Florida Senate - 2023                                    SB 1506
       
       
        
       By Senator Rodriguez
       
       
       
       
       
       40-01471A-23                                          20231506__
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; creating
    3         s. 381.875, F.S.; defining terms; prohibiting certain
    4         research in this state relating to enhanced potential
    5         pandemic pathogens; requiring researchers applying for
    6         state or local funding to disclose certain
    7         information; requiring the Department of Health to
    8         enjoin violations of specified provisions; providing
    9         construction; amending s. 381.986, F.S.; defining the
   10         term “attractive to children”; prohibiting medical
   11         marijuana treatment centers from producing marijuana
   12         products that are attractive to children or
   13         manufactured in specified manners; prohibiting
   14         marijuana packaging and labeling from including
   15         specified wording; prohibiting medical marijuana
   16         treatment centers from using certain content in their
   17         advertising which is attractive to children or
   18         promotes the recreational use of marijuana; requiring
   19         the department to adopt certain rules; revising
   20         background screening requirements for certain
   21         individuals; amending s. 381.988, F.S.; requiring
   22         medical marijuana testing laboratories to subject
   23         their employees to background screenings; revising
   24         background screening requirements for certain
   25         individuals; amending s. 382.005, F.S.; requiring
   26         local registrars to electronically file all live
   27         birth, death, and fetal death records in their
   28         respective jurisdictions in the department’s
   29         electronic registration system; requiring the local
   30         registrars to file a paper record with the department
   31         if the electronic system is unavailable; requiring
   32         local registrars to make blank paper forms available
   33         in such instances; providing requirements for such
   34         paper records; amending s. 382.008, F.S.; conforming
   35         provisions to changes made by the act; amending s.
   36         382.009, F.S.; revising the types of health care
   37         practitioners who may make certain determinations of
   38         death; amending ss. 382.013 and 382.015, F.S.;
   39         conforming provisions to changes made by the act;
   40         amending ss. 382.021 and 382.023, F.S.; revising the
   41         frequency with which circuit courts must transmit
   42         marriage licenses and certain dissolution-of-marriage
   43         records to the department; requiring that such records
   44         be transmitted electronically; amending s. 382.025,
   45         F.S.; extending the timeframe for the confidentiality
   46         of certain birth records; authorizing persons
   47         appointed by the department to issue certified copies
   48         of live birth, death, and fetal death certificates;
   49         amending s. 401.27, F.S.; revising requirements for
   50         applicants for certification or recertification as
   51         emergency medical technicians or paramedics; deleting
   52         a requirement that a certain certification examination
   53         be offered monthly; deleting related duties of the
   54         department; deleting a temporary certificate and
   55         related provisions; amending s. 401.2701, F.S.;
   56         exempting certain emergency medical services training
   57         program applicants from the requirement to have a
   58         certain affiliation agreement; amending s. 401.272,
   59         F.S.; revising the purpose of certain provisions;
   60         specifying requirements for the provision of specified
   61         services by paramedics and emergency medical
   62         technicians under certain circumstances; revising the
   63         department’s rulemaking authority; amending s. 401.34,
   64         F.S.; deleting certain provisions and fees related to
   65         the department’s grading of a certain certification
   66         examination; amending s. 401.435, F.S.; revising
   67         provisions related to minimum standards for emergency
   68         medical responder training; amending s. 464.203, F.S.;
   69         exempting certain applicants for certification as a
   70         certified nursing assistant from the skills
   71         demonstration portion of a certain competency
   72         examination; amending ss. 468.1225 and 468.1245, F.S.;
   73         revising the scope of practice for audiologists, as it
   74         relates to hearing aids to apply to prescription
   75         hearing aids only; amending s. 468.1246, F.S.;
   76         conforming provisions to changes made by the act;
   77         deleting obsolete language; amending ss. 468.1255,
   78         468.1265, and 468.1275, F.S.; conforming provisions to
   79         changes made by the act; amending s. 484.0401, F.S.;
   80         revising legislative findings and intent to conform to
   81         changes made by the act; reordering and amending s.
   82         484.041, F.S.; providing and revising definitions;
   83         amending s. 484.042, F.S.; revising membership
   84         requirements for members of the Board of Hearing Aid
   85         Specialists; amending s. 484.044, F.S.; revising the
   86         board’s rulemaking authority; deleting obsolete
   87         language; amending ss. 484.0445, 484.045, 484.0501,
   88         and 484.051, F.S.; revising the scope of practice for
   89         hearing aid specialists and making conforming changes
   90         to licensure and practice requirements; amending s.
   91         484.0512, F.S.; conforming provisions to changes made
   92         by the act; deleting obsolete language; amending ss.
   93         484.0513, 484.053, and 484.054, F.S.; conforming
   94         provisions to changes made by the act; amending s.
   95         484.059, F.S.; conforming provisions to changes made
   96         by the act; providing applicability; providing a
   97         directive to the Division of Law Revision; providing
   98         effective dates.
   99          
  100  Be It Enacted by the Legislature of the State of Florida:
  101  
  102         Section 1. Effective upon this act becoming law, section
  103  381.875, Florida Statutes, is created to read:
  104         381.875 Enhanced potential pandemic pathogen research
  105  prohibited.—
  106         (1) As used in this section, the term:
  107         (a) “Enhanced potential pandemic pathogen” means a
  108  potential pandemic pathogen that results from enhancing the
  109  transmissibility or virulence of a pathogen. The term does not
  110  include naturally occurring pathogens circulating in or
  111  recovered from nature, regardless of their pandemic potential.
  112         (b)“Enhanced potential pandemic pathogen research” means
  113  research that may be reasonably anticipated to create, transfer,
  114  or use potential pandemic pathogens that result from enhancing a
  115  pathogen’s transmissibility or virulence in humans.
  116         (c) “Potential pandemic pathogen” means a bacterium, virus,
  117  or other microorganism that is likely to be both:
  118         1.Highly transmissible and capable of wide, uncontrollable
  119  spread in human populations; and
  120         2.Highly virulent, making it likely to cause significant
  121  morbidity or mortality in humans.
  122         (2)Any research that is reasonably likely to create an
  123  enhanced potential pandemic pathogen or that has been determined
  124  by the United States Department of Health and Human Services,
  125  another federal agency, or a state agency as defined in s. 11.45
  126  to create such a pathogen is prohibited in this state.
  127         (3) Any researcher applying for state or local funding to
  128  conduct research in this state must disclose in the application
  129  to the funding source whether the research meets the definition
  130  of enhanced potential pandemic pathogen research.
  131         (4) The Department of Health shall exercise its authority
  132  under s. 381.0012 to enjoin violations of this section.
  133         (5) This section does not affect research funded or
  134  conducted before the effective date of this act.
  135         Section 2. Present paragraphs (a) through (o) of subsection
  136  (1) of section 381.986, Florida Statutes, are redesignated as
  137  paragraphs (b) through (p), respectively, a new paragraph (a) is
  138  added to that subsection, and paragraphs (a) and (c) of
  139  subsection (3), paragraphs (e), (h), and (k) of subsection (8),
  140  and subsection (9) of that section are amended, to read:
  141         381.986 Medical use of marijuana.—
  142         (1) DEFINITIONS.—As used in this section, the term:
  143         (a)“Attractive to children” means the use of any image or
  144  words designed or likely to appeal to persons younger than 18
  145  years of age, including, but not limited to, cartoons, toys,
  146  animals, food, or depictions of persons younger than 18 years of
  147  age; any other likeness to images, characters, or phrases that
  148  are popularly used to advertise to persons younger than 18 years
  149  of age; or any reasonable likeness to commercially available
  150  candy.
  151         (3) QUALIFIED PHYSICIANS AND MEDICAL DIRECTORS.—
  152         (a) Before being approved as a qualified physician, as
  153  defined in paragraph (1)(m), and before each license renewal, a
  154  physician must successfully complete a 2-hour course and
  155  subsequent examination offered by the Florida Medical
  156  Association or the Florida Osteopathic Medical Association which
  157  encompass the requirements of this section and any rules adopted
  158  hereunder. The course and examination must shall be administered
  159  at least annually and may be offered in a distance learning
  160  format, including an electronic, online format that is available
  161  upon request. The price of the course may not exceed $500. A
  162  physician who has met the physician education requirements of
  163  former s. 381.986(4), Florida Statutes 2016, before June 23,
  164  2017, shall be deemed to be in compliance with this paragraph
  165  from June 23, 2017, until 90 days after the course and
  166  examination required by this paragraph become available.
  167         (c) Before being employed as a medical director, as defined
  168  in paragraph (1)(i), and before each license renewal, a medical
  169  director must successfully complete a 2-hour course and
  170  subsequent examination offered by the Florida Medical
  171  Association or the Florida Osteopathic Medical Association which
  172  encompass the requirements of this section and any rules adopted
  173  hereunder. The course and examination must shall be administered
  174  at least annually and may be offered in a distance learning
  175  format, including an electronic, online format that is available
  176  upon request. The price of the course may not exceed $500.
  177         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
  178         (e) A licensed medical marijuana treatment center shall
  179  cultivate, process, transport, and dispense marijuana for
  180  medical use. A licensed medical marijuana treatment center may
  181  not contract for services directly related to the cultivation,
  182  processing, and dispensing of marijuana or marijuana delivery
  183  devices, except that a medical marijuana treatment center
  184  licensed pursuant to subparagraph (a)1. may contract with a
  185  single entity for the cultivation, processing, transporting, and
  186  dispensing of marijuana and marijuana delivery devices. A
  187  licensed medical marijuana treatment center must, at all times,
  188  maintain compliance with the criteria demonstrated and
  189  representations made in the initial application and the criteria
  190  established in this subsection. Upon request, the department may
  191  grant a medical marijuana treatment center a variance from the
  192  representations made in the initial application. Consideration
  193  of such a request shall be based upon the individual facts and
  194  circumstances surrounding the request. A variance may not be
  195  granted unless the requesting medical marijuana treatment center
  196  can demonstrate to the department that it has a proposed
  197  alternative to the specific representation made in its
  198  application which fulfills the same or a similar purpose as the
  199  specific representation in a way that the department can
  200  reasonably determine will not be a lower standard than the
  201  specific representation in the application. A variance may not
  202  be granted from the requirements in subparagraph 2. and
  203  subparagraphs (b)1. and 2.
  204         1. A licensed medical marijuana treatment center may
  205  transfer ownership to an individual or entity who meets the
  206  requirements of this section. A publicly traded corporation or
  207  publicly traded company that meets the requirements of this
  208  section is not precluded from ownership of a medical marijuana
  209  treatment center. To accommodate a change in ownership:
  210         a. The licensed medical marijuana treatment center shall
  211  notify the department in writing at least 60 days before the
  212  anticipated date of the change of ownership.
  213         b. The individual or entity applying for initial licensure
  214  due to a change of ownership must submit an application that
  215  must be received by the department at least 60 days before the
  216  date of change of ownership.
  217         c. Upon receipt of an application for a license, the
  218  department shall examine the application and, within 30 days
  219  after receipt, notify the applicant in writing of any apparent
  220  errors or omissions and request any additional information
  221  required.
  222         d. Requested information omitted from an application for
  223  licensure must be filed with the department within 21 days after
  224  the department’s request for omitted information or the
  225  application shall be deemed incomplete and shall be withdrawn
  226  from further consideration and the fees shall be forfeited.
  227         e. Within 30 days after the receipt of a complete
  228  application, the department shall approve or deny the
  229  application.
  230         2. A medical marijuana treatment center, and any individual
  231  or entity who directly or indirectly owns, controls, or holds
  232  with power to vote 5 percent or more of the voting shares of a
  233  medical marijuana treatment center, may not acquire direct or
  234  indirect ownership or control of any voting shares or other form
  235  of ownership of any other medical marijuana treatment center.
  236         3. A medical marijuana treatment center may not enter into
  237  any form of profit-sharing arrangement with the property owner
  238  or lessor of any of its facilities where cultivation,
  239  processing, storing, or dispensing of marijuana and marijuana
  240  delivery devices occurs.
  241         4. All employees of a medical marijuana treatment center
  242  must be 21 years of age or older and have passed a background
  243  screening pursuant to subsection (9).
  244         5. Each medical marijuana treatment center must adopt and
  245  enforce policies and procedures to ensure employees and
  246  volunteers receive training on the legal requirements to
  247  dispense marijuana to qualified patients.
  248         6. When growing marijuana, a medical marijuana treatment
  249  center:
  250         a. May use pesticides determined by the department, after
  251  consultation with the Department of Agriculture and Consumer
  252  Services, to be safely applied to plants intended for human
  253  consumption, but may not use pesticides designated as
  254  restricted-use pesticides pursuant to s. 487.042.
  255         b. Must grow marijuana within an enclosed structure and in
  256  a room separate from any other plant.
  257         c. Must inspect seeds and growing plants for plant pests
  258  that endanger or threaten the horticultural and agricultural
  259  interests of the state in accordance with chapter 581 and any
  260  rules adopted thereunder.
  261         d. Must perform fumigation or treatment of plants, or
  262  remove and destroy infested or infected plants, in accordance
  263  with chapter 581 and any rules adopted thereunder.
  264         7. Each medical marijuana treatment center must produce and
  265  make available for purchase at least one low-THC cannabis
  266  product.
  267         8. A medical marijuana treatment center that produces
  268  edibles must hold a permit to operate as a food establishment
  269  pursuant to chapter 500, the Florida Food Safety Act, and must
  270  comply with all the requirements for food establishments
  271  pursuant to chapter 500 and any rules adopted thereunder.
  272  Edibles may not contain more than 200 milligrams of
  273  tetrahydrocannabinol, and a single serving portion of an edible
  274  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  275  may have a potency variance of no greater than 15 percent.
  276  Marijuana products, including edibles, may not be attractive to
  277  children; be manufactured in the shape of humans, cartoons, or
  278  animals; be manufactured in a form that bears any reasonable
  279  resemblance to products available for consumption as
  280  commercially available candy; or contain any color additives. To
  281  discourage consumption of edibles by children, the department
  282  shall determine by rule any shapes, forms, and ingredients
  283  allowed and prohibited for edibles. Medical marijuana treatment
  284  centers may not begin processing or dispensing edibles until
  285  after the effective date of the rule. The department shall also
  286  adopt sanitation rules providing the standards and requirements
  287  for the storage, display, or dispensing of edibles.
  288         9. Within 12 months after licensure, a medical marijuana
  289  treatment center must demonstrate to the department that all of
  290  its processing facilities have passed a Food Safety Good
  291  Manufacturing Practices, such as Global Food Safety Initiative
  292  or equivalent, inspection by a nationally accredited certifying
  293  body. A medical marijuana treatment center must immediately stop
  294  processing at any facility which fails to pass this inspection
  295  until it demonstrates to the department that such facility has
  296  met this requirement.
  297         10. A medical marijuana treatment center that produces
  298  prerolled marijuana cigarettes may not use wrapping paper made
  299  with tobacco or hemp.
  300         11. When processing marijuana, a medical marijuana
  301  treatment center must:
  302         a. Process the marijuana within an enclosed structure and
  303  in a room separate from other plants or products.
  304         b. Comply with department rules when processing marijuana
  305  with hydrocarbon solvents or other solvents or gases exhibiting
  306  potential toxicity to humans. The department shall determine by
  307  rule the requirements for medical marijuana treatment centers to
  308  use such solvents or gases exhibiting potential toxicity to
  309  humans.
  310         c. Comply with federal and state laws and regulations and
  311  department rules for solid and liquid wastes. The department
  312  shall determine by rule procedures for the storage, handling,
  313  transportation, management, and disposal of solid and liquid
  314  waste generated during marijuana production and processing. The
  315  Department of Environmental Protection shall assist the
  316  department in developing such rules.
  317         d. Test the processed marijuana using a medical marijuana
  318  testing laboratory before it is dispensed. Results must be
  319  verified and signed by two medical marijuana treatment center
  320  employees. Before dispensing, the medical marijuana treatment
  321  center must determine that the test results indicate that low
  322  THC cannabis meets the definition of low-THC cannabis, the
  323  concentration of tetrahydrocannabinol meets the potency
  324  requirements of this section, the labeling of the concentration
  325  of tetrahydrocannabinol and cannabidiol is accurate, and all
  326  marijuana is safe for human consumption and free from
  327  contaminants that are unsafe for human consumption. The
  328  department shall determine by rule which contaminants must be
  329  tested for and the maximum levels of each contaminant which are
  330  safe for human consumption. The Department of Agriculture and
  331  Consumer Services shall assist the department in developing the
  332  testing requirements for contaminants that are unsafe for human
  333  consumption in edibles. The department shall also determine by
  334  rule the procedures for the treatment of marijuana that fails to
  335  meet the testing requirements of this section, s. 381.988, or
  336  department rule. The department may select samples of marijuana
  337  from a medical marijuana treatment center facility which shall
  338  be tested by the department to determine whether the marijuana
  339  meets the potency requirements of this section, is safe for
  340  human consumption, and is accurately labeled with the
  341  tetrahydrocannabinol and cannabidiol concentration or to verify
  342  the result of marijuana testing conducted by a marijuana testing
  343  laboratory. The department may also select samples of marijuana
  344  delivery devices from a medical marijuana treatment center to
  345  determine whether the marijuana delivery device is safe for use
  346  by qualified patients. A medical marijuana treatment center may
  347  not require payment from the department for the sample. A
  348  medical marijuana treatment center must recall marijuana,
  349  including all marijuana and marijuana products made from the
  350  same batch of marijuana, that fails to meet the potency
  351  requirements of this section, that is unsafe for human
  352  consumption, or for which the labeling of the
  353  tetrahydrocannabinol and cannabidiol concentration is
  354  inaccurate. The department shall adopt rules to establish
  355  marijuana potency variations of no greater than 15 percent using
  356  negotiated rulemaking pursuant to s. 120.54(2)(d) which accounts
  357  for, but is not limited to, time lapses between testing, testing
  358  methods, testing instruments, and types of marijuana sampled for
  359  testing. The department may not issue any recalls for product
  360  potency as it relates to product labeling before issuing a rule
  361  relating to potency variation standards. A medical marijuana
  362  treatment center must also recall all marijuana delivery devices
  363  determined to be unsafe for use by qualified patients. The
  364  medical marijuana treatment center must retain records of all
  365  testing and samples of each homogenous batch of marijuana for at
  366  least 9 months. The medical marijuana treatment center must
  367  contract with a marijuana testing laboratory to perform audits
  368  on the medical marijuana treatment center’s standard operating
  369  procedures, testing records, and samples and provide the results
  370  to the department to confirm that the marijuana or low-THC
  371  cannabis meets the requirements of this section and that the
  372  marijuana or low-THC cannabis is safe for human consumption. A
  373  medical marijuana treatment center shall reserve two processed
  374  samples from each batch and retain such samples for at least 9
  375  months for the purpose of such audits. A medical marijuana
  376  treatment center may use a laboratory that has not been
  377  certified by the department under s. 381.988 until such time as
  378  at least one laboratory holds the required certification, but in
  379  no event later than July 1, 2018.
  380         e. Package the marijuana in compliance with the United
  381  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  382  1471 et seq.
  383         f. Package the marijuana in a receptacle that has a firmly
  384  affixed and legible label stating the following information:
  385         (I) The marijuana or low-THC cannabis meets the
  386  requirements of sub-subparagraph d.
  387         (II) The name of the medical marijuana treatment center
  388  from which the marijuana originates.
  389         (III) The batch number and harvest number from which the
  390  marijuana originates and the date dispensed.
  391         (IV) The name of the physician who issued the physician
  392  certification.
  393         (V) The name of the patient.
  394         (VI) The product name, if applicable, and dosage form,
  395  including concentration of tetrahydrocannabinol and cannabidiol.
  396  The product name may not contain wording commonly associated
  397  with products that are attractive to children or which promote
  398  the recreational use of marijuana marketed by or to children.
  399         (VII) The recommended dose.
  400         (VIII) A warning that it is illegal to transfer medical
  401  marijuana to another person.
  402         (IX) A marijuana universal symbol developed by the
  403  department.
  404         12. The medical marijuana treatment center shall include in
  405  each package a patient package insert with information on the
  406  specific product dispensed related to:
  407         a. Clinical pharmacology.
  408         b. Indications and use.
  409         c. Dosage and administration.
  410         d. Dosage forms and strengths.
  411         e. Contraindications.
  412         f. Warnings and precautions.
  413         g. Adverse reactions.
  414         13. In addition to the packaging and labeling requirements
  415  specified in subparagraphs 11. and 12., marijuana in a form for
  416  smoking must be packaged in a sealed receptacle with a legible
  417  and prominent warning to keep away from children and a warning
  418  that states marijuana smoke contains carcinogens and may
  419  negatively affect health. Such receptacles for marijuana in a
  420  form for smoking must be plain, opaque, and white without
  421  depictions of the product or images other than the medical
  422  marijuana treatment center’s department-approved logo and the
  423  marijuana universal symbol.
  424         14. The department shall adopt rules to regulate the types,
  425  appearance, and labeling of marijuana delivery devices dispensed
  426  from a medical marijuana treatment center. The rules must
  427  require marijuana delivery devices to have an appearance
  428  consistent with medical use.
  429         15. Each edible must shall be individually sealed in plain,
  430  opaque wrapping marked only with the marijuana universal symbol.
  431  Where practical, each edible must shall be marked with the
  432  marijuana universal symbol. In addition to the packaging and
  433  labeling requirements in subparagraphs 11. and 12., edible
  434  receptacles must be plain, opaque, and white without depictions
  435  of the product or images other than the medical marijuana
  436  treatment center’s department-approved logo and the marijuana
  437  universal symbol. The receptacle must also include a list of all
  438  the edible’s ingredients, storage instructions, an expiration
  439  date, a legible and prominent warning to keep away from children
  440  and pets, and a warning that the edible has not been produced or
  441  inspected pursuant to federal food safety laws.
  442         16. When dispensing marijuana or a marijuana delivery
  443  device, a medical marijuana treatment center:
  444         a. May dispense any active, valid order for low-THC
  445  cannabis, medical cannabis and cannabis delivery devices issued
  446  pursuant to former s. 381.986, Florida Statutes 2016, which was
  447  entered into the medical marijuana use registry before July 1,
  448  2017.
  449         b. May not dispense more than a 70-day supply of marijuana
  450  within any 70-day period to a qualified patient or caregiver.
  451  May not dispense more than one 35-day supply of marijuana in a
  452  form for smoking within any 35-day period to a qualified patient
  453  or caregiver. A 35-day supply of marijuana in a form for smoking
  454  may not exceed 2.5 ounces unless an exception to this amount is
  455  approved by the department pursuant to paragraph (4)(f).
  456         c. Must have the medical marijuana treatment center’s
  457  employee who dispenses the marijuana or a marijuana delivery
  458  device enter into the medical marijuana use registry his or her
  459  name or unique employee identifier.
  460         d. Must verify that the qualified patient and the
  461  caregiver, if applicable, each have an active registration in
  462  the medical marijuana use registry and an active and valid
  463  medical marijuana use registry identification card, the amount
  464  and type of marijuana dispensed matches the physician
  465  certification in the medical marijuana use registry for that
  466  qualified patient, and the physician certification has not
  467  already been filled.
  468         e. May not dispense marijuana to a qualified patient who is
  469  younger than 18 years of age. If the qualified patient is
  470  younger than 18 years of age, marijuana may only be dispensed to
  471  the qualified patient’s caregiver.
  472         f. May not dispense or sell any other type of cannabis,
  473  alcohol, or illicit drug-related product, including pipes or
  474  wrapping papers made with tobacco or hemp, other than a
  475  marijuana delivery device required for the medical use of
  476  marijuana and which is specified in a physician certification.
  477         g. Must, upon dispensing the marijuana or marijuana
  478  delivery device, record in the registry the date, time,
  479  quantity, and form of marijuana dispensed; the type of marijuana
  480  delivery device dispensed; and the name and medical marijuana
  481  use registry identification number of the qualified patient or
  482  caregiver to whom the marijuana delivery device was dispensed.
  483         h. Must ensure that patient records are not visible to
  484  anyone other than the qualified patient, his or her caregiver,
  485  and authorized medical marijuana treatment center employees.
  486         (h) A medical marijuana treatment center may not engage in
  487  advertising that is visible to members of the public from any
  488  street, sidewalk, park, or other public place, except:
  489         1. The dispensing location of a medical marijuana treatment
  490  center may have a sign that is affixed to the outside or hanging
  491  in the window of the premises which identifies the dispensary by
  492  the licensee’s business name, a department-approved trade name,
  493  or a department-approved logo. A medical marijuana treatment
  494  center’s trade name and logo may not contain wording or images
  495  that are attractive to children commonly associated with
  496  marketing targeted toward children or which promote recreational
  497  use of marijuana.
  498         2. A medical marijuana treatment center may engage in
  499  Internet advertising and marketing under the following
  500  conditions:
  501         a. All advertisements must be approved by the department.
  502         b. An advertisement may not have any content that is
  503  attractive to children or which promotes the recreational use of
  504  marijuana specifically targets individuals under the age of 18,
  505  including cartoon characters or similar images.
  506         c. An advertisement may not be an unsolicited pop-up
  507  advertisement.
  508         d. Opt-in marketing must include an easy and permanent opt
  509  out feature.
  510         (k) The department may adopt rules pursuant to ss.
  511  120.536(1) and 120.54 to implement this subsection. The
  512  department shall adopt rules it deems necessary to protect the
  513  health and safety of qualified patients and minors, including,
  514  but not limited to, standards to ensure that medical marijuana
  515  treatment centers operate in a manner consistent with the
  516  provision of medical products and rules to discourage the
  517  diversion and illicit use of marijuana.
  518         (9) BACKGROUND SCREENING.—An individual required to undergo
  519  a background screening pursuant to this section must pass a
  520  level 2 background screening as provided under chapter 435,
  521  which, in addition to the disqualifying offenses provided in s.
  522  435.04, shall exclude an individual who has an arrest awaiting
  523  final disposition for, has been found guilty of, regardless of
  524  adjudication, or has entered a plea of nolo contendere or guilty
  525  to an offense under chapter 837, chapter 895, or chapter 896 or
  526  similar law of another jurisdiction. Exemptions from
  527  disqualification as provided under s. 435.07 do not apply to
  528  this subsection.
  529         (a) Such individual must submit a full set of fingerprints
  530  to the department or to a vendor, entity, or agency authorized
  531  by s. 943.053(13). The department, vendor, entity, or agency
  532  shall forward the fingerprints to the Department of Law
  533  Enforcement for state processing, and the Department of Law
  534  Enforcement shall forward the fingerprints to the Federal Bureau
  535  of Investigation for national processing.
  536         (b) Fees for state and federal fingerprint processing and
  537  retention shall be borne by the medical marijuana treatment
  538  center or caregiver, as applicable individual. The state cost
  539  for fingerprint processing shall be as provided in s.
  540  943.053(3)(e) for records provided to persons or entities other
  541  than those specified as exceptions therein.
  542         (c) Fingerprints submitted to the Department of Law
  543  Enforcement pursuant to this subsection shall be retained by the
  544  Department of Law Enforcement as provided in s. 943.05(2)(g) and
  545  (h) and, when the Department of Law Enforcement begins
  546  participation in the program, enrolled in the Federal Bureau of
  547  Investigation’s national retained print arrest notification
  548  program. Any arrest record identified shall be reported to the
  549  department.
  550         Section 3. Paragraph (d) of subsection (1) of section
  551  381.988, Florida Statutes, is amended to read:
  552         381.988 Medical marijuana testing laboratories; marijuana
  553  tests conducted by a certified laboratory.—
  554         (1) A person or entity seeking to be a certified marijuana
  555  testing laboratory must:
  556         (d) Require all employees, owners, and managers to submit
  557  to and pass a level 2 background screening pursuant to chapter
  558  435. The department s. 435.04 and shall deny certification if
  559  the person or entity seeking certification has a disqualifying
  560  offense as provided in s. 435.04 or has an arrest awaiting final
  561  disposition for, has been found guilty of, or has entered a plea
  562  of guilty or nolo contendere to, regardless of adjudication, any
  563  offense listed in chapter 837, chapter 895, or chapter 896 or
  564  similar law of another jurisdiction. Exemptions from
  565  disqualification as provided under s. 435.07 do not apply to
  566  this paragraph.
  567         1. Such employees, owners, and managers must submit a full
  568  set of fingerprints to the department or to a vendor, entity, or
  569  agency authorized by s. 943.053(13). The department, vendor,
  570  entity, or agency shall forward the fingerprints to the
  571  Department of Law Enforcement for state processing, and the
  572  Department of Law Enforcement shall forward the fingerprints to
  573  the Federal Bureau of Investigation for national processing.
  574         2. Fees for state and federal fingerprint processing and
  575  retention shall be borne by the certified marijuana testing
  576  laboratory such owners or managers. The state cost for
  577  fingerprint processing shall be as provided in s. 943.053(3)(e)
  578  for records provided to persons or entities other than those
  579  specified as exceptions therein.
  580         3. Fingerprints submitted to the Department of Law
  581  Enforcement pursuant to this paragraph shall be retained by the
  582  Department of Law Enforcement as provided in s. 943.05(2)(g) and
  583  (h) and, when the Department of Law Enforcement begins
  584  participation in the program, enrolled in the Federal Bureau of
  585  Investigation’s national retained print arrest notification
  586  program. Any arrest record identified shall be reported to the
  587  department.
  588         Section 4. Section 382.005, Florida Statutes, is amended to
  589  read:
  590         382.005 Duties of local registrars.—
  591         (1) Each local registrar is charged with the strict and
  592  thorough enforcement of the provisions of this chapter and rules
  593  adopted hereunder in his or her registration district, and shall
  594  make an immediate report to the department of any violation or
  595  apparent violation of this law or rules adopted hereunder.
  596         (2) Each local registrar must electronically file all live
  597  birth, death, and fetal death records within their respective
  598  jurisdictions in the department’s electronic registration
  599  system. If the department’s electronic registration system is
  600  unavailable, the local registrar must file a paper record with
  601  the department.
  602         (3) Each local registrar must shall make available blank
  603  forms available if the department’s electronic registration
  604  system is unavailable, as necessary and must shall examine each
  605  paper certificate of live birth, death, or fetal death when
  606  presented for registration in order to ascertain whether or not
  607  it has been completed in accordance with the provisions of this
  608  chapter and adopted rules. All paper birth, death, and fetal
  609  death certificates must shall be typewritten in permanent black
  610  ink, and a paper certificate is not complete and correct if it
  611  does not supply each item of information called for or
  612  satisfactorily account for its omission.
  613         (4)(3) The local registrar or his or her deputy, if
  614  authorized by the department, shall sign as registrar in
  615  attestation of the date of registration of any paper records
  616  filed, and may also make and preserve a local paper record of
  617  each birth, death, and fetal death certificate registered by him
  618  or her, in such manner as directed by the department. The local
  619  registrar shall transmit daily to the department all original
  620  paper certificates registered. If no births, deaths, or fetal
  621  deaths occurred in any month, the local registrar or deputy
  622  shall, on the 7th day of the following month, report that fact
  623  to the department on a form provided for such purpose.
  624         (5)(4) Each local registrar, immediately upon appointment,
  625  shall designate one or more deputy registrars to act on behalf
  626  of the local registrar.
  627         Section 5. Subsection (2) of section 382.008, Florida
  628  Statutes, is amended to read:
  629         382.008 Death, fetal death, and nonviable birth
  630  registration.—
  631         (2)(a) The funeral director who first assumes custody of a
  632  dead body or fetus shall electronically file the certificate of
  633  death or fetal death. In the absence of the funeral director,
  634  the physician, physician assistant, advanced practice registered
  635  nurse registered under s. 464.0123, or other person in
  636  attendance at or after the death or the district medical
  637  examiner of the county in which the death occurred or the body
  638  was found shall electronically file the certificate of death or
  639  fetal death. The person who files the certificate shall obtain
  640  personal data from a legally authorized person as described in
  641  s. 497.005 or the best qualified person or source available. The
  642  medical certification of cause of death must shall be furnished
  643  to the funeral director, either in person or via certified mail
  644  or electronic transfer, by the physician, physician assistant,
  645  advanced practice registered nurse registered under s. 464.0123,
  646  or medical examiner responsible for furnishing such information.
  647  For fetal deaths, the physician, physician assistant, advanced
  648  practice registered nurse registered under s. 464.0123, midwife,
  649  or hospital administrator shall provide any medical or health
  650  information to the funeral director within 72 hours after
  651  expulsion or extraction.
  652         (b) The State Registrar shall may receive electronically a
  653  certificate of death, fetal death, or nonviable birth which is
  654  required to be filed with the registrar under this chapter
  655  through facsimile or other electronic transfer for the purpose
  656  of filing the certificate. The receipt of a certificate of
  657  death, fetal death, or nonviable birth by electronic transfer
  658  constitutes delivery to the State Registrar as required by law.
  659         Section 6. Subsection (2) of section 382.009, Florida
  660  Statutes, is amended to read:
  661         382.009 Recognition of brain death under certain
  662  circumstances.—
  663         (2) Determination of death pursuant to this section must
  664  shall be made in accordance with currently accepted reasonable
  665  medical standards by two licensed health care practitioners who
  666  must be physicians or physician assistants licensed under
  667  chapter 458 or chapter 459 or advanced practice registered
  668  nurses registered under s. 464.0123. One of the health care
  669  practitioners must physician shall be the treating health care
  670  practitioner physician, and the other physician shall be a
  671  board-eligible or board-certified neurologist, neurosurgeon,
  672  internist, pediatrician, surgeon, or anesthesiologist.
  673         Section 7. Section 382.013, Florida Statutes, is amended to
  674  read:
  675         382.013 Birth registration.—A certificate for each live
  676  birth that occurs in this state shall be filed within 5 days
  677  after such birth in the department’s electronic registration
  678  system with the local registrar of the district in which the
  679  birth occurred and shall be registered by the local registrar if
  680  the certificate has been completed and filed in accordance with
  681  this chapter and adopted rules. The information regarding
  682  registered births shall be used for comparison with information
  683  in the state case registry, as defined in chapter 61.
  684         (1) FILING.—
  685         (a) If a birth occurs in a hospital, birth center, or other
  686  health care facility, or en route thereto, the person in charge
  687  of the facility is shall be responsible for preparing the
  688  certificate, certifying the facts of the birth, and filing the
  689  certificate in the department’s electronic registration system
  690  with the local registrar. Within 48 hours after the birth, the
  691  physician, midwife, or person in attendance during or
  692  immediately after the delivery shall provide the facility with
  693  the medical information required by the birth certificate.
  694         (b) If a birth occurs outside a facility and a physician
  695  licensed in this state, a certified nurse midwife, a midwife
  696  licensed in this state, or a public health nurse employed by the
  697  department was in attendance during or immediately after the
  698  delivery, that person shall prepare and file the certificate.
  699         (c) If a birth occurs outside a facility and the delivery
  700  is not attended by one of the persons described in paragraph
  701  (b), the person in attendance, the mother, or the father shall
  702  report the birth to the registrar and provide proof of the facts
  703  of birth. The department may require such documents to be
  704  presented and such proof to be filed as it deems necessary and
  705  sufficient to establish the truth of the facts to be recorded by
  706  the certificate and may withhold registering the birth until its
  707  requirements are met.
  708         (d) If a birth occurs in a moving conveyance and the child
  709  is first removed from the conveyance in this state, the birth
  710  shall be filed and registered in this state and the place to
  711  which the child is first removed shall be considered the place
  712  of birth.
  713         (e) The mother or the father of the child shall attest to
  714  the accuracy of the personal data entered on the certificate in
  715  time to permit the timely registration of the certificate.
  716         (f) If a certificate of live birth is incomplete, the local
  717  registrar shall immediately notify the health care facility or
  718  person filing the certificate and shall require the completion
  719  of the missing items of information if they can be obtained
  720  before prior to issuing certified copies of the birth
  721  certificate.
  722         (g) Regardless of any plan to place a child for adoption
  723  after birth, the information on the birth certificate as
  724  required by this section must be as to the child’s birth parents
  725  unless and until an application for a new birth record is made
  726  under s. 63.152.
  727         (h) The State Registrar may receive electronically a birth
  728  certificate for each live birth which is required to be filed
  729  with the registrar under this chapter through facsimile or other
  730  electronic transfer for the purpose of filing the birth
  731  certificate. The receipt of a birth certificate by electronic
  732  transfer constitutes delivery to the State Registrar as required
  733  by law.
  734         (2) PATERNITY.—
  735         (a) If the mother is married at the time of birth, the name
  736  of the husband shall be entered on the birth certificate as the
  737  father of the child, unless paternity has been determined
  738  otherwise by a court of competent jurisdiction.
  739         (b) Notwithstanding paragraph (a), if the husband of the
  740  mother dies while the mother is pregnant but before the birth of
  741  the child, the name of the deceased husband shall be entered on
  742  the birth certificate as the father of the child, unless
  743  paternity has been determined otherwise by a court of competent
  744  jurisdiction.
  745         (c) If the mother is not married at the time of the birth,
  746  the name of the father may not be entered on the birth
  747  certificate without the execution of an affidavit signed by both
  748  the mother and the person to be named as the father. The
  749  facility shall give notice orally or through the use of video or
  750  audio equipment, and in writing, of the alternatives to, the
  751  legal consequences of, and the rights, including, if one parent
  752  is a minor, any rights afforded due to minority status, and
  753  responsibilities that arise from signing an acknowledgment of
  754  paternity, as well as information provided by the Title IV-D
  755  agency established pursuant to s. 409.2557, regarding the
  756  benefits of voluntary establishment of paternity. Upon request
  757  of the mother and the person to be named as the father, the
  758  facility shall assist in the execution of the affidavit, a
  759  notarized voluntary acknowledgment of paternity, or a voluntary
  760  acknowledgment of paternity that is witnessed by two individuals
  761  and signed under penalty of perjury as specified by s.
  762  92.525(2).
  763         (d) If the paternity of the child is determined by a court
  764  of competent jurisdiction as provided under s. 382.015 or there
  765  is a final judgment of dissolution of marriage which requires
  766  the former husband to pay child support for the child, the name
  767  of the father and the surname of the child shall be entered on
  768  the certificate in accordance with the finding and order of the
  769  court. If the court fails to specify a surname for the child,
  770  the surname shall be entered in accordance with subsection (3).
  771         (e) If the paternity of the child is determined pursuant to
  772  s. 409.256, the name of the father and the surname of the child
  773  shall be entered on the certificate in accordance with the
  774  finding and order of the Department of Revenue.
  775         (f) If the mother and father marry each other at any time
  776  after the child’s birth, upon receipt of a marriage license that
  777  identifies any such child, the department shall amend the
  778  certificate with regard to the parents’ marital status as though
  779  the parents were married at the time of birth.
  780         (g) If the father is not named on the certificate, no other
  781  information about the father shall be entered on the
  782  certificate.
  783         (3) NAME OF CHILD.—
  784         (a) If the mother is married at the time of birth, the
  785  mother and father whose names are entered on the birth
  786  certificate shall select the given names and surname of the
  787  child if both parents have custody of the child, otherwise the
  788  parent who has custody shall select the child’s name.
  789         (b) If the mother and father whose names are entered on the
  790  birth certificate disagree on the surname of the child and both
  791  parents have custody of the child, the surname selected by the
  792  father and the surname selected by the mother shall both be
  793  entered on the birth certificate, separated by a hyphen, with
  794  the selected names entered in alphabetical order. If the parents
  795  disagree on the selection of a given name, the given name may
  796  not be entered on the certificate until a joint agreement that
  797  lists the agreed upon given name and is notarized by both
  798  parents is submitted to the department, or until a given name is
  799  selected by a court.
  800         (c) If the mother is not married at the time of birth, the
  801  parent who will have custody of the child shall select the
  802  child’s given name and surname.
  803         (d) If multiple names of the child exceed the space
  804  provided on the face of the birth certificate they shall be
  805  listed on the back of the certificate. Names listed on the back
  806  of the certificate shall be part of the official record.
  807         (4) UNDETERMINED PARENTAGE.—The person having custody of a
  808  child of undetermined parentage shall register a birth
  809  certificate showing all known or approximate facts relating to
  810  the birth. To assist in later determination, information
  811  concerning the place and circumstances under which the child was
  812  found shall be included on the portion of the birth certificate
  813  relating to marital status and medical details. In the event the
  814  child is later identified, a new birth certificate shall be
  815  prepared which shall bear the same number as the original birth
  816  certificate, and the original certificate shall be sealed and
  817  filed, shall be confidential and exempt from the provisions of
  818  s. 119.07(1), and shall not be opened to inspection by, nor
  819  shall certified copies of the same be issued except by court
  820  order to, any person other than the registrant if of legal age.
  821         (5) DISCLOSURE.—The original certificate of live birth
  822  shall contain all the information required by the department for
  823  legal, social, and health research purposes. However, all
  824  information concerning parentage, marital status, and medical
  825  details shall be confidential and exempt from the provisions of
  826  s. 119.07(1), except for health research purposes as approved by
  827  the department, nor shall copies of the same be issued except as
  828  provided in s. 382.025.
  829         Section 8. Section 382.015, Florida Statutes, is amended to
  830  read:
  831         382.015 New certificates of live birth; duty of clerks of
  832  court and department.—The clerk of the court in which any
  833  proceeding for adoption, annulment of an adoption, affirmation
  834  of parental status, or determination of paternity is to be
  835  registered, shall within 30 days after the final disposition,
  836  forward electronically to the department a certified copy of the
  837  court order, or a report of the proceedings upon a form to be
  838  furnished by the department, together with sufficient
  839  information to identify the original birth certificate and to
  840  enable the preparation of a new birth certificate. The clerk of
  841  the court shall implement a monitoring and quality control plan
  842  to ensure that all judicial determinations of paternity are
  843  reported to the department in compliance with this section. The
  844  department shall track paternity determinations reported monthly
  845  by county, monitor compliance with the 30-day timeframe, and
  846  report the data to the clerks of the court quarterly.
  847         (1) ADOPTION AND ANNULMENT OF ADOPTION.—
  848         (a) Upon receipt of the report or certified copy of an
  849  adoption decree, together with the information necessary to
  850  identify the original certificate of live birth, and establish a
  851  new certificate, the department shall prepare and file a new
  852  birth certificate, absent objection by the court decreeing the
  853  adoption, the adoptive parents, or the adoptee if of legal age.
  854  The certificate shall bear the same file number as the original
  855  birth certificate. All names and identifying information
  856  relating to the adoptive parents entered on the new certificate
  857  shall refer to the adoptive parents, but nothing in the
  858  certificate shall refer to or designate the parents as being
  859  adoptive. All other items not affected by adoption shall be
  860  copied as on the original certificate, including the date of
  861  registration and filing.
  862         (b) Upon receipt of the report or certified copy of an
  863  annulment-of-adoption decree, together with the sufficient
  864  information to identify the original certificate of live birth,
  865  the department shall, if a new certificate of birth was filed
  866  following an adoption report or decree, remove the new
  867  certificate and restore the original certificate to its original
  868  place in the files, and the certificate so removed shall be
  869  sealed by the department.
  870         (c) Upon receipt of a report or certified copy of an
  871  adoption decree or annulment-of-adoption decree for a person
  872  born in another state, the department shall forward the report
  873  or decree to the state of the registrant’s birth. If the adoptee
  874  was born in Canada, the department shall send a copy of the
  875  report or decree to the appropriate birth registration authority
  876  in Canada.
  877         (2) DETERMINATION OF PATERNITY.—Upon receipt of the report,
  878  a certified copy of a final decree of determination of
  879  paternity, or a certified copy of a final judgment of
  880  dissolution of marriage which requires the former husband to pay
  881  child support for the child, together with sufficient
  882  information to identify the original certificate of live birth,
  883  the department shall prepare and file a new birth certificate,
  884  which shall bear the same file number as the original birth
  885  certificate. The registrant’s name shall be entered as decreed
  886  by the court or as reflected in the final judgment or support
  887  order. The names and identifying information of the parents
  888  shall be entered as of the date of the registrant’s birth.
  889         (3) AFFIRMATION OF PARENTAL STATUS.—Upon receipt of an
  890  order of affirmation of parental status issued pursuant to s.
  891  742.16, together with sufficient information to identify the
  892  original certificate of live birth, the department shall prepare
  893  and file a new birth certificate which shall bear the same file
  894  number as the original birth certificate. The names and
  895  identifying information of the registrant’s parents entered on
  896  the new certificate shall be the commissioning couple, but the
  897  new certificate may not make reference to or designate the
  898  parents as the commissioning couple.
  899         (4) SUBSTITUTION OF NEW CERTIFICATE OF BIRTH FOR ORIGINAL.
  900  When a new certificate of birth is prepared, the department
  901  shall substitute the new certificate of birth for the original
  902  certificate on file. All copies of the original certificate of
  903  live birth in the custody of a local registrar or other state
  904  custodian of vital records shall be forwarded to the State
  905  Registrar. Thereafter, when a certified copy of the certificate
  906  of birth or portion thereof is issued, it shall be a copy of the
  907  new certificate of birth or portion thereof, except when a court
  908  order requires issuance of a certified copy of the original
  909  certificate of birth. In an adoption, change in paternity,
  910  affirmation of parental status, undetermined parentage, or
  911  court-ordered substitution, the department shall place the
  912  original certificate of birth and all papers pertaining thereto
  913  under seal, not to be broken except by order of a court of
  914  competent jurisdiction or as otherwise provided by law.
  915         (5) FORM.—Except for certificates of foreign birth which
  916  are registered as provided in s. 382.017, and delayed
  917  certificates of birth which are registered as provided in ss.
  918  382.019 and 382.0195, all original, new, or amended certificates
  919  of live birth shall be identical in form, regardless of the
  920  marital status of the parents or the fact that the registrant is
  921  adopted or of undetermined parentage.
  922         (6) RULES.—The department shall adopt and enforce all rules
  923  necessary for carrying out the provisions of this section.
  924         Section 9. Section 382.021, Florida Statutes, is amended to
  925  read:
  926         382.021 Department to receive marriage licenses.—Weekly On
  927  or before the 5th day of each month, the county court judge or
  928  clerk of the circuit court shall electronically transmit all
  929  original marriage licenses, with endorsements, received during
  930  the preceding calendar week month, to the department. Any
  931  marriage licenses issued and not returned or any marriage
  932  licenses returned but not recorded shall be reported by the
  933  issuing county court judge or clerk of the circuit court to the
  934  department at the time of transmitting the recorded licenses on
  935  the forms to be prescribed and furnished by the department. If
  936  during any month no marriage licenses are issued or returned,
  937  the county court judge or clerk of the circuit court shall
  938  report such fact to the department upon forms prescribed and
  939  furnished by the department.
  940         Section 10. Section 382.023, Florida Statutes, is amended
  941  to read:
  942         382.023 Department to receive dissolution-of-marriage
  943  records; fees.—Clerks of the circuit courts shall collect for
  944  their services at the time of the filing of a final judgment of
  945  dissolution of marriage a fee of up to $10.50, of which 43
  946  percent shall be retained by the clerk of the circuit court as a
  947  part of the cost in the cause in which the judgment is granted.
  948  The remaining 57 percent shall be remitted to the Department of
  949  Revenue for deposit to the Department of Health to defray part
  950  of the cost of maintaining the dissolution-of-marriage records.
  951  A record of each and every judgment of dissolution of marriage
  952  granted by the court during the preceding calendar week month,
  953  giving names of parties and such other data as required by forms
  954  prescribed by the department, shall be electronically
  955  transmitted to the department weekly, on or before the 10th day
  956  of each month, along with an accounting of the funds remitted to
  957  the Department of Revenue pursuant to this section.
  958         Section 11. Subsections (1) and (4) of section 382.025,
  959  Florida Statutes, are amended to read:
  960         382.025 Certified copies of vital records; confidentiality;
  961  research.—
  962         (1) BIRTH RECORDS.—Except for birth records over 125 100
  963  years old which are not under seal pursuant to court order, all
  964  birth records of this state shall be confidential and are exempt
  965  from the provisions of s. 119.07(1).
  966         (a) Certified copies of the original birth certificate or a
  967  new or amended certificate, or affidavits thereof, are
  968  confidential and exempt from the provisions of s. 119.07(1) and,
  969  upon receipt of a request and payment of the fee prescribed in
  970  s. 382.0255, shall be issued only as authorized by the
  971  department and in the form prescribed by the department, and
  972  only:
  973         1. To the registrant, if the registrant is of legal age, is
  974  a certified homeless youth, or is a minor who has had the
  975  disabilities of nonage removed under s. 743.01 or s. 743.015;
  976         2. To the registrant’s parent or guardian or other legal
  977  representative;
  978         3. Upon receipt of the registrant’s death certificate, to
  979  the registrant’s spouse or to the registrant’s child,
  980  grandchild, or sibling, if of legal age, or to the legal
  981  representative of any of such person persons;
  982         4. To any person if the birth record is more than 125 over
  983  100 years old and not under seal pursuant to court order;
  984         5. To a law enforcement agency for official purposes;
  985         6. To any agency of the state or the United States for
  986  official purposes upon approval of the department; or
  987         7. Upon order of any court of competent jurisdiction.
  988         (b) To protect the integrity of vital records and prevent
  989  the fraudulent use of the birth certificates of deceased
  990  persons, the department shall match birth and death certificates
  991  and post the fact of death to the appropriate birth certificate.
  992  Except for a commemorative birth certificate, any certification
  993  of a birth certificate of a deceased registrant shall be marked
  994  “deceased.” In the case of a commemorative birth certificate,
  995  such indication of death shall be made on the back of the
  996  certificate.
  997         (c) The department shall issue, upon request and upon
  998  payment of an additional fee as prescribed under s. 382.0255, a
  999  commemorative birth certificate representing that the birth of
 1000  the person named thereon is recorded in the office of the
 1001  registrar. The certificate issued under this paragraph shall be
 1002  in a form consistent with the need to protect the integrity of
 1003  vital records but shall be suitable for display. It may bear the
 1004  seal of the state printed thereon and may be signed by the
 1005  Governor.
 1006         (4) CERTIFIED COPIES OF ORIGINAL CERTIFICATES.—Only the
 1007  state registrar, and local registrars, and those persons
 1008  appointed by the department are authorized to issue any
 1009  certificate which purports to be a certified copy of an original
 1010  certificate of live birth, death, or fetal death. Except as
 1011  provided in this section, preparing or issuing certificates is
 1012  exempt from the provisions of s. 119.07(1).
 1013         Section 12. Subsections (3), (4), and (5) of section
 1014  401.27, Florida Statutes, are amended to read:
 1015         401.27 Personnel; standards and certification.—
 1016         (3) Any person who desires to be certified or recertified
 1017  as an emergency medical technician or paramedic must apply to
 1018  the department under oath on forms provided by the department
 1019  which shall contain such information as the department
 1020  reasonably requires, which may include affirmative evidence of
 1021  ability to comply with applicable laws and rules. The department
 1022  shall determine whether the applicant meets the requirements
 1023  specified in this section and in rules of the department and
 1024  shall issue a certificate to any person who meets such
 1025  requirements.
 1026         (4) An applicant for certification or recertification as an
 1027  emergency medical technician or paramedic must:
 1028         (a) Have completed an appropriate training program as
 1029  follows:
 1030         1. For an emergency medical technician, an emergency
 1031  medical technician training program approved by the department
 1032  as equivalent to the most recent EMT-Basic National Standard
 1033  Curriculum or the National EMS Education Standards of the United
 1034  States Department of Transportation;
 1035         2. For a paramedic, a paramedic training program approved
 1036  by the department as equivalent to the most recent EMT-Paramedic
 1037  National Standard Curriculum or the National EMS Education
 1038  Standards of the United States Department of Transportation;
 1039         (b) Attest Certify under oath that he or she is not
 1040  addicted to alcohol or any controlled substance;
 1041         (c) Attest Certify under oath that he or she is free from
 1042  any physical or mental defect or disease that might impair the
 1043  applicant’s ability to perform his or her duties;
 1044         (d) Within 2 years after program completion have passed an
 1045  examination developed or required by the department;
 1046         (e)1. For an emergency medical technician, hold a current
 1047  American Heart Association cardiopulmonary resuscitation course
 1048  card or an American Red Cross cardiopulmonary resuscitation
 1049  course card or its equivalent as defined by department rule;
 1050         2. For a paramedic, hold a certificate of successful course
 1051  completion in advanced cardiac life support from the American
 1052  Heart Association or its equivalent as defined by department
 1053  rule;
 1054         (f) Submit the certification fee and the nonrefundable
 1055  examination fee prescribed in s. 401.34, which examination fee
 1056  will be required for each examination administered to an
 1057  applicant; and
 1058         (g) Submit a completed application to the department, which
 1059  application documents compliance with paragraphs (a), (b), (c),
 1060  (e), (f), and this paragraph, and, if applicable, paragraph (d).
 1061  The application must be submitted so as to be received by the
 1062  department at least 30 calendar days before the next regularly
 1063  scheduled examination for which the applicant desires to be
 1064  scheduled.
 1065         (5) The certification examination must be offered monthly.
 1066  The department shall issue an examination admission notice to
 1067  the applicant advising him or her of the time and place of the
 1068  examination for which he or she is scheduled. Individuals
 1069  achieving a passing score on the certification examination may
 1070  be issued a temporary certificate with their examination grade
 1071  report. The department must issue an original certification
 1072  within 45 days after the examination. Examination questions and
 1073  answers are not subject to discovery but may be introduced into
 1074  evidence and considered only in camera in any administrative
 1075  proceeding under chapter 120. If an administrative hearing is
 1076  held, the department shall provide challenged examination
 1077  questions and answers to the administrative law judge. The
 1078  department shall establish by rule the procedure by which an
 1079  applicant, and the applicant’s attorney, may review examination
 1080  questions and answers in accordance with s. 119.071(1)(a).
 1081         Section 13. Paragraph (a) of subsection (1) of section
 1082  401.2701, Florida Statutes, is amended to read:
 1083         401.2701 Emergency medical services training programs.—
 1084         (1) Any private or public institution in Florida desiring
 1085  to conduct an approved program for the education of emergency
 1086  medical technicians and paramedics shall:
 1087         (a) Submit a completed application on a form provided by
 1088  the department, which must include:
 1089         1. Evidence that the institution is in compliance with all
 1090  applicable requirements of the Department of Education.
 1091         2. Evidence of an affiliation agreement with a hospital
 1092  that has an emergency department staffed by at least one
 1093  physician and one registered nurse.
 1094         3. Evidence of an affiliation agreement with a current
 1095  emergency medical services provider that is licensed in this
 1096  state. Such agreement shall include, at a minimum, a commitment
 1097  by the provider to conduct the field experience portion of the
 1098  education program. An applicant licensed as an advanced life
 1099  support service under s. 401.25 with permitted transport
 1100  vehicles pursuant to s. 401.26 is exempt from the requirements
 1101  of this subparagraph and need not submit evidence of an
 1102  affiliation agreement with a current emergency medical services
 1103  provider.
 1104         4. Documentation verifying faculty, including:
 1105         a. A medical director who is a licensed physician meeting
 1106  the applicable requirements for emergency medical services
 1107  medical directors as outlined in this chapter and rules of the
 1108  department. The medical director shall have the duty and
 1109  responsibility of certifying that graduates have successfully
 1110  completed all phases of the education program and are proficient
 1111  in basic or advanced life support techniques, as applicable.
 1112         b. A program director responsible for the operation,
 1113  organization, periodic review, administration, development, and
 1114  approval of the program.
 1115         5. Documentation verifying that the curriculum:
 1116         a. Meets the most recent Emergency Medical Technician-Basic
 1117  National Standard Curriculum or the National EMS Education
 1118  Standards approved by the department for emergency medical
 1119  technician programs and Emergency Medical Technician-Paramedic
 1120  National Standard Curriculum or the National EMS Education
 1121  Standards approved by the department for paramedic programs.
 1122         b. Includes 2 hours of instruction on the trauma scorecard
 1123  methodologies for assessment of adult trauma patients and
 1124  pediatric trauma patients as specified by the department by
 1125  rule.
 1126         6. Evidence of sufficient medical and educational equipment
 1127  to meet emergency medical services training program needs.
 1128         Section 14. Section 401.272, Florida Statutes, is amended
 1129  to read:
 1130         401.272 Emergency medical services community health care.—
 1131         (1) The purpose of this section is to encourage more
 1132  effective utilization of the skills of emergency medical
 1133  technicians and paramedics by enabling them to perform, in
 1134  partnership with local county health departments, specific
 1135  additional health care tasks that are consistent with the public
 1136  health and welfare.
 1137         (2) Notwithstanding any other provision of law to the
 1138  contrary:
 1139         (a) Paramedics or emergency medical technicians shall
 1140  operate under the medical direction of a physician through two
 1141  way voice communication or pursuant to established standing
 1142  orders or protocols and within the scope of their training when
 1143  providing basic life support, advanced life support, and may
 1144  perform health promotion and wellness activities and blood
 1145  pressure screenings in a nonemergency environment, within the
 1146  scope of their training, and under the direction of a medical
 1147  director. As used in this paragraph, the term “health promotion
 1148  and wellness” means the provision of public health programs
 1149  pertaining to the prevention of illness and injury.
 1150         (b) Paramedics and emergency medical technicians shall
 1151  operate under the medical direction of a physician through two
 1152  way communication or pursuant to established standing orders or
 1153  protocols and within the scope of their training when a patient
 1154  is not transported to an emergency department or is transported
 1155  to a facility other than a hospital as defined in s.
 1156  395.002(12).
 1157         (c) Paramedics may administer immunizations in a
 1158  nonemergency environment, within the scope of their training,
 1159  and under the medical direction of a physician through two-way
 1160  communication or pursuant to established standing orders or
 1161  protocols medical director. There must be a written agreement
 1162  between the physician providing medical direction paramedic’s
 1163  medical director and the department or the county health
 1164  department located in each county in which the paramedic
 1165  administers immunizations. This agreement must establish the
 1166  protocols, policies, and procedures under which the paramedic
 1167  must operate.
 1168         (d)(c) Paramedics may provide basic life support services
 1169  and advanced life support services to patients receiving acute
 1170  and postacute hospital care at home as specified in the
 1171  paramedic’s supervisory relationship with a physician or
 1172  standing orders as described in s. 401.265, s. 458.348, or s.
 1173  459.025. A physician who supervises or provides medical
 1174  direction to a paramedic who provides basic life support
 1175  services or advanced life support services to patients receiving
 1176  acute and postacute hospital care at home pursuant to a formal
 1177  supervisory relationship or standing orders is liable for any
 1178  act or omission of the paramedic acting under the physician’s
 1179  supervision or medical direction when providing such services.
 1180  The department may adopt and enforce rules necessary to
 1181  implement this paragraph.
 1182         (3) Each physician providing medical direction to medical
 1183  director under whose direction a paramedic who administers
 1184  immunizations must verify and document that the paramedic has
 1185  received sufficient training and experience to administer
 1186  immunizations. The verification must be documented on forms
 1187  developed by the department, and the completed forms must be
 1188  maintained at the service location of the licensee and made
 1189  available to the department upon request.
 1190         (4) The department may adopt and enforce all rules
 1191  necessary to enforce the provisions relating to a paramedic’s
 1192  administration of immunizations and the performance of health
 1193  promotion and wellness activities and blood pressure screenings
 1194  by a paramedic or emergency medical technician in a nonemergency
 1195  environment.
 1196         Section 15. Subsections (5), (6), and (7) of section
 1197  401.34, Florida Statutes, are amended to read:
 1198         401.34 Fees.—
 1199         (5) The department may provide same-day grading of the
 1200  examination for an applicant for emergency medical technician or
 1201  paramedic certification.
 1202         (6) The department may offer walk-in eligibility
 1203  determination and examination to applicants for emergency
 1204  medical technician or paramedic certification who pay to the
 1205  department a nonrefundable fee to be set by the department not
 1206  to exceed $65. The fee is in addition to the certification fee
 1207  and examination fee. The department must establish locations and
 1208  times for eligibility determination and examination.
 1209         (7) The cost of emergency medical technician or paramedic
 1210  certification examination review may not exceed $50.
 1211         Section 16. Section 401.435, Florida Statutes, is amended
 1212  to read:
 1213         401.435 Emergency medical First responder agencies and
 1214  training.—
 1215         (1) The department must adopt by rule the United States
 1216  Department of Transportation National Emergency Medical Services
 1217  Education Standards for the Emergency Medical Services: First
 1218  Responder level Training Course as the minimum standard for
 1219  emergency medical first responder training. In addition, the
 1220  department must adopt rules establishing minimum emergency
 1221  medical first responder instructor qualifications. For purposes
 1222  of this section, an emergency medical a first responder includes
 1223  any individual who receives training to render initial care to
 1224  an ill or injured person, other than an individual trained and
 1225  certified pursuant to s. 943.1395(1), but who does not have the
 1226  primary responsibility of treating and transporting ill or
 1227  injured persons.
 1228         (2) Each emergency medical first responder agency must take
 1229  all reasonable efforts to enter into a memorandum of
 1230  understanding with the emergency medical services licensee
 1231  within whose territory the agency operates in order to
 1232  coordinate emergency services at an emergency scene. The
 1233  department must provide a model memorandum of understanding for
 1234  this purpose. The memorandum of understanding should include
 1235  dispatch protocols, the roles and responsibilities of emergency
 1236  medical first responder personnel at an emergency scene, and the
 1237  documentation required for patient care rendered. For purposes
 1238  of this section, the term “emergency medical first responder
 1239  agency” includes a law enforcement agency, a fire service agency
 1240  not licensed under this part, a lifeguard agency, and a
 1241  volunteer organization that renders, as part of its routine
 1242  functions, on-scene patient care before emergency medical
 1243  technicians or paramedics arrive.
 1244         Section 17. Paragraph (a) of subsection (1) of section
 1245  464.203, Florida Statutes, is amended to read:
 1246         464.203 Certified nursing assistants; certification
 1247  requirement.—
 1248         (1) The board shall issue a certificate to practice as a
 1249  certified nursing assistant to any person who demonstrates a
 1250  minimum competency to read and write and successfully passes the
 1251  required background screening pursuant to s. 400.215. If the
 1252  person has successfully passed the required background screening
 1253  pursuant to s. 400.215 or s. 408.809 within 90 days before
 1254  applying for a certificate to practice and the person’s
 1255  background screening results are not retained in the
 1256  clearinghouse created under s. 435.12, the board shall waive the
 1257  requirement that the applicant successfully pass an additional
 1258  background screening pursuant to s. 400.215. The person must
 1259  also meet one of the following requirements:
 1260         (a) Has successfully completed an approved training program
 1261  and achieved a minimum score, established by rule of the board,
 1262  on the nursing assistant competency examination, which consists
 1263  of a written portion and skills-demonstration portion approved
 1264  by the board and administered at a site and by personnel
 1265  approved by the department. Any person who has successfully
 1266  completed an approved training program within 6 months before
 1267  filing an application for certification is not required to take
 1268  the skills-demonstration portion of the competency examination.
 1269         Section 18. Section 468.1225, Florida Statutes, is amended
 1270  to read:
 1271         468.1225 Procedures, equipment, and protocols.—
 1272         (1) The following minimal procedures shall be used when a
 1273  licensed audiologist fits and sells a prescription hearing aid:
 1274         (a) Pure tone audiometric testing by air and bone to
 1275  determine the type and degree of hearing deficiency when
 1276  indicated.
 1277         (b) Effective masking when indicated.
 1278         (c) Appropriate testing to determine speech reception
 1279  thresholds, speech discrimination scores, the most comfortable
 1280  listening levels, uncomfortable loudness levels, and the
 1281  selection of the best fitting arrangement for maximum hearing
 1282  aid benefit when indicated.
 1283         (2) The following equipment shall be used:
 1284         (a) A wide range audiometer that which meets the
 1285  specifications of the American National Standards Institute for
 1286  diagnostic audiometers when indicated.
 1287         (b) A speech audiometer or a master hearing aid in order to
 1288  determine the most comfortable listening level and speech
 1289  discrimination when indicated.
 1290         (3) A final fitting ensuring physical and operational
 1291  comfort of the prescription hearing aid shall be made when
 1292  indicated.
 1293         (4) A licensed audiologist who fits and sells prescription
 1294  hearing aids shall obtain the following medical clearance: If,
 1295  upon inspection of the ear canal with an otoscope in the common
 1296  procedure of fitting a prescription hearing aid and upon
 1297  interrogation of the client, there is any recent history of
 1298  infection or any observable anomaly, the client shall be
 1299  instructed to see a physician, and a prescription hearing aid
 1300  may shall not be fitted until medical clearance is obtained for
 1301  the condition noted. If, upon return, the condition noted is no
 1302  longer observable and the client signs a medical waiver, a
 1303  prescription hearing aid may be fitted. Any person with a
 1304  significant difference between bone conduction hearing and air
 1305  conduction hearing must be informed of the possibility of
 1306  medical or surgical correction.
 1307         (5)(a) A licensed audiologist’s office must have available,
 1308  or have access to, a selection of prescription hearing aid
 1309  models, hearing aid supplies, and services complete enough to
 1310  accommodate the various needs of the hearing aid wearers.
 1311         (b) At the time of the initial examination for fitting and
 1312  sale of a prescription hearing aid, the attending audiologist
 1313  must notify the prospective purchaser of the benefits of
 1314  telecoil, also known as “t” coil or “t” switch, technology,
 1315  including increased access to telephones and noninvasive access
 1316  to assistive listening systems required under the Americans with
 1317  Disabilities Act of 1990.
 1318         (6) Unless otherwise indicated, each audiometric test
 1319  conducted by a licensee or a certified audiology assistant in
 1320  the fitting and selling of prescription hearing aids must shall
 1321  be made in a testing room that has been certified by the
 1322  department, or by an agent approved by the department, not to
 1323  exceed the following sound pressure levels at the specified
 1324  frequencies: 250Hz-40dB, 500Hz-40dB, 750Hz-40dB, 1000Hz-40dB,
 1325  1500Hz-42dB, 2000Hz-47dB, 3000Hz-52dB, 4000Hz-57dB, 6000Hz-62dB,
 1326  and 8000Hz-67dB. An exception to this requirement shall be made
 1327  in the case of a client who, after being provided written notice
 1328  of the benefits and advantages of having the test conducted in a
 1329  certified testing room, requests that the test be conducted in a
 1330  place other than the licensee’s certified testing room. Such
 1331  request must shall be documented by a waiver that which includes
 1332  the written notice and is signed by the licensee and the client
 1333  before prior to the testing. The waiver must shall be executed
 1334  on a form provided by the department. The executed waiver must
 1335  shall be attached to the client’s copy of the contract, and a
 1336  copy of the executed waiver must shall be retained in the
 1337  licensee’s file.
 1338         (7) The board may shall have the power to prescribe the
 1339  minimum procedures and equipment used in the conducting of
 1340  hearing assessments and for the fitting and selling of
 1341  prescription hearing aids. The board shall adopt and enforce
 1342  rules necessary to implement carry out the provisions of this
 1343  subsection and subsection (6).
 1344         (8) Any duly authorized officer or employee of the
 1345  department may shall have the right to make such inspections and
 1346  investigations as are necessary in order to determine the state
 1347  of compliance with the provisions of this section and the
 1348  applicable rules and may enter the premises of a licensee and
 1349  inspect the records of same upon reasonable belief that a
 1350  violation of this law is being or has been committed or that the
 1351  licensee has failed or is failing to comply with the provisions
 1352  of this part.
 1353         Section 19. Section 468.1245, Florida Statutes, is amended
 1354  to read:
 1355         468.1245 Itemized listing of prices; delivery of
 1356  prescription hearing aid; receipt; guarantee; packaging;
 1357  disclaimer.—
 1358         (1) Before Prior to delivery of services or products to a
 1359  prospective purchaser, a licensee must shall disclose, upon
 1360  request by the prospective purchaser, an itemized listing of
 1361  prices, which must listing shall include separate price
 1362  estimates for each service component and each product. Provision
 1363  of such itemized listing of prices may shall not be predicated
 1364  on the prospective purchaser’s payment of any charge or
 1365  agreement to purchase any service or product.
 1366         (2) Any licensee who fits and sells a prescription hearing
 1367  aid shall, at the time of delivery, provide the purchaser with a
 1368  receipt containing the seller’s signature, the address of his or
 1369  her regular place of business, and his or her license or
 1370  certification number, if applicable, together with the brand,
 1371  model, manufacturer or manufacturer’s identification code, and
 1372  serial number of the prescription hearing aid furnished and the
 1373  amount charged for the prescription hearing aid. The receipt
 1374  must also shall specify whether the prescription hearing aid is
 1375  new, used, or rebuilt, and shall specify the length of time and
 1376  other terms of the guarantee, and by whom the prescription
 1377  hearing aid is guaranteed. When the client has requested an
 1378  itemized list of prices, the receipt must shall also provide an
 1379  itemization of the total purchase price, including, but not
 1380  limited to, the cost of the aid, ear mold, batteries, and other
 1381  accessories, and the cost of any services. Notice of the
 1382  availability of this service must be displayed in a conspicuous
 1383  manner in the office. The receipt must also shall state that any
 1384  complaint concerning the prescription hearing aid and its
 1385  guarantee, if not reconciled with the licensee from whom the
 1386  prescription hearing aid was purchased, should be directed by
 1387  the purchaser to the department. The address and telephone
 1388  number of such office must shall be stated on the receipt.
 1389         (3) A prescription No hearing aid may not be sold to any
 1390  person unless both the packaging containing the prescription
 1391  hearing aid and the contract provided pursuant to subsection (2)
 1392  carry the following disclaimer in 10-point or larger type: “A
 1393  hearing aid will not restore normal hearing, nor will it prevent
 1394  further hearing loss.”
 1395         Section 20. Section 468.1246, Florida Statutes, is amended
 1396  to read:
 1397         468.1246 Thirty-day trial period; purchaser’s right to
 1398  cancel; notice; refund; cancellation fee.—
 1399         (1) A person selling a prescription hearing aid in this
 1400  state must provide the buyer with written notice of a 30-day
 1401  trial period and money-back guarantee. The guarantee must permit
 1402  the purchaser to cancel the purchase for a valid reason as
 1403  defined by rule of the board within 30 days after receiving the
 1404  prescription hearing aid, by returning the prescription hearing
 1405  aid or mailing written notice of cancellation to the seller. If
 1406  the prescription hearing aid must be repaired, remade, or
 1407  adjusted during the 30-day trial period, the running of the 30
 1408  day trial period is suspended 1 day for each 24-hour period that
 1409  the prescription hearing aid is not in the purchaser’s
 1410  possession. A repaired, remade, or adjusted prescription hearing
 1411  aid must be claimed by the purchaser within 3 working days after
 1412  notification of availability. The running of the 30-day trial
 1413  period resumes on the day the purchaser reclaims a repaired,
 1414  remade, or adjusted prescription hearing aid or on the 4th day
 1415  after notification of availability.
 1416         (2) The board, in consultation with the Board of Hearing
 1417  Aid Specialists, shall prescribe by rule the terms and
 1418  conditions to be contained in the money-back guarantee and any
 1419  exceptions thereto. Such rule must shall provide, at a minimum,
 1420  that the charges for earmolds and service provided to fit the
 1421  prescription hearing aid may be retained by the licensee. The
 1422  rules must shall also set forth any reasonable charges to be
 1423  held by the licensee as a cancellation fee. Such rule shall be
 1424  effective on or before December 1, 1994. Should the board fail
 1425  to adopt such rule, a licensee may not charge a cancellation fee
 1426  which exceeds 5 percent of the total charge for a hearing aid
 1427  alone. The terms and conditions of the guarantee, including the
 1428  total amount available for refund, must shall be provided in
 1429  writing to the purchaser before prior to the signing of the
 1430  contract.
 1431         Section 21. Section 468.1255, Florida Statutes, is amended
 1432  to read:
 1433         468.1255 Cancellation by medical authorization; purchaser’s
 1434  right to return.—
 1435         (1) In addition to any other rights and remedies the
 1436  purchaser of a prescription hearing aid may have, the purchaser
 1437  has shall have the right to rescind the transaction if the
 1438  purchaser for whatever reason consults a licensed physician with
 1439  specialty board certification in otolaryngology or internal
 1440  medicine or a licensed family practice physician, subsequent to
 1441  purchasing a prescription hearing aid, and the physician
 1442  certifies in writing that the purchaser has a hearing impairment
 1443  for which a prescription hearing aid will not provide a benefit
 1444  or that the purchaser has a medical condition which
 1445  contraindicates the use of a prescription hearing aid.
 1446         (2) The purchaser of a prescription hearing aid has shall
 1447  have the right to rescind as provided in subsection (1) only if
 1448  the purchaser gives a written notice of the intent to rescind
 1449  the transaction to the seller at the seller’s place of business
 1450  by certified mail, return receipt requested, which notice shall
 1451  be posted not later than 60 days following the date of delivery
 1452  of the prescription hearing aid to the purchaser, and the
 1453  purchaser returns the prescription hearing aid to the seller in
 1454  the original condition less normal wear and tear.
 1455         (3) If the conditions of subsections (1) and (2) are met,
 1456  the seller must shall, without request, refund to the purchaser,
 1457  within 10 days after of the receipt of notice to rescind, a full
 1458  and complete refund of all moneys received, less 5 percent. The
 1459  purchaser does not shall incur any no additional liability for
 1460  rescinding the transaction.
 1461         Section 22. Section 468.1265, Florida Statutes, is amended
 1462  to read:
 1463         468.1265 Sale or distribution of prescription hearing aids
 1464  through mail; penalty.—It is unlawful for any person to sell or
 1465  distribute prescription hearing aids through the mail to the
 1466  ultimate consumer. Any person who violates this section commits
 1467  a misdemeanor of the second degree, punishable as provided in s.
 1468  775.082 or s. 775.083.
 1469         Section 23. Section 468.1275, Florida Statutes, is amended
 1470  to read:
 1471         468.1275 Place of business; display of license.—Each
 1472  licensee who fits and sells a prescription hearing aid shall
 1473  declare and establish a regular place of business, at which his
 1474  or her license shall be conspicuously displayed.
 1475         Section 24. Section 484.0401, Florida Statutes, is amended
 1476  to read:
 1477         484.0401 Purpose.—The Legislature recognizes that the
 1478  dispensing of prescription hearing aids requires particularized
 1479  knowledge and skill to ensure that the interests of the hearing
 1480  impaired public will be adequately served and safely protected.
 1481  It recognizes that a poorly selected or fitted prescription
 1482  hearing aid not only will give little satisfaction but may
 1483  interfere with hearing ability and, therefore, deems it
 1484  necessary in the interest of the public health, safety, and
 1485  welfare to regulate the dispensing of prescription hearing aids
 1486  in this state. Restrictions on the fitting and selling of
 1487  prescription hearing aids shall be imposed only to the extent
 1488  necessary to protect the public from physical and economic harm,
 1489  and restrictions shall not be imposed in a manner which will
 1490  unreasonably affect the competitive market.
 1491         Section 25. Section 484.041, Florida Statutes, is reordered
 1492  and amended to read:
 1493         484.041 Definitions.—As used in this part, the term:
 1494         (1) “Board” means the Board of Hearing Aid Specialists.
 1495         (2) “Department” means the Department of Health.
 1496         (3) “Dispensing prescription hearing aids” means and
 1497  includes:
 1498         (a) Conducting and interpreting hearing tests for purposes
 1499  of selecting suitable prescription hearing aids, making earmolds
 1500  or ear impressions, and providing appropriate counseling.
 1501         (b) All acts pertaining to the selling, renting, leasing,
 1502  pricing, delivery, and warranty of prescription hearing aids.
 1503         (6)(4) “Hearing aid specialist” means a person duly
 1504  licensed in this state to practice the dispensing of
 1505  prescription hearing aids.
 1506         (4)(5) “Hearing aid” means any wearable an amplifying
 1507  device designed for, offered for the purpose of, or represented
 1508  as aiding persons with, or compensating for, impaired hearing to
 1509  be worn by a hearing-impaired person to improve hearing.
 1510         (10)(6) “Trainee” means a person studying prescription
 1511  hearing aid dispensing under the direct supervision of an active
 1512  licensed hearing aid specialist for the purpose of qualifying
 1513  for certification to sit for the licensure examination.
 1514         (5)(7) “Hearing aid establishment” means any establishment
 1515  in this the state which employs a licensed hearing aid
 1516  specialist who offers, advertises, and performs hearing aid
 1517  services for the general public.
 1518         (7)“Over-the-counter hearing aid” means an air-conduction
 1519  hearing aid that does not require implantation or other surgical
 1520  intervention and is intended for use by a person 18 years of age
 1521  or older to compensate for perceived mild to moderate hearing
 1522  impairment.
 1523         (8) “Prescription hearing aid” means a hearing aid that is
 1524  not an over-the-counter hearing aid and that does not otherwise
 1525  meet the criteria for a prescription hearing aid under this
 1526  part.
 1527         (9) “Sponsor” means an active, licensed hearing aid
 1528  specialist under whose direct supervision one or more trainees
 1529  are studying prescription hearing aid dispensing for the purpose
 1530  of qualifying for certification to sit for the licensure
 1531  examination.
 1532         Section 26. Subsection (2) of section 484.042, Florida
 1533  Statutes, is amended to read:
 1534         484.042 Board of Hearing Aid Specialists; membership,
 1535  appointment, terms.—
 1536         (2) Five members of the board shall be hearing aid
 1537  specialists who have been licensed and practicing the dispensing
 1538  of prescription hearing aids in this state for at least the
 1539  preceding 4 years. The remaining four members, none of whom
 1540  shall derive economic benefit from the fitting or dispensing of
 1541  hearing aids, shall be appointed from the resident lay public of
 1542  this state. One of the lay members shall be a prescription
 1543  hearing aid user but may not neither be nor have been a hearing
 1544  aid specialist or a licensee of a closely related profession.
 1545  One lay member shall be an individual age 65 or over. One lay
 1546  member shall be an otolaryngologist licensed pursuant to chapter
 1547  458 or chapter 459.
 1548         Section 27. Subsection (2) of section 484.044, Florida
 1549  Statutes, is amended to read:
 1550         484.044 Authority to make rules.—
 1551         (2) The board shall adopt rules requiring that each
 1552  prospective purchaser of a prescription hearing aid be notified
 1553  by the attending hearing aid specialist, at the time of the
 1554  initial examination for fitting and sale of a hearing aid, of
 1555  telecoil, “t” coil, or “t” switch technology. The rules shall
 1556  further require that hearing aid specialists make available to
 1557  prospective purchasers or clients information regarding
 1558  telecoils, “t” coils, or “t” switches. These rules shall be
 1559  effective on or before October 1, 1994.
 1560         Section 28. Subsection (2) of section 484.0445, Florida
 1561  Statutes, is amended to read:
 1562         484.0445 Training program.—
 1563         (2) A trainee shall perform the functions of a hearing aid
 1564  specialist in accordance with board rules only under the direct
 1565  supervision of a licensed hearing aid specialist. The term
 1566  “direct supervision” means that the sponsor is responsible for
 1567  all work being performed by the trainee. The sponsor or a
 1568  hearing aid specialist designated by the sponsor shall give
 1569  final approval to work performed by the trainee and shall be
 1570  physically present at the time the prescription hearing aid is
 1571  delivered to the client.
 1572         Section 29. Subsection (2) of section 484.045, Florida
 1573  Statutes, is amended to read:
 1574         484.045 Licensure by examination.—
 1575         (2) The department shall license each applicant who the
 1576  board certifies meets all of the following criteria:
 1577         (a) Has completed the application form and remitted the
 1578  required fees.;
 1579         (b) Is of good moral character.;
 1580         (c) Is 18 years of age or older.;
 1581         (d) Is a graduate of an accredited high school or its
 1582  equivalent.;
 1583         (e)1. Has met the requirements of the training program; or
 1584         2.a. Has a valid, current license as a hearing aid
 1585  specialist or its equivalent from another state and has been
 1586  actively practicing in such capacity for at least 12 months; or
 1587         b. Is currently certified by the National Board for
 1588  Certification in Hearing Instrument Sciences and has been
 1589  actively practicing for at least 12 months.;
 1590         (f) Has passed an examination, as prescribed by board
 1591  rule.; and
 1592         (g) Has demonstrated, in a manner designated by rule of the
 1593  board, knowledge of state laws and rules relating to the fitting
 1594  and dispensing of prescription hearing aids.
 1595         Section 30. Section 484.0501, Florida Statutes, is amended
 1596  to read:
 1597         484.0501 Minimal procedures and equipment.—
 1598         (1) The following minimal procedures shall be used in the
 1599  fitting and selling of prescription hearing aids:
 1600         (a) Pure tone audiometric testing by air and bone to
 1601  determine the type and degree of hearing deficiency.
 1602         (b) Effective masking when indicated.
 1603         (c) Appropriate testing to determine speech reception
 1604  thresholds, speech discrimination scores, the most comfortable
 1605  listening levels, uncomfortable loudness levels, and the
 1606  selection of the best fitting arrangement for maximum hearing
 1607  aid benefit.
 1608         (2) The following equipment shall be used:
 1609         (a) A wide range audiometer that which meets the
 1610  specifications of the American National Standards Institute for
 1611  diagnostic audiometers.
 1612         (b) A speech audiometer or a master hearing aid in order to
 1613  determine the most comfortable listening level and speech
 1614  discrimination.
 1615         (3) A final fitting ensuring physical and operational
 1616  comfort of the prescription hearing aid shall be made.
 1617         (4) The following medical clearance shall be obtained: If,
 1618  upon inspection of the ear canal with an otoscope in the common
 1619  procedure of a prescription hearing aid fitter and upon
 1620  interrogation of the client, there is any recent history of
 1621  infection or any observable anomaly, the client must shall be
 1622  instructed to see a physician, and a prescription hearing aid
 1623  may shall not be fitted until medical clearance is obtained for
 1624  the condition noted. If, upon return, the condition noted is no
 1625  longer observable and the client signs a medical waiver, a
 1626  prescription hearing aid may be fitted. Any person with a
 1627  significant difference between bone conduction hearing and air
 1628  conduction hearing must be informed of the possibility of
 1629  medical correction.
 1630         (5)(a) A prescription hearing aid establishment office must
 1631  have available, or have access to, a selection of prescription
 1632  hearing aid models, hearing aid supplies, and services complete
 1633  enough to accommodate the various needs of the prescription
 1634  hearing aid wearers.
 1635         (b) At the time of the initial examination for fitting and
 1636  sale of a prescription hearing aid, the attending hearing aid
 1637  specialist shall must notify the prospective purchaser or client
 1638  of the benefits of telecoil, “t” coil, or “t” switch technology,
 1639  including increased access to telephones and noninvasive access
 1640  to assistive listening systems required under the Americans with
 1641  Disabilities Act of 1990.
 1642         (6) Each audiometric test conducted by a licensee or
 1643  authorized trainee in the fitting and selling of prescription
 1644  hearing aids must shall be made in a testing room that has been
 1645  certified by the department, or by an agent approved by the
 1646  department, not to exceed the following sound pressure levels at
 1647  the specified frequencies: 250Hz-40dB, 500Hz-40dB, 750Hz-40dB,
 1648  1000Hz-40dB, 1500Hz-42dB, 2000Hz-47dB, 3000Hz-52dB, 4000Hz-57dB,
 1649  6000Hz-62dB, and 8000Hz-67dB. An exception to this requirement
 1650  shall be made in the case of a client who, after being provided
 1651  written notice of the benefits and advantages of having the test
 1652  conducted in a certified testing room, requests that the test be
 1653  conducted in a place other than the licensee’s certified testing
 1654  room. Such request must shall be documented by a waiver which
 1655  includes the written notice and is signed by the licensee and
 1656  the client before prior to the testing. The waiver must shall be
 1657  executed on a form provided by the department. The executed
 1658  waiver must shall be attached to the client’s copy of the
 1659  contract, and a copy of the executed waiver must shall be
 1660  retained in the licensee’s file.
 1661         (7) The board may shall have the power to prescribe the
 1662  minimum procedures and equipment which must shall be used in the
 1663  conducting of hearing assessments, and for the fitting and
 1664  selling of prescription hearing aids, including equipment that
 1665  will measure the prescription hearing aid’s response curves to
 1666  ensure that they meet the manufacturer’s specifications. These
 1667  procedures and equipment may differ from those provided in this
 1668  section in order to take full advantage of devices and equipment
 1669  which may hereafter become available and which are demonstrated
 1670  to be of greater efficiency and accuracy. The board shall adopt
 1671  and enforce rules necessary to implement carry out the
 1672  provisions of this subsection and subsection (6).
 1673         (8) Any duly authorized officer or employee of the
 1674  department may shall have the right to make such inspections and
 1675  investigations as are necessary in order to determine the state
 1676  of compliance with the provisions of this section and the
 1677  applicable rules and may enter the premises of a licensee and
 1678  inspect the records of same upon reasonable belief that a
 1679  violation of this law is being or has been committed or that the
 1680  licensee has failed or is failing to comply with the provisions
 1681  of this part act.
 1682         (9)A licensed hearing aid specialist may service, market,
 1683  sell, dispense, provide customer support for, and distribute
 1684  prescription and over-the-counter hearing aids.
 1685         Section 31. Section 484.051, Florida Statutes, is amended
 1686  to read:
 1687         484.051 Itemization of prices; delivery of prescription
 1688  hearing aid; receipt, packaging, disclaimer, guarantee.—
 1689         (1) Before Prior to delivery of services or products to a
 1690  prospective purchaser, any person who fits and sells
 1691  prescription hearing aids must shall disclose on request by the
 1692  prospective purchaser an itemized listing of prices, which must
 1693  listing shall include separate price estimates for each service
 1694  component and each product. Provision of such itemized listing
 1695  of prices may shall not be predicated on the prospective
 1696  purchaser’s payment of any charge or agreement to purchase any
 1697  service or product.
 1698         (2) Any person who fits and sells a prescription hearing
 1699  aid must shall, at the time of delivery, provide the purchaser
 1700  with a receipt containing the seller’s signature, the address of
 1701  her or his regular place of business, and her or his license or
 1702  trainee registration number, if applicable, together with the
 1703  brand, model, manufacturer or manufacturer’s identification
 1704  code, and serial number of the prescription hearing aid
 1705  furnished and the amount charged for the prescription hearing
 1706  aid. The receipt must also shall specify whether the
 1707  prescription hearing aid is new, used, or rebuilt, and shall
 1708  specify the length of time and other terms of the guarantee, and
 1709  by whom the prescription hearing aid is guaranteed. If When the
 1710  client has requested an itemized list of prices, the receipt
 1711  must shall also provide an itemization of the total purchase
 1712  price, including, but not limited to, the cost of the aid,
 1713  earmold, batteries and other accessories, and any services.
 1714  Notice of the availability of this service shall be displayed in
 1715  a conspicuous manner in the office. The receipt must also shall
 1716  state that any complaint concerning the prescription hearing aid
 1717  and guarantee therefor, if not reconciled with the licensee from
 1718  whom the prescription hearing aid was purchased, should be
 1719  directed by the purchaser to the Department of Health. The
 1720  address and telephone number of such office must shall be stated
 1721  on the receipt.
 1722         (3) A prescription No hearing aid may not be sold to any
 1723  person unless both the packaging containing the prescription
 1724  hearing aid and the itemized receipt provided pursuant to
 1725  subsection (2) carry the following disclaimer in 10-point or
 1726  larger type: “A hearing aid will not restore normal hearing, nor
 1727  will it prevent further hearing loss.”
 1728         Section 32. Section 484.0512, Florida Statutes, is amended
 1729  to read:
 1730         484.0512 Thirty-day trial period; purchaser’s right to
 1731  cancel; notice; refund; cancellation fee; criminal penalty.—
 1732         (1) A person selling a prescription hearing aid in this
 1733  state must provide the buyer with written notice of a 30-day
 1734  trial period and money-back guarantee. The guarantee must permit
 1735  the purchaser to cancel the purchase for a valid reason, as
 1736  defined by rule of the board rule, within 30 days after
 1737  receiving the prescription hearing aid, by returning the
 1738  prescription hearing aid or mailing written notice of
 1739  cancellation to the seller. If the prescription hearing aid must
 1740  be repaired, remade, or adjusted during the 30-day trial period,
 1741  the running of the 30-day trial period is suspended 1 day for
 1742  each 24-hour period that the prescription hearing aid is not in
 1743  the purchaser’s possession. A repaired, remade, or adjusted
 1744  prescription hearing aid must be claimed by the purchaser within
 1745  3 working days after notification of availability. The running
 1746  of the 30-day trial period resumes on the day the purchaser
 1747  reclaims the repaired, remade, or adjusted prescription hearing
 1748  aid or on the fourth day after notification of availability,
 1749  whichever occurs earlier.
 1750         (2) The board, in consultation with the Board of Speech
 1751  Language Pathology and Audiology, shall prescribe by rule the
 1752  terms and conditions to be contained in the money-back guarantee
 1753  and any exceptions thereto. Such rules must rule shall provide,
 1754  at a minimum, that the charges for earmolds and service provided
 1755  to fit the prescription hearing aid may be retained by the
 1756  licensee. The rules must shall also set forth any reasonable
 1757  charges to be held by the licensee as a cancellation fee. Such
 1758  rule shall be effective on or before December 1, 1994. Should
 1759  the board fail to adopt such rule, a licensee may not charge a
 1760  cancellation fee which exceeds 5 percent of the total charge for
 1761  a hearing aid alone. The terms and conditions of the guarantee,
 1762  including the total amount available for refund, must shall be
 1763  provided in writing to the purchaser before prior to the signing
 1764  of the contract.
 1765         (3) Within 30 days after the return or attempted return of
 1766  the prescription hearing aid, the seller shall refund all moneys
 1767  that must be refunded to a purchaser pursuant to this section. A
 1768  violation of this subsection is a misdemeanor of the first
 1769  degree, punishable as provided in s. 775.082 or s. 775.083.
 1770         (4) For purposes of this section, the term “seller” or
 1771  “person selling a prescription hearing aid” includes:
 1772         (a) Any natural person licensed under this part or any
 1773  other natural person who signs a sales receipt required by s.
 1774  484.051(2) or s. 468.1245(2) or who otherwise fits, delivers, or
 1775  dispenses a prescription hearing aid.
 1776         (b) Any business organization, whether a sole
 1777  proprietorship, partnership, corporation, professional
 1778  association, joint venture, business trust, or other legal
 1779  entity, that which dispenses a prescription hearing aid or
 1780  enters into an agreement to dispense a prescription hearing aid.
 1781         (c) Any person who controls, manages, or operates an
 1782  establishment or business that dispenses a prescription hearing
 1783  aid or enters into an agreement to dispense a prescription
 1784  hearing aid.
 1785         Section 33. Section 484.0513, Florida Statutes, is amended
 1786  to read:
 1787         484.0513 Cancellation by medical authorization; purchaser’s
 1788  right to return.—
 1789         (1) In addition to any other rights and remedies the
 1790  purchaser of a prescription hearing aid may have, the purchaser
 1791  has shall have the right to rescind the transaction if the
 1792  purchaser for whatever reason consults a licensed physician with
 1793  specialty board certification in otolaryngology or internal
 1794  medicine or a licensed family practice physician, subsequent to
 1795  purchasing a prescription hearing aid, and the physician
 1796  certifies in writing that the purchaser has a hearing impairment
 1797  for which a prescription hearing aid will not provide a benefit
 1798  or that the purchaser has a medical condition which
 1799  contraindicates the use of a prescription hearing aid.
 1800         (2) The purchaser of a prescription hearing aid has shall
 1801  have the right to rescind as provided in subsection (1) only if
 1802  the purchaser gives a written notice of the intent to rescind
 1803  the transaction to the seller at the seller’s place of business
 1804  by certified mail, return receipt requested, which must notice
 1805  shall be posted within not later than 60 days after following
 1806  the date of delivery of the prescription hearing aid to the
 1807  purchaser, and the purchaser returns the prescription hearing
 1808  aid to the seller in the original condition less normal wear and
 1809  tear.
 1810         (3) If the conditions of subsections (1) and (2) are met,
 1811  the seller must shall, without request, refund to the purchaser,
 1812  within 10 days after of the receipt of the notice to rescind, a
 1813  full and complete refund of all moneys received, less 5 percent.
 1814  The purchaser does not shall incur any no additional liability
 1815  for rescinding the transaction.
 1816         Section 34. Section 484.053, Florida Statutes, is amended
 1817  to read:
 1818         484.053 Prohibitions; penalties.—
 1819         (1) A person may not:
 1820         (a) Practice dispensing prescription hearing aids unless
 1821  the person is a licensed hearing aid specialist;
 1822         (b) Use the name or title “hearing aid specialist” when the
 1823  person has not been licensed under this part;
 1824         (c) Present as her or his own the license of another;
 1825         (d) Give false, incomplete, or forged evidence to the board
 1826  or a member thereof for the purposes of obtaining a license;
 1827         (e) Use or attempt to use a hearing aid specialist license
 1828  that is delinquent or has been suspended, revoked, or placed on
 1829  inactive status;
 1830         (f) Knowingly employ unlicensed persons in the practice of
 1831  dispensing prescription hearing aids; or
 1832         (g) Knowingly conceal information relative to violations of
 1833  this part.
 1834         (2) Any person who violates any provision of the provisions
 1835  of this section is guilty of a felony of the third degree,
 1836  punishable as provided in s. 775.082 or s. 775.083.
 1837         (3) If a person licensed under this part allows the sale of
 1838  a prescription hearing aid by an unlicensed person not
 1839  registered as a trainee or fails to comply with the requirements
 1840  of s. 484.0445(2) relating to supervision of trainees, the board
 1841  must shall, upon determination of that violation, order the full
 1842  refund of moneys paid by the purchaser upon return of the
 1843  prescription hearing aid to the seller’s place of business.
 1844         Section 35. Section 484.054, Florida Statutes, is amended
 1845  to read:
 1846         484.054 Sale or distribution of prescription hearing aids
 1847  through mail; penalty.—It is unlawful for any person to sell or
 1848  distribute prescription hearing aids through the mail to the
 1849  ultimate consumer. Any violation of this section constitutes a
 1850  misdemeanor of the second degree, punishable as provided in s.
 1851  775.082 or s. 775.083.
 1852         Section 36. Section 484.059, Florida Statutes, is amended
 1853  to read:
 1854         484.059 Exemptions.—
 1855         (1) The licensure requirements of this part do not apply to
 1856  any person engaged in recommending prescription hearing aids as
 1857  part of the academic curriculum of an accredited institution of
 1858  higher education, or as part of a program conducted by a public
 1859  charitable institution supported primarily by voluntary
 1860  contribution, provided this organization does not dispense or
 1861  sell prescription hearing aids or accessories.
 1862         (2) The licensure requirements of this part do not apply to
 1863  any person licensed to practice medicine in this the state,
 1864  except that such physician must shall comply with the
 1865  requirement of periodic filing of the certificate of testing and
 1866  calibration of audiometric equipment as provided in this part. A
 1867  No person employed by or working under the supervision of a
 1868  person licensed to practice medicine may not shall perform any
 1869  services or acts which would constitute the dispensing of
 1870  prescription hearing aids as defined in s. 484.041 s.
 1871  484.041(3), unless such person is a licensed hearing aid
 1872  specialist.
 1873         (3) The licensure requirements of this part do not apply to
 1874  an audiologist licensed under pursuant to part I of chapter 468.
 1875         (4) Section The provisions of s. 484.053(1)(a) does shall
 1876  not apply to registered trainees operating in compliance with
 1877  this part and board rules of the board.
 1878         (5)The licensure requirements of this part do not apply to
 1879  a person who services, markets, sells, dispenses, provides
 1880  customer support for, or distributes exclusively over-the
 1881  counter hearing aids, whether through in-person transactions, by
 1882  mail, or online. For purposes of this subsection, over-the
 1883  counter hearing aids are those that are available without the
 1884  supervision, prescription, or other order, involvement, or
 1885  intervention of a licensed person to consumers through in-person
 1886  transactions, by mail, or online. These devices allow the user
 1887  to control the device and customize it to the user’s hearing
 1888  needs through the use of tools, tests, or software, including,
 1889  but not limited to, wireless technology or tests for self
 1890  assessment of hearing loss.
 1891         Section 37. The Division of Law Revision is directed to
 1892  replace the phrase “the effective date of this act” wherever it
 1893  occurs in this act with the date the act becomes a law.
 1894         Section 38. Except as otherwise expressly provided in this
 1895  act and except for this section, which shall take effect upon
 1896  this act becoming a law, this act shall take effect July 1,
 1897  2023.