Florida Senate - 2017              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 876
       
       
       
       
       
                               Ì926878gÎ926878                          
       
       576-04080A-17                                                   
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to health care practitioners; amending
    3         s. 456.076, F.S.; revising provisions related to
    4         impaired practitioner programs; providing definitions;
    5         deleting a requirement that the Department of Health
    6         designate approved programs by rule; deleting a
    7         requirement authorizing the department to adopt by
    8         rule the manner in which consultants work with the
    9         department in intervention, in evaluating and treating
   10         professionals, in providing and monitoring continued
   11         care of impaired professionals, and in expelling
   12         professionals from the program; authorizing, instead
   13         of requiring, the department to retain one or more
   14         consultants to operate its impaired practitioner
   15         program; requiring the department to establish the
   16         terms and conditions of the program by contract;
   17         providing contract terms; requiring consultants to
   18         establish the terms of monitoring impaired
   19         practitioners; authorizing consultants to consider the
   20         recommendations of certain persons in establishing the
   21         terms of monitoring; authorizing consultants to modify
   22         monitoring terms to protect the health, safety, and
   23         welfare of the public; requiring consultants to assist
   24         the department and licensure boards on matters
   25         relating to impaired practitioners; making technical
   26         changes; requiring the department to refer
   27         practitioners to consultants under certain
   28         circumstances; authorizing consultants to withhold
   29         certain information about self-reporting participants
   30         from the department under certain circumstances to
   31         encourage self-reporting; requiring consultants to
   32         disclose all information relating to practitioners who
   33         are terminated from the program for material
   34         noncompliance; providing that all information obtained
   35         by a consultant retains its confidential or exempt
   36         status; providing that consultants, and certain agents
   37         of consultants, may not be held liable financially or
   38         have a cause of action for damages brought against
   39         them for disclosing certain information or for any
   40         other act or omission relating to the program;
   41         authorizing consultants to contract with a school or
   42         program to provide services to certain students;
   43         amending s. 401.411, F.S.; providing that an impaired
   44         practitioner may be reported to a consultant rather
   45         than the department under certain circumstances;
   46         amending s. 455.227, F.S.; conforming provisions to
   47         changes made by the act; amending s. 456.0635, F.S.;
   48         providing that, under certain circumstances, a board
   49         or, if there is no board, the department, is not
   50         required to refuse to admit certain candidates to an
   51         examination, to issue a license, certificate, or
   52         registration to certain applicants, or to renew a
   53         license, certificate, or registration of certain
   54         applicants if they have successfully completed a
   55         pretrial diversion program; providing applicability;
   56         amending ss. 456.072, 457.109, 458.331, 459.015,
   57         460.413, 461.013, 462.14, 463.016, and 464.018, F.S.;
   58         providing that an impaired practitioner may be
   59         reported to a consultant rather than the department
   60         under certain circumstances; amending s. 464.204,
   61         F.S.; conforming provisions to changes made by the
   62         act; amending ss. 465.016, 466.028, 467.203, 468.217,
   63         and 468.3101, F.S.; providing that an impaired
   64         practitioner may be reported to a consultant rather
   65         than the department under certain circumstances;
   66         amending s. 474.221, F.S.; conforming provisions to
   67         changes made by the act; amending s. 483.825, F.S.;
   68         providing that certain persons may be reported to a
   69         consultant rather than the department under certain
   70         circumstances; creating s. 456.0495, F.S.; requiring
   71         licensed midwives and health care providers to report
   72         adverse incidents to the Department of Health within a
   73         certain period; requiring the department to adopt
   74         rules establishing guidelines for reporting specified
   75         adverse incidents; providing an effective date.
   76          
   77  Be It Enacted by the Legislature of the State of Florida:
   78  
   79         Section 1. Section 456.076, Florida Statutes, is amended to
   80  read:
   81         456.076 Impaired practitioner programs Treatment programs
   82  for impaired practitioners.—
   83         (1) As used in this section, the term:
   84         (a)“Consultant” means the individual or entity who
   85  operates an approved impaired practitioner program pursuant to a
   86  contract with the department and who is retained by the
   87  department as provided in subsection (2).
   88         (b)“Evaluator” means a state-licensed or nationally
   89  certified individual who has been approved by a consultant or
   90  the department, who has completed an evaluator training program
   91  established by the consultant, and who is therefore authorized
   92  to evaluate practitioners as part of an impaired practitioner
   93  program.
   94         (c)“Impaired practitioner” means a practitioner with an
   95  impairment.
   96         (d)“Impaired practitioner program” means a program
   97  established by the department by contract with one or more
   98  consultants to serve impaired and potentially impaired
   99  practitioners for the protection of the health, safety, and
  100  welfare of the public.
  101         (e)“Impairment” means a potentially impairing health
  102  condition that is the result of the misuse or abuse of alcohol,
  103  drugs, or both, or a mental or physical condition that could
  104  affect a practitioner’s ability to practice with skill and
  105  safety.
  106         (f)“Inability to progress” means a determination by a
  107  consultant based on a participant’s response to treatment and
  108  prognosis that the participant is unable to safely practice
  109  despite compliance with treatment requirements and his or her
  110  participant contract.
  111         (g)“Material noncompliance” means an act or omission by a
  112  participant in violation of his or her participant contract as
  113  determined by the department or consultant.
  114         (h)“Participant” means a practitioner who is participating
  115  in the impaired practitioner program by having entered into a
  116  participant contract. A practitioner ceases to be a participant
  117  when the participant contract is successfully completed or is
  118  terminated for any reason.
  119         (i)“Participant contract” means a formal written document
  120  outlining the requirements established by a consultant for a
  121  participant to successfully complete the impaired practitioner
  122  program, including the participant’s monitoring plan.
  123         (j)“Practitioner” means a person licensed, registered,
  124  certified, or regulated by the department under part III of
  125  chapter 401; chapter 457; chapter 458; chapter 459; chapter 460;
  126  chapter 461; chapter 462; chapter 463; chapter 464; chapter 465;
  127  chapter 466; chapter 467; part I, part II, part III, part V,
  128  part X, part XIII, or part XIV of chapter 468; chapter 478;
  129  chapter 480; part III or part IV of chapter 483; chapter 484;
  130  chapter 486; chapter 490; or chapter 491; or an applicant for a
  131  license, registration, or certification under the same laws.
  132         (k)“Referral” means a practitioner who has been referred,
  133  either as a self-referral or otherwise, or reported to a
  134  consultant for impaired practitioner program services, but who
  135  is not under a participant contract.
  136         (l)“Treatment program” means a department- or consultant
  137  approved residential, intensive outpatient, partial
  138  hospitalization or other program through which an impaired
  139  practitioner is treated based on the impaired practitioner’s
  140  diagnosis and the treatment plan approved by the consultant.
  141         (m)“Treatment provider” means a department- or consultant
  142  approved state-licensed or nationally certified individual who
  143  provides treatment to an impaired practitioner based on the
  144  practitioner’s individual diagnosis and a treatment plan
  145  approved by the consultant For professions that do not have
  146  impaired practitioner programs provided for in their practice
  147  acts, the department shall, by rule, designate approved impaired
  148  practitioner programs under this section. The department may
  149  adopt rules setting forth appropriate criteria for approval of
  150  treatment providers. The rules may specify the manner in which
  151  the consultant, retained as set forth in subsection (2), works
  152  with the department in intervention, requirements for evaluating
  153  and treating a professional, requirements for continued care of
  154  impaired professionals by approved treatment providers,
  155  continued monitoring by the consultant of the care provided by
  156  approved treatment providers regarding the professionals under
  157  their care, and requirements related to the consultant’s
  158  expulsion of professionals from the program.
  159         (2)(a) The department may shall retain one or more impaired
  160  practitioner consultants to operate its impaired practitioner
  161  program. Each consultant who are each licensees under the
  162  jurisdiction of the Division of Medical Quality Assurance within
  163  the department and who must be:
  164         (a)1. A practitioner or recovered practitioner licensed
  165  under chapter 458, chapter 459, or part I of chapter 464; or
  166         (b)2. An entity that employs:
  167         1.a. A medical director who is must be a practitioner or
  168  recovered practitioner licensed under chapter 458 or chapter
  169  459; or
  170         2.b. An executive director who is must be a registered
  171  nurse or a recovered registered nurse licensed under part I of
  172  chapter 464.
  173         (3)The terms and conditions of the impaired practitioner
  174  program must be established by the department by contract with a
  175  consultant for the protection of the health, safety, and welfare
  176  of the public and must provide, at a minimum, that the
  177  consultant:
  178         (a)Accepts referrals;
  179         (b)Arranges for the evaluation and treatment of impaired
  180  practitioners by a treatment provider, when the consultant deems
  181  the evaluation and treatment necessary;
  182         (c)Monitors the recovery progress and status of impaired
  183  practitioners to ensure that such practitioners are able to
  184  practice their profession with skill and safety. Such monitoring
  185  must continue until the consultant or department concludes that
  186  monitoring by the consultant is no longer required for the
  187  protection of the public or until the practitioner’s
  188  participation in the program is terminated for material
  189  noncompliance or inability to progress; and
  190         (d)Does not directly evaluate, treat, or otherwise provide
  191  patient care to a practitioner in the operation of the impaired
  192  practitioner program.
  193         (4)The department shall specify, in its contract with each
  194  consultant, the types of licenses, registrations, or
  195  certifications of the practitioners to be served by that
  196  consultant.
  197         (5)A consultant shall enter into a participant contract
  198  with an impaired practitioner and shall establish the terms of
  199  monitoring and shall include the terms in a participant
  200  contract. In establishing the terms of monitoring, the
  201  consultant may consider the recommendations of one or more
  202  approved evaluators, treatment programs, or treatment providers.
  203  A consultant may modify the terms of monitoring if the
  204  consultant concludes, through the course of monitoring, that
  205  extended, additional, or amended terms of monitoring are
  206  required for the protection of the health, safety, and welfare
  207  of the public.
  208         (6)(b)A An entity retained as an impaired practitioner
  209  consultant under this section which employs a medical director
  210  or an executive director is not required to be licensed as a
  211  substance abuse provider or mental health treatment provider
  212  under chapter 394, chapter 395, or chapter 397 for purposes of
  213  providing services under this program.
  214         (7)(c)1.Each The consultant shall assist the department
  215  and licensure boards on matters of impaired practitioners,
  216  including the determination of probable cause panel and the
  217  department in carrying out the responsibilities of this section.
  218  This includes working with department investigators to determine
  219  whether a practitioner is, in fact, impaired, as specified in
  220  the consultant’s contract with the department.
  221         2.The consultant may contract with a school or program to
  222  provide services to a student enrolled for the purpose of
  223  preparing for licensure as a health care practitioner as defined
  224  in this chapter or as a veterinarian under chapter 474 if the
  225  student is allegedly impaired as a result of the misuse or abuse
  226  of alcohol or drugs, or both, or due to a mental or physical
  227  condition. The department is not responsible for paying for the
  228  care provided by approved treatment providers or a consultant.
  229         (d)A medical school accredited by the Liaison Committee on
  230  Medical Education or the Commission on Osteopathic College
  231  Accreditation, or another school providing for the education of
  232  students enrolled in preparation for licensure as a health care
  233  practitioner as defined in this chapter or a veterinarian under
  234  chapter 474 which is governed by accreditation standards
  235  requiring notice and the provision of due process procedures to
  236  students, is not liable in any civil action for referring a
  237  student to the consultant retained by the department or for
  238  disciplinary actions that adversely affect the status of a
  239  student when the disciplinary actions are instituted in
  240  reasonable reliance on the recommendations, reports, or
  241  conclusions provided by such consultant, if the school, in
  242  referring the student or taking disciplinary action, adheres to
  243  the due process procedures adopted by the applicable
  244  accreditation entities and if the school committed no
  245  intentional fraud in carrying out the provisions of this
  246  section.
  247         (8)(3)Before issuing an approval of, or intent to deny, an
  248  application for licensure, each board and profession within the
  249  Division of Medical Quality Assurance may delegate to its chair
  250  or other designee its authority to determine, before certifying
  251  or declining to certify an application for licensure to the
  252  department, that an applicant for licensure under its
  253  jurisdiction may have an impairment be impaired as a result of
  254  the misuse or abuse of alcohol or drugs, or both, or due to a
  255  mental or physical condition that could affect the applicant’s
  256  ability to practice with skill and safety. Upon such
  257  determination, the chair or other designee may refer the
  258  applicant to the consultant to facilitate for an evaluation
  259  before the board issues an approval of, certifies or intent to
  260  deny, declines to certify his or her application to the
  261  department. If the applicant agrees to be evaluated by the
  262  consultant, the department’s deadline for approving or denying
  263  the application pursuant to s. 120.60(1) is tolled until the
  264  evaluation is completed and the result of the evaluation and
  265  recommendation by the consultant is communicated to the board by
  266  the consultant. If the applicant declines to be evaluated by the
  267  consultant, the board shall issue an approval of, or intent to
  268  deny, certify or decline to certify the applicant’s application
  269  to the department notwithstanding the lack of an evaluation and
  270  recommendation by the consultant.
  271         (9)(a)(4)(a)Except as provided in paragraph (b), when
  272  Whenever the department receives a written or oral legally
  273  sufficient complaint alleging that a practitioner has an
  274  impairment licensee under the jurisdiction of the Division of
  275  Medical Quality Assurance within the department is impaired as a
  276  result of the misuse or abuse of alcohol or drugs, or both, or
  277  due to a mental or physical condition which could affect the
  278  licensee’s ability to practice with skill and safety, and no
  279  complaint exists against the practitioner licensee other than
  280  impairment exists, the department shall refer the practitioner
  281  to the consultant, along with all information in the
  282  department’s possession relating to the impairment. The
  283  impairment does reporting of such information shall not
  284  constitute grounds for discipline pursuant to s. 456.072 or the
  285  corresponding grounds for discipline within the applicable
  286  practice act if the probable cause panel of the appropriate
  287  board, or the department when there is no board, finds:
  288         1. The practitioner licensee has acknowledged the
  289  impairment; problem.
  290         2. The practitioner becomes a participant licensee has
  291  voluntarily enrolled in an impaired practitioner program and
  292  successfully completes a participant contract under terms
  293  established by the consultant; appropriate, approved treatment
  294  program.
  295         3. The practitioner licensee has voluntarily withdrawn from
  296  practice or has limited the scope of his or her practice if as
  297  required by the consultant;, in each case, until such time as
  298  the panel, or the department when there is no board, is
  299  satisfied the licensee has successfully completed an approved
  300  treatment program.
  301         4. The practitioner licensee has provided to the
  302  consultant, or has authorized the consultant to obtain, all
  303  records and information relating to the impairment from any
  304  source and all other medical records of the practitioner
  305  requested by the consultant; and executed releases for medical
  306  records, authorizing the release of all records of evaluations,
  307  diagnoses, and treatment of the licensee, including records of
  308  treatment for emotional or mental conditions, to the consultant.
  309  The consultant shall make no copies or reports of records that
  310  do not regard the issue of the licensee’s impairment and his or
  311  her participation in a treatment program.
  312         5.The practitioner has authorized the consultant, in the
  313  event of the practitioner’s termination from the impaired
  314  practitioner program, to report the termination to the
  315  department and provide the department with copies of all
  316  information in the consultant’s possession relating to the
  317  practitioner.
  318         (b) For practitioners who are employed by governmental
  319  entities and who are also certified by the department pursuant
  320  to part III of chapter 401, the department may not refer the
  321  practitioner to the consultant if the practitioner is under a
  322  referral by the practitioner’s employer to an employee
  323  assistance program through the governmental entity. If the
  324  practitioner fails to satisfactorily complete the employee
  325  assistance program or if his or her employment is terminated,
  326  his or her employer must immediately notify the department,
  327  which shall then refer the practitioner to the consultant as
  328  required in paragraph (a). For purposes of this paragraph, the
  329  term governmental entity” has the same meaning as provided in
  330  s. 70.001(3)(c).
  331         (c) To encourage practitioners who are or may be impaired
  332  to voluntarily self-refer to a consultant, the consultant may
  333  not provide information to the department relating to a self
  334  referring participant if the consultant has no knowledge of a
  335  pending department investigation, complaint, or disciplinary
  336  action against the participant and if the participant is in
  337  compliance and making progress with the terms of the impaired
  338  practitioner program and contract, unless authorized by the
  339  participant If, however, the department has not received a
  340  legally sufficient complaint and the licensee agrees to withdraw
  341  from practice until such time as the consultant determines the
  342  licensee has satisfactorily completed an approved treatment
  343  program or evaluation, the probable cause panel, or the
  344  department when there is no board, shall not become involved in
  345  the licensee’s case.
  346         (c)Inquiries related to impairment treatment programs
  347  designed to provide information to the licensee and others and
  348  which do not indicate that the licensee presents a danger to the
  349  public shall not constitute a complaint within the meaning of s.
  350  456.073 and shall be exempt from the provisions of this
  351  subsection.
  352         (d)Whenever the department receives a legally sufficient
  353  complaint alleging that a licensee is impaired as described in
  354  paragraph (a) and no complaint against the licensee other than
  355  impairment exists, the department shall forward all information
  356  in its possession regarding the impaired licensee to the
  357  consultant. For the purposes of this section, a suspension from
  358  hospital staff privileges due to the impairment does not
  359  constitute a complaint.
  360         (e)The probable cause panel, or the department when there
  361  is no board, shall work directly with the consultant, and all
  362  information concerning a practitioner obtained from the
  363  consultant by the panel, or the department when there is no
  364  board, shall remain confidential and exempt from the provisions
  365  of s. 119.07(1), subject to the provisions of subsections (6)
  366  and (7).
  367         (f)A finding of probable cause shall not be made as long
  368  as the panel, or the department when there is no board, is
  369  satisfied, based upon information it receives from the
  370  consultant and the department, that the licensee is progressing
  371  satisfactorily in an approved impaired practitioner program and
  372  no other complaint against the licensee exists.
  373         (10)(5) In any disciplinary action for a violation other
  374  than impairment in which a practitioner licensee establishes the
  375  violation for which the practitioner licensee is being
  376  prosecuted was due to or connected with impairment and further
  377  establishes the practitioner licensee is satisfactorily
  378  progressing through or has successfully completed an impaired
  379  practitioner program approved treatment program pursuant to this
  380  section, such information may be considered by the board, or the
  381  department when there is no board, as a mitigating factor in
  382  determining the appropriate penalty. This subsection does not
  383  limit mitigating factors the board may consider.
  384         (11)(a)(6)(a)Upon request by the consultant, and with the
  385  authorization of the practitioner when required by law, an
  386  approved evaluator, treatment program, or treatment provider
  387  shall, upon request, disclose to the consultant all information
  388  in its possession regarding a referral or participant the issue
  389  of a licensee’s impairment and participation in the treatment
  390  program. All information obtained by the consultant and
  391  department pursuant to this section is confidential and exempt
  392  from the provisions of s. 119.07(1), subject to the provisions
  393  of this subsection and subsection (7). Failure to provide such
  394  information to the consultant is grounds for withdrawal of
  395  approval of such evaluator, treatment program, or treatment
  396  provider.
  397         (b) When a referral or participant is terminated from the
  398  impaired practitioner program for material noncompliance with a
  399  participant contract, inability to progress, or any other reason
  400  than completion, the consultant shall disclose If in the opinion
  401  of the consultant, after consultation with the treatment
  402  provider, an impaired licensee has not progressed satisfactorily
  403  in a treatment program, all information regarding the issue of a
  404  licensee’s impairment and participation in a treatment program
  405  in the consultant’s possession relating to the practitioner
  406  shall be disclosed to the department. Such disclosure shall
  407  constitute a complaint pursuant to the general provisions of s.
  408  456.073. In addition, whenever the consultant concludes that
  409  impairment affects a practitioner’s licensee’s practice and
  410  constitutes an immediate, serious danger to the public health,
  411  safety, or welfare, the consultant shall immediately communicate
  412  such that conclusion shall be communicated to the department and
  413  disclose all information in the consultant’s possession relating
  414  to the practitioner to the department State Surgeon General.
  415         (12)All information obtained by the consultant pursuant to
  416  this section is confidential and exempt from s. 119.07(1) and s.
  417  24(a), Art. I of the State Constitution.
  418         (13)(7) A consultant, or a director, officer, employee, or
  419  agent of a consultant, may not be held liable financially or may
  420  not have a cause of action for damages brought against him or
  421  her for making a disclosure pursuant to this section, for any
  422  other action or omission relating to the impaired practitioner
  423  program, or for the consequences of such disclosure or action or
  424  omission, including, without limitation, action by the
  425  department against a license, registration, or certification
  426  licensee, or approved treatment provider who makes a disclosure
  427  pursuant to this section is not subject to civil liability for
  428  such disclosure or its consequences.
  429         (14) The provisions of s. 766.101 apply to any consultant
  430  and the consultant’s directors, officers, employees, or agents
  431  in regards to providing information relating to a participant to
  432  a medical review committee if the participant authorizes such
  433  disclosure officer, employee, or agent of the department or the
  434  board and to any officer, employee, or agent of any entity with
  435  which the department has contracted pursuant to this section.
  436         (15)(a)(8)(a) A consultant retained pursuant to this
  437  section and subsection (2), a consultant’s directors, officers,
  438  and employees, or agents and those acting at the direction of
  439  the consultant for the limited purpose of an emergency
  440  intervention on behalf of a licensee or student as described in
  441  subsection (2) when the consultant is unable to perform such
  442  intervention shall be considered agents of the department for
  443  purposes of s. 768.28 while acting within the scope of the
  444  consultant’s duties under the contract with the department if
  445  the contract complies with the requirements of this section. The
  446  contract must require that:
  447         1.The consultant indemnify the state for any liabilities
  448  incurred up to the limits set out in chapter 768.
  449         2.The consultant establish a quality assurance program to
  450  monitor services delivered under the contract.
  451         3.The consultant’s quality assurance program, treatment,
  452  and monitoring records be evaluated quarterly.
  453         4.The consultant’s quality assurance program be subject to
  454  review and approval by the department.
  455         5.The consultant operate under policies and procedures
  456  approved by the department.
  457         6.The consultant provide to the department for approval a
  458  policy and procedure manual that comports with all statutes,
  459  rules, and contract provisions approved by the department.
  460         7.The department be entitled to review the records
  461  relating to the consultant’s performance under the contract for
  462  the purpose of management audits, financial audits, or program
  463  evaluation.
  464         8.All performance measures and standards be subject to
  465  verification and approval by the department.
  466         9.The department be entitled to terminate the contract
  467  with the consultant for noncompliance with the contract.
  468         (b) In accordance with s. 284.385, the Department of
  469  Financial Services shall defend any claim, suit, action, or
  470  proceeding, including a claim, suit, action, or proceeding for
  471  injunctive, affirmative, or declaratory relief, against the
  472  consultant, or the consultant’s directors, officers, or
  473  employees, and agents brought as the result of any action or
  474  omission relating to the impaired practitioner program or those
  475  acting at the direction of the consultant for the limited
  476  purpose of an emergency intervention on behalf of a licensee or
  477  student as described in subsection (2) when the consultant is
  478  unable to perform such intervention, which claim, suit, action,
  479  or proceeding is brought as a result of an act or omission by
  480  any of the consultant’s officers and employees and those acting
  481  under the direction of the consultant for the limited purpose of
  482  an emergency intervention on behalf of the licensee or student
  483  when the consultant is unable to perform such intervention, if
  484  the act or omission arises out of and is in the scope of the
  485  consultant’s duties under its contract with the department.
  486         (16)(c) If a the consultant retained by the department
  487  pursuant to this section subsection (2) is also retained by
  488  another any other state agency to operate an impaired
  489  practitioner program for that agency, this section also applies
  490  to the consultant’s operation of an impaired practitioner
  491  program for that agency, and if the contract between such state
  492  agency and the consultant complies with the requirements of this
  493  section, the consultant, the consultant’s officers and
  494  employees, and those acting under the direction of the
  495  consultant for the limited purpose of an emergency intervention
  496  on behalf of a licensee or student as described in subsection
  497  (2) when the consultant is unable to perform such intervention
  498  shall be considered agents of the state for the purposes of this
  499  section while acting within the scope of and pursuant to
  500  guidelines established in the contract between such state agency
  501  and the consultant.
  502         (17)(9)A An impaired practitioner consultant is the
  503  official custodian of records relating to the referral of an
  504  impaired licensee or applicant to that consultant and any other
  505  interaction between the licensee or applicant and the
  506  consultant. The consultant may disclose to a referral or
  507  participant, or to the legal representative of the referral or
  508  participant, the documents, records, or other information from
  509  the consultant’s file, including information received by the
  510  consultant from other sources, and information on the terms
  511  required for the referrals or participant’s monitoring
  512  contract, the referrals or participant’s progress or inability
  513  to progress, the referrals or participants discharge or
  514  termination, information supporting the conclusion of material
  515  noncompliance, or any other information required by law the
  516  impaired licensee or applicant or his or her designee any
  517  information that is disclosed to or obtained by the consultant
  518  or that is confidential under paragraph (6)(a), but only to the
  519  extent that it is necessary to do so to carry out the
  520  consultant’s duties under this section. The department, and any
  521  other entity that enters into a contract with the consultant to
  522  receive the services of the consultant, has direct
  523  administrative control over the consultant to the extent
  524  necessary to receive disclosures from the consultant as allowed
  525  by federal law. If a consultant discloses information to the
  526  department in accordance with this part, a referral or
  527  participant, or his or her legal representative, may obtain a
  528  complete copy of the consultant’s file from the consultant or
  529  disciplinary proceeding is pending, an impaired licensee may
  530  obtain such information from the department under s. 456.073.
  531         (18)(a)The consultant may contract with a school or
  532  program to provide impaired practitioner program services to a
  533  student enrolled for the purpose of preparing for licensure as a
  534  health care practitioner as defined in this chapter or as a
  535  veterinarian under chapter 474 if the student has or is
  536  suspected of having an impairment. The department is not
  537  responsible for paying for the care provided by approved
  538  treatment providers or approved treatment programs or for the
  539  services provided by a consultant to a student.
  540         (b)A medical school accredited by the Liaison Committee on
  541  Medical Education or the Commission on Osteopathic College
  542  Accreditation, or another school providing for the education of
  543  students enrolled in preparation for licensure as a health care
  544  practitioner as defined in this chapter, or a veterinarian under
  545  chapter 474, which is governed by accreditation standards
  546  requiring notice and the provision of due process procedures to
  547  students, is not liable in any civil action for referring a
  548  student to the consultant retained by the department or for
  549  disciplinary actions that adversely affect the status of a
  550  student when the disciplinary actions are instituted in
  551  reasonable reliance on the recommendations, reports, or
  552  conclusions provided by such consultant, if the school, in
  553  referring the student or taking disciplinary action, adheres to
  554  the due process procedures adopted by the applicable
  555  accreditation entities and if the school committed no
  556  intentional fraud in carrying out the provisions of this
  557  section.
  558         Section 2. Paragraph (l) of subsection (1) of section
  559  401.411, Florida Statutes, is amended to read:
  560         401.411 Disciplinary action; penalties.—
  561         (1) The department may deny, suspend, or revoke a license,
  562  certificate, or permit or may reprimand or fine any licensee,
  563  certificateholder, or other person operating under this part for
  564  any of the following grounds:
  565         (l) The failure to report to the department any person
  566  known to be in violation of this part. However, a professional
  567  known to be operating under this part without reasonable skill
  568  and without regard for the safety of the public by reason of
  569  illness, drunkenness, or the use of drugs, narcotics, chemicals,
  570  or any other type of material, or as a result of a mental or
  571  physical condition, may be reported to a consultant operating an
  572  impaired practitioner program as described in s. 456.076 rather
  573  than to the department.
  574         Section 3. Paragraph (u) of subsection (1) of section
  575  455.227, Florida Statutes, is amended to read:
  576         455.227 Grounds for discipline; penalties; enforcement.—
  577         (1) The following acts shall constitute grounds for which
  578  the disciplinary actions specified in subsection (2) may be
  579  taken:
  580         (u) Termination from an impaired practitioner program a
  581  treatment program for impaired practitioners as described in s.
  582  456.076 for failure to comply, without good cause, with the
  583  terms of the monitoring or participant treatment contract
  584  entered into by the licensee or failing to successfully complete
  585  a drug or alcohol treatment program.
  586         Section 4. Subsections (2) and (3) of section 456.0635,
  587  Florida Statutes, are amended to read:
  588         456.0635 Health care fraud; disqualification for license,
  589  certificate, or registration.—
  590         (2) Each board within the jurisdiction of the department,
  591  or the department if there is no board, shall refuse to admit a
  592  candidate to any examination and refuse to issue a license,
  593  certificate, or registration to any applicant if the candidate
  594  or applicant or any principal, officer, agent, managing
  595  employee, or affiliated person of the candidate or applicant:
  596         (a) Has been convicted of, or entered a plea of guilty or
  597  nolo contendere to, regardless of adjudication, a felony under
  598  chapter 409, chapter 817, or chapter 893, or a similar felony
  599  offense committed in another state or jurisdiction, unless the
  600  candidate or applicant has successfully completed a pretrial
  601  diversion or drug court program for that felony and provides
  602  proof that the plea has been withdrawn or the charges have been
  603  dismissed. Any such conviction or plea shall exclude the
  604  applicant or candidate from licensure, examination,
  605  certification, or registration unless the sentence and any
  606  subsequent period of probation for such conviction or plea
  607  ended:
  608         1. For felonies of the first or second degree, more than 15
  609  years before the date of application.
  610         2. For felonies of the third degree, more than 10 years
  611  before the date of application, except for felonies of the third
  612  degree under s. 893.13(6)(a).
  613         3. For felonies of the third degree under s. 893.13(6)(a),
  614  more than 5 years before the date of application;
  615         (b) Has been convicted of, or entered a plea of guilty or
  616  nolo contendere to, regardless of adjudication, a felony under
  617  21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the
  618  sentence and any subsequent period of probation for such
  619  conviction or plea ended more than 15 years before the date of
  620  the application;
  621         (c) Has been terminated for cause from the Florida Medicaid
  622  program pursuant to s. 409.913, unless the candidate or
  623  applicant has been in good standing with the Florida Medicaid
  624  program for the most recent 5 years;
  625         (d) Has been terminated for cause, pursuant to the appeals
  626  procedures established by the state, from any other state
  627  Medicaid program, unless the candidate or applicant has been in
  628  good standing with a state Medicaid program for the most recent
  629  5 years and the termination occurred at least 20 years before
  630  the date of the application; or
  631         (e) Is currently listed on the United States Department of
  632  Health and Human Services Office of Inspector General’s List of
  633  Excluded Individuals and Entities.
  634  
  635  This subsection does not apply to an applicant for initial
  636  licensure, certification, or registration who was arrested for
  637  or charged with a felony specified in paragraph (a) or paragraph
  638  (b) before July 1, 2009.
  639         (3) The department shall refuse to renew a license,
  640  certificate, or registration of any applicant if the applicant
  641  or any principal, officer, agent, managing employee, or
  642  affiliated person of the applicant:
  643         (a) Has been convicted of, or entered a plea of guilty or
  644  nolo contendere to, regardless of adjudication, a felony under
  645  chapter 409, chapter 817, or chapter 893, or a similar felony
  646  offense committed in another state or jurisdiction, unless the
  647  applicant is currently enrolled in a pretrial diversion or drug
  648  court program that allows the withdrawal of the plea for that
  649  felony upon successful completion of that program. Any such
  650  conviction or plea excludes the applicant from licensure renewal
  651  unless the sentence and any subsequent period of probation for
  652  such conviction or plea ended:
  653         1. For felonies of the first or second degree, more than 15
  654  years before the date of application.
  655         2. For felonies of the third degree, more than 10 years
  656  before the date of application, except for felonies of the third
  657  degree under s. 893.13(6)(a).
  658         3. For felonies of the third degree under s. 893.13(6)(a),
  659  more than 5 years before the date of application.
  660         (b) Has been convicted of, or entered a plea of guilty or
  661  nolo contendere to, regardless of adjudication, a felony under
  662  21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396 since July 1,
  663  2009, unless the sentence and any subsequent period of probation
  664  for such conviction or plea ended more than 15 years before the
  665  date of the application.
  666         (c) Has been terminated for cause from the Florida Medicaid
  667  program pursuant to s. 409.913, unless the applicant has been in
  668  good standing with the Florida Medicaid program for the most
  669  recent 5 years.
  670         (d) Has been terminated for cause, pursuant to the appeals
  671  procedures established by the state, from any other state
  672  Medicaid program, unless the applicant has been in good standing
  673  with a state Medicaid program for the most recent 5 years and
  674  the termination occurred at least 20 years before the date of
  675  the application.
  676         (e) Is currently listed on the United States Department of
  677  Health and Human Services Office of Inspector General’s List of
  678  Excluded Individuals and Entities.
  679  
  680  This subsection does not apply to an applicant for renewal of
  681  licensure, certification, or registration who was arrested for
  682  or charged with a felony specified in paragraph (a) or paragraph
  683  (b) before July 1, 2009.
  684         Section 5. Paragraphs (i) and (hh) of subsection (1) of
  685  section 456.072, Florida Statutes, are amended to read:
  686         456.072 Grounds for discipline; penalties; enforcement.—
  687         (1) The following acts shall constitute grounds for which
  688  the disciplinary actions specified in subsection (2) may be
  689  taken:
  690         (i) Except as provided in s. 465.016, failing to report to
  691  the department any person who the licensee knows is in violation
  692  of this chapter, the chapter regulating the alleged violator, or
  693  the rules of the department or the board. However, a person who
  694  the licensee knows is unable to practice with reasonable skill
  695  and safety to patients by reason of illness or use of alcohol,
  696  drugs, narcotics, chemicals, or any other type of material, or
  697  as a result of a mental or physical condition, may be reported
  698  to a consultant operating an impaired practitioner program as
  699  described in s. 456.076 rather than to the department.
  700         (hh) Being terminated from an impaired practitioner program
  701  that a treatment program for impaired practitioners, which is
  702  overseen by a an impaired practitioner consultant as described
  703  in s. 456.076, for failure to comply, without good cause, with
  704  the terms of the monitoring or participant treatment contract
  705  entered into by the licensee, or for not successfully completing
  706  any drug treatment or alcohol treatment program.
  707         Section 6. Paragraph (f) of subsection (1) of section
  708  457.109, Florida Statutes, is amended to read:
  709         457.109 Disciplinary actions; grounds; action by the
  710  board.—
  711         (1) The following acts constitute grounds for denial of a
  712  license or disciplinary action, as specified in s. 456.072(2):
  713         (f) Failing to report to the department any person who the
  714  licensee knows is in violation of this chapter or of the rules
  715  of the department. However, a person who the licensee knows is
  716  unable to practice acupuncture with reasonable skill and safety
  717  to patients by reason of illness or use of alcohol, drugs,
  718  narcotics, chemicals, or any other type of material, or as a
  719  result of a mental or physical condition, may be reported to a
  720  consultant operating an impaired practitioner program as
  721  described in s. 456.076 rather than to the department.
  722         Section 7. Paragraph (e) of subsection (1) of section
  723  458.331, Florida Statutes, is amended to read:
  724         458.331 Grounds for disciplinary action; action by the
  725  board and department.—
  726         (1) The following acts constitute grounds for denial of a
  727  license or disciplinary action, as specified in s. 456.072(2):
  728         (e) Failing to report to the department any person who the
  729  licensee knows is in violation of this chapter or of the rules
  730  of the department or the board. However, a person who the
  731  licensee knows is unable to practice medicine with reasonable
  732  skill and safety to patients by reason of illness or use of
  733  alcohol, drugs, narcotics, chemicals, or any other type of
  734  material, or as a result of a mental or physical condition, may
  735  be reported to a consultant operating an impaired practitioner
  736  program as described in s. 456.076 rather than to the department
  737  A treatment provider approved pursuant to s. 456.076 shall
  738  provide the department or consultant with information in
  739  accordance with the requirements of s. 456.076(4), (5), (6),
  740  (7), and (9).
  741         Section 8. Paragraph (e) of subsection (1) of section
  742  459.015, Florida Statutes, is amended to read:
  743         459.015 Grounds for disciplinary action; action by the
  744  board and department.—
  745         (1) The following acts constitute grounds for denial of a
  746  license or disciplinary action, as specified in s. 456.072(2):
  747         (e) Failing to report to the department or the department’s
  748  impaired professional consultant any person who the licensee or
  749  certificateholder knows is in violation of this chapter or of
  750  the rules of the department or the board. However, a person who
  751  the licensee knows is unable to practice osteopathic medicine
  752  with reasonable skill and safety to patients by reason of
  753  illness or use of alcohol, drugs, narcotics, chemicals, or any
  754  other type of material, or as a result of a mental or physical
  755  condition, may be reported to a consultant operating an impaired
  756  practitioner program as described in s. 456.076 rather than to
  757  the department A treatment provider, approved pursuant to s.
  758  456.076, shall provide the department or consultant with
  759  information in accordance with the requirements of s.
  760  456.076(4), (5), (6), (7), and (9).
  761         Section 9. Paragraph (g) of subsection (1) of section
  762  460.413, Florida Statutes, is amended to read:
  763         460.413 Grounds for disciplinary action; action by board or
  764  department.—
  765         (1) The following acts constitute grounds for denial of a
  766  license or disciplinary action, as specified in s. 456.072(2):
  767         (g) Failing to report to the department any person who the
  768  licensee knows is in violation of this chapter or of the rules
  769  of the department or the board. However, a person who the
  770  licensee knows is unable to practice chiropractic medicine with
  771  reasonable skill and safety to patients by reason of illness or
  772  use of alcohol, drugs, narcotics, chemicals, or any other type
  773  of material, or as a result of a mental or physical condition,
  774  may be reported to a consultant operating an impaired
  775  practitioner program as described in s. 456.076 rather than to
  776  the department.
  777         Section 10. Paragraph (f) of subsection (1) of section
  778  461.013, Florida Statutes, is amended to read:
  779         461.013 Grounds for disciplinary action; action by the
  780  board; investigations by department.—
  781         (1) The following acts constitute grounds for denial of a
  782  license or disciplinary action, as specified in s. 456.072(2):
  783         (f) Failing to report to the department any person who the
  784  licensee knows is in violation of this chapter or of the rules
  785  of the department or the board. However, a person who the
  786  licensee knows is unable to practice podiatric medicine with
  787  reasonable skill and safety to patients by reason of illness or
  788  use of alcohol, drugs, narcotics, chemicals, or any other type
  789  of material, or as a result of a mental or physical condition,
  790  may be reported to a consultant operating an impaired
  791  practitioner program as described in s. 456.076 rather than to
  792  the department.
  793         Section 11. Paragraph (f) of subsection (1) of section
  794  462.14, Florida Statutes, is amended to read:
  795         462.14 Grounds for disciplinary action; action by the
  796  department.—
  797         (1) The following acts constitute grounds for denial of a
  798  license or disciplinary action, as specified in s. 456.072(2):
  799         (f) Failing to report to the department any person who the
  800  licensee knows is in violation of this chapter or of the rules
  801  of the department. However, a person who the licensee knows is
  802  unable to practice naturopathic medicine with reasonable skill
  803  and safety to patients by reason of illness or use of alcohol,
  804  drugs, narcotics, chemicals, or any other type of material, or
  805  as a result of a mental or physical condition, may be reported
  806  to a consultant operating an impaired practitioner program as
  807  described in s. 456.076 rather than to the department.
  808         Section 12. Paragraph (l) of subsection (1) of section
  809  463.016, Florida Statutes, is amended to read:
  810         463.016 Grounds for disciplinary action; action by the
  811  board.—
  812         (1) The following acts constitute grounds for denial of a
  813  license or disciplinary action, as specified in s. 456.072(2):
  814         (l) Willfully failing to report any person who the licensee
  815  knows is in violation of this chapter or of rules of the
  816  department or the board. However, a person who the licensee
  817  knows is unable to practice optometry with reasonable skill and
  818  safety to patients by reason of illness or use of alcohol,
  819  drugs, narcotics, chemicals, or any other type of material, or
  820  as a result of a mental or physical condition, may be reported
  821  to a consultant operating an impaired practitioner program as
  822  described in s. 456.076 rather than to the department.
  823         Section 13. Paragraph (k) of subsection (1) of section
  824  464.018, Florida Statutes, is amended to read:
  825         464.018 Disciplinary actions.—
  826         (1) The following acts constitute grounds for denial of a
  827  license or disciplinary action, as specified in s. 456.072(2):
  828         (k) Failing to report to the department any person who the
  829  licensee knows is in violation of this part or of the rules of
  830  the department or the board. However, a person who the licensee
  831  knows is unable to practice nursing with reasonable skill and
  832  safety to patients by reason of illness or use of alcohol,
  833  drugs, narcotics, chemicals, or any other type of material, or
  834  as a result of a mental or physical condition, may be reported
  835  to a consultant operating an impaired practitioner program as
  836  described in s. 456.076 rather than to the department; however,
  837  if the licensee verifies that such person is actively
  838  participating in a board-approved program for the treatment of a
  839  physical or mental condition, the licensee is required to report
  840  such person only to an impaired professionals consultant.
  841         Section 14. Paragraph (c) of subsection (2) of section
  842  464.204, Florida Statutes, is amended to read:
  843         464.204 Denial, suspension, or revocation of certification;
  844  disciplinary actions.—
  845         (2) When the board finds any person guilty of any of the
  846  grounds set forth in subsection (1), it may enter an order
  847  imposing one or more of the following penalties:
  848         (c) Imposition of probation or restriction of
  849  certification, including conditions such as corrective actions
  850  as retraining or compliance with the department’s impaired
  851  practitioner program operated by a consultant as described in s.
  852  456.076 an approved treatment program for impaired
  853  practitioners.
  854         Section 15. Paragraph (o) of subsection (1) of section
  855  465.016, Florida Statutes, is amended to read:
  856         465.016 Disciplinary actions.—
  857         (1) The following acts constitute grounds for denial of a
  858  license or disciplinary action, as specified in s. 456.072(2):
  859         (o) Failing to report to the department any licensee under
  860  chapter 458 or under chapter 459 who the pharmacist knows has
  861  violated the grounds for disciplinary action set out in the law
  862  under which that person is licensed and who provides health care
  863  services in a facility licensed under chapter 395, or a health
  864  maintenance organization certificated under part I of chapter
  865  641, in which the pharmacist also provides services. However, a
  866  person who the licensee knows is unable to practice medicine or
  867  osteopathic medicine with reasonable skill and safety to
  868  patients by reason of illness or use of alcohol, drugs,
  869  narcotics, chemicals, or any other type of material, or as a
  870  result of a mental or physical condition, may be reported to a
  871  consultant operating an impaired practitioner program as
  872  described in s. 456.076 rather than to the department.
  873         Section 16. Paragraph (f) of subsection (1) of section
  874  466.028, Florida Statutes, is amended to read:
  875         466.028 Grounds for disciplinary action; action by the
  876  board.—
  877         (1) The following acts constitute grounds for denial of a
  878  license or disciplinary action, as specified in s. 456.072(2):
  879         (f) Failing to report to the department any person who the
  880  licensee knows, or has reason to believe, is clearly in
  881  violation of this chapter or of the rules of the department or
  882  the board. However, a person who the licensee knows, or has
  883  reason to believe, is clearly unable to practice her or his
  884  profession with reasonable skill and safety to patients by
  885  reason of illness or use of alcohol, drugs, narcotics,
  886  chemicals, or any other type of material, or as a result of a
  887  mental or physical condition, may be reported to a consultant
  888  operating an impaired practitioner program as described in s.
  889  456.076 rather than to the department.
  890         Section 17. Paragraph (h) of subsection (1) of section
  891  467.203, Florida Statutes, is amended to read:
  892         467.203 Disciplinary actions; penalties.—
  893         (1) The following acts constitute grounds for denial of a
  894  license or disciplinary action, as specified in s. 456.072(2):
  895         (h) Failing to report to the department any person who the
  896  licensee knows is in violation of this chapter or of the rules
  897  of the department. However, a person who the licensee knows is
  898  unable to practice midwifery with reasonable skill and safety to
  899  patients by reason of illness or use of alcohol, drugs,
  900  narcotics, chemicals, or any other type of material, or as a
  901  result of a mental or physical condition, may be reported to a
  902  consultant operating an impaired practitioner program as
  903  described in s. 456.076 rather than to the department.
  904         Section 18. Paragraph (f) of subsection (1) of section
  905  468.217, Florida Statutes, is amended to read:
  906         468.217 Denial of or refusal to renew license; suspension
  907  and revocation of license and other disciplinary measures.—
  908         (1) The following acts constitute grounds for denial of a
  909  license or disciplinary action, as specified in s. 456.072(2):
  910         (f) Failing to report to the department any person who the
  911  licensee knows is in violation of this part or of the rules of
  912  the department or of the board. However, a person who the
  913  licensee knows is unable to practice occupational therapy with
  914  reasonable skill and safety to patients by reason of illness or
  915  use of alcohol, drugs, narcotics, chemicals, or any other type
  916  of material, or as a result of a mental or physical condition,
  917  may be reported to a consultant operating an impaired
  918  practitioner program as described in s. 456.076 rather than to
  919  the department.
  920         Section 19. Paragraph (n) of subsection (1) of section
  921  468.3101, Florida Statutes, is amended to read:
  922         468.3101 Disciplinary grounds and actions.—
  923         (1) The department may make or require to be made any
  924  investigations, inspections, evaluations, and tests, and require
  925  the submission of any documents and statements, which it
  926  considers necessary to determine whether a violation of this
  927  part has occurred. The following acts shall be grounds for
  928  disciplinary action as set forth in this section:
  929         (n) Being terminated from an impaired practitioner program
  930  operated by a consultant as described in s. 456.076 for failure
  931  to comply, without good cause, with the terms of monitoring or a
  932  participant contract entered into by the licensee, or for not
  933  successfully completing a drug treatment or alcohol treatment
  934  program Failing to comply with the recommendations of the
  935  department’s impaired practitioner program for treatment,
  936  evaluation, or monitoring. A letter from the director of the
  937  impaired practitioner program that the certificateholder is not
  938  in compliance shall be considered conclusive proof under this
  939  part.
  940         Section 20. Section 474.221, Florida Statutes, is amended
  941  to read:
  942         474.221 Impaired practitioner provisions; applicability.
  943  Notwithstanding the transfer of the Division of Medical Quality
  944  Assurance to the Department of Health or any other provision of
  945  law to the contrary, veterinarians licensed under this chapter
  946  shall be governed by the treatment of impaired practitioner
  947  program provisions of s. 456.076 as if they were under the
  948  jurisdiction of the Division of Medical Quality Assurance,
  949  except that for veterinarians the Department of Business and
  950  Professional Regulation shall, at its option, exercise any of
  951  the powers granted to the Department of Health by that section,
  952  and “board” shall mean board as defined in this chapter.
  953         Section 21. Paragraph (o) of subsection (1) of section
  954  483.825, Florida Statutes, is amended to read:
  955         483.825 Grounds for disciplinary action.—
  956         (1) The following acts constitute grounds for denial of a
  957  license or disciplinary action, as specified in s. 456.072(2):
  958         (o) Failing to report to the department a person or other
  959  licensee who the licensee knows is in violation of this chapter
  960  or the rules of the department or board adopted hereunder.
  961  However, a person or other licensee who the licensee knows is
  962  unable to perform or report on clinical laboratory examinations
  963  with reasonable skill and safety to patients by reason of
  964  illness or use of alcohol, drugs, narcotics, chemicals, or any
  965  other type of material, or as a result of a mental or physical
  966  condition, may be reported to a consultant operating an impaired
  967  practitioner program as described in s. 456.076 rather than to
  968  the department.
  969         Section 22. Section 456.0495, Florida Statutes, is created
  970  to read:
  971         456.0495 Reporting adverse incidents occurring in out-of
  972  hospital births.—
  973         (1) A midwife licensed under chapter 467 or health care
  974  provider, as applicable, shall report any adverse incident, as
  975  defined by department rule, occurring as a result of an
  976  attempted or completed, planned birthing center or out-of
  977  hospital birth, along with a medical summary of events, to the
  978  department within 15 days after the adverse incident occurs.
  979         (2) The department shall adopt rules establishing
  980  guidelines for reporting adverse incidents, including, but not
  981  limited to:
  982         (a) Maternal deaths that occur during delivery or within 42
  983  days after delivery.
  984         (b) Transfers of maternal patients to a hospital intensive
  985  care unit.
  986         (c) Maternal patients who experience hemorrhagic shock or
  987  who require a transfusion of more than 4 units of blood or blood
  988  products.
  989         (d) Fetal or infant deaths, including stillbirths,
  990  associated with obstetrical deliveries.
  991         (e) Transfers of infants to a neonatal intensive care unit
  992  due to a traumatic physical or neurological birth injury,
  993  including any degree of a brachial plexus injury.
  994         (f) Transfers of infants to a neonatal intensive care unit
  995  within the first 72 hours after birth if the infant remains in
  996  such unit for more than 72 hours.
  997         Section 23. This act shall take effect upon becoming a law.