Senate Bill sb0248c1

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    Florida Senate - 2007                            CS for SB 248

    By the Committee on Health Regulation; and Senator Saunders





    588-1911-07

  1                      A bill to be entitled

  2         An act relating to nursing specialties;

  3         amending s. 464.003, F.S.; defining the terms

  4         "clinical nurse specialist practice" and

  5         "clinical nurse specialist"; creating s.

  6         464.0115, F.S.; providing requirements for

  7         certification as a clinical nurse specialist;

  8         providing fees; authorizing the Board of

  9         Nursing to adopt rules; amending s. 464.012,

10         F.S.; adding clinical nurse specialist to the

11         classifications of advanced registered nurse

12         practitioners; amending s. 464.015, F.S.;

13         restricting the use of professional titles and

14         abbreviations relating to practice by clinical

15         nurse specialists, certified registered nurse

16         anesthetists, and certified nurse midwives;

17         providing penalties; amending s. 464.016, F.S.;

18         prohibiting the use of any name or title

19         stating or implying that a person is a clinical

20         nurse specialist, certified registered nurse

21         anesthetist, or certified nurse midwife unless

22         the person is licensed or certified; providing

23         penalties; reenacting s. 921.0022(3)(g), F.S.,

24         relating to the offense severity ranking chart

25         of the Criminal Punishment Code, to incorporate

26         the amendment to s. 464.016, F.S., in a

27         reference thereto; amending ss. 458.348 and

28         459.025, F.S.; conforming cross-references;

29         providing an effective date.

30  

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

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    Florida Senate - 2007                            CS for SB 248
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 1         Section 1.  Section 464.003, Florida Statutes, is

 2  amended to read:

 3         464.003  Definitions.--As used in this part, the term:

 4         (1)  "Department" means the Department of Health.

 5         (2)  "Board" means the Board of Nursing.

 6         (3)(a)  "Practice of professional nursing" means the

 7  performance of those acts requiring substantial specialized

 8  knowledge, judgment, and nursing skill based upon applied

 9  principles of psychological, biological, physical, and social

10  sciences which shall include, but not be limited to:

11         1.  The observation, assessment, nursing diagnosis,

12  planning, intervention, and evaluation of care; health

13  teaching and counseling of the ill, injured, or infirm; and

14  the promotion of wellness, maintenance of health, and

15  prevention of illness of others.

16         2.  The administration of medications and treatments as

17  prescribed or authorized by a duly licensed practitioner

18  authorized by the laws of this state to prescribe such

19  medications and treatments.

20         3.  The supervision and teaching of other personnel in

21  the theory and performance of any of the above acts.

22         (b)  "Practice of practical nursing" means the

23  performance of selected acts, including the administration of

24  treatments and medications, in the care of the ill, injured,

25  or infirm and the promotion of wellness, maintenance of

26  health, and prevention of illness of others under the

27  direction of a registered nurse, a licensed physician, a

28  licensed osteopathic physician, a licensed podiatric

29  physician, or a licensed dentist.

30  

31  

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    Florida Senate - 2007                            CS for SB 248
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 1  The professional nurse and the practical nurse shall be

 2  responsible and accountable for making decisions that are

 3  based upon the individual's educational preparation and

 4  experience in nursing.

 5         (c)  "Clinical nurse specialist practice" means the

 6  delivery and management of advanced practice nursing care to

 7  individuals or groups, including the ability to:

 8         1.  Assess the health status of individuals and

 9  families using methods appropriate to the population and area

10  of practice.

11         2.  Diagnose human responses to actual or potential

12  health problems.

13         3.  Plan for health promotion, disease prevention, and

14  therapeutic intervention in collaboration with the patient or

15  client.

16         4.  Implement therapeutic interventions based on the

17  nurse specialist's area of expertise, including, but not

18  limited to, direct nursing care, counseling, teaching, and

19  collaboration with other licensed health care providers.

20         5.  Coordinate health care as necessary and appropriate

21  and evaluate with the patient or client the effectiveness of

22  care.

23         (d)(c)  "Advanced or specialized nursing practice"

24  means, in addition to the practice of professional nursing,

25  the performance of advanced-level nursing acts approved by the

26  board which, by virtue of postbasic specialized education,

27  training, and experience, are proper to be performed by an

28  advanced registered nurse practitioner.  Within the context of

29  advanced or specialized nursing practice, the advanced

30  registered nurse practitioner may perform acts of nursing

31  diagnosis and nursing treatment of alterations of the health

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    Florida Senate - 2007                            CS for SB 248
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 1  status.  The advanced registered nurse practitioner may also

 2  perform acts of medical diagnosis and treatment, prescription,

 3  and operation which are identified and approved by a joint

 4  committee composed of three members appointed by the Board of

 5  Nursing, two of whom shall be advanced registered nurse

 6  practitioners; three members appointed by the Board of

 7  Medicine, two of whom shall have had work experience with

 8  advanced registered nurse practitioners; and the secretary of

 9  the department or the secretary's designee. Each committee

10  member appointed by a board shall be appointed to a term of 4

11  years unless a shorter term is required to establish or

12  maintain staggered terms. The Board of Nursing shall adopt

13  rules authorizing the performance of any such acts approved by

14  the joint committee. Unless otherwise specified by the joint

15  committee, such acts shall be performed under the general

16  supervision of a practitioner licensed under chapter 458,

17  chapter 459, or chapter 466 within the framework of standing

18  protocols which identify the medical acts to be performed and

19  the conditions for their performance.  The department may, by

20  rule, require that a copy of the protocol be filed with the

21  department along with the notice required by s. 458.348.

22         (e)(d)  "Nursing diagnosis" means the observation and

23  evaluation of physical or mental conditions, behaviors, signs

24  and symptoms of illness, and reactions to treatment and the

25  determination as to whether such conditions, signs, symptoms,

26  and reactions represent a deviation from normal.

27         (f)(e)  "Nursing treatment" means the establishment and

28  implementation of a nursing regimen for the care and comfort

29  of individuals, the prevention of illness, and the education,

30  restoration, and maintenance of health.

31  

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    Florida Senate - 2007                            CS for SB 248
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 1         (4)  "Registered nurse" means any person licensed in

 2  this state to practice professional nursing.

 3         (5)  "Licensed practical nurse" means any person

 4  licensed in this state to practice practical nursing.

 5         (6)  "Clinical nurse specialist" means any person

 6  licensed in this state to practice professional nursing and

 7  certified in clinical nurse specialist practice.

 8         (7)(6)  "Advanced registered nurse practitioner" means

 9  any person licensed in this state to practice professional

10  nursing and certified in advanced or specialized nursing

11  practice, including certified registered nurse anesthetists,

12  certified nurse midwives, and nurse practitioners.

13         (8)(7)  "Approved program" means a nursing program

14  conducted in a school, college, or university which is

15  approved by the board pursuant to s. 464.019 for the education

16  of nurses.

17         Section 2.  Section 464.0115, Florida Statutes, is

18  created to read:

19         464.0115  Certification of clinical nurse

20  specialists.--

21         (1)  Any nurse desiring to be certified as a clinical

22  nurse specialist must apply to the department and submit proof

23  that he or she holds a current license to practice

24  professional nursing, a master's degree in a clinical nursing

25  specialty, and current certification in a specialty area as a

26  clinical nurse specialist from a nationally recognized

27  certifying body as determined by the board.

28         (2)  The board shall certify, and the department shall

29  issue a certificate to, any nurse who fulfills the

30  qualifications in this section. The board shall establish an

31  

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    Florida Senate - 2007                            CS for SB 248
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 1  application fee not to exceed $25 and a biennial renewal fee

 2  not to exceed $10.

 3         (3)  The board may adopt rules necessary to administer

 4  this section pursuant to ss. 120.536(1) and 120.54.

 5         Section 3.  Subsections (2) and (3) of section 464.012,

 6  Florida Statutes, are amended to read:

 7         464.012  Certification of advanced registered nurse

 8  practitioners; fees.--

 9         (2)  The board shall provide by rule the appropriate

10  requirements for advanced registered nurse practitioners in

11  the categories of certified registered nurse anesthetist,

12  certified nurse midwife, and nurse practitioner, and clinical

13  nurse specialist.

14         (3)  An advanced registered nurse practitioner shall

15  perform those functions authorized in this section within the

16  framework of an established protocol that is filed with the

17  board upon biennial license renewal and within 30 days after

18  entering into a supervisory relationship with a physician or

19  changes to the protocol. The board shall review the protocol

20  to ensure compliance with applicable regulatory standards for

21  protocols. The board shall refer to the department licensees

22  submitting protocols that are not compliant with the

23  regulatory standards for protocols. A practitioner currently

24  licensed under chapter 458, chapter 459, or chapter 466 shall

25  maintain supervision for directing the specific course of

26  medical treatment. Within the established framework, an

27  advanced registered nurse practitioner may:

28         (a)  Monitor and alter drug therapies.

29         (b)  Initiate appropriate therapies for certain

30  conditions.

31  

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    Florida Senate - 2007                            CS for SB 248
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 1         (c)  Perform additional functions as may be determined

 2  by rule in accordance with s. 464.003(3)(d) s. 464.003(3)(c).

 3         (d)  Order diagnostic tests and physical and

 4  occupational therapy.

 5         Section 4.  Section 464.015, Florida Statutes, is

 6  amended to read:

 7         464.015  Titles and abbreviations; restrictions;

 8  penalty.--

 9         (1)  Only persons who hold licenses to practice

10  professional nursing in this state or who are performing

11  nursing services pursuant to the exception set forth in s.

12  464.022(8) shall have the right to use the title "Registered

13  Nurse" and the abbreviation "R.N."

14         (2)  Only persons who hold licenses to practice as

15  licensed practical nurses in this state or who are performing

16  practical nursing services pursuant to the exception set forth

17  in s. 464.022(8) shall have the right to use the title

18  "Licensed Practical Nurse" and the abbreviation "L.P.N."

19         (3)  Only persons who are graduates of approved

20  programs or the equivalent may use the term "Graduate Nurse"

21  and the abbreviation "G.N.," pending the results of the first

22  licensure examination for which they are eligible.

23         (4)  Only persons who are graduates of approved

24  programs or the equivalent may use the term "Graduate

25  Practical Nurse" and the abbreviation "G.P.N.," pending the

26  results of the first licensure examination for which they are

27  eligible.

28         (5)  Only persons who hold valid certificates to

29  practice as clinical nurse specialists in this state may use

30  the title "Clinical Nurse Specialist" and the abbreviation

31  "C.N.S."

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    Florida Senate - 2007                            CS for SB 248
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 1         (6)  Only persons who hold valid certificates to

 2  practice as certified registered nurse anesthetists in this

 3  state may use the title "Certified Registered Nurse

 4  Anesthetist" and the abbreviations "C.R.N.A." or "nurse

 5  anesthetist."

 6         (7)  Only persons who hold valid certificates to

 7  practice as certified nurse midwives in this state may use the

 8  title "Certified Nurse Midwife" and the abbreviations "C.N.M."

 9  or "nurse midwife."

10         (8)(5)  Only persons who hold valid certificates to

11  practice as advanced registered nurse practitioners in this

12  state may shall have the right to use the title "Advanced

13  Registered Nurse Practitioner" and the abbreviation "A.R.N.P."

14         (9)(6)  A No person may not shall practice or advertise

15  as, or assume the title of, registered nurse, licensed

16  practical nurse, clinical nurse specialist, certified

17  registered nurse anesthetist, certified nurse midwife, or

18  advanced registered nurse practitioner or use the abbreviation

19  "R.N.," "L.P.N.," "C.N.S.," "C.R.N.A.," "C.N.M.," or

20  "A.R.N.P." or take any other action that would lead the public

21  to believe that person was certified as such or is performing

22  nursing services pursuant to the exception set forth in s.

23  464.022(8), unless that person is licensed or certified to

24  practice as such.

25         (10)(7)  A violation of this section is a misdemeanor

26  of the first degree, punishable as provided in s. 775.082 or

27  s. 775.083.

28         Section 5.  Section 464.016, Florida Statutes, is

29  amended to read:

30         464.016  Violations and penalties.--

31  

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    Florida Senate - 2007                            CS for SB 248
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 1         (1)  Each of the following acts constitutes a felony of

 2  the third degree, punishable as provided in s. 775.082, s.

 3  775.083, or s. 775.084:

 4         (a)  Practicing advanced or specialized, professional,

 5  or practical nursing, as defined in this part, unless holding

 6  an active license or certificate to do so.

 7         (b)  Using or attempting to use a license or

 8  certificate which has been suspended or revoked.

 9         (c)  Knowingly employing unlicensed persons in the

10  practice of nursing.

11         (d)  Obtaining or attempting to obtain a license or

12  certificate under this part by misleading statements or

13  knowing misrepresentation.

14         (2)  Each of the following acts constitutes a

15  misdemeanor of the first degree, punishable as provided in s.

16  775.082 or s. 775.083:

17         (a)  Using the name or title "Nurse," "Registered

18  Nurse," "Licensed Practical Nurse," "Clinical Nurse

19  Specialist," "Certified Registered Nurse Anesthetist,"

20  "Certified Nurse Midwife," "Advanced Registered Nurse

21  Practitioner," or any other name or title which implies that a

22  person was licensed or certified as same, unless such person

23  is duly licensed or certified.

24         (b)  Knowingly concealing information relating to

25  violations of this part.

26         Section 6.  For the purpose of incorporating the

27  amendment to section 464.016, Florida Statutes, in a reference

28  thereto, paragraph (g) of subsection (3) of section 921.0022,

29  Florida Statutes, is reenacted to read:

30         921.0022  Criminal Punishment Code; offense severity

31  ranking chart.--

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 1         (3)  OFFENSE SEVERITY RANKING CHART

 2  

 3  Florida           Felony

 4  Statute           Degree             Description

 5  

 6    

 7                              (g)  LEVEL 7

 8  316.027(1)(b)      1st      Accident involving death, failure

 9                              to stop; leaving scene.

10  316.193(3)(c)2.    3rd      DUI resulting in serious bodily

11                              injury.

12  316.1935(3)(b)     1st      Causing serious bodily injury or

13                              death to another person; driving

14                              at high speed or with wanton

15                              disregard for safety while

16                              fleeing or attempting to elude

17                              law enforcement officer who is in

18                              a patrol vehicle with siren and

19                              lights activated.

20  327.35(3)(c)2.     3rd      Vessel BUI resulting in serious

21                              bodily injury.

22  402.319(2)         2nd      Misrepresentation and negligence

23                              or intentional act resulting in

24                              great bodily harm, permanent

25                              disfiguration, permanent

26                              disability, or death.

27  409.920(2)         3rd      Medicaid provider fraud.

28  456.065(2)         3rd      Practicing a health care

29                              profession without a license.

30  

31  

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 1  456.065(2)         2nd      Practicing a health care

 2                              profession without a license

 3                              which results in serious bodily

 4                              injury.

 5  458.327(1)         3rd      Practicing medicine without a

 6                              license.

 7  459.013(1)         3rd      Practicing osteopathic medicine

 8                              without a license.

 9  460.411(1)         3rd      Practicing chiropractic medicine

10                              without a license.

11  461.012(1)         3rd      Practicing podiatric medicine

12                              without a license.

13  462.17             3rd      Practicing naturopathy without a

14                              license.

15  463.015(1)         3rd      Practicing optometry without a

16                              license.

17  464.016(1)         3rd      Practicing nursing without a

18                              license.

19  465.015(2)         3rd      Practicing pharmacy without a

20                              license.

21  466.026(1)         3rd      Practicing dentistry or dental

22                              hygiene without a license.

23  467.201            3rd      Practicing midwifery without a

24                              license.

25  468.366            3rd      Delivering respiratory care

26                              services without a license.

27  483.828(1)         3rd      Practicing as clinical laboratory

28                              personnel without a license.

29  483.901(9)         3rd      Practicing medical physics

30                              without a license.

31  

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 1  484.013(1)(c)      3rd      Preparing or dispensing optical

 2                              devices without a prescription.

 3  484.053            3rd      Dispensing hearing aids without a

 4                              license.

 5  494.0018(2)        1st      Conviction of any violation of

 6                              ss. 494.001-494.0077 in which the

 7                              total money and property

 8                              unlawfully obtained exceeded

 9                              $50,000 and there were five or

10                              more victims.

11  560.123(8)(b)1.    3rd      Failure to report currency or

12                              payment instruments exceeding

13                              $300 but less than $20,000 by

14                              money transmitter.

15  560.125(5)(a)      3rd      Money transmitter business by

16                              unauthorized person, currency or

17                              payment instruments exceeding

18                              $300 but less than $20,000.

19  655.50(10)(b)1.    3rd      Failure to report financial

20                              transactions exceeding $300 but

21                              less than $20,000 by financial

22                              institution.

23  775.21(10)(a)      3rd      Sexual predator; failure to

24                              register; failure to renew

25                              driver's license or

26                              identification card; other

27                              registration violations.

28  775.21(10)(b)      3rd      Sexual predator working where

29                              children regularly congregate.

30  

31  

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 1  775.21(10)(g)      3rd      Failure to report or providing

 2                              false information about a sexual

 3                              predator; harbor or conceal a

 4                              sexual predator.

 5  782.051(3)         2nd      Attempted felony murder of a

 6                              person by a person other than the

 7                              perpetrator or the perpetrator of

 8                              an attempted felony.

 9  782.07(1)          2nd      Killing of a human being by the

10                              act, procurement, or culpable

11                              negligence of another

12                              (manslaughter).

13  782.071            2nd      Killing of human being or viable

14                              fetus by the operation of a motor

15                              vehicle in a reckless manner

16                              (vehicular homicide).

17  782.072            2nd      Killing of a human being by the

18                              operation of a vessel in a

19                              reckless manner (vessel

20                              homicide).

21  784.045(1)(a)1.    2nd      Aggravated battery; intentionally

22                              causing great bodily harm or

23                              disfigurement.

24  784.045(1)(a)2.    2nd      Aggravated battery; using deadly

25                              weapon.

26  784.045(1)(b)      2nd      Aggravated battery; perpetrator

27                              aware victim pregnant.

28  784.048(4)         3rd      Aggravated stalking; violation of

29                              injunction or court order.

30  784.048(7)         3rd      Aggravated stalking; violation of

31                              court order.

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 1  784.07(2)(d)       1st      Aggravated battery on law

 2                              enforcement officer.

 3  784.074(1)(a)      1st      Aggravated battery on sexually

 4                              violent predators facility staff.

 5  784.08(2)(a)       1st      Aggravated battery on a person 65

 6                              years of age or older.

 7  784.081(1)         1st      Aggravated battery on specified

 8                              official or employee.

 9  784.082(1)         1st      Aggravated battery by detained

10                              person on visitor or other

11                              detainee.

12  784.083(1)         1st      Aggravated battery on code

13                              inspector.

14  790.07(4)          1st      Specified weapons violation

15                              subsequent to previous conviction

16                              of s. 790.07(1) or (2).

17  790.16(1)          1st      Discharge of a machine gun under

18                              specified circumstances.

19  790.165(2)         2nd      Manufacture, sell, possess, or

20                              deliver hoax bomb.

21  790.165(3)         2nd      Possessing, displaying, or

22                              threatening to use any hoax bomb

23                              while committing or attempting to

24                              commit a felony.

25  790.166(3)         2nd      Possessing, selling, using, or

26                              attempting to use a hoax weapon

27                              of mass destruction.

28  

29  

30  

31  

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 1  790.166(4)         2nd      Possessing, displaying, or

 2                              threatening to use a hoax weapon

 3                              of mass destruction while

 4                              committing or attempting to

 5                              commit a felony.

 6  796.03             2nd      Procuring any person under 16

 7                              years for prostitution.

 8  800.04(5)(c)1.     2nd      Lewd or lascivious molestation;

 9                              victim less than 12 years of age;

10                              offender less than 18 years.

11  800.04(5)(c)2.     2nd      Lewd or lascivious molestation;

12                              victim 12 years of age or older

13                              but less than 16 years; offender

14                              18 years or older.

15  806.01(2)          2nd      Maliciously damage structure by

16                              fire or explosive.

17  810.02(3)(a)       2nd      Burglary of occupied dwelling;

18                              unarmed; no assault or battery.

19  810.02(3)(b)       2nd      Burglary of unoccupied dwelling;

20                              unarmed; no assault or battery.

21  810.02(3)(d)       2nd      Burglary of occupied conveyance;

22                              unarmed; no assault or battery.

23  812.014(2)(a)1.    1st      Property stolen, valued at

24                              $100,000 or more or a semitrailer

25                              deployed by a law enforcement

26                              officer; property stolen while

27                              causing other property damage;

28                              1st degree grand theft.

29  812.014(2)(b)2.    2nd      Property stolen, cargo valued at

30                              less than $50,000, grand theft in

31                              2nd degree.

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 1  812.014(2)(b)3.    2nd      Property stolen, emergency

 2                              medical equipment; 2nd degree

 3                              grand theft.

 4  812.0145(2)(a)     1st      Theft from person 65 years of age

 5                              or older; $50,000 or more.

 6  812.019(2)         1st      Stolen property; initiates,

 7                              organizes, plans, etc., the theft

 8                              of property and traffics in

 9                              stolen property.

10  812.131(2)(a)      2nd      Robbery by sudden snatching.

11  812.133(2)(b)      1st      Carjacking; no firearm, deadly

12                              weapon, or other weapon.

13  817.234(8)(a)      2nd      Solicitation of motor vehicle

14                              accident victims with intent to

15                              defraud.

16  817.234(9)         2nd      Organizing, planning, or

17                              participating in an intentional

18                              motor vehicle collision.

19  817.234(11)(c)     1st      Insurance fraud; property value

20                              $100,000 or more.

21  817.2341(2)(b)&

22   (3)(b)            1st      Making false entries of material

23                              fact or false statements

24                              regarding property values

25                              relating to the solvency of an

26                              insuring entity which are a

27                              significant cause of the

28                              insolvency of that entity.

29  

30  

31  

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 1  825.102(3)(b)      2nd      Neglecting an elderly person or

 2                              disabled adult causing great

 3                              bodily harm, disability, or

 4                              disfigurement.

 5  825.103(2)(b)      2nd      Exploiting an elderly person or

 6                              disabled adult and property is

 7                              valued at $20,000 or more, but

 8                              less than $100,000.

 9  827.03(3)(b)       2nd      Neglect of a child causing great

10                              bodily harm, disability, or

11                              disfigurement.

12  827.04(3)          3rd      Impregnation of a child under 16

13                              years of age by person 21 years

14                              of age or older.

15  837.05(2)          3rd      Giving false information about

16                              alleged capital felony to a law

17                              enforcement officer.

18  838.015            2nd      Bribery.

19  838.016            2nd      Unlawful compensation or reward

20                              for official behavior.

21  838.021(3)(a)      2nd      Unlawful harm to a public

22                              servant.

23  838.22             2nd      Bid tampering.

24  847.0135(3)        3rd      Solicitation of a child, via a

25                              computer service, to commit an

26                              unlawful sex act.

27  872.06             2nd      Abuse of a dead human body.

28  

29  

30  

31  

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    Florida Senate - 2007                            CS for SB 248
    588-1911-07




 1  893.13(1)(c)1.     1st      Sell, manufacture, or deliver

 2                              cocaine (or other drug prohibited

 3                              under s. 893.03(1)(a), (1)(b),

 4                              (1)(d), (2)(a), (2)(b), or

 5                              (2)(c)4.) within 1,000 feet of a

 6                              child care facility, school, or

 7                              state, county, or municipal park

 8                              or publicly owned recreational

 9                              facility or community center.

10  893.13(1)(e)1.     1st      Sell, manufacture, or deliver

11                              cocaine or other drug prohibited

12                              under s. 893.03(1)(a), (1)(b),

13                              (1)(d), (2)(a), (2)(b), or

14                              (2)(c)4., within 1,000 feet of

15                              property used for religious

16                              services or a specified business

17                              site.

18  893.13(4)(a)       1st      Deliver to minor cocaine (or

19                              other s. 893.03(1)(a), (1)(b),

20                              (1)(d), (2)(a), (2)(b), or

21                              (2)(c)4. drugs).

22  893.135(1)(a)1.    1st      Trafficking in cannabis, more

23                              than 25 lbs., less than 2,000

24                              lbs.

25  893.135

26   (1)(b)1.a.        1st      Trafficking in cocaine, more than

27                              28 grams, less than 200 grams.

28  893.135

29   (1)(c)1.a.        1st      Trafficking in illegal drugs,

30                              more than 4 grams, less than 14

31                              grams.

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    Florida Senate - 2007                            CS for SB 248
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 1  893.135

 2   (1)(d)1.          1st      Trafficking in phencyclidine,

 3                              more than 28 grams, less than 200

 4                              grams.

 5  893.135(1)(e)1.    1st      Trafficking in methaqualone, more

 6                              than 200 grams, less than 5

 7                              kilograms.

 8  893.135(1)(f)1.    1st      Trafficking in amphetamine, more

 9                              than 14 grams, less than 28

10                              grams.

11  893.135

12   (1)(g)1.a.        1st      Trafficking in flunitrazepam, 4

13                              grams or more, less than 14

14                              grams.

15  893.135

16   (1)(h)1.a.        1st      Trafficking in

17                              gamma-hydroxybutyric acid (GHB),

18                              1 kilogram or more, less than 5

19                              kilograms.

20  893.135

21   (1)(j)1.a.        1st      Trafficking in 1,4-Butanediol, 1

22                              kilogram or more, less than 5

23                              kilograms.

24  893.135

25   (1)(k)2.a.        1st      Trafficking in Phenethylamines,

26                              10 grams or more, less than 200

27                              grams.

28  896.101(5)(a)      3rd      Money laundering, financial

29                              transactions exceeding $300 but

30                              less than $20,000.

31  

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    Florida Senate - 2007                            CS for SB 248
    588-1911-07




 1  896.104(4)(a)1.    3rd      Structuring transactions to evade

 2                              reporting or registration

 3                              requirements, financial

 4                              transactions exceeding $300 but

 5                              less than $20,000.

 6  943.0435(4)(c)     2nd      Sexual offender vacating

 7                              permanent residence; failure to

 8                              comply with reporting

 9                              requirements.

10  943.0435(8)        2nd      Sexual offender; remains in state

11                              after indicating intent to leave;

12                              failure to comply with reporting

13                              requirements.

14  943.0435(9)(a)     3rd      Sexual offender; failure to

15                              comply with reporting

16                              requirements.

17  943.0435(13)       3rd      Failure to report or providing

18                              false information about a sexual

19                              offender; harbor or conceal a

20                              sexual offender.

21  943.0435(14)       3rd      Sexual offender; failure to

22                              report and reregister; failure to

23                              respond to address verification.

24  944.607(9)         3rd      Sexual offender; failure to

25                              comply with reporting

26                              requirements.

27  944.607(10)(a)     3rd      Sexual offender; failure to

28                              submit to the taking of a

29                              digitized photograph.

30  

31  

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    Florida Senate - 2007                            CS for SB 248
    588-1911-07




 1  944.607(12)        3rd      Failure to report or providing

 2                              false information about a sexual

 3                              offender; harbor or conceal a

 4                              sexual offender.

 5  944.607(13)        3rd      Sexual offender; failure to

 6                              report and reregister; failure to

 7                              respond to address verification.

 8         Section 7.  Paragraph (a) of subsection (1) and

 9  subsection (2) of section 458.348, Florida Statutes, are

10  amended to read:

11         458.348  Formal supervisory relationships, standing

12  orders, and established protocols; notice; standards.--

13         (1)  NOTICE.--

14         (a)  When a physician enters into a formal supervisory

15  relationship or standing orders with an emergency medical

16  technician or paramedic licensed pursuant to s. 401.27, which

17  relationship or orders contemplate the performance of medical

18  acts, or when a physician enters into an established protocol

19  with an advanced registered nurse practitioner, which protocol

20  contemplates the performance of medical acts identified and

21  approved by the joint committee pursuant to s. 464.003(3)(d)

22  s. 464.003(3)(c) or acts set forth in s. 464.012(3) and (4),

23  the physician shall submit notice to the board. The notice

24  shall contain a statement in substantially the following form:

25  

26         I, ...(name and professional license number of

27  physician)..., of ...(address of physician)... have hereby

28  entered into a formal supervisory relationship, standing

29  orders, or an established protocol with ...(number of

30  persons)... emergency medical technician(s), ...(number of

31  

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    Florida Senate - 2007                            CS for SB 248
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 1  persons)... paramedic(s), or ...(number of persons)...

 2  advanced registered nurse practitioner(s).

 3         (2)  ESTABLISHMENT OF STANDARDS BY JOINT

 4  COMMITTEE.--The joint committee created under s. 464.003(3)(d)

 5  by s. 464.003(3)(c) shall determine minimum standards for the

 6  content of established protocols pursuant to which an advanced

 7  registered nurse practitioner may perform medical acts

 8  identified and approved by the joint committee pursuant to s.

 9  464.003(3)(d) s. 464.003(3)(c) or acts set forth in s.

10  464.012(3) and (4) and shall determine minimum standards for

11  supervision of such acts by the physician, unless the joint

12  committee determines that any act set forth in s. 464.012(3)

13  or (4) is not a medical act.  Such standards shall be based on

14  risk to the patient and acceptable standards of medical care

15  and shall take into account the special problems of medically

16  underserved areas. The standards developed by the joint

17  committee shall be adopted as rules by the Board of Nursing

18  and the Board of Medicine for purposes of carrying out their

19  responsibilities pursuant to part I of chapter 464 and this

20  chapter, respectively, but neither board shall have

21  disciplinary powers over the licensees of the other board.

22         Section 8.  Paragraph (a) of subsection (1) of section

23  459.025, Florida Statutes, is amended to read:

24         459.025  Formal supervisory relationships, standing

25  orders, and established protocols; notice; standards.--

26         (1)  NOTICE.--

27         (a)  When an osteopathic physician enters into a formal

28  supervisory relationship or standing orders with an emergency

29  medical technician or paramedic licensed pursuant to s.

30  401.27, which relationship or orders contemplate the

31  performance of medical acts, or when an osteopathic physician

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    Florida Senate - 2007                            CS for SB 248
    588-1911-07




 1  enters into an established protocol with an advanced

 2  registered nurse practitioner, which protocol contemplates the

 3  performance of medical acts identified and approved by the

 4  joint committee pursuant to s. 464.003(3)(d) s. 464.003(3)(c)

 5  or acts set forth in s. 464.012(3) and (4), the osteopathic

 6  physician shall submit notice to the board. The notice must

 7  contain a statement in substantially the following form:

 8         I, (name and professional license number of osteopathic

 9  physician), of (address of osteopathic physician) have hereby

10  entered into a formal supervisory relationship, standing

11  orders, or an established protocol with (number of persons)

12  emergency medical technician(s), (number of persons)

13  paramedic(s), or (number of persons) advanced registered nurse

14  practitioner(s).

15         Section 9.  This act shall take effect July 1, 2007.

16  

17          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
18                         Senate Bill 248

19                                 

20  The committee substitute revises the definition of "clinical
    nurse specialist practice" and also revises the list of
21  protected nursing titles.

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  

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