HB 1585

1	A bill to be entitled
2	An act relating to specialty nursing; amending s. 464.003,
3	F.S.; defining the terms "clinical nurse specialist
4	practice" and "clinical nurse specialist"; redefining the
5	term "advanced registered nurse practitioner" to include
6	certain anesthetists, midwives, practitioners, and
7	specialists; creating s. 464.0115, F.S.; providing
8	requirements for certification as a clinical nurse
9	specialist; providing fees; authorizing the Board of
10	Nursing to adopt rules; amending s. 464.012, F.S.; adding
11	clinical nurse specialist to the classifications of
12	advanced registered nurse practitioners; conforming a
13	cross reference; creating s. 464.0125, F.S.; requiring
14	advanced registered nurse practitioners to register with
15	the Board of Nursing to prescribe medicinal drugs,
16	including controlled substances; providing requirements
17	for registration and renewal of registration, including
18	continuing education; providing fees; prohibiting
19	prescription of controlled substances for personal use or
20	the use of immediate family members; providing for
21	disciplinary actions; authorizing the board to adopt
22	rules; amending s. 464.015, F.S.; restricting the use of
23	professional titles and abbreviations relating to clinical
24	nurse specialist, certified registered nurse anesthetist,
25	and certified nurse midwife; providing penalties; amending
26	s. 464.016, F.S.; prohibiting the use of any name or title
27	stating or implying that a person is a clinical nurse
28	specialist, certified registered nurse anesthetist, or
29	certified nurse midwife unless the person is licensed or
30	certified; providing penalties; amending s. 893.02, F.S.;
31	redefining the term "practitioner" under the Florida
32	Comprehensive Drug Abuse Prevention and Control Act to
33	include certain advanced registered nurse practitioners;
34	reenacting s. 921.0022(3)(g), F.S., relating to the
35	offense severity ranking chart of the Criminal Punishment
36	Code, to incorporate the amendment to s. 464.016, F.S., in
37	a reference thereto; amending s. 458.348, F.S.; conforming
38	cross references; providing an effective date.
39
40	Be It Enacted by the Legislature of the State of Florida:
41
42	Section 1.  Section 464.003, Florida Statutes, is amended
43	to read:
44	464.003  Definitions.--As used in this part, the term:
45	(1)  "Department" means the Department of Health.
46	(2)  "Board" means the Board of Nursing.
47	(3)(a)  "Practice of professional nursing" means the
48	performance of those acts requiring substantial specialized
49	knowledge, judgment, and nursing skill based upon applied
50	principles of psychological, biological, physical, and social
51	sciences which shall include, but not be limited to:
52	1.  The observation, assessment, nursing diagnosis,
53	planning, intervention, and evaluation of care; health teaching
54	and counseling of the ill, injured, or infirm; and the promotion
55	of wellness, maintenance of health, and prevention of illness of
56	others.
57	2.  The administration of medications and treatments as
58	prescribed or authorized by a duly licensed practitioner
59	authorized by the laws of this state to prescribe such
60	medications and treatments.
61	3.  The supervision and teaching of other personnel in the
62	theory and performance of any of the above acts.
63	(b)  "Practice of practical nursing" means the performance
64	of selected acts, including the administration of treatments and
65	medications, in the care of the ill, injured, or infirm and the
66	promotion of wellness, maintenance of health, and prevention of
67	illness of others under the direction of a registered nurse, a
68	licensed physician, a licensed osteopathic physician, a licensed
69	podiatric physician, or a licensed dentist.
70
71	The professional nurse and the practical nurse shall be
72	responsible and accountable for making decisions that are based
73	upon the individual's educational preparation and experience in
74	nursing.
75	(c)  "Clinical nurse specialist practice" means the
76	delivery and management of expert-level nursing care to
77	individuals or groups, including the ability to:
78	1.  Assess the health status of individuals and families
79	using methods appropriate to the population and area of
80	practice.
81	2.  Diagnose human responses to actual or potential health
82	problems.
83	3.  Plan for health promotion, disease prevention, and
84	therapeutic intervention in collaboration with the patient or
85	client.
86	4.  Implement therapeutic interventions based on the nurse
87	specialist's area of expertise, including, but not limited to,
88	direct nursing care, counseling, teaching, and collaboration
89	with other licensed health care providers.
90	5.  Coordinate health care as necessary and appropriate and
91	evaluate with the patient or client the effectiveness of care.
92	(d)(c)  "Advanced or specialized nursing practice" means,
93	in addition to the practice of professional nursing, the
94	performance of advanced-level nursing acts approved by the board
95	which, by virtue of postbasic specialized education, training,
96	and experience, are proper to be performed by an advanced
97	registered nurse practitioner.  Within the context of advanced
98	or specialized nursing practice, the advanced registered nurse
99	practitioner may perform acts of nursing diagnosis and nursing
100	treatment of alterations of the health status.  The advanced
101	registered nurse practitioner may also perform acts of medical
102	diagnosis and treatment, prescription, and operation which are
103	identified and approved by a joint committee composed of three
104	members appointed by the Board of Nursing, two of whom shall be
105	advanced registered nurse practitioners; three members appointed
106	by the Board of Medicine, two of whom shall have had work
107	experience with advanced registered nurse practitioners; and the
108	secretary of the department or the secretary's designee. Each
109	committee member appointed by a board shall be appointed to a
110	term of 4 years unless a shorter term is required to establish
111	or maintain staggered terms. The Board of Nursing shall adopt
112	rules authorizing the performance of any such acts approved by
113	the joint committee. Unless otherwise specified by the joint
114	committee, such acts shall be performed under the general
115	supervision of a practitioner licensed under chapter 458,
116	chapter 459, or chapter 466 within the framework of standing
117	protocols which identify the medical acts to be performed and
118	the conditions for their performance.  The department may, by
119	rule, require that a copy of the protocol be filed with the
120	department along with the notice required by s. 458.348.
121	(e)(d)  "Nursing diagnosis" means the observation and
122	evaluation of physical or mental conditions, behaviors, signs
123	and symptoms of illness, and reactions to treatment and the
124	determination as to whether such conditions, signs, symptoms,
125	and reactions represent a deviation from normal.
126	(f)(e)  "Nursing treatment" means the establishment and
127	implementation of a nursing regimen for the care and comfort of
128	individuals, the prevention of illness, and the education,
129	restoration, and maintenance of health.
130	(4)  "Registered nurse" means any person licensed in this
131	state to practice professional nursing.
132	(5)  "Licensed practical nurse" means any person licensed
133	in this state to practice practical nursing.
134	(6)  "Clinical nurse specialist" means any person licensed
135	in this state to practice professional nursing and certified in
136	clinical nurse specialist practice.
137	(7)(6)  "Advanced registered nurse practitioner" means any
138	person licensed in this state to practice professional nursing
139	and certified in advanced or specialized nursing practice,
140	including certified registered nurse anesthetists, certified
141	nurse midwives, nurse practitioners, and clinical nurse
142	specialists.
143	(8)(7)  "Approved program" means a nursing program
144	conducted in a school, college, or university which is approved
145	by the board pursuant to s. 464.019 for the education of nurses.
146	Section 2.  Section 464.0115, Florida Statutes, is created
147	to read:
148	464.0115  Certification of clinical nurse specialists.--
149	(1)  Any nurse desiring to be certified as a clinical nurse
150	specialist shall apply to the department and submit proof that
151	he or she holds a current license to practice professional
152	nursing, a master's degree in a clinical nursing specialty, and
153	current certification in a specialty area as a clinical nurse
154	specialist from a nationally recognized certifying body as
155	determined by the board.
156	(2)  The board shall certify, and the department shall
157	issue a certificate to, any nurse fulfilling the qualifications
158	in this section. The board shall establish an application fee
159	not to exceed $25 and a biennial renewal fee not to exceed $10.
160	(3)  The board may adopt rules pursuant to ss. 120.536(1)
161	and 120.54 necessary to administer this section.
162	Section 3.  Subsections (2) and (3) of section 464.012,
163	Florida Statutes, are amended to read:
164	464.012  Certification of advanced registered nurse
165	practitioners; fees.--
166	(2)  The board shall provide by rule the appropriate
167	requirements for advanced registered nurse practitioners in the
168	categories of certified registered nurse anesthetist, certified
169	nurse midwife, and nurse practitioner, and clinical nurse
170	specialist.
171	(3)  An advanced registered nurse practitioner shall
172	perform those functions authorized in this section within the
173	framework of an established protocol.  A practitioner currently
174	licensed under chapter 458, chapter 459, or chapter 466 shall
175	maintain supervision for directing the specific course of
176	medical treatment. Within the established framework, an advanced
177	registered nurse practitioner may:
178	(a)  Monitor and alter drug therapies.
179	(b)  Initiate appropriate therapies for certain conditions.
180	(c)  Perform additional functions as may be determined by
181	rule in accordance with s. 464.003(3)(d) s. 464.003(3)(c).
182	(d)  Order diagnostic tests and physical and occupational
183	therapy.
184	Section 4.  Section 464.0125, Florida Statutes, is created
185	to read:
186	464.0125  Registration of advanced registered nurse
187	practitioners to prescribe medicinal drugs.--
188	(1)  Any advanced registered nurse practitioner certified
189	pursuant to s. 464.012 must register with the board in
190	accordance with this section to prescribe medicinal drugs.
191	(2)  To register to prescribe medicinal drugs, an advanced
192	registered nurse practitioner must:
193	(a)  Possess an active and unrestricted license and be
194	certified as an advanced registered nurse practitioner.
195	(b)1.  Possess an active and current certification by an
196	appropriate specialty board; or
197	2.  Submit documentation to the board demonstrating that
198	the advanced registered nurse practitioner has been prescribing
199	medicinal drugs for a period of at least 12 months before
200	registering as a prescribing practitioner.
201	(c)1.  Submit documentation to the board demonstrating that
202	the advanced registered nurse practitioner has completed at
203	least 16 contact hours of approved continuing education in
204	pharmacology during the past 2 years, in addition to the
205	continuing education required for licensure renewal; or
206	2.  Submit documentation to the board demonstrating that
207	the advanced registered nurse practitioner has been prescribing
208	medicinal drugs for a period of at least 12 months before
209	registering as a prescribing practitioner.
210	(d)  Submit a copy of the protocol between the advanced
211	registered nurse practitioner and supervising physician which
212	complies with board rules, identifies the categories of
213	medicinal drugs that the advanced registered nurse practitioner
214	is authorized to prescribe, and requires as an element of
215	general supervision that the advanced registered nurse
216	practitioner confer with the supervising physician to review and
217	discuss patient care, prescribed treatments and medications, and
218	care outcomes. The board may by rule establish minimum
219	requirements for this conference. The supervising physician or
220	another physician designated by the supervising physician must
221	be available for consultation and collaboration with the
222	advanced registered nurse practitioner at all times, by phone or
223	other electronic means. The protocol must include a quality
224	assurance procedure. The board may by rule establish minimum
225	requirements for the quality assurance procedure to be included
226	in the protocol. The protocol must be filed with the initial
227	application for registration under this section, with the
228	application for renewal of license, and at any time there is a
229	change in the protocol or of any party to the protocol. For
230	purposes of this section, the supervising physician must have a
231	current and unrestricted license to practice medicine pursuant
232	to chapter 458 or osteopathic medicine pursuant to chapter 459,
233	a primary practice location in this state, and a current and
234	unrestricted federal Drug Enforcement Administration
235	registration number.
236	(e)  Agree to maintain adequate medical records pursuant to
237	board rule which include evidence of a patient history and
238	physical examination and, at a minimum, the following
239	information about each prescription for a medicinal drug:
240	1.  Drug name and strength.
241	2.  Dose.
242	3.  Amount prescribed.
243	4.  Directions for use.
244	5.  Number of refills.
245	6.  The signature of the prescribing practitioner.
246	(f)  Submit a completed registration form and remit a fee
247	set by the board not to exceed $75.
248	(3)  To prescribe controlled substances, an advanced
249	registered nurse practitioner must:
250	(a)  Possess a valid midlevel practitioner registration
251	issued by the federal Drug Enforcement Administration.
252	(b)  Submit documentation to the board demonstrating that
253	the advanced registered nurse practitioner has completed an
254	approved course in legal and clinical aspects of prescribing
255	controlled substances of not less than 3 contact hours.
256	(c)  Identify, as part of the protocol between the advanced
257	registered nurse practitioner and supervising physician, the
258	schedules of controlled substances that the advanced registered
259	nurse practitioner is authorized to prescribe.
260	(d)  Complete at least 2 contact hours of approved
261	continuing education in the prescribing of controlled substances
262	during each 2-year licensure period, in addition to the
263	continuing education required for licensure renewal. This
264	continuing education may be part of the 16 hours of continuing
265	education required pursuant to subsection (4).
266	(4)  To register or renew registration to prescribe
267	medicinal drugs, an advanced registered nurse practitioner must
268	complete at least 16 contact hours of approved continuing
269	education in pharmacology during each 2-year licensure period,
270	in addition to the continuing education required for licensure
271	renewal.
272	(5)  The board shall provide by rule for biennial renewal
273	of registration and a renewal fee not to exceed $25.
274	(6)  Advanced registered nurse practitioners who are
275	certified as certified registered nurse anesthetists pursuant to
276	s. 464.012 are not required to register under this section to
277	provide anesthesia care in accordance with s. 464.012(4).
278	(7)  An advanced registered nurse practitioner who
279	registers to prescribe controlled substances may not prescribe
280	controlled substances for personal use or use by any member of
281	the advanced registered nurse practitioner's immediate family.
282	(8)  The board may limit, suspend, or revoke an advanced
283	registered nurse practitioner's registration to prescribe under
284	this section in accordance with the provisions of s. 456.073.
285	(9)  The board may adopt rules pursuant to ss. 120.536(1)
286	and 120.54 to administer this section.
287	Section 5.  Section 464.015, Florida Statutes, is amended
288	to read:
289	464.015  Titles and abbreviations; restrictions; penalty.--
290	(1)  Only persons who hold licenses to practice
291	professional nursing in this state or who are performing nursing
292	services pursuant to the exception set forth in s. 464.022(8)
293	may shall have the right to use the title "Registered Nurse" and
294	the abbreviation "R.N."
295	(2)  Only persons who hold licenses to practice as licensed
296	practical nurses in this state or who are performing practical
297	nursing services pursuant to the exception set forth in s.
298	464.022(8) may shall have the right to use the title "Licensed
299	Practical Nurse" and the abbreviation "L.P.N."
300	(3)  Only persons who are graduates of approved programs or
301	the equivalent may use the term "Graduate Nurse" and the
302	abbreviation "G.N.," pending the results of the first licensure
303	examination for which they are eligible.
304	(4)  Only persons who are graduates of approved programs or
305	the equivalent may use the term "Graduate Practical Nurse" and
306	the abbreviation "G.P.N.," pending the results of the first
307	licensure examination for which they are eligible.
308	(5)  Only persons who hold valid certificates to practice
309	as clinical nurse specialists in this state may use the title
310	"Clinical Nurse Specialist" and the abbreviation "C.N.S."
311	(6)  Only persons who hold valid certificates to practice
312	as certified registered nurse anesthetists in this state may use
313	the title "Certified Registered Nurse Anesthetist" and the
314	abbreviations "C.R.N.A." or "anesthetist."
315	(7)  Only persons who hold valid certificates to practice
316	as certified nurse midwives in this state may use the title
317	"Certified Nurse Midwife" and the abbreviations "C.N.S." or
318	"nurse midwife."
319	(8)(5)  Only persons who hold valid certificates to
320	practice as advanced registered nurse practitioners in this
321	state may shall have the right to use the title "Advanced
322	Registered Nurse Practitioner" and the abbreviation "A.R.N.P."
323	(9)(6)  A No person may not shall practice or advertise as,
324	or assume the title of, registered nurse, licensed practical
325	nurse, clinical nurse specialist, certified registered nurse
326	anesthetist, certified nurse midwife, or advanced registered
327	nurse practitioner or use the abbreviation "R.N.," "L.P.N.,"
328	"C.N.S.," "C.R.N.A.," "C.N.M.," or "A.R.N.P." or take any other
329	action that would lead the public to believe that person was
330	certified as such or is performing nursing services pursuant to
331	the exception set forth in s. 464.022(8), unless that person is
332	licensed or certified to practice as such.
333	(10)(7)  A violation of this section is a misdemeanor of
334	the first degree, punishable as provided in s. 775.082 or s.
335	775.083.
336	Section 6.  Section 464.016, Florida Statutes, is amended
337	to read:
338	464.016  Violations and penalties.--
339	(1)  Each of the following acts constitutes a felony of the
340	third degree, punishable as provided in s. 775.082, s. 775.083,
341	or s. 775.084:
342	(a)  Practicing advanced or specialized, professional, or
343	practical nursing, as defined in this part, unless holding an
344	active license or certificate to do so.
345	(b)  Using or attempting to use a license or certificate
346	which has been suspended or revoked.
347	(c)  Knowingly employing unlicensed persons in the practice
348	of nursing.
349	(d)  Obtaining or attempting to obtain a license or
350	certificate under this part by misleading statements or knowing
351	misrepresentation.
352	(2)  Each of the following acts constitutes a misdemeanor
353	of the first degree, punishable as provided in s. 775.082 or s.
354	775.083:
355	(a)  Using the name or title "Nurse," "Registered Nurse,"
356	"Licensed Practical Nurse," "Clinical Nurse Specialist,"
357	"Certified Registered Nurse Anesthetist," "Certified Nurse
358	Midwife," "Advanced Registered Nurse Practitioner," or any other
359	name or title which implies that a person was licensed or
360	certified as same, unless such person is duly licensed or
361	certified.
362	(b)  Knowingly concealing information relating to
363	violations of this part.
364	Section 7.  Subsection (19) of section 893.02, Florida
365	Statutes, is amended to read:
366	893.02  Definitions.--The following words and phrases as
367	used in this chapter shall have the following meanings, unless
368	the context otherwise requires:
369	(19)  "Practitioner" means a physician licensed pursuant to
370	chapter 458, a dentist licensed pursuant to chapter 466, a
371	veterinarian licensed pursuant to chapter 474, an osteopathic
372	physician licensed pursuant to chapter 459, a naturopath
373	licensed pursuant to chapter 462, or a podiatric physician
374	licensed pursuant to chapter 461, provided such practitioner
375	holds a valid federal controlled substance registry number. The
376	term includes an advanced registered nurse practitioner
377	certified pursuant to s. 464.012 who holds a valid controlled
378	substance registry number for midlevel practitioners and who is
379	registered to prescribe controlled substances under s. 464.0125.
380	Section 8.  For the purpose of incorporating the amendment
381	to section 464.016, Florida Statutes, in a reference thereto,
382	paragraph (g) of subsection (3) of section 921.0022, Florida
383	Statutes, is reenacted to read:
384	921.0022  Criminal Punishment Code; offense severity
385	ranking chart.--
386	(3)  OFFENSE SEVERITY RANKING CHART
	Florida Felony
387
	Statute Degree Description
388
	(g)  LEVEL 7
389
	316.027(1)(b) 2nd Accident involving death, failure to stop; leaving scene.
390
	316.193(3)(c)2. 3rd DUI resulting in serious bodily injury.
391
	316.1935(3)(b) 1st Causing serious bodily injury or death to another person; driving at high speed or with wanton disregard for safety while fleeing or attempting to elude law enforcement officer who is in a patrol vehicle with siren and lights activated.
392
	327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury.
393
	402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
394
	409.920(2) 3rd Medicaid provider fraud.
395
	456.065(2) 3rd Practicing a health care profession without a license.
396
	456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury.
397
	458.327(1) 3rd Practicing medicine without a license.
398
	459.013(1) 3rd Practicing osteopathic medicine without a license.
399
	460.411(1) 3rd Practicing chiropractic medicine without a license.
400
	461.012(1) 3rd Practicing podiatric medicine without a license.
401
	462.17 3rd Practicing naturopathy without a license.
402
	463.015(1) 3rd Practicing optometry without a license.
403
	464.016(1) 3rd Practicing nursing without a license.
404
	465.015(2) 3rd Practicing pharmacy without a license.
405
	466.026(1) 3rd Practicing dentistry or dental hygiene without a license.
406
	467.201 3rd Practicing midwifery without a license.
407
	468.366 3rd Delivering respiratory care services without a license.
408
	483.828(1) 3rd Practicing as clinical laboratory personnel without a license.
409
	483.901(9) 3rd Practicing medical physics without a license.
410
	484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription.
411
	484.053 3rd Dispensing hearing aids without a license.
412
	494.0018(2) 1st Conviction of any violation of ss. 494.001-494.0077 in which the total money and property unlawfully obtained exceeded $50,000 and there were five or more victims.
413
	560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by money transmitter.
414
	560.125(5)(a) 3rd Money transmitter business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
415
	655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
416
	782.051(3) 2nd Attempted felony murder of a person by a person other than the perpetrator or the perpetrator of an attempted felony.
417
	782.07(1) 2nd Killing of a human being by the act, procurement, or culpable negligence of another (manslaughter).
418
	782.071 2nd Killing of human being or viable fetus by the operation of a motor vehicle in a reckless manner (vehicular homicide).
419
	782.072 2nd Killing of a human being by the operation of a vessel in a reckless manner (vessel homicide).
420
	784.045(1)(a)1. 2nd Aggravated battery; intentionally causing great bodily harm or disfigurement.
421
	784.045(1)(a)2. 2nd Aggravated battery; using deadly weapon.
422
	784.045(1)(b) 2nd Aggravated battery; perpetrator aware victim pregnant.
423
	784.048(4) 3rd Aggravated stalking; violation of injunction or court order.
424
	784.048(7) 3rd Aggravated stalking; violation of court order.
425
	784.07(2)(d) 1st Aggravated battery on law enforcement officer.
426
	784.074(1)(a) 1st Aggravated battery on sexually violent predators facility staff.
427
	784.08(2)(a) 1st Aggravated battery on a person 65 years of age or older.
428
	784.081(1) 1st Aggravated battery on specified official or employee.
429
	784.082(1) 1st Aggravated battery by detained person on visitor or other detainee.
430
	784.083(1) 1st Aggravated battery on code inspector.
431
	790.07(4) 1st Specified weapons violation subsequent to previous conviction of s. 790.07(1) or (2).
432
	790.16(1) 1st Discharge of a machine gun under specified circumstances.
433
	790.165(2) 2nd Manufacture, sell, possess, or deliver hoax bomb.
434
	790.165(3) 2nd Possessing, displaying, or threatening to use any hoax bomb while committing or attempting to commit a felony.
435
	790.166(3) 2nd Possessing, selling, using, or attempting to use a hoax weapon of mass destruction.
436
	790.166(4) 2nd Possessing, displaying, or threatening to use a hoax weapon of mass destruction while committing or attempting to commit a felony.
437
	796.03 2nd Procuring any person under 16 years for prostitution.
438
	800.04(5)(c)1. 2nd Lewd or lascivious molestation; victim less than 12 years of age; offender less than 18 years.
439
	800.04(5)(c)2. 2nd Lewd or lascivious molestation; victim 12 years of age or older but less than 16 years; offender 18 years or older.
440
	806.01(2) 2nd Maliciously damage structure by fire or explosive.
441
	810.02(3)(a) 2nd Burglary of occupied dwelling; unarmed; no assault or battery.
442
	810.02(3)(b) 2nd Burglary of unoccupied dwelling; unarmed; no assault or battery.
443
	810.02(3)(d) 2nd Burglary of occupied conveyance; unarmed; no assault or battery.
444
	812.014(2)(a)1. 1st Property stolen, valued at $100,000 or more; property stolen while causing other property damage; 1st degree grand theft.
445
	812.014(2)(b)2. 2nd Property stolen, cargo valued at less than $50,000, grand theft in 2nd degree.
446
	812.014(2)(b)3. 2nd Property stolen, emergency medical equipment; 2nd degree grand theft.
447
	812.0145(2)(a) 1st Theft from person 65 years of age or older; $50,000 or more.
448
	812.019(2) 1st Stolen property; initiates, organizes, plans, etc., the theft of property and traffics in stolen property.
449
	812.131(2)(a) 2nd Robbery by sudden snatching.
450
	812.133(2)(b) 1st Carjacking; no firearm, deadly weapon, or other weapon.
451
	817.234(8)(a) 2nd Solicitation of motor vehicle accident victims with intent to defraud.
452
	817.234(9) 2nd Organizing, planning, or participating in an intentional motor vehicle collision.
453
	817.234(11)(c) 1st Insurance fraud; property value $100,000 or more.
454
	817.2341(2)(b)&(3)(b) 1st Making false entries of material fact or false statements regarding property values relating to the solvency of an insuring entity which are a significant cause of the insolvency of that entity.
455
	825.102(3)(b) 2nd Neglecting an elderly person or disabled adult causing great bodily harm, disability, or disfigurement.
456
	825.103(2)(b) 2nd Exploiting an elderly person or disabled adult and property is valued at $20,000 or more, but less than $100,000.
457
	827.03(3)(b) 2nd Neglect of a child causing great bodily harm, disability, or disfigurement.
458
	827.04(3) 3rd Impregnation of a child under 16 years of age by person 21 years of age or older.
459
	837.05(2) 3rd Giving false information about alleged capital felony to a law enforcement officer.
460
	838.015 2nd Bribery.
461
	838.016 2nd Unlawful compensation or reward for official behavior.
462
	838.021(3)(a) 2nd Unlawful harm to a public servant.
463
	838.22 2nd Bid tampering.
464
	872.06 2nd Abuse of a dead human body.
465
	893.13(1)(c)1. 1st Sell, manufacture, or deliver cocaine (or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.) within 1,000 feet of a child care facility, school, or state, county, or municipal park or publicly owned recreational facility or community center.
466
	893.13(1)(e)1. 1st Sell, manufacture, or deliver cocaine or other drug prohibited under s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4., within 1,000 feet of property used for religious services or a specified business site.
467
	893.13(4)(a) 1st Deliver to minor cocaine (or other s. 893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4. drugs).
468
	893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
469
	893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams.
470
	893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
471
	893.135(1)(d)1. 1st Trafficking in phencyclidine, more than 28 grams, less than 200 grams.
472
	893.135(1)(e)1. 1st Trafficking in methaqualone, more than 200 grams, less than 5 kilograms.
473
	893.135(1)(f)1. 1st Trafficking in amphetamine, more than 14 grams, less than 28 grams.
474
	893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
475
	893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
476
	893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
477
	893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
478
	896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000.
479
	896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
480
481	Section 9.  Paragraph (a) of subsection (1) and subsection
482	(2) of section 458.348, Florida Statutes, are amended to read:
483	458.348  Formal supervisory relationships, standing orders,
484	and established protocols; notice; standards.--
485	(1)  NOTICE.--
486	(a)  When a physician enters into a formal supervisory
487	relationship or standing orders with an emergency medical
488	technician or paramedic licensed pursuant to s. 401.27, which
489	relationship or orders contemplate the performance of medical
490	acts, or when a physician enters into an established protocol
491	with an advanced registered nurse practitioner, which protocol
492	contemplates the performance of medical acts identified and
493	approved by the joint committee pursuant to s. 464.003(3)(d) s.
494	464.003(3)(c) or acts set forth in s. 464.012(3) and (4), the
495	physician shall submit notice to the board. The notice shall
496	contain a statement in substantially the following form:
497
498	I, ...(name and professional license number of
499	physician)..., of ...(address of physician)... have hereby
500	entered into a formal supervisory relationship, standing orders,
501	or an established protocol with ...(number of persons)...
502	emergency medical technician(s), ...(number of persons)...
503	paramedic(s), or ...(number of persons)... advanced registered
504	nurse practitioner(s).
505
506	(2)  ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.--The
507	joint committee created under s. 464.003(3)(d) by s.
508	464.003(3)(c) shall determine minimum standards for the content
509	of established protocols pursuant to which an advanced
510	registered nurse practitioner may perform medical acts
511	identified and approved by the joint committee pursuant to s.
512	464.003(3)(d) s. 464.003(3)(c) or acts set forth in s.
513	464.012(3) and (4) and shall determine minimum standards for
514	supervision of such acts by the physician, unless the joint
515	committee determines that any act set forth in s. 464.012(3) or
516	(4) is not a medical act.  Such standards shall be based on risk
517	to the patient and acceptable standards of medical care and
518	shall take into account the special problems of medically
519	underserved areas. The standards developed by the joint
520	committee shall be adopted as rules by the Board of Nursing and
521	the Board of Medicine for purposes of carrying out their
522	responsibilities pursuant to part I of chapter 464 and this
523	chapter, respectively, but neither board shall have disciplinary
524	powers over the licensees of the other board.
525	Section 10.  This act shall take effect July 1, 2005.

CODING: Words stricken are deletions; words underlined are additions.