Florida Senate - 2023 SENATOR AMENDMENT Bill No. CS/SB 254, 1st Eng. Ì738500uÎ738500 LEGISLATIVE ACTION Senate . House . . . Floor: AD/RM . Floor: C 05/04/2023 11:24 AM . 05/04/2023 11:59 AM ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— Senator Yarborough moved the following: 1 Senate Amendment to House Amendment (256341) (with title 2 amendment) 3 4 Delete lines 5 - 197 5 and insert: 6 being subjected to sex-reassignment prescriptions or procedures, 7 as defined in s. 456.001. 8 Section 2. Subsection (1) of section 61.534, Florida 9 Statutes, is amended to read: 10 61.534 Warrant to take physical custody of child.— 11 (1) Upon the filing of a petition seeking enforcement of a 12 child custody determination, the petitioner may file a verified 13 application for the issuance of a warrant to take physical 14 custody of the child if the child is likely to imminently suffer 15 serious physical harm or removal from this state. Serious 16 physical harm includes, but is not limited to, being subjected 17 to sex-reassignment prescriptions or procedures as defined in s. 18 456.001. 19 Section 3. Section 286.31, Florida Statutes, is created to 20 read: 21 286.31 Prohibited use of state funds.— 22 (1) As used in this section, the term “governmental entity” 23 means the state or any political subdivision thereof, including 24 the executive, legislative, and judicial branches of government; 25 the independent establishments of the state, counties, 26 municipalities, districts, authorities, boards, or commissions; 27 and any agencies that are subject to chapter 286. 28 (2) A governmental entity, a public postsecondary 29 educational institution as described in s. 1000.04, the state 30 group health insurance program, a managing entity as defined in 31 s. 394.9082, or a managed care plan providing services under 32 part IV of chapter 409 may not expend state funds as described 33 in s. 215.31 for sex-reassignment prescriptions or procedures as 34 defined in s. 456.001. 35 Section 4. Subsections (8) and (9) are added to section 36 456.001, Florida Statutes, to read: 37 456.001 Definitions.—As used in this chapter, the term: 38 (8) “Sex” means the classification of a person as either 39 male or female based on the organization of the human body of 40 such person for a specific reproductive role, as indicated by 41 the person’s sex chromosomes, naturally occurring sex hormones, 42 and internal and external genitalia present at birth. 43 (9)(a) “Sex-reassignment prescriptions or procedures” 44 means: 45 1. The prescription or administration of puberty blockers 46 for the purpose of attempting to stop or delay normal puberty in 47 order to affirm a person’s perception of his or her sex if that 48 perception is inconsistent with the person’s sex as defined in 49 subsection (8). 50 2. The prescription or administration of hormones or 51 hormone antagonists to affirm a person’s perception of his or 52 her sex if that perception is inconsistent with the person’s sex 53 as defined in subsection (8). 54 3. Any medical procedure, including a surgical procedure, 55 to affirm a person’s perception of his or her sex if that 56 perception is inconsistent with the person’s sex as defined in 57 subsection (8). 58 (b) The term does not include: 59 1. Treatment provided by a physician who, in his or her 60 good faith clinical judgment, performs procedures upon or 61 provides therapies to a minor born with a medically verifiable 62 genetic disorder of sexual development, including any of the 63 following: 64 a. External biological sex characteristics that are 65 unresolvably ambiguous. 66 b. A disorder of sexual development in which the physician 67 has determined through genetic or biochemical testing that the 68 patient does not have a normal sex chromosome structure, sex 69 steroid hormone production, or sex steroid hormone action for a 70 male or female, as applicable. 71 2. Prescriptions or procedures to treat an infection, an 72 injury, a disease, or a disorder that has been caused or 73 exacerbated by the performance of any sex-reassignment 74 prescription or procedure, regardless of whether such 75 prescription or procedure was performed in accordance with state 76 or federal law. 77 3. Prescriptions or procedures provided to a patient for 78 the treatment of a physical disorder, physical injury, or 79 physical illness that would, as certified by a physician 80 licensed under chapter 458 or chapter 459, place the individual 81 in imminent danger of death or impairment of a major bodily 82 function without the prescription or procedure. 83 Section 5. Section 456.52, Florida Statutes, is created to 84 read: 85 456.52 Sex-reassignment prescriptions and procedures; 86 prohibitions; informed consent.— 87 (1) Sex-reassignment prescriptions and procedures are 88 prohibited for patients younger than 18 years of age, except 89 that: 90 (a) The Board of Medicine and the Board of Osteopathic 91 Medicine shall, within 60 days after the effective date of this 92 act, adopt emergency rules pertaining to standards of practice 93 under which a patient younger than 18 years of age may continue 94 to be treated with a prescription consistent with those 95 referenced under s. 456.001(9)(a)1. or 2. if such treatment for 96 sex reassignment was commenced before, and is still active on, 97 the effective date of this act. In developing rules under this 98 paragraph, the boards shall consider requirements for physicians 99 to obtain informed consent from such patient′s parent or legal 100 guardian, consistent with the parameters of informed consent 101 under subsections (2) and (4), for such prescription treatment, 102 and shall consider the provision of professional counseling 103 services for such patient by a board-certified psychiatrist 104 licensed under chapter 458 or chapter 459 or a psychologist 105 licensed under chapter 490 in conjunction with such prescription 106 treatment. 107 (b) A patient meeting the criteria of paragraph (a) may 108 continue to be treated by a physician with such prescriptions 109 according to rules adopted under paragraph (a) or nonemergency 110 rules adopted under paragraph (6)(b). 111 (2) If sex-reassignment prescriptions or procedures are 112 prescribed for or administered or performed on patients 18 years 113 of age or older, consent must be voluntary, informed, and in 114 writing on forms adopted in rule by the Board of Medicine and 115 the Board of Osteopathic Medicine. Consent to sex-reassignment 116 prescriptions or procedures is voluntary and informed only if 117 the physician who is to prescribe or administer the 118 pharmaceutical product or perform the procedure has, at a 119 minimum, while physically present in the same room: 120 (a) Informed the patient of the nature and risks of the 121 prescription or procedure in order for the patient to make a 122 prudent decision; 123 (b) Provided the informed consent form, as adopted in rule 124 by the Board of Medicine and the Board of Osteopathic Medicine, 125 to the patient; and 126 (c) Received the patient’s written acknowledgment, before 127 the prescription or procedure is prescribed, administered, or 128 performed, that the information required to be provided under 129 this subsection has been provided. 130 (3) Sex-reassignment prescriptions or procedures may not be 131 prescribed, administered, or performed except by a physician. 132 For the purposes of this section, the term “physician” is 133 defined as a physician licensed under chapter 458 or chapter 459 134 or a physician practicing medicine or osteopathic medicine in 135 the employment of the Federal Government. 136 (4) Consent required under subsection (2) does not apply to 137 renewals of prescriptions consistent with those referenced under 138 s. 456.001(9)(a)1. and 2. if a physician and his or her patient 139 have met the requirements for consent for the initial 140 prescription or renewal. However, separate consent is required 141 for any new prescription for a pharmaceutical product not 142 previously prescribed to the patient. 143 (5)(a) Violation of this section constitutes grounds for 144 disciplinary action under this chapter and chapter 458 or 145 chapter 459, as applicable. 146 (b) Any health care practitioner who willfully or actively 147 participates in a violation of subsection (1) commits a felony 148 of the third degree, punishable as provided in s. 775.082, s. 149 775.083, or s. 775.084. 150 (c) Any health care practitioner who violates subsection 151 (2), subsection (3), or subsection (4) commits a misdemeanor of 152 the first degree, punishable as provided in s. 775.082 or s. 153 775.083. 154 (6)(a) The Board of Medicine and the Board of Osteopathic 155 Medicine shall adopt emergency rules to implement this section. 156 (b) Any emergency rules adopted under this section are 157 exempt from s. 120.54(4)(c) and shall remain in effect until 158 replaced by rules adopted under the nonemergency rulemaking 159 procedures of the Administrative Procedure Act. 160 Section 6. Present paragraphs (c) through (gg) of 161 subsection (5) of section 456.074, Florida Statutes, are 162 redesignated as paragraphs (d) through (hh), respectively, and a 163 new paragraph (c) is added to that subsection, to read: 164 456.074 Certain health care practitioners; immediate 165 suspension of license.— 166 (5) The department shall issue an emergency order 167 suspending the license of any health care practitioner who is 168 arrested for committing or attempting, soliciting, or conspiring 169 to commit any act that would constitute a violation of any of 170 the following criminal offenses in this state or similar 171 offenses in another jurisdiction: 172 (c) Section 456.52(5)(b), relating to prescribing, 173 administering, or performing sex-reassignment prescriptions or 174 procedures for a patient younger than 18 years of age. 175 Section 7. Section 766.318, Florida Statutes, is created to 176 read: 177 766.318 Civil liability for provision of sex-reassignment 178 prescriptions or procedures to minors.— 179 (1) A cause of action exists to recover damages for 180 personal injury or death resulting from the provision of sex 181 reassignment prescriptions or procedures, as defined in s. 182 456.001, to a person younger than 18 years of age which are 183 prohibited by s. 456.52(1). 184 (2) The limitations on punitive damages in s. 768.73(1) do 185 not apply to actions brought under this section. 186 (3) An action brought under this section: 187 (a) May be commenced within 20 years after the cessation or 188 completion of the sex-reassignment prescription or procedure. 189 (b) Is in addition to any other remedy authorized by law. 190 (4) The cause of action created by this section does not 191 apply to: 192 (a) Treatment with sex-reassignment prescriptions if such 193 treatment is consistent with s. 456.001(9)(a)1. or 2. and was 194 commenced on or before, and is still active on, the effective 195 date of this act. 196 (b) Sex-reassignment prescriptions or procedures that were 197 ceased or completed on or before the effective date of this act. 198 Section 8. If any provision of this act or its application 199 to any person or circumstance is held invalid, the invalidity 200 does not affect other provisions or applications of this act 201 which can be given effect without the invalid provision or 202 application, and to this end the provisions of this act are 203 severable. 204 Section 9. The Division of Law Revision is directed to 205 replace the phrase “the effective date of this act” wherever it 206 occurs in this act with the date this act becomes a law. 207 208 ================= T I T L E A M E N D M E N T ================ 209 And the title is amended as follows: 210 Delete lines 202 - 241 211 and insert: 212 to or is threatened with being subjected to sex 213 reassignment prescriptions or procedures; amending s. 214 61.534, F.S.; providing that, for purposes of warrants 215 to take physical custody of a child in certain child 216 custody enforcement proceedings, serious physical harm 217 to the child includes, but is not limited to, being 218 subjected to sex-reassignment prescriptions or 219 procedures; creating s. 286.31, F.S.; defining the 220 term “governmental entity”; prohibiting certain public 221 entities from expending state funds for the provision 222 of sex-reassignment prescriptions or procedures; 223 amending s. 456.001, F.S.; defining the terms “sex” 224 and “sex-reassignment prescriptions or procedures”; 225 creating s. 456.52, F.S.; prohibiting sex-reassignment 226 prescriptions and procedures for patients younger than 227 18 years of age; providing an exception; requiring the 228 Board of Medicine and the Board of Osteopathic 229 Medicine to adopt certain emergency rules within a 230 specified timeframe; requiring the boards to consider 231 specified factors in developing such rules; requiring 232 that such prescriptions and procedures for patients 233 older than 18 years of age be prescribed, 234 administered, or performed only with the voluntary and 235 informed consent of the patient; providing criteria 236 for what constitutes voluntary and informed consent; 237 providing that only a physician may prescribe, 238 administer, or perform such prescriptions and 239 procedures; defining the term “physician”; providing 240 applicability; providing for disciplinary action; 241 providing criminal penalties; requiring the Board of 242 Medicine and the Board of Osteopathic Medicine to 243 adopt certain emergency rules; providing that such 244 emergency rules remain in effect until they are 245 replaced by nonemergency rules; amending s. 456.074, 246 F.S.; requiring the department to immediately suspend 247 the license of a health care practitioner who is 248 arrested for committing or attempting, soliciting, or 249 conspiring to commit specified violations related to 250 sex-reassignment prescriptions or procedures for a 251 patient younger than 18 years of age; creating s. 252 766.318, F.S.; creating a cause of action to recover 253 damages for personal injury or death resulting from 254 the provision of sex-reassignment prescriptions or 255 procedures to a minor; providing that certain 256 limitations on punitive damages do not apply to such 257 actions; specifying the timeframe within which such 258 actions may be commenced; providing construction and 259 applicability; providing severability; providing a 260 directive to the Division of Law Revision;