| 1 | The Health Care Appropriations Committee recommends the |
| 2 | following: |
| 3 |
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| 4 | Council/Committee Substitute |
| 5 | Remove the entire bill and insert: |
| 6 | A bill to be entitled |
| 7 | An act relating to physicians; creating s. 381.0304, F.S.; |
| 8 | requiring the Division of Health Access and Tobacco of the |
| 9 | Department of Health to monitor, evaluate, and report on |
| 10 | the supply and distribution of allopathic physicians and |
| 11 | osteopathic physicians in the state; amending ss. 458.311 |
| 12 | and 458.313, F.S.; requiring applicants for physician |
| 13 | licensure to submit core credentials to specified |
| 14 | entities; amending ss. 458.316, 458.3165, and 458.317, |
| 15 | F.S.; conforming cross-references; requiring the division |
| 16 | to report on the supply and distribution of dentists in |
| 17 | specified Agency for Health Care Administration Medicaid |
| 18 | service areas; providing an appropriation; providing an |
| 19 | effective date. |
| 20 |
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| 21 | Be It Enacted by the Legislature of the State of Florida: |
| 22 |
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| 23 | Section 1. Section 381.0304, Florida Statutes, is created |
| 24 | to read: |
| 25 | 381.0304 Supply and distribution of physicians; |
| 26 | reports.--The Division of Health Access and Tobacco of the |
| 27 | department shall monitor, evaluate, and report on the supply and |
| 28 | distribution of allopathic physicians licensed under chapter 458 |
| 29 | and osteopathic physicians licensed under chapter 459 in this |
| 30 | state. The division shall develop a strategy to track and |
| 31 | analyze, on an ongoing basis, the distribution of state-licensed |
| 32 | physicians by specialty and geographic location using data that |
| 33 | are available from public and private sources. The division |
| 34 | shall submit a report to the Governor, the President of the |
| 35 | Senate, and the Speaker of the House of Representatives by March |
| 36 | 1, 2008, and annually thereafter. |
| 37 | Section 2. Subsection (1) of section 458.311, Florida |
| 38 | Statutes, is amended to read: |
| 39 | 458.311 Licensure by examination; requirements; fees.-- |
| 40 | (1) Any person desiring to be licensed as a physician, who |
| 41 | does not hold a valid license in any state, shall apply to the |
| 42 | department on forms furnished by the department. The department |
| 43 | shall license each applicant who the board certifies: |
| 44 | (a) Has completed the application form and remitted a |
| 45 | nonrefundable application fee not to exceed $500. |
| 46 | (b) Is at least 21 years of age. |
| 47 | (c) Is of good moral character. |
| 48 | (d) Has not committed any act or offense in this or any |
| 49 | other jurisdiction which would constitute the basis for |
| 50 | disciplining a physician pursuant to s. 458.331. |
| 51 | (e) For any applicant who has graduated from medical |
| 52 | school after October 1, 1992, has completed the equivalent of 2 |
| 53 | academic years of preprofessional, postsecondary education, as |
| 54 | determined by rule of the board, which shall include, at a |
| 55 | minimum, courses in such fields as anatomy, biology, and |
| 56 | chemistry prior to entering medical school. |
| 57 | (f) Meets one of the following medical education and |
| 58 | postgraduate training requirements: |
| 59 | 1.a. Is a graduate of an allopathic medical school or |
| 60 | allopathic college recognized and approved by an accrediting |
| 61 | agency recognized by the United States Office of Education or is |
| 62 | a graduate of an allopathic medical school or allopathic college |
| 63 | within a territorial jurisdiction of the United States |
| 64 | recognized by the accrediting agency of the governmental body of |
| 65 | that jurisdiction; |
| 66 | b. If the language of instruction of the medical school is |
| 67 | other than English, has demonstrated competency in English |
| 68 | through presentation of a satisfactory grade on the Test of |
| 69 | Spoken English of the Educational Testing Service or a similar |
| 70 | test approved by rule of the board; and |
| 71 | c. Has completed an approved residency of at least 1 year. |
| 72 | 2.a. Is a graduate of an allopathic foreign medical school |
| 73 | registered with the World Health Organization and certified |
| 74 | pursuant to s. 458.314 as having met the standards required to |
| 75 | accredit medical schools in the United States or reasonably |
| 76 | comparable standards; |
| 77 | b. If the language of instruction of the foreign medical |
| 78 | school is other than English, has demonstrated competency in |
| 79 | English through presentation of the Educational Commission for |
| 80 | Foreign Medical Graduates English proficiency certificate or by |
| 81 | a satisfactory grade on the Test of Spoken English of the |
| 82 | Educational Testing Service or a similar test approved by rule |
| 83 | of the board; and |
| 84 | c. Has completed an approved residency of at least 1 year. |
| 85 | 3.a. Is a graduate of an allopathic foreign medical school |
| 86 | which has not been certified pursuant to s. 458.314; |
| 87 | b. Has had his or her medical credentials evaluated by the |
| 88 | Educational Commission for Foreign Medical Graduates, holds an |
| 89 | active, valid certificate issued by that commission, and has |
| 90 | passed the examination utilized by that commission; and |
| 91 | c. Has completed an approved residency of at least 1 year; |
| 92 | however, after October 1, 1992, the applicant shall have |
| 93 | completed an approved residency or fellowship of at least 2 |
| 94 | years in one specialty area. However, to be acceptable, the |
| 95 | fellowship experience and training must be counted toward |
| 96 | regular or subspecialty certification by a board recognized and |
| 97 | certified by the American Board of Medical Specialties. |
| 98 | (g) Has either submitted core credentials to the |
| 99 | Federation Credentials Verification Services of the Federation |
| 100 | of State Medical Boards and submitted the Physician Information |
| 101 | Profile originating from the Federation Credentials Verification |
| 102 | Service to the department or has submitted core credentials |
| 103 | directly to the department. |
| 104 | (h)(g) Has submitted to the department a set of |
| 105 | fingerprints on a form and under procedures specified by the |
| 106 | department, along with a payment in an amount equal to the costs |
| 107 | incurred by the Department of Health for the criminal background |
| 108 | check of the applicant. |
| 109 | (i)(h) Has obtained a passing score, as established by |
| 110 | rule of the board, on the licensure examination of the United |
| 111 | States Medical Licensing Examination (USMLE); or a combination |
| 112 | of the United States Medical Licensing Examination (USMLE), the |
| 113 | examination of the Federation of State Medical Boards of the |
| 114 | United States, Inc. (FLEX), or the examination of the National |
| 115 | Board of Medical Examiners up to the year 2000; or for the |
| 116 | purpose of examination of any applicant who was licensed on the |
| 117 | basis of a state board examination and who is currently licensed |
| 118 | in at least one other jurisdiction of the United States or |
| 119 | Canada, and who has practiced pursuant to such licensure for a |
| 120 | period of at least 10 years, use of the Special Purpose |
| 121 | Examination of the Federation of State Medical Boards of the |
| 122 | United States (SPEX) upon receipt of a passing score as |
| 123 | established by rule of the board. However, for the purpose of |
| 124 | examination of any applicant who was licensed on the basis of a |
| 125 | state board examination prior to 1974, who is currently licensed |
| 126 | in at least three other jurisdictions of the United States or |
| 127 | Canada, and who has practiced pursuant to such licensure for a |
| 128 | period of at least 20 years, this paragraph does not apply. |
| 129 | Section 3. Paragraph (a) of subsection (1) of section |
| 130 | 458.313, Florida Statutes, is amended to read: |
| 131 | 458.313 Licensure by endorsement; requirements; fees.-- |
| 132 | (1) The department shall issue a license by endorsement to |
| 133 | any applicant who, upon applying to the department on forms |
| 134 | furnished by the department and remitting a fee set by the board |
| 135 | not to exceed $500, the board certifies: |
| 136 | (a) Has met the qualifications for licensure in s. |
| 137 | 458.311(1)(b)-(h) s. 458.311(1)(b)-(g) or in s. 458.311(1)(b)- |
| 138 | (e) and (h) (g) and (3); |
| 139 | Section 4. Subsection (1) of section 458.316, Florida |
| 140 | Statutes, is amended to read: |
| 141 | 458.316 Public health certificate.-- |
| 142 | (1) Any person desiring to obtain a public health |
| 143 | certificate shall submit an application fee not to exceed $300 |
| 144 | and shall demonstrate to the board that he or she is a graduate |
| 145 | of an accredited medical school and holds a master of public |
| 146 | health degree or is board eligible or certified in public health |
| 147 | or preventive medicine, or is licensed to practice medicine |
| 148 | without restriction in another jurisdiction in the United States |
| 149 | and holds a master of public health degree or is board eligible |
| 150 | or certified in public health or preventive medicine, and shall |
| 151 | meet the requirements in s. 458.311(1)(a)-(f) and (h) s. |
| 152 | 458.311(1)(a)-(g) and (5). |
| 153 | Section 5. Section 458.3165, Florida Statutes, is amended |
| 154 | to read: |
| 155 | 458.3165 Public psychiatry certificate.--The board shall |
| 156 | issue a public psychiatry certificate to an individual who |
| 157 | remits an application fee not to exceed $300, as set by the |
| 158 | board, who is a board-certified psychiatrist, who is licensed to |
| 159 | practice medicine without restriction in another state, and who |
| 160 | meets the requirements in s. 458.311(1)(a)-(f) and (h) s. |
| 161 | 458.311(1)(a)-(g) and (5). A recipient of a public psychiatry |
| 162 | certificate may use the certificate to work at any public mental |
| 163 | health facility or program funded in part or entirely by state |
| 164 | funds. |
| 165 | (1) Such certificate shall: |
| 166 | (a) Authorize the holder to practice only in a public |
| 167 | mental health facility or program funded in part or entirely by |
| 168 | state funds. |
| 169 | (b) Be issued and renewable biennially if the secretary of |
| 170 | the Department of Health and the chair of the department of |
| 171 | psychiatry at one of the public medical schools or the chair of |
| 172 | the department of psychiatry at the accredited medical school at |
| 173 | the University of Miami recommend in writing that the |
| 174 | certificate be issued or renewed. |
| 175 | (c) Automatically expire if the holder's relationship with |
| 176 | a public mental health facility or program expires. |
| 177 | (d) Not be issued to a person who has been adjudged |
| 178 | unqualified or guilty of any of the prohibited acts in this |
| 179 | chapter. |
| 180 | (2) The board may take disciplinary action against a |
| 181 | certificateholder for noncompliance with any part of this |
| 182 | section or for any reason for which a regular licensee may be |
| 183 | subject to discipline. |
| 184 | Section 6. Paragraph (a) of subsection (1) of section |
| 185 | 458.317, Florida Statutes, is amended to read: |
| 186 | 458.317 Limited licenses.-- |
| 187 | (1)(a) Any person desiring to obtain a limited license |
| 188 | shall: |
| 189 | 1. Submit to the board, with an application and fee not to |
| 190 | exceed $300, an affidavit stating that he or she has been |
| 191 | licensed to practice medicine in any jurisdiction in the United |
| 192 | States for at least 10 years and intends to practice only |
| 193 | pursuant to the restrictions of a limited license granted |
| 194 | pursuant to this section. However, a physician who is not fully |
| 195 | retired in all jurisdictions may use a limited license only for |
| 196 | noncompensated practice. If the person applying for a limited |
| 197 | license submits a notarized statement from the employing agency |
| 198 | or institution stating that he or she will not receive |
| 199 | compensation for any service involving the practice of medicine, |
| 200 | the application fee and all licensure fees shall be waived. |
| 201 | However, any person who receives a waiver of fees for a limited |
| 202 | license shall pay such fees if the person receives compensation |
| 203 | for the practice of medicine. |
| 204 | 2. Meet the requirements in s. 458.311(1)(b)-(f) and (h) |
| 205 | s. 458.311(1)(b)-(g) and (5). If the applicant graduated from |
| 206 | medical school prior to 1946, the board or its appropriate |
| 207 | committee may accept military medical training or medical |
| 208 | experience as a substitute for the approved 1-year residency |
| 209 | requirement in s. 458.311(1)(f). |
| 210 |
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| 211 | Nothing herein limits in any way any policy by the board, |
| 212 | otherwise authorized by law, to grant licenses to physicians |
| 213 | duly licensed in other states under conditions less restrictive |
| 214 | than the requirements of this section. Notwithstanding the other |
| 215 | provisions of this section, the board may refuse to authorize a |
| 216 | physician otherwise qualified to practice in the employ of any |
| 217 | agency or institution otherwise qualified if the agency or |
| 218 | institution has caused or permitted violations of the provisions |
| 219 | of this chapter which it knew or should have known were |
| 220 | occurring. |
| 221 | Section 7. The Division of Health Access and Tobacco of |
| 222 | the Department of Health shall analyze the supply and |
| 223 | distribution of state-licensed dentists in the Agency for Health |
| 224 | Care Administration's Areas One and Two using data that are |
| 225 | available from public and private sources. The division shall |
| 226 | determine whether such dentists are retired or working full |
| 227 | time. The division shall submit a preliminary report to the |
| 228 | Governor, the President of the Senate, and the Speaker of the |
| 229 | House of Representatives by March 1, 2007, that identifies the |
| 230 | supply and distribution of state-licensed dentists in the Agency |
| 231 | for Health Care Administration's Areas One and Two, indicates |
| 232 | whether state-licensed dentists in such areas are retired or |
| 233 | working full time, and recommends strategies to improve a |
| 234 | broader distribution of dentists in such areas if a shortage or |
| 235 | maldistribution is determined to exist. The division shall |
| 236 | submit a final report to the Governor, the President of the |
| 237 | Senate, and the Speaker of the House of Representatives by March |
| 238 | 1, 2008. |
| 239 | Section 8. The sum of $161,148, of which $110,771 is |
| 240 | recurring, is appropriated from the Medical Quality Assurance |
| 241 | Trust Fund to the Department of Health, and one full-time |
| 242 | equivalent position at 36,245 in salary rate is authorized, to |
| 243 | implement this act for fiscal year 2006-2007. |
| 244 | Section 9. This act shall take effect October 1, 2006. |