HB 129

1	A bill to be entitled
2	An act relating to reproductive health services and family
3	planning; creating the "Prevention First Act"; providing
4	definitions; providing duties of licensed health care
5	practitioners and facilities relating to the treatment of
6	rape survivors; requiring the Department of Health to
7	provide certain information; requiring the Agency for
8	Health Care Administration to provide for enforcement and
9	impose penalties; requiring the agency to adopt rules;
10	amending s. 390.011, F.S.; defining the term
11	"contraception"; creating s. 390.027, F.S.; specifying
12	that the provision of contraception is not subject to ch.
13	390, F.S., relating to the termination of pregnancies;
14	creating s. 465.191, F.S.; providing definitions;
15	requiring licensed pharmacies to dispense certain forms of
16	contraception without delay; specifying conditions under
17	which a pharmacy may refuse to provide a contraceptive;
18	providing for a person to file a complaint with the
19	Department of Health if he or she believes that a
20	violation of such provisions has occurred; providing for
21	the Attorney General to bring a civil action; amending ss.
22	465.016 and 465.023, F.S.; providing that a violation of
23	requirements for dispensing contraception constitutes
24	grounds for the Department of Health or the Board of
25	Pharmacy to impose disciplinary action or suspend or
26	revoke a pharmacist's license or permit; providing for
27	severability; providing an effective date.
28
29	WHEREAS, although the Centers for Disease Control and
30	Prevention included family planning in its published list of
31	Ten Great Public Health Achievements in the 20th Century, the
32	United States still has one of the highest rates of unintended
33	pregnancies among industrialized nations, and
34	WHEREAS, the Legislature finds that family planning is
35	basic health care for women and that access to contraception
36	helps women prevent unintended pregnancies and control the
37	timing and spacing of planned births, and
38	WHEREAS, 46.3 percent of pregnancies among women in this
39	state are unintended according to the Florida Pregnancy Risk
40	Assessment Monitoring System initiated by the United States
41	Centers for Disease Control and Prevention and the Florida
42	Department of Health, and
43	WHEREAS, currently more than 1.7 million women in Florida
44	are in need of contraceptive services and supplies, and
45	WHEREAS, the Legislature finds that the victimization of
46	women through rape is compounded by the possibility that the
47	rape survivors may suffer unintended pregnancies, and half of
48	such pregnancies end in abortion, and
49	WHEREAS, women rely on prescription contraceptives for a
50	range of medical purposes in addition to birth control, such as
51	regulation of menstrual cycles and the treatment of
52	endometriosis, and
53	WHEREAS, the Legislature further finds that providing
54	access to family planning information, services, and birth
55	control will prevent abortions and unintended pregnancies,
56	thereby significantly reducing the number of women and teens
57	who need medical assistance, Medicaid, Kidcare, and other
58	social services, and
59	WHEREAS, the Legislature recognizes that the most recent
60	study of women in need of family planning services by the
61	Florida State University Center for Prevention and Early
62	Intervention Policy found that only 26 percent of women in this
63	state who are in need of such services are currently receiving
64	them, and
65	WHEREAS, according to the Department of Health's Family
66	Planning Program, for every dollar spent on family planning
67	services, up to $24 is saved as a result of averting
68	expenditures for public programs that support women who have
69	unintended pregnancies and their infants, NOW, THEREFORE,
70
71	Be It Enacted by the Legislature of the State of Florida:
72
73	Section 1.  This act may be cited as the "Prevention First
74	Act."
75	Section 2.  Treatment for survivors of rape.--
76	(1)  DEFINITIONS.--As used in this section, the term:
77	(a)  "Agency" means the Agency for Health Care
78	Administration.
79	(b)  "Care to a rape survivor" means medical examinations,
80	procedures, and services provided to a rape survivor.
81	(c)  "Department" means the Department of Health.
82	(d)  "Emergency contraception" means one or more
83	prescription or over-the-counter drugs used separately or in
84	combination to be administered to or self-administered by a
85	patient to prevent pregnancy within a medically recommended
86	amount of time after sexual intercourse and dispensed for that
87	purpose, in accordance with professional standards of practice,
88	and determined to be safe by the United States Food and Drug
89	Administration.
90	(e)  "Health care facility" means a facility licensed under
91	chapter 395, Florida Statutes.
92	(f)  "Incest" means a sexual offense described in s.
93	826.04, Florida Statutes.
94	(g)  "Medically and factually accurate" means information
95	that is supported by the weight of research conducted in
96	compliance with accepted scientific methods and that is
97	recognized as accurate and objective by leading professional
98	organizations and agencies having relevant expertise in the
99	field.
100	(h)  "Rape" means sexual battery as described in ss.
101	794.011 and 827.071, Florida Statutes.
102	(i)  "Rape survivor" means a person who alleges or is
103	alleged to have been raped or who is the victim of alleged
104	incest and because of the alleged offense seeks treatment as a
105	patient.
106	(2)  DUTIES OF LICENSED PRACTITIONERS AND FACILITIES.--
107	(a)  A health care practitioner licensed under chapter 458,
108	chapter 459, or chapter 464, Florida Statutes, or a health care
109	facility licensed under chapter 395, Florida Statutes, providing
110	care to a rape survivor shall:
111	1.  Provide each female rape survivor with medically and
112	factually accurate, clear, and concise information concerning
113	emergency contraception, including its indications and
114	contraindications and the risks associated with its use.
115	2.  Inform each female rape survivor of her medical option
116	to receive emergency contraception.
117	(b)  If emergency contraception is requested, the health
118	care practitioner or health care facility shall immediately
119	provide the female rape survivor with the complete regimen of
120	emergency contraception, unless contraindicated as determined by
121	a pregnancy test approved by the United States Food and Drug
122	Administration.
123	(c)  The Agency for Health Care Administration, with input
124	from the Florida Hospital Association and the Florida Council
125	Against Sexual Violence, shall adopt a protocol to implement the
126	requirements of this subsection.
127	(3)  PATIENT INFORMATION.--
128	(a)  The department shall:
129	1.  Develop, prepare, and produce informational materials
130	relating to emergency contraception for the prevention of
131	pregnancy for distribution to and use in all health care
132	facilities in the state that provide care to rape survivors, in
133	quantities sufficient to comply with the requirements of this
134	section, to the extent that funds are available.
135	2.  Develop, prepare, and post information on the
136	department's Internet website relating to the duty of licensed
137	health care practitioners and health care facilities to provide
138	emergency contraception to female rape survivors.
139	(b)  Information provided to female rape survivors or
140	female victims of sexual assault must:
141	1.  Be medically and factually accurate;
142	2.  Be clearly written, readily comprehensible, and
143	culturally appropriate as determined by the department, in
144	collaboration with community sexual assault programs and other
145	relevant stakeholders; and
146	3.  Explain the nature of emergency contraception,
147	including its use, safety, efficacy, and availability.
148	(4)  ENFORCEMENT AND PENALTIES.--
149	(a)  In addition to any other remedies provided by law, the
150	agency shall respond to complaints, using all available
151	investigative tools, and shall periodically review whether a
152	health care facility is in compliance with this section. If the
153	agency finds that a health care facility is not in compliance
154	with this section, the agency shall:
155	1.  Impose a fine of $5,000 per woman who is:
156	a.  Denied medically and factually accurate and objective
157	information about emergency contraception;
158	b.  Not informed of her medical option to receive emergency
159	contraception; or
160	c.  Not provided the complete regimen of emergency
161	contraception, if emergency contraception is requested.
162	2.  Impose a fine of $5,000 for failure to comply with this
163	section. For every 30 days that a health care facility is not in
164	compliance with this section, an additional fine of $5,000 shall
165	be imposed.
166	(b)  The agency shall adopt rules as necessary to
167	administer the provisions of this section.
168	Section 3.  Subsections (4) through (8) of section 390.011,
169	Florida Statutes, are renumbered as subsections (5) through (9),
170	respectively, and a new subsection (4) is added to that section
171	to read:
172	390.011  Definitions.--As used in this chapter, the term:
173	(4)  "Contraception" means any drug or device approved by
174	the United States Food and Drug Administration to prevent
175	pregnancy.
176	Section 4.  Section 390.027, Florida Statutes, is created
177	to read:
178	390.027  Access to contraception.--The provision of
179	contraception is not subject to or governed by this chapter.
180	Section 5.  Section 465.191, Florida Statutes, is created
181	to read:
182	465.191  Patient contraceptive protection.--
183	(1)  DEFINITIONS.--As used in this section, the term:
184	(a)  "Contraception" or "contraceptive" means any
185	prescription drug or over-the-counter oral contraceptive
186	approved by the United States Food and Drug Administration to
187	prevent pregnancy.
188	(b)  "Employee" means a person hired, by contract or any
189	other form of agreement, by a pharmacy.
190	(c)  "Product" means a drug or device approved by the
191	United States Food and Drug Administration.
192	(d)  "Professional clinical judgment" means the use of
193	professional knowledge and skills to form a clinical judgment in
194	accordance with prevailing medical standards.
195	(e)  "Without delay," with respect to a pharmacy dispensing
196	a prescription for contraception, means within the pharmacy's
197	customary timeframe for dispensing a prescription for other
198	products.
199	(2)  DUTIES OF LICENSED PHARMACIES.--
200	(a)  If a patient requests a contraceptive that is in
201	stock, the pharmacy shall ensure that the contraceptive is
202	provided to the patient or patient representative without delay.
203	(b)  A pharmacy shall ensure that its employees do not:
204	1.  Intimidate, threaten, or harass a patient in the
205	delivery of services relating to a request for contraception;
206	2.  Interfere with or obstruct the delivery of services
207	relating to a request for contraception;
208	3.  Intentionally misrepresent or deceive a patient about
209	the availability of contraception or its mechanism of action;
210	4.  Breach medical confidentiality with respect to a
211	request for contraception or threaten to breach such
212	confidentiality; or
213	5.  Refuse to return a valid, lawful prescription for
214	contraception upon a patient's or patient representative's
215	request.
216	(c)  This section does not prohibit a pharmacy from
217	refusing to provide a contraceptive to a patient if:
218	1.  It is unlawful to dispense the contraceptive to the
219	patient without a valid, lawful prescription and such
220	prescription is not presented;
221	2.  The patient or patient representative is unable to pay
222	for the contraceptive; or
223	3.  The employee of the pharmacy refuses to provide the
224	contraceptive on the basis of a professional clinical judgment.
225	(d)  This section does not prevent a pharmacist or other
226	person from refusing to furnish any in-stock contraceptive for
227	religious reasons so long as the pharmacy reasonably
228	accommodates the patient or patient representative without delay
229	and in compliance with this section.
230	(e)  This section does not alter any standard established
231	under the Florida Civil Rights Act of 1992.
232	(f)  Any person who believes that a violation of this
233	section has occurred may file a complaint with the Department of
234	Health.
235	(g)  If the Attorney General has reasonable cause to
236	believe that any person or group of persons is being, has been,
237	or may be injured by conduct constituting a violation of this
238	section, the Attorney General may bring a civil action in the
239	name of the state, as parens patriae on behalf of natural
240	persons residing in the state.
241	Section 6.  Paragraph (t) is added to subsection (1) of
242	section 465.016, Florida Statutes, to read:
243	465.016  Disciplinary actions.--
244	(1)  The following acts constitute grounds for denial of a
245	license or disciplinary action, as specified in s. 456.072(2):
246	(t)  Violating the provisions of s. 465.191.
247	Section 7.  Paragraphs (d) and (e) of subsection (1) of
248	section 465.023, Florida Statutes, are amended, and paragraph
249	(f) is added to that subsection, to read:
250	465.023  Pharmacy permittee; disciplinary action.--
251	(1)  The department or the board may revoke or suspend the
252	permit of any pharmacy permittee, and may fine, place on
253	probation, or otherwise discipline any pharmacy permittee who
254	has:
255	(d)  Been convicted or found guilty, regardless of
256	adjudication, of a felony or any other crime involving moral
257	turpitude in any of the courts of this state, of any other
258	state, or of the United States; or
259	(e)  Dispensed any medicinal drug based upon a
260	communication that purports to be a prescription as defined by
261	s. 465.003(14) or s. 893.02 when the pharmacist knows or has
262	reason to believe that the purported prescription is not based
263	upon a valid practitioner-patient relationship that includes a
264	documented patient evaluation, including history and a physical
265	examination adequate to establish the diagnosis for which any
266	drug is prescribed and any other requirement established by
267	board rule under chapter 458, chapter 459, chapter 461, chapter
268	463, chapter 464, or chapter 466; or.
269	(f)  Violated the provisions of s. 465.191.
270	Section 8.  If any provision of this act or the application
271	thereof to any person or circumstance is held invalid, the
272	invalidity does not affect other provisions or applications of
273	the act which can be given effect without the invalid provision
274	or application, and to this end the provisions of this act are
275	severable.
276	Section 9.  This act shall take effect upon becoming a law.

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