Florida Senate - 2014                             CS for SB 1066
       By the Committee on Health Policy; and Senator Grimsley
       588-03218-14                                          20141066c1
    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         amending s. 456.025, F.S.; deleting a fee provision
   17         for the issuance of wall certificates for various
   18         health profession licenses; authorizing the boards or
   19         the department to adopt rules waiving certain fees for
   20         a specified period in certain circumstances; amending
   21         s. 458.319, F.S.; providing continuing medical
   22         education requirements for Board of Medicine
   23         licensees; authorizing the board to adopt rules;
   24         amending s. 458.3485, F.S.; deleting language relating
   25         to the certification and registration of medical
   26         assistants; amending s. 464.203, F.S.; revising
   27         certified nursing assistant inservice training
   28         requirements; repealing s. 464.2085, F.S., relating to
   29         the creation, membership, and duties of the Council on
   30         Certified Nursing Assistants; amending s. 466.032,
   31         F.S.; deleting a requirement that the department
   32         provide certain notice to a dental laboratory operator
   33         who fails to renew her or his registration; amending
   34         s. 467.009, F.S.; updating the name of the
   35         organization that accredits certain midwifery
   36         programs; amending s. 468.1665, F.S.; increasing the
   37         number of members of the Board of Nursing Home
   38         Administrators who must be licensed nursing home
   39         administrators and decreasing the number of members
   40         who must be health care practitioners; amending s.
   41         468.1695, F.S.; revising the qualifications of
   42         applicants who may sit for the licensed nursing home
   43         administrator examination to include an applicant with
   44         a master’s degree in certain subjects; repealing s.
   45         468.1735, F.S., relating to provisional licenses for
   46         nursing home administrators; amending ss. 468.503 and
   47         468.505, F.S.; revising the organization with whom an
   48         individual must be registered to be a registered
   49         dietitian; revising a definition; amending ss. 480.033
   50         and 480.041, F.S.; deleting provisions relating to
   51         massage therapy apprentices and apprenticeship
   52         programs; deleting a definition and revising licensure
   53         requirements for massage therapists, to conform;
   54         amending s. 480.042, F.S.; revising requirements for
   55         conducting massage therapist licensing examinations
   56         and maintaining examination records; amending s.
   57         480.044, F.S.; deleting a fee for massage therapy
   58         apprentices; amending s. 486.031, F.S.; revising
   59         provisions relating to the recognition of physical
   60         therapy programs and educational credentials from
   61         foreign countries to meet requirements for licensing
   62         as a physical therapist; amending s. 823.05, F.S.;
   63         conforming a cross-reference; providing an effective
   64         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. Subsection (2) of section 456.013, Florida
  158  Statutes, is 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         Section 4. Present subsections (5) through (11) of section
  173  456.025, Florida Statutes, are redesignated as subsections (4)
  174  through (10), respectively, and present subsections (4) and (6)
  175  are amended to read:
  176         456.025 Fees; receipts; disposition.—
  177         (4) Each board, or the department if there is no board, may
  178  charge a fee not to exceed $25, as determined by rule, for the
  179  issuance of a wall certificate pursuant to s. 456.013(2)
  180  requested by a licensee who was licensed prior to July 1, 1998,
  181  or for the issuance of a duplicate wall certificate requested by
  182  any licensee.
  183         (5)(6) If the cash balance of the trust fund at the end of
  184  any fiscal year exceeds the total appropriation provided for the
  185  regulation of the health care professions in the prior fiscal
  186  year, the boards, in consultation with the department, may lower
  187  the license renewal fees. When the department determines, based
  188  on long-range estimates of revenue, that a profession’s trust
  189  fund balance exceeds the amount required to cover necessary
  190  functions, each board, or the department when there is no board,
  191  may adopt rules to implement the waiver of initial application
  192  fees, initial licensure fees, unlicensed activity fees, or
  193  renewal fees for that profession. The waiver of renewal fees may
  194  not exceed 2 years.
  195         Section 5. Subsections (2) through (4) of section 458.319,
  196  Florida Statutes, are redesignated as subsections (3) through
  197  (5), respectively, and a new subsection (2) is added to that
  198  section, to read:
  199         458.319 Renewal of license.—
  200         (2) Each licensee shall demonstrate his or her professional
  201  competency by completing at least 40 hours of continuing medical
  202  education every 2 years. The board, by rule, may:
  203         (a) Provide that continuing medical education approved by
  204  the American Medical Association satisfies some or all of the
  205  continuing medical education requirements.
  206         (b) Mandate specific continuing medical education
  207  requirements.
  208         (c) Approve alternative methods for obtaining continuing
  209  medical education credits, including, but not limited to:
  210         1. Attendance at a board meeting at which another licensee
  211  is disciplined;
  212         2. Service as a volunteer expert witness for the department
  213  in a disciplinary proceeding; or
  214         3. Service as a member of a probable cause panel following
  215  expiration of a board member’s term.
  216         (d) Provide that up to 25 percent of the required
  217  continuing medical education hours may be fulfilled through pro
  218  bono services to the indigent, underserved populations, or
  219  patients in critical need areas in the state where the licensee
  220  practices.
  221         1. The board shall require that any pro bono service be
  222  approved in advance to receive credit for continuing medical
  223  education under this paragraph.
  224         2. The standard for determining indigency is that
  225  recognized by the federal poverty guidelines and must be less
  226  than 150 percent of the federal poverty level.
  227         (e) Provide that a portion of the continuing medical
  228  education hours may be fulfilled by performing research in
  229  critical need areas or by training for advanced professional
  230  certification.
  231         (f) Adopt rules to define underserved and critical need
  232  areas.
  233         Section 6. Subsection (3) of section 458.3485, Florida
  234  Statutes, is amended to read:
  235         458.3485 Medical assistant.—
  236         (3) CERTIFICATION.—Medical assistants may be certified by
  237  the American Association of Medical Assistants or as a
  238  Registered Medical Assistant by the American Medical
  239  Technologists.
  240         Section 7. Subsection (7) of section 464.203, Florida
  241  Statutes, is amended to read:
  242         464.203 Certified nursing assistants; certification
  243  requirement.—
  244         (7) A certified nursing assistant shall complete 24 12
  245  hours of inservice training during each biennium calendar year.
  246  The certified nursing assistant shall maintain be responsible
  247  for maintaining documentation demonstrating compliance with
  248  these provisions. The Council on Certified Nursing Assistants,
  249  in accordance with s. 464.2085(2)(b), shall propose rules to
  250  implement this subsection.
  251         Section 8. Section 464.2085, Florida Statutes, is repealed.
  252         Section 9. Subsection (2) of section 466.032, Florida
  253  Statutes, is amended to read:
  254         466.032 Registration.—
  255         (2) Upon the failure of any dental laboratory operator to
  256  comply with subsection (1), the department shall notify her or
  257  him by registered mail, within 1 month after the registration
  258  renewal date, return receipt requested, at her or his last known
  259  address, of such failure and inform her or him of the provisions
  260  of subsections (3) and (4).
  261         Section 10. Subsection (8) of section 467.009, Florida
  262  Statutes, is amended to read:
  263         467.009 Midwifery programs; education and training
  264  requirements.—
  265         (8) Nonpublic educational institutions that conduct
  266  approved midwifery programs shall be accredited by a member of
  267  the Council for Higher Education Commission on Recognition of
  268  Postsecondary Accreditation and shall be licensed by the
  269  Commission for Independent Education.
  270         Section 11. Subsection (2) of section 468.1665, Florida
  271  Statutes, is amended to read:
  272         468.1665 Board of Nursing Home Administrators; membership;
  273  appointment; terms.—
  274         (2) Four Three members of the board must be licensed
  275  nursing home administrators. One member Two members of the board
  276  must be a health care practitioner practitioners. The remaining
  277  two members of the board must be laypersons who are not, and
  278  have never been, nursing home administrators or members of any
  279  health care profession or occupation. At least one member of the
  280  board must be 60 years of age or older.
  281         Section 12. Subsection (2) of section 468.1695, Florida
  282  Statutes, is amended to read:
  283         468.1695 Licensure by examination.—
  284         (2) The department shall examine each applicant who the
  285  board certifies has completed the application form and remitted
  286  an examination fee set by the board not to exceed $250 and who:
  287         (a)1. Holds a baccalaureate or master’s degree from an
  288  accredited college or university and majored in health care
  289  administration, health services administration, or an equivalent
  290  major, or has credit for at least 60 semester hours in subjects,
  291  as prescribed by rule of the board, which prepare the applicant
  292  for total management of a nursing home; and
  293         2. Has fulfilled the requirements of a college-affiliated
  294  or university-affiliated internship in nursing home
  295  administration or of a 1,000-hour nursing home administrator-in
  296  training program prescribed by the board; or
  297         (b)1. Holds a baccalaureate degree from an accredited
  298  college or university; and
  299         2.a. Has fulfilled the requirements of a 2,000-hour nursing
  300  home administrator-in-training program prescribed by the board;
  301  or
  302         b. Has 1 year of management experience allowing for the
  303  application of executive duties and skills, including the
  304  staffing, budgeting, and directing of resident care, dietary,
  305  and bookkeeping departments within a skilled nursing facility,
  306  hospital, hospice, assisted living facility with a minimum of 60
  307  licensed beds, or geriatric residential treatment program and,
  308  if such experience is not in a skilled nursing facility, has
  309  fulfilled the requirements of a 1,000-hour nursing home
  310  administrator-in-training program prescribed by the board.
  311         Section 13. Section 468.1735, Florida Statutes, is
  312  repealed.
  313         Section 14. Subsection (11) of section 468.503, Florida
  314  Statutes, is amended to read:
  315         468.503 Definitions.—As used in this part:
  316         (11) “Registered dietitian” means an individual registered
  317  with the accrediting body of the Academy of Nutrition and
  318  Dietetics Commission on Dietetic Registration, the accrediting
  319  body of the American Dietetic Association.
  320         Section 15. Subsection (4) of section 468.505, Florida
  321  Statutes, is amended to read:
  322         468.505 Exemptions; exceptions.—
  323         (4) Notwithstanding any other provision of this part, an
  324  individual registered by the accrediting body of the Academy of
  325  Nutrition and Dietetics Commission on Dietetic Registration of
  326  the American Dietetic Association has the right to use the title
  327  “Registered Dietitian” and the designation “R.D.”
  328         Section 16. Subsection (5) of section 480.033, Florida
  329  Statutes, is amended to read:
  330         480.033 Definitions.—As used in this act:
  331         (5) “Apprentice” means a person approved by the board to
  332  study massage under the instruction of a licensed massage
  333  therapist.
  334         Section 17. Subsections (1) and (4) of section 480.041,
  335  Florida Statutes, are amended to read:
  336         480.041 Massage therapists; qualifications; licensure;
  337  endorsement.—
  338         (1) A Any person is qualified for licensure as a massage
  339  therapist under this act who:
  340         (a) Is at least 18 years of age or has received a high
  341  school diploma or graduate equivalency diploma;
  342         (b) Has completed a course of study at a board-approved
  343  massage school or has completed an apprenticeship program that
  344  meets standards adopted by the board; and
  345         (c) Has received a passing grade on an examination
  346  administered by the department.
  347         (4) The board shall adopt rules:
  348         (a) Establishing a minimum training program for
  349  apprentices.
  350         (b) Providing for educational standards, examination, and
  351  certification for the practice of colonic irrigation, as defined
  352  in s. 480.033(6), by massage therapists.
  353         (b)(c) Specifying licensing procedures for practitioners
  354  desiring to be licensed in this state who hold an active license
  355  and have practiced in any other state, territory, or
  356  jurisdiction of the United States or any foreign national
  357  jurisdiction which has licensing standards substantially similar
  358  to, equivalent to, or more stringent than the standards of this
  359  state.
  360         Section 18. Subsection (5) of section 480.042, Florida
  361  Statutes, is amended to read:
  362         480.042 Examinations.—
  363         (5) All licensing examinations shall be conducted in such
  364  manner that the applicant shall be known to the department by
  365  number until her or his examination is completed and the proper
  366  grade determined. An accurate record of each examination shall
  367  be maintained, made; and that record, together with all
  368  examination papers, shall be filed with the State Surgeon
  369  General and shall be kept by the testing entities for reference
  370  and inspection for a period of not less than 2 years immediately
  371  following the examination.
  372         Section 19. Paragraph (h) of subsection (1) of section
  373  480.044, Florida Statutes, is amended to read:
  374         480.044 Fees; disposition.—
  375         (1) The board shall set fees according to the following
  376  schedule:
  377         (h) Fee for apprentice: not to exceed $100.
  378         Section 20. Subsection (3) of section 486.031, Florida
  379  Statutes, is amended to read:
  380         486.031 Physical therapist; licensing requirements.—To be
  381  eligible for licensing as a physical therapist, an applicant
  382  must:
  383         (3)(a) Have been graduated from a school of physical
  384  therapy which has been approved for the educational preparation
  385  of physical therapists by the appropriate accrediting agency
  386  recognized by the Commission on Recognition of Postsecondary
  387  Accreditation or the United States Department of Education at
  388  the time of her or his graduation and have passed, to the
  389  satisfaction of the board, the American Registry Examination
  390  before prior to 1971 or a national examination approved by the
  391  board to determine her or his fitness for practice as a physical
  392  therapist as hereinafter provided;
  393         (b) Have received a diploma from a program in physical
  394  therapy in a foreign country and have educational credentials
  395  deemed equivalent to those required for the educational
  396  preparation of physical therapists in this country, as
  397  recognized by the board or by an appropriate agency as
  398  identified by the board, and have passed to the satisfaction of
  399  the board an examination to determine her or his fitness for
  400  practice as a physical therapist as hereinafter provided; or
  401         (c) Be entitled to licensure without examination as
  402  provided in s. 486.081.
  403         Section 21. Subsection (3) of section 823.05, Florida
  404  Statutes, is amended to read:
  405         823.05 Places and groups engaged in criminal gang-related
  406  activity declared a nuisance; massage establishments engaged in
  407  prohibited activity; may be abated and enjoined.—
  408         (3) A massage establishment as defined in s. 480.033(7)
  409  that operates in violation of s. 480.0475 or s. 480.0535(2) is
  410  declared a nuisance and may be abated or enjoined as provided in
  411  ss. 60.05 and 60.06.
  412         Section 22. This act shall take effect July 1, 2014.