Florida Senate - 2020 COMMITTEE AMENDMENT Bill No. SB 512 Ì846704+Î846704 LEGISLATIVE ACTION Senate . House Comm: RCS . 02/04/2020 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Health Policy (Hutson) recommended the following: 1 Senate Amendment (with title amendment) 2 3 Delete everything after the enacting clause 4 and insert: 5 Section 1. Section 381.06017, Florida Statutes, is created 6 to read: 7 381.06017 Nonembryonic stem cell banks; collection, 8 manufacturing, storage, dispensing, and use of human 9 nonembryonic stem cells.— 10 (1) DEFINITIONS.—As used in this section, the term: 11 (a) “Compounding” means combining, mixing, or altering the 12 ingredients of one or more drugs or products to create another 13 drug or product. 14 (b) “Dispense” has the same meaning as in s. 465.003(6). 15 (c) “Establishment” means a place of business which is at 16 one general physical location and may extend to one or more 17 contiguous suites, units, floors, or buildings operated and 18 controlled exclusively by entities under common operation and 19 control. The term includes multiple buildings with an 20 intervening thoroughfare if the buildings are under common 21 exclusive ownership, operation, and control. For purposes of 22 permitting, each suite, unit, floor, or building must be 23 identified in the most recent permit application. 24 (d) “Federal act” means the Federal Food, Drug, and 25 Cosmetic Act, 21 U.S.C. ss. 301 et seq.; 52 Stat. 1040 et seq. 26 (e) “Minimally manipulated” means: 27 1. For structural tissue, processing that does not alter 28 the original characteristics of the tissue which relate to the 29 tissue’s utility for reconstruction, repair, or replacement; or 30 2. For cells or nonstructural tissue, processing that does 31 not alter the relevant biological characteristics of the cell or 32 tissue. 33 (f) “Nonembryonic stem cell,” also referred to as a 34 “somatic stem cell” or an “adult human stem cell,” means an 35 allogenic or autologous cell that is undifferentiated and 36 unspecialized and that has the ability to divide for indefinite 37 periods of time in a medium and to become a specialized cell. 38 The term includes a human nonembryonic cell that is altered or 39 processed to become undifferentiated, losing its original 40 structural function, so that it can be differentiated into a 41 specialized cell type. The term does not include cells that are 42 minimally manipulated or are only rinsed, cleaned, or sized and 43 remain differentiated. 44 (g) “Nonembryonic stem cell bank” means a publicly or 45 privately owned establishment that does any of the following: 46 1. Collects and stores human nonembryonic stem cells for 47 use in a product or patient-specific medical administration. 48 2. Provides patient-specific health care services using 49 human nonembryonic stem cells. 50 3. Advertises human nonembryonic stem cell services, 51 including, but not limited to, collection, manufacturing, 52 storage, dispensing, use, or purported use of human nonembryonic 53 stem cells or products containing human nonembryonic stem cells, 54 which have not been approved by the United States Food and Drug 55 Administration or are not the subject of clinical trials 56 approved by the United States Food and Drug Administration and 57 which are intended to diagnose, cure, mitigate, treat, provide 58 therapy for, or prevent an injury or a disease. 59 4. Performs any procedure that is intended to: 60 a. Collect or store human nonembryonic stem cells for any 61 purpose; or 62 b. Diagnose, cure, mitigate, treat, provide therapy for, or 63 prevent an injury or a disease with the use or purported use of 64 human nonembryonic stem cells or any product containing human 65 nonembryonic stem cells which has not been approved by the 66 United States Food and Drug Administration or is not the subject 67 of a clinical trial approved by the United States Food and Drug 68 Administration. 69 5. Compounds human nonembryonic stem cells from human 70 nonembryonic cells or tissue into products by combining, mixing, 71 or altering the ingredients of one or more drugs or products to 72 create another drug or product. 73 6. Manufactures, through recovery, processing, 74 manipulation, enzymatic digestion, mechanical disruption, or a 75 similar process, human nonembryonic stem cells from human 76 nonembryonic cells or tissue into undifferentiated human 77 nonembryonic stem cells, causing the cells to lose their 78 original structural function so that the nonembryonic stem cells 79 may be differentiated into specialized cell types. 80 7. Dispenses human nonembryonic stem cells and products 81 containing nonembryonic stem cells to any of the following for a 82 specific patient pursuant to a valid prescription from a 83 licensed health care practitioner authorized within the scope of 84 his or her license to prescribe and administer human 85 nonembryonic stem cells: 86 a. A pharmacy permitted under chapter 465. 87 b. A health care practitioner with privileges to practice 88 at nonembryonic stem cell banks. 89 c. A health care practitioner’s office, a health care 90 facility, or a treatment setting where the health care 91 practitioner has privileges to practice, for office use. 92 (h) “Office use” means the provision and administration of 93 a drug, compounded drug, or compounded product to a patient by a 94 health care practitioner in the practitioner’s office or in a 95 health care facility or treatment setting, including a hospital, 96 ambulatory surgery center, or health care clinic licensed under 97 chapter 395 or chapter 400. The term also includes the 98 dispensing by a pharmacist at a nonembryonic stem cell bank that 99 is also permitted as a pharmacy under chapter 465 to a 100 nonembryonic stem cell bank within this state of any of the 101 following: 102 1. Human nonembryonic stem cells. 103 2. A compounded drug containing human nonembryonic stem 104 cells. 105 3. A compounded product containing nonembryonic stem cells. 106 (2) DUTIES AND REGISTRATION.—A nonembryonic stem cell bank 107 that advertises, collects, stores, manufactures, dispenses, 108 compounds, uses, or purports to use nonembryonic stem cells or 109 products containing nonembryonic stem cells is deemed a clinic 110 as defined in s. 400.9905 and must comply with all of the 111 following requirements: 112 (a) Adhere to the applicable current good manufacturing 113 practices for the collection, removal, manufacturing, 114 processing, compounding, and implantation of nonembryonic stem 115 cells or products containing nonembryonic stem cells pursuant to 116 the federal act and 21 C.F.R., parts 1270-1271. 117 (b) Obtain a health care clinic license from the agency 118 pursuant to s. 400.991 and part II of chapter 408 and register 119 each establishment separately, unless: 120 1. The clinic is a facility licensed under chapter 395; or 121 2. The clinic is affiliated with an accredited medical 122 school that provides training to medical students, residents, or 123 fellows. 124 (c) Have a physician medical director who is responsible 125 for complying with all requirements related to licensure, 126 operation of a nonembryonic stem cell bank, and good 127 manufacturing practices under this section, part X of chapter 128 400, and the federal act and 21 C.F.R., parts 1270-1271. 129 (d) Notify the agency in writing on a form approved by the 130 agency within 10 days after termination of a physician medical 131 director and notify the agency within 10 days after such 132 termination of the identity of the physician medical director 133 who has assumed responsibility for that nonembryonic stem cell 134 bank. Failure to have a physician medical director practicing at 135 the location of the licensed nonembryonic stem cell bank shall 136 be the basis for a summary suspension of the nonembryonic stem 137 cell bank’s license pursuant to s. 400.607 or s. 120.60(6). 138 (e) Require a physician medical director to have a full, 139 active, and unencumbered license issued under chapter 458 or 140 chapter 459 and to actively practice at the nonembryonic stem 141 cell bank location for which he or she has assumed 142 responsibility. 143 (f) Maintain commercial and professional liability 144 insurance in an amount not less than $250,000 per claim. 145 (g) Operate each establishment using the same name as the 146 one used to obtain the health care clinic license from the 147 agency. All invoices, packing slips, and other business records 148 must list the same name. 149 (h) Obtain a pharmacy permit for each person and 150 establishment before dispensing, offering office use for the 151 compounding of human nonembryonic stem cells, or dispensing a 152 compounded product for office use. 153 (i) Pay all costs associated with licensure, registration, 154 and inspection. 155 (3) DISPENSING OF DRUGS OR COMPOUNDED DRUGS OR PRODUCTS.— 156 (a) A pharmacist at a nonembryonic stem cell bank that is 157 also permitted as a pharmacy under chapter 465 may dispense any 158 of the following to a stem cell bank within the state, for 159 office use: 160 1. Human nonembryonic stem cells; 161 2. A compounded drug containing human nonembryonic stem 162 cells; or 163 3. A compounded product containing human nonembryonic stem 164 cells. 165 (b) Human nonembryonic stem cells, compounded drugs 166 containing human nonembryonic stem cells, or products containing 167 human nonembryonic stem cells may not be sold or dispensed by 168 any person or establishment other than the nonembryonic stem 169 cell bank or pharmacist at the nonembryonic stem cell bank that 170 manufactured the human nonembryonic stem cells or the compounded 171 drug or product containing human nonembryonic stem cells, except 172 that: 173 1. A health care practitioner who requests the dispensing 174 of the human nonembryonic stem cells, compounded drug, or 175 compounded product from the manufacturing nonembryonic stem cell 176 bank may sell or dispense such items to his or her patient if 177 the health care practitioner is authorized within the scope of 178 his or her license to prescribe and administer human 179 nonembryonic stem cells; or 180 2. A pharmacist, pharmacy, or establishment that requests 181 the dispensing of the human nonembryonic stem cells, compounded 182 drug, or compounded product from the manufacturing nonembryonic 183 stem cell bank may sell or dispense such items to a health care 184 practitioner who is authorized within the scope of his or her 185 license to prescribe and administer human nonembryonic stem 186 cells to patients. 187 (4) HEALTH CARE PRACTITIONER RESPONSIBILITIES.— 188 (a) A physician licensed under chapter 458 or chapter 459, 189 an advanced practice registered nurse licensed under chapter 190 464, or a physician assistant licensed under chapter 458 or 191 chapter 459 may not practice in a nonembryonic stem cell bank 192 that is not licensed with the agency as required by the rules 193 adopted pursuant to s. 400.9925. The license of a health care 194 practitioner who violates this paragraph is subject to 195 disciplinary action by the appropriate regulatory board. 196 (b) In the performance of any procedure collecting, 197 storing, using, or purporting to use nonembryonic stem cells or 198 products containing nonembryonic stem cells, a health care 199 practitioner must adhere to the applicable current good 200 manufacturing practices for the collection, removal, 201 manufacturing, processing, compounding, and implantation of stem 202 cells or products containing stem cells pursuant to the federal 203 act and 21 C.F.R., parts 1270-1271. 204 (5) RULEMAKING.—The agency shall adopt rules necessary to 205 administer the licensure and regulation of nonembryonic stem 206 cell banks, including, but not limited to, rules regarding all 207 of the following, which must be consistent with the best 208 practices specified in the federal act and 21 C.F.R., parts 209 1270-1271: 210 (a) Advertising. 211 (b) Nonembryonic stem cell bank procedures and protocols 212 for the collection, manufacturing, storing, dispensing, and use 213 of nonembryonic stem cells, drugs containing nonembryonic stem 214 cells, and products containing nonembryonic stem cells in 215 accordance with the applicable current best practices. 216 (c) Adverse incident reporting. 217 (d) Informed consent. 218 (e) Recordkeeping, record retention, and availability of 219 records for inspection. 220 Section 2. The act shall take effect July 1, 2020. 221 222 ================= T I T L E A M E N D M E N T ================ 223 And the title is amended as follows: 224 Delete everything before the enacting clause 225 and insert: 226 A bill to be entitled 227 An act relating to nonembryonic stem cell banks; 228 creating s. 381.06017, F.S.; defining terms; providing 229 that a nonembryonic stem cell bank that performs 230 certain functions is deemed a clinic; requiring such 231 nonembryonic stem cell banks to comply with specified 232 requirements; prohibiting an entity other than certain 233 nonembryonic stem cell banks and pharmacists from 234 dispensing certain compounded drugs or products, with 235 exceptions; prohibiting certain health care 236 practitioners from practicing in a nonembryonic stem 237 cell bank that is not licensed with the agency; 238 providing for disciplinary action; requiring health 239 care practitioners to adhere to specified regulations 240 in the performance of certain procedures; requiring 241 the agency to adopt specified rules; providing an 242 effective date.