Senate Bill sb1116

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    Florida Senate - 2005                                  SB 1116

    By Senator Saunders





    37-797A-05

  1                      A bill to be entitled

  2         An act relating to specialty nursing; amending

  3         s. 464.003, F.S.; defining the terms "clinical

  4         nurse specialist practice" and "clinical nurse

  5         specialist"; creating s. 464.0115, F.S.;

  6         providing requirements for certification as a

  7         clinical nurse specialist; providing fees;

  8         authorizing the Board of Nursing to adopt

  9         rules; amending 464.012, F.S.; adding clinical

10         nurse specialist to the classifications of

11         advanced registered nurse practitioners;

12         creating s. 464.0125, F.S.; requiring advanced

13         registered nurse practitioners to register with

14         the Board of Nursing to prescribe medicinal

15         drugs, including controlled substances;

16         providing requirements for registration and

17         renewal of registration, including continuing

18         education; providing fees; prohibiting

19         prescription of controlled substances for

20         personal use or the use of immediate family

21         members; providing for disciplinary actions;

22         authorizing the board to adopt rules; amending

23         s. 464.015, F.S.; restricting the use of

24         professional titles and abbreviations relating

25         to clinical nurse specialist and certified

26         registered nurse anesthetist practice;

27         providing penalties; amending s. 464.016, F.S.;

28         prohibiting the use of any name or title

29         stating or implying that a person is a clinical

30         nurse specialist, certified registered nurse

31         anesthetist, or certified nurse midwife unless

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    Florida Senate - 2005                                  SB 1116
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 1         the person is licensed or certified; providing

 2         penalties; amending s. 893.02, F.S.; redefining

 3         the term "practitioner" under the Florida

 4         Comprehensive Drug Abuse Prevention and Control

 5         Act to include certain advanced registered

 6         nurse practitioners; reenacting s.

 7         921.0022(3)(g), F.S., relating to the offense

 8         severity ranking chart of the Criminal

 9         Punishment Code, to incorporate the amendment

10         to s. 464.016, F.S., in a reference thereto;

11         amending s. 458.348, F.S.; conforming

12         cross-references; providing an effective date.

13  

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

15  

16         Section 1.  Section 464.003, Florida Statutes, is

17  amended to read:

18         464.003  Definitions.--As used in this part, the term:

19         (1)  "Department" means the Department of Health.

20         (2)  "Board" means the Board of Nursing.

21         (3)(a)  "Practice of professional nursing" means the

22  performance of those acts requiring substantial specialized

23  knowledge, judgment, and nursing skill based upon applied

24  principles of psychological, biological, physical, and social

25  sciences which shall include, but not be limited to:

26         1.  The observation, assessment, nursing diagnosis,

27  planning, intervention, and evaluation of care; health

28  teaching and counseling of the ill, injured, or infirm; and

29  the promotion of wellness, maintenance of health, and

30  prevention of illness of others.

31  

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    Florida Senate - 2005                                  SB 1116
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 1         2.  The administration of medications and treatments as

 2  prescribed or authorized by a duly licensed practitioner

 3  authorized by the laws of this state to prescribe such

 4  medications and treatments.

 5         3.  The supervision and teaching of other personnel in

 6  the theory and performance of any of the above acts.

 7         (b)  "Practice of practical nursing" means the

 8  performance of selected acts, including the administration of

 9  treatments and medications, in the care of the ill, injured,

10  or infirm and the promotion of wellness, maintenance of

11  health, and prevention of illness of others under the

12  direction of a registered nurse, a licensed physician, a

13  licensed osteopathic physician, a licensed podiatric

14  physician, or a licensed dentist.

15  

16  The professional nurse and the practical nurse shall be

17  responsible and accountable for making decisions that are

18  based upon the individual's educational preparation and

19  experience in nursing.

20         (c)  "Clinical nurse specialist practice" means the

21  delivery and management of expert-level nursing care to

22  individuals or groups, including the ability to:

23         1.  Assess the health status of individuals and

24  families using methods appropriate to the population and area

25  of practice.

26         2.  Diagnose human responses to actual or potential

27  health problems.

28         3.  Plan for health promotion, disease prevention, and

29  therapeutic intervention in collaboration with the patient or

30  client.

31  

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 1         4.  Implement therapeutic interventions based on the

 2  nurse specialist's area of expertise, including, but not

 3  limited to, direct nursing care, counseling, teaching, and

 4  collaboration with other licensed health care providers.

 5         5.  Coordinate health care as necessary and appropriate

 6  and evaluate with the patient or client the effectiveness of

 7  care.

 8         (d)(c)  "Advanced or specialized nursing practice"

 9  means, in addition to the practice of professional nursing,

10  the performance of advanced-level nursing acts approved by the

11  board which, by virtue of postbasic specialized education,

12  training, and experience, are proper to be performed by an

13  advanced registered nurse practitioner.  Within the context of

14  advanced or specialized nursing practice, the advanced

15  registered nurse practitioner may perform acts of nursing

16  diagnosis and nursing treatment of alterations of the health

17  status.  The advanced registered nurse practitioner may also

18  perform acts of medical diagnosis and treatment, prescription,

19  and operation which are identified and approved by a joint

20  committee composed of three members appointed by the Board of

21  Nursing, two of whom shall be advanced registered nurse

22  practitioners; three members appointed by the Board of

23  Medicine, two of whom shall have had work experience with

24  advanced registered nurse practitioners; and the secretary of

25  the department or the secretary's designee. Each committee

26  member appointed by a board shall be appointed to a term of 4

27  years unless a shorter term is required to establish or

28  maintain staggered terms. The Board of Nursing shall adopt

29  rules authorizing the performance of any such acts approved by

30  the joint committee. Unless otherwise specified by the joint

31  committee, such acts shall be performed under the general

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 1  supervision of a practitioner licensed under chapter 458,

 2  chapter 459, or chapter 466 within the framework of standing

 3  protocols which identify the medical acts to be performed and

 4  the conditions for their performance.  The department may, by

 5  rule, require that a copy of the protocol be filed with the

 6  department along with the notice required by s. 458.348.

 7         (e)(d)  "Nursing diagnosis" means the observation and

 8  evaluation of physical or mental conditions, behaviors, signs

 9  and symptoms of illness, and reactions to treatment and the

10  determination as to whether such conditions, signs, symptoms,

11  and reactions represent a deviation from normal.

12         (f)(e)  "Nursing treatment" means the establishment and

13  implementation of a nursing regimen for the care and comfort

14  of individuals, the prevention of illness, and the education,

15  restoration, and maintenance of health.

16         (4)  "Registered nurse" means any person licensed in

17  this state to practice professional nursing.

18         (5)  "Licensed practical nurse" means any person

19  licensed in this state to practice practical nursing.

20         (6)  "Clinical nurse specialist" means any person

21  licensed in this state to practice professional nursing and

22  certified in clinical nurse specialist practice.

23         (7)(6)  "Advanced registered nurse practitioner" means

24  any person licensed in this state to practice professional

25  nursing and certified in advanced or specialized nursing

26  practice, including certified registered nurse anesthetists,

27  certified nurse midwives, nurse practitioners, and clinical

28  nurse specialists.

29         (8)(7)  "Approved program" means a nursing program

30  conducted in a school, college, or university which is

31  

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 1  approved by the board pursuant to s. 464.019 for the education

 2  of nurses.

 3         Section 2.  Section 464.0115, Florida Statutes, is

 4  created to read:

 5         464.0115  Certification of clinical nurse

 6  specialists.--

 7         (1)  Any nurse desiring to be certified as a clinical

 8  nurse specialist shall apply to the department and submit

 9  proof that he or she holds a current license to practice

10  professional nursing, a master's degree in a clinical nursing

11  specialty, and current certification in a specialty area as a

12  clinical nurse specialist from a nationally recognized

13  certifying body as determined by the board.

14         (2)  The board shall certify, and the department shall

15  issue a certificate to, any nurse fulfilling the

16  qualifications in this section. The board shall establish an

17  application fee not to exceed $25 and a biennial renewal fee

18  not to exceed $10.

19         (3)  The board may adopt rules pursuant to ss.

20  120.536(1) and 120.54 necessary to administer this section.

21         Section 3.  Subsections (2) and (3) of section 464.012,

22  Florida Statutes, are amended to read:

23         464.012  Certification of advanced registered nurse

24  practitioners; fees.--

25         (2)  The board shall provide by rule the appropriate

26  requirements for advanced registered nurse practitioners in

27  the categories of certified registered nurse anesthetist,

28  certified nurse midwife, and nurse practitioner, and clinical

29  nurse specialist.

30         (3)  An advanced registered nurse practitioner shall

31  perform those functions authorized in this section within the

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    Florida Senate - 2005                                  SB 1116
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 1  framework of an established protocol.  A practitioner

 2  currently licensed under chapter 458, chapter 459, or chapter

 3  466 shall maintain supervision for directing the specific

 4  course of medical treatment.  Within the established

 5  framework, an advanced registered nurse practitioner may:

 6         (a)  Monitor and alter drug therapies.

 7         (b)  Initiate appropriate therapies for certain

 8  conditions.

 9         (c)  Perform additional functions as may be determined

10  by rule in accordance with s. 464.003(3)(d) s. 464.003(3)(c).

11         (d)  Order diagnostic tests and physical and

12  occupational therapy.

13         Section 4.  Section 464.0125, Florida Statutes, is

14  created to read:

15         464.0125  Registration of advanced registered nurse

16  practitioners to prescribe medicinal drugs.--

17         (1)  Any advanced registered nurse practitioner

18  certified pursuant to s. 464.012 must register with the board

19  in accordance with this section to prescribe medicinal drugs.

20         (2)  To register to prescribe medicinal drugs, an

21  advanced registered nurse practitioner must:

22         (a)  Possess an active and unrestricted license and be

23  certified as an advanced registered nurse practitioner.

24         (b)1.  Possess an active and current certification by

25  an appropriate specialty board; or

26         2.  Submit documentation to the board demonstrating

27  that the advanced registered nurse practitioner has been

28  prescribing medicinal drugs for a period of at least 12 months

29  before registering as a prescribing practitioner.

30         (c)1.  Submit documentation to the board demonstrating

31  that the advanced registered nurse practitioner has completed

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 1  at least 16 contact hours of approved continuing education in

 2  pharmacology during the past 2 years, in addition to the

 3  continuing education required for licensure renewal; or

 4         2.  Submit documentation to the board demonstrating

 5  that the advanced registered nurse practitioner has been

 6  prescribing medicinal drugs for a period of at least 12 months

 7  before registering as a prescribing practitioner.

 8         (d)  Submit a copy of the protocol between the advanced

 9  registered nurse practitioner and supervising physician which

10  complies with board rules, identifies the categories of

11  medicinal drugs that the advanced registered nurse

12  practitioner is authorized to prescribe, and requires as an

13  element of general supervision that the advanced registered

14  nurse practitioner confer with the supervising physician to

15  review and discuss patient care, prescribed treatments and

16  medications, and care outcomes. The board may by rule

17  establish minimum requirements for this conference. The

18  supervising physician or another physician designated by the

19  supervising physician must be available for consultation and

20  collaboration with the advanced registered nurse practitioner

21  at all times, by phone or other electronic means. The protocol

22  must include a quality assurance procedure. The board may by

23  rule establish minimum requirements for the quality assurance

24  procedure to be included in the protocol. The protocol must be

25  filed with the initial application for registration under this

26  section, with the application for renewal of license, and at

27  any time there is a change in the protocol or of any party to

28  the protocol. For purposes of this section, the supervising

29  physician must have a current and unrestricted license to

30  practice medicine pursuant to chapter 458 or osteopathic

31  medicine pursuant to chapter 459, a primary practice location

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 1  in this state, and a current and unrestricted federal Drug

 2  Enforcement Administration registration number.

 3         (e)  Agree to maintain adequate medical records

 4  pursuant to board rule which include evidence of a patient

 5  history and physical examination and, at a minimum, the

 6  following information about each prescription for a medicinal

 7  drug:

 8         1.  Drug name and strength.

 9         2.  Dose.

10         3.  Amount prescribed.

11         4.  Directions for use.

12         5.  Number of refills.

13         6.  The signature of the prescribing practitioner.

14         (f)  Submit a completed registration form and remit a

15  fee set by the board not to exceed $75.

16         (3)  To prescribe controlled substances, an advanced

17  registered nurse practitioner must:

18         (a)  Possess a valid midlevel practitioner registration

19  issued by the federal Drug Enforcement Administration.

20         (b)  Submit documentation to the board demonstrating

21  that the advanced registered nurse practitioner has completed

22  an approved course in legal and clinical aspects of

23  prescribing controlled substances of not less than 3 contact

24  hours.

25         (c)  Identify, as part of the protocol between the

26  advanced registered nurse practitioner and supervising

27  physician, the schedules of controlled substances that the

28  advanced registered nurse practitioner is authorized to

29  prescribe.

30         (d)  Complete at least 2 contact hours of approved

31  continuing education in the prescribing of controlled

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 1  substances during each 2-year licensure period, in addition to

 2  the continuing education required for licensure renewal. This

 3  continuing education may be part of the 16 hours of continuing

 4  education required pursuant to subsection (4).

 5         (4)  To register or renew registration to prescribe

 6  medicinal drugs, an advanced registered nurse practitioner

 7  must complete at least 16 contact hours of approved continuing

 8  education in pharmacology during each 2-year licensure period,

 9  in addition to the continuing education required for licensure

10  renewal.

11         (5)  The board shall provide by rule for biennial

12  renewal of registration and a renewal fee not to exceed $25.

13         (6)  Advanced registered nurse practitioners who are

14  certified as certified registered nurse anesthetists pursuant

15  to s. 464.012 are not required to register under this section

16  to provide anesthesia care in accordance with s. 464.012(4).

17         (7)  An advanced registered nurse practitioner who

18  registers to prescribe controlled substances may not prescribe

19  controlled substances for personal use or use by any member of

20  the advanced registered nurse practitioner's immediate family.

21         (8)  The board may limit, suspend, or revoke an

22  advanced registered nurse practitioner's registration to

23  prescribe under this section in accordance with the provisions

24  of s. 456.073.

25         (9)  The board may adopt rules pursuant to ss.

26  120.536(1) and 120.54 to administer this section.

27         Section 5.  Section 464.015, Florida Statutes, is

28  amended to read:

29         464.015  Titles and abbreviations; restrictions;

30  penalty.--

31  

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 1         (1)  Only persons who hold licenses to practice

 2  professional nursing in this state or who are performing

 3  nursing services pursuant to the exception set forth in s.

 4  464.022(8) shall have the right to use the title "Registered

 5  Nurse" and the abbreviation "R.N."

 6         (2)  Only persons who hold licenses to practice as

 7  licensed practical nurses in this state or who are performing

 8  practical nursing services pursuant to the exception set forth

 9  in s. 464.022(8) shall have the right to use the title

10  "Licensed Practical Nurse" and the abbreviation "L.P.N."

11         (3)  Only persons who are graduates of approved

12  programs or the equivalent may use the term "Graduate Nurse"

13  and the abbreviation "G.N.," pending the results of the first

14  licensure examination for which they are eligible.

15         (4)  Only persons who are graduates of approved

16  programs or the equivalent may use the term "Graduate

17  Practical Nurse" and the abbreviation "G.P.N.," pending the

18  results of the first licensure examination for which they are

19  eligible.

20         (5)  Only persons who hold valid certificates to

21  practice as clinical nurse specialists in this state may use

22  the title "Clinical Nurse Specialist" and the abbreviation

23  "C.N.S."

24         (6)  Only persons who hold valid certificates to

25  practice as certified registered nurse anesthetists in this

26  state may use the title "Certified Registered Nurse

27  Anesthetist" and the abbreviations "C.R.N.A." or

28  "anesthetist."

29         (7)  Only persons who hold valid certificates to

30  practice as certified nurse midwives in this state may use the

31  

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 1  title "Certified Nurse Midwife" and the abbreviations "C.N.S."

 2  or "nurse midwife."

 3         (8)(5)  Only persons who hold valid certificates to

 4  practice as advanced registered nurse practitioners in this

 5  state may shall have the right to use the title "Advanced

 6  Registered Nurse Practitioner" and the abbreviation "A.R.N.P."

 7         (9)(6)  A No person may not shall practice or advertise

 8  as, or assume the title of, registered nurse, licensed

 9  practical nurse, clinical nurse specialist, certified

10  registered nurse anesthetist, certified nurse midwife, or

11  advanced registered nurse practitioner or use the abbreviation

12  "R.N.," "L.P.N.," "C.N.S.," "C.R.N.A.," "C.N.M.," or

13  "A.R.N.P." or take any other action that would lead the public

14  to believe that person was certified as such or is performing

15  nursing services pursuant to the exception set forth in s.

16  464.022(8), unless that person is licensed or certified to

17  practice as such.

18         (10)(7)  A violation of this section is a misdemeanor

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

20  s. 775.083.

21         Section 6.  Section 464.016, Florida Statutes, is

22  amended to read:

23         464.016  Violations and penalties.--

24         (1)  Each of the following acts constitutes a felony of

25  the third degree, punishable as provided in s. 775.082, s.

26  775.083, or s. 775.084:

27         (a)  Practicing advanced or specialized, professional,

28  or practical nursing, as defined in this part, unless holding

29  an active license or certificate to do so.

30         (b)  Using or attempting to use a license or

31  certificate which has been suspended or revoked.

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 1         (c)  Knowingly employing unlicensed persons in the

 2  practice of nursing.

 3         (d)  Obtaining or attempting to obtain a license or

 4  certificate under this part by misleading statements or

 5  knowing misrepresentation.

 6         (2)  Each of the following acts constitutes a

 7  misdemeanor of the first degree, punishable as provided in s.

 8  775.082 or s. 775.083:

 9         (a)  Using the name or title "Nurse," "Registered

10  Nurse," "Licensed Practical Nurse," "Clinical Nurse

11  Specialist," "Certified Registered Nurse Anesthetist,"

12  "Certified Nurse Midwife," "Advanced Registered Nurse

13  Practitioner," or any other name or title which implies that a

14  person was licensed or certified as same, unless such person

15  is duly licensed or certified.

16         (b)  Knowingly concealing information relating to

17  violations of this part.

18         Section 7.  Subsection (19) of section 893.02, Florida

19  Statutes, is amended to read:

20         893.02  Definitions.--The following words and phrases

21  as used in this chapter shall have the following meanings,

22  unless the context otherwise requires:

23         (19)  "Practitioner" means a physician licensed

24  pursuant to chapter 458, a dentist licensed pursuant to

25  chapter 466, a veterinarian licensed pursuant to chapter 474,

26  an osteopathic physician licensed pursuant to chapter 459, a

27  naturopath licensed pursuant to chapter 462, or a podiatric

28  physician licensed pursuant to chapter 461, provided such

29  practitioner holds a valid federal controlled substance

30  registry number. The term includes an advanced registered

31  nurse practitioner certified pursuant to s. 464.012 who holds

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 1  a valid controlled substance registry number for midlevel

 2  practitioners and who is registered to prescribe controlled

 3  substances under s. 464.0125.

 4         Section 8.  For the purpose of incorporating the

 5  amendment to section 464.016, Florida Statutes, in a reference

 6  thereto, paragraph (g) of subsection (3) of section 921.0022,

 7  Florida Statutes, is reenacted to read:

 8         921.0022  Criminal Punishment Code; offense severity

 9  ranking chart.--

10         (3)  OFFENSE SEVERITY RANKING CHART

11  

12  Florida           Felony

13  Statute           Degree             Description

14  

15                     

16                              (g)  LEVEL 7

17  316.027(1)(b)      2nd      Accident involving death, failure

18                              to stop; leaving scene.

19  316.193(3)(c)2.    3rd      DUI resulting in serious bodily

20                              injury.

21  316.1935(3)(b)     1st      Causing serious bodily injury or

22                              death to another person; driving

23                              at high speed or with wanton

24                              disregard for safety while

25                              fleeing or attempting to elude

26                              law enforcement officer who is in

27                              a patrol vehicle with siren and

28                              lights activated.

29  327.35(3)(c)2.     3rd      Vessel BUI resulting in serious

30                              bodily injury.

31  

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 1  402.319(2)         2nd      Misrepresentation and negligence

 2                              or intentional act resulting in

 3                              great bodily harm, permanent

 4                              disfiguration, permanent

 5                              disability, or death.

 6  409.920(2)         3rd      Medicaid provider fraud.

 7  456.065(2)         3rd      Practicing a health care

 8                              profession without a license.

 9  456.065(2)         2nd      Practicing a health care

10                              profession without a license

11                              which results in serious bodily

12                              injury.

13  458.327(1)         3rd      Practicing medicine without a

14                              license.

15  459.013(1)         3rd      Practicing osteopathic medicine

16                              without a license.

17  460.411(1)         3rd      Practicing chiropractic medicine

18                              without a license.

19  461.012(1)         3rd      Practicing podiatric medicine

20                              without a license.

21  462.17             3rd      Practicing naturopathy without a

22                              license.

23  463.015(1)         3rd      Practicing optometry without a

24                              license.

25  464.016(1)         3rd      Practicing nursing without a

26                              license.

27  465.015(2)         3rd      Practicing pharmacy without a

28                              license.

29  466.026(1)         3rd      Practicing dentistry or dental

30                              hygiene without a license.

31  

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 1  467.201            3rd      Practicing midwifery without a

 2                              license.

 3  468.366            3rd      Delivering respiratory care

 4                              services without a license.

 5  483.828(1)         3rd      Practicing as clinical laboratory

 6                              personnel without a license.

 7  483.901(9)         3rd      Practicing medical physics

 8                              without a license.

 9  484.013(1)(c)      3rd      Preparing or dispensing optical

10                              devices without a prescription.

11  484.053            3rd      Dispensing hearing aids without a

12                              license.

13  494.0018(2)        1st      Conviction of any violation of

14                              ss. 494.001-494.0077 in which the

15                              total money and property

16                              unlawfully obtained exceeded

17                              $50,000 and there were five or

18                              more victims.

19  560.123(8)(b)1.    3rd      Failure to report currency or

20                              payment instruments exceeding

21                              $300 but less than $20,000 by

22                              money transmitter.

23  560.125(5)(a)      3rd      Money transmitter business by

24                              unauthorized person, currency or

25                              payment instruments exceeding

26                              $300 but less than $20,000.

27  655.50(10)(b)1.    3rd      Failure to report financial

28                              transactions exceeding $300 but

29                              less than $20,000 by financial

30                              institution.

31  

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 1  782.051(3)         2nd      Attempted felony murder of a

 2                              person by a person other than the

 3                              perpetrator or the perpetrator of

 4                              an attempted felony.

 5  782.07(1)          2nd      Killing of a human being by the

 6                              act, procurement, or culpable

 7                              negligence of another

 8                              (manslaughter).

 9  782.071            2nd      Killing of human being or viable

10                              fetus by the operation of a motor

11                              vehicle in a reckless manner

12                              (vehicular homicide).

13  782.072            2nd      Killing of a human being by the

14                              operation of a vessel in a

15                              reckless manner (vessel

16                              homicide).

17  784.045(1)(a)1.    2nd      Aggravated battery; intentionally

18                              causing great bodily harm or

19                              disfigurement.

20  784.045(1)(a)2.    2nd      Aggravated battery; using deadly

21                              weapon.

22  784.045(1)(b)      2nd      Aggravated battery; perpetrator

23                              aware victim pregnant.

24  784.048(4)         3rd      Aggravated stalking; violation of

25                              injunction or court order.

26  784.048(7)         3rd      Aggravated stalking; violation of

27                              court order.

28  784.07(2)(d)       1st      Aggravated battery on law

29                              enforcement officer.

30  784.074(1)(a)      1st      Aggravated battery on sexually

31                              violent predators facility staff.

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 1  784.08(2)(a)       1st      Aggravated battery on a person 65

 2                              years of age or older.

 3  784.081(1)         1st      Aggravated battery on specified

 4                              official or employee.

 5  784.082(1)         1st      Aggravated battery by detained

 6                              person on visitor or other

 7                              detainee.

 8  784.083(1)         1st      Aggravated battery on code

 9                              inspector.

10  790.07(4)          1st      Specified weapons violation

11                              subsequent to previous conviction

12                              of s. 790.07(1) or (2).

13  790.16(1)          1st      Discharge of a machine gun under

14                              specified circumstances.

15  790.165(2)         2nd      Manufacture, sell, possess, or

16                              deliver hoax bomb.

17  790.165(3)         2nd      Possessing, displaying, or

18                              threatening to use any hoax bomb

19                              while committing or attempting to

20                              commit a felony.

21  790.166(3)         2nd      Possessing, selling, using, or

22                              attempting to use a hoax weapon

23                              of mass destruction.

24  790.166(4)         2nd      Possessing, displaying, or

25                              threatening to use a hoax weapon

26                              of mass destruction while

27                              committing or attempting to

28                              commit a felony.

29  796.03             2nd      Procuring any person under 16

30                              years for prostitution.

31  

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 1  800.04(5)(c)1.     2nd      Lewd or lascivious molestation;

 2                              victim less than 12 years of age;

 3                              offender less than 18 years.

 4  800.04(5)(c)2.     2nd      Lewd or lascivious molestation;

 5                              victim 12 years of age or older

 6                              but less than 16 years; offender

 7                              18 years or older.

 8  806.01(2)          2nd      Maliciously damage structure by

 9                              fire or explosive.

10  810.02(3)(a)       2nd      Burglary of occupied dwelling;

11                              unarmed; no assault or battery.

12  810.02(3)(b)       2nd      Burglary of unoccupied dwelling;

13                              unarmed; no assault or battery.

14  810.02(3)(d)       2nd      Burglary of occupied conveyance;

15                              unarmed; no assault or battery.

16  812.014(2)(a)1.    1st      Property stolen, valued at

17                              $100,000 or more; property stolen

18                              while causing other property

19                              damage; 1st degree grand theft.

20  812.014(2)(b)2.    2nd      Property stolen, cargo valued at

21                              less than $50,000, grand theft in

22                              2nd degree.

23  812.014(2)(b)3.    2nd      Property stolen, emergency

24                              medical equipment; 2nd degree

25                              grand theft.

26  812.0145(2)(a)     1st      Theft from person 65 years of age

27                              or older; $50,000 or more.

28  812.019(2)         1st      Stolen property; initiates,

29                              organizes, plans, etc., the theft

30                              of property and traffics in

31                              stolen property.

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 1  812.131(2)(a)      2nd      Robbery by sudden snatching.

 2  812.133(2)(b)      1st      Carjacking; no firearm, deadly

 3                              weapon, or other weapon.

 4  817.234(8)(a)      2nd      Solicitation of motor vehicle

 5                              accident victims with intent to

 6                              defraud.

 7  817.234(9)         2nd      Organizing, planning, or

 8                              participating in an intentional

 9                              motor vehicle collision.

10  817.234(11)(c)     1st      Insurance fraud; property value

11                              $100,000 or more.

12  817.2341(2)(b)&

13   (3)(b)            1st      Making false entries of material

14                              fact or false statements

15                              regarding property values

16                              relating to the solvency of an

17                              insuring entity which are a

18                              significant cause of the

19                              insolvency of that entity.

20  825.102(3)(b)      2nd      Neglecting an elderly person or

21                              disabled adult causing great

22                              bodily harm, disability, or

23                              disfigurement.

24  825.103(2)(b)      2nd      Exploiting an elderly person or

25                              disabled adult and property is

26                              valued at $20,000 or more, but

27                              less than $100,000.

28  827.03(3)(b)       2nd      Neglect of a child causing great

29                              bodily harm, disability, or

30                              disfigurement.

31  

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 1  827.04(3)          3rd      Impregnation of a child under 16

 2                              years of age by person 21 years

 3                              of age or older.

 4  837.05(2)          3rd      Giving false information about

 5                              alleged capital felony to a law

 6                              enforcement officer.

 7  838.015            2nd      Bribery.

 8  838.016            2nd      Unlawful compensation or reward

 9                              for official behavior.

10  838.021(3)(a)      2nd      Unlawful harm to a public

11                              servant.

12  838.22             2nd      Bid tampering.

13  872.06             2nd      Abuse of a dead human body.

14  893.13(1)(c)1.     1st      Sell, manufacture, or deliver

15                              cocaine (or other drug prohibited

16                              under s. 893.03(1)(a), (1)(b),

17                              (1)(d), (2)(a), (2)(b), or

18                              (2)(c)4.) within 1,000 feet of a

19                              child care facility, school, or

20                              state, county, or municipal park

21                              or publicly owned recreational

22                              facility or community center.

23  893.13(1)(e)1.     1st      Sell, manufacture, or deliver

24                              cocaine or other drug prohibited

25                              under s. 893.03(1)(a), (1)(b),

26                              (1)(d), (2)(a), (2)(b), or

27                              (2)(c)4., within 1,000 feet of

28                              property used for religious

29                              services or a specified business

30                              site.

31  

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 1  893.13(4)(a)       1st      Deliver to minor cocaine (or

 2                              other s. 893.03(1)(a), (1)(b),

 3                              (1)(d), (2)(a), (2)(b), or

 4                              (2)(c)4. drugs).

 5  893.135(1)(a)1.    1st      Trafficking in cannabis, more

 6                              than 25 lbs., less than 2,000

 7                              lbs.

 8  893.135

 9   (1)(b)1.a.        1st      Trafficking in cocaine, more than

10                              28 grams, less than 200 grams.

11  893.135

12   (1)(c)1.a.        1st      Trafficking in illegal drugs,

13                              more than 4 grams, less than 14

14                              grams.

15  893.135

16   (1)(d)1.          1st      Trafficking in phencyclidine,

17                              more than 28 grams, less than 200

18                              grams.

19  893.135(1)(e)1.    1st      Trafficking in methaqualone, more

20                              than 200 grams, less than 5

21                              kilograms.

22  893.135(1)(f)1.    1st      Trafficking in amphetamine, more

23                              than 14 grams, less than 28

24                              grams.

25  893.135

26   (1)(g)1.a.        1st      Trafficking in flunitrazepam, 4

27                              grams or more, less than 14

28                              grams.

29  

30  

31  

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 1  893.135

 2   (1)(h)1.a.        1st      Trafficking in

 3                              gamma-hydroxybutyric acid (GHB),

 4                              1 kilogram or more, less than 5

 5                              kilograms.

 6  893.135

 7   (1)(j)1.a.        1st      Trafficking in 1,4-Butanediol, 1

 8                              kilogram or more, less than 5

 9                              kilograms.

10  893.135

11   (1)(k)2.a.        1st      Trafficking in Phenethylamines,

12                              10 grams or more, less than 200

13                              grams.

14  896.101(5)(a)      3rd      Money laundering, financial

15                              transactions exceeding $300 but

16                              less than $20,000.

17  896.104(4)(a)1.    3rd      Structuring transactions to evade

18                              reporting or registration

19                              requirements, financial

20                              transactions exceeding $300 but

21                              less than $20,000.

22         Section 9.  Paragraph (a) of subsection (1) and

23  subsection (2) of section 458.348, Florida Statutes, are

24  amended to read:

25         458.348  Formal supervisory relationships, standing

26  orders, and established protocols; notice; standards.--

27         (1)  NOTICE.--

28         (a)  When a physician enters into a formal supervisory

29  relationship or standing orders with an emergency medical

30  technician or paramedic licensed pursuant to s. 401.27, which

31  relationship or orders contemplate the performance of medical

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 1  acts, or when a physician enters into an established protocol

 2  with an advanced registered nurse practitioner, which protocol

 3  contemplates the performance of medical acts identified and

 4  approved by the joint committee pursuant to s. 464.003(3)(d)

 5  s. 464.003(3)(c) or acts set forth in s. 464.012(3) and (4),

 6  the physician shall submit notice to the board. The notice

 7  shall contain a statement in substantially the following form:

 8  

 9         I, ...(name and professional license number of

10  physician)..., of ...(address of physician)... have hereby

11  entered into a formal supervisory relationship, standing

12  orders, or an established protocol with ...(number of

13  persons)... emergency medical technician(s), ...(number of

14  persons)... paramedic(s), or ...(number of persons)...

15  advanced registered nurse practitioner(s).

16         (2)  ESTABLISHMENT OF STANDARDS BY JOINT

17  COMMITTEE.--The joint committee created under s. 464.003(3)(d)

18  by s. 464.003(3)(c) shall determine minimum standards for the

19  content of established protocols pursuant to which an advanced

20  registered nurse practitioner may perform medical acts

21  identified and approved by the joint committee pursuant to s.

22  464.003(3)(d) s. 464.003(3)(c) or acts set forth in s.

23  464.012(3) and (4) and shall determine minimum standards for

24  supervision of such acts by the physician, unless the joint

25  committee determines that any act set forth in s. 464.012(3)

26  or (4) is not a medical act.  Such standards shall be based on

27  risk to the patient and acceptable standards of medical care

28  and shall take into account the special problems of medically

29  underserved areas. The standards developed by the joint

30  committee shall be adopted as rules by the Board of Nursing

31  and the Board of Medicine for purposes of carrying out their

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 1  responsibilities pursuant to part I of chapter 464 and this

 2  chapter, respectively, but neither board shall have

 3  disciplinary powers over the licensees of the other board.

 4         Section 10.  This act shall take effect July 1, 2005.

 5  

 6            *****************************************

 7                          SENATE SUMMARY

 8    Defines the terms "clinical nurse specialist practice"
      and "clinical nurse specialist". Provides requirements
 9    for certification of clinical nurse specialists.
      Authorizes the Board of Nursing to adopt rules. Adds
10    clinical nurse specialist to the classifications of
      advanced registered nurse practitioners. Requires
11    advanced registered nurse practitioners to register with
      the Board of Nursing to prescribe medicinal drugs,
12    including controlled substances. Prohibits prescription
      of controlled substances for personal use or the use of
13    immediate family members. Restricts the use of
      professional titles and abbreviations relating to
14    clinical nurse specialist and certified registered nurse
      anesthetist practice. Prohibits a clinical nurse
15    specialist practice without an active license or
      certificate. Prohibits the use of any name or title
16    stating or implying that a person is a clinical nurse
      specialist or certified registered nurse anesthetist
17    unless the person is duly licensed or certified. Revises
      the definition of the term "practitioner" under the
18    Florida Comprehensive Drug Abuse Prevention and Control
      Act to include certain advanced registered nurse
19    practitioners.

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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