Florida Senate - 2014                                    SB 1066
       By Senator Grimsley
       21-00806A-14                                          20141066__
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; amending
    3         s. 322.142, F.S.; authorizing the Department of
    4         Highway Safety and Motor Vehicles to provide
    5         reproductions of specified records to the Department
    6         of Health under certain circumstances; amending s.
    7         395.3025, F.S.; clarifying duties of the Department of
    8         Health to maintain the confidentiality of patient
    9         records that it obtains under subpoena pursuant to an
   10         investigation; authorizing licensees under
   11         investigation to inspect or receive copies of patient
   12         records connected with the investigation, subject to
   13         certain conditions; amending s. 456.013, F.S.;
   14         deleting requirements for the physical size of
   15         licenses issued for various health professions;
   16         exempting Board of Medicine licensees from certain
   17         continuing education requirements applicable to other
   18         health professions; amending s. 456.025, F.S.;
   19         deleting a fee provision for the issuance of wall
   20         certificates for various health profession licenses;
   21         authorizing the boards or the department to adopt
   22         rules waiving certain fees for a specified period in
   23         certain circumstances; amending s. 456.033, F.S.;
   24         exempting Board of Medicine licensees from certain
   25         continuing education requirements relating to
   26         instruction on HIV and AIDS; amending s. 456.068,
   27         F.S.; requiring the department to establish a toll
   28         free telephone number for public reporting of certain
   29         complaints; amending s. 458.319, F.S.; providing
   30         continuing medical education requirements for Board of
   31         Medicine licensees; authorizing the board to adopt
   32         rules; amending s. 464.203, F.S.; revising certified
   33         nursing assistant inservice training requirements;
   34         repealing s. 464.2085, F.S., relating to the creation,
   35         membership, and duties of the Council on Certified
   36         Nursing Assistants; amending s. 466.032, F.S.;
   37         deleting a requirement that the department provide
   38         certain notice to a dental laboratory operator who
   39         fails to renew her or his registration; amending s.
   40         467.009, F.S.; revising the organization that must
   41         accredit certain midwifery programs; amending s.
   42         468.1665, F.S.; increasing the number of members of
   43         the Board of Nursing Home Administrators who must be
   44         licensed nursing home administrators and decreasing
   45         the number of members who must be laypersons; amending
   46         s. 468.1695, F.S.; revising the qualifications of
   47         applicants who may sit for the licensed nursing home
   48         administrator examination to include an applicant with
   49         a master’s degree in certain subjects; repealing s.
   50         468.1735, F.S., relating to provisional licenses for
   51         nursing home administrators; amending ss. 468.503 and
   52         468.505, F.S.; revising the organization with whom an
   53         individual must be registered to be a registered
   54         dietitian; revising a definition; amending ss. 480.033
   55         and 480.041, F.S.; deleting provisions relating to
   56         massage therapy apprentices and apprenticeship
   57         programs; deleting a definition and revising licensure
   58         requirements for massage therapists, to conform;
   59         amending s. 480.042, F.S.; revising requirements for
   60         conducting massage therapist licensing examinations
   61         and maintaining examination records; amending s.
   62         480.044, F.S.; deleting a fee for massage therapy
   63         apprentices; amending s. 823.05, F.S.; conforming a
   64         cross-reference; providing an effective date.
   66  Be It Enacted by the Legislature of the State of Florida:
   68         Section 1. Subsection (4) of section 322.142, Florida
   69  Statutes, is amended to read:
   70         322.142 Color photographic or digital imaged licenses.—
   71         (4) The department may maintain a film negative or print
   72  file. The department shall maintain a record of the digital
   73  image and signature of the licensees, together with other data
   74  required by the department for identification and retrieval.
   75  Reproductions from the file or digital record are exempt from
   76  the provisions of s. 119.07(1) and shall be made and issued
   77  only:
   78         (a) For departmental administrative purposes;
   79         (b) For the issuance of duplicate licenses;
   80         (c) In response to law enforcement agency requests;
   81         (d) To the Department of Business and Professional
   82  Regulation pursuant to an interagency agreement for the purpose
   83  of accessing digital images for reproduction of licenses issued
   84  by the Department of Business and Professional Regulation;
   85         (e) To the Department of State pursuant to an interagency
   86  agreement to facilitate determinations of eligibility of voter
   87  registration applicants and registered voters in accordance with
   88  ss. 98.045 and 98.075;
   89         (f) To the Department of Revenue pursuant to an interagency
   90  agreement for use in establishing paternity and establishing,
   91  modifying, or enforcing support obligations in Title IV-D cases;
   92         (g) To the Department of Children and Families pursuant to
   93  an interagency agreement to conduct protective investigations
   94  under part III of chapter 39 and chapter 415;
   95         (h) To the Department of Children and Families pursuant to
   96  an interagency agreement specifying the number of employees in
   97  each of that department’s regions to be granted access to the
   98  records for use as verification of identity to expedite the
   99  determination of eligibility for public assistance and for use
  100  in public assistance fraud investigations;
  101         (i) To the Department of Financial Services pursuant to an
  102  interagency agreement to facilitate the location of owners of
  103  unclaimed property, the validation of unclaimed property claims,
  104  and the identification of fraudulent or false claims;
  105         (j) To district medical examiners pursuant to an
  106  interagency agreement for the purpose of identifying a deceased
  107  individual, determining cause of death, and notifying next of
  108  kin of any investigations, including autopsies and other
  109  laboratory examinations, authorized in s. 406.11; or
  110         (k) To the following persons for the purpose of identifying
  111  a person as part of the official work of a court:
  112         1. A justice or judge of this state;
  113         2. An employee of the state courts system who works in a
  114  position that is designated in writing for access by the Chief
  115  Justice of the Supreme Court or a chief judge of a district or
  116  circuit court, or by his or her designee; or
  117         3. A government employee who performs functions on behalf
  118  of the state courts system in a position that is designated in
  119  writing for access by the Chief Justice or a chief judge, or by
  120  his or her designee; or
  121         (l) To the Department of Health, pursuant to an interagency
  122  agreement to access digital images to verify the identity of an
  123  individual during an investigation under chapter 456, and for
  124  the reproduction of licenses issued by the Department of Health.
  125         Section 2. Paragraph (e) of subsection (4) of section
  126  395.3025, Florida Statutes, is amended to read:
  127         395.3025 Patient and personnel records; copies;
  128  examination.—
  129         (4) Patient records are confidential and may must not be
  130  disclosed without the consent of the patient or his or her legal
  131  representative, but appropriate disclosure may be made without
  132  such consent to:
  133         (e) The department agency upon subpoena issued pursuant to
  134  s. 456.071., but The records obtained thereby must be used
  135  solely for the purpose of the department agency and the
  136  appropriate professional board in its investigation,
  137  prosecution, and appeal of disciplinary proceedings. If the
  138  department agency requests copies of the records, the facility
  139  shall charge a fee pursuant to this section no more than its
  140  actual copying costs, including reasonable staff time. The
  141  department and the appropriate professional board must maintain
  142  the confidentiality of patient records obtained under this
  143  paragraph pursuant to s. 456.057. A licensee who is the subject
  144  of a department investigation may inspect or receive a copy of a
  145  patient record connected with the investigation if the licensee
  146  agrees in writing to maintain the confidentiality of the patient
  147  record pursuant to s. 456.057 must be sealed and must not be
  148  available to the public pursuant to s. 119.07(1) or any other
  149  statute providing access to records, nor may they be available
  150  to the public as part of the record of investigation for and
  151  prosecution in disciplinary proceedings made available to the
  152  public by the agency or the appropriate regulatory board.
  153  However, the agency must make available, upon written request by
  154  a practitioner against whom probable cause has been found, any
  155  such records that form the basis of the determination of
  156  probable cause.
  157         Section 3. Subsections (2), (6), and (7) of section
  158  456.013, Florida Statutes, are amended to read:
  159         456.013 Department; general licensing provisions.—
  160         (2) Before the issuance of a any license, the department
  161  shall charge an initial license fee as determined by the
  162  applicable board or, if there is no board, by rule of the
  163  department. Upon receipt of the appropriate license fee, the
  164  department shall issue a license to a any person certified by
  165  the appropriate board, or its designee, as having met the
  166  licensure requirements imposed by law or rule. The license shall
  167  consist of a wallet-size identification card and a wall card
  168  measuring 6 1/2 inches by 5 inches. The licensee shall surrender
  169  the license to the department the wallet-size identification
  170  card and the wall card if the licensee’s license was is issued
  171  in error or is revoked.
  172         (6) As a condition of renewal of a license, the Board of
  173  Medicine, the Board of Osteopathic Medicine, the Board of
  174  Chiropractic Medicine, and the Board of Podiatric Medicine shall
  175  each require their respective licensees which they respectively
  176  regulate to periodically demonstrate their professional
  177  competency by completing at least 40 hours of continuing
  178  education every 2 years. The boards may require by rule that up
  179  to 1 hour of the required 40 or more hours be in the area of
  180  risk management or cost containment. This provision does shall
  181  not be construed to limit the number of hours that a licensee
  182  may obtain in risk management or cost containment to be credited
  183  toward satisfying the 40 or more required hours. This provision
  184  does shall not be construed to require the boards to impose any
  185  requirement on licensees except for the completion of at least
  186  40 hours of continuing education every 2 years. Each of the such
  187  boards shall determine whether any specific continuing education
  188  requirements not otherwise mandated by law will shall be
  189  mandated and shall approve criteria for, and the content of, any
  190  continuing education mandated by such board. Notwithstanding any
  191  other provision of law, the board, or the department when there
  192  is no board, may approve by rule alternative methods of
  193  obtaining continuing education credits in risk management. The
  194  alternative methods may include attending a board meeting at
  195  which another licensee is disciplined, serving as a volunteer
  196  expert witness for the department in a disciplinary case, or
  197  serving as a member of a probable cause panel following the
  198  expiration of a board member’s term. Other boards within the
  199  Division of Medical Quality Assurance, or the department if
  200  there is no board, may adopt rules granting continuing education
  201  hours in risk management for attending a board meeting at which
  202  another licensee is disciplined, for serving as a volunteer
  203  expert witness for the department in a disciplinary case, or for
  204  serving as a member of a probable cause panel following the
  205  expiration of a board member’s term.
  206         (7) The boards, except the Board of Medicine, or the
  207  department when there is no board, shall require the completion
  208  of a 2-hour course relating to prevention of medical errors as
  209  part of the licensure and renewal process. The 2-hour course
  210  shall count towards the total number of continuing education
  211  hours required for the profession. The course shall be approved
  212  by the board or department, as appropriate, and shall include a
  213  study of root-cause analysis, error reduction and prevention,
  214  and patient safety. In addition, the course approved by the
  215  Board of Medicine and the Board of Osteopathic Medicine shall
  216  include information relating to the five most misdiagnosed
  217  conditions during the previous biennium, as determined by the
  218  board. If the course is being offered by a facility licensed
  219  pursuant to chapter 395 for its employees, the board may approve
  220  up to 1 hour of the 2-hour course to be specifically related to
  221  error reduction and prevention methods used in that facility.
  222         Section 4. Present subsections (5) through (11) of section
  223  456.025, Florida Statutes, are redesignated as subsections (4)
  224  through (10), respectively, and present subsections (4) and (6)
  225  are amended to read:
  226         456.025 Fees; receipts; disposition.—
  227         (4) Each board, or the department if there is no board, may
  228  charge a fee not to exceed $25, as determined by rule, for the
  229  issuance of a wall certificate pursuant to s. 456.013(2)
  230  requested by a licensee who was licensed prior to July 1, 1998,
  231  or for the issuance of a duplicate wall certificate requested by
  232  any licensee.
  233         (5)(6) If the cash balance of the trust fund at the end of
  234  any fiscal year exceeds the total appropriation provided for the
  235  regulation of the health care professions in the prior fiscal
  236  year, the boards, in consultation with the department, may lower
  237  the license renewal fees. When the department determines, based
  238  on long-range estimates of revenue, that a profession’s trust
  239  fund balance exceeds the amount required to cover necessary
  240  functions, each board, or the department when there is no board,
  241  may adopt rules to implement the waiver of initial application
  242  fees, initial licensure fees, unlicensed activity fees, or
  243  renewal fees for that profession. The waiver of renewal fees may
  244  not exceed 2 years.
  245         Section 5. Section 456.033, Florida Statutes, is amended to
  246  read:
  247         456.033 Requirement for instruction for certain licensees
  248  on HIV and AIDS.—The following requirements apply to each person
  249  licensed or certified under chapter 457; chapter 458; chapter
  250  459; chapter 460; chapter 461; chapter 463; part I of chapter
  251  464; chapter 465; chapter 466; part II, part III, part V, or
  252  part X of chapter 468; or chapter 486:
  253         (1) Each person shall be required by the appropriate board
  254  to complete no later than upon first renewal a continuing
  255  educational course, approved by the board, on human
  256  immunodeficiency virus and acquired immune deficiency syndrome
  257  as part of biennial relicensure or recertification. The course
  258  shall consist of education on the modes of transmission,
  259  infection control procedures, clinical management, and
  260  prevention of human immunodeficiency virus and acquired immune
  261  deficiency syndrome. Such course shall include information on
  262  current Florida law on acquired immune deficiency syndrome and
  263  its impact on testing, confidentiality of test results,
  264  treatment of patients, and any protocols and procedures
  265  applicable to human immunodeficiency virus counseling and
  266  testing, reporting, the offering of HIV testing to pregnant
  267  women, and partner notification issues pursuant to ss. 381.004
  268  and 384.25.
  269         (2) Each person shall submit confirmation of having
  270  completed the course required under subsection (1), on a form as
  271  provided by the board, when submitting fees for first renewal.
  272         (3) The board shall have the authority to approve
  273  additional equivalent courses that may be used to satisfy the
  274  requirements in subsection (1). Each licensing board that
  275  requires a licensee to complete an educational course pursuant
  276  to this section may count the hours required for completion of
  277  the course included in the total continuing educational
  278  requirements as required by law.
  279         (4) Any person holding two or more licenses subject to the
  280  provisions of this section shall be permitted to show proof of
  281  having taken one board-approved course on human immunodeficiency
  282  virus and acquired immune deficiency syndrome, for purposes of
  283  relicensure or recertification for additional licenses.
  284         (5) Failure to comply with the above requirements shall
  285  constitute grounds for disciplinary action under each respective
  286  licensing chapter and s. 456.072(1)(e). In addition to
  287  discipline by the board, the licensee shall be required to
  288  complete the course.
  289         Section 6. Section 456.068, Florida Statutes, is amended to
  290  read:
  291         456.068 Toll-free telephone number for reporting of
  292  complaints.—The Department of Health Agency for Health Care
  293  Administration shall establish a toll-free telephone number for
  294  public reporting of complaints relating to medical treatment or
  295  services provided by health care professionals.
  296         Section 7. Subsections (2) through (4) of section 458.319,
  297  Florida Statutes, are redesignated as subsections (3) through
  298  (5), respectively, and a new subsection (2) is added to that
  299  section, to read:
  300         458.319 Renewal of license.—
  301         (2) Each licensee shall demonstrate his or her professional
  302  competency by completing at least 40 hours of continuing medical
  303  education every 2 years. The board, by rule, may:
  304         (a) Provide that continuing medical education approved by
  305  the American Medical Association satisfies some or all of the
  306  continuing medical education requirements.
  307         (b) Mandate specific continuing medical education
  308  requirements.
  309         (c) Approve alternative methods for obtaining continuing
  310  medical education credits, including, but not limited to:
  311         1. Attendance at a board meeting at which another licensee
  312  is disciplined;
  313         2. Service as a volunteer expert witness for the department
  314  in a disciplinary proceeding; or
  315         3. Service as a member of a probable cause panel following
  316  expiration of a board member’s term.
  317         (d) Provide that up to 25 percent of the required
  318  continuing medical education hours may be fulfilled through pro
  319  bono services to the indigent, underserved populations, or
  320  patients in critical need areas in the state where the licensee
  321  practices.
  322         1. The board shall require that any pro bono service be
  323  approved in advance to receive credit for continuing medical
  324  education under this paragraph.
  325         2. The standard for determining indigency shall be that
  326  recognized by the federal poverty guidelines and shall be less
  327  than 150 percent of the federal poverty level.
  328         (e) Provide that a portion of the continuing medical
  329  education hours may be fulfilled by performing research in
  330  critical need areas or by training for advanced professional
  331  certification.
  332         (f) Adopt rules to define underserved and critical need
  333  areas.
  334         Section 8. Subsection (7) of section 464.203, Florida
  335  Statutes, is amended to read:
  336         464.203 Certified nursing assistants; certification
  337  requirement.—
  338         (7) A certified nursing assistant shall complete 24 12
  339  hours of inservice training during each biennium calendar year.
  340  The certified nursing assistant is shall be responsible for
  341  maintaining documentation demonstrating compliance with these
  342  provisions. The Council on Certified Nursing Assistants, in
  343  accordance with s. 464.2085(2)(b), shall propose rules to
  344  implement this subsection.
  345         Section 9. Section 464.2085, Florida Statutes, is repealed.
  346         Section 10. Subsection (2) of section 466.032, Florida
  347  Statutes, is amended to read:
  348         466.032 Registration.—
  349         (2) Upon the failure of any dental laboratory operator to
  350  comply with subsection (1), the department shall notify her or
  351  him by registered mail, within 1 month after the registration
  352  renewal date, return receipt requested, at her or his last known
  353  address, of such failure and inform her or him of the provisions
  354  of subsections (3) and (4).
  355         Section 11. Subsection (8) of section 467.009, Florida
  356  Statutes, is amended to read:
  357         467.009 Midwifery programs; education and training
  358  requirements.—
  359         (8) Nonpublic educational institutions that conduct
  360  approved midwifery programs shall be accredited by a member of
  361  the Council for Higher Education Accreditation Commission on
  362  Recognition of Postsecondary Accreditation and shall be licensed
  363  by the Commission for Independent Education.
  364         Section 12. Subsection (2) of section 468.1665, Florida
  365  Statutes, is amended to read:
  366         468.1665 Board of Nursing Home Administrators; membership;
  367  appointment; terms.—
  368         (2) Four Three members of the board must be licensed
  369  nursing home administrators. Two members of the board must be
  370  health care practitioners. The remaining member two members of
  371  the board must be a layperson laypersons who is are not, and has
  372  have never been, a nursing home administrator administrators or
  373  member members of any health care profession or occupation. At
  374  least one member of the board must be 60 years of age or older.
  375         Section 13. Subsection (2) of section 468.1695, Florida
  376  Statutes, is amended to read:
  377         468.1695 Licensure by examination.—
  378         (2) The department shall examine each applicant who the
  379  board certifies has completed the application form and remitted
  380  an examination fee set by the board not to exceed $250 and who:
  381         (a)1. Holds a baccalaureate or master’s degree from an
  382  accredited college or university and majored in health care
  383  administration, health services administration, or an equivalent
  384  major, or has credit for at least 60 semester hours in subjects,
  385  as prescribed by rule of the board, which prepare the applicant
  386  for total management of a nursing home; and
  387         2. Has fulfilled the requirements of a college-affiliated
  388  or university-affiliated internship in nursing home
  389  administration or of a 1,000-hour nursing home administrator-in
  390  training program prescribed by the board; or
  391         (b)1. Holds a baccalaureate degree from an accredited
  392  college or university; and
  393         2.a. Has fulfilled the requirements of a 2,000-hour nursing
  394  home administrator-in-training program prescribed by the board;
  395  or
  396         b. Has 1 year of management experience allowing for the
  397  application of executive duties and skills, including the
  398  staffing, budgeting, and directing of resident care, dietary,
  399  and bookkeeping departments within a skilled nursing facility,
  400  hospital, hospice, assisted living facility with a minimum of 60
  401  licensed beds, or geriatric residential treatment program and,
  402  if such experience is not in a skilled nursing facility, has
  403  fulfilled the requirements of a 1,000-hour nursing home
  404  administrator-in-training program prescribed by the board.
  405         Section 14. Section 468.1735, Florida Statutes, is
  406  repealed.
  407         Section 15. Subsection (11) of section 468.503, Florida
  408  Statutes, is amended to read:
  409         468.503 Definitions.—As used in this part:
  410         (11) “Registered dietitian” means an individual registered
  411  with the accrediting body of the Academy of Nutrition and
  412  Dietetics Commission on Dietetic Registration, the accrediting
  413  body of the American Dietetic Association.
  414         Section 16. Subsection (4) of section 468.505, Florida
  415  Statutes, is amended to read:
  416         468.505 Exemptions; exceptions.—
  417         (4) Notwithstanding any other provision of this part, an
  418  individual registered by the accrediting body of the Academy of
  419  Nutrition and Dietetics Commission on Dietetic Registration of
  420  the American Dietetic Association has the right to use the title
  421  “Registered Dietitian” and the designation “R.D.”
  422         Section 17. Subsection (5) of section 480.033, Florida
  423  Statutes, is amended to read:
  424         480.033 Definitions.—As used in this act:
  425         (5) “Apprentice” means a person approved by the board to
  426  study massage under the instruction of a licensed massage
  427  therapist.
  428         Section 18. Subsections (1) and (4) of section 480.041,
  429  Florida Statutes, are amended to read:
  430         480.041 Massage therapists; qualifications; licensure;
  431  endorsement.—
  432         (1) A Any person is qualified for licensure as a massage
  433  therapist under this act who:
  434         (a) Is at least 18 years of age or has received a high
  435  school diploma or graduate equivalency diploma;
  436         (b) Has completed a course of study at a board-approved
  437  massage school or has completed an apprenticeship program that
  438  meets standards adopted by the board; and
  439         (c) Has received a passing grade on an examination
  440  administered by the department.
  441         (4) The board shall adopt rules:
  442         (a) Establishing a minimum training program for
  443  apprentices.
  444         (b) Providing for educational standards, examination, and
  445  certification for the practice of colonic irrigation, as defined
  446  in s. 480.033(6), by massage therapists.
  447         (b)(c) Specifying licensing procedures for practitioners
  448  desiring to be licensed in this state who hold an active license
  449  and have practiced in any other state, territory, or
  450  jurisdiction of the United States or any foreign national
  451  jurisdiction which has licensing standards substantially similar
  452  to, equivalent to, or more stringent than the standards of this
  453  state.
  454         Section 19. Subsection (5) of section 480.042, Florida
  455  Statutes, is amended to read:
  456         480.042 Examinations.—
  457         (5) All licensing examinations shall be conducted in such
  458  manner that the applicant shall be known to the department by
  459  number until her or his examination is completed and the proper
  460  grade determined. An accurate record of each examination shall
  461  be maintained, made; and that record, together with all
  462  examination papers, shall be filed with the State Surgeon
  463  General and shall be kept by the testing entities for reference
  464  and inspection for a period of not less than 2 years immediately
  465  following the examination.
  466         Section 20. Paragraph (h) of subsection (1) of section
  467  480.044, Florida Statutes, is amended to read:
  468         480.044 Fees; disposition.—
  469         (1) The board shall set fees according to the following
  470  schedule:
  471         (h) Fee for apprentice: not to exceed $100.
  472         Section 21. Subsection (3) of section 823.05, Florida
  473  Statutes, is amended to read:
  474         823.05 Places and groups engaged in criminal gang-related
  475  activity declared a nuisance; massage establishments engaged in
  476  prohibited activity; may be abated and enjoined.—
  477         (3) A massage establishment as defined in s. 480.033(7)
  478  that operates in violation of s. 480.0475 or s. 480.0535(2) is
  479  declared a nuisance and may be abated or enjoined as provided in
  480  ss. 60.05 and 60.06.
  481         Section 22. This act shall take effect July 1, 2014.