Florida Senate - 2023                          SENATOR AMENDMENT
       Bill No. CS/SB 254, 1st Eng.
       
       
       
       
       
       
                                Ì738500uÎ738500                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                 Floor: AD/RM          .            Floor: C            
             05/04/2023 11:24 AM       .      05/04/2023 11:59 AM       
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       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         286.31Prohibited 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;