Florida Senate - 2015                                     SB 532
       
       
        
       By Senator Grimsley
       
       
       
       
       
       21-00400-15                                            2015532__
    1                        A bill to be entitled                      
    2         An act relating to the ordering of medication;
    3         amending ss. 458.347 and 459.022, F.S.; revising the
    4         authority of a licensed physician assistant to order
    5         medication under the direction of a supervisory
    6         physician for a specified patient; amending s.
    7         464.012, F.S.; authorizing an advanced registered
    8         nurse practitioner to order medication for
    9         administration to a specified patient; amending s.
   10         465.003, F.S.; revising the term “prescription” to
   11         exclude an order for drugs or medicinal supplies by a
   12         licensed practitioner that is dispensed for certain
   13         administration; amending s. 893.02, F.S.; revising the
   14         term “administer” to include the term
   15         “administration”; revising the term “prescription” to
   16         exclude an order for drugs or medicinal supplies by a
   17         licensed practitioner that is dispensed for certain
   18         administration; amending s. 893.04, F.S.; conforming
   19         provisions to changes made by act; amending s. 893.05,
   20         F.S.; authorizing a licensed practitioner to authorize
   21         a licensed physician assistant or advanced registered
   22         nurse practitioner to order controlled substances for
   23         a specified patient under certain circumstances;
   24         reenacting ss. 400.462(26), 401.445(1), 409.906(18),
   25         and 766.103(3), F.S., to incorporate the amendments
   26         made to ss. 458.347 and 459.022, F.S., in references
   27         thereto; reenacting ss. 401.445(1) and 766.103(3),
   28         F.S., to incorporate the amendment made to s. 464.012,
   29         F.S., in references thereto; reenacting ss.
   30         409.9201(1)(a), 458.331(1)(pp), 459.015(1)(rr),
   31         465.014(1), 465.015(2)(c), 465.016(1)(s),
   32         465.022(5)(j), 465.023(1)(h), 465.1901, 499.003(43),
   33         and 831.30(1), F.S., to incorporate the amendment made
   34         to s. 465.003, F.S., in references thereto; reenacting
   35         ss. 112.0455(5)(i), 381.986(7)(b), 440.102(1)(l),
   36         458.331(1)(pp), 459.015(1)(rr), 465.015(3),
   37         465.016(1)(s), 465.022(5)(j), 465.023(1)(h),
   38         499.0121(14), 768.36(1)(b), 810.02(3)(f),
   39         812.014(2)(c), 856.015(1)(c), 944.47(1)(a), 951.22(1),
   40         985.711(1)(a), 1003.57(1)(i), and 1006.09(8), F.S., to
   41         incorporate the amendment made to s. 893.02, F.S., in
   42         references thereto; reenacting s. 893.0551(3)(e),
   43         F.S., to incorporate the amendment made to s. 893.04,
   44         F.S., in a reference thereto; reenacting s.
   45         893.0551(3)(d), F.S., to incorporate the amendment
   46         made to s. 893.05, F.S., in a reference thereto;
   47         providing an effective date.
   48  
   49  Be It Enacted by the Legislature of the State of Florida:
   50  
   51         Section 1. Paragraph (g) of subsection (4) of section
   52  458.347, Florida Statutes, is amended to read:
   53         458.347 Physician assistants.—
   54         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   55         (g) A supervisory physician may delegate to a licensed
   56  physician assistant the authority to, and the licensed physician
   57  assistant acting under the direction of the supervisory
   58  physician may, order any medication medications for
   59  administration to the supervisory physician’s patient during his
   60  or her care in a facility licensed under chapter 395,
   61  notwithstanding any provisions in chapter 465 or chapter 893
   62  which may prohibit this delegation. For the purpose of this
   63  paragraph, an order is not considered a prescription. A licensed
   64  physician assistant working in a facility that is licensed under
   65  chapter 395 may order any medication under the direction of the
   66  supervisory physician.
   67         Section 2. Paragraph (f) of subsection (4) of section
   68  459.022, Florida Statutes, is amended to read:
   69         459.022 Physician assistants.—
   70         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   71         (f) A supervisory physician may delegate to a licensed
   72  physician assistant the authority to, and the licensed physician
   73  assistant acting under the direction of the supervisory
   74  physician may, order any medication medications for
   75  administration to the supervisory physician’s patient during his
   76  or her care in a facility licensed under chapter 395,
   77  notwithstanding any provisions in chapter 465 or chapter 893
   78  which may prohibit this delegation. For the purpose of this
   79  paragraph, an order is not considered a prescription. A licensed
   80  physician assistant working in a facility that is licensed under
   81  chapter 395 may order any medication under the direction of the
   82  supervisory physician.
   83         Section 3. Paragraph (a) of subsection (3) of section
   84  464.012, Florida Statutes, is amended to read:
   85         464.012 Certification of advanced registered nurse
   86  practitioners; fees.—
   87         (3) An advanced registered nurse practitioner shall perform
   88  those functions authorized in this section within the framework
   89  of an established protocol that is filed with the board upon
   90  biennial license renewal and within 30 days after entering into
   91  a supervisory relationship with a physician or changes to the
   92  protocol. The board shall review the protocol to ensure
   93  compliance with applicable regulatory standards for protocols.
   94  The board shall refer to the department licensees submitting
   95  protocols that are not compliant with the regulatory standards
   96  for protocols. A practitioner currently licensed under chapter
   97  458, chapter 459, or chapter 466 shall maintain supervision for
   98  directing the specific course of medical treatment. Within the
   99  established framework, an advanced registered nurse practitioner
  100  may:
  101         (a) Monitor and alter drug therapies and order any
  102  medication for administration to a patient in a facility
  103  licensed under chapter 395.
  104         Section 4. Subsection (14) of section 465.003, Florida
  105  Statutes, is amended to read:
  106         465.003 Definitions.—As used in this chapter, the term:
  107         (14) “Prescription” includes any order for drugs or
  108  medicinal supplies written or transmitted by any means of
  109  communication by a duly licensed practitioner authorized by the
  110  laws of this the state to prescribe such drugs or medicinal
  111  supplies and intended to be dispensed by a pharmacist, except
  112  for an order that is dispensed for administration. The term also
  113  includes an orally transmitted order by the lawfully designated
  114  agent of such practitioner;. The term also includes an order
  115  written or transmitted by a practitioner licensed to practice in
  116  a jurisdiction other than this state, but only if the pharmacist
  117  called upon to dispense such order determines, in the exercise
  118  of her or his professional judgment, that the order is valid and
  119  necessary for the treatment of a chronic or recurrent illness;
  120  and. The term “prescription” also includes a pharmacist’s order
  121  for a product selected from the formulary created pursuant to s.
  122  465.186. Prescriptions may be retained in written form or the
  123  pharmacist may cause them to be recorded in a data processing
  124  system, provided that such order can be produced in printed form
  125  upon lawful request.
  126         Section 5. Subsections (1) and (22) of section 893.02,
  127  Florida Statutes, are amended to read:
  128         893.02 Definitions.—The following words and phrases as used
  129  in this chapter shall have the following meanings, unless the
  130  context otherwise requires:
  131         (1) “Administer” or “administration” means the direct
  132  application of a controlled substance, whether by injection,
  133  inhalation, ingestion, or any other means, to the body of a
  134  person or animal.
  135         (22) “Prescription” means and includes any an order for
  136  drugs or medicinal supplies which is written, signed, or
  137  transmitted by any word of mouth, telephone, telegram, or other
  138  means of communication by a duly licensed practitioner
  139  authorized licensed by the laws of this the state to prescribe
  140  such drugs or medicinal supplies, is issued in good faith and in
  141  the course of professional practice, is intended to be filled,
  142  compounded, or dispensed by a another person authorized licensed
  143  by the laws of this the state to do so, and meets meeting the
  144  requirements of s. 893.04.
  145         (a) The term also includes an order for drugs or medicinal
  146  supplies so transmitted or written by a physician, dentist,
  147  veterinarian, or other practitioner licensed to practice in a
  148  state other than Florida, but only if the pharmacist called upon
  149  to fill such an order determines, in the exercise of his or her
  150  professional judgment, that the order was issued pursuant to a
  151  valid patient-physician relationship, that it is authentic, and
  152  that the drugs or medicinal supplies so ordered are considered
  153  necessary for the continuation of treatment of a chronic or
  154  recurrent illness.
  155         (b) The term does not include an order that is dispensed
  156  for administration by a licensed practitioner authorized by the
  157  laws of this state to administer such drugs or medicinal
  158  supplies.
  159         (c)However, If the physician writing the prescription is
  160  not known to the pharmacist, the pharmacist shall obtain proof
  161  to a reasonable certainty of the validity of the said
  162  prescription.
  163         (d) A prescription order for a controlled substance may
  164  shall not be issued on the same prescription blank with another
  165  prescription order for a controlled substance that which is
  166  named or described in a different schedule or with another, nor
  167  shall any prescription order for a controlled substance be
  168  issued on the same prescription blank as a prescription order
  169  for a medicinal drug, as defined in s. 465.003(8), that is which
  170  does not fall within the definition of a controlled substance as
  171  defined in this act.
  172         Section 6. Paragraphs (a), (d), and (f) of subsection (2)
  173  of section 893.04, Florida Statutes, are amended to read:
  174         893.04 Pharmacist and practitioner.—
  175         (2)(a) A pharmacist may not dispense a controlled substance
  176  listed in Schedule II, Schedule III, or Schedule IV to any
  177  patient or patient’s agent without first determining, in the
  178  exercise of her or his professional judgment, that the
  179  prescription order is valid. The pharmacist may dispense the
  180  controlled substance, in the exercise of her or his professional
  181  judgment, when the pharmacist or pharmacist’s agent has obtained
  182  satisfactory patient information from the patient or the
  183  patient’s agent.
  184         (d) Each written prescription written prescribed by a
  185  practitioner in this state for a controlled substance listed in
  186  Schedule II, Schedule III, or Schedule IV must include both a
  187  written and a numerical notation of the quantity of the
  188  controlled substance prescribed and a notation of the date in
  189  numerical, month/day/year format, or with the abbreviated month
  190  written out, or the month written out in whole. A pharmacist
  191  may, upon verification by the prescriber, document any
  192  information required by this paragraph. If the prescriber is not
  193  available to verify a prescription, the pharmacist may dispense
  194  the controlled substance, but may insist that the person to whom
  195  the controlled substance is dispensed provide valid photographic
  196  identification. If a prescription includes a numerical notation
  197  of the quantity of the controlled substance or date, but does
  198  not include the quantity or date written out in textual format,
  199  the pharmacist may dispense the controlled substance without
  200  verification by the prescriber of the quantity or date if the
  201  pharmacy previously dispensed another prescription for the
  202  person to whom the prescription was written.
  203         (f) A pharmacist may not knowingly dispense fill a
  204  prescription that has been forged for a controlled substance
  205  listed in Schedule II, Schedule III, or Schedule IV.
  206         Section 7. Subsection (1) of section 893.05, Florida
  207  Statutes, is amended to read:
  208         893.05 Practitioners and persons administering controlled
  209  substances in their absence.—
  210         (1)(a) A practitioner, in good faith and in the course of
  211  his or her professional practice only, may prescribe,
  212  administer, dispense, mix, or otherwise prepare a controlled
  213  substance, or the practitioner may cause the controlled
  214  substance same to be administered by a licensed nurse or an
  215  intern practitioner under his or her direction and supervision
  216  only.
  217         (b)Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
  218  464.012(3), as applicable, a practitioner who supervises a
  219  licensed physician assistant or advanced registered nurse
  220  practitioner may authorize the licensed physician assistant or
  221  advanced registered nurse practitioner to order controlled
  222  substances for administration to a patient in a facility
  223  licensed under chapter 395.
  224         (c) A veterinarian may so prescribe, administer, dispense,
  225  mix, or prepare a controlled substance for use on animals only,
  226  and may cause the controlled substance it to be administered by
  227  an assistant or orderly under the veterinarian’s direction and
  228  supervision only.
  229         (d) A certified optometrist licensed under chapter 463 may
  230  not administer or prescribe a controlled substance listed in
  231  Schedule I or Schedule II of s. 893.03.
  232         Section 8. Subsection (26) of s. 400.462, subsection (1) of
  233  s. 401.445, subsection (18) of s. 409.906, and subsection (3) of
  234  s. 766.103, Florida Statutes, are reenacted for the purpose of
  235  incorporating the amendments made by this act to ss. 458.347 and
  236  459.022, Florida Statutes, in references thereto.
  237         Section 9. Subsection (1) of s. 401.445 and subsection (3)
  238  of s. 766.103, Florida Statutes, are reenacted for the purpose
  239  of incorporating the amendment made by this act to s. 464.012,
  240  Florida Statutes, in references thereto.
  241         Section 10. Paragraph (a) of subsection (1) of s. 409.9201,
  242  paragraph (pp) of subsection (1) of s. 458.331, paragraph (rr)
  243  of subsection (1) of s. 459.015, subsection (1) of s. 465.014,
  244  paragraph (c) of subsection (2) of s. 465.015, paragraph (s) of
  245  subsection (1) of s. 465.016, paragraph (j) of subsection (5) of
  246  s. 465.022, paragraph (h) of subsection (1) of s. 465.023, s.
  247  465.1901, subsection (43) of s. 499.003, and subsection (1) of
  248  s. 831.30, Florida Statutes, are reenacted for the purpose of
  249  incorporating the amendments made by this act to s. 465.003,
  250  Florida Statutes, in references thereto.
  251         Section 11. Paragraph (i) of subsection (5) of s. 112.0455,
  252  paragraph (b) of subsection (7) of s. 381.986, paragraph (l) of
  253  subsection (1) of s. 440.102, paragraph (pp) of subsection (1)
  254  of s. 458.331, paragraph (rr) of subsection (1) of s. 459.015,
  255  subsection (3) of s. 465.015, paragraph (s) of subsection (1) of
  256  s. 465.016, paragraph (j) of subsection (5) of s. 465.022,
  257  paragraph (h) of subsection (1) of s. 465.023, subsection (14)
  258  of s. 499.0121, paragraph (b) of subsection (1) of s. 768.36,
  259  paragraph (f) of subsection (3) of s. 810.02, paragraph (c) of
  260  subsection (2) of s. 812.014, paragraph (c) of subsection (1) of
  261  s. 856.015, paragraph (a) of subsection (1) of s. 944.47,
  262  subsection (1) of s. 951.22, paragraph (a) of subsection (1) of
  263  s. 985.711, paragraph (i) of subsection (1) of s. 1003.57, and
  264  subsection (8) of s. 1006.09, Florida Statutes, are reenacted
  265  for the purpose of incorporating the amendments made by this act
  266  to s. 893.02, Florida Statutes, in references thereto.
  267         Section 12. Paragraph (e) of subsection (3) of s. 893.0551,
  268  Florida Statutes, is reenacted for the purpose of incorporating
  269  the amendments made by this act to s. 893.04, Florida Statutes,
  270  in a reference thereto.
  271         Section 13. Paragraph (d) of subsection (3) of s. 893.0551,
  272  Florida Statutes, is reenacted for the purpose of incorporating
  273  the amendments made by this act to s. 893.05, Florida Statutes,
  274  in a reference thereto.
  275         Section 14. This act shall take effect July 1, 2015.