Senate Bill sb0770er

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


    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



  1                                 

  2         An act relating to the physician workforce;

  3         creating s. 381.4018, F.S.; providing

  4         legislative intent; requiring that the

  5         Department of Health serve as a coordinating

  6         and planning body to assess the state's future

  7         workforce needs for physicians; requiring the

  8         department to develop strategies for addressing

  9         the current and projected workforce needs;

10         specifying additional functions of the

11         department; requiring each allopathic and

12         osteopathic physician in the state to complete

13         a survey concerning the physician's practice as

14         a condition of license renewal; specifying the

15         information to be furnished to the department

16         in the physician survey; providing for a

17         nondisciplinary citation to be issued to a

18         physician or osteopathic physician who fails to

19         complete the required survey; requiring the

20         department to provide notice of the applicable

21         penalty; providing rulemaking authority;

22         requiring the department to annually analyze

23         and evaluate the results of the survey;

24         requiring the department to report its findings

25         to the Governor and the Legislature; providing

26         legislative intent concerning resources for

27         implementation of the act; providing an

28         effective date.

29  

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

31  


                                  1

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1         Section 1.  Section 381.4018, Florida Statutes, is

 2  created to read:

 3         381.4018  Physician workforce assessment and

 4  development.--

 5         (1)  LEGISLATIVE INTENT.--The Legislature recognizes

 6  that physician workforce planning is an essential component of

 7  ensuring that there is an adequate and appropriate supply of

 8  well-trained physicians to meet this state's future health

 9  care service needs as the general population and elderly

10  population of the state increase. The Legislature finds that

11  items to consider relative to assessing the physician

12  workforce may include physician practice status; specialty

13  mix; geographic distribution; demographic information,

14  including, but not limited to, age, gender, race, and cultural

15  considerations; and needs of current or projected medically

16  underserved areas in the state. Long-term strategic planning

17  is essential as the period from the time a medical student

18  enters medical school to completion of graduate medical

19  education may range from 7 to 10 years or longer. The

20  Legislature recognizes that strategies to provide for a

21  well-trained supply of physicians must include ensuring the

22  availability and capacity of quality graduate medical schools

23  in this state, as well as using new or existing state and

24  federal programs providing incentives for physicians to

25  practice in needed specialties and in underserved areas in a

26  manner that addresses projected needs for physician manpower.

27         (2)  PURPOSE.--The Department of Health shall serve as

28  a coordinating and strategic planning body to actively assess

29  the state's current and future physician workforce needs and

30  work with multiple stakeholders to develop strategies and

31  


                                  2

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1  alternatives to address current and projected physician

 2  workforce needs.

 3         (3)  GENERAL FUNCTIONS.--The department shall maximize

 4  the use of existing programs under the jurisdiction of the

 5  department and other state agencies and coordinate

 6  governmental and nongovernmental stakeholders and resources in

 7  order to develop a state strategic plan and assess the

 8  implementation of such strategic plan. In developing the state

 9  strategic plan, the department shall:

10         (a)  Monitor, evaluate, and report on the supply and

11  distribution of physicians licensed under chapter 458 or

12  chapter 459. The department shall maintain a database to serve

13  as a statewide source of data concerning the physician

14  workforce.

15         (b)  Develop a model and quantify, on an ongoing basis,

16  the adequacy of the state's current and future physician

17  workforce as reliable data becomes available. Such model must

18  take into account demographics, physician practice status,

19  place of education and training, generational changes,

20  population growth, economic indicators, and issues concerning

21  the "pipeline" into medical education.

22         (c)  Develop and recommend strategies to determine

23  whether the number of qualified medical school applicants who

24  might become competent, practicing physicians in this state

25  will be sufficient to meet the capacity of the state's medical

26  schools. If appropriate, the department shall, working with

27  representatives of appropriate governmental and

28  nongovernmental entities, develop strategies and

29  recommendations and identify best-practice programs that

30  introduce health care as a profession and strengthen skills

31  needed for medical school admission for elementary, middle,


                                  3

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1  and high school students, and improve premedical education at

 2  the precollege and college level in order to increase this

 3  state's potential pool of medical students.

 4         (d)  Develop strategies to ensure that the number of

 5  graduates from the state's public and private allopathic and

 6  osteopathic medical schools are adequate to meet physician

 7  workforce needs, based on the analysis of the physician

 8  workforce data, so as to provide a high-quality medical

 9  education to students in a manner that recognizes the

10  uniqueness of each new and existing medical school in this

11  state.

12         (e)  Pursue strategies and policies to create, expand,

13  and maintain graduate medical education positions in the state

14  based on the analysis of the physician workforce data. Such

15  strategies and policies must take into account the effect of

16  federal funding limitations on the expansion and creation of

17  positions in graduate medical education. The department shall

18  develop options to address such federal funding limitations.

19  The department shall consider options to provide direct state

20  funding for graduate medical education positions in a manner

21  that addresses requirements and needs relative to

22  accreditation of graduate medical education programs. The

23  department shall consider funding residency positions as a

24  means of addressing needed physician specialty areas, rural

25  areas having a shortage of physicians, and areas of ongoing

26  critical need, and as a means of addressing the state's

27  physician workforce needs based on an ongoing analysis of

28  physician workforce data.

29         (f)  Develop strategies to maximize federal and state

30  programs that provide for the use of incentives to attract

31  physicians to this state or retain physicians within the


                                  4

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1  state. Such strategies should explore and maximize

 2  federal-state partnerships that provide incentives for

 3  physicians to practice in federally designated shortage areas.

 4  Strategies shall also consider the use of state programs, such

 5  as the Florida Health Service Corps established pursuant to s.

 6  381.0302 and the Medical Education Reimbursement and Loan

 7  Repayment Program pursuant to s. 1009.65, which provide for

 8  education loan repayment or loan forgiveness and provide

 9  monetary incentives for physicians to relocate to underserved

10  areas of the state.

11         (g)  Coordinate and enhance activities relative to

12  physician workforce needs, undergraduate medical education,

13  and graduate medical education provided by the Division of

14  Medical Quality Assurance, the Community Hospital Education

15  Program and the Graduate Medical Education Committee

16  established pursuant to s. 381.0403, area health education

17  center networks established pursuant to s. 381.0402, and other

18  offices and programs within the Department of Health as

19  designated by the secretary.

20         (h)  Work in conjunction with and act as a coordinating

21  body for governmental and nongovernmental stakeholders to

22  address matters relating to the state's physician workforce

23  assessment and development for the purpose of ensuring an

24  adequate supply of well-trained physicians to meet the state's

25  future needs. Such governmental stakeholders shall include,

26  but need not be limited to, the Secretary of Health or his or

27  her designee, the Commissioner of Education or his or her

28  designee, the Secretary of Health Care Administration or his

29  or her designee, and the Chancellor of the State University

30  System or his or her designee from the Board of Governors of

31  the State University System, and, at the discretion of the


                                  5

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1  department, other representatives of state and local agencies

 2  that are involved in assessing, educating, or training the

 3  state's current or future physicians. Other stakeholders shall

 4  include, but need not be limited to, organizations

 5  representing the state's public and private allopathic and

 6  osteopathic medical schools; organizations representing

 7  hospitals and other institutions providing health care,

 8  particularly those that have an interest in providing

 9  accredited medical education and graduate medical education to

10  medical students and medical residents; organizations

11  representing allopathic and osteopathic practicing physicians;

12  and, at the discretion of the department, representatives of

13  other organizations or entities involved in assessing,

14  educating, or training the state's current or future

15  physicians.

16         (i)  Serve as a liaison with other states and federal

17  agencies and programs in order to enhance resources available

18  to the state's physician workforce and medical education

19  continuum.

20         (j)  Act as a clearinghouse for collecting and

21  disseminating information concerning the physician workforce

22  and medical education continuum in this state.

23         Section 2.  (1)  Each person who applies for licensure

24  renewal as a physician under chapter 458 or chapter 459,

25  Florida Statutes, must, in conjunction with the renewal of

26  such license under procedures adopted by the Department of

27  Health and in addition to any other information that may be

28  required from the applicant, furnish the following to the

29  Department of Health in a physician survey:

30         (a)  Licensee information, including, but not limited

31  to:


                                  6

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1         1.  Frequency and geographic location of practice

 2  within the state.

 3         2.  Practice setting.

 4         3.  Percentage of time spent in direct-patient care.

 5         4.  Anticipated change to license or practice status.

 6         5.  Areas of specialty or certification.

 7         (b)  Availability and trends relating to critically

 8  needed services, including, but not limited to:

 9         1.  Obstetric care and services, including incidents of

10  deliveries.

11         2.  Radiological services, particularly performance of

12  mammograms and breast-imaging services.

13         3.  Physician services for hospital emergency

14  departments and trauma centers, including on-call hours.

15         4.  Other critically-needed specialty areas, as

16  determined by the department.

17         (2)  Such information furnished must include a

18  statement submitted by the physician that the information

19  provided is true and accurate to the best of his or her

20  knowledge and the submission does not contain any knowingly

21  false information.

22         (3)(a)  The Department of Health shall issue a

23  nondisciplinary citation to any physician licensed under

24  chapter 458 or chapter 459, Florida Statutes, who fails to

25  complete the survey within 90 days after the renewal of his or

26  her license to practice as a physician.

27         (b)  The citation must notify a physician who fails to

28  complete the survey required by this section that his or her

29  license will not be renewed for any subsequent license renewal

30  unless the physician completes the survey.

31  


                                  7

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1         (c)  In conjunction with issuing the license-renewal

 2  notice required by s. 456.038, Florida Statutes, the

 3  Department of Health shall notify each physician licensed

 4  under 458 or chapter 459, Florida Statutes, who has failed to

 5  complete the survey at the licensee's last known address of

 6  record with the Department of Health of the requirement that

 7  the physician survey be completed prior to the subsequent

 8  license renewal. At any subsequent license renewal, the

 9  Department of Health may not renew the license of any

10  physician licensed under chapter 458 or chapter 459, Florida

11  Statutes, until the survey required under this section is

12  completed by the licensee.

13         (4)  The Department of Health shall adopt rules

14  pursuant to ss. 120.536(1) and 120.54, Florida Statutes,

15  necessary to implement this section.

16         Section 3.  (1)  Each year, the Department of Health

17  shall analyze the results of the physician survey required by

18  section 2 of this act and determine by geographic area and

19  specialty the number of physicians who:

20         (a)  Perform deliveries of children in Florida.

21         (b)  Read mammograms and perform breast-imaging-guided

22  procedures in Florida.

23         (c)  Perform emergency care on a on-call basis for a

24  hospital emergency department.

25         (d)  Plan to reduce or increase emergency on-call hours

26  in a hospital emergency department.

27         (e)  Plan to relocate their allopathic or osteopathic

28  practice outside the state.

29         (2)  The Department of Health must report its findings

30  to the Governor, the President of Senate, and the Speaker of

31  the House of Representatives by November 1 each year.


                                  8

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




    ENROLLED

    2007 Legislature           CS for CS for SB 770, 3rd Engrossed



 1         Section 4.  It is the intent of the Legislature that

 2  the Department of Health implement the provisions of this act

 3  within existing resources.

 4         Section 5.  This act shall take effect upon becoming a

 5  law.

 6  

 7  

 8  

 9  

10  

11  

12  

13  

14  

15  

16  

17  

18  

19  

20  

21  

22  

23  

24  

25  

26  

27  

28  

29  

30  

31  


                                  9

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