Florida Senate - 2020                       CS for CS for SB 230
       
       
        
       By the Committees on Appropriations; and Health Policy; and
       Senator Harrell
       
       
       
       
       576-03169-20                                           2020230c2
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; amending
    3         s. 39.303, F.S.; specifying direct reporting
    4         requirements for certain positions within the
    5         Children’s Medical Services Program; amending s.
    6         381.0042, F.S.; revising the purpose of patient care
    7         networks from serving patients with acquired immune
    8         deficiency syndrome to serving those with human
    9         immunodeficiency virus; conforming provisions to
   10         changes made by the act; deleting obsolete language;
   11         amending s. 381.4018, F.S.; requiring the department
   12         to develop strategies to maximize federal-state
   13         partnerships that provide incentives for physicians to
   14         practice in medically underserved or rural areas;
   15         authorizing the department to adopt certain rules;
   16         amending s. 381.915, F.S.; revising term limits for
   17         Tier 3 cancer center designations within the Florida
   18         Consortium of National Cancer Institute Centers
   19         Program; amending s. 401.35, F.S.; clarifying
   20         applicability of certain ambulance rules to include
   21         emergency medical services vehicles; deleting the
   22         requirement that the department base rules governing
   23         medical supplies and equipment required in ambulances
   24         and emergency medical services vehicles on a certain
   25         association’s standards; deleting the requirement that
   26         the department base rules governing ambulance or
   27         emergency medical services vehicle design and
   28         construction on a certain agency’s standards and
   29         instead requiring the department to base such rules on
   30         national standards recognized by the department;
   31         amending s. 404.031, F.S.; defining the term ″useful
   32         beam″; amending s. 404.22, F.S.; providing limitations
   33         on the maintenance, operation, and modification of
   34         certain radiation machines; providing conditions for
   35         the authorized exposure of human beings to the
   36         radiation emitted from a radiation machine; amending
   37         s. 456.013, F.S.; revising health care practitioner
   38         licensure application requirements; authorizing the
   39         board or department to issue a temporary license to
   40         certain applicants which expires after 60 days;
   41         amending s. 456.072, F.S.; revising grounds for
   42         certain disciplinary actions to conform to changes
   43         made by the act; repealing s. 456.0721, F.S., relating
   44         to health care practitioners in default on student
   45         loan or scholarship obligations; amending s. 456.074,
   46         F.S.; conforming provisions to changes made by the
   47         act; amending s. 458.3145, F.S.; revising the list of
   48         individuals who may be issued a medical faculty
   49         certificate without examination; amending s. 458.3312,
   50         F.S.; removing a prohibition against physicians
   51         representing themselves as board-certified specialists
   52         in dermatology unless the recognizing agency is
   53         reviewed and reauthorized on a specified basis by the
   54         Board of Medicine; amending s. 459.0055, F.S.;
   55         revising licensure requirements for a person seeking
   56         licensure or certification as an osteopathic
   57         physician; repealing s. 460.4166, F.S., relating to
   58         registered chiropractic assistants; amending s.
   59         464.019, F.S.; extending through 2025 the Florida
   60         Center for Nursing’s responsibility to study and issue
   61         an annual report on the implementation of nursing
   62         education programs; amending s. 464.202, F.S.;
   63         requiring the Board of Nursing to adopt rules that
   64         include disciplinary procedures and standards of
   65         practice for certified nursing assistants; amending s.
   66         464.203, F.S.; revising certification requirements for
   67         nursing assistants; amending s. 464.204, F.S.;
   68         revising grounds for board-imposed disciplinary
   69         sanctions; amending s. 466.006, F.S.; revising certain
   70         examination requirements for applicants seeking dental
   71         licensure; reviving, reenacting, and amending s.
   72         466.0067, F.S., relating to the application for a
   73         health access dental license; reviving, reenacting,
   74         and amending s. 466.00671, F.S., relating to the
   75         renewal of such a license; reviving and reenacting s.
   76         466.00672, F.S., relating to the revocation of such a
   77         license; amending s. 466.007, F.S.; revising
   78         requirements for examinations of dental hygienists;
   79         amending s. 466.017, F.S.; requiring dentists and
   80         certified registered dental hygienists to report in
   81         writing certain adverse incidents to the department
   82         within a specified timeframe; providing for
   83         disciplinary action by the Board of Dentistry for
   84         violations; defining the term “adverse incident”;
   85         authorizing the board to adopt rules; amending s.
   86         466.031, F.S.; making technical changes; authorizing
   87         an employee or an independent contractor of a dental
   88         laboratory, acting as an agent of that dental
   89         laboratory, to engage in onsite consultation with a
   90         licensed dentist during a dental procedure; amending
   91         s. 466.036, F.S.; revising the frequency of dental
   92         laboratory inspections during a specified period;
   93         amending s. 468.701, F.S.; revising the definition of
   94         the term “athletic trainer”; deleting a requirement
   95         that is relocated to another section; amending s.
   96         468.707, F.S.; revising athletic trainer licensure
   97         requirements; amending s. 468.711, F.S.; requiring
   98         certain licensees to maintain certification in good
   99         standing without lapse as a condition of renewal of
  100         their athletic trainer licenses; amending s. 468.713,
  101         F.S.; requiring that an athletic trainer work within a
  102         specified scope of practice; relocating an existing
  103         requirement that was stricken from another section;
  104         amending s. 468.723, F.S.; requiring the direct
  105         supervision of an athletic training student to be in
  106         accordance with rules adopted by the Board of Athletic
  107         Training; amending s. 468.803, F.S.; revising
  108         orthotic, prosthetic, and pedorthic licensure,
  109         registration, and examination requirements; amending
  110         s. 480.033, F.S.; revising the definition of the term
  111         “apprentice”; amending s. 480.041, F.S.; revising
  112         qualifications for licensure as a massage therapist;
  113         specifying that massage apprentices licensed before a
  114         specified date may continue to perform massage therapy
  115         as authorized under their licenses; authorizing
  116         massage apprentices to apply for full licensure upon
  117         completion of their apprenticeships, under certain
  118         conditions; repealing s. 480.042, F.S., relating to
  119         examinations for licensure as a massage therapist;
  120         amending s. 490.003, F.S.; revising the definition of
  121         the terms “doctoral-level psychological education” and
  122         “doctoral degree in psychology”; amending s. 490.005,
  123         F.S.; revising requirements for licensure by
  124         examination of psychologists and school psychologists;
  125         amending s. 490.006, F.S.; revising requirements for
  126         licensure by endorsement of psychologists and school
  127         psychologists; amending s. 491.0045, F.S.; exempting
  128         clinical social worker interns, marriage and family
  129         therapist interns, and mental health counselor interns
  130         from registration requirements, under certain
  131         circumstances; amending s. 491.005, F.S.; revising
  132         requirements for the licensure by examination of
  133         marriage and family therapists; revising requirements
  134         for the licensure by examination of mental health
  135         counselors; amending s. 491.006, F.S.; revising
  136         requirements for licensure by endorsement or
  137         certification for specified professions; amending s.
  138         491.007, F.S.; removing a biennial intern registration
  139         fee; amending s. 491.009, F.S.; authorizing the Board
  140         of Clinical Social Work, Marriage and Family Therapy,
  141         and Mental Health Counseling or, under certain
  142         circumstances, the department to enter an order
  143         denying licensure or imposing penalties against an
  144         applicant for licensure under certain circumstances;
  145         amending ss. 491.0046 and 945.42, F.S.; conforming
  146         cross-references; reenacting s. 459.021(6), F.S.,
  147         relating to registration of osteopathic resident
  148         physicians, interns, and fellows, to incorporate the
  149         amendment made to s. 459.0055, F.S., in a reference
  150         thereto; providing for retroactive applicability of
  151         specified provisions; providing an effective date.
  152          
  153  Be It Enacted by the Legislature of the State of Florida:
  154  
  155         Section 1. Paragraphs (a) and (b) of subsection (2) of
  156  section 39.303, Florida Statutes, are amended to read:
  157         39.303 Child Protection Teams and sexual abuse treatment
  158  programs; services; eligible cases.—
  159         (2)(a) The Statewide Medical Director for Child Protection
  160  must be a physician licensed under chapter 458 or chapter 459
  161  who is a board-certified pediatrician with a subspecialty
  162  certification in child abuse from the American Board of
  163  Pediatrics. The Statewide Medical Director for Child Protection
  164  shall report directly to the Deputy Secretary for Children’s
  165  Medical Services.
  166         (b) Each Child Protection Team medical director must be a
  167  physician licensed under chapter 458 or chapter 459 who is a
  168  board-certified physician in pediatrics or family medicine and,
  169  within 2 years after the date of employment as a Child
  170  Protection Team medical director, obtains a subspecialty
  171  certification in child abuse from the American Board of
  172  Pediatrics or within 2 years meet the minimum requirements
  173  established by a third-party credentialing entity recognizing a
  174  demonstrated specialized competence in child abuse pediatrics
  175  pursuant to paragraph (d). Each Child Protection Team medical
  176  director employed on July 1, 2015, must, by July 1, 2019, either
  177  obtain a subspecialty certification in child abuse from the
  178  American Board of Pediatrics or meet the minimum requirements
  179  established by a third-party credentialing entity recognizing a
  180  demonstrated specialized competence in child abuse pediatrics
  181  pursuant to paragraph (d). Child Protection Team medical
  182  directors shall be responsible for oversight of the teams in the
  183  circuits. Each Child Protection Team medical director shall
  184  report directly to the Statewide Medical Director for Child
  185  Protection.
  186         Section 2. Section 381.0042, Florida Statutes, is amended
  187  to read:
  188         381.0042 Patient care for persons with HIV infection.—The
  189  department may establish human immunodeficiency virus acquired
  190  immune deficiency syndrome patient care networks in each region
  191  of the state where the number numbers of cases of acquired
  192  immune deficiency syndrome and other human immunodeficiency
  193  virus transmission infections justifies the establishment of
  194  cost-effective regional patient care networks. Such networks
  195  shall be delineated by rule of the department which shall take
  196  into account natural trade areas and centers of medical
  197  excellence that specialize in the treatment of human
  198  immunodeficiency virus acquired immune deficiency syndrome, as
  199  well as available federal, state, and other funds. Each patient
  200  care network shall include representation of persons with human
  201  immunodeficiency virus infection; health care providers;
  202  business interests; the department, including, but not limited
  203  to, county health departments; and local units of government.
  204  Each network shall plan for the care and treatment of persons
  205  with human immunodeficiency virus acquired immune deficiency
  206  syndrome and acquired immune deficiency syndrome related complex
  207  in a cost-effective, dignified manner that which emphasizes
  208  outpatient and home care. Once per each year, beginning April
  209  1989, each network shall make its recommendations concerning the
  210  needs for patient care to the department.
  211         Section 3. Subsection (3) of section 381.4018, Florida
  212  Statutes, is amended to read:
  213         381.4018 Physician workforce assessment and development.—
  214         (3) GENERAL FUNCTIONS.—The department shall maximize the
  215  use of existing programs under the jurisdiction of the
  216  department and other state agencies and coordinate governmental
  217  and nongovernmental stakeholders and resources in order to
  218  develop a state strategic plan and assess the implementation of
  219  such strategic plan. In developing the state strategic plan, the
  220  department shall:
  221         (a) Monitor, evaluate, and report on the supply and
  222  distribution of physicians licensed under chapter 458 or chapter
  223  459. The department shall maintain a database to serve as a
  224  statewide source of data concerning the physician workforce.
  225         (b) Develop a model and quantify, on an ongoing basis, the
  226  adequacy of the state’s current and future physician workforce
  227  as reliable data becomes available. Such model must take into
  228  account demographics, physician practice status, place of
  229  education and training, generational changes, population growth,
  230  economic indicators, and issues concerning the “pipeline” into
  231  medical education.
  232         (c) Develop and recommend strategies to determine whether
  233  the number of qualified medical school applicants who might
  234  become competent, practicing physicians in this state will be
  235  sufficient to meet the capacity of the state’s medical schools.
  236  If appropriate, the department shall, working with
  237  representatives of appropriate governmental and nongovernmental
  238  entities, develop strategies and recommendations and identify
  239  best practice programs that introduce health care as a
  240  profession and strengthen skills needed for medical school
  241  admission for elementary, middle, and high school students, and
  242  improve premedical education at the precollege and college level
  243  in order to increase this state’s potential pool of medical
  244  students.
  245         (d) Develop strategies to ensure that the number of
  246  graduates from the state’s public and private allopathic and
  247  osteopathic medical schools is adequate to meet physician
  248  workforce needs, based on the analysis of the physician
  249  workforce data, so as to provide a high-quality medical
  250  education to students in a manner that recognizes the uniqueness
  251  of each new and existing medical school in this state.
  252         (e) Pursue strategies and policies to create, expand, and
  253  maintain graduate medical education positions in the state based
  254  on the analysis of the physician workforce data. Such strategies
  255  and policies must take into account the effect of federal
  256  funding limitations on the expansion and creation of positions
  257  in graduate medical education. The department shall develop
  258  options to address such federal funding limitations. The
  259  department shall consider options to provide direct state
  260  funding for graduate medical education positions in a manner
  261  that addresses requirements and needs relative to accreditation
  262  of graduate medical education programs. The department shall
  263  consider funding residency positions as a means of addressing
  264  needed physician specialty areas, rural areas having a shortage
  265  of physicians, and areas of ongoing critical need, and as a
  266  means of addressing the state’s physician workforce needs based
  267  on an ongoing analysis of physician workforce data.
  268         (f) Develop strategies to maximize federal and state
  269  programs that provide for the use of incentives to attract
  270  physicians to this state or retain physicians within the state.
  271  Such strategies should explore and maximize federal-state
  272  partnerships that provide incentives for physicians to practice
  273  in federally designated shortage areas, in otherwise medically
  274  underserved areas, or in rural areas. Strategies shall also
  275  consider the use of state programs, such as the Medical
  276  Education Reimbursement and Loan Repayment Program pursuant to
  277  s. 1009.65, which provide for education loan repayment or loan
  278  forgiveness and provide monetary incentives for physicians to
  279  relocate to underserved areas of the state.
  280         (g) Coordinate and enhance activities relative to physician
  281  workforce needs, undergraduate medical education, graduate
  282  medical education, and reentry of retired military and other
  283  physicians into the physician workforce provided by the Division
  284  of Medical Quality Assurance, area health education center
  285  networks established pursuant to s. 381.0402, and other offices
  286  and programs within the department as designated by the State
  287  Surgeon General.
  288         (h) Work in conjunction with and act as a coordinating body
  289  for governmental and nongovernmental stakeholders to address
  290  matters relating to the state’s physician workforce assessment
  291  and development for the purpose of ensuring an adequate supply
  292  of well-trained physicians to meet the state’s future needs.
  293  Such governmental stakeholders shall include, but need not be
  294  limited to, the State Surgeon General or his or her designee,
  295  the Commissioner of Education or his or her designee, the
  296  Secretary of Health Care Administration or his or her designee,
  297  and the Chancellor of the State University System or his or her
  298  designee, and, at the discretion of the department, other
  299  representatives of state and local agencies that are involved in
  300  assessing, educating, or training the state’s current or future
  301  physicians. Other stakeholders shall include, but need not be
  302  limited to, organizations representing the state’s public and
  303  private allopathic and osteopathic medical schools;
  304  organizations representing hospitals and other institutions
  305  providing health care, particularly those that currently provide
  306  or have an interest in providing accredited medical education
  307  and graduate medical education to medical students and medical
  308  residents; organizations representing allopathic and osteopathic
  309  practicing physicians; and, at the discretion of the department,
  310  representatives of other organizations or entities involved in
  311  assessing, educating, or training the state’s current or future
  312  physicians.
  313         (i) Serve as a liaison with other states and federal
  314  agencies and programs in order to enhance resources available to
  315  the state’s physician workforce and medical education continuum.
  316         (j) Act as a clearinghouse for collecting and disseminating
  317  information concerning the physician workforce and medical
  318  education continuum in this state.
  319  
  320  The department may adopt rules to implement this subsection,
  321  including rules that establish guidelines to implement the
  322  federal Conrad 30 Waiver Program created under s. 214(l) of the
  323  Immigration and Nationality Act.
  324         Section 4. Paragraph (c) of subsection (4) of section
  325  381.915, Florida Statutes, is amended to read:
  326         381.915 Florida Consortium of National Cancer Institute
  327  Centers Program.—
  328         (4) Tier designations and corresponding weights within the
  329  Florida Consortium of National Cancer Institute Centers Program
  330  are as follows:
  331         (c) Tier 3: Florida-based cancer centers seeking
  332  designation as either a NCI-designated cancer center or NCI
  333  designated comprehensive cancer center, which shall be weighted
  334  at 1.0.
  335         1. A cancer center shall meet the following minimum
  336  criteria to be considered eligible for Tier 3 designation in any
  337  given fiscal year:
  338         a. Conducting cancer-related basic scientific research and
  339  cancer-related population scientific research;
  340         b. Offering and providing the full range of diagnostic and
  341  treatment services on site, as determined by the Commission on
  342  Cancer of the American College of Surgeons;
  343         c. Hosting or conducting cancer-related interventional
  344  clinical trials that are registered with the NCI’s Clinical
  345  Trials Reporting Program;
  346         d. Offering degree-granting programs or affiliating with
  347  universities through degree-granting programs accredited or
  348  approved by a nationally recognized agency and offered through
  349  the center or through the center in conjunction with another
  350  institution accredited by the Commission on Colleges of the
  351  Southern Association of Colleges and Schools;
  352         e. Providing training to clinical trainees, medical
  353  trainees accredited by the Accreditation Council for Graduate
  354  Medical Education or the American Osteopathic Association, and
  355  postdoctoral fellows recently awarded a doctorate degree; and
  356         f. Having more than $5 million in annual direct costs
  357  associated with their total NCI peer-reviewed grant funding.
  358         2. The General Appropriations Act or accompanying
  359  legislation may limit the number of cancer centers which shall
  360  receive Tier 3 designations or provide additional criteria for
  361  such designation.
  362         3. A cancer center’s participation in Tier 3 may not extend
  363  beyond June 30, 2024 shall be limited to 6 years.
  364         4. A cancer center that qualifies as a designated Tier 3
  365  center under the criteria provided in subparagraph 1. by July 1,
  366  2014, is authorized to pursue NCI designation as a cancer center
  367  or a comprehensive cancer center until June 30, 2024 for 6 years
  368  after qualification.
  369         Section 5. Paragraphs (c) and (d) of subsection (1) of
  370  section 401.35, Florida Statutes, are amended to read:
  371         401.35 Rules.—The department shall adopt rules, including
  372  definitions of terms, necessary to carry out the purposes of
  373  this part.
  374         (1) The rules must provide at least minimum standards
  375  governing:
  376         (c) Ground ambulance and vehicle equipment and supplies
  377  that a licensee with a valid vehicle permit under s. 401.26 is
  378  required to maintain to provide basic or advanced life support
  379  services at least as comprehensive as those published in the
  380  most current edition of the American College of Surgeons,
  381  Committee on Trauma, list of essential equipment for ambulances,
  382  as interpreted by rules of the department.
  383         (d) Ground ambulance or vehicle design and construction
  384  based on national standards recognized by the department and at
  385  least equal to those most currently recommended by the United
  386  States General Services Administration as interpreted by
  387  department rule rules of the department.
  388         Section 6. Subsection (21) is added to section 404.031,
  389  Florida Statutes, to read:
  390         404.031 Definitions.—As used in this chapter, unless the
  391  context clearly indicates otherwise, the term:
  392         (21) ″Useful beam″ means that portion of the radiation
  393  emitted from a radiation machine through the aperture of the
  394  machine′s beam-limiting device which is designed to focus the
  395  radiation on the intended target in order to accomplish the
  396  machine′s purpose when the machine′s exposure controls are in a
  397  mode to cause the system to produce radiation.
  398         Section 7. Subsections (7) and (8) are added to section
  399  404.22, Florida Statutes, to read:
  400         404.22 Radiation machines and components; inspection.—
  401         (7) Radiation machines that are used to intentionally
  402  expose a human being to the useful beam:
  403         (a) Must be maintained and operated according to
  404  manufacturer standards or nationally recognized consensus
  405  standards accepted by the department;
  406         (b) Must be operated at the lowest exposure that will
  407  achieve the intended purpose of the exposure; and
  408         (c) May not be modified in a manner that causes the
  409  original parts to operate in a way that differs from the
  410  original manufacturer′s design specification or the parameters
  411  approved for the machine and its components by the United States
  412  Food and Drug Administration.
  413         (8) A human being may be exposed to the useful beam of a
  414  radiation machine only under the following conditions:
  415         (a) For the purpose of medical or health care, if a
  416  licensed health care practitioner operating within the scope of
  417  his or her practice has determined that the exposure provides a
  418  medical or health benefit greater than the health risks posed by
  419  the exposure and the health care practitioner uses the results
  420  of the exposure in the medical or health care of the exposed
  421  individual; or
  422         (b) For the purpose of providing security for facilities or
  423  other venues, if the exposure is determined to provide a life
  424  safety benefit to the individual exposed which is greater than
  425  the health risk posed by the exposure. Such determination must
  426  be made by an individual trained in evaluating and calculating
  427  comparative mortality and morbidity risks according to standards
  428  set by the department. To be valid, the calculation and method
  429  of making the determination must be submitted to and accepted by
  430  the department. Limits to annual total exposure for security
  431  purposes must be adopted by department rule based on nationally
  432  recognized limits or relevant consensus standards.
  433         Section 8. Paragraphs (a) and (b) of subsection (1) of
  434  section 456.013, Florida Statutes, are amended to read:
  435         456.013 Department; general licensing provisions.—
  436         (1)(a) Any person desiring to be licensed in a profession
  437  within the jurisdiction of the department must shall apply to
  438  the department in writing to take the licensure examination. The
  439  application must shall be made on a form prepared and furnished
  440  by the department. The application form must be available on the
  441  Internet, World Wide Web and the department may accept
  442  electronically submitted applications. The application shall
  443  require the social security number and date of birth of the
  444  applicant, except as provided in paragraphs (b) and (c). The
  445  form shall be supplemented as needed to reflect any material
  446  change in any circumstance or condition stated in the
  447  application which takes place between the initial filing of the
  448  application and the final grant or denial of the license and
  449  which might affect the decision of the department. If an
  450  application is submitted electronically, the department may
  451  require supplemental materials, including an original signature
  452  of the applicant and verification of credentials, to be
  453  submitted in a nonelectronic format. An incomplete application
  454  shall expire 1 year after initial filing. In order to further
  455  the economic development goals of the state, and notwithstanding
  456  any law to the contrary, the department may enter into an
  457  agreement with the county tax collector for the purpose of
  458  appointing the county tax collector as the department’s agent to
  459  accept applications for licenses and applications for renewals
  460  of licenses. The agreement must specify the time within which
  461  the tax collector must forward any applications and accompanying
  462  application fees to the department.
  463         (b) If an applicant has not been issued a social security
  464  number by the Federal Government at the time of application
  465  because the applicant is not a citizen or resident of this
  466  country, the department may process the application using a
  467  unique personal identification number. If such an applicant is
  468  otherwise eligible for licensure, the board, or the department
  469  when there is no board, may issue a temporary license to the
  470  applicant, which shall expire 30 days after issuance unless a
  471  social security number is obtained and submitted in writing to
  472  the department. A temporary license issued under this paragraph
  473  to an applicant who has accepted a position with an accredited
  474  residency, internship, or fellowship program in this state and
  475  is applying for registration under s. 458.345 or s. 459.021
  476  shall expire 60 days after issuance unless the applicant obtains
  477  a social security number and submits it in writing to the
  478  department. Upon receipt of the applicant’s social security
  479  number, the department shall issue a new license, which shall
  480  expire at the end of the current biennium.
  481         Section 9. Paragraph (k) of subsection (1) of section
  482  456.072, Florida Statutes, is amended to read:
  483         456.072 Grounds for discipline; penalties; enforcement.—
  484         (1) The following acts shall constitute grounds for which
  485  the disciplinary actions specified in subsection (2) may be
  486  taken:
  487         (k) Failing to perform any statutory or legal obligation
  488  placed upon a licensee. For purposes of this section, failing to
  489  repay a student loan issued or guaranteed by the state or the
  490  Federal Government in accordance with the terms of the loan is
  491  not or failing to comply with service scholarship obligations
  492  shall be considered a failure to perform a statutory or legal
  493  obligation, and the minimum disciplinary action imposed shall be
  494  a suspension of the license until new payment terms are agreed
  495  upon or the scholarship obligation is resumed, followed by
  496  probation for the duration of the student loan or remaining
  497  scholarship obligation period, and a fine equal to 10 percent of
  498  the defaulted loan amount. Fines collected shall be deposited
  499  into the Medical Quality Assurance Trust Fund.
  500         Section 10. Section 456.0721, Florida Statutes, is
  501  repealed.
  502         Section 11. Subsection (4) of section 456.074, Florida
  503  Statutes, is amended to read:
  504         456.074 Certain health care practitioners; immediate
  505  suspension of license.—
  506         (4)Upon receipt of information that a Florida-licensed
  507  health care practitioner has defaulted on a student loan issued
  508  or guaranteed by the state or the Federal Government, the
  509  department shall notify the licensee by certified mail that he
  510  or she shall be subject to immediate suspension of license
  511  unless, within 45 days after the date of mailing, the licensee
  512  provides proof that new payment terms have been agreed upon by
  513  all parties to the loan. The department shall issue an emergency
  514  order suspending the license of any licensee who, after 45 days
  515  following the date of mailing from the department, has failed to
  516  provide such proof. Production of such proof shall not prohibit
  517  the department from proceeding with disciplinary action against
  518  the licensee pursuant to s. 456.073.
  519         Section 12. Subsection (1) of section 458.3145, Florida
  520  Statutes, is amended to read:
  521         458.3145 Medical faculty certificate.—
  522         (1) A medical faculty certificate may be issued without
  523  examination to an individual who:
  524         (a) Is a graduate of an accredited medical school or its
  525  equivalent, or is a graduate of a foreign medical school listed
  526  with the World Health Organization;
  527         (b) Holds a valid, current license to practice medicine in
  528  another jurisdiction;
  529         (c) Has completed the application form and remitted a
  530  nonrefundable application fee not to exceed $500;
  531         (d) Has completed an approved residency or fellowship of at
  532  least 1 year or has received training which has been determined
  533  by the board to be equivalent to the 1-year residency
  534  requirement;
  535         (e) Is at least 21 years of age;
  536         (f) Is of good moral character;
  537         (g) Has not committed any act in this or any other
  538  jurisdiction which would constitute the basis for disciplining a
  539  physician under s. 458.331;
  540         (h) For any applicant who has graduated from medical school
  541  after October 1, 1992, has completed, before entering medical
  542  school, the equivalent of 2 academic years of preprofessional,
  543  postsecondary education, as determined by rule of the board,
  544  which must include, at a minimum, courses in such fields as
  545  anatomy, biology, and chemistry; and
  546         (i) Has been offered and has accepted a full-time faculty
  547  appointment to teach in a program of medicine at:
  548         1. The University of Florida;
  549         2. The University of Miami;
  550         3. The University of South Florida;
  551         4. The Florida State University;
  552         5. The Florida International University;
  553         6. The University of Central Florida;
  554         7. The Mayo Clinic College of Medicine and Science in
  555  Jacksonville, Florida;
  556         8. The Florida Atlantic University; or
  557         9. The Johns Hopkins All Children’s Hospital in St.
  558  Petersburg, Florida;
  559         10.Nova Southeastern University; or
  560         11.Lake Erie College of Osteopathic Medicine.
  561         Section 13. Section 458.3312, Florida Statutes, is amended
  562  to read:
  563         458.3312 Specialties.—A physician licensed under this
  564  chapter may not hold himself or herself out as a board-certified
  565  specialist unless the physician has received formal recognition
  566  as a specialist from a specialty board of the American Board of
  567  Medical Specialties or other recognizing agency that has been
  568  approved by the board. However, a physician may indicate the
  569  services offered and may state that his or her practice is
  570  limited to one or more types of services when this accurately
  571  reflects the scope of practice of the physician. A physician may
  572  not hold himself or herself out as a board-certified specialist
  573  in dermatology unless the recognizing agency, whether authorized
  574  in statute or by rule, is triennially reviewed and reauthorized
  575  by the Board of Medicine.
  576         Section 14. Subsection (1) of section 459.0055, Florida
  577  Statutes, is amended to read:
  578         459.0055 General licensure requirements.—
  579         (1) Except as otherwise provided herein, any person
  580  desiring to be licensed or certified as an osteopathic physician
  581  pursuant to this chapter shall:
  582         (a) Complete an application form and submit the appropriate
  583  fee to the department;
  584         (b) Be at least 21 years of age;
  585         (c) Be of good moral character;
  586         (d) Have completed at least 3 years of preprofessional
  587  postsecondary education;
  588         (e) Have not previously committed any act that would
  589  constitute a violation of this chapter, unless the board
  590  determines that such act does not adversely affect the
  591  applicant’s present ability and fitness to practice osteopathic
  592  medicine;
  593         (f) Not be under investigation in any jurisdiction for an
  594  act that would constitute a violation of this chapter. If, upon
  595  completion of such investigation, it is determined that the
  596  applicant has committed an act that would constitute a violation
  597  of this chapter, the applicant is ineligible for licensure
  598  unless the board determines that such act does not adversely
  599  affect the applicant’s present ability and fitness to practice
  600  osteopathic medicine;
  601         (g) Have not had an application for a license to practice
  602  osteopathic medicine denied or a license to practice osteopathic
  603  medicine revoked, suspended, or otherwise acted against by the
  604  licensing authority of any jurisdiction unless the board
  605  determines that the grounds on which such action was taken do
  606  not adversely affect the applicant’s present ability and fitness
  607  to practice osteopathic medicine. A licensing authority’s
  608  acceptance of a physician’s relinquishment of license,
  609  stipulation, consent order, or other settlement, offered in
  610  response to or in anticipation of the filing of administrative
  611  charges against the osteopathic physician, shall be considered
  612  action against the osteopathic physician’s license;
  613         (h) Not have received less than a satisfactory evaluation
  614  from an internship, residency, or fellowship training program,
  615  unless the board determines that such act does not adversely
  616  affect the applicant’s present ability and fitness to practice
  617  osteopathic medicine. Such evaluation shall be provided by the
  618  director of medical education from the medical training
  619  facility;
  620         (i) Have met the criteria set forth in s. 459.0075, s.
  621  459.0077, or s. 459.021, whichever is applicable;
  622         (j) Submit to the department a set of fingerprints on a
  623  form and under procedures specified by the department, along
  624  with a payment in an amount equal to the costs incurred by the
  625  Department of Health for the criminal background check of the
  626  applicant;
  627         (k) Demonstrate that he or she is a graduate of a medical
  628  college recognized and approved by the American Osteopathic
  629  Association;
  630         (l) Demonstrate that she or he has successfully completed
  631  an internship or residency a resident internship of not less
  632  than 12 months in a program accredited hospital approved for
  633  this purpose by the Board of Trustees of the American
  634  Osteopathic Association or the Accreditation Council for
  635  Graduate Medical Education any other internship program approved
  636  by the board upon a showing of good cause by the applicant. This
  637  requirement may be waived for an applicant who matriculated in a
  638  college of osteopathic medicine during or before 1948; and
  639         (m) Demonstrate that she or he has obtained a passing
  640  score, as established by rule of the board, on all parts of the
  641  examination conducted by the National Board of Osteopathic
  642  Medical Examiners or other examination approved by the board no
  643  more than 5 years before making application in this state or, if
  644  holding a valid active license in another state, that the
  645  initial licensure in the other state occurred no more than 5
  646  years after the applicant obtained a passing score on the
  647  examination conducted by the National Board of Osteopathic
  648  Medical Examiners or other substantially similar examination
  649  approved by the board.
  650         Section 15. Section 460.4166, Florida Statutes, is
  651  repealed.
  652         Section 16. Subsection (10) of section 464.019, Florida
  653  Statutes, is amended to read:
  654         464.019 Approval of nursing education programs.—
  655         (10) IMPLEMENTATION STUDY.—The Florida Center for Nursing
  656  shall study the administration of this section and submit
  657  reports to the Governor, the President of the Senate, and the
  658  Speaker of the House of Representatives annually by January 30,
  659  through January 30, 2025 2020. The annual reports shall address
  660  the previous academic year; provide data on the measures
  661  specified in paragraphs (a) and (b), as such data becomes
  662  available; and include an evaluation of such data for purposes
  663  of determining whether this section is increasing the
  664  availability of nursing education programs and the production of
  665  quality nurses. The department and each approved program or
  666  accredited program shall comply with requests for data from the
  667  Florida Center for Nursing.
  668         (a) The Florida Center for Nursing shall evaluate program
  669  specific data for each approved program and accredited program
  670  conducted in the state, including, but not limited to:
  671         1. The number of programs and student slots available.
  672         2. The number of student applications submitted, the number
  673  of qualified applicants, and the number of students accepted.
  674         3. The number of program graduates.
  675         4. Program retention rates of students tracked from program
  676  entry to graduation.
  677         5. Graduate passage rates on the National Council of State
  678  Boards of Nursing Licensing Examination.
  679         6. The number of graduates who become employed as practical
  680  or professional nurses in the state.
  681         (b) The Florida Center for Nursing shall evaluate the
  682  board’s implementation of the:
  683         1. Program application approval process, including, but not
  684  limited to, the number of program applications submitted under
  685  subsection (1),; the number of program applications approved and
  686  denied by the board under subsection (2),; the number of denials
  687  of program applications reviewed under chapter 120,; and a
  688  description of the outcomes of those reviews.
  689         2. Accountability processes, including, but not limited to,
  690  the number of programs on probationary status, the number of
  691  approved programs for which the program director is required to
  692  appear before the board under subsection (5), the number of
  693  approved programs terminated by the board, the number of
  694  terminations reviewed under chapter 120, and a description of
  695  the outcomes of those reviews.
  696         (c) The Florida Center for Nursing shall complete an annual
  697  assessment of compliance by programs with the accreditation
  698  requirements of subsection (11), include in the assessment a
  699  determination of the accreditation process status for each
  700  program, and submit the assessment as part of the reports
  701  required by this subsection.
  702         Section 17. Section 464.202, Florida Statutes, is amended
  703  to read:
  704         464.202 Duties and powers of the board.—The board shall
  705  maintain, or contract with or approve another entity to
  706  maintain, a state registry of certified nursing assistants. The
  707  registry must consist of the name of each certified nursing
  708  assistant in this state; other identifying information defined
  709  by board rule; certification status; the effective date of
  710  certification; other information required by state or federal
  711  law; information regarding any crime or any abuse, neglect, or
  712  exploitation as provided under chapter 435; and any disciplinary
  713  action taken against the certified nursing assistant. The
  714  registry shall be accessible to the public, the
  715  certificateholder, employers, and other state agencies. The
  716  board shall adopt by rule testing procedures for use in
  717  certifying nursing assistants and shall adopt rules regulating
  718  the practice of certified nursing assistants, including
  719  disciplinary procedures and standards of practice, and
  720  specifying the scope of practice authorized and the level of
  721  supervision required for the practice of certified nursing
  722  assistants. The board may contract with or approve another
  723  entity or organization to provide the examination services,
  724  including the development and administration of examinations.
  725  The board shall require that the contract provider offer
  726  certified nursing assistant applications via the Internet, and
  727  may require the contract provider to accept certified nursing
  728  assistant applications for processing via the Internet. The
  729  board shall require the contract provider to provide the
  730  preliminary results of the certified nursing examination on the
  731  date the test is administered. The provider shall pay all
  732  reasonable costs and expenses incurred by the board in
  733  evaluating the provider’s application and performance during the
  734  delivery of services, including examination services and
  735  procedures for maintaining the certified nursing assistant
  736  registry.
  737         Section 18. Paragraph (c) of subsection (1) of section
  738  464.203, Florida Statutes, is amended to read:
  739         464.203 Certified nursing assistants; certification
  740  requirement.—
  741         (1) The board shall issue a certificate to practice as a
  742  certified nursing assistant to any person who demonstrates a
  743  minimum competency to read and write and successfully passes the
  744  required background screening pursuant to s. 400.215. If the
  745  person has successfully passed the required background screening
  746  pursuant to s. 400.215 or s. 408.809 within 90 days before
  747  applying for a certificate to practice and the person’s
  748  background screening results are not retained in the
  749  clearinghouse created under s. 435.12, the board shall waive the
  750  requirement that the applicant successfully pass an additional
  751  background screening pursuant to s. 400.215. The person must
  752  also meet one of the following requirements:
  753         (c) Is currently certified in another state or territory of
  754  the United States or in the District of Columbia; is listed on
  755  that jurisdiction’s state’s certified nursing assistant
  756  registry; and has not been found to have committed abuse,
  757  neglect, or exploitation in that jurisdiction state.
  758         Section 19. Paragraph (b) of subsection (1) of section
  759  464.204, Florida Statutes, is amended to read:
  760         464.204 Denial, suspension, or revocation of certification;
  761  disciplinary actions.—
  762         (1) The following acts constitute grounds for which the
  763  board may impose disciplinary sanctions as specified in
  764  subsection (2):
  765         (b) Intentionally Violating any provision of this chapter,
  766  chapter 456, or the rules adopted by the board.
  767         Section 20. Subsections (3) and (4) of section 466.006,
  768  Florida Statutes, are amended to read:
  769         466.006 Examination of dentists.—
  770         (3) If an applicant is a graduate of a dental college or
  771  school not accredited in accordance with paragraph (2)(b) or of
  772  a dental college or school not approved by the board, the
  773  applicant is not entitled to take the examinations required in
  774  this section to practice dentistry until she or he satisfies one
  775  of the following:
  776         (a) Completes a program of study, as defined by the board
  777  by rule, at an accredited American dental school and
  778  demonstrates receipt of a D.D.S. or D.M.D. from said school; or
  779         (b) Submits proof of having successfully completed at least
  780  2 consecutive academic years at a full-time supplemental general
  781  dentistry program accredited by the American Dental Association
  782  Commission on Dental Accreditation. This program must provide
  783  didactic and clinical education at the level of a D.D.S. or
  784  D.M.D. program accredited by the American Dental Association
  785  Commission on Dental Accreditation. For purposes of this
  786  paragraph, a supplemental general dentistry program does not
  787  include an advanced education program in a dental specialty.
  788         (4) Notwithstanding any other provision of law in chapter
  789  456 pertaining to the clinical dental licensure examination or
  790  national examinations, to be licensed as a dentist in this
  791  state, an applicant must successfully complete both of the
  792  following:
  793         (a) A written examination on the laws and rules of the
  794  state regulating the practice of dentistry.;
  795         (b)1. A practical or clinical examination, which must shall
  796  be the American Dental Licensing Examination produced by the
  797  American Board of Dental Examiners, Inc., or its successor
  798  entity, if any, that is administered in this state and graded by
  799  dentists licensed in this state and employed by the department
  800  for just such purpose, provided that the board has attained, and
  801  continues to maintain thereafter, representation on the board of
  802  directors of the American Board of Dental Examiners, the
  803  examination development committee of the American Board of
  804  Dental Examiners, and such other committees of the American
  805  Board of Dental Examiners as the board deems appropriate by rule
  806  to assure that the standards established herein are maintained
  807  organizationally. A passing score on the American Dental
  808  Licensing Examination administered in this state and graded by
  809  dentists who are licensed in this state is valid for 365 days
  810  after the date the official examination results are published.
  811         1.2.a. As an alternative to such practical or clinical
  812  examination the requirements of subparagraph 1., an applicant
  813  may submit scores from an American Dental Licensing Examination
  814  previously administered in a jurisdiction other than this state
  815  after October 1, 2011, and such examination results shall be
  816  recognized as valid for the purpose of licensure in this state.
  817  A passing score on the American Dental Licensing Examination
  818  administered out of state out-of-state shall be the same as the
  819  passing score for the American Dental Licensing Examination
  820  administered in this state and graded by dentists who are
  821  licensed in this state. The examination results are valid for
  822  365 days after the date the official examination results are
  823  published. The applicant must have completed the examination
  824  after October 1, 2011.
  825         b. This subparagraph may not be given retroactive
  826  application.
  827         2.3. If the date of an applicant’s passing American Dental
  828  Licensing Examination scores from an examination previously
  829  administered in a jurisdiction other than this state under
  830  subparagraph 1. subparagraph 2. is older than 365 days, then
  831  such scores are shall nevertheless be recognized as valid for
  832  the purpose of licensure in this state, but only if the
  833  applicant demonstrates that all of the following additional
  834  standards have been met:
  835         a.(I) The applicant completed the American Dental Licensing
  836  Examination after October 1, 2011.
  837         (II) This sub-subparagraph may not be given retroactive
  838  application;
  839         b. The applicant graduated from a dental school accredited
  840  by the American Dental Association Commission on Dental
  841  Accreditation or its successor entity, if any, or any other
  842  dental accrediting organization recognized by the United States
  843  Department of Education. Provided, however, if the applicant did
  844  not graduate from such a dental school, the applicant may submit
  845  proof of having successfully completed a full-time supplemental
  846  general dentistry program accredited by the American Dental
  847  Association Commission on Dental Accreditation of at least 2
  848  consecutive academic years at such accredited sponsoring
  849  institution. Such program must provide didactic and clinical
  850  education at the level of a D.D.S. or D.M.D. program accredited
  851  by the American Dental Association Commission on Dental
  852  Accreditation. For purposes of this paragraph, a supplemental
  853  general dentistry program does not include an advanced education
  854  program in a dental specialty;
  855         c. The applicant currently possesses a valid and active
  856  dental license in good standing, with no restriction, which has
  857  never been revoked, suspended, restricted, or otherwise
  858  disciplined, from another state or territory of the United
  859  States, the District of Columbia, or the Commonwealth of Puerto
  860  Rico;
  861         d. The applicant submits proof that he or she has never
  862  been reported to the National Practitioner Data Bank, the
  863  Healthcare Integrity and Protection Data Bank, or the American
  864  Association of Dental Boards Clearinghouse. This sub
  865  subparagraph does not apply if the applicant successfully
  866  appealed to have his or her name removed from the data banks of
  867  these agencies;
  868         e.(I)(A)In the 5 years immediately preceding the date of
  869  application for licensure in this state, The applicant submits
  870  must submit proof of having been consecutively engaged in the
  871  full-time practice of dentistry in another state or territory of
  872  the United States, the District of Columbia, or the Commonwealth
  873  of Puerto Rico in the 5 years immediately preceding the date of
  874  application for licensure in this state;, or,
  875         (B) If the applicant has been licensed in another state or
  876  territory of the United States, the District of Columbia, or the
  877  Commonwealth of Puerto Rico for less than 5 years, the applicant
  878  submits must submit proof of having been engaged in the full
  879  time practice of dentistry since the date of his or her initial
  880  licensure.
  881         (II) As used in this section, “full-time practice” is
  882  defined as a minimum of 1,200 hours per year for each and every
  883  year in the consecutive 5-year period or, when where applicable,
  884  the period since initial licensure, and must include any
  885  combination of the following:
  886         (A) Active clinical practice of dentistry providing direct
  887  patient care.
  888         (B) Full-time practice as a faculty member employed by a
  889  dental or dental hygiene school approved by the board or
  890  accredited by the American Dental Association Commission on
  891  Dental Accreditation.
  892         (C) Full-time practice as a student at a postgraduate
  893  dental education program approved by the board or accredited by
  894  the American Dental Association Commission on Dental
  895  Accreditation.
  896         (III) The board shall develop rules to determine what type
  897  of proof of full-time practice is required and to recoup the
  898  cost to the board of verifying full-time practice under this
  899  section. Such proof must, at a minimum, be:
  900         (A) Admissible as evidence in an administrative proceeding;
  901         (B) Submitted in writing;
  902         (C) Submitted by the applicant under oath with penalties of
  903  perjury attached;
  904         (D) Further documented by an affidavit of someone unrelated
  905  to the applicant who is familiar with the applicant’s practice
  906  and testifies with particularity that the applicant has been
  907  engaged in full-time practice; and
  908         (E) Specifically found by the board to be both credible and
  909  admissible.
  910         (IV) An affidavit of only the applicant is not acceptable
  911  proof of full-time practice unless it is further attested to by
  912  someone unrelated to the applicant who has personal knowledge of
  913  the applicant’s practice. If the board deems it necessary to
  914  assess credibility or accuracy, the board may require the
  915  applicant or the applicant’s witnesses to appear before the
  916  board and give oral testimony under oath;
  917         f. The applicant submits must submit documentation that he
  918  or she has completed, or will complete before he or she is
  919  licensed, prior to licensure in this state, continuing education
  920  equivalent to this state’s requirements for the last full
  921  reporting biennium;
  922         g. The applicant proves must prove that he or she has never
  923  been convicted of, or pled nolo contendere to, regardless of
  924  adjudication, any felony or misdemeanor related to the practice
  925  of a health care profession in any jurisdiction;
  926         h. The applicant has must successfully passed pass a
  927  written examination on the laws and rules of this state
  928  regulating the practice of dentistry and must successfully pass
  929  the computer-based diagnostic skills examination; and
  930         i. The applicant submits must submit documentation that he
  931  or she has successfully completed the applicable examination
  932  administered by the Joint Commission on National Dental
  933  Examinations or its successor organization National Board of
  934  Dental Examiners dental examination.
  935         Section 21. Notwithstanding the January 1, 2020, repeal of
  936  section 466.0067, Florida Statutes, that section is revived,
  937  reenacted, and amended, to read:
  938         466.0067 Application for health access dental license.—The
  939  Legislature finds that there is an important state interest in
  940  attracting dentists to practice in underserved health access
  941  settings in this state and further, that allowing out-of-state
  942  dentists who meet certain criteria to practice in health access
  943  settings without the supervision of a dentist licensed in this
  944  state is substantially related to achieving this important state
  945  interest. Therefore, notwithstanding the requirements of s.
  946  466.006, the board shall grant a health access dental license to
  947  practice dentistry in this state in health access settings as
  948  defined in s. 466.003 to an applicant who that:
  949         (1) Files an appropriate application approved by the board;
  950         (2) Pays an application license fee for a health access
  951  dental license, laws-and-rule exam fee, and an initial licensure
  952  fee. The fees specified in this subsection may not differ from
  953  an applicant seeking licensure pursuant to s. 466.006;
  954         (3) Has not been convicted of or pled nolo contendere to,
  955  regardless of adjudication, any felony or misdemeanor related to
  956  the practice of a health care profession;
  957         (4) Submits proof of graduation from a dental school
  958  accredited by the Commission on Dental Accreditation of the
  959  American Dental Association or its successor agency;
  960         (5) Submits documentation that she or he has completed, or
  961  will obtain before prior to licensure, continuing education
  962  equivalent to this state’s requirement for dentists licensed
  963  under s. 466.006 for the last full reporting biennium before
  964  applying for a health access dental license;
  965         (6) Submits proof of her or his successful completion of
  966  parts I and II of the dental examination by the National Board
  967  of Dental Examiners and a state or regional clinical dental
  968  licensing examination that the board has determined effectively
  969  measures the applicant’s ability to practice safely;
  970         (7) Currently holds a valid, active, dental license in good
  971  standing which has not been revoked, suspended, restricted, or
  972  otherwise disciplined from another of the United States, the
  973  District of Columbia, or a United States territory;
  974         (8) Has never had a license revoked from another of the
  975  United States, the District of Columbia, or a United States
  976  territory;
  977         (9) Has never failed the examination specified in s.
  978  466.006, unless the applicant was reexamined pursuant to s.
  979  466.006 and received a license to practice dentistry in this
  980  state;
  981         (10) Has not been reported to the National Practitioner
  982  Data Bank, unless the applicant successfully appealed to have
  983  his or her name removed from the data bank;
  984         (11) Submits proof that he or she has been engaged in the
  985  active, clinical practice of dentistry providing direct patient
  986  care for 5 years immediately preceding the date of application,
  987  or in instances when the applicant has graduated from an
  988  accredited dental school within the preceding 5 years, submits
  989  proof of continuous clinical practice providing direct patient
  990  care since graduation; and
  991         (12) Has passed an examination covering the laws and rules
  992  of the practice of dentistry in this state as described in s.
  993  466.006(4)(a).
  994         Section 22. Notwithstanding the January 1, 2020, repeal of
  995  section 466.00671, Florida Statutes, that section is revived,
  996  reenacted, and amended to read:
  997         466.00671 Renewal of the health access dental license.—
  998         (1) A health access dental licensee shall apply for renewal
  999  each biennium. At the time of renewal, the licensee shall sign a
 1000  statement that she or he has complied with all continuing
 1001  education requirements of an active dentist licensee. The board
 1002  shall renew a health access dental license for an applicant who
 1003  that:
 1004         (a) Submits documentation, as approved by the board, from
 1005  the employer in the health access setting that the licensee has
 1006  at all times pertinent remained an employee;
 1007         (b) Has not been convicted of or pled nolo contendere to,
 1008  regardless of adjudication, any felony or misdemeanor related to
 1009  the practice of a health care profession;
 1010         (c) Has paid a renewal fee set by the board. The fee
 1011  specified herein may not differ from the renewal fee adopted by
 1012  the board pursuant to s. 466.013. The department may provide
 1013  payment for these fees through the dentist’s salary, benefits,
 1014  or other department funds;
 1015         (d) Has not failed the examination specified in s. 466.006
 1016  since initially receiving a health access dental license or
 1017  since the last renewal; and
 1018         (e) Has not been reported to the National Practitioner Data
 1019  Bank, unless the applicant successfully appealed to have his or
 1020  her name removed from the data bank.
 1021         (2) The board may undertake measures to independently
 1022  verify the health access dental licensee’s ongoing employment
 1023  status in the health access setting.
 1024         Section 23. Notwithstanding the January 1, 2020, repeal of
 1025  section 466.00672, Florida Statutes, that section is revived and
 1026  reenacted to read:
 1027         466.00672 Revocation of health access dental license.—
 1028         (1) The board shall revoke a health access dental license
 1029  upon:
 1030         (a) The licensee’s termination from employment from a
 1031  qualifying health access setting;
 1032         (b) Final agency action determining that the licensee has
 1033  violated any provision of s. 466.027 or s. 466.028, other than
 1034  infractions constituting citation offenses or minor violations;
 1035  or
 1036         (c) Failure of the Florida dental licensure examination.
 1037         (2) Failure of an individual licensed pursuant to s.
 1038  466.0067 to limit the practice of dentistry to health access
 1039  settings as defined in s. 466.003 constitutes the unlicensed
 1040  practice of dentistry.
 1041         Section 24. Paragraph (b) of subsection (4) and paragraph
 1042  (a) of subsection (6) of section 466.007, Florida Statutes, are
 1043  amended to read:
 1044         466.007 Examination of dental hygienists.—
 1045         (4) Effective July 1, 2012, to be licensed as a dental
 1046  hygienist in this state, an applicant must successfully complete
 1047  the following:
 1048         (b) A practical or clinical examination approved by the
 1049  board. The examination shall be the Dental Hygiene Examination
 1050  produced by the American Board of Dental Examiners, Inc. (ADEX)
 1051  or its successor entity, if any, if the board finds that the
 1052  successor entity’s clinical examination meets or exceeds the
 1053  provisions of this section. The board shall approve the ADEX
 1054  Dental Hygiene Examination if the board has attained and
 1055  continues to maintain representation on the ADEX House of
 1056  Representatives, the ADEX Dental Hygiene Examination Development
 1057  Committee, and such other ADEX Dental Hygiene committees as the
 1058  board deems appropriate through rulemaking to ensure that the
 1059  standards established in this section are maintained
 1060  organizationally. The ADEX Dental Hygiene Examination or the
 1061  examination produced by its successor entity is a comprehensive
 1062  examination in which an applicant must demonstrate skills within
 1063  the dental hygiene scope of practice on a live patient and any
 1064  other components that the board deems necessary for the
 1065  applicant to successfully demonstrate competency for the purpose
 1066  of licensure. The ADEX Dental Hygiene Examination or the
 1067  examination by the successor entity administered in this state
 1068  shall be graded by dentists and dental hygienists licensed in
 1069  this state who are employed by the department for this purpose.
 1070         (6)(a) A passing score on the ADEX Dental Hygiene
 1071  Examination administered out of state must shall be considered
 1072  the same as a passing score for the ADEX Dental Hygiene
 1073  Examination administered in this state and graded by licensed
 1074  dentists and dental hygienists.
 1075         Section 25. Subsections (9) through (15) are added to
 1076  section 466.017, Florida Statutes, to read:
 1077         466.017 Prescription of drugs; anesthesia.—
 1078         (9)Any adverse incident that occurs in an office
 1079  maintained by a dentist must be reported to the department. The
 1080  required notification to the department must be submitted in
 1081  writing by certified mail and postmarked within 48 hours after
 1082  the incident occurs.
 1083         (10)A dentist practicing in this state must notify the
 1084  board in writing by certified mail within 48 hours after any
 1085  adverse incident that occurs in the dentist’s outpatient
 1086  facility. A complete written report must be filed with the board
 1087  within 30 days after the incident occurs.
 1088         (11)Any certified registered dental hygienist
 1089  administering local anesthesia must notify the board in writing
 1090  by registered mail within 48 hours after any adverse incident
 1091  that was related to or the result of the administration of local
 1092  anesthesia. A complete written report must be filed with the
 1093  board within 30 days after the mortality or other adverse
 1094  incident.
 1095         (12)A failure by the dentist or dental hygienist to timely
 1096  and completely comply with all the reporting requirements in
 1097  this section is the basis for disciplinary action by the board
 1098  pursuant to s. 466.028(1).
 1099         (13)The department shall review each adverse incident and
 1100  determine whether it involved conduct by a health care
 1101  professional subject to disciplinary action, in which case s.
 1102  456.073 applies. Disciplinary action, if any, shall be taken by
 1103  the board under which the health care professional is licensed.
 1104         (14)As used in subsections (9)-(13), the term “adverse
 1105  incident” means any mortality that occurs during or as the
 1106  result of a dental procedure, or an incident that results in a
 1107  temporary or permanent physical or mental injury that requires
 1108  hospitalization or emergency room treatment of a dental patient
 1109  which occurs during or as a direct result of the use of general
 1110  anesthesia, deep sedation, moderate sedation, pediatric moderate
 1111  sedation, oral sedation, minimal sedation (anxiolysis), nitrous
 1112  oxide, or local anesthesia.
 1113         (15)The board may adopt rules to administer this section.
 1114         Section 26. Section 466.031, Florida Statutes, is amended
 1115  to read:
 1116         466.031 Dental laboratories laboratory” defined.—
 1117         (1)As used in this chapter, the term “dental laboratory”
 1118  as used in this chapter:
 1119         (1) includes any person, firm, or corporation that who
 1120  performs for a fee of any kind, gratuitously, or otherwise,
 1121  directly or through an agent or an employee, by any means or
 1122  method, or who in any way supplies or manufactures artificial
 1123  substitutes for the natural teeth;, or who furnishes, supplies,
 1124  constructs, or reproduces or repairs any prosthetic denture,
 1125  bridge, or appliance to be worn in the human mouth; or who in
 1126  any way represents holds itself out as a dental laboratory.
 1127         (2) The term does not include a Excludes any dental
 1128  laboratory technician who constructs or repairs dental
 1129  prosthetic appliances in the office of a licensed dentist
 1130  exclusively for that such dentist only and under her or his
 1131  supervision and work order.
 1132         (2) An employee or independent contractor of a dental
 1133  laboratory, acting as an agent of that dental laboratory, may
 1134  engage in onsite consultation with a licensed dentist during a
 1135  dental procedure.
 1136         Section 27. Section 466.036, Florida Statutes, is amended
 1137  to read:
 1138         466.036 Information; periodic inspections; equipment and
 1139  supplies.—The department may require from the applicant for a
 1140  registration certificate to operate a dental laboratory any
 1141  information necessary to carry out the purpose of this chapter,
 1142  including proof that the applicant has the equipment and
 1143  supplies necessary to operate as determined by rule of the
 1144  department, and shall require periodic inspection of all dental
 1145  laboratories operating in this state at least once each biennial
 1146  registration period. Such inspections must shall include, but
 1147  need not be limited to, inspection of sanitary conditions,
 1148  equipment, supplies, and facilities on the premises. The
 1149  department shall specify dental equipment and supplies that are
 1150  not allowed permitted in a registered dental laboratory.
 1151         Section 28. Subsection (1) of section 468.701, Florida
 1152  Statutes, is amended to read:
 1153         468.701 Definitions.—As used in this part, the term:
 1154         (1) “Athletic trainer” means a person licensed under this
 1155  part who has met the requirements of under this part, including
 1156  the education requirements established as set forth by the
 1157  Commission on Accreditation of Athletic Training Education or
 1158  its successor organization and necessary credentials from the
 1159  Board of Certification. An individual who is licensed as an
 1160  athletic trainer may not provide, offer to provide, or represent
 1161  that he or she is qualified to provide any care or services that
 1162  he or she lacks the education, training, or experience to
 1163  provide, or that he or she is otherwise prohibited by law from
 1164  providing.
 1165         Section 29. Section 468.707, Florida Statutes, is amended
 1166  to read:
 1167         468.707 Licensure requirements.—Any person desiring to be
 1168  licensed as an athletic trainer shall apply to the department on
 1169  a form approved by the department. An applicant shall also
 1170  provide records or other evidence, as determined by the board,
 1171  to prove he or she has met the requirements of this section. The
 1172  department shall license each applicant who:
 1173         (1) Has completed the application form and remitted the
 1174  required fees.
 1175         (2) For a person who applies on or after July 1, 2016, Has
 1176  submitted to background screening pursuant to s. 456.0135. The
 1177  board may require a background screening for an applicant whose
 1178  license has expired or who is undergoing disciplinary action.
 1179         (3)(a) Has obtained, at a minimum, a bachelor’s
 1180  baccalaureate or higher degree from a college or university
 1181  professional athletic training degree program accredited by the
 1182  Commission on Accreditation of Athletic Training Education or
 1183  its successor organization recognized and approved by the United
 1184  States Department of Education or the Commission on Recognition
 1185  of Postsecondary Accreditation, approved by the board, or
 1186  recognized by the Board of Certification, and has passed the
 1187  national examination to be certified by the Board of
 1188  Certification; or.
 1189         (b)(4)Has obtained, at a minimum, a bachelor’s degree, has
 1190  completed the Board of Certification internship requirements,
 1191  and holds If graduated before 2004, has a current certification
 1192  from the Board of Certification.
 1193         (4)(5) Has current certification in both cardiopulmonary
 1194  resuscitation and the use of an automated external defibrillator
 1195  set forth in the continuing education requirements as determined
 1196  by the board pursuant to s. 468.711.
 1197         (5)(6) Has completed any other requirements as determined
 1198  by the department and approved by the board.
 1199         Section 30. Subsection (3) of section 468.711, Florida
 1200  Statutes, is amended to read:
 1201         468.711 Renewal of license; continuing education.—
 1202         (3) If initially licensed after January 1, 1998, the
 1203  licensee must be currently certified by the Board of
 1204  Certification or its successor agency and maintain that
 1205  certification in good standing without lapse.
 1206         Section 31. Section 468.713, Florida Statutes, is amended
 1207  to read:
 1208         468.713 Responsibilities of athletic trainers.—
 1209         (1) An athletic trainer shall practice under the direction
 1210  of a physician licensed under chapter 458, chapter 459, chapter
 1211  460, or otherwise authorized by Florida law to practice
 1212  medicine. The physician shall communicate his or her direction
 1213  through oral or written prescriptions or protocols as deemed
 1214  appropriate by the physician for the provision of services and
 1215  care by the athletic trainer. An athletic trainer shall provide
 1216  service or care in the manner dictated by the physician.
 1217         (2) An athletic trainer shall work within his or her
 1218  allowable scope of practice as specified in board rule under s.
 1219  468.705. An athletic trainer may not provide, offer to provide,
 1220  or represent that he or she is qualified to provide any care or
 1221  services that he or she lacks the education, training, or
 1222  experience to provide or that he or she is otherwise prohibited
 1223  by law from providing.
 1224         Section 32. Subsection (2) of section 468.723, Florida
 1225  Statutes, is amended to read:
 1226         468.723 Exemptions.—This part does not prohibit prevent or
 1227  restrict:
 1228         (2) An athletic training student acting under the direct
 1229  supervision of a licensed athletic trainer. For purposes of this
 1230  subsection, “direct supervision” means the physical presence of
 1231  an athletic trainer so that the athletic trainer is immediately
 1232  available to the athletic training student and able to intervene
 1233  on behalf of the athletic training student. The supervision must
 1234  comply with board rule in accordance with the standards set
 1235  forth by the Commission on Accreditation of Athletic Training
 1236  Education or its successor.
 1237         Section 33. Subsections (1), (3), and (4) of section
 1238  468.803, Florida Statutes, are amended to read:
 1239         468.803 License, registration, and examination
 1240  requirements.—
 1241         (1) The department shall issue a license to practice
 1242  orthotics, prosthetics, or pedorthics, or a registration for a
 1243  resident to practice orthotics or prosthetics, to qualified
 1244  applicants. Licenses to practice shall be granted independently
 1245  in orthotics, prosthetics, or pedorthics must be granted
 1246  independently, but a person may be licensed in more than one
 1247  such discipline, and a prosthetist-orthotist license may be
 1248  granted to persons meeting the requirements for licensure both
 1249  as a prosthetist and as an orthotist license. Registrations to
 1250  practice shall be granted independently in orthotics or
 1251  prosthetics must be granted independently, and a person may be
 1252  registered in both disciplines fields at the same time or
 1253  jointly in orthotics and prosthetics as a dual registration.
 1254         (3) A person seeking to attain the required orthotics or
 1255  prosthetics experience required for licensure in this state must
 1256  be approved by the board and registered as a resident by the
 1257  department. Although a registration may be held in both
 1258  disciplines practice fields, for independent registrations the
 1259  board may shall not approve a second registration until at least
 1260  1 year after the issuance of the first registration.
 1261  Notwithstanding subsection (2), a person an applicant who has
 1262  been approved by the board and registered by the department in
 1263  one discipline practice field may apply for registration in the
 1264  second discipline practice field without an additional state or
 1265  national criminal history check during the period in which the
 1266  first registration is valid. Each independent registration or
 1267  dual registration is valid for 2 years after from the date of
 1268  issuance unless otherwise revoked by the department upon
 1269  recommendation of the board. The board shall set a registration
 1270  fee not to exceed $500 to be paid by the applicant. A
 1271  registration may be renewed once by the department upon
 1272  recommendation of the board for a period no longer than 1 year,
 1273  as such renewal is defined by the board by rule. The
 1274  registration renewal fee may shall not exceed one-half the
 1275  current registration fee. To be considered by the board for
 1276  approval of registration as a resident, the applicant must have
 1277  one of the following:
 1278         (a) A Bachelor of Science or higher-level postgraduate
 1279  degree in orthotics and prosthetics from a regionally accredited
 1280  college or university recognized by the Commission on
 1281  Accreditation of Allied Health Education Programs. or, at
 1282         (b) A minimum of, a bachelor’s degree from a regionally
 1283  accredited college or university and a certificate in orthotics
 1284  or prosthetics from a program recognized by the Commission on
 1285  Accreditation of Allied Health Education Programs, or its
 1286  equivalent, as determined by the board.; or
 1287         (c)A minimum of a bachelor’s degree from a regionally
 1288  accredited college or university and a dual certificate in both
 1289  orthotics and prosthetics from programs recognized by the
 1290  Commission on Accreditation of Allied Health Education Programs,
 1291  or its equivalent, as determined by the board.
 1292         (b)A Bachelor of Science or higher-level postgraduate
 1293  degree in Orthotics and Prosthetics from a regionally accredited
 1294  college or university recognized by the Commission on
 1295  Accreditation of Allied Health Education Programs or, at a
 1296  minimum, a bachelor’s degree from a regionally accredited
 1297  college or university and a certificate in prosthetics from a
 1298  program recognized by the Commission on Accreditation of Allied
 1299  Health Education Programs, or its equivalent, as determined by
 1300  the board.
 1301         (4) The department may develop and administer a state
 1302  examination for an orthotist or a prosthetist license, or the
 1303  board may approve the existing examination of a national
 1304  standards organization. The examination must be predicated on a
 1305  minimum of a baccalaureate-level education and formalized
 1306  specialized training in the appropriate field. Each examination
 1307  must demonstrate a minimum level of competence in basic
 1308  scientific knowledge, written problem solving, and practical
 1309  clinical patient management. The board shall require an
 1310  examination fee not to exceed the actual cost to the board in
 1311  developing, administering, and approving the examination, which
 1312  fee must be paid by the applicant. To be considered by the board
 1313  for examination, the applicant must have:
 1314         (a) For an examination in orthotics:
 1315         1. A Bachelor of Science or higher-level postgraduate
 1316  degree in orthotics and prosthetics from a regionally accredited
 1317  college or university recognized by the Commission on
 1318  Accreditation of Allied Health Education Programs or, at a
 1319  minimum, a bachelor’s degree from a regionally accredited
 1320  college or university and a certificate in orthotics from a
 1321  program recognized by the Commission on Accreditation of Allied
 1322  Health Education Programs, or its equivalent, as determined by
 1323  the board; and
 1324         2. An approved orthotics internship of 1 year of qualified
 1325  experience, as determined by the board, or an orthotic residency
 1326  or dual residency program recognized by the board.
 1327         (b) For an examination in prosthetics:
 1328         1. A Bachelor of Science or higher-level postgraduate
 1329  degree in orthotics and prosthetics from a regionally accredited
 1330  college or university recognized by the Commission on
 1331  Accreditation of Allied Health Education Programs or, at a
 1332  minimum, a bachelor’s degree from a regionally accredited
 1333  college or university and a certificate in prosthetics from a
 1334  program recognized by the Commission on Accreditation of Allied
 1335  Health Education Programs, or its equivalent, as determined by
 1336  the board; and
 1337         2. An approved prosthetics internship of 1 year of
 1338  qualified experience, as determined by the board, or a
 1339  prosthetic residency or dual residency program recognized by the
 1340  board.
 1341         Section 34. Subsection (5) of section 480.033, Florida
 1342  Statutes, is amended to read:
 1343         480.033 Definitions.—As used in this act:
 1344         (5) “Apprentice” means a person approved by the board to
 1345  study colonic irrigation massage under the instruction of a
 1346  licensed massage therapist practicing colonic irrigation.
 1347         Section 35. Subsections (1) and (2) of section 480.041,
 1348  Florida Statutes, are amended, and subsection (8) is added to
 1349  that section, to read:
 1350         480.041 Massage therapists; qualifications; licensure;
 1351  endorsement.—
 1352         (1) Any person is qualified for licensure as a massage
 1353  therapist under this act who:
 1354         (a) Is at least 18 years of age or has received a high
 1355  school diploma or high school equivalency diploma;
 1356         (b) Has completed a course of study at a board-approved
 1357  massage school or has completed an apprenticeship program that
 1358  meets standards adopted by the board; and
 1359         (c) Has received a passing grade on a national an
 1360  examination designated administered by the board department.
 1361         (2) Every person desiring to be examined for licensure as a
 1362  massage therapist must shall apply to the department in writing
 1363  upon forms prepared and furnished by the department. Such
 1364  applicants are shall be subject to the provisions of s.
 1365  480.046(1). Applicants may take an examination administered by
 1366  the department only upon meeting the requirements of this
 1367  section as determined by the board.
 1368         (8)A person issued a license as a massage apprentice
 1369  before July 1, 2020, may continue that apprenticeship and
 1370  perform massage therapy as authorized under that license until
 1371  it expires. Upon completion of the apprenticeship, which must
 1372  occur before July 1, 2023, a massage apprentice may apply to the
 1373  board for full licensure and be granted a license if all other
 1374  applicable licensure requirements are met.
 1375         Section 36. Section 480.042, Florida Statutes, is repealed.
 1376         Section 37. Subsection (3) of section 490.003, Florida
 1377  Statutes, is amended to read:
 1378         490.003 Definitions.—As used in this chapter:
 1379         (3)(a)Prior to July 1, 1999, “doctoral-level psychological
 1380  education” and “doctoral degree in psychology” mean a Psy.D., an
 1381  Ed.D. in psychology, or a Ph.D. in psychology from:
 1382         1.An educational institution which, at the time the
 1383  applicant was enrolled and graduated, had institutional
 1384  accreditation from an agency recognized and approved by the
 1385  United States Department of Education or was recognized as a
 1386  member in good standing with the Association of Universities and
 1387  Colleges of Canada; and
 1388         2.A psychology program within that educational institution
 1389  which, at the time the applicant was enrolled and graduated, had
 1390  programmatic accreditation from an accrediting agency recognized
 1391  and approved by the United States Department of Education or was
 1392  comparable to such programs.
 1393         (b) Effective July 1, 1999, “doctoral-level psychological
 1394  education” and “doctoral degree in psychology” mean a Psy.D., an
 1395  Ed.D. in psychology, or a Ph.D. in psychology from a psychology
 1396  program at:
 1397         1. an educational institution that which, at the time the
 1398  applicant was enrolled and graduated:
 1399         (a), Had institutional accreditation from an agency
 1400  recognized and approved by the United States Department of
 1401  Education or was recognized as a member in good standing with
 1402  the Association of Universities and Colleges of Canada; and
 1403         (b)2.A psychology program within that educational
 1404  institution which, at the time the applicant was enrolled and
 1405  graduated, Had programmatic accreditation from the American
 1406  Psychological Association an agency recognized and approved by
 1407  the United States Department of Education.
 1408         Section 38. Paragraph (b) of subsection (1) and paragraph
 1409  (b) of subsection (2) of section 490.005, Florida Statutes, are
 1410  amended to read:
 1411         490.005 Licensure by examination.—
 1412         (1) Any person desiring to be licensed as a psychologist
 1413  shall apply to the department to take the licensure examination.
 1414  The department shall license each applicant who the board
 1415  certifies has:
 1416         (b) Submitted proof satisfactory to the board that the
 1417  applicant has received:
 1418         1. Received Doctoral-level psychological education, as
 1419  defined in s. 490.003(3); or
 1420         2. Received The equivalent of a doctoral-level
 1421  psychological education, as defined in s. 490.003(3), from a
 1422  program at a school or university located outside the United
 1423  States of America and Canada, which was officially recognized by
 1424  the government of the country in which it is located as an
 1425  institution or program to train students to practice
 1426  professional psychology. The applicant has the burden of
 1427  establishing that this requirement has the requirements of this
 1428  provision have been met shall be upon the applicant;
 1429         3.Received and submitted to the board, prior to July 1,
 1430  1999, certification of an augmented doctoral-level psychological
 1431  education from the program director of a doctoral-level
 1432  psychology program accredited by a programmatic agency
 1433  recognized and approved by the United States Department of
 1434  Education; or
 1435         4.Received and submitted to the board, prior to August 31,
 1436  2001, certification of a doctoral-level program that at the time
 1437  the applicant was enrolled and graduated maintained a standard
 1438  of education and training comparable to the standard of training
 1439  of programs accredited by a programmatic agency recognized and
 1440  approved by the United States Department of Education. Such
 1441  certification of comparability shall be provided by the program
 1442  director of a doctoral-level psychology program accredited by a
 1443  programmatic agency recognized and approved by the United States
 1444  Department of Education.
 1445         (2) Any person desiring to be licensed as a school
 1446  psychologist shall apply to the department to take the licensure
 1447  examination. The department shall license each applicant who the
 1448  department certifies has:
 1449         (b) Submitted satisfactory proof to the department that the
 1450  applicant:
 1451         1. Has received a doctorate, specialist, or equivalent
 1452  degree from a program primarily psychological in nature and has
 1453  completed 60 semester hours or 90 quarter hours of graduate
 1454  study, in areas related to school psychology as defined by rule
 1455  of the department, from a college or university which at the
 1456  time the applicant was enrolled and graduated was accredited by
 1457  an accrediting agency recognized and approved by the Council for
 1458  Higher Education Accreditation or its successor organization
 1459  Commission on Recognition of Postsecondary Accreditation or from
 1460  an institution that which is publicly recognized as a member in
 1461  good standing with the Association of Universities and Colleges
 1462  of Canada.
 1463         2. Has had a minimum of 3 years of experience in school
 1464  psychology, 2 years of which must be supervised by an individual
 1465  who is a licensed school psychologist or who has otherwise
 1466  qualified as a school psychologist supervisor, by education and
 1467  experience, as set forth by rule of the department. A doctoral
 1468  internship may be applied toward the supervision requirement.
 1469         3. Has passed an examination provided by the department.
 1470         Section 39. Subsection (1) of section 490.006, Florida
 1471  Statutes, is amended to read:
 1472         490.006 Licensure by endorsement.—
 1473         (1) The department shall license a person as a psychologist
 1474  or school psychologist who, upon applying to the department and
 1475  remitting the appropriate fee, demonstrates to the department
 1476  or, in the case of psychologists, to the board that the
 1477  applicant:
 1478         (a)Holds a valid license or certificate in another state
 1479  to practice psychology or school psychology, as applicable,
 1480  provided that, when the applicant secured such license or
 1481  certificate, the requirements were substantially equivalent to
 1482  or more stringent than those set forth in this chapter at that
 1483  time; and, if no Florida law existed at that time, then the
 1484  requirements in the other state must have been substantially
 1485  equivalent to or more stringent than those set forth in this
 1486  chapter at the present time;
 1487         (a)(b) Is a diplomate in good standing with the American
 1488  Board of Professional Psychology, Inc.; or
 1489         (b)(c) Possesses a doctoral degree in psychology as
 1490  described in s. 490.003 and has at least 10 20 years of
 1491  experience as a licensed psychologist in any jurisdiction or
 1492  territory of the United States within the 25 years preceding the
 1493  date of application.
 1494         Section 40. Subsection (6) of section 491.0045, Florida
 1495  Statutes, as amended by chapters 2016-80 and 2016-241, Laws of
 1496  Florida, is amended to read:
 1497         491.0045 Intern registration; requirements.—
 1498         (6) A registration issued on or before March 31, 2017,
 1499  expires March 31, 2022, and may not be renewed or reissued. Any
 1500  registration issued after March 31, 2017, expires 60 months
 1501  after the date it is issued. The board may make a one-time
 1502  exception from the requirements of this subsection in emergency
 1503  or hardship cases, as defined by board rule, if A subsequent
 1504  intern registration may not be issued unless the candidate has
 1505  passed the theory and practice examination described in s.
 1506  491.005(1)(d), (3)(d), and (4)(d).
 1507         Section 41. Subsections (3) and (4) of section 491.005,
 1508  Florida Statutes, are amended to read:
 1509         491.005 Licensure by examination.—
 1510         (3) MARRIAGE AND FAMILY THERAPY.—Upon verification of
 1511  documentation and payment of a fee not to exceed $200, as set by
 1512  board rule, plus the actual cost of to the department for the
 1513  purchase of the examination from the Association of Marital and
 1514  Family Therapy Regulatory Board, or similar national
 1515  organization, the department shall issue a license as a marriage
 1516  and family therapist to an applicant who the board certifies:
 1517         (a) Has submitted an application and paid the appropriate
 1518  fee.
 1519         (b)1. Has a minimum of a master’s degree with major
 1520  emphasis in marriage and family therapy, or a closely related
 1521  field from a program accredited by the Commission on
 1522  Accreditation for Marriage and Family Therapy Education or from
 1523  a Florida university program accredited by the Council for
 1524  Accreditation of Counseling and Related Educational Programs,
 1525  and graduate courses approved by the Board of Clinical Social
 1526  Work, Marriage and Family Therapy, and Mental Health Counseling.
 1527  has completed all of the following requirements:
 1528         a.Thirty-six semester hours or 48 quarter hours of
 1529  graduate coursework, which must include a minimum of 3 semester
 1530  hours or 4 quarter hours of graduate-level course credits in
 1531  each of the following nine areas: dynamics of marriage and
 1532  family systems; marriage therapy and counseling theory and
 1533  techniques; family therapy and counseling theory and techniques;
 1534  individual human development theories throughout the life cycle;
 1535  personality theory or general counseling theory and techniques;
 1536  psychopathology; human sexuality theory and counseling
 1537  techniques; psychosocial theory; and substance abuse theory and
 1538  counseling techniques. Courses in research, evaluation,
 1539  appraisal, assessment, or testing theories and procedures;
 1540  thesis or dissertation work; or practicums, internships, or
 1541  fieldwork may not be applied toward this requirement.
 1542         b.A minimum of one graduate-level course of 3 semester
 1543  hours or 4 quarter hours in legal, ethical, and professional
 1544  standards issues in the practice of marriage and family therapy
 1545  or a course determined by the board to be equivalent.
 1546         c.A minimum of one graduate-level course of 3 semester
 1547  hours or 4 quarter hours in diagnosis, appraisal, assessment,
 1548  and testing for individual or interpersonal disorder or
 1549  dysfunction; and a minimum of one 3-semester-hour or 4-quarter
 1550  hour graduate-level course in behavioral research which focuses
 1551  on the interpretation and application of research data as it
 1552  applies to clinical practice. Credit for thesis or dissertation
 1553  work, practicums, internships, or fieldwork may not be applied
 1554  toward this requirement.
 1555         d.A minimum of one supervised clinical practicum,
 1556  internship, or field experience in a marriage and family
 1557  counseling setting, during which the student provided 180 direct
 1558  client contact hours of marriage and family therapy services
 1559  under the supervision of an individual who met the requirements
 1560  for supervision under paragraph (c). This requirement may be met
 1561  by a supervised practice experience which took place outside the
 1562  academic arena, but which is certified as equivalent to a
 1563  graduate-level practicum or internship program which required a
 1564  minimum of 180 direct client contact hours of marriage and
 1565  family therapy services currently offered within an academic
 1566  program of a college or university accredited by an accrediting
 1567  agency approved by the United States Department of Education, or
 1568  an institution which is publicly recognized as a member in good
 1569  standing with the Association of Universities and Colleges of
 1570  Canada or a training institution accredited by the Commission on
 1571  Accreditation for Marriage and Family Therapy Education
 1572  recognized by the United States Department of Education.
 1573  Certification shall be required from an official of such
 1574  college, university, or training institution.
 1575         2. If the course title that which appears on the
 1576  applicant’s transcript does not clearly identify the content of
 1577  the coursework, the applicant shall be required to provide
 1578  additional documentation, including, but not limited to, a
 1579  syllabus or catalog description published for the course.
 1580  
 1581  The required master’s degree must have been received in an
 1582  institution of higher education that, which at the time the
 1583  applicant graduated, was: fully accredited by a regional
 1584  accrediting body recognized by the Commission on Recognition of
 1585  Postsecondary Accreditation or; publicly recognized as a member
 1586  in good standing with the Association of Universities and
 1587  Colleges of Canada,; or an institution of higher education
 1588  located outside the United States and Canada, which, at the time
 1589  the applicant was enrolled and at the time the applicant
 1590  graduated, maintained a standard of training substantially
 1591  equivalent to the standards of training of those institutions in
 1592  the United States which are accredited by a regional accrediting
 1593  body recognized by the Commission on Recognition of
 1594  Postsecondary Accreditation. Such foreign education and training
 1595  must have been received in an institution or program of higher
 1596  education officially recognized by the government of the country
 1597  in which it is located as an institution or program to train
 1598  students to practice as professional marriage and family
 1599  therapists or psychotherapists. The applicant has the burden of
 1600  establishing that the requirements of this provision have been
 1601  met shall be upon the applicant, and the board shall require
 1602  documentation, such as, but not limited to, an evaluation by a
 1603  foreign equivalency determination service, as evidence that the
 1604  applicant’s graduate degree program and education were
 1605  equivalent to an accredited program in this country. An
 1606  applicant with a master’s degree from a program that which did
 1607  not emphasize marriage and family therapy may complete the
 1608  coursework requirement in a training institution fully
 1609  accredited by the Commission on Accreditation for Marriage and
 1610  Family Therapy Education recognized by the United States
 1611  Department of Education.
 1612         (c) Has had at least 2 years of clinical experience during
 1613  which 50 percent of the applicant’s clients were receiving
 1614  marriage and family therapy services, which must be at the post
 1615  master’s level under the supervision of a licensed marriage and
 1616  family therapist with at least 5 years of experience, or the
 1617  equivalent, who is a qualified supervisor as determined by the
 1618  board. An individual who intends to practice in Florida to
 1619  satisfy the clinical experience requirements must register
 1620  pursuant to s. 491.0045 before commencing practice. If a
 1621  graduate has a master’s degree with a major emphasis in marriage
 1622  and family therapy or a closely related field which that did not
 1623  include all of the coursework required by subparagraph (b)1.
 1624  under sub-subparagraphs (b)1.a.-c., credit for the post-master’s
 1625  level clinical experience may shall not commence until the
 1626  applicant has completed a minimum of 10 of the courses required
 1627  by subparagraph (b)1. under sub-subparagraphs (b)1.a.-c., as
 1628  determined by the board, and at least 6 semester hours or 9
 1629  quarter hours of the course credits must have been completed in
 1630  the area of marriage and family systems, theories, or
 1631  techniques. Within the 2 3 years of required experience, the
 1632  applicant shall provide direct individual, group, or family
 1633  therapy and counseling, to include the following categories of
 1634  cases including those involving: unmarried dyads, married
 1635  couples, separating and divorcing couples, and family groups
 1636  that include including children. A doctoral internship may be
 1637  applied toward the clinical experience requirement. A licensed
 1638  mental health professional must be on the premises when clinical
 1639  services are provided by a registered intern in a private
 1640  practice setting.
 1641         (d) Has passed a theory and practice examination provided
 1642  by the department for this purpose.
 1643         (e) Has demonstrated, in a manner designated by board rule
 1644  of the board, knowledge of the laws and rules governing the
 1645  practice of clinical social work, marriage and family therapy,
 1646  and mental health counseling.
 1647         (f) 
 1648  
 1649  For the purposes of dual licensure, the department shall license
 1650  as a marriage and family therapist any person who meets the
 1651  requirements of s. 491.0057. Fees for dual licensure may shall
 1652  not exceed those stated in this subsection.
 1653         (4) MENTAL HEALTH COUNSELING.—Upon verification of
 1654  documentation and payment of a fee not to exceed $200, as set by
 1655  board rule, plus the actual per applicant cost of to the
 1656  department for purchase of the examination from the National
 1657  Board for Certified Counselors or its successor Professional
 1658  Examination Service for the National Academy of Certified
 1659  Clinical Mental Health Counselors or a similar national
 1660  organization, the department shall issue a license as a mental
 1661  health counselor to an applicant who the board certifies:
 1662         (a) Has submitted an application and paid the appropriate
 1663  fee.
 1664         (b)1. Has a minimum of an earned master’s degree from a
 1665  mental health counseling program accredited by the Council for
 1666  the Accreditation of Counseling and Related Educational Programs
 1667  which that consists of at least 60 semester hours or 80 quarter
 1668  hours of clinical and didactic instruction, including a course
 1669  in human sexuality and a course in substance abuse. If the
 1670  master’s degree is earned from a program related to the practice
 1671  of mental health counseling which that is not accredited by the
 1672  Council for the Accreditation of Counseling and Related
 1673  Educational Programs, then the coursework and practicum,
 1674  internship, or fieldwork must consist of at least 60 semester
 1675  hours or 80 quarter hours and meet all of the following
 1676  requirements:
 1677         a. Thirty-three semester hours or 44 quarter hours of
 1678  graduate coursework, which must include a minimum of 3 semester
 1679  hours or 4 quarter hours of graduate-level coursework in each of
 1680  the following 11 content areas: counseling theories and
 1681  practice; human growth and development; diagnosis and treatment
 1682  of psychopathology; human sexuality; group theories and
 1683  practice; individual evaluation and assessment; career and
 1684  lifestyle assessment; research and program evaluation; social
 1685  and cultural foundations; substance abuse; and legal, ethical,
 1686  and professional standards issues in the practice of mental
 1687  health counseling in community settings; and substance abuse.
 1688  Courses in research, thesis or dissertation work, practicums,
 1689  internships, or fieldwork may not be applied toward this
 1690  requirement.
 1691         b. A minimum of 3 semester hours or 4 quarter hours of
 1692  graduate-level coursework addressing diagnostic processes,
 1693  including differential diagnosis and the use of the current
 1694  diagnostic tools, such as the current edition of the American
 1695  Psychiatric Association’s Diagnostic and Statistical Manual of
 1696  Mental Disorders. The graduate program must have emphasized the
 1697  common core curricular experience in legal, ethical, and
 1698  professional standards issues in the practice of mental health
 1699  counseling, which includes goals, objectives, and practices of
 1700  professional counseling organizations, codes of ethics, legal
 1701  considerations, standards of preparation, certifications and
 1702  licensing, and the role identity and professional obligations of
 1703  mental health counselors. Courses in research, thesis or
 1704  dissertation work, practicums, internships, or fieldwork may not
 1705  be applied toward this requirement.
 1706         c. The equivalent, as determined by the board, of at least
 1707  700 1,000 hours of university-sponsored supervised clinical
 1708  practicum, internship, or field experience that includes at
 1709  least 280 hours of direct client services, as required in the
 1710  accrediting standards of the Council for Accreditation of
 1711  Counseling and Related Educational Programs for mental health
 1712  counseling programs. This experience may not be used to satisfy
 1713  the post-master’s clinical experience requirement.
 1714         2. Has provided additional documentation if a the course
 1715  title that which appears on the applicant’s transcript does not
 1716  clearly identify the content of the coursework., The applicant
 1717  shall be required to provide additional documentation must
 1718  include, including, but is not limited to, a syllabus or catalog
 1719  description published for the course.
 1720  
 1721  Education and training in mental health counseling must have
 1722  been received in an institution of higher education that, which
 1723  at the time the applicant graduated, was: fully accredited by a
 1724  regional accrediting body recognized by the Council for Higher
 1725  Education Accreditation or its successor organization or
 1726  Commission on Recognition of Postsecondary Accreditation;
 1727  publicly recognized as a member in good standing with the
 1728  Association of Universities and Colleges of Canada,; or an
 1729  institution of higher education located outside the United
 1730  States and Canada, which, at the time the applicant was enrolled
 1731  and at the time the applicant graduated, maintained a standard
 1732  of training substantially equivalent to the standards of
 1733  training of those institutions in the United States which are
 1734  accredited by a regional accrediting body recognized by the
 1735  Council for Higher Education Accreditation or its successor
 1736  organization Commission on Recognition of Postsecondary
 1737  Accreditation. Such foreign education and training must have
 1738  been received in an institution or program of higher education
 1739  officially recognized by the government of the country in which
 1740  it is located as an institution or program to train students to
 1741  practice as mental health counselors. The applicant has the
 1742  burden of establishing that the requirements of this provision
 1743  have been met shall be upon the applicant, and the board shall
 1744  require documentation, such as, but not limited to, an
 1745  evaluation by a foreign equivalency determination service, as
 1746  evidence that the applicant’s graduate degree program and
 1747  education were equivalent to an accredited program in this
 1748  country. Beginning July 1, 2025, an applicant must have a
 1749  master’s degree from a program that is accredited by the Council
 1750  for Accreditation of Counseling and Related Educational Programs
 1751  which consists of at least 60 semester hours or 80 quarter hours
 1752  to apply for licensure under this paragraph.
 1753         (c) Has had at least 2 years of clinical experience in
 1754  mental health counseling, which must be at the post-master’s
 1755  level under the supervision of a licensed mental health
 1756  counselor or the equivalent who is a qualified supervisor as
 1757  determined by the board. An individual who intends to practice
 1758  in Florida to satisfy the clinical experience requirements must
 1759  register pursuant to s. 491.0045 before commencing practice. If
 1760  a graduate has a master’s degree with a major related to the
 1761  practice of mental health counseling which that did not include
 1762  all the coursework required under sub-subparagraphs (b)1.a. and
 1763  b. (b)1.a.-b., credit for the post-master’s level clinical
 1764  experience may shall not commence until the applicant has
 1765  completed a minimum of seven of the courses required under sub
 1766  subparagraphs (b)1.a. and b. (b)1.a.-b., as determined by the
 1767  board, one of which must be a course in psychopathology or
 1768  abnormal psychology. A doctoral internship may be applied toward
 1769  the clinical experience requirement. A licensed mental health
 1770  professional must be on the premises when clinical services are
 1771  provided by a registered intern in a private practice setting.
 1772         (d) Has passed a theory and practice examination provided
 1773  by the department for this purpose.
 1774         (e) Has demonstrated, in a manner designated by board rule
 1775  of the board, knowledge of the laws and rules governing the
 1776  practice of clinical social work, marriage and family therapy,
 1777  and mental health counseling.
 1778         Section 42. Paragraph (b) of subsection (1) of section
 1779  491.006, Florida Statutes, is amended to read:
 1780         491.006 Licensure or certification by endorsement.—
 1781         (1) The department shall license or grant a certificate to
 1782  a person in a profession regulated by this chapter who, upon
 1783  applying to the department and remitting the appropriate fee,
 1784  demonstrates to the board that he or she:
 1785         (b)1. Holds an active valid license to practice and has
 1786  actively practiced the licensed profession for which licensure
 1787  is applied in another state for 3 of the last 5 years
 1788  immediately preceding licensure;.
 1789         2.Meets the education requirements of this chapter for the
 1790  profession for which licensure is applied.
 1791         2.3. Has passed a substantially equivalent licensing
 1792  examination in another state or has passed the licensure
 1793  examination in this state in the profession for which the
 1794  applicant seeks licensure; and.
 1795         3.4. Holds a license in good standing, is not under
 1796  investigation for an act that would constitute a violation of
 1797  this chapter, and has not been found to have committed any act
 1798  that would constitute a violation of this chapter.
 1799  
 1800  The fees paid by any applicant for certification as a master
 1801  social worker under this section are nonrefundable.
 1802         Section 43. Subsection (3) of section 491.007, Florida
 1803  Statutes, is amended to read:
 1804         491.007 Renewal of license, registration, or certificate.—
 1805         (3)The board or department shall prescribe by rule a
 1806  method for the biennial renewal of an intern registration at a
 1807  fee set by rule, not to exceed $100.
 1808         Section 44. Subsection (2) of section 491.009, Florida
 1809  Statutes, is amended to read:
 1810         491.009 Discipline.—
 1811         (2) The board department, or, in the case of certified
 1812  master social workers psychologists, the department board, may
 1813  enter an order denying licensure or imposing any of the
 1814  penalties authorized in s. 456.072(2) against any applicant for
 1815  licensure or any licensee who violates is found guilty of
 1816  violating any provision of subsection (1) of this section or who
 1817  is found guilty of violating any provision of s. 456.072(1).
 1818         Section 45. Subsection (2) of section 491.0046, Florida
 1819  Statutes, is amended to read:
 1820         491.0046 Provisional license; requirements.—
 1821         (2) The department shall issue a provisional clinical
 1822  social worker license, provisional marriage and family therapist
 1823  license, or provisional mental health counselor license to each
 1824  applicant who the board certifies has:
 1825         (a) Completed the application form and remitted a
 1826  nonrefundable application fee not to exceed $100, as set by
 1827  board rule; and
 1828         (b) Earned a graduate degree in social work, a graduate
 1829  degree with a major emphasis in marriage and family therapy or a
 1830  closely related field, or a graduate degree in a major related
 1831  to the practice of mental health counseling; and
 1832         (c) Has Met the following minimum coursework requirements:
 1833         1. For clinical social work, a minimum of 15 semester hours
 1834  or 22 quarter hours of the coursework required by s.
 1835  491.005(1)(b)2.b.
 1836         2. For marriage and family therapy, 10 of the courses
 1837  required by s. 491.005(3)(b)1. s. 491.005(3)(b)1.a.-c., as
 1838  determined by the board, and at least 6 semester hours or 9
 1839  quarter hours of the course credits must have been completed in
 1840  the area of marriage and family systems, theories, or
 1841  techniques.
 1842         3. For mental health counseling, a minimum of seven of the
 1843  courses required under s. 491.005(4)(b)1.a.-c.
 1844         Section 46. Subsection (11) of section 945.42, Florida
 1845  Statutes, is amended to read:
 1846         945.42 Definitions; ss. 945.40-945.49.—As used in ss.
 1847  945.40-945.49, the following terms shall have the meanings
 1848  ascribed to them, unless the context shall clearly indicate
 1849  otherwise:
 1850         (11) “Psychological professional” means a behavioral
 1851  practitioner who has an approved doctoral degree in psychology
 1852  as defined in s. 490.003(3) s. 490.003(3)(b) and is employed by
 1853  the department or who is licensed as a psychologist pursuant to
 1854  chapter 490.
 1855         Section 47. For the purpose of incorporating the amendment
 1856  made by this act to section 459.0055, Florida Statutes, in a
 1857  reference thereto, subsection (6) of section 459.021, Florida
 1858  Statutes, is reenacted to read:
 1859         459.021 Registration of resident physicians, interns, and
 1860  fellows; list of hospital employees; penalty.—
 1861         (6) Any person desiring registration pursuant to this
 1862  section shall meet all the requirements of s. 459.0055, except
 1863  paragraphs (1)(l) and (m).
 1864         Section 48. The amendments and reenactments made by this
 1865  act to sections 466.0067, 466.00671, and 466.00672, Florida
 1866  Statutes, are remedial in nature and apply retroactively to
 1867  January 1, 2020.
 1868         Section 49. This act shall take effect July 1, 2020.
 1869