Senate Bill sb2448er

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    2004 Legislature                 CS for SB 2448, 2nd Engrossed



  1                                 

  2         An act relating to public health; amending s.

  3         17.41, F.S.; authorizing funds from the Tobacco

  4         Settlement Clearing Trust Fund to be disbursed

  5         to the Biomedical Research Trust Fund in the

  6         Department of Health; amending s. 20.43, F.S.;

  7         establishing the Officer of Women's Health

  8         Strategy in the Department of Health;

  9         establishing the Office of Minority Health in

10         the Department of Health; designating the

11         Division of Emergency Medical Services and

12         Community Health Resources as the "Division of

13         Emergency Medical Operations"; designating the

14         Division of Information Resource Management as

15         the "Division of Information Technology";

16         designating the Division of Health Awareness

17         and Tobacco as the "Division of Health Access

18         and Tobacco"; creating the Division of

19         Disability Determinations; creating s.

20         381.04015, F.S.; providing legislative intent;

21         providing the duties of the Officer of Women's

22         Health Strategy; requiring an annual report to

23         the Governor and Legislature with policy

24         recommendations for implementing the Women's

25         Health Strategy; requiring consideration of

26         women's health issues and gender in state

27         policy, planning, and budgeting; providing for

28         responsibility and coordination; transferring

29         and amending s. 216.341, F.S.; providing that

30         certain positions within the Department of

31         Health are exempt from a limitation on the


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    2004 Legislature                 CS for SB 2448, 2nd Engrossed



 1         number of authorized positions; amending s.

 2         381.0011, F.S.; revising duties of the

 3         Department of Health; providing for a statewide

 4         injury prevention program; amending s. 381.006,

 5         F.S.; including within the department's

 6         environmental health program the function of

 7         investigating elevated levels of lead in blood;

 8         amending s. 381.0065, F.S., relating to onsite

 9         sewage treatment and disposal systems; revising

10         a definition; deleting a requirement that the

11         department make certain biennial reports to the

12         Legislature; authorizing the department to

13         require the submission of certain construction

14         plans pursuant to adopted rule; continuing a

15         requirement imposing a permit fee on new

16         construction; amending s. 381.0072, F.S.;

17         exempting certain schools, bars, and lounges

18         from certification requirements for food

19         service managers; creating s. 381.86, F.S.;

20         establishing the Institutional Review Board

21         within the Department of Health to review

22         certain biomedical and behavioral research;

23         providing for the membership of the board;

24         authorizing board members to be reimbursed for

25         per diem and travel expenses; authorizing the

26         department to charge fees for the research

27         oversight performed by the board; authorizing

28         the department to adopt rules; amending s.

29         381.89, F.S.; authorizing the Department of

30         Health to impose certain licensure fees on

31         tanning facilities; amending s. 381.90, F.S.;


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 1         revising the membership and reporting

 2         requirements of the Health Information Systems

 3         Council; amending s. 383.14, F.S.; authorizing

 4         the State Public Health Laboratory to release

 5         certain test results to a newborn's primary

 6         care physician; revising certain testing

 7         requirements for newborns; increasing the

 8         membership of the Genetics and Newborn

 9         Screening Advisory Council; amending s.

10         383.402, F.S.; revising the criteria under

11         which the state and local child abuse death

12         review committees are required to review the

13         death of a child; amending s. 391.021, F.S.;

14         redefining the term "children with special

15         health care needs" for purposes of the

16         Children's Medical Services Act; amending ss.

17         391.025, 391.029, 391.035, and 391.055, F.S.,

18         relating to the Children's Medical Services

19         program; revising the application requirements

20         for the program; revising requirements for

21         eligibility for services under the program;

22         authorizing the department to contract with

23         out-of-state health care providers to provide

24         services to program participants; authorizing

25         the department to adopt rules; requiring that

26         certain newborns with abnormal screening

27         results be referred to the program; amending s.

28         391.302, F.S.; revising certain definitions

29         relating to developmental evaluation and

30         intervention services; amending s. 391.303,

31         F.S.; revising certain requirements for


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 1         providing those services; amending s. 391.308,

 2         F.S.; creating the Infants and Toddlers Early

 3         Intervention Program within the Department of

 4         Health; requiring the department, jointly with

 5         the Department of Education, to prepare grant

 6         applications and to include certain services

 7         under the program; amending s. 395.003, F.S.;

 8         requiring a report by the Agency for Health

 9         Care Administration regarding the licensure of

10         emergency departments located off the premises

11         of hospitals; prohibiting the issuance of

12         licenses for such departments before July 1,

13         2005; amending s. 395.1027, F.S.; authorizing

14         certain licensed facilities to release patient

15         information to regional poison control centers;

16         amending s. 395.404, F.S.; revising reporting

17         requirements to the trauma registry data system

18         maintained by the Department of Health;

19         providing that hospitals, pediatric trauma

20         referral centers, and trauma centers subject to

21         reporting trauma registry data to the

22         department are required to comply with other

23         duties concerning the moderate-to-severe brain

24         or spinal cord injury registry maintained by

25         the department; correcting references to the

26         term "trauma center"; amending s. 400.9905,

27         F.S.; revising the definitions of "clinic" and

28         "medical director" and defining "chief

29         financial officer," "mobile clinic," and

30         "portable equipment provider" for purposes of

31         the Health Care Clinic Act; providing that


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    2004 Legislature                 CS for SB 2448, 2nd Engrossed



 1         certain entities providing oncology or

 2         radiation therapy services are exempt from the

 3         licensure requirements of part XIII of ch. 400,

 4         F.S.; providing legislative intent with respect

 5         to such exemption; providing for retroactive

 6         application; amending s. 400.991, F.S.;

 7         requiring each mobile clinic to obtain a health

 8         care clinic license; requiring a portable

 9         equipment provider to obtain a health care

10         clinic license for a single office and

11         exempting such a provider from submitting

12         certain information to the Agency for Health

13         Care Administration; revising the date by which

14         an initial application for a health care clinic

15         license must be filed with the agency; revising

16         the definition of "applicant"; amending s.

17         400.9935, F.S.; assigning responsibilities for

18         ensuring billing; providing that an exemption

19         from licensure is not transferable; providing

20         that the agency may charge a fee of applicants

21         for certificates of exemption; providing that

22         the agency may deny an application or revoke a

23         license under certain circumstances; amending

24         s. 400.995, F.S.; providing that the agency may

25         deny, revoke, or suspend specified licenses and

26         impose fines for certain violations; providing

27         that a temporary license expires after a notice

28         of intent to deny an application is issued by

29         the agency; providing that persons or entities

30         made exempt under the act and which have paid

31         the clinic licensure fee to the agency are


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 1         entitled to a partial refund from the agency;

 2         providing that certain persons or entities are

 3         not in violation of part XIII of ch. 400, F.S.,

 4         due to failure to apply for a clinic license by

 5         a specified date; providing that certain

 6         payments may not be denied to such persons or

 7         entities for failure to apply for or obtain a

 8         clinic license before a specified date;

 9         amending s. 400.9905, F.S.; providing that

10         certain entities providing oncology or

11         radiation therapy services are exempt from the

12         licensure requirements of part XIII of ch. 400,

13         F.S.; providing legislative intent with respect

14         to such exemption; providing for retroactive

15         application; amending s. 401.211, F.S.;

16         providing legislative intent with respect to a

17         statewide injury-prevention program; creating

18         s. 401.243, F.S.; providing duties of the

19         department for establishing such a program;

20         authorizing the department to adopt rules;

21         amending s. 404.056, F.S.; revising the radon

22         testing requirements for schools and certain

23         state-operated or state-licensed facilities;

24         amending s. 468.302, F.S.; revising certain

25         requirements for administering radiation and

26         performing certain other procedures; amending

27         s. 468.304, F.S.; revising requirements for

28         obtaining certification from the department as

29         an X-ray machine operator, a radiographer, or a

30         nuclear medicine technologist; amending s.

31         468.306, F.S.; requiring remedial education for


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 1         certain applicants for certification; amending

 2         s. 468.3065, F.S.; providing that the

 3         application fee is nonrefundable; amending s.

 4         468.307, F.S.; revising the expiration date of

 5         a certificate; amending s. 468.309, F.S.;

 6         revising requirements for certification as a

 7         radiologic technologist; providing for a

 8         certificateholder to resign a certification;

 9         amending s. 468.3095, F.S.; revising

10         requirements for reactivating an expired

11         certificate; amending s. 468.3101, F.S.;

12         authorizing the department to conduct

13         investigations and inspections; clarifying

14         certain grounds for disciplinary actions;

15         amending s. 489.553, F.S.; providing

16         requirements for registration as a master

17         septic tank contractor; amending s. 489.554,

18         F.S.; authorizing inactive registration as a

19         septic tank contractor; providing for renewing

20         a certification of registration following a

21         period of inactive status; amending s. 784.081,

22         F.S.; increasing certain penalties for an

23         assault or battery that is committed against an

24         employee of the Department of Health or against

25         a direct service provider of the department;

26         repealing ss. 381.0098(9), 385.103(2)(f),

27         385.205, 385.209, 391.301(3), 391.305(2),

28         393.064(5), and 445.033(7), F.S., relating to

29         obsolete provisions governing the handling of

30         biomedical waste, rulemaking authority with

31         respect to community intervention programs,


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    2004 Legislature                 CS for SB 2448, 2nd Engrossed



 1         programs covering chronic renal disease,

 2         information on cholesterol, intervention

 3         programs for certain hearing-impaired infants,

 4         contract authority over the Raymond C. Philips

 5         Research and Education Unit, and an exemption

 6         from the Florida Biomedical and Social Research

 7         Act for certain evaluations; requiring a report

 8         relating to a disciplinary board for the onsite

 9         sewage industry; amending s. 381.7355, F.S.;

10         providing an additional priority area; amending

11         s. 381.005, F.S.; requiring hospitals licensed

12         under ch. 395, F.S., to implement a program

13         offering immunizations against the influenza

14         virus and pneumococcal bacteria to all patients

15         who have attained a specified age; amending s.

16         409.907, F.S.; providing criteria for

17         establishing the effective date of approval of

18         certain applications to be a Medicaid provider;

19         preempting the regulation, identification, and

20         packaging of meat, poultry, and fish to the

21         state and the Department of Agriculture and

22         Consumer Services; providing an effective date.

23  

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

25  

26         Section 1.  Subsection (5) of section 17.41, Florida

27  Statutes, is amended to read:

28         17.41  Department of Financial Services Tobacco

29  Settlement Clearing Trust Fund.--

30         (5)  The department shall disburse funds, by

31  nonoperating transfer, from the Tobacco Settlement Clearing


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    2004 Legislature                 CS for SB 2448, 2nd Engrossed



 1  Trust Fund to the tobacco settlement trust funds of the

 2  various agencies or the Biomedical Research Trust Fund in the

 3  Department of Health, as appropriate, in amounts equal to the

 4  annual appropriations made from those agencies' trust funds in

 5  the General Appropriations Act.

 6         Section 2.  Subsection (2) and paragraphs (f), (i), and

 7  (j) of subsection (3) of section 20.43, Florida Statutes, are

 8  amended, and paragraph (k) is added to that subsection, and

 9  subsection (9) is added to that section, to read:

10         20.43  Department of Health.--There is created a

11  Department of Health.

12         (2)(a)  The head of the Department of Health is the

13  Secretary of Health and State Health Officer. The secretary

14  must be a physician licensed under chapter 458 or chapter 459

15  who has advanced training or extensive experience in public

16  health administration. The secretary is appointed by the

17  Governor subject to confirmation by the Senate. The secretary

18  serves at the pleasure of the Governor.

19         (b)  The Officer of Women's Health Strategy is

20  established within the Department of Health and shall report

21  directly to the secretary.

22         (3)  The following divisions of the Department of

23  Health are established:

24         (f)  Division of Emergency Medical Operations Services

25  and Community Health Resources.

26         (i)  Division of Information Technology Resource

27  Management.

28         (j)  Division of Health Access Awareness and Tobacco.

29         (k)  Division of Disability Determinations.

30         (9)  There is established within the Department of

31  Health the Office of Minority Health.


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 1         Section 3.  Section 381.04015, Florida Statutes, is

 2  created to read:

 3         381.04015  Women's Health Strategy; legislative intent;

 4  duties of Officer of Women's Health Strategy; other state

 5  agency duties.--

 6         (1)  LEGISLATIVE INTENT.--The Legislature recognizes

 7  that the health care needs of women are gender-specific and

 8  that public policy must take into account the distinct

 9  characteristics of women's health issues. Priority shall be

10  given to improve the overall health status of women through

11  research and education on women's health issues. The

12  Legislature recognizes the importance of understanding why

13  there are such large differences between how women and men

14  experience certain diseases and also recognizes that

15  biomedical research is the key to finding these answers. Such

16  research has important implications for both women and men in

17  terms of clinical practice and disease prevention and

18  manifestation. The Legislature recognizes that as the state's

19  population continues to age and life expectancy for women

20  continues to rise, it is of the utmost importance for the

21  Legislature to encourage effective medical research on

22  long-term health issues for women and to educate elder women

23  about the importance of participating in medical studies. The

24  Legislature finds and declares that the design and delivery of

25  health care services and the medical education of health care

26  practitioners shall be directed by the principle that health

27  care needs are gender-specific.

28         (2)  DUTIES.--The Officer of Women's Health Strategy in

29  the Department of Health shall:

30  

31  


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 1         (a)  Ensure that the state's policies and programs are

 2  responsive to sex and gender differences and to women's health

 3  needs across the life span.

 4         (b)  Organize an interagency Committee for Women's

 5  Health for the purpose of integrating women's health programs

 6  in current operating and service delivery structures and

 7  setting priorities for women's health. This committee shall be

 8  comprised of the heads or directors of state agencies with

 9  programs affecting women's health, including, but not limited

10  to, the Department of Health, the Agency for Health Care

11  Administration, the Department of Education, the Department of

12  Elderly Affairs, the Department of Corrections, the Office of

13  Insurance Regulation of the Department of Financial Services,

14  and the Department of Juvenile Justice.

15         (c)  Assess the health status of women in the state

16  through the collection and review of health data and trends.

17         (d)  Review the state's insurance code as it relates to

18  women's health issues.

19         (e)  Work with medical school curriculum committees to

20  develop course requirements on women's health and promote

21  clinical practice guidelines specific to women.

22         (f)  Organize statewide Women's Health Month

23  activities.

24         (g)  Coordinate a Governor's statewide conference on

25  women's health, cosponsored by the agencies participating in

26  the Committee for Women's Health and other private

27  organizations and entities impacting women's health in the

28  state.

29         (h)  Promote research, treatment, and collaboration on

30  women's health issues at universities and medical centers in

31  the state.


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 1         (i)  Promote employer incentives for wellness programs

 2  targeting women's health programs.

 3         (j)  Serve as the primary state resource for women's

 4  health information.

 5         (k)  Develop a statewide women's health plan

 6  emphasizing collaborative approaches to meeting the health

 7  needs of women. The plan shall:

 8         1.  Identify activities designed to reduce the number

 9  of premature deaths in women, including:

10         a.  Providing specific strategies for reducing the

11  mortality rate of women.

12         b.  Listing conditions that may cause or contribute to

13  disease in women and the best methods by which to identify,

14  control, and prevent these conditions from developing.

15         c.  Identifying the best methods for ensuring an

16  increase in the percentage of women in the state who receive

17  diagnostic and screening testing.

18         2.  Provide for increasing research and appropriate

19  funding at institutions in the state studying disease in

20  women.

21         3.  Provide recommendations for the development of

22  practice guidelines for addressing disease in women.

23         4.  Provide recommendations for reducing health

24  disparities among women in all races and ethnic groups.

25         5.  Coordinate with existing program plans that address

26  women's health issues.

27         (l)  Promote clinical practice guidelines specific to

28  women.

29         (m)  Serve as the state's liaison with other states and

30  federal agencies and programs to develop best practices in

31  women's health.


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 1         (n)  Develop a statewide, web-based clearinghouse on

 2  women's health issues and resources.

 3         (o)  Promote public awareness campaigns and education

 4  on the health needs of women.

 5         (p)  By January 15 of each year, provide the Governor,

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

 7  Representatives a report with policy recommendations for

 8  implementing the provisions of this section.

 9         (3)  DUTIES OF OTHER STATE AGENCIES.--

10         (a)  Women's health issues shall be taken into

11  consideration in the annual budget planning of the Department

12  of Health, the Agency for Health Care Administration, and the

13  Department of Elderly Affairs.

14         (b)  The inclusion of gender considerations and

15  differential impact shall be one of the criteria when

16  assessing research and demonstration proposals for which state

17  funding is being sought from the Department of Health, the

18  Agency for Health Care Administration, and the Department of

19  Elderly Affairs.

20         (c)  Boards or advisory bodies that fall under the

21  purview of the Department of Health, the Agency for Health

22  Care Administration, and the Department of Elderly Affairs

23  shall be encouraged to seek equal representation of women and

24  men and the inclusion of persons who are knowledgeable and

25  sensitive to gender and diversity issues.

26         (4)  RESPONSIBILITY AND COORDINATION.--The officer and

27  the department shall direct and carry out the Women's Health

28  Strategy established under this section in accordance with the

29  requirements of this section and may work with the Executive

30  Office of the Governor and other state agencies to carry out

31  their duties and responsibilities under this section.


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 1         Section 4.  Section 216.341, Florida Statutes, is

 2  transferred, renumbered as section 216.2625, Florida Statutes,

 3  and amended to read:

 4         216.2625 216.341  Disbursement of county health

 5  department trust funds of the Department of Health; authorized

 6  positions.--

 7         (1)  County health department trust funds may be

 8  expended by the Department of Health for the respective county

 9  health departments in accordance with budgets and plans agreed

10  upon by the county authorities of each county and the

11  Department of Health.

12         (2)  The limitations on the number of authorized

13  positions appropriations provided in s. 216.262(1) do shall

14  not apply to positions within the Department of Health which

15  are funded by:

16         (a)  County health department trust funds; or.

17         (b)  The United States Trust Fund.

18         Section 5.  Subsection (12) of section 381.0011,

19  Florida Statutes, is amended to read:

20         381.0011  Duties and powers of the Department of

21  Health.--It is the duty of the Department of Health to:

22         (12)  Maintain Cooperate with other departments, local

23  officials, and private organizations in developing and

24  implementing a statewide injury-prevention injury control

25  program.

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

27  381.006, Florida Statutes, to read:

28         381.006  Environmental health.--The department shall

29  conduct an environmental health program as part of fulfilling

30  the state's public health mission. The purpose of this program

31  is to detect and prevent disease caused by natural and manmade


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 1  factors in the environment.  The environmental health program

 2  shall include, but not be limited to:

 3         (17)  A function for investigating elevated levels of

 4  lead in blood. Each participating county health department may

 5  expend funds for federally mandated certification or

 6  recertification fees related to conducting investigations of

 7  elevated levels of lead in blood.

 8  

 9  The department may adopt rules to carry out the provisions of

10  this section.

11         Section 7.  Paragraph (k) of subsection (2) and

12  paragraphs (d) and (e) of subsection (4), of section 381.0065,

13  Florida Statutes, are amended, and paragraph (v) is added to

14  subsection (4) of that section, to read:

15         381.0065  Onsite sewage treatment and disposal systems;

16  regulation.--

17         (2)  DEFINITIONS.--As used in ss. 381.0065-381.0067,

18  the term:

19         (k)  "Permanent nontidal surface water body" means a

20  perennial stream, a perennial river, an intermittent stream, a

21  perennial lake, a submerged marsh or swamp, a submerged wooded

22  marsh or swamp, a spring, or a seep, as identified on the most

23  recent quadrangle map, 7.5 minute series (topographic),

24  produced by the United States Geological Survey, or products

25  derived from that series. "Permanent nontidal surface water

26  body" shall also mean an artificial surface water body that

27  does not have an impermeable bottom and side and that is

28  designed to hold, or does hold, visible standing water for at

29  least 180 days of the year. However, a nontidal surface water

30  body that is drained, either naturally or artificially, where

31  the intent or the result is that such drainage be temporary,


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 1  shall be considered a permanent nontidal surface water body. A

 2  nontidal surface water body that is drained of all visible

 3  surface water, where the lawful intent or the result of such

 4  drainage is that such drainage will be permanent, shall not be

 5  considered a permanent nontidal surface water body. The

 6  boundary of a permanent nontidal surface water body shall be

 7  the mean annual flood line.

 8         (4)  PERMITS; INSTALLATION; AND CONDITIONS.--A person

 9  may not construct, repair, modify, abandon, or operate an

10  onsite sewage treatment and disposal system without first

11  obtaining a permit approved by the department. The department

12  may issue permits to carry out this section, but shall not

13  make the issuance of such permits contingent upon prior

14  approval by the Department of Environmental Protection. A

15  construction permit is valid for 18 months from the issuance

16  date and may be extended by the department for one 90-day

17  period under rules adopted by the department.  A repair permit

18  is valid for 90 days from the date of issuance. An operating

19  permit must be obtained prior to the use of any aerobic

20  treatment unit or if the establishment generates commercial

21  waste. Buildings or establishments that use an aerobic

22  treatment unit or generate commercial waste shall be inspected

23  by the department at least annually to assure compliance with

24  the terms of the operating permit. The operating permit for a

25  commercial wastewater system is valid for 1 year from the date

26  of issuance and must be renewed annually. The operating permit

27  for an aerobic treatment unit is valid for 2 years from the

28  date of issuance and must be renewed every 2 years.  If all

29  information pertaining to the siting, location, and

30  installation conditions or repair of an onsite sewage

31  treatment and disposal system remains the same, a construction


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 1  or repair permit for the onsite sewage treatment and disposal

 2  system may be transferred to another person, if the transferee

 3  files, within 60 days after the transfer of ownership, an

 4  amended application providing all corrected information and

 5  proof of ownership of the property.  There is no fee

 6  associated with the processing of this supplemental

 7  information.  A person may not contract to construct, modify,

 8  alter, repair, service, abandon, or maintain any portion of an

 9  onsite sewage treatment and disposal system without being

10  registered under part III of chapter 489.  A property owner

11  who personally performs construction, maintenance, or repairs

12  to a system serving his or her own owner-occupied

13  single-family residence is exempt from registration

14  requirements for performing such construction, maintenance, or

15  repairs on that residence, but is subject to all permitting

16  requirements. A municipality or political subdivision of the

17  state may not issue a building or plumbing permit for any

18  building that requires the use of an onsite sewage treatment

19  and disposal system unless the owner or builder has received a

20  construction permit for such system from the department. A

21  building or structure may not be occupied and a municipality,

22  political subdivision, or any state or federal agency may not

23  authorize occupancy until the department approves the final

24  installation of the onsite sewage treatment and disposal

25  system. A municipality or political subdivision of the state

26  may not approve any change in occupancy or tenancy of a

27  building that uses an onsite sewage treatment and disposal

28  system until the department has reviewed the use of the system

29  with the proposed change, approved the change, and amended the

30  operating permit.

31  


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 1         (d)  Paragraphs (a) and (b) do not apply to any

 2  proposed residential subdivision with more than 50 lots or to

 3  any proposed commercial subdivision with more than 5 lots

 4  where a publicly owned or investor-owned sewerage system is

 5  available.  It is the intent of this paragraph not to allow

 6  development of additional proposed subdivisions in order to

 7  evade the requirements of this paragraph.  The department

 8  shall report to the Legislature by February 1 of each

 9  odd-numbered year concerning the success in meeting this

10  intent.

11         (e)  Onsite sewage treatment and disposal systems must

12  not be placed closer than:

13         1.  Seventy-five feet from a private potable well.

14         2.  Two hundred feet from a public potable well serving

15  a residential or nonresidential establishment having a total

16  sewage flow of greater than 2,000 gallons per day.

17         3.  One hundred feet from a public potable well serving

18  a residential or nonresidential establishment having a total

19  sewage flow of less than or equal to 2,000 gallons per day.

20         4.  Fifty feet from any nonpotable well.

21         5.  Ten feet from any storm sewer pipe, to the maximum

22  extent possible, but in no instance shall the setback be less

23  than 5 feet.

24         6.  Seventy-five feet from the mean high-water line of

25  a tidally influenced surface water body.

26         7.  Seventy-five feet from the mean normal annual flood

27  line of a permanent nontidal surface water body.

28         8.  Fifteen feet from the design high-water line of

29  retention areas, detention areas, or swales designed to

30  contain standing or flowing water for less than 72 hours after

31  a rainfall or the design high-water level of normally dry


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 1  drainage ditches or normally dry individual lot stormwater

 2  retention areas.

 3         (v)  The department may require the submission of

 4  detailed system construction plans that are prepared by a

 5  professional engineer registered in this state. The department

 6  shall establish by rule criteria for determining when such a

 7  submission is required.

 8         Section 8.  Paragraph (k) of subsection (2) of section

 9  381.0066, Florida Statutes, is amended to read:

10         381.0066  Onsite sewage treatment and disposal systems;

11  fees.--

12         (2)  The minimum fees in the following fee schedule

13  apply until changed by rule by the department within the

14  following limits:

15         (k)  Research: An additional $5 fee shall be added to

16  each new system construction permit issued during fiscal years

17  1996-2004 to be used for onsite sewage treatment and disposal

18  system research, demonstration, and training projects. Five

19  dollars from any repair permit fee collected under this

20  section shall be used for funding the hands-on training

21  centers described in s. 381.0065(3)(j).

22  

23  The funds collected pursuant to this subsection must be

24  deposited in a trust fund administered by the department, to

25  be used for the purposes stated in this section and ss.

26  381.0065 and 381.00655.

27         Section 9.  Paragraph (a) of subsection (2), paragraph

28  (a) of subsection (3), and paragraph (a) of subsection (4) of

29  section 381.0072, Florida Statutes, are amended to read:

30         381.0072  Food service protection.--It shall be the

31  duty of the Department of Health to adopt and enforce


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 1  sanitation rules consistent with law to ensure the protection

 2  of the public from food-borne illness. These rules shall

 3  provide the standards and requirements for the storage,

 4  preparation, serving, or display of food in food service

 5  establishments as defined in this section and which are not

 6  permitted or licensed under chapter 500 or chapter 509.

 7         (2)  DUTIES.--

 8         (a)  The department shall adopt rules, including

 9  definitions of terms which are consistent with law prescribing

10  minimum sanitation standards and manager certification

11  requirements as prescribed in s. 509.039, and which shall be

12  enforced in food service establishments as defined in this

13  section. The sanitation standards must address the

14  construction, operation, and maintenance of the establishment;

15  lighting, ventilation, laundry rooms, lockers, use and storage

16  of toxic materials and cleaning compounds, and first-aid

17  supplies; plan review; design, construction, installation,

18  location, maintenance, sanitation, and storage of food

19  equipment and utensils; employee training, health, hygiene,

20  and work practices; food supplies, preparation, storage,

21  transportation, and service, including access to the areas

22  where food is stored or prepared; and sanitary facilities and

23  controls, including water supply and sewage disposal; plumbing

24  and toilet facilities; garbage and refuse collection, storage,

25  and disposal; and vermin control. Public and private schools,

26  if the food service is operated by school employees; hospitals

27  licensed under chapter 395;, nursing homes licensed under part

28  II of chapter 400;, child care facilities as defined in s.

29  402.301;, and residential facilities colocated with a nursing

30  home or hospital, if all food is prepared in a central kitchen

31  that complies with nursing or hospital regulations; and bars


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 1  and lounges, as defined by department rule, are shall be

 2  exempt from the rules developed for manager certification. The

 3  department shall administer a comprehensive inspection,

 4  monitoring, and sampling program to ensure such standards are

 5  maintained. With respect to food service establishments

 6  permitted or licensed under chapter 500 or chapter 509, the

 7  department shall assist the Division of Hotels and Restaurants

 8  of the Department of Business and Professional Regulation and

 9  the Department of Agriculture and Consumer Services with

10  rulemaking by providing technical information.

11         Section 10.  Section 381.86, Florida Statutes, is

12  created to read:

13         381.86  Institutional Review Board.--

14         (1)  The Institutional Review Board is created within

15  the Department of Health in order to satisfy federal

16  requirements under 45 C.F.R. part 46 and 21 C.F.R. parts 50

17  and 56 that an institutional review board review all

18  biomedical and behavioral research on human subjects which is

19  funded or supported in any manner by the department.

20         (2)  Consistent with federal requirements, the

21  Secretary of Health shall determine and appoint the membership

22  of the board and designate its chair.

23         (3)  The department's Institutional Review Board may

24  serve as an institutional review board for other agencies at

25  the discretion of the secretary.

26         (4)  Each board member is entitled to reimbursement for

27  per diem and travel expenses as provided in s. 112.061 while

28  carrying out the official business of the board.

29         (5)  The department shall charge for costs it incurs

30  for the research oversight it provides according to a fee

31  schedule, except that fees shall be waived for any student who


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 1  is a candidate for a degree at a university located in this

 2  state. The fee schedule shall provide fees for initial review,

 3  amendments, and continuing review. The department may adopt

 4  any rules necessary to comply with federal requirements and

 5  this section. The rules must also prescribe procedures for

 6  submitting an application for the Institutional Review Board's

 7  review.

 8         Section 11.  Paragraphs (b) and (c) of subsection (3)

 9  of section 381.89, Florida Statutes, are amended to read:

10         381.89  Regulation of tanning facilities.--

11         (3)

12         (b)  The department shall establish procedures for the

13  issuance and annual renewal of licenses and shall establish

14  annual license and renewal fees and late-payment fees in an

15  amount necessary to cover the expenses of administering this

16  section. Annual license and renewal fees may not shall be not

17  less than $125 nor more than $250 per tanning device and a

18  maximum total fee per individual tanning facility may be set

19  by rule.  Effective October 1, 1991, the fee amount shall be

20  the minimum fee proscribed in this paragraph and such fee

21  amount shall remain in effect until the effective date of a

22  fee schedule adopted by the department.

23         (c)  The department may adopt a system under which

24  licenses expire on staggered dates and the annual renewal fees

25  are prorated quarterly monthly to reflect the actual number of

26  months the license is valid.

27         Section 12.  Subsection (3) and paragraph (a) of

28  subsection (7) of section 381.90, Florida Statutes, are

29  amended to read:

30         381.90  Health Information Systems Council; legislative

31  intent; creation, appointment, duties.--


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 1         (3)  The council shall be composed of the following

 2  members or their senior executive-level designees:

 3         (a)  The Secretary of the Department of Health;

 4         (b)  The Executive Director secretary of the Department

 5  of Veterans' Affairs Business and Professional Regulation;

 6         (c)  The Secretary of the Department of Children and

 7  Family Services;

 8         (d)  The Secretary of Health Care Administration;

 9         (e)  The Secretary of the Department of Corrections;

10         (f)  The Attorney General;

11         (g)  The Executive Director of the Correctional Medical

12  Authority;

13         (h)  Two members representing county health

14  departments, one from a small county and one from a large

15  county, appointed by the Governor;

16         (i)  A representative from the Florida Association of

17  Counties;

18         (j)  The Chief Financial Officer;

19         (k)  A representative from the Florida Healthy Kids

20  Corporation;

21         (l)  A representative from a school of public health

22  chosen by the Commissioner of Education Board of Regents;

23         (m)  The Commissioner of Education;

24         (n)  The Secretary of the Department of Elderly

25  Affairs; and

26         (o)  The Secretary of the Department of Juvenile

27  Justice.

28  

29  Representatives of the Federal Government may serve without

30  voting rights.

31  


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 1         (7)  The council's duties and responsibilities include,

 2  but are not limited to, the following:

 3         (a)  By June March 1 of each year, to develop and

 4  approve a strategic plan pursuant to the requirements set

 5  forth in s. 186.022 s. 186.022(9). Copies of the plan shall be

 6  transmitted electronically or in writing to the Executive

 7  Office of the Governor, the Speaker of the House of

 8  Representatives, and the President of the Senate.

 9         Section 13.  Subsections (1) and (2), paragraphs (f)

10  and (g) of subsection (3), and subsection (5) of section

11  383.14, Florida Statutes, are amended to read:

12         383.14  Screening for metabolic disorders, other

13  hereditary and congenital disorders, and environmental risk

14  factors.--

15         (1)  SCREENING REQUIREMENTS.--To help ensure access to

16  the maternal and child health care system, the Department of

17  Health shall promote the screening of all newborns infants

18  born in Florida for phenylketonuria and other metabolic,

19  hereditary, and congenital disorders known to result in

20  significant impairment of health or intellect, as screening

21  programs accepted by current medical practice become available

22  and practical in the judgment of the department.  The

23  department shall also promote the identification and screening

24  of all newborns infants born in this state and their families

25  for environmental risk factors such as low income, poor

26  education, maternal and family stress, emotional instability,

27  substance abuse, and other high-risk conditions associated

28  with increased risk of infant mortality and morbidity to

29  provide early intervention, remediation, and prevention

30  services, including, but not limited to, parent support and

31  training programs, home visitation, and case management.


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 1  Identification, perinatal screening, and intervention efforts

 2  shall begin prior to and immediately following the birth of

 3  the child by the attending health care provider.  Such efforts

 4  shall be conducted in hospitals, perinatal centers, county

 5  health departments, school health programs that provide

 6  prenatal care, and birthing centers, and reported to the

 7  Office of Vital Statistics.

 8         (a)  Prenatal screening.--The department shall develop

 9  a multilevel screening process that includes a risk assessment

10  instrument to identify women at risk for a preterm birth or

11  other high-risk condition.  The primary health care provider

12  shall complete the risk assessment instrument and report the

13  results to the Office of Vital Statistics so that the woman

14  may immediately be notified and referred to appropriate

15  health, education, and social services.

16         (b)  Postnatal screening.--A risk factor analysis using

17  the department's designated risk assessment instrument shall

18  also be conducted as part of the medical screening process

19  upon the birth of a child and submitted to the department's

20  Office of Vital Statistics for recording and other purposes

21  provided for in this chapter.  The department's screening

22  process for risk assessment shall include a scoring mechanism

23  and procedures that establish thresholds for notification,

24  further assessment, referral, and eligibility for services by

25  professionals or paraprofessionals consistent with the level

26  of risk. Procedures for developing and using the screening

27  instrument, notification, referral, and care coordination

28  services, reporting requirements, management information, and

29  maintenance of a computer-driven registry in the Office of

30  Vital Statistics which ensures privacy safeguards must be

31  consistent with the provisions and plans established under


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 1  chapter 411, Pub. L. No. 99-457, and this chapter.  Procedures

 2  established for reporting information and maintaining a

 3  confidential registry must include a mechanism for a

 4  centralized information depository at the state and county

 5  levels.  The department shall coordinate with existing risk

 6  assessment systems and information registries.  The department

 7  must ensure, to the maximum extent possible, that the

 8  screening information registry is integrated with the

 9  department's automated data systems, including the Florida

10  On-line Recipient Integrated Data Access (FLORIDA) system.

11  Tests and screenings must be performed by the State Public

12  Health Laboratory, in coordination with Children's Medical

13  Services, at such times and in such manner as is prescribed by

14  the department after consultation with the Genetics and Infant

15  Screening Advisory Council and the State Coordinating Council

16  for School Readiness Programs.

17         (c)  Release of screening results.--Notwithstanding any

18  other law to the contrary, the State Public Health Laboratory

19  may release, directly or through the Children's Medical

20  Services program, the results of a newborn's hearing and

21  metabolic tests or screening to the newborn's primary care

22  physician.

23         (2)  RULES.--After consultation with the Genetics and

24  Newborn Infant Screening Advisory Council, the department

25  shall adopt and enforce rules requiring that every newborn

26  infant born in this state shall, prior to becoming 1 week 2

27  weeks of age, be subjected to a test for phenylketonuria and,

28  at the appropriate age, be tested for such other metabolic

29  diseases and hereditary or congenital disorders as the

30  department may deem necessary from time to time. After

31  consultation with the State Coordinating Council for School


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 1  Readiness Programs, the department shall also adopt and

 2  enforce rules requiring every newborn infant born in this

 3  state to be screened for environmental risk factors that place

 4  children and their families at risk for increased morbidity,

 5  mortality, and other negative outcomes.  The department shall

 6  adopt such additional rules as are found necessary for the

 7  administration of this section, including rules providing

 8  definitions of terms, rules relating to the methods used and

 9  time or times for testing as accepted medical practice

10  indicates, rules relating to charging and collecting fees for

11  screenings authorized by this section, rules for processing

12  requests and releasing test and screening results, and rules

13  requiring mandatory reporting of the results of tests and

14  screenings for these conditions to the department.

15         (3)  DEPARTMENT OF HEALTH; POWERS AND DUTIES.--The

16  department shall administer and provide certain services to

17  implement the provisions of this section and shall:

18         (f)  Promote the availability of genetic studies and

19  counseling in order that the parents, siblings, and affected

20  newborns infants may benefit from available knowledge of the

21  condition.

22         (g)  Have the authority to charge and collect fees for

23  screenings authorized in this section, as follows:

24         1.  A fee of $20 will be charged for each live birth,

25  as recorded by the Office of Vital Statistics, occurring in a

26  hospital licensed under part I of chapter 395 or a birth

27  center licensed under s. 383.305, up to 3,000 live births per

28  licensed hospital per year or over 60 births per birth center

29  per year.  The department shall calculate the annual

30  assessment for each hospital and birth center, and this

31  assessment must be paid in equal amounts quarterly. Quarterly,


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 1  the department shall generate and mail to each hospital and

 2  birth center a statement of the amount due.

 3         2.  As part of the department's legislative budget

 4  request prepared pursuant to chapter 216, the department shall

 5  submit a certification by the department's inspector general,

 6  or the director of auditing within the inspector general's

 7  office, of the annual costs of the uniform testing and

 8  reporting procedures of the newborn infant screening program.

 9  In certifying the annual costs, the department's inspector

10  general or the director of auditing within the inspector

11  general's office shall calculate the direct costs of the

12  uniform testing and reporting procedures, including applicable

13  administrative costs. Administrative costs shall be limited to

14  those department costs which are reasonably and directly

15  associated with the administration of the uniform testing and

16  reporting procedures of the newborn infant screening program.

17  

18  All provisions of this subsection must be coordinated with the

19  provisions and plans established under this chapter, chapter

20  411, and Pub. L. No. 99-457.

21         (5)  ADVISORY COUNCIL.--There is established a Genetics

22  and Newborn Infant Screening Advisory Council made up of 15 12

23  members appointed by the Secretary of Health.  The council

24  shall be composed of two consumer members, three practicing

25  pediatricians, at least one of whom must be a pediatric

26  hematologist, one representative from each of the four medical

27  schools in the state, the Secretary of Health or his or her

28  designee, one representative from the Department of Health

29  representing Children's Medical Services, one representative

30  from the Florida Hospital Association, one individual with

31  experience in newborn screening programs, one individual


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 1  representing audiologists, and one representative from the

 2  Developmental Disabilities Program Office of the Department of

 3  Children and Family Services. All appointments shall be for a

 4  term of 4 years.  The chairperson of the council shall be

 5  elected from the membership of the council and shall serve for

 6  a period of 2 years.  The council shall meet at least

 7  semiannually or upon the call of the chairperson. The council

 8  may establish ad hoc or temporary technical advisory groups to

 9  assist the council with specific topics which come before the

10  council. Council members shall serve without pay. Pursuant to

11  the provisions of s. 112.061, the council members are entitled

12  to be reimbursed for per diem and travel expenses.  It is the

13  purpose of the council to advise the department about:

14         (a)  Conditions for which testing should be included

15  under the screening program and the genetics program.;

16         (b)  Procedures for collection and transmission of

17  specimens and recording of results.; and

18         (c)  Methods whereby screening programs and genetics

19  services for children now provided or proposed to be offered

20  in the state may be more effectively evaluated, coordinated,

21  and consolidated.

22         Section 14.  Subsection (1) of section 383.402, Florida

23  Statutes, is amended to read:

24         383.402  Child abuse death review; State Child Abuse

25  Death Review Committee; local child abuse death review

26  committees.--

27         (1)  It is the intent of the Legislature to establish a

28  statewide multidisciplinary, multiagency child abuse death

29  assessment and prevention system that consists of state and

30  local review committees. The state and local review committees

31  shall review the facts and circumstances of all deaths of


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 1  children from birth through age 18 which occur in this state

 2  as the result of verified child abuse or neglect and for whom

 3  at least one report of abuse or neglect was accepted by the

 4  central abuse hotline within the Department of Children and

 5  Family Services. The purpose of the review shall be to:

 6         (a)  Achieve a greater understanding of the causes and

 7  contributing factors of deaths resulting from child abuse.

 8         (b)  Whenever possible, develop a communitywide

 9  approach to address such cases and contributing factors.

10         (c)  Identify any gaps, deficiencies, or problems in

11  the delivery of services to children and their families by

12  public and private agencies which may be related to deaths

13  that are the result of child abuse.

14         (d)  Make and implement recommendations for changes in

15  law, rules, and policies, as well as develop practice

16  standards that support the safe and healthy development of

17  children and reduce preventable child abuse deaths.

18         Section 15.  Subsection (2) of section 391.021, Florida

19  Statutes, is amended to read:

20         391.021  Definitions.--When used in this act, unless

21  the context clearly indicates otherwise:

22         (2)  "Children with special health care needs" means

23  those children younger than under age 21 years of age who have

24  chronic physical, developmental, behavioral, or emotional

25  conditions and who also require health care and related

26  services of a type or amount beyond that which is generally

27  required by children whose serious or chronic physical or

28  developmental conditions require extensive preventive and

29  maintenance care beyond that required by typically healthy

30  children.  Health care utilization by these children exceeds

31  the statistically expected usage of the normal child adjusted


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 1  for chronological age.  These children often need complex care

 2  requiring multiple providers, rehabilitation services, and

 3  specialized equipment in a number of different settings.

 4         Section 16.  Section 391.025, Florida Statutes, is

 5  amended to read:

 6         391.025  Applicability and scope.--

 7         (1)  This act applies to health services provided to

 8  eligible individuals who are:

 9         (a)1.  Enrolled in the Medicaid program;

10         2.  Enrolled in the Florida Kidcare program; and

11         3.  Uninsured or underinsured, provided that they meet

12  the financial eligibility requirements established in this

13  act, and to the extent that resources are appropriated for

14  their care; or

15         (b)  Infants who receive an award of compensation under

16  s. 766.31(1).

17         (1)(2)  The Children's Medical Services program

18  consists of the following components:

19         (a)  The newborn infant metabolic screening program

20  established in s. 383.14.

21         (b)  The regional perinatal intensive care centers

22  program established in ss. 383.15-383.21.

23         (c)  A federal or state program authorized by the

24  Legislature.

25         (d)  The developmental evaluation and intervention

26  program, including the Florida Infants and Toddlers Early

27  Intervention Program.

28         (e)  The Children's Medical Services network.

29         (2)(3)  The Children's Medical Services program shall

30  not be deemed an insurer and is not subject to the licensing

31  requirements of the Florida Insurance Code or the rules


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 1  adopted thereunder, when providing services to children who

 2  receive Medicaid benefits, other Medicaid-eligible children

 3  with special health care needs, and children participating in

 4  the Florida Kidcare program.

 5         Section 17.  Section 391.029, Florida Statutes, is

 6  amended to read:

 7         391.029  Program eligibility.--

 8         (1)  The department shall establish the medical

 9  criteria to determine if an applicant for the Children's

10  Medical Services program is an eligible individual.

11         (2)  The following individuals are financially eligible

12  to receive services through for the program:

13         (a)  A high-risk pregnant female who is eligible for

14  Medicaid.

15         (b)  Children A child with special health care needs

16  from birth to age 21 years of age who are is eligible for

17  Medicaid.

18         (c)  Children A child with special health care needs

19  from birth to age 19 years of age who are is eligible for a

20  program under Title XXI of the Social Security Act.

21         (3)  Subject to the availability of funds, the

22  following individuals may receive services through the

23  program:

24         (a)(d)  Children A child with special health care needs

25  from birth to age 21 years of age whose family income is above

26  the requirements for financial eligibility under Title XXI of

27  the Social Security Act and whose projected annual cost of

28  care adjusts the family income to Medicaid financial criteria.

29  In cases where the family income is adjusted based on a

30  projected annual cost of care, the family shall participate

31  


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 1  financially in the cost of care based on criteria established

 2  by the department.

 3         (b)(e)  Children A child with special health care needs

 4  from birth to 21 years of age, as provided defined in Title V

 5  of the Social Security Act relating to children with special

 6  health care needs.

 7         (c)(f)  An infant who receives an award of compensation

 8  under s. 766.31(1). The Florida Birth-Related Neurological

 9  Injury Compensation Association shall reimburse the Children's

10  Medical Services Network the state's share of funding, which

11  must thereafter be used to obtain matching federal funds under

12  Title XXI of the Social Security Act.

13  

14  The department may continue to serve certain children with

15  special health care needs who are 21 years of age or older and

16  who were receiving services from the program prior to April 1,

17  1998.  Such children may be served by the department until

18  July 1, 2000.

19         (4)(3)  The department shall determine the financial

20  and medical eligibility of children for the program. The

21  department shall also determine the financial ability of the

22  parents, or persons or other agencies having legal custody

23  over such individuals, to pay the costs of health services

24  under the program. The department may pay reasonable travel

25  expenses related to the determination of eligibility for or

26  the provision of health services.

27         (5)(4)  Any child who has been provided with surgical

28  or medical care or treatment under this act prior to being

29  adopted shall continue to be eligible to be provided with such

30  care or treatment after his or her adoption, regardless of the

31  financial ability of the persons adopting the child.


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 1         Section 18.  Subsection (4) is added to section

 2  391.035, Florida Statutes, to read:

 3         391.035  Provider qualifications.--

 4         (4)  Notwithstanding any other law, the department may

 5  contract with health care providers licensed in another state

 6  to provide health services to participants in the Children's

 7  Medical Services program when necessary due to an emergency or

 8  in order to provide specialty services or greater convenience

 9  to the participants for receiving timely and effective health

10  care services. The department may adopt rules to administer

11  this subsection.

12         Section 19.  Subsection (4) is added to section

13  391.055, Florida Statutes, to read:

14         391.055  Service delivery systems.--

15         (4)  If a newborn has an abnormal screening result for

16  metabolic or other hereditary and congenital disorders which

17  is identified through the newborn screening program pursuant

18  to s. 383.14, the newborn shall be referred to the Children's

19  Medical Services program for additional testing, medical

20  management, early intervention services, or medical referral.

21         Section 20.  Section 391.302, Florida Statutes, is

22  amended to read:

23         391.302  Definitions.--As used in ss. 391.301-391.307,

24  the term:

25         (1)  "Developmental intervention" means individualized

26  therapies and services needed to enhance both the infant's or

27  toddler's growth and development and family functioning.

28         (2)  "Hearing-impaired infant" means an infant who is

29  born with or who has acquired prelingually a hearing loss so

30  severe that, unaided, the infant cannot learn speech and

31  language through normal means.


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 1         (3)  "High-risk hearing-impaired infant" means an

 2  infant who exhibits conditions and factors that include, but

 3  are not limited to, a family history of hearing impairment or

 4  anatomic malformation which place the infant at an increased

 5  risk for hearing impairment.

 6         (2)(4)  "Infant or toddler" means a child from birth

 7  until the child's third birthday.

 8         (3)(5)  "In-hospital intervention services" means the

 9  provision of assessments; the provision of individualized

10  services therapies; monitoring and modifying the delivery of

11  medical interventions; and enhancing the environment for the

12  high-risk, developmentally disabled, or medically involved, or

13  hearing-impaired infant or toddler in order to achieve optimum

14  growth and development.

15         (4)(6)  "Parent support and training" means a range of

16  services to families of high-risk, developmentally disabled,

17  or medically involved, or hearing-impaired infants or

18  toddlers, including family counseling; financial planning;

19  agency referral; development of parent-to-parent support

20  groups; education concerning growth, development, and

21  developmental intervention and objective measurable skills,

22  including abuse avoidance skills; training of parents to

23  advocate for their child; and bereavement counseling.

24         Section 21.  Section 391.303, Florida Statutes, is

25  amended to read:

26         391.303  Program requirements.--

27         (1)  Developmental evaluation and intervention services

28  shall be established at each hospital that provides Level II

29  or Level III neonatal intensive care services. Program

30  services shall be made available to an infant or toddler

31  identified as being at risk for developmental disabilities, or


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 1  identified as medically involved, who, along with his or her

 2  family, would benefit from program services. Program services

 3  shall be made available to infants or toddlers in a Level II

 4  or Level III neonatal intensive care unit or in a pediatric

 5  intensive care unit, infants who are identified as being at

 6  high risk for hearing impairment or who are hearing-impaired,

 7  or infants who have a metabolic or genetic disorder or a

 8  condition identified through the newborn screening program.

 9  The developmental evaluation and intervention programs are

10  subject to the availability of moneys and the limitations

11  established by the General Appropriations Act or chapter 216.

12  Hearing screening, Evaluation and referral services, and

13  initial developmental assessments services shall be provided

14  to each infant or toddler. Other program services may be

15  provided to an infant or toddler, and the family of the infant

16  or toddler, who do not meet the financial eligibility criteria

17  for the Children's Medical Services program based on the

18  availability of funding, including insurance and fees.

19         (2)  Each developmental evaluation and intervention

20  program shall have a program director, a medical director, and

21  necessary staff to carry out the program. The program director

22  shall establish and coordinate the developmental evaluation

23  and intervention program. The program shall include, but is

24  not limited to:

25         (a)  In-hospital evaluation and intervention services,

26  parent support and training, and family support planning and

27  case management.

28         (b)  Screening and evaluation services to identify each

29  infant at risk of hearing impairment, and a medical and

30  educational followup and care management program for an infant

31  who is identified as hearing-impaired, with management


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 1  beginning as soon after birth as practicable. The medical

 2  management program must include the genetic evaluation of an

 3  infant suspected to have genetically determined deafness and

 4  an evaluation of the relative risk.

 5         (b)(c)  Regularly held multidisciplinary team meetings

 6  to develop and update the family support plan. In addition to

 7  the family, a multidisciplinary team may include a physician,

 8  physician assistant, psychologist, psychotherapist, educator,

 9  social worker, nurse, physical or occupational therapist,

10  speech pathologist, developmental evaluation and intervention

11  program director, case manager, others who are involved with

12  the in-hospital and posthospital discharge care plan, and

13  anyone the family wishes to include as a member of the team.

14  The family support plan is a written plan that describes the

15  infant or toddler, the therapies and services the infant or

16  toddler and his or her family need, and the intended outcomes

17  of the services.

18         (c)(d)  Discharge planning by the multidisciplinary

19  team, including referral and followup to primary medical care

20  and modification of the family support plan.

21         (d)(e)  Education and training for neonatal and

22  pediatric intensive care services staff, volunteers, and

23  others, as needed, in order to expand the services provided to

24  high-risk, developmentally disabled, or medically involved, or

25  hearing-impaired infants and toddlers and their families.

26         (e)(f)  Followup intervention services after hospital

27  discharge, to aid the family and the high-risk,

28  developmentally disabled, or medically involved, or

29  hearing-impaired infant's or toddler's transition into the

30  community. Support services shall be coordinated at the

31  


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 1  request of the family and within the context of the family

 2  support plan.

 3         (f)(g)  Referral to and coordination of services with

 4  community providers.

 5         (g)(h)  Educational materials about infant care, infant

 6  growth and development, community resources, medical

 7  conditions and treatments, and family advocacy. Materials

 8  regarding hearing impairments shall be provided to each parent

 9  or guardian of a hearing-impaired infant or toddler.

10         (h)(i)  Involvement of the parents and guardians of

11  each identified high-risk, developmentally disabled, or

12  medically involved, or hearing-impaired infant or toddler.

13         Section 22.  Section 391.308, Florida Statutes, is

14  created to read:

15         391.308  Infants and Toddlers Early Intervention

16  Program.--The Department of Health may implement and

17  administer Part C of the federal Individuals with Disabilities

18  Education Act (IDEA).

19         (1)  The department, jointly with the Department of

20  Education, shall annually prepare a grant application to the

21  United States Department of Education for funding early

22  intervention services for infants and toddlers with

23  disabilities, from birth through 36 months of age, and their

24  families pursuant to Part C of the federal Individuals with

25  Disabilities Education Act.

26         (2)  The department, jointly with the Department of

27  Education, shall include a reading initiative as an early

28  intervention service for infants and toddlers.

29         Section 23.  Subsection (1) of section 395.003, Florida

30  Statutes, is amended to read:

31  


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 1         395.003  Licensure; issuance, renewal, denial,

 2  modification, suspension, and revocation.--

 3         (1)(a)  A No person may not shall establish, conduct,

 4  or maintain a hospital, ambulatory surgical center, or mobile

 5  surgical facility in this state without first obtaining a

 6  license under this part.

 7         (b)1.  It is unlawful for a any person to use or

 8  advertise to the public, in any way or by any medium

 9  whatsoever, any facility as a "hospital," "ambulatory surgical

10  center," or "mobile surgical facility" unless such facility

11  has first secured a license under the provisions of this part.

12         2.  Nothing in This part does not apply applies to

13  veterinary hospitals or to commercial business establishments

14  using the word "hospital," "ambulatory surgical center," or

15  "mobile surgical facility" as a part of a trade name if no

16  treatment of human beings is performed on the premises of such

17  establishments.

18         3.  By December 31, 2004, the agency shall submit a

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

20  House of Representatives recommending whether it is in the

21  public interest to allow a hospital to license or operate an

22  emergency department located off the premises of the hospital.

23  If the agency finds it to be in the public interest, the

24  report shall also recommend licensure criteria for such

25  medical facilities, including criteria related to quality of

26  care and, if deemed necessary, the elimination of the

27  possibility of confusion related to the service capabilities

28  of such facility in comparison to the service capabilities of

29  an emergency department located on the premises of the

30  hospital. Until July 1, 2005, additional emergency departments

31  


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 1  located off the premises of licensed hospitals may not be

 2  authorized by the agency.

 3         Section 24.  Present subsections (3) and (4) of section

 4  395.1027, Florida Statutes, are redesignated as subsections

 5  (4) and (5), respectively, and a new subsection (3) is added

 6  to that section, to read:

 7         395.1027  Regional poison control centers.--

 8         (3)  Upon request, a licensed facility shall release to

 9  a regional poison control center any patient information that

10  is necessary for case management of poison cases.

11         Section 25.  Section 395.404, Florida Statutes, is

12  amended to read:

13         395.404  Review of trauma registry data; report to

14  central registry; confidentiality and limited release.--

15         (1)(a)  Each trauma center shall furnish, and, upon

16  request of the department, all acute care hospitals shall

17  furnish for department review, trauma registry data as

18  prescribed by rule of the department for the purpose of

19  monitoring patient outcome and ensuring compliance with the

20  standards of approval.

21         (b)  Trauma registry data obtained pursuant to this

22  subsection are confidential and exempt from the provisions of

23  s. 119.07(1) and s. 24(a), Art. I of the State Constitution.

24  However, the department may provide such trauma registry data

25  to the person, trauma center, hospital, emergency medical

26  service provider, local or regional trauma agency, medical

27  examiner, or other entity from which the data were obtained.

28  The department may also use or provide trauma registry data

29  for purposes of research in accordance with the provisions of

30  chapter 405.

31  


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 1         (2)  Each trauma center, pediatric trauma referral

 2  center, and acute care hospital shall report to the

 3  department's brain and spinal cord injury central registry,

 4  consistent with the procedures and timeframes of s. 381.74,

 5  any person who has a moderate-to-severe brain or spinal cord

 6  injury, and shall include in the report the name, age,

 7  residence, and type of disability of the individual and any

 8  additional information that the department finds necessary.

 9  Notwithstanding the provisions of s. 381.74, each trauma

10  center and acute care hospital shall submit severe disability

11  and head-injury registry data to the department as provided by

12  rule. Each trauma center and acute care hospital shall

13  continue to provide initial notification of persons who have

14  severe disabilities and head injuries to the Department of

15  Health within timeframes provided in chapter 413. Such initial

16  notification shall be made in the manner prescribed by the

17  Department of Health for the purpose of providing timely

18  vocational rehabilitation services to the severely disabled or

19  head-injured person.

20         (3)  Trauma registry data obtained pursuant to this

21  section are confidential and exempt from the provisions of s.

22  119.07(1) and s. 24(a), Art. I of the State Constitution.

23  However, the department may provide such trauma registry data

24  to the person, trauma center, pediatric trauma referral

25  center, hospital, emergency medical service provider, local or

26  regional trauma agency, medical examiner, or other entity from

27  which the data were obtained. The department may also use or

28  provide trauma registry data for purposes of research in

29  accordance with the provisions of chapter 405.

30  

31  


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 1         Section 26.  Subsections (3) and (4) of section

 2  400.9905, Florida Statutes, are amended, and subsections (5),

 3  (6), and (7) are added to that section, to read:

 4         400.9905  Definitions.--

 5         (3)  "Clinic" means an entity at which health care

 6  services are provided to individuals and which tenders charges

 7  for reimbursement for such services, including a mobile clinic

 8  and a portable equipment provider. For purposes of this part,

 9  the term does not include and the licensure requirements of

10  this part do not apply to:

11         (a)  Entities licensed or registered by the state under

12  chapter 395; or entities licensed or registered by the state

13  and providing only health care services within the scope of

14  services authorized under their respective licenses granted

15  under ss. 383.30-383.335, chapter 390, chapter 394, chapter

16  395, chapter 397, this chapter except part XIII, chapter 463,

17  chapter 465, chapter 466, chapter 478, part I of chapter 483

18  480, chapter 484, or chapter 651, end-stage renal disease

19  providers authorized under 42 C.F.R. part 405, subpart U, or

20  providers certified under 42 C.F.R. part 485, subpart B or

21  subpart H, or any entity that provides neonatal or pediatric

22  hospital-based healthcare services by licensed practitioners

23  solely within a hospital licensed under chapter 395.

24         (b)  Entities that own, directly or indirectly,

25  entities licensed or registered by the state pursuant to

26  chapter 395; or entities that own, directly or indirectly,

27  entities licensed or registered by the state and providing

28  only health care services within the scope of services

29  authorized pursuant to their respective licenses granted under

30  ss. 383.30-383.335, chapter 390, chapter 394, chapter 395,

31  chapter 397, this chapter except part XIII, chapter 463,


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 1  chapter 465, chapter 466, chapter 478, part I of chapter 483

 2  480, chapter 484, or chapter 651, end-stage renal disease

 3  providers authorized under 42 C.F.R. part 405, subpart U, or

 4  providers certified under 42 C.F.R. part 485, subpart B or

 5  subpart H, or any entity that provides neonatal or pediatric

 6  hospital-based healthcare services by licensed practitioners

 7  solely within a hospital licensed under chapter 395.

 8         (c)  Entities that are owned, directly or indirectly,

 9  by an entity licensed or registered by the state pursuant to

10  chapter 395; or entities that are owned, directly or

11  indirectly, by an entity licensed or registered by the state

12  and providing only health care services within the scope of

13  services authorized pursuant to their respective licenses

14  granted under ss. 383.30-383.335, chapter 390, chapter 394,

15  chapter 395, chapter 397, this chapter except part XIII,

16  chapter 463, chapter 465, chapter 466, chapter 478, part I of

17  chapter 483 480, chapter 484, or chapter 651, end-stage renal

18  disease providers authorized under 42 C.F.R. part 405, subpart

19  U, or providers certified under 42 C.F.R. part 485, subpart B

20  or subpart H, or any entity that provides neonatal or

21  pediatric hospital-based healthcare services by licensed

22  practitioners solely within a hospital licensed under chapter

23  395.

24         (d)  Entities that are under common ownership, directly

25  or indirectly, with an entity licensed or registered by the

26  state pursuant to chapter 395; or entities that are under

27  common ownership, directly or indirectly, with an entity

28  licensed or registered by the state and providing only health

29  care services within the scope of services authorized pursuant

30  to its respective license granted under ss. 383.30-383.335,

31  chapter 390, chapter 394, chapter 395, chapter 397, this


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 1  chapter except part XIII, chapter 463, chapter 465, chapter

 2  466, chapter 478, part I of chapter 483 480, chapter 484, or

 3  chapter 651, end-stage renal disease providers authorized

 4  under 42 C.F.R. part 405, subpart U, or providers certified

 5  under 42 C.F.R. part 485, subpart B or subpart H, or any

 6  entity that provides neonatal or pediatric hospital-based

 7  services by licensed practitioners solely within a hospital

 8  licensed under chapter 395.

 9         (e)  An entity that is exempt from federal taxation

10  under 26 U.S.C. s. 501(c)(3) or s. 501(c)(4), and any

11  community college or university clinic, and any entity owned

12  or operated by federal or state government, including

13  agencies, subdivisions, or municipalities thereof.

14         (f)  A sole proprietorship, group practice,

15  partnership, or corporation that provides health care services

16  by physicians covered by s. 627.419, that is directly

17  supervised by one or more of such physicians, and that is

18  wholly owned by one or more of those physicians or by a

19  physician and the spouse, parent, child, or sibling of that

20  physician.

21         (g)(f)  A sole proprietorship, group practice,

22  partnership, or corporation that provides health care services

23  by licensed health care practitioners under chapter 457,

24  chapter 458, chapter 459, chapter 460, chapter 461, chapter

25  462, chapter 463, chapter 466, chapter 467, chapter 480,

26  chapter 484, chapter 486, chapter 490, chapter 491, or part I,

27  part III, part X, part XIII, or part XIV of chapter 468, or s.

28  464.012, which are wholly owned by one or more a licensed

29  health care practitioners practitioner, or the licensed health

30  care practitioners set forth in this paragraph practitioner

31  and the spouse, parent, or child, or sibling of a licensed


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 1  health care practitioner, so long as one of the owners who is

 2  a licensed health care practitioner is supervising the

 3  services performed therein and is legally responsible for the

 4  entity's compliance with all federal and state laws. However,

 5  a health care practitioner may not supervise services beyond

 6  the scope of the practitioner's license, except that, for the

 7  purposes of this part, a clinic owned by a licensee in s.

 8  456.053(3)(b) that provides only services authorized pursuant

 9  to s. 456.053(3)(b) may be supervised by a licensee specified

10  in s. 456.053(3)(b).

11         (h)(g)  Clinical facilities affiliated with an

12  accredited medical school at which training is provided for

13  medical students, residents, or fellows.

14         (i)  Entities that provide only oncology or radiation

15  therapy services by physicians licensed under chapter 458 or

16  459.

17         (4)  "Medical director" means a physician who is

18  employed or under contract with a clinic and who maintains a

19  full and unencumbered physician license in accordance with

20  chapter 458, chapter 459, chapter 460, or chapter 461.

21  However, if the clinic does not provide services pursuant to

22  the respective physician practice acts listed in this

23  subsection, it is limited to providing health care services

24  pursuant to chapter 457, chapter 484, chapter 486, chapter

25  490, or chapter 491 or part I, part III, part X, part XIII, or

26  part XIV of chapter 468, the clinic may appoint a

27  Florida-licensed health care practitioner who does not provide

28  services pursuant to the respective physician practice acts

29  listed in this subsection licensed under that chapter to serve

30  as a clinic director who is responsible for the clinic's

31  activities. A health care practitioner may not serve as the


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 1  clinic director if the services provided at the clinic are

 2  beyond the scope of that practitioner's license, except that a

 3  licensee specified in s. 456.053(3)(b) that provides only

 4  services authorized pursuant to s. 456.053(3)(b) may serve as

 5  clinic director of an entity providing services as specified

 6  in s. 456.053(3)(b).

 7         (5)  "Mobile clinic" means a movable or detached

 8  self-contained health care unit within or from which direct

 9  health care services are provided to individuals and that

10  otherwise meets the definition of a clinic in subsection (3).

11         (6)  "Portable equipment provider" means an entity that

12  contracts with or employs persons to provide portable

13  equipment to multiple locations performing treatment or

14  diagnostic testing of individuals, that bills third-party

15  payors for those services, and that otherwise meets the

16  definition of a clinic in subsection (3).

17         (7)  "Chief financial officer" means an individual who

18  has at least a minimum of a bachelor's degree from an

19  accredited university in accounting, finance, or a related

20  field and is the person responsible for the preparation of the

21  clinic billing.

22         Section 27.  The creation of paragraph 400.9905(3)(i),

23  Florida Statutes, by this act is intended to clarify the

24  legislative intent of this provision as it existed at the time

25  the provision initially took effect as section 456.0375(1)(b),

26  Florida Statutes, and paragraph 400.9905(3)(i), Florida

27  Statutes, as created by this act, shall operate retroactively

28  to October 1, 2001. Nothing in this section shall be construed

29  as amending, modifying, limiting, or otherwise affecting in

30  any way the legislative intent, scope, terms, prohibition, or

31  requirements of section 456.053, Florida Statutes.


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 1         Section 28.  Subsections (1), (2), and (3) and

 2  paragraphs (a) and (b) of subsection (7) of section 400.991,

 3  Florida Statutes, are amended to read:

 4         400.991  License requirements; background screenings;

 5  prohibitions.--

 6         (1)(a)  Each clinic, as defined in s. 400.9905, must be

 7  licensed and shall at all times maintain a valid license with

 8  the agency. Each clinic location shall be licensed separately

 9  regardless of whether the clinic is operated under the same

10  business name or management as another clinic.

11         (b)  Each mobile clinic must obtain a separate health

12  care clinic license and clinics must provide to the agency, at

13  least quarterly, its their projected street location locations

14  to enable the agency to locate and inspect such clinic

15  clinics. A portable equipment provider must obtain a health

16  care clinic license for a single administrative office and is

17  not required to submit quarterly projected street locations.

18         (2)  The initial clinic license application shall be

19  filed with the agency by all clinics, as defined in s.

20  400.9905, on or before July March 1, 2004. A clinic license

21  must be renewed biennially.

22         (3)  Applicants that submit an application on or before

23  July March 1, 2004, which meets all requirements for initial

24  licensure as specified in this section shall receive a

25  temporary license until the completion of an initial

26  inspection verifying that the applicant meets all requirements

27  in rules authorized by s. 400.9925. However, a clinic engaged

28  in magnetic resonance imaging services may not receive a

29  temporary license unless it presents evidence satisfactory to

30  the agency that such clinic is making a good faith effort and

31  


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 1  substantial progress in seeking accreditation required under

 2  s. 400.9935.

 3         (7)  Each applicant for licensure shall comply with the

 4  following requirements:

 5         (a)  As used in this subsection, the term "applicant"

 6  means individuals owning or controlling, directly or

 7  indirectly, 5 percent or more of an interest in a clinic; the

 8  medical or clinic director, or a similarly titled person who

 9  is responsible for the day-to-day operation of the licensed

10  clinic; the financial officer or similarly titled individual

11  who is responsible for the financial operation of the clinic;

12  and licensed health care practitioners medical providers at

13  the clinic.

14         (b)  Upon receipt of a completed, signed, and dated

15  application, the agency shall require background screening of

16  the applicant, in accordance with the level 2 standards for

17  screening set forth in chapter 435. Proof of compliance with

18  the level 2 background screening requirements of chapter 435

19  which has been submitted within the previous 5 years in

20  compliance with any other health care licensure requirements

21  of this state is acceptable in fulfillment of this paragraph.

22  Applicants who own less than 10 percent of a health care

23  clinic are not required to submit fingerprints under this

24  section.

25         Section 29.  Subsections (1), (9), and (11) of section

26  400.9935, Florida Statutes, are amended to read:

27         400.9935  Clinic responsibilities.--

28         (1)  Each clinic shall appoint a medical director or

29  clinic director who shall agree in writing to accept legal

30  responsibility for the following activities on behalf of the

31  clinic. The medical director or the clinic director shall:


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 1         (a)  Have signs identifying the medical director or

 2  clinic director posted in a conspicuous location within the

 3  clinic readily visible to all patients.

 4         (b)  Ensure that all practitioners providing health

 5  care services or supplies to patients maintain a current

 6  active and unencumbered Florida license.

 7         (c)  Review any patient referral contracts or

 8  agreements executed by the clinic.

 9         (d)  Ensure that all health care practitioners at the

10  clinic have active appropriate certification or licensure for

11  the level of care being provided.

12         (e)  Serve as the clinic records owner as defined in s.

13  456.057.

14         (f)  Ensure compliance with the recordkeeping, office

15  surgery, and adverse incident reporting requirements of

16  chapter 456, the respective practice acts, and rules adopted

17  under this part.

18         (g)  Conduct systematic reviews of clinic billings to

19  ensure that the billings are not fraudulent or unlawful. Upon

20  discovery of an unlawful charge, the medical director or

21  clinic director shall take immediate corrective action. If the

22  clinic performs only the technical component of magnetic

23  resonance imaging, static radiographs, computed tomography, or

24  position emission tomography, and provides the professional

25  interpretation of such services, in a fixed facility that is

26  accredited by the Joint Commission on Accreditation of

27  Healthcare Organizations or the Accreditation Association for

28  Ambulatory Health Care, and the American College of Radiology;

29  and if, in the preceding quarter, the percentage of scans

30  performed by that clinic which was billed to all personal

31  injury protection insurance carriers was less than 15 percent,


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 1  the chief financial officer of the clinic may, in a written

 2  acknowledgement provided to the agency, assume the

 3  responsibility for the conduct of the systematic reviews of

 4  clinic billings to ensure that the billings are not fraudulent

 5  or unlawful.

 6         (9)  Any person or entity providing health care

 7  services which is not a clinic, as defined under s. 400.9905,

 8  may voluntarily apply for a certificate of exemption from

 9  licensure under its exempt status with the agency on a form

10  that sets forth its name or names and addresses, a statement

11  of the reasons why it cannot be defined as a clinic, and other

12  information deemed necessary by the agency. An exemption is

13  not transferable. The agency may charge an applicant for a

14  certificate of exemption $100 or the actual cost, whichever is

15  less, for processing the certificate.

16         (11)(a)  Each clinic engaged in magnetic resonance

17  imaging services must be accredited by the Joint Commission on

18  Accreditation of Healthcare Organizations, the American

19  College of Radiology, or the Accreditation Association for

20  Ambulatory Health Care, within 1 year after licensure.

21  However, a clinic may request a single, 6-month extension if

22  it provides evidence to the agency establishing that, for good

23  cause shown, such clinic can not be accredited within 1 year

24  after licensure, and that such accreditation will be completed

25  within the 6-month extension. After obtaining accreditation as

26  required by this subsection, each such clinic must maintain

27  accreditation as a condition of renewal of its license.

28         (b)  The agency may deny disallow the application or

29  revoke the license of any entity formed for the purpose of

30  avoiding compliance with the accreditation provisions of this

31  subsection and whose principals were previously principals of


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 1  an entity that was unable to meet the accreditation

 2  requirements within the specified timeframes. The agency may

 3  adopt rules as to the accreditation of magnetic resonance

 4  imaging clinics.

 5         Section 30.  Subsections (1) and (3) of section

 6  400.995, Florida Statutes, are amended, and subsection (10) is

 7  added to said section, to read:

 8         400.995  Agency administrative penalties.--

 9         (1)  The agency may deny the application for a license

10  renewal, revoke or suspend the license, and impose

11  administrative fines penalties against clinics of up to $5,000

12  per violation for violations of the requirements of this part

13  or rules of the agency. In determining if a penalty is to be

14  imposed and in fixing the amount of the fine, the agency shall

15  consider the following factors:

16         (a)  The gravity of the violation, including the

17  probability that death or serious physical or emotional harm

18  to a patient will result or has resulted, the severity of the

19  action or potential harm, and the extent to which the

20  provisions of the applicable laws or rules were violated.

21         (b)  Actions taken by the owner, medical director, or

22  clinic director to correct violations.

23         (c)  Any previous violations.

24         (d)  The financial benefit to the clinic of committing

25  or continuing the violation.

26         (3)  Any action taken to correct a violation shall be

27  documented in writing by the owner, medical director, or

28  clinic director of the clinic and verified through followup

29  visits by agency personnel. The agency may impose a fine and,

30  in the case of an owner-operated clinic, revoke or deny a

31  clinic's license when a clinic medical director or clinic


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 1  director knowingly fraudulently misrepresents actions taken to

 2  correct a violation.

 3         (10)  If the agency issues a notice of intent to deny a

 4  license application after a temporary license has been issued

 5  pursuant to s. 400.991(3), the temporary license shall expire

 6  on the date of the notice and may not be extended during any

 7  proceeding for administrative or judicial review pursuant to

 8  chapter 120.

 9         Section 31.  The agency shall refund 90 percent of the

10  license application fee to applicants that submitted their

11  health care clinic licensure fees and applications but were

12  subsequently exempted from licensure by this act.

13         Section 32.  Any person or entity defined as a clinic

14  under s. 400.9905, Florida Statutes, shall not be in violation

15  of part XIII of chapter 400, Florida Statutes, due to failure

16  to apply for a clinic license by March 1, 2004, as previously

17  required by s. 400.991, Florida Statutes. Payment to any such

18  person or entity by an insurer or other person liable for

19  payment to such person or entity may not be denied on the

20  grounds that the person or entity failed to apply for or

21  obtain a clinic license before March 1, 2004.

22         Section 33.  Paragraph (h) is added to subsection (3)

23  of section 400.9905, Florida Statutes, to read:

24         400.9905  Definitions.--

25         (3)  "Clinic" means an entity at which health care

26  services are provided to individuals and which tenders charges

27  for reimbursement for such services. For purposes of this

28  part, the term does not include and the licensure requirements

29  of this part do not apply to:

30  

31  


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 1         (h)  Entities that provide only oncology or radiation

 2  therapy services by physicians licensed under chapter 458 or

 3  chapter 459.

 4         Section 34.  The amendment made by this act to section

 5  400.9905(3), Florida Statutes, is intended to clarify the

 6  legislative intent of this provision as it existed at the time

 7  the provision initially took effect as section 456.0375(1)(b),

 8  Florida Statutes, and section 400.9905(3)(h), Florida

 9  Statutes, as created by this act, shall operate retroactively

10  to October 1, 2001.

11         Section 35.  Section 401.211, Florida Statutes, is

12  amended to read:

13         401.211  Legislative intent.--The Legislature

14  recognizes that the systematic provision of emergency medical

15  services saves lives and reduces disability associated with

16  illness and injury.  In addition, that system of care must be

17  equally capable of assessing, treating, and transporting

18  children, adults, and frail elderly persons.  Further, it is

19  the intent of the Legislature to encourage the development and

20  maintenance of emergency medical services because such

21  services are essential to the health and well-being of all

22  citizens of the state. The Legislature also recognizes that

23  the establishment of a comprehensive statewide

24  injury-prevention program supports state and community health

25  systems by further enhancing the total delivery system of

26  emergency medical services and reduces injuries for all

27  persons. The purpose of this part is to protect and enhance

28  the public health, welfare, and safety through the

29  establishment of an emergency medical services state plan, an

30  advisory council, a comprehensive statewide injury-prevention

31  program, minimum standards for emergency medical services


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 1  personnel, vehicles, services and medical direction, and the

 2  establishment of a statewide inspection program created to

 3  monitor the quality of patient care delivered by each licensed

 4  service and appropriately certified personnel.

 5         Section 36.  Section 401.243, Florida Statutes, is

 6  created to read:

 7         401.243  Injury prevention.--The department shall

 8  establish an injury-prevention program with responsibility for

 9  the statewide coordination and expansion of injury-prevention

10  activities. The duties of the department under the program may

11  include, but are not limited to, data collection,

12  surveillance, education, and the promotion of interventions.

13  In addition, the department may:

14         (1)  Provide communities, county health departments,

15  and other state agencies with expertise and guidance in injury

16  prevention.

17         (2)  Seek, receive, and expend funds received from

18  grants, donations, or contributions from public or private

19  sources for program purposes.

20         (3)  Develop, and revise as necessary, a comprehensive

21  state plan for injury prevention.

22         (4)  Adopt rules governing the implementation of grant

23  programs. The rules may include, but need not be limited to,

24  criteria regarding the application process, the selection of

25  grantees, the implementation of injury-prevention activities,

26  data collection, surveillance, education, and the promotion of

27  interventions.

28         Section 37.  Subsection (4) of section 404.056, Florida

29  Statutes, is amended to read:

30         404.056  Environmental radiation standards and

31  projects; certification of persons performing measurement or


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 1  mitigation services; mandatory testing; notification on real

 2  estate documents; rules.--

 3         (4)  MANDATORY TESTING.--All public and private school

 4  buildings or school sites housing students in kindergarten

 5  through grade 12; all state-owned, state-operated,

 6  state-regulated, or state-licensed 24-hour care facilities;

 7  and all state-licensed day care centers for children or minors

 8  which are located in counties designated within the Department

 9  of Community Affairs' Florida Radon Protection Map Categories

10  as "Intermediate" or "Elevated Radon Potential" shall be

11  measured to determine the level of indoor radon, using

12  measurement procedures established by the department. Initial

13  measurements Testing shall be conducted completed within the

14  first year of construction in 20 percent of the habitable

15  first floor spaces within any of the regulated buildings and.

16  Initial measurements shall be completed and reported to the

17  department within 1 by July 1 of the year after the date the

18  building is opened for occupancy or within 1 year after

19  license approval for the entity residing in the existing

20  building. Followup testing must be completed in 5 percent of

21  the habitable first floor spaces within any of the regulated

22  buildings after the building has been occupied for 5 years,

23  and results must be reported to the department by the first

24  day July 1 of the 6th 5th year of occupancy. After radon

25  measurements have been made twice, regulated buildings need

26  not undergo further testing unless significant structural

27  changes occur. No funds collected pursuant to s. 553.721 shall

28  be used to carry out the provisions of this subsection.

29         Section 38.  Subsection (1) and paragraph (g) of

30  subsection (3) of section 468.302, Florida Statutes, are

31  amended to read:


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 1         468.302  Use of radiation; identification of certified

 2  persons; limitations; exceptions.--

 3         (1)  Except as hereinafter provided in this section, a

 4  no person may not shall use radiation or otherwise practice

 5  radiologic technology on a human being unless he or she:

 6         (a)  Is a licensed practitioner; or

 7         (b)  Is the holder of a certificate, as provided in

 8  this part, and is operating under the direct supervision or

 9  general supervision of a licensed practitioner in each

10  particular case.

11         (3)

12         (g)1.  A person holding a certificate as a nuclear

13  medicine technologist may only:

14         a.  Conduct in vivo and in vitro measurements of

15  radioactivity and administer radiopharmaceuticals to human

16  beings for diagnostic and therapeutic purposes.

17         b.  Administer X radiation from a combination nuclear

18  medicine-computed tomography device if that radiation is

19  administered as an integral part of a nuclear medicine

20  procedure that uses an automated computed tomography protocol

21  for the purposes of attenuation correction and anatomical

22  localization and the person has received device-specific

23  training on the combination device. However,

24         2.  The authority of a nuclear medicine technologist

25  under this paragraph excludes:

26         a.  Radioimmunoassay and other clinical laboratory

27  testing regulated pursuant to chapter 483;.

28         b.  Creating or modifying automated computed tomography

29  protocols; and

30         c.  Any other operation of a computed tomography

31  device, especially for the purposes of stand-alone diagnostic


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 1  imaging, which must be performed by a general radiographer

 2  certified under this part.

 3         Section 39.  Section 468.304, Florida Statutes, is

 4  amended to read:

 5         468.304  Certification examination; admission.--The

 6  department shall certify admit to examination for

 7  certification any applicant who meets the following criteria

 8  pays to the department a nonrefundable fee not to exceed $100

 9  plus the actual per-applicant cost to the department for

10  purchasing the examination from a national organization and

11  submits satisfactory evidence, verified by oath or

12  affirmation, that she or he:

13         (1)  Pays to the department a nonrefundable fee that

14  may not exceed $100, plus the actual per-applicant cost to the

15  department for purchasing the examination from a national

16  organization.

17         (2)  Submits a completed application on a form

18  specified by the department. An incomplete application expires

19  6 months after initial filing. The application must include

20  the social security number of the applicant. Each applicant

21  shall notify the department in writing of his or her current

22  mailing address. Notwithstanding any other law, service by

23  regular mail to an applicant's last reported mailing address

24  constitutes adequate and sufficient notice of any official

25  departmental communication to the applicant.

26         (3)  Submits satisfactory evidence, verified by oath or

27  affirmation, that she or he:

28         (a)(1)  Is at least 18 years of age at the time of

29  application;

30         (b)(2)  Is a high school, vocational school, technical

31  school, or college graduate or has successfully completed the


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 1  requirements for a graduate equivalency diploma (GED) or its

 2  equivalent;

 3         (c)(3)  Is of good moral character; and

 4         (d)  Has passed an examination as specified in s.

 5  468.306 or meets the requirements specified in s. 468.3065;

 6  and

 7         (e)1.(4)(a)  Has successfully completed an educational

 8  program, which program may be established in a hospital

 9  licensed pursuant to chapter 395 or in an accredited

10  postsecondary academic institution which is subject to

11  approval by the department as maintaining a satisfactory

12  standard; or

13         2.a.(b)1.  With respect to an applicant for a basic

14  X-ray machine operator's certificate, has completed a course

15  of study approved by the department with appropriate study

16  material provided the applicant by the department;

17         b.2.  With respect to an applicant for a basic X-ray

18  machine operator-podiatric medicine certificate, has completed

19  a course of study approved by the department, provided that

20  such course of study shall be limited to that information

21  necessary to perform radiographic procedures within the scope

22  of practice of a podiatric physician licensed pursuant to

23  chapter 461;

24         c.3.  With respect only to an applicant for a general

25  radiographer's certificate who is a basic X-ray machine

26  operator certificateholder, has completed an educational

27  program or a 2-year training program that takes into account

28  the types of procedures and level of supervision usually and

29  customarily practiced in a hospital, which educational or

30  training program complies with the rules of the department; or

31  


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 1         d.4.  With respect only to an applicant for a nuclear

 2  medicine technologist's certificate who is a general

 3  radiographer certificateholder, has completed an educational

 4  program or a 2-year training program that takes into account

 5  the types of procedures and level of supervision usually and

 6  customarily practiced in a hospital, which educational or

 7  training program complies with the rules of the department.

 8         (4)  Submits complete documentation of any criminal

 9  offense in any jurisdiction of which the applicant has been

10  found guilty, regardless of whether adjudication of guilt was

11  withheld, or to which the applicant has pled guilty or nolo

12  contendere.

13         (5)  Submits complete documentation of any final

14  disciplinary action taken against the applicant by a licensing

15  or regulatory body in any jurisdiction, by a national

16  organization, or by a specialty board that is recognized by

17  the department. Disciplinary action includes revocation,

18  suspension, probation, reprimand, or being otherwise acted

19  against, including being denied certification or resigning

20  from or nonrenewal of membership taken in lieu of or in

21  settlement of a pending disciplinary case.

22  

23  The department may not certify any applicant who has committed

24  an offense that would constitute a violation of any of the

25  provisions of s. 468.3101 or the rules adopted thereunder if

26  the applicant had been certified by the department at the time

27  of the offense. No application for a limited computed

28  tomography certificate shall be accepted.  All persons holding

29  valid computed tomography certificates as of October 1, 1984,

30  are subject to the provisions of s. 468.309.

31  


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 1         Section 40.  Section 468.306, Florida Statutes, is

 2  amended to read:

 3         468.306  Examinations.--All applicants, except those

 4  certified pursuant to s. 468.3065, shall be required to pass

 5  an examination.  The department is authorized to develop or

 6  use examinations for each type of certificate. The department

 7  may require an applicant who does not pass an examination

 8  after five attempts to complete additional remedial education,

 9  as specified by rule of the department, before admitting the

10  applicant to subsequent examinations.

11         (1)  The department shall have the authority to

12  contract with organizations that develop such test

13  examinations. Examinations may be administered by the

14  department or the contracting organization.

15         (2)  Examinations shall be given for each type of

16  certificate at least twice a year at such times and places as

17  the department may determine to be advantageous for

18  applicants. If an applicant applies less than 75 days before

19  an examination, the department may schedule the applicant for

20  a later examination.

21         (3)  All examinations shall be written and include

22  positioning, technique, and radiation protection.  The

23  department shall either pass or fail each applicant on the

24  basis of his or her final grade.  The examination for a basic

25  X-ray machine operator shall include basic positioning and

26  basic techniques directly related to the skills necessary to

27  safely operate radiographic equipment.

28         (4)  A nonrefundable fee not to exceed $75 plus the

29  actual per-applicant cost for purchasing the examination from

30  a national organization shall be charged for any subsequent

31  examination.


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 1         Section 41.  Section 468.3065, Florida Statutes, is

 2  amended to read:

 3         468.3065  Certification by endorsement.--The department

 4  may issue a certificate by endorsement to practice radiologic

 5  technology to an applicant who, upon applying to the

 6  department and remitting a nonrefundable fee not to exceed

 7  $50, demonstrates to the department that he or she holds a

 8  current certificate, license, or registration to practice

 9  radiologic technology, provided that the requirements for such

10  certificate, license, or registration are deemed by the

11  department to be substantially equivalent to those established

12  under this part and rules adopted under this part hereunder.

13         Section 42.  Subsection (1) of section 468.307, Florida

14  Statutes, is amended to read:

15         468.307  Certificate; issuance; display.--

16         (1)  The department shall issue a certificate to each

17  candidate who has met the requirements of ss. 468.304 and

18  468.306 or has qualified under s. 468.3065. The department may

19  by rule establish a subcategory of a certificate issued under

20  this part limiting the certificateholder to a specific

21  procedure or specific type of equipment. The first regular

22  certificate issued to a new certificateholder expires on the

23  last day of the certificateholder's birth month and shall be

24  valid for at least 12 months but no more than 24 months.

25  However, if the new certificateholder already holds a regular,

26  active certificate in a different category under this part,

27  the new certificate shall be combined with and expire on the

28  same date as the existing certificate.

29         Section 43.  Section 468.309, Florida Statutes, is

30  amended to read:

31  


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 1         468.309  Certificate; duration; renewal; reversion to

 2  inactive status; members of Armed Forces and spouses.--

 3         (1)(a)  A radiologic technologist's certificate issued

 4  in accordance with this part expires as specified in rules

 5  adopted by the department which establish a procedure for the

 6  biennial renewal of certificates. A certificate shall be

 7  renewed by the department for a period of 2 years upon payment

 8  of a renewal fee in an amount not to exceed $75 and upon

 9  submission of a renewal application containing such

10  information as the department deems necessary to show that the

11  applicant for renewal is a radiologic technologist in good

12  standing and has completed any continuing education

13  requirements that the department establishes.

14         (b)  Sixty days before the end of the biennium, the

15  department shall mail a notice of renewal to the last known

16  address of the certificateholder.

17         (c)  Each certificateholder shall notify the department

18  in writing of his or her current mailing address and place of

19  practice. Notwithstanding any other law, service by regular

20  mail to a certificateholder's last reported mailing address

21  constitutes adequate and sufficient notice of any official

22  departmental communication to the certificateholder.

23         (2)  The department shall adopt rules establishing a

24  procedure for the biennial renewal of certificates.

25         (3)  The department may, by rule, prescribe continuing

26  education requirements, not to exceed 24 hours each licensure

27  period, as a condition for renewal of a certificate.  The

28  criteria for approval of continuing education providers,

29  courses, and programs shall be as specified approved by the

30  department.  Continuing education, which may be required for

31  


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 1  persons certified under this part, may be obtained through

 2  home study courses approved by the department.

 3         (4)  Any certificate that which is not renewed by its

 4  expiration date at the end of the biennium prescribed by the

 5  department shall automatically be placed in an expired status,

 6  and the certificateholder may not practice radiologic

 7  technology until the certificate has been reactivated revert

 8  to an inactive status. Such certificate may be reactivated

 9  only if the certificateholder meets the other qualifications

10  for reactivation in s. 468.3095.

11         (5)  A certificateholder in good standing remains in

12  good standing when he or she becomes a member of the Armed

13  Forces of the United States on active duty without paying

14  renewal fees or accruing continuing education credits as long

15  as he or she is a member of the Armed Forces on active duty

16  and for a period of 6 months after discharge from active duty,

17  if he or she is not engaged in practicing radiologic

18  technology in the private sector for profit.  The

19  certificateholder must pay a renewal fee and complete

20  continuing education not to exceed 12 classroom hours to renew

21  the certificate.

22         (6)  A certificateholder who is in good standing

23  remains in good standing if he or she is absent from the state

24  because of his or her spouse's active duty with the Armed

25  Forces of the United States.  The certificateholder remains in

26  good standing without paying renewal fees or completing

27  continuing education as long as his or her spouse is a member

28  of the Armed Forces on active duty and for a period of 6

29  months after the spouse's discharge from active duty, if the

30  certificateholder is not engaged in practicing radiologic

31  technology in the private sector for profit.  The


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 1  certificateholder must pay a renewal fee and complete

 2  continuing education not to exceed 12 classroom hours to renew

 3  the certificate.

 4         (7)  A certificateholder may resign his or her

 5  certification by submitting to the department a written,

 6  notarized resignation on a form specified by the department.

 7  The resignation automatically becomes effective upon the

 8  department's receipt of the resignation form, at which time

 9  the certificateholder's certification automatically becomes

10  null and void and may not be reactivated or renewed or used to

11  practice radiologic technology. A certificateholder who has

12  resigned may become certified again only by reapplying to the

13  department for certification as a new applicant and meeting

14  the certification requirements pursuant to s. 468.304 or s.

15  468.3065. Any disciplinary action that had been imposed on the

16  certificateholder prior to his or her resignation shall be

17  tolled until he or she again becomes certified. Any

18  disciplinary action proposed at the time of the

19  certificateholder's resignation shall be tolled until he or

20  she again becomes certified.

21         Section 44.  Subsection (2) of section 468.3095,

22  Florida Statutes, is amended to read:

23         468.3095  Inactive status; reactivation; automatic

24  suspension; reinstatement.--

25         (2)(a)  A certificate that which has been expired

26  inactive for less than 10 years 1 year after the end of the

27  biennium prescribed by the department may be reactivated

28  renewed pursuant to s. 468.309 upon payment of the biennial

29  renewal fee and a late renewal fee, not to exceed $100, and

30  submission of a reactivation application containing any

31  information that the department deems necessary to show that


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 1  the applicant is a radiologic technologist in good standing

 2  and has met the requirements for continuing education. The

 3  renewed certificate shall expire 2 years after the date the

 4  certificate automatically reverted to inactive status.

 5         (b)  A certificate which has been inactive for more

 6  than 1 year may be reactivated upon application to the

 7  department. The department shall prescribe, by rule,

 8  continuing education requirements as a condition of

 9  reactivating a certificate.  The continuing education

10  requirements for reactivating a certificate may shall not

11  exceed 10 classroom hours for each year the certificate was

12  expired inactive and may not shall in no event exceed 100

13  classroom hours for all years in which the certificate was

14  expired inactive.

15         (b)  A certificate that has been inactive for less than

16  10 years may be reactivated by meeting all of the requirements

17  of paragraph (a) for expired certificates, except for payment

18  of the fee for late renewal.

19         (c)  A certificate that which has been inactive for

20  more than 10 years or more shall automatically becomes null

21  and void and may not be reactivated, renewed, or used to

22  practice radiologic technology be suspended. A

23  certificateholder whose certificate has become null and void

24  may become certified again only by reapplying to the

25  department as a new applicant and meeting the requirements of

26  s. 468.304 or s. 468.3065.

27         (d)  When an expired or inactive certificate is

28  reactivated, the reactivated certificate expires on the last

29  day of the certificateholder's birth month and shall be valid

30  for at least 12 months but no more than 24 months. However, if

31  the reactivating certificateholder already holds a regular,


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 1  active certificate in a different category under this part,

 2  the reactivated certificate shall be combined with and expire

 3  on the same date as the existing certificate. One year before

 4  the suspension, the department shall give notice to the

 5  certificateholder.  A suspended certificate may be reinstated

 6  as provided for original issuance in s. 468.307.

 7         Section 45.  Subsection (1) of section 468.3101,

 8  Florida Statutes, is amended, and subsections (5) and (6) are

 9  added to that section, to read:

10         468.3101  Disciplinary grounds and actions.--

11         (1)  The department may make or require to be made any

12  investigations, inspections, evaluations, and tests, and

13  require the submission of any documents and statements, which

14  it considers necessary to determine whether a violation of

15  this part has occurred. The following acts shall be grounds

16  for disciplinary action as set forth in this section:

17         (a)  Procuring, attempting to procure, or renewing a

18  certificate to practice radiologic technology by bribery, by

19  fraudulent misrepresentation, or through an error of the

20  department.

21         (b)  Having a voluntary or mandatory certificate to

22  practice radiologic technology revoked, suspended, or

23  otherwise acted against, including being denied certification,

24  by a national organization; by a specialty board recognized by

25  the department; or by a the certification authority of another

26  state, territory, or country.

27         (c)  Being convicted or found guilty, regardless of

28  adjudication, in any jurisdiction of a crime that which

29  directly relates to the practice of radiologic technology or

30  to the ability to practice radiologic technology.  Pleading A

31  


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 1  plea of nolo contendere shall be considered a conviction for

 2  the purpose of this provision.

 3         (d)  Being convicted or found guilty, regardless of

 4  adjudication, in any jurisdiction of a crime against a person.

 5  Pleading A plea of nolo contendere shall be considered a

 6  conviction for the purposes of this provision.

 7         (e)  Making or filing a false report or record that

 8  which the certificateholder knows to be false, intentionally

 9  or negligently failing to file a report or record required by

10  state or federal law, or willfully impeding or obstructing

11  such filing or inducing another to do so.  Such reports or

12  records include only those reports or records which are signed

13  in the capacity as a radiologic technologist.

14         (f)  Engaging in unprofessional conduct, which

15  includes, but is not limited to, any departure from, or the

16  failure to conform to, the standards of practice of radiologic

17  technology as established by the department, in which case

18  actual injury need not be established.

19         (g)  Being unable to practice radiologic technology

20  with reasonable skill and safety to patients by reason of

21  illness; drunkenness; or use of alcohol, drugs, narcotics,

22  chemicals, or other materials or as a result of any mental or

23  physical condition.  A radiologic technologist affected under

24  this paragraph shall, at reasonable intervals, be afforded an

25  opportunity to demonstrate that he or she can resume the

26  competent practice of radiologic technology with reasonable

27  skill and safety.

28         (h)  Failing to report to the department any person who

29  the certificateholder knows is in violation of this part or of

30  the rules of the department.

31  


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 1         (i)  Violating any provision of this part, any rule of

 2  the department, or any lawful order of the department

 3  previously entered in a disciplinary proceeding or failing to

 4  comply with a lawfully issued subpoena of the department.

 5         (j)  Employing, for the purpose of applying ionizing

 6  radiation or otherwise practicing radiologic technology on a

 7  to any human being, any individual who is not certified under

 8  the provisions of this part.

 9         (k)  Testing positive for any drug, as defined in s.

10  112.0455, on any confirmed preemployment or employer-required

11  drug screening when the radiologic technologist does not have

12  a lawful prescription and legitimate medical reason for using

13  such drug.

14         (l)  Failing to report to the department in writing

15  within 30 days after the certificateholder has had a voluntary

16  or mandatory certificate to practice radiologic technology

17  revoked, suspended, or otherwise acted against, including

18  being denied certification, by a national organization, by a

19  specialty board recognized by the department, or by a

20  certification authority of another state, territory, or

21  country.

22         (m)  Having been found guilty of, regardless of

23  adjudication, or pleading guilty or nolo contendere to, any

24  offense prohibited under s. 435.03 or under any similar

25  statute of another jurisdiction.

26         (n)  Failing to comply with the recommendations of the

27  department's impaired practitioner program for treatment,

28  evaluation, or monitoring. A letter from the director of the

29  impaired practitioner program that the certificateholder is

30  not in compliance shall be considered conclusive proof under

31  this part.


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 1         (5)  A final disciplinary action taken against a

 2  radiologic technologist in another jurisdiction, whether

 3  voluntary or mandatory, shall be considered conclusive proof

 4  of grounds for a disciplinary proceeding under this part.

 5         (6)  The department may revoke approval of a continuing

 6  education provider and its approved courses if the provider's

 7  certification has been revoked, suspended, or otherwise acted

 8  against by a national organization; by a specialty board

 9  recognized by the department; or by a certification authority

10  of another state, territory, or country. The department may

11  establish by rule additional guidelines and criteria for the

12  discipline of continuing education providers, including, but

13  not limited to, revoking approval of a continuing education

14  provider or a continuing education course and refusing to

15  approve a continuing education provider or continuing

16  education course.

17         Section 46.  Paragraph (a) of subsection (5) of section

18  489.553, Florida Statutes, is amended to read:

19         489.553  Administration of part; registration

20  qualifications; examination.--

21         (5)  To be eligible for registration by the department

22  as a master septic tank contractor, the applicant must:

23         (a)  Have been a registered septic tank contractor in

24  Florida for at least 3 years or a plumbing contractor

25  certified under part I of this chapter who has provided septic

26  tank contracting services for at least 3 years. The 3 years

27  must immediately precede the date of application and may not

28  be interrupted by any probation, suspension, or revocation

29  imposed by the licensing agency.

30         Section 47.  Section 489.554, Florida Statutes, is

31  amended to read:


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 1         489.554  Registration renewal.--

 2         (1)  The department shall prescribe by rule the method

 3  for approving approval of continuing education courses, and

 4  for renewing renewal of annual registration, for approving

 5  inactive status for the late filing of a renewal application,

 6  for allowing a contractor to hold a registration in inactive

 7  status for a specified period, and for reactivating a

 8  registration.

 9         (2)  At a minimum, annual renewal shall include

10  continuing education requirements of not less than 6 classroom

11  hours annually for septic tank contractors and not less than

12  12 classroom hours annually for master septic tank

13  contractors.  The 12 classroom hours of continuing education

14  required for master septic tank contractors may include the 6

15  classroom hours required for septic tank contractors, but at a

16  minimum must include 6 classroom hours of approved master

17  septic tank contractor coursework.

18         (3)  A certificate of registration becomes inactive

19  when a renewal application is not filed in a timely manner. A

20  certificate that has become inactive may be reactivated under

21  this section by application to the department. A licensed

22  contractor may apply to the department for voluntary inactive

23  status at any time during the period of registration.

24         (4)  A master septic tank contractor may elect to

25  revert to the status of a registered septic tank contractor at

26  any time during the period of registration. The department

27  shall prescribe by rule the method for a master septic tank

28  contractor who has reverted to the status of a registered

29  septic tank contractor to apply for status as a master septic

30  tank contractor.

31  


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 1         (5)  The department shall deny an application for

 2  renewal if the applicant has failed to pay any administrative

 3  penalty imposed by the department if the penalty is final

 4  agency action and all judicial reviews have been exhausted.

 5         Section 48.  Section 784.081, Florida Statutes, is

 6  amended to read:

 7         784.081  Assault or battery on specified officials or

 8  employees; reclassification of offenses.--Whenever a person is

 9  charged with committing an assault or aggravated assault or a

10  battery or aggravated battery upon any elected official or

11  employee of: a school district; a private school; the Florida

12  School for the Deaf and the Blind; a university developmental

13  research school; a state university or any other entity of the

14  state system of public education, as defined in s. 1000.04; an

15  employee or protective investigator of the Department of

16  Children and Family Services; or an employee of a lead

17  community-based provider and its direct service contract

18  providers; or an employee of the Department of Health or its

19  direct service contract providers, when the person committing

20  the offense knows or has reason to know the identity or

21  position or employment of the victim, the offense for which

22  the person is charged shall be reclassified as follows:

23         (1)  In the case of aggravated battery, from a felony

24  of the second degree to a felony of the first degree.

25         (2)  In the case of aggravated assault, from a felony

26  of the third degree to a felony of the second degree.

27         (3)  In the case of battery, from a misdemeanor of the

28  first degree to a felony of the third degree.

29         (4)  In the case of assault, from a misdemeanor of the

30  second degree to a misdemeanor of the first degree.

31  


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 1         Section 49.  Paragraph (a) of subsection (2) of section

 2  381.7355, Florida Statutes, is amended to read:

 3         381.7355  Project requirements; review criteria.--

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

 5  elements:

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

 7  including identification of the particular racial or ethnic

 8  disparity the project will address. The proposal must address

 9  one or more of the following priority areas:

10         1.  Decreasing racial and ethnic disparities in

11  maternal and infant mortality rates.

12         2.  Decreasing racial and ethnic disparities in

13  morbidity and mortality rates relating to cancer.

14         3.  Decreasing racial and ethnic disparities in

15  morbidity and mortality rates relating to HIV/AIDS.

16         4.  Decreasing racial and ethnic disparities in

17  morbidity and mortality rates relating to cardiovascular

18  disease.

19         5.  Decreasing racial and ethnic disparities in

20  morbidity and mortality rates relating to diabetes.

21         6.  Increasing adult and child immunization rates in

22  certain racial and ethnic populations.

23         7.  Decreasing racial and ethnic disparities in oral

24  health care.

25         Section 50.  Present subsection (2) of section 381.005,

26  Florida Statutes, is redesignated as subsection (3), and a new

27  subsection (2) is added to that section, to read:

28         381.005  Primary and preventive health services.--

29         (2)  Between October 1, or earlier if the vaccination

30  is available, and February 1 of each year, subject to the

31  availability of an adequate supply of the necessary vaccine,


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 1  each hospital licensed pursuant to chapter 395 shall implement

 2  a program to offer immunizations against the influenza virus

 3  and pneumococcal bacteria to all patients age 65 or older, in

 4  accordance with the recommendations of the Advisory Committee

 5  on Immunization Practices of the United States Centers for

 6  Disease Control and Prevention and subject to the clinical

 7  judgment of the responsible practitioner.

 8         Section 51.  Subsection (9) of section 381.0098,

 9  paragraph (f) of subsection (2) of section 385.103, sections

10  385.205 and 385.209, subsection (3) of section 391.301,

11  subsection (2) of section 391.305, subsection (5) of section

12  393.064, and subsection (7) of section 445.033, Florida

13  Statutes, are repealed.

14         Section 52.  The Technical Review and Advisory Panel of

15  the Department of Health, created by section 381.0068, Florida

16  Statutes, shall review and advise the Legislature on the need

17  and structure of a disciplinary board for the onsite sewage

18  industry. The panel shall submit a report to the Legislature

19  by January 2, 2005.

20         Section 53.  Subsection (9) of section 409.907, Florida

21  Statutes, is amended to read:

22         409.907  Medicaid provider agreements.--The agency may

23  make payments for medical assistance and related services

24  rendered to Medicaid recipients only to an individual or

25  entity who has a provider agreement in effect with the agency,

26  who is performing services or supplying goods in accordance

27  with federal, state, and local law, and who agrees that no

28  person shall, on the grounds of handicap, race, color, or

29  national origin, or for any other reason, be subjected to

30  discrimination under any program or activity for which the

31  provider receives payment from the agency.


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 1         (9)  Upon receipt of a completed, signed, and dated

 2  application, and completion of any necessary background

 3  investigation and criminal history record check, the agency

 4  must either:

 5         (a)  Enroll the applicant as a Medicaid provider no

 6  earlier than the effective date of the approval of the

 7  provider application. With respect to providers who were

 8  recently granted a change of ownership and those who primarily

 9  provide emergency medical services transportation or emergency

10  services and care pursuant to s. 395.1041 or s. 401.45, or

11  services provided by entities under s. 409.91255, and

12  out-of-state providers, upon approval of the provider

13  application, the effective date of approval is considered to

14  be the date the agency receives the provider application; or

15         (b)  Deny the application if the agency finds that it

16  is in the best interest of the Medicaid program to do so. The

17  agency may consider the factors listed in subsection (10), as

18  well as any other factor that could affect the effective and

19  efficient administration of the program, including, but not

20  limited to, the applicant's demonstrated ability to provide

21  services, conduct business, and operate a financially viable

22  concern; the current availability of medical care, services,

23  or supplies to recipients, taking into account geographic

24  location and reasonable travel time; the number of providers

25  of the same type already enrolled in the same geographic area;

26  and the credentials, experience, success, and patient outcomes

27  of the provider for the services that it is making application

28  to provide in the Medicaid program. The agency shall deny the

29  application if the agency finds that a provider; any officer,

30  director, agent, managing employee, or affiliated person; or

31  any partner or shareholder having an ownership interest equal


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 1  to 5 percent or greater in the provider if the provider is a

 2  corporation, partnership, or other business entity, has failed

 3  to pay all outstanding fines or overpayments assessed by final

 4  order of the agency or final order of the Centers for Medicare

 5  and Medicaid Services, not subject to further appeal, unless

 6  the provider agrees to a repayment plan that includes

 7  withholding Medicaid reimbursement until the amount due is

 8  paid in full.

 9         Section 54.  Notwithstanding any other law or local

10  ordinance to the contrary and to ensure uniform health and

11  safety standards, the regulation, identification, and

12  packaging of meat, poultry, and fish is preempted to the state

13  and the Department of Agriculture and Consumer Services.

14         Section 55.  This act shall take effect July 1, 2004.

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