HB 485

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"; creating s.
5	464.0115, F.S.; providing requirements for certification
6	as a clinical nurse specialist; providing fees;
7	authorizing the Board of Nursing to adopt rules; amending
8	s. 464.012, F.S.; adding clinical nurse specialist to the
9	classifications of advanced registered nurse
10	practitioners; creating s. 464.0125, F.S.; requiring
11	advanced registered nurse practitioners to register with
12	the Board of Nursing to prescribe medicinal drugs,
13	including controlled substances; providing requirements
14	for registration and renewal of registration, including
15	continuing education; providing fees; prohibiting
16	prescription of controlled substances for personal use or
17	the use of immediate family members; providing for
18	disciplinary actions; authorizing the board to adopt
19	rules; amending s. 464.015, F.S.; restricting the use of
20	professional titles and abbreviations relating to clinical
21	nurse specialist, certified registered nurse anesthetist,
22	and certified nurse midwife practice; providing penalties;
23	amending s. 464.016, F.S.; prohibiting the use of any name
24	or title stating or implying that a person is a clinical
25	nurse specialist, certified registered nurse anesthetist,
26	or certified nurse midwife unless the person is licensed
27	or certified; providing penalties; amending s. 893.02,
28	F.S.; redefining the term "practitioner" under the Florida
29	Comprehensive Drug Abuse Prevention and Control Act to
30	include certain advanced registered nurse practitioners;
31	reenacting s. 921.0022(3)(g), F.S., relating to the
32	offense severity ranking chart of the Criminal Punishment
33	Code, to incorporate the amendment to s. 464.016, F.S., in
34	a reference thereto; amending s. 458.348, F.S.; conforming
35	cross-references; providing an effective date.
36
37	Be It Enacted by the Legislature of the State of Florida:
38
39	Section 1.  Section 464.003, Florida Statutes, is amended
40	to read:
41	464.003  Definitions.--As used in this part, the term:
42	(1)  "Department" means the Department of Health.
43	(2)  "Board" means the Board of Nursing.
44	(3)(a)  "Practice of professional nursing" means the
45	performance of those acts requiring substantial specialized
46	knowledge, judgment, and nursing skill based upon applied
47	principles of psychological, biological, physical, and social
48	sciences which shall include, but not be limited to:
49	1.  The observation, assessment, nursing diagnosis,
50	planning, intervention, and evaluation of care; health teaching
51	and counseling of the ill, injured, or infirm; and the promotion
52	of wellness, maintenance of health, and prevention of illness of
53	others.
54	2.  The administration of medications and treatments as
55	prescribed or authorized by a duly licensed practitioner
56	authorized by the laws of this state to prescribe such
57	medications and treatments.
58	3.  The supervision and teaching of other personnel in the
59	theory and performance of any of the above acts.
60	(b)  "Practice of practical nursing" means the performance
61	of selected acts, including the administration of treatments and
62	medications, in the care of the ill, injured, or infirm and the
63	promotion of wellness, maintenance of health, and prevention of
64	illness of others under the direction of a registered nurse, a
65	licensed physician, a licensed osteopathic physician, a licensed
66	podiatric physician, or a licensed dentist.
67
68	The professional nurse and the practical nurse shall be
69	responsible and accountable for making decisions that are based
70	upon the individual's educational preparation and experience in
71	nursing.
72	(c)  "Clinical nurse specialist practice" means the
73	delivery and management of expert-level nursing care to
74	individuals or groups, including the ability to:
75	1.  Assess the health status of individuals and families
76	using methods appropriate to the population and area of
77	practice.
78	2.  Diagnose human responses to actual or potential health
79	problems.
80	3.  Plan for health promotion, disease prevention, and
81	therapeutic intervention in collaboration with the patient or
82	client.
83	4.  Implement therapeutic interventions based on the nurse
84	specialist's area of expertise, including, but not limited to,
85	direct nursing care, counseling, teaching, and collaboration
86	with other licensed health care providers.
87	5.  Coordinate health care as necessary and appropriate and
88	evaluate with the patient or client the effectiveness of care.
89	(d)(c)  "Advanced or specialized nursing practice" means,
90	in addition to the practice of professional nursing, the
91	performance of advanced-level nursing acts approved by the board
92	which, by virtue of postbasic specialized education, training,
93	and experience, are proper to be performed by an advanced
94	registered nurse practitioner. Within the context of advanced or
95	specialized nursing practice, the advanced registered nurse
96	practitioner may perform acts of nursing diagnosis and nursing
97	treatment of alterations of the health status. The advanced
98	registered nurse practitioner may also perform acts of medical
99	diagnosis and treatment, prescription, and operation which are
100	identified and approved by a joint committee composed of three
101	members appointed by the Board of Nursing, two of whom shall be
102	advanced registered nurse practitioners; three members appointed
103	by the Board of Medicine, two of whom shall have had work
104	experience with advanced registered nurse practitioners; and the
105	secretary of the department or the secretary's designee. Each
106	committee member appointed by a board shall be appointed to a
107	term of 4 years unless a shorter term is required to establish
108	or maintain staggered terms. The Board of Nursing shall adopt
109	rules authorizing the performance of any such acts approved by
110	the joint committee. Unless otherwise specified by the joint
111	committee, such acts shall be performed under the general
112	supervision of a practitioner licensed under chapter 458,
113	chapter 459, or chapter 466 within the framework of standing
114	protocols which identify the medical acts to be performed and
115	the conditions for their performance. The department may, by
116	rule, require that a copy of the protocol be filed with the
117	department along with the notice required by s. 458.348.
118	(e)(d)  "Nursing diagnosis" means the observation and
119	evaluation of physical or mental conditions, behaviors, signs
120	and symptoms of illness, and reactions to treatment and the
121	determination as to whether such conditions, signs, symptoms,
122	and reactions represent a deviation from normal.
123	(f)(e)  "Nursing treatment" means the establishment and
124	implementation of a nursing regimen for the care and comfort of
125	individuals, the prevention of illness, and the education,
126	restoration, and maintenance of health.
127	(4)  "Registered nurse" means any person licensed in this
128	state to practice professional nursing.
129	(5)  "Licensed practical nurse" means any person licensed
130	in this state to practice practical nursing.
131	(6)  "Clinical nurse specialist" means any person licensed
132	in this state to practice professional nursing and certified in
133	clinical nurse specialist practice.
134	(7)(6)  "Advanced registered nurse practitioner" means any
135	person licensed in this state to practice professional nursing
136	and certified in advanced or specialized nursing practice,
137	including certified registered nurse anesthetists, certified
138	nurse midwives, nurse practitioners, and clinical nurse
139	specialists.
140	(8)(7)  "Approved program" means a nursing program
141	conducted in a school, college, or university which is approved
142	by the board pursuant to s. 464.019 for the education of nurses.
143	Section 2.  Section 464.0115, Florida Statutes, is created
144	to read:
145	464.0115  Certification of clinical nurse specialists.--
146	(1)  Any nurse desiring to be certified as a clinical nurse
147	specialist shall apply to the department and submit proof that
148	he or she holds a current license to practice professional
149	nursing, a master's degree in a clinical nursing specialty, and
150	current certification in a specialty area as a clinical nurse
151	specialist from a nationally recognized certifying body as
152	determined by the board.
153	(2)  The board shall certify, and the department shall
154	issue a certificate to, any nurse fulfilling the qualifications
155	in this section. The board shall establish an application fee
156	not to exceed $25 and a biennial renewal fee not to exceed $10.
157	(3)  The board may adopt rules pursuant to ss. 120.536(1)
158	and 120.54 necessary to administer this section.
159	Section 3.  Subsections (2) and (3) of section 464.012,
160	Florida Statutes, are amended to read:
161	464.012  Certification of advanced registered nurse
162	practitioners; fees.--
163	(2)  The board shall provide by rule the appropriate
164	requirements for advanced registered nurse practitioners in the
165	categories of certified registered nurse anesthetist, certified
166	nurse midwife, and nurse practitioner, and clinical nurse
167	specialist.
168	(3)  An advanced registered nurse practitioner shall
169	perform those functions authorized in this section within the
170	framework of an established protocol. A practitioner currently
171	licensed under chapter 458, chapter 459, or chapter 466 shall
172	maintain supervision for directing the specific course of
173	medical treatment.  Within the established framework, an
174	advanced registered nurse practitioner may:
175	(a)  Monitor and alter drug therapies.
176	(b)  Initiate appropriate therapies for certain conditions.
177	(c)  Perform additional functions as may be determined by
178	rule in accordance with s. 464.003(3)(d) s. 464.003(3)(c).
179	(d)  Order diagnostic tests and physical and occupational
180	therapy.
181	Section 4.  Section 464.0125, Florida Statutes, is created
182	to read:
183	464.0125  Registration of advanced registered nurse
184	practitioners to prescribe medicinal drugs.--
185	(1)  Any advanced registered nurse practitioner certified
186	pursuant to s. 464.012 must register with the board in
187	accordance with this section to prescribe medicinal drugs.
188	(2)  To register to prescribe medicinal drugs, an advanced
189	registered nurse practitioner must:
190	(a)  Possess an active and unrestricted license and be
191	certified as an advanced registered nurse practitioner.
192	(b)1.  Possess an active and current certification by an
193	appropriate specialty board; or
194	2.  Submit documentation to the board demonstrating that
195	the advanced registered nurse practitioner has been prescribing
196	medicinal drugs for a period of at least 12 months before
197	registering as a prescribing practitioner.
198	(c)1.  Submit documentation to the board demonstrating that
199	the advanced registered nurse practitioner has completed at
200	least 16 contact hours of approved continuing education in
201	pharmacology during the past 2 years, in addition to the
202	continuing education required for licensure renewal; or
203	2.  Submit documentation to the board demonstrating that
204	the advanced registered nurse practitioner has been prescribing
205	medicinal drugs for a period of at least 12 months before
206	registering as a prescribing practitioner.
207	(d)  Submit a copy of the protocol between the advanced
208	registered nurse practitioner and supervising physician which
209	complies with board rules, identifies the categories of
210	medicinal drugs that the advanced registered nurse practitioner
211	is authorized to prescribe, and requires as an element of
212	general supervision that the advanced registered nurse
213	practitioner confer with the supervising physician to review and
214	discuss patient care, prescribed treatments and medications, and
215	care outcomes. The board may by rule establish minimum
216	requirements for this conference. The supervising physician or
217	another physician designated by the supervising physician must
218	be available for consultation and collaboration with the
219	advanced registered nurse practitioner at all times, by phone or
220	other electronic means. The protocol must include a quality
221	assurance procedure. The board may by rule establish minimum
222	requirements for the quality assurance procedure to be included
223	in the protocol. The protocol must be filed with the initial
224	application for registration under this section, with the
225	application for renewal of license, and at any time there is a
226	change in the protocol or of any party to the protocol. For
227	purposes of this section, the supervising physician must have a
228	current and unrestricted license to practice medicine pursuant
229	to chapter 458 or osteopathic medicine pursuant to chapter 459,
230	a primary practice location in this state, and a current and
231	unrestricted federal Drug Enforcement Administration
232	registration number.
233	(e)  Agree to maintain adequate medical records pursuant to
234	board rule which include evidence of a patient history and
235	physical examination and, at a minimum, the following
236	information about each prescription for a medicinal drug:
237	1.  Drug name and strength.
238	2.  Dose.
239	3.  Amount prescribed.
240	4.  Directions for use.
241	5.  Number of refills.
242	6.  The signature of the prescribing practitioner.
243	(f)  Submit a completed registration form and remit a fee
244	set by the board not to exceed $75.
245	(3)  To prescribe controlled substances, an advanced
246	registered nurse practitioner must:
247	(a)  Possess a valid midlevel practitioner registration
248	issued by the federal Drug Enforcement Administration.
249	(b)  Submit documentation to the board demonstrating that
250	the advanced registered nurse practitioner has completed an
251	approved course in legal and clinical aspects of prescribing
252	controlled substances of not less than 3 contact hours.
253	(c)  Identify, as part of the protocol between the advanced
254	registered nurse practitioner and supervising physician, the
255	schedules of controlled substances that the advanced registered
256	nurse practitioner is authorized to prescribe.
257	(d)  Complete at least 2 contact hours of approved
258	continuing education in the prescribing of controlled substances
259	during each 2-year licensure period, in addition to the
260	continuing education required for licensure renewal. This
261	continuing education may be part of the 16 hours of continuing
262	education required pursuant to subsection (4).
263	(4)  To register or renew registration to prescribe
264	medicinal drugs, an advanced registered nurse practitioner must
265	complete at least 16 contact hours of approved continuing
266	education in pharmacology during each 2-year licensure period,
267	in addition to the continuing education required for licensure
268	renewal.
269	(5)  The board shall provide by rule for biennial renewal
270	of registration and a renewal fee not to exceed $25.
271	(6)  Advanced registered nurse practitioners who are
272	certified as certified registered nurse anesthetists pursuant to
273	s. 464.012 are not required to register under this section to
274	provide anesthesia care in accordance with s. 464.012(4).
275	(7)  An advanced registered nurse practitioner who
276	registers to prescribe controlled substances may not prescribe
277	controlled substances for personal use or use by any member of
278	the advanced registered nurse practitioner's immediate family.
279	(8)  The board may limit, suspend, or revoke an advanced
280	registered nurse practitioner's registration to prescribe under
281	this section in accordance with the provisions of s. 456.073.
282	(9)  The board may adopt rules pursuant to ss. 120.536(1)
283	and 120.54 to administer this section.
284	Section 5.  Section 464.015, Florida Statutes, is amended
285	to read:
286	464.015  Titles and abbreviations; restrictions; penalty.--
287	(1)  Only persons who hold licenses to practice
288	professional nursing in this state or who are performing nursing
289	services pursuant to the exception set forth in s. 464.022(8)
290	shall have the right to use the title "Registered Nurse" and the
291	abbreviation "R.N."
292	(2)  Only persons who hold licenses to practice as licensed
293	practical nurses in this state or who are performing practical
294	nursing services pursuant to the exception set forth in s.
295	464.022(8) shall have the right to use the title "Licensed
296	Practical Nurse" and the abbreviation "L.P.N."
297	(3)  Only persons who are graduates of approved programs or
298	the equivalent may use the term "Graduate Nurse" and the
299	abbreviation "G.N.," pending the results of the first licensure
300	examination for which they are eligible.
301	(4)  Only persons who are graduates of approved programs or
302	the equivalent may use the term "Graduate Practical Nurse" and
303	the abbreviation "G.P.N.," pending the results of the first
304	licensure examination for which they are eligible.
305	(5)  Only persons who hold valid certificates to practice
306	as clinical nurse specialists in this state may use the title
307	"Clinical Nurse Specialist" and the abbreviation "C.N.S."
308	(6)  Only persons who hold valid certificates to practice
309	as certified registered nurse anesthetists in this state may use
310	the title "Certified Registered Nurse Anesthetist" and the
311	abbreviations "C.R.N.A." or "anesthetist."
312	(7)  Only persons who hold valid certificates to practice
313	as certified nurse midwives in this state may use the title
314	"Certified Nurse Midwife" and the abbreviations "C.N.M." or
315	"nurse midwife."
316	(8)(5)  Only persons who hold valid certificates to
317	practice as advanced registered nurse practitioners in this
318	state may shall have the right to use the title "Advanced
319	Registered Nurse Practitioner" and the abbreviation "A.R.N.P."
320	(9)(6)  A No person may not shall practice or advertise as,
321	or assume the title of, registered nurse, licensed practical
322	nurse, clinical nurse specialist, certified registered nurse
323	anesthetist, certified nurse midwife, or advanced registered
324	nurse practitioner or use the abbreviation "R.N.," "L.P.N.,"
325	"C.N.S.," "C.R.N.A.," "C.N.M.," or "A.R.N.P." or take any other
326	action that would lead the public to believe that person was
327	certified as such or is performing nursing services pursuant to
328	the exception set forth in s. 464.022(8), unless that person is
329	licensed or certified to practice as such.
330	(10)(7)  A violation of this section is a misdemeanor of
331	the first degree, punishable as provided in s. 775.082 or s.
332	775.083.
333	Section 6.  Section 464.016, Florida Statutes, is amended
334	to read:
335	464.016  Violations and penalties.--
336	(1)  Each of the following acts constitutes a felony of the
337	third degree, punishable as provided in s. 775.082, s. 775.083,
338	or s. 775.084:
339	(a)  Practicing advanced or specialized, professional, or
340	practical nursing, as defined in this part, unless holding an
341	active license or certificate to do so.
342	(b)  Using or attempting to use a license or certificate
343	which has been suspended or revoked.
344	(c)  Knowingly employing unlicensed persons in the practice
345	of nursing.
346	(d)  Obtaining or attempting to obtain a license or
347	certificate under this part by misleading statements or knowing
348	misrepresentation.
349	(2)  Each of the following acts constitutes a misdemeanor
350	of the first degree, punishable as provided in s. 775.082 or s.
351	775.083:
352	(a)  Using the name or title "Nurse," "Registered Nurse,"
353	"Licensed Practical Nurse," "Clinical Nurse Specialist,"
354	"Certified Registered Nurse Anesthetist," "Certified Nurse
355	Midwife," "Advanced Registered Nurse Practitioner," or any other
356	name or title which implies that a person was licensed or
357	certified as same, unless such person is duly licensed or
358	certified.
359	(b)  Knowingly concealing information relating to
360	violations of this part.
361	Section 7.  Subsection (19) of section 893.02, Florida
362	Statutes, is amended to read:
363	893.02  Definitions.--The following words and phrases as
364	used in this chapter shall have the following meanings, unless
365	the context otherwise requires:
366	(19)  "Practitioner" means a physician licensed pursuant to
367	chapter 458, a dentist licensed pursuant to chapter 466, a
368	veterinarian licensed pursuant to chapter 474, an osteopathic
369	physician licensed pursuant to chapter 459, a naturopath
370	licensed pursuant to chapter 462, or a podiatric physician
371	licensed pursuant to chapter 461, provided such practitioner
372	holds a valid federal controlled substance registry number. The
373	term includes an advanced registered nurse practitioner
374	certified pursuant to s. 464.012 who holds a valid controlled
375	substance registry number for midlevel practitioners and who is
376	registered to prescribe controlled substances under s. 464.0125.
377	Section 8.  For the purpose of incorporating the amendment
378	made by this act to section 464.016, Florida Statutes, in a
379	reference thereto, paragraph (g) of subsection (3) of section
380	921.0022, Florida Statutes, is reenacted to read:
381	921.0022  Criminal Punishment Code; offense severity
382	ranking chart.--
383	(3)  OFFENSE SEVERITY RANKING CHART
	Florida Felony
384
	Statute Degree Description
385
	(g)  LEVEL 7
386
	316.027(1)(b) 2nd Accident involving death, failure to stop; leaving scene.
387
	316.193(3)(c)2. 3rd DUI resulting in serious bodily injury.
388
	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.
389
	327.35(3)(c)2. 3rd Vessel BUI resulting in serious bodily injury.
390
	402.319(2) 2nd Misrepresentation and negligence or intentional act resulting in great bodily harm, permanent disfiguration, permanent disability, or death.
391
	409.920(2) 3rd Medicaid provider fraud.
392
	456.065(2) 3rd Practicing a health care profession without a license.
393
	456.065(2) 2nd Practicing a health care profession without a license which results in serious bodily injury.
394
	458.327(1) 3rd Practicing medicine without a license.
395
	459.013(1) 3rd Practicing osteopathic medicine without a license.
396
	460.411(1) 3rd Practicing chiropractic medicine without a license.
397
	461.012(1) 3rd Practicing podiatric medicine without a license.
398
	462.17 3rd Practicing naturopathy without a license.
399
	463.015(1) 3rd Practicing optometry without a license.
400
	464.016(1) 3rd Practicing nursing without a license.
401
	465.015(2) 3rd Practicing pharmacy without a license.
402
	466.026(1) 3rd Practicing dentistry or dental hygiene without a license.
403
	467.201 3rd Practicing midwifery without a license.
404
	468.366 3rd Delivering respiratory care services without a license.
405
	483.828(1) 3rd Practicing as clinical laboratory personnel without a license.
406
	483.901(9) 3rd Practicing medical physics without a license.
407
	484.013(1)(c) 3rd Preparing or dispensing optical devices without a prescription.
408
	484.053 3rd Dispensing hearing aids without a license.
409
	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.
410
	560.123(8)(b)1. 3rd Failure to report currency or payment instruments exceeding $300 but less than $20,000 by money transmitter.
411
	560.125(5)(a) 3rd Money transmitter business by unauthorized person, currency or payment instruments exceeding $300 but less than $20,000.
412
	655.50(10)(b)1. 3rd Failure to report financial transactions exceeding $300 but less than $20,000 by financial institution.
413
	775.21(10)(a) 3rd Sexual predator; failure to register; failure to renew driver's license or identification card; other registration violations.
414
	775.21(10)(b) 3rd Sexual predator working where children regularly congregate.
415
	775.21(10)(g) 3rd Failure to report or providing false information about a sexual predator; harbor or conceal a sexual predator.
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
	847.0135(3) 3rd Solicitation of a child, via a computer service, to commit an unlawful sex act.
465
	872.06 2nd Abuse of a dead human body.
466
	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.
467
	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.
468
	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).
469
	893.135(1)(a)1. 1st Trafficking in cannabis, more than 25 lbs., less than 2,000 lbs.
470
	893.135(1)(b)1.a. 1st Trafficking in cocaine, more than 28 grams, less than 200 grams.
471
	893.135(1)(c)1.a. 1st Trafficking in illegal drugs, more than 4 grams, less than 14 grams.
472
	893.135(1)(d)1. 1st Trafficking in phencyclidine, more than 28 grams, less than 200 grams.
473
	893.135(1)(e)1. 1st Trafficking in methaqualone, more than 200 grams, less than 5 kilograms.
474
	893.135(1)(f)1. 1st Trafficking in amphetamine, more than 14 grams, less than 28 grams.
475
	893.135(1)(g)1.a. 1st Trafficking in flunitrazepam, 4 grams or more, less than 14 grams.
476
	893.135(1)(h)1.a. 1st Trafficking in gamma-hydroxybutyric acid (GHB), 1 kilogram or more, less than 5 kilograms.
477
	893.135(1)(j)1.a. 1st Trafficking in 1,4-Butanediol, 1 kilogram or more, less than 5 kilograms.
478
	893.135(1)(k)2.a. 1st Trafficking in Phenethylamines, 10 grams or more, less than 200 grams.
479
	896.101(5)(a) 3rd Money laundering, financial transactions exceeding $300 but less than $20,000.
480
	896.104(4)(a)1. 3rd Structuring transactions to evade reporting or registration requirements, financial transactions exceeding $300 but less than $20,000.
481
	943.0435(4)(c) 2nd Sexual offender vacating permanent residence; failure to comply with reporting requirements.
482
	943.0435(8) 2nd Sexual offender; remains in state after indicating intent to leave; failure to comply with reporting requirements.
483
	943.0435(9)(a) 3rd Sexual offender; failure to comply with reporting requirements.
484
	943.0435(13) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
485
	943.0435(14) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
486
	944.607(9) 3rd Sexual offender; failure to comply with reporting requirements.
487
	944.607(10)(a) 3rd Sexual offender; failure to submit to the taking of a digitized photograph.
488
	944.607(12) 3rd Failure to report or providing false information about a sexual offender; harbor or conceal a sexual offender.
489
	944.607(13) 3rd Sexual offender; failure to report and reregister; failure to respond to address verification.
490
491	Section 9.  Paragraph (a) of subsection (1) and subsection
492	(2) of section 458.348, Florida Statutes, are amended to read:
493	458.348  Formal supervisory relationships, standing orders,
494	and established protocols; notice; standards.--
495	(1)  NOTICE.--
496	(a)  When a physician enters into a formal supervisory
497	relationship or standing orders with an emergency medical
498	technician or paramedic licensed pursuant to s. 401.27, which
499	relationship or orders contemplate the performance of medical
500	acts, or when a physician enters into an established protocol
501	with an advanced registered nurse practitioner, which protocol
502	contemplates the performance of medical acts identified and
503	approved by the joint committee pursuant to s. 464.003(3)(d) s.
504	464.003(3)(c) or acts set forth in s. 464.012(3) and (4), the
505	physician shall submit notice to the board. The notice shall
506	contain a statement in substantially the following form:
507
508	I,   (name and professional license number of physician)  ,
509	of   (address of physician)   have hereby entered into a formal
510	supervisory relationship, standing orders, or an established
511	protocol with   (number of persons)   emergency medical
512	technician(s),   (number of persons)   paramedic(s), or
513	(number of persons)   advanced registered nurse practitioner(s).
514	(2)  ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.--The
515	joint committee created under s. 464.003(3)(d) by s.
516	464.003(3)(c) shall determine minimum standards for the content
517	of established protocols pursuant to which an advanced
518	registered nurse practitioner may perform medical acts
519	identified and approved by the joint committee pursuant to s.
520	464.003(3)(d) s. 464.003(3)(c) or acts set forth in s.
521	464.012(3) and (4) and shall determine minimum standards for
522	supervision of such acts by the physician, unless the joint
523	committee determines that any act set forth in s. 464.012(3) or
524	(4) is not a medical act. Such standards shall be based on risk
525	to the patient and acceptable standards of medical care and
526	shall take into account the special problems of medically
527	underserved areas. The standards developed by the joint
528	committee shall be adopted as rules by the Board of Nursing and
529	the Board of Medicine for purposes of carrying out their
530	responsibilities pursuant to part I of chapter 464 and this
531	chapter, respectively, but neither board shall have disciplinary
532	powers over the licensees of the other board.
533	Section 10.  This act shall take effect July 1, 2006.

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