Florida Senate - 2018 SB 1486
By Senator Grimsley
26-00949-18 20181486__
1 A bill to be entitled
2 An act relating to the Department of Health; amending
3 s. 381.4018, F.S.; requiring the Department of Health
4 to adopt rules to implement a federal program to
5 further encourage qualified physicians to relocate to
6 and practice in underserved areas; amending s.
7 456.013, F.S.; revising health care practitioner
8 licensure application requirements; amending s.
9 456.024, F.S.; revising health care practitioner
10 licensure eligibility requirements for certain members
11 of the armed forces and their spouses; amending s.
12 458.309, F.S.; deleting a provision requiring certain
13 physicians to register an office with the department;
14 removing departmental responsibilities; creating s.
15 458.3266, F.S.; defining terms; requiring office
16 surgery centers to register with the department under
17 certain circumstances; providing registration
18 requirements; providing responsibilities for office
19 surgery center physicians; requiring the department to
20 inspect office surgery centers; providing an
21 exception; requiring the Board of Medicine to adopt
22 rules; providing penalties; amending s. 459.005, F.S.;
23 deleting a provision requiring certain physicians to
24 register an office with the department; removing
25 departmental responsibilities; creating s. 459.0138,
26 F.S.; defining terms; requiring office surgery centers
27 to register with the department under certain
28 circumstances; providing registration requirements;
29 providing responsibilities for office surgery center
30 physicians; requiring the department to inspect office
31 surgery centers; providing an exception; requiring the
32 Board of Osteopathic Medicine to adopt rules;
33 providing penalties; repealing s. 460.4166, F.S.,
34 relating to registered chiropractic assistants;
35 amending s. 463.006, F.S.; revising examination
36 requirements for the licensure and certification of
37 optometrists; creating s. 463.0061, F.S.; authorizing
38 licensure of optometrists by endorsement and providing
39 requirements therefor; defining the term “active
40 licensed practice of optometry”; amending s. 464.006,
41 F.S.; authorizing the Board of Nursing to establish
42 certain standards of care; amending s. 464.202, F.S.;
43 requiring the board to adopt by rule discipline and
44 standards of care for certified nursing assistants;
45 amending s. 464.203, F.S.; revising certification
46 requirements for nursing assistants; amending s.
47 464.204, F.S.; revising grounds for board-imposed
48 disciplinary sanctions; amending s. 465.019, F.S.;
49 requiring an institutional pharmacy to pass an onsite
50 inspection by the department within a specified time
51 before the issuance of an initial permit or a permit
52 for change of location; amending s. 465.0193, F.S.;
53 requiring a nuclear pharmacy to pass an onsite
54 inspection by the department within a specified time
55 before issuance of an initial permit or a permit for
56 change of location; creating s. 465.0195, F.S.;
57 requiring certain pharmacies and outsourcing
58 facilities located in this state to obtain a permit in
59 order to create, ship, mail, deliver, or dispense
60 compounded sterile products; providing application
61 requirements; providing inspection requirements;
62 providing permit requirements; authorizing the Board
63 of Pharmacy to adopt certain rules; providing
64 applicability; amending s. 465.0196, F.S.; requiring a
65 special pharmacy to pass an onsite inspection by the
66 department within a specified time before the issuance
67 of an initial permit or a permit for change of
68 location; amending s. 465.0197, F.S.; requiring an
69 Internet pharmacy to pass an onsite inspection by the
70 department within a specified time before the issuance
71 of an initial permit or a permit for change of
72 location; amending s. 466.006, F.S.; revising certain
73 requirements for examinations to be completed by
74 applicants seeking dental licensure; amending s.
75 466.007, F.S.; revising requirements for examinations
76 of dental hygienists; amending s. 466.017, F.S.;
77 providing adverse incident reporting requirements;
78 defining the term “adverse incident”; providing for
79 disciplinary action by the Board of Dentistry;
80 authorizing the board to adopt rules; repealing s.
81 466.032, F.S., relating to registration; repealing s.
82 466.033, F.S., relating to registration certificates;
83 repealing s. 466.034, F.S., relating to change of
84 ownership or address; repealing s. 466.035, F.S.,
85 relating to advertising; repealing s. 466.036, F.S.,
86 relating to information, periodic inspections, and
87 equipment and supplies; repealing s. 466.037, F.S.,
88 relating to suspension and revocation and
89 administrative fines; repealing s. 466.038, F.S.,
90 relating to rules; repealing s. 466.039, F.S.,
91 relating to violations; amending s. 468.701, F.S.;
92 revising a definition; amending s. 468.707, F.S.;
93 revising athletic trainer licensure requirements;
94 amending s. 468.711, F.S.; revising requirements for
95 the renewal of a license relating to continuing
96 education; amending s. 468.723, F.S.; revising a
97 definition; amending s. 468.803, F.S.; revising
98 orthotic, prosthetic, and pedorthic licensure,
99 registration, and examination requirements; amending
100 s. 480.033, F.S.; revising a definition; amending s.
101 480.041, F.S.; revising qualifications for licensure
102 as a massage therapist; repealing s. 480.042, F.S.,
103 relating to examinations; amending s. 480.046, F.S.;
104 revising instances under which disciplinary action may
105 be taken against massage establishments; prohibiting a
106 certain disciplined massage establishment from
107 applying for relicensure; providing an exception;
108 amending s. 483.824, F.S.; revising qualification
109 requirements for a clinical laboratory director;
110 amending s. 490.003, F.S.; revising definitions;
111 amending s. 490.005, F.S.; revising examination
112 requirements for licensure of a psychologist; amending
113 s. 490.006, F.S.; revising requirements for licensure
114 by endorsement of certain psychologists; amending s.
115 491.0045, F.S.; providing an exemption for intern
116 registration requirements under certain circumstances;
117 amending s. 491.005, F.S.; revising education
118 requirements for the licensure of marriage and family
119 therapists; revising examination requirements for the
120 licensure of mental health counselors; amending s.
121 491.006, F.S.; revising requirements for licensure or
122 certification by endorsement for certain professions;
123 amending s. 491.007, F.S.; removing a biennial intern
124 registration fee; amending s. 491.009, F.S.;
125 authorizing the Board of Clinical Social Work,
126 Marriage and Family Therapy, and Mental Health
127 Counseling, or the department under certain
128 circumstances, to enter an order denying licensure or
129 imposing penalties against an applicant for licensure
130 under certain circumstances; providing penalties;
131 amending ss. 463.0057, 491.0046, and 945.42, F.S.;
132 conforming provisions to changes made by the act;
133 providing an effective date.
134
135 Be It Enacted by the Legislature of the State of Florida:
136
137 Section 1. Paragraph (f) of subsection (3) of section
138 381.4018, Florida Statutes, is amended to read:
139 381.4018 Physician workforce assessment and development.—
140 (3) GENERAL FUNCTIONS.—The department shall maximize the
141 use of existing programs under the jurisdiction of the
142 department and other state agencies and coordinate governmental
143 and nongovernmental stakeholders and resources in order to
144 develop a state strategic plan and assess the implementation of
145 such strategic plan. In developing the state strategic plan, the
146 department shall:
147 (f) Develop strategies to maximize federal and state
148 programs that provide for the use of incentives to attract
149 physicians to this state or retain physicians within the state.
150 Such strategies should explore and maximize federal-state
151 partnerships that provide incentives for physicians to practice
152 in federally designated shortage areas. Strategies shall also
153 consider the use of state programs, such as the Medical
154 Education Reimbursement and Loan Repayment Program pursuant to
155 s. 1009.65, which provide for education loan repayment or loan
156 forgiveness and provide monetary incentives for physicians to
157 relocate to underserved areas of the state. To further encourage
158 qualified physicians to relocate to and practice in underserved
159 areas, the department, following federal requirements, shall
160 adopt any rules necessary for the implementation of the Conrad
161 30 Waiver Program established under s. 214(1) of the Immigration
162 and Nationality Act.
163 Section 2. Paragraph (a) of subsection (1) of section
164 456.013, Florida Statutes, is amended to read:
165 456.013 Department; general licensing provisions.—
166 (1)(a) Any person desiring to be licensed in a profession
167 within the jurisdiction of the department shall apply to the
168 department in writing to take the licensure examination. The
169 application shall be made on a form prepared and furnished by
170 the department. The application form must be available on the
171 World Wide Web and the department may accept electronically
172 submitted applications beginning July 1, 2001. The application
173 shall require the social security number and date of birth of
174 the applicant, except as provided in paragraphs (b) and (c). The
175 form shall be supplemented as needed to reflect any material
176 change in any circumstance or condition stated in the
177 application which takes place between the initial filing of the
178 application and the final grant or denial of the license and
179 which might affect the decision of the department. If an
180 application is submitted electronically, the department may
181 require supplemental materials, including an original signature
182 of the applicant and verification of credentials, to be
183 submitted in a nonelectronic format. An incomplete application
184 shall expire 1 year after initial filing. In order to further
185 the economic development goals of the state, and notwithstanding
186 any law to the contrary, the department may enter into an
187 agreement with the county tax collector for the purpose of
188 appointing the county tax collector as the department’s agent to
189 accept applications for licenses and applications for renewals
190 of licenses. The agreement must specify the time within which
191 the tax collector must forward any applications and accompanying
192 application fees to the department.
193 Section 3. Paragraphs (a) and (b) of subsection (3) and
194 paragraph (j) of subsection (4) of section 456.024, Florida
195 Statutes, are amended to read:
196 456.024 Members of Armed Forces in good standing with
197 administrative boards or the department; spouses; licensure.—
198 (3)(a) A person is eligible for licensure as a health care
199 practitioner in this state if he or she:
200 1. Serves or has served as a health care practitioner in
201 the United States Armed Forces, the United States Reserve
202 Forces, or the National Guard;
203 2. Serves or has served on active duty with the United
204 States Armed Forces as a health care practitioner in the United
205 States Public Health Service; or
206 3. Is a health care practitioner, other than a dentist, in
207 another state, the District of Columbia, or a possession or
208 territory of the United States and is the spouse of a person
209 serving on active duty with the United States Armed Forces.
210
211 The department shall develop an application form, and each
212 board, or the department if there is no board, shall waive the
213 application fee, licensure fee, and unlicensed activity fee for
214 such applicants. For purposes of this subsection, “health care
215 practitioner” means a health care practitioner as defined in s.
216 456.001 and a person licensed under part III of chapter 401 or
217 part IV of chapter 468.
218 (b) The board, or the department if there is no board,
219 shall issue a license to practice in this state to a person who:
220 1. Submits a complete application.
221 2. If he or she is a member of the United States Armed
222 Forces, the United States Reserve Forces, or the National Guard,
223 submits proof that he or she has received an honorable discharge
224 within 6 months before, or will receive an honorable discharge
225 within 6 months after, the date of submission of the
226 application.
227 3.a. Holds an active, unencumbered license issued by
228 another state, the District of Columbia, or a possession or
229 territory of the United States and who has not had disciplinary
230 action taken against him or her in the 5 years preceding the
231 date of submission of the application;
232 b. Is a military health care practitioner in a profession
233 for which licensure in a state or jurisdiction is not required
234 to practice in the United States Armed Forces, if he or she
235 submits to the department evidence of military training or
236 experience substantially equivalent to the requirements for
237 licensure in this state in that profession and evidence that he
238 or she has obtained a passing score on the appropriate
239 examination of a national or regional standards organization if
240 required for licensure in this state; or
241 c. Is the spouse of a person serving on active duty in the
242 United States Armed Forces and is a health care practitioner in
243 a profession, excluding dentistry, for which licensure in
244 another state or jurisdiction is not required, if he or she
245 submits to the department evidence of training or experience
246 substantially equivalent to the requirements for licensure in
247 this state in that profession and evidence that he or she has
248 obtained a passing score on the appropriate examination of a
249 national or regional standards organization if required for
250 licensure in this state.
251 4. Attests that he or she is not, at the time of submission
252 of the application, the subject of a disciplinary proceeding in
253 a jurisdiction in which he or she holds a license or by the
254 United States Department of Defense for reasons related to the
255 practice of the profession for which he or she is applying.
256 5. Actively practiced the profession for which he or she is
257 applying for the 3 years preceding the date of submission of the
258 application.
259 6. Submits a set of fingerprints for a background screening
260 pursuant to s. 456.0135, if required for the profession for
261 which he or she is applying.
262
263 The department shall verify information submitted by the
264 applicant under this subsection using the National Practitioner
265 Data Bank.
266 (4)
267 (j) An applicant who is issued a temporary professional
268 license to practice as a dentist pursuant to this section must
269 practice under the indirect supervision, as defined in s.
270 466.003, of a dentist licensed pursuant to chapter 466.
271 Section 4. Subsection (3) of section 458.309, Florida
272 Statutes, is amended to read:
273 458.309 Rulemaking authority.—
274 (3) A physician who performs liposuction procedures in
275 which more than 1,000 cubic centimeters of supernatant fat is
276 removed, level 2 procedures lasting more than 5 minutes, and all
277 level 3 surgical procedures in an office setting must register
278 the office with the department unless that office is licensed as
279 a facility under chapter 395. The department shall inspect the
280 physician’s office annually unless the office is accredited by a
281 nationally recognized accrediting agency or an accrediting
282 organization subsequently approved by the Board of Medicine. The
283 actual costs for registration and inspection or accreditation
284 shall be paid by the person seeking to register and operate the
285 office setting in which office surgery is performed.
286 Section 5. Section 458.3266, Florida Statutes, is created
287 to read:
288 458.3266 Office surgery centers.—
289 (1) DEFINITIONS.—As used in this section, the term:
290 (a) “Designated physician” means a physician licensed under
291 this chapter or chapter 459 who practices at the office surgery
292 center location for which the physician has assumed
293 responsibility for complying with all requirements in this
294 section and related rules of the board.
295 (b) “Office surgery center” means any facility where a
296 physician performs liposuction procedures in which more than
297 1,000 cubic centimeters of supernatant fat are removed, level 2
298 procedures lasting more than 5 minutes, and all level 3 surgical
299 procedures in an office setting, or any facility in which
300 surgery is performed outside of any facility licensed under
301 chapter 390 or chapter 395.
302 (2) REGISTRATION.—
303 (a) An office surgery center must register with the
304 department unless the center is:
305 1. Licensed as a facility pursuant to chapter 395; or
306 2. Affiliated with an accredited medical school at which
307 training is provided for medical students, residents, or
308 fellows.
309 (b) Office surgery center locations shall be registered
310 separately regardless of whether the center is operated under
311 the same business name or management as another center. The
312 actual costs for registration shall be paid by the person
313 seeking to register and operate the office surgery center in
314 which office surgery is performed.
315 (c) As a part of registration, an office surgery center
316 must have a designated physician. Within 10 days after
317 termination of a designated physician, the center must notify
318 the department of the identity of another designated physician
319 for that center. Failing to have a designated physician
320 practicing at the location of the registered center may result
321 in the suspension of the center’s certificate of registration,
322 as described in s. 456.073(8), or agency action under s.
323 120.60(6).
324 (d) The department shall deny registration to an office
325 surgery center that is:
326 1. Not fully owned by a physician licensed under this
327 chapter or chapter 459 or a group of physicians licensed under
328 this chapter or chapter 459;
329 2. Not a health care center licensed under part X of
330 chapter 400; or
331 3. Owned by or in any contractual or employment
332 relationship with a physician licensed under this chapter or
333 chapter 459 who:
334 a. Had hospital privileges revoked in the last 5 years;
335 b. Does not have a clear and active license with the
336 department; or
337 c. Had a license disciplined by the department or another
338 jurisdiction in the last 5 years for an offense related to
339 standard of care.
340 (e) If the department finds that an office surgery center
341 does not meet the requirements of paragraph (c) or is owned,
342 directly or indirectly, by a person meeting criteria listed in
343 paragraph (d), the department shall revoke the certificate of
344 registration previously issued by the department.
345 (f) The department may revoke an office surgery center’s
346 certificate of registration and prohibit all physicians
347 associated with the center from practicing at that location
348 based upon an annual inspection and evaluation of the factors
349 described in subsection (4).
350 (g) If the certificate of registration is revoked or
351 suspended, the designated physician of the center, the owner or
352 lessor of the center property, the manager, and the proprietor
353 shall:
354 1. Cease to operate the facility as an office surgery
355 center as of the effective date of the suspension or revocation.
356 2. Remove any signs and symbols identifying the premises as
357 an office surgery center.
358 (h) Upon the effective date of the suspension or
359 revocation, the designated physician of the office surgery
360 center shall advise the department of the disposition of the
361 medicinal drugs located on the premises. Such disposition is
362 subject to the supervision and approval of the department.
363 Medicinal drugs that are purchased or held by a center that is
364 not registered may be deemed adulterated pursuant to s. 499.006.
365 (i) If the office surgery center’s registration is revoked,
366 any person named in the registration documents of the center,
367 including persons owning or operating the center, may not, as an
368 individual or as a part of a group, apply to operate an office
369 surgery center for 5 years after the date the registration is
370 revoked.
371 (j) The period of suspension for the registration of an
372 office surgery center shall be prescribed by the department, but
373 may not exceed 2 years.
374 (k) A change of ownership of a registered office surgery
375 center requires submission of a new registration application. An
376 office surgery registration may not be transferred.
377 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
378 apply to any physician who provides professional services in an
379 office surgery center that is required to register with the
380 department in subsection (2).
381 (a)1. A physician may not practice medicine in an office
382 surgery center, as described in subsection (5), if the office
383 surgery center is not registered with the department as required
384 by this section. A physician who violates this paragraph is
385 subject to disciplinary action by his or her appropriate medical
386 regulatory board.
387 2. Surgical procedures performed in an office surgery
388 center may not include any procedure that may result in blood
389 loss of more than 10 percent of estimated blood volume in a
390 patient with a normal hemoglobin level; require major or
391 prolonged intracranial, intrathoracic, abdominal, or major joint
392 replacement procedures, except for laparoscopic procedures;
393 involve major blood vessels when such procedure is performed
394 with direct visualization by open exposure of the major vessel,
395 except for percutaneous endovascular intervention; or are
396 generally emergent or life-threatening in nature.
397 (b) The designated physician of an office surgery center
398 shall notify the applicable board in writing of the date of
399 termination of employment within 10 days after terminating his
400 or her employment with a center registered under subsection (2).
401 Each physician practicing in an office surgery center shall
402 notify the board, in writing, within 10 calendar days after
403 beginning or ending his or her practice at an office surgery
404 center.
405 (c) Each physician practicing in an office surgery center
406 is responsible for ensuring compliance with the following:
407 1. Facility and physical operations requirements,
408 including:
409 a. An office surgery center that is located and operated at
410 a publicly accessible, fixed location.
411 b. The public display of a visible printed sign that
412 clearly identifies the name, hours of operations, and street
413 address of the center.
414 c. Maintaining a publicly listed telephone number and other
415 methods of communication available to the public.
416 d. Emergency lighting and communications.
417 e. A reception and waiting area.
418 f. A restroom.
419 g. An administrative area, including room for storage of
420 medical records, supplies, and equipment.
421 h. Private patient examination rooms.
422 i. Treatment rooms, if treatment is being provided to the
423 patients.
424 j. The public display of a visible printed sign located in
425 a conspicuous place in the waiting room with the name and
426 contact information of the center’s designated physician and the
427 names of all physicians practicing in the center.
428 k. Compliance with ss. 499.0121 and 893.07, if the center
429 stores and dispenses prescription drugs.
430 2. Infection control requirements, including:
431 a. The maintenance of equipment and supplies to support
432 infection prevention and control.
433 b. The identification of infection risks that shall be
434 based on the following:
435 (I) Geographic location, community, and population served.
436 (II) The provided care, treatment, and services.
437 (III) An analysis of its infection surveillance and control
438 data.
439 c. Center maintenance of written infection prevention
440 policies and procedures that address prioritized risks and limit
441 the following:
442 (I) Unprotected exposure to pathogens.
443 (II) Transmission of infections associated with procedures
444 performed in the center.
445 (III) Transmission of infections associated with the
446 center’s use of medical equipment, devices, and supplies.
447 3. Health and safety requirements, including:
448 a. Being structurally sound, in good repair, clean, and
449 free from health and safety hazards, including grounds,
450 buildings, furniture, appliances, and equipment.
451 b. Having evacuation procedures in case of the event of an
452 emergency, which shall include provisions for the evacuation of
453 disabled patients and employees.
454 c. Having a written facility-specific disaster plan setting
455 forth actions to be taken in the event of center closure due to
456 unforeseen disasters and which shall include provisions for the
457 protection of medical records and any controlled substances.
458 d. Having at least one employee on the premises during
459 patient care hours who is certified in basic life support and is
460 trained in reacting to accidents and medical emergencies until
461 emergency medical personnel arrive.
462 (d) The designated physician of an office surgery center is
463 responsible for ensuring the center complies with the following
464 quality assurance requirements:
465 1. The center shall maintain an ongoing quality assurance
466 program that objectively and systematically monitors and
467 evaluates the quality and appropriateness of patient care,
468 evaluates methods to improve patient care, identifies and
469 corrects deficiencies within the facility, alerts the designated
470 physician to identify and resolve recurring problems, and
471 provides for opportunities to improve the facility’s performance
472 and to enhance and improve the quality of care provided to the
473 public.
474 2. The designated physician shall establish a quality
475 assurance program that includes the following components:
476 a. Identification, investigation, and analysis of the
477 frequency and causes of adverse incidents.
478 b. Identification of trends or patterns of adverse
479 incidents.
480 c. Development of measures to correct, reduce, minimize, or
481 eliminate the risk of adverse incidents to patients.
482 d. Documentation of the functions provided in this
483 subparagraph and periodic review no less than quarterly of such
484 information by the designated physician.
485 (e) The designated physician for each office surgery center
486 shall report all adverse incidents to the department as set
487 forth in s. 458.351.
488
489 This section does not excuse a physician from providing any
490 treatment or performing any medical duty without the proper
491 equipment and materials as required by the standard of care or
492 rules adopted by the board. This section does not supersede the
493 level of care, skill, and treatment recognized in general law
494 related to health care licensure.
495 (4) INSPECTION.—
496 (a) The department shall inspect each office surgery center
497 annually, including a review of the patient records, to ensure
498 that it complies with this section and the rules of the board
499 adopted pursuant to subsection (5) unless the center is
500 accredited by a nationally recognized accrediting agency or an
501 accrediting organization approved by the board.
502 (b) The actual costs for inspection or accreditation shall
503 be paid by the person seeking to register and operate the office
504 center in which office surgery is performed.
505 (c) During an onsite inspection, the department shall make
506 a reasonable attempt to discuss each violation with the owner or
507 designated physician of the office surgery center before issuing
508 a formal written notification.
509 (d) Any action taken to correct a violation shall be
510 documented in writing by the owner or designated physician of
511 the office surgery center and verified by follow-up inspections
512 by department personnel.
513 (5) RULEMAKING.—The board shall adopt rules:
514 (a) Necessary to administer the registration and inspection
515 of office surgery centers which establish the specific
516 requirements, procedures, forms, and fees.
517 (b) Setting forth training requirements for all facility
518 health care practitioners who are not regulated by another
519 board.
520 (6) PENALTIES; ENFORCEMENT.—
521 (a) The department may impose an administrative fine on an
522 office surgery center of up to $5,000 per violation for
523 violating the requirements of this section; chapter 499, the
524 Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
525 Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
526 the Comprehensive Drug Abuse Prevention and Control Act; chapter
527 893, the Florida Comprehensive Drug Abuse Prevention and Control
528 Act; or the rules of the department.
529 (b) In determining whether a penalty is to be imposed upon
530 a center, and in determining the amount of the fine, the
531 department shall consider the following factors:
532 1. The gravity of the violation, including the probability
533 that death or serious physical or emotional harm to a patient
534 has resulted, or could have resulted, from the center’s actions
535 or the actions of the physician; the severity of the action or
536 potential harm; and the extent to which the applicable laws or
537 rules were violated.
538 2. What actions, if any, the owner or designated physician
539 took to correct the violation.
540 3. Whether there were any previous violations at the
541 center.
542 4. The financial benefits that the center derived from
543 committing or continuing to commit the violation.
544 (c) Each day a violation continues after the date fixed for
545 termination of the violation as ordered by the department
546 constitutes an additional, separate, and distinct violation.
547 (d) The department may impose a fine and, in the case of an
548 owner-operated office surgery center, revoke or deny a center’s
549 registration if the center’s designated physician knowingly and
550 intentionally misrepresents actions taken to correct a
551 violation.
552 (e) An owner or designated physician of an office surgery
553 center who concurrently operates an unregistered center is
554 subject to an administrative fine of $5,000 per day.
555 (f) If the new owner of an office surgery center that
556 requires registration fails to apply to register the center upon
557 a change of ownership and operates the center under the new
558 ownership, the new owner is subject to a fine of $10,000.
559 Section 6. Subsection (2) of section 459.005, Florida
560 Statutes, is amended to read:
561 459.005 Rulemaking authority.—
562 (2) A physician who performs liposuction procedures in
563 which more than 1,000 cubic centimeters of supernatant fat is
564 removed, level 2 procedures lasting more than 5 minutes, and all
565 level 3 surgical procedures in an office setting must register
566 the office with the department unless that office is licensed as
567 a facility under chapter 395. The department shall inspect the
568 physician’s office annually unless the office is accredited by a
569 nationally recognized accrediting agency or an accrediting
570 organization subsequently approved by the Board of Osteopathic
571 Medicine. The actual costs for registration and inspection or
572 accreditation shall be paid by the person seeking to register
573 and operate the office setting in which office surgery is
574 performed.
575 Section 7. Section 459.0138, Florida Statutes, is created
576 to read:
577 459.0138 Office surgery centers.-
578 (1) DEFINITIONS.—As used in this section, the term:
579 (a) “Designated physician” means a physician licensed under
580 this chapter or chapter 458 who practices at the office surgery
581 center location for which the physician has assumed
582 responsibility for complying with all requirements in this
583 section and related rules of the board.
584 (b) “Office surgery center” means any facility where a
585 physician performs liposuction procedures in which more than
586 1,000 cubic centimeters of supernatant fat are removed, level 2
587 procedures lasting more than 5 minutes, and all level 3 surgical
588 procedures in an office setting, or any facility in which
589 surgery is performed outside of any facility licensed under
590 chapter 390 or chapter 395.
591 (2) REGISTRATION.—
592 (a) An office surgery center must register with the
593 department unless the center is:
594 1. Licensed as a facility pursuant to chapter 395; or
595 2. Affiliated with an accredited medical school at which
596 training is provided for medical students, residents, or
597 fellows.
598 (b) Office surgery center locations shall be registered
599 separately regardless of whether the center is operated under
600 the same business name or management as another center. The
601 actual costs for registration shall be paid by the person
602 seeking to register and operate the office surgery center in
603 which office surgery is performed.
604 (c) As a part of registration, an office surgery center
605 must have a designated physician. Within 10 days after
606 termination of a designated physician, the center must notify
607 the department of the identity of another designated physician
608 for that center. Failing to have a designated physician
609 practicing at the location of the registered center may result
610 in the suspension of the center’s certificate of registration,
611 as described in s. 456.073(8) or agency action under s.
612 120.60(6).
613 (d) The department shall deny registration to an office
614 surgery center that is:
615 1. Not fully owned by a physician licensed under this
616 chapter or chapter 458 or a group of physicians licensed under
617 this chapter or chapter 458;
618 2. Not a health care center licensed under part X of
619 chapter 400; or
620 3. Owned by or in any contractual or employment
621 relationship with a physician licensed under this chapter or
622 chapter 458 who:
623 a. Had hospital privileges revoked in the last 5 years.
624 b. Does not have a clear and active license with the
625 department; or
626 c. Had a license disciplined by the department or another
627 jurisdiction in the last 5 years for an offense related to
628 standard of care.
629 (e) If the department finds that an office surgery center
630 does not meet the requirements of paragraph (c) or is owned,
631 directly or indirectly, by a person meeting criteria listed in
632 paragraph (d), the department shall revoke the certificate of
633 registration previously issued by the department.
634 (f) The department may revoke an office surgery center’s
635 certificate of registration and prohibit all physicians
636 associated with the center from practicing at that location
637 based upon an annual inspection and evaluation of the factors
638 described in subsection (4).
639 (g) If the certificate of registration is revoked or
640 suspended, the designated physician of the center, the owner or
641 lessor of the center property, the manager, and the proprietor
642 shall:
643 1. Cease to operate the facility as an office surgery
644 center as of the effective date of the suspension or revocation.
645 2. Remove any signs and symbols identifying the premises as
646 an office surgery center.
647 (h) Upon the effective date of the suspension or
648 revocation, the designated physician of the office surgery
649 center shall advise the department of the disposition of the
650 medicinal drugs located on the premises. Such disposition is
651 subject to the supervision and approval of the department.
652 Medicinal drugs that are purchased or held by a center that is
653 not registered may be deemed adulterated pursuant to s. 499.006.
654 (i) If the office surgery center’s registration is revoked,
655 any person named in the registration documents of the center,
656 including persons owning or operating the center, may not, as an
657 individual or as a part of a group, apply to operate an office
658 surgery center for 5 years after the date the registration is
659 revoked.
660 (j) The period of suspension for the registration of an
661 office surgery center shall be prescribed by the department, but
662 may not exceed 2 years.
663 (k) A change of ownership of a registered office surgery
664 center requires submission of a new registration application. An
665 office surgery registration may not be transferred.
666 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
667 apply to any physician who provides professional services in an
668 office surgery center that is required to register with the
669 department in subsection (2).
670 (a)1. A physician may not practice medicine in an office
671 surgery center, as described in subsection (5), if the office
672 surgery center is not registered with the department as required
673 by this section. A physician who violates this paragraph is
674 subject to disciplinary action by his or her appropriate medical
675 regulatory board.
676 2. Surgical procedures performed in an office surgery
677 center may not include any procedure that may result in blood
678 loss of more than 10 percent of estimated blood volume in a
679 patient with a normal hemoglobin level; require major or
680 prolonged intracranial, intrathoracic, abdominal, or major joint
681 replacement procedures, except for laparoscopic procedures;
682 involve major blood vessels when such procedure is performed
683 with direct visualization by open exposure of the major vessel,
684 except for percutaneous endovascular intervention; or are
685 generally emergent or life-threatening in nature.
686 (b) The designated physician of an office surgery center
687 shall notify the applicable board in writing of the date of
688 termination of employment within 10 days after terminating his
689 or her employment with a center registered under subsection (2).
690 Each physician practicing in an office surgery center shall
691 notify the board, in writing, within 10 calendar days after
692 beginning or ending his or her practice at an office surgery
693 center.
694 (c) Each physician practicing in an office surgery center
695 is responsible for ensuring compliance with the following:
696 1. Facility and physical operations requirements,
697 including:
698 a. An office surgery center that is located and operated at
699 a publicly accessible, fixed location.
700 b. The public display of a visible printed sign that
701 clearly identifies the name, hours of operations, and street
702 address of the center.
703 c. Maintaining a publicly listed telephone number and other
704 methods of communication available to the public.
705 d. Emergency lighting and communications.
706 e. A reception and waiting area.
707 f. A restroom.
708 g. An administrative area, including room for storage of
709 medical records, supplies, and equipment.
710 h. Private patient examination rooms.
711 i. Treatment rooms, if treatment is being provided to the
712 patients.
713 j. The public display of a visible printed sign located in
714 a conspicuous place in the waiting room with the name and
715 contact information of the center’s designated physician and the
716 names of all physicians practicing in the center.
717 k. Compliance with ss. 499.0121 and 893.07, if the center
718 stores and dispenses prescription drugs.
719 2. Infection control requirements, including:
720 a. The maintenance of equipment and supplies to support
721 infection prevention and control.
722 b. The identification of infection risks that shall be
723 based on the following:
724 (I) Geographic location, community, and population served.
725 (II) The provided care, treatment, and services.
726 (III) An analysis of its infection surveillance and control
727 data.
728 c. Center maintenance of written infection prevention
729 policies and procedures that address prioritized risks and limit
730 the following:
731 (I) Unprotected exposure to pathogens.
732 (II) Transmission of infections associated with procedures
733 performed in the center.
734 (III) Transmission of infections associated with the
735 center’s use of medical equipment, devices, and supplies.
736 3. Health and safety requirements, including:
737 a. Being structurally sound, in good repair, clean, and
738 free from health and safety hazards, including grounds,
739 buildings, furniture, appliances, and equipment.
740 b. Having evacuation procedures in case of the event of an
741 emergency, which shall include provisions for the evacuation of
742 disabled patients and employees.
743 c. Having a written facility-specific disaster plan setting
744 forth actions to be taken in the event of center closure due to
745 unforeseen disasters and which shall include provisions for the
746 protection of medical records and any controlled substances.
747 d. Having at least one employee on the premises during
748 patient care hours who is certified in basic life support and is
749 trained in reacting to accidents and medical emergencies until
750 emergency medical personnel arrive.
751 (d) The designated physician of an office surgery center is
752 responsible for ensuring the center complies with the following
753 quality assurance requirements:
754 1. The center shall maintain an ongoing quality assurance
755 program that objectively and systematically monitors and
756 evaluates the quality and appropriateness of patient care,
757 evaluates methods to improve patient care, identifies and
758 corrects deficiencies within the facility, alerts the designated
759 physician to identify and resolve recurring problems, and
760 provides for opportunities to improve the facility’s performance
761 and to enhance and improve the quality of care provided to the
762 public.
763 2. The designated physician shall establish a quality
764 assurance program that includes the following components:
765 a. Identification, investigation, and analysis of the
766 frequency and causes of adverse incidents.
767 b. Identification of trends or patterns of adverse
768 incidents.
769 c. Development of measures to correct, reduce, minimize, or
770 eliminate the risk of adverse incidents to patients.
771 d. Documentation of the functions provided in this
772 subparagraph and periodic review no less than quarterly of such
773 information by the designated physician.
774 (e) The designated physician for each office surgery center
775 shall report all adverse incidents to the department as set
776 forth in s. 458.351.
777
778 This section does not excuse a physician from providing any
779 treatment or performing any medical duty without the proper
780 equipment and materials as required by the standard of care or
781 rules adopted by the board. This section does not supersede the
782 level of care, skill, and treatment recognized in general law
783 related to health care licensure.
784 (4) INSPECTION.—
785 (a) The department shall inspect each office surgery center
786 annually, including a review of the patient records, to ensure
787 that it complies with this section and the rules of the board
788 adopted pursuant to subsection (5) unless the center is
789 accredited by a nationally recognized accrediting agency or an
790 accrediting organization approved by the board.
791 (b) The actual costs for inspection or accreditation shall
792 be paid by the person seeking to register and operate the office
793 center in which office surgery is performed.
794 (c) During an onsite inspection, the department shall make
795 a reasonable attempt to discuss each violation with the owner or
796 designated physician of the office surgery center before issuing
797 a formal written notification.
798 (d) Any action taken to correct a violation shall be
799 documented in writing by the owner or designated physician of
800 the office surgery center and verified by follow-up inspections
801 by department personnel.
802 (5) RULEMAKING.—The board shall adopt rules:
803 (a) Necessary to administer the registration and inspection
804 of office surgery centers which establish the specific
805 requirements, procedures, forms, and fees.
806 (b) Setting forth training requirements for all facility
807 health care practitioners who are not regulated by another
808 board.
809 (6) PENALTIES; ENFORCEMENT.—
810 (a) The department may impose an administrative fine on an
811 office surgery center of up to $5,000 per violation for
812 violating the requirements of this section; chapter 499, the
813 Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
814 Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
815 the Comprehensive Drug Abuse Prevention and Control Act; chapter
816 893, the Florida Comprehensive Drug Abuse Prevention and Control
817 Act; or the rules of the department.
818 (b) In determining whether a penalty is to be imposed upon
819 a center, and in determining the amount of the fine, the
820 department shall consider the following factors:
821 1. The gravity of the violation, including the probability
822 that death or serious physical or emotional harm to a patient
823 has resulted, or could have resulted, from the center’s actions
824 or the actions of the physician; the severity of the action or
825 potential harm; and the extent to which the applicable laws or
826 rules were violated.
827 2. What actions, if any, the owner or designated physician
828 took to correct the violation.
829 3. Whether there were any previous violations at the
830 center.
831 4. The financial benefits that the center derived from
832 committing or continuing to commit the violation.
833 (c) Each day a violation continues after the date fixed for
834 termination of the violation as ordered by the department
835 constitutes an additional, separate, and distinct violation.
836 (d) The department may impose a fine and, in the case of an
837 owner-operated office surgery center, revoke or deny a center’s
838 registration if the center’s designated physician knowingly and
839 intentionally misrepresents actions taken to correct a
840 violation.
841 (e) An owner or designated physician of an office surgery
842 center who concurrently operates an unregistered center is
843 subject to an administrative fine of $5,000 per day.
844 (f) If the new owner of an office surgery center that
845 requires registration fails to apply to register the center upon
846 a change of ownership and operates the center under the new
847 ownership, the new owner is subject to a fine of $10,000.
848 Section 8. Section 460.4166, Florida Statutes, is repealed.
849 Section 9. Section 463.006, Florida Statutes, is amended to
850 read:
851 463.006 Licensure and certification by examination.—
852 (1) Any person desiring to be a licensed practitioner
853 pursuant to this chapter shall apply to the department to take
854 the licensure and certification examinations. The department
855 shall license examine each applicant who the board determines
856 has:
857 (a) Completed the application forms as required by the
858 board, remitted an application fee for certification not to
859 exceed $250, remitted an examination fee for certification not
860 to exceed $250, and remitted a an examination fee for licensure
861 not to exceed $325, all as set by the board.
862 (b) Submitted proof satisfactory to the department that she
863 or he:
864 1. Is at least 18 years of age.
865 2. Has graduated from an accredited school or college of
866 optometry approved by rule of the board.
867 3. Is of good moral character.
868 3.4. Has successfully completed at least 110 hours of
869 transcript-quality coursework and clinical training in general
870 and ocular pharmacology as determined by the board, at an
871 institution that:
872 a. Has facilities for both didactic and clinical
873 instructions in pharmacology; and
874 b. Is accredited by a regional or professional accrediting
875 organization that is recognized and approved by the Commission
876 on Recognition of Postsecondary Accreditation or the United
877 States Department of Education.
878 4.5. Has completed at least 1 year of supervised experience
879 in differential diagnosis of eye disease or disorders as part of
880 the optometric training or in a clinical setting as part of the
881 optometric experience.
882 5. Has obtained a passing score, as established by rule of
883 the board, on the licensure examination of the National Board of
884 Examiners in Optometry or a similar nationally recognized
885 examination approved by the board.
886 (2) The examination shall consist of the appropriate
887 subjects, including applicable state laws and rules and general
888 and ocular pharmacology with emphasis on the use and side
889 effects of ocular pharmaceutical agents. The board may by rule
890 substitute a national examination as part or all of the
891 examination and may by rule offer a practical examination in
892 addition to the written examination.
893 (2)(3) Each applicant who successfully passes the
894 examination and otherwise meets the requirements of this chapter
895 is entitled to be licensed as a practitioner and to be certified
896 to administer and prescribe ocular pharmaceutical agents in the
897 diagnosis and treatment of ocular conditions.
898 Section 10. Section 463.0061, Florida Statutes, is created
899 to read:
900 463.0061 Licensure by endorsement; requirements; fees.—
901 (1) Any person desiring to be a licensed practitioner
902 pursuant to this chapter shall apply to the department. The
903 department shall issue a license by endorsement to any applicant
904 who, upon applying to the department on forms furnished by the
905 department and remitting a nonrefundable application fee set by
906 the board not to exceed $250 and a licensure fee not to exceed
907 $325, the board certifies:
908 (a) Has graduated from an accredited school or college of
909 optometry accredited by a regional or professional accrediting
910 organization that is recognized and approved by the Commission
911 on Recognition of Postsecondary Accreditation or the United
912 States Department of Education.
913 (b) Has obtained an overall passing score, as established
914 by rule of the board, on the licensure examination of the
915 National Board of Examiners in Optometry or a similar nationally
916 recognized examination approved by the board.
917 (c) Has submitted evidence of an active, licensed practice
918 of optometry in another jurisdiction, for at least 5 of the
919 immediately preceding 7 years, or evidence of successful
920 completion of a board-approved clinical competency examination
921 within the year preceding the filing of an application for
922 licensure. For purposes of this paragraph, “active licensed
923 practice of optometry” means the practice of optometry by
924 optometrists, including those employed by any federal or state
925 governmental entity in community or public health.
926 (d) Has successfully completed the clinical skills portion
927 of the examination developed by the National Board of Examiners
928 in Optometry. In addition to an overall passing score on the
929 clinical skills portion, an applicant must obtain a score of 75
930 percent or better on each of the biomicroscopy, binocular
931 indirect ophthalmoscopy, and dilated biomicroscopy and
932 noncontact fundus lens evaluation skills individually.
933 (e) Has successfully completed a written examination on
934 applicable general laws and rules governing the practice of
935 optometry.
936 (f) Has obtained a passing score on either the Treatment
937 and Management of Ocular Disease examination in the Patient
938 Assessment and Management portion of the examination developed
939 by the National Board of Examiners in Optometry or the stand
940 alone Treatment and Management of Ocular Disease examination
941 developed by the National Board of Examiners in Optometry.
942 (2) The applicant shall submit evidence of completing a
943 total of at least 30 hours of board-approved continuing
944 education for the 2 calendar years immediately preceding
945 application.
946 (3) The department shall not issue a license by endorsement
947 to any applicant who is under investigation in any jurisdiction
948 for an act or offense which would constitute a violation of this
949 chapter until such time as the investigation is complete, at
950 which time the provisions of s. 463.016 shall apply.
951 Furthermore, the department may not issue an unrestricted
952 license to any individual who has committed any act or offense
953 in any jurisdiction constituting the basis for disciplining an
954 optometrist pursuant to s. 463.016. If the board finds that an
955 individual has committed an act or offense constituting the
956 basis for disciplining an optometrist pursuant to s. 463.016,
957 the board may enter an order imposing one or more of the terms
958 set forth in subsection (4).
959 (4) If the board determines that an applicant for licensure
960 by endorsement has failed to satisfy the appropriate
961 requirements in this section, it may enter an order that
962 requires one or more of the following actions:
963 (a) A refusal to certify to the department an application
964 for licensure or certification;
965 (b) A certification to the department of an application for
966 licensure or certification with restrictions on the scope of
967 practice of the licensee; or
968 (c) A certification to the department of an application for
969 licensure or certification with a probationary period subject to
970 conditions specified by the board, including, but not limited
971 to, requiring the optometrist to submit to treatment, attend
972 continuing education courses, submit to reexamination, or work
973 under the supervision of another licensed optometrist.
974 Section 11. Section 464.006, Florida Statutes, is amended
975 to read:
976 464.006 Rulemaking authority.—The board may has authority
977 to adopt rules pursuant to ss. 120.536(1) and 120.54 to
978 implement the provisions of this part conferring duties upon it
979 and establish standards of care.
980 Section 12. Section 464.202, Florida Statutes, is amended
981 to read:
982 464.202 Duties and powers of the board.—The board shall
983 maintain, or contract with or approve another entity to
984 maintain, a state registry of certified nursing assistants. The
985 registry must consist of the name of each certified nursing
986 assistant in this state; other identifying information defined
987 by board rule; certification status; the effective date of
988 certification; other information required by state or federal
989 law; information regarding any crime or any abuse, neglect, or
990 exploitation as provided under chapter 435; and any disciplinary
991 action taken against the certified nursing assistant. The
992 registry shall be accessible to the public, the
993 certificateholder, employers, and other state agencies. The
994 board shall adopt by rule testing procedures for use in
995 certifying nursing assistants and shall adopt rules regulating
996 the practice of certified nursing assistants, including
997 discipline and establishing standards of care, and specifying
998 the scope of practice authorized and the level of supervision
999 required for the practice of certified nursing assistants. The
1000 board may contract with or approve another entity or
1001 organization to provide the examination services, including the
1002 development and administration of examinations. The board shall
1003 require that the contract provider offer certified nursing
1004 assistant applications via the Internet, and may require the
1005 contract provider to accept certified nursing assistant
1006 applications for processing via the Internet. The board shall
1007 require the contract provider to provide the preliminary results
1008 of the certified nursing examination on the date the test is
1009 administered. The provider shall pay all reasonable costs and
1010 expenses incurred by the board in evaluating the provider’s
1011 application and performance during the delivery of services,
1012 including examination services and procedures for maintaining
1013 the certified nursing assistant registry.
1014 Section 13. Paragraph (c) of subsection (1) of section
1015 464.203, Florida Statutes, is amended to read:
1016 464.203 Certified nursing assistants; certification
1017 requirement.—
1018 (1) The board shall issue a certificate to practice as a
1019 certified nursing assistant to any person who demonstrates a
1020 minimum competency to read and write and successfully passes the
1021 required background screening pursuant to s. 400.215. If the
1022 person has successfully passed the required background screening
1023 pursuant to s. 400.215 or s. 408.809 within 90 days before
1024 applying for a certificate to practice and the person’s
1025 background screening results are not retained in the
1026 clearinghouse created under s. 435.12, the board shall waive the
1027 requirement that the applicant successfully pass an additional
1028 background screening pursuant to s. 400.215. The person must
1029 also meet one of the following requirements:
1030 (c) Is currently certified in another state or territory or
1031 the District of Columbia; is listed on that state’s certified
1032 nursing assistant registry; and has not been found to have
1033 committed abuse, neglect, or exploitation in that state.
1034 Section 14. Subsection (1) of section 464.204, Florida
1035 Statutes, is amended to read:
1036 464.204 Denial, suspension, or revocation of certification;
1037 disciplinary actions.—
1038 (1) The following acts constitute grounds for which the
1039 board may impose disciplinary sanctions as specified in
1040 subsection (2):
1041 (a) Obtaining or attempting to obtain certification or an
1042 exemption, or possessing or attempting to possess certification
1043 or a letter of exemption, by bribery, misrepresentation, deceit,
1044 or through an error of the board.
1045 (b) Intentionally Violating any provision of this chapter,
1046 chapter 456, or the rules adopted by the board.
1047 Section 15. Subsection (7) is added to section 465.019,
1048 Florida Statutes, to read:
1049 465.019 Institutional pharmacies; permits.—
1050 (7) An institutional pharmacy must pass an onsite
1051 inspection by the department as a prerequisite to the issuance
1052 of an initial permit or a permit for a change of location. The
1053 inspection must be completed within 90 days before the issuance
1054 of the permit.
1055 Section 16. Section 465.0193, Florida Statutes, is amended
1056 to read:
1057 465.0193 Nuclear pharmacy permits.—Any person desiring a
1058 permit to operate a nuclear pharmacy shall apply to the
1059 department. If the board certifies that the application complies
1060 with applicable law, the department shall issue the permit. No
1061 permit shall be issued unless a duly licensed and qualified
1062 nuclear pharmacist is designated as being responsible for
1063 activities described in s. 465.0126. A nuclear pharmacy must
1064 pass an onsite inspection by the department as a prerequisite to
1065 the issuance of an initial permit or a permit for a change of
1066 location. The inspection must be completed within 90 days before
1067 the issuance of the permit. The permittee shall notify the
1068 department within 10 days of any change of the licensed
1069 pharmacist responsible for the compounding and dispensing of
1070 nuclear pharmaceuticals.
1071 Section 17. Section 465.0195, Florida Statutes, is created
1072 to read:
1073 465.0195 Pharmacy or outsourcing facility; sterile
1074 compounding permit.—Before a pharmacy or outsourcing facility
1075 located in this state dispenses, creates, delivers, ships, or
1076 mails, in any manner, a compounded sterile product, the pharmacy
1077 or outsourcing facility must hold a sterile compounding permit.
1078 (1) An application for a sterile compounding permit shall
1079 be submitted on a form furnished by the board. The board may
1080 require such information as it deems reasonably necessary to
1081 carry out the purposes of this section.
1082 (2) If the board certifies that the application complies
1083 with applicable laws and rules of the board governing
1084 pharmacies, the department shall issue the permit.
1085 (3) A pharmacy or outsourcing facility must pass an onsite
1086 inspection by the department as a prerequisite to the issuance
1087 of an initial permit or a permit for a change of location. The
1088 inspection must be completed within 90 days before the issuance
1089 of the permit. The board may adopt by rule standards for
1090 conducting an onsite inspection for issuance of a sterile
1091 compounding permit.
1092 (4) A permit may not be issued unless a licensed pharmacist
1093 is designated to undertake the professional supervision of the
1094 compounding and dispensing of all drugs dispensed by the
1095 permittee.
1096 (5) A permittee must notify the department within 10 days
1097 after any change of the licensed pharmacist under subsection
1098 (4). Each permittee that employs or otherwise uses registered
1099 pharmacy technicians shall have a written policy and procedures
1100 manual specifying those duties, tasks, and functions that a
1101 registered pharmacy technician is authorized to perform.
1102 (6) The board may adopt by rule standards of practice for
1103 sterile compounding. In adopting such rules, the board shall
1104 give due consideration to the standards and requirements
1105 provided in chapter 797 of the United States Pharmacopeia, or
1106 other professionally accepted standards deemed authoritative by
1107 the board. In adopting such rules for an outsourcing facility,
1108 the board shall consider the standards and requirements of
1109 current good manufacturing practices as set forth by federal law
1110 and any other professionally accepted standards deemed
1111 authoritative by the board.
1112 (7) All provisions relating to pharmacy permits found in
1113 ss. 465.022 and 465.023 apply to permits issued pursuant to this
1114 section.
1115 Section 18. Section 465.0196, Florida Statutes, is amended
1116 to read:
1117 465.0196 Special pharmacy permits.—Any person desiring a
1118 permit to operate a special pharmacy shall apply to the
1119 department for a special pharmacy permit. If the board certifies
1120 that the application complies with the applicable laws and rules
1121 of the board governing the practice of the profession of
1122 pharmacy, the department shall issue the permit. A special
1123 pharmacy must pass an onsite inspection by the department as a
1124 prerequisite to the issuance of an initial permit or a permit
1125 for a change of location. The inspection must be completed
1126 within 90 days before the issuance of the permit. A permit may
1127 not be issued unless a licensed pharmacist is designated to
1128 undertake the professional supervision of the compounding and
1129 dispensing of all drugs dispensed by the pharmacy. The licensed
1130 pharmacist shall be responsible for maintaining all drug records
1131 and for providing for the security of the area in the facility
1132 in which the compounding, storing, and dispensing of medicinal
1133 drugs occurs. The permittee shall notify the department within
1134 10 days after any change of the licensed pharmacist responsible
1135 for such duties. Each permittee that employs or otherwise uses
1136 registered pharmacy technicians shall have a written policy and
1137 procedures manual specifying those duties, tasks, and functions
1138 that a registered pharmacy technician is allowed to perform.
1139 Section 19. Subsection (2) of section 465.0197, Florida
1140 Statutes, is amended to read:
1141 465.0197 Internet pharmacy permits.—
1142 (2) An Internet pharmacy must obtain a permit under this
1143 section to sell medicinal drugs to persons in this state. An
1144 Internet pharmacy must pass an onsite inspection by the
1145 department as a prerequisite to the issuance of an initial
1146 permit or a permit for a change of location. The inspection must
1147 be completed within 90 days before the issuance of the permit.
1148 Section 20. Subsection (4) of section 466.006, Florida
1149 Statutes, is amended to read:
1150 466.006 Examination of dentists.—
1151 (4) Notwithstanding any other provision of law in chapter
1152 456 pertaining to the clinical dental licensure examination or
1153 national examinations, to be licensed as a dentist in this
1154 state, an applicant must successfully complete the following:
1155 (a) A written examination on the laws and rules of the
1156 state regulating the practice of dentistry;
1157 (b)1. A practical or clinical examination, which shall be
1158 the American Dental Licensing Examination produced by the
1159 American Board of Dental Examiners, Inc., or its successor
1160 entity, if any, that is administered in this state and graded by
1161 dentists licensed in this state and employed by the department
1162 for just such purpose, provided that the board has attained, and
1163 continues to maintain thereafter, representation on the board of
1164 directors of the American Board of Dental Examiners, the
1165 examination development committee of the American Board of
1166 Dental Examiners, and such other committees of the American
1167 Board of Dental Examiners as the board deems appropriate by rule
1168 to assure that the standards established herein are maintained
1169 organizationally. A passing score on the American Dental
1170 Licensing Examination administered in this state and graded by
1171 dentists who are licensed in this state is valid for 365 days
1172 after the date the official examination results are published.
1173 2.a. As an alternative to the requirements of subparagraph
1174 1., an applicant may submit scores from an American Dental
1175 Licensing Examination previously administered in a jurisdiction
1176 other than this state after October 1, 2011, and such
1177 examination results shall be recognized as valid for the purpose
1178 of licensure in this state. A passing score on the American
1179 Dental Licensing Examination administered out-of-state shall be
1180 the same as the passing score for the American Dental Licensing
1181 Examination administered in this state and graded by dentists
1182 who are licensed in this state. The examination results are
1183 valid for 365 days after the date the official examination
1184 results are published. The applicant must have completed the
1185 examination after October 1, 2011.
1186 b. This subparagraph may not be given retroactive
1187 application.
1188 3. If the date of an applicant’s passing American Dental
1189 Licensing Examination scores from an examination previously
1190 administered in a jurisdiction other than this state under
1191 subparagraph 2. is older than 365 days, then such scores shall
1192 nevertheless be recognized as valid for the purpose of licensure
1193 in this state, but only if the applicant demonstrates that all
1194 of the following additional standards have been met:
1195 a.(I) The applicant completed the American Dental Licensing
1196 Examination after October 1, 2011.
1197 (II) This sub-subparagraph may not be given retroactive
1198 application;
1199 b. The applicant graduated from a dental school accredited
1200 by the American Dental Association Commission on Dental
1201 Accreditation or its successor entity, if any, or any other
1202 dental accrediting organization recognized by the United States
1203 Department of Education. Provided, however, if the applicant did
1204 not graduate from such a dental school, the applicant may submit
1205 proof of having successfully completed a full-time supplemental
1206 general dentistry program accredited by the American Dental
1207 Association Commission on Dental Accreditation of at least 2
1208 consecutive academic years at such accredited sponsoring
1209 institution. Such program must provide didactic and clinical
1210 education at the level of a D.D.S. or D.M.D. program accredited
1211 by the American Dental Association Commission on Dental
1212 Accreditation;
1213 c. The applicant currently possesses a valid and active
1214 dental license in good standing, with no restriction, which has
1215 never been revoked, suspended, restricted, or otherwise
1216 disciplined, from another state or territory of the United
1217 States, the District of Columbia, or the Commonwealth of Puerto
1218 Rico;
1219 d. The applicant submits proof that he or she has never
1220 been reported to the National Practitioner Data Bank, the
1221 Healthcare Integrity and Protection Data Bank, or the American
1222 Association of Dental Boards Clearinghouse. This sub
1223 subparagraph does not apply if the applicant successfully
1224 appealed to have his or her name removed from the data banks of
1225 these agencies;
1226 e.(I) In the 5 years immediately preceding the date of
1227 application for licensure in this state, the applicant must
1228 submit proof of having been consecutively engaged in the full
1229 time practice of dentistry in another state or territory of the
1230 United States, the District of Columbia, or the Commonwealth of
1231 Puerto Rico, or, if the applicant has been licensed in another
1232 state or territory of the United States, the District of
1233 Columbia, or the Commonwealth of Puerto Rico for less than 5
1234 years, the applicant must submit proof of having been engaged in
1235 the full-time practice of dentistry since the date of his or her
1236 initial licensure.
1237 (II) As used in this section, “full-time practice” is
1238 defined as a minimum of 1,200 hours per year for each and every
1239 year in the consecutive 5-year period or, where applicable, the
1240 period since initial licensure, and must include any combination
1241 of the following:
1242 (A) Active clinical practice of dentistry providing direct
1243 patient care.
1244 (B) Full-time practice as a faculty member employed by a
1245 dental or dental hygiene school approved by the board or
1246 accredited by the American Dental Association Commission on
1247 Dental Accreditation.
1248 (C) Full-time practice as a student at a postgraduate
1249 dental education program approved by the board or accredited by
1250 the American Dental Association Commission on Dental
1251 Accreditation.
1252 (III) The board shall develop rules to determine what type
1253 of proof of full-time practice is required and to recoup the
1254 cost to the board of verifying full-time practice under this
1255 section. Such proof must, at a minimum, be:
1256 (A) Admissible as evidence in an administrative proceeding;
1257 (B) Submitted in writing;
1258 (C) Submitted by the applicant under oath with penalties of
1259 perjury attached;
1260 (D) Further documented by an affidavit of someone unrelated
1261 to the applicant who is familiar with the applicant’s practice
1262 and testifies with particularity that the applicant has been
1263 engaged in full-time practice; and
1264 (E) Specifically found by the board to be both credible and
1265 admissible.
1266 (IV) An affidavit of only the applicant is not acceptable
1267 proof of full-time practice unless it is further attested to by
1268 someone unrelated to the applicant who has personal knowledge of
1269 the applicant’s practice. If the board deems it necessary to
1270 assess credibility or accuracy, the board may require the
1271 applicant or the applicant’s witnesses to appear before the
1272 board and give oral testimony under oath;
1273 f. The applicant must submit documentation that he or she
1274 has completed, or will complete, prior to licensure in this
1275 state, continuing education equivalent to this state’s
1276 requirements for the last full reporting biennium;
1277 g. The applicant must prove that he or she has never been
1278 convicted of, or pled nolo contendere to, regardless of
1279 adjudication, any felony or misdemeanor related to the practice
1280 of a health care profession in any jurisdiction;
1281 h. The applicant must successfully pass a written
1282 examination on the laws and rules of this state regulating the
1283 practice of dentistry and must successfully pass the computer
1284 based diagnostic skills examination; and
1285 i. The applicant must submit documentation that he or she
1286 has successfully completed the National Board of Dental
1287 Examiners dental examination.
1288 Section 21. Paragraph (b) of subsection (4) and paragraph
1289 (a) of subsection (6) of section 466.007, Florida Statutes, are
1290 amended to read:
1291 466.007 Examination of dental hygienists.—
1292 (4) Effective July 1, 2012, to be licensed as a dental
1293 hygienist in this state, an applicant must successfully complete
1294 the following:
1295 (b) A practical or clinical examination approved by the
1296 board. The examination shall be the Dental Hygiene Examination
1297 produced by the American Board of Dental Examiners, Inc. (ADEX)
1298 or its successor entity, if any, if the board finds that the
1299 successor entity’s clinical examination meets or exceeds the
1300 provisions of this section. The board shall approve the ADEX
1301 Dental Hygiene Examination if the board has attained and
1302 continues to maintain representation on the ADEX House of
1303 Representatives, the ADEX Dental Hygiene Examination Development
1304 Committee, and such other ADEX Dental Hygiene committees as the
1305 board deems appropriate through rulemaking to ensure that the
1306 standards established in this section are maintained
1307 organizationally. The ADEX Dental Hygiene Examination or the
1308 examination produced by its successor entity is a comprehensive
1309 examination in which an applicant must demonstrate skills within
1310 the dental hygiene scope of practice on a live patient and any
1311 other components that the board deems necessary for the
1312 applicant to successfully demonstrate competency for the purpose
1313 of licensure. The ADEX Dental Hygiene Examination or the
1314 examination by the successor entity administered in this state
1315 shall be graded by dentists and dental hygienists licensed in
1316 this state who are employed by the department for this purpose.
1317 (6)(a) A passing score on the ADEX Dental Hygiene
1318 Examination administered out of state shall be considered the
1319 same as a passing score for the ADEX Dental Hygiene Examination
1320 administered in this state and graded by licensed dentists and
1321 dental hygienists.
1322 Section 22. Subsections (9) through (15) are added to
1323 section 466.017, Florida Statutes, to read:
1324 466.017 Prescription of drugs; anesthesia.—
1325 (9) Any adverse incident that occurs in an office
1326 maintained by a dentist must be reported to the department. The
1327 required notification to the department must be submitted in
1328 writing by certified mail and postmarked within 48 hours after
1329 the incident occurs.
1330 (10) A dentist practicing in this state must notify the
1331 board in writing by certified mail within 48 hours of any
1332 mortality or other adverse incident that occurs in the dentist’s
1333 outpatient facility. A complete written report must be filed
1334 with the board within 30 days after the mortality or other
1335 adverse incident.
1336 (11) For purposes of notification to the department
1337 pursuant to this section, the term “adverse incident” means any
1338 mortality that occurs during or as the result of a dental
1339 procedure, or an incident that results in a temporary or
1340 permanent physical or mental injury that requires
1341 hospitalization or emergency room treatment of a dental patient
1342 which occurred during or as a direct result of the use of
1343 general anesthesia, deep sedation, conscious sedation, pediatric
1344 conscious sedation, oral sedation, minimal sedation
1345 (anxiolysis), nitrous oxide, or local anesthesia.
1346 (12) Any certified registered dental hygienist
1347 administering local anesthesia must notify the board, in writing
1348 by registered mail within 48 hours of any adverse incident that
1349 was related to or the result of the administration of local
1350 anesthesia. A complete written report must be filed with the
1351 board within 30 days after the mortality or other adverse
1352 incident.
1353 (13) A failure by the dentist or dental hygienist to timely
1354 and completely comply with all the reporting requirements in
1355 this section is the basis for disciplinary action by the board
1356 pursuant to s. 466.028(1).
1357 (14) The department shall review each incident and
1358 determine whether it involved conduct by a health care
1359 professional subject to disciplinary action, in which case s.
1360 456.073 applies. Disciplinary action, if any, shall be taken by
1361 the board under which the health care professional is licensed.
1362 (15) The board may adopt rules to administer this section.
1363 Section 23. Sections 466.032, 466.033, 466.034, 466.035,
1364 466.036, 466.037, 466.038, and 466.039, Florida Statutes, are
1365 repealed.
1366 Section 24. Subsection (1) of section 468.701, Florida
1367 Statutes, is amended to read:
1368 468.701 Definitions.—As used in this part, the term:
1369 (1) “Athletic trainer” means a person licensed under this
1370 part who has met the requirements under this part, including
1371 education requirements as set forth by the Commission on
1372 Accreditation of Athletic Training Education or its successor
1373 and necessary credentials from the Board of Certification. An
1374 athletic trainer must work within his or her scope of practice
1375 as established in the rules adopted by the board under s.
1376 468.705. An individual who is licensed as an athletic trainer
1377 may not otherwise provide, offer to provide, or represent that
1378 he or she is qualified to provide any care or services beyond
1379 his or her scope of practice, or that he or she lacks the
1380 education, training, or experience to provide, or that he or she
1381 is otherwise prohibited by law from providing.
1382 Section 25. Section 468.707, Florida Statutes, is amended
1383 to read:
1384 468.707 Licensure requirements.—Any person desiring to be
1385 licensed as an athletic trainer shall apply to the department on
1386 a form approved by the department. An applicant shall also
1387 provide records or other evidence, as determined by the board,
1388 to prove he or she has met the requirements of this section. The
1389 department shall license each applicant who:
1390 (1) Has completed the application form and remitted the
1391 required fees.
1392 (2) For a person who applies on or after July 1, 2016, Has
1393 submitted to background screening pursuant to s. 456.0135. The
1394 board may require a background screening for an applicant whose
1395 license has expired or who is undergoing disciplinary action.
1396 (3)(a) Has obtained a baccalaureate or higher degree from a
1397 college or university professional athletic training degree
1398 program accredited by the Commission on Accreditation of
1399 Athletic Training Education or its successor recognized and
1400 approved by the United States Department of Education or the
1401 Commission on Recognition of Postsecondary Accreditation,
1402 approved by the board, or recognized by the Board of
1403 Certification, and has passed the national examination to be
1404 certified by the Board of Certification; or.
1405 (b)(4) Has obtained, at a minimum, a bachelor’s degree and
1406 has completed the Board of Certification internship requirements
1407 and If graduated before 2004, has a current certification from
1408 the Board of Certification.
1409 (4)(5) Has current certification in both cardiopulmonary
1410 resuscitation and the use of an automated external defibrillator
1411 set forth in the continuing education requirements as determined
1412 by the board pursuant to s. 468.711.
1413 (5)(6) Has completed any other requirements as determined
1414 by the department and approved by the board.
1415 Section 26. Subsection (3) of section 468.711, Florida
1416 Statutes, is amended to read:
1417 468.711 Renewal of license; continuing education.—
1418 (3) If initially licensed after January 1, 1998, the
1419 licensee must be currently certified by the Board of
1420 Certification or its successor agency and maintain that
1421 certification in good standing without lapse.
1422 Section 27. Subsection (2) of section 468.723, Florida
1423 Statutes, is amended to read:
1424 468.723 Exemptions.—This part does not prevent or restrict:
1425 (2) An athletic training student acting under the direct
1426 supervision of a licensed athletic trainer. For purposes of this
1427 subsection, “direct supervision” means the physical presence of
1428 an athletic trainer so that the athletic trainer is immediately
1429 available to the athletic training student and able to intervene
1430 on behalf of the athletic training student. The supervision must
1431 be in accordance with rules adopted by the board the standards
1432 set forth by the Commission on Accreditation of Athletic
1433 Training Education or its successor.
1434 Section 28. Subsections (1), (3), and (4) of section
1435 468.803, Florida Statutes, are amended to read:
1436 468.803 License, registration, and examination
1437 requirements.—
1438 (1) The department shall issue a license to practice
1439 orthotics, prosthetics, or pedorthics, or a registration for a
1440 resident to practice orthotics or prosthetics, to qualified
1441 applicants. Licenses shall be granted independently in
1442 orthotics, prosthetics, or pedorthics, but a person may be
1443 licensed in more than one such discipline, and a prosthetist
1444 orthotist license may be granted to persons meeting the
1445 requirements for both a prosthetist and an orthotist license.
1446 Registrations shall be granted independently in orthotics or
1447 prosthetics, and a person may be registered in both fields at
1448 the same time or jointly in orthotics and prosthetics as a dual
1449 registration.
1450 (3) A person seeking to attain the required orthotics or
1451 prosthetics experience in this state must be approved by the
1452 board and registered as a resident by the department. Although a
1453 registration may be held in both practice fields, for
1454 independent registrations, the board shall not approve a second
1455 registration until at least 1 year after the issuance of the
1456 first registration. Notwithstanding subsection (2), an applicant
1457 for independent registrations who has been approved by the board
1458 and registered by the department in one practice field may apply
1459 for registration in the second practice field without an
1460 additional state or national criminal history check during the
1461 period in which the first registration is valid. Each
1462 independent registration or dual registration is valid for 2
1463 years from the date of issuance unless otherwise revoked by the
1464 department upon recommendation of the board. The board shall set
1465 a registration fee not to exceed $500 to be paid by the
1466 applicant. A registration may be renewed once by the department
1467 upon recommendation of the board for a period no longer than 1
1468 year, as such renewal is defined by the board by rule. The
1469 registration renewal fee shall not exceed one-half the current
1470 registration fee. To be considered by the board for approval of
1471 registration as a resident, the applicant must have:
1472 (a) A Bachelor of Science or higher-level postgraduate
1473 degree in Orthotics and Prosthetics from a regionally accredited
1474 college or university recognized by the Commission on
1475 Accreditation of Allied Health Education Programs or, at a
1476 minimum, a bachelor’s degree from a regionally accredited
1477 college or university and a certificate in orthotics from a
1478 program recognized by the Commission on Accreditation of Allied
1479 Health Education Programs, or its equivalent, as determined by
1480 the board; or
1481 (b) A Bachelor of Science or higher-level postgraduate
1482 degree in Orthotics and Prosthetics from a regionally accredited
1483 college or university recognized by the Commission on
1484 Accreditation of Allied Health Education Programs or, at a
1485 minimum, a bachelor’s degree from a regionally accredited
1486 college or university and a certificate in prosthetics from a
1487 program recognized by the Commission on Accreditation of Allied
1488 Health Education Programs, or its equivalent, as determined by
1489 the board; or
1490 (c) A Bachelor of Science or higher-level postgraduate
1491 degree in Orthotics and Prosthetics from a regionally accredited
1492 college or university recognized by the Commission on
1493 Accreditation of Allied Health Education Programs or, at a
1494 minimum, a bachelor’s degree from a regionally accredited
1495 college or university and a dual certificate in both orthotics
1496 and prosthetics from a program recognized by the Commission on
1497 Accreditation of Allied Health Education Programs, or its
1498 equivalent, as determined by the board.
1499 (4) The department may develop and administer a state
1500 examination for an orthotist or a prosthetist license, or the
1501 board may approve the existing examination of a national
1502 standards organization. The examination must be predicated on a
1503 minimum of a baccalaureate-level education and formalized
1504 specialized training in the appropriate field. Each examination
1505 must demonstrate a minimum level of competence in basic
1506 scientific knowledge, written problem solving, and practical
1507 clinical patient management. The board shall require an
1508 examination fee not to exceed the actual cost to the board in
1509 developing, administering, and approving the examination, which
1510 fee must be paid by the applicant. To be considered by the board
1511 for examination, the applicant must have:
1512 (a) For an examination in orthotics:
1513 1. A Bachelor of Science or higher-level postgraduate
1514 degree in Orthotics and Prosthetics from a regionally accredited
1515 college or university recognized by the Commission on
1516 Accreditation of Allied Health Education Programs or, at a
1517 minimum, a bachelor’s degree from a regionally accredited
1518 college or university and a certificate in orthotics from a
1519 program recognized by the Commission on Accreditation of Allied
1520 Health Education Programs, or its equivalent, as determined by
1521 the board; and
1522 2. An approved orthotics internship of 1 year of qualified
1523 experience, as determined by the board, or an orthotic residency
1524 program or a dual residency program recognized by the board.
1525 (b) For an examination in prosthetics:
1526 1. A Bachelor of Science or higher-level postgraduate
1527 degree in Orthotics and Prosthetics from a regionally accredited
1528 college or university recognized by the Commission on
1529 Accreditation of Allied Health Education Programs or, at a
1530 minimum, a bachelor’s degree from a regionally accredited
1531 college or university and a certificate in prosthetics from a
1532 program recognized by the Commission on Accreditation of Allied
1533 Health Education Programs, or its equivalent, as determined by
1534 the board; and
1535 2. An approved prosthetics internship of 1 year of
1536 qualified experience, as determined by the board, or a
1537 prosthetic residency program or dual residency program
1538 recognized by the board.
1539 Section 29. Subsection (5) of section 480.033, Florida
1540 Statutes, is amended to read:
1541 480.033 Definitions.—As used in this act:
1542 (5) “Apprentice” means a person approved by the board to
1543 study colonic irrigation massage under the instruction of a
1544 licensed massage therapist practicing colonic irrigation.
1545 Section 30. Subsections (1) and (2) of section 480.041,
1546 Florida Statutes, are amended, and subsection (8) is added to
1547 that section, to read:
1548 480.041 Massage therapists; qualifications; licensure;
1549 endorsement.—
1550 (1) Any person is qualified for licensure as a massage
1551 therapist under this act who:
1552 (a) Is at least 18 years of age or has received a high
1553 school diploma or high school equivalency diploma;
1554 (b) Has completed a course of study at a board-approved
1555 massage school or has completed an apprenticeship program that
1556 meets standards adopted by the board; and
1557 (c) Has received a passing grade on a national an
1558 examination designated administered by the board department.
1559 (2) Every person desiring to be examined for licensure as a
1560 massage therapist shall apply to the department in writing upon
1561 forms prepared and furnished by the department. Such applicants
1562 shall be subject to the provisions of s. 480.046(1). Applicants
1563 may take an examination administered by the department only upon
1564 meeting the requirements of this section as determined by the
1565 board.
1566 (8) A person issued a license as a massage apprentice
1567 before July 1, 2018, may continue that apprenticeship and
1568 perform massage therapy as permitted under that license until it
1569 expires. Upon completion of the apprenticeship, before July 1,
1570 2021, a massage apprentice may apply to the board for full
1571 licensure and be granted a license if all other applicable
1572 licensure requirements are met.
1573 Section 31. Section 480.042, Florida Statutes, is repealed.
1574 Section 32. Subsection (3) of section 480.046, Florida
1575 Statutes, is amended, and subsection (5) is added to that
1576 section, to read:
1577 480.046 Grounds for disciplinary action by the board.—
1578 (3) The board may shall have the power to revoke or suspend
1579 the license of a massage establishment licensed under this act,
1580 or to deny subsequent licensure of such an establishment, if the
1581 establishment is owned by an individual or entity who has had a
1582 prior establishment license revoked, in either of the following
1583 cases:
1584 (a) Upon proof that a license has been obtained by fraud or
1585 misrepresentation.
1586 (b) Upon proof that the holder of a license is guilty of
1587 fraud or deceit or of gross negligence, incompetency, or
1588 misconduct in the operation of the establishment so licensed.
1589 (c) Upon proof that the owner of the massage establishment
1590 or any individual or individuals providing massage therapy
1591 services within the establishment, in the aggregate or
1592 individually, have had three convictions of, or pleas of guilty
1593 or nolo contendere to, or dismissals of a criminal action after
1594 a successful completion of a pretrial intervention, diversion,
1595 or substance abuse program for any misdemeanor or felony,
1596 regardless of adjudication, a crime in any jurisdiction related
1597 to prostitution and related acts as defined in s. 796.07, which
1598 occurred at or within the establishment.
1599 (5) An establishment may not apply for relicensure if
1600 disciplined under this section unless there is a change in
1601 ownership.
1602 Section 33. Section 483.824, Florida Statutes, is amended
1603 to read:
1604 483.824 Qualifications of clinical laboratory director.—A
1605 clinical laboratory director must qualify as a clinical
1606 laboratory director according to 42 C.F.R. part 493, must be a
1607 currently licensed laboratory director, have 4 years of clinical
1608 laboratory experience with 2 years of experience in the
1609 specialty to be directed or be nationally board certified in the
1610 specialty to be directed, and must meet one of the following
1611 requirements:
1612 (1) Be a physician licensed under chapter 458 or chapter
1613 459;
1614 (2) Hold an earned doctoral degree in a chemical, physical,
1615 or biological science from a regionally accredited institution
1616 and maintain national certification requirements equal to those
1617 required by the federal Centers for Medicare and Medicaid
1618 Services or the federal Health Care Financing Administration; or
1619 (3) For the subspecialty of oral pathology, be a physician
1620 licensed under chapter 458 or chapter 459 or a dentist licensed
1621 under chapter 466. The laboratory director, if qualified, may
1622 perform the duties of the technical supervisor, clinical
1623 consultant, general supervisor, and testing personnel, or
1624 delegate these responsibilities to personnel meeting the
1625 qualifications under 42 C.F.R. ss. 493.1447, 493.1453, 493.1459,
1626 and 493.1487.
1627 Section 34. Subsection (3) of section 490.003, Florida
1628 Statutes, is amended to read:
1629 490.003 Definitions.—As used in this chapter:
1630 (3)(a) Prior to July 1, 1999, “doctoral-level psychological
1631 education” and “doctoral degree in psychology” mean a Psy.D., an
1632 Ed.D. in psychology, or a Ph.D. in psychology from:
1633 1. An educational institution which, at the time the
1634 applicant was enrolled and graduated, had institutional
1635 accreditation from an agency recognized and approved by the
1636 United States Department of Education or was recognized as a
1637 member in good standing with the Association of Universities and
1638 Colleges of Canada; and
1639 2. A psychology program within that educational institution
1640 which, at the time the applicant was enrolled and graduated, had
1641 programmatic accreditation from an accrediting agency recognized
1642 and approved by the United States Department of Education or was
1643 comparable to such programs.
1644 (b) Effective July 1, 1999, “doctoral-level psychological
1645 education” and “doctoral degree in psychology” mean a Psy.D., an
1646 Ed.D. in psychology, or a Ph.D. in psychology from:
1647 (a)1. An educational institution that which, at the time
1648 the applicant was enrolled and graduated, had institutional
1649 accreditation from an agency recognized and approved by the
1650 United States Department of Education or was recognized as a
1651 member in good standing with the Association of Universities and
1652 Colleges of Canada; and
1653 (b)2. A psychology program within that educational
1654 institution which, at the time the applicant was enrolled and
1655 graduated, had programmatic accreditation from the American
1656 Psychological Association an agency recognized and approved by
1657 the United States Department of Education.
1658 Section 35. Paragraph (b) of subsection (1) and paragraph
1659 (b) of subsection (2) of section 490.005, Florida Statutes, are
1660 amended to read:
1661 490.005 Licensure by examination.—
1662 (1) Any person desiring to be licensed as a psychologist
1663 shall apply to the department to take the licensure examination.
1664 The department shall license each applicant who the board
1665 certifies has:
1666 (b) Submitted proof satisfactory to the board that the
1667 applicant has:
1668 1. Received doctoral-level psychological education, as
1669 defined in s. 490.003(3); or
1670 2. Received the equivalent of a doctoral-level
1671 psychological education, as defined in s. 490.003(3), from a
1672 program at a school or university located outside the United
1673 States of America and Canada, which was officially recognized by
1674 the government of the country in which it is located as an
1675 institution or program to train students to practice
1676 professional psychology. The burden of establishing that the
1677 requirements of this provision have been met shall be upon the
1678 applicant;
1679 3. Received and submitted to the board, prior to July 1,
1680 1999, certification of an augmented doctoral-level psychological
1681 education from the program director of a doctoral-level
1682 psychology program accredited by a programmatic agency
1683 recognized and approved by the United States Department of
1684 Education; or
1685 4. Received and submitted to the board, prior to August 31,
1686 2001, certification of a doctoral-level program that at the time
1687 the applicant was enrolled and graduated maintained a standard
1688 of education and training comparable to the standard of training
1689 of programs accredited by a programmatic agency recognized and
1690 approved by the United States Department of Education. Such
1691 certification of comparability shall be provided by the program
1692 director of a doctoral-level psychology program accredited by a
1693 programmatic agency recognized and approved by the United States
1694 Department of Education.
1695 (2) Any person desiring to be licensed as a school
1696 psychologist shall apply to the department to take the licensure
1697 examination. The department shall license each applicant who the
1698 department certifies has:
1699 (b) Submitted satisfactory proof to the department that the
1700 applicant:
1701 1. Has received a doctorate, specialist, or equivalent
1702 degree from a program primarily psychological in nature and has
1703 completed 60 semester hours or 90 quarter hours of graduate
1704 study, in areas related to school psychology as defined by rule
1705 of the department, from a college or university which at the
1706 time the applicant was enrolled and graduated was accredited by
1707 an accrediting agency recognized and approved by the Council for
1708 Higher Education Accreditation, its successor, Commission on
1709 Recognition of Postsecondary Accreditation or an institution
1710 which is publicly recognized as a member in good standing with
1711 the Association of Universities and Colleges of Canada.
1712 2. Has had a minimum of 3 years of experience in school
1713 psychology, 2 years of which must be supervised by an individual
1714 who is a licensed school psychologist or who has otherwise
1715 qualified as a school psychologist supervisor, by education and
1716 experience, as set forth by rule of the department. A doctoral
1717 internship may be applied toward the supervision requirement.
1718 3. Has passed an examination provided by the department.
1719 Section 36. Subsection (1) of section 490.006, Florida
1720 Statutes, is amended to read:
1721 490.006 Licensure by endorsement.—
1722 (1) The department shall license a person as a psychologist
1723 or school psychologist who, upon applying to the department and
1724 remitting the appropriate fee, demonstrates to the department
1725 or, in the case of psychologists, to the board that the
1726 applicant:
1727 (a) Holds a valid license or certificate in another state
1728 to practice psychology or school psychology, as applicable,
1729 provided that, when the applicant secured such license or
1730 certificate, the requirements were substantially equivalent to
1731 or more stringent than those set forth in this chapter at that
1732 time; and, if no Florida law existed at that time, then the
1733 requirements in the other state must have been substantially
1734 equivalent to or more stringent than those set forth in this
1735 chapter at the present time;
1736 (a)(b) Is a diplomate in good standing with the American
1737 Board of Professional Psychology, Inc.; or
1738 (b)(c) Possesses a doctoral degree in psychology as
1739 described in s. 490.003 and has at least 10 20 years of
1740 experience as a licensed psychologist in any jurisdiction or
1741 territory of the United States within 25 years preceding the
1742 date of application.
1743 Section 37. Subsection (6) of section 491.0045, Florida
1744 Statutes, as amended by chapter 2016-80 and chapter 2016-241,
1745 Laws of Florida, is amended to read:
1746 491.0045 Intern registration; requirements.—
1747 (6) A registration issued on or before March 31, 2017,
1748 expires March 31, 2022, and may not be renewed or reissued. Any
1749 registration issued after March 31, 2017, expires 60 months
1750 after the date it is issued. The board may make a one-time
1751 exception from the requirements of this section in emergency or
1752 hardship cases, as defined by board rule, if A subsequent intern
1753 registration may not be issued unless the candidate has passed
1754 the theory and practice examination described in s.
1755 491.005(1)(d), (3)(d), and (4)(d).
1756 Section 38. Subsections (3) and (4) of section 491.005,
1757 Florida Statutes, are amended to read:
1758 491.005 Licensure by examination.—
1759 (3) MARRIAGE AND FAMILY THERAPY.—Upon verification of
1760 documentation and payment of a fee not to exceed $200, as set by
1761 board rule, plus the actual cost to the department for the
1762 purchase of the examination from the Association of Marital and
1763 Family Therapy Regulatory Board, or similar national
1764 organization, the department shall issue a license as a marriage
1765 and family therapist to an applicant who the board certifies:
1766 (a) Has submitted an application and paid the appropriate
1767 fee.
1768 (b)1. Has a minimum of a master’s degree with major
1769 emphasis in marriage and family therapy from a program
1770 accredited by the Commission on Accreditation for Marriage and
1771 Family Therapy Education or from a Florida university program
1772 accredited by the Council for Accreditation of Counseling and
1773 Related Educational Programs, or a closely related field, and
1774 has completed graduate courses approved by the Board of Clinical
1775 Social Work, Marriage and Family Therapy, and Mental Health
1776 Counseling. has completed all of the following requirements:
1777 a. Thirty-six semester hours or 48 quarter hours of
1778 graduate coursework, which must include a minimum of 3 semester
1779 hours or 4 quarter hours of graduate-level course credits in
1780 each of the following nine areas: dynamics of marriage and
1781 family systems; marriage therapy and counseling theory and
1782 techniques; family therapy and counseling theory and techniques;
1783 individual human development theories throughout the life cycle;
1784 personality theory or general counseling theory and techniques;
1785 psychopathology; human sexuality theory and counseling
1786 techniques; psychosocial theory; and substance abuse theory and
1787 counseling techniques. Courses in research, evaluation,
1788 appraisal, assessment, or testing theories and procedures;
1789 thesis or dissertation work; or practicums, internships, or
1790 fieldwork may not be applied toward this requirement.
1791 b. A minimum of one graduate-level course of 3 semester
1792 hours or 4 quarter hours in legal, ethical, and professional
1793 standards issues in the practice of marriage and family therapy
1794 or a course determined by the board to be equivalent.
1795 c. A minimum of one graduate-level course of 3 semester
1796 hours or 4 quarter hours in diagnosis, appraisal, assessment,
1797 and testing for individual or interpersonal disorder or
1798 dysfunction; and a minimum of one 3-semester-hour or 4-quarter
1799 hour graduate-level course in behavioral research which focuses
1800 on the interpretation and application of research data as it
1801 applies to clinical practice. Credit for thesis or dissertation
1802 work, practicums, internships, or fieldwork may not be applied
1803 toward this requirement.
1804 d. A minimum of one supervised clinical practicum,
1805 internship, or field experience in a marriage and family
1806 counseling setting, during which the student provided 180 direct
1807 client contact hours of marriage and family therapy services
1808 under the supervision of an individual who met the requirements
1809 for supervision under paragraph (c). This requirement may be met
1810 by a supervised practice experience which took place outside the
1811 academic arena, but which is certified as equivalent to a
1812 graduate-level practicum or internship program which required a
1813 minimum of 180 direct client contact hours of marriage and
1814 family therapy services currently offered within an academic
1815 program of a college or university accredited by an accrediting
1816 agency approved by the United States Department of Education, or
1817 an institution which is publicly recognized as a member in good
1818 standing with the Association of Universities and Colleges of
1819 Canada or a training institution accredited by the Commission on
1820 Accreditation for Marriage and Family Therapy Education
1821 recognized by the United States Department of Education.
1822 Certification shall be required from an official of such
1823 college, university, or training institution.
1824 2. If the course title which appears on the applicant’s
1825 transcript does not clearly identify the content of the
1826 coursework, the applicant shall be required to provide
1827 additional documentation, including, but not limited to, a
1828 syllabus or catalog description published for the course.
1829
1830 The required master’s degree must have been received in an
1831 institution of higher education which at the time the applicant
1832 graduated was: fully accredited by a regional accrediting body
1833 recognized by the Commission on Recognition of Postsecondary
1834 Accreditation; publicly recognized as a member in good standing
1835 with the Association of Universities and Colleges of Canada; or
1836 an institution of higher education located outside the United
1837 States and Canada, which at the time the applicant was enrolled
1838 and at the time the applicant graduated maintained a standard of
1839 training substantially equivalent to the standards of training
1840 of those institutions in the United States which are accredited
1841 by a regional accrediting body recognized by the Commission on
1842 Recognition of Postsecondary Accreditation. Such foreign
1843 education and training must have been received in an institution
1844 or program of higher education officially recognized by the
1845 government of the country in which it is located as an
1846 institution or program to train students to practice as
1847 professional marriage and family therapists or psychotherapists.
1848 The burden of establishing that the requirements of this
1849 provision have been met shall be upon the applicant, and the
1850 board shall require documentation, such as, but not limited to,
1851 an evaluation by a foreign equivalency determination service, as
1852 evidence that the applicant’s graduate degree program and
1853 education were equivalent to an accredited program in this
1854 country. An applicant with a master’s degree from a program
1855 which did not emphasize marriage and family therapy may complete
1856 the coursework requirement in a training institution fully
1857 accredited by the Commission on Accreditation for Marriage and
1858 Family Therapy Education recognized by the United States
1859 Department of Education.
1860 (c) Has had at least 2 years of clinical experience during
1861 which 50 percent of the applicant’s clients were receiving
1862 marriage and family therapy services, which must be at the post
1863 master’s level under the supervision of a licensed marriage and
1864 family therapist with at least 5 years of experience, or the
1865 equivalent, who is a qualified supervisor as determined by the
1866 board. An individual who intends to practice in Florida to
1867 satisfy the clinical experience requirements must register
1868 pursuant to s. 491.0045 before commencing practice. If a
1869 graduate has a master’s degree with a major emphasis in marriage
1870 and family therapy or a closely related field that did not
1871 include all the coursework required under subparagraph (b)1.
1872 sub-subparagraphs (b)1.a.-c., credit for the post-master’s level
1873 clinical experience shall not commence until the applicant has
1874 completed a minimum of 10 of the courses required under
1875 subparagraph (b)1. sub-subparagraphs (b)1.a.-c., as determined
1876 by the board, and at least 6 semester hours or 9 quarter hours
1877 of the course credits must have been completed in the area of
1878 marriage and family systems, theories, or techniques. Within the
1879 2 3 years of required experience, the applicant shall provide
1880 direct individual, group, or family therapy and counseling, to
1881 include the following categories of cases: unmarried dyads,
1882 married couples, separating and divorcing couples, and family
1883 groups including children. A doctoral internship may be applied
1884 toward the clinical experience requirement. A licensed mental
1885 health professional must be on the premises when clinical
1886 services are provided by a registered intern in a private
1887 practice setting.
1888 (d) Has passed a theory and practice examination provided
1889 by the department for this purpose.
1890 (e) Has demonstrated, in a manner designated by rule of the
1891 board, knowledge of the laws and rules governing the practice of
1892 clinical social work, marriage and family therapy, and mental
1893 health counseling.
1894 (f) For the purposes of dual licensure, the department
1895 shall license as a marriage and family therapist any person who
1896 meets the requirements of s. 491.0057. Fees for dual licensure
1897 shall not exceed those stated in this subsection.
1898 (4) MENTAL HEALTH COUNSELING.—Upon verification of
1899 documentation and payment of a fee not to exceed $200, as set by
1900 board rule, plus the actual per applicant cost to the department
1901 for purchase of the examination from the National Board for
1902 Certified Counselors or its successor Professional Examination
1903 Service for the National Academy of Certified Clinical Mental
1904 Health Counselors or a similar national organization, the
1905 department shall issue a license as a mental health counselor to
1906 an applicant who the board certifies:
1907 (a) Has submitted an application and paid the appropriate
1908 fee.
1909 (b)1. Has a minimum of an earned master’s degree from a
1910 mental health counseling program accredited by the Council for
1911 the Accreditation of Counseling and Related Educational Programs
1912 that consists of at least 60 semester hours or 80 quarter hours
1913 of clinical and didactic instruction, including a course in
1914 human sexuality and a course in substance abuse. If the master’s
1915 degree is earned from a program related to the practice of
1916 mental health counseling that is not accredited by the Council
1917 for the Accreditation of Counseling and Related Educational
1918 Programs, then the coursework and practicum, internship, or
1919 fieldwork must consist of at least 60 semester hours or 80
1920 quarter hours and meet the following requirements:
1921 a. Thirty-three semester hours or 44 quarter hours of
1922 graduate coursework, which must include a minimum of 3 semester
1923 hours or 4 quarter hours of graduate-level coursework in each of
1924 the following 11 content areas: counseling theories and
1925 practice; human growth and development; diagnosis and treatment
1926 of psychopathology; human sexuality; group theories and
1927 practice; individual evaluation and assessment; career and
1928 lifestyle assessment; research and program evaluation; social
1929 and cultural foundations; counseling in community settings; and
1930 substance abuse. Courses in research, thesis or dissertation
1931 work, practicums, internships, or fieldwork may not be applied
1932 toward this requirement.
1933 b. A minimum of 3 semester hours or 4 quarter hours of
1934 graduate-level coursework in legal, ethical, and professional
1935 standards issues in the practice of mental health counseling,
1936 which includes goals, objectives, and practices of professional
1937 counseling organizations, codes of ethics, legal considerations,
1938 standards of preparation, certifications and licensing, and the
1939 role identity and professional obligations of mental health
1940 counselors. Courses in research, thesis or dissertation work,
1941 practicums, internships, or fieldwork may not be applied toward
1942 this requirement.
1943 c. The equivalent, as determined by the board, of at least
1944 700 1,000 hours of university-sponsored supervised clinical
1945 practicum, internship, or field experience as required in the
1946 accrediting standards of the Council for Accreditation of
1947 Counseling and Related Educational Programs for mental health
1948 counseling programs. This experience may not be used to satisfy
1949 the post-master’s clinical experience requirement.
1950 2. If the course title which appears on the applicant’s
1951 transcript does not clearly identify the content of the
1952 coursework, the applicant shall be required to provide
1953 additional documentation, including, but not limited to, a
1954 syllabus or catalog description published for the course.
1955
1956 Education and training in mental health counseling must have
1957 been received in an institution of higher education which at the
1958 time the applicant graduated was: fully accredited by a regional
1959 accrediting body recognized by the Commission on Recognition of
1960 Postsecondary Accreditation; publicly recognized as a member in
1961 good standing with the Association of Universities and Colleges
1962 of Canada; or an institution of higher education located outside
1963 the United States and Canada, which at the time the applicant
1964 was enrolled and at the time the applicant graduated maintained
1965 a standard of training substantially equivalent to the standards
1966 of training of those institutions in the United States which are
1967 accredited by a regional accrediting body recognized by the
1968 Commission on Recognition of Postsecondary Accreditation. Such
1969 foreign education and training must have been received in an
1970 institution or program of higher education officially recognized
1971 by the government of the country in which it is located as an
1972 institution or program to train students to practice as mental
1973 health counselors. The burden of establishing that the
1974 requirements of this provision have been met shall be upon the
1975 applicant, and the board shall require documentation, such as,
1976 but not limited to, an evaluation by a foreign equivalency
1977 determination service, as evidence that the applicant’s graduate
1978 degree program and education were equivalent to an accredited
1979 program in this country.
1980 (c) Has had at least 2 years of clinical experience in
1981 mental health counseling, which must be at the post-master’s
1982 level under the supervision of a licensed mental health
1983 counselor or the equivalent who is a qualified supervisor as
1984 determined by the board. An individual who intends to practice
1985 in Florida to satisfy the clinical experience requirements must
1986 register pursuant to s. 491.0045 before commencing practice. If
1987 a graduate has a master’s degree with a major related to the
1988 practice of mental health counseling that did not include all
1989 the coursework required under sub-subparagraphs (b)1.a.-b.,
1990 credit for the post-master’s level clinical experience shall not
1991 commence until the applicant has completed a minimum of seven of
1992 the courses required under sub-subparagraphs (b)1.a.-b., as
1993 determined by the board, one of which must be a course in
1994 psychopathology or abnormal psychology. A doctoral internship
1995 may be applied toward the clinical experience requirement. A
1996 licensed mental health professional must be on the premises when
1997 clinical services are provided by a registered intern in a
1998 private practice setting.
1999 (d) Has passed a theory and practice examination provided
2000 by the department for this purpose.
2001 (e) Has demonstrated, in a manner designated by rule of the
2002 board, knowledge of the laws and rules governing the practice of
2003 clinical social work, marriage and family therapy, and mental
2004 health counseling.
2005 Section 39. Paragraph (b) of subsection (1) of section
2006 491.006, Florida Statutes, is amended to read:
2007 491.006 Licensure or certification by endorsement.—
2008 (1) The department shall license or grant a certificate to
2009 a person in a profession regulated by this chapter who, upon
2010 applying to the department and remitting the appropriate fee,
2011 demonstrates to the board that he or she:
2012 (b)1. Holds an active valid license to practice and has
2013 actively practiced the profession for which licensure is applied
2014 in another state for 3 of the last 5 years immediately preceding
2015 licensure.
2016 2. Meets the education requirements of this chapter for the
2017 profession for which licensure is applied.
2018 2.3. Has passed a substantially equivalent licensing
2019 examination in another state or has passed the licensure
2020 examination in this state in the profession for which the
2021 applicant seeks licensure.
2022 3.4. Holds a license in good standing, is not under
2023 investigation for an act that would constitute a violation of
2024 this chapter, and has not been found to have committed any act
2025 that would constitute a violation of this chapter. The fees paid
2026 by any applicant for certification as a master social worker
2027 under this section are nonrefundable.
2028 Section 40. Subsection (3) of section 491.007, Florida
2029 Statutes, is amended to read:
2030 491.007 Renewal of license, registration, or certificate.—
2031 (3) The board or department shall prescribe by rule a
2032 method for the biennial renewal of an intern registration at a
2033 fee set by rule, not to exceed $100.
2034 Section 41. Subsection (2) of section 491.009, Florida
2035 Statutes, is amended to read:
2036 491.009 Discipline.—
2037 (2) The board department, or, in the case of certified
2038 master social workers psychologists, the department board, may
2039 enter an order denying licensure or imposing any of the
2040 penalties in s. 456.072(2) against any applicant for licensure
2041 or licensee who is found guilty of violating any provision of
2042 subsection (1) of this section or who is found guilty of
2043 violating any provision of s. 456.072(1).
2044 Section 42. Subsection (3) of section 463.0057, Florida
2045 Statutes, is amended to read:
2046 463.0057 Optometric faculty certificate.—
2047 (3) The holder of a faculty certificate may engage in the
2048 practice of optometry as permitted by this section but may not
2049 administer or prescribe topical ocular pharmaceutical agents
2050 unless the certificateholder has satisfied the requirements of
2051 s. 463.006(1)(b)3. and 4. s. 463.006(1)(b)4. and 5. If a
2052 certificateholder wishes to administer or prescribe oral ocular
2053 pharmaceutical agents, the certificateholder must also satisfy
2054 the requirements of s. 463.0055(1)(b).
2055 Section 43. Paragraph (c) of subsection (2) of section
2056 491.0046, Florida Statutes, is amended to read:
2057 491.0046 Provisional license; requirements.—
2058 (2) The department shall issue a provisional clinical
2059 social worker license, provisional marriage and family therapist
2060 license, or provisional mental health counselor license to each
2061 applicant who the board certifies has:
2062 (c) Has met the following minimum coursework requirements:
2063 1. For clinical social work, a minimum of 15 semester hours
2064 or 22 quarter hours of the coursework required by s.
2065 491.005(1)(b)2.b.
2066 2. For marriage and family therapy, 10 of the courses
2067 required by s. 491.005(3)(b)1. s. 491.005(3)(b)1.a.-c., as
2068 determined by the board, and at least 6 semester hours or 9
2069 quarter hours of the course credits must have been completed in
2070 the area of marriage and family systems, theories, or
2071 techniques.
2072 3. For mental health counseling, a minimum of seven of the
2073 courses required under s. 491.005(4)(b)1.a.-c.
2074 Section 44. Subsection (11) of section 945.42, Florida
2075 Statutes, is amended to read:
2076 945.42 Definitions; ss. 945.40-945.49.—As used in ss.
2077 945.40-945.49, the following terms shall have the meanings
2078 ascribed to them, unless the context shall clearly indicate
2079 otherwise:
2080 (11) “Psychological professional” means a behavioral
2081 practitioner who has an approved doctoral degree in psychology
2082 as defined in s. 490.003(3) s. 490.003(3)(b) and is employed by
2083 the department or who is licensed as a psychologist pursuant to
2084 chapter 490.
2085 Section 45. This act shall take effect July 1, 2018.