Senate Bill sb7064pb

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064

    FOR CONSIDERATION By the Committee on Health Care





    587-945-06

  1                      A bill to be entitled

  2         An act relating to physicians; creating s.

  3         381.0304, F.S.; requiring the Division of

  4         Health Access and Tobacco within the Department

  5         of Health to monitor, evaluate, and report on

  6         the supply and distribution of physicians and

  7         osteopathic physicians in Florida; amending ss.

  8         458.311, 458.313, F.S.; requiring applicants

  9         for physician licensure to submit core

10         credentials to the Federation of State Medical

11         Boards for verification; reenacting s.

12         458.347(7)(b), F.S., relating to physician

13         assistants, in order to incorporate the

14         amendment to s. 458.311, F.S., in a reference

15         thereto; amending ss. 458.316, 458.3165,

16         458.317, F.S.; conforming cross-references;

17         providing an appropriation; providing an

18         effective date.

19  

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

21  

22         Section 1.  Section 381.0304, Florida Statutes, is

23  created to read:

24         381.0304  Supply and distribution of physicians;

25  reports.--The Division of Health Access and Tobacco of the

26  department shall monitor, evaluate, and report on the supply

27  and distribution of physicians and osteopathic physicians in

28  this state. The division shall develop a strategy to track and

29  analyze, on an ongoing basis, the distribution of

30  Florida-licensed physicians by specialty and geographic

31  location using data that are available from public and private

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  sources. The division shall submit a report to the Governor,

 2  the President of the Senate, and the Speaker of the House of

 3  Representatives by January 1, 2008, and annually thereafter.

 4         Section 2.  Subsection (1) of section 458.311, Florida

 5  Statutes, is amended to read:

 6         458.311  Licensure by examination; requirements;

 7  fees.--

 8         (1)  Any person desiring to be licensed as a physician,

 9  who does not hold a valid license in any state, shall apply to

10  the department on forms furnished by the department. The

11  department shall license each applicant who the board

12  certifies:

13         (a)  Has completed the application form and remitted a

14  nonrefundable application fee not to exceed $500.

15         (b)  Is at least 21 years of age.

16         (c)  Is of good moral character.

17         (d)  Has not committed any act or offense in this or

18  any other jurisdiction which would constitute the basis for

19  disciplining a physician pursuant to s. 458.331.

20         (e)  For any applicant who has graduated from medical

21  school after October 1, 1992, has completed the equivalent of

22  2 academic years of preprofessional, postsecondary education,

23  as determined by rule of the board, which shall include, at a

24  minimum, courses in such fields as anatomy, biology, and

25  chemistry prior to entering medical school.

26         (f)  Meets one of the following medical education and

27  postgraduate training requirements:

28         1.a.  Is a graduate of an allopathic medical school or

29  allopathic college recognized and approved by an accrediting

30  agency recognized by the United States Office of Education or

31  is a graduate of an allopathic medical school or allopathic

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  college within a territorial jurisdiction of the United States

 2  recognized by the accrediting agency of the governmental body

 3  of that jurisdiction;

 4         b.  If the language of instruction of the medical

 5  school is other than English, has demonstrated competency in

 6  English through presentation of a satisfactory grade on the

 7  Test of Spoken English of the Educational Testing Service or a

 8  similar test approved by rule of the board; and

 9         c.  Has completed an approved residency of at least 1

10  year.

11         2.a.  Is a graduate of an allopathic foreign medical

12  school registered with the World Health Organization and

13  certified pursuant to s. 458.314 as having met the standards

14  required to accredit medical schools in the United States or

15  reasonably comparable standards;

16         b.  If the language of instruction of the foreign

17  medical school is other than English, has demonstrated

18  competency in English through presentation of the Educational

19  Commission for Foreign Medical Graduates English proficiency

20  certificate or by a satisfactory grade on the Test of Spoken

21  English of the Educational Testing Service or a similar test

22  approved by rule of the board; and

23         c.  Has completed an approved residency of at least 1

24  year.

25         3.a.  Is a graduate of an allopathic foreign medical

26  school which has not been certified pursuant to s. 458.314;

27         b.  Has had his or her medical credentials evaluated by

28  the Educational Commission for Foreign Medical Graduates,

29  holds an active, valid certificate issued by that commission,

30  and has passed the examination utilized by that commission;

31  and

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1         c.  Has completed an approved residency of at least 1

 2  year; however, after October 1, 1992, the applicant shall have

 3  completed an approved residency or fellowship of at least 2

 4  years in one specialty area.  However, to be acceptable, the

 5  fellowship experience and training must be counted toward

 6  regular or subspecialty certification by a board recognized

 7  and certified by the American Board of Medical Specialties.

 8         (g)  Has submitted core credentials to the Federation

 9  Credentials Verification Services of the Federation of State

10  Medical Boards for verification.

11         (h)(g)  Has submitted to the department a set of

12  fingerprints on a form and under procedures specified by the

13  department, along with a payment in an amount equal to the

14  costs incurred by the Department of Health for the criminal

15  background check of the applicant.

16         (i)(h)  Has obtained a passing score, as established by

17  rule of the board, on the licensure examination of the United

18  States Medical Licensing Examination (USMLE); or a combination

19  of the United States Medical Licensing Examination (USMLE),

20  the examination of the Federation of State Medical Boards of

21  the United States, Inc. (FLEX), or the examination of the

22  National Board of Medical Examiners up to the year 2000; or

23  for the purpose of examination of any applicant who was

24  licensed on the basis of a state board examination and who is

25  currently licensed in at least one other jurisdiction of the

26  United States or Canada, and who has practiced pursuant to

27  such licensure for a period of at least 10 years, use of the

28  Special Purpose Examination of the Federation of State Medical

29  Boards of the United States (SPEX) upon receipt of a passing

30  score as established by rule of the board. However, for the

31  purpose of examination of any applicant who was licensed on

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  the basis of a state board examination prior to 1974, who is

 2  currently licensed in at least three other jurisdictions of

 3  the United States or Canada, and who has practiced pursuant to

 4  such licensure for a period of at least 20 years, this

 5  paragraph does not apply.

 6         Section 3.  Subsection (1) of section 458.313, Florida

 7  Statutes, is amended to read:

 8         458.313  Licensure by endorsement; requirements;

 9  fees.--

10         (1)  The department shall issue a license by

11  endorsement to any applicant who, upon applying to the

12  department on forms furnished by the department and remitting

13  a fee set by the board not to exceed $500, the board

14  certifies:

15         (a)  Has met the qualifications for licensure in s.

16  458.311(1)(b)-(h) s. 458.311(1)(b)-(g) or in s.

17  458.311(1)(b)-(e) and (h) (g) and (3);

18         (b)  Prior to January 1, 2000, has obtained a passing

19  score, as established by rule of the board, on the licensure

20  examination of the Federation of State Medical Boards of the

21  United States, Inc. (FLEX), on the United States Medical

22  Licensing Examination (USMLE), or on the examination of the

23  National Board of Medical Examiners, or on a combination

24  thereof, and on or after January 1, 2000, has obtained a

25  passing score on the United States Medical Licensing

26  Examination (USMLE); and

27         (c)  Has submitted evidence of the active licensed

28  practice of medicine in another jurisdiction, for at least 2

29  of the immediately preceding 4 years, or evidence of

30  successful completion of either a board-approved postgraduate

31  training program within 2 years preceding filing of an

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  application or a board-approved clinical competency

 2  examination within the year preceding the filing of an

 3  application for licensure.  For purposes of this paragraph,

 4  "active licensed practice of medicine" means that practice of

 5  medicine by physicians, including those employed by any

 6  governmental entity in community or public health, as defined

 7  by this chapter, medical directors under s. 641.495(11) who

 8  are practicing medicine, and those on the active teaching

 9  faculty of an accredited medical school.

10         Section 4.  For the purpose of incorporating the

11  amendment to section 458.311, Florida Statutes, in a reference

12  thereto, paragraph (b) of subsection (7) of section 458.347,

13  Florida Statutes, is reenacted to read:

14         458.347  Physician assistants.--

15         (7)  PHYSICIAN ASSISTANT LICENSURE.--

16         (b)1.  Notwithstanding subparagraph (a)2. and

17  sub-subparagraph (a)3.a., the department shall examine each

18  applicant who the Board of Medicine certifies:

19         a.  Has completed the application form and remitted a

20  nonrefundable application fee not to exceed $500 and an

21  examination fee not to exceed $300, plus the actual cost to

22  the department to provide the examination. The examination fee

23  is refundable if the applicant is found to be ineligible to

24  take the examination. The department shall not require the

25  applicant to pass a separate practical component of the

26  examination. For examinations given after July 1, 1998,

27  competencies measured through practical examinations shall be

28  incorporated into the written examination through a

29  multiple-choice format. The department shall translate the

30  examination into the native language of any applicant who

31  requests and agrees to pay all costs of such translation,

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  provided that the translation request is filed with the board

 2  office no later than 9 months before the scheduled examination

 3  and the applicant remits translation fees as specified by the

 4  department no later than 6 months before the scheduled

 5  examination, and provided that the applicant demonstrates to

 6  the department the ability to communicate orally in basic

 7  English. If the applicant is unable to pay translation costs,

 8  the applicant may take the next available examination in

 9  English if the applicant submits a request in writing by the

10  application deadline and if the applicant is otherwise

11  eligible under this section. To demonstrate the ability to

12  communicate orally in basic English, a passing score or grade

13  is required, as determined by the department or organization

14  that developed it, on the test for spoken English (TSE) by the

15  Educational Testing Service (ETS), the test of English as a

16  foreign language (TOEFL) by ETS, a high school or college

17  level English course, or the English examination for

18  citizenship, Bureau of Citizenship and Immigration Services. A

19  notarized copy of an Educational Commission for Foreign

20  Medical Graduates (ECFMG) certificate may also be used to

21  demonstrate the ability to communicate in basic English; and

22         b.(I)  Is an unlicensed physician who graduated from a

23  foreign medical school listed with the World Health

24  Organization who has not previously taken and failed the

25  examination of the National Commission on Certification of

26  Physician Assistants and who has been certified by the Board

27  of Medicine as having met the requirements for licensure as a

28  medical doctor by examination as set forth in s. 458.311(1),

29  (3), (4), and (5), with the exception that the applicant is

30  not required to have completed an approved residency of at

31  least 1 year and the applicant is not required to have passed

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  the licensing examination specified under s. 458.311 or hold a

 2  valid, active certificate issued by the Educational Commission

 3  for Foreign Medical Graduates; was eligible and made initial

 4  application for certification as a physician assistant in this

 5  state between July 1, 1990, and June 30, 1991; and was a

 6  resident of this state on July 1, 1990, or was licensed or

 7  certified in any state in the United States as a physician

 8  assistant on July 1, 1990; or

 9         (II)  Completed all coursework requirements of the

10  Master of Medical Science Physician Assistant Program offered

11  through the Florida College of Physician's Assistants prior to

12  its closure in August of 1996. Prior to taking the

13  examination, such applicant must successfully complete any

14  clinical rotations that were not completed under such program

15  prior to its termination and any additional clinical rotations

16  with an appropriate physician assistant preceptor, not to

17  exceed 6 months, that are determined necessary by the council.

18  The boards shall determine, based on recommendations from the

19  council, the facilities under which such incomplete or

20  additional clinical rotations may be completed and shall also

21  determine what constitutes successful completion thereof,

22  provided such requirements are comparable to those established

23  by accredited physician assistant programs. This

24  sub-sub-subparagraph is repealed July 1, 2001.

25         2.  The department may grant temporary licensure to an

26  applicant who meets the requirements of subparagraph 1.

27  Between meetings of the council, the department may grant

28  temporary licensure to practice based on the completion of all

29  temporary licensure requirements. All such administratively

30  issued licenses shall be reviewed and acted on at the next

31  regular meeting of the council. A temporary license expires 30

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  days after receipt and notice of scores to the licenseholder

 2  from the first available examination specified in subparagraph

 3  1. following licensure by the department. An applicant who

 4  fails the proficiency examination is no longer temporarily

 5  licensed, but may apply for a one-time extension of temporary

 6  licensure after reapplying for the next available examination.

 7  Extended licensure shall expire upon failure of the

 8  licenseholder to sit for the next available examination or

 9  upon receipt and notice of scores to the licenseholder from

10  such examination.

11         3.  Notwithstanding any other provision of law, the

12  examination specified pursuant to subparagraph 1. shall be

13  administered by the department only five times. Applicants

14  certified by the board for examination shall receive at least

15  6 months' notice of eligibility prior to the administration of

16  the initial examination. Subsequent examinations shall be

17  administered at 1-year intervals following the reporting of

18  the scores of the first and subsequent examinations. For the

19  purposes of this paragraph, the department may develop,

20  contract for the development of, purchase, or approve an

21  examination that adequately measures an applicant's ability to

22  practice with reasonable skill and safety. The minimum passing

23  score on the examination shall be established by the

24  department, with the advice of the board. Those applicants

25  failing to pass that examination or any subsequent examination

26  shall receive notice of the administration of the next

27  examination with the notice of scores following such

28  examination. Any applicant who passes the examination and

29  meets the requirements of this section shall be licensed as a

30  physician assistant with all rights defined thereby.

31  

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1         Section 5.  Subsection (1) of section 458.316, Florida

 2  Statutes, is amended to read:

 3         458.316  Public health certificate.--

 4         (1)  Any person desiring to obtain a public health

 5  certificate shall submit an application fee not to exceed $300

 6  and shall demonstrate to the board that he or she is a

 7  graduate of an accredited medical school and holds a master of

 8  public health degree or is board eligible or certified in

 9  public health or preventive medicine, or is licensed to

10  practice medicine without restriction in another jurisdiction

11  in the United States and holds a master of public health

12  degree or is board eligible or certified in public health or

13  preventive medicine, and shall meet the requirements in s.

14  458.311(1)(a)-(f) and (h) s. 458.311(1)(a)-(g) and (5).

15         Section 6.  Section 458.3165, Florida Statutes, is

16  amended to read:

17         458.3165  Public psychiatry certificate.--The board

18  shall issue a public psychiatry certificate to an individual

19  who remits an application fee not to exceed $300, as set by

20  the board, who is a board-certified psychiatrist, who is

21  licensed to practice medicine without restriction in another

22  state, and who meets the requirements in s. 458.311(1)(a)-(f)

23  and (h) s. 458.311(1)(a)-(g) and (5). A recipient of a public

24  psychiatry certificate may use the certificate to work at any

25  public mental health facility or program funded in part or

26  entirely by state funds.

27         (1)  Such certificate shall:

28         (a)  Authorize the holder to practice only in a public

29  mental health facility or program funded in part or entirely

30  by state funds.

31  

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1         (b)  Be issued and renewable biennially if the

 2  secretary of the Department of Health and the chair of the

 3  department of psychiatry at one of the public medical schools

 4  or the chair of the department of psychiatry at the accredited

 5  medical school at the University of Miami recommend in writing

 6  that the certificate be issued or renewed.

 7         (c)  Automatically expire if the holder's relationship

 8  with a public mental health facility or program expires.

 9         (d)  Not be issued to a person who has been adjudged

10  unqualified or guilty of any of the prohibited acts in this

11  chapter.

12         (2)  The board may take disciplinary action against a

13  certificateholder for noncompliance with any part of this

14  section or for any reason for which a regular licensee may be

15  subject to discipline.

16         Section 7.  Paragraph (a) of subsection (1) of section

17  458.317, Florida Statutes, is amended to read:

18         458.317  Limited licenses.--

19         (1)(a)  Any person desiring to obtain a limited license

20  shall:

21         1.  Submit to the board, with an application and fee

22  not to exceed $300, an affidavit stating that he or she has

23  been licensed to practice medicine in any jurisdiction in the

24  United States for at least 10 years and intends to practice

25  only pursuant to the restrictions of a limited license granted

26  pursuant to this section.  However, a physician who is not

27  fully retired in all jurisdictions may use a limited license

28  only for noncompensated practice. If the person applying for a

29  limited license submits a notarized statement from the

30  employing agency or institution stating that he or she will

31  not receive compensation for any service involving the

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1  practice of medicine, the application fee and all licensure

 2  fees shall be waived.  However, any person who receives a

 3  waiver of fees for a limited license shall pay such fees if

 4  the person receives compensation for the practice of medicine.

 5         2.  Meet the requirements in s. 458.311(1)(b)-(f) and

 6  (h) s. 458.311(1)(b)-(g) and (5).  If the applicant graduated

 7  from medical school prior to 1946, the board or its

 8  appropriate committee may accept military medical training or

 9  medical experience as a substitute for the approved 1-year

10  residency requirement in s. 458.311(1)(f).

11  

12  Nothing herein limits in any way any policy by the board,

13  otherwise authorized by law, to grant licenses to physicians

14  duly licensed in other states under conditions less

15  restrictive than the requirements of this section.

16  Notwithstanding the other provisions of this section, the

17  board may refuse to authorize a physician otherwise qualified

18  to practice in the employ of any agency or institution

19  otherwise qualified if the agency or institution has caused or

20  permitted violations of the provisions of this chapter which

21  it knew or should have known were occurring.

22         Section 8.  The sum of $        is appropriated from

23  the General Revenue Fund to the Department of Health for

24  implementing this act during the 2006-2007 fiscal year. This

25  act shall be implemented contingent on an appropriation in the

26  General Appropriations Act.

27         Section 9.  This act shall take effect October 1, 2006.

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    Florida Senate - 2006   (PROPOSED COMMITTEE BILL)     SPB 7064
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 1            *****************************************

 2                          SENATE SUMMARY

 3    Directs the Division of Health Access and Tobacco of the
      Department of Health to monitor, evaluate, and report on
 4    the supply and distribution of physicians and osteopathic
      physicians in the state. Requires applicants for
 5    licensure as a physician to submit core credentials to
      the Federation Credentials Verification Services of the
 6    Federation of State Medical Boards.

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