SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
CHAMBER ACTION
Senate House
.
.
1 .
.
2 .
.
3 .
.
4 ______________________________________________________________
5
6
7
8
9
10 ______________________________________________________________
11 Senator Peaden moved the following amendment:
12
13 Senate Amendment (with title amendment)
14 Delete everything after the enacting clause
15
16 and insert:
17 Section 1. Present subsections (3) through (8) of
18 section 20.43, Florida Statutes, are redesignated as
19 subsections (4) through (9), respectively, and a new
20 subsection (3) is added to that section, to read:
21 20.43 Department of Health.--There is created a
22 Department of Health.
23 (3) There is established within the Department of
24 Health the Office of Minority Health.
25 Section 2. Paragraph (e) of subsection (2) of section
26 381.7353, Florida Statutes, is amended to read:
27 381.7353 Reducing Racial and Ethnic Health
28 Disparities: Closing the Gap grant program; administration;
29 department duties.--
30 (2) The department shall:
31 (e) Coordinate with existing community-based programs,
1
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 such as chronic disease community intervention programs,
2 cancer prevention and control programs, diabetes control
3 programs, oral health care programs, the Healthy Start
4 program, the Florida KidCare Program, the HIV/AIDS program,
5 immunization programs, and other related programs at the state
6 and local levels, to avoid duplication of effort and promote
7 consistency.
8 Section 3. Paragraph (a) of subsection (2) of section
9 381.7355, Florida Statutes, is amended to read:
10 381.7355 Project requirements; review criteria.--
11 (2) A proposal must include each of the following
12 elements:
13 (a) The purpose and objectives of the proposal,
14 including identification of the particular racial or ethnic
15 disparity the project will address. The proposal must address
16 one or more of the following priority areas:
17 1. Decreasing racial and ethnic disparities in
18 maternal and infant mortality rates.
19 2. Decreasing racial and ethnic disparities in
20 morbidity and mortality rates relating to cancer.
21 3. Decreasing racial and ethnic disparities in
22 morbidity and mortality rates relating to HIV/AIDS.
23 4. Decreasing racial and ethnic disparities in
24 morbidity and mortality rates relating to cardiovascular
25 disease.
26 5. Decreasing racial and ethnic disparities in
27 morbidity and mortality rates relating to diabetes.
28 6. Increasing adult and child immunization rates in
29 certain racial and ethnic populations.
30 7. Decreasing racial and ethnic disparities relating
31 to oral health care.
2
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Section 4. Subsection (5) of section 393.064, Florida
2 Statutes, is amended to read:
3 393.064 Prevention.--
4 (5) The Department of Health Children and Family
5 Services shall have the authority, within available resources,
6 to contract for the supervision and management of the Raymond
7 C. Philips Research and Education Unit, and such contract
8 shall include specific program objectives.
9 Section 5. Subsection (10) of section 394.4615,
10 Florida Statutes, is amended to read:
11 394.4615 Clinical records; confidentiality.--
12 (10) Patients shall have reasonable access to their
13 clinical records, unless such access is determined by the
14 patient's physician to be a danger to the patient's life or
15 safety harmful to the patient. If the patient's right to
16 inspect his or her clinical record is restricted by the
17 facility, written notice of such restriction shall be given to
18 the patient and the patient's guardian, guardian advocate,
19 attorney, and representative. In addition, the restriction
20 shall be recorded in the clinical record, together with the
21 reasons for it. The restriction of a patient's right to
22 inspect his or her clinical record shall expire after 7 days
23 but may be renewed, after review, for subsequent 7-day
24 periods.
25 Section 6. Paragraphs (a) and (e) of subsection (4)
26 and paragraph (b) of subsection (7) of section 395.3025,
27 Florida Statutes, are amended, and a new paragraph (l) is
28 added to subsection (4) of that section, to read:
29 395.3025 Patient and personnel records; copies;
30 examination.--
31 (4) Patient records are confidential and must not be
3
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 disclosed without the consent of the person to whom they
2 pertain, but appropriate disclosure may be made without such
3 consent to:
4 (a) Licensed Facility personnel and all licensed
5 health care practitioners attending physicians for use in
6 connection with the treatment of the patient.
7 (e) The Department of Health agency upon subpoena
8 issued pursuant to s. 456.071, but the records obtained
9 thereby must be used solely for the purpose of the department
10 agency and the appropriate professional board in its
11 investigation, prosecution, and appeal of disciplinary
12 proceedings. The administrator or records custodian in a
13 facility licensed under this chapter shall certify that a true
14 and complete copy of the records requested pursuant to a
15 subpoena or patient release have been provided to the
16 department or otherwise identify those documents that have not
17 been provided. If the department agency requests copies of the
18 records, the facility shall charge no more than its actual
19 copying costs, including reasonable staff time. The records
20 must be sealed and must not be available to the public
21 pursuant to s. 119.07(1) or any other statute providing access
22 to records, nor may they be available to the public as part of
23 the record of investigation for and prosecution in
24 disciplinary proceedings made available to the public by the
25 department agency or the appropriate regulatory board.
26 However, the department agency must make available, upon
27 written request by a practitioner against whom probable cause
28 has been found, any such records that form the basis of the
29 determination of probable cause.
30 (l) Researchers or facility personnel for research
31 purposes, provided that the researchers or facility personnel
4
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 demonstrate compliance with the requirements of 45 C.F.R. s.
2 164.512(i).
3 (7)
4 (b) Absent a specific written release or authorization
5 permitting utilization of patient information for solicitation
6 or marketing the sale of goods or services, any use of such
7 that information for that purpose those purposes is
8 prohibited. For purposes of this paragraph, the term
9 "marketing" is defined as set forth in 45 C.F.R. s. 164.501.
10 Section 7. Paragraph (b) of subsection (2) of section
11 395.7015, Florida Statutes, is amended to read:
12 395.7015 Annual assessment on health care entities.--
13 (2) There is imposed an annual assessment against
14 certain health care entities as described in this section:
15 (b) For the purpose of this section, "health care
16 entities" include the following:
17 1. Ambulatory surgical centers and mobile surgical
18 facilities licensed under s. 395.003. This subsection shall
19 only apply to mobile surgical facilities operating under
20 contracts entered into on or after July 1, 1998.
21 2. Clinical laboratories licensed under s. 483.091,
22 excluding any hospital laboratory defined under s. 483.041(6),
23 any clinical laboratory operated by the state or a political
24 subdivision of the state, any clinical laboratory which
25 qualifies as an exempt organization under s. 501(c)(3) of the
26 Internal Revenue Code of 1986, as amended, and which receives
27 70 percent or more of its gross revenues from services to
28 charity patients or Medicaid patients, and any blood, plasma,
29 or tissue bank procuring, storing, or distributing blood,
30 plasma, or tissue either for future manufacture or research or
31 distributed on a nonprofit basis, and further excluding any
5
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 clinical laboratory which is wholly owned and operated by 6 or
2 fewer physicians who are licensed pursuant to chapter 458 or
3 chapter 459 and who practice in the same group practice, and
4 at which no clinical laboratory work is performed for patients
5 referred by any health care provider who is not a member of
6 the same group.
7 3. Diagnostic-imaging centers that are freestanding
8 outpatient facilities that provide specialized services for
9 the identification or determination of a disease through
10 examination and also provide sophisticated radiological
11 services, and in which services are rendered by a physician
12 licensed by the Board of Medicine under s. 458.311, s.
13 458.313, or s. 458.315 458.317, or by an osteopathic physician
14 licensed by the Board of Osteopathic Medicine under s.
15 459.006, s. 459.007, or s. 459.0075. For purposes of this
16 paragraph, "sophisticated radiological services" means the
17 following: magnetic resonance imaging; nuclear medicine;
18 angiography; arteriography; computed tomography; positron
19 emission tomography; digital vascular imaging; bronchography;
20 lymphangiography; splenography; ultrasound, excluding
21 ultrasound providers that are part of a private physician's
22 office practice or when ultrasound is provided by two or more
23 physicians licensed under chapter 458 or chapter 459 who are
24 members of the same professional association and who practice
25 in the same medical specialties; and such other sophisticated
26 radiological services, excluding mammography, as adopted in
27 rule by the board.
28 Section 8. Subsection (10) of section 400.141, Florida
29 Statutes, is amended to read:
30 400.141 Administration and management of nursing home
31 facilities.--Every licensed facility shall comply with all
6
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 applicable standards and rules of the agency and shall:
2 (10) Keep full records of resident admissions and
3 discharges; medical and general health status, including
4 medical records, personal and social history, and identity and
5 address of next of kin or other persons who may have
6 responsibility for the affairs of the residents; and
7 individual resident care plans including, but not limited to,
8 prescribed services, service frequency and duration, and
9 service goals. The records shall be open to inspection by the
10 agency. A certified complete copy of the records shall be
11 provided to the Department of Health upon subpoena issued
12 pursuant to ss. 456.057 and 456.071. The provisions of chapter
13 456 apply to records obtained pursuant to this section.
14
15 Facilities that have been awarded a Gold Seal under the
16 program established in s. 400.235 may develop a plan to
17 provide certified nursing assistant training as prescribed by
18 federal regulations and state rules and may apply to the
19 agency for approval of their program.
20 Section 9. Subsection (3) is added to section 400.145,
21 Florida Statutes, to read:
22 400.145 Records of care and treatment of resident;
23 copies to be furnished.--
24 (3) The administrator or records custodian in a
25 facility licensed under this part shall certify that a true
26 and complete copy of the records requested pursuant to a
27 subpoena or patient release has been provided to the
28 department or otherwise identify those documents that have not
29 been provided.
30 Section 10. Subsection (4) of section 400.211, Florida
31 Statutes, is amended to read:
7
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 400.211 Persons employed as nursing assistants;
2 certification requirement.--
3 (4) When employed by a nursing home facility for a
4 12-month period or longer, a nursing assistant, to maintain
5 certification, shall submit to a performance review every 12
6 months and must receive regular inservice education based on
7 the outcome of such reviews. The inservice training must:
8 (a) Be sufficient to ensure the continuing competence
9 of nursing assistants, must be at least 12 18 hours per year,
10 and may include hours accrued under s. 464.203(7)(8);
11 (b) Include, at a minimum:
12 1. Techniques for assisting with eating and proper
13 feeding;
14 2. Principles of adequate nutrition and hydration;
15 3. Techniques for assisting and responding to the
16 cognitively impaired resident or the resident with difficult
17 behaviors;
18 4. Techniques for caring for the resident at the
19 end-of-life; and
20 5. Recognizing changes that place a resident at risk
21 for pressure ulcers and falls; and
22 (c) Address areas of weakness as determined in nursing
23 assistant performance reviews and may address the special
24 needs of residents as determined by the nursing home facility
25 staff.
26
27 Costs associated with this training may not be reimbursed from
28 additional Medicaid funding through interim rate adjustments.
29 Section 11. Section 400.455, Florida Statutes, is
30 created to read:
31 400.455 Certified copy of subpoenaed records.--Upon a
8
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 subpoena issued by the Department of Health pursuant to s.
2 456.057 or s. 456.071, a certified complete copy of the
3 requested records shall be provided. The provisions of chapter
4 456 apply to the records obtained pursuant to this section.
5 Section 12. Subsection (7) is added to section
6 456.017, Florida Statutes, to read:
7 456.017 Examinations.--
8 (7) The department may post examination scores
9 electronically on the Internet in lieu of mailing the scores
10 to each applicant. Such electronic posting of the examination
11 scores shall meet the requirements of chapter 120 if the
12 department also posts with the examination scores a
13 notification of rights, as set forth in chapter 120. The date
14 of receipt for purposes of the requirements of chapter 120
15 shall be the date the examination scores are posted
16 electronically. The department shall also notify the examinee
17 when scores are posted electronically of the availability of a
18 post-examination review, if applicable.
19 Section 13. Paragraph (b) of subsection (1) of section
20 456.0375, Florida Statutes, is amended to read:
21 456.0375 Registration of certain clinics;
22 requirements; discipline; exemptions.--
23 (1)
24 (b) For purposes of this section, the term "clinic"
25 does not include and the registration requirements herein do
26 not apply to:
27 1. Entities licensed or registered by the state
28 pursuant to chapter 390, chapter 394, chapter 395, chapter
29 397, chapter 400, chapter 463, chapter 465, chapter 466,
30 chapter 478, chapter 480, or chapter 484.
31 2. Preferred provider organizations under s. 627.6471,
9
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 exclusive provider organizations under s. 627.6472, and
2 independent provider organizations.
3 3.2. Entities exempt from federal taxation under 26
4 U.S.C. s. 501(c)(3) and community college and university
5 clinics.
6 4.3. Sole proprietorships, group practices,
7 partnerships, or corporations that provide health care
8 services by licensed health care practitioners pursuant to
9 chapters 457, 458, 459, 460, 461, 462, 463, 466, 467, 484,
10 486, 490, 491, or part I, part III, part X, part XIII, or part
11 XIV of chapter 468, or s. 464.012, which are wholly owned by
12 licensed health care practitioners or the licensed health care
13 practitioner and the spouse, parent, or child of a licensed
14 health care practitioner, so long as one of the owners who is
15 a licensed health care practitioner is supervising the
16 administrative services performed therein and is legally
17 responsible for the entity's compliance with all federal and
18 state laws. However, no health care practitioner may supervise
19 the health care delivery services beyond the scope of the
20 practitioner's license. Supervision of the administrative
21 services for compliance with federal and state laws is
22 different and distinct from supervision of the delivery of
23 health care services. Health care delivery is the sole
24 responsibility of the health care practitioner delivering
25 health care services.
26 5. Clinical facilities affiliated with an accredited
27 medical school at which training is provided for medical
28 students, residents, or fellows.
29 6. Entities that own, directly or indirectly, entities
30 licensed or registered by the state pursuant to chapter 390,
31 chapter 394, chapter 395, chapter 397, chapter 400, chapter
10
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 463, chapter 465, chapter 466, chapter 478, chapter 480, or
2 chapter 484.
3 7. Entities that are owned, directly or indirectly, by
4 an entity licensed or registered by the state pursuant to
5 chapter 390, chapter 394, chapter 395, chapter 397, chapter
6 400, chapter 463, chapter 465, chapter 466, chapter 478,
7 chapter 480, or chapter 484.
8 8. Entities that are under common ownership, directly
9 or indirectly, with an entity licensed or registered by the
10 state pursuant to chapter 390, chapter 394, chapter 395,
11 chapter 397, chapter 400, chapter 463, chapter 465, chapter
12 466, chapter 478, chapter 480, or chapter 484.
13 9. Clinical facilities affiliated with an accredited
14 medical school at which training is provided for medical
15 students, residents, or fellows.
16 Section 14. The amendment made by this act to section
17 456.0375(1)(b)6.-9., Florida Statutes, is intended to clarify
18 the legislative intent of that paragraph as it existed at the
19 time the paragraph initially took effect. Accordingly, section
20 456.0375(1)(b)6.-9., Florida Statutes, as amended by this act
21 shall operate retroactively to October 1, 2001.
22 Section 15. Paragraph (a) of subsection (4) of section
23 456.039, Florida Statutes, is amended to read:
24 456.039 Designated health care professionals;
25 information required for licensure.--
26 (4)(a) An applicant for initial licensure must submit
27 a set of fingerprints to the Department of Health in
28 accordance with s. 458.311, s. 458.3115, s. 458.3124, s.
29 458.313, s. 459.0055, s. 460.406, or s. 461.006.
30 Section 16. Subsection (4) of section 456.041, Florida
31 Statutes, is amended to read:
11
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 456.041 Practitioner profile; creation.--
2 (4) The Department of Health shall include, with
3 respect to a practitioner licensed under chapter 458 or
4 chapter 459, a statement of how the practitioner has elected
5 to comply with the financial responsibility requirements of s.
6 458.320 or s. 459.0085. The department shall include, with
7 respect to practitioners subject to s. 456.048, a statement of
8 how the practitioner has elected to comply with the financial
9 responsibility requirements of that section. The department
10 shall include, with respect to practitioners licensed under
11 chapter 458, chapter 459, or chapter 461, information relating
12 to liability actions which has been reported under s. 456.049
13 or s. 627.912 within the previous 10 years for any paid claim
14 of $50,000 or more that exceeds $5,000. Such claims
15 information shall be reported in the context of comparing an
16 individual practitioner's claims to the experience of other
17 practitioners within the same specialty, or profession if the
18 practitioner is not a specialist, to the extent such
19 information is available to the Department of Health. If
20 information relating to a liability action is included in a
21 practitioner's practitioner profile, the profile must also
22 include the following statement: "Settlement of a claim may
23 occur for a variety of reasons that do not necessarily reflect
24 negatively on the professional competence or conduct of the
25 practitioner. A payment in settlement of a medical
26 malpractice action or claim should not be construed as
27 creating a presumption that medical malpractice has occurred."
28 Section 17. Subsection (1) of section 456.049, Florida
29 Statutes, is amended to read:
30 456.049 Health care practitioners; reports on
31 professional liability claims and actions.--
12
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (1) Any practitioner of medicine licensed pursuant to
2 the provisions of chapter 458, practitioner of osteopathic
3 medicine licensed pursuant to the provisions of chapter 459,
4 podiatric physician licensed pursuant to the provisions of
5 chapter 461, or dentist licensed pursuant to the provisions of
6 chapter 466 shall report to the department any claim or action
7 for damages for personal injury alleged to have been caused by
8 error, omission, or negligence in the performance of such
9 licensee's professional services or based on a claimed
10 performance of professional services without consent if the
11 claim was not covered by an insurer required to report under
12 s. 627.912 and the claim resulted in:
13 (a) A final judgment of $50,000 or more or, for a
14 dentist licensed under chapter 466, a final judgment of
15 $25,000 or more in any amount.
16 (b) A settlement of $50,000 or more or, for a dentist
17 licensed under chapter 466, a settlement of $25,000 or more in
18 any amount.
19 (c) A final disposition not resulting in payment on
20 behalf of the licensee.
21
22 Reports shall be filed with the department no later than 60
23 days following the occurrence of any event listed in paragraph
24 (a), paragraph (b), or paragraph (c).
25 Section 18. Paragraph (a) of subsection (7) and
26 subsection (16) of section 456.057, Florida Statutes, are
27 amended to read:
28 456.057 Ownership and control of patient records;
29 report or copies of records to be furnished.--
30 (7)(a)1. The department may obtain patient records
31 pursuant to a subpoena without written authorization from the
13
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 patient if the department and the probable cause panel of the
2 appropriate board, if any, find reasonable cause to believe
3 that a health care practitioner has excessively or
4 inappropriately prescribed any controlled substance specified
5 in chapter 893 in violation of this chapter or any
6 professional practice act or that a health care practitioner
7 has practiced his or her profession below that level of care,
8 skill, and treatment required as defined by this chapter or
9 any professional practice act and also find that appropriate,
10 reasonable attempts were made to obtain a patient release.
11 However, if the matter under investigation was reported to the
12 department as a professional liability claim or action
13 pursuant to s. 456.049 or s. 627.912, an attempt to obtain a
14 patient release is not required.
15 2. The department may obtain patient records and
16 insurance information pursuant to a subpoena without written
17 authorization from the patient if the department and the
18 probable cause panel of the appropriate board, if any, find
19 reasonable cause to believe that a health care practitioner
20 has provided inadequate medical care based on termination of
21 insurance and also find that appropriate, reasonable attempts
22 were made to obtain a patient release.
23 3. The department may obtain patient records, billing
24 records, insurance information, provider contracts, and all
25 attachments thereto pursuant to a subpoena without written
26 authorization from the patient if the department and probable
27 cause panel of the appropriate board, if any, find reasonable
28 cause to believe that a health care practitioner has submitted
29 a claim, statement, or bill using a billing code that would
30 result in payment greater in amount than would be paid using a
31 billing code that accurately describes the services performed,
14
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 requested payment for services that were not performed by that
2 health care practitioner, used information derived from a
3 written report of an automobile accident generated pursuant to
4 chapter 316 to solicit or obtain patients personally or
5 through an agent regardless of whether the information is
6 derived directly from the report or a summary of that report
7 or from another person, solicited patients fraudulently,
8 received a kickback as defined in s. 456.054, violated the
9 patient brokering provisions of s. 817.505, or presented or
10 caused to be presented a false or fraudulent insurance claim
11 within the meaning of s. 817.234(1)(a), and also find that,
12 within the meaning of s. 817.234(1)(a), patient authorization
13 cannot be obtained because the patient cannot be located or is
14 deceased, incapacitated, or suspected of being a participant
15 in the fraud or scheme, and if the subpoena is issued for
16 specific and relevant records.
17 4. For purposes of this subsection, the department may
18 obtain patient records pursuant to a subpoena without written
19 authorization from the patient if the patient refuses to
20 cooperate or if, in the department's discretion, an attempt to
21 obtain a patient release would be detrimental to the
22 investigation.
23 (16) A health care practitioner or records owner
24 furnishing copies of reports or records or making the reports
25 or records available for digital scanning pursuant to this
26 section shall charge no more than the actual cost of copying,
27 including reasonable staff time, or the amount specified in
28 administrative rule by the appropriate board, or the
29 department when there is no board. The health care
30 practitioner or owner of the records shall certify that a true
31 and complete copy of the records requested pursuant to a
15
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 subpoena or patient release has been provided to the
2 department or otherwise identify those documents that have not
3 been provided.
4 Section 19. Subsection (3) of section 456.063, Florida
5 Statutes, is amended to read:
6 456.063 Sexual misconduct; disqualification for
7 license, certificate, or registration.--
8 (3) Licensed health care practitioners shall report
9 allegations of sexual misconduct to the department, regardless
10 of the practice setting in which the alleged sexual misconduct
11 occurred. Each board, or the department if there is no board,
12 may adopt rules to administer the requirements for reporting
13 allegations of sexual misconduct, including rules to determine
14 the sufficiency of the allegations.
15 Section 20. Paragraphs (d), (aa), and (bb) of
16 subsection (1) and subsection (4) of section 456.072, Florida
17 Statutes, are amended, paragraph (dd) is added to subsection
18 (1), and subsection (7) is added to that section, to read:
19 456.072 Grounds for discipline; penalties;
20 enforcement.--
21 (1) The following acts shall constitute grounds for
22 which the disciplinary actions specified in subsection (2) may
23 be taken:
24 (d) Using a Class III or a Class IV laser device or
25 product, as defined by federal regulations, without having
26 complied with the rules adopted pursuant to s. 404.24(2)
27 501.122(2) governing the registration of such devices.
28 (aa) Performing or attempting to perform health care
29 services on the wrong patient, a wrong-site procedure, a wrong
30 procedure, or an unauthorized procedure or a procedure that is
31 medically unnecessary or otherwise unrelated to the patient's
16
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 diagnosis or medical condition. For the purposes of this
2 paragraph, performing or attempting to perform health care
3 services includes invasive actions taken in furtherance of the
4 preparation of the patient, but does not include those
5 preparations that are noninvasive.
6 (bb) Leaving a foreign body in a patient, such as a
7 sponge, clamp, forceps, surgical needle, or other
8 paraphernalia commonly used in surgical, examination, or other
9 diagnostic procedures, unless leaving the foreign body is
10 medically indicated and documented in the patient record. For
11 the purposes of this paragraph, it shall be legally presumed
12 that retention of a foreign body is not in the best interest
13 of the patient and is not within the standard of care of the
14 profession, unless medically indicated and documented in the
15 patient record regardless of the intent of the professional.
16 (dd) Being terminated from an impaired practitioner
17 program that is overseen by an impaired practitioner
18 consultant as described in s. 456.076 for failure to comply
19 with the terms of the monitoring or treatment contract entered
20 into by the licensee without good cause.
21 (4) In any addition to any other discipline imposed
22 through final order, or citation, entered on or after July 1,
23 2001, that imposes a penalty or other form of discipline
24 pursuant to this section or discipline imposed through final
25 order, or citation, entered on or after July 1, 2001, for a
26 violation of any practice act, the board, or the department
27 when there is no board, shall assess costs related to the
28 investigation and prosecution of the case, including costs
29 associated with an attorney's time. The amount of costs to be
30 assessed shall be determined by the board, or the department
31 when there is no board, following its consideration of an
17
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 affidavit of itemized costs and any written objections
2 thereto. In any case where the board or the department imposes
3 a fine or assessment of costs imposed by the board or
4 department and the fine or assessment is not paid within a
5 reasonable time, such reasonable time to be prescribed in the
6 rules of the board, or the department when there is no board,
7 or in the order assessing such fines or costs, the department
8 or the Department of Legal Affairs may contract for the
9 collection of, or bring a civil action to recover, the fine or
10 assessment.
11 (7) In any formal administrative hearing conducted
12 under s. 120.57(1), the department shall establish grounds for
13 revocation or suspension of a license by clear and convincing
14 evidence. Any other forms of discipline shall be established
15 by the greater weight of the evidence.
16 Section 21. Subsections (1) and (5) of section
17 456.073, Florida Statutes, are amended to read:
18 456.073 Disciplinary proceedings.--Disciplinary
19 proceedings for each board shall be within the jurisdiction of
20 the department.
21 (1) The department, for the boards under its
22 jurisdiction, shall cause to be investigated any complaint
23 that is filed before it if the complaint is in writing, signed
24 by the complainant, and legally sufficient. A complaint is
25 legally sufficient if it contains ultimate facts that show
26 that a violation of this chapter, of any of the practice acts
27 relating to the professions regulated by the department, or of
28 any rule adopted by the department or a regulatory board in
29 the department has occurred. In order to determine legal
30 sufficiency, the department may require supporting information
31 or documentation. The department may investigate, and the
18
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 department or the appropriate board may take appropriate final
2 action on, a complaint even though the original complainant
3 withdraws it or otherwise indicates a desire not to cause the
4 complaint to be investigated or prosecuted to completion. The
5 department may investigate an anonymous complaint if the
6 complaint is in writing and is legally sufficient, if the
7 alleged violation of law or rules is substantial, and if the
8 department has reason to believe, after preliminary inquiry,
9 that the violations alleged in the complaint are true. The
10 department may investigate a complaint made by a confidential
11 informant if the complaint is legally sufficient, if the
12 alleged violation of law or rule is substantial, and if the
13 department has reason to believe, after preliminary inquiry,
14 that the allegations of the complainant are true. The
15 department may initiate an investigation if it has reasonable
16 cause to believe that a licensee or a group of licensees has
17 violated a Florida statute, a rule of the department, or a
18 rule of a board. Except as provided in ss. 458.331(9),
19 459.015(9), 460.413(5), and 461.013(6), When an investigation
20 of any subject is undertaken, the department shall promptly
21 furnish to the subject or the subject's attorney a copy of the
22 complaint or document that resulted in the initiation of the
23 investigation. The subject may submit a written response to
24 the information contained in such complaint or document within
25 30 20 days after service to the subject of the complaint or
26 document. The subject's written response shall be considered
27 by the probable cause panel. The right to respond does not
28 prohibit the issuance of a summary emergency order if
29 necessary to protect the public. However, if the secretary, or
30 the secretary's designee, and the chair of the respective
31 board or the chair of its probable cause panel agree in
19
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 writing that such notification would be detrimental to the
2 investigation, the department may withhold notification. The
3 department may conduct an investigation without notification
4 to any subject if the act under investigation is a criminal
5 offense.
6 (5)(a) A formal hearing before an administrative law
7 judge from the Division of Administrative Hearings shall be
8 requested held pursuant to chapter 120 if there are any
9 disputed issues of material fact raised within 45 days after
10 service of the administrative complaint. The administrative
11 law judge shall issue a recommended order pursuant to chapter
12 120. If any party raises an issue of disputed fact during an
13 informal hearing, the hearing shall be terminated and a formal
14 hearing pursuant to chapter 120 shall be held.
15 (b) Notwithstanding s. 120.569(2), the department
16 shall notify the division within 45 days after receipt of a
17 petition or request for a hearing which the department has
18 determined requires a formal hearing before an administrative
19 law judge.
20 Section 22. Section 456.077, Florida Statutes, is
21 amended to read:
22 456.077 Authority to issue citations.--
23 (1) Notwithstanding s. 456.073, the board, or the
24 department if there is no board, shall adopt rules to permit
25 the issuance of citations. The citation shall be issued to the
26 subject and shall contain the subject's name and address, the
27 subject's license number if applicable, a brief factual
28 statement, the sections of the law allegedly violated, and the
29 penalty imposed. The citation must clearly state that the
30 subject may choose, in lieu of accepting the citation, to
31 follow the procedure under s. 456.073. If the subject disputes
20
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the matter in the citation, the procedures set forth in s.
2 456.073 must be followed. However, if the subject does not
3 dispute the matter in the citation with the department within
4 30 days after the citation is served, the citation becomes a
5 public final order and does not constitute constitutes
6 discipline for a first offense. The penalty shall be a fine or
7 other conditions as established by rule.
8 (2) The board, or the department if there is no board,
9 shall adopt rules designating violations for which a citation
10 may be issued. Such rules shall designate as citation
11 violations those violations for which there is no substantial
12 threat to the public health, safety, and welfare. Violations
13 for which a citation may be issued shall include violations of
14 continuing education requirements; failure to timely pay
15 required fees and fines; failure to comply with the
16 requirements of ss. 381.026 and 381.0261 regarding the
17 dissemination of information regarding patient rights; failure
18 to comply with advertising requirements; failure to timely
19 update practitioner profile and credentialing files; failure
20 to display signs, licenses, and permits; failure to have
21 required reference books available; and all other violations
22 that do not pose a direct and serious threat to the health and
23 safety of the patient.
24 (3) The department shall be entitled to recover the
25 costs of investigation, in addition to any penalty provided
26 according to board or department rule, as part of the penalty
27 levied pursuant to the citation.
28 (4) A citation must be issued within 6 months after
29 the filing of the complaint that is the basis for the
30 citation.
31 (4)(5) Service of a citation may be made by personal
21
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 service or certified mail, restricted delivery, to the subject
2 at the subject's last known address.
3 (5)(6) A board has 6 months in which to enact rules
4 designating violations and penalties appropriate for citation
5 offenses. Failure to enact such rules gives the department
6 exclusive authority to adopt rules as required for
7 implementing this section. A board has continuous authority to
8 amend its rules adopted pursuant to this section.
9 Section 23. Section 456.078, Florida Statutes, is
10 amended to read:
11 456.078 Mediation.--
12 (1) Notwithstanding the provisions of s. 456.073, the
13 board, or the department when there is no board, shall adopt
14 rules to designate which violations of the applicable
15 professional practice act are appropriate for mediation. The
16 board, or the department when there is no board, shall may
17 designate as mediation offenses those complaints where harm
18 caused by the licensee is economic in nature, except
19 complaints involving fraud, or can be remedied by the
20 licensee, or does not result in an adverse incident. For the
21 purposes of this section, an adverse incident is defined as an
22 event that results in:
23 (a) The death of a patient;
24 (b) Brain or spinal damage to a patient;
25 (c) The performance of a surgical procedure on the
26 wrong patient;
27 (d) The performance of a wrong-site surgical
28 procedure;
29 (e) The performance of a wrong surgical procedure;
30 (f) The performance of a surgical procedure that is
31 medically unnecessary or otherwise unrelated to the patient's
22
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 diagnosis or medical condition;
2 (g) The surgical repair of damage resulting to a
3 patient from a planned surgical procedure, where the damage is
4 not a recognized specific risk, as disclosed to the patient
5 and documented through the informed-consent process; or
6 (h) The performance of procedures to remove unplanned
7 foreign objects remaining from a surgical procedure.
8 (2) After the department determines a complaint is
9 legally sufficient and the alleged violations are defined as
10 mediation offenses, the department or any agent of the
11 department may conduct informal mediation to resolve the
12 complaint. If the complainant and the subject of the complaint
13 agree to a resolution of a complaint within 14 days after
14 contact by the mediator, the mediator shall notify the
15 department of the terms of the resolution. The department or
16 board shall take no further action unless the complainant and
17 the subject each fail to record with the department an
18 acknowledgment of satisfaction of the terms of mediation
19 within 60 days of the mediator's notification to the
20 department. A successful mediation shall include a statement
21 of whether or not the resolution constitutes discipline.
22 However, in the event the complainant and subject fail to
23 reach settlement terms or to record the required
24 acknowledgment, the department shall process the complaint
25 according to the provisions of s. 456.073.
26 (3) Conduct or statements made during mediation are
27 inadmissible in any proceeding pursuant to s. 456.073.
28 Further, any information relating to the mediation of a case
29 shall be subject to the confidentiality provisions of s.
30 456.073.
31 (4) Any licensee who completes a successful mediation
23
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 shall pay the department's administrative costs for the
2 mediation. No licensee shall go through the mediation process
3 more than once if the allegation relates to the breach of the
4 standard of care for that health care professional. In any
5 event, no licensee shall go through the mediation process more
6 than three times without approval of the department. The
7 department may consider the subject and dates of the earlier
8 complaints in rendering its decision. Such decision shall not
9 be considered a final agency action for purposes of chapter
10 120.
11 (5) A board has 6 months in which to adopt rules
12 designating violations appropriate for mediation. Failure to
13 adopt such rules gives the department exclusive authority to
14 adopt rules as required for implementing this section Any
15 board created on or after January 1, 1995, shall have 6 months
16 to adopt rules designating which violations are appropriate
17 for mediation, after which time the department shall have
18 exclusive authority to adopt rules pursuant to this section. A
19 board shall have continuing authority to amend its rules
20 adopted pursuant to this section.
21 Section 24. Section 458.303, Florida Statutes, is
22 amended to read:
23 458.303 Provisions not applicable to other
24 practitioners; exceptions, etc.--
25 (1) The provisions of ss. 458.301, 458.303, 458.305,
26 458.307, 458.309, 458.311, 458.313, 458.315, 458.317, 458.319,
27 458.321, 458.327, 458.329, 458.331, 458.337, 458.339, 458.341,
28 458.343, 458.345, and 458.347 shall have no application to:
29 (a) Other duly licensed health care practitioners
30 acting within their scope of practice authorized by statute.
31 (b) Any physician lawfully licensed in another state
24
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 or territory or foreign country, when meeting duly licensed
2 physicians of this state in consultation.
3 (c) Commissioned medical officers of the Armed Forces
4 of the United States and of the Public Health Service of the
5 United States while on active duty and while acting within the
6 scope of their military or public health responsibilities.
7 (d) Any person while actually serving without salary
8 or professional fees on the resident medical staff of a
9 hospital in this state, subject to the provisions of s.
10 458.321.
11 (e) Any person furnishing medical assistance in case
12 of an emergency.
13 (f) The domestic administration of recognized family
14 remedies.
15 (g) The practice of the religious tenets of any church
16 in this state.
17 (h) Any person or manufacturer who, without the use of
18 drugs or medicine, mechanically fits or sells lenses,
19 artificial eyes or limbs, or other apparatus or appliances or
20 is engaged in the mechanical examination of eyes for the
21 purpose of constructing or adjusting spectacles, eyeglasses,
22 or lenses.
23 (2) Nothing in s. 458.301, s. 458.303, s. 458.305, s.
24 458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.
25 458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.
26 458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347
27 shall be construed to prohibit any service rendered by a
28 registered nurse or a licensed practical nurse, if such
29 service is rendered under the direct supervision and control
30 of a licensed physician who provides specific direction for
31 any service to be performed and gives final approval to all
25
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 services performed. Further, nothing in this or any other
2 chapter shall be construed to prohibit any service rendered by
3 a medical assistant in accordance with the provisions of s.
4 458.3485.
5 Section 25. Section 458.311, Florida Statutes, is
6 amended to read:
7 (Substantial rewording of section. See
8 s. 458.311, F.S., for present text.)
9 458.311 Licensure; requirements; fees.--
10 (1) Any person desiring to be licensed as a physician
11 shall apply to the department on forms furnished by the
12 department. The department shall license each applicant who
13 the board certifies has met the provisions of this section.
14 (2) Each applicant must demonstrate compliance with
15 the following:
16 (a) Has completed the application form and remitted a
17 nonrefundable application fee not to exceed $500.
18 (b) Is at least 21 years of age.
19 (c) Is of good moral character.
20 (d) Has not committed any act or offense in this or
21 any other jurisdiction which would constitute the basis for
22 disciplining a physician pursuant to s. 458.331.
23 (e) Has submitted to the department a set of
24 fingerprints on a form and under procedures specified by the
25 department, along with a payment in an amount equal to the
26 costs incurred by the department for the criminal history
27 check of the applicant.
28 (f) Has caused to be submitted to the department core
29 credentials verified by the Federation Credentials
30 Verification Service of the Federation of State Medical
31 Boards.
26
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (g) For an applicant holding a valid active license in
2 another state, has submitted evidence of the active licensed
3 practice of medicine in another jurisdiction for at least 2 of
4 the immediately preceding 4 years or evidence of successful
5 completion of either a board-approved postgraduate training
6 program within 2 years preceding filing of an application or a
7 board-approved clinical competency examination within the year
8 preceding the filing of an application for licensure. For
9 purposes of this paragraph, the term "active licensed practice
10 of medicine" means that practice of medicine by physicians,
11 including those employed by any governmental entity in
12 community or public health, as defined by this chapter, those
13 designated as medical directors under s. 641.495(11) who are
14 practicing medicine, and those on the active teaching faculty
15 of an accredited medical school. If the applicant fails to
16 meet the requirements of this paragraph, the board may impose
17 conditions on the license, including, but not limited to,
18 supervision of practice.
19 (3) Each applicant must demonstrate that he or she has
20 complied with one of the following:
21 (a) Is a graduate of an allopathic medical school or
22 allopathic college recognized and approved by an accrediting
23 agency recognized by the United States Department of Education
24 or is a graduate of an allopathic medical school or allopathic
25 college within a territorial jurisdiction of the United States
26 recognized by the accrediting agency of the governmental body
27 of that jurisdiction; or
28 (b) Is a graduate of an allopathic international
29 medical school registered with the World Health Organization
30 and has had his or her medical credentials evaluated by the
31 Educational Commission for Foreign Medical Graduates, holds an
27
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 active, valid certificate issued by that commission, and has
2 passed the examination utilized by that commission. However, a
3 graduate of an international medical school need not present
4 the certificate issued by the Educational Commission for
5 Foreign Medical Graduates or pass the examination utilized by
6 that commission if the graduate has:
7 1. Received a bachelor's degree from an accredited
8 United States college or university.
9 2. Studied at a medical school which is recognized by
10 the World Health Organization.
11 3. Completed all of the formal requirements of the
12 international medical school, except the internship or social
13 service requirements, and passed part I of the National Board
14 of Medical Examiners examination or the Educational Commission
15 for Foreign Medical Graduates examination equivalent.
16 4. Completed an academic year of supervised clinical
17 training in a hospital affiliated with a medical school
18 approved by the Council on Medical Education of the American
19 Medical Association and, upon completion, passed part II of
20 the National Board of Medical Examiners examination or the
21 Educational Commission for Foreign Medical Graduates
22 examination equivalent.
23 (4) Each applicant must demonstrate that he or she has
24 completed an Accreditation Council for Graduate Medical
25 Education (ACGME) approved residency, as defined by board
26 rule, of at least 2 years, or a fellowship of at least 2 years
27 in one specialty area which is counted toward regular or
28 subspecialty certification by a board recognized and certified
29 by the American Board of Medical Specialties. However,
30 applicants who meet the requirements of paragraph (3)(a) who
31 completed their training prior to October 1, 2003, must
28
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 demonstrate completion of at least 1 year of an approved
2 residency.
3 (5)(a) Each applicant must demonstrate that he or she
4 has complied with one of the following examination
5 requirements:
6 1. Prior to January 1, 2000, has obtained a passing
7 score, as established by rule of the board, on the licensure
8 examination of the National Board of Medical Examiners (NBME),
9 the licensure examination of the Federation of State Medical
10 Boards of the United States, Inc. (FLEX), the United States
11 Medical Licensing Examination (USMLE), or a combination
12 thereof;
13 2. On or after January 1, 2000, has obtained a passing
14 score on all three steps of the United States Medical
15 Licensing Examination (USMLE); or
16 3. Has obtained a passing score on a state board
17 examination or the Canadian licensing examination (LLMCC) if
18 the applicant has a current active license in at least one
19 other jurisdiction of the United States or Canada and has
20 practiced pursuant to such licensure continuously for the
21 immediately preceding 10 years without encumbrance on the
22 license.
23 (b) As prescribed by board rule, the board may require
24 an applicant who does not pass any step of the national
25 licensing examination after five attempts to complete
26 additional remedial education or training.
27 (c) As prescribed by board rule, the board may require
28 an applicant who does not pass all steps of the United States
29 Medical Licensing Examination (USMLE) within 7 years to
30 complete additional remedial education or training or to
31 retake the step of the examination which the applicant passed
29
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 first.
2 (6) The department and the board shall ensure that
3 applicants for licensure meet the criteria of this section
4 through an investigative process.
5 (7) The board may not certify to the department for
6 licensure any applicant who is under investigation in another
7 jurisdiction for an offense which would constitute a violation
8 of this chapter until such investigation is completed. Upon
9 completion of the investigation, the provisions of s. 458.331
10 shall apply. Furthermore, the department may not issue an
11 unrestricted license to any individual who has committed any
12 act or offense in any jurisdiction which would constitute the
13 basis for disciplining a physician pursuant to s. 458.331.
14 When the board finds that an individual has committed an act
15 or offense in any jurisdiction which would constitute the
16 basis for disciplining a physician pursuant to s. 458.331, the
17 board may enter an order imposing one or more of the terms set
18 forth in s. 456.072(2).
19 (8) The board may adopt rules pursuant to ss.
20 120.536(1) and 120.54 necessary to carry out the provisions of
21 this section, which shall be applied on a uniform and
22 consistent basis.
23 (9) When the board determines that any applicant for
24 licensure has failed to meet, to the board's satisfaction,
25 each of the appropriate requirements set forth in this
26 section, it may enter an order requiring one or more of the
27 following terms:
28 (a) Refusal to certify to the department an
29 application for licensure, certification, or registration;
30 (b) Certification to the department of an application
31 for licensure, certification, or registration with
30
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 restrictions on the scope of practice of the licensee; or
2 (c) Certification to the department of an application
3 for licensure, certification, or registration with placement
4 of the physician on probation for a period of time and subject
5 to such conditions as the board may specify, including, but
6 not limited to, requiring the physician to submit to
7 treatment, attend continuing education courses, submit to
8 reexamination, or work under the supervision of another
9 physician.
10 Section 26. Subsection (5) of section 458.3124,
11 Florida Statutes, is amended to read:
12 458.3124 Restricted license; certain experienced
13 foreign-trained physicians.--
14 (5) Notwithstanding s. 458.311(3) and (4) (1)(f), a
15 person who successfully meets the requirements of this section
16 and who successfully passes Step III of the United States
17 Medical Licensing Examination is eligible for full licensure
18 as a physician.
19 Section 27. Section 458.315, Florida Statutes, is
20 amended to read:
21 (Substantial rewording of section. See
22 s. 458.315, F.S., for present text.)
23 458.315 Limited licenses.--
24 (1) Any person desiring to obtain a limited license
25 shall apply to the department on forms furnished by the
26 department. The department shall license each applicant who
27 the board certifies:
28 (a) Has submitted to the department, with an
29 application and fee not to exceed $300, a statement stating
30 that he or she has been licensed to practice medicine in any
31 jurisdiction or territory of the United States or Canada for
31
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 at least 2 years and intends to practice only pursuant to the
2 restrictions of a limited license granted pursuant to this
3 section. However, if the physician will only use the limited
4 license for noncompensated practice, and submits a statement
5 from the employing agency or institution stating that he or
6 she will not receive compensation for any service involving
7 the practice of medicine, the application fee and all
8 licensure fees shall be waived.
9 (b) Has submitted evidence of the active licensed
10 practice of medicine in any jurisdiction or territory of the
11 United States or Canada for at least 2 of the immediately
12 preceding 4 years. For purposes of this paragraph, the term
13 "active licensed practice of medicine" means that practice of
14 medicine by physicians, including those employed by any
15 government entity in community or public health, as defined by
16 this chapter, those designated as medical directors under s.
17 641.495(11) who are practicing medicine, and those on the
18 active teaching faculty of an accredited medical school. If it
19 has been more than 3 years since active practice was conducted
20 by the applicant, a licensed physician approved by the board
21 shall supervise the applicant for a period of 6 months after
22 he or she is granted a limited license for practice, unless
23 the board determines that a shorter period of supervision will
24 be sufficient to ensure that the applicant is qualified for
25 licensure. Procedures for such supervision shall be
26 established by the board.
27 (c) Has submitted to the department a set of
28 fingerprints on a form and under procedures by the department
29 for the criminal history check of the applicant.
30 (d) Has not committed any act or offense in this or
31 any other jurisdiction which would constitute the basis for
32
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 disciplining a physician pursuant to s. 458.331.
2 (2) After approval of an application under this
3 section, a limited license may not be issued until the
4 applicant provides to the board an affidavit that there have
5 been no substantial changes in his or her status since initial
6 application.
7 (3) The recipient of a limited license used for
8 noncompensated practice shall only practice in the employ of
9 programs or facilities that provide uncompensated health care
10 services by volunteer licensed health care professionals to
11 low-income persons whose family income does not exceed 120
12 percent of the federal poverty level or to uninsured persons.
13 These facilities shall include, but not be limited to, the
14 department, community and migrant health centers funded under
15 s. 330 of the Public Health Service Act, and volunteer health
16 care provider programs contracted with the department to
17 provide uncompensated care under the provisions of s.
18 766.1115.
19 (4) The recipient of a limited license used for
20 compensated practice shall only practice in the employ of
21 certain programs and facilities that provide health care
22 services and are located within federally designated primary
23 care health professional shortage areas, unless otherwise
24 approved by the Secretary of Health. These programs and
25 facilities shall include, but not be limited to, the
26 department, the Department of Corrections, county or municipal
27 correctional facilities, the Department of Juvenile Justice,
28 the Department of Children and Family Services, and those
29 programs and facilities funded under s. 330 of the Public
30 Health Service Act.
31 (5) The recipient of a limited license shall, within
33
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 30 days after accepting employment, notify the board of all
2 approved institutions in which the licensee practices and all
3 approved institutions in which the licensee's practice
4 privileges have been denied. Evidence of noncompensated
5 employment shall be required for the fee waiver under
6 paragraph (1)(a).
7 (6) Upon renewal, a limited licenseholder shall, in
8 addition to complying with other applicable provisions of this
9 chapter, document compliance with the restrictions prescribed
10 in this section.
11 (7) Any person holding an active or inactive license
12 to practice medicine in the state may convert that license to
13 a limited license for the purpose of providing volunteer,
14 uncompensated care for low-income Floridians. The licensee
15 must submit a statement from the employing agency or
16 institution stating that he or she will not receive
17 compensation for any service involving the practice of
18 medicine. All licensure fees, including neurological injury
19 compensation assessments, shall be waived.
20 (8) Nothing in this section limits in any way any
21 policy by the board otherwise authorized by law to grant
22 licenses to physicians duly licensed in other states under
23 conditions less restrictive than the requirements of this
24 section. Notwithstanding any other provision of this section,
25 the board may refuse to authorize a physician otherwise
26 qualified to practice in the employ of any agency or
27 institution otherwise qualified if the agency or institution
28 has caused or permitted violations of the provisions of this
29 chapter which it knew or should have known were occurring.
30 Section 28. Subsection (4) of section 458.319, Florida
31 Statutes, is amended to read:
34
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 458.319 Renewal of license.--
2 (4) Notwithstanding the provisions of s. 456.033, A
3 physician may complete continuing education on end-of-life
4 care and palliative care in lieu of continuing education in
5 AIDS/HIV, if that physician has completed the AIDS/HIV
6 continuing education in the immediately preceding biennium.
7 Section 29. Paragraph (c) of subsection (5) of section
8 458.320, Florida Statutes, is amended to read:
9 458.320 Financial responsibility.--
10 (5) The requirements of subsections (1), (2), and (3)
11 shall not apply to:
12 (c) Any person holding a limited license pursuant to
13 s. 458.315 458.317 and practicing under the scope of such
14 limited license.
15 Section 30. Any physician who meets the requirements
16 for limited licensure under section 458.315 or section
17 459.0075, Florida Statutes, may be certified by the Board of
18 Medicine or the Board of Osteopathic Medicine for a limited
19 license to conduct clinical research if the physician
20 previously held a Florida medical license that was
21 unencumbered and not under investigation at the time that the
22 license became null and void for nonrenewal or was voluntarily
23 surrendered.
24 Section 31. Paragraph (t) of subsection (1) and
25 subsections (6) and (9) of section 458.331, Florida Statutes,
26 are amended to read:
27 458.331 Grounds for disciplinary action; action by the
28 board and department.--
29 (1) The following acts constitute grounds for denial
30 of a license or disciplinary action, as specified in s.
31 456.072(2):
35
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (t) Gross or repeated malpractice or the failure to
2 practice medicine with that level of care, skill, and
3 treatment which is recognized by a reasonably prudent similar
4 physician as being acceptable under similar conditions and
5 circumstances. The board shall give great weight to the
6 provisions of s. 766.102 when enforcing this paragraph. As
7 used in this paragraph, "repeated malpractice" includes, but
8 is not limited to, three or more claims for medical
9 malpractice within the previous 5-year period resulting in
10 indemnities being paid in excess of $50,000 $25,000 each to
11 the claimant in a judgment or settlement and which incidents
12 involved negligent conduct by the physician. As used in this
13 paragraph, "gross malpractice" or "the failure to practice
14 medicine with that level of care, skill, and treatment which
15 is recognized by a reasonably prudent similar physician as
16 being acceptable under similar conditions and circumstances,"
17 shall not be construed so as to require more than one
18 instance, event, or act. Nothing in this paragraph shall be
19 construed to require that a physician be incompetent to
20 practice medicine in order to be disciplined pursuant to this
21 paragraph.
22 (6) Upon the department's receipt from an insurer or
23 self-insurer of a report of a closed claim against a physician
24 pursuant to s. 627.912 or from a health care practitioner of a
25 report pursuant to s. 456.049, or upon the receipt from a
26 claimant of a presuit notice against a physician pursuant to
27 s. 766.106, the department shall review each report and
28 determine whether it potentially involved conduct by a
29 licensee that is subject to disciplinary action, in which case
30 the provisions of s. 456.073 shall apply. However, if it is
31 reported that a physician has had three or more claims with
36
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 indemnities exceeding $50,000 $25,000 each within the previous
2 5-year period, the department shall investigate the
3 occurrences upon which the claims were based and determine if
4 action by the department against the physician is warranted.
5 (9) When an investigation of a physician is
6 undertaken, the department shall promptly furnish to the
7 physician or the physician's attorney a copy of the complaint
8 or document which resulted in the initiation of the
9 investigation. For purposes of this subsection, such documents
10 include, but are not limited to: the pertinent portions of an
11 annual report submitted to the department pursuant to s.
12 395.0197(6); a report of an adverse incident which is provided
13 to the department pursuant to s. 395.0197; a report of peer
14 review disciplinary action submitted to the department
15 pursuant to s. 395.0193(4) or s. 458.337, providing that the
16 investigations, proceedings, and records relating to such peer
17 review disciplinary action shall continue to retain their
18 privileged status even as to the licensee who is the subject
19 of the investigation, as provided by ss. 395.0193(8) and
20 458.337(3); a report of a closed claim submitted pursuant to
21 s. 627.912; a presuit notice submitted pursuant to s.
22 766.106(2); and a petition brought under the Florida
23 Birth-Related Neurological Injury Compensation Plan, pursuant
24 to s. 766.305(2). The physician may submit a written response
25 to the information contained in the complaint or document
26 which resulted in the initiation of the investigation within
27 30 45 days after service to the physician of the complaint or
28 document. The physician's written response shall be considered
29 by the probable cause panel.
30 Section 32. Paragraph (c) of subsection (1) of section
31 458.345, Florida Statutes, is amended to read:
37
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 458.345 Registration of resident physicians, interns,
2 and fellows; list of hospital employees; prescribing of
3 medicinal drugs; penalty.--
4 (1) Any person desiring to practice as a resident
5 physician, assistant resident physician, house physician,
6 intern, or fellow in fellowship training which leads to
7 subspecialty board certification in this state, or any person
8 desiring to practice as a resident physician, assistant
9 resident physician, house physician, intern, or fellow in
10 fellowship training in a teaching hospital in this state as
11 defined in s. 408.07(44) or s. 395.805(2), who does not hold a
12 valid, active license issued under this chapter shall apply to
13 the department to be registered and shall remit a fee not to
14 exceed $300 as set by the board. The department shall register
15 any applicant the board certifies has met the following
16 requirements:
17 (c) Is a graduate of a medical school or college as
18 specified in s. 458.311(3)(1)(f).
19 Section 33. Paragraph (b) of subsection (7) of section
20 458.347, Florida Statutes, is amended to read:
21 458.347 Physician assistants.--
22 (7) PHYSICIAN ASSISTANT LICENSURE.--
23 (b)1. Notwithstanding subparagraph (a)2. and
24 sub-subparagraph (a)3.a., the department shall examine each
25 applicant who the Board of Medicine certifies:
26 a. Has completed the application form and remitted a
27 nonrefundable application fee not to exceed $500 and an
28 examination fee not to exceed $300, plus the actual cost to
29 the department to provide the examination. The examination fee
30 is refundable if the applicant is found to be ineligible to
31 take the examination. The department shall not require the
38
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 applicant to pass a separate practical component of the
2 examination. For examinations given after July 1, 1998,
3 competencies measured through practical examinations shall be
4 incorporated into the written examination through a
5 multiple-choice format. The department shall translate the
6 examination into the native language of any applicant who
7 requests and agrees to pay all costs of such translation,
8 provided that the translation request is filed with the board
9 office no later than 9 months before the scheduled examination
10 and the applicant remits translation fees as specified by the
11 department no later than 6 months before the scheduled
12 examination, and provided that the applicant demonstrates to
13 the department the ability to communicate orally in basic
14 English. If the applicant is unable to pay translation costs,
15 the applicant may take the next available examination in
16 English if the applicant submits a request in writing by the
17 application deadline and if the applicant is otherwise
18 eligible under this section. To demonstrate the ability to
19 communicate orally in basic English, a passing score or grade
20 is required, as determined by the department or organization
21 that developed it, on the test for spoken English (TSE) by the
22 Educational Testing Service (ETS), the test of English as a
23 foreign language (TOEFL) by ETS, a high school or college
24 level English course, or the English examination for
25 citizenship, Immigration and Naturalization Service. A
26 notarized copy of an Educational Commission for Foreign
27 Medical Graduates (ECFMG) certificate may also be used to
28 demonstrate the ability to communicate in basic English; and
29 b.(I) Is an unlicensed physician who graduated from a
30 foreign medical school listed with the World Health
31 Organization who has not previously taken and failed the
39
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 examination of the National Commission on Certification of
2 Physician Assistants and who has been certified by the Board
3 of Medicine as having met the requirements for licensure as a
4 medical doctor by examination as set forth in s.
5 458.311(2)-(7)(1), (3), (4), and (5), with the exception that
6 the applicant is not required to have completed an approved
7 residency of at least 1 year and the applicant is not required
8 to have passed the licensing examination specified under s.
9 458.311 or hold a valid, active certificate issued by the
10 Educational Commission for Foreign Medical Graduates; was
11 eligible and made initial application for certification as a
12 physician assistant in this state between July 1, 1990, and
13 June 30, 1991; and was a resident of this state on July 1,
14 1990, or was licensed or certified in any state in the United
15 States as a physician assistant on July 1, 1990; or
16 (II) Completed all coursework requirements of the
17 Master of Medical Science Physician Assistant Program offered
18 through the Florida College of Physician's Assistants prior to
19 its closure in August of 1996. Prior to taking the
20 examination, such applicant must successfully complete any
21 clinical rotations that were not completed under such program
22 prior to its termination and any additional clinical rotations
23 with an appropriate physician assistant preceptor, not to
24 exceed 6 months, that are determined necessary by the council.
25 The boards shall determine, based on recommendations from the
26 council, the facilities under which such incomplete or
27 additional clinical rotations may be completed and shall also
28 determine what constitutes successful completion thereof,
29 provided such requirements are comparable to those established
30 by accredited physician assistant programs. This
31 sub-sub-subparagraph is repealed July 1, 2001.
40
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 2. The department may grant temporary licensure to an
2 applicant who meets the requirements of subparagraph 1.
3 Between meetings of the council, the department may grant
4 temporary licensure to practice based on the completion of all
5 temporary licensure requirements. All such administratively
6 issued licenses shall be reviewed and acted on at the next
7 regular meeting of the council. A temporary license expires 30
8 days after receipt and notice of scores to the licenseholder
9 from the first available examination specified in subparagraph
10 1. following licensure by the department. An applicant who
11 fails the proficiency examination is no longer temporarily
12 licensed, but may apply for a one-time extension of temporary
13 licensure after reapplying for the next available examination.
14 Extended licensure shall expire upon failure of the
15 licenseholder to sit for the next available examination or
16 upon receipt and notice of scores to the licenseholder from
17 such examination.
18 3. Notwithstanding any other provision of law, the
19 examination specified pursuant to subparagraph 1. shall be
20 administered by the department only five times. Applicants
21 certified by the board for examination shall receive at least
22 6 months' notice of eligibility prior to the administration of
23 the initial examination. Subsequent examinations shall be
24 administered at 1-year intervals following the reporting of
25 the scores of the first and subsequent examinations. For the
26 purposes of this paragraph, the department may develop,
27 contract for the development of, purchase, or approve an
28 examination that adequately measures an applicant's ability to
29 practice with reasonable skill and safety. The minimum passing
30 score on the examination shall be established by the
31 department, with the advice of the board. Those applicants
41
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 failing to pass that examination or any subsequent examination
2 shall receive notice of the administration of the next
3 examination with the notice of scores following such
4 examination. Any applicant who passes the examination and
5 meets the requirements of this section shall be licensed as a
6 physician assistant with all rights defined thereby.
7 Section 34. Subsection (5) of section 459.008, Florida
8 Statutes, is amended to read:
9 459.008 Renewal of licenses and certificates.--
10 (5) Notwithstanding the provisions of s. 456.033, An
11 osteopathic physician may complete continuing education on
12 end-of-life and palliative care in lieu of continuing
13 education in AIDS/HIV, if that physician has completed the
14 AIDS/HIV continuing education in the immediately preceding
15 biennium.
16 Section 35. Subsections (6) and (9) of section
17 459.015, Florida Statutes, are amended to read:
18 459.015 Grounds for disciplinary action; action by the
19 board and department.--
20 (6) Upon the department's receipt from an insurer or
21 self-insurer of a report of a closed claim against an
22 osteopathic physician pursuant to s. 627.912 or from a health
23 care practitioner of a report pursuant to s. 456.049, or upon
24 the receipt from a claimant of a presuit notice against an
25 osteopathic physician pursuant to s. 766.106, the department
26 shall review each report and determine whether it potentially
27 involved conduct by a licensee that is subject to disciplinary
28 action, in which case the provisions of s. 456.073 shall
29 apply. However, if it is reported that an osteopathic
30 physician has had three or more claims with indemnities
31 exceeding $50,000 $25,000 each within the previous 5-year
42
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 period, the department shall investigate the occurrences upon
2 which the claims were based and determine if action by the
3 department against the osteopathic physician is warranted.
4 (9) When an investigation of an osteopathic physician
5 is undertaken, the department shall promptly furnish to the
6 osteopathic physician or his or her attorney a copy of the
7 complaint or document which resulted in the initiation of the
8 investigation. For purposes of this subsection, such documents
9 include, but are not limited to: the pertinent portions of an
10 annual report submitted to the department pursuant to s.
11 395.0197(6); a report of an adverse incident which is provided
12 to the department pursuant to s. 395.0197; a report of peer
13 review disciplinary action submitted to the department
14 pursuant to s. 395.0193(4) or s. 459.016, provided that the
15 investigations, proceedings, and records relating to such peer
16 review disciplinary action shall continue to retain their
17 privileged status even as to the licensee who is the subject
18 of the investigation, as provided by ss. 395.0193(8) and
19 459.016(3); a report of a closed claim submitted pursuant to
20 s. 627.912; a presuit notice submitted pursuant to s.
21 766.106(2); and a petition brought under the Florida
22 Birth-Related Neurological Injury Compensation Plan, pursuant
23 to s. 766.305(2). The osteopathic physician may submit a
24 written response to the information contained in the complaint
25 or document which resulted in the initiation of the
26 investigation within 30 45 days after service to the
27 osteopathic physician of the complaint or document. The
28 osteopathic physician's written response shall be considered
29 by the probable cause panel.
30 Section 36. Subsection (5) of section 460.413, Florida
31 Statutes, is amended to read:
43
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 460.413 Grounds for disciplinary action; action by
2 board or department.--
3 (5) When an investigation of a chiropractic physician
4 is undertaken, the department shall promptly furnish to the
5 chiropractic physician or her or his attorney a copy of the
6 complaint or document which resulted in the initiation of the
7 investigation. The chiropractic physician may submit a written
8 response to the information contained in such complaint or
9 document within 30 45 days after service to the chiropractic
10 physician of the complaint or document. The chiropractic
11 physician's written response shall be considered by the
12 probable cause panel.
13 Section 37. Paragraph (s) of subsection (1) of section
14 461.013, Florida Statutes, is amended to read:
15 461.013 Grounds for disciplinary action; action by the
16 board; investigations by department.--
17 (1) The following acts constitute grounds for denial
18 of a license or disciplinary action, as specified in s.
19 456.072(2):
20 (s) Gross or repeated malpractice or the failure to
21 practice podiatric medicine at a level of care, skill, and
22 treatment which is recognized by a reasonably prudent
23 podiatric physician as being acceptable under similar
24 conditions and circumstances. The board shall give great
25 weight to the standards for malpractice in s. 766.102 in
26 interpreting this section. As used in this paragraph,
27 "repeated malpractice" includes, but is not limited to, three
28 or more claims for medical malpractice within the previous
29 5-year period resulting in indemnities being paid in excess of
30 $50,000 $10,000 each to the claimant in a judgment or
31 settlement and which incidents involved negligent conduct by
44
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the podiatric physicians. As used in this paragraph, "gross
2 malpractice" or "the failure to practice podiatric medicine
3 with the level of care, skill, and treatment which is
4 recognized by a reasonably prudent similar podiatric physician
5 as being acceptable under similar conditions and
6 circumstances" shall not be construed so as to require more
7 than one instance, event, or act.
8 Section 38. Sections 38-54 of this act may be cited as
9 the "Clara Ramsey Care of the Elderly Act."
10 Section 39. Certified Geriatric Specialist Preparation
11 Pilot Program.--
12 (1) The Agency for Workforce Innovation shall
13 establish a pilot program for delivery of geriatric nursing
14 education to certified nursing assistants who wish to become
15 certified geriatric specialists. The agency shall select two
16 pilot sites in nursing homes that have received the Gold Seal
17 designation under section 400.235, Florida Statutes; have been
18 designated as a teaching nursing home under section 430.80,
19 Florida Statutes; or have not received a class I or class II
20 deficiency within the 30 months preceding application for this
21 program.
22 (2) To be eligible to receive geriatric nursing
23 education, a certified nursing assistant must have been
24 employed by a participating nursing home for at least 1 year
25 and have received a high school diploma or its equivalent.
26 (3) The education shall be provided at the worksite
27 and in coordination with the certified nursing assistant's
28 work schedule.
29 (4) Faculty shall provide the instruction under an
30 approved nursing program pursuant to section 464.019, Florida
31 Statutes.
45
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (5) The education shall prepare the certified nursing
2 assistant to meet the requirements for certification as a
3 geriatric specialist. The didactic and clinical education
4 shall include all portions of the practical nursing curriculum
5 pursuant to section 464.019, Florida Statutes, except for
6 pediatric and obstetric/maternal-child education, and shall
7 include additional education in the care of ill, injured, or
8 infirm geriatric patients and the maintenance of health, the
9 prevention of injury, and the provision of palliative care for
10 geriatric patients.
11 Section 40. Certified Geriatric Specialty Nursing
12 Initiative Steering Committee.--
13 (1) In order to guide the implementation of the
14 Certified Geriatric Specialist Preparation Pilot Program,
15 there is created a Certified Geriatric Specialty Nursing
16 Initiative Steering Committee. The steering committee shall be
17 composed of the following members:
18 (a) The chair of the Board of Nursing or his or her
19 designee;
20 (b) A representative of the Agency for Workforce
21 Innovation, appointed by the Director of Workforce Innovation;
22 (c) A representative of Workforce Florida, Inc.,
23 appointed by the chair of the Board of Directors of Workforce
24 Florida, Inc.;
25 (d) A representative of the Department of Education,
26 appointed by the Secretary of Education;
27 (e) A representative of the Agency for Health Care
28 Administration, appointed by the Secretary of Health Care
29 Administration;
30 (f) The Director of the Florida Center for Nursing;
31 and
46
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (g) A representative of a Gold Seal nursing home that
2 is not one of the pilot program sites, appointed by the
3 Secretary of Health Care Administration.
4 (2) The steering committee shall:
5 (a) Provide consultation and guidance to the Agency
6 for Workforce Innovation on matters of policy during the
7 implementation of the pilot program; and
8 (b) Provide oversight to the evaluation of the pilot
9 program.
10 (3) Members of the steering committee are entitled to
11 reimbursement for per diem and travel expenses under section
12 112.061, Florida Statutes.
13 (4) The steering committee shall complete its
14 activities by June 30, 2006, and the authorization for the
15 steering committee ends on that date.
16 Section 41. Evaluation of the Certified Geriatric
17 Specialist Preparation Pilot Program.--The Agency for
18 Workforce Innovation, in consultation with the Certified
19 Geriatric Specialty Nursing Initiative Steering Committee,
20 shall conduct, or contract for an evaluation of the pilot
21 program. The agency shall ensure that an evaluation report is
22 submitted to the Governor, the President of the Senate, and
23 the Speaker of the House of Representatives by January 1,
24 2006. The evaluation must address the experience and success
25 of the certified nursing assistants in the pilot program and
26 must contain recommendations regarding the expansion of the
27 delivery of geriatric nursing education in nursing homes.
28 Section 42. Reports.--The Agency for Workforce
29 Innovation shall submit status reports and recommendations
30 regarding legislation necessary to further the implementation
31 of the pilot program to the Governor, the President of the
47
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Senate, and the Speaker of the House of Representatives on
2 January 1, 2004, January 1, 2005, and January 1, 2006.
3 Section 43. Section 464.0125, Florida Statutes, is
4 created to read:
5 464.0125 Certified geriatric specialists;
6 certification requirements.--
7 (1) DEFINITIONS; RESPONSIBILITIES.--
8 (a) As used in this section, the term:
9 1. "Certified geriatric specialist" means a person who
10 meets the qualifications specified in this section and who is
11 certified by the board to practice as a certified geriatric
12 specialist.
13 2. "Geriatric patient" means any patient who is 60
14 years of age or older.
15 3. "Practice of certified geriatric specialty nursing"
16 means the performance of selected acts in facilities licensed
17 under part II or part III of chapter 400, including the
18 administration of treatments and medications, in the care of
19 ill, injured, or infirm geriatric patients and the promotion
20 of wellness, maintenance of health, and prevention of illness
21 of geriatric patients under the direction of a registered
22 nurse, a licensed physician, a licensed osteopathic physician,
23 a licensed podiatric physician, or a licensed dentist. The
24 scope of practice of a certified geriatric specialist includes
25 the practice of practical nursing as defined in s. 464.003 for
26 geriatric patients only, except for any act in which
27 instruction and clinical knowledge of pediatric nursing or
28 obstetric/maternal-child nursing is required. A certified
29 geriatric specialist, while providing nursing services in
30 facilities licensed under part II or part III of chapter 400,
31 may supervise the activities of certified nursing assistants
48
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 and other unlicensed personnel providing services in such
2 facilities in accordance with rules adopted by the board.
3 (b) The certified geriatric specialist shall be
4 responsible and accountable for making decisions that are
5 based upon the individual's educational preparation and
6 experience in performing certified geriatric specialty
7 nursing.
8 (2) CERTIFICATION.--
9 (a) Any certified nursing assistant desiring to be
10 certified as a certified geriatric specialist shall apply to
11 the department and submit proof that he or she holds a current
12 certificate as a certified nursing assistant under this part
13 and has satisfactorily completed the following requirements:
14 1. Is in good mental and physical health, is a
15 recipient of a high school diploma or its equivalent and has
16 completed the requirements for graduation from an approved
17 program for nursing or its equivalent, as determined by the
18 board, for the preparation of licensed practical nurses,
19 except for instruction and clinical knowledge of pediatric
20 nursing or obstetric/maternal-child nursing. Any program that
21 is approved on July 1, 2003, by the board for the preparation
22 of registered nurses or licensed practical nurses may provide
23 education for the preparation of certified geriatric
24 specialists without further board approval.
25 2. Has the ability to communicate in the English
26 language, which may be determined by an examination given by
27 the department.
28 3. Has provided sufficient information, which must be
29 submitted by the department for a statewide criminal records
30 correspondence check through the Department of Law
31 Enforcement.
49
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (b) Each applicant who meets the requirements of this
2 subsection shall, unless denied pursuant to s. 464.018, be
3 entitled to certification as a certified geriatric specialist.
4 The board shall certify, and the department shall issue a
5 certificate to practice as a certified geriatric specialist
6 to, any certified nursing assistant meeting the qualifications
7 in this section. The board shall establish an application fee
8 not to exceed $100 and a biennial renewal fee not to exceed
9 $50. The board may adopt rules to administer this section.
10 (c) A person receiving certification under this
11 section shall:
12 1. Work only within the confines of a facility
13 licensed under part II or part III of chapter 400.
14 2. Care for geriatric patients only.
15 3. Comply with the minimum standards of practice for
16 nurses and be subject to disciplinary action for violations of
17 s. 464.018.
18 (3) ARTICULATION.--Any certified geriatric specialist
19 who completes the additional instruction and coursework in an
20 approved nursing program pursuant to s. 464.019 for the
21 preparation of practical nursing in the areas of pediatric
22 nursing and obstetric/maternal-child nursing shall, unless
23 denied pursuant to s. 464.018, be entitled to licensure as a
24 licensed practical nurse if the applicant otherwise meets the
25 requirements of s. 464.008.
26 (4) TITLES AND ABBREVIATIONS; RESTRICTIONS;
27 PENALTIES.--
28 (a) Only persons who hold certificates to practice as
29 certified geriatric specialists in this state or who are
30 performing services within the practice of certified geriatric
31 specialty nursing pursuant to the exception set forth in s.
50
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 464.022(8) shall have the right to use the title "Certified
2 Geriatric Specialist" and the abbreviation "C.G.S."
3 (b) No person shall practice or advertise as, or
4 assume the title of, certified geriatric specialist or use the
5 abbreviation "C.G.S." or take any other action that would lead
6 the public to believe that person was certified as such or is
7 performing services within the practice of certified geriatric
8 specialty nursing pursuant to the exception set forth in s.
9 464.022(8), unless that person is certified to practice as
10 such.
11 (c) A violation of this subsection is a misdemeanor of
12 the first degree, punishable as provided in s. 775.082 or s.
13 775.083.
14 (5) VIOLATIONS AND PENALTIES.--Practicing certified
15 geriatric specialty nursing, as defined in this section,
16 without holding an active certificate to do so constitutes a
17 felony of the third degree, punishable as provided in s.
18 775.082, s. 775.083, or s. 775.084.
19 Section 44. Paragraph (b) of subsection (1) of section
20 381.00315, Florida Statutes, is amended to read:
21 381.00315 Public health advisories; public health
22 emergencies.--The State Health Officer is responsible for
23 declaring public health emergencies and issuing public health
24 advisories.
25 (1) As used in this section, the term:
26 (b) "Public health emergency" means any occurrence, or
27 threat thereof, whether natural or man made, which results or
28 may result in substantial injury or harm to the public health
29 from infectious disease, chemical agents, nuclear agents,
30 biological toxins, or situations involving mass casualties or
31 natural disasters. Prior to declaring a public health
51
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 emergency, the State Health Officer shall, to the extent
2 possible, consult with the Governor and shall notify the Chief
3 of Domestic Security Initiatives as created in s. 943.03. The
4 declaration of a public health emergency shall continue until
5 the State Health Officer finds that the threat or danger has
6 been dealt with to the extent that the emergency conditions no
7 longer exist and he or she terminates the declaration.
8 However, a declaration of a public health emergency may not
9 continue for longer than 60 days unless the Governor concurs
10 in the renewal of the declaration. The State Health Officer,
11 upon declaration of a public health emergency, may take
12 actions that are necessary to protect the public health. Such
13 actions include, but are not limited to:
14 1. Directing manufacturers of prescription drugs or
15 over-the-counter drugs who are permitted under chapter 499 and
16 wholesalers of prescription drugs located in this state who
17 are permitted under chapter 499 to give priority to the
18 shipping of specified drugs to pharmacies and health care
19 providers within geographic areas that have been identified by
20 the State Health Officer. The State Health Officer must
21 identify the drugs to be shipped. Manufacturers and
22 wholesalers located in the state must respond to the State
23 Health Officer's priority shipping directive before shipping
24 the specified drugs.
25 2. Notwithstanding chapters 465 and 499 and rules
26 adopted thereunder, directing pharmacists employed by the
27 department to compound bulk prescription drugs and provide
28 these bulk prescription drugs to physicians and nurses of
29 county health departments or any qualified person authorized
30 by the State Health Officer for administration to persons as
31 part of a prophylactic or treatment regimen.
52
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 3. Notwithstanding s. 456.036, temporarily
2 reactivating the inactive license of the following health care
3 practitioners, when such practitioners are needed to respond
4 to the public health emergency: physicians licensed under
5 chapter 458 or chapter 459; physician assistants licensed
6 under chapter 458 or chapter 459; certified geriatric
7 specialists certified under part I of chapter 464; licensed
8 practical nurses, registered nurses, and advanced registered
9 nurse practitioners licensed under part I of chapter 464;
10 respiratory therapists licensed under part V of chapter 468;
11 and emergency medical technicians and paramedics certified
12 under part III of chapter 401. Only those health care
13 practitioners specified in this paragraph who possess an
14 unencumbered inactive license and who request that such
15 license be reactivated are eligible for reactivation. An
16 inactive license that is reactivated under this paragraph
17 shall return to inactive status when the public health
18 emergency ends or prior to the end of the public health
19 emergency if the State Health Officer determines that the
20 health care practitioner is no longer needed to provide
21 services during the public health emergency. Such licenses may
22 only be reactivated for a period not to exceed 90 days without
23 meeting the requirements of s. 456.036 or chapter 401, as
24 applicable.
25 4. Ordering an individual to be examined, tested,
26 vaccinated, treated, or quarantined for communicable diseases
27 that have significant morbidity or mortality and present a
28 severe danger to public health. Individuals who are unable or
29 unwilling to be examined, tested, vaccinated, or treated for
30 reasons of health, religion, or conscience may be subjected to
31 quarantine.
53
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 a. Examination, testing, vaccination, or treatment may
2 be performed by any qualified person authorized by the State
3 Health Officer.
4 b. If the individual poses a danger to the public
5 health, the State Health Officer may subject the individual to
6 quarantine. If there is no practical method to quarantine the
7 individual, the State Health Officer may use any means
8 necessary to vaccinate or treat the individual.
9
10 Any order of the State Health Officer given to effectuate this
11 paragraph shall be immediately enforceable by a law
12 enforcement officer under s. 381.0012.
13 Section 45. Subsection (14) of section 400.021,
14 Florida Statutes, is amended to read:
15 400.021 Definitions.--When used in this part, unless
16 the context otherwise requires, the term:
17 (14) "Nursing service" means such services or acts as
18 may be rendered, directly or indirectly, to and in behalf of a
19 person by individuals as defined in ss. s. 464.003 and
20 464.0125.
21 Section 46. Subsection (1) of section 400.211, Florida
22 Statutes, is amended to read:
23 400.211 Persons employed as nursing assistants;
24 certification requirement.--
25 (1) To serve as a nursing assistant in any nursing
26 home, a person must be certified as a nursing assistant under
27 part II of chapter 464, unless the person is a registered
28 nurse, a or practical nurse, or a certified geriatric
29 specialist certified or licensed in accordance with part I of
30 chapter 464 or an applicant for such licensure who is
31 permitted to practice nursing in accordance with rules adopted
54
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 by the Board of Nursing pursuant to part I of chapter 464.
2 Section 47. Paragraphs (a) and (c) of subsection (3)
3 of section 400.23, Florida Statutes, are amended to read:
4 400.23 Rules; evaluation and deficiencies; licensure
5 status.--
6 (3)(a) The agency shall adopt rules providing for the
7 minimum staffing requirements for nursing homes. These
8 requirements shall include, for each nursing home facility, a
9 minimum certified nursing assistant staffing of 2.3 hours of
10 direct care per resident per day beginning January 1, 2002,
11 increasing to 2.6 hours of direct care per resident per day
12 beginning January 1, 2003, and increasing to 2.9 hours of
13 direct care per resident per day beginning January 1, 2004.
14 Beginning January 1, 2002, no facility shall staff below one
15 certified nursing assistant per 20 residents, and a minimum
16 licensed nursing staffing of 1.0 hour of direct resident care
17 per resident per day but never below one licensed nurse per 40
18 residents. For purposes of computing nursing staffing minimums
19 and ratios, certified geriatric specialists shall be
20 considered licensed nursing staff. Nursing assistants employed
21 under s. 400.211(2) may be included in computing the staffing
22 ratio for certified nursing assistants only if they provide
23 nursing assistance services to residents on a full-time basis.
24 Each nursing home must document compliance with staffing
25 standards as required under this paragraph and post daily the
26 names of staff on duty for the benefit of facility residents
27 and the public. The agency shall recognize the use of licensed
28 nurses for compliance with minimum staffing requirements for
29 certified nursing assistants, provided that the facility
30 otherwise meets the minimum staffing requirements for licensed
31 nurses and that the licensed nurses so recognized are
55
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 performing the duties of a certified nursing assistant. Unless
2 otherwise approved by the agency, licensed nurses counted
3 towards the minimum staffing requirements for certified
4 nursing assistants must exclusively perform the duties of a
5 certified nursing assistant for the entire shift and shall not
6 also be counted towards the minimum staffing requirements for
7 licensed nurses. If the agency approved a facility's request
8 to use a licensed nurse to perform both licensed nursing and
9 certified nursing assistant duties, the facility must allocate
10 the amount of staff time specifically spent on certified
11 nursing assistant duties for the purpose of documenting
12 compliance with minimum staffing requirements for certified
13 and licensed nursing staff. In no event may the hours of a
14 licensed nurse with dual job responsibilities be counted
15 twice.
16 (c) Licensed practical nurses licensed under chapter
17 464 who are providing nursing services in nursing home
18 facilities under this part may supervise the activities of
19 other licensed practical nurses, certified geriatric
20 specialists, certified nursing assistants, and other
21 unlicensed personnel providing services in such facilities in
22 accordance with rules adopted by the Board of Nursing.
23 Section 48. Paragraph (b) of subsection (2) of section
24 409.908, Florida Statutes, is amended to read:
25 409.908 Reimbursement of Medicaid providers.--Subject
26 to specific appropriations, the agency shall reimburse
27 Medicaid providers, in accordance with state and federal law,
28 according to methodologies set forth in the rules of the
29 agency and in policy manuals and handbooks incorporated by
30 reference therein. These methodologies may include fee
31 schedules, reimbursement methods based on cost reporting,
56
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 negotiated fees, competitive bidding pursuant to s. 287.057,
2 and other mechanisms the agency considers efficient and
3 effective for purchasing services or goods on behalf of
4 recipients. If a provider is reimbursed based on cost
5 reporting and submits a cost report late and that cost report
6 would have been used to set a lower reimbursement rate for a
7 rate semester, then the provider's rate for that semester
8 shall be retroactively calculated using the new cost report,
9 and full payment at the recalculated rate shall be affected
10 retroactively. Medicare-granted extensions for filing cost
11 reports, if applicable, shall also apply to Medicaid cost
12 reports. Payment for Medicaid compensable services made on
13 behalf of Medicaid eligible persons is subject to the
14 availability of moneys and any limitations or directions
15 provided for in the General Appropriations Act or chapter 216.
16 Further, nothing in this section shall be construed to prevent
17 or limit the agency from adjusting fees, reimbursement rates,
18 lengths of stay, number of visits, or number of services, or
19 making any other adjustments necessary to comply with the
20 availability of moneys and any limitations or directions
21 provided for in the General Appropriations Act, provided the
22 adjustment is consistent with legislative intent.
23 (2)
24 (b) Subject to any limitations or directions provided
25 for in the General Appropriations Act, the agency shall
26 establish and implement a Florida Title XIX Long-Term Care
27 Reimbursement Plan (Medicaid) for nursing home care in order
28 to provide care and services in conformance with the
29 applicable state and federal laws, rules, regulations, and
30 quality and safety standards and to ensure that individuals
31 eligible for medical assistance have reasonable geographic
57
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 access to such care.
2 1. Changes of ownership or of licensed operator do not
3 qualify for increases in reimbursement rates associated with
4 the change of ownership or of licensed operator. The agency
5 shall amend the Title XIX Long Term Care Reimbursement Plan to
6 provide that the initial nursing home reimbursement rates, for
7 the operating, patient care, and MAR components, associated
8 with related and unrelated party changes of ownership or
9 licensed operator filed on or after September 1, 2001, are
10 equivalent to the previous owner's reimbursement rate.
11 2. The agency shall amend the long-term care
12 reimbursement plan and cost reporting system to create direct
13 care and indirect care subcomponents of the patient care
14 component of the per diem rate. These two subcomponents
15 together shall equal the patient care component of the per
16 diem rate. Separate cost-based ceilings shall be calculated
17 for each patient care subcomponent. The direct care
18 subcomponent of the per diem rate shall be limited by the
19 cost-based class ceiling, and the indirect care subcomponent
20 shall be limited by the lower of the cost-based class ceiling,
21 by the target rate class ceiling, or by the individual
22 provider target. The agency shall adjust the patient care
23 component effective January 1, 2002. The cost to adjust the
24 direct care subcomponent shall be net of the total funds
25 previously allocated for the case mix add-on. The agency shall
26 make the required changes to the nursing home cost reporting
27 forms to implement this requirement effective January 1, 2002.
28 3. The direct care subcomponent shall include salaries
29 and benefits of direct care staff providing nursing services
30 including registered nurses, licensed practical nurses,
31 certified geriatric specialists, certified under part I of
58
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 chapter 464, and certified nursing assistants who deliver care
2 directly to residents in the nursing home facility. This
3 excludes nursing administration, MDS, and care plan
4 coordinators, staff development, and staffing coordinator.
5 4. All other patient care costs shall be included in
6 the indirect care cost subcomponent of the patient care per
7 diem rate. There shall be no costs directly or indirectly
8 allocated to the direct care subcomponent from a home office
9 or management company.
10 5. On July 1 of each year, the agency shall report to
11 the Legislature direct and indirect care costs, including
12 average direct and indirect care costs per resident per
13 facility and direct care and indirect care salaries and
14 benefits per category of staff member per facility.
15 6. In order to offset the cost of general and
16 professional liability insurance, the agency shall amend the
17 plan to allow for interim rate adjustments to reflect
18 increases in the cost of general or professional liability
19 insurance for nursing homes. This provision shall be
20 implemented to the extent existing appropriations are
21 available.
22
23 It is the intent of the Legislature that the reimbursement
24 plan achieve the goal of providing access to health care for
25 nursing home residents who require large amounts of care while
26 encouraging diversion services as an alternative to nursing
27 home care for residents who can be served within the
28 community. The agency shall base the establishment of any
29 maximum rate of payment, whether overall or component, on the
30 available moneys as provided for in the General Appropriations
31 Act. The agency may base the maximum rate of payment on the
59
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 results of scientifically valid analysis and conclusions
2 derived from objective statistical data pertinent to the
3 particular maximum rate of payment.
4 Section 49. Subsection (2) of section 458.303, Florida
5 Statutes, is amended to read:
6 458.303 Provisions not applicable to other
7 practitioners; exceptions, etc.--
8 (2) Nothing in s. 458.301, s. 458.303, s. 458.305, s.
9 458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.
10 458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.
11 458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347
12 shall be construed to prohibit any service rendered by a
13 registered nurse, or a licensed practical nurse, or a
14 certified geriatric specialist certified under part I of
15 chapter 464, if such service is rendered under the direct
16 supervision and control of a licensed physician who provides
17 specific direction for any service to be performed and gives
18 final approval to all services performed. Further, nothing in
19 this or any other chapter shall be construed to prohibit any
20 service rendered by a medical assistant in accordance with the
21 provisions of s. 458.3485.
22 Section 50. Subsection (1) and paragraph (a) of
23 subsection (2) of section 1009.65, Florida Statutes, are
24 amended to read:
25 1009.65 Medical Education Reimbursement and Loan
26 Repayment Program.--
27 (1) To encourage qualified medical professionals to
28 practice in underserved locations where there are shortages of
29 such personnel, there is established the Medical Education
30 Reimbursement and Loan Repayment Program. The function of the
31 program is to make payments that offset loans and educational
60
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 expenses incurred by students for studies leading to a medical
2 or nursing degree, medical or nursing licensure, or advanced
3 registered nurse practitioner certification or physician
4 assistant licensure. The following licensed or certified
5 health care professionals are eligible to participate in this
6 program: medical doctors with primary care specialties,
7 doctors of osteopathic medicine with primary care specialties,
8 physician's assistants, certified geriatric specialists
9 certified under part I of chapter 464, licensed practical
10 nurses and registered nurses, and advanced registered nurse
11 practitioners with primary care specialties such as certified
12 nurse midwives. Primary care medical specialties for
13 physicians include obstetrics, gynecology, general and family
14 practice, internal medicine, pediatrics, and other specialties
15 which may be identified by the Department of Health.
16 (2) From the funds available, the Department of Health
17 shall make payments to selected medical professionals as
18 follows:
19 (a) Up to $4,000 per year for certified geriatric
20 specialists certified under part I of chapter 464, licensed
21 practical nurses, and registered nurses, up to $10,000 per
22 year for advanced registered nurse practitioners and
23 physician's assistants, and up to $20,000 per year for
24 physicians. Penalties for noncompliance shall be the same as
25 those in the National Health Services Corps Loan Repayment
26 Program. Educational expenses include costs for tuition,
27 matriculation, registration, books, laboratory and other fees,
28 other educational costs, and reasonable living expenses as
29 determined by the Department of Health.
30 Section 51. Subsection (2) of section 1009.66, Florida
31 Statutes, is amended to read:
61
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 1009.66 Nursing Student Loan Forgiveness Program.--
2 (2) To be eligible, a candidate must have graduated
3 from an accredited or approved nursing program and have
4 received a Florida license as a licensed practical nurse, a
5 certified geriatric specialist certified under part I of
6 chapter 464, or a registered nurse or a Florida certificate as
7 an advanced registered nurse practitioner.
8 Section 52. The sum of $157,017 is appropriated from
9 the General Revenue Fund to the Agency for Workforce
10 Innovation to support the work of the Certified Geriatric
11 Specialty Nursing Initiative Steering Committee, to administer
12 the pilot sites, contract for an evaluation, and to provide,
13 if necessary, nursing faculty, substitute certified nursing
14 assistants for those who are in clinical education, and
15 technical support to the pilot sites during the 2003-2004
16 fiscal year.
17 Section 53. Subsection (6) is added to section
18 464.201, Florida Statutes, to read:
19 464.201 Definitions.--As used in this part, the term:
20 (6) "Practice of a certified nursing assistant" means
21 providing care and assisting persons with tasks relating to
22 the activities of daily living. Such tasks are those
23 associated with personal care, maintaining mobility, nutrition
24 and hydration, toileting and elimination, assistive devices,
25 safety and cleanliness, data gathering, reporting abnormal
26 signs and symptoms, post mortem care, patient socialization
27 and reality orientation, end-of-life care, CPR and emergency
28 care, residents' or patients' rights, documentation of nursing
29 assistant services, and other tasks that a certified nurse
30 assistant may perform after training beyond that required for
31 initial certification and upon validation of competence in
62
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 that skill by a registered nurse. This section does not
2 restrict the ability of any person who is otherwise trained
3 and educated from performing such tasks.
4 Section 54. Section 464.202, Florida Statutes, is
5 amended to read:
6 464.202 Duties and powers of the board.--The board
7 shall maintain, or contract with or approve another entity to
8 maintain, a state registry of certified nursing assistants.
9 The registry must consist of the name of each certified
10 nursing assistant in this state; other identifying information
11 defined by board rule; certification status; the effective
12 date of certification; other information required by state or
13 federal law; information regarding any crime or any abuse,
14 neglect, or exploitation as provided under chapter 435; and
15 any disciplinary action taken against the certified nursing
16 assistant. The registry shall be accessible to the public, the
17 certificateholder, employers, and other state agencies. The
18 board shall adopt by rule testing procedures for use in
19 certifying nursing assistants and shall adopt rules regulating
20 the practice of certified nursing assistants which specify the
21 scope of practice authorized and level of supervision required
22 for the practice of certified nursing assistants to enforce
23 this part. The board may contract with or approve another
24 entity or organization to provide the examination services,
25 including the development and administration of examinations.
26 The board shall require that the contract provider offer
27 certified nursing assistant applications via the Internet, and
28 may require the contract provider to accept certified nursing
29 assistant applications for processing via the Internet. The
30 board shall require the contract provider to provide the
31 preliminary results of the certified nursing examination on
63
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the date the test is administered. The provider shall pay all
2 reasonable costs and expenses incurred by the board in
3 evaluating the provider's application and performance during
4 the delivery of services, including examination services and
5 procedures for maintaining the certified nursing assistant
6 registry.
7 Section 55. Paragraph (a) of subsection (4) of section
8 464.0205, Florida Statutes, is amended to read:
9 464.0205 Retired volunteer nurse certificate.--
10 (4) A retired volunteer nurse receiving certification
11 from the board shall:
12 (a) Work under the direct supervision of the director
13 of a county health department, a physician working under a
14 limited license issued pursuant to s. 458.315 458.317 or s.
15 459.0075, a physician licensed under chapter 458 or chapter
16 459, an advanced registered nurse practitioner certified under
17 s. 464.012, or a registered nurse licensed under s. 464.008 or
18 s. 464.009.
19 Section 56. Subsections (1) and (5) of section
20 464.203, Florida Statutes, are amended and subsections (8) and
21 (9) are added to that section, to read:
22 464.203 Certified nursing assistants; certification
23 requirement.--
24 (1) The board shall issue a certificate to practice as
25 a certified nursing assistant to any person who demonstrates a
26 minimum competency to read and write and successfully passes
27 the required statewide criminal screening through the
28 Department of Law Enforcement, including Level I screening
29 pursuant to chapter 435, or, if the applicant has not
30 maintained continuous residency within the state for 5 years
31 immediately preceding the date of application, Level II
64
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 screening which includes a fingerprint check through the
2 Department of Law Enforcement and the Federal Bureau of
3 Investigation pursuant to chapter 435, Level I or Level II
4 screening pursuant to s. 400.215 and meets one of the
5 following requirements:
6 (a) Has successfully completed an approved training
7 program and achieved a minimum score, established by rule of
8 the board, on the nursing assistant competency examination,
9 which consists of a written portion and skills-demonstration
10 portion approved by the board and administered at a site and
11 by personnel approved by the department.
12 (b) Has achieved a minimum score, established by rule
13 of the board, on the nursing assistant competency examination,
14 which consists of a written portion and skills-demonstration
15 portion, approved by the board and administered at a site and
16 by personnel approved by the department and:
17 1. Has a high school diploma, or its equivalent; or
18 2. Is at least 18 years of age.
19 (c) Is currently certified in another state; is listed
20 on that state's certified nursing assistant registry; and has
21 not been found to have committed abuse, neglect, or
22 exploitation in that state.
23 (d) Has completed the curriculum developed under the
24 Enterprise Florida Jobs and Education Partnership Grant and
25 achieved a minimum score, established by rule of the board, on
26 the nursing assistant competency examination, which consists
27 of a written portion and skills-demonstration portion,
28 approved by the board and administered at a site and by
29 personnel approved by the department.
30 (5) Certification as a nursing assistant, in
31 accordance with this part, may be renewed continues in effect
65
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 until such time as the nursing assistant allows a period of 24
2 consecutive months to pass during which period the nursing
3 assistant fails to perform any nursing-related services for
4 monetary compensation. When a nursing assistant fails to
5 perform any nursing-related services for monetary compensation
6 for a period of 24 consecutive months, the nursing assistant
7 must complete a new training and competency evaluation program
8 or a new competency evaluation program.
9 (8) The department shall renew a certificate upon
10 receipt of the renewal application and imposition of a fee of
11 not less than $20 and not more than $50 biennially. The
12 department shall adopt rules establishing a procedure for the
13 biennial renewal of certificates. Any certificate not renewed
14 by July 1, 2005, shall be void.
15 (9) Notwithstanding any provision of law to the
16 contrary, any entity required to conduct a Level I or Level II
17 screening, pursuant to chapter 435, is exempt from rescreening
18 any certified nursing assistant upon employment if the
19 screening date on the certificate issued by the board is
20 within the last 12 months, the certified nursing assistant has
21 not been unemployed for more than 180 days, and the nursing
22 assistant attests under penalty of perjury to not having been
23 convicted of a disqualifying offense since the completion of
24 such screening.
25 Section 57. Subsection (1) of section 464.204, Florida
26 Statutes, is amended to read:
27 464.204 Denial, suspension, or revocation of
28 certification; disciplinary actions.--
29 (1) The following acts constitute grounds for which
30 the board may impose disciplinary sanctions as specified in
31 subsection (2):
66
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (a) Obtaining or attempting to obtain certification or
2 an exemption, or possessing or attempting to possess
3 certification or a letter of exemption, by bribery,
4 misrepresentation, deceit, or through an error of the board.
5 (b) Intentionally Violating any provision of part I or
6 part II of this chapter, chapter 456, or the rules adopted by
7 the board.
8 Section 58. Paragraph (a) of subsection (2) of section
9 466.004, Florida Statutes, is amended to read:
10 466.004 Board of Dentistry.--
11 (2) To advise the board, it is the intent of the
12 Legislature that councils be appointed as specified in
13 paragraphs (a), (b), and (c). The department shall provide
14 administrative support to the councils and shall provide
15 public notice of meetings and agenda of the councils. Councils
16 shall include at least one board member who shall chair the
17 council and shall include nonboard members. All council
18 members shall be appointed by the board chair. Council
19 members shall be appointed for 4-year terms, and all members
20 shall be eligible for reimbursement of expenses in the manner
21 of board members.
22 (a) A Council on Dental Hygiene shall be appointed by
23 the board chair and shall include one dental hygienist member
24 of the board, who shall chair the council, one dental member
25 of the board, and three dental hygienists who are actively
26 engaged in the practice of dental hygiene in this state. The
27 council shall meet at the request of the board chair, a
28 majority of the members of the board, or the council chair, if
29 the council meets at least twice each year. The council is
30 charged with the responsibility of and shall meet for the
31 purpose of developing rules and policies for recommendation to
67
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the board, which the board shall consider, on matters
2 pertaining to that part of dentistry consisting of
3 educational, preventive, or therapeutic dental hygiene
4 services; dental hygiene licensure, discipline, or regulation;
5 and dental hygiene education. Rule and policy recommendations
6 of the council shall be considered by the board at its next
7 regularly scheduled meeting in the same manner it considers
8 rule and policy recommendations from designated subcommittees
9 of the board. Any rule or policy proposed by the board
10 pertaining to the specified part of dentistry defined by this
11 paragraph shall be referred to the council for a
12 recommendation prior to final action by the board.
13 Section 59. Section 466.055, Florida Statutes, is
14 created to read:
15 466.055 Board of Dentistry Empowerment Act.--
16 (1) If requested by the Board of Dentistry, it shall
17 direct the department whom to appoint as executive director
18 pursuant to the rules of the state personnel system. The
19 committee conducting interviews of candidates for executive
20 director shall consist of the board chairman or his designee
21 and the secretary or his or her designee. A list of final
22 candidates shall be submitted to the board, which shall
23 approve the candidate to be hired. The approval process shall
24 include the right of the board to interview the list of
25 submitted candidates. The board may reject all the candidates
26 on the submitted list and request that a new list be submitted
27 by the interview committee. The executive director shall
28 perform those duties and responsibilities specific to the
29 Board of Dentistry and shall exclusively serve the Board of
30 Dentistry. The board shall monitor the performance of the
31 executive director, based on established performance standards
68
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 and should the board determine, by a majority vote, that the
2 performance of the executive director is consistently below
3 the performance standards of the board and thus unacceptable,
4 the board shall promptly notify the department of its
5 findings, in writing, and the department shall take
6 appropriate action to replace the executive director, pursuant
7 to the state personnel rules.
8 (2) The executive director shall be responsible for
9 overseeing the hiring of all other staff members who work
10 directly for the executive director and who perform services
11 for the board.
12 (3) The department shall contract for a dental intake
13 officer when requested by the Board of Dentistry in accordance
14 with the state personnel system and qualifications established
15 for such position by the Board of Dentistry. The
16 qualifications for the position shall include a requirement
17 that the candidate be a licensed Florida dentist in good
18 standing.
19 (4) The dental intake officer shall be responsible for
20 determining the legal sufficiency of all dental complaints
21 received by the department within 5 working days after the
22 complaint is filed; advising the board regarding dental health
23 regulation issues; and advising field investigators on dental
24 issues related to the complaints to assure that complaints are
25 properly investigated in a timely and efficacious manner.
26 (5) The Board of Dentistry, in consultation with the
27 department, shall establish reasonable and comprehensive
28 performance parameters for the prosecution of disciplinary
29 cases by the department. Such parameters shall reflect the
30 quality and quantity of services to be provided to the board,
31 including, but not limited to, the proportion of cases that
69
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 are successfully prosecuted through final hearing and appeal
2 if such cases involve irremediable harm or injury or the
3 immediate threat of irremediable harm or injury to the
4 patient. The board shall conduct an annual evaluation to
5 determine if the department has met the established
6 performance parameters. A finding by the board that the
7 department has failed to meet established parameters shall
8 enable the board, by a majority vote, to instruct the
9 department to retain sufficient outside contractual
10 prosecutorial services pursuant to s. 287.057(3), to fulfill
11 the immediate and forseeable prosecutorial needs of the board.
12 Contract negotiations and vendor selection shall be conducted
13 in consultation with the chairman of the board or his
14 designee. Each contract for prosecutorial services shall
15 include, at a minimum, the performance parameters developed by
16 the board for its assessment of the department.
17 (6) If requested, a representative of testing services
18 of the Department of Health shall appear before the board, or
19 a committee of the board, following the completion of each
20 examination cycle to discuss examination issues. If the board
21 identifies issues to be addressed, testing services shall
22 report to the board, as requested at the next board meeting,
23 on its progress in addressing the issues identified by the
24 board.
25 (7)(a) In conjunction with each fiscal year budgetary
26 cycle, the department, in consultation with the board, shall
27 develop a Board of Dentistry spending plan encompassing
28 anticipated revenue of all types along with all anticipated
29 operating expenses of the board and associated support
30 services of the department, which shall include all direct and
31 allocated expenses necessary to enable the board to fulfill
70
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 its responsibilities. All expenditure detail as provided
2 herein shall reflect the methodology and calculations of the
3 department in allocating common expenses among all regulatory
4 boards.
5 (b) The Board of Dentistry shall have spending
6 authority over discretionary budgetary items, as determined by
7 the department and the board jointly. Discretionary budgetary
8 items shall include the selection of board meeting venue,
9 hotel facilities, and accommodations; travel of board members
10 and necessary staff to all meetings of the board; attendance
11 by board members at meetings and conferences deemed to be
12 important by the board in fulfilling its responsibilities,
13 monitoring performance, and confirming the accuracy of
14 information provided to the board or others which relates to
15 the duties and responsibilities of the board; and an
16 operational contingency. Operational contingency is that
17 portion of cash on hand that exceeds that required for the
18 5-year spending plan as described in s. 456.005. The
19 operational contingency may be used for a special project by
20 the board in fulfilling its responsibilities if a deficit does
21 not or would not exist for the profession. In exercising its
22 spending authority over discretionary budget items, the board
23 must adhere to all applicable state laws and directives;
24 assure that all meeting locations are accessible to the public
25 and licensees; assure that board meetings are conducted in an
26 effective and efficient manner for the public and licensees;
27 assure that the minimal number of board members or staff
28 attend any meeting or conference; and assure the maximum use
29 of technology. When requested by the board, the department
30 shall provide timely procurement assistance to facilitate all
31 discretionary expenditures of the board.
71
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (8)(a) The department shall submit a report to the
2 Governor, the President of the Senate, and the Speaker of the
3 House of Representatives by November 1 of each year on the
4 effectiveness and efficiency of this section, including:
5 1. The revenues, expenditures, and cash balances for
6 the prior year, and a review of the adequacy of existing
7 revenues;
8 2. The nature and extent of all services provided to
9 the board by the department;
10 3. The total cost allocated by the department for each
11 service provided by the department to the board and the amount
12 and percent by which each cost is appropriate to dentistry's
13 pro-rata share of the total cost of such services provided by
14 the department to all affected boards, councils, and
15 professions;
16 4. The number of licensure examinations taken, the
17 fees collected for licensure examination, and the time from
18 which a candidate for licensure completed the required
19 examination to the time in which the candidate received the
20 results;
21 5. The number of licenses issued, revoked, or
22 suspended;
23 6. The number of disciplinary complaints received,
24 determined to be legally sufficient, investigated, referred to
25 the board's probable cause panel, prosecuted, subject to final
26 board action, and appealed; the number, maximum, and average
27 duration of licenses suspended; the number of licenses
28 revoked; the number of cases spanning more than 180,270, and
29 365 days from receipt of complaints to submission to the
30 board's probable cause panel; the proportion of cases which
31 were eligible for and the number of cases actually resolved by
72
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 citation; the proportion of cases where probable cause was
2 found; the number of cases were probable cause was found that
3 were not prosecuted or that did not result in stipulated
4 agreements; the number of cases involving stipulated
5 agreements; the number of cases involving stipulated
6 agreements which were changed by the board and the number of
7 cases involving stipulated agreements that were rejected
8 without modification by the board; the number of cases taking
9 in excess of 1 year from the date of receipt of a complaint to
10 final board action; the number of cases involving formal
11 hearings; the status of all cases appealed; the number of
12 cases where licensure suspension or revocation was stayed
13 pending appeal; the number of emergency suspension orders
14 issued; the average and maximum range of costs of complaint
15 investigations and prosecutions; and the amount of fines and
16 expenses collected by type of cases prosecuted;
17 7. The status of the development and implementation of
18 rules providing for disciplinary guidelines pursuant to s.
19 456.079; and
20 8. Such recommendations for administrative and
21 statutory changes necessary to facilitate efficient and
22 cost-effective operation of the board and the department.
23 (b) The department shall include in the report any
24 statement, comment, suggestion, recommendation, or objection
25 made by the board in response to the report.
26 Section 60. Section 467.013, Florida Statutes, is
27 amended to read:
28 467.013 Inactive status.--A licensee may request that
29 his or her license be placed in an inactive status by making
30 application to the department pursuant to department rule and
31 paying a fee.
73
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (1) An inactive license may be renewed for one
2 additional biennium upon application to the department and
3 payment of the applicable biennium renewal fee. The department
4 shall establish by rule procedures and fees for applying to
5 place a license on inactive status, renewing an inactive
6 license, and reactivating an inactive license. The fee for any
7 of these procedures may not exceed the biennial renewal fee
8 established by the department.
9 (2) Any license that is not renewed by the end of the
10 biennium established by the department automatically reverts
11 to involuntary inactive status unless the licensee has applied
12 for voluntary inactive status. Such license may be reactivated
13 only if the licensee meets the requirements for reactivating
14 the license established by department rule.
15 (3) A midwife who desires to reactivate an inactive
16 license shall apply to the department, complete the
17 reactivation application, remit the applicable fees, and
18 submit proof of compliance with the requirements for
19 continuing education established by department rule.
20 (4) Each licensed midwife whose license has been
21 placed on inactive status for more than 1 year must complete
22 continuing education hours as a condition of reactivating the
23 inactive license.
24 (5) The licensee shall submit to the department
25 evidence of participation in 10 hours of continuing education,
26 approved by the department and clinically related to the
27 practice of midwifery, for each year of the biennium in which
28 the license was inactive. This requirement is in addition to
29 submitting evidence of completing the continuing education
30 required for the most recent biennium in which the licensee
31 held an active license.
74
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Section 61. Section 467.0135, Florida Statutes, is
2 amended to read:
3 467.0135 Fees.--The department shall establish fees
4 for application, examination, initial licensure, renewal of
5 licensure, licensure by endorsement, inactive status,
6 delinquent status, and reactivation of an inactive license.
7 The appropriate fee must be paid at the time of application
8 and is payable to the Department of Health, in accordance with
9 rules adopted by the department. A fee is nonrefundable,
10 unless otherwise provided by rule. A fee may not exceed:
11 (1) Five hundred dollars for examination.
12 (1)(2) Five hundred dollars for initial licensure.
13 (2)(3) Five hundred dollars for renewal of an active
14 license licensure.
15 (3)(4) Two hundred dollars for application, which fee
16 is nonrefundable.
17 (4)(5) Five hundred dollars for renewal reactivation
18 of an inactive license.
19 (5)(6) Five hundred dollars for licensure by
20 endorsement.
21
22 A fee for inactive status, reactivation of an inactive
23 license, or delinquency may not exceed the fee established by
24 the department for biennial renewal of an active license. All
25 fees collected under this section shall be deposited in the
26 Medical Quality Assurance Trust Fund.
27 Section 62. Subsection (1) of section 467.017, Florida
28 Statutes, is amended to read:
29 467.017 Emergency care plan; immunity.--
30 (1) Every licensed midwife shall develop a written
31 plan for the appropriate delivery of emergency care. A copy
75
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 of the plan shall accompany any application for license
2 issuance and must be made available upon the request of the
3 department or renewal. The plan shall address the following:
4 (a) Consultation with other health care providers.
5 (b) Emergency transfer.
6 (c) Access to neonatal intensive care units and
7 obstetrical units or other patient care areas.
8 Section 63. Section 468.352, Florida Statutes, is
9 amended to read:
10 (Substantial rewording of section. See
11 s. 468.352, F.S., for present text.)
12 468.352 Definitions.--As used in this part, the term:
13 (1) "Board" means the Board of Respiratory Care.
14 (2) "Certified respiratory therapist" means any person
15 licensed pursuant to this part who is certified by the
16 National Board for Respiratory Care or its successor; who is
17 employed to deliver respiratory care services, under the order
18 of a physician licensed pursuant to chapter 458 or chapter
19 459, in accordance with protocols established by a hospital or
20 other health care provider or the board; and who functions in
21 situations of unsupervised patient contact requiring
22 individual judgment.
23 (3) "Critical care" means care given to a patient in
24 any setting involving a life-threatening emergency.
25 (4) "Department" means the Department of Health.
26 (5) "Direct supervision" means practicing under the
27 direction of a licensed, registered, or certified respiratory
28 therapist who is physically on the premises and readily
29 available, as defined by the board.
30 (6) "Physician supervision" means supervision and
31 control by a physician licensed under chapter 458 or chapter
76
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 459 who assumes the legal liability for the services rendered
2 by the personnel employed in his or her office. Except in the
3 case of an emergency, physician supervision requires the easy
4 availability of the physician within the office or the
5 physical presence of the physician for consultation and
6 direction of the actions of the persons who deliver
7 respiratory care services.
8 (7) "Practice of respiratory care" or "respiratory
9 therapy" means the allied health specialty associated with the
10 cardiopulmonary system that is practiced under the orders of a
11 physician licensed under chapter 458 or chapter 459 and in
12 accordance with protocols, policies, and procedures
13 established by a hospital or other health care provider or the
14 board, including the assessment, diagnostic evaluation,
15 treatment, management, control, rehabilitation, education, and
16 care of patients in all care settings.
17 (8) "Registered respiratory therapist" means any
18 person licensed under this part who is registered by the
19 National Board for Respiratory Care or its successor, and who
20 is employed to deliver respiratory care services under the
21 order of a physician licensed under chapter 458 or chapter
22 459, in accordance with protocols established by a hospital or
23 other health care provider or the board, and who functions in
24 situations of unsupervised patient contact requiring
25 individual judgment.
26 (9) "Respiratory care practitioner" means any person
27 licensed under this part who is employed to deliver
28 respiratory care services, under direct supervision, pursuant
29 to the order of a physician licensed under chapter 458 or
30 chapter 459.
31 (10) "Respiratory care services" includes:
77
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (a) Evaluation and disease management.
2 (b) Diagnostic and therapeutic use of respiratory
3 equipment, devices, or medical gas.
4 (c) Administration of drugs, as duly ordered or
5 prescribed by a physician licensed under chapter 458 or
6 chapter 459 and in accordance with protocols, policies, and
7 procedures established by a hospital or other health care
8 provider or the board.
9 (d) Initiation, management, and maintenance of
10 equipment to assist and support ventilation and respiration.
11 (e) Diagnostic procedures, research, and therapeutic
12 treatment and procedures, including measurement of ventilatory
13 volumes, pressures, and flows; specimen collection and
14 analysis of blood for gas transport and acid/base
15 determinations; pulmonary-function testing; and other related
16 physiological monitoring of cardiopulmonary systems.
17 (f) Cardiopulmonary rehabilitation.
18 (g) Cardiopulmonary resuscitation, advanced cardiac
19 life support, neonatal resuscitation, and pediatric advanced
20 life support, or equivalent functions.
21 (h) Insertion and maintenance of artificial airways
22 and intravascular catheters.
23 (i) Performing sleep-disorder studies.
24 (j) Education of patients, families, the public, or
25 other health care providers, including disease process and
26 management programs and smoking prevention and cessation
27 programs.
28 (k) Initiation and management of hyperbaric oxygen.
29 Section 64. Section 468.355, Florida Statutes, is
30 amended to read:
31 (Substantial rewording of section. See
78
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 s. 468.355, F.S., for present text.)
2 468.355 Licensure requirements.--To be eligible for
3 licensure by the board, an applicant must be an active
4 "Certified Respiratory Therapist" or be an active "Registered
5 Respiratory Therapist" by the National Board for Respiratory
6 Care, or its successor.
7 Section 65. Section 468.368, Florida Statutes, is
8 amended to read:
9 (Substantial rewording of section. See
10 s. 468.368, F.S., for present text.)
11 468.368 Exemptions.--This part may not be construed to
12 prevent or restrict the practice, service, or activities of:
13 (1) Any person licensed in this state by any other law
14 from engaging in the profession or occupation for which he or
15 she is licensed.
16 (2) Any legally qualified person in the state or
17 another state or territory who is employed by the United
18 States Government or any agency thereof while such person is
19 discharging his or her official duties.
20 (3) A friend or family member who is providing
21 respiratory care services to an ill person and who does not
22 represent himself or herself to be a respiratory care
23 practitioner or respiratory therapist.
24 (4) An individual providing respiratory care services
25 in an emergency who does not represent himself or herself as a
26 respiratory care practitioner or respiratory therapist.
27 (5) Any individual employed to deliver, assemble, set
28 up, or test equipment for use in a home, upon the order of a
29 physician licensed pursuant to chapter 458 or chapter 459.
30 This subsection does not, however, authorize the practice of
31 respiratory care without a license.
79
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (6) Any individual performing polysomnography under
2 medical direction as related to the diagnosis and evaluation
3 of treatment for sleep disorders.
4 (7) Any individual certified or registered as a
5 pulmonary function technologist who is credentialed by the
6 National Board for Respiratory Care for performing
7 cardiopulmonary diagnostic studies.
8 (8) Any student who is enrolled in an accredited
9 respiratory care program approved by the board, while
10 performing respiratory care as an integral part of a required
11 course.
12 (9) The delivery of incidental respiratory care to
13 noninstitutionalized persons by surrogate family members who
14 do not represent themselves as registered or certified
15 respiratory care therapists.
16 (10) Any individual credentialed by the Underseas
17 Hyperbaric Society in hyperbaric medicine or its equivalent as
18 determined by the board, while performing related duties. This
19 subsection does not, however, authorize the practice of
20 respiratory care without a license.
21 Section 66. Sections 468.356 and 468.357, Florida
22 Statutes, are repealed, effective January 1, 2004.
23 Section 67. Subsection (1) of section 491.005, Florida
24 Statutes, is amended to read:
25 491.005 Licensure by examination.--
26 (1) CLINICAL SOCIAL WORK.--Upon verification of
27 documentation and payment of a fee not to exceed $200, as set
28 by board rule, plus the actual per applicant cost to the
29 department for purchase of the examination from the American
30 Association of State Social Worker's Boards or a similar
31 national organization, the department shall issue a license as
80
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 a clinical social worker to an applicant who the board
2 certifies:
3 (a) Has made application therefor and paid the
4 appropriate fee.
5 (b)1. Has received a doctoral degree in social work
6 from a graduate school of social work which at the time the
7 applicant graduated was accredited by an accrediting agency
8 recognized by the United States Department of Education or has
9 received a master's degree in social work from a graduate
10 school of social work which at the time the applicant
11 graduated:
12 a. Was accredited by the Council on Social Work
13 Education;
14 b. Was accredited by the Canadian Association of
15 Schools of Social Work; or
16 c. Has been determined to have been a program
17 equivalent to programs approved by the Council on Social Work
18 Education by the Foreign Equivalency Determination Service of
19 the Council on Social Work Education. An applicant who
20 graduated from a program at a university or college outside of
21 the United States or Canada must present documentation of the
22 equivalency determination from the council in order to
23 qualify.
24 2. The applicant's graduate program must have
25 emphasized direct clinical patient or client health care
26 services, including, but not limited to, coursework in
27 clinical social work, psychiatric social work, medical social
28 work, social casework, psychotherapy, or group therapy. The
29 applicant's graduate program must have included all of the
30 following coursework:
31 a. A supervised field placement which was part of the
81
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 applicant's advanced concentration in direct practice, during
2 which the applicant provided clinical services directly to
3 clients.
4 b. Completion of 24 semester hours or 32 quarter hours
5 in theory of human behavior and practice methods as courses in
6 clinically oriented services, including a minimum of one
7 course in psychopathology, and no more than one course in
8 research, taken in a school of social work accredited or
9 approved pursuant to subparagraph 1.
10 3. If the course title which appears on the
11 applicant's transcript does not clearly identify the content
12 of the coursework, the applicant shall be required to provide
13 additional documentation, including, but not limited to, a
14 syllabus or catalog description published for the course.
15 (c) Has had not less than 2 years of clinical social
16 work experience, which took place subsequent to completion of
17 a graduate degree in social work at an institution meeting the
18 accreditation requirements of this section, under the
19 supervision of a licensed clinical social worker or the
20 equivalent who is a qualified supervisor as determined by the
21 board. An individual who intends to practice in Florida to
22 satisfy clinical experience requirements must register
23 pursuant to s. 491.0045 prior to commencing practice. If the
24 applicant's graduate program was not a program which
25 emphasized direct clinical patient or client health care
26 services as described in subparagraph (b)2., the supervised
27 experience requirement must take place after the applicant has
28 completed a minimum of 15 semester hours or 22 quarter hours
29 of the coursework required. A doctoral internship may be
30 applied toward the clinical social work experience
31 requirement. The experience requirement may be met by work
82
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 performed on or off the premises of the supervising clinical
2 social worker or the equivalent, provided the off-premises
3 work is not the independent private practice rendering of
4 clinical social work that does not have a licensed mental
5 health professional, as determined by the board, on the
6 premises at the same time the intern is providing services.
7 (d) Has passed a theory and practice examination
8 approved provided by the board department for this purpose,
9 which may be taken only following completion of the clinical
10 experience requirement.
11 (e) Has demonstrated, in a manner designated by rule
12 of the board, knowledge of the laws and rules governing the
13 practice of clinical social work, marriage and family therapy,
14 and mental health counseling.
15
16 All coursework requirements in this section shall be satisfied
17 by successfully completing the required course as a student or
18 by teaching the required graduate course as an instructor or
19 professor in an accredited institution.
20 Section 68. Section 491.0145, Florida Statutes, is
21 amended to read:
22 491.0145 Certified master social worker.--The
23 department may not adopt any rules that would allow a person
24 who was not licensed as a certified master social worker in
25 accordance with this chapter on January 1, 1990, to become
26 licensed. The department may certify an applicant for a
27 designation as a certified master social worker upon the
28 following conditions:
29 (1) The applicant completes an application to be
30 provided by the department and pays a nonrefundable fee not to
31 exceed $250 to be established by rule of the department. The
83
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 completed application must be received by the department at
2 least 60 days before the date of the examination in order for
3 the applicant to qualify to take the scheduled exam.
4 (2) The applicant submits proof satisfactory to the
5 department that the applicant has received a doctoral degree
6 in social work, or a master's degree with a major emphasis or
7 specialty in clinical practice or administration, including,
8 but not limited to, agency administration and supervision,
9 program planning and evaluation, staff development, research,
10 community organization, community services, social planning,
11 and human service advocacy. Doctoral degrees must have been
12 received from a graduate school of social work which at the
13 time the applicant was enrolled and graduated was accredited
14 by an accrediting agency approved by the United States
15 Department of Education. Master's degrees must have been
16 received from a graduate school of social work which at the
17 time the applicant was enrolled and graduated was accredited
18 by the Council on Social Work Education or the Canadian
19 Association of Schools of Social Work or by one that meets
20 comparable standards.
21 (3) The applicant has had at least 3 years'
22 experience, as defined by rule, including, but not limited to,
23 clinical services or administrative activities as defined in
24 subsection (2), 2 years of which must be at the post-master's
25 level under the supervision of a person who meets the
26 education and experience requirements for certification as a
27 certified master social worker, as defined by rule, or
28 licensure as a clinical social worker under this chapter. A
29 doctoral internship may be applied toward the supervision
30 requirement.
31 (4) Any person who holds a master's degree in social
84
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 work from institutions outside the United States may apply to
2 the department for certification if the academic training in
3 social work has been evaluated as equivalent to a degree from
4 a school accredited by the Council on Social Work Education.
5 Any such person shall submit a copy of the academic training
6 from the Foreign Equivalency Determination Service of the
7 Council on Social Work Education.
8 (5) The applicant has passed an examination required
9 by the department for this purpose. The nonrefundable fee for
10 such examination may not exceed $250 as set by department
11 rule.
12 (6) Nothing in this chapter shall be construed to
13 authorize a certified master social worker to provide clinical
14 social work services.
15 Section 69. Section 491.0146, Florida Statutes, is
16 created to read:
17 491.0146 Savings clause.--All licenses to practice as
18 a certified master social worker issued pursuant to this
19 chapter and valid on October 1, 2002, shall remain in full
20 force and effect.
21 Section 70. Subsection (3) of section 491.0147,
22 Florida Statutes, is amended to read:
23 491.0147 Confidentiality and privileged
24 communications.--Any communication between any person licensed
25 or certified under this chapter and her or his patient or
26 client shall be confidential. This secrecy may be waived under
27 the following conditions:
28 (3)(a) When there is a clear and immediate probability
29 of physical harm to the patient or client, to other
30 individuals, or to society and the person licensed or
31 certified under this chapter communicates the information only
85
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 to the potential victim, appropriate family member, or law
2 enforcement or other appropriate authorities.
3 (b) There shall be no civil or criminal liability
4 arising from the disclosure of otherwise confidential
5 communications by a person licensed or certified under this
6 chapter when the disclosure is made pursuant to paragraph (a).
7 Section 71. Subsection (1) of section 627.912, Florida
8 Statutes, is amended to read:
9 627.912 Professional liability claims and actions;
10 reports by insurers.--
11 (1) Each self-insurer authorized under s. 627.357 and
12 each insurer or joint underwriting association providing
13 professional liability insurance to a practitioner of medicine
14 licensed under chapter 458, to a practitioner of osteopathic
15 medicine licensed under chapter 459, to a podiatric physician
16 licensed under chapter 461, to a dentist licensed under
17 chapter 466, to a hospital licensed under chapter 395, to a
18 crisis stabilization unit licensed under part IV of chapter
19 394, to a health maintenance organization certificated under
20 part I of chapter 641, to clinics included in chapter 390, to
21 an ambulatory surgical center as defined in s. 395.002, or to
22 a member of The Florida Bar shall report in duplicate to the
23 Department of Insurance any claim or action for damages for
24 personal injuries claimed to have been caused by error,
25 omission, or negligence in the performance of such insured's
26 professional services or based on a claimed performance of
27 professional services without consent, if the claim resulted
28 in:
29 (a) A final judgment in any amount.
30 (b) A settlement in any amount.
31
86
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Reports shall be filed with the department and, if the insured
2 party is licensed under chapter 458, chapter 459, or chapter
3 461, and the final judgment or settlement amount was $50,000
4 or more, if the insured party is licensed under chapter 466
5 and the final judgment or settlement amount was $25,000 or
6 more or chapter 466, with the Department of Health, no later
7 than 30 days following the occurrence of any event listed in
8 paragraph (a) or paragraph (b). The Department of Health shall
9 review each report and determine whether any of the incidents
10 that resulted in the claim potentially involved conduct by the
11 licensee that is subject to disciplinary action, in which case
12 the provisions of s. 456.073 shall apply. The Department of
13 Health, as part of the annual report required by s. 456.026,
14 shall publish annual statistics, without identifying
15 licensees, on the reports it receives, including final action
16 taken on such reports by the Department of Health or the
17 appropriate regulatory board.
18 Section 72. Paragraph (a) of subsection (1) of section
19 766.101, Florida Statutes, is amended to read:
20 766.101 Medical review committee, immunity from
21 liability.--
22 (1) As used in this section:
23 (a) The term "medical review committee" or "committee"
24 means:
25 1.a. A committee of a hospital or ambulatory surgical
26 center licensed under chapter 395 or a health maintenance
27 organization certificated under part I of chapter 641,
28 b. A committee of a physician-hospital organization, a
29 provider-sponsored organization, or an integrated delivery
30 system,
31 c. A committee of a state or local professional
87
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 society of health care providers,
2 d. A committee of a medical staff of a licensed
3 hospital or nursing home, provided the medical staff operates
4 pursuant to written bylaws that have been approved by the
5 governing board of the hospital or nursing home,
6 e. A committee of the Department of Corrections or the
7 Correctional Medical Authority as created under s. 945.602, or
8 employees, agents, or consultants of either the department or
9 the authority or both,
10 f. A committee of a professional service corporation
11 formed under chapter 621 or a corporation organized under
12 chapter 607 or chapter 617, which is formed and operated for
13 the practice of medicine as defined in s. 458.305(3), and
14 which has at least 25 health care providers who routinely
15 provide health care services directly to patients,
16 g. A committee of a mental health treatment facility
17 licensed under chapter 394 or a community mental health center
18 as defined in s. 394.907, provided the quality assurance
19 program operates pursuant to the guidelines which have been
20 approved by the governing board of the agency,
21 h. A committee of a substance abuse treatment and
22 education prevention program licensed under chapter 397
23 provided the quality assurance program operates pursuant to
24 the guidelines which have been approved by the governing board
25 of the agency,
26 i. A peer review or utilization review committee
27 organized under chapter 440,
28 j. A committee of the Department of Health, a county
29 health department, healthy start coalition, or certified rural
30 health network, when reviewing quality of care, or employees
31 of these entities when reviewing mortality records, or
88
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 k. A continuous quality improvement committee of a
2 pharmacy licensed pursuant to chapter 465,
3 l. A committee established by a university board of
4 trustees, or
5 m. A committee comprised of faculty, residents,
6 students, and administrators of an accredited college of
7 medicine, college of nursing, or other health care discipline.
8
9 which committee is formed to evaluate and improve the quality
10 of health care rendered by providers of health service or to
11 determine that health services rendered were professionally
12 indicated or were performed in compliance with the applicable
13 standard of care or that the cost of health care rendered was
14 considered reasonable by the providers of professional health
15 services in the area; or
16 2. A committee of an insurer, self-insurer, or joint
17 underwriting association of medical malpractice insurance, or
18 other persons conducting review under s. 766.106.
19 Section 73. Paragraph (a) of subsection (4) of section
20 766.314, Florida Statutes, is amended to read:
21 766.314 Assessment; plan of operation.--
22 (4) The following persons and entities shall pay into
23 the association an initial assessment in accordance with the
24 plan of operation:
25 (a) On or before October 1, 1988, each hospital
26 licensed under chapter 395 shall pay an initial assessment of
27 $50 per infant delivered in the hospital during the prior
28 calendar year, as reported to the Agency for Health Care
29 Administration; provided, however, that a hospital owned or
30 operated by the state or a county, special taxing district, or
31 other political subdivision of the state shall not be required
89
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 to pay the initial assessment or any assessment required by
2 subsection (5). The term "infant delivered" includes live
3 births and not stillbirths, but the term does not include
4 infants delivered by employees or agents of the Board of
5 Regents, or those born in a teaching hospital as defined in s.
6 408.07, or those born in a family practice teaching hospital
7 designated pursuant to s. 395.806 which was exempted by the
8 association from assessments for fiscal years 1997-1998
9 through 2001-2002. The initial assessment and any assessment
10 imposed pursuant to subsection (5) may not include any infant
11 born to a charity patient (as defined by rule of the Agency
12 for Health Care Administration) or born to a patient for whom
13 the hospital receives Medicaid reimbursement, if the sum of
14 the annual charges for charity patients plus the annual
15 Medicaid contractuals of the hospital exceeds 10 percent of
16 the total annual gross operating revenues of the hospital.
17 The hospital is responsible for documenting, to the
18 satisfaction of the association, the exclusion of any birth
19 from the computation of the assessment. Upon demonstration of
20 financial need by a hospital, the association may provide for
21 installment payments of assessments.
22 Section 74. Section 456.031, Florida Statutes, is
23 amended to read:
24 456.031 Requirement for instruction on domestic
25 violence.--
26 (1)(a) The appropriate board shall require each person
27 licensed or certified under chapter 458, chapter 459, part I
28 of chapter 464, chapter 466, chapter 467, chapter 490, or
29 chapter 491 to complete a 1-hour continuing education course,
30 approved by the board, on domestic violence, as defined in s.
31 741.28, as part of initial licensure, biennial relicensure, or
90
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 recertification. The course shall consist of a skills-based
2 curriculum that includes practice protocols for identifying
3 and treating a victim of domestic violence consistent with the
4 profession and instructions on practical applications. For
5 purposes of this section, the term "skills-based curriculum"
6 means a curriculum that details methods of practical
7 application to improve responses to domestic violence victims
8 through culturally competent methods of routine screening,
9 assessment, intervention, and health-records documentation.
10 Each licensee must complete 2 hours of continuing education on
11 domestic violence every 4 years, as prescribed by board rule.
12 Initial applicants for licensure must be allowed 1 year
13 following the date of licensure to complete the required
14 course information on the number of patients in that
15 professional's practice who are likely to be victims of
16 domestic violence and the number who are likely to be
17 perpetrators of domestic violence, screening procedures for
18 determining whether a patient has any history of being either
19 a victim or a perpetrator of domestic violence, and
20 instruction on how to provide such patients with information
21 on, or how to refer such patients to, resources in the local
22 community, such as domestic violence centers and other
23 advocacy groups, that provide legal aid, shelter, victim
24 counseling, batterer counseling, or child protection services.
25 (b) Each such licensee or certificateholder shall
26 submit confirmation of having completed such course, on a form
27 provided by the board, when submitting fees for each biennial
28 renewal.
29 (c) The board may approve additional equivalent
30 courses that may be used to satisfy the requirements of
31 paragraph (a). Each licensing board that requires a licensee
91
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 to complete an educational course pursuant to this subsection
2 may include the hour required for completion of the course in
3 the total hours of continuing education required by law for
4 such profession unless the continuing education requirements
5 for such profession consist of fewer than 30 hours biennially.
6 (b)(d) Any person holding two or more licenses subject
7 to the provisions of this subsection shall be permitted to
8 show proof of having taken one board-approved course on
9 domestic violence, for purposes of initial licensure,
10 relicensure, or recertification for additional licenses.
11 (e) Failure to comply with the requirements of this
12 subsection shall constitute grounds for disciplinary action
13 under each respective practice act and under s. 456.072(1)(k).
14 In addition to discipline by the board, the licensee shall be
15 required to complete such course.
16 (2) The board shall also require, as a condition of
17 granting a license under any chapter specified in paragraph
18 (1)(a), that each applicant for initial licensure under the
19 appropriate chapter complete an educational course acceptable
20 to the board on domestic violence which is substantially
21 equivalent to the course required in subsection (1). An
22 applicant who has not taken such course at the time of
23 licensure shall, upon submission of an affidavit showing good
24 cause, be allowed 6 months to complete such requirement.
25 (3)(a) In lieu of completing a course as required in
26 subsection (1), a licensee or certificateholder may complete a
27 course in end-of-life care and palliative health care, if the
28 licensee or certificateholder has completed an approved
29 domestic violence course in the immediately preceding
30 biennium.
31 (b) In lieu of completing a course as required by
92
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 subsection (1), a person licensed under chapter 466 who has
2 completed an approved domestic-violence education course in
3 the immediately preceding 2 years may complete a course
4 approved by the Board of Dentistry.
5 (2)(4) Each board may adopt rules to carry out the
6 provisions of this section.
7 (5) Each board shall report to the President of the
8 Senate, the Speaker of the House of Representatives, and the
9 chairs of the appropriate substantive committees of the
10 Legislature by March 1 of each year as to the implementation
11 of and compliance with the requirements of this section.
12 Section 75. Paragraph (b) of subsection (4) of section
13 766.314, Florida Statutes, is amended to read:
14 766.314 Assessments; plan of operation.--
15 (4) The following persons and entities shall pay into
16 the association an initial assessment in accordance with the
17 plan of operation:
18 (b)1. On or before October 15, 1988, all physicians
19 licensed pursuant to chapter 458 or chapter 459 as of October
20 1, 1988, other than participating physicians, shall be
21 assessed an initial assessment of $250, which must be paid no
22 later than December 1, 1988.
23 2. Any such physician who becomes licensed after
24 September 30, 1988, and before January 1, 1989, shall pay into
25 the association an initial assessment of $250 upon licensure.
26 3. Any such physician who becomes licensed on or after
27 January 1, 1989, shall pay an initial assessment equal to the
28 most recent assessment made pursuant to this paragraph,
29 paragraph (5)(a), or paragraph (7)(b).
30 4. However, if the physician is a physician specified
31 in this subparagraph, the assessment is not applicable:
93
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 a. A resident physician, assistant resident physician,
2 or intern in an approved postgraduate training program, as
3 defined by the Board of Medicine or the Board of Osteopathic
4 Medicine by rule;
5 b. A retired physician who has withdrawn from the
6 practice of medicine but who maintains an active license as
7 evidenced by an affidavit filed with the Department of Health.
8 Prior to reentering the practice of medicine in this state, a
9 retired physician as herein defined must notify the Board of
10 Medicine or the Board of Osteopathic Medicine and pay the
11 appropriate assessments pursuant to this section;
12 c. A physician who holds a limited license pursuant to
13 s. 458.315 458.317 and who is not being compensated for
14 medical services;
15 d. A physician who is employed full time by the United
16 States Department of Veterans Affairs and whose practice is
17 confined to United States Department of Veterans Affairs
18 hospitals; or
19 e. A physician who is a member of the Armed Forces of
20 the United States and who meets the requirements of s.
21 456.024.
22 f. A physician who is employed full time by the State
23 of Florida and whose practice is confined to state-owned
24 correctional institutions, a county health department, or
25 state-owned mental health or developmental services
26 facilities, or who is employed full time by the Department of
27 Health.
28 Section 76. Paragraph (a) of subsection (1) of section
29 817.567, Florida Statutes, is amended to read:
30 817.567 Making false claims of academic degree or
31 title.--
94
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (1) No person in the state may claim, either orally or
2 in writing, to possess an academic degree, as defined in s.
3 1005.02, or the title associated with said degree, unless the
4 person has, in fact, been awarded said degree from an
5 institution that is:
6 (a) Accredited by a regional or professional
7 accrediting agency recognized by the United States Department
8 of Education or the Council for Higher Education Commission on
9 Recognition of Postsecondary Accreditation;
10 Section 77. Subsection (13) of section 1009.992,
11 Florida Statutes, is amended to read:
12 1009.992 Definitions.--As used in this act:
13 (13) "Institution" means any college or university
14 which, by virtue of law or charter, is accredited by and holds
15 membership in the Council for Higher Education Commission on
16 Recognition of Postsecondary Accreditation; which grants
17 baccalaureate or associate degrees; which is not a pervasively
18 sectarian institution; and which does not discriminate in the
19 admission of students on the basis of race, color, religion,
20 sex, or creed.
21 Section 78. Section 1012.46, Florida Statutes, is
22 amended to read:
23 1012.46 Athletic trainers.--
24 (1) School districts may establish and implement an
25 athletic injuries prevention and treatment program. Central to
26 this program should be the employment and availability of
27 persons trained in the prevention and treatment of physical
28 injuries which may occur during athletic activities. The
29 program should reflect opportunities for progressive
30 advancement and compensation in employment as provided in
31 subsection (2) and meet certain other minimum standards
95
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 developed by the Department of Education. The goal of the
2 Legislature is to have school districts employ and have
3 available a full-time teacher athletic trainer in each high
4 school in the state.
5 (2) To the extent practicable, a school district
6 program should include the following employment classification
7 and advancement scheme:
8 (a) First responder.--To qualify as a first responder,
9 a person must possess a professional, temporary, part-time,
10 adjunct, or substitute certificate pursuant to s. 1012.56, be
11 certified in cardiopulmonary resuscitation, first aid, and
12 have 15 semester hours in courses such as care and prevention
13 of athletic injuries, anatomy, physiology, nutrition,
14 counseling, and other similar courses approved by the
15 Commissioner of Education. This person may only administer
16 first aid and similar care, and shall not hold himself or
17 herself out to the school district or public as an athletic
18 trainer pursuant to part XIII of chapter 468.
19 (b) Teacher Athletic trainer.--To qualify as an a
20 teacher athletic trainer, a person must be licensed as
21 required by part XIII of chapter 468 and may be utilized by
22 the school district as possess a professional, temporary,
23 part-time, adjunct, or substitute teacher certificate pursuant
24 to s. 1012.35, s. 1012.56, or s. 1012.57, and be licensed as
25 required by part XIII of chapter 468.
26 Section 79. Sections 456.033, 456.034, 458.313,
27 458.316, 458.3165, and 458.317, Florida Statutes, are
28 repealed.
29 Section 80. The Division of Administrative Hearings
30 shall designate at least two administrative law judges who
31 shall specifically preside over actions involving the
96
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Department of Health or boards within the Department of Health
2 and a health care practitioner or professional as defined in
3 section 456.001, Florida Statutes. Each designated
4 administrative law judge must be a member of The Florida Bar
5 in good standing and must have experience working in the
6 health care industry or have attained board certification in
7 health care law from The Florida Bar.
8 Section 81. Sections 58-61 of this act may be cited as
9 the "Florida Alzheimer's Training Act."
10 Section 82. Section 400.4785, Florida Statutes, is
11 amended to read:
12 400.4785 Patients with Alzheimer's disease or other
13 related disorders; staff training requirements; certain
14 disclosures.--
15 (1) A home health agency must provide the following
16 staff training:
17 (a) Upon beginning employment with the agency, each
18 employee must receive basic written information about
19 interacting with participants who have Alzheimer's disease or
20 dementia-related disorders.
21 (b) In addition to the information provided under
22 paragraph (a), newly hired home health agency personnel who
23 will be providing direct care to patients must complete 2
24 hours of training in Alzheimer's disease and dementia-related
25 disorders within 9 months after beginning employment with the
26 agency. This training must include, but is not limited to, an
27 overview of dementia, a demonstration of basic skills in
28 communicating with persons who have dementia, the management
29 of problem behaviors, information about promoting the client's
30 independence in activities of daily living, and instruction in
31 skills for working with families and caregivers.
97
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (c) For certified nursing assistants, the required 2
2 hours of training shall be part of the total hours of training
3 required annually.
4 (d) For a health care practitioner as defined in s.
5 456.001, continuing education hours taken as required by that
6 practitioner's licensing board shall be counted toward this
7 total of 2 hours.
8 (e) For an employee who is a licensed health care
9 practitioner as defined in s. 456.001, training that is
10 sanctioned by that practitioner's licensing board shall be
11 considered to be approved by the Department of Elderly
12 Affairs.
13 (f) The Department of Elderly Affairs, or its
14 designee, must approve the required training. The department
15 must consider for approval training offered in a variety of
16 formats. The department shall keep a list of current providers
17 who are approved to provide the 2-hour training. The
18 department shall adopt rules to establish standards for
19 employees who are subject to this training and for the
20 trainers and the training required in this section.
21 (g) Upon completing the training listed in this
22 section, the employee shall be issued a certificate that
23 states that the training mandated under this section has been
24 received. The certificate shall be dated and signed by the
25 training provider. The certificate is evidence of completion
26 of this training, and the employee is not required to repeat
27 this training if the employee changes employment to a
28 different home health agency.
29 (h) An employee who is hired on or after July 1, 2004,
30 must complete the required training by July 1, 2005, or by the
31 deadline specified in this section, whichever is later.
98
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (2) An agency licensed under this part which claims
2 that it provides special care for persons who have Alzheimer's
3 disease or other related disorders must disclose in its
4 advertisements or in a separate document those services that
5 distinguish the care as being especially applicable to, or
6 suitable for, such persons. The agency must give a copy of all
7 such advertisements or a copy of the document to each person
8 who requests information about the agency and must maintain a
9 copy of all such advertisements and documents in its records.
10 The Agency for Health Care Administration shall examine all
11 such advertisements and documents in the agency's records as
12 part of the license renewal procedure.
13 Section 83. Section 400.5571, Florida Statutes, is
14 amended to read:
15 400.5571 Patients with Alzheimer's disease or other
16 related disorders; staff training requirements; certain
17 disclosures.--
18 (1) An adult day care center licensed under this part
19 must provide the following staff training:
20 (a) Upon beginning employment with the facility, each
21 employee must receive basic written information about
22 interacting with participants who have Alzheimer's disease or
23 dementia-related disorders.
24 (b) In addition to the information provided under
25 paragraph (a), newly hired adult-day-care-center personnel who
26 are expected to, or whose responsibilities require them to,
27 have direct contact with participants who have Alzheimer's
28 disease or dementia-related disorders must complete initial
29 training of at least 1 hour within the first 3 months after
30 beginning employment. The training must include an overview of
31 dementias and must provide instruction in basic skills for
99
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 communicating with persons who have dementia.
2 (c) In addition to the requirements of paragraphs (a)
3 and (b), an employee who will be providing direct care to a
4 participant who has Alzheimer's disease or dementia-related
5 disorders must complete an additional 3 hours of training
6 within 9 months after beginning employment. This training must
7 include, but is not limited to, the management of problem
8 behaviors, information about promoting the participant's
9 independence in activities of daily living, and instruction in
10 skills for working with families and caregivers.
11 (d) For certified nursing assistants, the required 4
12 hours of training shall be part of the total hours of training
13 required annually.
14 (e) For a health care practitioner as defined in s.
15 456.001, continuing education hours taken as required by that
16 practitioner's licensing board shall be counted toward this
17 total of 4 hours.
18 (f) For an employee who is a licensed health care
19 practitioner as defined in s. 456.001, training that is
20 sanctioned by that practitioner's licensing board shall be
21 considered to be approved by the Department of Elderly
22 Affairs.
23 (g) The Department of Elderly Affairs or its designee
24 must approve the 1-hour and 3-hour training provided to
25 employees and direct caregivers under this section. The
26 department must consider for approval training offered in a
27 variety of formats. The department shall keep a list of
28 current providers who are approved to provide the 1-hour and
29 3-hour training. The department shall adopt rules to establish
30 standards for employees who are subject to this training and
31 for the trainers and the training required in this section.
100
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (h) Upon completing any training described in this
2 section, the employee or direct caregiver shall be issued a
3 certificate that includes the name of the training provider,
4 the topic covered, and the date and signature of the training
5 provider. The certificate is evidence of completion of
6 training in the identified topic, and the employee or direct
7 caregiver is not required to repeat training in that topic if
8 the employee or direct caregiver changes employment to a
9 different adult day care center or to an assisted living
10 facility, nursing home, home health agency, or hospice. The
11 direct caregiver must comply with other applicable continuing
12 education requirements.
13 (i) An employee who is hired on or after July 1, 2003,
14 must complete the required training by July 1, 2004, or by the
15 deadline specified in this section, whichever is later.
16 (2) A center licensed under this part which claims
17 that it provides special care for persons who have Alzheimer's
18 disease or other related disorders must disclose in its
19 advertisements or in a separate document those services that
20 distinguish the care as being especially applicable to, or
21 suitable for, such persons. The center must give a copy of
22 all such advertisements or a copy of the document to each
23 person who requests information about the center and must
24 maintain a copy of all such advertisements and documents in
25 its records. The agency shall examine all such advertisements
26 and documents in the center's records as part of the license
27 renewal procedure.
28 Section 84. Section 400.6045, Florida Statutes, is
29 amended to read:
30 400.6045 Patients with Alzheimer's disease or other
31 related disorders; staff training requirements; certain
101
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 disclosures.--
2 (1) A hospice licensed under this part must provide
3 the following staff training:
4 (a) Upon beginning employment with the agency, each
5 employee must receive basic written information about
6 interacting with persons who have Alzheimer's disease or
7 dementia-related disorders.
8 (b) In addition to the information provided under
9 paragraph (a), employees who are expected to, or whose
10 responsibilities require them to, have direct contact with
11 participants who have Alzheimer's disease or dementia-related
12 disorders must complete initial training of at least 1 hour
13 within the first 3 months after beginning employment. The
14 training must include an overview of dementias and must
15 provide instruction in basic skills for communicating with
16 persons who have dementia.
17 (c) In addition to the requirements of paragraphs (a)
18 and (b), an employee who will be providing direct care to a
19 participant who has Alzheimer's disease or dementia-related
20 disorders must complete an additional 3 hours of training
21 within 9 months after beginning employment. This training must
22 include, but is not limited to, the management of problem
23 behaviors, information about promoting the patient's
24 independence in activities of daily living, and instruction in
25 skills for working with families and caregivers.
26 (d) For certified nursing assistants, the required 4
27 hours of training shall be part of the total hours of training
28 required annually.
29 (e) For a health care practitioner as defined in s.
30 456.001, continuing education hours taken as required by that
31 practitioner's licensing board shall be counted toward this
102
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 total of 4 hours.
2 (f) For an employee who is a licensed health care
3 practitioner as defined in s. 456.001, training that is
4 sanctioned by that practitioner's licensing board shall be
5 considered to be approved by the Department of Elderly
6 Affairs.
7 (g) The Department of Elderly Affairs or its designee
8 must approve the required 1-hour and 3-hour training provided
9 to employees or direct caregivers under this section. The
10 department must consider for approval training offered in a
11 variety of formats. The department shall keep a list of
12 current providers who are approved to provide the 1-hour and
13 3-hour training. The department shall adopt rules to establish
14 standards for employees who are subject to this training and
15 for the trainers and the training required in this section.
16 (h) Upon completing any training described in this
17 section, the employee or direct caregiver shall be issued a
18 certificate that includes the name of the training provider,
19 the topic covered, and the date and signature of the training
20 provider. The certificate is evidence of completion of
21 training in the identified topic, and the employee or direct
22 caregiver is not required to repeat training in that topic if
23 the employee or direct caregiver changes employment to a
24 different hospice or to a home health agency, assisted living
25 facility, nursing home, or adult day care center.
26 (i) An employee who is hired on or after July 1, 2003,
27 must complete the required training by July 1, 2004, or by the
28 deadline specified in this section, whichever is later.
29 (2) A hospice licensed under this part which claims
30 that it provides special care for persons who have Alzheimer's
31 disease or other related disorders must disclose in its
103
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 advertisements or in a separate document those services that
2 distinguish the care as being especially applicable to, or
3 suitable for, such persons. The hospice must give a copy of
4 all such advertisements or a copy of the document to each
5 person who requests information about programs and services
6 for persons with Alzheimer's disease or other related
7 disorders offered by the hospice and must maintain a copy of
8 all such advertisements and documents in its records. The
9 agency shall examine all such advertisements and documents in
10 the hospice's records as part of the license renewal
11 procedure.
12 Section 85. Subsection (1) of section 391.025, Florida
13 Statutes, is amended to read:
14 391.025 Applicability and scope.--
15 (1) This act applies to health services provided to
16 eligible individuals who are:
17 (a) Enrolled in the Medicaid program;
18 (b) Enrolled in the Florida Kidcare program; and
19 (c) Uninsured or underinsured, provided that they meet
20 the financial eligibility requirements established in this
21 act, and to the extent that resources are appropriated for
22 their care; and.
23 (d) Infants who receive an award of compensation
24 pursuant to s. 766.31(1).
25 Section 86. Paragraph (f) is added to subsection (2)
26 of section 391.029, Florida Statutes, to read:
27 391.029 Program eligibility.--
28 (2) The following individuals are financially eligible
29 for the program:
30 (f) An infant who receives an award of compensation
31 pursuant to s. 766.31(1), provided the Florida Birth-Related
104
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Neurological Injury Compensation Association shall reimburse
2 the Children's Medical Services Network the state's share of
3 funding, which funding shall be used to obtain matching
4 federal funds under Title XXI of the Social Security Act.
5
6 The department may continue to serve certain children with
7 special health care needs who are 21 years of age or older and
8 who were receiving services from the program prior to April 1,
9 1998. Such children may be served by the department until
10 July 1, 2000.
11 Section 87. Section 766.304, Florida Statutes, is
12 amended to read:
13 766.304 Administrative law judge to determine
14 claims.--The administrative law judge shall hear and determine
15 all claims filed pursuant to ss. 766.301-766.316 and shall
16 exercise the full power and authority granted to her or him in
17 chapter 120, as necessary, to carry out the purposes of such
18 sections. The administrative law judge has exclusive
19 jurisdiction to determine whether a claim filed under this act
20 is compensable. No civil action may be brought until the
21 determinations under s. 766.309 have been made by the
22 administrative law judge. If the administrative law judge
23 determines that the claimant is entitled to compensation from
24 the association, no civil action may be brought or continued
25 in violation of the exclusiveness of remedy provisions of s.
26 766.303. If it is determined that a claim filed under this act
27 is not compensable, neither the doctrine of collateral
28 estoppel nor res judicata shall prohibit the claimant from
29 pursuing any and all civil remedies available under common law
30 and statutory law. The findings of fact and conclusions of law
31 of the administrative law judge shall not be admissible in any
105
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 subsequent proceeding; however, the sworn testimony of any
2 person and the exhibits introduced into evidence in the
3 administrative case are admissible as impeachment in any
4 subsequent civil action only against a party to the
5 administrative proceeding, subject to the Rules of Evidence.
6 An award action may not be awarded or paid brought under ss.
7 766.301-766.316 if the claimant recovers under a settlement or
8 a final judgment is entered in a civil action. The division
9 may adopt rules to promote the efficient administration of,
10 and to minimize the cost associated with, the prosecution of
11 claims.
12 Section 88. Section 766.305, Florida Statutes, is
13 amended to read:
14 766.305 Filing of claims and responses; medical
15 disciplinary review.--
16 (1) All claims filed for compensation under the plan
17 shall commence by the claimant filing with the division a
18 petition seeking compensation. Such petition shall include
19 the following information:
20 (a) The name and address of the legal representative
21 and the basis for her or his representation of the injured
22 infant.
23 (b) The name and address of the injured infant.
24 (c) The name and address of any physician providing
25 obstetrical services who was present at the birth and the name
26 and address of the hospital at which the birth occurred.
27 (d) A description of the disability for which the
28 claim is made.
29 (e) The time and place the injury occurred.
30 (f) A brief statement of the facts and circumstances
31 surrounding the injury and giving rise to the claim.
106
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (g) All available relevant medical records relating to
2 the birth-related neurological injury, and an identification
3 of any unavailable records known to the claimant and the
4 reasons for their unavailability.
5 (h) Appropriate assessments, evaluations, and
6 prognoses, and such other records and documents as are
7 reasonably necessary for the determination of the amount of
8 compensation to be paid to, or on behalf of, the injured
9 infant on account of the birth-related neurological injury.
10 (i) Documentation of expenses and services incurred to
11 date, which indicates any payment made for such expenses and
12 services, and by whom.
13 (j) Documentation of any applicable private or
14 governmental source of services or reimbursement relative to
15 the impairments.
16 (2) The claimant shall furnish the division with as
17 many copies of the petition as required for service upon the
18 association, any physician and hospital named in the petition,
19 and the Division of Medical Quality Assurance, along with a
20 $15 filing fee payable to the Division of Administrative
21 Hearings. Upon receipt of the petition, the division shall
22 immediately serve the association, by service upon the agent
23 designated to accept service on behalf of the association, by
24 registered or certified mail, and shall mail copies of the
25 petition, by registered or certified mail, to any physician,
26 health care provider, and hospital named in the petition, and
27 furnish a copy by regular mail to the Di vision of Medical
28 Quality Assurance, and the Agency for Health Care
29 Administration.
30 (3) The claimant shall furnish to the executive
31 director of the Florida Birth-Related Neurological
107
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Compensation Association one copy of the following information
2 which shall be filed with the association within 10 days after
3 the filing of the petition as set forth in s. 766.305(1):
4 (a) All available relevant medical records relating to
5 the birth-related neurological injury and an identification of
6 any unavailable records known to the claimant and the reasons
7 for their unavailability.
8 (b) Appropriate assessments, evaluations, and
9 prognoses and such other records and documents as are
10 reasonably necessary for the determination of the amount of
11 compensation to be paid to, or on behalf of, the injured
12 infant on account of the birth-related neurological injury.
13 (c) Documentation of expenses and services incurred to
14 date, which indicates any payment made for such expenses and
15 services and by whom.
16 (d) Documentation of any applicable private or
17 governmental source of services or reimbursement relative to
18 the impairments.
19
20 The information contained in paragraphs (a)-(d) is
21 confidential and exempt pursuant to the provisions of s.
22 766.315(5)(b).
23 (4)(3) The association shall have 45 days from the
24 date of service of a complete claim, filed pursuant to
25 subsections (1) and (2), in which to file a response to the
26 petition and to submit relevant written information relating
27 to the issue of whether the injury alleged is a birth-related
28 neurological injury.
29 (5)(4) Upon receipt of such petition, the Division of
30 Medical Quality Assurance shall review the information therein
31 and determine whether it involved conduct by a physician
108
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 licensed under chapter 458 or an osteopathic physician
2 licensed under chapter 459 that is subject to disciplinary
3 action, in which case the provisions of s. 456.073 shall
4 apply.
5 (6)(5) Upon receipt of such petition, the Agency for
6 Health Care Administration shall investigate the claim, and if
7 it determines that the injury resulted from, or was aggravated
8 by, a breach of duty on the part of a hospital in violation of
9 chapter 395, it shall take any such action consistent with its
10 disciplinary authority as may be appropriate.
11 (7)(6) Any claim which the association determines to
12 be compensable may be accepted for compensation, provided that
13 the acceptance is approved by the administrative law judge to
14 whom the claim for compensation is assigned.
15 Section 89. Subsection (4) is added to section
16 766.309, Florida Statutes, to read:
17 766.309 Determination of claims; presumption; findings
18 of administrative law judge binding on participants.--
19 (4) If it is in the interest of judicial economy or if
20 requested to by the claimant, the administrative law judge may
21 bifurcate the proceeding, addressing compensability and notice
22 pursuant to s. 766.316 first and addressing any award pursuant
23 to s. 766.31 in a separate proceeding. The administrative law
24 judge may issue a final order on compensability and notice
25 which is subject to appeal under s. 766.311, prior to issuance
26 of award pursuant to s. 766.31.
27 Section 90. Subsection (1) of section 766.31, Florida
28 Statutes, is amended to read:
29 766.31 Administrative law judge awards for
30 birth-related neurological injuries; notice of award.--
31 (1) Upon determining that an infant has sustained a
109
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 birth-related neurological injury and that obstetrical
2 services were delivered by a participating physician at the
3 birth, the administrative law judge shall make an award
4 providing compensation for the following items relative to
5 such injury:
6 (a) Actual expenses for medically necessary and
7 reasonable medical and hospital, habilitative and training,
8 family residential or custodial care, professional
9 residential, and custodial care and service, for medically
10 necessary drugs, special equipment, and facilities, and for
11 related travel. However, such expenses shall not include:
12 1. Expenses for items or services that the infant has
13 received, or is entitled to receive, under the laws of any
14 state or the Federal Government, including Medicaid, except to
15 the extent such exclusion may be prohibited by federal law.
16 2. Expenses for items or services that the infant has
17 received, or is contractually entitled to receive, from any
18 prepaid health plan, health maintenance organization, or other
19 private insuring entity.
20 3. Expenses for which the infant has received
21 reimbursement, or for which the infant is entitled to receive
22 reimbursement, under the laws of any state or the Federal
23 Government, including Medicaid, except to the extent such
24 exclusion may be prohibited by federal law.
25 4. Expenses for which the infant has received
26 reimbursement, or for which the infant is contractually
27 entitled to receive reimbursement, pursuant to the provisions
28 of any health or sickness insurance policy or other private
29 insurance program.
30
31 Expenses included under this paragraph shall be limited to
110
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 reasonable charges prevailing in the same community for
2 similar treatment of injured persons when such treatment is
3 paid for by the injured person.
4 (b)1. Periodic payments of an award to the parents or
5 legal guardians of the infant found to have sustained a
6 birth-related neurological injury, which award shall not
7 exceed $100,000. However, at the discretion of the
8 administrative law judge, such award may be made in a lump
9 sum.
10 2. A death benefit for the infant in an amount of
11 $10,000 Payment for funeral expenses not to exceed $1,500.
12 (c) Reasonable expenses incurred in connection with
13 the filing of a claim under ss. 766.301-766.316, including
14 reasonable attorney's fees, which shall be subject to the
15 approval and award of the administrative law judge. In
16 determining an award for attorney's fees, the administrative
17 law judge shall consider the following factors:
18 1. The time and labor required, the novelty and
19 difficulty of the questions involved, and the skill requisite
20 to perform the legal services properly.
21 2. The fee customarily charged in the locality for
22 similar legal services.
23 3. The time limitations imposed by the claimant or the
24 circumstances.
25 4. The nature and length of the professional
26 relationship with the claimant.
27 5. The experience, reputation, and ability of the
28 lawyer or lawyers performing services.
29 6. The contingency or certainty of a fee.
30
31 If there is an award of benefits under the plan, the claimants
111
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 shall not be liable for any attorney's fees incurred in
2 connection with the filing of a claim under ss.
3 766.301-766.316 other than those fees awarded under this
4 section.
5 Section 91. Subsection (4) of section 766.314, Florida
6 Statutes, is amended to read:
7 766.314 Assessments; plan of operation.--
8 (4) The following persons and entities shall pay into
9 the association an initial assessment in accordance with the
10 plan of operation:
11 (a) On or before October 1, 1988, each hospital
12 licensed under chapter 395 shall pay an initial assessment of
13 $50 per infant delivered in the hospital during the prior
14 calendar year, as reported to the Agency for Health Care
15 Administration; provided, however, that a hospital owned or
16 operated by the state or a county, special taxing district, or
17 other political subdivision of the state shall not be required
18 to pay the initial assessment or any assessment required by
19 subsection (5). The term "infant delivered" includes live
20 births and not stillbirths, but the term does not include
21 infants delivered by employees or agents of the board of
22 trustees, Regents or those born in a teaching hospital as
23 defined in s. 408.07, or those born in a family practice
24 teaching hospital as defined in s. 395.806 that have been
25 deemed by the association as being exempt from assessments
26 since fiscal year 1997 to fiscal year 2001. The initial
27 assessment and any assessment imposed pursuant to subsection
28 (5) may not include any infant born to a charity patient (as
29 defined by rule of the Agency for Health Care Administration)
30 or born to a patient for whom the hospital receives Medicaid
31 reimbursement, if the sum of the annual charges for charity
112
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 patients plus the annual Medicaid contractuals of the hospital
2 exceeds 10 percent of the total annual gross operating
3 revenues of the hospital. The hospital is responsible for
4 documenting, to the satisfaction of the association, the
5 exclusion of any birth from the computation of the assessment.
6 Upon demonstration of financial need by a hospital, the
7 association may provide for installment payments of
8 assessments.
9 (b)1. On or before October 15, 1988, all physicians
10 licensed pursuant to chapter 458 or chapter 459 as of October
11 1, 1988, other than participating physicians, shall be
12 assessed an initial assessment of $250, which must be paid no
13 later than December 1, 1988.
14 2. Any such physician who becomes licensed after
15 September 30, 1988, and before January 1, 1989, shall pay into
16 the association an initial assessment of $250 upon licensure.
17 3. Any such physician who becomes licensed on or after
18 January 1, 1989, shall pay an initial assessment equal to the
19 most recent assessment made pursuant to this paragraph,
20 paragraph (5)(a), or paragraph (7)(b).
21 4. However, if the physician is a physician specified
22 in this subparagraph, the assessment is not applicable:
23 a. A resident physician, assistant resident physician,
24 or intern in an approved postgraduate training program, as
25 defined by the Board of Medicine or the Board of Osteopathic
26 Medicine by rule;
27 b. A retired physician who has withdrawn from the
28 practice of medicine but who maintains an active license as
29 evidenced by an affidavit filed with the Department of Health.
30 Prior to reentering the practice of medicine in this state, a
31 retired physician as herein defined must notify the Board of
113
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Medicine or the Board of Osteopathic Medicine and pay the
2 appropriate assessments pursuant to this section;
3 c. A physician who holds a limited license pursuant to
4 s. 458.317 and who is not being compensated for medical
5 services;
6 d. A physician who is employed full time by the United
7 States Department of Veterans Affairs and whose practice is
8 confined to United States Department of Veterans Affairs
9 hospitals; or
10 e. A physician who is a member of the Armed Forces of
11 the United States and who meets the requirements of s.
12 456.024.
13 f. A physician who is employed full time by the State
14 of Florida and whose practice is confined to state-owned
15 correctional institutions, a county health department, or
16 state-owned mental health or developmental services
17 facilities, or who is employed full time by the Department of
18 Health.
19 (c) On or before December 1 of each year, beginning
20 January 1, 2003 1988, each physician licensed pursuant to
21 chapter 458 or chapter 459 who wishes to participate in the
22 Florida Birth-Related Neurological Injury Compensation Plan
23 and who otherwise qualifies as a participating physician under
24 ss. 766.301-766.316 shall pay an initial assessment of $5,000.
25 A physician shall be a participating physician for the entire
26 calendar year if such assessment is paid on or before January
27 31. However, if the physician is either a resident physician,
28 assistant resident physician, or intern in an approved
29 postgraduate training program, as defined by the Board of
30 Medicine or the Board of Osteopathic Medicine by rule, and is
31 supervised in accordance with program requirements established
114
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 by the Accreditation Council for Graduate Medical Education or
2 the American Osteopathic Association by a physician who is
3 participating in the plan, such resident physician, assistant
4 resident physician, or intern is deemed to be a participating
5 physician without the payment of the assessment.
6 Participating physicians also include any employee of the
7 board of trustees Regents who has paid the assessment required
8 by this paragraph and paragraph (5)(a), and any certified
9 nurse midwife supervised by such employee. Participating
10 physicians include any certified nurse midwife who has paid 50
11 percent of the physician assessment required by this paragraph
12 and paragraph (5)(a) and who is supervised by a participating
13 physician who has paid the assessment required by this
14 paragraph and paragraph (5)(a). Supervision for nurse midwives
15 shall require that the supervising physician will be easily
16 available and have a prearranged plan of treatment for
17 specified patient problems which the supervised certified
18 nurse midwife may carry out in the absence of any complicating
19 features. Any physician who elects to participate in such
20 plan on or after January 1, 1989, who was not a participating
21 physician at the time of such election to participate and who
22 otherwise qualifies as a participating physician under ss.
23 766.301-766.316 shall pay an additional initial assessment
24 equal to the most recent assessment made pursuant to this
25 paragraph, paragraph (5)(a), or paragraph (7)(b).
26 (d) Any hospital located in any county with a gross
27 population in excess of 1.1 million as of January 1, 2003, as
28 determined by the Agency for Health Care Administration,
29 pursuant to the Health Care Responsibility Act, may elect to
30 pay the fee for the participating physician and the certified
31 nurse midwife if the hospital first determines that the
115
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 primary motivating purpose for making such payment is to
2 ensure coverage for the hospital's patients under the
3 provisions of ss. 766.301-766.316, provided no hospital may
4 restrict any participating physician or nurse midwife,
5 directly or indirectly, from being on the staff of hospitals
6 other than the staff of the hospital making such payment. Each
7 hospital shall file with the association an affidavit setting
8 forth specifically the reasons why such hospital elected to
9 39ke such payment on behalf of each participating physician
10 and certified nurse midwife. The payments authorized pursuant
11 to this paragraph shall be in addition to the assessment set
12 forth in paragraph (5)(a).
13 Section 92. James and Esther King Center for Universal
14 Research to Eradicate Disease.--
15 (1) The Legislature finds that an estimated 128
16 million Americans suffer from acute, chronic, and degenerative
17 diseases and that biomedical research is the key to finding
18 cures for these diseases that negatively affect all
19 Floridians. The Legislature further finds that, while there is
20 much research being conducted throughout this state and
21 throughout the world, there is a lack of coordination of
22 efforts among researchers. The Legislature, therefore, finds
23 that there is a significant need for a coordinated effort if
24 the goal of curing disease is to be achieved. Moreover, the
25 Legislature finds that the biomedical technology sector meets
26 the criteria of a high-impact sector, pursuant to section
27 288.108, Florida Statutes, having a high importance to this
28 state's economy with a significant potential for growth and
29 contribution to our universities and quality of life.
30 (2) It is the intent of the Legislature that Florida
31 strive to become the nation's leader in biomedical research
116
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 and commit itself to being the state to find cures for the
2 most deadly and widespread diseases. It is further the intent
3 of the Legislature that there be a coordinated effort among
4 the state's public and private universities and the biomedical
5 industry to discover such cures. Moreover, it is the intent of
6 the Legislature to expand the state economy by attracting
7 biomedical researchers and research companies to this state.
8 (3) There is established the James and Esther King
9 Center for Universal Research to Eradicate Disease, which
10 shall be known as the "CURED."
11 (a) The purpose of the center is to coordinate,
12 improve, expand, and monitor all biomedical research programs
13 within the state, facilitate funding opportunities, and foster
14 improved technology transfer of research findings into
15 clinical trials and widespread public use.
16 (b) The goal of the center is to find cures for
17 diseases such as cancer, heart disease, lung disease,
18 diabetes, and neurological disorders, including Alzheimer's
19 disease, epilepsy, and Parkinson's disease.
20 (c) The center shall hold an annual biomedical
21 technology summit in Florida to which biomedical researchers,
22 biomedical technology companies, business incubators,
23 pharmaceutical manufacturers, and others around the nation and
24 world are invited to share biomedical research findings in
25 order to expedite the discovery of cures. Summit attendees
26 will be required to cover the costs of such attendance or
27 obtain sponsorship for such attendance.
28 (d) The center shall encourage clinical trials in this
29 state on research that holds promise of curing a disease or
30 condition. The center shall facilitate partnerships between
31 researchers, treating physicians, and community hospitals for
117
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the purpose of sharing new techniques and new research
2 findings, as well as coordinating voluntary donations to
3 ensure an adequate supply of adult stem cells or cord blood.
4 (e) The center shall also encourage the discovery and
5 production in Florida of vaccines that prevent disease.
6 (f) The center shall monitor the supply and demand
7 needs of researchers relating to stem cell research and other
8 types of human tissue research. If the center determines that
9 there is a need for increased donation of human tissue, it
10 shall notify hospitals licensed pursuant to chapter 395,
11 Florida Statutes, that have entered into partnership
12 agreements with research institutes conducting stem cell
13 research located in the same geographic region as the
14 researchers demanding the stem cells or other tissues. Such
15 hospitals shall then implement programs that encourage
16 voluntary donations of cord blood or other needed adult
17 tissue.
18 (g) The center shall be funded through private, state,
19 and federal sources.
20 (h) The center shall serve as a registry of all known
21 biomedical grant opportunities and may assist any public or
22 private biomedical research program in this state in preparing
23 grant requests.
24 (i) The center shall maintain a website with links to
25 peer-reviewed biomedical research. The website shall also
26 contain a list of all known biomedical research being
27 conducted in Florida and shall facilitate communication among
28 researchers and other interested parties.
29 (j) The center shall submit an annual report to the
30 Governor, the President of the Senate, and the Speaker of the
31 House of Representatives no later than January 15 which
118
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 contains recommendations for legislative change necessary to
2 foster a positive climate for biomedical research in this
3 state.
4 (k) The duties of the center may be outsourced by the
5 Department of Health to a private entity or state university.
6 (4) There is established within the center an advisory
7 council which shall meet at least annually.
8 (a) The council shall consist of the members of the
9 board of directors of the Florida Research Consortium and at
10 least one representative from:
11 1. The Emerging Technology Commission.
12 2. Enterprise Florida, Inc.
13 3. BioFlorida.
14 4. The Florida Biomedical Research Advisory Council.
15 5. The Florida Medical Foundation.
16 6. Pharmaceutical Research and Manufacturers of
17 America.
18 (b) Members of the council shall serve without
19 compensation and each organization represented shall cover all
20 expenses of its representative.
21 Section 93. Paragraphs (a) and (b) of subsection (1),
22 subsection (2), and paragraph (f) of subsection (10) of
23 section 215.5602, Florida Statutes, are amended to read:
24 215.5602 Florida Biomedical Research Program.--
25 (1) There is established within the Department of
26 Health the Florida Biomedical Research Program funded by the
27 proceeds of the Lawton Chiles Endowment Fund pursuant to s.
28 215.5601. The purpose of the Florida Biomedical Research
29 Program is to provide an annual and perpetual source of
30 funding in order to support research initiatives that address
31 the health care problems of Floridians in the areas of
119
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 tobacco-related cancer, cardiovascular disease, stroke, and
2 pulmonary disease. The long-term goals of the program are to:
3 (a) Improve the health of Floridians by researching
4 better prevention, diagnoses, and treatments, and cures for
5 cancer, cardiovascular disease, stroke, and pulmonary disease.
6 (b) Expand the foundation of biomedical knowledge
7 relating to the prevention, diagnosis, and treatment, and cure
8 of diseases related to tobacco use, including cancer,
9 cardiovascular disease, stroke, and pulmonary disease.
10 (2) Funds appropriated for the Florida Biomedical
11 Research Program shall be used exclusively for the award of
12 grants and fellowships as established in this section; for
13 research relating to the prevention, diagnosis, and treatment,
14 and cure of diseases related to tobacco use, including cancer,
15 cardiovascular disease, stroke, and pulmonary disease; and for
16 expenses incurred in the administration of this section.
17 Priority shall be granted to research designed to prevent or
18 cure disease.
19 (10) The council shall submit an annual progress
20 report on the state of biomedical research in this state to
21 the Governor, the Secretary of Health, the President of the
22 Senate, and the Speaker of the House of Representatives by
23 February 1. The report must include:
24 (f) Progress in the prevention, diagnosis, and
25 treatment, and cure of diseases related to tobacco use,
26 including cancer, cardiovascular disease, stroke, and
27 pulmonary disease.
28 Section 94. Florida Cancer Research Cooperative.--
29 (1) Effective July 1, 2003, the Florida Cancer
30 Research Cooperative is established for the purpose of making
31 the State of Florida a world class center for cancer research.
120
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (2)(a) A not-for-profit corporation, acting as an
2 instrumentality of the Florida Dialogue on Cancer, shall be
3 organized for the purpose of governing the affairs of the
4 cooperative.
5 (b) The Florida Cancer Research Cooperative, Inc., may
6 create not-for-profit corporate subsidiaries to fulfill its
7 mission. The not-for-profit corporation and its subsidiaries
8 are authorized to receive, hold, invest, and administer
9 property and any moneys acquired from private, local, state,
10 and federal sources, as well as technical and professional
11 income generated or derived from the mission-related
12 activities of the cooperative.
13 (c) The affairs of the not-for-profit corporation
14 shall be managed by a board of directors which shall consist
15 of:
16 1. The Secretary of the Department of Health or his or
17 her designee;
18 2. The Chief Executive Officer of the H. Lee Moffitt
19 Cancer Center or his or her designee;
20 3. The President of the University of Florida Shands
21 Cancer Center or his or her designee;
22 4. The Chief Executive Officer of the University of
23 Miami Sylvester Comprehensive Cancer Center or his or her
24 designee;
25 5. The Chief Executive Officer of the Mayo Clinic,
26 Jacksonville or his or her designee;
27 6. The Chief Executive Officer of the American Cancer
28 Society, Florida Division or his or her designee;
29 7. The President of the American Cancer Society,
30 Florida Division Board of Directors or his or her designee;
31 8. The President of the Florida Society of Clinical
121
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Oncology or his or her designee;
2 9. The Chief Executive Officer of Enterprise Florida,
3 Inc., or his or her designee;
4 10. Three representatives from large Florida hospitals
5 or institutions, not delineated in subparagraphs 1. through
6 6., that treat a large volume of cancer patients. One shall be
7 appointed by the Governor, one shall be appointed by the
8 Speaker of the House of Representatives, and one shall be
9 appointed by the President of the Senate;
10 11. Three representatives from community-based,
11 statewide organizations serving populations that experience
12 cancer disparities, one of whom shall be appointed by the
13 Governor, one of whom shall be appointed by the Speaker of the
14 House of Representatives, and one of whom shall be appointed
15 by the President of the Senate;
16 12. One member of the Florida House of
17 Representatives, to be appointed by the Speaker of the House
18 of Representatives;
19 13. One member of the Florida Senate, to be appointed
20 by the President of the Senate;
21 14. Three university presidents, one of whom shall be
22 appointed by the Governor, one of whom shall be appointed by
23 the Speaker of the House of Representatives, and one of whom
24 shall be appointed by the President of the Senate; and
25 15. Five representatives from other statewide public
26 health organizations whose missions include public education
27 and the eradication of cancer, three of whom shall be
28 appointed by the Governor, one of whom shall be appointed by
29 the Speaker of the House of Representatives, and one of whom
30 shall be appointed by the President of the Senate.
31 (d) Appointments made by the Speaker of the House of
122
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Representatives and the President of the Senate pursuant to
2 paragraph (c) shall be for 2-year terms, concurrent with the
3 bienniums in which they serve as presiding officers.
4 (e) Appointments made by the Governor pursuant to
5 paragraph (c) shall be for 2-year terms, although the Governor
6 may reappoint directors.
7 (f) Members of the board of directors of the
8 not-for-profit corporation or any subsidiaries shall serve
9 without compensation.
10 (3) The cooperative shall issue an annual report to
11 the Governor, the Speaker of the House of Representatives, and
12 the President of the Senate, by December 15 of each year, with
13 policy and funding recommendations regarding cancer research
14 capacity in Florida and related issues.
15 Section 95. Florida Cancer Research Cooperative;
16 mission and duties.--
17 (1) The cooperative shall develop and centralize the
18 processes and shared services for expanding cancer research in
19 Florida through:
20 (a) Support through bioinformatics, in order to create
21 a cancer informatics infrastructure that enhances information
22 and resource exchange and integration through researchers
23 working in diverse disciplines to facilitate the full spectrum
24 of cancer investigations;
25 (b) Technical coordination, business development, and
26 support of intellectual property;
27 (c) Development of a statewide cancer clinical trials
28 network as contemplated in section 1; and
29 (d) Other multidisciplinary research support
30 activities.
31 (2) The cooperative shall work in concert with the
123
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Center for Universal Research to Eradicate Disease created in
2 section 1 to ensure that the goals of the center are advanced.
3 Section 96. Section 484.0512, Florida Statutes, is
4 amended to read:
5 484.0512 Thirty-day trial period; purchaser's right to
6 cancel; notice; refund; cancellation fee; criminal penalty
7 procedures.--
8 (1) A person selling a hearing aid in this state must
9 provide the buyer with written notice of a 30-day trial period
10 and money-back guarantee. The guarantee must permit the
11 purchaser to cancel the purchase for a valid reason as defined
12 by rule of the board within 30 days after receiving the
13 hearing aid, by returning the hearing aid or mailing written
14 notice of cancellation to the seller. If the hearing aid must
15 be repaired, remade, or adjusted during the 30-day trial
16 period, the running of the 30-day trial period is suspended 1
17 day for each 24-hour period that the hearing aid is not in the
18 purchaser's possession. A repaired, remade, or adjusted
19 hearing aid must be claimed by the purchaser within 3 working
20 days after notification of availability. The running of the
21 30-day trial period resumes on the day the purchaser reclaims
22 the repaired, remade, or adjusted hearing aid or on the fourth
23 day after notification of availability.
24 (2) The board, in consultation with the Board of
25 Speech-Language Pathology and Audiology, shall prescribe by
26 rule the terms and conditions to be contained in the
27 money-back guarantee and any exceptions thereto. Such rule
28 shall provide, at a minimum, that the charges for earmolds and
29 service provided to fit the hearing aid may be retained by the
30 licensee. The rules shall also set forth any reasonable
31 charges to be held by the licensee as a cancellation fee. Such
124
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 rule shall be effective on or before December 1, 1994. Should
2 the board fail to adopt such rule, a licensee may not charge a
3 cancellation fee which exceeds 5 percent of the total charge
4 for a hearing aid alone. The terms and conditions of the
5 guarantee, including the total amount available for refund,
6 shall be provided in writing to the purchaser prior to the
7 signing of the contract.
8 (3) Within 30 days after the return or attempted
9 return of the hearing aid, the seller shall refund all moneys
10 that must be refunded to a purchaser pursuant to this section.
11 A violation of this subsection is a misdemeanor of the first
12 degree, punishable as provided in s. 775.082 or s. 775.083.
13 (4) For purposes of this section, the term "seller" or
14 "person selling a hearing aid" includes:
15 (a) Any natural person licensed under this part or any
16 other natural person who signs a sales receipt required by s.
17 484.051(2) or s. 468.1245(2) or who otherwise fits, delivers,
18 or dispenses a hearing aid.
19 (b) Any business organization, whether a sole
20 proprietorship, partnership, corporation, professional
21 association, joint venture, business trust, or other legal
22 entity, which dispenses a hearing aid or enters into an
23 agreement to dispense a hearing aid.
24 (c) Any person who controls, manages, or operates an
25 establishment or business that dispenses a hearing aid or
26 enters into an agreement to dispense a hearing aid.
27 Section 97. Effective upon this act becoming a law,
28 subsection (1) of section 456.073, Florida Statutes, is
29 amended to read:
30 456.073 Disciplinary proceedings.--Disciplinary
31 proceedings for each board shall be within the jurisdiction of
125
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the department.
2 (1) The department, for the boards under its
3 jurisdiction, shall cause to be investigated any complaint
4 that is filed before it if the complaint is in writing, signed
5 by the complainant, and legally sufficient. A complaint filed
6 by a state prisoner against a health care practitioner
7 employed by or otherwise providing health care services within
8 a facility of the Department of Corrections is not legally
9 sufficient unless there is a showing that the prisoner
10 complainant has exhausted all available administrative
11 remedies within the state correctional system before filing
12 the complaint. However, if the department determines after a
13 preliminary inquiry of a state prisoner's complaint, that the
14 practitioner may present a serious threat to the health and
15 safety of any individual who is not a state prisoner, the
16 department may determine legal sufficiency and proceed with
17 discipline. The Department of Health shall be notified within
18 15 days whenever the Department of Corrections disciplines or
19 allows a health care practitioner to resign for an offense
20 related to the practice of his or her profession. A complaint
21 is legally sufficient if it contains ultimate facts that show
22 that a violation of this chapter, of any of the practice acts
23 relating to the professions regulated by the department, or of
24 any rule adopted by the department or a regulatory board in
25 the department has occurred. In order to determine legal
26 sufficiency, the department may require supporting information
27 or documentation. The department may investigate, and the
28 department or the appropriate board may take appropriate final
29 action on, a complaint even though the original complainant
30 withdraws it or otherwise indicates a desire not to cause the
31 complaint to be investigated or prosecuted to completion. The
126
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 department may investigate an anonymous complaint if the
2 complaint is in writing and is legally sufficient, if the
3 alleged violation of law or rules is substantial, and if the
4 department has reason to believe, after preliminary inquiry,
5 that the violations alleged in the complaint are true. The
6 department may investigate a complaint made by a confidential
7 informant if the complaint is legally sufficient, if the
8 alleged violation of law or rule is substantial, and if the
9 department has reason to believe, after preliminary inquiry,
10 that the allegations of the complainant are true. The
11 department may initiate an investigation if it has reasonable
12 cause to believe that a licensee or a group of licensees has
13 violated a Florida statute, a rule of the department, or a
14 rule of a board. Except as provided in ss. 458.331(9),
15 459.015(9), 460.413(5), and 461.013(6), when an investigation
16 of any subject is undertaken, the department shall promptly
17 furnish to the subject or the subject's attorney a copy of the
18 complaint or document that resulted in the initiation of the
19 investigation. The subject may submit a written response to
20 the information contained in such complaint or document within
21 20 days after service to the subject of the complaint or
22 document. The subject's written response shall be considered
23 by the probable cause panel. The right to respond does not
24 prohibit the issuance of a summary emergency order if
25 necessary to protect the public. However, if the secretary, or
26 the secretary's designee, and the chair of the respective
27 board or the chair of its probable cause panel agree in
28 writing that such notification would be detrimental to the
29 investigation, the department may withhold notification. The
30 department may conduct an investigation without notification
31 to any subject if the act under investigation is a criminal
127
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 offense.
2 Section 98. (1) The Division of Medical Quality
3 Assurance of the Department of Health shall conduct a study of
4 clinical and academic training requirements of certified
5 optometric practitioners, licensed pursuant to chapter 463,
6 Florida Statutes, to determine the extent to which prescribing
7 authority may be expanded. The study group shall be composed
8 of the following members:
9 (a) One pharmacologist representing the University of
10 Florida;
11 (b) One pharmacologist representing Nova Southeastern
12 University;
13 (c) One pharmacologist representing Florida
14 Agricultural and Mechanical University;
15 (d) One ophthalmologist representing Mayo Clinic
16 Jacksonville;
17 (e) One ophthalmologist representing Bascom Palmer Eye
18 Institute;
19 (f) One board-certified internist appointed by the
20 University of South Florida;
21 (g) One optometrist representing the Florida Board of
22 Optometry;
23 (h) One certified optometric practitioner representing
24 the Florida Optometric Association; and
25 (i) One certified optometric practitioner appointed by
26 the Nova Southeastern University College of Optometry.
27 (2) The study group shall be chaired by the Secretary
28 of Health or his or her designee. The study shall be completed
29 and a final report presented to the Governor, the President of
30 the Senate, and the Speaker of the House of Representatives by
31 January 15, 2004. If applicable, a minority report shall be
128
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 completed and presented to the Governor, the President of the
2 Senate, and the Speaker of the House of Representatives by
3 January 31, 2004.
4 (3) This section shall take effect upon becoming a
5 law.
6 Section 99. Present subsection (4) of section
7 465.0265, Florida Statutes, is redesignated as subsection (5),
8 and a new subsection (4) is added to that section, to read:
9 465.0265 Centralized prescription filling.--
10 (4) Pharmacies accessing the same prescription records
11 in a centralized database or pharmacy computers linked in any
12 other manner may refill or dispense prescriptions at the
13 request of another pharmacy so linked if the pharmacies have
14 the same owner or have a written contract specifying the
15 services to be provided by each pharmacy, the responsibilities
16 of each pharmacy, and the manner in which the pharmacies will
17 comply with federal and state laws and rules. Prescriptions
18 refilled or dispensed using such a system shall not be
19 considered prescription transfers or copies if the computer
20 system registers a complete and full audit trail of all
21 activities and includes the identification of the pharmacies
22 and pharmacists accessing the centralized database and if the
23 system restricts access to the computerized prescription
24 records to pharmacies or other authorized personnel.
25 Section 100. Subsection (2) of section 466.006,
26 Florida Statutes, is amended to read:
27 466.006 Examination of dentists.--
28 (2) An applicant shall be entitled to take the
29 examinations required in this section to practice dentistry in
30 this state if the applicant:
31 (a) Is 18 years of age or older.
129
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (b)1. Is a graduate of a dental school accredited by
2 the Commission on Accreditation of the American Dental
3 Association or its successor agency, if any, or any other
4 nationally recognized accrediting agency; or.
5 2. Is a dental student in the final year of a program
6 at such an accredited school who has completed all the
7 coursework necessary to prepare the student to perform the
8 clinical and diagnostic procedures required to pass the
9 examinations. With respect to a dental student in the final
10 year of a program at a dental school, a passing score on the
11 examinations is valid for 180 days after the date the
12 examinations were completed. A dental school student who takes
13 the licensure examinations during the student's final year of
14 an approved dental school must have graduated before being
15 certified for licensure pursuant to s. 466.011.
16 (c) Has successfully completed the National Board of
17 Dental Examiners dental examination within 10 years of the
18 date of application.
19 Section 101. Section 466.0065, Florida Statutes, is
20 created to read:
21 466.0065 Regional licensure examinations.--
22 (1) It is the intent of the Legislature that schools
23 of dentistry be allowed to offer regional licensure
24 examinations to dental students who are in the final year of a
25 program at an approved dental school for the sole purpose of
26 facilitating the student's licensing in other jurisdictions.
27 This section does not allow a person to be licensed as a
28 dentist in this state without taking the examinations as set
29 forth in s. 466.006, nor does this section mean that regional
30 examinations administered under this section may be
31 substituted for complying with testing requirements under s.
130
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 466.006.
2 (2) Each school of dentistry in this state which is
3 accredited by the Commission on Accreditation of the American
4 Dental Association or its successor agency may, upon written
5 approval by the Board of Dentistry, offer regional licensure
6 examinations only to dental students in the final year of a
7 program at an approved dental school, if the board has
8 approved the hosting school's written plan to comply with the
9 following conditions:
10 (a) The examining body must be a member of the
11 American Association of Dental Examiners.
12 (b) The student must have successfully completed parts
13 I and II of the National Board of Dental Examiners examination
14 within 2 years before taking the regional examination.
15 (c) The student must possess medical malpractice
16 insurance in amounts that the board determines to be
17 sufficient to cover any reasonably forseeable incident of harm
18 to a patient during the clinical portion of the regional
19 examination.
20 (d) At least one of the examination monitors must be a
21 dentist licensed in this state who has completed all necessary
22 standardization exercises required by the regional examination
23 body.
24 (e) Adequate arrangements must be made, when
25 necessary, for patients who require followup care as a result
26 of procedures performed during the clinical portion of the
27 regional examination.
28 (f) The board chair or the chair's designee must be
29 allowed to observe testing while it is in progress.
30 (g) Each student, upon applying to take the regional
31 examination, must receive written disclosure in at least
131
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 12-point boldface type which states: "This examination does
2 not meet the licensure requirements of chapter 466, Florida
3 Statutes, for licensure in the State of Florida. Persons
4 wishing to practice dentistry in Florida must pass the Florida
5 licensure examinations. For more information on Florida's
6 licensure examination procedures, please contact the Florida
7 Board of Dentistry."
8 (h) The student must be enrolled as a dental student
9 in the student's final year of a program at an approved dental
10 school that is accredited by the Commission on Accreditation
11 of the American Dental Association or its successor agency.
12 (i) The student must have completed all the coursework
13 necessary to prepare the student to perform all clinical and
14 diagnostic procedures required to pass the regional
15 examination.
16 (j) The student's academic record must not include any
17 evidence suggesting that the student poses an unreasonable
18 risk to any live patients who are required for the clinical
19 portion of the regional examination. In order to protect the
20 health and safety of the public, the board may request
21 additional information and documents pertaining to the
22 candidate's mental and physical health in order to fully
23 assess the candidate's fitness to engage in exercises
24 involving a live patient.
25 (3) A student who takes the examination pursuant to
26 this section, a dental school that submits a plan pursuant to
27 this section, or a regional examination body that a dental
28 school proposes to host under this section does not have
29 standing to assert that a state agency has taken action for
30 which a hearing may be sought under ss. 120.569 and 120.57.
31 Section 102. This act may be cited as the "Nick
132
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Oelrich Gift of Life Act."
2 Section 103. Subsections (1), (2), and (6) of section
3 765.512, Florida Statutes, are amended to read:
4 765.512 Persons who may make an anatomical gift.--
5 (1) Any person who may make a will may give all or
6 part of his or her body for any purpose specified in s.
7 765.510, the gift to take effect upon death. An anatomical
8 gift made by an adult donor and not revoked by the donor as
9 provided in s. 765.516 is irrevocable and does not require the
10 consent or concurrence of any person after the donor's death.
11 A family member, guardian, representative ad litem, or health
12 care surrogate of an adult donor who has made an anatomical
13 gift pursuant to subsection (2) may not modify, deny or
14 prevent a donor's wish or intent to make an anatomical gift
15 from being made after the donor's death.
16 (2) If the decedent has executed an agreement
17 concerning an anatomical gift, by including signing an organ
18 and tissue donor card, by expressing his or her wish to donate
19 in a living will or advance directive, or by signifying his or
20 her intent to donate on his or her driver's license or in some
21 other written form has indicated his or her wish to make an
22 anatomical gift, and in the absence of actual notice of
23 contrary indications by the decedent, the document is evidence
24 of legally sufficient informed consent to donate an anatomical
25 gift and is legally binding. Any surrogate designated by the
26 decedent pursuant to part II of this chapter may give all or
27 any part of the decedent's body for any purpose specified in
28 s. 765.510.
29 (6) A gift of all or part of a body authorizes:
30 (a) Any examination necessary to assure medical
31 acceptability of the gift for the purposes intended.
133
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (b) The decedent's medical provider, family, or a
2 third party to furnish medical records requested concerning
3 the decedent's medical and social history.
4 Section 104. Section 765.516, Florida Statutes, is
5 amended to read:
6 765.516 Amendment of the terms of or the revocation of
7 the gift.--
8 (1) A donor may amend the terms of or revoke an
9 anatomical gift by:
10 (a) The execution and delivery to the donee of a
11 signed statement.
12 (b) An oral statement that is:
13 1. Made to the donor's spouse; or
14 2. made in the presence of two persons, one of whom
15 must not be a family member, and communicated to the donor's
16 family or attorney or to the donee.
17 (c) A statement during a terminal illness or injury
18 addressed to an attending physician, who must communicate the
19 revocation of the gift to the procurement organization that is
20 certified by the state.
21 (d) A signed document found on or about the donor's
22 person or in the donor's effects.
23 (2) Any gift made by a will may also be amended or
24 revoked in the manner provided for amendment or revocation of
25 wills or as provided in subsection (1).
26 Section 105. Subsection (1) of section 765.401,
27 Florida Statutes, is amended to read:
28 765.401 The proxy.--
29 (1) If an incapacitated or developmentally disabled
30 patient has not executed an advance directive, or designated a
31 surrogate to execute an advance directive, or the designated
134
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 or alternate surrogate is no longer available to make health
2 care decisions, health care decisions may be made for the
3 patient by any of the following individuals, in the following
4 order of priority, if no individual in a prior class is
5 reasonably available, willing, or competent to act:
6 (a) The judicially appointed guardian of the patient
7 or the guardian advocate of the person having a developmental
8 disability as defined in s. 393.063, who has been authorized
9 to consent to medical treatment, if such guardian has
10 previously been appointed; however, this paragraph shall not
11 be construed to require such appointment before a treatment
12 decision can be made under this subsection;
13 (b) The patient's spouse;
14 (c) An adult child of the patient, or if the patient
15 has more than one adult child, a majority of the adult
16 children who are reasonably available for consultation;
17 (d) A parent of the patient;
18 (e) The adult sibling of the patient or, if the
19 patient has more than one sibling, a majority of the adult
20 siblings who are reasonably available for consultation;
21 (f) An adult relative of the patient who has exhibited
22 special care and concern for the patient and who has
23 maintained regular contact with the patient and who is
24 familiar with the patient's activities, health, and religious
25 or moral beliefs; or
26 (g) A close friend of the patient; or.
27 (h) A clinical social worker licensed pursuant to
28 chapter 491, or a graduate of a court-approved guardianship
29 program. Such a proxy must be selected by the provider's
30 bioethics committee and must not be employed by the provider.
31 If the provider does not have a bioethics committee, then such
135
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 a proxy may be chosen through an arrangement with the
2 bioethics committee of another provider. The proxy must be
3 notified that upon request the provider shall make available a
4 second physician, not involved in the patient's care, to
5 assist the proxy in evaluating treatment. Decisions to
6 withhold or withdraw life-prolonging procedures must be
7 reviewed by the facility's bioethics committee. Documentation
8 of efforts to locate proxies from prior classes must be
9 recorded in the patient record.
10 Section 106. Subsection (22) is added to section
11 641.19, Florida Statutes, to read:
12 641.19 Definitions.--As used in this part, the term:
13 (22) "Specialty" does not include services performed
14 by a chiropractic physician licensed under chapter 460.
15 Section 107. Subsection (5) is added to section
16 401.272, Florida Statutes, to read:
17 401.272 Emergency medical services community health
18 care.--
19 (5) Notwithstanding any other provision of law to the
20 contrary, a pilot program is authorized in Orange County where
21 paramedics may provide basic life support and advanced life
22 support as defined in s. 401.23(1) and (7):
23 (a) In a hospital emergency department. Such services
24 provided by paramedics employed by the hospital must be under
25 the direction of the emergency department nursing director or
26 manager. If the services provided by paramedics employed by
27 the physician group is pursuant to a contract between a
28 hospital and a physician group to provide emergency services,
29 such paramedics shall be employees of the physician group and
30 services provided by the paramedics must be under the
31 supervision of a physician.
136
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (b) As part of a private corporate emergency
2 management and response program. Such services must be
3 provided under the supervision of a physician.
4 Section 108. The Department of Health, in consultation
5 with the Miami-Dade Community College Physician Assistant
6 Program, the University of Florida Physician Assistant
7 Program, the Nova Southeastern University Physician Assistant
8 Program, Florida Academy of Physician Assistants, and the
9 Barry University Physician Assistant Program, shall conduct a
10 study to establish the most advantageous methods to utilize
11 the medical skills of foreign-trained physicians to practice
12 as physician assistants in this state. Such joint study shall
13 indicate:
14 (1) The existing pathways or methods for a
15 foreign-trained physician to receive a license to practice as
16 a physician assistant in Florida;
17 (2) National standards, national examinations, and
18 credentialing requirements for a foreign-trained physician to
19 be licensed to practice as a physician assistant in other
20 states in the United States;
21 (3) Training, education requirements, remedial
22 courses, and supervisory needs of a foreign-trained physician
23 desiring to become eligible to practice as a physician
24 assistant;
25 (4) The scope of practice of a foreign-trained
26 physician assistant; and
27 (5) Any other areas of study that the department and
28 educational institutions deem appropriate to further the
29 intent of this section.
30
31 Such study shall be presented to the Governor, the President
137
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 of the Senate and the Speaker of the House of Representatives
2 no later than January 1, 2004.
3 Section 109. Section 1012.46, Florida Statutes, is
4 amended to read:
5 1012.46 Athletic trainers.--
6 (1) School districts may establish and implement an
7 athletic injuries prevention and treatment program. Central to
8 this program should be the employment and availability of
9 persons trained in the prevention and treatment of physical
10 injuries which may occur during athletic activities. The
11 program should reflect opportunities for progressive
12 advancement and compensation in employment as provided in
13 subsection (2) and meet certain other minimum standards
14 developed by the Department of Education. The goal of the
15 Legislature is to have school districts employ and have
16 available a full-time teacher athletic trainer in each high
17 school in the state.
18 (2) To the extent practicable, a school district
19 program should include the following employment classification
20 and advancement scheme:
21 (a) First responder.--To qualify as a first responder,
22 a person must possess a professional, temporary, part-time,
23 adjunct, or substitute certificate pursuant to s. 1012.56, be
24 certified in cardiopulmonary resuscitation, first aid, and
25 have 15 semester hours in courses such as care and prevention
26 of athletic injuries, anatomy, physiology, nutrition,
27 counseling, and other similar courses approved by the
28 Commissioner of Education. This person may only administer
29 first aid and similar care and may not hold himself or herself
30 out to a school district or the public as an athletic trainer
31 licensed under part XIII of chapter 468.
138
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (b) Teacher Athletic trainer.--To qualify as an a
2 teacher athletic trainer, a person must be licensed under part
3 XIII of chapter 468 and may be utilized by a school district
4 as possess a professional, temporary, part-time, adjunct, or
5 substitute teacher certificate pursuant to s. 1012.35, s.
6 1012.56 or s. 1012.57, and be licensed as required by part
7 XIII of chapter 468.
8 Section 110. Subsection (5) of section 17.41, Florida
9 Statutes, is amended to read:
10 17.41 Department of Banking and Finance Tobacco
11 Settlement Clearing Trust Fund.--
12 (5) The department shall disburse funds, by
13 nonoperating transfer, from the Tobacco Settlement Clearing
14 Trust Fund to the tobacco settlement trust funds of the
15 various agencies or the Biomedical Research Trust Fund in the
16 Department of Health, as appropriate, in amounts equal to the
17 annual appropriations made from those agencies' trust funds in
18 the General Appropriations Act.
19 Section 111. Paragraphs (f) and (j) of subsection (3)
20 of section 20.43, Florida Statutes, are amended, and paragraph
21 (k) is added to that section, to read:
22 20.43 Department of Health.--There is created a
23 Department of Health.
24 (3) The following divisions of the Department of
25 Health are established:
26 (f) Division of Emergency Medical Operations Services
27 and Community Health Resources.
28 (j) Division of Health Access Awareness and Tobacco.
29 (k) Division of Disability Determinations.
30 Section 112. Paragraph (a) of subsection (2) and
31 subsection (3) of section 154.01, Florida Statutes, are
139
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 amended to read:
2 154.01 County health department delivery system.--
3 (2) A functional system of county health department
4 services shall be established which shall include the
5 following three levels of service and be funded as follows:
6 (a) "Environmental health services" are those services
7 which are organized and operated to protect the health of the
8 general public by monitoring and regulating activities in the
9 environment which may contribute to the occurrence or
10 transmission of disease. Environmental health services shall
11 be supported by available federal, state, and local funds and
12 shall include those services mandated on a state or federal
13 level. Examples of environmental health services include, but
14 are not limited to, food hygiene, investigations of elevated
15 blood lead levels, safe drinking water supply, sewage and
16 solid waste disposal, swimming pools, group care facilities,
17 migrant labor camps, toxic material control, radiological
18 health, occupational health, and entomology.
19 (3) The Department of Health shall enter into
20 contracts with the several counties for the purposes of this
21 part. All contracts shall be negotiated and approved by the
22 appropriate local governing bodies and the appropriate
23 district administrators on behalf of the department. In
24 accordance with federal guidelines, the state may utilize
25 federal funds for county health department services. A
26 standard contract format shall be developed and used by the
27 department in contract negotiations. The contract shall
28 include the three levels of county health department services
29 outlined in subsection (2) above and shall contain a section
30 which stipulates, for the contract year:
31 (a) All revenue sources, including federal, state, and
140
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 local general revenue, fees, and other cash contributions,
2 which shall be used by the county health department for county
3 health department services;
4 (b) The types of services to be provided in each level
5 of service. Each participating county may expend funds for
6 federally mandated certification or recertification fees
7 related to investigations of elevated blood lead levels as
8 provided under paragraph (2)(a);
9 (c) The estimated number of clients, where applicable,
10 who will be served, by type of service;
11 (d) The estimated number of services, where
12 applicable, that will be provided, by type of service;
13 (e) The estimated number of staff positions (full-time
14 equivalent positions) who will work in each type of service
15 area; and
16 (f) The estimated expenditures for each type of
17 service and for each level of service.
18
19 The contract shall also provide for financial and service
20 reporting for each type of service according to standard
21 service and reporting procedures established by the
22 department.
23 Section 113. Section 216.342, Florida Statutes, is
24 created to read:
25 216.342 Disbursement of the United States Trust
26 Fund.--The United States Trust Fund may be expended by the
27 Department of Health in accordance with the budget and plans
28 agreed upon by the Social Security Administration and the
29 Department of Health for the operation of the Division of
30 Disability Determinations. The limitations on appropriations
31 provided in s. 216.262 (1) do not apply to the United States
141
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Trust Fund.
2 Section 114. Subsection (12) of section 381.0011,
3 Florida Statutes, is amended to read:
4 381.0011 Duties and powers of the Department of
5 Health.--It is the duty of the Department of Health to:
6 (12) Maintain Cooperate with other departments, local
7 officials, and private organizations in developing and
8 implementing a statewide injury prevention and control
9 program.
10 Section 115. Paragraph (d) of subsection (3) of
11 section 381.004, Florida Statutes, is amended to read:
12 381.004 HIV testing.--
13 (3) HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED
14 CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--
15 (d) No test result shall be determined as positive,
16 and no positive test result shall be revealed to any person,
17 without corroborating or confirmatory tests being conducted
18 except in the following situations:
19 1. Preliminary test results may be released to
20 licensed physicians or the medical or nonmedical personnel
21 subject to the significant exposure for purposes of
22 subparagraphs (h)10., 11., and 12.
23 2. Preliminary test results may be released to health
24 care providers and to the person tested when decisions about
25 medical care or treatment of, or recommendation to, the person
26 tested and, in the case of an intrapartum or postpartum woman,
27 when care, treatment, or recommendations regarding her
28 newborn, cannot await the results of confirmatory testing.
29 Positive preliminary HIV test results shall not be
30 characterized to the patient as a diagnosis of HIV infection.
31 Justification for the use of preliminary test results must be
142
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 documented in the medical record by the health care provider
2 who ordered the test. This subparagraph does not authorize the
3 release of preliminary test results for the purpose of routine
4 identification of HIV-infected individuals or when HIV testing
5 is incidental to the preliminary diagnosis or care of a
6 patient. Corroborating or confirmatory testing must be
7 conducted as followup to a positive preliminary test.
8 3. A positive rapid test result is preliminary and may
9 be released in accordance with the manufacturer's
10 instructions, as approved by the United States Food and Drug
11 Administration. A positive rapid test result shall be subject
12 to confirmatory testing for purposes of diagnosis and
13 reporting of HIV infection.
14
15 Results shall be communicated to the patient according to
16 statute regardless of the outcome. Except as provided in this
17 section, test results are confidential and exempt from the
18 provisions of s. 119.07(1).
19 Section 116. Paragraph (k) of subsection (2) and
20 paragraph (j) of subsection (4) of section 381.0065, Florida
21 Statutes, are amended to read:
22 381.0065 Onsite sewage treatment and disposal systems;
23 regulation.--
24 (2) DEFINITIONS.--As used in ss. 381.0065-381.0067,
25 the term:
26 (k) "Permanent nontidal surface water body" means a
27 perennial stream, a perennial river, an intermittent stream, a
28 perennial lake, a submerged marsh or swamp, a submerged wooded
29 marsh or swamp, a spring, or a seep, as identified on the most
30 recent quadrangle map, 7.5 minute series (topographic),
31 produced by the United States Geological Survey, or products
143
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 derived from that series. "Permanent nontidal surface water
2 body" shall also mean an artificial surface water body that
3 does not have an impermeable bottom and side and that is
4 designed to hold, or does hold, visible standing water for at
5 least 180 days of the year. However, a nontidal surface water
6 body that is drained, either naturally or artificially, where
7 the intent or the result is that such drainage be temporary,
8 shall be considered a permanent nontidal surface water body. A
9 nontidal surface water body that is drained of all visible
10 surface water, where the lawful intent or the result of such
11 drainage is that such drainage will be permanent, shall not be
12 considered a permanent nontidal surface water body. The
13 boundary of a permanent nontidal surface water body shall be
14 the mean annual flood line.
15 (4) PERMITS; INSTALLATION; AND CONDITIONS.--A person
16 may not construct, repair, modify, abandon, or operate an
17 onsite sewage treatment and disposal system without first
18 obtaining a permit approved by the department. The department
19 may issue permits to carry out this section, but shall not
20 make the issuance of such permits contingent upon prior
21 approval by the Department of Environmental Protection. A
22 construction permit is valid for 18 months from the issuance
23 date and may be extended by the department for one 90-day
24 period under rules adopted by the department. A repair permit
25 is valid for 90 days from the date of issuance. An operating
26 permit must be obtained prior to the use of any aerobic
27 treatment unit or if the establishment generates commercial
28 waste. Buildings or establishments that use an aerobic
29 treatment unit or generate commercial waste shall be inspected
30 by the department at least annually to assure compliance with
31 the terms of the operating permit. The operating permit for a
144
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 commercial wastewater system is valid for 1 year from the date
2 of issuance and must be renewed annually. The operating permit
3 for an aerobic treatment unit is valid for 2 years from the
4 date of issuance and must be renewed every 2 years. If all
5 information pertaining to the siting, location, and
6 installation conditions or repair of an onsite sewage
7 treatment and disposal system remains the same, a construction
8 or repair permit for the onsite sewage treatment and disposal
9 system may be transferred to another person, if the transferee
10 files, within 60 days after the transfer of ownership, an
11 amended application providing all corrected information and
12 proof of ownership of the property. There is no fee
13 associated with the processing of this supplemental
14 information. A person may not contract to construct, modify,
15 alter, repair, service, abandon, or maintain any portion of an
16 onsite sewage treatment and disposal system without being
17 registered under part III of chapter 489. A property owner
18 who personally performs construction, maintenance, or repairs
19 to a system serving his or her own owner-occupied
20 single-family residence is exempt from registration
21 requirements for performing such construction, maintenance, or
22 repairs on that residence, but is subject to all permitting
23 requirements. A municipality or political subdivision of the
24 state may not issue a building or plumbing permit for any
25 building that requires the use of an onsite sewage treatment
26 and disposal system unless the owner or builder has received a
27 construction permit for such system from the department. A
28 building or structure may not be occupied and a municipality,
29 political subdivision, or any state or federal agency may not
30 authorize occupancy until the department approves the final
31 installation of the onsite sewage treatment and disposal
145
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 system. A municipality or political subdivision of the state
2 may not approve any change in occupancy or tenancy of a
3 building that uses an onsite sewage treatment and disposal
4 system until the department has reviewed the use of the system
5 with the proposed change, approved the change, and amended the
6 operating permit.
7 (j) An onsite sewage treatment and disposal system for
8 a single-family residence that is designed by a professional
9 engineer registered in the state and certified by such
10 engineer as complying with performance criteria adopted by the
11 department must be approved by the department subject to the
12 following:
13 1. The performance criteria applicable to
14 engineer-designed systems must be limited to those necessary
15 to ensure that such systems do not adversely affect the public
16 health or significantly degrade the groundwater or surface
17 water. Such performance criteria shall include consideration
18 of the quality of system effluent, the proposed total sewage
19 flow per acre, wastewater treatment capabilities of the
20 natural or replaced soil, water quality classification of the
21 potential surface-water-receiving body, and the structural and
22 maintenance viability of the system for the treatment of
23 domestic wastewater. However, performance criteria shall
24 address only the performance of a system and not a system's
25 design.
26 2. The technical review and advisory panel shall
27 assist the department in the development of performance
28 criteria applicable to engineer-designed systems. Workshops
29 on the development of the rules delineating such criteria
30 shall commence not later than September 1, 1996, and the
31 department shall advertise such rules for public hearing no
146
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 later than October 1, 1997.
2 3. A person electing to utilize an engineer-designed
3 system shall, upon completion of the system design, submit
4 such design, certified by a registered professional engineer,
5 to the county health department. The county health department
6 may utilize an outside consultant to review the
7 engineer-designed system, with the actual cost of such review
8 to be borne by the applicant. Within 5 working days after
9 receiving an engineer-designed system permit application, the
10 county health department shall request additional information
11 if the application is not complete. Within 15 working days
12 after receiving a complete application for an
13 engineer-designed system, the county health department either
14 shall issue the permit or, if it determines that the system
15 does not comply with the performance criteria, shall notify
16 the applicant of that determination and refer the application
17 to the department for a determination as to whether the system
18 should be approved, disapproved, or approved with
19 modification. The department engineer's determination shall
20 prevail over the action of the county health department. The
21 applicant shall be notified in writing of the department's
22 determination and of the applicant's rights to pursue a
23 variance or seek review under the provisions of chapter 120.
24 4. The owner of an engineer-designed performance-based
25 system must maintain a current maintenance service agreement
26 with a maintenance entity permitted by the department. The
27 maintenance entity shall obtain a biennial system operating
28 permit from the department for each system under service
29 contract. The department shall inspect the system at least
30 annually, or on such periodic basis as the fee collected
31 permits, and may collect system-effluent samples if
147
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 appropriate to determine compliance with the performance
2 criteria. The fee for the biennial operating permit shall be
3 collected beginning with the second year of system operation.
4 The maintenance entity shall inspect each system at least
5 twice each year and shall report quarterly to the department
6 on the number of systems inspected and serviced.
7 5. If an engineer-designed system fails to properly
8 function or fails to meet performance standards, the system
9 shall be re-engineered, if necessary, to bring the system into
10 compliance with the provisions of this section.
11 Section 117. Paragraph (k) of subsection (2) of
12 section 381.0066, Florida Statutes, as amended by section 16
13 of chapter 2002-402, Laws of Florida, is amended to read:
14 381.0066 Onsite sewage treatment and disposal systems;
15 fees.--
16 (2) The minimum fees in the following fee schedule
17 apply until changed by rule by the department within the
18 following limits:
19 (k) Research: An additional $5 fee shall be added to
20 each new system construction permit issued during fiscal years
21 1996-2003 to be used for onsite sewage treatment and disposal
22 system research, demonstration, and training projects. Five
23 dollars from any repair permit fee collected under this
24 section shall be used for funding the hands-on training
25 centers described in s. 381.0065(3)(j).
26
27 The funds collected pursuant to this subsection must be
28 deposited in a trust fund administered by the department, to
29 be used for the purposes stated in this section and ss.
30 381.0065 and 381.00655.
31 Section 118. Paragraph (a) of subsection (2) of
148
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 section 381.0072, Florida Statutes, is amended to read:
2 381.0072 Food service protection.--It shall be the
3 duty of the Department of Health to adopt and enforce
4 sanitation rules consistent with law to ensure the protection
5 of the public from food-borne illness. These rules shall
6 provide the standards and requirements for the storage,
7 preparation, serving, or display of food in food service
8 establishments as defined in this section and which are not
9 permitted or licensed under chapter 500 or chapter 509.
10 (2) DUTIES.--
11 (a) The department shall adopt rules, including
12 definitions of terms which are consistent with law prescribing
13 minimum sanitation standards and manager certification
14 requirements as prescribed in s. 509.039, and which shall be
15 enforced in food service establishments as defined in this
16 section. The sanitation standards must address the
17 construction, operation, and maintenance of the establishment;
18 lighting, ventilation, laundry rooms, lockers, use and storage
19 of toxic materials and cleaning compounds, and first-aid
20 supplies; plan review; design, construction, installation,
21 location, maintenance, sanitation, and storage of food
22 equipment and utensils; employee training, health, hygiene,
23 and work practices; food supplies, preparation, storage,
24 transportation, and service, including access to the areas
25 where food is stored or prepared; and sanitary facilities and
26 controls, including water supply and sewage disposal; plumbing
27 and toilet facilities; garbage and refuse collection, storage,
28 and disposal; and vermin control. Public and private schools
29 if the food service is operated by school employees, hospitals
30 licensed under chapter 395, nursing homes licensed under part
31 II of chapter 400, child care facilities as defined in s.
149
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 402.301, and residential facilities colocated with a nursing
2 home or hospital if all food is prepared in a central kitchen
3 that complies with nursing or hospital regulations, and bars
4 and lounges shall be exempt from the rules developed for
5 manager certification. The department shall administer a
6 comprehensive inspection, monitoring, and sampling program to
7 ensure such standards are maintained. With respect to food
8 service establishments permitted or licensed under chapter 500
9 or chapter 509, the department shall assist the Division of
10 Hotels and Restaurants of the Department of Business and
11 Professional Regulation and the Department of Agriculture and
12 Consumer Services with rulemaking by providing technical
13 information.
14 Section 119. Section 381.104, Florida Statutes, is
15 created to read:
16 381.104 Employee health and wellness program.--
17 (1) Each state agency may allocate, from existing
18 resources, the necessary funding and facilities for the
19 development and maintenance of an employee health and wellness
20 program and may seek additional funding from other sources to
21 support the program for the benefit of the agency's employees.
22 (2) Each state agency may dedicate resources to
23 develop and coordinate an employee health and wellness program
24 or arrange to cooperate with other agencies in their
25 geographic proximity for program coordination, including
26 providers of state employee benefits.
27 (3) Each state agency may establish an employee health
28 and wellness coordinator and an advisory committee to guide
29 the development of an operational plan, including the
30 collection of data, to plan events and activities, and to
31 oversee program evaluation and the allocation of funds.
150
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (4) Each state agency may conduct and dedicate
2 resources toward an employee needs assessment to ascertain the
3 health and wellness-related needs of its employees.
4 (5) Each state agency may establish policies that
5 allow employees no longer than 30 minutes of work time three
6 times each week, as individual workloads allow, which may be
7 used for the purpose of engaging in wellness activities,
8 including physical activity, stress-reduction programs,
9 tobacco cessation, personal training, nutrition counseling, or
10 weight reduction and control.
11 (6) Each state agency participating in the program
12 must use an employee health and wellness activity agreement
13 form, which must be completed and signed by the employee,
14 signed by the employee's immediate supervisor, and kept in the
15 employee's personnel file prior to participating in any
16 activity. This form shall be developed by the Department of
17 Health. It is the responsibility of the employee to complete
18 the form, including the time of the workday the wellness
19 activity will be observed and on which days of the week,
20 obtain the signature of his or her supervisor, and submit the
21 form to the personnel office. The employee must submit a
22 revised employee health and wellness activity agreement form
23 prior to any change in the employee's activities.
24 (7) Each state agency may designate up to 1 hour each
25 month for the purpose of providing wellness training for its
26 employees.
27 (8) Each state agency may use the e-mail and other
28 communication systems to promote the agency's employee health
29 and wellness activities.
30 (9) Each state agency may, and is encouraged to:
31 (a) Enter into an agreement or contract with other
151
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 state agencies, including a state-supported college or
2 university, or with a local or federal department,
3 institution, commission, agency, or private enterprise to
4 present, collaborate, or participate jointly in health or
5 fitness education or activity programs.
6 (b) Implement as a part of the employee health and
7 wellness program, health education activities that focus on
8 skill development and lifestyle behavior change, along with
9 information dissemination and awareness building, preferably
10 tailored to an employee's interests and needs.
11 (c) Review and offer recommendations on environmental
12 and social support policies that pertain to improving the
13 health of employees.
14 (d) Link the employee health and wellness program to
15 programs such as the employee assistance program and other
16 related programs to help employees balance work and family.
17 (e) Offer free, low-cost, or employee fee-based
18 employee wellness programs.
19 (10) Each agency that develops and implements an
20 employee health and wellness program shall include and
21 document an evaluation and improvement process to help enhance
22 the program's efficiency and effectiveness over time.
23 (11) The Department of Health shall provide model
24 program guidelines for the employee health and wellness
25 program and shall provide ongoing technical assistance to
26 other state agencies to assist in developing the agency's
27 employee health and wellness program.
28 Section 120. Section 381.86, Florida Statutes, is
29 created to read:
30 381.86 Review Council for Human Subjects.--
31 (1) The Review Council for Human Subjects is created
152
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 within the Department of Health to comply with federal
2 requirements under 45 C.F.R. part 46 and 21 C.F.R. parts 50
3 and 56 for an institutional review board to review all
4 biomedical and behavioral research on human subjects which is
5 funded by the department or supported by the department in any
6 manner, including the permitting of access to department data
7 or department resources.
8 (2) Consistent with federal requirements the Secretary
9 of Health shall determine and appoint the membership on the
10 council and designate the chair.
11 (3) The council may serve as an institutional review
12 board for other agencies at the discretion of the secretary.
13 (4) Each council member is entitled to reimbursement
14 for per diem and travel expenses as provided in s. 112.061
15 while carrying out the official business of the council.
16 (5) The department shall charge for costs incurred by
17 the council for research oversight according to a fee
18 schedule, except that fees shall be waived for any student who
19 is a candidate for a degree at a university located in this
20 state. The fee schedule shall provide for fees for initial
21 review, amendments, and continuing review. The department
22 shall adopt rules necessary to comply with federal
23 requirements and this section. Such rules shall also prescribe
24 procedures for requesting council review.
25 (6) Fees collected pursuant to this section shall be
26 deposited into the Administrative Trust Fund and used solely
27 for the purpose of administering the program authorized by
28 this section.
29 Section 121. Paragraphs (b) and (c) of subsection (3)
30 of section 381.89, Florida Statutes, are amended to read:
31 381.89 Regulation of tanning facilities.--
153
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (3)
2 (b) The department shall establish procedures for the
3 issuance and annual renewal of licenses and shall establish
4 annual license and renewal fees and late payment fees in an
5 amount necessary to cover the expenses of administering this
6 section. Annual license and renewal fees may not shall be not
7 less than $125 nor more than $250 per tanning device and a
8 maximum total fee per individual tanning facility may be set
9 by rule. Effective October 1, 1991, the fee amount shall be
10 the minimum fee proscribed in this paragraph and such fee
11 amount shall remain in effect until the effective date of a
12 fee schedule adopted by the department.
13 (c) The department may adopt a system under which
14 licenses expire on staggered dates and the annual renewal fees
15 are prorated quarterly monthly to reflect the actual number of
16 months the license is valid.
17 Section 122. Subsection (3) and paragraph (a) of
18 subsection (7) of section 381.90, Florida Statutes, are
19 amended to read:
20 381.90 Health Information Systems Council; legislative
21 intent; creation, appointment, duties.--
22 (3) The council shall be composed of the following
23 members or their senior executive-level designees:
24 (a) The Secretary of the Department of Health;
25 (b) The Executive Director secretary of the Department
26 of Veterans' Affairs Business and Professional Regulation;
27 (c) The Secretary of the Department of Children and
28 Family Services;
29 (d) The Secretary of Health Care Administration;
30 (e) The Secretary of the Department of Corrections;
31 (f) The Attorney General;
154
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (g) The Executive Director of the Correctional Medical
2 Authority;
3 (h) Two members representing county health
4 departments, one from a small county and one from a large
5 county, appointed by the Governor;
6 (i) A representative from the Florida Association of
7 Counties;
8 (j) The Chief Financial Officer State Treasurer and
9 Insurance Commissioner;
10 (k) A representative from the Florida Healthy Kids
11 Corporation;
12 (l) A representative from a school of public health
13 chosen by the Commissioner of Education Board of Regents;
14 (m) The Commissioner of Education;
15 (n) The Secretary of the Department of Elderly
16 Affairs; and
17 (o) The Secretary of the Department of Juvenile
18 Justice.
19
20 Representatives of the Federal Government may serve without
21 voting rights.
22 (7) The council's duties and responsibilities include,
23 but are not limited to, the following:
24 (a) By June March 1 of each year, to develop and
25 approve a strategic plan pursuant to the requirements set
26 forth in s. 186.022(9). Copies of the plan shall be
27 transmitted electronically or in writing to the Executive
28 Office of the Governor, the Speaker of the House of
29 Representatives, and the President of the Senate.
30 Section 123. Subsections (1) and (2), paragraphs (f)
31 and (g) of subsection (3), and subsection (5) of section
155
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 383.14, Florida Statutes, are amended to read:
2 383.14 Screening for metabolic disorders, other
3 hereditary and congenital disorders, and environmental risk
4 factors.--
5 (1) SCREENING REQUIREMENTS.--To help ensure access to
6 the maternal and child health care system, the Department of
7 Health shall promote the screening of all newborns infants
8 born in Florida for phenylketonuria and other metabolic,
9 hereditary, and congenital disorders known to result in
10 significant impairment of health or intellect, as screening
11 programs accepted by current medical practice become available
12 and practical in the judgment of the department. The
13 department shall also promote the identification and screening
14 of all newborns infants born in this state and their families
15 for environmental risk factors such as low income, poor
16 education, maternal and family stress, emotional instability,
17 substance abuse, and other high-risk conditions associated
18 with increased risk of infant mortality and morbidity to
19 provide early intervention, remediation, and prevention
20 services, including, but not limited to, parent support and
21 training programs, home visitation, and case management.
22 Identification, perinatal screening, and intervention efforts
23 shall begin prior to and immediately following the birth of
24 the child by the attending health care provider. Such efforts
25 shall be conducted in hospitals, perinatal centers, county
26 health departments, school health programs that provide
27 prenatal care, and birthing centers, and reported to the
28 Office of Vital Statistics.
29 (a) Prenatal screening.--The department shall develop
30 a multilevel screening process that includes a risk assessment
31 instrument to identify women at risk for a preterm birth or
156
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 other high-risk condition. The primary health care provider
2 shall complete the risk assessment instrument and report the
3 results to the Office of Vital Statistics so that the woman
4 may immediately be notified and referred to appropriate
5 health, education, and social services.
6 (b) Postnatal screening.--A risk factor analysis using
7 the department's designated risk assessment instrument shall
8 also be conducted as part of the medical screening process
9 upon the birth of a child and submitted to the department's
10 Office of Vital Statistics for recording and other purposes
11 provided for in this chapter. The department's screening
12 process for risk assessment shall include a scoring mechanism
13 and procedures that establish thresholds for notification,
14 further assessment, referral, and eligibility for services by
15 professionals or paraprofessionals consistent with the level
16 of risk. Procedures for developing and using the screening
17 instrument, notification, referral, and care coordination
18 services, reporting requirements, management information, and
19 maintenance of a computer-driven registry in the Office of
20 Vital Statistics which ensures privacy safeguards must be
21 consistent with the provisions and plans established under
22 chapter 411, Pub. L. No. 99-457, and this chapter. Procedures
23 established for reporting information and maintaining a
24 confidential registry must include a mechanism for a
25 centralized information depository at the state and county
26 levels. The department shall coordinate with existing risk
27 assessment systems and information registries. The department
28 must ensure, to the maximum extent possible, that the
29 screening information registry is integrated with the
30 department's automated data systems, including the Florida
31 On-line Recipient Integrated Data Access (FLORIDA) system.
157
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Tests and screenings must be performed by the State Public
2 Health Laboratory, in coordination with Children's Medical
3 Services, at such times and in such manner as is prescribed by
4 the department after consultation with the Genetics and
5 Newborn Infant Screening Advisory Council and the State
6 Coordinating Council for School Readiness Programs.
7 (2) RULES.--After consultation with the Genetics and
8 Newborn Infant Screening Advisory Council, the department
9 shall adopt and enforce rules requiring that every newborn
10 infant born in this state shall, prior to becoming 2 weeks of
11 age, be subjected to a test for phenylketonuria and, at the
12 appropriate age, be tested for such other metabolic diseases
13 and hereditary or congenital disorders as the department may
14 deem necessary from time to time. After consultation with the
15 State Coordinating Council for School Readiness Programs, the
16 department shall also adopt and enforce rules requiring every
17 newborn infant born in this state to be screened for
18 environmental risk factors that place children and their
19 families at risk for increased morbidity, mortality, and other
20 negative outcomes. The department shall adopt such additional
21 rules as are found necessary for the administration of this
22 section, including rules providing definitions of terms, rules
23 relating to the methods used and time or times for testing as
24 accepted medical practice indicates, rules relating to
25 charging and collecting fees for screenings authorized by this
26 section, and rules requiring mandatory reporting of the
27 results of tests and screenings for these conditions to the
28 department.
29 (3) DEPARTMENT OF HEALTH; POWERS AND DUTIES.--The
30 department shall administer and provide certain services to
31 implement the provisions of this section and shall:
158
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (f) Promote the availability of genetic studies and
2 counseling in order that the parents, siblings, and affected
3 newborns infants may benefit from available knowledge of the
4 condition.
5 (g) Have the authority to charge and collect fees for
6 screenings authorized in this section, as follows:
7 1. A fee of $20 will be charged for each live birth,
8 as recorded by the Office of Vital Statistics, occurring in a
9 hospital licensed under part I of chapter 395 or a birth
10 center licensed under s. 383.305, up to 3,000 live births per
11 licensed hospital per year or over 60 births per birth center
12 per year. The department shall calculate the annual
13 assessment for each hospital and birth center, and this
14 assessment must be paid in equal amounts quarterly. Quarterly,
15 the department shall generate and mail to each hospital and
16 birth center a statement of the amount due.
17 2. As part of the department's legislative budget
18 request prepared pursuant to chapter 216, the department shall
19 submit a certification by the department's inspector general,
20 or the director of auditing within the inspector general's
21 office, of the annual costs of the uniform testing and
22 reporting procedures of the newborn infant screening program.
23 In certifying the annual costs, the department's inspector
24 general or the director of auditing within the inspector
25 general's office shall calculate the direct costs of the
26 uniform testing and reporting procedures, including applicable
27 administrative costs. Administrative costs shall be limited to
28 those department costs which are reasonably and directly
29 associated with the administration of the uniform testing and
30 reporting procedures of the newborn infant screening program.
31
159
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 All provisions of this subsection must be coordinated with the
2 provisions and plans established under this chapter, chapter
3 411, and Pub. L. No. 99-457.
4 (5) ADVISORY COUNCIL.--There is established a Genetics
5 and Newborn Infant Screening Advisory Council made up of 12
6 members appointed by the Secretary of Health. The council
7 shall be composed of two consumer members, three practicing
8 pediatricians, at least one of whom must be a pediatric
9 hematologist, one representative from each of the four medical
10 schools in the state, the Secretary of Health or his or her
11 designee, one representative from the Department of Health
12 representing Children's Medical Services, and one
13 representative from the Developmental Disabilities Program
14 Office of the Department of Children and Family Services. All
15 appointments shall be for a term of 4 years. The chairperson
16 of the council shall be elected from the membership of the
17 council and shall serve for a period of 2 years. The council
18 shall meet at least semiannually or upon the call of the
19 chairperson. The council may establish ad hoc or temporary
20 technical advisory groups to assist the council with specific
21 topics which come before the council. Council members shall
22 serve without pay. Pursuant to the provisions of s. 112.061,
23 the council members are entitled to be reimbursed for per diem
24 and travel expenses. It is the purpose of the council to
25 advise the department about:
26 (a) Conditions for which testing should be included
27 under the screening program and the genetics program;
28 (b) Procedures for collection and transmission of
29 specimens and recording of results; and
30 (c) Methods whereby screening programs and genetics
31 services for children now provided or proposed to be offered
160
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 in the state may be more effectively evaluated, coordinated,
2 and consolidated.
3 Section 124. Section 384.25, Florida Statutes, is
4 amended to read:
5 384.25 Reporting required.--
6 (1) Each person who makes a diagnosis of or treats a
7 person with a sexually transmissible disease and each
8 laboratory that performs a test for a sexually transmissible
9 disease which concludes with a positive result shall report
10 such facts as may be required by the department by rule,
11 within a time period as specified by rule of the department,
12 but in no case to exceed 2 weeks.
13 (a)(2) The department shall adopt rules specifying the
14 information required in and a minimum time period for
15 reporting a sexually transmissible disease. In adopting such
16 rules, the department shall consider the need for information,
17 protections for the privacy and confidentiality of the
18 patient, and the practical ability of persons and laboratories
19 to report in a reasonable fashion. To ensure the
20 confidentiality of persons infected with the human
21 immunodeficiency virus (HIV), reporting of HIV infection and
22 acquired immune deficiency syndrome (AIDS) must be conducted
23 using a system the HIV/AIDS Reporting System (HARS) developed
24 by the Centers for Disease Control and Prevention of the
25 United States Public Health Service or an equivalent system.
26 (b)(3) The department shall require reporting of
27 physician diagnosed cases of AIDS and HIV infection consistent
28 with based upon diagnostic criteria for surveillance-case
29 definition for HIV/AIDS reporting from the Centers for Disease
30 Control and Prevention.
31 (c)(4) The department shall may require physician and
161
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 laboratory reporting of HIV infection. However, only reports
2 of HIV infection identified on or after the effective date of
3 the rule developed by the department pursuant to this
4 subsection shall be accepted. The Reporting may not affect or
5 relate to anonymous HIV testing programs conducted pursuant to
6 s. 381.004(4) or to university-based medical research
7 protocols as determined by the department.
8 (2)(5) After notification of the test subject under
9 subsection (4), the department may, with the consent of the
10 test subject, notify school superintendents of students and
11 school personnel whose HIV tests are positive.
12 (3) The department shall adopt rules requiring each
13 physician and laboratory to report any newborn or infant up to
14 18 months of age who has been exposed to HIV. The rules may
15 include the method and time period for reporting, information
16 to be included in the report, requirements for enforcement,
17 and followup activities by the department.
18 (4)(6) The department shall by February 1 of each year
19 submit to the Legislature an annual report relating to all
20 information obtained pursuant to this section.
21 (5)(7) Each person who violates the provisions of this
22 section or the rules adopted hereunder may be fined by the
23 department up to $500 for each offense. The department shall
24 report each violation of this section to the regulatory agency
25 responsible for licensing each health care professional and
26 each laboratory to which these provisions apply.
27 Section 125. Subsection (1) of section 385.204,
28 Florida Statutes, is amended to read:
29 385.204 Insulin; purchase, distribution; penalty for
30 fraudulent application for and obtaining of insulin.--
31 (1) The Department of Health, to the extent funds are
162
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 available, shall purchase and distribute insulin through its
2 agents or other appropriate agent of the state or Federal
3 Government in any county or municipality in the state to any
4 bona fide resident of this state suffering from diabetes or a
5 kindred disease requiring insulin in its treatment who makes
6 application for insulin and furnishes proof of his or her
7 financial inability to purchase in accordance with the rules
8 adopted promulgated by the department concerning the
9 distribution of insulin.
10 Section 126. Subsection (2) of section 391.021,
11 Florida Statutes, is amended to read:
12 391.021 Definitions.--When used in this act, unless
13 the context clearly indicates otherwise:
14 (2) "Children with special health care needs" means
15 those children under the age of 21 years who have, or are at
16 increased risk for, chronic physical, developmental,
17 behavioral, or emotional conditions and who also require
18 health care and related services of a type or amount beyond
19 that which is generally required by children whose serious or
20 chronic physical or developmental conditions require extensive
21 preventive and maintenance care beyond that required by
22 typically healthy children. Health care utilization by these
23 children exceeds the statistically expected usage of the
24 normal child adjusted for chronological age. These children
25 often need complex care requiring multiple providers,
26 rehabilitation services, and specialized equipment in a number
27 of different settings.
28 Section 127. Section 391.025, Florida Statutes, is
29 amended to read:
30 391.025 Applicability and scope.--
31 (1) This act applies to health services provided to
163
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 eligible individuals who are:
2 (a) Enrolled in the Medicaid program;
3 (b) Enrolled in the Florida Kidcare program; and
4 (c) Uninsured or underinsured, provided that they meet
5 the financial eligibility requirements established in this
6 act, and to the extent that resources are appropriated for
7 their care.
8 (1)(2) The Children's Medical Services program
9 consists of the following components:
10 (a) The newborn infant metabolic screening program
11 established in s. 383.14.
12 (b) The regional perinatal intensive care centers
13 program established in ss. 383.15-383.21.
14 (c) A federal or state program authorized by the
15 Legislature.
16 (d) The developmental evaluation and intervention
17 program, including the infants and toddlers early intervention
18 program.
19 (e) The Children's Medical Services network.
20 (2)(3) The Children's Medical Services program shall
21 not be deemed an insurer and is not subject to the licensing
22 requirements of the Florida Insurance Code or the rules of the
23 Department of Insurance, when providing services to children
24 who receive Medicaid benefits, other Medicaid-eligible
25 children with special health care needs, and children
26 participating in the Florida Kidcare program.
27 Section 128. Subsection (2) of section 391.029,
28 Florida Statutes, is amended to read:
29 391.029 Program eligibility.--
30 (2) The following individuals are financially eligible
31 to receive services through for the program:
164
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (a) A high-risk pregnant female who is eligible for
2 Medicaid.
3 (b) Children A child with special health care needs
4 from birth to age 21 years who are is eligible for Medicaid.
5 (c) Children A child with special health care needs
6 from birth to age 19 years who are is eligible for a program
7 under Title XXI of the Social Security Act.
8 (3) Subject to the availability of funds, the
9 following individuals may receive services through the
10 program:
11 (a)(d) Children A child with special health care needs
12 from birth to age 21 years whose family income is above
13 financial eligibility requirements under Title XXI of the
14 Social Security Act and whose projected annual cost of care
15 adjusts the family income to Medicaid financial criteria. In
16 cases where the family income is adjusted based on a projected
17 annual cost of care, the family shall participate financially
18 in the cost of care based on criteria established by the
19 department.
20 (b)(e) Children A child with special health care needs
21 from birth to 21 years of age, as provided defined in Title V
22 of the Social Security Act relating to children with special
23 health care needs.
24
25 The department may continue to serve certain children with
26 special health care needs who are 21 years of age or older and
27 who were receiving services from the program prior to April 1,
28 1998. Such children may be served by the department until
29 July 1, 2000.
30 Section 129. Subsection (4) is added to section
31 391.035, Florida Statutes, to read:
165
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 391.035 Provider qualifications.--
2 (4) Notwithstanding any other provision of law, the
3 department may contract with health care providers licensed in
4 another state to provide health services to participants in
5 the Children's Medical Services program when necessary due to
6 an emergency, the availability of specialty services, or a
7 greater convenience to the participant for receiving timely
8 and effective health care services. The department may adopt
9 rules to administer this subsection.
10 Section 130. Subsection (4) is added to section
11 391.055, Florida Statutes, to read:
12 391.055 Service delivery systems.--
13 (4) If a newborn has a presumptively abnormal
14 screening result for metabolic or other hereditary and
15 congenital disorders which is identified through the newborn
16 screening program pursuant to s. 383.14, the newborn shall be
17 referred to the Children's Medical Services network for
18 confirmatory testing, medical management, or medical referral.
19 Section 131. Section 391.309, Florida Statutes, is
20 created to read:
21 391.309 Florida Infants and Toddlers Early
22 Intervention Program.--The Department of Health may implement
23 and administer Part C of the federal Individuals with
24 Disabilities Education Act (IDEA), which shall be known as the
25 Florida Infants and Toddlers Early Intervention Program.
26 (1) The department, jointly with the Department of
27 Education, shall annually prepare a grant application to the
28 United States Department of Education for funding early
29 intervention services for infants and toddlers with
30 disabilities, ages birth through 36 months, and their families
31 pursuant to Part C of the federal Individuals with
166
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Disabilities Education Act.
2 (2) The department shall ensure that no early
3 intervention provider participating in the program provides
4 both core and required services without a waiver from the
5 Deputy Secretary for Children's Medical Services or his or her
6 designee, as expressed in the contract between the department
7 and the provider. For purposes of this section, "core"
8 services are limited to child find and referral services,
9 family support planning, service coordination, and
10 multidisciplinary evaluation.
11 Section 132. Section 394.9151, Florida Statutes, is
12 amended to read:
13 394.9151 Contract authority.--The Department of
14 Children and Family Services may contract with a private
15 entity or state agency for use of and operation of facilities
16 to comply with the requirements of this act. The department of
17 Children and Family Services may also contract with the
18 Correctional Privatization Commission as defined in chapter
19 957 to issue a request for proposals and monitor contract
20 compliance for these services. The department may enter into
21 an agreement or may contract with the Correctional Medical
22 Authority, as defined in chapter 945, to conduct surveys of
23 medical services and to provide medical quality assurance and
24 improvement assistance at secure confinement and treatment
25 facilities for persons confined under this chapter.
26 Section 133. Subsection (2) of section 395.404,
27 Florida Statutes, is amended to read:
28 395.404 Review of trauma registry data;
29 confidentiality and limited release.--
30 (2) Notwithstanding the provisions of s. 381.74, each
31 trauma center and acute care hospital shall submit severe
167
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 disability and head-injury registry data to the department as
2 provided by rule. Each trauma center and acute care hospital
3 shall continue to provide initial notification of any person
4 who has a moderate-to-severe brain or spinal cord injury
5 persons who have severe disabilities and head injuries to the
6 brain and spinal cord injury central registry of the
7 Department of Health within timeframes provided in s. 381.74
8 chapter 413. Such initial notification shall be made in the
9 manner prescribed by the Department of Health for the purpose
10 of providing timely vocational rehabilitation and transitional
11 services to an individual who sustains traumatic
12 moderate-to-severe brain or spinal cord injury to enable such
13 individual to return to his or her community services to the
14 severely disabled or head-injured person.
15 Section 134. Subsection (2) of section 401.113,
16 Florida Statutes, is amended to read:
17 401.113 Department; powers and duties.--
18 (2)(a) The department shall annually dispense funds
19 contained in the Emergency Medical Services Trust Fund as
20 follows:
21 1.(a) Forty-five percent of such moneys must be
22 divided among the counties according to the proportion of the
23 combined amount deposited in the trust fund from the county.
24 These funds may not be used to match grant funds as identified
25 in subparagraph 2 paragraph (b). An individual board of county
26 commissioners may distribute these funds to emergency medical
27 service organizations within the county, as it deems
28 appropriate.
29 2.(b) Forty percent of such moneys must be used by the
30 department for making matching grants to local agencies,
31 municipalities, and emergency medical services organizations
168
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 for the purpose of conducting research, increasing existing
2 levels of emergency medical services, evaluation, community
3 education, injury prevention programs, and training in
4 cardiopulmonary resuscitation and other lifesaving and first
5 aid techniques.
6 a.1. At least 90 percent of these moneys must be made
7 available on a cash matching basis. A grant made under this
8 subparagraph must be contingent upon the recipient providing a
9 cash sum equal to 25 percent of the total department-approved
10 grant amount.
11 b.2. No more than 10 percent of these moneys must be
12 made available to rural emergency medical services, and
13 notwithstanding the restrictions specified in subsection (1),
14 these moneys may be used for improvement, expansion, or
15 continuation of services provided. A grant made under this
16 subparagraph must be contingent upon the recipient providing a
17 cash sum equal to no more than 10 percent of the total
18 department-approved grant amount.
19
20 The department shall develop procedures and standards for
21 grant disbursement under this paragraph based on the need for
22 emergency medical services, the requirements of the population
23 to be served, and the objectives of the state emergency
24 medical services plan.
25 3.(c) Fifteen percent of such moneys must be used by
26 the department for capital equipment outlay, personnel,
27 community education, evaluation, and other costs associated
28 with the administration of this chapter. Any moneys not
29 annually used for this purpose must be used for making
30 additional rural grant funds available.
31 (b) Notwithstanding any other law to the contrary, any
169
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 interest generated from grant funds may be expended by the
2 grantee on the budget items approved by the department.
3 Grantees receiving funds, which require a match, may not
4 expend interest funds until all match requirements have been
5 satisfied. Such grantees shall return to the department any
6 interest and grant funds not expended at the conclusion of the
7 grant period. All such returned funds shall be used by the
8 department for additional matching grant awards.
9 Section 135. Section 401.211, Florida Statutes, is
10 amended to read:
11 401.211 Legislative intent.--The Legislature
12 recognizes that the systematic provision of emergency medical
13 services saves lives and reduces disability associated with
14 illness and injury. In addition, that system of care must be
15 equally capable of assessing, treating, and transporting
16 children, adults, and frail elderly persons. Further, it is
17 the intent of the Legislature to encourage the development and
18 maintenance of emergency medical services because such
19 services are essential to the health and well-being of all
20 citizens of the state. The Legislature also recognizes that
21 the establishment of a statewide comprehensive injury
22 prevention program supports state and community health systems
23 by further enhancing the total delivery system of emergency
24 medical services and reduces injuries for all persons. The
25 purpose of this part is to protect and enhance the public
26 health, welfare, and safety through the establishment of an
27 emergency medical services state plan, an advisory council, a
28 comprehensive statewide injury prevention and control program,
29 minimum standards for emergency medical services personnel,
30 vehicles, services and medical direction, and the
31 establishment of a statewide inspection program created to
170
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 monitor the quality of patient care delivered by each licensed
2 service and appropriately certified personnel.
3 Section 136. Section 401.243, Florida Statutes, is
4 created to read:
5 401.243 Injury prevention and control.--The injury
6 prevention and control program is responsible for the
7 statewide coordination and expansion of injury prevention and
8 control activities. The duties of the department may include,
9 but not be limited to, data collection, surveillance,
10 education, and the promotion of interventions. The department
11 may:
12 (1) Assist county health departments and community and
13 other state agencies by serving as a focal point for injury
14 prevention expertise and guidance.
15 (2) Seek, receive, and expend any funds received
16 through appropriations, grants, donations, or contributions
17 from public or private sources for program purposes.
18 (3) Adopt rules related to the activities of the
19 program, including, but not limited to, those needed for
20 implementation of injury prevention and control activities,
21 data collection, surveillance, education, promotion of
22 interventions, and for assistance to other entities.
23 (4) Develop, and revise as necessary, a comprehensive
24 state plan for injury prevention and control.
25 Section 137. Subsections (3), (4), (5), and (13) of
26 section 401.27, Florida Statutes, are amended, and subsection
27 (14) is added to that section, to read:
28 401.27 Personnel; standards and certification.--
29 (3) Any person who desires to be certified or
30 recertified as an emergency medical technician or paramedic
31 must apply to the department under oath on forms provided by
171
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the department which shall contain such information as the
2 department reasonably requires, which may include affirmative
3 evidence of ability to comply with applicable laws and rules.
4 The department may accept electronically submitted
5 applications. If an application is submitted electronically,
6 the department may require supplemental materials, including
7 an original signature of the applicant and documentation
8 verifying eligibility for certification to be submitted in a
9 nonelectronic format. The department shall determine whether
10 the applicant meets the requirements specified in this section
11 and in rules of the department and shall issue a certificate
12 to any person who meets such requirements.
13 (4) An applicant for certification or recertification
14 as an emergency medical technician or paramedic must:
15 (a) Have completed an appropriate training course as
16 follows:
17 1. For an emergency medical technician, an emergency
18 medical technician training course equivalent to the most
19 recent emergency medical technician basic training course of
20 the United States Department of Transportation as approved by
21 the department;
22 2. For a paramedic, a paramedic training program
23 equivalent to the most recent paramedic course of the United
24 States Department of Transportation as approved by the
25 department;
26 (b) Certify under oath that he or she is not addicted
27 to alcohol or any controlled substance;
28 (c) Certify under oath that he or she is free from any
29 physical or mental defect or disease that might impair the
30 applicant's ability to perform his or her duties;
31 (d) Within 1 year after course completion have passed
172
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 an examination developed or required by the department;
2 (e)1. For an emergency medical technician, hold either
3 a current American Heart Association cardiopulmonary
4 resuscitation course card or an American Red Cross
5 cardiopulmonary resuscitation course card or its equivalent as
6 defined by department rule;
7 2. For a paramedic, hold a certificate of successful
8 course completion in advanced cardiac life support from the
9 American Heart Association or its equivalent as defined by
10 department rule;
11 (f) Submit the certification fee and the nonrefundable
12 examination fee prescribed in s. 401.34, which examination fee
13 will be required for each examination administered to an
14 applicant; and
15 (g) Submit a completed application to the department,
16 which application documents compliance with paragraphs (a),
17 (b), (c), (e), (f), (g), and, if applicable, (d). The
18 application must be submitted so as to be received by the
19 department at least 30 calendar days before the next regularly
20 scheduled examination for which the applicant desires to be
21 scheduled.
22 (5) The certification examination must be offered
23 monthly. The department shall issue an examination admission
24 notice to the applicant advising him or her of the time and
25 place of the examination for which he or she is scheduled.
26 Individuals achieving a passing score on the certification
27 examination may be issued a temporary certificate with their
28 examination grade report. The department must issue an
29 original certification within 45 days after the examination.
30 Examination questions and answers are not subject to discovery
31 but may be introduced into evidence and considered only in
173
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 camera in any administrative proceeding under chapter 120. If
2 an administrative hearing is held, the department shall
3 provide challenged examination questions and answers to the
4 administrative law judge. The department shall establish by
5 rule the procedure by which an applicant, and the applicant's
6 attorney, may review examination questions and answers in
7 accordance with s. 119.07(3)(a).
8 (13) The department shall adopt a standard state
9 insignia for emergency medical technicians and paramedics. The
10 department shall establish by rule the requirements to display
11 the state emergency medical technician and paramedic insignia.
12 The rules may not require a person to wear the standard
13 insignia but must require that If a person wears any insignia
14 that identifies the person as a certified emergency medical
15 technician or paramedic in this state, the insignia must be
16 the standard state insignia adopted under this section. The
17 insignia must denote the individual's level of certification
18 at which he or she is functioning.
19 (14)(a) An applicant for initial certification under
20 this section must submit information and a set of fingerprints
21 to the Department of Health on a form and under procedures
22 specified by the department, along with payment in an amount
23 equal to the costs incurred by the Department of Health for a
24 a statewide criminal history check and a national criminal
25 history check of the applicant.
26 (b) An applicant for renewed certification who has not
27 previously submitted a set of fingerprints to the Department
28 of Health must submit information required to perform a
29 statewide criminal background check and a set of fingerprints
30 to the department for a national criminal history check as a
31 condition of the initial renewal of his or her certificate
174
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 after July 1, 2003. The applicant must submit the fingerprints
2 on a form and under procedures specified by the department for
3 a national criminal history check, along with payment in an
4 amount equal to the costs incurred by the department. For
5 subsequent renewals, the department shall, by rule, adopt an
6 application form that includes a sworn oath or affirmation
7 attesting to the existence of any criminal convictions,
8 regardless of plea or adjudication, which have occurred since
9 the previous certification. If there has been a criminal
10 conviction, the provisions of this subsection shall apply. The
11 department shall notify current certificateholders of their
12 requirement to undergo a criminal history background screening
13 sufficiently in advance of the 2004 biennial expiration for
14 the certificateholder to provide the required information
15 prior to submission of the renewal certification application.
16 Eligibility for renewal shall not be denied by the department
17 for the first renewal application subsequent to enactment of
18 this subsection for delays created in obtaining the criminal
19 history from the Department of Law Enforcement, the Federal
20 Bureau of Investigation, or the Division of State Fire Marshal
21 if the applicant has submitted the required criminal
22 background screening information or affidavit and fees with
23 the renewal certification application. A certificate that
24 expires on December 1, 2004, may be renewed subject to
25 withdrawal of certification pending the department's
26 determination of whether the certificateholder will be granted
27 an exemption as provided in paragraph (h). The
28 certificateholder must make timely application for renewal and
29 request the exemption from denial prior to the expiration of
30 the certificate.
31 (c) Pursuant to the requirements of s. 120.60,
175
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 applications for certification must be processed within 90
2 days after receipt of a completed application. Applications
3 for certification are not complete until the criminal history
4 and certified copies of all court documents for those
5 applications with prior criminal convictions, pursuant to this
6 section, have been received by the department.
7 (d) The department shall submit the fingerprints and
8 information required for a statewide criminal history check to
9 the Department of Law Enforcement, and the Department of Law
10 Enforcement shall forward the fingerprints to the Federal
11 Bureau of Investigation for a national criminal history check
12 of the applicant.
13 (e) If an applicant has undergone a criminal history
14 check as a condition of employment or certification as a
15 firefighter under s. 633.34, the Division of State Fire
16 Marshal of the Department of Financial Services shall provide
17 the criminal history information regarding the applicant
18 seeking certification or renewal of certification under this
19 section to the department. Any applicant for initial
20 certification or renewal of certification who has already
21 submitted a set of fingerprints and information to the
22 Division of State Fire Marshal of the Department of Financial
23 Services for the criminal history check required for
24 employment and certification of firefighters under s. 633.34
25 within 2 years prior to application under this section is not
26 required to provide to the department a subsequent set of
27 fingerprints or other duplicate information required for a
28 criminal history check if the applicant submits an affidavit
29 in a form prescribed by the department attesting that he or
30 she has been a state resident for the previous 2 years.
31 (f) Notwithstanding the grounds for certification
176
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 denial outlined in s. 401.411, an applicant must not have been
2 found guilty of, regardless of plea or adjudication, any
3 offense prohibited under any of the following provisions of
4 the Florida Statutes or under any similar statute of another
5 jurisdiction:
6 1. Section 415.111, relating to abuse, neglect, or
7 exploitation of a vulnerable adult.
8 2. Section 782.04, relating to murder.
9 3. Section 782.07, relating to manslaughter,
10 aggravated manslaughter of an elderly person or disabled
11 adult, or aggravated manslaughter of a child.
12 4. Section 782.071, relating to vehicular homicide.
13 5. Section 782.09, relating to killing of an unborn
14 child by injury to the mother.
15 6. Section 784.011, relating to assault, if the victim
16 of the offense was a minor.
17 7. Section 784.021, relating to aggravated assault.
18 8. Section 784.03, relating to battery, if the victim
19 of the offense was a minor.
20 9. Section 784.045, relating to aggravated battery.
21 10. Section 784.01, relating to kidnapping.
22 11. Section 787.02, relating to false imprisonment.
23 12. Section 794.011, relating to sexual battery.
24 13. Former s. 794.041, relating to prohibited acts of
25 persons in familial or custodial authority.
26 14. Chapter 796, relating to prostitution.
27 15. Section 798.02, relating to lewd and lascivious
28 behavior.
29 16. Chapter 800, relating to lewdness and indecent
30 exposure.
31 17. Section 806.01, relating to arson.
177
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 18. Chapter 812, relating to theft, robbery, and
2 related crimes, only if the offense was a felony.
3 19. Section 817.563, relating to fraudulent sale of
4 controlled substances, only if the offense was a felony.
5 20. Section 825.102, relating to abuse, aggravated
6 abuse, or neglect of an elderly person or disabled adult.
7 21. Section 825.1025, relating to lewd or lascivious
8 offenses committed upon or in the presence of an elderly
9 person or disabled adult.
10 22. Section 825.103, relating to exploitation of an
11 elderly person or disabled adult, if the offense was a felony.
12 23. Section 826.04, relating to incest.
13 24. Section 827.03, relating to child abuse,
14 aggravated child abuse, or neglect of a child.
15 25. Section 827.04, relating to contributing to the
16 delinquency or dependency of a child.
17 26. Former s. 827.05, relating to negligent treatment
18 of children.
19 27. Section 827.071, relating to sexual performance by
20 a child.
21 28. Chapter 847, relating to obscene literature.
22 29. Chapter 893, relating to drug abuse prevention and
23 control, only if the offense was a felony or if any other
24 person involved in the offense was a minor.
25 30. An act that constitutes domestic violence, as
26 defined in s. 741.28.
27 (g) The department may grant to any applicant who
28 would otherwise be denied certification or recertification
29 under this subsection an exemption from that denial for:
30 1. Felonies committed more than 3 years prior to the
31 date of disqualification;
178
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 2. Misdemeanors prohibited under any of the Florida
2 Statutes cited in this subsection or under similar statutes of
3 other jurisdictions;
4 3. Offenses that were felonies when committed but that
5 are now misdemeanors;
6 4. Findings of delinquency; or
7 5. Commissions of acts of domestic violence as defined
8 in s. 741.28.
9 (h) For the department to grant an exemption to any
10 applicant under this section, the applicant must demonstrate
11 by clear and convincing evidence that the applicant should not
12 be disqualified from certification or renewed certification.
13 Applicants seeking an exemption have the burden of setting
14 forth sufficient evidence of rehabilitation, including, but
15 not limited to, the circumstances surrounding the criminal
16 incident for which an exemption is sought, the time period
17 that has elapsed since the incident, the nature of the harm
18 caused to the victim, and the history of the applicant since
19 the incident, or any other evidence or circumstances
20 indicating that the applicant will not present a danger if the
21 certification or renewed certification is granted. To make the
22 necessary demonstration, the applicant must request an
23 exemption and submit the required information supporting that
24 request at the time of application in order for the department
25 to make a determination in accordance with this section.
26 (i) Denial of certification or renewed certification
27 under paragraph (f) may not be removed from, nor may an
28 exemption be granted to, any applicant who is found guilty of,
29 regardless of plea or adjudication, any felony covered by
30 paragraph (f) solely by reason of any pardon, executive
31 clemency, or restoration of civil rights.
179
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (k) If an applicant has undergone a criminal history
2 check as a condition of employment or licensing under any
3 Florida Statute within 2 years prior to application under this
4 section, the applicant may submit a copy of the official
5 Florida criminal history record or national criminal history
6 record produced under that requirement in lieu of the
7 fingerprint card required in paragraphs (a) and (b). The
8 department shall determine if the submission meets its
9 requirements, and, if not, the applicant shall be required to
10 comply with the provisions of this section. The department may
11 share criminal history background information with local,
12 state, and federal agencies for purposes of licensing or
13 employment background checks.
14 Section 138. Subsection (6) is added to section
15 401.2701, Florida Statutes, to read:
16 401.2701 Emergency medical services training
17 programs.--
18 (6) Training programs approved by the department
19 shall, at initiation of an emergency medical technician or
20 paramedic course, advise students of the certification and
21 regulatory requirements of this chapter, including, but not
22 limited to, the criminal history background screening
23 requirement for initial and renewal certification under s.
24 401.27. The department shall prescribe by rule the required
25 content of this component of the course.
26 Section 139. Subsection (2) of section 401.2715,
27 Florida Statutes, is amended to read:
28 401.2715 Recertification training of emergency medical
29 technicians and paramedics.--
30 (2) Any individual, institution, school, corporation,
31 or governmental entity may conduct emergency medical
180
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 technician or paramedic recertification training upon
2 application to the department and payment of a nonrefundable
3 fee to be deposited into the Emergency Medical Services Trust
4 Fund. Institutions conducting department-approved educational
5 programs as provided in this chapter and licensed ambulance
6 services are exempt from the application process and payment
7 of fees. The department shall adopt rules for the application
8 and payment of a fee not to exceed the actual cost of
9 administering this approval process. Upon application, the
10 department shall recognize any entity in this state which has
11 approval from the Continuing Education Coordinating Board for
12 Emergency Medical Services for courses in cardiopulmonary
13 resuscitation or advanced cardiac life support for
14 equivalency.
15 Section 140. Subsection (4) of section 404.056,
16 Florida Statutes, is amended to read:
17 404.056 Environmental radiation standards and
18 projects; certification of persons performing measurement or
19 mitigation services; mandatory testing; notification on real
20 estate documents; rules.--
21 (4) MANDATORY TESTING.--All public and private school
22 buildings or school sites housing students in kindergarten
23 through grade 12; all state-owned, state-operated,
24 state-regulated, or state-licensed 24-hour care facilities;
25 and all state-licensed day care centers for children or minors
26 which are located in counties designated within the Department
27 of Community Affairs' Florida Radon Protection Map Categories
28 as "Intermediate" or "Elevated Radon Potential" shall be
29 measured to determine the level of indoor radon, using
30 measurement procedures established by the department. Initial
31 measurements Testing shall be performed completed within the
181
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 first year of construction in 20 percent of the habitable
2 first floor spaces within any of the regulated buildings.
3 Initial measurements shall be completed and reported to the
4 department within 1 by July 1 of the year after the date the
5 building is opened for occupancy or within 1 year after
6 license approval for an entity residing in an existing
7 building. Followup testing must be completed in 5 percent of
8 the habitable first floor spaces within any of the regulated
9 buildings after the building has been occupied for 5 years,
10 and results must be reported to the department by the first
11 day July 1 of the 6th 5th year of occupancy. After radon
12 measurements have been made twice, regulated buildings need
13 not undergo further testing unless significant structural
14 changes occur. No funds collected pursuant to s. 553.721 shall
15 be used to carry out the provisions of this subsection.
16 Section 141. Subsection (5) of section 409.814,
17 Florida Statutes, is amended to read:
18 409.814 Eligibility.--A child whose family income is
19 equal to or below 200 percent of the federal poverty level is
20 eligible for the Florida Kidcare program as provided in this
21 section. In determining the eligibility of such a child, an
22 assets test is not required. An applicant under 19 years of
23 age who, based on a complete application, appears to be
24 eligible for the Medicaid component of the Florida Kidcare
25 program is presumed eligible for coverage under Medicaid,
26 subject to federal rules. A child who has been deemed
27 presumptively eligible for Medicaid shall not be enrolled in a
28 managed care plan until the child's full eligibility
29 determination for Medicaid has been completed. The Florida
30 Healthy Kids Corporation may, subject to compliance with
31 applicable requirements of the Agency for Health Care
182
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Administration and the Department of Children and Family
2 Services, be designated as an entity to conduct presumptive
3 eligibility determinations. An applicant under 19 years of age
4 who, based on a complete application, appears to be eligible
5 for the Medikids, Florida Healthy Kids, or Children's Medical
6 Services network program component, who is screened as
7 ineligible for Medicaid and prior to the monthly verification
8 of the applicant's enrollment in Medicaid or of eligibility
9 for coverage under the state employee health benefit plan, may
10 be enrolled in and begin receiving coverage from the
11 appropriate program component on the first day of the month
12 following the receipt of a completed application. For
13 enrollment in the Children's Medical Services network, a
14 complete application includes the medical or behavioral health
15 screening. If, after verification, an individual is determined
16 to be ineligible for coverage, he or she must be disenrolled
17 from the respective Title XXI-funded Kidcare program
18 component.
19 (5) A child whose family income is above 200 percent
20 of the federal poverty level or a child who is excluded under
21 the provisions of subsection (4) may participate in the
22 Florida Healthy Kids program or the Medikids program, Kidcare
23 program, excluding the Medicaid program, but is subject to the
24 following provisions:
25 (a) The family is not eligible for premium assistance
26 payments and must pay the full cost of the premium, including
27 any administrative costs.
28 (b) The agency is authorized to place limits on
29 enrollment in Medikids by these children in order to avoid
30 adverse selection. The number of children participating in
31 Medikids whose family income exceeds 200 percent of the
183
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 federal poverty level must not exceed 10 percent of total
2 enrollees in the Medikids program.
3 (c) The board of directors of the Florida Healthy Kids
4 Corporation is authorized to place limits on enrollment of
5 these children in order to avoid adverse selection. In
6 addition, the board is authorized to offer a reduced benefit
7 package to these children in order to limit program costs for
8 such families. The number of children participating in the
9 Florida Healthy Kids program whose family income exceeds 200
10 percent of the federal poverty level must not exceed 10
11 percent of total enrollees in the Florida Healthy Kids
12 program.
13 (d) Children described in this subsection are not
14 counted in the annual enrollment ceiling for the Florida
15 Kidcare program.
16 Section 142. Section 409.91188, Florida Statutes, is
17 amended to read:
18 409.91188 Specialty prepaid health plans for Medicaid
19 recipients with HIV or AIDS.--
20 (1) The Agency for Health Care Administration shall
21 issue a request for proposal or intent to implement a is
22 authorized to contract with specialty prepaid health plans
23 authorized pursuant to subsection (2) of this section and to
24 pay them on a prepaid capitated basis to provide Medicaid
25 benefits to Medicaid-eligible recipients who have human
26 immunodeficiency syndrome (HIV) or acquired immunodeficiency
27 syndrome (AIDS). The agency shall apply for or amend existing
28 applications for and is authorized to implement federal
29 waivers or other necessary federal authorization to implement
30 the prepaid health plans authorized by this section. The
31 agency shall procure the specialty prepaid health plans
184
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 through a competitive procurement. In awarding a contract to a
2 managed care plan, the agency shall take into account price,
3 quality, accessibility, linkages to community-based
4 organizations, and the comprehensiveness of the benefit
5 package offered by the plan. The agency may bid the HIV/AIDS
6 specialty plans on a county, regional, or statewide basis.
7 Qualified plans must be licensed under chapter 641. The agency
8 shall monitor and evaluate the implementation of this waiver
9 program if it is approved by the Federal Government and shall
10 report on its status to the President of the Senate and the
11 Speaker of the House of Representatives by February 1, 2001.
12 To improve coordination of medical care delivery and to
13 increase cost efficiency for the Medicaid program in treating
14 HIV disease, the Agency for Health Care Administration shall
15 seek all necessary federal waivers to allow participation in
16 the Medipass HIV disease management program for Medicare
17 beneficiaries who test positive for HIV infection and who also
18 qualify for Medicaid benefits such as prescription medications
19 not covered by Medicare.
20 (2) The agency may contract with any public or private
21 entity authorized by this section on a prepaid or fixed-sum
22 basis for the provision of health care services to recipients.
23 An entity may provide prepaid services to recipients, either
24 directly or through arrangements with other entities. Each
25 entity shall:
26 (a) Be organized primarily for the purpose of
27 providing health care or other services of the type regularly
28 offered to Medicaid recipients in compliance with federal
29 laws.
30 (b) Ensure that services meet the standards set by the
31 agency for quality, appropriateness, and timeliness.
185
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (c) Make provisions satisfactory to the agency for
2 insolvency protection and ensure that neither enrolled
3 Medicaid recipients nor the agency is liable for the debts of
4 the entity.
5 (d) Provide to the agency a financial plan that
6 ensures fiscal soundness and that may include provisions
7 pursuant to which the entity and the agency share in the risk
8 of providing health care services. The contractual arrangement
9 between an entity and the agency shall provide for risk
10 sharing. The agency may bear the cost of providing certain
11 services when those costs exceed established risk limits or
12 arrangements whereby certain services are specifically
13 excluded under the terms of the contract between an entity and
14 the agency.
15 (e) Provide, through contract or otherwise, for
16 periodic review of its medical facilities and services, as
17 required by the agency.
18 (f) Furnish evidence satisfactory to the agency of
19 adequate liability insurance coverage or an adequate plan of
20 self-insurance to respond to claims for injuries arising out
21 of the furnishing of health care.
22 (g) Provides organizational, operational, financial,
23 and other information required by the agency.
24 Section 143. Paragraph (d) of subsection (1) of
25 section 455.227, Florida Statutes, is amended to read:
26 455.227 Grounds for discipline; penalties;
27 enforcement.--
28 (1) The following acts shall constitute grounds for
29 which the disciplinary actions specified in subsection (2) may
30 be taken:
31 (d) Using a Class III or a Class IV laser device or
186
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 product, as defined by federal regulations, without having
2 complied with the rules adopted pursuant to s. 404.24(2)
3 501.122(2) governing the registration of such devices.
4 Section 144. Subsection (7) of section 456.025,
5 Florida Statutes, is amended to read:
6 456.025 Fees; receipts; disposition.--
7 (7) Each board, or the department if there is no
8 board, shall establish, by rule, a fee not to exceed $250 for
9 anyone seeking approval to provide continuing education
10 courses or programs and shall establish by rule a biennial
11 renewal fee not to exceed $250 for the renewal of providership
12 of such courses. The fees collected from continuing education
13 providers shall be used for the purposes of reviewing course
14 provider applications, monitoring the integrity of the courses
15 provided, and covering legal expenses incurred as a result of
16 not granting or renewing a providership, and developing and
17 maintaining an electronic continuing education tracking
18 system. The department shall implement an electronic
19 continuing education tracking system for each new biennial
20 renewal cycle for which electronic renewals are implemented
21 after the effective date of this act and shall integrate such
22 system into the licensure and renewal system. All approved
23 continuing education providers shall provide information on
24 course attendance to the department necessary to implement the
25 electronic tracking system. The department shall, by rule,
26 specify the form and procedures by which the information is to
27 be submitted.
28 Section 145. Section 456.055, Florida Statutes, is
29 amended to read:
30 456.055 Chiropractic and podiatric health care; denial
31 of payment; limitation.--
187
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 (1) A chiropractic physician licensed under chapter
2 460 or a podiatric physician licensed under chapter 461 shall
3 not be denied payment for treatment rendered solely on the
4 basis that the chiropractic physician or podiatric physician
5 is not a member of a particular preferred provider
6 organization or exclusive provider organization which is
7 composed only of physicians licensed under the same chapter.
8 (2) A claim for payment of a service performed by a
9 health care provider licensed in this state, identified on the
10 claim by a Physicians' Current Procedural Terminology (CPT)
11 code, and submitted under a health insurance policy or health
12 care services plan or submitted to a preferred provider
13 organization, exclusive provider organization, or health
14 maintenance organization in which the health care provider
15 participates, shall be paid in the same amount to all health
16 care providers submitting a claim for payment of a service
17 identified by the same CPT code, regardless of the chapter
18 under which the health care provider is licensed.
19 (3) The provisions of this section may not be waived,
20 voided, or nullified by contract.
21 (4) The provisions of this section as amended by this
22 act shall apply only to health insurance policies, health care
23 services plans or other contracts entered into or renewed
24 after the effective date of this act.
25 Section 146. Paragraph (d) of subsection (1) of
26 section 460.406, Florida Statutes, is amended to read:
27 460.406 Licensure by examination.--
28 (1) Any person desiring to be licensed as a
29 chiropractic physician shall apply to the department to take
30 the licensure examination. There shall be an application fee
31 set by the board not to exceed $100 which shall be
188
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 nonrefundable. There shall also be an examination fee not to
2 exceed $500 plus the actual per applicant cost to the
3 department for purchase of portions of the examination from
4 the National Board of Chiropractic Examiners or a similar
5 national organization, which may be refundable if the
6 applicant is found ineligible to take the examination. The
7 department shall examine each applicant who the board
8 certifies has:
9 (d)1. For an applicant who has matriculated in a
10 chiropractic college prior to July 2, 1990, completed at least
11 2 years of residence college work, consisting of a minimum of
12 one-half the work acceptable for a bachelor's degree granted
13 on the basis of a 4-year period of study, in a college or
14 university accredited by an accrediting agency recognized and
15 approved by the United States Department of Education.
16 However, prior to being certified by the board to sit for the
17 examination, each applicant who has matriculated in a
18 chiropractic college after July 1, 1990, shall have been
19 granted a bachelor's degree, based upon 4 academic years of
20 study, by a college or university accredited by a regional
21 accrediting agency which is recognized and approved by the
22 Council for Higher Education Accreditation or the United
23 States Department of Education a member of the Commission on
24 Recognition of Postsecondary Accreditation.
25 2. Effective July 1, 2000, completed, prior to
26 matriculation in a chiropractic college, at least 3 years of
27 residence college work, consisting of a minimum of 90 semester
28 hours leading to a bachelor's degree in a liberal arts college
29 or university accredited by an accrediting agency recognized
30 and approved by the United States Department of Education.
31 However, prior to being certified by the board to sit for the
189
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 examination, each applicant who has matriculated in a
2 chiropractic college after July 1, 2000, shall have been
3 granted a bachelor's degree from an institution holding
4 accreditation for that degree from a regional accrediting
5 agency which is recognized by the United States Department of
6 Education. The applicant's chiropractic degree must consist
7 of credits earned in the chiropractic program and may not
8 include academic credit for courses from the bachelor's
9 degree.
10 Section 147. Paragraph (b) of subsection (1) of
11 section 463.006, Florida Statutes, is amended to read:
12 463.006 Licensure and certification by examination.--
13 (1) Any person desiring to be a licensed practitioner
14 pursuant to this chapter shall apply to the department to take
15 the licensure and certification examinations. The department
16 shall examine each applicant who the board determines has:
17 (b) Submitted proof satisfactory to the department
18 that she or he:
19 1. Is at least 18 years of age.
20 2. Has graduated from an accredited school or college
21 of optometry approved by rule of the board.
22 3. Is of good moral character.
23 4. Has successfully completed at least 110 hours of
24 transcript-quality coursework and clinical training in general
25 and ocular pharmacology as determined by the board, at an
26 institution that:
27 a. Has facilities for both didactic and clinical
28 instructions in pharmacology; and
29 b. Is accredited by a regional or professional
30 accrediting organization that is recognized and approved by
31 the Council for Higher Education Accreditation Commission on
190
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Recognition of Postsecondary Accreditation or the United
2 States Department of Education.
3 5. Has completed at least 1 year of supervised
4 experience in differential diagnosis of eye disease or
5 disorders as part of the optometric training or in a clinical
6 setting as part of the optometric experience.
7 Section 148. Subsection (8) of section 467.009,
8 Florida Statutes, is amended to read:
9 467.009 Midwifery programs; education and training
10 requirements.--
11 (8) Nonpublic educational institutions that conduct
12 approved midwifery programs shall be accredited by an
13 accrediting agency recognized and approved by the Council for
14 Higher Education Accreditation or the United States Department
15 of Education a member of the Commission on Recognition of
16 Postsecondary Accreditation and shall be licensed by the
17 Commission for Independent Education State Board of Nonpublic
18 Career Education.
19 Section 149. Paragraph (g) of subsection (3) of
20 section 468.302, Florida Statutes, is amended to read:
21 468.302 Use of radiation; identification of certified
22 persons; limitations; exceptions.--
23 (3)
24 (g)1. A person holding a certificate as a nuclear
25 medicine technologist may only:
26 a. Conduct in vivo and in vitro measurements of
27 radioactivity and administer radiopharmaceuticals to human
28 beings for diagnostic and therapeutic purposes.
29 b. Administer X radiation from a combination nuclear
30 medicine-computed tomography device if that radiation is
31 administered as an integral part of a nuclear medicine
191
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 procedure that uses an automated computed tomography protocol
2 for the purposes of attenuation correction and anatomical
3 localization and the person has received device-specific
4 training on the combination device.
5 2. However, The authority of a nuclear medicine
6 technologist under this paragraph excludes:
7 a. Radioimmunoassay and other clinical laboratory
8 testing regulated pursuant to chapter 483.
9 b. Creating or modifying automated computed tomography
10 protocols.
11 c. Any other operation of a computed tomography
12 device, especially for the purposes of stand-alone diagnostic
13 imaging, which is regulated pursuant to the general
14 radiographic scope in this part.
15 Section 150. Subsection (2) of section 468.509,
16 Florida Statutes, is amended to read:
17 468.509 Dietitian/nutritionist; requirements for
18 licensure.--
19 (2) The agency shall examine any applicant who the
20 board certifies has completed the application form and
21 remitted the application and examination fees specified in s.
22 468.508 and who:
23 (a)1. Possesses a baccalaureate or postbaccalaureate
24 degree with a major course of study in human nutrition, food
25 and nutrition, dietetics, or food management, or an equivalent
26 major course of study, from a school or program accredited, at
27 the time of the applicant's graduation, by the appropriate
28 accrediting agency recognized by the Council for Higher
29 Education Accreditation or Commission on Recognition of
30 Postsecondary Accreditation and the United States Department
31 of Education; and
192
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 2. Has completed a preprofessional experience
2 component of not less than 900 hours or has education or
3 experience determined to be equivalent by the board; or
4 (b)1. Has an academic degree, from a foreign country,
5 that has been validated by an accrediting agency approved by
6 the United States Department of Education as equivalent to the
7 baccalaureate or postbaccalaureate degree conferred by a
8 regionally accredited college or university in the United
9 States;
10 2. Has completed a major course of study in human
11 nutrition, food and nutrition, dietetics, or food management;
12 and
13 3. Has completed a preprofessional experience
14 component of not less than 900 hours or has education or
15 experience determined to be equivalent by the board.
16 Section 151. Paragraph (a) of subsection (1) of
17 section 468.707, Florida Statutes, is amended to read:
18 468.707 Licensure by examination; requirements.--
19 (1) Any person desiring to be licensed as an athletic
20 trainer shall apply to the department on a form approved by
21 the department.
22 (a) The department shall license each applicant who:
23 1. Has completed the application form and remitted the
24 required fees.
25 2. Is at least 21 years of age.
26 3. Has obtained a baccalaureate degree from a college
27 or university accredited by an accrediting agency recognized
28 and approved by the United States Department of Education or
29 the Council for Higher Education Accreditation or Commission
30 on Recognition of Postsecondary Accreditation approved by the
31 board.
193
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 4. Has completed coursework from a college or
2 university accredited by an accrediting agency recognized and
3 approved by the United States Department of Education or the
4 Council for Higher Education Accreditation Commission on
5 Recognition of Postsecondary Accreditation, or approved by the
6 board, in each of the following areas, as provided by rule:
7 health, human anatomy, kinesiology/biomechanics, human
8 physiology, physiology of exercise, basic athletic training,
9 and advanced athletic training.
10 5. Has current certification in standard first aid and
11 cardiovascular pulmonary resuscitation from the American Red
12 Cross or an equivalent certification as determined by the
13 board.
14 6. Has, within 2 of the preceding 5 years, attained a
15 minimum of 800 hours of athletic training experience under the
16 direct supervision of a licensed athletic trainer or an
17 athletic trainer certified by the National Athletic Trainers'
18 Association or a comparable national athletic standards
19 organization.
20 7. Has passed an examination administered or approved
21 by the board.
22 Section 152. Section 486.031, Florida Statutes, is
23 amended to read:
24 486.031 Physical therapist; licensing
25 requirements.--To be eligible for licensing as a physical
26 therapist, an applicant must:
27 (1) Be at least 18 years old;
28 (2) Be of good moral character; and
29 (3)(a) Have been graduated from a school of physical
30 therapy which has been approved for the educational
31 preparation of physical therapists by the appropriate
194
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 accrediting agency recognized by the Council for Higher
2 Education Accreditation Commission on Recognition of
3 Postsecondary Accreditation or the United States Department of
4 Education at the time of her or his graduation and have
5 passed, to the satisfaction of the board, the American
6 Registry Examination prior to 1971 or a national examination
7 approved by the board to determine her or his fitness for
8 practice as a physical therapist as hereinafter provided;
9 (b) Have received a diploma from a program in physical
10 therapy in a foreign country and have educational credentials
11 deemed equivalent to those required for the educational
12 preparation of physical therapists in this country, as
13 recognized by the appropriate agency as identified by the
14 board, and have passed to the satisfaction of the board an
15 examination to determine her or his fitness for practice as a
16 physical therapist as hereinafter provided; or
17 (c) Be entitled to licensure without examination as
18 provided in s. 486.081.
19 Section 153. Section 486.102, Florida Statutes, is
20 amended to read:
21 486.102 Physical therapist assistant; licensing
22 requirements.--To be eligible for licensing by the board as a
23 physical therapist assistant, an applicant must:
24 (1) Be at least 18 years old;
25 (2) Be of good moral character; and
26 (3)(a) Have been graduated from a school giving a
27 course of not less than 2 years for physical therapist
28 assistants, which has been approved for the educational
29 preparation of physical therapist assistants by the
30 appropriate accrediting agency recognized by the Council for
31 Higher Education Accreditation Commission on Recognition of
195
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Postsecondary Accreditation or the United States Department of
2 Education at the time of her or his graduation and have passed
3 to the satisfaction of the board an examination to determine
4 her or his fitness for practice as a physical therapist
5 assistant as hereinafter provided;
6 (b) Have been graduated from a school giving a course
7 for physical therapist assistants in a foreign country and
8 have educational credentials deemed equivalent to those
9 required for the educational preparation of physical therapist
10 assistants in this country, as recognized by the appropriate
11 agency as identified by the board, and passed to the
12 satisfaction of the board an examination to determine her or
13 his fitness for practice as a physical therapist assistant as
14 hereinafter provided; or
15 (c) Be entitled to licensure without examination as
16 provided in s. 486.107.
17 Section 154. Paragraph (a) of subsection (5) of
18 section 489.553, Florida Statutes, is amended to read:
19 489.553 Administration of part; registration
20 qualifications; examination.--
21 (5) To be eligible for registration by the department
22 as a master septic tank contractor, the applicant must:
23 (a) Have been a registered septic tank contractor in
24 Florida for at least 3 years or a plumbing contractor
25 certified under part I of this chapter who has provided septic
26 tank contracting services for at least 3 years. The 3 years
27 must immediately precede the date of application and may not
28 be interrupted by any probation, suspension, or revocation
29 imposed by the licensing agency.
30 Section 155. Section 489.554, Florida Statutes, is
31 amended to read:
196
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 489.554 Registration renewal.--
2 (1) The department shall prescribe by rule the method
3 for approval of continuing education courses, and for renewal
4 of annual registration, for inactive status for late filing of
5 a renewal application, for allowing a contractor to hold his
6 or her registration in inactive status for a specified period,
7 and for reactivating a license.
8 (2) At a minimum, annual renewal shall include
9 continuing education requirements of not less than 6 classroom
10 hours annually for septic tank contractors and not less than
11 12 classroom hours annually for master septic tank
12 contractors. The 12 classroom hours of continuing education
13 required for master septic tank contractors may include the 6
14 classroom hours required for septic tank contractors, but at a
15 minimum must include 6 classroom hours of approved master
16 septic tank contractor coursework.
17 (3) A certificate of registration shall become
18 inactive if a renewal application is not filed in a timely
19 manner. A certificate that has become inactive may be
20 reactivated under this section by application to the
21 department. A licensed contractor may apply to the department
22 for voluntary inactive status at any time during the period of
23 registration.
24 (4) A master septic tank contractor may elect to
25 revert to registered septic tank contractor status at any time
26 during the period of registration. The department shall
27 prescribe by rule the method for a master septic tank
28 contractor whose registration has reverted to registered
29 septic tank contractor status to apply for master septic tank
30 contractor status.
31 (5) The department shall deny an application for
197
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 renewal if there is any outstanding administrative penalty
2 against the applicant which is final agency action and all
3 judicial reviews are exhausted.
4 Section 156. Paragraph (b) of subsection (2) of
5 section 490.005, Florida Statutes, is amended to read:
6 490.005 Licensure by examination.--
7 (2) Any person desiring to be licensed as a school
8 psychologist shall apply to the department to take the
9 licensure examination. The department shall license each
10 applicant who the department certifies has:
11 (b) Submitted satisfactory proof to the department
12 that the applicant:
13 1. Has received a doctorate, specialist, or equivalent
14 degree from a program primarily psychological in nature and
15 has completed 60 semester hours or 90 quarter hours of
16 graduate study, in areas related to school psychology as
17 defined by rule of the department, from a college or
18 university which at the time the applicant was enrolled and
19 graduated was accredited by an accrediting agency recognized
20 and approved by the Council for Higher Education Accreditation
21 or the United States Department of Education Commission on
22 Recognition of Postsecondary Accreditation or an institution
23 which is publicly recognized as a member in good standing with
24 the Association of Universities and Colleges of Canada.
25 2. Has had a minimum of 3 years of experience in
26 school psychology, 2 years of which must be supervised by an
27 individual who is a licensed school psychologist or who has
28 otherwise qualified as a school psychologist supervisor, by
29 education and experience, as set forth by rule of the
30 department. A doctoral internship may be applied toward the
31 supervision requirement.
198
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 3. Has passed an examination provided by the
2 department.
3 Section 157. Paragraph (b) of subsection (3) and
4 paragraph (b) of subsection (4) of section 491.005, Florida
5 Statutes, are amended to read:
6 491.005 Licensure by examination.--
7 (3) MARRIAGE AND FAMILY THERAPY.--Upon verification of
8 documentation and payment of a fee not to exceed $200, as set
9 by board rule, plus the actual cost to the department for the
10 purchase of the examination from the Association of Marital
11 and Family Therapy Regulatory Board, or similar national
12 organization, the department shall issue a license as a
13 marriage and family therapist to an applicant who the board
14 certifies:
15 (b)1. Has a minimum of a master's degree with major
16 emphasis in marriage and family therapy, or a closely related
17 field, and has completed all of the following requirements:
18 a. Thirty-six semester hours or 48 quarter hours of
19 graduate coursework, which must include a minimum of 3
20 semester hours or 4 quarter hours of graduate-level course
21 credits in each of the following nine areas: dynamics of
22 marriage and family systems; marriage therapy and counseling
23 theory and techniques; family therapy and counseling theory
24 and techniques; individual human development theories
25 throughout the life cycle; personality theory or general
26 counseling theory and techniques; psychopathology; human
27 sexuality theory and counseling techniques; psychosocial
28 theory; and substance abuse theory and counseling techniques.
29 Courses in research, evaluation, appraisal, assessment, or
30 testing theories and procedures; thesis or dissertation work;
31 or practicums, internships, or fieldwork may not be applied
199
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 toward this requirement.
2 b. A minimum of one graduate-level course of 3
3 semester hours or 4 quarter hours in legal, ethical, and
4 professional standards issues in the practice of marriage and
5 family therapy or a course determined by the board to be
6 equivalent.
7 c. A minimum of one graduate-level course of 3
8 semester hours or 4 quarter hours in diagnosis, appraisal,
9 assessment, and testing for individual or interpersonal
10 disorder or dysfunction; and a minimum of one 3-semester-hour
11 or 4-quarter-hour graduate-level course in behavioral research
12 which focuses on the interpretation and application of
13 research data as it applies to clinical practice. Credit for
14 thesis or dissertation work, practicums, internships, or
15 fieldwork may not be applied toward this requirement.
16 d. A minimum of one supervised clinical practicum,
17 internship, or field experience in a marriage and family
18 counseling setting, during which the student provided 180
19 direct client contact hours of marriage and family therapy
20 services under the supervision of an individual who met the
21 requirements for supervision under paragraph (c). This
22 requirement may be met by a supervised practice experience
23 which took place outside the academic arena, but which is
24 certified as equivalent to a graduate-level practicum or
25 internship program which required a minimum of 180 direct
26 client contact hours of marriage and family therapy services
27 currently offered within an academic program of a college or
28 university accredited by an accrediting agency approved by the
29 United States Department of Education, or an institution which
30 is publicly recognized as a member in good standing with the
31 Association of Universities and Colleges of Canada or a
200
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 training institution accredited by the Commission on
2 Accreditation for Marriage and Family Therapy Education
3 recognized by the United States Department of Education.
4 Certification shall be required from an official of such
5 college, university, or training institution.
6 2. If the course title which appears on the
7 applicant's transcript does not clearly identify the content
8 of the coursework, the applicant shall be required to provide
9 additional documentation, including, but not limited to, a
10 syllabus or catalog description published for the course.
11
12 The required master's degree must have been received in an
13 institution of higher education which at the time the
14 applicant graduated was: fully accredited by a regional
15 accrediting body recognized by the Council for Higher
16 Education Accreditation or the United States Department of
17 Education Commission on Recognition of Postsecondary
18 Accreditation; publicly recognized as a member in good
19 standing with the Association of Universities and Colleges of
20 Canada; or an institution of higher education located outside
21 the United States and Canada, which at the time the applicant
22 was enrolled and at the time the applicant graduated
23 maintained a standard of training substantially equivalent to
24 the standards of training of those institutions in the United
25 States which are accredited by a regional accrediting body
26 recognized by the Council for Higher Education Accreditation
27 or the United States Department of Education Commission on
28 Recognition of Postsecondary Accreditation. Such foreign
29 education and training must have been received in an
30 institution or program of higher education officially
31 recognized by the government of the country in which it is
201
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 located as an institution or program to train students to
2 practice as professional marriage and family therapists or
3 psychotherapists. The burden of establishing that the
4 requirements of this provision have been met shall be upon the
5 applicant, and the board shall require documentation, such as,
6 but not limited to, an evaluation by a foreign equivalency
7 determination service, as evidence that the applicant's
8 graduate degree program and education were equivalent to an
9 accredited program in this country. An applicant with a
10 master's degree from a program which did not emphasize
11 marriage and family therapy may complete the coursework
12 requirement in a training institution fully accredited by the
13 Commission on Accreditation for Marriage and Family Therapy
14 Education recognized by the United States Department of
15 Education.
16 (4) MENTAL HEALTH COUNSELING.--Upon verification of
17 documentation and payment of a fee not to exceed $200, as set
18 by board rule, plus the actual per applicant cost to the
19 department for purchase of the examination from the
20 Professional Examination Service for the National Academy of
21 Certified Clinical Mental Health Counselors or a similar
22 national organization, the department shall issue a license as
23 a mental health counselor to an applicant who the board
24 certifies:
25 (b)1. Has a minimum of an earned master's degree from
26 a mental health counseling program accredited by the Council
27 for the Accreditation of Counseling and Related Educational
28 Programs that consists of at least 60 semester hours or 80
29 quarter hours of clinical and didactic instruction, including
30 a course in human sexuality and a course in substance abuse.
31 If the master's degree is earned from a program related to the
202
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 practice of mental health counseling that is not accredited by
2 the Council for the Accreditation of Counseling and Related
3 Educational Programs, then the coursework and practicum,
4 internship, or fieldwork must consist of at least 60 semester
5 hours or 80 quarter hours and meet the following requirements:
6 a. Thirty-three semester hours or 44 quarter hours of
7 graduate coursework, which must include a minimum of 3
8 semester hours or 4 quarter hours of graduate-level coursework
9 in each of the following 11 content areas: counseling theories
10 and practice; human growth and development; diagnosis and
11 treatment of psychopathology; human sexuality; group theories
12 and practice; individual evaluation and assessment; career and
13 lifestyle assessment; research and program evaluation; social
14 and cultural foundations; counseling in community settings;
15 and substance abuse. Courses in research, thesis or
16 dissertation work, practicums, internships, or fieldwork may
17 not be applied toward this requirement.
18 b. A minimum of 3 semester hours or 4 quarter hours of
19 graduate-level coursework in legal, ethical, and professional
20 standards issues in the practice of mental health counseling,
21 which includes goals, objectives, and practices of
22 professional counseling organizations, codes of ethics, legal
23 considerations, standards of preparation, certifications and
24 licensing, and the role identity and professional obligations
25 of mental health counselors. Courses in research, thesis or
26 dissertation work, practicums, internships, or fieldwork may
27 not be applied toward this requirement.
28 c. The equivalent, as determined by the board, of at
29 least 1,000 hours of university-sponsored supervised clinical
30 practicum, internship, or field experience as required in the
31 accrediting standards of the Council for Accreditation of
203
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Counseling and Related Educational Programs for mental health
2 counseling programs. This experience may not be used to
3 satisfy the post-master's clinical experience requirement.
4 2. If the course title which appears on the
5 applicant's transcript does not clearly identify the content
6 of the coursework, the applicant shall be required to provide
7 additional documentation, including, but not limited to, a
8 syllabus or catalog description published for the course.
9
10 Education and training in mental health counseling must have
11 been received in an institution of higher education which at
12 the time the applicant graduated was: fully accredited by a
13 regional accrediting body recognized by the Council for Higher
14 Education Accreditation or the United States Department of
15 Education Commission on Recognition of Postsecondary
16 Accreditation; publicly recognized as a member in good
17 standing with the Association of Universities and Colleges of
18 Canada; or an institution of higher education located outside
19 the United States and Canada, which at the time the applicant
20 was enrolled and at the time the applicant graduated
21 maintained a standard of training substantially equivalent to
22 the standards of training of those institutions in the United
23 States which are accredited by a regional accrediting body
24 recognized by the Council for Higher Education Accreditation
25 or the United States Department of Education Commission on
26 Recognition of Postsecondary Accreditation. Such foreign
27 education and training must have been received in an
28 institution or program of higher education officially
29 recognized by the government of the country in which it is
30 located as an institution or program to train students to
31 practice as mental health counselors. The burden of
204
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 establishing that the requirements of this provision have been
2 met shall be upon the applicant, and the board shall require
3 documentation, such as, but not limited to, an evaluation by a
4 foreign equivalency determination service, as evidence that
5 the applicant's graduate degree program and education were
6 equivalent to an accredited program in this country.
7 Section 158. Subsection (6) of section 499.003,
8 Florida Statutes, is amended to read:
9 499.003 Definitions of terms used in ss.
10 499.001-499.081.--As used in ss. 499.001-499.081, the term:
11 (6) "Compressed medical gas" means any liquefied or
12 vaporized gas that is classified as a prescription drug or
13 medical device, whether it is alone or in combination with
14 other gases.
15 Section 159. Subsection (2) of section 499.007,
16 Florida Statutes, is amended to read:
17 499.007 Misbranded drug or device.--A drug or device
18 is misbranded:
19 (2) Unless, if in package form, it bears a label
20 containing:
21 (a) The name and place of business of the manufacturer
22 or distributor; in addition, for a medicinal drug, as defined
23 in s. 499.003, the label must contain the name and place of
24 business of the manufacturer of the finished dosage form of
25 the drug. For the purpose of this paragraph, the finished
26 dosage form of a medicinal drug is that form of the drug which
27 is, or is intended to be, dispensed or administered to the
28 patient and requires no further manufacturing or processing
29 other than packaging, reconstitution, and labeling; and
30 (b) An accurate statement of the quantity of the
31 contents in terms of weight, measure, or numerical count;
205
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 however, under this section, reasonable variations are
2 permitted, and the department shall establish by rule
3 exemptions for small packages.
4
5 A drug dispensed by filling or refilling a written or oral
6 prescription of a practitioner licensed by law to prescribe
7 such drug is exempt from the requirements of this section,
8 except subsections (1), (8), (10), and (11) and the packaging
9 requirements of subsections (6) and (7), if the drug bears a
10 label that contains the name and address of the dispenser or
11 seller, the prescription number and the date the prescription
12 was written or filled, the name of the prescriber and the name
13 of the patient, and the directions for use and cautionary
14 statements. This exemption does not apply to any drug
15 dispensed in the course of the conduct of a business of
16 dispensing drugs pursuant to diagnosis by mail or to any drug
17 dispensed in violation of subsection (12). The department
18 may, by rule, exempt drugs subject to ss. 499.062-499.064 from
19 subsection (12) if compliance with that subsection is not
20 necessary to protect the public health, safety, and welfare.
21 Section 160. Paragraph (e) of subsection (1) of
22 section 499.01, Florida Statutes, is amended to read:
23 499.01 Permits; applications; renewal; general
24 requirements.--
25 (1) Any person that is required under ss.
26 499.001-499.081 to have a permit must apply to the department
27 on forms furnished by the department.
28 (e) The department may not issue a permit for a
29 prescription drug manufacturer, prescription drug wholesaler,
30 or retail pharmacy wholesaler may not be issued to the address
31 of a health care entity, except as provided in this paragraph.
206
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 The department may issue a prescription drug manufacturer
2 permit to an applicant at the same address as a licensed
3 nuclear pharmacy that is a health care entity for the purpose
4 of manufacturing prescription drugs used in positron emission
5 tomography or other radiopharmaceuticals, as listed in a rule
6 adopted by the department pursuant to this paragraph. The
7 purpose of this exemption is to assure availability of
8 state-of-the-art pharmaceuticals that would pose a significant
9 danger to the public health if manufactured at a separate
10 establishment address other than the nuclear pharmacy from
11 which the prescription drugs are dispensed.
12 Section 161. Paragraph (b) of subsection (6) of
13 section 499.0121, Florida Statutes, is amended to read:
14 499.0121 Storage and handling of prescription drugs;
15 recordkeeping.--The department shall adopt rules to implement
16 this section as necessary to protect the public health,
17 safety, and welfare. Such rules shall include, but not be
18 limited to, requirements for the storage and handling of
19 prescription drugs and for the establishment and maintenance
20 of prescription drug distribution records.
21 (6) RECORDKEEPING.--The department shall adopt rules
22 that require keeping such records of prescription drugs as are
23 necessary for the protection of the public health.
24 (b) Inventories and records must be made available for
25 inspection and photocopying by authorized federal, state, or
26 local officials for a period of 2 years following disposition
27 of the drugs or 3 years after the date the inventory or record
28 was created, whichever is longer.
29
30 For the purposes of this subsection, the term "authorized
31 distributors of record" means those distributors with whom a
207
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 manufacturer has established an ongoing relationship to
2 distribute the manufacturer's products.
3 Section 162. Section 501.122, Florida Statutes, is
4 transferred and renumbered as section 404.24, Florida
5 Statutes.
6 Section 163. Section 784.081, Florida Statutes, is
7 amended to read:
8 784.081 Assault or battery on specified officials or
9 employees; reclassification of offenses.--Whenever a person is
10 charged with committing an assault or aggravated assault or a
11 battery or aggravated battery upon any elected official or
12 employee of: a school district; a private school; the Florida
13 School for the Deaf and the Blind; a university developmental
14 research school; a state university or any other entity of the
15 state system of public education, as defined in s. 1000.04; an
16 employee or protective investigator of the Department of
17 Children and Family Services; or an employee of a lead
18 community-based provider and its direct service contract
19 providers; or an employee of the Department of Health and its
20 direct service contract providers, when the person committing
21 the offense knows or has reason to know the identity or
22 position or employment of the victim, the offense for which
23 the person is charged shall be reclassified as follows:
24 (1) In the case of aggravated battery, from a felony
25 of the second degree to a felony of the first degree.
26 (2) In the case of aggravated assault, from a felony
27 of the third degree to a felony of the second degree.
28 (3) In the case of battery, from a misdemeanor of the
29 first degree to a felony of the third degree.
30 (4) In the case of assault, from a misdemeanor of the
31 second degree to a misdemeanor of the first degree.
208
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Section 164. Section 945.6038, Florida Statutes, is
2 created to read:
3 945.6038 Additional services.--The authority may enter
4 into an agreement or may contract with the Department of
5 Children and Family Services, subject to the availability of
6 funds, to conduct surveys of medical services and to provide
7 medical quality assurance and improvement assistance at secure
8 confinement and treatment facilities for persons confined
9 under part V of chapter 394. The authority may enter into
10 similar agreements with other state agencies, subject to the
11 availability of funds. The authority may not enter any such
12 agreement if to do so would impair the authority's ability to
13 fulfill its obligations under this chapter.
14 Section 165. Paragraph (t) is added to subsection (3)
15 of section 408.036, Florida Statutes, to read:
16 408.036 Projects subject to review.--
17 (3) EXEMPTIONS.--Upon request, the following projects
18 are subject to exemption from the provisions of subsection
19 (1):
20 (t)1. For the provision of adult open-heart services
21 in a hospital located within the boundaries of Palm Beach,
22 Polk, Martin, St. Lucie, and Indian River Counties if the
23 following conditions are met: The exemption must be based upon
24 objective criteria and address and solve the twin problems of
25 geographic and temporal access. A hospital shall be exempt
26 from the certificate-of-need review for the establishment of
27 an open-heart-surgery program when the application for
28 exemption submitted under this paragraph complies with the
29 following criteria:
30 a. The applicant must certify that it will meet and
31 continuously maintain the minimum licensure requirements
209
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 adopted by the agency governing adult open-heart programs,
2 including the most current guidelines of the American College
3 of Cardiology and American Heart Association Guidelines for
4 Adult Open Heart Programs.
5 b. The applicant must certify that it will maintain
6 sufficient appropriate equipment and health personnel to
7 ensure quality and safety.
8 c. The applicant must certify that it will maintain
9 appropriate times of operation and protocols to ensure
10 availability and appropriate referrals in the event of
11 emergencies.
12 d. The applicant can demonstrate that it is referring
13 300 or more patients per year from the hospital, including the
14 emergency room, for cardiac services at a hospital with
15 cardiac services, or that the average wait for transfer for 50
16 percent or more of the cardiac patients exceeds 4 hours.
17 e. The applicant is a general acute care hospital that
18 is in operation for 3 years or more.
19 f. The applicant is performing more than 300
20 diagnostic cardiac catheterization procedures per year,
21 combined inpatient and outpatient.
22 g. The applicant's payor mix at a minimum reflects the
23 community average for Medicaid, charity care, and self-pay
24 patients or the applicant must certify that it will provide a
25 minimum of 5 percent of Medicaid, charity care, and self-pay
26 to open-heart-surgery patients.
27 h. If the applicant fails to meet the established
28 criteria for open-heart programs or fails to reach 300
29 surgeries per year by the end of its third year of operation,
30 it must show cause why its exemption should not be revoked.
31 2. By December 31, 2004, and annually thereafter, the
210
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Agency for Health Care Administration shall submit a report to
2 the Legislature providing information concerning the number of
3 requests for exemption received under this paragraph and the
4 number of exemptions granted or denied.
5 Section 166. Section 381.85, subsection (9) of section
6 381.0098, paragraph (f) of subsection (2) of section 385.103,
7 section 385.205, section 385.209, and subsection (7) of
8 section 445.033, Florida Statutes, are repealed.
9 Section 167. Section 57 of chapter 98-288, Laws of
10 Florida, is repealed.
11 Section 168. Except as otherwise expressly provided in
12 this act, this act shall take effect July 1, 2003, and this
13 section and sections 38-54 of this act shall take effect upon
14 becoming a law.
15
16
17 ================ T I T L E A M E N D M E N T ===============
18 And the title is amended as follows:
19 Delete everything before the enacting clause
20
21 and insert:
22 A bill to be entitled
23 An act relating to health care; amending s.
24 20.43, F.S.; establishing the Office of
25 Minority Health within the Department of
26 Health; amending ss. 381.7353, 381.7355, F.S.;
27 providing duties of the Department of Health
28 with respect to oral health care programs;
29 amending s. 393.064, F.S.; providing for the
30 Department of Health rather than the Department
31 of Children and Family Services to manage the
211
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Raymond C. Philips Research and Education Unit;
2 amending s. 394.4615, F.S.; revising the
3 standard under which a patient's access to his
4 or her own clinical records may be restricted;
5 amending s. 395.3025, F.S.; authorizing the
6 release of patient records to a health care
7 practitioner, the Department of Health, or a
8 researcher or facility personnel under certain
9 circumstances; revising a restriction on the
10 use of patient information for certain
11 purposes; amending s. 395.7015, F.S.;
12 conforming cross-references; amending s.
13 400.141, F.S.; providing for the release of
14 certain nursing home resident records to the
15 Department of Health pursuant to subpoena;
16 amending s. 400.145, F.S., and creating s.
17 400.455, F.S.; requiring certification of
18 certain records by the nursing home
19 administrator or records custodian; amending s.
20 400.211, F.S.; reducing required inservice
21 training hours for nursing assistants; amending
22 s. 395.3025, F.S.; authorizing the release of
23 patient records to a health care practitioner,
24 the Department of Health, or a researcher or
25 facility personnel under certain circumstances;
26 revising a restriction on the use of patient
27 information for certain purposes; amending s.
28 400.141, F.S.; providing for the release of
29 certain nursing home resident records to the
30 Department of Health pursuant to subpoena;
31 amending s. 400.145, F.S., and creating s.
212
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 400.455, F.S.; requiring certification of
2 certain records by the nursing home
3 administrator or records custodian; amending s.
4 456.017, F.S.; authorizing the Department of
5 Health to post examination scores
6 electronically in lieu of mailing; amending s.
7 456.0375, F.S.; revising the definition of
8 "clinic" for purposes of a registration
9 requirement; providing an exemption from
10 registration for certain entities; providing
11 for retroactive application; providing a
12 distinction between supervision of
13 administrative services and supervision of
14 health care delivery services; providing an
15 exemption from registration for clinical
16 facilities where training is provided by
17 certain medical schools; amending s. 456.039,
18 F.S.; deleting a cross-reference; amending s.
19 456.041, F.S.; revising certain requirements
20 concerning information on paid claims which is
21 included in the practitioner profile; amending
22 s. 456.049, F.S.; specifying the amount of
23 final professional liability claims to be
24 reported for physicians and dentists; amending
25 s. 456.057, F.S.; specifying certain
26 circumstances under which a patient release for
27 the furnishing of records is not required;
28 authorizing the department to obtain records
29 pursuant to subpoena; requiring the
30 certification of certain records; amending s.
31 456.063, F.S.; providing professional
213
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 regulatory boards, or the Department of Health
2 if there is no board, rulemaking authority for
3 reporting allegations of sexual misconduct;
4 amending s. 456.072, F.S.; clarifying grounds
5 for discipline for performing or attempting to
6 perform health care services on the wrong
7 patient or that are otherwise wrong or
8 unnecessary or leaving a foreign body in the
9 patient; providing for discipline for being
10 terminated from an impaired practitioner
11 program for failing to comply with the terms of
12 a treatment contract; providing for additional
13 costs to be assessed as part of any penalty or
14 other form of discipline; requiring clear and
15 convincing evidence to revoke or suspend a
16 license and the greater weight of the evidence
17 for other forms of discipline; conforming a
18 cross-reference; amending s. 456.073, F.S.;
19 extending the time within which the subject of
20 an investigation may submit a written response
21 to the information in the complaint or other
22 documentation; requiring the Department of
23 Health to give 45 days' notice to the Division
24 of Administrative Hearings when a hearing is
25 needed; amending s. 456.077, F.S.; providing
26 that citations for first offenses do not
27 constitute discipline; deleting the required
28 period for issuing a citation; amending s.
29 456.078, F.S.; requiring designation of certain
30 violations as appropriate for mediation;
31 excluding certain violations from mediation;
214
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 requiring successful mediation to include a
2 statement of whether of not the resolution
3 constitutes discipline; requiring payment for
4 the administrative costs of mediation;
5 prohibiting mediation more than once involving
6 a breach of the standard of care for health
7 care professionals; providing rulemaking
8 authority; amending s. 458.303, F.S.;
9 conforming cross-references; amending s.
10 458.311, F.S.; consolidating and revising
11 provisions relating to requirements for
12 licensure of physicians; amending s. 458.3124,
13 F.S.; conforming a cross-reference; amending s.
14 458.315, F.S.; consolidating and revising
15 provisions relating to requirements for limited
16 licensure of physicians; amending s. 458.319,
17 F.S.; deleting a cross-reference; amending s.
18 458.320, F.S.; conforming a cross-reference;
19 providing requirements for issuance of a
20 physician's license for clinical research
21 purposes; amending s. 458.331, F.S.; increasing
22 the threshold amount of claims against a
23 physician which represent repeated malpractice;
24 revising a reporting requirement, to conform;
25 reducing the time period for a physician to
26 respond to information contained in a complaint
27 or other documentation; amending ss. 458.345
28 and 458.347, F.S.; conforming cross-references;
29 amending s. 459.008, F.S.; deleting a
30 cross-reference; amending s. 459.015, F.S.;
31 revising requirements for the department with
215
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 respect to investigating a claim against an
2 osteopathic physician; amending s. 460.413,
3 F.S.; revising the period for a chiropractic
4 physician to respond to a complaint; amending
5 s. 461.013, F.S.; revising requirements for
6 determining a case of repeated malpractice and
7 for requiring an investigation by the
8 department; providing a short title; requiring
9 the Agency for Workforce Innovation to
10 establish a pilot program for delivery of
11 certified geriatric specialty nursing
12 education; specifying eligibility requirements
13 for certified nursing assistants to obtain
14 certified geriatric specialty nursing
15 education; specifying requirements for the
16 education of certified nursing assistants to
17 prepare for certification as a certified
18 geriatric specialist; creating a Certified
19 Geriatric Specialty Nursing Initiative Steering
20 Committee; providing for the composition of and
21 manner of appointment to the Certified
22 Geriatric Specialty Nursing Initiative Steering
23 Committee; providing responsibilities of the
24 steering committee; providing for reimbursement
25 for per diem and travel expenses; requiring the
26 Agency for Workforce Innovation to conduct or
27 contract for an evaluation of the pilot program
28 for delivery of certified geriatric specialty
29 nursing education; requiring the evaluation to
30 include recommendations regarding the expansion
31 of the delivery of certified geriatric
216
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 specialty nursing education in nursing homes;
2 requiring the Agency for Workforce Innovation
3 to report to the Governor and Legislature
4 regarding the status and evaluation of the
5 pilot program; creating s. 464.0125, F.S.;
6 providing definitions; providing requirements
7 for persons to become certified geriatric
8 specialists; specifying fees; providing for
9 articulation of geriatric specialty nursing
10 coursework and practical nursing coursework;
11 providing practice standards and grounds for
12 which certified geriatric specialists may be
13 subject to discipline by the Board of Nursing;
14 creating restrictions on the use of
15 professional nursing titles; prohibiting the
16 use of certain professional titles; providing
17 penalties; authorizing approved nursing
18 programs to provide education for the
19 preparation of certified geriatric specialists
20 without further board approval; authorizing
21 certified geriatric specialists to supervise
22 the activities of others in nursing home
23 facilities according to rules by the Board of
24 Nursing; revising terminology relating to
25 nursing to conform to the certification of
26 geriatric specialists; amending s. 381.00315,
27 F.S.; revising requirements for the
28 reactivation of the licenses of specified
29 health care practitioners in the event of
30 public health emergency to include certified
31 geriatric specialists; amending s. 400.021,
217
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 F.S.; including services provided by a
2 certified geriatric specialist within the
3 definition of nursing service; amending s.
4 400.211, F.S.; revising requirements for
5 persons employed as nursing assistants to
6 conform to the certification of certified
7 geriatric specialists; amending s. 400.23,
8 F.S.; specifying that certified geriatric
9 specialists shall be considered licensed
10 nursing staff; authorizing licensed practical
11 nurses to supervise the activities of certified
12 geriatric specialists in nursing home
13 facilities according to rules adopted by the
14 Board of Nursing; amending s. 409.908, F.S.;
15 revising the methodology for reimbursement of
16 Medicaid program providers to include services
17 of certified geriatric specialists; amending s.
18 458.303, F.S.; revising exceptions to the
19 practice of medicine to include services
20 delegated to a certified geriatric specialist
21 under specified circumstances; amending s.
22 1009.65, F.S.; revising eligibility for the
23 Medical Education Reimbursement and Loan
24 Repayment Program to include certified
25 geriatric specialists; amending s. 1009.66,
26 F.S.; revising eligibility requirements for the
27 Nursing Student Loan Forgiveness Program to
28 include certified geriatric specialists;
29 providing an appropriation; amending s.
30 464.201, F.S.; defining terms; amending s.
31 464.202, F.S.; authorizing the Board of Nursing
218
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 to adopt rules regarding the practice and
2 supervision of certified nursing assistants;
3 amending s. 464.0205, F.S.; conforming a
4 cross-reference; amending s. 464.203, F.S.;
5 revising requirements for the screening of
6 certified nursing assistants; revising hours
7 required for inservice training; providing for
8 certification renewal fees; amending s.
9 464.204, F.S.; revising standards under which
10 disciplinary sanctions may be imposed; amending
11 s. 466.004, F.S.; requiring the Council on
12 Dental Hygiene to meet at least twice a year;
13 providing for consideration by the Board of
14 Dentistry of rule and policy recommendations of
15 the council; creating s. 466.055, F.S.;
16 providing for the appointment of an executive
17 director; providing for duties, and board
18 oversight; requiring director to oversee staff;
19 requiring the department to contract for a
20 dental intake officer and providing
21 qualifications; requiring certain
22 responsibilities of the officer; requiring the
23 board to establish certain performance
24 parameters for departmental handling of
25 disciplinary cases, and consequences; requiring
26 testing services to report to the board if
27 requested; requiring a board spending plan and
28 its content; requiring board spending authority
29 over discretionary budget items; requiring a
30 department report of certain information;
31 providing for a board response; amending s.
219
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 467.013, F.S.; providing for the department to
2 adopt rules governing applications for inactive
3 status for midwives; amending s. 467.0135,
4 F.S.; revising the schedule of fees; amending
5 s. 467.017, F.S.; requiring that the emergency
6 care plan be available to the department;
7 amending s. 468.352, F.S.; revising and
8 providing definitions applicable to the
9 regulation of respiratory therapy; amending s.
10 468.355, F.S.; revising provisions relating to
11 respiratory therapy licensure and testing
12 requirements; amending s. 468.368, F.S.;
13 revising exemptions from respiratory therapy
14 licensure requirements; repealing s. 468.356,
15 F.S., relating to the approval of educational
16 programs; repealing s. 468.357, F.S., relating
17 to licensure by examination; amending s.
18 491.005, F.S.; revising certain licensing
19 requirements for clinical social workers;
20 amending s. 491.0145, F.S.; prohibiting the
21 Department of Health from adopting certain
22 rules governing licensure; creating s.
23 491.0146, F.S.; providing for effect of certain
24 licenses; amending s. 491.0147, F.S.; providing
25 an exemption from liability for disclosure of
26 confidential information under certain
27 circumstances; amending s. 627.912, F.S.;
28 revising requirements for liability reports by
29 insurers; amending s. 766.101, F.S.; providing
30 immunity from liability for a medical review
31 committee established by a university board of
220
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 trustees and a committee of a college of
2 medicine, college of nursing, or other health
3 care discipline; amending s. 766.314, F.S.;
4 excluding infants born in certain family
5 practice teaching hospitals from assessments
6 used to fund the Florida Birth-Related
7 Neurological Injury Compensation Plan; amending
8 s. 456.031, F.S.; revising requirements for
9 licensed health care practitioners to take
10 continuing education relating to domestic
11 violence; amending s. 766.314, F.S.; correcting
12 a cross-reference; amending s. 817.567, F.S.;
13 revising an accrediting agency for institutions
14 awarding academic degrees and titles; amending
15 s. 1009.992, F.S.; revising the definition of
16 the term "institution" to update a reference to
17 an accrediting agency; amending s. 1012.46,
18 F.S.; revising provisions relating to athletic
19 trainers in school districts; removing a
20 legislative goal; revising requirements for
21 athletic trainers used by school districts;
22 repealing ss. 456.033, 456.034, 458.313,
23 458.316, 458.3165, and 458.317, F.S., relating
24 to instruction on HIV and AIDS, licensure by
25 endorsement, public health certificates, and
26 limited licenses; requiring the Division of
27 Administrative Hearings to designate
28 administrative law judges with specified
29 qualifications for hearings involving certain
30 licensed health care practitioners; specifying
31 qualifications; amending ss. 400.4785,
221
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 400.5571, 400.6045, F.S.; prescribing training
2 standards for employees of home health
3 agencies, adult day care centers, and hospices,
4 respectively, that provide care for persons who
5 have Alzheimer's disease or related disorders;
6 prescribing duties of the Department of Elderly
7 Affairs; providing for compliance with
8 guidelines within a certain time period;
9 providing for approval of Alzheimer's training
10 and trainers; providing for application of
11 training to meet specified requirements;
12 providing authority to adopt rules; providing
13 legislative findings and intent; amending s.
14 391.025, F.S.; including certain infants as
15 eligible individuals for certain health
16 services; amending s. 391.029, F.S.; providing
17 for financial eligibility under the Children's
18 Medical Services program for certain infants;
19 providing certain reimbursement and funding
20 requirements; amending s. 766.304, F.S.;
21 limiting certain awards under certain
22 circumstances; amending s. 766.305, F.S.;
23 deleting certain information required in a
24 petition; revising certain copying
25 requirements; specifying information required
26 to be provided by a claimant; specifying
27 confidentiality of certain information;
28 amending s. 766.309, F.S.; providing for
29 bifurcating certain proceedings under certain
30 circumstances; providing procedures; providing
31 authority to an administrative law judge for
222
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 certain actions; amending s. 766.31, F.S.,
2 relating to administrative law judge awards for
3 birth-related neurological injuries; excluding
4 expenses for items or services received under
5 Medicaid; revising the amount of the death
6 benefit; limiting claimants' liability, in
7 specified circumstances, to expenses awarded
8 under this section; amending s. 766.314, F.S.;
9 redefining the term "infant delivered" to
10 exclude those delivered by employees or agents
11 of the board of trustees or in certain
12 hospitals; revising qualifications for
13 physician participation in the Florida
14 Birth-related Neurological Injury Compensation
15 Plan; providing for certain hospitals to pay
16 the fee for participation in the plan on behalf
17 of a participating physician or certified nurse
18 midwife; providing restrictions on such a
19 hospital; requiring the hospital to file
20 certain information; creating the James and
21 Esther King Center for Universal Research to
22 Eradicate Disease; providing intent and duties;
23 creating an advisory council; amending s.
24 215.5602, F.S.; expanding the long-term goals
25 and funding of the Florida Biomedical Research
26 Program to include the cure of specified
27 diseases; creating the Florida Cancer Research
28 Cooperative; providing for a board of
29 directors; providing the cooperative's mission
30 and duties; amending s. 484.0512, F.S.;
31 providing a criminal penalty for failure of a
223
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 seller to refund within a specified time moneys
2 required to be refunded to a purchaser for the
3 return or attempted return of a hearing aid;
4 providing a definition; amending s. 456.073,
5 F.S.; providing that a state prisoner must
6 exhaust all available administrative remedies
7 before filing a complaint with the Department
8 of Health against a health care practitioner
9 who is providing health care services within
10 the Department of Corrections, unless the
11 practitioner poses a serious threat to the
12 health or safety of a person who is not a state
13 prisoner; requiring the Department of Health to
14 be notified if a health care practitioner is
15 disciplined or allowed to resign for a
16 practice-related offense; requiring the
17 Division of Medical Quality Assurance of the
18 Department of Health to conduct a study of
19 clinical and academic training requirements of
20 certified optometric practitioners; providing
21 for appointment of members; requiring a report
22 to be submitted to the Governor and
23 Legislature; amending s. 465.0265, F.S.;
24 providing requirements for the filing of
25 prescriptions by pharmacies that are under
26 common ownership or that have a contractual
27 relationship with one another; specifying
28 requirements for exceptions to prescription
29 transfers between certain pharmacies; amending
30 s. 466.006, F.S.; allowing certain dental
31 students to take the examinations required to
224
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 practice dentistry in this state under
2 specified conditions; providing a prerequisite
3 to licensure of such students; creating s.
4 466.0065, F.S.; allowing certain dental
5 students to take regional licensure
6 examinations under specified conditions;
7 restricting the applicability of examination
8 results to licensing in other jurisdictions;
9 requiring approval by the Board of Dentistry
10 and providing prerequisites to such approval;
11 creating the "Nick Oelrich Gift of Life Act";
12 amending s. 765.512, F.S., relating to
13 anatomical gifts; prohibiting modification of a
14 donor's intent; providing that a donor document
15 is legally binding; authorizing specified
16 persons to furnish a donor's medical records
17 upon request; amending s. 765.516, F.S.;
18 revising procedures by which the terms of an
19 anatomical gift may be amended or the gift may
20 be revoked; amending s. 765.401, F.S.;
21 providing additional persons who may be given a
22 proxy for the making of health care decisions;
23 requiring review by the facility's bioethics
24 committee of decisions to withhold or withdraw
25 life-prolonging procedures; requiring
26 documentation of efforts to locate certain
27 proxies; amending s. 641.19, F.S.; providing
28 that the term "speciality" does not include the
29 services of a licensed chiropractic physician
30 for purposes of the regulation of managed care;
31 amending s. 401.272, Florida Statutes;
225
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 providing for certain paramedics to provide
2 basic and advanced life support; providing
3 supervision requirements; requiring the
4 Department of Health, in consultation with
5 specified educational institutions, to conduct
6 a study with respect to using skills of
7 foreign-trained physicians and to report the
8 results; amending s. 1012.46, F.S.; revising
9 criteria of athletic trainers working in school
10 districts; amending s. 17.41, F.S.; providing
11 for funds from the tobacco settlement to be
12 transferred to the Biomedical Trust Fund within
13 the Department of Health Services and Community
14 Health Resources and the Division of Health
15 Awareness and Tobacco; amending s. 20.43, F.S.;
16 establishing the Division of Disability
17 Determinations within the Department of Health
18 and renaming the Division of Emergency Medical
19 Services and Community Health Resources and the
20 Division of Health Awareness and Tobacco;
21 amending s. 154.01, F.S.; providing for
22 environmental health services to include
23 investigations of elevated blood lead levels;
24 authorizing the expenditure of funds for such
25 investigations; creating s. 216.342, F.S.;
26 authorizing the expenditure of funds in the
27 United States Trust Fund for the operation of
28 the Division of Disability Determinations;
29 amending s. 381.0011, F.S.; revising duties of
30 the department with respect to injury
31 prevention and control; amending s. 381.004,
226
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 F.S.; revising requirements for the release of
2 HIV test results; amending s. 381.0065, F.S.,
3 relating to onsite sewage treatment and
4 disposal systems; clarifying a definition;
5 deleting obsolete provisions; amending s.
6 381.0066, F.S.; deleting a limitation on the
7 period for imposing a fee on new sewage system
8 construction; amending s. 381.0072, F.S.;
9 clarifying provisions governing the authority
10 of the department to adopt and enforce
11 sanitation rules; creating s. 381.104, F.S.;
12 authorizing state agencies to establish
13 employee health and wellness programs;
14 providing requirements for the programs;
15 requiring the use of an employee health and
16 wellness activity agreement form; requiring an
17 evaluation and improvement process for the
18 program; requiring the department to provide
19 model program guidelines; creating s. 381.86,
20 F.S.; creating the Review Council for Human
21 Subjects within the Department of Health;
22 providing duties and membership; providing for
23 reimbursement for per diem and travel expenses;
24 requiring the department to charge for costs
25 incurred by the council for research oversight;
26 providing an exception; requiring the
27 department to adopt rules; amending s. 381.89,
28 F.S.; revising the fees imposed for the
29 licensure of tanning facilities; amending s.
30 381.90, F.S.; revising the membership of the
31 Health Information Systems Council; revising
227
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 the date for submitting an annual plan;
2 amending s. 383.14, F.S.; clarifying provisions
3 with respect to the screening of newborns;
4 amending s. 384.25, F.S.; revising requirements
5 for the reporting of sexually transmissible
6 disease; requiring the department to adopt
7 rules; amending s. 385.204, F.S.; revising
8 requirements for the purchase and distribution
9 of insulin by the department; amending s.
10 391.021, F.S.; redefining the term "children
11 with special health care needs" for purposes of
12 the Children's Medical Services Act; amending
13 s. 391.025, F.S.; revising applicability and
14 scope of the act; amending s. 391.029, F.S.;
15 revising requirements for program eligibility;
16 amending s. 391.035, F.S.; authorizing the
17 department to contract for services provided
18 under the act; amending s. 391.055, F.S.;
19 requiring the referral of a newborn having a
20 certain abnormal screening result; creating s.
21 391.309, F.S.; establishing the Florida Infants
22 and Toddlers Early Intervention Program;
23 providing requirements for the department under
24 the program; requiring certain federal waivers;
25 amending s. 394.9151, F.S.; authorizing the
26 Department of Children and Family Services to
27 contract with the Correctional Medical
28 Authority for medical quality assurance
29 assistance at certain facilities; amending s.
30 395.404, F.S.; revising requirements for
31 reports to the department concerning brain or
228
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 spinal cord injuries; amending s. 401.113,
2 F.S.; providing for the use of funds generated
3 from interest on certain grant moneys; amending
4 s. 401.211, F.S.; providing legislative intent
5 with respect to a statewide comprehensive
6 injury prevention program; creating s. 401.243,
7 F.S.; providing duties of the department in
8 operating the program; amending s. 401.27,
9 F.S.; authorizing electronically submitted
10 applications for certification or
11 recertification as an emergency medical
12 technician or a paramedic; revising
13 requirements for an insignia identifying such
14 person; requiring the screening of applicants
15 through the Department of Law Enforcement;
16 amending s. 401.2701, F.S., relating to
17 emergency medical services training programs;
18 requiring that students be notified of certain
19 regulatory and screening requirements;
20 requiring the department to adopt rules;
21 amending s. 401.2715, F.S.; providing for
22 approval of continuing education courses;
23 amending s. 404.056, F.S.; revising
24 requirements for mandatory testing of certain
25 buildings and facilities for radon; amending s.
26 409.814, F.S.; revising eligibility for certain
27 children to participate in the Healthy Kids
28 program and the Medikids program; amending s.
29 409.91188, F.S.; authorizing the agency to
30 contract with private or public entities for
31 health care services; amending s. 455.227,
229
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 F.S.; conforming a cross-reference; amending s.
2 456.025, F.S.; revising requirements for
3 tracking continuing education; amending s.
4 456.055, F.S.; providing requirements for
5 claims for services for chiropractic and
6 podiatric health care; providing for the
7 applicability of the requirements for claims
8 for services for chiropractic and podiatric
9 health care; amending ss. 460.406, 463.006, and
10 467.009, F.S., relating to licensure;
11 conforming provisions to changes made with
12 respect to an accrediting agency; amending s.
13 468.302, F.S.; authorizing a nuclear medicine
14 technologist to administer certain X radiation;
15 amending ss. 468.509, 468.707, 486.031, and
16 486.102, F.S., relating to licensure;
17 conforming provisions to changes made with
18 respect to an accrediting agency; amending ss.
19 489.553 and 489.554, F.S.; revising
20 certification requirements for septic tank
21 contractors; authorizing an inactive
22 registration; amending ss. 490.005 and 491.005,
23 F.S., relating to licensure; conforming
24 provisions to changes made with respect to an
25 accrediting agency; amending s. 499.003, F.S.;
26 redefining the term "compressed medical gas"
27 for purposes of the Florida Drug and Cosmetic
28 Act; amending s. 499.007, F.S.; revising
29 requirements for labeling medicinal drugs;
30 amending s. 499.01, F.S.; authorizing the
31 department to issue a prescription drug
230
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 manufacturer permit to a nuclear pharmacy that
2 is a health care entity; amending s. 499.0121,
3 F.S.; providing requirements for retaining
4 inventories and records; transferring and
5 renumbering s. 501.122, F.S., relating to the
6 control of nonionizing radiations; amending s.
7 784.081, F.S.; providing for the
8 reclassification of the offense of assault or
9 battery if committed on an employee of the
10 Department of Health or upon a direct services
11 provider of the department; creating s.
12 945.6038, F.S.; authorizing the Correctional
13 Medical Authority to contract with the
14 Department of Children and Family Services to
15 provide assistance in medical quality assurance
16 at certain facilities; amending s. 408.036,
17 F.S.; providing an exemption from
18 certificate-of-need requirements for certain
19 open-heart-surgery programs; providing criteria
20 for qualifying for the exemption; requiring the
21 Agency for Health Care Administration to report
22 to the Legislature; repealing s. 381.85, s.
23 381.0098(9), s. 385.103(2)(f), ss. 385.205 and
24 385.209, and s. 445.033(7), F.S; relating to
25 biomedical and social research, obsolete
26 provisions concerning biomedical waste,
27 rulemaking authority of the department,
28 programs in kidney disease control,
29 dissemination of information on cholesterol
30 health risks, and an exemption for certain
31 evaluations conducted by Workforce Florida,
231
4:53 PM 05/02/03 h1925c-02c5y
SENATE AMENDMENT
Bill No. HB 1925, 1st Eng.
Amendment No. ___ Barcode 935422
1 Inc.; repealing s. 57 of chapter 98-288, Laws
2 of Florida; abrogating the repeal of the
3 Florida Kidcare Act; providing effective dates.
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
232
4:53 PM 05/02/03 h1925c-02c5y