Florida Senate - 2017 CS for CS for SB 876
By the Committees on Appropriations; and Health Policy; and
Senators Young, Bean, and Rouson
576-04401-17 2017876c2
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 within a certain
73 period; requiring the department to adopt rules
74 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 referral’s or participant’s monitoring
512 contract, the referral’s or participant’s progress or inability
513 to progress, the referral’s or participant’s 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.