HB 385

1
A bill to be entitled
2An act relating to reproductive health services and family
3planning; creating the "Prevention First Act"; providing
4definitions; providing duties of licensed health care
5practitioners and facilities relating to treatment of rape
6survivors; requiring the Department of Health to provide
7certain information; authorizing the Agency for Health
8Care Administration to provide for enforcement and
9penalties; prohibiting interference with the right to
10obtain and use certain methods of contraception; requiring
11licensed pharmacies to dispense certain forms of
12contraception without discrimination or delay; specifying
13conditions for refusal to provide contraception; providing
14for civil action by aggrieved persons; authorizing the
15Attorney General to bring a civil action; providing for
16penalties; providing severability; providing an effective
17date.
18
19     WHEREAS, although the Centers for Disease Control and
20Prevention included family planning in its published list of the
21Ten Great Public Health Achievements in the 20th Century, the
22United States still has one of the highest rates of unintended
23pregnancies among industrialized nations, and
24     WHEREAS, the Legislature finds that family planning is
25basic health care for women and that access to contraception
26helps women prevent unintended pregnancy and control the timing
27and spacing of planned births, and
28     WHEREAS, 46.3 percent of pregnancies among women in the
29state are unintended, according to the Florida Pregnancy Risk
30Assessment Monitoring System initiated by the United States
31Centers for Disease Control and Prevention and the Florida
32Department of Health, and
33     WHEREAS, according to a 2005 study by the Guttmacher
34Institute, more than 1,726,160 women in Florida are in need of
35contraceptive services and supplies, and
36     WHEREAS, the Legislature finds that the victimization of
37women through rape is compounded by the possibility that rape
38survivors may suffer unintended pregnancies, and half of such
39pregnancies end in abortion, and
40     WHEREAS, women rely on prescription contraceptives for a
41range of medical purposes in addition to birth control, such as
42regulation of cycles and endometriosis, and
43     WHEREAS, the Legislature further finds that providing
44access to family planning information, services, and birth
45control will prevent abortions and unintended pregnancies,
46thereby significantly reducing the number of women and teens who
47need medical assistance, Medicaid, KidCare, and other social
48services, and
49     WHEREAS, the Legislature recognizes that the most recent
50study of women in need of family planning services by the
51Florida State University Center for Prevention and Early
52Intervention Policy found that only 26 percent of women in this
53state who are in need of such services are currently receiving
54them, and
55     WHEREAS, according to the Department of Health's Family
56Planning Program, for every dollar spent in family planning
57services, up to $24 is saved as a result of averting
58expenditures for public programs that support women who have
59unintended pregnancies and their infants, NOW, THEREFORE,
60
61Be It Enacted by the Legislature of the State of Florida:
62
63     Section 1.  This act may be cited as the "Prevention First
64Act."
65     Section 2.  Treatment for survivors of rape.--
66     (1)  DEFINITIONS.--As used in this section, the term:
67     (a)  "Agency" means the Agency for Health Care
68Administration.
69     (b)  "Care to a rape survivor" means medical examinations,
70procedures, and services provided to a rape survivor.
71     (c)  "Department" means the Department of Health.
72     (d)  "Emergency birth control" means any drug or device
73approved by the United States Food and Drug Administration that
74prevents pregnancy after sexual intercourse.
75     (e)  "Health care facility" means a facility licensed under
76chapter 395, Florida Statutes.
77     (f)  "Incest" means a sexual offense described in s.
78826.04, Florida Statutes.
79     (g)  "Medically and factually accurate" means information
80supported by the weight of research conducted in compliance with
81accepted scientific methods and recognized as accurate and
82objective by leading professional organizations and agencies
83with relevant expertise in the field.
84     (h)  "Rape" means sexual battery as described in ss.
85794.011 and 827.071, Florida Statutes.
86     (i)  "Rape survivor" means a person who alleges or is
87alleged to have been raped or is the victim of alleged incest
88and because of the alleged offense seeks treatment as a patient.
89     (2)  DUTIES OF LICENSED PRACTITIONERS AND FACILITIES.--
90     (a)  A health care practitioner licensed under chapter 458,
91chapter 459, or chapter 464, Florida Statutes, or a health care
92facility licensed under chapter 395, Florida Statutes, that
93provides care to a rape survivor shall:
94     1.  Provide each female rape survivor with medically and
95factually accurate, clear, and concise information concerning
96emergency birth control, including its indications and
97contraindications and the risks associated with its use.
98     2.  Inform each female rape survivor of her medical option
99to receive emergency birth control.
100     (b)  If emergency birth control is requested, the health
101care practitioner shall immediately provide the female rape
102survivor with the complete regimen of emergency birth control.
103     (3)  PATIENT INFORMATION.--
104     (a)  The department shall:
105     1.  Develop, prepare, and produce informational materials
106relating to emergency birth control for the prevention of
107pregnancy for distribution to and use in all emergency
108departments in the state, in quantities sufficient to comply
109with the requirements of this section, to the extent that funds
110are available.
111     2.  Develop, prepare, and post information relating to the
112duty of licensed health care practitioners and health care
113facilities to provide emergency birth control to female rape
114survivors on the department's Internet website.
115     (b)  Information provided to female victims of sexual
116assault must:
117     1.  Be medically and factually accurate and objective.
118     2.  Be clearly written, readily comprehensible, and
119culturally appropriate, as the department, in collaboration with
120community sexual assault programs and other relevant
121stakeholders, deems necessary to explain the nature of emergency
122birth control, including its use, safety, efficacy, and
123availability.
124     (4)  ENFORCEMENT AND PENALTIES.--In addition to any other
125remedies provided by law, the agency shall respond to complaints
126and shall periodically determine, using all available
127investigative tools, whether a health care facility is in
128compliance with this section. If the agency determines that a
129health care facility is not in compliance with this section, the
130agency shall:
131     (a)  Impose a fine of $5,000 per woman who is denied
132medically and factually accurate and objective information about
133emergency birth control or who is not offered or provided with
134emergency birth control.
135     (b)  Impose a fine of $5,000 for failure to comply with
136subsection (2). For every 30 days that a health care facility is
137not in compliance with subsection (2), an additional fine of
138$5,000 shall be imposed.
139     (c)  After two violations, suspend or revoke the health
140care facility's license or deny the health care facility's
141application for a license.
142     Section 3.  Access to contraception.--
143     (1)  For all purposes, "contraception" means any drug or
144device approved by the United States Food and Drug
145Administration to prevent pregnancy.
146     (2)  The provision of contraception shall not be subject to
147or governed by chapter 390, Florida Statutes.
148     Section 4.  Patient protection.--
149     (1)  DEFINITIONS.--As used in this section, the term:
150     (a)  "Contraception" or "contraceptive" means any drug or
151device approved by the United States Food and Drug
152Administration to prevent pregnancy.
153     (b)  "Employee" means a person hired, by contract or any
154other form of agreement, by a pharmacy.
155     (c)  "Pharmacist" means a person licensed under chapter
156465, Florida Statutes.
157     (d)  "Pharmacy" means an entity that is authorized by the
158state to engage in the business of selling prescription drugs at
159retail and that employs one or more employees.
160     (e)  "Product" means a drug or device approved by the
161United States Food and Drug Administration.
162     (f)  "Professional clinical judgment" means the use of
163professional knowledge and skills to form a clinical judgment in
164accordance with prevailing medical standards.
165     (g)  "Without delay," with respect to a pharmacy providing,
166providing a referral for, or ordering contraception, or
167transferring the prescription for contraception, means within
168the pharmacy's customary timeframe for providing, providing a
169referral for, or ordering other products, or transferring the
170prescription for other products.
171     (2)  DUTIES OF LICENSED PHARMACIES.--
172     (a)  If a customer requests a contraceptive that is in
173stock, the pharmacy shall ensure that the contraceptive is
174provided to the customer without delay.
175     (b)  If a customer requests a contraceptive that is not in
176stock and the pharmacy, in the normal course of business, stocks
177contraception, the pharmacy shall immediately inform the
178customer that the contraceptive is not in stock and without
179delay offer the customer the following options:
180     1.  If the customer prefers to obtain the contraceptive
181through a referral or transfer, the pharmacy shall:
182     a.  Locate a pharmacy of the customer's choice or the
183closest pharmacy confirmed to have the contraceptive in stock;
184and
185     b.  Refer the customer or transfer the prescription to that
186pharmacy.
187     2.  If the customer prefers that the pharmacy order the
188contraceptive, the pharmacy shall obtain the contraceptive under
189the pharmacy's standard procedure for expedited ordering of
190medication and notify the customer when the contraceptive
191arrives.
192     (c)  A pharmacy shall ensure that its employees do not:
193     1.  Intimidate, threaten, or harass a customer in the
194delivery of services relating to a request for contraception;
195     2.  Interfere with or obstruct the delivery of services
196relating to a request for contraception;
197     3.  Intentionally misrepresent or deceive a customer about
198the availability of contraception or its mechanism of action;
199     4.  Breach medical confidentiality with respect to a
200request for contraception or threaten to breach such
201confidentiality; or
202     5.  Refuse to return a valid, lawful prescription for
203contraception upon customer request.
204     (d)  This section does not prohibit a pharmacy from
205refusing to provide a contraceptive to a customer in accordance
206with any of the following:
207     1.  If it is unlawful to dispense the contraceptive to the
208customer without a valid, lawful prescription and no such
209prescription is presented;
210     2.  If the customer is unable to pay for the contraceptive;
211or
212     3.  If the employee of the pharmacy refuses to provide the
213contraceptive on the basis of a professional clinical judgment.
214     (e)  The provisions of this section shall not be
215interpreted so as to prevent a pharmacist or other person from
216refusing to furnish any contraceptive or family planning
217service, supplies, or information for religious reasons so long
218as the pharmacy ensures the customer receives the contraceptive
219without delay and in compliance with this section.
220     (f)  Nothing in this section shall be construed to alter
221any standard established under the Florida Civil Rights Act of
2221992.
223     (g)  Any person who believes that a violation of this act
224has occurred may file a complaint with the department. Within 30
225days after receiving a complaint, the department must
226investigate the complaint and determine whether a violation
227occurred. If the department determines that a violation has
228occurred, the department shall impose a fine no greater than
229$10,000 or any other penalty in accordance with s. 456.072(2),
230Florida Statutes. A pharmacy that violates this act is subject
231to denial or revocation of a permit issued by the department.
232     (h)  Any person who has been injured by a violation of this
233act may bring a civil action for compensatory and punitive
234damages as well as the costs of suit and reasonable fees for
235attorneys and expert witnesses. With respect to compensatory
236damages, the plaintiff may elect, at any time prior to the
237rendering of final judgment, to recover, in lieu of actual
238damages, an award of statutory damages in the amount of $5,000.
239     (i)  If the Attorney General has reasonable cause to
240believe that any person or group of persons is being, has been,
241or may be injured by conduct constituting a violation of this
242act, the Attorney General may bring a civil action in the name
243of the state, as parens patriae on behalf of natural persons
244residing in the state. In such an action by the Attorney
245General, the court may award appropriate relief, including
246compensatory damages and civil penalties of not more than
247$10,000 for each violation.
248     Section 5.  If any provision, word, phrase, or clause of
249this act or the application thereof to any person, entity, or
250circumstance should be held invalid, such invalidity shall not
251affect the remaining provisions, words, phrases, or clauses of
252this act which can be given effect without the invalid
253provision, word, phrase, clause, or application, and to this end
254the provisions, words, phrases, or clauses of this act are
255declared severable.
256     Section 6.  This act shall take effect upon becoming a law.


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