Florida Senate - 2022 COMMITTEE AMENDMENT
Bill No. SB 1222
Ì758824@Î758824
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
01/19/2022 .
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The Committee on Health Policy (Bean) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 26 - 130
4 and insert:
5 Section 1. Section 401.272, Florida Statutes, is amended to
6 read:
7 401.272 Emergency medical services community health care.—
8 (1) The purpose of this section is to encourage more
9 effective use utilization of the skills of emergency medical
10 technicians and paramedics in nonemergent community settings by
11 enabling them to perform, in partnership with local county
12 health departments and hospitals as defined in s. 395.002(13),
13 specific additional health care tasks that are consistent with
14 the public health and welfare.
15 (2) Notwithstanding any other provision of law to the
16 contrary:
17 (a) Certified paramedics or emergency medical technicians
18 may perform health promotion and wellness activities and blood
19 pressure screenings in a nonemergency environment, within the
20 scope of their training, and under the supervision of a
21 physician or the direction of a medical director. As used in
22 this paragraph, the term “health promotion and wellness” means
23 the provision of public health programs pertaining to the
24 prevention of illness and injury.
25 (b) Certified paramedics may administer immunizations in a
26 nonemergency environment, within the scope of their training,
27 and under the supervision of a physician or the direction of a
28 medical director. There must be a written agreement between the
29 paramedic’s supervising physician or medical director and the
30 county health department located in each county in which the
31 paramedic administers immunizations. This agreement must
32 establish the protocols, policies, and procedures under which
33 the paramedic must operate.
34 (c) Certified paramedics may provide basic life support
35 services, advanced life support services, and additional health
36 care services to acute care at-home patients in a nonemergent
37 community setting as specified in the paramedic’s formal
38 supervisory relationship with a physician or standing orders as
39 described in s. 401.265, s. 458.348, or s. 459.025. Each
40 physician who supervises or provides medical direction to a
41 paramedic who administers basic life support services, advanced
42 life support services, or additional health care services to
43 acute care at-home patients in a nonemergent community setting
44 pursuant to a formal supervisory relationship or standing orders
45 is liable for any act or omission of the paramedic acting under
46 the physician’s supervision or medical direction when performing
47 such services.
48 (3) Each physician or medical director under whose
49 supervision or direction a paramedic administers immunizations
50 or provides basic life support services, advanced life support
51 services, or additional health care services to acute care at
52 home patients in a nonemergency community setting must verify
53 and document that the paramedic has received sufficient training
54 and experience to administer immunizations or provide basic life
55 support services, advanced life support services, or additional
56 health care services to acute care at-home patients in a
57 nonemergency community setting, as applicable. The verification
58 must be documented on forms developed by the department, and the
59 completed forms must be maintained at the service location of
60 the licensee and made available to the department upon request.
61 (4) The department may adopt and enforce all rules
62 necessary to enforce the provisions relating to paramedics and
63 emergency medical technicians practicing in a nonemergent
64 community setting under subsection (2) a paramedic’s
65 administration of immunizations and the performance of health
66 promotion and wellness activities and blood pressure screenings
67 by a paramedic or emergency medical technician in a nonemergency
68 environment.
69 Section 2. Paragraph (d) of subsection (2) and paragraph
70 (a) of subsection (4) of section 465.019, Florida Statutes, are
71 amended to read:
72 465.019 Institutional pharmacies; permits.—
73 (2) The following classes of institutional pharmacies are
74 established:
75 (d)1. “Class III institutional pharmacies” are those
76 institutional pharmacies, including central distribution
77 facilities, affiliated with a hospital which that provide the
78 same services that are authorized by a Class II institutional
79 pharmacy permit. Class III institutional pharmacies may also:
80 a. Dispense, distribute, compound, and fill prescriptions
81 for medicinal drugs for inpatient treatment or for acute care
82 at-home patients in a nonemergent community setting.
83 b. Prepare prepackaged drug products.
84 c. Conduct other pharmaceutical services for the affiliated
85 hospital and for entities under common control that are each
86 permitted under this chapter to possess medicinal drugs.
87 d. Provide the services in sub-subparagraphs a.-c. to an
88 entity under common control which holds an active health care
89 clinic establishment permit as required under s. 499.01(2)(r).
90 2. A Class III institutional pharmacy shall maintain
91 policies and procedures addressing:
92 a. The consultant pharmacist responsible for pharmaceutical
93 services.
94 b. Safe practices for the preparation, dispensing,
95 prepackaging, distribution, and transportation of medicinal
96 drugs and prepackaged drug products.
97 c. Recordkeeping to monitor the movement, distribution, and
98 transportation of medicinal drugs and prepackaged drug products.
99 d. Recordkeeping of pharmacy staff responsible for each
100 step in the preparation, dispensing, prepackaging,
101 transportation, and distribution of medicinal drugs and
102 prepackaged drug products.
103 e. Medicinal drugs and prepackaged drug products that may
104 not be safely distributed among Class III institutional
105 pharmacies.
106 (4)(a) Medicinal drugs shall be dispensed in an
107 institutional pharmacy to outpatients only when that institution
108 has secured a community pharmacy permit from the department.
109 However, medicinal drugs may be dispensed by a hospital that has
110 not secured a community pharmacy permit but operates a Class II
111 or Class III institutional pharmacy may dispense medicinal drugs
112 to a patient of the hospital’s emergency department, an acute
113 care at-home patient in a nonemergent community setting, or a
114 hospital inpatient upon discharge if a prescriber, as defined in
115 s. 465.025(1), treating the patient in such hospital determines
116 that the medicinal drug is warranted and that community pharmacy
117 services are not readily accessible, geographically or
118 otherwise, to the patient. Such prescribing and dispensing must
119 be for a supply of the drug that will last for the greater of
120 the following:
121 1. Up to 48 hours; or
122 2. Through the end of the next business day.
123 Section 3. Subsection (19) of section 401.23, Florida
124 Statutes, is amended to read:
125 401.23 Definitions.—As used in this part, the term:
126 (19) “Physician” means a practitioner who is licensed under
127 the provisions of chapter 458 or chapter 459. For the purpose of
128 providing “medical direction” as defined in this section
129 subsection (14) for the treatment of patients immediately before
130 prior to or during transportation to a United States Department
131 of Veterans Affairs medical facility, “physician” also means a
132 practitioner employed by the United States Department of
133 Veterans Affairs.
134
135 ================= T I T L E A M E N D M E N T ================
136 And the title is amended as follows:
137 Delete lines 2 - 21
138 and insert:
139 An act relating to acute care at-home patients in
140 nonemergent community settings; amending s. 401.272,
141 F.S.; revising a legislative purpose regarding
142 emergency medical services community health care;
143 authorizing certified paramedics to perform basic life
144 support services, advanced life support services, and
145 additional health care services to acute care at-home
146 patients in nonemergent community settings under
147 certain circumstances; providing that a physician or
148 medical director who supervises or directs the
149 provision of such services by a paramedic is liable
150 for any act or omission during the provision of such
151 services; requiring supervising physicians and medical
152 directors to verify and document that paramedics
153 providing such services under their supervision or
154 direction are sufficiently trained and experienced to
155 do so; revising the Department of Health’s rulemaking
156 authority to conform to changes made by the act;
157 amending s. 465.019, F.S.; specifying that Class III
158 institutional pharmacies may dispense, distribute,
159 compound, and fill prescriptions for medicinal drugs
160 for inpatients and acute care at-home patients in
161 nonemergent community settings; authorizing hospitals
162 to dispense medicinal drugs to certain patients
163 without first securing a community pharmacy permit
164 under certain circumstances; amending ss. 14.33,
165 252.515, 395.1027, 401.23, and 401.245, F.S.; making
166 technical changes; providing an effective