Florida Senate - 2025                          SENATOR AMENDMENT
       Bill No. CS for CS for CS for SB 1270
       
       
       
       
       
       
                                Ì620726)Î620726                         
       
                              LEGISLATIVE ACTION                        
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       Senator Collins moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Effective upon becoming a law, or, if this act
    6  fails to become a law until after June 1, 2025, operating
    7  retroactively to June 1, 2025, section 9 of chapter 2023-43,
    8  Laws of Florida, is amended to read:
    9         Section 9. Sections 381.00316(2)(g) and 381.00319(1)(e),
   10  Florida Statutes, as created by this act, are repealed June 1,
   11  2027 2025.
   12         Section 2. Effective upon becoming a law, or, if this act
   13  fails to become a law until after June 1, 2025, operating
   14  retroactively to June 1, 2025, paragraph (g) of subsection (2)
   15  of section 381.00316, Florida Statutes, is reenacted to read:
   16         381.00316 Discrimination by governmental and business
   17  entities based on health care choices; prohibition.—
   18         (2) As used in this section, the term:
   19         (g) “Messenger ribonucleic acid vaccine” means any vaccine
   20  that uses laboratory-produced messenger ribonucleic acid to
   21  trigger the human body’s immune system to generate an immune
   22  response.
   23         Section 3. Effective upon becoming a law, or, if this act
   24  fails to become a law until after June 1, 2025, operating
   25  retroactively to June 1, 2025, paragraph (e) of subsection (1)
   26  of section 381.00319, Florida Statutes, is reenacted to read:
   27         381.00319 Prohibition on mask mandates and vaccination and
   28  testing mandates for educational institutions.—
   29         (1) For purposes of this section, the term:
   30         (e) “Messenger ribonucleic acid vaccine” has the same
   31  meaning as in s. 381.00316.
   32         Section 4. Paragraphs (b) and (d) of subsection (4) and
   33  subsection (6) of section 381.026, Florida Statutes, are amended
   34  to read:
   35         381.026 Florida Patient’s Bill of Rights and
   36  Responsibilities.—
   37         (4) RIGHTS OF PATIENTS.—Each health care facility or
   38  provider shall observe the following standards:
   39         (b) Information.—
   40         1. A patient has the right to know the name, function, and
   41  qualifications of each health care provider who is providing
   42  medical services to the patient. A patient may request such
   43  information from his or her responsible provider or the health
   44  care facility in which he or she is receiving medical services.
   45         2. A patient in a health care facility has the right to
   46  know what patient support services are available in the
   47  facility.
   48         3. A patient has the right to be given by his or her health
   49  care provider information concerning diagnosis, planned course
   50  of treatment, alternatives, risks, and prognosis, unless it is
   51  medically inadvisable or impossible to give this information to
   52  the patient, in which case the information must be given to the
   53  patient’s guardian or a person designated as the patient’s
   54  representative. A patient has the right to refuse this
   55  information.
   56         4. A patient has the right to refuse any treatment based on
   57  information required by this paragraph, except as otherwise
   58  provided by law. The responsible provider shall document any
   59  such refusal.
   60         5. A patient in a health care facility has the right to
   61  know what facility rules and regulations apply to patient
   62  conduct.
   63         6. A patient has the right to express grievances to a
   64  health care provider, a health care facility, or the appropriate
   65  state licensing agency regarding alleged violations of patients’
   66  rights. A patient has the right to know the health care
   67  provider’s or health care facility’s procedures for expressing a
   68  grievance.
   69         7. A patient in a health care facility who does not speak
   70  English has the right to be provided an interpreter when
   71  receiving medical services if the facility has a person readily
   72  available who can interpret on behalf of the patient.
   73         8. A health care provider or health care facility shall
   74  respect a patient’s right to privacy and should refrain from
   75  making a written inquiry or asking questions concerning the
   76  ownership of a firearm or ammunition by the patient or by a
   77  family member of the patient, or the presence of a firearm in a
   78  private home or other domicile of the patient or a family member
   79  of the patient. Notwithstanding this provision, a health care
   80  provider or health care facility that in good faith believes
   81  that this information is relevant to the patient’s medical care
   82  or safety, or safety of others, may make such a verbal or
   83  written inquiry.
   84         9. A patient may decline to answer or provide any
   85  information regarding ownership of a firearm by the patient or a
   86  family member of the patient, or the presence of a firearm in
   87  the domicile of the patient or a family member of the patient. A
   88  patient’s decision not to answer a question relating to the
   89  presence or ownership of a firearm does not alter existing law
   90  regarding a physician’s authorization to choose his or her
   91  patients.
   92         10. A health care provider or health care facility may not
   93  discriminate against a patient based solely upon the patient’s
   94  exercise of the constitutional right to own and possess firearms
   95  or ammunition.
   96         11. A health care provider or health care facility shall
   97  respect a patient’s legal right to own or possess a firearm and
   98  should refrain from unnecessarily harassing a patient about
   99  firearm ownership during an examination.
  100         12.A health care provider or health care facility may not
  101  discriminate against a patient based solely upon the patient’s
  102  vaccination status.
  103         (d) Access to health care.—
  104         1. A patient has the right to impartial access to medical
  105  treatment or accommodations, regardless of race, national
  106  origin, religion, handicap, vaccination status, or source of
  107  payment.
  108         2. A patient has the right to treatment for any emergency
  109  medical condition that will deteriorate from failure to provide
  110  such treatment.
  111         3. A patient has the right to access any mode of treatment
  112  that is, in his or her own judgment and the judgment of his or
  113  her health care practitioner, in the best interests of the
  114  patient, including complementary or alternative health care
  115  treatments, in accordance with the provisions of s. 456.41.
  116         (6) SUMMARY OF RIGHTS AND RESPONSIBILITIES.—Any health care
  117  provider who treats a patient in an office or any health care
  118  facility licensed under chapter 395 that provides emergency
  119  services and care or outpatient services and care to a patient,
  120  or admits and treats a patient, shall adopt and make available
  121  to the patient, in writing, a statement of the rights and
  122  responsibilities of patients, including the following:
  123  
  124                SUMMARY OF THE FLORIDA PATIENT’S BILL              
  125                   OF RIGHTS AND RESPONSIBILITIES                  
  126  
  127         Florida law requires that your health care
  128         provider or health care facility recognize your rights
  129         while you are receiving medical care and that you
  130         respect the health care provider’s or health care
  131         facility’s right to expect certain behavior on the
  132         part of patients. You may request a copy of the full
  133         text of this law from your health care provider or
  134         health care facility. A summary of your rights and
  135         responsibilities follows:
  136         A patient has the right to be treated with
  137         courtesy and respect, with appreciation of his or her
  138         individual dignity, and with protection of his or her
  139         need for privacy.
  140         A patient has the right to a prompt and
  141         reasonable response to questions and requests.
  142         A patient has the right to know who is providing
  143         medical services and who is responsible for his or her
  144         care.
  145         A patient has the right to know what patient
  146         support services are available, including whether an
  147         interpreter is available if he or she does not speak
  148         English.
  149         A patient has the right to bring any person of
  150         his or her choosing to the patient-accessible areas of
  151         the health care facility or provider’s office to
  152         accompany the patient while the patient is receiving
  153         inpatient or outpatient treatment or is consulting
  154         with his or her health care provider, unless doing so
  155         would risk the safety or health of the patient, other
  156         patients, or staff of the facility or office or cannot
  157         be reasonably accommodated by the facility or
  158         provider.
  159         A patient has the right to know what rules and
  160         regulations apply to his or her conduct.
  161         A patient has the right to be given by the health
  162         care provider information concerning diagnosis,
  163         planned course of treatment, alternatives, risks, and
  164         prognosis.
  165         A patient has the right to refuse any treatment,
  166         except as otherwise provided by law.
  167         A patient has the right to be given, upon
  168         request, full information and necessary counseling on
  169         the availability of known financial resources for his
  170         or her care.
  171         A patient who is eligible for Medicare has the
  172         right to know, upon request and in advance of
  173         treatment, whether the health care provider or health
  174         care facility accepts the Medicare assignment rate.
  175         A patient has the right to receive, upon request,
  176         prior to treatment, a reasonable estimate of charges
  177         for medical care.
  178         A patient has the right to receive a copy of a
  179         reasonably clear and understandable, itemized bill
  180         and, upon request, to have the charges explained.
  181         A patient has the right to impartial access to
  182         medical treatment or accommodations, regardless of
  183         race, national origin, religion, handicap, vaccination
  184         status, or source of payment.
  185         A patient has the right to treatment for any
  186         emergency medical condition that will deteriorate from
  187         failure to provide treatment.
  188         A patient has the right to know if medical
  189         treatment is for purposes of experimental research and
  190         to give his or her consent or refusal to participate
  191         in such experimental research.
  192         A patient has the right to express grievances
  193         regarding any violation of his or her rights, as
  194         stated in Florida law, through the grievance procedure
  195         of the health care provider or health care facility
  196         which served him or her and to the appropriate state
  197         licensing agency.
  198         A patient is responsible for providing to the
  199         health care provider, to the best of his or her
  200         knowledge, accurate and complete information about
  201         present complaints, past illnesses, hospitalizations,
  202         medications, and other matters relating to his or her
  203         health.
  204         A patient is responsible for reporting unexpected
  205         changes in his or her condition to the health care
  206         provider.
  207         A patient is responsible for reporting to the
  208         health care provider whether he or she comprehends a
  209         contemplated course of action and what is expected of
  210         him or her.
  211         A patient is responsible for following the
  212         treatment plan recommended by the health care
  213         provider.
  214         A patient is responsible for keeping appointments
  215         and, when he or she is unable to do so for any reason,
  216         for notifying the health care provider or health care
  217         facility.
  218         A patient is responsible for his or her actions
  219         if he or she refuses treatment or does not follow the
  220         health care provider’s instructions.
  221         A patient is responsible for assuring that the
  222         financial obligations of his or her health care are
  223         fulfilled as promptly as possible.
  224         A patient is responsible for following health
  225         care facility rules and regulations affecting patient
  226         care and conduct.
  227  
  228         Section 5. Paragraphs (b), (e), and (f) of subsection (8)
  229  of section 381.986, Florida Statutes, are amended to read:
  230         381.986 Medical use of marijuana.—
  231         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
  232         (b) An applicant for licensure as a medical marijuana
  233  treatment center must shall apply to the department on a form
  234  prescribed by the department and adopted in rule. The department
  235  shall adopt rules pursuant to ss. 120.536(1) and 120.54
  236  establishing a procedure for the issuance and biennial renewal
  237  of licenses, including initial application and biennial renewal
  238  fees sufficient to cover the costs of implementing and
  239  administering this section, and establishing supplemental
  240  licensure fees for payment beginning May 1, 2018, sufficient to
  241  cover the costs of administering ss. 381.989 and 1004.4351. The
  242  department shall identify applicants with strong diversity plans
  243  reflecting this state’s commitment to diversity and implement
  244  training programs and other educational programs to enable
  245  minority persons and minority business enterprises, as defined
  246  in s. 288.703, and veteran business enterprises, as defined in
  247  s. 295.187, to compete for medical marijuana treatment center
  248  licensure and contracts. Subject to the requirements in
  249  subparagraphs (a)2.-4., the department shall issue a license to
  250  an applicant if the applicant meets the requirements of this
  251  section and pays the initial application fee. The department
  252  shall renew the licensure of a medical marijuana treatment
  253  center biennially if the licensee meets the requirements of this
  254  section and pays the biennial renewal fee. However, the
  255  department may not renew the license of a medical marijuana
  256  treatment center that has not begun to cultivate, process, and
  257  dispense marijuana by the date that the medical marijuana
  258  treatment center is required to renew its license. An individual
  259  may not be an applicant, owner, officer, board member, or
  260  manager on more than one application for licensure as a medical
  261  marijuana treatment center. An individual or entity may not be
  262  awarded more than one license as a medical marijuana treatment
  263  center. An applicant for licensure as a medical marijuana
  264  treatment center must demonstrate:
  265         1. That, for the 5 consecutive years before submitting the
  266  application, the applicant has been registered to do business in
  267  this the state.
  268         2. Possession of a valid certificate of registration issued
  269  by the Department of Agriculture and Consumer Services pursuant
  270  to s. 581.131.
  271         3. The technical and technological ability to cultivate and
  272  produce marijuana, including, but not limited to, low-THC
  273  cannabis.
  274         4. The ability to secure the premises, resources, and
  275  personnel necessary to operate as a medical marijuana treatment
  276  center.
  277         5. The ability to maintain accountability of all raw
  278  materials, finished products, and any byproducts to prevent
  279  diversion or unlawful access to or possession of these
  280  substances.
  281         6. An infrastructure reasonably located to dispense
  282  marijuana to registered qualified patients statewide or
  283  regionally as determined by the department.
  284         7. The financial ability to maintain operations for the
  285  duration of the 2-year approval cycle, including the provision
  286  of certified financial statements to the department.
  287         a. Upon approval, the applicant must post a $5 million
  288  performance bond issued by an authorized surety insurance
  289  company rated in one of the three highest rating categories by a
  290  nationally recognized rating service. However, a medical
  291  marijuana treatment center serving at least 1,000 qualified
  292  patients is only required to maintain a $2 million performance
  293  bond.
  294         b. In lieu of the performance bond required under sub
  295  subparagraph a., the applicant may provide an irrevocable letter
  296  of credit payable to the department or provide cash to the
  297  department. If provided with cash under this sub-subparagraph,
  298  the department must shall deposit the cash in the Grants and
  299  Donations Trust Fund within the Department of Health, subject to
  300  the same conditions as the bond regarding requirements for the
  301  applicant to forfeit ownership of the funds. If the funds
  302  deposited under this sub-subparagraph generate interest, the
  303  amount of that interest must shall be used by the department for
  304  the administration of this section.
  305         8. That all owners, officers, board members, and managers
  306  have passed a background screening pursuant to subsection (9).
  307  As used in this subparagraph, the term:
  308         a.“Manager” means any person with the authority to
  309  exercise or contribute to the operational control, direction, or
  310  management of an applicant or a medical marijuana treatment
  311  center or who has authority to supervise any employee of an
  312  applicant or a medical marijuana treatment center. The term
  313  includes an individual with the power or authority to direct or
  314  influence the direction or operation of an applicant or a
  315  medical marijuana treatment center through board membership, an
  316  agreement, or a contract.
  317         b.“Owner” means any person who owns or controls a 5
  318  percent or greater share of interests of the applicant or a
  319  medical marijuana treatment center which include beneficial or
  320  voting rights to interests. In the event that one person owns a
  321  beneficial right to interests and another person holds the
  322  voting rights with respect to such interests, then in such case,
  323  both are considered the owner of such interests.
  324         9. The employment of a medical director to supervise the
  325  activities of the medical marijuana treatment center.
  326         10. A diversity plan that promotes and ensures the
  327  involvement of minority persons and minority business
  328  enterprises, as defined in s. 288.703, or veteran business
  329  enterprises, as defined in s. 295.187, in ownership, management,
  330  and employment. An applicant for licensure renewal must show the
  331  effectiveness of the diversity plan by including the following
  332  with his or her application for renewal:
  333         a. Representation of minority persons and veterans in the
  334  medical marijuana treatment center’s workforce;
  335         b. Efforts to recruit minority persons and veterans for
  336  employment; and
  337         c. A record of contracts for services with minority
  338  business enterprises and veteran business enterprises.
  339         (e) A licensed medical marijuana treatment center shall
  340  cultivate, process, transport, and dispense marijuana for
  341  medical use. A licensed medical marijuana treatment center may
  342  not contract for services directly related to the cultivation,
  343  processing, and dispensing of marijuana or marijuana delivery
  344  devices, except that a medical marijuana treatment center
  345  licensed pursuant to subparagraph (a)1. may contract with a
  346  single entity for the cultivation, processing, transporting, and
  347  dispensing of marijuana and marijuana delivery devices. A
  348  licensed medical marijuana treatment center shall must, at all
  349  times, maintain compliance with the criteria demonstrated and
  350  representations made in the initial application and the criteria
  351  established in this subsection. Upon request, the department may
  352  grant a medical marijuana treatment center a variance from the
  353  representations made in the initial application. Consideration
  354  of such a request must shall be based upon the individual facts
  355  and circumstances surrounding the request. A variance may not be
  356  granted unless the requesting medical marijuana treatment center
  357  can demonstrate to the department that it has a proposed
  358  alternative to the specific representation made in its
  359  application which fulfills the same or a similar purpose as the
  360  specific representation in a way that the department can
  361  reasonably determine will not be a lower standard than the
  362  specific representation in the application. A variance may not
  363  be granted from the requirements in subparagraph 2. and
  364  subparagraphs (b)1. and 2.
  365         1. A licensed medical marijuana treatment center may
  366  transfer ownership to an individual or entity who meets the
  367  requirements of this section. A publicly traded corporation or
  368  publicly traded company that meets the requirements of this
  369  section is not precluded from ownership of a medical marijuana
  370  treatment center. To accommodate a change in ownership:
  371         a. The licensed medical marijuana treatment center shall
  372  notify the department in writing at least 60 days before the
  373  anticipated date of the change of ownership.
  374         b. The individual or entity applying for initial licensure
  375  due to a change of ownership must submit an application that
  376  must be received by the department at least 60 days before the
  377  date of change of ownership.
  378         c. Upon receipt of an application for a license, the
  379  department shall examine the application and, within 30 days
  380  after receipt, notify the applicant in writing of any apparent
  381  errors or omissions and request any additional information
  382  required.
  383         d. Requested information omitted from an application for
  384  licensure must be filed with the department within 21 days after
  385  the department’s request for omitted information or the
  386  application will shall be deemed incomplete and shall be
  387  withdrawn from further consideration and the fees shall be
  388  forfeited.
  389         e. Within 30 days after the receipt of a complete
  390  application, the department shall approve or deny the
  391  application.
  392         2. A medical marijuana treatment center, and any individual
  393  or entity who directly or indirectly owns, controls, or holds
  394  with power to vote 5 percent or more of the voting shares of a
  395  medical marijuana treatment center, may not acquire direct or
  396  indirect ownership or control of any voting shares or other form
  397  of ownership of any other medical marijuana treatment center.
  398         3. A medical marijuana treatment center may not enter into
  399  any form of profit-sharing arrangement with the property owner
  400  or lessor of any of its facilities where cultivation,
  401  processing, storing, or dispensing of marijuana and marijuana
  402  delivery devices occurs.
  403         4. All employees of a medical marijuana treatment center
  404  must be 21 years of age or older and have passed a background
  405  screening pursuant to subsection (9). As used in this
  406  subparagraph, the term “employee” means any person employed by a
  407  medical marijuana treatment center licensee in any capacity,
  408  including those whose duties involve any aspect of the
  409  cultivation, processing, transportation, or dispensing of
  410  marijuana. This requirement applies to all employees, regardless
  411  of the compensation received.
  412         5. Each medical marijuana treatment center must adopt and
  413  enforce policies and procedures to ensure employees and
  414  volunteers receive training on the legal requirements to
  415  dispense marijuana to qualified patients.
  416         6. When growing marijuana, a medical marijuana treatment
  417  center:
  418         a. May use pesticides determined by the department, after
  419  consultation with the Department of Agriculture and Consumer
  420  Services, to be safely applied to plants intended for human
  421  consumption, but may not use pesticides designated as
  422  restricted-use pesticides pursuant to s. 487.042.
  423         b. Must grow marijuana within an enclosed structure and in
  424  a room separate from any other plant.
  425         c. Must inspect seeds and growing plants for plant pests
  426  that endanger or threaten the horticultural and agricultural
  427  interests of the state in accordance with chapter 581 and any
  428  rules adopted thereunder.
  429         d. Must perform fumigation or treatment of plants, or
  430  remove and destroy infested or infected plants, in accordance
  431  with chapter 581 and any rules adopted thereunder.
  432         7. Each medical marijuana treatment center must produce and
  433  make available for purchase at least one low-THC cannabis
  434  product.
  435         8. A medical marijuana treatment center that produces
  436  edibles must hold a permit to operate as a food establishment
  437  pursuant to chapter 500, the Florida Food Safety Act, and must
  438  comply with all the requirements for food establishments
  439  pursuant to chapter 500 and any rules adopted thereunder.
  440  Edibles may not contain more than 200 milligrams of
  441  tetrahydrocannabinol, and a single serving portion of an edible
  442  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  443  may not have a potency variance of no greater than 15 percent.
  444  Marijuana products, including edibles, may not be attractive to
  445  children; be manufactured in the shape of humans, cartoons, or
  446  animals; be manufactured in a form that bears any reasonable
  447  resemblance to products available for consumption as
  448  commercially available candy; or contain any color additives. To
  449  discourage consumption of edibles by children, the department
  450  shall determine by rule any shapes, forms, and ingredients
  451  allowed and prohibited for edibles. Medical marijuana treatment
  452  centers may not begin processing or dispensing edibles until
  453  after the effective date of the rule. The department shall also
  454  adopt sanitation rules providing the standards and requirements
  455  for the storage, display, or dispensing of edibles.
  456         9. Within 12 months after licensure, a medical marijuana
  457  treatment center must demonstrate to the department that all of
  458  its processing facilities have passed a Food Safety Good
  459  Manufacturing Practices, such as Global Food Safety Initiative
  460  or equivalent, inspection by a nationally accredited certifying
  461  body. A medical marijuana treatment center must immediately stop
  462  processing at any facility which fails to pass this inspection
  463  until it demonstrates to the department that such facility has
  464  met this requirement.
  465         10. A medical marijuana treatment center that produces
  466  prerolled marijuana cigarettes may not use wrapping paper made
  467  with tobacco or hemp.
  468         11. When processing marijuana, a medical marijuana
  469  treatment center must:
  470         a. Process the marijuana within an enclosed structure and
  471  in a room separate from other plants or products.
  472         b. Comply with department rules when processing marijuana
  473  with hydrocarbon solvents or other solvents or gases exhibiting
  474  potential toxicity to humans. The department shall determine by
  475  rule the requirements for medical marijuana treatment centers to
  476  use such solvents or gases exhibiting potential toxicity to
  477  humans.
  478         c. Comply with federal and state laws and regulations and
  479  department rules for solid and liquid wastes. The department
  480  shall determine by rule procedures for the storage, handling,
  481  transportation, management, and disposal of solid and liquid
  482  waste generated during marijuana production and processing. The
  483  Department of Environmental Protection shall assist the
  484  department in developing such rules.
  485         d. Test the processed marijuana using a medical marijuana
  486  testing laboratory before it is dispensed. Results must be
  487  verified and signed by two medical marijuana treatment center
  488  employees. Before dispensing, the medical marijuana treatment
  489  center must determine that the test results indicate that low
  490  THC cannabis meets the definition of low-THC cannabis, the
  491  concentration of tetrahydrocannabinol meets the potency
  492  requirements of this section, the labeling of the concentration
  493  of tetrahydrocannabinol and cannabidiol is accurate, and all
  494  marijuana is safe for human consumption and free from
  495  contaminants that are unsafe for human consumption. The
  496  department shall determine by rule which contaminants must be
  497  tested for and the maximum levels of each contaminant which are
  498  safe for human consumption. The Department of Agriculture and
  499  Consumer Services shall assist the department in developing the
  500  testing requirements for contaminants that are unsafe for human
  501  consumption in edibles. The department shall also determine by
  502  rule the procedures for the treatment of marijuana that fails to
  503  meet the testing requirements of this section, s. 381.988, or
  504  department rule. The department may select samples of marijuana
  505  from a medical marijuana treatment center facility which shall
  506  be tested by the department to determine whether the marijuana
  507  meets the potency requirements of this section, is safe for
  508  human consumption, and is accurately labeled with the
  509  tetrahydrocannabinol and cannabidiol concentration or to verify
  510  the result of marijuana testing conducted by a marijuana testing
  511  laboratory. The department may also select samples of marijuana
  512  delivery devices from a medical marijuana treatment center to
  513  determine whether the marijuana delivery device is safe for use
  514  by qualified patients. A medical marijuana treatment center may
  515  not require payment from the department for the sample. A
  516  medical marijuana treatment center must recall marijuana,
  517  including all marijuana and marijuana products made from the
  518  same batch of marijuana, that fails to meet the potency
  519  requirements of this section, that is unsafe for human
  520  consumption, or for which the labeling of the
  521  tetrahydrocannabinol and cannabidiol concentration is
  522  inaccurate. The department shall adopt rules to establish
  523  marijuana potency variations of no greater than 15 percent using
  524  negotiated rulemaking pursuant to s. 120.54(2)(d) which accounts
  525  for, but is not limited to, time lapses between testing, testing
  526  methods, testing instruments, and types of marijuana sampled for
  527  testing. The department may not issue any recalls for product
  528  potency as it relates to product labeling before issuing a rule
  529  relating to potency variation standards. A medical marijuana
  530  treatment center must also recall all marijuana delivery devices
  531  determined to be unsafe for use by qualified patients. The
  532  medical marijuana treatment center must retain records of all
  533  testing and samples of each homogeneous batch of marijuana for
  534  at least 9 months. The medical marijuana treatment center must
  535  contract with a marijuana testing laboratory to perform audits
  536  on the medical marijuana treatment center’s standard operating
  537  procedures, testing records, and samples and provide the results
  538  to the department to confirm that the marijuana or low-THC
  539  cannabis meets the requirements of this section and that the
  540  marijuana or low-THC cannabis is safe for human consumption. A
  541  medical marijuana treatment center shall reserve two processed
  542  samples from each batch and retain such samples for at least 9
  543  months for the purpose of such audits. A medical marijuana
  544  treatment center may use a laboratory that has not been
  545  certified by the department under s. 381.988 until such time as
  546  at least one laboratory holds the required certification, but in
  547  no event later than July 1, 2018.
  548         e. Package the marijuana in compliance with the United
  549  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  550  1471 et seq.
  551         f. Package the marijuana in a receptacle that has a firmly
  552  affixed and legible label stating the following information:
  553         (I) The marijuana or low-THC cannabis meets the
  554  requirements of sub-subparagraph d.
  555         (II) The name of the medical marijuana treatment center
  556  from which the marijuana originates.
  557         (III) The batch number and harvest number from which the
  558  marijuana originates and the date dispensed.
  559         (IV) The name of the physician who issued the physician
  560  certification.
  561         (V) The name of the patient.
  562         (VI) The product name, if applicable, and dosage form,
  563  including concentration of tetrahydrocannabinol and cannabidiol.
  564  The product name may not contain wording commonly associated
  565  with products that are attractive to children or which promote
  566  the recreational use of marijuana.
  567         (VII) The recommended dose.
  568         (VIII) A warning that it is illegal to transfer medical
  569  marijuana to another person.
  570         (IX) A marijuana universal symbol developed by the
  571  department.
  572         12. The medical marijuana treatment center shall include in
  573  each package a patient package insert with information on the
  574  specific product dispensed related to:
  575         a. Clinical pharmacology.
  576         b. Indications and use.
  577         c. Dosage and administration.
  578         d. Dosage forms and strengths.
  579         e. Contraindications.
  580         f. Warnings and precautions.
  581         g. Adverse reactions.
  582         13. In addition to the packaging and labeling requirements
  583  specified in subparagraphs 11. and 12., marijuana in a form for
  584  smoking must be packaged in a sealed receptacle with a legible
  585  and prominent warning to keep away from children and a warning
  586  that states marijuana smoke contains carcinogens and may
  587  negatively affect health. Such receptacles for marijuana in a
  588  form for smoking must be plain, opaque, and white without
  589  depictions of the product or images other than the medical
  590  marijuana treatment center’s department-approved logo and the
  591  marijuana universal symbol.
  592         14. The department shall adopt rules to regulate the types,
  593  appearance, and labeling of marijuana delivery devices dispensed
  594  from a medical marijuana treatment center. The rules must
  595  require marijuana delivery devices to have an appearance
  596  consistent with medical use.
  597         15. Each edible must be individually sealed in plain,
  598  opaque wrapping marked only with the marijuana universal symbol.
  599  Where practical, each edible must be marked with the marijuana
  600  universal symbol. In addition to the packaging and labeling
  601  requirements in subparagraphs 11. and 12., edible receptacles
  602  must be plain, opaque, and white without depictions of the
  603  product or images other than the medical marijuana treatment
  604  center’s department-approved logo and the marijuana universal
  605  symbol. The receptacle must also include a list of all the
  606  edible’s ingredients, storage instructions, an expiration date,
  607  a legible and prominent warning to keep away from children and
  608  pets, and a warning that the edible has not been produced or
  609  inspected pursuant to federal food safety laws.
  610         16. When dispensing marijuana or a marijuana delivery
  611  device, a medical marijuana treatment center:
  612         a. May dispense any active, valid order for low-THC
  613  cannabis, medical cannabis and cannabis delivery devices issued
  614  pursuant to former s. 381.986, Florida Statutes 2016, which was
  615  entered into the medical marijuana use registry before July 1,
  616  2017.
  617         b. May not dispense more than a 70-day supply of marijuana
  618  within any 70-day period to a qualified patient or caregiver.
  619  May not dispense more than one 35-day supply of marijuana in a
  620  form for smoking within any 35-day period to a qualified patient
  621  or caregiver. A 35-day supply of marijuana in a form for smoking
  622  may not exceed 2.5 ounces unless an exception to this amount is
  623  approved by the department pursuant to paragraph (4)(f).
  624         c. Must have the medical marijuana treatment center’s
  625  employee who dispenses the marijuana or a marijuana delivery
  626  device enter into the medical marijuana use registry his or her
  627  name or unique employee identifier.
  628         d. Must verify that the qualified patient and the
  629  caregiver, if applicable, each have an active registration in
  630  the medical marijuana use registry and an active and valid
  631  medical marijuana use registry identification card, the amount
  632  and type of marijuana dispensed matches the physician
  633  certification in the medical marijuana use registry for that
  634  qualified patient, and the physician certification has not
  635  already been filled.
  636         e. May not dispense marijuana to a qualified patient who is
  637  younger than 18 years of age. If the qualified patient is
  638  younger than 18 years of age, marijuana may only be dispensed to
  639  the qualified patient’s caregiver.
  640         f. May not dispense or sell any other type of cannabis,
  641  alcohol, or illicit drug-related product, including pipes or
  642  wrapping papers made with tobacco or hemp, other than a
  643  marijuana delivery device required for the medical use of
  644  marijuana and which is specified in a physician certification.
  645         g. Must, upon dispensing the marijuana or marijuana
  646  delivery device, record in the registry the date, time,
  647  quantity, and form of marijuana dispensed; the type of marijuana
  648  delivery device dispensed; and the name and medical marijuana
  649  use registry identification number of the qualified patient or
  650  caregiver to whom the marijuana delivery device was dispensed.
  651         h. Must ensure that patient records are not visible to
  652  anyone other than the qualified patient, his or her caregiver,
  653  and authorized medical marijuana treatment center employees.
  654         (f) To ensure the safety and security of premises where the
  655  cultivation, processing, storing, or dispensing of marijuana
  656  occurs, and to maintain adequate controls against the diversion,
  657  theft, and loss of marijuana or marijuana delivery devices, a
  658  medical marijuana treatment center shall:
  659         1.a. Maintain a fully operational security alarm system
  660  that secures all entry points and perimeter windows and is
  661  equipped with motion detectors; pressure switches; and duress,
  662  panic, and hold-up alarms; and
  663         b. Maintain a video surveillance system that records
  664  continuously 24 hours a day and meets the following criteria:
  665         (I) Cameras are fixed in a place that allows for the clear
  666  identification of persons and activities in controlled areas of
  667  the premises. Controlled areas include grow rooms, processing
  668  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  669  rooms.
  670         (II) Cameras are fixed in entrances and exits to the
  671  premises, which must shall record from both indoor and outdoor,
  672  or ingress and egress, vantage points.
  673         (III) Recorded images must clearly and accurately display
  674  the time and date.
  675         (IV) Retain video surveillance recordings for at least 45
  676  days or longer upon the request of a law enforcement agency.
  677         2. Ensure that the medical marijuana treatment center’s
  678  outdoor premises have sufficient lighting from dusk until dawn.
  679         3. Ensure that the indoor premises where dispensing occurs
  680  includes a waiting area with sufficient space and seating to
  681  accommodate qualified patients and caregivers and at least one
  682  private consultation area that is isolated from the waiting area
  683  and area where dispensing occurs. A medical marijuana treatment
  684  center may not display products or dispense marijuana or
  685  marijuana delivery devices in the waiting area.
  686         4. Not dispense from its premises marijuana or a marijuana
  687  delivery device between the hours of 9 p.m. and 7 a.m., but may
  688  perform all other operations and deliver marijuana to qualified
  689  patients 24 hours a day.
  690         5. Store marijuana in a secured, locked room or a vault.
  691         6. Require at least two of its employees, or two employees
  692  of a security agency with whom it contracts, to be on the
  693  premises at all times where cultivation, processing, or storing
  694  of marijuana occurs.
  695         7. Require each employee or contractor to wear a photo
  696  identification badge at all times while on the premises.
  697         8. Require each visitor to wear a visitor pass at all times
  698  while on the premises.
  699         9. Implement an alcohol and drug-free workplace policy.
  700         10. Report to local law enforcement and notify the
  701  department through e-mail within 24 hours after the medical
  702  marijuana treatment center is notified or becomes aware of any
  703  actual or attempted the theft, diversion, or loss of marijuana.
  704         Section 6. Paragraph (d) of subsection (1) of section
  705  381.988, Florida Statutes, is amended to read:
  706         381.988 Medical marijuana testing laboratories; marijuana
  707  tests conducted by a certified laboratory.—
  708         (1) A person or entity seeking to be a certified marijuana
  709  testing laboratory must:
  710         (d) Require all employees, owners, and managers to submit
  711  to and pass a level 2 background screening pursuant to chapter
  712  435. The department shall deny certification if the person or
  713  entity seeking certification has a disqualifying offense as
  714  provided in s. 435.04 or has an arrest awaiting final
  715  disposition for, has been found guilty of, or has entered a plea
  716  of guilty or nolo contendere to, regardless of adjudication, any
  717  offense listed in chapter 837, chapter 895, or chapter 896 or
  718  similar law of another jurisdiction. Exemptions from
  719  disqualification as provided under s. 435.07 do not apply to
  720  this paragraph.
  721         1. As used in this paragraph, the term:
  722         a.“Employee” means any person whose duties or activities
  723  involve any aspect of regulatory compliance testing or research
  724  and development testing of marijuana for a certified marijuana
  725  testing laboratory, regardless of whether such person is
  726  compensated for his or her work.
  727         b.“Manager” means any person with authority to exercise or
  728  contribute to the operational control, direction, or management
  729  of an applicant or certified marijuana testing laboratory or who
  730  has authority to supervise any employee of an applicant or a
  731  certified marijuana testing laboratory. The term includes an
  732  individual with the power or authority to direct or influence
  733  the direction or operation of an applicant or a certified
  734  marijuana testing laboratory through board membership, an
  735  agreement, or a contract.
  736         c.“Owner” means any person who owns or controls a 5
  737  percent or greater share of interests of the applicant or a
  738  certified marijuana testing laboratory which include beneficial
  739  or voting rights to interests. In the event that one person owns
  740  a beneficial right to interests and another person holds the
  741  voting rights with respect to such interests, then in such case,
  742  both are considered the owner of such interests.
  743         2. Such employees, owners, and managers must submit a full
  744  set of fingerprints to the department or to a vendor, entity, or
  745  agency authorized by s. 943.053(13). The department, vendor,
  746  entity, or agency shall forward the fingerprints to the
  747  Department of Law Enforcement for state processing, and the
  748  Department of Law Enforcement shall forward the fingerprints to
  749  the Federal Bureau of Investigation for national processing.
  750         3.2. Fees for state and federal fingerprint processing and
  751  retention must shall be borne by the certified marijuana testing
  752  laboratory. The state cost for fingerprint processing is shall
  753  be as provided in s. 943.053(3)(e) for records provided to
  754  persons or entities other than those specified as exceptions
  755  therein.
  756         4.3. Fingerprints submitted to the Department of Law
  757  Enforcement pursuant to this paragraph must shall be retained by
  758  the Department of Law Enforcement as provided in s. 943.05(2)(g)
  759  and (h) and, when the Department of Law Enforcement begins
  760  participation in the program, enrolled in the Federal Bureau of
  761  Investigation’s national retained print arrest notification
  762  program. Any arrest record identified must shall be reported to
  763  the department.
  764         Section 7. Paragraphs (a) and (c) of subsection (2) of
  765  section 456.0145, Florida Statutes, are amended to read:
  766         456.0145 Mobile Opportunity by Interstate Licensure
  767  Endorsement (MOBILE) Act.—
  768         (2) LICENSURE BY ENDORSEMENT.—
  769         (a) An applicable board, or the department if there is no
  770  board, shall issue a license to practice in this state to an
  771  applicant who meets all of the following criteria:
  772         1. Submits a complete application.
  773         2. Holds an active, unencumbered license issued by another
  774  state, the District of Columbia, or a territory of the United
  775  States in a profession with a similar scope of practice, as
  776  determined by the board or department, as applicable. The term
  777  “scope of practice” means the full spectrum of functions,
  778  procedures, actions, and services that a health care
  779  practitioner is deemed competent and authorized to perform under
  780  a license issued in this state.
  781         3.a. Has obtained a passing score on a national licensure
  782  examination or holds a national certification recognized by the
  783  board, or the department if there is no board, as applicable to
  784  the profession for which the applicant is seeking licensure in
  785  this state; or
  786         b. Meets the requirements of paragraph (b).
  787         4. Has actively practiced the profession for which the
  788  applicant is applying for at least 2 3 years during the 4-year
  789  period immediately preceding the date of submission of the
  790  application.
  791         5. Attests that he or she is not, at the time of submission
  792  of the application, the subject of a disciplinary proceeding in
  793  a jurisdiction in which he or she holds a license or by the
  794  United States Department of Defense for reasons related to the
  795  practice of the profession for which he or she is applying.
  796         6. Has not had disciplinary action taken against him or her
  797  in the 5 years immediately preceding the date of submission of
  798  the application.
  799         7. Meets the financial responsibility requirements of s.
  800  456.048 or the applicable practice act, if required for the
  801  profession for which the applicant is seeking licensure.
  802         8. Submits a set of fingerprints for a background screening
  803  pursuant to s. 456.0135, if required for the profession for
  804  which he or she is applying.
  805  
  806  The department shall verify information submitted by the
  807  applicant under this subsection using the National Practitioner
  808  Data Bank, as applicable.
  809         (c) A person is ineligible for a license under this section
  810  if he or she:
  811         1. Has a complaint, an allegation, or an investigation
  812  pending before a licensing entity in another state, the District
  813  of Columbia, or a possession or territory of the United States;
  814         2. Has been convicted of or pled nolo contendere to,
  815  regardless of adjudication, any felony or misdemeanor related to
  816  the practice of a health care profession;
  817         3. Has had a health care provider license revoked or
  818  suspended by another state, the District of Columbia, or a
  819  territory of the United States, or has voluntarily surrendered
  820  any such license in lieu of having disciplinary action taken
  821  against the license; or
  822         4. Has been reported to the National Practitioner Data
  823  Bank, unless the applicant has successfully appealed to have his
  824  or her name removed from the data bank. If the reported adverse
  825  action was a result of conduct that would not constitute a
  826  violation of any law or rule in this state, the board, or the
  827  department if there is no board, may:
  828         a.Approve the application;
  829         b.Approve the application with restrictions on the scope
  830  of practice of the licensee;
  831         c.Approve the application with placement of the licensee
  832  on probation for a period of time and subject to such conditions
  833  as the board, or the department if there is no board, may
  834  specify, including, but not limited to, requiring the applicant
  835  to submit to treatment, attend continuing education courses, or
  836  submit to reexamination; or
  837         d.Deny the application.
  838         Section 8. Paragraph (d) of subsection (1) and subsection
  839  (3) of section 456.44, Florida Statutes, are amended to read:
  840         456.44 Controlled substance prescribing.—
  841         (1) DEFINITIONS.—As used in this section, the term:
  842         (d) “Board-certified pain management physician” means a
  843  physician who possesses board certification in pain medicine by
  844  the American Board of Pain Medicine, board certification by the
  845  American Board of Interventional Pain Physicians, or board
  846  certification or subcertification in pain management or pain
  847  medicine by a specialty board recognized by the American Board
  848  of Physician Specialties American Association of Physician
  849  Specialists or the American Board of Medical Specialties or an
  850  osteopathic physician who holds a certificate in Pain Management
  851  by the American Osteopathic Association.
  852         (3) STANDARDS OF PRACTICE FOR TREATMENT OF CHRONIC
  853  NONMALIGNANT PAIN.—The standards of practice in this section do
  854  not supersede the level of care, skill, and treatment recognized
  855  in general law related to health care licensure.
  856         (a) A complete medical history and a physical examination
  857  must be conducted before beginning any treatment and must be
  858  documented in the medical record. The exact components of the
  859  physical examination shall be left to the judgment of the
  860  registrant who is expected to perform a physical examination
  861  proportionate to the diagnosis that justifies a treatment. The
  862  medical record must, at a minimum, document the nature and
  863  intensity of the pain, current and past treatments for pain,
  864  underlying or coexisting diseases or conditions, the effect of
  865  the pain on physical and psychological function, a review of
  866  previous medical records, previous diagnostic studies, and
  867  history of alcohol and substance abuse. The medical record shall
  868  also document the presence of one or more recognized medical
  869  indications for the use of a controlled substance. Each
  870  registrant must develop a written plan for assessing each
  871  patient’s risk of aberrant drug-related behavior, which may
  872  include patient drug testing. Registrants must assess each
  873  patient’s risk for aberrant drug-related behavior and monitor
  874  that risk on an ongoing basis in accordance with the plan.
  875         (b) Each registrant must develop a written individualized
  876  treatment plan for each patient. The treatment plan shall state
  877  objectives that will be used to determine treatment success,
  878  such as pain relief and improved physical and psychosocial
  879  function, and shall indicate if any further diagnostic
  880  evaluations or other treatments are planned. After treatment
  881  begins, the registrant shall adjust drug therapy to the
  882  individual medical needs of each patient. Other treatment
  883  modalities, including a rehabilitation program, shall be
  884  considered depending on the etiology of the pain and the extent
  885  to which the pain is associated with physical and psychosocial
  886  impairment. The interdisciplinary nature of the treatment plan
  887  shall be documented.
  888         (c) The registrant shall discuss the risks and benefits of
  889  the use of controlled substances, including the risks of abuse
  890  and addiction, as well as physical dependence and its
  891  consequences, with the patient, persons designated by the
  892  patient, or the patient’s surrogate or guardian if the patient
  893  is incompetent. The registrant shall use a written controlled
  894  substance agreement between the registrant and the patient
  895  outlining the patient’s responsibilities, including, but not
  896  limited to:
  897         1. Number and frequency of controlled substance
  898  prescriptions and refills.
  899         2. Patient compliance and reasons for which drug therapy
  900  may be discontinued, such as a violation of the agreement.
  901         3. An agreement that controlled substances for the
  902  treatment of chronic nonmalignant pain shall be prescribed by a
  903  single treating registrant unless otherwise authorized by the
  904  treating registrant and documented in the medical record.
  905         (d) The patient shall be seen by the registrant at regular
  906  intervals, not to exceed 3 months, to assess the efficacy of
  907  treatment, ensure that controlled substance therapy remains
  908  indicated, evaluate the patient’s progress toward treatment
  909  objectives, consider adverse drug effects, and review the
  910  etiology of the pain. Continuation or modification of therapy
  911  shall depend on the registrant’s evaluation of the patient’s
  912  progress. If treatment goals are not being achieved, despite
  913  medication adjustments, the registrant shall reevaluate the
  914  appropriateness of continued treatment. The registrant shall
  915  monitor patient compliance in medication usage, related
  916  treatment plans, controlled substance agreements, and
  917  indications of substance abuse or diversion at a minimum of 3
  918  month intervals.
  919         (e) The registrant shall refer the patient as necessary for
  920  additional evaluation and treatment in order to achieve
  921  treatment objectives. Special attention shall be given to those
  922  patients who are at risk for misusing their medications and
  923  those whose living arrangements pose a risk for medication
  924  misuse or diversion. The management of pain in patients with a
  925  history of substance abuse or with a comorbid psychiatric
  926  disorder requires extra care, monitoring, and documentation and
  927  requires consultation with or referral to an addiction medicine
  928  specialist or a psychiatrist.
  929         (f) A registrant must maintain accurate, current, and
  930  complete records that are accessible and readily available for
  931  review and comply with the requirements of this section, the
  932  applicable practice act, and applicable board rules. The medical
  933  records must include, but are not limited to:
  934         1. The complete medical history and a physical examination,
  935  including history of drug abuse or dependence.
  936         2. Diagnostic, therapeutic, and laboratory results.
  937         3. Evaluations and consultations.
  938         4. Treatment objectives.
  939         5. Discussion of risks and benefits.
  940         6. Treatments.
  941         7. Medications, including date, type, dosage, and quantity
  942  prescribed.
  943         8. Instructions and agreements.
  944         9. Periodic reviews.
  945         10. Results of any drug testing.
  946         11. A photocopy of the patient’s government-issued photo
  947  identification.
  948         12. If a written prescription for a controlled substance is
  949  given to the patient, a duplicate of the prescription.
  950         13. The registrant’s full name presented in a legible
  951  manner.
  952         (g) A registrant shall immediately refer patients with
  953  signs or symptoms of substance abuse to a board-certified pain
  954  management physician, an addiction medicine specialist, or a
  955  mental health addiction facility as it pertains to drug abuse or
  956  addiction unless the registrant is a physician who is board
  957  certified or board-eligible in pain management. Throughout the
  958  period of time before receiving the consultant’s report, a
  959  prescribing registrant shall clearly and completely document
  960  medical justification for continued treatment with controlled
  961  substances and those steps taken to ensure medically appropriate
  962  use of controlled substances by the patient. Upon receipt of the
  963  consultant’s written report, the prescribing registrant shall
  964  incorporate the consultant’s recommendations for continuing,
  965  modifying, or discontinuing controlled substance therapy. The
  966  resulting changes in treatment shall be specifically documented
  967  in the patient’s medical record. Evidence or behavioral
  968  indications of diversion shall be followed by discontinuation of
  969  controlled substance therapy, and the patient shall be
  970  discharged, and all results of testing and actions taken by the
  971  registrant shall be documented in the patient’s medical record.
  972  
  973  This subsection does not apply to a board-eligible or board
  974  certified anesthesiologist, physiatrist, rheumatologist, or
  975  neurologist, or to a board-certified physician who has surgical
  976  privileges at a hospital or ambulatory surgery center and
  977  primarily provides surgical services. This subsection does not
  978  apply to a board-eligible or board-certified medical specialist
  979  who has also completed a fellowship in pain medicine approved by
  980  the Accreditation Council for Graduate Medical Education or the
  981  American Osteopathic Association, or who is board eligible or
  982  board certified in pain medicine by the American Board of Pain
  983  Medicine, the American Board of Interventional Pain Physicians,
  984  the American Board of Physician Specialties American Association
  985  of Physician Specialists, or a board approved by the American
  986  Board of Medical Specialties or the American Osteopathic
  987  Association and performs interventional pain procedures of the
  988  type routinely billed using surgical codes. This subsection does
  989  not apply to a registrant who prescribes medically necessary
  990  controlled substances for a patient during an inpatient stay in
  991  a hospital licensed under chapter 395.
  992         Section 9. Paragraph (i) of subsection (1) of section
  993  458.3145, Florida Statutes, is amended to read:
  994         458.3145 Medical faculty certificate.—
  995         (1) A medical faculty certificate may be issued without
  996  examination to an individual who meets all of the following
  997  criteria:
  998         (i) Has been offered and has accepted a full-time faculty
  999  appointment to teach in a program of medicine at any of the
 1000  following institutions:
 1001         1. The University of Florida.
 1002         2. The University of Miami.
 1003         3. The University of South Florida.
 1004         4. The Florida State University.
 1005         5. The Florida International University.
 1006         6. The University of Central Florida.
 1007         7. The Mayo Clinic College of Medicine and Science in
 1008  Jacksonville, Florida.
 1009         8. The Florida Atlantic University.
 1010         9. The Johns Hopkins All Children’s Hospital in St.
 1011  Petersburg, Florida.
 1012         10. Nova Southeastern University.
 1013         11. Lake Erie College of Osteopathic Medicine in Bradenton,
 1014  Florida.
 1015         12. Burrell College of Osteopathic Medicine in Melbourne,
 1016  Florida.
 1017         13.The Orlando College of Osteopathic Medicine.
 1018         14.Lincoln Memorial University-DeBusk College of
 1019  Osteopathic Medicine in Orange Park, Florida.
 1020         Section 10. Subsection (1) of section 458.315, Florida
 1021  Statutes, is amended to read:
 1022         458.315 Temporary certificate for practice in areas of
 1023  critical need.—
 1024         (1) A physician or physician assistant who is licensed to
 1025  practice in any jurisdiction of the United States and whose
 1026  license is currently valid may be issued a temporary certificate
 1027  for practice in areas of critical need. A physician seeking such
 1028  certificate must pay an application fee of $300. A physician
 1029  assistant licensed to practice in any state of the United States
 1030  or the District of Columbia whose license is currently valid may
 1031  be issued a temporary certificate for practice in areas of
 1032  critical need.
 1033         Section 11. Subsection (1) of section 459.0076, Florida
 1034  Statutes, is amended to read:
 1035         459.0076 Temporary certificate for practice in areas of
 1036  critical need.—
 1037         (1) A physician or physician assistant who holds a valid
 1038  license to practice in any jurisdiction of the United States may
 1039  be issued a temporary certificate for practice in areas of
 1040  critical need. A physician seeking such certificate must pay an
 1041  application fee of $300. A physician assistant licensed to
 1042  practice in any state of the United States or the District of
 1043  Columbia whose license is currently valid may be issued a
 1044  temporary certificate for practice in areas of critical need.
 1045         Section 12. Paragraph (a) of subsection (1) of section
 1046  458.3265, Florida Statutes, is amended to read:
 1047         458.3265 Pain-management clinics.—
 1048         (1) REGISTRATION.—
 1049         (a)1. As used in this section, the term:
 1050         a. “Board eligible” means successful completion of an
 1051  anesthesia, physical medicine and rehabilitation, rheumatology,
 1052  or neurology residency program approved by the Accreditation
 1053  Council for Graduate Medical Education or the American
 1054  Osteopathic Association for a period of 6 years from successful
 1055  completion of such residency program.
 1056         b. “Chronic nonmalignant pain” means pain unrelated to
 1057  cancer which persists beyond the usual course of disease or the
 1058  injury that is the cause of the pain or more than 90 days after
 1059  surgery.
 1060         c. “Pain-management clinic” or “clinic” means any publicly
 1061  or privately owned facility:
 1062         (I) That advertises in any medium for any type of pain
 1063  management services; or
 1064         (II) Where in any month a majority of patients are
 1065  prescribed opioids, benzodiazepines, barbiturates, or
 1066  carisoprodol for the treatment of chronic nonmalignant pain.
 1067         2. Each pain-management clinic must register with the
 1068  department or hold a valid certificate of exemption pursuant to
 1069  subsection (2).
 1070         3. The following clinics are exempt from the registration
 1071  requirement of paragraphs (c)-(m) and must apply to the
 1072  department for a certificate of exemption:
 1073         a. A clinic licensed as a facility pursuant to chapter 395;
 1074         b. A clinic in which the majority of the physicians who
 1075  provide services in the clinic primarily provide surgical
 1076  services;
 1077         c. A clinic owned by a publicly held corporation whose
 1078  shares are traded on a national exchange or on the over-the
 1079  counter market and whose total assets at the end of the
 1080  corporation’s most recent fiscal quarter exceeded $50 million;
 1081         d. A clinic affiliated with an accredited medical school at
 1082  which training is provided for medical students, residents, or
 1083  fellows;
 1084         e. A clinic that does not prescribe controlled substances
 1085  for the treatment of pain;
 1086         f. A clinic owned by a corporate entity exempt from federal
 1087  taxation under 26 U.S.C. s. 501(c)(3);
 1088         g. A clinic wholly owned and operated by one or more board
 1089  eligible or board-certified anesthesiologists, physiatrists,
 1090  rheumatologists, or neurologists; or
 1091         h. A clinic wholly owned and operated by a physician
 1092  multispecialty practice where one or more board-eligible or
 1093  board-certified medical specialists, who have also completed
 1094  fellowships in pain medicine approved by the Accreditation
 1095  Council for Graduate Medical Education or who are also board
 1096  certified in pain medicine by the American Board of Pain
 1097  Medicine or a board approved by the American Board of Medical
 1098  Specialties, the American Board of Physician Specialties
 1099  American Association of Physician Specialists, or the American
 1100  Osteopathic Association, perform interventional pain procedures
 1101  of the type routinely billed using surgical codes.
 1102         Section 13. Paragraph (a) of subsection (1) of section
 1103  458.3475, Florida Statutes, is amended to read:
 1104         458.3475 Anesthesiologist assistants.—
 1105         (1) DEFINITIONS.—As used in this section, the term:
 1106         (a) “Anesthesiologist” means an allopathic physician who
 1107  holds an active, unrestricted license; who has successfully
 1108  completed an anesthesiology training program approved by the
 1109  Accreditation Council on Graduate Medical Education or its
 1110  equivalent; and who is certified by the American Board of
 1111  Anesthesiology, is eligible to take that board’s examination, or
 1112  is certified by the Board of Certification in Anesthesiology
 1113  affiliated with the American Board of Physician Specialties
 1114  American Association of Physician Specialists.
 1115         Section 14. Paragraph (a) of subsection (1) of section
 1116  459.0137, Florida Statutes, is amended to read:
 1117         459.0137 Pain-management clinics.—
 1118         (1) REGISTRATION.—
 1119         (a)1. As used in this section, the term:
 1120         a. “Board eligible” means successful completion of an
 1121  anesthesia, physical medicine and rehabilitation, rheumatology,
 1122  or neurology residency program approved by the Accreditation
 1123  Council for Graduate Medical Education or the American
 1124  Osteopathic Association for a period of 6 years from successful
 1125  completion of such residency program.
 1126         b. “Chronic nonmalignant pain” means pain unrelated to
 1127  cancer which persists beyond the usual course of disease or the
 1128  injury that is the cause of the pain or more than 90 days after
 1129  surgery.
 1130         c. “Pain-management clinic” or “clinic” means any publicly
 1131  or privately owned facility:
 1132         (I) That advertises in any medium for any type of pain
 1133  management services; or
 1134         (II) Where in any month a majority of patients are
 1135  prescribed opioids, benzodiazepines, barbiturates, or
 1136  carisoprodol for the treatment of chronic nonmalignant pain.
 1137         2. Each pain-management clinic must register with the
 1138  department or hold a valid certificate of exemption pursuant to
 1139  subsection (2).
 1140         3. The following clinics are exempt from the registration
 1141  requirement of paragraphs (c)-(m) and must apply to the
 1142  department for a certificate of exemption:
 1143         a. A clinic licensed as a facility pursuant to chapter 395;
 1144         b. A clinic in which the majority of the physicians who
 1145  provide services in the clinic primarily provide surgical
 1146  services;
 1147         c. A clinic owned by a publicly held corporation whose
 1148  shares are traded on a national exchange or on the over-the
 1149  counter market and whose total assets at the end of the
 1150  corporation’s most recent fiscal quarter exceeded $50 million;
 1151         d. A clinic affiliated with an accredited medical school at
 1152  which training is provided for medical students, residents, or
 1153  fellows;
 1154         e. A clinic that does not prescribe controlled substances
 1155  for the treatment of pain;
 1156         f. A clinic owned by a corporate entity exempt from federal
 1157  taxation under 26 U.S.C. s. 501(c)(3);
 1158         g. A clinic wholly owned and operated by one or more board
 1159  eligible or board-certified anesthesiologists, physiatrists,
 1160  rheumatologists, or neurologists; or
 1161         h. A clinic wholly owned and operated by a physician
 1162  multispecialty practice where one or more board-eligible or
 1163  board-certified medical specialists, who have also completed
 1164  fellowships in pain medicine approved by the Accreditation
 1165  Council for Graduate Medical Education or the American
 1166  Osteopathic Association or who are also board-certified in pain
 1167  medicine by the American Board of Pain Medicine or a board
 1168  approved by the American Board of Medical Specialties, the
 1169  American Board of Physician Specialties American Association of
 1170  Physician Specialists, or the American Osteopathic Association,
 1171  perform interventional pain procedures of the type routinely
 1172  billed using surgical codes.
 1173         Section 15. Paragraph (a) of subsection (1) of section
 1174  459.023, Florida Statutes, is amended to read:
 1175         459.023 Anesthesiologist assistants.—
 1176         (1) DEFINITIONS.—As used in this section, the term:
 1177         (a) “Anesthesiologist” means an osteopathic physician who
 1178  holds an active, unrestricted license; who has successfully
 1179  completed an anesthesiology training program approved by the
 1180  Accreditation Council on Graduate Medical Education, or its
 1181  equivalent, or the American Osteopathic Association; and who is
 1182  certified by the American Osteopathic Board of Anesthesiology or
 1183  is eligible to take that board’s examination, is certified by
 1184  the American Board of Anesthesiology or is eligible to take that
 1185  board’s examination, or is certified by the Board of
 1186  Certification in Anesthesiology affiliated with the American
 1187  Board of Physician Specialties American Association of Physician
 1188  Specialists.
 1189         Section 16. Subsection (4) of section 466.006, Florida
 1190  Statutes, is amended to read:
 1191         466.006 Examination of dentists.—
 1192         (4) Notwithstanding any other provision of law in chapter
 1193  456 pertaining to the clinical dental licensure examination or
 1194  national examinations, to be licensed as a dentist in this
 1195  state, an applicant must successfully complete all both of the
 1196  following:
 1197         (a) A written examination on the laws and rules of the
 1198  state regulating the practice of dentistry.
 1199         (b) A practical or clinical examination, which must be the
 1200  American Dental Licensing Examination produced by the American
 1201  Board of Dental Examiners, Inc., or its successor entity, if
 1202  any, which is administered in this state, provided that the
 1203  board has attained, and continues to maintain thereafter,
 1204  representation on the board of directors of the American Board
 1205  of Dental Examiners, the examination development committee of
 1206  the American Board of Dental Examiners, and such other
 1207  committees of the American Board of Dental Examiners as the
 1208  board deems appropriate by rule to assure that the standards
 1209  established herein are maintained organizationally.
 1210         1. As an alternative to such practical or clinical
 1211  examination, an applicant may submit scores from an American
 1212  Dental Licensing Examination previously administered in a
 1213  jurisdiction other than this state after October 1, 2011, and
 1214  such examination results are recognized as valid for the purpose
 1215  of licensure in this state. A passing score on the American
 1216  Dental Licensing Examination administered out of state is the
 1217  same as the passing score for the American Dental Licensing
 1218  Examination administered in this state. The applicant must have
 1219  completed the examination after October 1, 2011. This
 1220  subparagraph may not be given retroactive application.
 1221         2. If the date of an applicant’s passing American Dental
 1222  Licensing Examination scores from an examination previously
 1223  administered in a jurisdiction other than this state under
 1224  subparagraph 1. is older than 365 days, such scores are
 1225  nevertheless valid for the purpose of licensure in this state,
 1226  but only if the applicant demonstrates that all of the following
 1227  additional standards have been met:
 1228         a. The applicant completed the American Dental Licensing
 1229  Examination after October 1, 2011. This sub-subparagraph may not
 1230  be given retroactive application.
 1231         b. The applicant graduated from a dental school accredited
 1232  by the American Dental Association Commission on Dental
 1233  Accreditation or its successor entity, if any, or any other
 1234  dental accrediting organization recognized by the United States
 1235  Department of Education. Provided, however, if the applicant did
 1236  not graduate from such a dental school, the applicant may submit
 1237  proof of having successfully completed a full-time supplemental
 1238  general dentistry program accredited by the American Dental
 1239  Association Commission on Dental Accreditation of at least 2
 1240  consecutive academic years at such accredited sponsoring
 1241  institution. Such program must provide didactic and clinical
 1242  education at the level of a D.D.S. or D.M.D. program accredited
 1243  by the American Dental Association Commission on Dental
 1244  Accreditation. For purposes of this sub-subparagraph, a
 1245  supplemental general dentistry program does not include an
 1246  advanced education program in a dental specialty.
 1247         c. The applicant currently possesses a valid and active
 1248  dental license in good standing, with no restriction, which has
 1249  never been revoked, suspended, restricted, or otherwise
 1250  disciplined, from another state or territory of the United
 1251  States, the District of Columbia, or the Commonwealth of Puerto
 1252  Rico.
 1253         d. The applicant must disclose to the board during the
 1254  application process if he or she has been reported to the
 1255  National Practitioner Data Bank, the Healthcare Integrity and
 1256  Protection Data Bank, or the American Association of Dental
 1257  Boards Clearinghouse. This sub-subparagraph does not apply if
 1258  the applicant successfully appealed to have his or her name
 1259  removed from the data banks of these agencies.
 1260         e.(I)(A) The applicant submits proof of having been
 1261  consecutively engaged in the full-time practice of dentistry in
 1262  another state or territory of the United States, the District of
 1263  Columbia, or the Commonwealth of Puerto Rico in the 5 years
 1264  immediately preceding the date of application for licensure in
 1265  this state; or
 1266         (B) If the applicant has been licensed in another state or
 1267  territory of the United States, the District of Columbia, or the
 1268  Commonwealth of Puerto Rico for less than 5 years, the applicant
 1269  submits proof of having been engaged in the full-time practice
 1270  of dentistry since the date of his or her initial licensure.
 1271         (II) As used in this section, “full-time practice” is
 1272  defined as a minimum of 1,200 hours per year for each year in
 1273  the consecutive 5-year period or, when applicable, the period
 1274  since initial licensure, and must include any combination of the
 1275  following:
 1276         (A) Active clinical practice of dentistry providing direct
 1277  patient care.
 1278         (B) Full-time practice as a faculty member employed by a
 1279  dental or dental hygiene school approved by the board or
 1280  accredited by the American Dental Association Commission on
 1281  Dental Accreditation.
 1282         (C) Full-time practice as a student at a postgraduate
 1283  dental education program approved by the board or accredited by
 1284  the American Dental Association Commission on Dental
 1285  Accreditation.
 1286         (III) The board shall develop rules to determine what type
 1287  of proof of full-time practice is required and to recoup the
 1288  cost to the board of verifying full-time practice under this
 1289  section. Such proof must, at a minimum, be:
 1290         (A) Admissible as evidence in an administrative proceeding;
 1291         (B) Submitted in writing;
 1292         (C) Further documented by an applicant’s annual income tax
 1293  return filed with the Internal Revenue Service for each year in
 1294  the preceding 5-year period or, if the applicant has been
 1295  practicing for less than 5 years, the period since initial
 1296  licensure; and
 1297         (D) Specifically found by the board to be both credible and
 1298  admissible.
 1299         (IV) The board may excuse applicants from the 1,200-hour
 1300  requirement in the event of hardship, as defined by the board.
 1301         f. The applicant submits documentation that he or she has
 1302  completed, or will complete before he or she is licensed in this
 1303  state, continuing education equivalent to this state’s
 1304  requirements for the last full reporting biennium.
 1305         g. The applicant proves that he or she has never been
 1306  convicted of, or pled nolo contendere to, regardless of
 1307  adjudication, any felony or misdemeanor related to the practice
 1308  of a health care profession in any jurisdiction.
 1309         h. The applicant has successfully passed a written
 1310  examination on the laws and rules of this state regulating the
 1311  practice of dentistry and the computer-based diagnostic skills
 1312  examination.
 1313         i. The applicant submits documentation that he or she has
 1314  successfully completed the applicable examination administered
 1315  by the Joint Commission on National Dental Examinations or its
 1316  successor organization.
 1317         (c) The educational requirements provided under paragraph
 1318  (2)(b) or subsection (3).
 1319         Section 17. Section 486.112, Florida Statutes, is amended
 1320  to read:
 1321         486.112 Physical Therapy Licensure Compact.—The Physical
 1322  Therapy Licensure Compact is hereby enacted into law and entered
 1323  into by this state with all other jurisdictions legally joining
 1324  therein in the form substantially as follows:
 1325  
 1326                              ARTICLE I                            
 1327                       PURPOSE AND OBJECTIVES                      
 1328  
 1329         (1) The purpose of the compact is to facilitate interstate
 1330  practice of physical therapy with the goal of improving public
 1331  access to physical therapy services. The compact preserves the
 1332  regulatory authority of member states to protect public health
 1333  and safety through their current systems of state licensure. For
 1334  purposes of state regulation under the compact, the practice of
 1335  physical therapy is deemed to have occurred in the state where
 1336  the patient is located at the time physical therapy is provided
 1337  to the patient.
 1338         (2) The compact is designed to achieve all of the following
 1339  objectives:
 1340         (a) Increase public access to physical therapy services by
 1341  providing for the mutual recognition of other member state
 1342  licenses.
 1343         (b) Enhance the states’ ability to protect the public’s
 1344  health and safety.
 1345         (c) Encourage the cooperation of member states in
 1346  regulating multistate physical therapy practice.
 1347         (d) Support spouses of relocating military members.
 1348         (e) Enhance the exchange of licensure, investigative, and
 1349  disciplinary information between member states.
 1350         (f) Allow a remote state to hold a provider of services
 1351  with a compact privilege in that state accountable to that
 1352  state’s practice standards.
 1353  
 1354                             ARTICLE II                            
 1355                             DEFINITIONS                           
 1356  
 1357         As used in the compact, and except as otherwise provided,
 1358  the term:
 1359         (1) “Active duty military” means full-time duty status in
 1360  the active uniformed service of the United States, including
 1361  members of the National Guard and Reserve on active duty orders
 1362  pursuant to 10 U.S.C. chapter 1209 or chapter 1211.
 1363         (2) “Adverse action” means disciplinary action taken by a
 1364  physical therapy licensing board based upon misconduct,
 1365  unacceptable performance, or a combination of both.
 1366         (3) “Alternative program” means a nondisciplinary
 1367  monitoring or practice remediation process approved by a state’s
 1368  physical therapy licensing board. The term includes, but is not
 1369  limited to, programs that address substance abuse issues.
 1370         (4) “Compact privilege” means the authorization granted by
 1371  a remote state to allow a licensee from another member state to
 1372  practice as a physical therapist or physical therapist assistant
 1373  in the remote state under its laws and rules.
 1374         (5) “Continuing competence” means a requirement, as a
 1375  condition of license renewal, to provide evidence of
 1376  participation in, and completion of, educational and
 1377  professional activities relevant to the practice of physical
 1378  therapy.
 1379         (6) “Data system” means the coordinated database and
 1380  reporting system created by the Physical Therapy Compact
 1381  Commission for the exchange of information between member states
 1382  relating to licensees or applicants under the compact, including
 1383  identifying information, licensure data, investigative
 1384  information, adverse actions, nonconfidential information
 1385  related to alternative program participation, any denials of
 1386  applications for licensure, and other information as specified
 1387  by commission rule.
 1388         (7) “Encumbered license” means a license that a physical
 1389  therapy licensing board has limited in any way.
 1390         (8) “Executive board” means a group of directors elected or
 1391  appointed to act on behalf of, and within the powers granted to
 1392  them by, the commission.
 1393         (9) “Home state” means the member state that is the
 1394  licensee’s primary state of residence.
 1395         (10) “Investigative information” means information,
 1396  records, and documents received or generated by a physical
 1397  therapy licensing board pursuant to an investigation.
 1398         (11) “Jurisprudence requirement” means the assessment of an
 1399  individual’s knowledge of the laws and rules governing the
 1400  practice of physical therapy in a specific state.
 1401         (12) “Licensee” means an individual who currently holds an
 1402  authorization from a state to practice as a physical therapist
 1403  or physical therapist assistant.
 1404         (13) “Member state” means a state that has enacted the
 1405  compact.
 1406         (14) “Party state” means any member state in which a
 1407  licensee holds a current license or compact privilege or is
 1408  applying for a license or compact privilege.
 1409         (15) “Physical therapist” means an individual licensed by a
 1410  state to practice physical therapy.
 1411         (16)(15) “Physical therapist assistant” means an individual
 1412  licensed by a state to assist a physical therapist in specified
 1413  areas of physical therapy.
 1414         (17)(16) “Physical therapy” or “the practice of physical
 1415  therapy” means the care and services provided by or under the
 1416  direction and supervision of a licensed physical therapist.
 1417         (18)(17) “Physical Therapy Compact Commission” or
 1418  “commission” means the national administrative body whose
 1419  membership consists of all states that have enacted the compact.
 1420         (19)(18) “Physical therapy licensing board” means the
 1421  agency of a state which is responsible for the licensing and
 1422  regulation of physical therapists and physical therapist
 1423  assistants.
 1424         (20)(19) “Remote state” means a member state other than the
 1425  home state where a licensee is exercising or seeking to exercise
 1426  the compact privilege.
 1427         (21)(20) “Rule” means a regulation, principle, or directive
 1428  adopted by the commission which has the force of law.
 1429         (22)(21) “State” means any state, commonwealth, district,
 1430  or territory of the United States of America which regulates the
 1431  practice of physical therapy.
 1432  
 1433                             ARTICLE III                           
 1434                 STATE PARTICIPATION IN THE COMPACT                
 1435  
 1436         (1) To participate in the compact, a state must do all of
 1437  the following:
 1438         (a) Participate fully in the commission’s data system,
 1439  including using the commission’s unique identifier, as defined
 1440  by commission rule.
 1441         (b) Have a mechanism in place for receiving and
 1442  investigating complaints about licensees.
 1443         (c) Notify the commission, in accordance with the terms of
 1444  the compact and rules, of any adverse action or the availability
 1445  of investigative information regarding a licensee.
 1446         (d) Fully implement a criminal background check
 1447  requirement, within a timeframe established by commission rule,
 1448  which uses results from the Federal Bureau of Investigation
 1449  record search on criminal background checks to make licensure
 1450  decisions in accordance with subsection (2).
 1451         (e) Comply with the commission’s rules.
 1452         (f) Use a recognized national examination as a requirement
 1453  for licensure pursuant to the commission’s rules.
 1454         (g) Have continuing competence requirements as a condition
 1455  for license renewal.
 1456         (2) Upon adoption of the compact, a member state has the
 1457  authority to obtain biometric-based information from each
 1458  licensee applying for a compact privilege and submit this
 1459  information to the Federal Bureau of Investigation for a
 1460  criminal background check in accordance with 28 U.S.C. s. 534
 1461  and 34 U.S.C. s. 40316.
 1462         (3) A member state must grant the compact privilege to a
 1463  licensee holding a valid unencumbered license in another member
 1464  state in accordance with the terms of the compact and rules.
 1465  
 1466                             ARTICLE IV                            
 1467                          COMPACT PRIVILEGE                        
 1468  
 1469         (1) To exercise the compact privilege under the compact, a
 1470  licensee must satisfy all of the following conditions:
 1471         (a) Hold a license in the home state.
 1472         (b) Not have an encumbrance on any state license.
 1473         (c) Be eligible for a compact privilege in all member
 1474  states in accordance with subsections (4), (7), and (8).
 1475         (d) Not have had an adverse action against any license or
 1476  compact privilege within the preceding 2 years.
 1477         (e) Notify the commission that the licensee is seeking the
 1478  compact privilege within a remote state.
 1479         (f) Meet any jurisprudence requirements established by the
 1480  remote state in which the licensee is seeking a compact
 1481  privilege.
 1482         (g) Report to the commission adverse action taken by any
 1483  nonmember state within 30 days after the date the adverse action
 1484  is taken.
 1485         (2) The compact privilege is valid until the expiration
 1486  date of the home license. The licensee must continue to meet the
 1487  requirements of subsection (1) to maintain the compact privilege
 1488  in a remote state.
 1489         (3) A licensee providing physical therapy in a remote state
 1490  under the compact privilege must comply with the laws and rules
 1491  of the remote state.
 1492         (4) A licensee providing physical therapy in a remote state
 1493  is subject to that state’s regulatory authority. A remote state
 1494  may, in accordance with due process and that state’s laws,
 1495  remove a licensee’s compact privilege in the remote state for a
 1496  specific period of time, impose fines, and take any other
 1497  necessary actions to protect the health and safety of its
 1498  citizens. The licensee is not eligible for a compact privilege
 1499  in any member state until the specific period of time for
 1500  removal has ended and all fines are paid.
 1501         (5) If a home state license is encumbered, the licensee
 1502  loses the compact privilege in any remote state until the
 1503  following conditions are met:
 1504         (a) The home state license is no longer encumbered.
 1505         (b) Two years have elapsed from the date of the adverse
 1506  action.
 1507         (6) Once an encumbered license in the home state is
 1508  restored to good standing, the licensee must meet the
 1509  requirements of subsection (1) to obtain a compact privilege in
 1510  any remote state.
 1511         (7) If a licensee’s compact privilege in any remote state
 1512  is removed, the licensee loses the compact privilege in all
 1513  remote states until all of the following conditions are met:
 1514         (a) The specific period of time for which the compact
 1515  privilege was removed has ended.
 1516         (b) All fines have been paid.
 1517         (c) Two years have elapsed from the date of the adverse
 1518  action.
 1519         (8) Once the requirements of subsection (7) have been met,
 1520  the licensee must meet the requirements of subsection (1) to
 1521  obtain a compact privilege in a remote state.
 1522  
 1523                              ARTICLE V                            
 1524                   ACTIVE DUTY MILITARY PERSONNEL                  
 1525                          AND THEIR SPOUSES                        
 1526  
 1527         A licensee who is active duty military or is the spouse of
 1528  an individual who is active duty military may choose any of the
 1529  following locations to designate his or her home state:
 1530         (1) Home of record.
 1531         (2) Permanent change of station location.
 1532         (3) State of current residence, if it is different from the
 1533  home of record or permanent change of station location.
 1534  
 1535                             ARTICLE VI                            
 1536                           ADVERSE ACTIONS                         
 1537  
 1538         (1) A home state has exclusive power to impose adverse
 1539  action against a license issued by the home state.
 1540         (2) A home state may take adverse action based on the
 1541  investigative information of a remote state, so long as the home
 1542  state follows its own procedures for imposing adverse action.
 1543         (3) The compact does not override a member state’s decision
 1544  that participation in an alternative program may be used in lieu
 1545  of adverse action and that such participation remain nonpublic
 1546  if required by the member state’s laws. Member states must
 1547  require licensees who enter any alternative programs in lieu of
 1548  discipline to agree not to practice in any other member state
 1549  during the term of the alternative program without prior
 1550  authorization from such other member state.
 1551         (4) A member state may investigate actual or alleged
 1552  violations of the laws and rules for the practice of physical
 1553  therapy committed in any other member state by a physical
 1554  therapist or physical therapist assistant practicing under the
 1555  compact who holds a license or compact privilege in such other
 1556  member state.
 1557         (5) A remote state may do any of the following:
 1558         (a) Take adverse actions as set forth in subsection (4) of
 1559  Article IV against a licensee’s compact privilege in the state.
 1560         (b) Issue subpoenas for both hearings and investigations
 1561  which require the attendance and testimony of witnesses and the
 1562  production of evidence. Subpoenas issued by a physical therapy
 1563  licensing board in a party member state for the attendance and
 1564  testimony of witnesses or for the production of evidence from
 1565  another party member state must be enforced in the latter state
 1566  by any court of competent jurisdiction, according to the
 1567  practice and procedure of that court applicable to subpoenas
 1568  issued in proceedings pending before it. The issuing authority
 1569  shall pay any witness fees, travel expenses, mileage, and other
 1570  fees required by the service laws of the state where the
 1571  witnesses or evidence is located.
 1572         (c) If otherwise permitted by state law, recover from the
 1573  licensee the costs of investigations and disposition of cases
 1574  resulting from any adverse action taken against that licensee.
 1575         (6)(a) In addition to the authority granted to a member
 1576  state by its respective physical therapy practice act or other
 1577  applicable state law, a member state may participate with other
 1578  member states in joint investigations of licensees.
 1579         (b) Member states shall share any investigative,
 1580  litigation, or compliance materials in furtherance of any joint
 1581  or individual investigation initiated under the compact.
 1582  
 1583                             ARTICLE VII                           
 1584                        ESTABLISHMENT OF THE                       
 1585                 PHYSICAL THERAPY COMPACT COMMISSION               
 1586  
 1587         (1) COMMISSION CREATED.—The member states hereby create and
 1588  establish a joint public agency known as the Physical Therapy
 1589  Compact Commission:
 1590         (a) The commission is an instrumentality of the member
 1591  states.
 1592         (b) Venue is proper, and judicial proceedings by or against
 1593  the commission must be brought solely and exclusively, in a
 1594  court of competent jurisdiction where the principal office of
 1595  the commission is located. The commission may waive venue and
 1596  jurisdictional defenses to the extent it adopts or consents to
 1597  participate in alternative dispute resolution proceedings.
 1598         (c) The compact may not be construed to be a waiver of
 1599  sovereign immunity.
 1600         (2) MEMBERSHIP, VOTING, AND MEETINGS.—
 1601         (a) Each member state has and is limited to one delegate
 1602  selected by that member state’s physical therapy licensing board
 1603  to serve on the commission. The delegate must be a current
 1604  member of the physical therapy licensing board who is a physical
 1605  therapist, a physical therapist assistant, a public member, or
 1606  the board administrator.
 1607         (b) A delegate may be removed or suspended from office as
 1608  provided by the law of the state from which the delegate is
 1609  appointed. Any vacancy occurring on the commission must be
 1610  filled by the physical therapy licensing board of the member
 1611  state for which the vacancy exists.
 1612         (c) Each delegate is entitled to one vote with regard to
 1613  the adoption of rules and bylaws and shall otherwise have an
 1614  opportunity to participate in the business and affairs of the
 1615  commission.
 1616         (d) A delegate shall vote in person or by such other means
 1617  as provided in the bylaws. The bylaws may provide for delegates’
 1618  participation in meetings by telephone or other means of
 1619  communication.
 1620         (e) The commission shall meet at least once during each
 1621  calendar year. Additional meetings may be held as set forth in
 1622  the bylaws.
 1623         (f) All meetings must be open to the public, and public
 1624  notice of meetings must be given in the same manner as required
 1625  under the rulemaking provisions in Article IX.
 1626         (g) The commission or the executive board or other
 1627  committees of the commission may convene in a closed, nonpublic
 1628  meeting if the commission or executive board or other committees
 1629  of the commission must discuss any of the following:
 1630         1. Noncompliance of a member state with its obligations
 1631  under the compact.
 1632         2. The employment, compensation, or discipline of, or other
 1633  matters, practices, or procedures related to, specific employees
 1634  or other matters related to the commission’s internal personnel
 1635  practices and procedures.
 1636         3. Current, threatened, or reasonably anticipated
 1637  litigation against the commission, executive board, or other
 1638  committees of the commission.
 1639         4. Negotiation of contracts for the purchase, lease, or
 1640  sale of goods, services, or real estate.
 1641         5. An accusation of any person of a crime or a formal
 1642  censure of any person.
 1643         6. Information disclosing trade secrets or commercial or
 1644  financial information that is privileged or confidential.
 1645         7. Information of a personal nature where disclosure would
 1646  constitute a clearly unwarranted invasion of personal privacy.
 1647         8. Investigatory records compiled for law enforcement
 1648  purposes.
 1649         9. Information related to any investigative reports
 1650  prepared by or on behalf of or for use of the commission or
 1651  other committee charged with responsibility for investigation or
 1652  determination of compliance issues pursuant to the compact.
 1653         10. Matters specifically exempted from disclosure by
 1654  federal or member state statute.
 1655         (h) If a meeting, or portion of a meeting, is closed
 1656  pursuant to this subsection, the commission’s legal counsel or
 1657  designee must certify that the meeting may be closed and must
 1658  reference each relevant exempting provision.
 1659         (i) The commission shall keep minutes that fully and
 1660  clearly describe all matters discussed in a meeting and shall
 1661  provide a full and accurate summary of actions taken and the
 1662  reasons therefor, including a description of the views
 1663  expressed. All documents considered in connection with an action
 1664  must be identified in the minutes. All minutes and documents of
 1665  a closed meeting must remain under seal, subject to release only
 1666  by a majority vote of the commission or order of a court of
 1667  competent jurisdiction.
 1668         (3) DUTIES.—The commission shall do all of the following:
 1669         (a) Establish the fiscal year of the commission.
 1670         (b) Establish bylaws.
 1671         (c) Maintain its financial records in accordance with the
 1672  bylaws.
 1673         (d) Meet and take such actions as are consistent with the
 1674  provisions of the compact and the bylaws.
 1675         (4) POWERS.—The commission may do any of the following:
 1676         (a) Adopt uniform rules to facilitate and coordinate
 1677  implementation and administration of the compact. The rules have
 1678  the force and effect of law and are binding in all member
 1679  states.
 1680         (b) Bring and prosecute legal proceedings or actions in the
 1681  name of the commission, provided that the standing of any state
 1682  physical therapy licensing board to sue or be sued under
 1683  applicable law is not affected.
 1684         (c) Purchase and maintain insurance and bonds.
 1685         (d) Borrow, accept, or contract for services of personnel,
 1686  including, but not limited to, employees of a member state.
 1687         (e) Hire employees and elect or appoint officers; fix the
 1688  compensation of, define the duties of, and grant appropriate
 1689  authority to such individuals to carry out the purposes of the
 1690  compact; and establish the commission’s personnel policies and
 1691  programs relating to conflicts of interest, qualifications of
 1692  personnel, and other related personnel matters.
 1693         (f) Accept any appropriate donations and grants of money,
 1694  equipment, supplies, materials, and services and receive, use,
 1695  and dispose of the same, provided that at all times the
 1696  commission avoids any appearance of impropriety or conflict of
 1697  interest.
 1698         (g) Lease, purchase, accept appropriate gifts or donations
 1699  of, or otherwise own, hold, improve, or use any property, real,
 1700  personal, or mixed, provided that at all times the commission
 1701  avoids any appearance of impropriety or conflict of interest.
 1702         (h) Sell, convey, mortgage, pledge, lease, exchange,
 1703  abandon, or otherwise dispose of any property, real, personal,
 1704  or mixed.
 1705         (i) Establish a budget and make expenditures.
 1706         (j) Borrow money.
 1707         (k) Appoint committees, including standing committees
 1708  composed of members, state regulators, state legislators or
 1709  their representatives, and consumer representatives, and such
 1710  other interested persons as may be designated in the compact and
 1711  the bylaws.
 1712         (l) Provide information to, receive information from, and
 1713  cooperate with law enforcement agencies.
 1714         (m) Establish and elect an executive board.
 1715         (n) Perform such other functions as may be necessary or
 1716  appropriate to achieve the purposes of the compact consistent
 1717  with the state regulation of physical therapy licensure and
 1718  practice.
 1719         (5) THE EXECUTIVE BOARD.—
 1720         (a) The executive board may act on behalf of the commission
 1721  according to the terms of the compact.
 1722         (b) The executive board shall be composed of the following
 1723  nine members:
 1724         1. Seven voting members who are elected by the commission
 1725  from the current membership of the commission.
 1726         2. One ex officio, nonvoting member from the recognized
 1727  national physical therapy professional association.
 1728         3. One ex officio, nonvoting member from the recognized
 1729  membership organization of the physical therapy licensing
 1730  boards.
 1731         (c) The ex officio members shall be selected by their
 1732  respective organizations.
 1733         (d) The commission may remove any member of the executive
 1734  board as provided in its bylaws.
 1735         (e) The executive board shall meet at least annually.
 1736         (f) The executive board shall do all of the following:
 1737         1. Recommend to the entire commission changes to the rules
 1738  or bylaws, compact legislation, fees paid by compact member
 1739  states, such as annual dues, and any commission compact fee
 1740  charged to licensees for the compact privilege.
 1741         2. Ensure compact administration services are appropriately
 1742  provided, contractually or otherwise.
 1743         3. Prepare and recommend the budget.
 1744         4. Maintain financial records on behalf of the commission.
 1745         5. Monitor compact compliance of member states and provide
 1746  compliance reports to the commission.
 1747         6. Establish additional committees as necessary.
 1748         7. Perform other duties as provided in the rules or bylaws.
 1749         (6) FINANCING OF THE COMMISSION.—
 1750         (a) The commission shall pay, or provide for the payment
 1751  of, the reasonable expenses of its establishment, organization,
 1752  and ongoing activities.
 1753         (b) The commission may accept any appropriate revenue
 1754  sources, donations, and grants of money, equipment, supplies,
 1755  materials, and services.
 1756         (c) The commission may levy and collect an annual
 1757  assessment from each member state or impose fees on other
 1758  parties to cover the cost of the operations and activities of
 1759  the commission and its staff. Such assessments and fees must
 1760  total to an amount sufficient to cover the commission’s annual
 1761  budget as approved each year for which revenue is not provided
 1762  by other sources. The aggregate annual assessment amount must be
 1763  allocated based upon a formula to be determined by the
 1764  commission, which shall adopt a rule binding upon all member
 1765  states.
 1766         (d) The commission may not incur obligations of any kind
 1767  before securing the funds adequate to meet such obligations; nor
 1768  may the commission pledge the credit of any of the member
 1769  states, except by and with the authority of the member state.
 1770         (e) The commission shall keep accurate accounts of all
 1771  receipts and disbursements. The receipts and disbursements of
 1772  the commission are subject to the audit and accounting
 1773  procedures established under its bylaws. However, all receipts
 1774  and disbursements of funds handled by the commission must be
 1775  audited yearly by a certified or licensed public accountant, and
 1776  the report of the audit must be included in and become part of
 1777  the annual report of the commission.
 1778         (7) QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION.—
 1779         (a) The members, officers, executive director, employees,
 1780  and representatives of the commission are immune from suit and
 1781  liability, whether personally or in their official capacity, for
 1782  any claim for damage to or loss of property or personal injury
 1783  or other civil liability caused by or arising out of any actual
 1784  or alleged act, error, or omission that occurred, or that the
 1785  person against whom the claim is made had a reasonable basis for
 1786  believing occurred, within the scope of commission employment,
 1787  duties, or responsibilities. However, this paragraph may not be
 1788  construed to protect any such person from suit or liability for
 1789  any damage, loss, injury, or liability caused by the
 1790  intentional, willful, or wanton misconduct of that person.
 1791         (b) The commission shall defend any member, officer,
 1792  executive director, employee, or representative of the
 1793  commission in any civil action seeking to impose liability
 1794  arising out of any actual or alleged act, error, or omission
 1795  that occurred within the scope of commission employment, duties,
 1796  or responsibilities, or that the person against whom the claim
 1797  is made had a reasonable basis for believing occurred within the
 1798  scope of commission employment, duties, or responsibilities.
 1799  However, this subsection may not be construed to prohibit any
 1800  member, officer, executive director, employee, or representative
 1801  of the commission from retaining his or her own counsel or to
 1802  require the commission to defend such person if the actual or
 1803  alleged act, error, or omission resulted from that person’s
 1804  intentional, willful, or wanton misconduct.
 1805         (c) The commission shall indemnify and hold harmless any
 1806  member, officer, executive director, employee, or representative
 1807  of the commission for the amount of any settlement or judgment
 1808  obtained against that person arising out of any actual or
 1809  alleged act, error, or omission that occurred within the scope
 1810  of commission employment, duties, or responsibilities, or that
 1811  such person had a reasonable basis for believing occurred within
 1812  the scope of commission employment, duties, or responsibilities,
 1813  provided that the actual or alleged act, error, or omission did
 1814  not result from the intentional, willful, or wanton misconduct
 1815  of that person.
 1816  
 1817                            ARTICLE VIII                           
 1818                             DATA SYSTEM                           
 1819  
 1820         (1) The commission shall provide for the development,
 1821  maintenance, and use of a coordinated database and reporting
 1822  system containing licensure, adverse action, and investigative
 1823  information on all licensees in member states.
 1824         (2) Notwithstanding any other provision of state law to the
 1825  contrary, a member state shall submit a uniform data set to the
 1826  data system on all individuals to whom the compact is applicable
 1827  as required by the rules of the commission, which data set must
 1828  include all of the following:
 1829         (a) Identifying information.
 1830         (b) Licensure data.
 1831         (c) Investigative information.
 1832         (d) Adverse actions against a license or compact privilege.
 1833         (e) Nonconfidential information related to alternative
 1834  program participation.
 1835         (f) Any denial of application for licensure, and the reason
 1836  for such denial.
 1837         (g) Other information that may facilitate the
 1838  administration of the compact, as determined by the rules of the
 1839  commission.
 1840         (3) Investigative information in the system pertaining to a
 1841  licensee in any member state must be available only to other
 1842  party member states.
 1843         (4) The commission shall promptly notify all member states
 1844  of any adverse action taken against a licensee or an individual
 1845  applying for a license in a member state. Adverse action
 1846  information pertaining to a licensee in any member state must be
 1847  available to all other member states.
 1848         (5) Member states contributing information to the data
 1849  system may designate information that may not be shared with the
 1850  public without the express permission of the contributing state.
 1851         (6) Any information submitted to the data system which is
 1852  subsequently required to be expunged by the laws of the member
 1853  state contributing the information must be removed from the data
 1854  system.
 1855  
 1856                             ARTICLE IX                            
 1857                             RULEMAKING                            
 1858  
 1859         (1) The commission shall exercise its rulemaking powers
 1860  pursuant to the criteria set forth in this article and the rules
 1861  adopted thereunder. Rules and amendments become binding as of
 1862  the date specified in each rule or amendment.
 1863         (2) If a majority of the legislatures of the member states
 1864  rejects a rule by enactment of a statute or resolution in the
 1865  same manner used to adopt the compact within 4 years after the
 1866  date of adoption of the rule, such rule does not have further
 1867  force and effect in any member state.
 1868         (3) Rules or amendments to the rules must be adopted at a
 1869  regular or special meeting of the commission.
 1870         (4) Before adoption of a final rule by the commission, and
 1871  at least 30 days before the meeting at which the rule will be
 1872  considered and voted upon, the commission must file a notice of
 1873  proposed rulemaking on all of the following:
 1874         (a) The website of the commission or another publicly
 1875  accessible platform.
 1876         (b) The website of each member state physical therapy
 1877  licensing board or another publicly accessible platform or the
 1878  publication in which each state would otherwise publish proposed
 1879  rules.
 1880         (5) The notice of proposed rulemaking must include all of
 1881  the following:
 1882         (a) The proposed date, time, and location of the meeting in
 1883  which the rule or amendment will be considered and voted upon.
 1884         (b) The text of the proposed rule or amendment and the
 1885  reason for the proposed rule.
 1886         (c) A request for comments on the proposed rule or
 1887  amendment from any interested person.
 1888         (d) The manner in which interested persons may submit
 1889  notice to the commission of their intention to attend the public
 1890  hearing and any written comments.
 1891         (6) Before adoption of a proposed rule or amendment, the
 1892  commission must allow persons to submit written data, facts,
 1893  opinions, and arguments, which must be made available to the
 1894  public.
 1895         (7) The commission must grant an opportunity for a public
 1896  hearing before it adopts a rule or an amendment if a hearing is
 1897  requested by any of the following:
 1898         (a) At least 25 persons.
 1899         (b) A state or federal governmental subdivision or agency.
 1900         (c) An association having at least 25 members.
 1901         (8) If a scheduled public hearing is held on the proposed
 1902  rule or amendment, the commission must publish the date, time,
 1903  and location of the hearing. If the hearing is held through
 1904  electronic means, the commission must publish the mechanism for
 1905  access to the electronic hearing.
 1906         (a) All persons wishing to be heard at the hearing must
 1907  notify the executive director of the commission or another
 1908  designated member in writing of their desire to appear and
 1909  testify at the hearing at least 5 business days before the
 1910  scheduled date of the hearing.
 1911         (b) Hearings must be conducted in a manner providing each
 1912  person who wishes to comment a fair and reasonable opportunity
 1913  to comment orally or in writing.
 1914         (c) All hearings must be recorded. A copy of the recording
 1915  must be made available on request.
 1916         (d) This article may not be construed to require a separate
 1917  hearing on each rule. Rules may be grouped for the convenience
 1918  of the commission at hearings required by this article.
 1919         (9) Following the scheduled hearing date, or by the close
 1920  of business on the scheduled hearing date if the hearing was not
 1921  held, the commission shall consider all written and oral
 1922  comments received.
 1923         (10) If no written notice of intent to attend the public
 1924  hearing by interested parties is received, the commission may
 1925  proceed with adoption of the proposed rule without a public
 1926  hearing.
 1927         (11) The commission shall, by majority vote of all members,
 1928  take final action on the proposed rule and shall determine the
 1929  effective date of the rule, if any, based on the rulemaking
 1930  record and the full text of the rule.
 1931         (12) Upon determination that an emergency exists, the
 1932  commission may consider and adopt an emergency rule without
 1933  prior notice, opportunity for comment, or hearing, provided that
 1934  the usual rulemaking procedures provided in the compact and in
 1935  this article are retroactively applied to the rule as soon as
 1936  reasonably possible, in no event later than 90 days after the
 1937  effective date of the rule. For the purposes of this subsection,
 1938  an emergency rule is one that must be adopted immediately in
 1939  order to do any of the following:
 1940         (a) Meet an imminent threat to public health, safety, or
 1941  welfare.
 1942         (b) Prevent a loss of commission or member state funds.
 1943         (c) Meet a deadline for the adoption of an administrative
 1944  rule established by federal law or rule.
 1945         (d) Protect public health and safety.
 1946         (13) The commission or an authorized committee of the
 1947  commission may direct revisions to a previously adopted rule or
 1948  amendment for purposes of correcting typographical errors,
 1949  errors in format, errors in consistency, or grammatical errors.
 1950  Public notice of any revisions must be posted on the website of
 1951  the commission. The revision is subject to challenge by any
 1952  person for a period of 30 days after posting. The revision may
 1953  be challenged only on grounds that the revision results in a
 1954  material change to a rule. A challenge must be made in writing
 1955  and delivered to the chair of the commission before the end of
 1956  the notice period. If a challenge is not made, the revision
 1957  takes effect without further action. If the revision is
 1958  challenged, the revision may not take effect without the
 1959  approval of the commission.
 1960  
 1961                              ARTICLE X                            
 1962                   OVERSIGHT, DISPUTE RESOLUTION,                  
 1963                           AND ENFORCEMENT                         
 1964  
 1965         (1) OVERSIGHT.—
 1966         (a) The executive, legislative, and judicial branches of
 1967  state government in each member state shall enforce the compact
 1968  and take all actions necessary and appropriate to carry out the
 1969  compact’s purposes and intent. The provisions of the compact and
 1970  the rules adopted pursuant thereto shall have standing as
 1971  statutory law.
 1972         (b) All courts shall take judicial notice of the compact
 1973  and the rules in any judicial or administrative proceeding in a
 1974  member state pertaining to the subject matter of the compact
 1975  which may affect the powers, responsibilities, or actions of the
 1976  commission.
 1977         (c) The commission is entitled to receive service of
 1978  process in any such proceeding and has standing to intervene in
 1979  such a proceeding for all purposes. Failure to provide service
 1980  of process to the commission renders a judgment or an order void
 1981  as to the commission, the compact, or the adopted rules.
 1982         (2) DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION.—
 1983         (a) If the commission determines that a member state has
 1984  defaulted in the performance of its obligations or
 1985  responsibilities under the compact or the adopted rules, the
 1986  commission must do all of the following:
 1987         1. Provide written notice to the defaulting state and other
 1988  member states of the nature of the default, the proposed means
 1989  of curing the default, and any other action to be taken by the
 1990  commission.
 1991         2. Provide remedial training and specific technical
 1992  assistance regarding the default.
 1993         (b) If a state in default fails to cure the default, the
 1994  defaulting state may be terminated from the compact upon an
 1995  affirmative vote of a majority of the member states, and all
 1996  rights, privileges, and benefits conferred by the compact may be
 1997  terminated on the effective date of termination. A cure of the
 1998  default does not relieve the offending state of obligations or
 1999  liabilities incurred during the period of default.
 2000         (c) Termination of membership in the compact may be imposed
 2001  only after all other means of securing compliance have been
 2002  exhausted. The commission shall give notice of intent to suspend
 2003  or terminate a defaulting member state to the governor and
 2004  majority and minority leaders of the defaulting state’s
 2005  legislature and to each of the member states.
 2006         (d) A state that has been terminated from the compact is
 2007  responsible for all assessments, obligations, and liabilities
 2008  incurred through the effective date of termination, including
 2009  obligations that extend beyond the effective date of
 2010  termination.
 2011         (e) The commission does not bear any costs related to a
 2012  state that is found to be in default or that has been terminated
 2013  from the compact, unless agreed upon in writing between the
 2014  commission and the defaulting state.
 2015         (f) The defaulting state may appeal the action of the
 2016  commission by petitioning the United States District Court for
 2017  the District of Columbia or the federal district where the
 2018  commission has its principal offices. The prevailing member
 2019  shall be awarded all costs of such litigation, including
 2020  reasonable attorney fees.
 2021         (3) DISPUTE RESOLUTION.—
 2022         (a) Upon request by a member state, the commission must
 2023  attempt to resolve disputes related to the compact which arise
 2024  among member states and between member and nonmember states.
 2025         (b) The commission shall adopt a rule providing for both
 2026  mediation and binding dispute resolution for disputes as
 2027  appropriate.
 2028         (4) ENFORCEMENT.—
 2029         (a) The commission, in the reasonable exercise of its
 2030  discretion, shall enforce the compact and the commission’s
 2031  rules.
 2032         (b) By majority vote, the commission may initiate legal
 2033  action in the United States District Court for the District of
 2034  Columbia or the federal district where the commission has its
 2035  principal offices against a member state in default to enforce
 2036  compliance with the provisions of the compact and its adopted
 2037  rules and bylaws. The relief sought may include both injunctive
 2038  relief and damages. In the event judicial enforcement is
 2039  necessary, the prevailing member shall be awarded all costs of
 2040  such litigation, including reasonable attorney fees.
 2041         (c) The remedies under this article are not the exclusive
 2042  remedies of the commission. The commission may pursue any other
 2043  remedies available under federal or state law.
 2044  
 2045                             ARTICLE XI                            
 2046                    DATE OF IMPLEMENTATION OF THE                  
 2047                      PHYSICAL THERAPY COMPACT                     
 2048                        AND ASSOCIATED RULES;                      
 2049                     WITHDRAWAL; AND AMENDMENTS                    
 2050  
 2051         (1) The compact becomes effective on the date that the
 2052  compact statute is enacted into law in the tenth member state.
 2053  The provisions that become effective at that time are limited to
 2054  the powers granted to the commission relating to assembly and
 2055  the adoption of rules. Thereafter, the commission shall meet and
 2056  exercise rulemaking powers necessary for the implementation and
 2057  administration of the compact.
 2058         (2) Any state that joins the compact subsequent to the
 2059  commission’s initial adoption of the rules is subject to the
 2060  rules as they exist on the date that the compact becomes law in
 2061  that state. Any rule that has been previously adopted by the
 2062  commission has the full force and effect of law on the day the
 2063  compact becomes law in that state.
 2064         (3) Any member state may withdraw from the compact by
 2065  enacting a statute repealing the same.
 2066         (a) A member state’s withdrawal does not take effect until
 2067  6 months after enactment of the repealing statute.
 2068         (b) Withdrawal does not affect the continuing requirement
 2069  of the withdrawing state’s physical therapy licensing board to
 2070  comply with the investigative and adverse action reporting
 2071  requirements of this act before the effective date of
 2072  withdrawal.
 2073         (4) The compact may not be construed to invalidate or
 2074  prevent any physical therapy licensure agreement or other
 2075  cooperative arrangement between a member state and a nonmember
 2076  state which does not conflict with the provisions of the
 2077  compact.
 2078         (5) The compact may be amended by the member states. An
 2079  amendment to the compact does not become effective and binding
 2080  upon any member state until it is enacted into the laws of all
 2081  member states.
 2082  
 2083                             ARTICLE XII                           
 2084                    CONSTRUCTION AND SEVERABILITY                  
 2085  
 2086         The compact must be liberally construed so as to carry out
 2087  the purposes thereof. The provisions of the compact are
 2088  severable, and if any phrase, clause, sentence, or provision of
 2089  the compact is declared to be contrary to the constitution of
 2090  any party member state or of the United States or the
 2091  applicability thereof to any government, agency, person, or
 2092  circumstance is held invalid, the validity of the remainder of
 2093  the compact and the applicability thereof to any government,
 2094  agency, person, or circumstance is not affected thereby. If the
 2095  compact is held contrary to the constitution of any party member
 2096  state, the compact remains in full force and effect as to the
 2097  remaining party member states and in full force and effect as to
 2098  the party member state affected as to all severable matters.
 2099         Section 18. Paragraph (d) of subsection (3) of section
 2100  766.1115, Florida Statutes, is amended to read:
 2101         766.1115 Health care providers; creation of agency
 2102  relationship with governmental contractors.—
 2103         (3) DEFINITIONS.—As used in this section, the term:
 2104         (d) “Health care provider” or “provider” means:
 2105         1. A birth center licensed under chapter 383.
 2106         2. An ambulatory surgical center licensed under chapter
 2107  395.
 2108         3. A hospital licensed under chapter 395.
 2109         4. A physician or physician assistant licensed under
 2110  chapter 458.
 2111         5. An osteopathic physician or osteopathic physician
 2112  assistant licensed under chapter 459.
 2113         6. A chiropractic physician licensed under chapter 460.
 2114         7. A podiatric physician licensed under chapter 461.
 2115         8. A registered nurse, nurse midwife, licensed practical
 2116  nurse, or advanced practice registered nurse licensed or
 2117  registered under part I of chapter 464 or any facility which
 2118  employs nurses licensed or registered under part I of chapter
 2119  464 to supply all or part of the care delivered under this
 2120  section.
 2121         9. A midwife licensed under chapter 467.
 2122         10. A health maintenance organization certificated under
 2123  part I of chapter 641.
 2124         11. A health care professional association and its
 2125  employees or a corporate medical group and its employees.
 2126         12. Any other medical facility the primary purpose of which
 2127  is to deliver human medical diagnostic services or which
 2128  delivers nonsurgical human medical treatment, and which includes
 2129  an office maintained by a provider.
 2130         13. A dentist or dental hygienist licensed under chapter
 2131  466.
 2132         14. A free clinic that delivers only medical diagnostic
 2133  services or nonsurgical medical treatment free of charge to all
 2134  low-income recipients.
 2135         15. Any other health care professional, practitioner,
 2136  provider, or facility under contract with a governmental
 2137  contractor, including a student enrolled in an accredited
 2138  program that prepares the student for licensure as any one of
 2139  the professionals listed in subparagraphs 4.-9. and 13.
 2140  
 2141  The term includes any nonprofit corporation qualified as exempt
 2142  from federal income taxation under s. 501(a) of the Internal
 2143  Revenue Code, and described in s. 501(c) of the Internal Revenue
 2144  Code, which delivers health care services provided by licensed
 2145  professionals listed in this paragraph, any federally funded
 2146  community health center, and any volunteer corporation or
 2147  volunteer health care provider that delivers health care
 2148  services.
 2149         Section 19. Except as otherwise expressly provided in this
 2150  act and except for this section, which shall take effect upon
 2151  this act becoming a law, or, if this act fails to become a law
 2152  until after June 1, 2025, it shall take effect upon becoming a
 2153  law and shall operate retroactively to June 1, 2025, this act
 2154  shall take effect July 1, 2025.
 2155  
 2156  ================= T I T L E  A M E N D M E N T ================
 2157  And the title is amended as follows:
 2158         Delete everything before the enacting clause
 2159  and insert:
 2160                        A bill to be entitled                      
 2161         An act relating to the Department of Health; amending
 2162         chapter 2023-43, Laws of Florida; revising the repeal
 2163         date of the definition of the term “messenger
 2164         ribonucleic acid vaccine”; providing for contingent
 2165         retroactive operation; reenacting ss. 381.00316(2)(g)
 2166         and 381.00319(1)(e), F.S., relating to the prohibition
 2167         on discrimination by governmental and business
 2168         entities based on health care choices and the
 2169         prohibition on mask mandates and vaccination and
 2170         testing mandates for educational institutions,
 2171         respectively, for purposes of preserving the
 2172         definition of the term “messenger ribonucleic acid
 2173         vaccine,” notwithstanding its scheduled repeal;
 2174         amending s. 381.026, F.S.; revising the rights of
 2175         patients, which each health care provider and facility
 2176         are required to observe, to include that such
 2177         facilities and providers may not discriminate based on
 2178         a patient’s vaccination status; amending s. 381.986,
 2179         F.S.; defining terms for purposes of background
 2180         screening requirements for persons affiliated with
 2181         medical marijuana treatment centers; requiring medical
 2182         marijuana treatment centers to notify the Department
 2183         of Health through e-mail within a specified timeframe
 2184         after an actual or attempted theft, diversion, or loss
 2185         of marijuana; requiring medical marijuana treatment
 2186         centers to report attempted thefts, in addition to
 2187         actual thefts, to law enforcement within a specified
 2188         timeframe; amending s. 381.988, F.S.; defining terms
 2189         for purposes of background screening requirements for
 2190         persons affiliated with medical marijuana testing
 2191         laboratories; amending s. 456.0145, F.S.; revising
 2192         eligibility criteria for licensure by endorsement
 2193         under the MOBILE Act; amending s. 456.44, F.S.;
 2194         revising the definition of the term “board-certified
 2195         pain management physician” to replace the term
 2196         “American Association of Physician Specialists” with
 2197         “American Board of Physician Specialties”; making a
 2198         technical change; amending s. 458.3145, F.S.; revising
 2199         the list of institutions at which the department is
 2200         authorized to issue a medical faculty certificate to
 2201         an individual who has been offered and has accepted a
 2202         full-time faculty appointment; amending ss. 458.315
 2203         and 459.0076, F.S.; revising criteria authorizing
 2204         physician assistants to be issued temporary
 2205         certificates for practice in areas of critical need;
 2206         amending ss. 458.3265, 458.3475, 459.0137, and
 2207         459.023, F.S.; revising definitions to replace the
 2208         term “American Association of Physician Specialists”
 2209         with “American Board of Physician Specialties”;
 2210         amending s. 466.006, F.S.; revising the requirements
 2211         for licensure as a dentist; amending s. 486.112, F.S.;
 2212         defining the term “party state”; authorizing a remote
 2213         state to issue subpoenas to individuals to testify or
 2214         for the production of evidence from a party located in
 2215         a party state; providing that such subpoenas are
 2216         enforceable in the party state; requiring that
 2217         investigative information pertaining to certain
 2218         licensees in a certain system be available only to
 2219         other party states; revising construction and
 2220         severability of the compact to conform to changes made
 2221         by the act; amending s. 766.1115, F.S.; revising the
 2222         definition of the term “health care provider” or
 2223         “provider”; providing effective dates.