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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; requiring the agency to adopt rules;

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amending s. 390.011, F.S.; defining the term

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"contraception"; creating s. 390.027, F.S.; specifying

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that the provision of contraception is not subject to ch.

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390, F.S., relating to the termination of pregnancies;

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creating s. 465.190, F.S.; providing definitions;

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requiring licensed pharmacies to dispense certain forms of

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contraception without delay; specifying conditions under

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which a pharmacy may refuse to provide a contraceptive;

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providing for a person to file a complaint with the

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Department of Health if he or she believes that a

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violation of such provisions has occurred; providing for

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the Attorney General to bring a civil action; amending ss.

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465.016 and 465.023, F.S.; providing that a violation of

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requirements for dispensing contraception constitutes

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grounds for the Department of Health or the Board of

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Pharmacy to impose disciplinary action or suspend or

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revoke a pharmacist's license or permit; 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

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

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United 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

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basic health care for women and that access to contraception

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helps women prevent unintended pregnancy and control the timing

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and 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

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rape survivors may suffer unintended pregnancies, and half of

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such 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

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access to family planning information, services, and birth

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control will prevent abortions and unintended pregnancies,

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thereby significantly reducing the number of women and teens

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who need medical assistance, Medicaid, Kidcare, and other

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social services, 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

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Florida State University Center for Prevention and Early

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Intervention Policy found that only 26 percent of women in this

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state who are in need of such services are currently receiving

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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

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expenditures for public programs that support women who have

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unintended 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 contraception" means one or more

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prescription or over-the-counter drugs used separately or in

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combination to be administered to or self-administered by a

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patient to prevent pregnancy within a medically recommended

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amount of time after sexual intercourse and dispensed for that

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purpose, in accordance with professional standards of practice,

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and determined to be safe by the United States Food and Drug

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Administration.

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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 contraception, 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 contraception.

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     (b) If emergency contraception 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 contraception, unless contraindicated as determined by

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a pregnancy test approved by the United States Food and Drug

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Administration.

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     (c) The Agency for Health Care Administration, with input

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from the Florida Hospital Association and the Florida Council

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Against Sexual Violence, shall adopt a protocol to implement the

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requirements of this subsection.

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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 contraception for the prevention of

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pregnancy for distribution to and use in all health care

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facilities in the state that provide care to rape survivors, in

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quantities sufficient to comply with the requirements of this

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section, to the extent that funds are 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 contraception 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:

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     1. Be medically and factually accurate;

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     2. Be clearly written, readily comprehensible, and

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culturally appropriate as determined by the department, in

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collaboration with community sexual assault programs and other

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relevant stakeholders; and

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     3. Explain the nature of emergency contraception, including

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its use, safety, efficacy, and availability.

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     (4) ENFORCEMENT AND PENALTIES.--

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     (a) In addition to any other remedies provided by law, the

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agency shall respond to complaints, using all available

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investigative tools, and shall periodically review whether a

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health care facility is in compliance with this section. If the

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agency finds that a health care facility is not in compliance

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with this section, the agency shall:

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     1. Impose a fine of $5,000 per woman who is:

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     a. Denied medically and factually accurate and objective

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information about emergency contraception;

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     b. Not informed of her medical option to receive emergency

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contraception; or

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     c. Not provided the complete regimen of emergency

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contraception, if emergency contraception is requested.

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     2. Impose a fine of $5,000 for failure to comply with this

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section. For every 30 days that a health care facility is not in

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compliance with this section, an additional fine of $5,000 shall

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be imposed.

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     (b) The agency shall adopt rules as necessary to administer

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the provisions of this section.

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     Section 3.  Subsection (9) is added to section 390.011,

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Florida Statutes, to read:

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     390.011  Definitions.--As used in this chapter, the term:

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     (9) "Contraception" means any drug or device approved by

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the United States Food and Drug Administration to prevent

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pregnancy.

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     Section 4.  Section 390.027, Florida Statutes, is created to

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read:

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     390.027 Access to contraception.--The provision of

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contraception is not subject to or governed by this chapter.

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     Section 5.  Section 465.190, Florida Statutes, is created to

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read:

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     465.190 Patient contraceptive protection.--

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

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

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prescription drug or over-the-counter oral contraceptive approved

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by the United States Food and Drug Administration to prevent

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

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States Food and Drug Administration.

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     (d) "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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     (e) "Without delay," with respect to a pharmacy dispensing

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a prescription for contraception, means within the pharmacy's

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customary timeframe for dispensing the prescription for other

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products.

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     (2) DUTIES OF LICENSED PHARMACIES.--

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     (a) If a patient requests a contraceptive that is in stock,

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the pharmacy shall ensure that the contraceptive is provided to

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the patient or patient representative without delay.

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

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     1. Intimidate, threaten, or harass a patient 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 patient 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 patient's or patient representative's

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request.

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

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to provide a contraceptive to a patient if:

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     1. It is unlawful to dispense the contraceptive to the

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patient without a valid, lawful prescription and such

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prescription is not presented;

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     2. The patient or patient representative is unable to pay

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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 in-stock contraceptive for

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religious reasons so long as the pharmacy reasonably accommodates

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the patient or patient representative without delay and in

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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.

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     (h) 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.

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     Section 6.  Paragraph (t) is added to subsection (1) of

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section 465.016, Florida Statutes, to read:

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     465.016  Disciplinary actions.--

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     (1)  The following acts constitute grounds for denial of a

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license or disciplinary action, as specified in s. 456.072(2):

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     (t) Violating the provisions of s. 465.190.

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     Section 7.  Paragraph (f) is added to subsection (1) of

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section 465.023, Florida Statutes, to read:

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     465.023  Pharmacy permittee; disciplinary action.--

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     (1)  The department or the board may revoke or suspend the

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permit of any pharmacy permittee, and may fine, place on

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probation, or otherwise discipline any pharmacy permittee who

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has:

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     (f) Violated the provisions of s. 465.190.

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     Section 8. 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 9.  This act shall take effect upon becoming a law.