HB 1093

1
A bill to be entitled
2An act relating to physicians; creating s. 381.0304, F.S.;
3requiring the Division of Health Access and Tobacco within
4the Department of Health to monitor, evaluate, and report
5on the supply and distribution of physicians and
6osteopathic physicians in the state; amending ss. 458.311
7and 458.313, F.S.; requiring applicants for physician
8licensure to submit core credentials to the Federation of
9State Medical Boards for verification; reenacting s.
10458.347(7)(b), F.S., relating to physician assistants, in
11order to incorporate the amendment to s. 458.311, F.S., in
12a reference thereto; amending ss. 458.316, 458.3165, and
13458.317, F.S.; conforming cross-references; providing an
14appropriation; providing an effective date.
15
16Be It Enacted by the Legislature of the State of Florida:
17
18     Section 1.  Section 381.0304, Florida Statutes, is created
19to read:
20     381.0304  Supply and distribution of physicians;
21reports.--The Division of Health Access and Tobacco of the
22department shall monitor, evaluate, and report on the supply and
23distribution of physicians and osteopathic physicians in this
24state. The division shall develop a strategy to track and
25analyze, on an ongoing basis, the distribution of state-licensed
26physicians by specialty and geographic location using data that
27are available from public and private sources. The division
28shall submit a report to the Governor, the President of the
29Senate, and the Speaker of the House of Representatives by
30January 1, 2008, and annually thereafter.
31     Section 2.  Subsection (1) of section 458.311, Florida
32Statutes, is amended to read:
33     458.311  Licensure by examination; requirements; fees.--
34     (1)  Any person desiring to be licensed as a physician, who
35does not hold a valid license in any state, shall apply to the
36department on forms furnished by the department. The department
37shall license each applicant who the board certifies:
38     (a)  Has completed the application form and remitted a
39nonrefundable application fee not to exceed $500.
40     (b)  Is at least 21 years of age.
41     (c)  Is of good moral character.
42     (d)  Has not committed any act or offense in this or any
43other jurisdiction which would constitute the basis for
44disciplining a physician pursuant to s. 458.331.
45     (e)  For any applicant who has graduated from medical
46school after October 1, 1992, has completed the equivalent of 2
47academic years of preprofessional, postsecondary education, as
48determined by rule of the board, which shall include, at a
49minimum, courses in such fields as anatomy, biology, and
50chemistry prior to entering medical school.
51     (f)  Meets one of the following medical education and
52postgraduate training requirements:
53     1.a.  Is a graduate of an allopathic medical school or
54allopathic college recognized and approved by an accrediting
55agency recognized by the United States Office of Education or is
56a graduate of an allopathic medical school or allopathic college
57within a territorial jurisdiction of the United States
58recognized by the accrediting agency of the governmental body of
59that jurisdiction;
60     b.  If the language of instruction of the medical school is
61other than English, has demonstrated competency in English
62through presentation of a satisfactory grade on the Test of
63Spoken English of the Educational Testing Service or a similar
64test approved by rule of the board; and
65     c.  Has completed an approved residency of at least 1 year.
66     2.a.  Is a graduate of an allopathic foreign medical school
67registered with the World Health Organization and certified
68pursuant to s. 458.314 as having met the standards required to
69accredit medical schools in the United States or reasonably
70comparable standards;
71     b.  If the language of instruction of the foreign medical
72school is other than English, has demonstrated competency in
73English through presentation of the Educational Commission for
74Foreign Medical Graduates English proficiency certificate or by
75a satisfactory grade on the Test of Spoken English of the
76Educational Testing Service or a similar test approved by rule
77of the board; and
78     c.  Has completed an approved residency of at least 1 year.
79     3.a.  Is a graduate of an allopathic foreign medical school
80which has not been certified pursuant to s. 458.314;
81     b.  Has had his or her medical credentials evaluated by the
82Educational Commission for Foreign Medical Graduates, holds an
83active, valid certificate issued by that commission, and has
84passed the examination utilized by that commission; and
85     c.  Has completed an approved residency of at least 1 year;
86however, after October 1, 1992, the applicant shall have
87completed an approved residency or fellowship of at least 2
88years in one specialty area. However, to be acceptable, the
89fellowship experience and training must be counted toward
90regular or subspecialty certification by a board recognized and
91certified by the American Board of Medical Specialties.
92     (g)  Has submitted core credentials to the Federation
93Credentials Verification Services of the Federation of State
94Medical Boards for verification.
95     (h)(g)  Has submitted to the department a set of
96fingerprints on a form and under procedures specified by the
97department, along with a payment in an amount equal to the costs
98incurred by the Department of Health for the criminal background
99check of the applicant.
100     (i)(h)  Has obtained a passing score, as established by
101rule of the board, on the licensure examination of the United
102States Medical Licensing Examination (USMLE); or a combination
103of the United States Medical Licensing Examination (USMLE), the
104examination of the Federation of State Medical Boards of the
105United States, Inc. (FLEX), or the examination of the National
106Board of Medical Examiners up to the year 2000; or for the
107purpose of examination of any applicant who was licensed on the
108basis of a state board examination and who is currently licensed
109in at least one other jurisdiction of the United States or
110Canada, and who has practiced pursuant to such licensure for a
111period of at least 10 years, use of the Special Purpose
112Examination of the Federation of State Medical Boards of the
113United States (SPEX) upon receipt of a passing score as
114established by rule of the board. However, for the purpose of
115examination of any applicant who was licensed on the basis of a
116state board examination prior to 1974, who is currently licensed
117in at least three other jurisdictions of the United States or
118Canada, and who has practiced pursuant to such licensure for a
119period of at least 20 years, this paragraph does not apply.
120     Section 3.  Paragraph (a) of subsection (1) of section
121458.313, Florida Statutes, is amended to read:
122     458.313  Licensure by endorsement; requirements; fees.--
123     (1)  The department shall issue a license by endorsement to
124any applicant who, upon applying to the department on forms
125furnished by the department and remitting a fee set by the board
126not to exceed $500, the board certifies:
127     (a)  Has met the qualifications for licensure in s.
128458.311(1)(b)-(h) s. 458.311(1)(b)-(g) or in s. 458.311(1)(b)-
129(e) and (h) (g) and (3);
130     Section 4.  For the purpose of incorporating the amendment
131made by this act to section 458.311, Florida Statutes, in a
132reference thereto, and not for the purpose of superseding the
133provisions of section 456.017(1)(c), Florida Statutes, paragraph
134(b) of subsection (7) of section 458.347, Florida Statutes, is
135reenacted to read:
136     458.347  Physician assistants.--
137     (7)  PHYSICIAN ASSISTANT LICENSURE.--
138     (b)1.  Notwithstanding subparagraph (a)2. and
139sub-subparagraph (a)3.a., the department shall examine each
140applicant who the Board of Medicine certifies:
141     a.  Has completed the application form and remitted a
142nonrefundable application fee not to exceed $500 and an
143examination fee not to exceed $300, plus the actual cost to the
144department to provide the examination. The examination fee is
145refundable if the applicant is found to be ineligible to take
146the examination. The department shall not require the applicant
147to pass a separate practical component of the examination. For
148examinations given after July 1, 1998, competencies measured
149through practical examinations shall be incorporated into the
150written examination through a multiple-choice format. The
151department shall translate the examination into the native
152language of any applicant who requests and agrees to pay all
153costs of such translation, provided that the translation request
154is filed with the board office no later than 9 months before the
155scheduled examination and the applicant remits translation fees
156as specified by the department no later than 6 months before the
157scheduled examination, and provided that the applicant
158demonstrates to the department the ability to communicate orally
159in basic English. If the applicant is unable to pay translation
160costs, the applicant may take the next available examination in
161English if the applicant submits a request in writing by the
162application deadline and if the applicant is otherwise eligible
163under this section. To demonstrate the ability to communicate
164orally in basic English, a passing score or grade is required,
165as determined by the department or organization that developed
166it, on the test for spoken English (TSE) by the Educational
167Testing Service (ETS), the test of English as a foreign language
168(TOEFL) by ETS, a high school or college level English course,
169or the English examination for citizenship, Bureau of
170Citizenship and Immigration Services. A notarized copy of an
171Educational Commission for Foreign Medical Graduates (ECFMG)
172certificate may also be used to demonstrate the ability to
173communicate in basic English; and
174     b.(I)  Is an unlicensed physician who graduated from a
175foreign medical school listed with the World Health Organization
176who has not previously taken and failed the examination of the
177National Commission on Certification of Physician Assistants and
178who has been certified by the Board of Medicine as having met
179the requirements for licensure as a medical doctor by
180examination as set forth in s. 458.311(1), (3), (4), and (5),
181with the exception that the applicant is not required to have
182completed an approved residency of at least 1 year and the
183applicant is not required to have passed the licensing
184examination specified under s. 458.311 or hold a valid, active
185certificate issued by the Educational Commission for Foreign
186Medical Graduates; was eligible and made initial application for
187certification as a physician assistant in this state between
188July 1, 1990, and June 30, 1991; and was a resident of this
189state on July 1, 1990, or was licensed or certified in any state
190in the United States as a physician assistant on July 1, 1990;
191or
192     (II)  Completed all coursework requirements of the Master
193of Medical Science Physician Assistant Program offered through
194the Florida College of Physician's Assistants prior to its
195closure in August of 1996. Prior to taking the examination, such
196applicant must successfully complete any clinical rotations that
197were not completed under such program prior to its termination
198and any additional clinical rotations with an appropriate
199physician assistant preceptor, not to exceed 6 months, that are
200determined necessary by the council. The boards shall determine,
201based on recommendations from the council, the facilities under
202which such incomplete or additional clinical rotations may be
203completed and shall also determine what constitutes successful
204completion thereof, provided such requirements are comparable to
205those established by accredited physician assistant programs.
206This sub-sub-subparagraph is repealed July 1, 2001.
207     2.  The department may grant temporary licensure to an
208applicant who meets the requirements of subparagraph 1. Between
209meetings of the council, the department may grant temporary
210licensure to practice based on the completion of all temporary
211licensure requirements. All such administratively issued
212licenses shall be reviewed and acted on at the next regular
213meeting of the council. A temporary license expires 30 days
214after receipt and notice of scores to the licenseholder from the
215first available examination specified in subparagraph 1.
216following licensure by the department. An applicant who fails
217the proficiency examination is no longer temporarily licensed,
218but may apply for a one-time extension of temporary licensure
219after reapplying for the next available examination. Extended
220licensure shall expire upon failure of the licenseholder to sit
221for the next available examination or upon receipt and notice of
222scores to the licenseholder from such examination.
223     3.  Notwithstanding any other provision of law, the
224examination specified pursuant to subparagraph 1. shall be
225administered by the department only five times. Applicants
226certified by the board for examination shall receive at least 6
227months' notice of eligibility prior to the administration of the
228initial examination. Subsequent examinations shall be
229administered at 1-year intervals following the reporting of the
230scores of the first and subsequent examinations. For the
231purposes of this paragraph, the department may develop, contract
232for the development of, purchase, or approve an examination that
233adequately measures an applicant's ability to practice with
234reasonable skill and safety. The minimum passing score on the
235examination shall be established by the department, with the
236advice of the board. Those applicants failing to pass that
237examination or any subsequent examination shall receive notice
238of the administration of the next examination with the notice of
239scores following such examination. Any applicant who passes the
240examination and meets the requirements of this section shall be
241licensed as a physician assistant with all rights defined
242thereby.
243     Section 5.  Subsection (1) of section 458.316, Florida
244Statutes, is amended to read:
245     458.316  Public health certificate.--
246     (1)  Any person desiring to obtain a public health
247certificate shall submit an application fee not to exceed $300
248and shall demonstrate to the board that he or she is a graduate
249of an accredited medical school and holds a master of public
250health degree or is board eligible or certified in public health
251or preventive medicine, or is licensed to practice medicine
252without restriction in another jurisdiction in the United States
253and holds a master of public health degree or is board eligible
254or certified in public health or preventive medicine, and shall
255meet the requirements in s. 458.311(1)(a)-(f) and (h) s.
256458.311(1)(a)-(g) and (5).
257     Section 6.  Section 458.3165, Florida Statutes, is amended
258to read:
259     458.3165  Public psychiatry certificate.--The board shall
260issue a public psychiatry certificate to an individual who
261remits an application fee not to exceed $300, as set by the
262board, who is a board-certified psychiatrist, who is licensed to
263practice medicine without restriction in another state, and who
264meets the requirements in s. 458.311(1)(a)-(f) and (h) s.
265458.311(1)(a)-(g) and (5). A recipient of a public psychiatry
266certificate may use the certificate to work at any public mental
267health facility or program funded in part or entirely by state
268funds.
269     (1)  Such certificate shall:
270     (a)  Authorize the holder to practice only in a public
271mental health facility or program funded in part or entirely by
272state funds.
273     (b)  Be issued and renewable biennially if the secretary of
274the Department of Health and the chair of the department of
275psychiatry at one of the public medical schools or the chair of
276the department of psychiatry at the accredited medical school at
277the University of Miami recommend in writing that the
278certificate be issued or renewed.
279     (c)  Automatically expire if the holder's relationship with
280a public mental health facility or program expires.
281     (d)  Not be issued to a person who has been adjudged
282unqualified or guilty of any of the prohibited acts in this
283chapter.
284     (2)  The board may take disciplinary action against a
285certificateholder for noncompliance with any part of this
286section or for any reason for which a regular licensee may be
287subject to discipline.
288     Section 7.  Paragraph (a) of subsection (1) of section
289458.317, Florida Statutes, is amended to read:
290     458.317  Limited licenses.--
291     (1)
292     (a)  Any person desiring to obtain a limited license shall:
293     1.  Submit to the board, with an application and fee not to
294exceed $300, an affidavit stating that he or she has been
295licensed to practice medicine in any jurisdiction in the United
296States for at least 10 years and intends to practice only
297pursuant to the restrictions of a limited license granted
298pursuant to this section. However, a physician who is not fully
299retired in all jurisdictions may use a limited license only for
300noncompensated practice. If the person applying for a limited
301license submits a notarized statement from the employing agency
302or institution stating that he or she will not receive
303compensation for any service involving the practice of medicine,
304the application fee and all licensure fees shall be waived.
305However, any person who receives a waiver of fees for a limited
306license shall pay such fees if the person receives compensation
307for the practice of medicine.
308     2.  Meet the requirements in s. 458.311(1)(b)-(f) and (h)
309s. 458.311(1)(b)-(g) and (5). If the applicant graduated from
310medical school prior to 1946, the board or its appropriate
311committee may accept military medical training or medical
312experience as a substitute for the approved 1-year residency
313requirement in s. 458.311(1)(f).
314
315Nothing herein limits in any way any policy by the board,
316otherwise authorized by law, to grant licenses to physicians
317duly licensed in other states under conditions less restrictive
318than the requirements of this section. Notwithstanding the other
319provisions of this section, the board may refuse to authorize a
320physician otherwise qualified to practice in the employ of any
321agency or institution otherwise qualified if the agency or
322institution has caused or permitted violations of the provisions
323of this chapter which it knew or should have known were
324occurring.
325     Section 8.  The sum of $        is appropriated from the
326General Revenue Fund to the Department of Health for
327implementing this act during the 2006-2007 fiscal year. This act
328shall be implemented contingent on an appropriation in the
329General Appropriations Act.
330     Section 9.  This act shall take effect October 1, 2006.


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