Florida Senate - 2009 COMMITTEE AMENDMENT Bill No. SB 462 Barcode 469286 LEGISLATIVE ACTION Senate . House Comm: RCS . 03/04/2009 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Regulation (Jones) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 893.055, Florida Statutes, is created to 6 read: 7 893.055 Prescription drug validation program.— 8 (1) As used in this section, the term: 9 (a) “Advisory report” means information provided by the 10 department in writing to a prescriber, dispenser, pharmacy, or 11 patient concerning the dispensing of controlled substances. All 12 advisory reports are for informational purposes only and impose 13 no obligations of any nature or any legal duty on a prescriber, 14 dispenser, pharmacy, or patient. The advisory reports issued by 15 the department are not subject to discovery or introduction into 16 evidence in any civil or administrative action against a 17 prescriber, dispenser, pharmacy, or patient arising out of the 18 matters that are the subject of the report, and no person who 19 participates in preparing an advisory report is permitted or 20 required to testify in any such civil action as to any findings, 21 recommendations, evaluations, opinions, or other actions taken 22 in connection with preparing such a report. 23 (b) “Controlled substance” means a controlled substance 24 listed in Schedule II, Schedule III, or Schedule IV in s. 25 893.03. 26 (c) “Department” means the Department of Health. 27 (d) “Dispenser” means a dispensing pharmacist or dispensing 28 health care practitioner. 29 (e) “Health care practitioner” or “practitioner” means any 30 practitioner subject to licensure or regulation by the 31 department under chapter 458, chapter 459, chapter 461, or 32 chapter 466. 33 (f) “Health care regulatory board” means any board that 34 licenses a practitioner or health care practitioner who is 35 regulated by the department. 36 (g) “Pharmacy” means any pharmacy subject to licensure or 37 regulation by the department under chapter 465 which dispenses 38 or delivers a controlled substance to a patient in this state. 39 (h) “Prescriber” means a prescribing physician, prescribing 40 practitioner, or other prescribing health care practitioner. 41 (2)(a) By December 1, 2010, the department shall design and 42 establish a comprehensive electronic system that has controlled 43 substance prescriptions provided to it and that provides 44 prescription information to a patient’s health care practitioner 45 and, as determined by the department, may provide advisory 46 reports to authorized pharmacists, pharmacies, prescribing 47 practitioners, and dispensing health care practitioners. The 48 system shall be designed to provide information regarding 49 dispensed prescriptions of controlled substances in order to 50 prevent the inadvertent, improper, or illegal use of controlled 51 substances and shall not infringe upon the legitimate 52 prescribing of a controlled substance by a prescribing 53 practitioner, dispensing pharmacist, or dispensing practitioner 54 acting in good faith and in the course of professional practice. 55 The system shall be consistent with standards of the American 56 Society for Automation in Pharmacy for the validation of 57 prescribing and dispensing controlled substances to an 58 individual. The electronic system shall also comply with the 59 Health Insurance Portability and Accountability Act (HIPAA) as 60 it pertains to protected health information (PHI), electronic 61 protected health information (EPHI), and all other relevant 62 state and federal privacy and security laws and regulations. The 63 validating of prescribed controlled substances shall include a 64 dispensing transaction with a dispenser not located in this 65 state but which is otherwise subject to the jurisdiction of this 66 state as to that dispensing transaction. 67 (b) The department shall adopt rules concerning the 68 reporting, evaluation, management, and storage of information 69 within the system, including rules for when information is 70 provided to pharmacies, prescribers, health care practitioners, 71 health care regulatory boards, and law enforcement agencies, and 72 such rules shall be developed with a reasonable-person standard 73 for prescription drug dispensers, prescribers, and patients. The 74 department shall work with the professional health care 75 licensure boards, such as the Board of Medicine and the Board of 76 Pharmacy and other appropriate organizations, such as the 77 Florida Pharmacy Association and the Florida Medical 78 Association, including those relating to pain management, the 79 the Attorney General, the Department of Law Enforcement, and the 80 Agency for Health Care Administration, to develop the 81 reasonable-person standard for rules appropriate for the 82 prescription drug validation program. 83 (c) All dispensers and prescribers subject to such 84 reporting requirements shall be notified by the department of 85 the implementation date for such reporting requirements. 86 (3) The pharmacist in charge of each pharmacy, regarding 87 each controlled substance dispensed by a pharmacist under the 88 supervision of the pharmacist in charge, and each prescriber who 89 directly dispenses a controlled substance shall submit to the 90 electronic system, by a procedure and in a format established by 91 the department, the following minimum information for inclusion 92 in the database: 93 (a) The name of the prescribing practitioner and the 94 practitioner’s federal Drug Enforcement Administration 95 registration number, the practitioner’s National Provider 96 Identification (NPI) or other appropriate identifier, and the 97 date of the prescription. 98 (b) The date the prescription was filled and the method of 99 payment therefor, including cash. This paragraph does not 100 authorize the department to include individual credit card or 101 other account numbers in the database. 102 (c) The name, address, and date of birth of the person for 103 whom the prescription was written. 104 (d) The name, national drug code, quantity, and strength of 105 the controlled substance dispensed. 106 (e) The name and address of the pharmacy or other location 107 from which the controlled substance was dispensed. 108 (f) The name of the pharmacist or practitioner dispensing 109 the controlled substance, the practitioner’s National Provider 110 Identification (NPI), and other appropriate identifying 111 information as determined by department rule. 112 (4) Each time a controlled substance is dispensed to an 113 individual, the controlled substance shall be reported to the 114 department through the system as soon thereafter as possible, 115 but not more than 15 days after the date the controlled 116 substance is dispensed. A dispenser must meet the reporting 117 requirements of this section by providing the required 118 information concerning each controlled substance that it 119 dispensed in a department-approved, secure methodology and 120 format. Such approved formats may include, but are not limited 121 to, submission via the Internet, on a disc, or by use of regular 122 mail. 123 (5) The following are exempt from this section when 124 administering controlled substances: 125 (a) A health care practitioner administering a controlled 126 substance directly to a patient if the amount of the controlled 127 substance is adequate to treat the patient during that 128 particular treatment session. 129 (b) A pharmacist or health care practitioner administering 130 a controlled substance to a patient or resident receiving care 131 as an admitted patient at a hospital, nursing home, hospice, or 132 intermediate care facility for the developmentally disabled 133 which is licensed in this state. 134 (c) A person administering a controlled substance in the 135 health care system of the Department of Corrections. 136 (d) A person administering a controlled substance in the 137 emergency room of a licensed hospital. 138 (e) A pharmacist or health care practitioner administering 139 a controlled substance to a person under the age of 16. 140 (6) The department may establish when to suspend and when 141 to resume requirements for reporting dispensing information to 142 the electronic system of controlled prescription drugs during a 143 state-declared or nationally declared disaster. 144 (7)(a) A practitioner or pharmacist who dispenses a 145 controlled substance must submit the information required by 146 this section in an electronic or other format approved by rule 147 of the department. The cost to the dispenser in submitting the 148 information required by this section may not be material or 149 extraordinary. Costs not considered to be material or 150 extraordinary include, but are not limited to, regular postage, 151 electronic media, regular electronic mail, and facsimile 152 charges. 153 (b) A pharmacy, prescriber, or dispenser may access 154 information in the prescription drug validation program’s 155 electronic system which relates to a patient of that pharmacy, 156 prescriber, or dispenser for the purpose of reviewing the 157 patient’s controlled drug prescription history to ensure a 158 proper standard of care. Other access to the program’s 159 electronic system shall be limited to the program’s manager and 160 designated program staff, who may act only in the absence of the 161 program manager. Access by the program manager or such 162 designated staff is only for prescription drug management and 163 for management of the database. Confidential and exempt 164 information in the database shall be released only as provided 165 in s. 893.0551. The individual who requests his or her own 166 information, the attorney general, a health care regulatory 167 board, any law enforcement agency, or any criminal justice 168 agency may request this information from the program manager and 169 may not directly access the database for this information. 170 (c) All transmissions of data required by this section must 171 comply with relevant state and federal privacy and security laws 172 and regulations. However, any authorized agency or person 173 receiving such information may maintain the information received 174 for up to 24 months before purging it from his or her records or 175 maintain it for longer than 24 months if the information is 176 pertinent to an ongoing health care or active law enforcement 177 investigation or prosecution. 178 (8) To assist in fulfilling the program responsibilities, 179 performance measures shall be reported annually by the 180 department each December 1, beginning in 2011. Data that does 181 not contain patient, physician, health care practitioner, or 182 dispenser identifying information may be requested during the 183 year by department employees so that the department may 184 undertake public health care and safety initiatives that take 185 advantage of observed trends. Performance measures may include, 186 but are not limited to, efforts to achieve the following 187 outcomes: 188 (a) Reduction of the rate of inappropriate use of 189 prescription drugs through department education and safety 190 efforts. 191 (b) Reduction of the quantity of pharmaceutical controlled 192 substances obtained by individuals attempting to engage in fraud 193 and deceit. 194 (c) Increased coordination among prescription drug 195 validation program partners. 196 (d) Involvement of stakeholders in achieving improved 197 patient health care and reduction of prescription drug abuse and 198 prescription drug diversion. 199 (9) Any person who knowingly fails to report the dispensing 200 of a controlled substance as required by this section commits a 201 misdemeanor of the first degree, punishable as provided in s. 202 775.082 or s. 775.083. 203 (10) All costs incurred by the department in administering 204 the prescription drug validation program shall be reimbursed 205 through federal grants or private funding applied for or 206 received by the state. The department and state government shall 207 cooperate in seeking federal grant funds, other nonstate grant 208 funds, gifts, donations, or other private moneys for the 209 department so long as the costs of doing so are not considered 210 material. Nonmaterial costs for this purpose include, but are 211 not limited to, the costs of mailing and personnel assigned to 212 research or apply for a grant. Notwithstanding the exemptions to 213 competitive-solicitation requirements under s. 287.057(5)(f), 214 the Department of Health shall comply with the competitive 215 solicitation requirements for the procurement of any goods or 216 services required by this section. 217 (11) The Office of Drug Control, in coordination with the 218 department, may establish a direct-support organization that has 219 a board consisting of at least five members to provide 220 assistance, funding, and promotional support for the activities 221 authorized for the prescription drug validation program. 222 (a) As used in this subsection, the term “direct-support 223 organization” means an organization that is: 224 1. A Florida corporation not for profit incorporated under 225 chapter 617, exempted from filing fees, and approved by the 226 Department of State. 227 2. Organized and operated to conduct programs and 228 activities; raise funds; request and receive grants, gifts, and 229 bequests of money; acquire, receive, hold, and invest, in its 230 own name, securities, funds, objects of value, or other 231 property, either real or personal; and make expenditures to or 232 for the direct or indirect benefit of the department in the 233 furtherance of the prescription drug validation program. 234 (b) The direct-support organization is not considered a 235 lobbying firm within the meaning of s. 11.045. 236 (c) The director of the Office of Drug Control shall 237 appoint a board of directors for the direct-support 238 organization. The director may designate employees of the Office 239 of Drug Control; state employees other than state employees from 240 the Department of Health; members of provider associations, such 241 as the Florida Pharmacy Association or the Florida Medical 242 Association; and any other nonstate employees as appropriate, to 243 serve on such board. Members of the board shall serve at the 244 pleasure of the director of the Office of Drug Control. 245 (d) The direct-support organization may operate under 246 written contract with the Office of Drug Control. The contract 247 must provide for: 248 1. Approval of the articles of incorporation and bylaws of 249 the direct-support organization by the Office of Drug Control. 250 2. Submission of an annual budget for the approval of the 251 Office of Drug Control. 252 3. Certification by the Office of Drug Control in 253 consultation with the department that the direct-support 254 organization is complying with the terms of the contract in a 255 manner consistent with and in furtherance of the goals and 256 purposes of the prescription drug validation program and in the 257 best interest of the state. Such certification must be made 258 annually and reported in the official minutes of a meeting of 259 the direct-support organization. 260 4. The reversion, without penalty, to the Office of Drug 261 Control, or to the state if the Office of Drug Control ceases to 262 exist, of all moneys and property held in trust by the direct 263 support organization for the benefit of the prescription drug 264 validation program if the direct-support organization ceases to 265 exist or if the contract is terminated. 266 5. The fiscal year of the direct-support organization, 267 which must begin July 1 of each year and end June 30 of the 268 following year. 269 6. The disclosure of the material provisions of the 270 contract to donors of gifts, contributions, or bequests, 271 including such disclosure on all promotional and fundraising 272 publications, and an explanation to such donors of the 273 distinction between the Office of Drug Control and the direct 274 support organization. 275 (e) The direct-support organization is specifically 276 authorized to collect and expend funds to be used for the 277 functions of the direct-support organization’s board of 278 directors, as necessary; establishing and administering the 279 prescription drug validation program’s electronic database, 280 including hardware, software, and personnel; conducting studies 281 on the efficiency and effectiveness of the program; providing 282 funds for future enhancements of the program within the intent 283 of this section; providing health care practitioner education, 284 including distribution of materials to promote public awareness 285 and education and conducting workshops or other meetings; travel 286 expenses; administrative costs, including personnel, audits, 287 facilities, and equipment; and all other requirements necessary 288 to establish the program as outlined in this section. 289 (f) The activities of the direct-support organization must 290 be consistent with the goals and mission of the Office of Drug 291 Control, as determined by the office in consultation with the 292 department, and in the best interests of the state. The direct 293 support organization must obtain a written approval from the 294 director of the Office of Drug Control for any activities in 295 support of the prescription drug validation program before 296 undertaking those activities. 297 (g) The Office of Drug Control, in consultation with the 298 department, may permit, without charge, appropriate use of 299 administrative services, property, and facilities of the Office 300 of Drug Control and the department by the direct-support 301 organization, subject to this section. The use must be directly 302 in keeping with the approved purposes of the direct-support 303 organization and may not be made at times or places that would 304 unreasonably interfere with opportunities for the public to use 305 such facilities for established purposes. Any moneys received 306 from rentals of facilities and properties managed by the Office 307 of Drug Control and the department may be held by the Office of 308 Drug Control or in a separate depository account in the name of 309 the direct-support organization and subject to the provisions of 310 the letter of agreement with the Office of Drug Control. The 311 letter of agreement must provide that any funds held in the 312 separate depository account in the name of the direct-support 313 organization must revert to the Office of Drug Control if the 314 direct-support organization is no longer approved by the Office 315 of Drug Control to operate in the best interests of the state. 316 (h) The Office of Drug Control, in consultation with the 317 department, may adopt requirements with which a direct-support 318 organization must comply in order to use department and Office 319 of Drug Control administrative services, property, or 320 facilities. 321 (i) The Office of Drug Control may not permit the use of 322 any administrative services, property, or facilities of the 323 state by a direct-support organization if that organization does 324 not provide equal membership and employment opportunities to all 325 persons regardless of race, color, religion, gender, age, or 326 national origin. 327 (j) The direct-support organization shall provide for an 328 independent annual financial audit in accordance with s. 329 215.981. Copies of the audit shall be provided to the Office of 330 Drug Control and the Office of Policy and Budget in the 331 Executive Office of the Governor. 332 (k) The direct-support organization may not exercise any 333 power under s. 617.0302(12) or (16). 334 (12) A prescriber or dispenser is authorized access to the 335 information under this section for his or her patient for his or 336 her review of the patient’s controlled drug prescription history 337 to ensure a proper standard of care. A prescriber or dispenser 338 acting in good faith is immune from any civil, criminal, or 339 administrative liability that might otherwise be incurred or 340 imposed for receiving or using information from the prescription 341 drug validation program. This subsection does not create a 342 private cause of action, and a person may not recover damages 343 against a prescriber or dispenser authorized to access 344 information under this subsection for accessing or failing to 345 access such information. 346 (13) To the extent that funding is provided for such 347 purpose through federal or private grants or gifts and other 348 types of available moneys, the department, in collaboration with 349 the Office of Drug Control, shall study the feasibility of 350 enhancing the prescription drug validation program for the 351 purposes of public health initiatives and statistical reporting 352 that respects the privacy of the patient, the prescriber, and 353 the dispenser. Such a study shall be conducted in order to 354 further improve the quality of health care services and safety 355 by improving prescription drug prescribing practices, taking 356 advantage of advances in technology, reducing duplicative 357 prescriptions and the overprescribing of prescription drugs, and 358 reducing drug abuse. In addition, the direct-support 359 organization shall provide funding for the department, in 360 collaboration with the Office of Drug Control, to conduct 361 training for health care practitioners and other appropriate 362 persons in using the program to support the program 363 enhancements. 364 (14) A pharmacist, pharmacy, or dispensing health care 365 practitioner or his or her agent, prior to releasing a 366 controlled substance to any person not known to such dispenser, 367 shall require the person purchasing, receiving, or otherwise 368 acquiring the controlled substance to present valid photographic 369 identification or other verification of his or her identity to 370 the dispenser. If the person does not have proper 371 identification, the dispenser may verify the validity of the 372 prescription and the identity of the patient with the prescriber 373 or his or her authorized agent, or by a method determined by the 374 department, before dispensing the controlled substance. The 375 person purchasing, receiving, or otherwise acquiring the 376 controlled substance does not have to be the specific patient to 377 whom the prescription is prescribed. A record shall be 378 maintained for 2 years of the person acquiring the controlled 379 substance, which record shall include the person’s name and 380 signature using the proper identification. This subsection does 381 not apply in an institutional setting or to a long-term care 382 facility, including, but not limited to, an assisted living 383 facility or a hospital to which patients are admitted. As used 384 in this subsection, the term “proper identification” means a 385 government-issued identification containing the person’s 386 picture, printed name, and signature. 387 (15) The Agency for Health Care Administration shall 388 continue the implementation of electronic prescribing by health 389 care practitioners, health care facilities, and pharmacies under 390 s. 408.061 and the electronic prescribing clearinghouse 391 collaboration with the private sector under s. 408.0611. 392 (16) By October 1, 2010, the department shall adopt rules 393 pursuant to ss. 120.536(1) and 120.54 to implement the 394 provisions of this section. 395 Section 2. (1) The Program Implementation and Oversight 396 Workgroup is created within the Executive Office of the 397 Governor. The director of the Office of Drug Control shall be a 398 nonvoting, ex officio member of the workgroup and shall act as 399 chair. The Office of Drug Control and the Department of Health 400 shall provide staff support for the workgroup. 401 (a) The following state officials shall serve on the 402 workgroup: 403 1. The Attorney General or his or her designee. 404 2. The Secretary of Children and Family Services or his or 405 her designee. 406 3. The Secretary of Health Care Administration or his or 407 her designee. 408 4. The State Surgeon General or his or her designee. 409 (b) In addition, the Governor shall appoint 10 members of 410 the public to serve on the workgroup. Of these 10 appointed 411 members, one member must have professional or occupational 412 expertise in computer security; one member must be a Florida 413 licensed, board-certified oncologist; two members must be 414 Florida-licensed, board-certified, fellowship-trained physicians 415 who have experience in pain management; one member must have 416 professional or occupational expertise in e-Prescribing or 417 prescription drug validation programs; one member must be a 418 Florida-licensed pharmacist; one member must have professional 419 or occupational expertise in law enforcement with experience in 420 prescription drug investigations; one member must have 421 professional or occupational expertise as an epidemiologist with 422 a background in tracking and analyzing drug trends; and two 423 members must have professional or occupational expertise as 424 providers of substance abuse treatment, with priority given to a 425 member who is a former substance abuser. 426 (c) Members appointed by the Governor shall be appointed to 427 a term of 3 years each. Any vacancy on the workgroup shall be 428 filled in the same manner as the original appointment, and any 429 member appointed to fill a vacancy shall serve only for the 430 unexpired term of the member’s predecessor. 431 (d) Members of the workgroup and members of subcommittees 432 appointed under subsection (4) shall serve without compensation, 433 but are entitled to reimbursement for per diem and travel 434 expenses as provided in s. 112.061, Florida Statutes. 435 (e) The workgroup shall meet at least quarterly or upon the 436 call of the chair. 437 (2) The purpose of the workgroup is to monitor the 438 implementation and safeguarding of the electronic system 439 established for the prescription drug validation program under 440 s. 893.055, Florida Statutes, and to ensure privacy, protection 441 of individual medication history, and the electronic system’s 442 appropriate use by physicians, dispensers, pharmacies, law 443 enforcement agencies, and those authorized to request 444 information from the electronic system. 445 (3) The Office of Drug Control shall submit a report to the 446 Governor, the President of the Senate, and the Speaker of the 447 House of Representatives by December 1 of each year which 448 contains a summary of the work of the workgroup during that year 449 and the recommendations developed in accordance with the 450 workgroup’s purpose as provided in subsection (2). Interim 451 reports may be submitted at the discretion of the chair. 452 (4) The chair of the workgroup shall appoint subcommittees 453 that include members of state agencies that are not represented 454 on the workgroup for the purpose of soliciting input and 455 recommendations from those state agencies as needed by the 456 workgroup to accomplish its purposes. In addition, the chair may 457 appoint subcommittees as necessary from among the members of the 458 workgroup in order to efficiently address specific issues. If a 459 state agency is to be represented on any subcommittee, the 460 representative shall be the head of the agency or his or her 461 designee. The chair may designate lead and contributing agencies 462 within a subcommittee. 463 (5) The workgroup shall provide a final report in 464 accordance with the workgroup’s purpose as provided in 465 subsection (2) on July 1, 2012, to the Governor, the President 466 of the Senate, and the Speaker of the House of Representatives. 467 Such report shall be prepared using only data that does not 468 identify a patient or dispenser. The workgroup shall expire and 469 this section is repealed on that date. 470 Section 3. Subsections (4) and (5) are added to section 471 458.309, Florida Statutes, to read: 472 458.309 Rulemaking authority.— 473 (4) Each physician who practices in a privately owned pain 474 management facility that primarily engages in the treatment of 475 pain by prescribing narcotic medications shall register the 476 facility with the department unless it is licensed as a facility 477 under chapter 395. The department shall inspect the facility 478 annually to ensure that it complies with board rules adopted 479 pursuant to s. 458.309(4) and (5) unless the facility is 480 accredited by a nationally recognized accrediting agency 481 approved by the board. The actual costs for registration and 482 inspection or accreditation shall be paid by the physician 483 seeking to register the facility. 484 (5) The board shall adopt rules setting forth standards of 485 practice for physicians practicing in privately owned pain 486 management facilities that primarily engage in the treatment of 487 pain by prescribing controlled substance medications. These 488 rules shall address, but need not be limited to, the following 489 subjects: 490 (a) Facility operations; 491 (b) Physical operations; 492 (c) Infection control requirements; 493 (d) Health and safety requirements; 494 (e) Quality assurance requirements; 495 (f) Patient records; 496 (g) Training requirements for all facility health care 497 practitioners; and 498 (h) Inspections. 499 500 A physician is primarily engaged in the treatment of pain by 501 prescribing narcotic medications when the majority of the 502 patients seen on any day the facility is open are issued 503 narcotic prescriptions for the treatment of nonmalignant pain. 504 Section 4. This act shall take effect July 1, 2009. 505 506 ================= T I T L E A M E N D M E N T ================ 507 And the title is amended as follows: 508 Delete everything before the enacting clause 509 and insert: 510 A bill to be entitled 511 An act relating to a prescription drug validation 512 program (PDVP); creating s. 893.055, F.S.; providing 513 definitions; requiring the Department of Health to 514 establish a comprehensive electronic system to 515 validate the prescribing and dispensing of certain 516 controlled substances; requiring specified prescribing 517 and dispensing information to be reported to the 518 electronic system; requiring the department, in 519 conjunction with specified organizations, to adopt by 520 rule a reasonable-person standard appropriate for the 521 prescription drug validation program; providing a 522 reporting period; providing for implementation of a 523 shorter reporting period; providing exemptions from 524 participation in the system; authorizing the 525 Department of Health to establish when to suspend and 526 when to resume requirements for reporting dispensing 527 information during declared emergencies; requiring all 528 nonexempt pharmacists, pharmacies, dispensing 529 physicians, or prescribing and dispensing health care 530 practitioners to submit information in a specified 531 format; providing that the cost to the dispenser in 532 submitting the required information may not be 533 material or extraordinary; providing that specified 534 costs are not material or extraordinary; limiting 535 access to the system; providing for the use of data 536 for specified purposes; requiring compliance with 537 state and federal privacy and security laws; 538 authorizing an agency or person to maintain the data 539 for a specified period if the data is pertinent to an 540 ongoing health care or active law enforcement 541 investigation or prosecution; requiring the reporting 542 of certain performance measures; providing criminal 543 penalties for violations; requiring that all costs 544 incurred by the department for the program be paid 545 through a federal grant or through available private 546 funding sources; authorizing the Office of Drug 547 Control, in coordination with the Department of 548 Health, to establish a direct-support organization; 549 providing a definition; providing for a board of 550 directors appointed by the director of the Office of 551 Drug Control; authorizing the direct-support 552 organization to operate under written contract with 553 the Office of Drug Control; authorizing certain 554 activities and expenditures of the direct-support 555 organization; providing requirements for the use of 556 certain facilities and services; providing for audits; 557 prohibiting the direct-support organization from 558 exercising certain powers; establishing that a 559 prescribing health care practitioner, dispensing 560 physician, or pharmacist is not liable for use of the 561 department-provided controlled substances prescription 562 information of a patient; requiring a study of the 563 feasibility of enhancing the prescription drug 564 validation program for specified purposes; requiring 565 certain persons to present specified identification to 566 obtain prescriptions; providing for recordkeeping for 567 certain transactions; requiring the Agency for Health 568 Care Administration to continue implementation of 569 electronic prescribing and an electronic prescribing 570 clearinghouse; requiring the Department of Health to 571 adopt rules; establishing a Program Implementation and 572 Oversight Workgroup; providing for membership; 573 providing for reimbursement of certain member 574 expenses; providing for meetings; providing purposes; 575 requiring reports; providing for the creation, 576 membership, and duties of subcommittees; providing for 577 a final report and termination of the workgroup; 578 amending s. 458.309, F.S.; requiring certain 579 physicians who engage in pain management to register 580 their facility with the department; requiring the 581 department to inspect the facility; requiring the 582 Board of Medicine to adopt rules setting forth 583 standards of practice for certain physicians who 584 engage in pain management; providing criteria for the 585 rules; providing an effective date. 586 587 WHEREAS, as has been advocated by numerous pain management 588 experts, addiction medicine experts, pharmacists, and law 589 enforcement personnel, a prescription drug validation program 590 that provides for reporting and advisory information is 591 established pursuant to this act to serve as a means to promote 592 the public health and welfare and to detect and prevent 593 controlled substance abuse and diversion, and 594 WHEREAS, while the importance and necessity of the proper 595 prescribing, dispensing, and monitoring of controlled 596 substances, particularly pain medication, have been established, 597 controlled prescription drugs are too often diverted in this 598 state, often through fraudulent means, including outright theft, 599 phony pharmacy fronts, loose Internet medical evaluations, and 600 inappropriate importation; in addition, there is a criminal 601 element that facilitates the prescription drug abuse epidemic 602 through illegal profitmaking from the diversion of certain 603 controlled substances that are prescribed or dispensed by 604 physicians, health care practitioners, and pharmacists, and 605 WHEREAS, in 2007, 8,620 drug-related deaths occurred in 606 this state, 3,159 of which were caused by prescription drugs, an 607 average of nearly 9 Floridians dying each day from prescription 608 drugs; Schedule IV benzodiazepines, such as Xanax and Valium, 609 were found to be present in more drug-related deaths than 610 cocaine; and opiate pain medications contribute to increasing 611 numbers of drug-related deaths, and 612 WHEREAS, pharmaceutical drug diversion hurts this state 613 significantly in terms of lost lives, increased crime, human 614 misery from addiction, and ballooning health care costs 615 connected to treatment, medical expenses, and Medicaid fraud 616 that all Floridians ultimately bear, and 617 WHEREAS, the intent of this act is not to interfere with 618 the legitimate medical use of controlled substances; however, 619 the people of this state are in need of and will benefit from a 620 secure and privacy-protected statewide electronic system of 621 specified prescription drug medication information created 622 primarily to encourage safer controlled substance prescription 623 decisions that reduce the number of prescription drug overdoses 624 and the number of drug overdose deaths; to educate and inform 625 health care practitioners and provide an added tool in patient 626 care, including appropriate treatment for patients who have 627 become addicted; to guide public health initiatives to educate 628 the population on the dangers of misusing prescription drugs; to 629 prevent the abuse or diversion of prescribed controlled 630 substances; and to ensure that those who need prescribed 631 controlled substances receive them in a manner that protects 632 patient confidentiality, and 633 WHEREAS, while certain medicines are very helpful if 634 properly prescribed to a patient in need and then used as 635 prescribed, they may be dangerous or even deadly if improperly 636 dispensed, misused, or diverted, and 637 WHEREAS, it is the intent of the Legislature to encourage 638 patient safety, responsible pain management, and proper access 639 to useful prescription drugs that are prescribed by a 640 knowledgeable, properly licensed health care practitioner who 641 dispenses prescription drugs and that are dispensed by a 642 pharmacist who is made aware of the patient’s prescription drug 643 medication history, thus preventing, in some cases, an abuse or 644 addiction problem from developing or worsening, making such a 645 problem possible or easier to identify, and facilitating the 646 order of appropriate medical treatment or referral, and 647 WHEREAS, such an electronic system will also aid 648 administrative and law enforcement agencies in an active and 649 ongoing controlled drug-related investigation, maintaining such 650 information for any such investigation with a reasonable, good 651 faith anticipation of securing an arrest or prosecution in the 652 foreseeable future, and 653 WHEREAS, a Program Implementation and Oversight Workgroup 654 will provide information to the Governor and Legislature 655 regarding the implementation of the program and ensure that 656 privacy and confidentiality of the patient’s prescription 657 history is respected, NOW, THEREFORE,