chairman's designee must

24  be allowed to observe testing while it is in progress.

25         (g)  Each student, upon applying to take the regional

26  examination, must receive written disclosure in at least

27  12-point boldface type which states: "This examination does

28  not meet the licensure requirements of chapter 466, Florida

29  Statutes, for  licensure in the State of Florida. Persons

30  wishing to practice dentistry in Florida must pass the Florida

31  licensure examination. For more information on Florida's


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    CS for CS for SB 572                           First Engrossed



 1  licensure examination procedures, please contact the Florida

 2  Board of Dentistry."

 3         (h)  The student must be enrolled as a dental student

 4  in his or her final year of an approved dental school that is

 5  accredited by the Commission on Accreditation of the American

 6  Dental Association or its successor agency.

 7         (i)  The student must have completed all the coursework

 8  necessary to prepare him or her to perform all clinical and

 9  didactic procedures required to pass the examination.

10         (j)  The student's academic record must not include any

11  evidence suggesting that the student poses an unreasonable

12  risk to any live patients who are required for the clinical

13  examination. In order to protect the health and safety of the

14  residents of this state, the board may request additional

15  information and documents pertaining to the candidate's mental

16  and physical health in order to fully assess the candidate's

17  fitness to engage in exercises involving a live patient.

18         (3)  A student who takes a regional examination

19  pursuant to this section does not have standing to assert that

20  a state agency has taken action for which a hearing may be

21  sought under ss. 120.569 and 120.57.

22         Section 37.  The sum of $58,179 is appropriated from

23  the Medical Quality Assurance Trust Fund to the Department of

24  Health, and one position is authorized for the purpose of

25  implementing sections 1 and 2 of this act during the 2003-2004

26  fiscal year.

27         Section 38.  Paragraph (e) of subsection (2) of section

28  381.7353, Florida Statutes, is amended to read:

29         381.7353  Reducing Racial and Ethnic Health

30  Disparities:  Closing the Gap grant program; administration;

31  department duties.--


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    CS for CS for SB 572                           First Engrossed



 1         (2)  The department shall:

 2         (e)  Coordinate with existing community-based programs,

 3  such as chronic disease community intervention programs,

 4  cancer prevention and control programs, diabetes control

 5  programs, oral health care programs, the Healthy Start

 6  program, the Florida KidCare Program, the HIV/AIDS program,

 7  immunization programs, and other related programs at the state

 8  and local levels, to avoid duplication of effort and promote

 9  consistency.

10         Section 39.  Paragraph (a) of subsection (2) of section

11  381.7355, Florida Statutes, is amended to read:

12         381.7355  Project requirements; review criteria.--

13         (2)  A proposal must include each of the following

14  elements:

15         (a)  The purpose and objectives of the proposal,

16  including identification of the particular racial or ethnic

17  disparity the project will address. The proposal must address

18  one or more of the following priority areas:

19         1.  Decreasing racial and ethnic disparities in

20  maternal and infant mortality rates.

21         2.  Decreasing racial and ethnic disparities in

22  morbidity and mortality rates relating to cancer.

23         3.  Decreasing racial and ethnic disparities in

24  morbidity and mortality rates relating to HIV/AIDS.

25         4.  Decreasing racial and ethnic disparities in

26  morbidity and mortality rates relating to cardiovascular

27  disease.

28         5.  Decreasing racial and ethnic disparities in

29  morbidity and mortality rates relating to diabetes.

30         6.  Increasing adult and child immunization rates in

31  certain racial and ethnic populations.


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    CS for CS for SB 572                           First Engrossed



 1         7.  Decreasing racial and ethnic disparities in oral

 2  health care.

 3         Section 40.  Section 768.1335, Florida Statutes, is

 4  created to read:

 5         768.1335  Emergency Medical Dispatch Act;

 6  presumption.--

 7         (1)  This section may be known by the popular name the

 8  "Emergency Medical Dispatch Act."

 9         (2)  As used in this section:

10         (a)  "Emergency medical dispatch" means the function of

11  utilizing emergency medical dispatch protocols.

12         (b)  "Emergency medical dispatcher" means a person who

13  is trained or certified in the prompt and accurate processing

14  of calls for emergency medical assistance.

15         (c)  "Emergency medical dispatch agency" means any

16  private or public entity that is responsible for the emergency

17  medical dispatch by emergency medical dispatchers.

18         (d)  "Emergency medical dispatch protocol" means

19  guidelines for processing calls for emergency medical

20  assistance or for the dispatching of emergency medical

21  services in a prehospital setting, which are substantially

22  similar to standards set forth by the American Society for

23  Testing and Materials or the National Highway Traffic Safety

24  Administration and which have been incorporated into an

25  emergency medical dispatch training program.

26         (3)  Notwithstanding any other provision of law to the

27  contrary and unless otherwise immune under s. 768.28, any

28  emergency medical dispatcher or the emergency medical dispatch

29  agency, its agents, or employees who utilize emergency medical

30  dispatch protocols are presumed not to have acted negligently

31  regarding any injuries or damages resulting from the use of


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    CS for CS for SB 572                           First Engrossed



 1  emergency medical dispatch protocols, if the emergency medical

 2  dispatcher or the emergency dispatch agency, its agents, or

 3  employees:

 4         (a)  Properly trained their emergency medical

 5  dispatchers in an emergency medical dispatch that is

 6  substantially similar to standards set forth by the American

 7  Society for Testing and Materials or the National Highway

 8  Traffic Safety Administration;

 9         (b)  Implemented standard practices and management for

10  emergency medical dispatch or practices that are substantially

11  similar to standards set forth by the American Society for

12  Testing and Materials or the National Highway Traffic Safety

13  Administration; and

14         (c)  Utilized standard practices for training,

15  instructor qualification, and certification eligibility of

16  emergency medical dispatchers or standards that are

17  substantially similar to the American Society for Testing and

18  Materials or the National Highway Traffic Safety

19  Administration.

20         Section 41.  Section 401.111, Florida Statutes, is

21  amended to read:

22         401.111  Emergency medical services grant program;

23  authority.--The department is hereby authorized to make grants

24  to local agencies and emergency medical services organizations

25  in accordance with any agreement entered into pursuant to this

26  part.  These grants shall be designed to assist said agencies

27  and organizations in providing emergency medical services,

28  including emergency medical dispatch.  The cost of

29  administering this program shall be paid by the department

30  from funds appropriated to it.

31  


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 1         Section 42.  This act shall take effect July 1, 2003,

 2  except that sections 40 and 41 of this act shall take effect

 3  September 11, 2003.

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