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A bill to be entitled

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An act relating to reproductive health services and family

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planning; creating the "Prevention First Act"; providing

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definitions; providing duties of licensed health care

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practitioners and facilities relating to the treatment of

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rape survivors; requiring the Department of Health to

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provide certain information; requiring the Agency for

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Health Care Administration to provide for enforcement and

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impose penalties; defining the term "contraception";

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specifying that the provision of contraception is not

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subject to ch. 390, F.S., relating to the termination of

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pregnancies; providing definitions; requiring licensed

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pharmacies to dispense certain forms of contraception

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without delay; specifying conditions under which a

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pharmacy may refuse to provide a contraceptive; requiring

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the Department of Health to investigate complaints

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alleging a violation of certain provisions; providing for

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an aggrieved person or the Attorney General to bring a

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civil action; providing for penalties; providing for

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severability; providing an effective date.

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     WHEREAS, although the Centers for Disease Control and

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Prevention included family planning in its published list of Ten

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Great Public Health Achievements in the 20th Century, the United

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States still has one of the highest rates of unintended

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pregnancies among industrialized nations, and

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     WHEREAS, the Legislature finds that family planning is basic

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health care for women and that access to contraception helps

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women prevent unintended pregnancy and control the timing and

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spacing of planned births, and

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     WHEREAS, 46.3 percent of pregnancies among women in this

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state are unintended according to the Florida Pregnancy Risk

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Assessment Monitoring System initiated by the United States

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Centers for Disease Control and Prevention and the Florida

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Department of Health, and

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     WHEREAS, currently more than 1.7 million women in Florida

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are in need of contraceptive services and supplies, and

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     WHEREAS, the Legislature finds that the victimization of

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women through rape is compounded by the possibility that the rape

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survivors may suffer unintended pregnancies, and half of such

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pregnancies end in abortion, and

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     WHEREAS, women rely on prescription contraceptives for a

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range of medical purposes in addition to birth control, such as

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regulation of menstrual cycles and the treatment of

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endometriosis, and

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     WHEREAS, the Legislature further finds that providing access

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to family planning information, services, and birth control will

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prevent abortions and unintended pregnancies, thereby

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significantly reducing the number of women and teens who need

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medical assistance, Medicaid, Kidcare, and other social services,

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and

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     WHEREAS, the Legislature recognizes that the most recent

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study of women in need of family planning services by the Florida

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State University Center for Prevention and Early Intervention

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Policy found that only 26 percent of women in this state who are

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in need of such services are currently receiving them, and

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     WHEREAS, according to the Department of Health's Family

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Planning Program, for every dollar spent on family planning

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services, up to $24 is saved as a result of averting expenditures

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for public programs that support women who have unintended

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pregnancies and their infants, NOW, THEREFORE,

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

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     Section 1. This act may be cited as the "Prevention First

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Act."

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     Section 2. Treatment for survivors of rape.--

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     (1) DEFINITIONS.--As used in this section, the term:

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     (a) "Agency" means the Agency for Health Care

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Administration.

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     (b) "Care to a rape survivor" means medical examinations,

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procedures, and services provided to a rape survivor.

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     (c) "Department" means the Department of Health.

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     (d) "Emergency birth control" means any drug or device

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approved by the United States Food and Drug Administration which

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prevents pregnancy after sexual intercourse.

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     (e) "Health care facility" means a facility licensed under

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chapter 395, Florida Statutes.

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     (f) "Incest" means a sexual offense described in s. 826.04,

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Florida Statutes.

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     (g) "Medically and factually accurate" means information

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that is supported by the weight of research conducted in

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compliance with accepted scientific methods and that is

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recognized as accurate and objective by leading professional

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organizations and agencies having relevant expertise in the

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field.

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     (h) "Rape" means sexual battery as described in ss. 794.011

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and 827.071, Florida Statutes.

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     (i) "Rape survivor" means a person who alleges or is

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alleged to have been raped or who is the victim of alleged incest

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and because of the alleged offense seeks treatment as a patient.

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     (2) DUTIES OF LICENSED PRACTITIONERS AND FACILITIES.--

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     (a) A health care practitioner licensed under chapter 458,

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chapter 459, or chapter 464, Florida Statutes, or a health care

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facility licensed under chapter 395, Florida Statutes, providing

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care to a rape survivor shall:

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     1. Provide each female rape survivor with medically and

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factually accurate, clear, and concise information concerning

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emergency birth control, including its indications and

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contraindications and the risks associated with its use.

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     2. Inform each female rape survivor of her medical option

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to receive emergency birth control.

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     (b) If emergency birth control is requested, the health

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care practitioner or health care facility shall immediately

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provide the female rape survivor with the complete regimen of

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emergency birth control.

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     (3) PATIENT INFORMATION.--

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     (a) The department shall:

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     1. Develop, prepare, and produce informational materials

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relating to emergency birth control for the prevention of

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pregnancy for distribution to and use in all emergency

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departments in the state, in quantities sufficient to comply with

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the requirements of this section, to the extent that funds are

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available.

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     2. Develop, prepare, and post information on the

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department's Internet website relating to the duty of licensed

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health care practitioners and health care facilities to provide

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emergency birth control to female rape survivors.

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     (b) Information provided to female rape survivors or female

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victims of sexual assault must be:

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     1. Medically and factually accurate and objective.

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     2. Clearly written, readily comprehensible, and culturally

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appropriate, as the department, in collaboration with community

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sexual assault programs and other relevant stakeholders,

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considers necessary to explain the nature of emergency birth

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control, including its use, safety, efficacy, and availability.

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     (4) ENFORCEMENT AND PENALTIES.--In addition to any other

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remedies provided by law, the agency shall respond to complaints

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and shall periodically determine, using all available

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investigative tools, whether a health care facility is in

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compliance with this section. If the agency finds that a health

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care facility is not in compliance with this section, the agency

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shall:

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     (a) Impose a fine of $5,000 per woman who is denied

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medically and factually accurate and objective information about

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emergency birth control or who is not offered or provided with

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emergency birth control.

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     (b) Impose a fine of $5,000 for failure to comply with

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subsection (2). For every 30 days that a health care facility is

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not in compliance with subsection (2), an additional fine of

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$5,000 shall be imposed.

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     (c) After two violations, suspend or revoke the health care

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facility's license or deny the health care facility's application

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for a license.

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     Section 3. Access to contraception.--

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     (1) The term "contraception" means any drug or device

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approved by the United States Food and Drug Administration to

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prevent pregnancy.

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     (2) The provision of contraception is not subject to or

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governed by chapter 390, Florida Statutes.

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     Section 4. Patient protection.--

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     (1) DEFINITIONS.--As used in this section, the term:

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     (a) "Contraception" or "contraceptive" means any drug or

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device approved by the United States Food and Drug Administration

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to prevent pregnancy.

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     (b) "Employee" means a person hired, by contract or any

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other form of agreement, by a pharmacy.

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     (c) "Pharmacist" means a person licensed under chapter 465,

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Florida Statutes.

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     (d) "Pharmacy" means an entity that is authorized by the

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state to engage in the business of selling prescription drugs at

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retail and that employs one or more employees.

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     (e) "Product" means a drug or device approved by the United

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States Food and Drug Administration.

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     (f) "Professional clinical judgment" means the use of

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professional knowledge and skills to form a clinical judgment in

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accordance with prevailing medical standards.

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     (g) "Without delay," with respect to a pharmacy providing,

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providing a referral for, or ordering contraception, or

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transferring a prescription for contraception, means within the

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pharmacy's customary timeframe for providing, providing a

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referral for, or ordering other products, or transferring the

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prescription for other products.

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     (2) DUTIES OF LICENSED PHARMACIES.--

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     (a) If a customer requests a contraceptive that is in

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stock, the pharmacy shall ensure that the contraceptive is

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provided to the customer without delay.

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     (b) If a customer requests a contraceptive that is not in

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stock and the pharmacy, in the normal course of business, stocks

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contraceptives, the pharmacy shall immediately inform the

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customer that the contraceptive is not in stock and without delay

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offer the customer the following options:

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     1. If the customer prefers to obtain the contraceptive

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through a referral or transfer, the pharmacy shall:

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     a. Locate a pharmacy of the customer's choice or the

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closest pharmacy confirmed to have the contraceptive in stock;

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and

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     b. Refer the customer or transfer the prescription to that

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pharmacy.

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     2. If the customer prefers that the pharmacy order the

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contraceptive, the pharmacist shall obtain the contraceptive

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under the pharmacy's standard procedure for expedited ordering of

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medication and notify the customer when the contraceptive

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arrives.

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     (c) A pharmacy shall ensure that its employees do not:

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     1. Intimidate, threaten, or harass a customer in the

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delivery of services relating to a request for contraception;

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     2. Interfere with or obstruct the delivery of services

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relating to a request for contraception;

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     3. Intentionally misrepresent or deceive a customer about

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the availability of contraception or its mechanism of action;

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     4. Breach medical confidentiality with respect to a request

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for contraception or threaten to breach such confidentiality; or

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     5. Refuse to return a valid, lawful prescription for

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contraception upon a customer's request.

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     (d) This section does not prohibit a pharmacy from refusing

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to provide a contraceptive to a customer if:

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     1. It is unlawful to dispense the contraceptive to the

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customer without a valid, lawful prescription and such

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prescription is not presented;

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     2. The customer is unable to pay for the contraceptive; or

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     3. The employee of the pharmacy refuses to provide the

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contraceptive on the basis of a professional clinical judgment.

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     (e) This section does not prevent a pharmacist or other

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person from refusing to furnish any contraceptive or family

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planning service, supplies, or information for religious reasons

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so long as the pharmacy ensures that the customer receives the

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contraceptive without delay and in compliance with this section.

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     (f) This section does not alter any standard established

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under the Florida Civil Rights Act of 1992.

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     (g) Any person who believes that a violation of this

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section has occurred may file a complaint with the Department of

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Health. Within 30 days after receiving the complaint, the

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department must investigate the complaint and determine whether a

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violation occurred. If the department finds that a violation

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occurred, the department shall impose a fine no greater than

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$10,000 or any other penalty in accordance with s. 456.072(2),

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Florida Statutes. A pharmacy that violates this section is

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subject to denial or revocation of a permit issued by the

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department.

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     (h) Any person who has been injured by a violation of this

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section may bring a civil action for compensatory and punitive

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damages as well as the costs of the suit and reasonable fees for

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attorneys and expert witnesses. With respect to compensatory

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damages, the plaintiff may elect, at any time prior to the

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rendering of final judgment, to recover, in lieu of actual

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damages, an award of statutory damages in the amount of $5,000.

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     (i) If the Attorney General has reasonable cause to believe

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that any person or group of persons is being, has been, or may be

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injured by conduct constituting a violation of this section, the

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Attorney General may bring a civil action in the name of the

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state, as parens patriae on behalf of natural persons residing in

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the state. In such an action by the Attorney General, the court

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may award appropriate relief, including compensatory damages and

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civil penalties of not more than $10,000 for each violation.

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     Section 5. If any provision of this act or the application

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thereof to any person or circumstance is held invalid, the

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invalidity does not affect other provisions or applications of

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the act which can be given effect without the invalid provision

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or application, and to this end the provisions of this act are

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severable.

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     Section 6.  This act shall take effect upon becoming a law.