CS/HB 209

1
A bill to be entitled
2An act relating to anatomical gifts; amending s. 765.511,
3F.S.; providing additional definitions; amending s.
4765.512, F.S.; conforming terms; amending s. 765.513,
5F.S.; revising the list of donees that may accept
6anatomical gifts and the purposes for which such gifts may
7be used; amending ss. 765.514, 765.515, 765.5155, and
8765.51551, F.S.; conforming terms; amending s. 765.516,
9F.S.; revising provisions relating to a donor's amendment
10or revocation of an anatomical gift; amending s. 765.517,
11F.S.; revising provisions relating to a donee's use of an
12anatomical gift at the time of the donor's death;
13providing liability protection for the person making a
14gift and for the donor's estate; amending s. 765.521,
15F.S.; conforming terms; amending s. 765.522, F.S.;
16providing that the laws of this state govern the
17interpretation of a valid document of gift and that a
18document of gift is presumed to be valid; amending ss.
19765.53, 765.541, 765.542, 765.543, 765.544, and 765.545,
20F.S.; conforming terms; creating s. 765.547, F.S.;
21requiring medical examiners and procurement organizations
22to cooperate and maximize opportunities for organ
23donations; authorizing the Florida Medical Examiners
24Commission to adopt rules; amending ss. 408.802 and
25408.820, F.S.; conforming terms; providing an effective
26date.
27
28Be It Enacted by the Legislature of the State of Florida:
29
30     Section 1.  Section 765.511, Florida Statutes, is amended
31to read:
32     765.511  Definitions.--As used in this part, the term:
33     (1)  "Agency" means the Agency for Health Care
34Administration.
35     (2)  "Anatomical gift" or "gift" means a donation of all or
36part of a human body to take effect after the donor's death and
37to be used for transplantation, therapy, research, or education.
38     (3)(1)  "Bank" or "storage facility" means a facility
39licensed, accredited, or approved under the laws of any state
40for storage of human bodies or body parts thereof.
41     (4)(2)  "Death" means the absence of life as determined, in
42accordance with currently accepted medical standards, by the
43irreversible cessation of all respiration and circulatory
44function, or as determined, in accordance with s. 382.009, by
45the irreversible cessation of the functions of the entire brain,
46including the brain stem.
47     (5)  "Decedent" means a deceased individual whose body or
48body parts may be, or are, the source of an anatomical gift.
49     (6)  "Department" means the Department of Highway Safety
50and Motor Vehicles.
51     (7)  "Disinterested witness" means a witness other than a
52person listed in s. 765.512(3) or other family member.
53     (8)  "Document of gift" means any of the documents or
54mechanisms used in making an anatomical gift under s. 765.514.
55     (9)(3)  "Donor" means an individual who makes an anatomical
56a gift of all or part of his or her body.
57     (10)  "Donor registry" means a database that contains
58records of anatomical gifts and amendments to, or revocations
59of, such gifts.
60     (11)  "Eye bank" means an entity that is accredited by the
61Eye Bank Association of America or otherwise regulated under
62federal or state law to engage in the retrieval, screening,
63testing, processing, storage, or distribution of human eye
64tissue.
65     (12)  "Guardian" means a person appointed pursuant to
66chapter 744. The term does not include a guardian ad litem.
67     (13)(4)  "Hospital" means a hospital licensed, accredited,
68or approved under the laws of any state and includes a hospital
69operated by the United States Government or a state, or a
70subdivision thereof, although not required to be licensed under
71state laws.
72     (14)  "Identification card" means an official
73identification card issued by a governmental entity, state
74agency, or subdivision thereof.
75     (15)  "Organ procurement organization" means an entity that
76is designated as an organ procurement organization by the
77Secretary of the United States Department of Health and Human
78Services and that engages in the retrieval, screening, testing,
79processing, storage, or distribution of human organs.
80     (16)  "Part of the body" or "body part" means an organ,
81eye, or tissue of a human being. The term does not include the
82whole body.
83     (17)(5)  "Physician" or "surgeon" means a physician or
84surgeon licensed to practice under chapter 458 or chapter 459 or
85similar laws of any state. "Surgeon" includes dental or oral
86surgeon.
87     (18)  "Procurement" means any retrieval, recovery,
88processing, storage, or distribution of human organs or tissues
89for transplantation, therapy, research, or education.
90     (19)  "Procurement organization" means an organ procurement
91organization, eye bank, or tissue bank.
92     (20)  "Reasonably available" means able to be contacted by
93a procurement organization in a timely manner without undue
94effort, and willing and able to act in a manner consistent with
95existing medical protocols necessary for the making of an
96anatomical gift.
97     (21)  "Record" means information that is inscribed on a
98tangible medium or that is stored in an electronic or other
99medium and is retrievable in perceivable form.
100     (22)  "Sign" or "signed" means, with the present intent to
101authenticate or adopt a record, to execute or adopt a tangible
102symbol, or attach to or logically associate an electronic
103symbol, sound, or process with the record.
104     (23)  "Tissue bank" means an entity that is accredited by
105the American Association of Tissue Banks or otherwise regulated
106under federal or state law to engage in the retrieval,
107screening, testing, processing, storage, or distribution of
108human tissue.
109     Section 2.  Subsections (1), (4), (5), (6), and (7) of
110section 765.512, Florida Statutes, are amended to read:
111     765.512  Persons who may make an anatomical gift.--
112     (1)  Any person who may make a will may make an anatomical
113gift give all or part of his or her body for any purpose
114specified in s. 765.513. The gift is effective upon the death of
115the donor.
116     (a)  If the decedent makes an anatomical gift by one of the
117methods listed in s. 765.514(1), and in the absence of actual
118notice of contrary indications by the decedent, the document or
119entry in the donor organ and tissue registry is legally
120sufficient evidence of the decedent's informed consent to donate
121an anatomical gift.
122     (b)  An anatomical gift made by a qualified donor and not
123revoked by the donor, as provided in s. 765.516, is irrevocable
124after the donor's death. A family member, guardian,
125representative ad litem, or health care surrogate may not
126modify, deny, or prevent a donor's wish or intent to make an
127anatomical gift after the donor's death.
128     (4)  A donee may not accept an anatomical gift if the donee
129has actual notice of contrary indications by the donor or actual
130notice that an anatomical a gift by a member of a class is
131opposed by a member of a prior class.
132     (5)  The person authorized by subsection (3) may make the
133anatomical gift after the decedent's death or immediately before
134the decedent's death.
135     (6)  An anatomical A gift of all or part of a body
136authorizes:
137     (a)  Any examination necessary to assure medical
138acceptability of the gift for the purposes intended.
139     (b)  The decedent's medical provider, family, or a third
140party to furnish medical records requested concerning the
141decedent's medical and social history.
142     (7)  Once the anatomical gift has been made, the rights of
143the donee are paramount to the rights of others, except as
144provided by s. 765.517.
145     Section 3.  Section 765.513, Florida Statutes, is amended
146to read:
147     765.513  Persons and entities that may become Donees;
148purposes for which anatomical gifts may be made.--
149     (1)  The following persons or entities may become donees of
150anatomical gifts of bodies or parts of them for the purposes
151stated:
152     (a)(1)  Any procurement organization or accredited
153hospital, surgeon, or physician for medical or dental school,
154college, or university for education, or research, advancement
155of medical or dental science, therapy, or transplantation.
156     (2)  Any accredited medical or dental school, college, or
157university for education, research, advancement of medical or
158dental science, or therapy.
159     (3)  Any bank or storage facility for medical or dental
160education, research, advancement of medical or dental science,
161therapy, or transplantation.
162     (b)(4)  Any individual specified by name for therapy or
163transplantation needed by him or her.
164     (2)  If multiple purposes are set forth in the document of
165gift but are not set forth in any priority order, the anatomical
166gift shall be used first for transplantation or therapy, if
167suitable. If the gift cannot be used for transplantation or
168therapy, the gift may be used for research or education.
169     (3)  However, The Legislature declares that the public
170policy of this state prohibits restrictions on the possible
171recipients of an anatomical gift on the basis of race, color,
172religion, gender sex, national origin, age, physical disability
173handicap, health status, marital status, or economic status, and
174such restrictions are hereby declared void and unenforceable.
175     Section 4.  Section 765.514, Florida Statutes, is amended
176to read:
177     765.514  Manner of making anatomical gifts.--
178     (1)  A person may make an anatomical a gift of all or part
179of his or her body under s. 765.512(1) by:
180     (a)  Signing an organ and tissue donor card.
181     (b)  Registering online with the organ and tissue donor
182registry.
183     (c)  Signifying an intent to donate on his or her driver's
184license or identification card issued by the department of
185Highway Safety and Motor Vehicles. Revocation, suspension,
186expiration, or cancellation of the driver's license or
187identification card does not invalidate the gift.
188     (d)  Expressing a wish to donate in a living will or other
189advance directive.
190     (e)  Executing a will that includes a provision indicating
191that the testator wishes to make an anatomical gift. The gift
192becomes effective upon the death of the testator without waiting
193for probate. If the will is not probated or if it is declared
194invalid for testamentary purposes, the gift is nevertheless
195valid to the extent that it has been acted upon in good faith.
196     (f)  Expressing a wish to donate in a document other than a
197will. The document must be signed by the donor in the presence
198of two witnesses who shall sign the document in the donor's
199presence. If the donor cannot sign, the document may be signed
200for him or her at the donor's direction and in his or her
201presence and the presence of two witnesses who must sign the
202document in the donor's presence. Delivery of the document of
203gift during the donor's lifetime is not necessary to make the
204gift valid. The following form of written document is sufficient
205for any person to make an anatomical gift give all or part of
206his or her body for the purposes of this part:
207
208
UNIFORM DONOR CARD
209
210The undersigned hereby makes this anatomical gift, if medically
211acceptable, to take effect on death. The words and marks below
212indicate my desires:
213I give:
214     (a)  .... any needed organs, tissues, or eyes;
215     (b)  .... only the following organs, tissues, or eyes
216
...[Specify the organs, tissues, or eyes]...
217for the purpose of transplantation, therapy, medical research,
218or education;
219     (c)  .... my body for anatomical study if needed.
220Limitations or special wishes, if any:
221
...(If applicable, list specific donee; this must be arranged in
222
advance with the donee.)...
223
224Signed by the donor and the following witnesses in the presence
225of each other:
226
227...(Signature of donor)...     ...(Date of birth of donor)...
228...(Date signed)...     ...(City and State)...
229
230...(Witness)...     ...(Witness)...
231...(Address)...     ...(Address)...
232
233     (2)  The anatomical gift may be made to a donee listed in
234s. 765.513, and the donee may be specified by name.
235     (3)  Any anatomical gift by a health care surrogate
236designated by the decedent pursuant to part II of this chapter
237or a member of a class designated in s. 765.512(3) must be made
238by a document signed by that person or made by that person's
239witnessed telephonic discussion, telegraphic message, or other
240recorded message.
241     Section 5.  Section 765.515, Florida Statutes, is amended
242to read:
243     765.515  Delivery of donor document.--
244     (1)  If an anatomical a gift is made pursuant to s.
245765.521, the completed donor registration card shall be
246delivered to the department of Highway Safety and Motor Vehicles
247and the department must communicate the donor's intent to the
248organ and tissue donor registry, but delivery is not necessary
249to the validity of the gift. If the donor withdraws the gift,
250the records of the department of Highway Safety and Motor
251Vehicles must be updated to reflect such withdrawal and the
252department must communicate the withdrawal to the organ and
253tissue donor registry for the purpose of updating the registry.
254     (2)  If an anatomical a gift is made by the donor to a
255specified donee, the document of gift, other than a will, may be
256delivered to the donee to expedite the appropriate procedures
257immediately after death, but delivery is not necessary to the
258validity of the gift. The Such document of gift may be deposited
259in any hospital, bank, storage facility, or registry office that
260accepts such documents for safekeeping or to facilitate the
261donation of organs and tissue after death.
262     (3)  At the request of any interested party upon or after
263the donor's death, the person in possession shall produce the
264document of gift for examination.
265     Section 6.  Section 765.5155, Florida Statutes, is amended
266to read:
267     765.5155  Organ and tissue Donor registry; education
268program.--
269     (1)  The Legislature finds that:
270     (a)  There is a shortage of organ and tissue donors in this
271state willing to provide the organs and tissue that could save
272lives or enhance the quality of life for many persons.
273     (b)  There is a need to encourage the various minority
274populations of this state to donate organs and tissue.
275     (c)  A statewide organ and tissue donor registry having an
276online donor registration process coupled with an enhanced
277program of donor education will lead to an increase in the
278number of organ and tissue donors registered in this state, thus
279affording more persons who are awaiting organ or tissue
280transplants the opportunity for a full and productive life.
281     (2)  The agency for Health Care Administration and the
282department of Highway Safety and Motor Vehicles shall jointly
283contract for the operation of a an organ and tissue donor
284registry and education program. The contractor shall be procured
285by competitive solicitation pursuant to chapter 287,
286notwithstanding any exemption in s. 287.057(5)(f). When awarding
287the contract, priority shall be given to existing nonprofit
288groups that are based within the state, have expertise working
289with organ and tissue procurement organizations, have expertise
290in conducting statewide organ and tissue donor public education
291campaigns, and represent the needs of the organ and tissue
292donation community in the state.
293     (3)  The contractor shall be responsible for:
294     (a)  The development, implementation, and maintenance of an
295interactive web-based organ and tissue donor registry that,
296through electronic means, allows for online organ donor
297registration and the recording of organ and tissue donation
298records submitted through the driver's license identification
299program or through other sources.
300     1.  The registry must be maintained in a manner that
301allows, through electronic and telephonic methods, immediate
302access to organ and tissue donation records 24 hours a day, 7
303days a week.
304     2.  Access to the registry must be through coded and secure
305means to protect the integrity of the data in the registry.
306     (b)  A continuing program to educate and inform medical
307professionals, law enforcement agencies and officers, other
308state and local government employees, high school students,
309minorities, and the public about the laws of this state relating
310to anatomical gifts and the need for anatomical gifts.
311     1.  Existing community resources, when available, must be
312used to support the program and volunteers may assist the
313program to the maximum extent possible.
314     2.  The contractor shall coordinate with the head of a
315state agency or other political subdivision of the state, or his
316or her designee, to establish convenient times, dates, and
317locations for educating that entity's employees.
318     (c)  Preparing and submitting an annual written report to
319the agency for Health Care Administration by December 31 of each
320year. The report must include:
321     1.  The number of donors on the registry and an analysis of
322the registration rates by location and method of donation;
323     2.  The characteristics of donors as determined from
324registry information submitted directly by the donors or by the
325department of Highway Safety and Motor Vehicles;
326     3.  The annual dollar amount of voluntary contributions
327received by the contractor;
328     4.  A description of the educational campaigns and
329initiatives implemented during the year and an evaluation of
330their effectiveness in increasing enrollment on the registry;
331and
332     5.  An analysis of Florida's registry compared with other
333states' donor registries.
334     (4)  Costs for the organ and tissue donor registry and
335education program shall be paid by the agency for Health Care
336Administration from the funds deposited into the Health Care
337Trust Fund pursuant to ss. 320.08047 and 322.08, which are
338designated for maintaining the organ and tissue donor registry
339and education program. In addition, the contractor may receive
340and use voluntary contributions to help support the registry and
341provide education.
342     (5)  The organ and tissue donor registry established by
343this section is designated as the "Joshua Abbott Organ and
344Tissue Registry."
345     Section 7.  Section 765.51551, Florida Statutes, is amended
346to read
347     765.51551  Organ and tissue Donor registry; public records
348exemption.--
349     (1)  Information held in the organ and tissue donor
350registry which identifies a donor is confidential and exempt
351from s. 119.07(1) and s. 24(a), Art. I of the State
352Constitution.
353     (2)  Such information may be disclosed to the following:
354     (a)  Organ, tissue, and eye Procurement organizations that
355have been certified by the agency for Health Care Administration
356for the purpose of ascertaining or effectuating the existence of
357a gift under s. 765.522.
358     (b)  Persons engaged in bona fide research if the person
359agrees to:
360     1.  Submit a research plan to the agency that specifies the
361exact nature of the information requested and the intended use
362of the information;
363     2.  Maintain the confidentiality of the records or
364information if personal identifying information is made
365available to the researcher;
366     3.  Destroy any confidential records or information
367obtained after the research is concluded; and
368     4.  Not directly or indirectly contact, for any purpose,
369any donor or donee.
370     (3)  This section is subject to the Open Government Sunset
371Review Act in accordance with s. 119.15 and shall stand repealed
372on October 2, 2013, unless reviewed and saved from repeal
373through reenactment by the Legislature.
374     Section 8.  Section 765.516, Florida Statutes, is amended
375to read:
376     765.516  Donor amendment of the terms of or the revocation
377of anatomical the gift.--
378     (1)  A donor may amend the terms of or revoke an anatomical
379gift by:
380     (a)  The execution and delivery to the donee of a signed
381statement witnessed by at least two adults, at least one of whom
382is a disinterested witness.
383     (b)  An oral statement that is made in the presence of two
384persons, one of whom is must not be a family member, and
385communicated to the donor's family or attorney or to the donee.
386An oral statement is effective only if the procurement
387organization, transplant hospital, or physician or technician
388has actual notice of the oral amendment or revocation before an
389incision is made to the decedent's body or an invasive procedure
390to prepare the recipient has begun.
391     (c)  A statement made during a terminal illness or injury
392addressed to an attending physician, who must communicate the
393revocation of the gift to the procurement organization that is
394certified by the state.
395     (d)  A signed document found on or about the donor's
396person.
397     (e)  Removing his or her name from the organ and tissue
398donor registry.
399     (f)  A later-executed document of gift which amends or
400revokes a previous anatomical gift or portion of an anatomical
401gift, either expressly or by inconsistency.
402     (g)  The destruction or cancellation of the document of
403gift or the destruction or cancellation of that portion of the
404document of gift used to make the gift with the intent to revoke
405the gift.
406     (2)  Any anatomical gift made by a will may also be amended
407or revoked in the manner provided for the amendment or
408revocation of wills or as provided in paragraph (1)(a)
409subsection (1).
410     Section 9.  Section 765.517, Florida Statutes, is amended
411to read:
412     765.517  Rights and duties at death.--
413     (1)  The donee, pursuant to as specified under the
414provisions of s. 765.515(2), may accept or reject an anatomical
415the gift. If the donee accepts a gift of the entire body or a
416part of the body to be used for research or education scientific
417purposes other than a transplant, the donee may authorize
418embalming and the use of the body in funeral services, subject
419to the terms of the gift. If the gift is of a part of the body,
420the donee shall cause the part to be removed without unnecessary
421mutilation upon the death of the donor and before or after
422embalming. After removal of the body part, custody of the
423remainder of the body vests in the surviving spouse, next of
424kin, or other persons under obligation to dispose of the body.
425     (2)  The time of death shall be determined by a physician
426who attends the donor at the donor's death or, if there is no
427such physician, the physician who certifies the death. After
428death, those physicians or the donor's primary care and in the
429absence of other qualified personnel, this physician may
430participate in, but may shall not obstruct, the procedures to
431preserve the donor's organs or tissues and may shall not be paid
432or reimbursed for such participation by, nor be associated with
433or employed by, a an organ procurement organization, tissue
434bank, or eye bank. These physicians may This physician shall not
435participate in the procedures for removing or transplanting a
436part. However, this subsection does not prevent a physician from
437serving in a voluntary capacity on the board of directors of a
438procurement organization or participating on any board, council,
439commission, or similar body related to the organ and tissue
440procurement system.
441     (3)  The organ procurement organizations organization,
442tissue bank, or eye bank, or hospital medical professionals
443under the direction thereof, may perform any and all tests to
444evaluate the deceased as a potential donor and any invasive
445procedures on the deceased body in order to preserve the
446potential donor's organs. These procedures do not include the
447surgical removal of an organ or penetrating any body cavity,
448specifically for the purpose of donation, until:
449     (a)  It has been verified that the deceased's consent to
450donate appears in the organ and tissue donor registry or a
451properly executed donor card or document of gift is located; or
452     (b)  If a properly executed donor card or document of gift
453cannot be located or the deceased's consent is not listed in the
454organ and tissue donor registry, a person specified in s.
455765.512(2) or (3) has been located, has been notified of the
456death, and has granted legal permission for the donation.
457     (4)  All reasonable additional expenses incurred in the
458procedures to preserve the donor's organs or tissues shall be
459reimbursed by the organ procurement organization, tissue bank,
460or eye bank.
461     (5)  A person who acts in good faith and without negligence
462in accord with the terms of this part or under the anatomical
463gift laws of another state or a foreign country, or attempts to
464do so, may not be subject to any civil action for damages, may
465not be subject to any criminal proceeding, and may not be
466subject to discipline, penalty, or liability in any
467administrative proceeding is not liable for damages in any civil
468action or subject to prosecution for his or her acts in any
469criminal proceeding.
470     (6)  The provisions of this part are subject to the laws of
471this state prescribing powers and duties with respect to
472autopsies.
473     (7)  The person making an anatomical gift and the donor's
474estate are not liable for any injury or damages that result from
475the making or use of the gift.
476     (8)  In determining whether an anatomical gift has been
477made, amended, or revoked under this part, a person may rely
478upon the representation of an individual listed in s. 765.512,
479relating to the individual's relationship to the donor or
480prospective donor, unless the person knows that the
481representation is untrue.
482     Section 10.  Section 765.521, Florida Statutes, is amended
483to read:
484     765.521  Donations as part of driver license or
485identification card process.--
486     (1)  The agency for Health Care Administration and the
487department of Highway Safety and Motor Vehicles shall develop
488and implement a program encouraging and allowing persons to make
489anatomical gifts as a part of the process of issuing
490identification cards and issuing and renewing driver licenses.
491The donor registration card distributed by the department of
492Highway Safety and Motor Vehicles shall include the information
493required by the uniform donor card under s. 765.514 and such
494additional information as determined necessary by the
495department. The department shall also develop and implement a
496program to identify donors, which includes notations on
497identification cards, driver licenses, and driver records or
498such other methods as the department develops to clearly
499indicate the individual's intent to make an anatomical gift
500donate the individual's organs, tissues, or eyes. A notation on
501an individual's driver license or identification card that the
502individual intends to make an anatomical gift donate organs,
503tissues, or eyes satisfies all requirements for consent to organ
504or tissue donation. The agency for Health Care Administration
505shall provide the necessary supplies and forms from funds
506appropriated from general revenue or contributions from
507interested voluntary, nonprofit organizations. The department
508shall provide the necessary recordkeeping system from funds
509appropriated from general revenue. The department of Highway
510Safety and Motor Vehicles and the agency for Health Care
511Administration shall incur no liability in connection with the
512performance of any acts authorized herein.
513     (2)  The department of Highway Safety and Motor Vehicles,
514after consultation with and concurrence by the agency for Health
515Care Administration, shall adopt rules to implement the
516provisions of this section according to the provisions of
517chapter 120.
518     (3)  Funds expended by the agency for Health Care
519Administration to carry out the intent of this section may shall
520not be taken from any funds appropriated for patient care.
521     Section 11.  Section 765.522, Florida Statutes, is amended
522to read:
523     765.522  Duty of certain hospital administrators; liability
524of hospital administrators and, organ procurement organizations,
525eye banks, and tissue banks.--
526     (1)  When used in this section, "hospital" means any
527establishment licensed under chapter 395 except psychiatric and
528rehabilitation hospitals.
529     (1)(2)  If Where, based on accepted medical standards, a
530hospital patient is a suitable candidate for organ or tissue
531donation, the hospital administrator or the hospital
532administrator's designee shall, at or near the time of death,
533notify the appropriate procurement organization organ, eye, or
534tissue recovery program, which shall access the organ and tissue
535donor registry created by s. 765.5155 or any other donor
536registry to ascertain the existence of an entry in the registry
537which that has not been revoked, a donor card, or a document of
538gift executed by the decedent. In the absence of an entry in the
539donor registry, a document of gift donor card, organ donation
540sticker or organ donation imprint on a driver's license, or
541other properly executed document, the procurement organization
542organ, eye, or tissue recovery program shall request:
543     (a)  The patient's health care surrogate, as authorized in
544s. 765.512(2); or
545     (b)  If the patient does not have a surrogate, or the
546surrogate is not reasonably available, any of the persons
547specified in s. 765.512(3), in the order and manner listed,
548
549to consent to the anatomical gift of all or any part of the
550decedent's body for any purpose specified in this part. Except
551as provided in s. 765.512, in the absence of actual notice of
552opposition, consent need only be obtained from the person or
553persons in the highest priority class reasonably available.
554     (3)  A document of gift is valid if made pursuant to a
555request required by this section shall be executed in accordance
556with this part or the laws of the state or country where it was
557executed and where the person making the anatomical gift was
558domiciled, has a place of residence, or was a citizen at the
559time the document of gift was executed pursuant to s. 765.514.
560     (4)  The agency for Health Care Administration shall
561establish rules and guidelines concerning the education of
562individuals who may be designated to perform the request and the
563procedures to be used in making the request. The agency is
564authorized to adopt rules concerning the documentation of the
565request, where such request is made.
566     (5)  If a document of gift is valid under this section, the
567laws of this state govern the interpretation of the document of
568gift.
569     (6)  A document of gift or amendment of an anatomical gift
570is presumed to be valid unless it was not validly executed or
571was revoked.
572     (7)(5)  There shall be no civil or criminal liability
573against any organ procurement organization, eye bank, or tissue
574bank certified under s. 765.542, or against any hospital or
575hospital administrator or designee who complies, when complying
576with the provisions of this part and agency the rules of the
577agency for Health Care Administration or if when, in the
578exercise of reasonable care, a request for organ donation is
579inappropriate and the gift is not made according to this part
580and agency the rules of the agency for Health Care
581Administration.
582     (8)(6)  The hospital administrator or a designee shall, at
583or near the time of death of a potential organ donor, directly
584notify the affiliated organ procurement organization designated
585by the United States Department of Health and Human Services of
586the potential organ donor. The This organ procurement
587organization must offer any organ from such a donor first to
588patients on a Florida-based local or state organ sharing
589transplant list. For the purpose of this subsection, the term
590"transplant list" includes certain categories of national or
591regional organ sharing for patients of exceptional need or
592exceptional match, as approved or mandated by the Organ
593Procurement and Transplantation Network, or its agent. This
594notification may not be made to a tissue bank or eye bank in
595lieu of the organ procurement organization unless the tissue
596bank or eye bank is also designated as an organ procurement
597organization by the United States Department of Health and Human
598Services.
599     Section 12.  Subsections (1), (5), and (6) of section
600765.53, Florida Statutes, are amended to read:
601     765.53  Organ Transplant Advisory Council; membership;
602responsibilities.--
603     (1)  There is hereby created within the agency for Health
604Care Administration A statewide technical Organ Transplant
605Advisory Council is created within the agency, consisting of 12
606twelve members who are physicians licensed under chapter 458 or
607chapter 459, to represent the interests of the public and the
608clients of the Department of Health or the agency. The members
609shall be physicians licensed according to chapter 458 or chapter
610459. A person employed by the agency may not be appointed as a
611member of the council.
612     (5)  Members of the council shall receive no compensation,
613but shall be reimbursed for per diem and travel expenses by the
614agency for Health Care Administration in accordance with the
615provisions of s. 112.061 while engaged in the performance of
616their duties.
617     (6)  The responsibilities of the council shall be to
618recommend to the agency for Health Care Administration
619indications for adult and pediatric organ transplants. The
620council shall also formulate guidelines and standards for organ
621transplants and for the development of End Stage Organ Disease
622and Tissue/Organ Transplant programs. The recommendations,
623guidelines, and standards developed by the council are
624applicable only to those health programs funded through the
625agency for Health Care Administration.
626     Section 13.  Section 765.541, Florida Statutes, is amended
627to read:
628     765.541  Certification of procurement organizations engaged
629in the practice of cadaveric organ and tissue procurement.--The
630agency for Health Care Administration shall:
631     (1)  Establish a program for the certification of
632organizations, corporations agencies, or other entities engaged
633in the procurement of organs, tissues, and eyes for
634transplantation.;
635     (2)  Adopt rules that set forth appropriate standards and
636guidelines for the program in accordance with ss. 765.541-
637765.546 and part II of chapter 408. These standards and
638guidelines must be substantially based on the existing laws of
639the Federal Government and this state and the existing standards
640and guidelines of the United Network for Organ Sharing (UNOS),
641the American Association of Tissue Banks (AATB), the South-
642Eastern Organ Procurement Foundation (SEOPF), the North American
643Transplant Coordinators Organization (NATCO), and the Eye Bank
644Association of America (EBAA). In addition, the agency for
645Health Care Administration shall, before adopting these
646standards and guidelines, seek input from all organ procurement
647organizations, tissue banks, and eye banks based in this state.;
648     (3)  Collect, keep, and make available to the Governor and
649the Legislature information regarding the numbers and
650disposition of organs, and tissues, and eyes procured by each
651certified procurement organization. entity;
652     (4)  Monitor procurement organizations participating
653facilities and agencies for program compliance.; and
654     (5)  Provide for the administration of the Organ and Tissue
655Procurement and Transplantation Advisory Board.
656     Section 14.  Section 765.542, Florida Statutes, is amended
657to read:
658     765.542  Certification of organ procurement organizations,
659tissue banks, and eye banks.--
660     (1)  The requirements of part II of chapter 408 apply to
661the provision of services that require licensure pursuant to ss.
662765.541-765.546 and part II of chapter 408 and to entities
663licensed or certified by or applying for such licensure or
664certification from the agency for Health Care Administration
665pursuant to ss. 765.541-765.546. A person An organization,
666agency, or other entity may not engage in the practice of organ
667procurement in this state without being designated as an organ
668procurement organization by the secretary of the United States
669Department of Health and Human Services and being appropriately
670certified by the agency for Health Care Administration. As used
671in this subsection, the term "procurement" includes the
672retrieval, processing, or distribution of human organs. A
673physician or organ procurement organization based outside this
674state is exempt from these certification requirements if:
675     (a)  The organs are procured for an out-of-state patient
676who is listed on, or referred through, the United Network for
677Organ Sharing System; and
678     (b)  The organs are procured through an agreement of an
679organ procurement organization certified by the state.
680     (2)  A person An organization, agency, or other entity may
681not engage in tissue procurement in this state unless it is
682appropriately certified as a tissue bank by the agency for
683Health Care Administration. As used in this subsection, the term
684"procurement" includes any retrieval, processing, storage, or
685distribution of human tissue for transplantation.
686     (3)  A person An organization, agency, or other entity may
687not engage in the practice of eye procurement in this state
688without being appropriately certified as an eye bank by the
689agency for Health Care Administration. As used in this
690subsection, the term "procurement" includes the retrieval,
691processing, or distribution of human eye tissue. Funeral
692directors or direct disposers who that retrieve eye tissue for
693an eye bank certified under this subsection are exempt from the
694certification requirements under this subsection.
695     (4)  A limited certificate may be issued to a tissue bank
696or eye bank, certifying only those components of procurement
697which the bank has chosen to perform. The agency for Health Care
698Administration may issue a limited certificate if it determines
699that the tissue bank or eye bank is adequately staffed and
700equipped to operate in conformity with the rules adopted under
701this section.
702     Section 15.  Subsection (3) of section 765.543, Florida
703Statutes, is amended to read:
704     765.543  Organ and Tissue Procurement and Transplantation
705Advisory Board; creation; duties.--
706     (3)  The board shall:
707     (a)  Assist the agency for Health Care Administration in
708the development of necessary professional qualifications,
709including, but not limited to, the education, training, and
710performance of persons engaged in the various facets of organ
711and tissue procurement, processing, preservation, and
712distribution for transplantation;
713     (b)  Assist the agency for Health Care Administration in
714monitoring the appropriate and legitimate expenses associated
715with organ and tissue procurement, processing, and distribution
716for transplantation and developing methodologies to ensure
717assure the uniform statewide reporting of data to facilitate the
718accurate and timely evaluation of the organ and tissue
719procurement and transplantation system;
720     (c)  Provide assistance to the Florida Medical Examiners
721Commission in the development of appropriate procedures and
722protocols to ensure assure continued improvement in the approval
723and release of potential organ and tissue donors by the district
724medical examiners and associate medical examiners;
725     (d)  Develop with and recommend to the agency for Health
726Care Administration the necessary procedures and protocols
727required to assure that all residents of this state have
728reasonable access to available organ and tissue transplantation
729therapy and that residents of this state can be reasonably
730assured that the statewide procurement transplantation system is
731will be able to fulfill their organ and tissue requirements
732within the limits of the available supply and according to the
733severity of their medical condition and need; and
734     (e)  Develop with and recommend to the agency for Health
735Care Administration any changes to the laws of this state or
736administrative rules or procedures required to ensure assure
737that the statewide organ and tissue procurement and
738transplantation system is will be able to function smoothly,
739effectively, and efficiently, in accordance with the Federal
740Anatomical Gift Act and in a manner that assures the residents
741of this state that no person or entity profits from the
742altruistic voluntary donation of organs or tissues.
743     Section 16.  Section 765.544, Florida Statutes, is amended
744to read
745     765.544  Fees; organ and tissue donor education and
746procurement.--
747     (1)  In accordance with s. 408.805, an applicant or a
748certificateholder shall pay a fee for each application submitted
749under this part, part II of chapter 408, and applicable rules.
750The amount of the fee shall be as follows:
751     (a)  An initial application fee of $1,000 from organ
752procurement organizations and tissue banks and $500 from eye
753banks.
754     (b)  Annual fees to be used, in the following order of
755priority, for the certification program, the advisory board,
756maintenance of the organ and tissue donor registry, and the
757organ and tissue donor education program in the following
758amounts, which may not exceed $35,000 per organization:
759     1.  Each general organ procurement organization shall pay
760the greater of $1,000 or 0.25 percent of its total revenues
761produced from procurement activity in this state by the
762certificateholder during its most recently completed fiscal year
763or operational year.
764     2.  Each bone and tissue procurement organization agency or
765bone and tissue bank shall pay the greater of $1,000 or 0.25
766percent of its total revenues from procurement and processing
767activity in this state by the certificateholder during its most
768recently completed fiscal year or operational year.
769     3.  Each eye bank shall pay the greater of $500 or 0.25
770percent of its total revenues produced from procurement activity
771in this state by the certificateholder during its most recently
772completed fiscal year or operational year.
773     (2)  The agency for Health Care Administration shall
774specify by rule the administrative penalties for the purpose of
775ensuring adherence to the standards of quality and practice
776required by this chapter, part II of chapter 408, and applicable
777rules of the agency for continued certification.
778     (3)(a)  Proceeds from fees, administrative penalties, and
779surcharges collected pursuant to this section must be deposited
780into the Health Care Trust Fund.
781     (b)  Moneys deposited in the trust fund pursuant to this
782section must be used exclusively for the implementation,
783administration, and operation of the certification program and
784the advisory board, for maintaining the organ and tissue donor
785registry, and for organ and tissue donor education.
786     (4)  As used in this section, the term "procurement
787activity in this state" includes the bringing into this state
788for processing, storage, distribution, or transplantation of
789organs or tissues that are initially procured in another state
790or country.
791     Section 17.  Section 765.545, Florida Statutes, is amended
792to read:
793     765.545  Physician supervision of cadaveric organ and
794tissue procurement coordinators.--Organ Procurement
795organizations, tissue banks, and eye banks may employ
796coordinators, who are registered nurses, physician's assistants,
797or other medically trained personnel who meet the relevant
798standards for organ procurement organizations, tissue banks, or
799eye banks as adopted by the agency for Health Care
800Administration under s. 765.541, to assist in the medical
801management of organ donors or in the surgical procurement of
802cadaveric organs, tissues, or eyes for transplantation or
803research. A coordinator who assists in the medical management of
804organ donors or in the surgical procurement of cadaveric organs,
805tissues, or eyes for transplantation or research must do so
806under the direction and supervision of a licensed physician
807medical director pursuant to rules and guidelines to be adopted
808by the agency for Health Care Administration. With the exception
809of organ procurement surgery, this supervision may be indirect
810supervision. For purposes of this section, the term "indirect
811supervision" means that the medical director is responsible for
812the medical actions of the coordinator, that the coordinator is
813operating under protocols expressly approved by the medical
814director, and that the medical director or his or her physician
815designee is always available, in person or by telephone, to
816provide medical direction, consultation, and advice in cases of
817organ, tissue, and eye donation and procurement. Although
818indirect supervision is authorized under this section, direct
819physician supervision is to be encouraged when appropriate.
820     Section 18.  Section 765.547, Florida Statutes, is created
821to read:
822     765.547  Cooperation between medical examiner and
823procurement organization.--
824     (1)  A medical examiner and procurement organization shall
825cooperate with each other in order to maximize opportunities to
826recover anatomical gifts for the purpose of transplantation,
827therapy, research, or education.
828     (2)  The Florida Medical Examiners Commission shall adopt
829rules establishing cooperative responsibilities between medical
830examiners and procurement organizations to facilitate and
831expedite completion of the medical examiner's responsibilities
832under chapter 406 in a manner that will maximize opportunities
833to recover anatomical gifts.
834     (3)  This part does not supersede any part of chapter 406
835relating to medical examiners and the disposition of dead
836bodies.
837     Section 19.  Subsection (30) of section 408.802, Florida
838Statutes, is amended to read:
839     408.802  Applicability.--The provisions of this part apply
840to the provision of services that require licensure as defined
841in this part and to the following entities licensed, registered,
842or certified by the agency, as described in chapters 112, 383,
843390, 394, 395, 400, 429, 440, 483, and 765:
844     (30)  Organ, and tissue, and eye procurement organizations
845agencies, as provided under part V of chapter 765.
846     Section 20.  Subsection (29) of section 408.820, Florida
847Statutes, is amended to read:
848     408.820  Exemptions.--Except as prescribed in authorizing
849statutes, the following exemptions shall apply to specified
850requirements of this part:
851     (29)  Organ, and tissue, and eye procurement organizations
852agencies, as provided under part V of chapter 765, are exempt
853from s. 408.810(5)-(10).
854     Section 21.  This act shall take effect July 1, 2009.


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