Florida Senate - 2017                              CS for SB 876
       
       
        
       By the Committee on Health Policy; and Senators Young, Bean, and
       Rouson
       
       
       
       
       588-02419-17                                           2017876c1
    1                        A bill to be entitled                      
    2         An act relating to programs for impaired health care
    3         practitioners; amending s. 456.076, F.S.; revising
    4         provisions related to impaired practitioner programs;
    5         providing definitions; deleting a requirement that the
    6         Department of Health designate approved programs by
    7         rule; deleting a requirement authorizing the
    8         department to adopt by rule the manner in which
    9         consultants work with the department in intervention,
   10         in evaluating and treating professionals, in providing
   11         and monitoring continued care of impaired
   12         professionals, and in expelling professionals from the
   13         program; authorizing, instead of requiring, the
   14         department to retain one or more consultants to
   15         operate its impaired practitioner program; requiring
   16         the department to establish the terms and conditions
   17         of the program by contract; providing contract terms;
   18         requiring consultants to establish the terms of
   19         monitoring impaired practitioners; authorizing
   20         consultants to consider the recommendations of certain
   21         persons in establishing the terms of monitoring;
   22         authorizing consultants to modify monitoring terms to
   23         protect the health, safety, and welfare of the public;
   24         requiring consultants to assist the department and
   25         licensure boards on matters relating to impaired
   26         practitioners; making technical changes; requiring the
   27         department to refer practitioners to consultants under
   28         certain circumstances; authorizing consultants to
   29         withhold certain information about self-reporting
   30         participants from the department under certain
   31         circumstances to encourage self-reporting; requiring
   32         consultants to disclose all information relating to
   33         practitioners who are terminated from the program for
   34         material noncompliance; providing that all information
   35         obtained by a consultant retains its confidential or
   36         exempt status; providing that consultants, and certain
   37         agents of consultants, may not be held liable
   38         financially or have a cause of action for damages
   39         brought against them for disclosing certain
   40         information or for any other act or omission relating
   41         to the program; authorizing consultants to contract
   42         with a school or program to provide services to
   43         certain students; amending s. 401.411, F.S.; providing
   44         that an impaired practitioner may be reported to a
   45         consultant rather than the department under certain
   46         circumstances; amending s. 455.227, F.S.; conforming
   47         provisions to changes made by the act; amending s.
   48         456.0635, F.S.; providing that, under certain
   49         circumstances, a board or, if there is no board, the
   50         department, is not required to refuse to admit certain
   51         candidates to an examination, to issue a license,
   52         certificate, or registration to certain applicants, or
   53         to renew a license, certificate, or registration of
   54         certain applicants if they have successfully completed
   55         a 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; providing an effective date.
   71          
   72  Be It Enacted by the Legislature of the State of Florida:
   73  
   74         Section 1. Section 456.076, Florida Statutes, is amended to
   75  read:
   76         456.076 Impaired practitioner programs Treatment programs
   77  for impaired practitioners.—
   78         (1) As used in this section, the term:
   79         (a)“Consultant” means the individual or entity who
   80  operates an approved impaired practitioner program pursuant to a
   81  contract with the department and who is retained by the
   82  department as provided in subsection (2).
   83         (b)“Evaluator” means a state-licensed or nationally
   84  certified individual who has been approved by a consultant or
   85  the department, who has completed an evaluator training program
   86  established by the consultant, and who is therefore authorized
   87  to evaluate practitioners as part of an impaired practitioner
   88  program.
   89         (c)“Impaired practitioner” means a practitioner with an
   90  impairment.
   91         (d)“Impaired practitioner program” means a program
   92  established by the department by contract with one or more
   93  consultants to serve impaired and potentially impaired
   94  practitioners for the protection of the health, safety, and
   95  welfare of the public.
   96         (e)“Impairment” means a potentially impairing health
   97  condition that is the result of the misuse or abuse of alcohol,
   98  drugs, or both, or a mental or physical condition that could
   99  affect a practitioner’s ability to practice with skill and
  100  safety.
  101         (f)“Inability to progress” means a determination by a
  102  consultant based on a participant’s response to treatment and
  103  prognosis that the participant is unable to safely practice
  104  despite compliance with treatment requirements and his or her
  105  participant contract.
  106         (g)“Material noncompliance” means an act or omission by a
  107  participant in violation of his or her participant contract as
  108  determined by the department or consultant.
  109         (h)“Participant” means a practitioner who is participating
  110  in the impaired practitioner program by having entered into a
  111  participant contract. A practitioner ceases to be a participant
  112  when the participant contract is successfully completed or is
  113  terminated for any reason.
  114         (i)“Participant contract” means a formal written document
  115  outlining the requirements established by a consultant for a
  116  participant to successfully complete the impaired practitioner
  117  program, including the participant’s monitoring plan.
  118         (j)“Practitioner” means a person licensed, registered,
  119  certified, or regulated by the department under part III of
  120  chapter 401; chapter 457; chapter 458; chapter 459; chapter 460;
  121  chapter 461; chapter 462; chapter 463; chapter 464; chapter 465;
  122  chapter 466; chapter 467; part I, part II, part III, part V,
  123  part X, part XIII, or part XIV of chapter 468; chapter 478;
  124  chapter 480; part III or part IV of chapter 483; chapter 484;
  125  chapter 486; chapter 490; or chapter 491; or an applicant for a
  126  license, registration, or certification under the same laws.
  127         (k)“Referral” means a practitioner who has been referred,
  128  either as a self-referral or otherwise, or reported to a
  129  consultant for impaired practitioner program services, but who
  130  is not under a participant contract.
  131         (l)“Treatment program” means a department- or consultant
  132  approved residential, intensive outpatient, partial
  133  hospitalization or other program through which an impaired
  134  practitioner is treated based on the impaired practitioner’s
  135  diagnosis and the treatment plan approved by the consultant.
  136         (m)“Treatment provider” means a department- or consultant
  137  approved state-licensed or nationally certified individual who
  138  provides treatment to an impaired practitioner based on the
  139  practitioner’s individual diagnosis and a treatment plan
  140  approved by the consultant For professions that do not have
  141  impaired practitioner programs provided for in their practice
  142  acts, the department shall, by rule, designate approved impaired
  143  practitioner programs under this section. The department may
  144  adopt rules setting forth appropriate criteria for approval of
  145  treatment providers. The rules may specify the manner in which
  146  the consultant, retained as set forth in subsection (2), works
  147  with the department in intervention, requirements for evaluating
  148  and treating a professional, requirements for continued care of
  149  impaired professionals by approved treatment providers,
  150  continued monitoring by the consultant of the care provided by
  151  approved treatment providers regarding the professionals under
  152  their care, and requirements related to the consultant’s
  153  expulsion of professionals from the program.
  154         (2)(a) The department may shall retain one or more impaired
  155  practitioner consultants to operate its impaired practitioner
  156  program. Each consultant who are each licensees under the
  157  jurisdiction of the Division of Medical Quality Assurance within
  158  the department and who must be:
  159         (a)1. A practitioner or recovered practitioner licensed
  160  under chapter 458, chapter 459, or part I of chapter 464; or
  161         (b)2. An entity that employs:
  162         1.a. A medical director who is must be a practitioner or
  163  recovered practitioner licensed under chapter 458 or chapter
  164  459; or
  165         2.b. An executive director who is must be a registered
  166  nurse or a recovered registered nurse licensed under part I of
  167  chapter 464.
  168         (3)The terms and conditions of the impaired practitioner
  169  program must be established by the department by contract with a
  170  consultant for the protection of the health, safety, and welfare
  171  of the public and must provide, at a minimum, that the
  172  consultant:
  173         (a)Accepts referrals;
  174         (b)Arranges for the evaluation and treatment of impaired
  175  practitioners by a treatment provider, when the consultant deems
  176  the evaluation and treatment necessary;
  177         (c)Monitors the recovery progress and status of impaired
  178  practitioners to ensure that such practitioners are able to
  179  practice their profession with skill and safety. Such monitoring
  180  must continue until the consultant or department concludes that
  181  monitoring by the consultant is no longer required for the
  182  protection of the public or until the practitioner’s
  183  participation in the program is terminated for material
  184  noncompliance or inability to progress; and
  185         (d)Does not directly evaluate, treat, or otherwise provide
  186  patient care to a practitioner in the operation of the impaired
  187  practitioner program.
  188         (4)The department shall specify, in its contract with each
  189  consultant, the types of licenses, registrations, or
  190  certifications of the practitioners to be served by that
  191  consultant.
  192         (5)A consultant shall enter into a participant contract
  193  with an impaired practitioner and shall establish the terms of
  194  monitoring and shall include the terms in a participant
  195  contract. In establishing the terms of monitoring, the
  196  consultant may consider the recommendations of one or more
  197  approved evaluators, treatment programs, or treatment providers.
  198  A consultant may modify the terms of monitoring if the
  199  consultant concludes, through the course of monitoring, that
  200  extended, additional, or amended terms of monitoring are
  201  required for the protection of the health, safety, and welfare
  202  of the public.
  203         (6)(b)A An entity retained as an impaired practitioner
  204  consultant under this section which employs a medical director
  205  or an executive director is not required to be licensed as a
  206  substance abuse provider or mental health treatment provider
  207  under chapter 394, chapter 395, or chapter 397 for purposes of
  208  providing services under this program.
  209         (7)(c)1.Each The consultant shall assist the department
  210  and licensure boards on matters of impaired practitioners,
  211  including the determination of probable cause panel and the
  212  department in carrying out the responsibilities of this section.
  213  This includes working with department investigators to determine
  214  whether a practitioner is, in fact, impaired, as specified in
  215  the consultant’s contract with the department.
  216         2.The consultant may contract with a school or program to
  217  provide services to a student enrolled for the purpose of
  218  preparing for licensure as a health care practitioner as defined
  219  in this chapter or as a veterinarian under chapter 474 if the
  220  student is allegedly impaired as a result of the misuse or abuse
  221  of alcohol or drugs, or both, or due to a mental or physical
  222  condition. The department is not responsible for paying for the
  223  care provided by approved treatment providers or a consultant.
  224         (d)A medical school accredited by the Liaison Committee on
  225  Medical Education or the Commission on Osteopathic College
  226  Accreditation, or another school providing for the education of
  227  students enrolled in preparation for licensure as a health care
  228  practitioner as defined in this chapter or a veterinarian under
  229  chapter 474 which is governed by accreditation standards
  230  requiring notice and the provision of due process procedures to
  231  students, is not liable in any civil action for referring a
  232  student to the consultant retained by the department or for
  233  disciplinary actions that adversely affect the status of a
  234  student when the disciplinary actions are instituted in
  235  reasonable reliance on the recommendations, reports, or
  236  conclusions provided by such consultant, if the school, in
  237  referring the student or taking disciplinary action, adheres to
  238  the due process procedures adopted by the applicable
  239  accreditation entities and if the school committed no
  240  intentional fraud in carrying out the provisions of this
  241  section.
  242         (8)(3)Before issuing an approval of, or intent to deny, an
  243  application for licensure, each board and profession within the
  244  Division of Medical Quality Assurance may delegate to its chair
  245  or other designee its authority to determine, before certifying
  246  or declining to certify an application for licensure to the
  247  department, that an applicant for licensure under its
  248  jurisdiction may have an impairment be impaired as a result of
  249  the misuse or abuse of alcohol or drugs, or both, or due to a
  250  mental or physical condition that could affect the applicant’s
  251  ability to practice with skill and safety. Upon such
  252  determination, the chair or other designee may refer the
  253  applicant to the consultant to facilitate for an evaluation
  254  before the board issues an approval of, certifies or intent to
  255  deny, declines to certify his or her application to the
  256  department. If the applicant agrees to be evaluated by the
  257  consultant, the department’s deadline for approving or denying
  258  the application pursuant to s. 120.60(1) is tolled until the
  259  evaluation is completed and the result of the evaluation and
  260  recommendation by the consultant is communicated to the board by
  261  the consultant. If the applicant declines to be evaluated by the
  262  consultant, the board shall issue an approval of, or intent to
  263  deny, certify or decline to certify the applicant’s application
  264  to the department notwithstanding the lack of an evaluation and
  265  recommendation by the consultant.
  266         (9)(a)(4)(a)When Whenever the department receives a
  267  written or oral legally sufficient complaint alleging that a
  268  practitioner has an impairment licensee under the jurisdiction
  269  of the Division of Medical Quality Assurance within the
  270  department is impaired as a result of the misuse or abuse of
  271  alcohol or drugs, or both, or due to a mental or physical
  272  condition which could affect the licensee’s ability to practice
  273  with skill and safety, and no complaint exists against the
  274  practitioner licensee other than impairment exists, the
  275  department shall refer the practitioner to the consultant, along
  276  with all information in the department’s possession relating to
  277  the impairment. The impairment does reporting of such
  278  information shall not constitute grounds for discipline pursuant
  279  to s. 456.072 or the corresponding grounds for discipline within
  280  the applicable practice act if the probable cause panel of the
  281  appropriate board, or the department when there is no board,
  282  finds:
  283         1. The practitioner licensee has acknowledged the
  284  impairment; problem.
  285         2. The practitioner becomes a participant licensee has
  286  voluntarily enrolled in an impaired practitioner program and
  287  successfully completes a participant contract under terms
  288  established by the consultant; appropriate, approved treatment
  289  program.
  290         3. The practitioner licensee has voluntarily withdrawn from
  291  practice or has limited the scope of his or her practice if as
  292  required by the consultant;, in each case, until such time as
  293  the panel, or the department when there is no board, is
  294  satisfied the licensee has successfully completed an approved
  295  treatment program.
  296         4. The practitioner licensee has provided to the
  297  consultant, or has authorized the consultant to obtain, all
  298  records and information relating to the impairment from any
  299  source and all other medical records of the practitioner
  300  requested by the consultant; and executed releases for medical
  301  records, authorizing the release of all records of evaluations,
  302  diagnoses, and treatment of the licensee, including records of
  303  treatment for emotional or mental conditions, to the consultant.
  304  The consultant shall make no copies or reports of records that
  305  do not regard the issue of the licensee’s impairment and his or
  306  her participation in a treatment program.
  307         5.The practitioner has authorized the consultant, in the
  308  event of the practitioner’s termination from the impaired
  309  practitioner program, to report the termination to the
  310  department and provide the department with copies of all
  311  information in the consultant’s possession relating to the
  312  practitioner.
  313         (b) To encourage practitioners who are or may be impaired
  314  to voluntarily self-refer to a consultant, the consultant may
  315  not provide information to the department relating to a self
  316  referring participant if the consultant has no knowledge of a
  317  pending department investigation, complaint, or disciplinary
  318  action against the participant and if the participant is in
  319  compliance and making progress with the terms of the impaired
  320  practitioner program and contract, unless authorized by the
  321  participant If, however, the department has not received a
  322  legally sufficient complaint and the licensee agrees to withdraw
  323  from practice until such time as the consultant determines the
  324  licensee has satisfactorily completed an approved treatment
  325  program or evaluation, the probable cause panel, or the
  326  department when there is no board, shall not become involved in
  327  the licensee’s case.
  328         (c)Inquiries related to impairment treatment programs
  329  designed to provide information to the licensee and others and
  330  which do not indicate that the licensee presents a danger to the
  331  public shall not constitute a complaint within the meaning of s.
  332  456.073 and shall be exempt from the provisions of this
  333  subsection.
  334         (d)Whenever the department receives a legally sufficient
  335  complaint alleging that a licensee is impaired as described in
  336  paragraph (a) and no complaint against the licensee other than
  337  impairment exists, the department shall forward all information
  338  in its possession regarding the impaired licensee to the
  339  consultant. For the purposes of this section, a suspension from
  340  hospital staff privileges due to the impairment does not
  341  constitute a complaint.
  342         (e)The probable cause panel, or the department when there
  343  is no board, shall work directly with the consultant, and all
  344  information concerning a practitioner obtained from the
  345  consultant by the panel, or the department when there is no
  346  board, shall remain confidential and exempt from the provisions
  347  of s. 119.07(1), subject to the provisions of subsections (6)
  348  and (7).
  349         (f)A finding of probable cause shall not be made as long
  350  as the panel, or the department when there is no board, is
  351  satisfied, based upon information it receives from the
  352  consultant and the department, that the licensee is progressing
  353  satisfactorily in an approved impaired practitioner program and
  354  no other complaint against the licensee exists.
  355         (10)(5) In any disciplinary action for a violation other
  356  than impairment in which a practitioner licensee establishes the
  357  violation for which the practitioner licensee is being
  358  prosecuted was due to or connected with impairment and further
  359  establishes the practitioner licensee is satisfactorily
  360  progressing through or has successfully completed an impaired
  361  practitioner program approved treatment program pursuant to this
  362  section, such information may be considered by the board, or the
  363  department when there is no board, as a mitigating factor in
  364  determining the appropriate penalty. This subsection does not
  365  limit mitigating factors the board may consider.
  366         (11)(a)(6)(a)Upon request by the consultant, and with the
  367  authorization of the practitioner when required by law, an
  368  approved evaluator, treatment program, or treatment provider
  369  shall, upon request, disclose to the consultant all information
  370  in its possession regarding a referral or participant the issue
  371  of a licensee’s impairment and participation in the treatment
  372  program. All information obtained by the consultant and
  373  department pursuant to this section is confidential and exempt
  374  from the provisions of s. 119.07(1), subject to the provisions
  375  of this subsection and subsection (7). Failure to provide such
  376  information to the consultant is grounds for withdrawal of
  377  approval of such evaluator, treatment program, or treatment
  378  provider.
  379         (b) When a referral or participant is terminated from the
  380  impaired practitioner program for material noncompliance with a
  381  participant contract, inability to progress, or any other reason
  382  than completion, the consultant shall disclose If in the opinion
  383  of the consultant, after consultation with the treatment
  384  provider, an impaired licensee has not progressed satisfactorily
  385  in a treatment program, all information regarding the issue of a
  386  licensee’s impairment and participation in a treatment program
  387  in the consultant’s possession relating to the practitioner
  388  shall be disclosed to the department. Such disclosure shall
  389  constitute a complaint pursuant to the general provisions of s.
  390  456.073. In addition, whenever the consultant concludes that
  391  impairment affects a practitioner’s licensee’s practice and
  392  constitutes an immediate, serious danger to the public health,
  393  safety, or welfare, the consultant shall immediately communicate
  394  such that conclusion shall be communicated to the department and
  395  disclose all information in the consultant’s possession relating
  396  to the practitioner to the department State Surgeon General.
  397         (12)All information obtained by the consultant pursuant to
  398  this section is confidential and exempt from s. 119.07(1) and s.
  399  24(a), Art. I of the State Constitution.
  400         (13)(7) A consultant, or a director, officer, employee, or
  401  agent of a consultant, may not be held liable financially or may
  402  not have a cause of action for damages brought against him or
  403  her for making a disclosure pursuant to this section, for any
  404  other action or omission relating to the impaired practitioner
  405  program, or for the consequences of such disclosure or action or
  406  omission, including, without limitation, action by the
  407  department against a license, registration, or certification
  408  licensee, or approved treatment provider who makes a disclosure
  409  pursuant to this section is not subject to civil liability for
  410  such disclosure or its consequences.
  411         (14) The provisions of s. 766.101 apply to any consultant
  412  and the consultant’s directors, officers, employees, or agents
  413  in regards to providing information relating to a participant to
  414  a medical review committee if the participant authorizes such
  415  disclosure officer, employee, or agent of the department or the
  416  board and to any officer, employee, or agent of any entity with
  417  which the department has contracted pursuant to this section.
  418         (15)(a)(8)(a) A consultant retained pursuant to this
  419  section and subsection (2), a consultant’s directors, officers,
  420  and employees, or agents and those acting at the direction of
  421  the consultant for the limited purpose of an emergency
  422  intervention on behalf of a licensee or student as described in
  423  subsection (2) when the consultant is unable to perform such
  424  intervention shall be considered agents of the department for
  425  purposes of s. 768.28 while acting within the scope of the
  426  consultant’s duties under the contract with the department if
  427  the contract complies with the requirements of this section. The
  428  contract must require that:
  429         1.The consultant indemnify the state for any liabilities
  430  incurred up to the limits set out in chapter 768.
  431         2.The consultant establish a quality assurance program to
  432  monitor services delivered under the contract.
  433         3.The consultant’s quality assurance program, treatment,
  434  and monitoring records be evaluated quarterly.
  435         4.The consultant’s quality assurance program be subject to
  436  review and approval by the department.
  437         5.The consultant operate under policies and procedures
  438  approved by the department.
  439         6.The consultant provide to the department for approval a
  440  policy and procedure manual that comports with all statutes,
  441  rules, and contract provisions approved by the department.
  442         7.The department be entitled to review the records
  443  relating to the consultant’s performance under the contract for
  444  the purpose of management audits, financial audits, or program
  445  evaluation.
  446         8.All performance measures and standards be subject to
  447  verification and approval by the department.
  448         9.The department be entitled to terminate the contract
  449  with the consultant for noncompliance with the contract.
  450         (b) In accordance with s. 284.385, the Department of
  451  Financial Services shall defend any claim, suit, action, or
  452  proceeding, including a claim, suit, action, or proceeding for
  453  injunctive, affirmative, or declaratory relief, against the
  454  consultant, or the consultant’s directors, officers, or
  455  employees, and agents brought as the result of any action or
  456  omission relating to the impaired practitioner program or those
  457  acting at the direction of the consultant for the limited
  458  purpose of an emergency intervention on behalf of a licensee or
  459  student as described in subsection (2) when the consultant is
  460  unable to perform such intervention, which claim, suit, action,
  461  or proceeding is brought as a result of an act or omission by
  462  any of the consultant’s officers and employees and those acting
  463  under the direction of the consultant for the limited purpose of
  464  an emergency intervention on behalf of the licensee or student
  465  when the consultant is unable to perform such intervention, if
  466  the act or omission arises out of and is in the scope of the
  467  consultant’s duties under its contract with the department.
  468         (16)(c) If a the consultant retained by the department
  469  pursuant to this section subsection (2) is also retained by
  470  another any other state agency to operate an impaired
  471  practitioner program for that agency, this section also applies
  472  to the consultant’s operation of an impaired practitioner
  473  program for that agency, and if the contract between such state
  474  agency and the consultant complies with the requirements of this
  475  section, the consultant, the consultant’s officers and
  476  employees, and those acting under the direction of the
  477  consultant for the limited purpose of an emergency intervention
  478  on behalf of a licensee or student as described in subsection
  479  (2) when the consultant is unable to perform such intervention
  480  shall be considered agents of the state for the purposes of this
  481  section while acting within the scope of and pursuant to
  482  guidelines established in the contract between such state agency
  483  and the consultant.
  484         (17)(9)A An impaired practitioner consultant is the
  485  official custodian of records relating to the referral of an
  486  impaired licensee or applicant to that consultant and any other
  487  interaction between the licensee or applicant and the
  488  consultant. The consultant may disclose to a referral or
  489  participant, or to the legal representative of the referral or
  490  participant, the documents, records, or other information from
  491  the consultant’s file, including information received by the
  492  consultant from other sources, and information on the terms
  493  required for the referrals or participant’s monitoring
  494  contract, the referrals or participant’s progress or inability
  495  to progress, the referrals or participants discharge or
  496  termination, information supporting the conclusion of material
  497  noncompliance, or any other information required by law the
  498  impaired licensee or applicant or his or her designee any
  499  information that is disclosed to or obtained by the consultant
  500  or that is confidential under paragraph (6)(a), but only to the
  501  extent that it is necessary to do so to carry out the
  502  consultant’s duties under this section. The department, and any
  503  other entity that enters into a contract with the consultant to
  504  receive the services of the consultant, has direct
  505  administrative control over the consultant to the extent
  506  necessary to receive disclosures from the consultant as allowed
  507  by federal law. If a consultant discloses information to the
  508  department in accordance with this part, a referral or
  509  participant, or his or her legal representative, may obtain a
  510  complete copy of the consultant’s file from the consultant or
  511  disciplinary proceeding is pending, an impaired licensee may
  512  obtain such information from the department under s. 456.073.
  513         (18)(a)The consultant may contract with a school or
  514  program to provide impaired practitioner program services to a
  515  student enrolled for the purpose of preparing for licensure as a
  516  health care practitioner as defined in this chapter or as a
  517  veterinarian under chapter 474 if the student has or is
  518  suspected of having an impairment. The department is not
  519  responsible for paying for the care provided by approved
  520  treatment providers or approved treatment programs or for the
  521  services provided by a consultant to a student.
  522         (b)A medical school accredited by the Liaison Committee on
  523  Medical Education or the Commission on Osteopathic College
  524  Accreditation, or another school providing for the education of
  525  students enrolled in preparation for licensure as a health care
  526  practitioner as defined in this chapter, or a veterinarian under
  527  chapter 474, which is governed by accreditation standards
  528  requiring notice and the provision of due process procedures to
  529  students, is not liable in any civil action for referring a
  530  student to the consultant retained by the department or for
  531  disciplinary actions that adversely affect the status of a
  532  student when the disciplinary actions are instituted in
  533  reasonable reliance on the recommendations, reports, or
  534  conclusions provided by such consultant, if the school, in
  535  referring the student or taking disciplinary action, adheres to
  536  the due process procedures adopted by the applicable
  537  accreditation entities and if the school committed no
  538  intentional fraud in carrying out the provisions of this
  539  section.
  540         Section 2. Paragraph (l) of subsection (1) of section
  541  401.411, Florida Statutes, is amended to read:
  542         401.411 Disciplinary action; penalties.—
  543         (1) The department may deny, suspend, or revoke a license,
  544  certificate, or permit or may reprimand or fine any licensee,
  545  certificateholder, or other person operating under this part for
  546  any of the following grounds:
  547         (l) The failure to report to the department any person
  548  known to be in violation of this part. However, a professional
  549  known to be operating under this part without reasonable skill
  550  and without regard for the safety of the public by reason of
  551  illness, drunkenness, or the use of drugs, narcotics, chemicals,
  552  or any other type of material, or as a result of a mental or
  553  physical condition, may be reported to a consultant operating an
  554  impaired practitioner program as described in s. 456.076 rather
  555  than to the department.
  556         Section 3. Paragraph (u) of subsection (1) of section
  557  455.227, Florida Statutes, is amended to read:
  558         455.227 Grounds for discipline; penalties; enforcement.—
  559         (1) The following acts shall constitute grounds for which
  560  the disciplinary actions specified in subsection (2) may be
  561  taken:
  562         (u) Termination from an impaired practitioner program a
  563  treatment program for impaired practitioners as described in s.
  564  456.076 for failure to comply, without good cause, with the
  565  terms of the monitoring or participant treatment contract
  566  entered into by the licensee or failing to successfully complete
  567  a drug or alcohol treatment program.
  568         Section 4. Subsections (2) and (3) of section 456.0635,
  569  Florida Statutes, are amended to read:
  570         456.0635 Health care fraud; disqualification for license,
  571  certificate, or registration.—
  572         (2) Each board within the jurisdiction of the department,
  573  or the department if there is no board, shall refuse to admit a
  574  candidate to any examination and refuse to issue a license,
  575  certificate, or registration to any applicant if the candidate
  576  or applicant or any principal, officer, agent, managing
  577  employee, or affiliated person of the candidate or applicant:
  578         (a) Has been convicted of, or entered a plea of guilty or
  579  nolo contendere to, regardless of adjudication, a felony under
  580  chapter 409, chapter 817, or chapter 893, or a similar felony
  581  offense committed in another state or jurisdiction, unless the
  582  candidate or applicant has successfully completed a pretrial
  583  diversion or drug court program for that felony and provides
  584  proof that the plea has been withdrawn or the charges have been
  585  dismissed. Any such conviction or plea shall exclude the
  586  applicant or candidate from licensure, examination,
  587  certification, or registration unless the sentence and any
  588  subsequent period of probation for such conviction or plea
  589  ended:
  590         1. For felonies of the first or second degree, more than 15
  591  years before the date of application.
  592         2. For felonies of the third degree, more than 10 years
  593  before the date of application, except for felonies of the third
  594  degree under s. 893.13(6)(a).
  595         3. For felonies of the third degree under s. 893.13(6)(a),
  596  more than 5 years before the date of application;
  597         (b) Has been convicted of, or entered a plea of guilty or
  598  nolo contendere to, regardless of adjudication, a felony under
  599  21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396, unless the
  600  sentence and any subsequent period of probation for such
  601  conviction or plea ended more than 15 years before the date of
  602  the application;
  603         (c) Has been terminated for cause from the Florida Medicaid
  604  program pursuant to s. 409.913, unless the candidate or
  605  applicant has been in good standing with the Florida Medicaid
  606  program for the most recent 5 years;
  607         (d) Has been terminated for cause, pursuant to the appeals
  608  procedures established by the state, from any other state
  609  Medicaid program, unless the candidate or applicant has been in
  610  good standing with a state Medicaid program for the most recent
  611  5 years and the termination occurred at least 20 years before
  612  the date of the application; or
  613         (e) Is currently listed on the United States Department of
  614  Health and Human Services Office of Inspector General’s List of
  615  Excluded Individuals and Entities.
  616  
  617  This subsection does not apply to an applicant for initial
  618  licensure, certification, or registration who was enrolled on or
  619  before July 1, 2009, in an educational or training program that
  620  was recognized by a board or, if there was no board, recognized
  621  by the department, and was arrested or charged with a felony
  622  specified in paragraph (a) or paragraph (b) before July 1, 2009.
  623         (3) The department shall refuse to renew a license,
  624  certificate, or registration of any applicant if the applicant
  625  or any principal, officer, agent, managing employee, or
  626  affiliated person of the applicant:
  627         (a) Has been convicted of, or entered a plea of guilty or
  628  nolo contendere to, regardless of adjudication, a felony under
  629  chapter 409, chapter 817, or chapter 893, or a similar felony
  630  offense committed in another state or jurisdiction, unless the
  631  applicant is currently enrolled in a pretrial diversion or drug
  632  court program that allows the withdrawal of the plea for that
  633  felony upon successful completion of that program. Any such
  634  conviction or plea excludes the applicant from licensure renewal
  635  unless the sentence and any subsequent period of probation for
  636  such conviction or plea ended:
  637         1. For felonies of the first or second degree, more than 15
  638  years before the date of application.
  639         2. For felonies of the third degree, more than 10 years
  640  before the date of application, except for felonies of the third
  641  degree under s. 893.13(6)(a).
  642         3. For felonies of the third degree under s. 893.13(6)(a),
  643  more than 5 years before the date of application.
  644         (b) Has been convicted of, or entered a plea of guilty or
  645  nolo contendere to, regardless of adjudication, a felony under
  646  21 U.S.C. ss. 801-970, or 42 U.S.C. ss. 1395-1396 since July 1,
  647  2009, unless the sentence and any subsequent period of probation
  648  for such conviction or plea ended more than 15 years before the
  649  date of the application. However, if the applicant was arrested
  650  or charged with such felony before July 1, 2009, he or she is
  651  not excluded from licensure renewal under this paragraph.
  652         (c) Has been terminated for cause from the Florida Medicaid
  653  program pursuant to s. 409.913, unless the applicant has been in
  654  good standing with the Florida Medicaid program for the most
  655  recent 5 years.
  656         (d) Has been terminated for cause, pursuant to the appeals
  657  procedures established by the state, from any other state
  658  Medicaid program, unless the applicant has been in good standing
  659  with a state Medicaid program for the most recent 5 years and
  660  the termination occurred at least 20 years before the date of
  661  the application.
  662         (e) Is currently listed on the United States Department of
  663  Health and Human Services Office of Inspector General’s List of
  664  Excluded Individuals and Entities.
  665         Section 5. Paragraphs (i) and (hh) of subsection (1) of
  666  section 456.072, Florida Statutes, are amended to read:
  667         456.072 Grounds for discipline; penalties; enforcement.—
  668         (1) The following acts shall constitute grounds for which
  669  the disciplinary actions specified in subsection (2) may be
  670  taken:
  671         (i) Except as provided in s. 465.016, failing to report to
  672  the department any person who the licensee knows is in violation
  673  of this chapter, the chapter regulating the alleged violator, or
  674  the rules of the department or the board. However, a person who
  675  the licensee knows is unable to practice with reasonable skill
  676  and safety to patients by reason of illness or use of alcohol,
  677  drugs, narcotics, chemicals, or any other type of material, or
  678  as a result of a mental or physical condition, may be reported
  679  to a consultant operating an impaired practitioner program as
  680  described in s. 456.076 rather than to the department.
  681         (hh) Being terminated from an impaired practitioner program
  682  that a treatment program for impaired practitioners, which is
  683  overseen by a an impaired practitioner consultant as described
  684  in s. 456.076, for failure to comply, without good cause, with
  685  the terms of the monitoring or participant treatment contract
  686  entered into by the licensee, or for not successfully completing
  687  any drug treatment or alcohol treatment program.
  688         Section 6. Paragraph (f) of subsection (1) of section
  689  457.109, Florida Statutes, is amended to read:
  690         457.109 Disciplinary actions; grounds; action by the
  691  board.—
  692         (1) The following acts constitute grounds for denial of a
  693  license or disciplinary action, as specified in s. 456.072(2):
  694         (f) Failing to report to the department any person who the
  695  licensee knows is in violation of this chapter or of the rules
  696  of the department. However, a person who the licensee knows is
  697  unable to practice acupuncture with reasonable skill and safety
  698  to patients by reason of illness or use of alcohol, drugs,
  699  narcotics, chemicals, or any other type of material, or as a
  700  result of a mental or physical condition, may be reported to a
  701  consultant operating an impaired practitioner program as
  702  described in s. 456.076 rather than to the department.
  703         Section 7. Paragraph (e) of subsection (1) of section
  704  458.331, Florida Statutes, is amended to read:
  705         458.331 Grounds for disciplinary action; action by the
  706  board and department.—
  707         (1) The following acts constitute grounds for denial of a
  708  license or disciplinary action, as specified in s. 456.072(2):
  709         (e) Failing to report to the department any person who the
  710  licensee knows is in violation of this chapter or of the rules
  711  of the department or the board. However, a person who the
  712  licensee knows is unable to practice medicine with reasonable
  713  skill and safety to patients by reason of illness or use of
  714  alcohol, drugs, narcotics, chemicals, or any other type of
  715  material, or as a result of a mental or physical condition, may
  716  be reported to a consultant operating an impaired practitioner
  717  program as described in s. 456.076 rather than to the department
  718  A treatment provider approved pursuant to s. 456.076 shall
  719  provide the department or consultant with information in
  720  accordance with the requirements of s. 456.076(4), (5), (6),
  721  (7), and (9).
  722         Section 8. Paragraph (e) of subsection (1) of section
  723  459.015, Florida Statutes, is amended to read:
  724         459.015 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 or the department’s
  729  impaired professional consultant any person who the licensee or
  730  certificateholder knows is in violation of this chapter or of
  731  the rules of the department or the board. However, a person who
  732  the licensee knows is unable to practice osteopathic medicine
  733  with reasonable skill and safety to patients by reason of
  734  illness or use of alcohol, drugs, narcotics, chemicals, or any
  735  other type of material, or as a result of a mental or physical
  736  condition, may be reported to a consultant operating an impaired
  737  practitioner program as described in s. 456.076 rather than to
  738  the department A treatment provider, approved pursuant to s.
  739  456.076, shall provide the department or consultant with
  740  information in accordance with the requirements of s.
  741  456.076(4), (5), (6), (7), and (9).
  742         Section 9. Paragraph (g) of subsection (1) of section
  743  460.413, Florida Statutes, is amended to read:
  744         460.413 Grounds for disciplinary action; action by board or
  745  department.—
  746         (1) The following acts constitute grounds for denial of a
  747  license or disciplinary action, as specified in s. 456.072(2):
  748         (g) Failing to report to the department any person who the
  749  licensee knows is in violation of this chapter or of the rules
  750  of the department or the board. However, a person who the
  751  licensee knows is unable to practice chiropractic medicine with
  752  reasonable skill and safety to patients by reason of illness or
  753  use of alcohol, drugs, narcotics, chemicals, or any other type
  754  of material, or as a result of a mental or physical condition,
  755  may be reported to a consultant operating an impaired
  756  practitioner program as described in s. 456.076 rather than to
  757  the department.
  758         Section 10. Paragraph (f) of subsection (1) of section
  759  461.013, Florida Statutes, is amended to read:
  760         461.013 Grounds for disciplinary action; action by the
  761  board; investigations by department.—
  762         (1) The following acts constitute grounds for denial of a
  763  license or disciplinary action, as specified in s. 456.072(2):
  764         (f) Failing to report to the department any person who the
  765  licensee knows is in violation of this chapter or of the rules
  766  of the department or the board. However, a person who the
  767  licensee knows is unable to practice podiatric medicine with
  768  reasonable skill and safety to patients by reason of illness or
  769  use of alcohol, drugs, narcotics, chemicals, or any other type
  770  of material, or as a result of a mental or physical condition,
  771  may be reported to a consultant operating an impaired
  772  practitioner program as described in s. 456.076 rather than to
  773  the department.
  774         Section 11. Paragraph (f) of subsection (1) of section
  775  462.14, Florida Statutes, is amended to read:
  776         462.14 Grounds for disciplinary action; action by the
  777  department.—
  778         (1) The following acts constitute grounds for denial of a
  779  license or disciplinary action, as specified in s. 456.072(2):
  780         (f) Failing to report to the department any person who the
  781  licensee knows is in violation of this chapter or of the rules
  782  of the department. However, a person who the licensee knows is
  783  unable to practice naturopathic medicine with reasonable skill
  784  and safety to patients by reason of illness or use of alcohol,
  785  drugs, narcotics, chemicals, or any other type of material, or
  786  as a result of a mental or physical condition, may be reported
  787  to a consultant operating an impaired practitioner program as
  788  described in s. 456.076 rather than to the department.
  789         Section 12. Paragraph (l) of subsection (1) of section
  790  463.016, Florida Statutes, is amended to read:
  791         463.016 Grounds for disciplinary action; action by the
  792  board.—
  793         (1) The following acts constitute grounds for denial of a
  794  license or disciplinary action, as specified in s. 456.072(2):
  795         (l) Willfully failing to report any person who the licensee
  796  knows is in violation of this chapter or of rules of the
  797  department or the board. However, a person who the licensee
  798  knows is unable to practice optometry with reasonable skill and
  799  safety to patients by reason of illness or use of alcohol,
  800  drugs, narcotics, chemicals, or any other type of material, or
  801  as a result of a mental or physical condition, may be reported
  802  to a consultant operating an impaired practitioner program as
  803  described in s. 456.076 rather than to the department.
  804         Section 13. Paragraph (k) of subsection (1) of section
  805  464.018, Florida Statutes, is amended to read:
  806         464.018 Disciplinary actions.—
  807         (1) The following acts constitute grounds for denial of a
  808  license or disciplinary action, as specified in s. 456.072(2):
  809         (k) Failing to report to the department any person who the
  810  licensee knows is in violation of this part or of the rules of
  811  the department or the board. However, a person who the licensee
  812  knows is unable to practice nursing with reasonable skill and
  813  safety to patients by reason of illness or use of alcohol,
  814  drugs, narcotics, chemicals, or any other type of material, or
  815  as a result of a mental or physical condition, may be reported
  816  to a consultant operating an impaired practitioner program as
  817  described in s. 456.076 rather than to the department; however,
  818  if the licensee verifies that such person is actively
  819  participating in a board-approved program for the treatment of a
  820  physical or mental condition, the licensee is required to report
  821  such person only to an impaired professionals consultant.
  822         Section 14. Paragraph (c) of subsection (2) of section
  823  464.204, Florida Statutes, is amended to read:
  824         464.204 Denial, suspension, or revocation of certification;
  825  disciplinary actions.—
  826         (2) When the board finds any person guilty of any of the
  827  grounds set forth in subsection (1), it may enter an order
  828  imposing one or more of the following penalties:
  829         (c) Imposition of probation or restriction of
  830  certification, including conditions such as corrective actions
  831  as retraining or compliance with the department’s impaired
  832  practitioner program operated by a consultant as described in s.
  833  456.076 an approved treatment program for impaired
  834  practitioners.
  835         Section 15. Paragraph (o) of subsection (1) of section
  836  465.016, Florida Statutes, is amended to read:
  837         465.016 Disciplinary actions.—
  838         (1) The following acts constitute grounds for denial of a
  839  license or disciplinary action, as specified in s. 456.072(2):
  840         (o) Failing to report to the department any licensee under
  841  chapter 458 or under chapter 459 who the pharmacist knows has
  842  violated the grounds for disciplinary action set out in the law
  843  under which that person is licensed and who provides health care
  844  services in a facility licensed under chapter 395, or a health
  845  maintenance organization certificated under part I of chapter
  846  641, in which the pharmacist also provides services. However, a
  847  person who the licensee knows is unable to practice medicine or
  848  osteopathic medicine with reasonable skill and safety to
  849  patients by reason of illness or use of alcohol, drugs,
  850  narcotics, chemicals, or any other type of material, or as a
  851  result of a mental or physical condition, may be reported to a
  852  consultant operating an impaired practitioner program as
  853  described in s. 456.076 rather than to the department.
  854         Section 16. Paragraph (f) of subsection (1) of section
  855  466.028, Florida Statutes, is amended to read:
  856         466.028 Grounds for disciplinary action; action by the
  857  board.—
  858         (1) The following acts constitute grounds for denial of a
  859  license or disciplinary action, as specified in s. 456.072(2):
  860         (f) Failing to report to the department any person who the
  861  licensee knows, or has reason to believe, is clearly in
  862  violation of this chapter or of the rules of the department or
  863  the board. However, a person who the licensee knows, or has
  864  reason to believe, is clearly unable to practice her or his
  865  profession with reasonable skill and safety to patients by
  866  reason of illness or use of alcohol, drugs, narcotics,
  867  chemicals, or any other type of material, or as a result of a
  868  mental or physical condition, may be reported to a consultant
  869  operating an impaired practitioner program as described in s.
  870  456.076 rather than to the department.
  871         Section 17. Paragraph (h) of subsection (1) of section
  872  467.203, Florida Statutes, is amended to read:
  873         467.203 Disciplinary actions; penalties.—
  874         (1) The following acts constitute grounds for denial of a
  875  license or disciplinary action, as specified in s. 456.072(2):
  876         (h) Failing to report to the department any person who the
  877  licensee knows is in violation of this chapter or of the rules
  878  of the department. However, a person who the licensee knows is
  879  unable to practice midwifery with reasonable skill and safety to
  880  patients by reason of illness or use of alcohol, drugs,
  881  narcotics, chemicals, or any other type of material, or as a
  882  result of a mental or physical condition, may be reported to a
  883  consultant operating an impaired practitioner program as
  884  described in s. 456.076 rather than to the department.
  885         Section 18. Paragraph (f) of subsection (1) of section
  886  468.217, Florida Statutes, is amended to read:
  887         468.217 Denial of or refusal to renew license; suspension
  888  and revocation of license and other disciplinary measures.—
  889         (1) The following acts constitute grounds for denial of a
  890  license or disciplinary action, as specified in s. 456.072(2):
  891         (f) Failing to report to the department any person who the
  892  licensee knows is in violation of this part or of the rules of
  893  the department or of the board. However, a person who the
  894  licensee knows is unable to practice occupational therapy with
  895  reasonable skill and safety to patients by reason of illness or
  896  use of alcohol, drugs, narcotics, chemicals, or any other type
  897  of material, or as a result of a mental or physical condition,
  898  may be reported to a consultant operating an impaired
  899  practitioner program as described in s. 456.076 rather than to
  900  the department.
  901         Section 19. Paragraph (n) of subsection (1) of section
  902  468.3101, Florida Statutes, is amended to read:
  903         468.3101 Disciplinary grounds and actions.—
  904         (1) The department may make or require to be made any
  905  investigations, inspections, evaluations, and tests, and require
  906  the submission of any documents and statements, which it
  907  considers necessary to determine whether a violation of this
  908  part has occurred. The following acts shall be grounds for
  909  disciplinary action as set forth in this section:
  910         (n) Being terminated from an impaired practitioner program
  911  operated by a consultant as described in s. 456.076 for failure
  912  to comply, without good cause, with the terms of monitoring or a
  913  participant contract entered into by the licensee, or for not
  914  successfully completing a drug treatment or alcohol treatment
  915  program Failing to comply with the recommendations of the
  916  department’s impaired practitioner program for treatment,
  917  evaluation, or monitoring. A letter from the director of the
  918  impaired practitioner program that the certificateholder is not
  919  in compliance shall be considered conclusive proof under this
  920  part.
  921         Section 20. Section 474.221, Florida Statutes, is amended
  922  to read:
  923         474.221 Impaired practitioner provisions; applicability.
  924  Notwithstanding the transfer of the Division of Medical Quality
  925  Assurance to the Department of Health or any other provision of
  926  law to the contrary, veterinarians licensed under this chapter
  927  shall be governed by the treatment of impaired practitioner
  928  program provisions of s. 456.076 as if they were under the
  929  jurisdiction of the Division of Medical Quality Assurance,
  930  except that for veterinarians the Department of Business and
  931  Professional Regulation shall, at its option, exercise any of
  932  the powers granted to the Department of Health by that section,
  933  and “board” shall mean board as defined in this chapter.
  934         Section 21. Paragraph (o) of subsection (1) of section
  935  483.825, Florida Statutes, is amended to read:
  936         483.825 Grounds for disciplinary action.—
  937         (1) The following acts constitute grounds for denial of a
  938  license or disciplinary action, as specified in s. 456.072(2):
  939         (o) Failing to report to the department a person or other
  940  licensee who the licensee knows is in violation of this chapter
  941  or the rules of the department or board adopted hereunder.
  942  However, a person or other licensee who the licensee knows is
  943  unable to perform or report on clinical laboratory examinations
  944  with reasonable skill and safety to patients by reason of
  945  illness or use of alcohol, drugs, narcotics, chemicals, or any
  946  other type of material, or as a result of a mental or physical
  947  condition, may be reported to a consultant operating an impaired
  948  practitioner program as described in s. 456.076 rather than to
  949  the department.
  950         Section 22. This act shall take effect upon becoming a law.
  951