Florida Senate - 2025                      CS for CS for SB 1270
       
       
        
       By the Appropriations Committee on Health and Human Services;
       the Committee on Health Policy; and Senator Collins
       
       
       
       
       603-03442-25                                          20251270c2
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health;
    3         reenacting ss. 381.00316(2)(g) and 381.00319(1)(e),
    4         F.S., relating to the prohibition on discrimination by
    5         governmental and business entities based on health
    6         care choices and the prohibition on mask mandates and
    7         vaccination and testing mandates for educational
    8         institutions, respectively, for purposes of preserving
    9         the definition of the term “messenger ribonucleic acid
   10         vaccine” notwithstanding its scheduled repeal;
   11         repealing s. 9 of chapter 2023-43, Laws of Florida,
   12         which provides for the repeal of the definition of the
   13         term “messenger ribonucleic acid vaccine”; amending s.
   14         381.026, F.S.; revising the rights of patients, which
   15         each health care provider and facility are required to
   16         observe, to include that such facilities and providers
   17         may not discriminate based on a patient’s vaccination
   18         status; amending s. 381.986, F.S.; defining terms for
   19         purposes of background screening requirements for
   20         persons affiliated with medical marijuana treatment
   21         centers; requiring medical marijuana treatment centers
   22         to notify the Department of Health through electronic
   23         mail within a specified timeframe after an actual or
   24         attempted theft, diversion, or loss of marijuana;
   25         requiring medical marijuana treatment centers to
   26         report attempted thefts, in addition to actual thefts,
   27         to law enforcement within a specified timeframe;
   28         amending s. 381.988, F.S.; defining terms for purposes
   29         of background screening requirements for persons
   30         affiliated with medical marijuana testing
   31         laboratories; amending s. 456.0145, F.S.; revising
   32         eligibility criteria for licensure by endorsement
   33         under the MOBILE Act; amending ss. 458.315 and
   34         459.0076, F.S.; authorizing certain physician
   35         assistants to be issued temporary certificates for
   36         practice in areas of critical need; amending s.
   37         486.112, F.S.; defining the term “party state”;
   38         authorizing a remote state to issue subpoenas to
   39         individuals to testify or for the production of
   40         evidence from a party located in a party state;
   41         providing that such subpoenas are enforceable in the
   42         party state; requiring that investigative information
   43         pertaining to certain licensees in a certain system be
   44         available only to other party states; revising
   45         construction and severability of the compact to
   46         conform to changes made by the act; amending s.
   47         766.1115, F.S.; revising the definition of the term
   48         “health care provider” or “provider”; providing
   49         effective dates.
   50          
   51  Be It Enacted by the Legislature of the State of Florida:
   52  
   53         Section 1. Effective upon becoming a law, or, if this act
   54  fails to become a law until after June 1, 2025, operating
   55  retroactively to June 1, 2025, notwithstanding the scheduled
   56  repeal in section 9 of chapter 2023-43, Laws of Florida,
   57  paragraph (g) of subsection (2) of section 381.00316, Florida
   58  Statutes, is reenacted to read:
   59         381.00316 Discrimination by governmental and business
   60  entities based on health care choices; prohibition.—
   61         (2) As used in this section, the term:
   62         (g) “Messenger ribonucleic acid vaccine” means any vaccine
   63  that uses laboratory-produced messenger ribonucleic acid to
   64  trigger the human body’s immune system to generate an immune
   65  response.
   66         Section 2. Effective upon becoming a law, or, if this act
   67  fails to become a law until after June 1, 2025, operating
   68  retroactively to June 1, 2025, notwithstanding the scheduled
   69  repeal in section 9 of chapter 2023-43, Laws of Florida,
   70  paragraph (e) of subsection (1) of section 381.00319, Florida
   71  Statutes, is reenacted to read:
   72         381.00319 Prohibition on mask mandates and vaccination and
   73  testing mandates for educational institutions.—
   74         (1) For purposes of this section, the term:
   75         (e) “Messenger ribonucleic acid vaccine” has the same
   76  meaning as in s. 381.00316.
   77         Section 3. Effective upon becoming a law, or, if this act
   78  fails to become a law until after June 1, 2025, operating
   79  retroactively to June 1, 2025, section 9 of chapter 2023-43,
   80  Laws of Florida, is repealed.
   81         Section 4. Paragraphs (b) and (d) of subsection (4) and
   82  subsection (6) of section 381.026, Florida Statutes, are amended
   83  to read:
   84         381.026 Florida Patient’s Bill of Rights and
   85  Responsibilities.—
   86         (4) RIGHTS OF PATIENTS.—Each health care facility or
   87  provider shall observe the following standards:
   88         (b) Information.—
   89         1. A patient has the right to know the name, function, and
   90  qualifications of each health care provider who is providing
   91  medical services to the patient. A patient may request such
   92  information from his or her responsible provider or the health
   93  care facility in which he or she is receiving medical services.
   94         2. A patient in a health care facility has the right to
   95  know what patient support services are available in the
   96  facility.
   97         3. A patient has the right to be given by his or her health
   98  care provider information concerning diagnosis, planned course
   99  of treatment, alternatives, risks, and prognosis, unless it is
  100  medically inadvisable or impossible to give this information to
  101  the patient, in which case the information must be given to the
  102  patient’s guardian or a person designated as the patient’s
  103  representative. A patient has the right to refuse this
  104  information.
  105         4. A patient has the right to refuse any treatment based on
  106  information required by this paragraph, except as otherwise
  107  provided by law. The responsible provider shall document any
  108  such refusal.
  109         5. A patient in a health care facility has the right to
  110  know what facility rules and regulations apply to patient
  111  conduct.
  112         6. A patient has the right to express grievances to a
  113  health care provider, a health care facility, or the appropriate
  114  state licensing agency regarding alleged violations of patients’
  115  rights. A patient has the right to know the health care
  116  provider’s or health care facility’s procedures for expressing a
  117  grievance.
  118         7. A patient in a health care facility who does not speak
  119  English has the right to be provided an interpreter when
  120  receiving medical services if the facility has a person readily
  121  available who can interpret on behalf of the patient.
  122         8. A health care provider or health care facility shall
  123  respect a patient’s right to privacy and should refrain from
  124  making a written inquiry or asking questions concerning the
  125  ownership of a firearm or ammunition by the patient or by a
  126  family member of the patient, or the presence of a firearm in a
  127  private home or other domicile of the patient or a family member
  128  of the patient. Notwithstanding this provision, a health care
  129  provider or health care facility that in good faith believes
  130  that this information is relevant to the patient’s medical care
  131  or safety, or safety of others, may make such a verbal or
  132  written inquiry.
  133         9. A patient may decline to answer or provide any
  134  information regarding ownership of a firearm by the patient or a
  135  family member of the patient, or the presence of a firearm in
  136  the domicile of the patient or a family member of the patient. A
  137  patient’s decision not to answer a question relating to the
  138  presence or ownership of a firearm does not alter existing law
  139  regarding a physician’s authorization to choose his or her
  140  patients.
  141         10. A health care provider or health care facility may not
  142  discriminate against a patient based solely upon the patient’s
  143  exercise of the constitutional right to own and possess firearms
  144  or ammunition.
  145         11. A health care provider or health care facility shall
  146  respect a patient’s legal right to own or possess a firearm and
  147  should refrain from unnecessarily harassing a patient about
  148  firearm ownership during an examination.
  149         12.A health care provider or health care facility may not
  150  discriminate against a patient based solely upon the patient’s
  151  vaccination status.
  152         (d) Access to health care.—
  153         1. A patient has the right to impartial access to medical
  154  treatment or accommodations, regardless of race, national
  155  origin, religion, handicap, vaccination status, or source of
  156  payment.
  157         2. A patient has the right to treatment for any emergency
  158  medical condition that will deteriorate from failure to provide
  159  such treatment.
  160         3. A patient has the right to access any mode of treatment
  161  that is, in his or her own judgment and the judgment of his or
  162  her health care practitioner, in the best interests of the
  163  patient, including complementary or alternative health care
  164  treatments, in accordance with the provisions of s. 456.41.
  165         (6) SUMMARY OF RIGHTS AND RESPONSIBILITIES.—Any health care
  166  provider who treats a patient in an office or any health care
  167  facility licensed under chapter 395 that provides emergency
  168  services and care or outpatient services and care to a patient,
  169  or admits and treats a patient, shall adopt and make available
  170  to the patient, in writing, a statement of the rights and
  171  responsibilities of patients, including the following:
  172  
  173                SUMMARY OF THE FLORIDA PATIENT’S BILL              
  174                   OF RIGHTS AND RESPONSIBILITIES                  
  175  
  176         Florida law requires that your health care
  177         provider or health care facility recognize your rights
  178         while you are receiving medical care and that you
  179         respect the health care provider’s or health care
  180         facility’s right to expect certain behavior on the
  181         part of patients. You may request a copy of the full
  182         text of this law from your health care provider or
  183         health care facility. A summary of your rights and
  184         responsibilities follows:
  185         A patient has the right to be treated with
  186         courtesy and respect, with appreciation of his or her
  187         individual dignity, and with protection of his or her
  188         need for privacy.
  189         A patient has the right to a prompt and
  190         reasonable response to questions and requests.
  191         A patient has the right to know who is providing
  192         medical services and who is responsible for his or her
  193         care.
  194         A patient has the right to know what patient
  195         support services are available, including whether an
  196         interpreter is available if he or she does not speak
  197         English.
  198         A patient has the right to bring any person of
  199         his or her choosing to the patient-accessible areas of
  200         the health care facility or provider’s office to
  201         accompany the patient while the patient is receiving
  202         inpatient or outpatient treatment or is consulting
  203         with his or her health care provider, unless doing so
  204         would risk the safety or health of the patient, other
  205         patients, or staff of the facility or office or cannot
  206         be reasonably accommodated by the facility or
  207         provider.
  208         A patient has the right to know what rules and
  209         regulations apply to his or her conduct.
  210         A patient has the right to be given by the health
  211         care provider information concerning diagnosis,
  212         planned course of treatment, alternatives, risks, and
  213         prognosis.
  214         A patient has the right to refuse any treatment,
  215         except as otherwise provided by law.
  216         A patient has the right to be given, upon
  217         request, full information and necessary counseling on
  218         the availability of known financial resources for his
  219         or her care.
  220         A patient who is eligible for Medicare has the
  221         right to know, upon request and in advance of
  222         treatment, whether the health care provider or health
  223         care facility accepts the Medicare assignment rate.
  224         A patient has the right to receive, upon request,
  225         prior to treatment, a reasonable estimate of charges
  226         for medical care.
  227         A patient has the right to receive a copy of a
  228         reasonably clear and understandable, itemized bill
  229         and, upon request, to have the charges explained.
  230         A patient has the right to impartial access to
  231         medical treatment or accommodations, regardless of
  232         race, national origin, religion, handicap, vaccination
  233         status, or source of payment.
  234         A patient has the right to treatment for any
  235         emergency medical condition that will deteriorate from
  236         failure to provide treatment.
  237         A patient has the right to know if medical
  238         treatment is for purposes of experimental research and
  239         to give his or her consent or refusal to participate
  240         in such experimental research.
  241         A patient has the right to express grievances
  242         regarding any violation of his or her rights, as
  243         stated in Florida law, through the grievance procedure
  244         of the health care provider or health care facility
  245         which served him or her and to the appropriate state
  246         licensing agency.
  247         A patient is responsible for providing to the
  248         health care provider, to the best of his or her
  249         knowledge, accurate and complete information about
  250         present complaints, past illnesses, hospitalizations,
  251         medications, and other matters relating to his or her
  252         health.
  253         A patient is responsible for reporting unexpected
  254         changes in his or her condition to the health care
  255         provider.
  256         A patient is responsible for reporting to the
  257         health care provider whether he or she comprehends a
  258         contemplated course of action and what is expected of
  259         him or her.
  260         A patient is responsible for following the
  261         treatment plan recommended by the health care
  262         provider.
  263         A patient is responsible for keeping appointments
  264         and, when he or she is unable to do so for any reason,
  265         for notifying the health care provider or health care
  266         facility.
  267         A patient is responsible for his or her actions
  268         if he or she refuses treatment or does not follow the
  269         health care provider’s instructions.
  270         A patient is responsible for assuring that the
  271         financial obligations of his or her health care are
  272         fulfilled as promptly as possible.
  273         A patient is responsible for following health
  274         care facility rules and regulations affecting patient
  275         care and conduct.
  276  
  277         Section 5. Paragraphs (b), (e), and (f) of subsection (8)
  278  of section 381.986, Florida Statutes, are amended to read:
  279         381.986 Medical use of marijuana.—
  280         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
  281         (b) An applicant for licensure as a medical marijuana
  282  treatment center must shall apply to the department on a form
  283  prescribed by the department and adopted in rule. The department
  284  shall adopt rules pursuant to ss. 120.536(1) and 120.54
  285  establishing a procedure for the issuance and biennial renewal
  286  of licenses, including initial application and biennial renewal
  287  fees sufficient to cover the costs of implementing and
  288  administering this section, and establishing supplemental
  289  licensure fees for payment beginning May 1, 2018, sufficient to
  290  cover the costs of administering ss. 381.989 and 1004.4351. The
  291  department shall identify applicants with strong diversity plans
  292  reflecting this state’s commitment to diversity and implement
  293  training programs and other educational programs to enable
  294  minority persons and minority business enterprises, as defined
  295  in s. 288.703, and veteran business enterprises, as defined in
  296  s. 295.187, to compete for medical marijuana treatment center
  297  licensure and contracts. Subject to the requirements in
  298  subparagraphs (a)2.-4., the department shall issue a license to
  299  an applicant if the applicant meets the requirements of this
  300  section and pays the initial application fee. The department
  301  shall renew the licensure of a medical marijuana treatment
  302  center biennially if the licensee meets the requirements of this
  303  section and pays the biennial renewal fee. However, the
  304  department may not renew the license of a medical marijuana
  305  treatment center that has not begun to cultivate, process, and
  306  dispense marijuana by the date that the medical marijuana
  307  treatment center is required to renew its license. An individual
  308  may not be an applicant, owner, officer, board member, or
  309  manager on more than one application for licensure as a medical
  310  marijuana treatment center. An individual or entity may not be
  311  awarded more than one license as a medical marijuana treatment
  312  center. An applicant for licensure as a medical marijuana
  313  treatment center must demonstrate:
  314         1. That, for the 5 consecutive years before submitting the
  315  application, the applicant has been registered to do business in
  316  this the state.
  317         2. Possession of a valid certificate of registration issued
  318  by the Department of Agriculture and Consumer Services pursuant
  319  to s. 581.131.
  320         3. The technical and technological ability to cultivate and
  321  produce marijuana, including, but not limited to, low-THC
  322  cannabis.
  323         4. The ability to secure the premises, resources, and
  324  personnel necessary to operate as a medical marijuana treatment
  325  center.
  326         5. The ability to maintain accountability of all raw
  327  materials, finished products, and any byproducts to prevent
  328  diversion or unlawful access to or possession of these
  329  substances.
  330         6. An infrastructure reasonably located to dispense
  331  marijuana to registered qualified patients statewide or
  332  regionally as determined by the department.
  333         7. The financial ability to maintain operations for the
  334  duration of the 2-year approval cycle, including the provision
  335  of certified financial statements to the department.
  336         a. Upon approval, the applicant must post a $5 million
  337  performance bond issued by an authorized surety insurance
  338  company rated in one of the three highest rating categories by a
  339  nationally recognized rating service. However, a medical
  340  marijuana treatment center serving at least 1,000 qualified
  341  patients is only required to maintain a $2 million performance
  342  bond.
  343         b. In lieu of the performance bond required under sub
  344  subparagraph a., the applicant may provide an irrevocable letter
  345  of credit payable to the department or provide cash to the
  346  department. If provided with cash under this sub-subparagraph,
  347  the department must shall deposit the cash in the Grants and
  348  Donations Trust Fund within the Department of Health, subject to
  349  the same conditions as the bond regarding requirements for the
  350  applicant to forfeit ownership of the funds. If the funds
  351  deposited under this sub-subparagraph generate interest, the
  352  amount of that interest must shall be used by the department for
  353  the administration of this section.
  354         8. That all owners, officers, board members, and managers
  355  have passed a background screening pursuant to subsection (9).
  356  As used in this subparagraph, the term:
  357         a.“Manager” means any person with the authority to
  358  exercise or contribute to the operational control, direction, or
  359  management of an applicant or a medical marijuana treatment
  360  center or who has authority to supervise any employee of an
  361  applicant or a medical marijuana treatment center. The term
  362  includes an individual with the power or authority to direct or
  363  influence the direction or operation of an applicant or a
  364  medical marijuana treatment center through board membership,
  365  voting power, an agreement, or a contract.
  366         b.“Owner” means any person who owns or controls a 5
  367  percent or greater share of interests of the applicant or a
  368  medical marijuana treatment center which include beneficial or
  369  voting rights to interests. In the event that one person owns a
  370  beneficial right to interests and another person holds the
  371  voting rights with respect to such interests, then in such case,
  372  both are considered the owner of such interests.
  373         9. The employment of a medical director to supervise the
  374  activities of the medical marijuana treatment center.
  375         10. A diversity plan that promotes and ensures the
  376  involvement of minority persons and minority business
  377  enterprises, as defined in s. 288.703, or veteran business
  378  enterprises, as defined in s. 295.187, in ownership, management,
  379  and employment. An applicant for licensure renewal must show the
  380  effectiveness of the diversity plan by including the following
  381  with his or her application for renewal:
  382         a. Representation of minority persons and veterans in the
  383  medical marijuana treatment center’s workforce;
  384         b. Efforts to recruit minority persons and veterans for
  385  employment; and
  386         c. A record of contracts for services with minority
  387  business enterprises and veteran business enterprises.
  388         (e) A licensed medical marijuana treatment center shall
  389  cultivate, process, transport, and dispense marijuana for
  390  medical use. A licensed medical marijuana treatment center may
  391  not contract for services directly related to the cultivation,
  392  processing, and dispensing of marijuana or marijuana delivery
  393  devices, except that a medical marijuana treatment center
  394  licensed pursuant to subparagraph (a)1. may contract with a
  395  single entity for the cultivation, processing, transporting, and
  396  dispensing of marijuana and marijuana delivery devices. A
  397  licensed medical marijuana treatment center shall must, at all
  398  times, maintain compliance with the criteria demonstrated and
  399  representations made in the initial application and the criteria
  400  established in this subsection. Upon request, the department may
  401  grant a medical marijuana treatment center a variance from the
  402  representations made in the initial application. Consideration
  403  of such a request must shall be based upon the individual facts
  404  and circumstances surrounding the request. A variance may not be
  405  granted unless the requesting medical marijuana treatment center
  406  can demonstrate to the department that it has a proposed
  407  alternative to the specific representation made in its
  408  application which fulfills the same or a similar purpose as the
  409  specific representation in a way that the department can
  410  reasonably determine will not be a lower standard than the
  411  specific representation in the application. A variance may not
  412  be granted from the requirements in subparagraph 2. and
  413  subparagraphs (b)1. and 2.
  414         1. A licensed medical marijuana treatment center may
  415  transfer ownership to an individual or entity who meets the
  416  requirements of this section. A publicly traded corporation or
  417  publicly traded company that meets the requirements of this
  418  section is not precluded from ownership of a medical marijuana
  419  treatment center. To accommodate a change in ownership:
  420         a. The licensed medical marijuana treatment center shall
  421  notify the department in writing at least 60 days before the
  422  anticipated date of the change of ownership.
  423         b. The individual or entity applying for initial licensure
  424  due to a change of ownership must submit an application that
  425  must be received by the department at least 60 days before the
  426  date of change of ownership.
  427         c. Upon receipt of an application for a license, the
  428  department shall examine the application and, within 30 days
  429  after receipt, notify the applicant in writing of any apparent
  430  errors or omissions and request any additional information
  431  required.
  432         d. Requested information omitted from an application for
  433  licensure must be filed with the department within 21 days after
  434  the department’s request for omitted information or the
  435  application will shall be deemed incomplete and shall be
  436  withdrawn from further consideration and the fees shall be
  437  forfeited.
  438         e. Within 30 days after the receipt of a complete
  439  application, the department shall approve or deny the
  440  application.
  441         2. A medical marijuana treatment center, and any individual
  442  or entity who directly or indirectly owns, controls, or holds
  443  with power to vote 5 percent or more of the voting shares of a
  444  medical marijuana treatment center, may not acquire direct or
  445  indirect ownership or control of any voting shares or other form
  446  of ownership of any other medical marijuana treatment center.
  447         3. A medical marijuana treatment center may not enter into
  448  any form of profit-sharing arrangement with the property owner
  449  or lessor of any of its facilities where cultivation,
  450  processing, storing, or dispensing of marijuana and marijuana
  451  delivery devices occurs.
  452         4. All employees of a medical marijuana treatment center
  453  must be 21 years of age or older and have passed a background
  454  screening pursuant to subsection (9). As used in this
  455  subparagraph, the term “employee” means any person employed by a
  456  medical marijuana treatment center licensee in any capacity,
  457  including those whose duties involve any aspect of the
  458  cultivation, processing, transportation, or dispensing of
  459  marijuana. This requirement applies to all employees, regardless
  460  of the compensation received.
  461         5. Each medical marijuana treatment center must adopt and
  462  enforce policies and procedures to ensure employees and
  463  volunteers receive training on the legal requirements to
  464  dispense marijuana to qualified patients.
  465         6. When growing marijuana, a medical marijuana treatment
  466  center:
  467         a. May use pesticides determined by the department, after
  468  consultation with the Department of Agriculture and Consumer
  469  Services, to be safely applied to plants intended for human
  470  consumption, but may not use pesticides designated as
  471  restricted-use pesticides pursuant to s. 487.042.
  472         b. Must grow marijuana within an enclosed structure and in
  473  a room separate from any other plant.
  474         c. Must inspect seeds and growing plants for plant pests
  475  that endanger or threaten the horticultural and agricultural
  476  interests of the state in accordance with chapter 581 and any
  477  rules adopted thereunder.
  478         d. Must perform fumigation or treatment of plants, or
  479  remove and destroy infested or infected plants, in accordance
  480  with chapter 581 and any rules adopted thereunder.
  481         7. Each medical marijuana treatment center must produce and
  482  make available for purchase at least one low-THC cannabis
  483  product.
  484         8. A medical marijuana treatment center that produces
  485  edibles must hold a permit to operate as a food establishment
  486  pursuant to chapter 500, the Florida Food Safety Act, and must
  487  comply with all the requirements for food establishments
  488  pursuant to chapter 500 and any rules adopted thereunder.
  489  Edibles may not contain more than 200 milligrams of
  490  tetrahydrocannabinol, and a single serving portion of an edible
  491  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  492  may not have a potency variance of no greater than 15 percent.
  493  Marijuana products, including edibles, may not be attractive to
  494  children; be manufactured in the shape of humans, cartoons, or
  495  animals; be manufactured in a form that bears any reasonable
  496  resemblance to products available for consumption as
  497  commercially available candy; or contain any color additives. To
  498  discourage consumption of edibles by children, the department
  499  shall determine by rule any shapes, forms, and ingredients
  500  allowed and prohibited for edibles. Medical marijuana treatment
  501  centers may not begin processing or dispensing edibles until
  502  after the effective date of the rule. The department shall also
  503  adopt sanitation rules providing the standards and requirements
  504  for the storage, display, or dispensing of edibles.
  505         9. Within 12 months after licensure, a medical marijuana
  506  treatment center must demonstrate to the department that all of
  507  its processing facilities have passed a Food Safety Good
  508  Manufacturing Practices, such as Global Food Safety Initiative
  509  or equivalent, inspection by a nationally accredited certifying
  510  body. A medical marijuana treatment center must immediately stop
  511  processing at any facility which fails to pass this inspection
  512  until it demonstrates to the department that such facility has
  513  met this requirement.
  514         10. A medical marijuana treatment center that produces
  515  prerolled marijuana cigarettes may not use wrapping paper made
  516  with tobacco or hemp.
  517         11. When processing marijuana, a medical marijuana
  518  treatment center must:
  519         a. Process the marijuana within an enclosed structure and
  520  in a room separate from other plants or products.
  521         b. Comply with department rules when processing marijuana
  522  with hydrocarbon solvents or other solvents or gases exhibiting
  523  potential toxicity to humans. The department shall determine by
  524  rule the requirements for medical marijuana treatment centers to
  525  use such solvents or gases exhibiting potential toxicity to
  526  humans.
  527         c. Comply with federal and state laws and regulations and
  528  department rules for solid and liquid wastes. The department
  529  shall determine by rule procedures for the storage, handling,
  530  transportation, management, and disposal of solid and liquid
  531  waste generated during marijuana production and processing. The
  532  Department of Environmental Protection shall assist the
  533  department in developing such rules.
  534         d. Test the processed marijuana using a medical marijuana
  535  testing laboratory before it is dispensed. Results must be
  536  verified and signed by two medical marijuana treatment center
  537  employees. Before dispensing, the medical marijuana treatment
  538  center must determine that the test results indicate that low
  539  THC cannabis meets the definition of low-THC cannabis, the
  540  concentration of tetrahydrocannabinol meets the potency
  541  requirements of this section, the labeling of the concentration
  542  of tetrahydrocannabinol and cannabidiol is accurate, and all
  543  marijuana is safe for human consumption and free from
  544  contaminants that are unsafe for human consumption. The
  545  department shall determine by rule which contaminants must be
  546  tested for and the maximum levels of each contaminant which are
  547  safe for human consumption. The Department of Agriculture and
  548  Consumer Services shall assist the department in developing the
  549  testing requirements for contaminants that are unsafe for human
  550  consumption in edibles. The department shall also determine by
  551  rule the procedures for the treatment of marijuana that fails to
  552  meet the testing requirements of this section, s. 381.988, or
  553  department rule. The department may select samples of marijuana
  554  from a medical marijuana treatment center facility which shall
  555  be tested by the department to determine whether the marijuana
  556  meets the potency requirements of this section, is safe for
  557  human consumption, and is accurately labeled with the
  558  tetrahydrocannabinol and cannabidiol concentration or to verify
  559  the result of marijuana testing conducted by a marijuana testing
  560  laboratory. The department may also select samples of marijuana
  561  delivery devices from a medical marijuana treatment center to
  562  determine whether the marijuana delivery device is safe for use
  563  by qualified patients. A medical marijuana treatment center may
  564  not require payment from the department for the sample. A
  565  medical marijuana treatment center must recall marijuana,
  566  including all marijuana and marijuana products made from the
  567  same batch of marijuana, that fails to meet the potency
  568  requirements of this section, that is unsafe for human
  569  consumption, or for which the labeling of the
  570  tetrahydrocannabinol and cannabidiol concentration is
  571  inaccurate. The department shall adopt rules to establish
  572  marijuana potency variations of no greater than 15 percent using
  573  negotiated rulemaking pursuant to s. 120.54(2)(d) which accounts
  574  for, but is not limited to, time lapses between testing, testing
  575  methods, testing instruments, and types of marijuana sampled for
  576  testing. The department may not issue any recalls for product
  577  potency as it relates to product labeling before issuing a rule
  578  relating to potency variation standards. A medical marijuana
  579  treatment center must also recall all marijuana delivery devices
  580  determined to be unsafe for use by qualified patients. The
  581  medical marijuana treatment center must retain records of all
  582  testing and samples of each homogeneous batch of marijuana for
  583  at least 9 months. The medical marijuana treatment center must
  584  contract with a marijuana testing laboratory to perform audits
  585  on the medical marijuana treatment center’s standard operating
  586  procedures, testing records, and samples and provide the results
  587  to the department to confirm that the marijuana or low-THC
  588  cannabis meets the requirements of this section and that the
  589  marijuana or low-THC cannabis is safe for human consumption. A
  590  medical marijuana treatment center shall reserve two processed
  591  samples from each batch and retain such samples for at least 9
  592  months for the purpose of such audits. A medical marijuana
  593  treatment center may use a laboratory that has not been
  594  certified by the department under s. 381.988 until such time as
  595  at least one laboratory holds the required certification, but in
  596  no event later than July 1, 2018.
  597         e. Package the marijuana in compliance with the United
  598  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  599  1471 et seq.
  600         f. Package the marijuana in a receptacle that has a firmly
  601  affixed and legible label stating the following information:
  602         (I) The marijuana or low-THC cannabis meets the
  603  requirements of sub-subparagraph d.
  604         (II) The name of the medical marijuana treatment center
  605  from which the marijuana originates.
  606         (III) The batch number and harvest number from which the
  607  marijuana originates and the date dispensed.
  608         (IV) The name of the physician who issued the physician
  609  certification.
  610         (V) The name of the patient.
  611         (VI) The product name, if applicable, and dosage form,
  612  including concentration of tetrahydrocannabinol and cannabidiol.
  613  The product name may not contain wording commonly associated
  614  with products that are attractive to children or which promote
  615  the recreational use of marijuana.
  616         (VII) The recommended dose.
  617         (VIII) A warning that it is illegal to transfer medical
  618  marijuana to another person.
  619         (IX) A marijuana universal symbol developed by the
  620  department.
  621         12. The medical marijuana treatment center shall include in
  622  each package a patient package insert with information on the
  623  specific product dispensed related to:
  624         a. Clinical pharmacology.
  625         b. Indications and use.
  626         c. Dosage and administration.
  627         d. Dosage forms and strengths.
  628         e. Contraindications.
  629         f. Warnings and precautions.
  630         g. Adverse reactions.
  631         13. In addition to the packaging and labeling requirements
  632  specified in subparagraphs 11. and 12., marijuana in a form for
  633  smoking must be packaged in a sealed receptacle with a legible
  634  and prominent warning to keep away from children and a warning
  635  that states marijuana smoke contains carcinogens and may
  636  negatively affect health. Such receptacles for marijuana in a
  637  form for smoking must be plain, opaque, and white without
  638  depictions of the product or images other than the medical
  639  marijuana treatment center’s department-approved logo and the
  640  marijuana universal symbol.
  641         14. The department shall adopt rules to regulate the types,
  642  appearance, and labeling of marijuana delivery devices dispensed
  643  from a medical marijuana treatment center. The rules must
  644  require marijuana delivery devices to have an appearance
  645  consistent with medical use.
  646         15. Each edible must be individually sealed in plain,
  647  opaque wrapping marked only with the marijuana universal symbol.
  648  Where practical, each edible must be marked with the marijuana
  649  universal symbol. In addition to the packaging and labeling
  650  requirements in subparagraphs 11. and 12., edible receptacles
  651  must be plain, opaque, and white without depictions of the
  652  product or images other than the medical marijuana treatment
  653  center’s department-approved logo and the marijuana universal
  654  symbol. The receptacle must also include a list of all the
  655  edible’s ingredients, storage instructions, an expiration date,
  656  a legible and prominent warning to keep away from children and
  657  pets, and a warning that the edible has not been produced or
  658  inspected pursuant to federal food safety laws.
  659         16. When dispensing marijuana or a marijuana delivery
  660  device, a medical marijuana treatment center:
  661         a. May dispense any active, valid order for low-THC
  662  cannabis, medical cannabis and cannabis delivery devices issued
  663  pursuant to former s. 381.986, Florida Statutes 2016, which was
  664  entered into the medical marijuana use registry before July 1,
  665  2017.
  666         b. May not dispense more than a 70-day supply of marijuana
  667  within any 70-day period to a qualified patient or caregiver.
  668  May not dispense more than one 35-day supply of marijuana in a
  669  form for smoking within any 35-day period to a qualified patient
  670  or caregiver. A 35-day supply of marijuana in a form for smoking
  671  may not exceed 2.5 ounces unless an exception to this amount is
  672  approved by the department pursuant to paragraph (4)(f).
  673         c. Must have the medical marijuana treatment center’s
  674  employee who dispenses the marijuana or a marijuana delivery
  675  device enter into the medical marijuana use registry his or her
  676  name or unique employee identifier.
  677         d. Must verify that the qualified patient and the
  678  caregiver, if applicable, each have an active registration in
  679  the medical marijuana use registry and an active and valid
  680  medical marijuana use registry identification card, the amount
  681  and type of marijuana dispensed matches the physician
  682  certification in the medical marijuana use registry for that
  683  qualified patient, and the physician certification has not
  684  already been filled.
  685         e. May not dispense marijuana to a qualified patient who is
  686  younger than 18 years of age. If the qualified patient is
  687  younger than 18 years of age, marijuana may only be dispensed to
  688  the qualified patient’s caregiver.
  689         f. May not dispense or sell any other type of cannabis,
  690  alcohol, or illicit drug-related product, including pipes or
  691  wrapping papers made with tobacco or hemp, other than a
  692  marijuana delivery device required for the medical use of
  693  marijuana and which is specified in a physician certification.
  694         g. Must, upon dispensing the marijuana or marijuana
  695  delivery device, record in the registry the date, time,
  696  quantity, and form of marijuana dispensed; the type of marijuana
  697  delivery device dispensed; and the name and medical marijuana
  698  use registry identification number of the qualified patient or
  699  caregiver to whom the marijuana delivery device was dispensed.
  700         h. Must ensure that patient records are not visible to
  701  anyone other than the qualified patient, his or her caregiver,
  702  and authorized medical marijuana treatment center employees.
  703         (f) To ensure the safety and security of premises where the
  704  cultivation, processing, storing, or dispensing of marijuana
  705  occurs, and to maintain adequate controls against the diversion,
  706  theft, and loss of marijuana or marijuana delivery devices, a
  707  medical marijuana treatment center shall:
  708         1.a. Maintain a fully operational security alarm system
  709  that secures all entry points and perimeter windows and is
  710  equipped with motion detectors; pressure switches; and duress,
  711  panic, and hold-up alarms; and
  712         b. Maintain a video surveillance system that records
  713  continuously 24 hours a day and meets the following criteria:
  714         (I) Cameras are fixed in a place that allows for the clear
  715  identification of persons and activities in controlled areas of
  716  the premises. Controlled areas include grow rooms, processing
  717  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  718  rooms.
  719         (II) Cameras are fixed in entrances and exits to the
  720  premises, which must shall record from both indoor and outdoor,
  721  or ingress and egress, vantage points.
  722         (III) Recorded images must clearly and accurately display
  723  the time and date.
  724         (IV) Retain video surveillance recordings for at least 45
  725  days or longer upon the request of a law enforcement agency.
  726         2. Ensure that the medical marijuana treatment center’s
  727  outdoor premises have sufficient lighting from dusk until dawn.
  728         3. Ensure that the indoor premises where dispensing occurs
  729  includes a waiting area with sufficient space and seating to
  730  accommodate qualified patients and caregivers and at least one
  731  private consultation area that is isolated from the waiting area
  732  and area where dispensing occurs. A medical marijuana treatment
  733  center may not display products or dispense marijuana or
  734  marijuana delivery devices in the waiting area.
  735         4. Not dispense from its premises marijuana or a marijuana
  736  delivery device between the hours of 9 p.m. and 7 a.m., but may
  737  perform all other operations and deliver marijuana to qualified
  738  patients 24 hours a day.
  739         5. Store marijuana in a secured, locked room or a vault.
  740         6. Require at least two of its employees, or two employees
  741  of a security agency with whom it contracts, to be on the
  742  premises at all times where cultivation, processing, or storing
  743  of marijuana occurs.
  744         7. Require each employee or contractor to wear a photo
  745  identification badge at all times while on the premises.
  746         8. Require each visitor to wear a visitor pass at all times
  747  while on the premises.
  748         9. Implement an alcohol and drug-free workplace policy.
  749         10. Report to local law enforcement and notify the
  750  department through e-mail within 24 hours after the medical
  751  marijuana treatment center is notified or becomes aware of any
  752  actual or attempted the theft, diversion, or loss of marijuana.
  753         Section 6. Paragraph (d) of subsection (1) of section
  754  381.988, Florida Statutes, is amended to read:
  755         381.988 Medical marijuana testing laboratories; marijuana
  756  tests conducted by a certified laboratory.—
  757         (1) A person or entity seeking to be a certified marijuana
  758  testing laboratory must:
  759         (d) Require all employees, owners, and managers to submit
  760  to and pass a level 2 background screening pursuant to chapter
  761  435. The department shall deny certification if the person or
  762  entity seeking certification has a disqualifying offense as
  763  provided in s. 435.04 or has an arrest awaiting final
  764  disposition for, has been found guilty of, or has entered a plea
  765  of guilty or nolo contendere to, regardless of adjudication, any
  766  offense listed in chapter 837, chapter 895, or chapter 896 or
  767  similar law of another jurisdiction. Exemptions from
  768  disqualification as provided under s. 435.07 do not apply to
  769  this paragraph.
  770         1. As used in this paragraph, the term:
  771         a.“Employee” means any person whose duties or activities
  772  involve any aspect of regulatory compliance testing or research
  773  and development testing of marijuana for a certified marijuana
  774  testing laboratory, regardless of whether such person is
  775  compensated for his or her work.
  776         b.“Manager” means any person with authority to exercise or
  777  contribute to the operational control, direction, or management
  778  of an applicant or certified marijuana testing laboratory or who
  779  has authority to supervise any employee of an applicant or a
  780  certified marijuana testing laboratory. The term includes an
  781  individual with the power or authority to direct or influence
  782  the direction or operation of an applicant or a certified
  783  marijuana testing laboratory through board membership, voting
  784  power, an agreement, or a contract.
  785         c.“Owner” means any person who owns or controls a 5
  786  percent or greater share of interests of the applicant or a
  787  certified marijuana testing laboratory which include beneficial
  788  or voting rights to interests. In the event that one person owns
  789  a beneficial right to interests and another person holds the
  790  voting rights with respect to such interests, then in such case,
  791  both are considered the owner of such interests.
  792         2. Such employees, owners, and managers must submit a full
  793  set of fingerprints to the department or to a vendor, entity, or
  794  agency authorized by s. 943.053(13). The department, vendor,
  795  entity, or agency shall forward the fingerprints to the
  796  Department of Law Enforcement for state processing, and the
  797  Department of Law Enforcement shall forward the fingerprints to
  798  the Federal Bureau of Investigation for national processing.
  799         3.2. Fees for state and federal fingerprint processing and
  800  retention must shall be borne by the certified marijuana testing
  801  laboratory. The state cost for fingerprint processing is shall
  802  be as provided in s. 943.053(3)(e) for records provided to
  803  persons or entities other than those specified as exceptions
  804  therein.
  805         4.3. Fingerprints submitted to the Department of Law
  806  Enforcement pursuant to this paragraph must shall be retained by
  807  the Department of Law Enforcement as provided in s. 943.05(2)(g)
  808  and (h) and, when the Department of Law Enforcement begins
  809  participation in the program, enrolled in the Federal Bureau of
  810  Investigation’s national retained print arrest notification
  811  program. Any arrest record identified must shall be reported to
  812  the department.
  813         Section 7. Paragraph (c) of subsection (2) of section
  814  456.0145, Florida Statutes, is amended to read:
  815         456.0145 Mobile Opportunity by Interstate Licensure
  816  Endorsement (MOBILE) Act.—
  817         (2) LICENSURE BY ENDORSEMENT.—
  818         (c) A person is ineligible for a license under this section
  819  if he or she:
  820         1. Has a complaint, an allegation, or an investigation
  821  pending before a licensing entity in another state, the District
  822  of Columbia, or a possession or territory of the United States;
  823         2. Has been convicted of or pled nolo contendere to,
  824  regardless of adjudication, any felony or misdemeanor related to
  825  the practice of a health care profession;
  826         3. Has had a health care provider license revoked or
  827  suspended by another state, the District of Columbia, or a
  828  territory of the United States, or has voluntarily surrendered
  829  any such license in lieu of having disciplinary action taken
  830  against the license; or
  831         4. Has been reported to the National Practitioner Data
  832  Bank, unless the applicant has successfully appealed to have his
  833  or her name removed from the data bank. If the reported adverse
  834  action was a result of conduct that would not constitute a
  835  violation of any law or rule in this state, the board, or the
  836  department if there is no board, may:
  837         a.Approve the application;
  838         b.Approve the application with restrictions on the scope
  839  of practice of the licensee;
  840         c.Approve the application with placement of the licensee
  841  on probation for a period of time and subject to such conditions
  842  as the board, or the department if there is no board, may
  843  specify, including, but not limited to, requiring the applicant
  844  to submit to treatment, attend continuing education courses, or
  845  submit to reexamination; or
  846         d.Deny the application.
  847         Section 8. Subsection (1) of section 458.315, Florida
  848  Statutes, is amended to read:
  849         458.315 Temporary certificate for practice in areas of
  850  critical need.—
  851         (1) A physician or physician assistant who is licensed to
  852  practice in any jurisdiction of the United States and whose
  853  license is currently valid may be issued a temporary certificate
  854  for practice in areas of critical need. A physician seeking such
  855  certificate must pay an application fee of $300. A physician
  856  assistant licensed to practice in any state of the United States
  857  or the District of Columbia whose license is currently valid may
  858  be issued a temporary certificate for practice in areas of
  859  critical need.
  860         Section 9. Subsection (1) of section 459.0076, Florida
  861  Statutes, is amended to read:
  862         459.0076 Temporary certificate for practice in areas of
  863  critical need.—
  864         (1) A physician or physician assistant who holds a valid
  865  license to practice in any jurisdiction of the United States may
  866  be issued a temporary certificate for practice in areas of
  867  critical need. A physician seeking such certificate must pay an
  868  application fee of $300. A physician assistant licensed to
  869  practice in any state of the United States or the District of
  870  Columbia whose license is currently valid may be issued a
  871  temporary certificate for practice in areas of critical need.
  872         Section 10. Section 486.112, Florida Statutes, is amended
  873  to read:
  874         486.112 Physical Therapy Licensure Compact.—The Physical
  875  Therapy Licensure Compact is hereby enacted into law and entered
  876  into by this state with all other jurisdictions legally joining
  877  therein in the form substantially as follows:
  878  
  879                              ARTICLE I                            
  880                       PURPOSE AND OBJECTIVES                      
  881  
  882         (1) The purpose of the compact is to facilitate interstate
  883  practice of physical therapy with the goal of improving public
  884  access to physical therapy services. The compact preserves the
  885  regulatory authority of member states to protect public health
  886  and safety through their current systems of state licensure. For
  887  purposes of state regulation under the compact, the practice of
  888  physical therapy is deemed to have occurred in the state where
  889  the patient is located at the time physical therapy is provided
  890  to the patient.
  891         (2) The compact is designed to achieve all of the following
  892  objectives:
  893         (a) Increase public access to physical therapy services by
  894  providing for the mutual recognition of other member state
  895  licenses.
  896         (b) Enhance the states’ ability to protect the public’s
  897  health and safety.
  898         (c) Encourage the cooperation of member states in
  899  regulating multistate physical therapy practice.
  900         (d) Support spouses of relocating military members.
  901         (e) Enhance the exchange of licensure, investigative, and
  902  disciplinary information between member states.
  903         (f) Allow a remote state to hold a provider of services
  904  with a compact privilege in that state accountable to that
  905  state’s practice standards.
  906  
  907                             ARTICLE II                            
  908                             DEFINITIONS                           
  909  
  910         As used in the compact, and except as otherwise provided,
  911  the term:
  912         (1) “Active duty military” means full-time duty status in
  913  the active uniformed service of the United States, including
  914  members of the National Guard and Reserve on active duty orders
  915  pursuant to 10 U.S.C. chapter 1209 or chapter 1211.
  916         (2) “Adverse action” means disciplinary action taken by a
  917  physical therapy licensing board based upon misconduct,
  918  unacceptable performance, or a combination of both.
  919         (3) “Alternative program” means a nondisciplinary
  920  monitoring or practice remediation process approved by a state’s
  921  physical therapy licensing board. The term includes, but is not
  922  limited to, programs that address substance abuse issues.
  923         (4) “Compact privilege” means the authorization granted by
  924  a remote state to allow a licensee from another member state to
  925  practice as a physical therapist or physical therapist assistant
  926  in the remote state under its laws and rules.
  927         (5) “Continuing competence” means a requirement, as a
  928  condition of license renewal, to provide evidence of
  929  participation in, and completion of, educational and
  930  professional activities relevant to the practice of physical
  931  therapy.
  932         (6) “Data system” means the coordinated database and
  933  reporting system created by the Physical Therapy Compact
  934  Commission for the exchange of information between member states
  935  relating to licensees or applicants under the compact, including
  936  identifying information, licensure data, investigative
  937  information, adverse actions, nonconfidential information
  938  related to alternative program participation, any denials of
  939  applications for licensure, and other information as specified
  940  by commission rule.
  941         (7) “Encumbered license” means a license that a physical
  942  therapy licensing board has limited in any way.
  943         (8) “Executive board” means a group of directors elected or
  944  appointed to act on behalf of, and within the powers granted to
  945  them by, the commission.
  946         (9) “Home state” means the member state that is the
  947  licensee’s primary state of residence.
  948         (10) “Investigative information” means information,
  949  records, and documents received or generated by a physical
  950  therapy licensing board pursuant to an investigation.
  951         (11) “Jurisprudence requirement” means the assessment of an
  952  individual’s knowledge of the laws and rules governing the
  953  practice of physical therapy in a specific state.
  954         (12) “Licensee” means an individual who currently holds an
  955  authorization from a state to practice as a physical therapist
  956  or physical therapist assistant.
  957         (13) “Member state” means a state that has enacted the
  958  compact.
  959         (14) “Party state” means any member state in which a
  960  licensee holds a current license or compact privilege or is
  961  applying for a license or compact privilege.
  962         (15) “Physical therapist” means an individual licensed by a
  963  state to practice physical therapy.
  964         (16)(15) “Physical therapist assistant” means an individual
  965  licensed by a state to assist a physical therapist in specified
  966  areas of physical therapy.
  967         (17)(16) “Physical therapy” or “the practice of physical
  968  therapy” means the care and services provided by or under the
  969  direction and supervision of a licensed physical therapist.
  970         (18)(17) “Physical Therapy Compact Commission” or
  971  “commission” means the national administrative body whose
  972  membership consists of all states that have enacted the compact.
  973         (19)(18) “Physical therapy licensing board” means the
  974  agency of a state which is responsible for the licensing and
  975  regulation of physical therapists and physical therapist
  976  assistants.
  977         (20)(19) “Remote state” means a member state other than the
  978  home state where a licensee is exercising or seeking to exercise
  979  the compact privilege.
  980         (21)(20) “Rule” means a regulation, principle, or directive
  981  adopted by the commission which has the force of law.
  982         (22)(21) “State” means any state, commonwealth, district,
  983  or territory of the United States of America which regulates the
  984  practice of physical therapy.
  985  
  986                             ARTICLE III                           
  987                 STATE PARTICIPATION IN THE COMPACT                
  988  
  989         (1) To participate in the compact, a state must do all of
  990  the following:
  991         (a) Participate fully in the commission’s data system,
  992  including using the commission’s unique identifier, as defined
  993  by commission rule.
  994         (b) Have a mechanism in place for receiving and
  995  investigating complaints about licensees.
  996         (c) Notify the commission, in accordance with the terms of
  997  the compact and rules, of any adverse action or the availability
  998  of investigative information regarding a licensee.
  999         (d) Fully implement a criminal background check
 1000  requirement, within a timeframe established by commission rule,
 1001  which uses results from the Federal Bureau of Investigation
 1002  record search on criminal background checks to make licensure
 1003  decisions in accordance with subsection (2).
 1004         (e) Comply with the commission’s rules.
 1005         (f) Use a recognized national examination as a requirement
 1006  for licensure pursuant to the commission’s rules.
 1007         (g) Have continuing competence requirements as a condition
 1008  for license renewal.
 1009         (2) Upon adoption of the compact, a member state has the
 1010  authority to obtain biometric-based information from each
 1011  licensee applying for a compact privilege and submit this
 1012  information to the Federal Bureau of Investigation for a
 1013  criminal background check in accordance with 28 U.S.C. s. 534
 1014  and 34 U.S.C. s. 40316.
 1015         (3) A member state must grant the compact privilege to a
 1016  licensee holding a valid unencumbered license in another member
 1017  state in accordance with the terms of the compact and rules.
 1018  
 1019                             ARTICLE IV                            
 1020                          COMPACT PRIVILEGE                        
 1021  
 1022         (1) To exercise the compact privilege under the compact, a
 1023  licensee must satisfy all of the following conditions:
 1024         (a) Hold a license in the home state.
 1025         (b) Not have an encumbrance on any state license.
 1026         (c) Be eligible for a compact privilege in all member
 1027  states in accordance with subsections (4), (7), and (8).
 1028         (d) Not have had an adverse action against any license or
 1029  compact privilege within the preceding 2 years.
 1030         (e) Notify the commission that the licensee is seeking the
 1031  compact privilege within a remote state.
 1032         (f) Meet any jurisprudence requirements established by the
 1033  remote state in which the licensee is seeking a compact
 1034  privilege.
 1035         (g) Report to the commission adverse action taken by any
 1036  nonmember state within 30 days after the date the adverse action
 1037  is taken.
 1038         (2) The compact privilege is valid until the expiration
 1039  date of the home license. The licensee must continue to meet the
 1040  requirements of subsection (1) to maintain the compact privilege
 1041  in a remote state.
 1042         (3) A licensee providing physical therapy in a remote state
 1043  under the compact privilege must comply with the laws and rules
 1044  of the remote state.
 1045         (4) A licensee providing physical therapy in a remote state
 1046  is subject to that state’s regulatory authority. A remote state
 1047  may, in accordance with due process and that state’s laws,
 1048  remove a licensee’s compact privilege in the remote state for a
 1049  specific period of time, impose fines, and take any other
 1050  necessary actions to protect the health and safety of its
 1051  citizens. The licensee is not eligible for a compact privilege
 1052  in any member state until the specific period of time for
 1053  removal has ended and all fines are paid.
 1054         (5) If a home state license is encumbered, the licensee
 1055  loses the compact privilege in any remote state until the
 1056  following conditions are met:
 1057         (a) The home state license is no longer encumbered.
 1058         (b) Two years have elapsed from the date of the adverse
 1059  action.
 1060         (6) Once an encumbered license in the home state is
 1061  restored to good standing, the licensee must meet the
 1062  requirements of subsection (1) to obtain a compact privilege in
 1063  any remote state.
 1064         (7) If a licensee’s compact privilege in any remote state
 1065  is removed, the licensee loses the compact privilege in all
 1066  remote states until all of the following conditions are met:
 1067         (a) The specific period of time for which the compact
 1068  privilege was removed has ended.
 1069         (b) All fines have been paid.
 1070         (c) Two years have elapsed from the date of the adverse
 1071  action.
 1072         (8) Once the requirements of subsection (7) have been met,
 1073  the licensee must meet the requirements of subsection (1) to
 1074  obtain a compact privilege in a remote state.
 1075  
 1076                              ARTICLE V                            
 1077                   ACTIVE DUTY MILITARY PERSONNEL                  
 1078                          AND THEIR SPOUSES                        
 1079  
 1080         A licensee who is active duty military or is the spouse of
 1081  an individual who is active duty military may choose any of the
 1082  following locations to designate his or her home state:
 1083         (1) Home of record.
 1084         (2) Permanent change of station location.
 1085         (3) State of current residence, if it is different from the
 1086  home of record or permanent change of station location.
 1087  
 1088                             ARTICLE VI                            
 1089                           ADVERSE ACTIONS                         
 1090  
 1091         (1) A home state has exclusive power to impose adverse
 1092  action against a license issued by the home state.
 1093         (2) A home state may take adverse action based on the
 1094  investigative information of a remote state, so long as the home
 1095  state follows its own procedures for imposing adverse action.
 1096         (3) The compact does not override a member state’s decision
 1097  that participation in an alternative program may be used in lieu
 1098  of adverse action and that such participation remain nonpublic
 1099  if required by the member state’s laws. Member states must
 1100  require licensees who enter any alternative programs in lieu of
 1101  discipline to agree not to practice in any other member state
 1102  during the term of the alternative program without prior
 1103  authorization from such other member state.
 1104         (4) A member state may investigate actual or alleged
 1105  violations of the laws and rules for the practice of physical
 1106  therapy committed in any other member state by a physical
 1107  therapist or physical therapist assistant practicing under the
 1108  compact who holds a license or compact privilege in such other
 1109  member state.
 1110         (5) A remote state may do any of the following:
 1111         (a) Take adverse actions as set forth in subsection (4) of
 1112  Article IV against a licensee’s compact privilege in the state.
 1113         (b) Issue subpoenas for both hearings and investigations
 1114  which require the attendance and testimony of witnesses and the
 1115  production of evidence. Subpoenas issued by a physical therapy
 1116  licensing board in a party member state for the attendance and
 1117  testimony of witnesses or for the production of evidence from
 1118  another party member state must be enforced in the latter state
 1119  by any court of competent jurisdiction, according to the
 1120  practice and procedure of that court applicable to subpoenas
 1121  issued in proceedings pending before it. The issuing authority
 1122  shall pay any witness fees, travel expenses, mileage, and other
 1123  fees required by the service laws of the state where the
 1124  witnesses or evidence is located.
 1125         (c) If otherwise permitted by state law, recover from the
 1126  licensee the costs of investigations and disposition of cases
 1127  resulting from any adverse action taken against that licensee.
 1128         (6)(a) In addition to the authority granted to a member
 1129  state by its respective physical therapy practice act or other
 1130  applicable state law, a member state may participate with other
 1131  member states in joint investigations of licensees.
 1132         (b) Member states shall share any investigative,
 1133  litigation, or compliance materials in furtherance of any joint
 1134  or individual investigation initiated under the compact.
 1135  
 1136                             ARTICLE VII                           
 1137                        ESTABLISHMENT OF THE                       
 1138                 PHYSICAL THERAPY COMPACT COMMISSION               
 1139  
 1140         (1) COMMISSION CREATED.—The member states hereby create and
 1141  establish a joint public agency known as the Physical Therapy
 1142  Compact Commission:
 1143         (a) The commission is an instrumentality of the member
 1144  states.
 1145         (b) Venue is proper, and judicial proceedings by or against
 1146  the commission must be brought solely and exclusively, in a
 1147  court of competent jurisdiction where the principal office of
 1148  the commission is located. The commission may waive venue and
 1149  jurisdictional defenses to the extent it adopts or consents to
 1150  participate in alternative dispute resolution proceedings.
 1151         (c) The compact may not be construed to be a waiver of
 1152  sovereign immunity.
 1153         (2) MEMBERSHIP, VOTING, AND MEETINGS.—
 1154         (a) Each member state has and is limited to one delegate
 1155  selected by that member state’s physical therapy licensing board
 1156  to serve on the commission. The delegate must be a current
 1157  member of the physical therapy licensing board who is a physical
 1158  therapist, a physical therapist assistant, a public member, or
 1159  the board administrator.
 1160         (b) A delegate may be removed or suspended from office as
 1161  provided by the law of the state from which the delegate is
 1162  appointed. Any vacancy occurring on the commission must be
 1163  filled by the physical therapy licensing board of the member
 1164  state for which the vacancy exists.
 1165         (c) Each delegate is entitled to one vote with regard to
 1166  the adoption of rules and bylaws and shall otherwise have an
 1167  opportunity to participate in the business and affairs of the
 1168  commission.
 1169         (d) A delegate shall vote in person or by such other means
 1170  as provided in the bylaws. The bylaws may provide for delegates’
 1171  participation in meetings by telephone or other means of
 1172  communication.
 1173         (e) The commission shall meet at least once during each
 1174  calendar year. Additional meetings may be held as set forth in
 1175  the bylaws.
 1176         (f) All meetings must be open to the public, and public
 1177  notice of meetings must be given in the same manner as required
 1178  under the rulemaking provisions in Article IX.
 1179         (g) The commission or the executive board or other
 1180  committees of the commission may convene in a closed, nonpublic
 1181  meeting if the commission or executive board or other committees
 1182  of the commission must discuss any of the following:
 1183         1. Noncompliance of a member state with its obligations
 1184  under the compact.
 1185         2. The employment, compensation, or discipline of, or other
 1186  matters, practices, or procedures related to, specific employees
 1187  or other matters related to the commission’s internal personnel
 1188  practices and procedures.
 1189         3. Current, threatened, or reasonably anticipated
 1190  litigation against the commission, executive board, or other
 1191  committees of the commission.
 1192         4. Negotiation of contracts for the purchase, lease, or
 1193  sale of goods, services, or real estate.
 1194         5. An accusation of any person of a crime or a formal
 1195  censure of any person.
 1196         6. Information disclosing trade secrets or commercial or
 1197  financial information that is privileged or confidential.
 1198         7. Information of a personal nature where disclosure would
 1199  constitute a clearly unwarranted invasion of personal privacy.
 1200         8. Investigatory records compiled for law enforcement
 1201  purposes.
 1202         9. Information related to any investigative reports
 1203  prepared by or on behalf of or for use of the commission or
 1204  other committee charged with responsibility for investigation or
 1205  determination of compliance issues pursuant to the compact.
 1206         10. Matters specifically exempted from disclosure by
 1207  federal or member state statute.
 1208         (h) If a meeting, or portion of a meeting, is closed
 1209  pursuant to this subsection, the commission’s legal counsel or
 1210  designee must certify that the meeting may be closed and must
 1211  reference each relevant exempting provision.
 1212         (i) The commission shall keep minutes that fully and
 1213  clearly describe all matters discussed in a meeting and shall
 1214  provide a full and accurate summary of actions taken and the
 1215  reasons therefor, including a description of the views
 1216  expressed. All documents considered in connection with an action
 1217  must be identified in the minutes. All minutes and documents of
 1218  a closed meeting must remain under seal, subject to release only
 1219  by a majority vote of the commission or order of a court of
 1220  competent jurisdiction.
 1221         (3) DUTIES.—The commission shall do all of the following:
 1222         (a) Establish the fiscal year of the commission.
 1223         (b) Establish bylaws.
 1224         (c) Maintain its financial records in accordance with the
 1225  bylaws.
 1226         (d) Meet and take such actions as are consistent with the
 1227  provisions of the compact and the bylaws.
 1228         (4) POWERS.—The commission may do any of the following:
 1229         (a) Adopt uniform rules to facilitate and coordinate
 1230  implementation and administration of the compact. The rules have
 1231  the force and effect of law and are binding in all member
 1232  states.
 1233         (b) Bring and prosecute legal proceedings or actions in the
 1234  name of the commission, provided that the standing of any state
 1235  physical therapy licensing board to sue or be sued under
 1236  applicable law is not affected.
 1237         (c) Purchase and maintain insurance and bonds.
 1238         (d) Borrow, accept, or contract for services of personnel,
 1239  including, but not limited to, employees of a member state.
 1240         (e) Hire employees and elect or appoint officers; fix the
 1241  compensation of, define the duties of, and grant appropriate
 1242  authority to such individuals to carry out the purposes of the
 1243  compact; and establish the commission’s personnel policies and
 1244  programs relating to conflicts of interest, qualifications of
 1245  personnel, and other related personnel matters.
 1246         (f) Accept any appropriate donations and grants of money,
 1247  equipment, supplies, materials, and services and receive, use,
 1248  and dispose of the same, provided that at all times the
 1249  commission avoids any appearance of impropriety or conflict of
 1250  interest.
 1251         (g) Lease, purchase, accept appropriate gifts or donations
 1252  of, or otherwise own, hold, improve, or use any property, real,
 1253  personal, or mixed, provided that at all times the commission
 1254  avoids any appearance of impropriety or conflict of interest.
 1255         (h) Sell, convey, mortgage, pledge, lease, exchange,
 1256  abandon, or otherwise dispose of any property, real, personal,
 1257  or mixed.
 1258         (i) Establish a budget and make expenditures.
 1259         (j) Borrow money.
 1260         (k) Appoint committees, including standing committees
 1261  composed of members, state regulators, state legislators or
 1262  their representatives, and consumer representatives, and such
 1263  other interested persons as may be designated in the compact and
 1264  the bylaws.
 1265         (l) Provide information to, receive information from, and
 1266  cooperate with law enforcement agencies.
 1267         (m) Establish and elect an executive board.
 1268         (n) Perform such other functions as may be necessary or
 1269  appropriate to achieve the purposes of the compact consistent
 1270  with the state regulation of physical therapy licensure and
 1271  practice.
 1272         (5) THE EXECUTIVE BOARD.—
 1273         (a) The executive board may act on behalf of the commission
 1274  according to the terms of the compact.
 1275         (b) The executive board shall be composed of the following
 1276  nine members:
 1277         1. Seven voting members who are elected by the commission
 1278  from the current membership of the commission.
 1279         2. One ex officio, nonvoting member from the recognized
 1280  national physical therapy professional association.
 1281         3. One ex officio, nonvoting member from the recognized
 1282  membership organization of the physical therapy licensing
 1283  boards.
 1284         (c) The ex officio members shall be selected by their
 1285  respective organizations.
 1286         (d) The commission may remove any member of the executive
 1287  board as provided in its bylaws.
 1288         (e) The executive board shall meet at least annually.
 1289         (f) The executive board shall do all of the following:
 1290         1. Recommend to the entire commission changes to the rules
 1291  or bylaws, compact legislation, fees paid by compact member
 1292  states, such as annual dues, and any commission compact fee
 1293  charged to licensees for the compact privilege.
 1294         2. Ensure compact administration services are appropriately
 1295  provided, contractually or otherwise.
 1296         3. Prepare and recommend the budget.
 1297         4. Maintain financial records on behalf of the commission.
 1298         5. Monitor compact compliance of member states and provide
 1299  compliance reports to the commission.
 1300         6. Establish additional committees as necessary.
 1301         7. Perform other duties as provided in the rules or bylaws.
 1302         (6) FINANCING OF THE COMMISSION.—
 1303         (a) The commission shall pay, or provide for the payment
 1304  of, the reasonable expenses of its establishment, organization,
 1305  and ongoing activities.
 1306         (b) The commission may accept any appropriate revenue
 1307  sources, donations, and grants of money, equipment, supplies,
 1308  materials, and services.
 1309         (c) The commission may levy and collect an annual
 1310  assessment from each member state or impose fees on other
 1311  parties to cover the cost of the operations and activities of
 1312  the commission and its staff. Such assessments and fees must
 1313  total to an amount sufficient to cover the commission’s annual
 1314  budget as approved each year for which revenue is not provided
 1315  by other sources. The aggregate annual assessment amount must be
 1316  allocated based upon a formula to be determined by the
 1317  commission, which shall adopt a rule binding upon all member
 1318  states.
 1319         (d) The commission may not incur obligations of any kind
 1320  before securing the funds adequate to meet such obligations; nor
 1321  may the commission pledge the credit of any of the member
 1322  states, except by and with the authority of the member state.
 1323         (e) The commission shall keep accurate accounts of all
 1324  receipts and disbursements. The receipts and disbursements of
 1325  the commission are subject to the audit and accounting
 1326  procedures established under its bylaws. However, all receipts
 1327  and disbursements of funds handled by the commission must be
 1328  audited yearly by a certified or licensed public accountant, and
 1329  the report of the audit must be included in and become part of
 1330  the annual report of the commission.
 1331         (7) QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION.—
 1332         (a) The members, officers, executive director, employees,
 1333  and representatives of the commission are immune from suit and
 1334  liability, whether personally or in their official capacity, for
 1335  any claim for damage to or loss of property or personal injury
 1336  or other civil liability caused by or arising out of any actual
 1337  or alleged act, error, or omission that occurred, or that the
 1338  person against whom the claim is made had a reasonable basis for
 1339  believing occurred, within the scope of commission employment,
 1340  duties, or responsibilities. However, this paragraph may not be
 1341  construed to protect any such person from suit or liability for
 1342  any damage, loss, injury, or liability caused by the
 1343  intentional, willful, or wanton misconduct of that person.
 1344         (b) The commission shall defend any member, officer,
 1345  executive director, employee, or representative of the
 1346  commission in any civil action seeking to impose liability
 1347  arising out of any actual or alleged act, error, or omission
 1348  that occurred within the scope of commission employment, duties,
 1349  or responsibilities, or that the person against whom the claim
 1350  is made had a reasonable basis for believing occurred within the
 1351  scope of commission employment, duties, or responsibilities.
 1352  However, this subsection may not be construed to prohibit any
 1353  member, officer, executive director, employee, or representative
 1354  of the commission from retaining his or her own counsel or to
 1355  require the commission to defend such person if the actual or
 1356  alleged act, error, or omission resulted from that person’s
 1357  intentional, willful, or wanton misconduct.
 1358         (c) The commission shall indemnify and hold harmless any
 1359  member, officer, executive director, employee, or representative
 1360  of the commission for the amount of any settlement or judgment
 1361  obtained against that person arising out of any actual or
 1362  alleged act, error, or omission that occurred within the scope
 1363  of commission employment, duties, or responsibilities, or that
 1364  such person had a reasonable basis for believing occurred within
 1365  the scope of commission employment, duties, or responsibilities,
 1366  provided that the actual or alleged act, error, or omission did
 1367  not result from the intentional, willful, or wanton misconduct
 1368  of that person.
 1369  
 1370                            ARTICLE VIII                           
 1371                             DATA SYSTEM                           
 1372  
 1373         (1) The commission shall provide for the development,
 1374  maintenance, and use of a coordinated database and reporting
 1375  system containing licensure, adverse action, and investigative
 1376  information on all licensees in member states.
 1377         (2) Notwithstanding any other provision of state law to the
 1378  contrary, a member state shall submit a uniform data set to the
 1379  data system on all individuals to whom the compact is applicable
 1380  as required by the rules of the commission, which data set must
 1381  include all of the following:
 1382         (a) Identifying information.
 1383         (b) Licensure data.
 1384         (c) Investigative information.
 1385         (d) Adverse actions against a license or compact privilege.
 1386         (e) Nonconfidential information related to alternative
 1387  program participation.
 1388         (f) Any denial of application for licensure, and the reason
 1389  for such denial.
 1390         (g) Other information that may facilitate the
 1391  administration of the compact, as determined by the rules of the
 1392  commission.
 1393         (3) Investigative information in the system pertaining to a
 1394  licensee in any member state must be available only to other
 1395  party member states.
 1396         (4) The commission shall promptly notify all member states
 1397  of any adverse action taken against a licensee or an individual
 1398  applying for a license in a member state. Adverse action
 1399  information pertaining to a licensee in any member state must be
 1400  available to all other member states.
 1401         (5) Member states contributing information to the data
 1402  system may designate information that may not be shared with the
 1403  public without the express permission of the contributing state.
 1404         (6) Any information submitted to the data system which is
 1405  subsequently required to be expunged by the laws of the member
 1406  state contributing the information must be removed from the data
 1407  system.
 1408  
 1409                             ARTICLE IX                            
 1410                             RULEMAKING                            
 1411  
 1412         (1) The commission shall exercise its rulemaking powers
 1413  pursuant to the criteria set forth in this article and the rules
 1414  adopted thereunder. Rules and amendments become binding as of
 1415  the date specified in each rule or amendment.
 1416         (2) If a majority of the legislatures of the member states
 1417  rejects a rule by enactment of a statute or resolution in the
 1418  same manner used to adopt the compact within 4 years after the
 1419  date of adoption of the rule, such rule does not have further
 1420  force and effect in any member state.
 1421         (3) Rules or amendments to the rules must be adopted at a
 1422  regular or special meeting of the commission.
 1423         (4) Before adoption of a final rule by the commission, and
 1424  at least 30 days before the meeting at which the rule will be
 1425  considered and voted upon, the commission must file a notice of
 1426  proposed rulemaking on all of the following:
 1427         (a) The website of the commission or another publicly
 1428  accessible platform.
 1429         (b) The website of each member state physical therapy
 1430  licensing board or another publicly accessible platform or the
 1431  publication in which each state would otherwise publish proposed
 1432  rules.
 1433         (5) The notice of proposed rulemaking must include all of
 1434  the following:
 1435         (a) The proposed date, time, and location of the meeting in
 1436  which the rule or amendment will be considered and voted upon.
 1437         (b) The text of the proposed rule or amendment and the
 1438  reason for the proposed rule.
 1439         (c) A request for comments on the proposed rule or
 1440  amendment from any interested person.
 1441         (d) The manner in which interested persons may submit
 1442  notice to the commission of their intention to attend the public
 1443  hearing and any written comments.
 1444         (6) Before adoption of a proposed rule or amendment, the
 1445  commission must allow persons to submit written data, facts,
 1446  opinions, and arguments, which must be made available to the
 1447  public.
 1448         (7) The commission must grant an opportunity for a public
 1449  hearing before it adopts a rule or an amendment if a hearing is
 1450  requested by any of the following:
 1451         (a) At least 25 persons.
 1452         (b) A state or federal governmental subdivision or agency.
 1453         (c) An association having at least 25 members.
 1454         (8) If a scheduled public hearing is held on the proposed
 1455  rule or amendment, the commission must publish the date, time,
 1456  and location of the hearing. If the hearing is held through
 1457  electronic means, the commission must publish the mechanism for
 1458  access to the electronic hearing.
 1459         (a) All persons wishing to be heard at the hearing must
 1460  notify the executive director of the commission or another
 1461  designated member in writing of their desire to appear and
 1462  testify at the hearing at least 5 business days before the
 1463  scheduled date of the hearing.
 1464         (b) Hearings must be conducted in a manner providing each
 1465  person who wishes to comment a fair and reasonable opportunity
 1466  to comment orally or in writing.
 1467         (c) All hearings must be recorded. A copy of the recording
 1468  must be made available on request.
 1469         (d) This article may not be construed to require a separate
 1470  hearing on each rule. Rules may be grouped for the convenience
 1471  of the commission at hearings required by this article.
 1472         (9) Following the scheduled hearing date, or by the close
 1473  of business on the scheduled hearing date if the hearing was not
 1474  held, the commission shall consider all written and oral
 1475  comments received.
 1476         (10) If no written notice of intent to attend the public
 1477  hearing by interested parties is received, the commission may
 1478  proceed with adoption of the proposed rule without a public
 1479  hearing.
 1480         (11) The commission shall, by majority vote of all members,
 1481  take final action on the proposed rule and shall determine the
 1482  effective date of the rule, if any, based on the rulemaking
 1483  record and the full text of the rule.
 1484         (12) Upon determination that an emergency exists, the
 1485  commission may consider and adopt an emergency rule without
 1486  prior notice, opportunity for comment, or hearing, provided that
 1487  the usual rulemaking procedures provided in the compact and in
 1488  this article are retroactively applied to the rule as soon as
 1489  reasonably possible, in no event later than 90 days after the
 1490  effective date of the rule. For the purposes of this subsection,
 1491  an emergency rule is one that must be adopted immediately in
 1492  order to do any of the following:
 1493         (a) Meet an imminent threat to public health, safety, or
 1494  welfare.
 1495         (b) Prevent a loss of commission or member state funds.
 1496         (c) Meet a deadline for the adoption of an administrative
 1497  rule established by federal law or rule.
 1498         (d) Protect public health and safety.
 1499         (13) The commission or an authorized committee of the
 1500  commission may direct revisions to a previously adopted rule or
 1501  amendment for purposes of correcting typographical errors,
 1502  errors in format, errors in consistency, or grammatical errors.
 1503  Public notice of any revisions must be posted on the website of
 1504  the commission. The revision is subject to challenge by any
 1505  person for a period of 30 days after posting. The revision may
 1506  be challenged only on grounds that the revision results in a
 1507  material change to a rule. A challenge must be made in writing
 1508  and delivered to the chair of the commission before the end of
 1509  the notice period. If a challenge is not made, the revision
 1510  takes effect without further action. If the revision is
 1511  challenged, the revision may not take effect without the
 1512  approval of the commission.
 1513  
 1514                              ARTICLE X                            
 1515                   OVERSIGHT, DISPUTE RESOLUTION,                  
 1516                           AND ENFORCEMENT                         
 1517  
 1518         (1) OVERSIGHT.—
 1519         (a) The executive, legislative, and judicial branches of
 1520  state government in each member state shall enforce the compact
 1521  and take all actions necessary and appropriate to carry out the
 1522  compact’s purposes and intent. The provisions of the compact and
 1523  the rules adopted pursuant thereto shall have standing as
 1524  statutory law.
 1525         (b) All courts shall take judicial notice of the compact
 1526  and the rules in any judicial or administrative proceeding in a
 1527  member state pertaining to the subject matter of the compact
 1528  which may affect the powers, responsibilities, or actions of the
 1529  commission.
 1530         (c) The commission is entitled to receive service of
 1531  process in any such proceeding and has standing to intervene in
 1532  such a proceeding for all purposes. Failure to provide service
 1533  of process to the commission renders a judgment or an order void
 1534  as to the commission, the compact, or the adopted rules.
 1535         (2) DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION.—
 1536         (a) If the commission determines that a member state has
 1537  defaulted in the performance of its obligations or
 1538  responsibilities under the compact or the adopted rules, the
 1539  commission must do all of the following:
 1540         1. Provide written notice to the defaulting state and other
 1541  member states of the nature of the default, the proposed means
 1542  of curing the default, and any other action to be taken by the
 1543  commission.
 1544         2. Provide remedial training and specific technical
 1545  assistance regarding the default.
 1546         (b) If a state in default fails to cure the default, the
 1547  defaulting state may be terminated from the compact upon an
 1548  affirmative vote of a majority of the member states, and all
 1549  rights, privileges, and benefits conferred by the compact may be
 1550  terminated on the effective date of termination. A cure of the
 1551  default does not relieve the offending state of obligations or
 1552  liabilities incurred during the period of default.
 1553         (c) Termination of membership in the compact may be imposed
 1554  only after all other means of securing compliance have been
 1555  exhausted. The commission shall give notice of intent to suspend
 1556  or terminate a defaulting member state to the governor and
 1557  majority and minority leaders of the defaulting state’s
 1558  legislature and to each of the member states.
 1559         (d) A state that has been terminated from the compact is
 1560  responsible for all assessments, obligations, and liabilities
 1561  incurred through the effective date of termination, including
 1562  obligations that extend beyond the effective date of
 1563  termination.
 1564         (e) The commission does not bear any costs related to a
 1565  state that is found to be in default or that has been terminated
 1566  from the compact, unless agreed upon in writing between the
 1567  commission and the defaulting state.
 1568         (f) The defaulting state may appeal the action of the
 1569  commission by petitioning the United States District Court for
 1570  the District of Columbia or the federal district where the
 1571  commission has its principal offices. The prevailing member
 1572  shall be awarded all costs of such litigation, including
 1573  reasonable attorney fees.
 1574         (3) DISPUTE RESOLUTION.—
 1575         (a) Upon request by a member state, the commission must
 1576  attempt to resolve disputes related to the compact which arise
 1577  among member states and between member and nonmember states.
 1578         (b) The commission shall adopt a rule providing for both
 1579  mediation and binding dispute resolution for disputes as
 1580  appropriate.
 1581         (4) ENFORCEMENT.—
 1582         (a) The commission, in the reasonable exercise of its
 1583  discretion, shall enforce the compact and the commission’s
 1584  rules.
 1585         (b) By majority vote, the commission may initiate legal
 1586  action in the United States District Court for the District of
 1587  Columbia or the federal district where the commission has its
 1588  principal offices against a member state in default to enforce
 1589  compliance with the provisions of the compact and its adopted
 1590  rules and bylaws. The relief sought may include both injunctive
 1591  relief and damages. In the event judicial enforcement is
 1592  necessary, the prevailing member shall be awarded all costs of
 1593  such litigation, including reasonable attorney fees.
 1594         (c) The remedies under this article are not the exclusive
 1595  remedies of the commission. The commission may pursue any other
 1596  remedies available under federal or state law.
 1597  
 1598                             ARTICLE XI                            
 1599                    DATE OF IMPLEMENTATION OF THE                  
 1600                      PHYSICAL THERAPY COMPACT                     
 1601                        AND ASSOCIATED RULES;                      
 1602                     WITHDRAWAL; AND AMENDMENTS                    
 1603  
 1604         (1) The compact becomes effective on the date that the
 1605  compact statute is enacted into law in the tenth member state.
 1606  The provisions that become effective at that time are limited to
 1607  the powers granted to the commission relating to assembly and
 1608  the adoption of rules. Thereafter, the commission shall meet and
 1609  exercise rulemaking powers necessary for the implementation and
 1610  administration of the compact.
 1611         (2) Any state that joins the compact subsequent to the
 1612  commission’s initial adoption of the rules is subject to the
 1613  rules as they exist on the date that the compact becomes law in
 1614  that state. Any rule that has been previously adopted by the
 1615  commission has the full force and effect of law on the day the
 1616  compact becomes law in that state.
 1617         (3) Any member state may withdraw from the compact by
 1618  enacting a statute repealing the same.
 1619         (a) A member state’s withdrawal does not take effect until
 1620  6 months after enactment of the repealing statute.
 1621         (b) Withdrawal does not affect the continuing requirement
 1622  of the withdrawing state’s physical therapy licensing board to
 1623  comply with the investigative and adverse action reporting
 1624  requirements of this act before the effective date of
 1625  withdrawal.
 1626         (4) The compact may not be construed to invalidate or
 1627  prevent any physical therapy licensure agreement or other
 1628  cooperative arrangement between a member state and a nonmember
 1629  state which does not conflict with the provisions of the
 1630  compact.
 1631         (5) The compact may be amended by the member states. An
 1632  amendment to the compact does not become effective and binding
 1633  upon any member state until it is enacted into the laws of all
 1634  member states.
 1635  
 1636                             ARTICLE XII                           
 1637                    CONSTRUCTION AND SEVERABILITY                  
 1638  
 1639         The compact must be liberally construed so as to carry out
 1640  the purposes thereof. The provisions of the compact are
 1641  severable, and if any phrase, clause, sentence, or provision of
 1642  the compact is declared to be contrary to the constitution of
 1643  any party member state or of the United States or the
 1644  applicability thereof to any government, agency, person, or
 1645  circumstance is held invalid, the validity of the remainder of
 1646  the compact and the applicability thereof to any government,
 1647  agency, person, or circumstance is not affected thereby. If the
 1648  compact is held contrary to the constitution of any party member
 1649  state, the compact remains in full force and effect as to the
 1650  remaining party member states and in full force and effect as to
 1651  the party member state affected as to all severable matters.
 1652         Section 11. Paragraph (d) of subsection (3) of section
 1653  766.1115, Florida Statutes, is amended to read:
 1654         766.1115 Health care providers; creation of agency
 1655  relationship with governmental contractors.—
 1656         (3) DEFINITIONS.—As used in this section, the term:
 1657         (d) “Health care provider” or “provider” means:
 1658         1. A birth center licensed under chapter 383.
 1659         2. An ambulatory surgical center licensed under chapter
 1660  395.
 1661         3. A hospital licensed under chapter 395.
 1662         4. A physician or physician assistant licensed under
 1663  chapter 458.
 1664         5. An osteopathic physician or osteopathic physician
 1665  assistant licensed under chapter 459.
 1666         6. A chiropractic physician licensed under chapter 460.
 1667         7. A podiatric physician licensed under chapter 461.
 1668         8. A registered nurse, nurse midwife, licensed practical
 1669  nurse, or advanced practice registered nurse licensed or
 1670  registered under part I of chapter 464 or any facility which
 1671  employs nurses licensed or registered under part I of chapter
 1672  464 to supply all or part of the care delivered under this
 1673  section.
 1674         9. A midwife licensed under chapter 467.
 1675         10. A health maintenance organization certificated under
 1676  part I of chapter 641.
 1677         11. A health care professional association and its
 1678  employees or a corporate medical group and its employees.
 1679         12. Any other medical facility the primary purpose of which
 1680  is to deliver human medical diagnostic services or which
 1681  delivers nonsurgical human medical treatment, and which includes
 1682  an office maintained by a provider.
 1683         13. A dentist or dental hygienist licensed under chapter
 1684  466.
 1685         14. A free clinic that delivers only medical diagnostic
 1686  services or nonsurgical medical treatment free of charge to all
 1687  low-income recipients.
 1688         15. Any other health care professional, practitioner,
 1689  provider, or facility under contract with a governmental
 1690  contractor, including a student enrolled in an accredited
 1691  program that prepares the student for licensure as any one of
 1692  the professionals listed in subparagraphs 4.-9. and 13.
 1693  
 1694  The term includes any nonprofit corporation qualified as exempt
 1695  from federal income taxation under s. 501(a) of the Internal
 1696  Revenue Code, and described in s. 501(c) of the Internal Revenue
 1697  Code, which delivers health care services provided by licensed
 1698  professionals listed in this paragraph, any federally funded
 1699  community health center, and any volunteer corporation or
 1700  volunteer health care provider that delivers health care
 1701  services.
 1702         Section 12. Except as otherwise expressly provided in this
 1703  act and except for this section, which shall take effect upon
 1704  this act becoming a law, or, if this act fails to become a law
 1705  until after June 1, 2025, it shall take effect upon becoming a
 1706  law and shall operate retroactively to June 1, 2025, this act
 1707  shall take effect July 1, 2025.