Senate Bill sb2390e1
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    CS for CS for SB 2390                          First Engrossed
  1                      A bill to be entitled
  2         An act relating to health care; creating the
  3         James and Esther King Center for Universal
  4         Research to Eradicate Disease; providing intent
  5         and duties; creating an advisory council;
  6         amending s. 215.5602, F.S.; expanding the
  7         long-term goals and funding of the Florida
  8         Biomedical Research Program to include the cure
  9         of specified diseases; creating the Florida
10         Cancer Research Cooperative; providing for a
11         board of directors; providing the cooperative's
12         mission and duties; amending s. 484.0512, F.S.;
13         providing a criminal penalty for failure of a
14         seller to refund within a specified time moneys
15         required to be refunded to a purchaser for the
16         return or attempted return of a hearing aid;
17         providing a definition; amending s. 456.073,
18         F.S.; providing that a state prisoner must
19         exhaust all available administrative remedies
20         before filing a complaint with the Department
21         of Health against a health care practitioner
22         who is providing health care services within
23         the Department of Corrections, unless the
24         practitioner poses a serious threat to the
25         health or safety of a person who is not a state
26         prisoner; requiring the Department of Health to
27         be notified if a health care practitioner is
28         disciplined or allowed to resign for a
29         practice-related offense; requiring the
30         Division of Medical Quality Assurance of the
31         Department of Health to conduct a study of
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 1         clinical and academic training requirements of
 2         certified optometric practitioners; providing
 3         for appointment of members; requiring a report
 4         to be submitted to the Governor and
 5         Legislature; amending s. 465.0265, F.S.;
 6         providing requirements for the filing of
 7         prescriptions by pharmacies that are under
 8         common ownership or that have a contractual
 9         relationship with one another; specifying
10         requirements for exceptions to prescription
11         transfers between certain pharmacies; amending
12         s. 466.006, F.S.; allowing certain dental
13         students to take the examinations required to
14         practice dentistry in this state under
15         specified conditions; providing a prerequisite
16         to licensure of such students; creating s.
17         466.0065, F.S.; allowing certain dental
18         students to take regional licensure
19         examinations under specified conditions;
20         restricting the applicability of examination
21         results to licensing in other jurisdictions;
22         requiring approval by the Board of Dentistry
23         and providing prerequisites to such approval;
24         creating the "Nick Oelrich Gift of Life Act";
25         amending s. 765.512, F.S., relating to
26         anatomical gifts; prohibiting modification of a
27         donor's intent; providing that a donor document
28         is legally binding; authorizing specified
29         persons to furnish a donor's medical records
30         upon request; amending s. 765.516, F.S.;
31         revising procedures by which the terms of an
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 1         anatomical gift may be amended or the gift may
 2         be revoked; amending s. 765.401, F.S.;
 3         providing additional persons who may be given a
 4         proxy for the making of health care decisions;
 5         requiring review by the facility's bioethics
 6         committee of decisions to withhold or withdraw
 7         life-prolonging procedures; requiring
 8         documentation of efforts to locate certain
 9         proxies; amending s. 641.19, F.S.; providing
10         that the term "speciality" does not include the
11         services of a licensed chiropractic physician
12         for purposes of the regulation of managed care;
13         providing a short title; requiring the Agency
14         for Workforce Innovation to establish a pilot
15         program for delivery of certified geriatric
16         specialty nursing education; specifying
17         eligibility requirements for certified nursing
18         assistants to obtain certified geriatric
19         specialty nursing education; specifying
20         requirements for the education of certified
21         nursing assistants to prepare for certification
22         as a certified geriatric specialist; creating a
23         Certified Geriatric Specialty Nursing
24         Initiative Steering Committee; providing for
25         the composition of and manner of appointment to
26         the Certified Geriatric Specialty Nursing
27         Initiative Steering Committee; providing
28         responsibilities of the steering committee;
29         providing for reimbursement for per diem and
30         travel expenses; requiring the Agency for
31         Workforce Innovation to conduct or contract for
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 1         an evaluation of the pilot program for delivery
 2         of certified geriatric specialty nursing
 3         education; requiring the evaluation to include
 4         recommendations regarding the expansion of the
 5         delivery of certified geriatric specialty
 6         nursing education in nursing homes; requiring
 7         the Agency for Workforce Innovation to report
 8         to the Governor and Legislature regarding the
 9         status and evaluation of the pilot program;
10         creating s. 464.0125, F.S.; providing
11         definitions; providing requirements for persons
12         to become certified geriatric specialists;
13         specifying fees; providing for articulation of
14         geriatric specialty nursing coursework and
15         practical nursing coursework; providing
16         practice standards and grounds for which
17         certified geriatric specialists may be subject
18         to discipline by the Board of Nursing; creating
19         restrictions on the use of professional nursing
20         titles; prohibiting the use of certain
21         professional titles; providing penalties;
22         authorizing approved nursing programs to
23         provide education for the preparation of
24         certified geriatric specialists without further
25         board approval; authorizing certified geriatric
26         specialists to supervise the activities of
27         others in nursing home facilities according to
28         rules by the Board of Nursing; revising
29         terminology relating to nursing to conform to
30         the certification of geriatric specialists;
31         amending s. 381.00315, F.S.; revising
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 1         requirements for the reactivation of the
 2         licenses of specified health care practitioners
 3         in the event of public health emergency to
 4         include certified geriatric specialists;
 5         amending s. 400.021, F.S.; including services
 6         provided by a certified geriatric specialist
 7         within the definition of nursing service;
 8         amending s. 400.211, F.S.; revising
 9         requirements for persons employed as nursing
10         assistants to conform to the certification of
11         certified geriatric specialists; amending s.
12         400.23, F.S.; specifying that certified
13         geriatric specialists shall be considered
14         licensed nursing staff; authorizing licensed
15         practical nurses to supervise the activities of
16         certified geriatric specialists in nursing home
17         facilities according to rules adopted by the
18         Board of Nursing; amending s. 409.908, F.S.;
19         revising the methodology for reimbursement of
20         Medicaid program providers to include services
21         of certified geriatric specialists; amending s.
22         458.303, F.S.; revising exceptions to the
23         practice of medicine to include services
24         delegated to a certified geriatric specialist
25         under specified circumstances; amending s.
26         1009.65, F.S.; revising eligibility for the
27         Medical Education Reimbursement and Loan
28         Repayment Program to include certified
29         geriatric specialists; amending s. 1009.66,
30         F.S.; revising eligibility requirements for the
31         Nursing Student Loan Forgiveness Program to
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 1         include certified geriatric specialists;
 2         providing an appropriation; amending s.
 3         464.201, F.S.; defining terms; amending s.
 4         464.202, F.S.; authorizing the Board of Nursing
 5         to adopt rules regarding the practice and
 6         supervision of certified nursing assistants;
 7         creating s. 831.311, F.S.; prohibiting the
 8         sale, manufacture, alteration, delivery,
 9         uttering, or possession of
10         counterfeit-resistant prescription blanks for
11         controlled substances; providing penalties;
12         amending s. 893.04, F.S.; providing additional
13         requirements for the dispensing of a controlled
14         substance listed in Schedule II, Schedule III,
15         or Schedule IV; providing rulemaking authority
16         to the Board of Pharmacy; creating s. 893.055,
17         F.S.; requiring the Department of Health to
18         establish an electronic system to monitor the
19         prescribing of controlled substances listed in
20         Schedule II, Schedule III, and Schedule IV;
21         requiring the dispensing of such controlled
22         substances to be reported through the system;
23         providing exceptions; providing reporting
24         requirements; providing penalties; providing
25         rulemaking authority to the department;
26         requiring the department to cover all costs for
27         the system; providing for an appropriation,
28         subject to availability of funds; providing
29         that a certain trust fund may not be used to
30         fund the program; creating s. 893.065, F.S.;
31         requiring the department to develop and adopt
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 1         by rule the form and content for a
 2         counterfeit-proof prescription blank for
 3         voluntary use by physicians to prescribe a
 4         controlled substance listed in Schedule II,
 5         Schedule III, or Schedule IV; providing an
 6         appropriation and authorizing positions;
 7         providing contingent applicability of
 8         penalties; amending s. 409.904, F.S.;
 9         postponing the effective date of changes to
10         standards for eligibility for certain optional
11         medical assistance, including coverage under
12         the medically needy program; providing
13         appropriations; providing for retroactive
14         application; providing effective dates,
15         including a contingent effective date.
16  
17  Be It Enacted by the Legislature of the State of Florida:
18  
19         Section 1.  James and Esther King Center for Universal
20  Research to Eradicate Disease.--
21         (1)  The Legislature finds that an estimated 128
22  million Americans suffer from acute, chronic, and degenerative
23  diseases and that biomedical research is the key to finding
24  cures for these diseases that negatively affect all
25  Floridians. The Legislature further finds that, while there is
26  much research being conducted throughout this state and
27  throughout the world, there is a lack of coordination of
28  efforts among researchers. The Legislature, therefore, finds
29  that there is a significant need for a coordinated effort if
30  the goal of curing disease is to be achieved. Moreover, the
31  Legislature finds that the biomedical technology sector meets
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 1  the criteria of a high-impact sector, pursuant to section
 2  288.108, Florida Statutes, having a high importance to this
 3  state's economy with a significant potential for growth and
 4  contribution to our universities and quality of life.
 5         (2)  It is the intent of the Legislature that Florida
 6  strive to become the nation's leader in biomedical research
 7  and commit itself to being the state to find cures for the
 8  most deadly and widespread diseases. It is further the intent
 9  of the Legislature that there be a coordinated effort among
10  the state's public and private universities and the biomedical
11  industry to discover such cures. Moreover, it is the intent of
12  the Legislature to expand the state economy by attracting
13  biomedical researchers and research companies to this state.
14         (3)  There is established the James and Esther King
15  Center for Universal Research to Eradicate Disease, which
16  shall be known as the "CURED."
17         (a)  The purpose of the center is to coordinate,
18  improve, expand, and monitor all biomedical research programs
19  within the state, facilitate funding opportunities, and foster
20  improved technology transfer of research findings into
21  clinical trials and widespread public use.
22         (b)  The goal of the center is to find cures for
23  diseases such as cancer, heart disease, lung disease,
24  diabetes, and neurological disorders, including Alzheimer's
25  disease, epilepsy, and Parkinson's disease.
26         (c)  The center shall hold an annual biomedical
27  technology summit in Florida to which biomedical researchers,
28  biomedical technology companies, business incubators,
29  pharmaceutical manufacturers, and others around the nation and
30  world are invited to share biomedical research findings in
31  order to expedite the discovery of cures.  Summit attendees
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 1  will be required to cover the costs of such attendance or
 2  obtain sponsorship for such attendance.
 3         (d)  The center shall encourage clinical trials in this
 4  state on research that holds promise of curing a disease or
 5  condition. The center shall facilitate partnerships between
 6  researchers, treating physicians, and community hospitals for
 7  the purpose of sharing new techniques and new research
 8  findings, as well as coordinating voluntary donations to
 9  ensure an adequate supply of adult stem cells or cord blood.
10         (e)  The center shall also encourage the discovery and
11  production in Florida of vaccines that prevent disease.
12         (f)  The center shall monitor the supply and demand
13  needs of researchers relating to stem cell research and other
14  types of human tissue research. If the center determines that
15  there is a need for increased donation of human tissue, it
16  shall notify hospitals licensed pursuant to chapter 395,
17  Florida Statutes, that have entered into partnership
18  agreements with research institutes conducting stem cell
19  research located in the same geographic region as the
20  researchers demanding the stem cells or other tissues. Such
21  hospitals shall then implement programs that encourage
22  voluntary donations of cord blood or other needed adult
23  tissue.
24         (g)  The center shall be funded through private, state,
25  and federal sources.
26         (h)  The center shall serve as a registry of all known
27  biomedical grant opportunities and may assist any public or
28  private biomedical research program in this state in preparing
29  grant requests.
30         (i)  The center shall maintain a website with links to
31  peer-reviewed biomedical research. The website shall also
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 1  contain a list of all known biomedical research being
 2  conducted in Florida and shall facilitate communication among
 3  researchers and other interested parties.
 4         (j)  The center shall submit an annual report to the
 5  Governor, the President of the Senate, and the Speaker of the
 6  House of Representatives no later than January 15 which
 7  contains recommendations for legislative change necessary to
 8  foster a positive climate for biomedical research in this
 9  state.
10         (k)  The duties of the center may be outsourced by the
11  Department of Health to a private entity or state university.
12         (4)  There is established within the center an advisory
13  council which shall meet at least annually.
14         (a)  The council shall consist of the members of the
15  board of directors of the Florida Research Consortium and at
16  least one representative from:
17         1.  The Emerging Technology Commission.
18         2.  Enterprise Florida, Inc.
19         3.  BioFlorida.
20         4.  The Florida Biomedical Research Advisory Council.
21         5.  The Florida Medical Foundation.
22         6.  Pharmaceutical Research and Manufacturers of
23  America.
24         (b)  Members of the council shall serve without
25  compensation and each organization represented shall cover all
26  expenses of its representative.
27         Section 2.  Paragraphs (a) and (b) of subsection (1),
28  subsection (2), and paragraph (f) of subsection (10) of
29  section 215.5602, Florida Statutes, are amended to read:
30         215.5602  Florida Biomedical Research Program.--
31  
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 1         (1)  There is established within the Department of
 2  Health the Florida Biomedical Research Program funded by the
 3  proceeds of the Lawton Chiles Endowment Fund pursuant to s.
 4  215.5601. The purpose of the Florida Biomedical Research
 5  Program is to provide an annual and perpetual source of
 6  funding in order to support research initiatives that address
 7  the health care problems of Floridians in the areas of
 8  tobacco-related cancer, cardiovascular disease, stroke, and
 9  pulmonary disease. The long-term goals of the program are to:
10         (a)  Improve the health of Floridians by researching
11  better prevention, diagnoses, and treatments, and cures for
12  cancer, cardiovascular disease, stroke, and pulmonary disease.
13         (b)  Expand the foundation of biomedical knowledge
14  relating to the prevention, diagnosis, and treatment, and cure
15  of diseases related to tobacco use, including cancer,
16  cardiovascular disease, stroke, and pulmonary disease.
17         (2)  Funds appropriated for the Florida Biomedical
18  Research Program shall be used exclusively for the award of
19  grants and fellowships as established in this section; for
20  research relating to the prevention, diagnosis, and treatment,
21  and cure of diseases related to tobacco use, including cancer,
22  cardiovascular disease, stroke, and pulmonary disease; and for
23  expenses incurred in the administration of this section.
24  Priority shall be granted to research designed to prevent or
25  cure disease.
26         (10)  The council shall submit an annual progress
27  report on the state of biomedical research in this state to
28  the Governor, the Secretary of Health, the President of the
29  Senate, and the Speaker of the House of Representatives by
30  February 1. The report must include:
31  
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 1         (f)  Progress in the prevention, diagnosis, and
 2  treatment, and cure of diseases related to tobacco use,
 3  including cancer, cardiovascular disease, stroke, and
 4  pulmonary disease.
 5         Section 3.  Florida Cancer Research Cooperative.--
 6         (1)  Effective July 1, 2003, the Florida Cancer
 7  Research Cooperative is established for the purpose of making
 8  the State of Florida a world class center for cancer research.
 9         (2)(a)  A not-for-profit corporation, acting as an
10  instrumentality of the Florida Dialogue on Cancer, shall be
11  organized for the purpose of governing the affairs of the
12  cooperative.
13         (b)  The Florida Cancer Research Cooperative, Inc., may
14  create not-for-profit corporate subsidiaries to fulfill its
15  mission. The not-for-profit corporation and its subsidiaries
16  are authorized to receive, hold, invest, and administer
17  property and any moneys acquired from private, local, state,
18  and federal sources, as well as technical and professional
19  income generated or derived from the mission-related
20  activities of the cooperative.
21         (c)  The affairs of the not-for-profit corporation
22  shall be managed by a board of directors which shall consist
23  of:
24         1.  The Secretary of the Department of Health or his or
25  her designee;
26         2.  The Chief Executive Officer of the H. Lee Moffitt
27  Cancer Center or his or her designee;
28         3.  The President of the University of Florida Shands
29  Cancer Center or his or her designee;
30  
31  
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 1         4.  The Chief Executive Officer of the University of
 2  Miami Sylvester Comprehensive Cancer Center or his or her
 3  designee;
 4         5.  The Chief Executive Officer of the Mayo Clinic,
 5  Jacksonville or his or her designee;
 6         6.  The Chief Executive Officer of the American Cancer
 7  Society, Florida Division or his or her designee;
 8         7.  The President of the American Cancer Society,
 9  Florida Division Board of Directors or his or her designee;
10         8.  The President of the Florida Society of Clinical
11  Oncology or his or her designee;
12         9.  The Chief Executive Officer of Enterprise Florida,
13  Inc., or his or her designee;
14         10.  Three representatives from large Florida hospitals
15  or institutions, not delineated in subparagraphs 1. through
16  6., that treat a large volume of cancer patients. One shall be
17  appointed by the Governor, one shall be appointed by the
18  Speaker of the House of Representatives, and one shall be
19  appointed by the President of the Senate;
20         11.  Three representatives from community-based,
21  statewide organizations serving populations that experience
22  cancer disparities, one of whom shall be appointed by the
23  Governor, one of whom shall be appointed by the Speaker of the
24  House of Representatives, and one of whom shall be appointed
25  by the President of the Senate;
26         12.  One member of the Florida House of
27  Representatives, to be appointed by the Speaker of the House
28  of Representatives;
29         13.  One member of the Florida Senate, to be appointed
30  by the President of the Senate;
31  
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 1         14.  Three university presidents, one of whom shall be
 2  appointed by the Governor, one of whom shall be appointed by
 3  the Speaker of the House of Representatives, and one of whom
 4  shall be appointed by the President of the Senate; and
 5         15.  Five representatives from other statewide public
 6  health organizations whose missions include public education
 7  and the eradication of cancer, three of whom shall be
 8  appointed by the Governor, one of whom shall be appointed by
 9  the Speaker of the House of Representatives, and one of whom
10  shall be appointed by the President of the Senate.
11         (d)  Appointments made by the Speaker of the House of
12  Representatives and the President of the Senate pursuant to
13  paragraph (c) shall be for 2-year terms, concurrent with the
14  bienniums in which they serve as presiding officers.
15         (e)  Appointments made by the Governor pursuant to
16  paragraph (c) shall be for 2-year terms, although the Governor
17  may reappoint directors.
18         (f)  Members of the board of directors of the
19  not-for-profit corporation or any subsidiaries shall serve
20  without compensation.
21         (3)  The cooperative shall issue an annual report to
22  the Governor, the Speaker of the House of Representatives, and
23  the President of the Senate, by December 15 of each year, with
24  policy and funding recommendations regarding cancer research
25  capacity in Florida and related issues.
26         Section 4.  Florida Cancer Research Cooperative;
27  mission and duties.--
28         (1)  The cooperative shall develop and centralize the
29  processes and shared services for expanding cancer research in
30  Florida through:
31  
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 1         (a)  Support through bioinformatics, in order to create
 2  a cancer informatics infrastructure that enhances information
 3  and resource exchange and integration through researchers
 4  working in diverse disciplines to facilitate the full spectrum
 5  of cancer investigations;
 6         (b)  Technical coordination, business development, and
 7  support of intellectual property;
 8         (c)  Development of a statewide cancer clinical trials
 9  network as contemplated in section 1; and
10         (d)  Other multidisciplinary research support
11  activities.
12         (2)  The cooperative shall work in concert with the
13  Center for Universal Research to Eradicate Disease created in
14  section 1 to ensure that the goals of the center are advanced.
15         Section 5.  Section 484.0512, Florida Statutes, is
16  amended to read:
17         484.0512  Thirty-day trial period; purchaser's right to
18  cancel; notice; refund; cancellation fee; criminal penalty
19  procedures.--
20         (1)  A person selling a hearing aid in this state must
21  provide the buyer with written notice of a 30-day trial period
22  and money-back guarantee. The guarantee must permit the
23  purchaser to cancel the purchase for a valid reason as defined
24  by rule of the board within 30 days after receiving the
25  hearing aid, by returning the hearing aid or mailing written
26  notice of cancellation to the seller. If the hearing aid must
27  be repaired, remade, or adjusted during the 30-day trial
28  period, the running of the 30-day trial period is suspended 1
29  day for each 24-hour period that the hearing aid is not in the
30  purchaser's possession. A repaired, remade, or adjusted
31  hearing aid must be claimed by the purchaser within 3 working
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    CS for CS for SB 2390                          First Engrossed
 1  days after notification of availability. The running of the
 2  30-day trial period resumes on the day the purchaser reclaims
 3  the repaired, remade, or adjusted hearing aid or on the fourth
 4  day after notification of availability.
 5         (2)  The board, in consultation with the Board of
 6  Speech-Language Pathology and Audiology, shall prescribe by
 7  rule the terms and conditions to be contained in the
 8  money-back guarantee and any exceptions thereto. Such rule
 9  shall provide, at a minimum, that the charges for earmolds and
10  service provided to fit the hearing aid may be retained by the
11  licensee. The rules shall also set forth any reasonable
12  charges to be held by the licensee as a cancellation fee. Such
13  rule shall be effective on or before December 1, 1994. Should
14  the board fail to adopt such rule, a licensee may not charge a
15  cancellation fee which exceeds 5 percent of the total charge
16  for a hearing aid alone. The terms and conditions of the
17  guarantee, including the total amount available for refund,
18  shall be provided in writing to the purchaser prior to the
19  signing of the contract.
20         (3)  Within 30 days after the return or attempted
21  return of the hearing aid, the seller shall refund all moneys
22  that must be refunded to a purchaser pursuant to this section.
23  A violation of this subsection is a misdemeanor of the first
24  degree, punishable as provided in s. 775.082 or s. 775.083.
25         (4)  For purposes of this section, the term "seller" or
26  "person selling a hearing aid" includes:
27         (a)  Any natural person licensed under this part or any
28  other natural person who signs a sales receipt required by s.
29  484.051(2) or s. 468.1245(2) or who otherwise fits, delivers,
30  or dispenses a hearing aid.
31  
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    CS for CS for SB 2390                          First Engrossed
 1         (b)  Any business organization, whether a sole
 2  proprietorship, partnership, corporation, professional
 3  association, joint venture, business trust, or other legal
 4  entity, which dispenses a hearing aid or enters into an
 5  agreement to dispense a hearing aid.
 6         (c)  Any person who controls, manages, or operates an
 7  establishment or business that dispenses a hearing aid or
 8  enters into an agreement to dispense a hearing aid.
 9         Section 6.  Effective upon this act becoming a law,
10  subsection (1) of section 456.073, Florida Statutes, is
11  amended to read:
12         456.073  Disciplinary proceedings.--Disciplinary
13  proceedings for each board shall be within the jurisdiction of
14  the department.
15         (1)  The department, for the boards under its
16  jurisdiction, shall cause to be investigated any complaint
17  that is filed before it if the complaint is in writing, signed
18  by the complainant, and legally sufficient. A complaint filed
19  by a state prisoner against a health care practitioner
20  employed by or otherwise providing health care services within
21  a facility of the Department of Corrections is not legally
22  sufficient unless there is a showing that the prisoner
23  complainant has exhausted all available administrative
24  remedies within the state correctional system before filing
25  the complaint. However, if the department determines after a
26  preliminary inquiry of a state prisoner's complaint, that the
27  practitioner may present a serious threat to the health and
28  safety of any individual who is not a state prisoner, the
29  department may determine legal sufficiency and proceed with
30  discipline. The Department of Health shall be notified within
31  15 days whenever the Department of Corrections disciplines or
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    CS for CS for SB 2390                          First Engrossed
 1  allows a health care practitioner to resign for an offense
 2  related to the practice of his or her profession. A complaint
 3  is legally sufficient if it contains ultimate facts that show
 4  that a violation of this chapter, of any of the practice acts
 5  relating to the professions regulated by the department, or of
 6  any rule adopted by the department or a regulatory board in
 7  the department has occurred. In order to determine legal
 8  sufficiency, the department may require supporting information
 9  or documentation. The department may investigate, and the
10  department or the appropriate board may take appropriate final
11  action on, a complaint even though the original complainant
12  withdraws it or otherwise indicates a desire not to cause the
13  complaint to be investigated or prosecuted to completion. The
14  department may investigate an anonymous complaint if the
15  complaint is in writing and is legally sufficient, if the
16  alleged violation of law or rules is substantial, and if the
17  department has reason to believe, after preliminary inquiry,
18  that the violations alleged in the complaint are true. The
19  department may investigate a complaint made by a confidential
20  informant if the complaint is legally sufficient, if the
21  alleged violation of law or rule is substantial, and if the
22  department has reason to believe, after preliminary inquiry,
23  that the allegations of the complainant are true. The
24  department may initiate an investigation if it has reasonable
25  cause to believe that a licensee or a group of licensees has
26  violated a Florida statute, a rule of the department, or a
27  rule of a board. Except as provided in ss. 458.331(9),
28  459.015(9), 460.413(5), and 461.013(6), when an investigation
29  of any subject is undertaken, the department shall promptly
30  furnish to the subject or the subject's attorney a copy of the
31  complaint or document that resulted in the initiation of the
                                  18
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    CS for CS for SB 2390                          First Engrossed
 1  investigation. The subject may submit a written response to
 2  the information contained in such complaint or document within
 3  20 days after service to the subject of the complaint or
 4  document. The subject's written response shall be considered
 5  by the probable cause panel. The right to respond does not
 6  prohibit the issuance of a summary emergency order if
 7  necessary to protect the public. However, if the secretary, or
 8  the secretary's designee, and the chair of the respective
 9  board or the chair of its probable cause panel agree in
10  writing that such notification would be detrimental to the
11  investigation, the department may withhold notification. The
12  department may conduct an investigation without notification
13  to any subject if the act under investigation is a criminal
14  offense.
15         Section 7.  (1)  The Division of Medical Quality
16  Assurance of the Department of Health shall conduct a study of
17  clinical and academic training requirements of certified
18  optometric practitioners, licensed pursuant to chapter 463,
19  Florida Statutes, to determine the extent to which prescribing
20  authority may be expanded. The study group shall be composed
21  of the following members:
22         (a)  One pharmacologist representing the University of
23  Florida;
24         (b)  One pharmacologist representing Nova Southeastern
25  University;
26         (c)  One pharmacologist representing Florida
27  Agricultural and Mechanical University;
28         (d)  One ophthalmologist representing Mayo Clinic
29  Jacksonville;
30         (e)  One ophthalmologist representing Bascom Palmer Eye
31  Institute;
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 1         (f)  One board-certified internist appointed by the
 2  University of South Florida;
 3         (g)  One optometrist representing the Florida Board of
 4  Optometry;
 5         (h)  One certified optometric practitioner representing
 6  the Florida Optometric Association; and
 7         (i)  One certified optometric practitioner appointed by
 8  the Nova Southeastern University College of Optometry.
 9         (2)  The study group shall be chaired by the Secretary
10  of Health or his or her designee. The study shall be completed
11  and a final report presented to the Governor, the President of
12  the Senate, and the Speaker of the House of Representatives by
13  January 15, 2004. If applicable, a minority report shall be
14  completed and presented to the Governor, the President of the
15  Senate, and the Speaker of the House of Representatives by
16  January 31, 2004.
17         (3)  This section shall take effect upon becoming a
18  law.
19         Section 8.  Present subsection (4) of section 465.0265,
20  Florida Statutes, is redesignated as subsection (5), and a new
21  subsection (4) is added to that section, to read:
22         465.0265  Centralized prescription filling.--
23         (4)  Pharmacies accessing the same prescription records
24  in a centralized database or pharmacy computers linked in any
25  other manner may refill or dispense prescriptions at the
26  request of another pharmacy so linked if the pharmacies have
27  the same owner or have a written contract specifying the
28  services to be provided by each pharmacy, the responsibilities
29  of each pharmacy, and the manner in which the pharmacies will
30  comply with federal and state laws and rules. Prescriptions
31  refilled or dispensed using such a system shall not be
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    CS for CS for SB 2390                          First Engrossed
 1  considered prescription transfers or copies if the computer
 2  system registers a complete and full audit trail of all
 3  activities and includes the identification of the pharmacies
 4  and pharmacists accessing the centralized database and if the
 5  system restricts access to the computerized prescription
 6  records to pharmacies or other authorized personnel.
 7         Section 9.  Subsection (2) of section 466.006, Florida
 8  Statutes, is amended to read:
 9         466.006  Examination of dentists.--
10         (2)  An applicant shall be entitled to take the
11  examinations required in this section to practice dentistry in
12  this state if the applicant:
13         (a)  Is 18 years of age or older.
14         (b)1.  Is a graduate of a dental school accredited by
15  the Commission on Accreditation of the American Dental
16  Association or its successor agency, if any, or any other
17  nationally recognized accrediting agency; or.
18         2.  Is a dental student in the final year of a program
19  at such an accredited school who has completed all the
20  coursework necessary to prepare the student to perform the
21  clinical and diagnostic procedures required to pass the
22  examinations. With respect to a dental student in the final
23  year of a program at a dental school, a passing score on the
24  examinations is valid for 180 days after the date the
25  examinations were completed. A dental school student who takes
26  the licensure examinations during the student's final year of
27  an approved dental school must have graduated before being
28  certified for licensure pursuant to s. 466.011.
29         (c)  Has successfully completed the National Board of
30  Dental Examiners dental examination within 10 years of the
31  date of application.
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 1         Section 10.  Section 466.0065, Florida Statutes, is
 2  created to read:
 3         466.0065  Regional licensure examinations.--
 4         (1)  It is the intent of the Legislature that schools
 5  of dentistry be allowed to offer regional licensure
 6  examinations to dental students who are in the final year of a
 7  program at an approved dental school for the sole purpose of
 8  facilitating the student's licensing in other jurisdictions.
 9  This section does not allow a person to be licensed as a
10  dentist in this state without taking the examinations as set
11  forth in s. 466.006, nor does this section mean that regional
12  examinations administered under this section may be
13  substituted for complying with testing requirements under s.
14  466.006.
15         (2)  Each school of dentistry in this state which is
16  accredited by the Commission on Accreditation of the American
17  Dental Association or its successor agency may, upon written
18  approval by the Board of Dentistry, offer regional licensure
19  examinations only to dental students in the final year of a
20  program at an approved dental school, if the board has
21  approved the hosting school's written plan to comply with the
22  following conditions:
23         (a)  The examining body must be a member of the
24  American Association of Dental Examiners.
25         (b)  The student must have successfully completed parts
26  I and II of the National Board of Dental Examiners examination
27  within 2 years before taking the regional examination.
28         (c)  The student must possess medical malpractice
29  insurance in amounts that the board determines to be
30  sufficient to cover any reasonably forseeable incident of harm
31  
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 1  to a patient during the clinical portion of the regional
 2  examination.
 3         (d)  At least one of the examination monitors must be a
 4  dentist licensed in this state who has completed all necessary
 5  standardization exercises required by the regional examination
 6  body.
 7         (e)  Adequate arrangements must be made, when
 8  necessary, for patients who require followup care as a result
 9  of procedures performed during the clinical portion of the
10  regional examination.
11         (f)  The board chair or the chair's designee must be
12  allowed to observe testing while it is in progress.
13         (g)  Each student, upon applying to take the regional
14  examination, must receive written disclosure in at least
15  12-point boldface type which states: "This examination does
16  not meet the licensure requirements of chapter 466, Florida
17  Statutes, for licensure in the State of Florida. Persons
18  wishing to practice dentistry in Florida must pass the Florida
19  licensure examinations. For more information on Florida's
20  licensure examination procedures, please contact the Florida
21  Board of Dentistry."
22         (h)  The student must be enrolled as a dental student
23  in the student's final year of a program at an approved dental
24  school that is accredited by the Commission on Accreditation
25  of the American Dental Association or its successor agency.
26         (i)  The student must have completed all the coursework
27  necessary to prepare the student to perform all clinical and
28  diagnostic procedures required to pass the regional
29  examination.
30         (j)  The student's academic record must not include any
31  evidence suggesting that the student poses an unreasonable
                                  23
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 1  risk to any live patients who are required for the clinical
 2  portion of the regional examination. In order to protect the
 3  health and safety of the public, the board may request
 4  additional information and documents pertaining to the
 5  candidate's mental and physical health in order to fully
 6  assess the candidate's fitness to engage in exercises
 7  involving a live patient.
 8         (3)  A student who takes the examination pursuant to
 9  this section, a dental school that submits a plan pursuant to
10  this section, or a regional examination body that a dental
11  school proposes to host under this section does not have
12  standing to assert that a state agency has taken action for
13  which a hearing may be sought under ss. 120.569 and 120.57.
14         Section 11.  This act may be cited as the "Nick Oelrich
15  Gift of Life Act."
16         Section 12.  Subsections (1), (2), and (6) of section
17  765.512, Florida Statutes, are amended to read:
18         765.512  Persons who may make an anatomical gift.--
19         (1)  Any person who may make a will may give all or
20  part of his or her body for any purpose specified in s.
21  765.510, the gift to take effect upon death.  An anatomical
22  gift made by an adult donor and not revoked by the donor as
23  provided in s. 765.516 is irrevocable and does not require the
24  consent or concurrence of any person after the donor's death.
25  A family member, guardian, representative ad litem, or health
26  care surrogate of an adult donor who has made an anatomical
27  gift pursuant to subsection (2) may not modify, deny or
28  prevent a donor's wish or intent to make an anatomical gift
29  from being made after the donor's death.
30         (2)  If the decedent has executed an agreement
31  concerning an anatomical gift, by including signing an organ
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    CS for CS for SB 2390                          First Engrossed
 1  and tissue donor card, by expressing his or her wish to donate
 2  in a living will or advance directive, or by signifying his or
 3  her intent to donate on his or her driver's license or in some
 4  other written form has indicated his or her wish to make an
 5  anatomical gift, and in the absence of actual notice of
 6  contrary indications by the decedent, the document is evidence
 7  of legally sufficient informed consent to donate an anatomical
 8  gift and is legally binding. Any surrogate designated by the
 9  decedent pursuant to part II of this chapter may give all or
10  any part of the decedent's body for any purpose specified in
11  s. 765.510.
12         (6)  A gift of all or part of a body authorizes:
13         (a)  Any examination necessary to assure medical
14  acceptability of the gift for the purposes intended.
15         (b)  The decedent's medical provider, family, or a
16  third party to furnish medical records requested concerning
17  the decedent's medical and social history.
18         Section 13.  Section 765.516, Florida Statutes, is
19  amended to read:
20         765.516  Amendment of the terms of or the revocation of
21  the gift.--
22         (1)  A donor may amend the terms of or revoke an
23  anatomical gift by:
24         (a)  The execution and delivery to the donee of a
25  signed statement.
26         (b)  An oral statement that is:
27         1.  Made to the donor's spouse; or
28         2. made in the presence of two persons, one of whom
29  must not be a family member, and communicated to the donor's
30  family or attorney or to the donee.
31  
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 1         (c)  A statement during a terminal illness or injury
 2  addressed to an attending physician, who must communicate the
 3  revocation of the gift to the procurement organization that is
 4  certified by the state.
 5         (d)  A signed document found on or about the donor's
 6  person or in the donor's effects.
 7         (2)  Any gift made by a will may also be amended or
 8  revoked in the manner provided for amendment or revocation of
 9  wills or as provided in subsection (1).
10         Section 14.  Subsection (1) of section 765.401, Florida
11  Statutes, is amended to read:
12         765.401  The proxy.--
13         (1)  If an incapacitated or developmentally disabled
14  patient has not executed an advance directive, or designated a
15  surrogate to execute an advance directive, or the designated
16  or alternate surrogate is no longer available to make health
17  care decisions, health care decisions may be made for the
18  patient by any of the following individuals, in the following
19  order of priority, if no individual in a prior class is
20  reasonably available, willing, or competent to act:
21         (a)  The judicially appointed guardian of the patient
22  or the guardian advocate of the person having a developmental
23  disability as defined in s. 393.063, who has been authorized
24  to consent to medical treatment, if such guardian has
25  previously been appointed; however, this paragraph shall not
26  be construed to require such appointment before a treatment
27  decision can be made under this subsection;
28         (b)  The patient's spouse;
29         (c)  An adult child of the patient, or if the patient
30  has more than one adult child, a majority of the adult
31  children who are reasonably available for consultation;
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 1         (d)  A parent of the patient;
 2         (e)  The adult sibling of the patient or, if the
 3  patient has more than one sibling, a majority of the adult
 4  siblings who are reasonably available for consultation;
 5         (f)  An adult relative of the patient who has exhibited
 6  special care and concern for the patient and who has
 7  maintained regular contact with the patient and who is
 8  familiar with the patient's activities, health, and religious
 9  or moral beliefs; or
10         (g)  A close friend of the patient; or.
11         (h)  A clinical social worker licensed pursuant to
12  chapter 491, or a graduate of a court-approved guardianship
13  program. Such a proxy must be selected by the provider's
14  bioethics committee and must not be employed by the provider.
15  If the provider does not have a bioethics committee, then such
16  a proxy may be chosen through an arrangement with the
17  bioethics committee of another provider. The proxy must be
18  notified that upon request the provider shall make available a
19  second physician, not involved in the patient's care, to
20  assist the proxy in evaluating treatment. Decisions to
21  withhold or withdraw life-prolonging procedures must be
22  reviewed by the facility's bioethics committee. Documentation
23  of efforts to locate proxies from prior classes must be
24  recorded in the patient record.
25         Section 15.  Subsection (22) is added to section
26  641.19, Florida Statutes, to read:
27         641.19  Definitions.--As used in this part, the term:
28         (22)  "Specialty" does not include services performed
29  by a chiropractic physician licensed under chapter 460.
30         Section 16.  This act may be cited as the "Clara Ramsey
31  Care of the Elderly Act."
                                  27
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 1         Section 17.  Certified Geriatric Specialist Preparation
 2  Pilot Program.--
 3         (1)  The Agency for Workforce Innovation shall
 4  establish a pilot program for delivery of geriatric nursing
 5  education to certified nursing assistants who wish to become
 6  certified geriatric specialists. The agency shall select two
 7  pilot sites in nursing homes that have received the Gold Seal
 8  designation under section 400.235, Florida Statutes; have been
 9  designated as a teaching nursing home under section 430.80,
10  Florida Statutes; or have not received a class I or class II
11  deficiency within the 30 months preceding application for this
12  program.
13         (2)  To be eligible to receive geriatric nursing
14  education, a certified nursing assistant must have been
15  employed by a participating nursing home for at least 1 year
16  and have received a high school diploma or its equivalent.
17         (3)  The education shall be provided at the worksite
18  and in coordination with the certified nursing assistant's
19  work schedule.
20         (4)  Faculty shall provide the instruction under an
21  approved nursing program pursuant to section 464.019, Florida
22  Statutes.
23         (5)  The education shall prepare the certified nursing
24  assistant to meet the requirements for certification as a
25  geriatric specialist. The didactic and clinical education
26  shall include all portions of the practical nursing curriculum
27  pursuant to section 464.019, Florida Statutes, except for
28  pediatric and obstetric/maternal-child education, and shall
29  include additional education in the care of ill, injured, or
30  infirm geriatric patients and the maintenance of health, the
31  
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 1  prevention of injury, and the provision of palliative care for
 2  geriatric patients.
 3         Section 18.  Certified Geriatric Specialty Nursing
 4  Initiative Steering Committee.--
 5         (1)  In order to guide the implementation of the
 6  Certified Geriatric Specialist Preparation Pilot Program,
 7  there is created a Certified Geriatric Specialty Nursing
 8  Initiative Steering Committee. The steering committee shall be
 9  composed of the following members:
10         (a)  The chair of the Board of Nursing or his or her
11  designee;
12         (b)  A representative of the Agency for Workforce
13  Innovation, appointed by the Director of Workforce Innovation;
14         (c)  A representative of Workforce Florida, Inc.,
15  appointed by the chair of the Board of Directors of Workforce
16  Florida, Inc.;
17         (d)  A representative of the Department of Education,
18  appointed by the Secretary of Education;
19         (e)  A representative of the Agency for Health Care
20  Administration, appointed by the Secretary of Health Care
21  Administration;
22         (f)  The Director of the Florida Center for Nursing;
23  and
24         (g)  A representative of a Gold Seal nursing home that
25  is not one of the pilot program sites, appointed by the
26  Secretary of Health Care Administration.
27         (2)  The steering committee shall:
28         (a)  Provide consultation and guidance to the Agency
29  for Workforce Innovation on matters of policy during the
30  implementation of the pilot program; and
31  
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 1         (b)  Provide oversight to the evaluation of the pilot
 2  program.
 3         (3)  Members of the steering committee are entitled to
 4  reimbursement for per diem and travel expenses under section
 5  112.061, Florida Statutes.
 6         (4)  The steering committee shall complete its
 7  activities by June 30, 2006, and the authorization for the
 8  steering committee ends on that date.
 9         Section 19.  Evaluation of the Certified Geriatric
10  Specialist Preparation Pilot Program.--The Agency for
11  Workforce Innovation, in consultation with the Certified
12  Geriatric Specialty Nursing Initiative Steering Committee,
13  shall conduct, or contract for an evaluation of the pilot
14  program. The agency shall ensure that an evaluation report is
15  submitted to the Governor, the President of the Senate, and
16  the Speaker of the House of Representatives by January 1,
17  2006. The evaluation must address the experience and success
18  of the certified nursing assistants in the pilot program and
19  must contain recommendations regarding the expansion of the
20  delivery of geriatric nursing education in nursing homes.
21         Section 20.  Reports.--The Agency for Workforce
22  Innovation shall submit status reports and recommendations
23  regarding legislation necessary to further the implementation
24  of the pilot program to the Governor, the President of the
25  Senate, and the Speaker of the House of Representatives on
26  January 1, 2004, January 1, 2005, and January 1, 2006.
27         Section 21.  Section 464.0125, Florida Statutes, is
28  created to read:
29         464.0125  Certified geriatric specialists;
30  certification requirements.--
31         (1)  DEFINITIONS; RESPONSIBILITIES.--
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 1         (a)  As used in this section, the term:
 2         1.  "Certified geriatric specialist" means a person who
 3  meets the qualifications specified in this section and who is
 4  certified by the board to practice as a certified geriatric
 5  specialist.
 6         2.  "Geriatric patient" means any patient who is 60
 7  years of age or older.
 8         3.  "Practice of certified geriatric specialty nursing"
 9  means the performance of selected acts in facilities licensed
10  under part II or part III of chapter 400, including the
11  administration of treatments and medications, in the care of
12  ill, injured, or infirm geriatric patients and the promotion
13  of wellness, maintenance of health, and prevention of illness
14  of geriatric patients under the direction of a registered
15  nurse, a licensed physician, a licensed osteopathic physician,
16  a licensed podiatric physician, or a licensed dentist. The
17  scope of practice of a certified geriatric specialist includes
18  the practice of practical nursing as defined in s. 464.003 for
19  geriatric patients only, except for any act in which
20  instruction and clinical knowledge of pediatric nursing or
21  obstetric/maternal-child nursing is required. A certified
22  geriatric specialist, while providing nursing services in
23  facilities licensed under part II or part III of chapter 400,
24  may supervise the activities of certified nursing assistants
25  and other unlicensed personnel providing services in such
26  facilities in accordance with rules adopted by the board.
27         (b)  The certified geriatric specialist shall be
28  responsible and accountable for making decisions that are
29  based upon the individual's educational preparation and
30  experience in performing certified geriatric specialty
31  nursing.
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 1         (2)  CERTIFICATION.--
 2         (a)  Any certified nursing assistant desiring to be
 3  certified as a certified geriatric specialist shall apply to
 4  the department and submit proof that he or she holds a current
 5  certificate as a certified nursing assistant under this part
 6  and has satisfactorily completed the following requirements:
 7         1.  Is in good mental and physical health, is a
 8  recipient of a high school diploma or its equivalent and has
 9  completed the requirements for graduation from an approved
10  program for nursing or its equivalent, as determined by the
11  board, for the preparation of licensed practical nurses,
12  except for instruction and clinical knowledge of pediatric
13  nursing or obstetric/maternal-child nursing. Any program that
14  is approved on July 1, 2003, by the board for the preparation
15  of registered nurses or licensed practical nurses may provide
16  education for the preparation of certified geriatric
17  specialists without further board approval.
18         2.  Has the ability to communicate in the English
19  language, which may be determined by an examination given by
20  the department.
21         3.  Has provided sufficient information, which must be
22  submitted by the department for a statewide criminal records
23  correspondence check through the Department of Law
24  Enforcement.
25         (b)  Each applicant who meets the requirements of this
26  subsection shall, unless denied pursuant to s. 464.018, be
27  entitled to certification as a certified geriatric specialist.
28  The board shall certify, and the department shall issue a
29  certificate to practice as a certified geriatric specialist
30  to, any certified nursing assistant meeting the qualifications
31  in this section. The board shall establish an application fee
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    CS for CS for SB 2390                          First Engrossed
 1  not to exceed $100 and a biennial renewal fee not to exceed
 2  $50. The board may adopt rules to administer this section.
 3         (c)  A person receiving certification under this
 4  section shall:
 5         1.  Work only within the confines of a facility
 6  licensed under part II or part III of chapter 400.
 7         2.  Care for geriatric patients only.
 8         3.  Comply with the minimum standards of practice for
 9  nurses and be subject to disciplinary action for violations of
10  s. 464.018.
11         (3)  ARTICULATION.--Any certified geriatric specialist
12  who completes the additional instruction and coursework in an
13  approved nursing program pursuant to s. 464.019 for the
14  preparation of practical nursing in the areas of pediatric
15  nursing and obstetric/maternal-child nursing shall, unless
16  denied pursuant to s. 464.018, be entitled to licensure as a
17  licensed practical nurse if the applicant otherwise meets the
18  requirements of s. 464.008.
19         (4)  TITLES AND ABBREVIATIONS; RESTRICTIONS;
20  PENALTIES.--
21         (a)  Only persons who hold certificates to practice as
22  certified geriatric specialists in this state or who are
23  performing services within the practice of certified geriatric
24  specialty nursing pursuant to the exception set forth in s.
25  464.022(8) shall have the right to use the title "Certified
26  Geriatric Specialist" and the abbreviation "C.G.S."
27         (b)  No person shall practice or advertise as, or
28  assume the title of, certified geriatric specialist or use the
29  abbreviation "C.G.S." or take any other action that would lead
30  the public to believe that person was certified as such or is
31  performing services within the practice of certified geriatric
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    CS for CS for SB 2390                          First Engrossed
 1  specialty nursing pursuant to the exception set forth in s.
 2  464.022(8), unless that person is certified to practice as
 3  such.
 4         (c)  A violation of this subsection is a misdemeanor of
 5  the first degree, punishable as provided in s. 775.082 or s.
 6  775.083.
 7         (5)  VIOLATIONS AND PENALTIES.--Practicing certified
 8  geriatric specialty nursing, as defined in this section,
 9  without holding an active certificate to do so constitutes a
10  felony of the third degree, punishable as provided in s.
11  775.082, s. 775.083, or s. 775.084.
12         Section 22.  Paragraph (b) of subsection (1) of section
13  381.00315, Florida Statutes, is amended to read:
14         381.00315  Public health advisories; public health
15  emergencies.--The State Health Officer is responsible for
16  declaring public health emergencies and issuing public health
17  advisories.
18         (1)  As used in this section, the term:
19         (b)  "Public health emergency" means any occurrence, or
20  threat thereof, whether natural or man made, which results or
21  may result in substantial injury or harm to the public health
22  from infectious disease, chemical agents, nuclear agents,
23  biological toxins, or situations involving mass casualties or
24  natural disasters. Prior to declaring a public health
25  emergency, the State Health Officer shall, to the extent
26  possible, consult with the Governor and shall notify the Chief
27  of Domestic Security Initiatives as created in s. 943.03. The
28  declaration of a public health emergency shall continue until
29  the State Health Officer finds that the threat or danger has
30  been dealt with to the extent that the emergency conditions no
31  longer exist and he or she terminates the declaration.
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 1  However, a declaration of a public health emergency may not
 2  continue for longer than 60 days unless the Governor concurs
 3  in the renewal of the declaration. The State Health Officer,
 4  upon declaration of a public health emergency, may take
 5  actions that are necessary to protect the public health. Such
 6  actions include, but are not limited to:
 7         1.  Directing manufacturers of prescription drugs or
 8  over-the-counter drugs who are permitted under chapter 499 and
 9  wholesalers of prescription drugs located in this state who
10  are permitted under chapter 499 to give priority to the
11  shipping of specified drugs to pharmacies and health care
12  providers within geographic areas that have been identified by
13  the State Health Officer. The State Health Officer must
14  identify the drugs to be shipped. Manufacturers and
15  wholesalers located in the state must respond to the State
16  Health Officer's priority shipping directive before shipping
17  the specified drugs.
18         2.  Notwithstanding chapters 465 and 499 and rules
19  adopted thereunder, directing pharmacists employed by the
20  department to compound bulk prescription drugs and provide
21  these bulk prescription drugs to physicians and nurses of
22  county health departments or any qualified person authorized
23  by the State Health Officer for administration to persons as
24  part of a prophylactic or treatment regimen.
25         3.  Notwithstanding s. 456.036, temporarily
26  reactivating the inactive license of the following health care
27  practitioners, when such practitioners are needed to respond
28  to the public health emergency: physicians licensed under
29  chapter 458 or chapter 459; physician assistants licensed
30  under chapter 458 or chapter 459; certified geriatric
31  specialists certified under part I of chapter 464; licensed
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    CS for CS for SB 2390                          First Engrossed
 1  practical nurses, registered nurses, and advanced registered
 2  nurse practitioners licensed under part I of chapter 464;
 3  respiratory therapists licensed under part V of chapter 468;
 4  and emergency medical technicians and paramedics certified
 5  under part III of chapter 401. Only those health care
 6  practitioners specified in this paragraph who possess an
 7  unencumbered inactive license and who request that such
 8  license be reactivated are eligible for reactivation. An
 9  inactive license that is reactivated under this paragraph
10  shall return to inactive status when the public health
11  emergency ends or prior to the end of the public health
12  emergency if the State Health Officer determines that the
13  health care practitioner is no longer needed to provide
14  services during the public health emergency. Such licenses may
15  only be reactivated for a period not to exceed 90 days without
16  meeting the requirements of s. 456.036 or chapter 401, as
17  applicable.
18         4.  Ordering an individual to be examined, tested,
19  vaccinated, treated, or quarantined for communicable diseases
20  that have significant morbidity or mortality and present a
21  severe danger to public health. Individuals who are unable or
22  unwilling to be examined, tested, vaccinated, or treated for
23  reasons of health, religion, or conscience may be subjected to
24  quarantine.
25         a.  Examination, testing, vaccination, or treatment may
26  be performed by any qualified person authorized by the State
27  Health Officer.
28         b.  If the individual poses a danger to the public
29  health, the State Health Officer may subject the individual to
30  quarantine. If there is no practical method to quarantine the
31  
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    CS for CS for SB 2390                          First Engrossed
 1  individual, the State Health Officer may use any means
 2  necessary to vaccinate or treat the individual.
 3  
 4  Any order of the State Health Officer given to effectuate this
 5  paragraph shall be immediately enforceable by a law
 6  enforcement officer under s. 381.0012.
 7         Section 23.  Subsection (14) of section 400.021,
 8  Florida Statutes, is amended to read:
 9         400.021  Definitions.--When used in this part, unless
10  the context otherwise requires, the term:
11         (14)  "Nursing service" means such services or acts as
12  may be rendered, directly or indirectly, to and in behalf of a
13  person by individuals as defined in ss. s. 464.003 and
14  464.0125.
15         Section 24.  Subsection (1) of section 400.211, Florida
16  Statutes, is amended to read:
17         400.211  Persons employed as nursing assistants;
18  certification requirement.--
19         (1)  To serve as a nursing assistant in any nursing
20  home, a person must be certified as a nursing assistant under
21  part II of chapter 464, unless the person is a registered
22  nurse, a or practical nurse, or a certified geriatric
23  specialist certified or licensed in accordance with part I of
24  chapter 464 or an applicant for such licensure who is
25  permitted to practice nursing in accordance with rules adopted
26  by the Board of Nursing pursuant to part I of chapter 464.
27         Section 25.  Paragraphs (a) and (c) of subsection (3)
28  of section 400.23, Florida Statutes, are amended to read:
29         400.23  Rules; evaluation and deficiencies; licensure
30  status.--
31  
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    CS for CS for SB 2390                          First Engrossed
 1         (3)(a)  The agency shall adopt rules providing for the
 2  minimum staffing requirements for nursing homes. These
 3  requirements shall include, for each nursing home facility, a
 4  minimum certified nursing assistant staffing of 2.3 hours of
 5  direct care per resident per day beginning January 1, 2002,
 6  increasing to 2.6 hours of direct care per resident per day
 7  beginning January 1, 2003, and increasing to 2.9 hours of
 8  direct care per resident per day beginning January 1, 2004.
 9  Beginning January 1, 2002, no facility shall staff below one
10  certified nursing assistant per 20 residents, and a minimum
11  licensed nursing staffing of 1.0 hour of direct resident care
12  per resident per day but never below one licensed nurse per 40
13  residents. For purposes of computing nursing staffing minimums
14  and ratios, certified geriatric specialists shall be
15  considered licensed nursing staff. Nursing assistants employed
16  under s. 400.211(2) may be included in computing the staffing
17  ratio for certified nursing assistants only if they provide
18  nursing assistance services to residents on a full-time basis.
19  Each nursing home must document compliance with staffing
20  standards as required under this paragraph and post daily the
21  names of staff on duty for the benefit of facility residents
22  and the public. The agency shall recognize the use of licensed
23  nurses for compliance with minimum staffing requirements for
24  certified nursing assistants, provided that the facility
25  otherwise meets the minimum staffing requirements for licensed
26  nurses and that the licensed nurses so recognized are
27  performing the duties of a certified nursing assistant. Unless
28  otherwise approved by the agency, licensed nurses counted
29  towards the minimum staffing requirements for certified
30  nursing assistants must exclusively perform the duties of a
31  certified nursing assistant for the entire shift and shall not
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    CS for CS for SB 2390                          First Engrossed
 1  also be counted towards the minimum staffing requirements for
 2  licensed nurses. If the agency approved a facility's request
 3  to use a licensed nurse to perform both licensed nursing and
 4  certified nursing assistant duties, the facility must allocate
 5  the amount of staff time specifically spent on certified
 6  nursing assistant duties for the purpose of documenting
 7  compliance with minimum staffing requirements for certified
 8  and licensed nursing staff. In no event may the hours of a
 9  licensed nurse with dual job responsibilities be counted
10  twice.
11         (c)  Licensed practical nurses licensed under chapter
12  464 who are providing nursing services in nursing home
13  facilities under this part may supervise the activities of
14  other licensed practical nurses, certified geriatric
15  specialists, certified nursing assistants, and other
16  unlicensed personnel providing services in such facilities in
17  accordance with rules adopted by the Board of Nursing.
18         Section 26.  Paragraph (b) of subsection (2) of section
19  409.908, Florida Statutes, is amended to read:
20         409.908  Reimbursement of Medicaid providers.--Subject
21  to specific appropriations, the agency shall reimburse
22  Medicaid providers, in accordance with state and federal law,
23  according to methodologies set forth in the rules of the
24  agency and in policy manuals and handbooks incorporated by
25  reference therein.  These methodologies may include fee
26  schedules, reimbursement methods based on cost reporting,
27  negotiated fees, competitive bidding pursuant to s. 287.057,
28  and other mechanisms the agency considers efficient and
29  effective for purchasing services or goods on behalf of
30  recipients. If a provider is reimbursed based on cost
31  reporting and submits a cost report late and that cost report
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    CS for CS for SB 2390                          First Engrossed
 1  would have been used to set a lower reimbursement rate for a
 2  rate semester, then the provider's rate for that semester
 3  shall be retroactively calculated using the new cost report,
 4  and full payment at the recalculated rate shall be affected
 5  retroactively. Medicare-granted extensions for filing cost
 6  reports, if applicable, shall also apply to Medicaid cost
 7  reports. Payment for Medicaid compensable services made on
 8  behalf of Medicaid eligible persons is subject to the
 9  availability of moneys and any limitations or directions
10  provided for in the General Appropriations Act or chapter 216.
11  Further, nothing in this section shall be construed to prevent
12  or limit the agency from adjusting fees, reimbursement rates,
13  lengths of stay, number of visits, or number of services, or
14  making any other adjustments necessary to comply with the
15  availability of moneys and any limitations or directions
16  provided for in the General Appropriations Act, provided the
17  adjustment is consistent with legislative intent.
18         (2)
19         (b)  Subject to any limitations or directions provided
20  for in the General Appropriations Act, the agency shall
21  establish and implement a Florida Title XIX Long-Term Care
22  Reimbursement Plan (Medicaid) for nursing home care in order
23  to provide care and services in conformance with the
24  applicable state and federal laws, rules, regulations, and
25  quality and safety standards and to ensure that individuals
26  eligible for medical assistance have reasonable geographic
27  access to such care.
28         1.  Changes of ownership or of licensed operator do not
29  qualify for increases in reimbursement rates associated with
30  the change of ownership or of licensed operator. The agency
31  shall amend the Title XIX Long Term Care Reimbursement Plan to
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    CS for CS for SB 2390                          First Engrossed
 1  provide that the initial nursing home reimbursement rates, for
 2  the operating, patient care, and MAR components, associated
 3  with related and unrelated party changes of ownership or
 4  licensed operator filed on or after September 1, 2001, are
 5  equivalent to the previous owner's reimbursement rate.
 6         2.  The agency shall amend the long-term care
 7  reimbursement plan and cost reporting system to create direct
 8  care and indirect care subcomponents of the patient care
 9  component of the per diem rate. These two subcomponents
10  together shall equal the patient care component of the per
11  diem rate. Separate cost-based ceilings shall be calculated
12  for each patient care subcomponent. The direct care
13  subcomponent of the per diem rate shall be limited by the
14  cost-based class ceiling, and the indirect care subcomponent
15  shall be limited by the lower of the cost-based class ceiling,
16  by the target rate class ceiling, or by the individual
17  provider target. The agency shall adjust the patient care
18  component effective January 1, 2002. The cost to adjust the
19  direct care subcomponent shall be net of the total funds
20  previously allocated for the case mix add-on. The agency shall
21  make the required changes to the nursing home cost reporting
22  forms to implement this requirement effective January 1, 2002.
23         3.  The direct care subcomponent shall include salaries
24  and benefits of direct care staff providing nursing services
25  including registered nurses, licensed practical nurses,
26  certified geriatric specialists, certified under part I of
27  chapter 464, and certified nursing assistants who deliver care
28  directly to residents in the nursing home facility. This
29  excludes nursing administration, MDS, and care plan
30  coordinators, staff development, and staffing coordinator.
31  
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    CS for CS for SB 2390                          First Engrossed
 1         4.  All other patient care costs shall be included in
 2  the indirect care cost subcomponent of the patient care per
 3  diem rate. There shall be no costs directly or indirectly
 4  allocated to the direct care subcomponent from a home office
 5  or management company.
 6         5.  On July 1 of each year, the agency shall report to
 7  the Legislature direct and indirect care costs, including
 8  average direct and indirect care costs per resident per
 9  facility and direct care and indirect care salaries and
10  benefits per category of staff member per facility.
11         6.  In order to offset the cost of general and
12  professional liability insurance, the agency shall amend the
13  plan to allow for interim rate adjustments to reflect
14  increases in the cost of general or professional liability
15  insurance for nursing homes. This provision shall be
16  implemented to the extent existing appropriations are
17  available.
18  
19  It is the intent of the Legislature that the reimbursement
20  plan achieve the goal of providing access to health care for
21  nursing home residents who require large amounts of care while
22  encouraging diversion services as an alternative to nursing
23  home care for residents who can be served within the
24  community. The agency shall base the establishment of any
25  maximum rate of payment, whether overall or component, on the
26  available moneys as provided for in the General Appropriations
27  Act. The agency may base the maximum rate of payment on the
28  results of scientifically valid analysis and conclusions
29  derived from objective statistical data pertinent to the
30  particular maximum rate of payment.
31  
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    CS for CS for SB 2390                          First Engrossed
 1         Section 27.  Subsection (2) of section 458.303, Florida
 2  Statutes, is amended to read:
 3         458.303  Provisions not applicable to other
 4  practitioners; exceptions, etc.--
 5         (2)  Nothing in s. 458.301, s. 458.303, s. 458.305, s.
 6  458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.
 7  458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.
 8  458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347
 9  shall be construed to prohibit any service rendered by a
10  registered nurse, or a licensed practical nurse, or a
11  certified geriatric specialist certified under part I of
12  chapter 464, if such service is rendered under the direct
13  supervision and control of a licensed physician who provides
14  specific direction for any service to be performed and gives
15  final approval to all services performed.  Further, nothing in
16  this or any other chapter shall be construed to prohibit any
17  service rendered by a medical assistant in accordance with the
18  provisions of s. 458.3485.
19         Section 28.  Subsection (1) and paragraph (a) of
20  subsection (2) of section 1009.65, Florida Statutes, are
21  amended to read:
22         1009.65  Medical Education Reimbursement and Loan
23  Repayment Program.--
24         (1)  To encourage qualified medical professionals to
25  practice in underserved locations where there are shortages of
26  such personnel, there is established the Medical Education
27  Reimbursement and Loan Repayment Program. The function of the
28  program is to make payments that offset loans and educational
29  expenses incurred by students for studies leading to a medical
30  or nursing degree, medical or nursing licensure, or advanced
31  registered nurse practitioner certification or physician
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    CS for CS for SB 2390                          First Engrossed
 1  assistant licensure. The following licensed or certified
 2  health care professionals are eligible to participate in this
 3  program: medical doctors with primary care specialties,
 4  doctors of osteopathic medicine with primary care specialties,
 5  physician's assistants, certified geriatric specialists
 6  certified under part I of chapter 464, licensed practical
 7  nurses and registered nurses, and advanced registered nurse
 8  practitioners with primary care specialties such as certified
 9  nurse midwives. Primary care medical specialties for
10  physicians include obstetrics, gynecology, general and family
11  practice, internal medicine, pediatrics, and other specialties
12  which may be identified by the Department of Health.
13         (2)  From the funds available, the Department of Health
14  shall make payments to selected medical professionals as
15  follows:
16         (a)  Up to $4,000 per year for certified geriatric
17  specialists certified under part I of chapter 464, licensed
18  practical nurses, and registered nurses, up to $10,000 per
19  year for advanced registered nurse practitioners and
20  physician's assistants, and up to $20,000 per year for
21  physicians.  Penalties for noncompliance shall be the same as
22  those in the National Health Services Corps Loan Repayment
23  Program. Educational expenses include costs for tuition,
24  matriculation, registration, books, laboratory and other fees,
25  other educational costs, and reasonable living expenses as
26  determined by the Department of Health.
27         Section 29.  Subsection (2) of section 1009.66, Florida
28  Statutes, is amended to read:
29         1009.66  Nursing Student Loan Forgiveness Program.--
30         (2)  To be eligible, a candidate must have graduated
31  from an accredited or approved nursing program and have
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    CS for CS for SB 2390                          First Engrossed
 1  received a Florida license as a licensed practical nurse, a
 2  certified geriatric specialist certified under part I of
 3  chapter 464, or a registered nurse or a Florida certificate as
 4  an advanced registered nurse practitioner.
 5         Section 30.  The sum of $157,017 is appropriated from
 6  the General Revenue Fund to the Agency for Workforce
 7  Innovation to support the work of the Certified Geriatric
 8  Specialty Nursing Initiative Steering Committee, to administer
 9  the pilot sites, contract for an evaluation, and to provide,
10  if necessary, nursing faculty, substitute certified nursing
11  assistants for those who are in clinical education, and
12  technical support to the pilot sites during the 2003-2004
13  fiscal year.
14         Section 31.  Subsection (6) is added to section
15  464.201, Florida Statutes, to read:
16         464.201  Definitions.--As used in this part, the term:
17         (6)  "Practice of a certified nursing assistant" means
18  providing care and assisting persons with tasks relating to
19  the activities of daily living. Such tasks are those
20  associated with personal care, maintaining mobility, nutrition
21  and hydration, toileting and elimination, assistive devices,
22  safety and cleanliness, data gathering, reporting abnormal
23  signs and symptoms, post mortem care, patient socialization
24  and reality orientation, end-of-life care, CPR and emergency
25  care, residents' or patients' rights, documentation of nursing
26  assistant services, and other tasks that a certified nurse
27  assistant may perform after training beyond that required for
28  initial certification and upon validation of competence in
29  that skill by a registered nurse. This section does not
30  restrict the ability of any person who is otherwise trained
31  and educated from performing such tasks.
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    CS for CS for SB 2390                          First Engrossed
 1         Section 32.  Section 464.202, Florida Statutes, is
 2  amended to read:
 3         464.202  Duties and powers of the board.--The board
 4  shall maintain, or contract with or approve another entity to
 5  maintain, a state registry of certified nursing assistants.
 6  The registry must consist of the name of each certified
 7  nursing assistant in this state; other identifying information
 8  defined by board rule; certification status; the effective
 9  date of certification; other information required by state or
10  federal law; information regarding any crime or any abuse,
11  neglect, or exploitation as provided under chapter 435; and
12  any disciplinary action taken against the certified nursing
13  assistant. The registry shall be accessible to the public, the
14  certificateholder, employers, and other state agencies. The
15  board shall adopt by rule testing procedures for use in
16  certifying nursing assistants and shall adopt rules regulating
17  the practice of certified nursing assistants which specify the
18  scope of practice authorized and level of supervision required
19  for the practice of certified nursing assistants to enforce
20  this part. The board may contract with or approve another
21  entity or organization to provide the examination services,
22  including the development and administration of examinations.
23  The board shall require that the contract provider offer
24  certified nursing assistant applications via the Internet, and
25  may require the contract provider to accept certified nursing
26  assistant applications for processing via the Internet.  The
27  board shall require the contract provider to provide the
28  preliminary results of the certified nursing examination on
29  the date the test is administered. The provider shall pay all
30  reasonable costs and expenses incurred by the board in
31  evaluating the provider's application and performance during
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    CS for CS for SB 2390                          First Engrossed
 1  the delivery of services, including examination services and
 2  procedures for maintaining the certified nursing assistant
 3  registry.
 4         Section 33.  Section 831.311, Florida Statutes, is
 5  created to read:
 6         831.311  Unlawful sale, manufacture, alteration,
 7  delivery, uttering, or possession of counterfeit-resistant
 8  prescription blanks for controlled substances listed in
 9  Schedules II, III, and IV.--
10         (1)  It is unlawful for any person with the intent to
11  injure or defraud any person or to facilitate any violation of
12  s. 893.13 to sell, manufacture, alter, deliver, utter, or
13  possess any counterfeit-resistant prescription blanks for
14  controlled substances adopted by rule of the Department of
15  Health pursuant to s. 893.065.
16         (2)  Any person who violates this section commits a
17  felony of the third degree, punishable as provided in s.
18  775.082, s. 775.083, or s. 775.084.
19         Section 34.  Section 893.04, Florida Statutes, is
20  amended to read:
21         893.04  Pharmacist and practitioner.--
22         (1)  A pharmacist, in good faith and in the course of
23  professional practice only, may dispense controlled substances
24  upon a written or oral prescription of a practitioner, under
25  the following conditions:
26         (a)  Oral prescriptions must be promptly reduced to
27  writing by the pharmacist or recorded electronically if
28  permitted by federal law.
29         (b)  The written prescription must be dated and signed
30  by the prescribing practitioner on the day when issued.
31  
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    CS for CS for SB 2390                          First Engrossed
 1         (c)  There shall appear on the face of the prescription
 2  or written record thereof for the controlled substance the
 3  following information:
 4         1.  The full name and address of the person for whom,
 5  or the owner of the animal for which, the controlled substance
 6  is dispensed.
 7         2.  The full name and address of the prescribing
 8  practitioner and the practitioner's federal controlled
 9  substance registry number shall be printed thereon.
10         3.  If the prescription is for an animal, the species
11  of animal for which the controlled substance is prescribed.
12         4.  The name of the controlled substance prescribed and
13  the strength, quantity, and directions for use thereof.
14         5.  The number of the prescription, as recorded in the
15  prescription files of the pharmacy in which it is filled.
16         6.  The initials of the pharmacist filling the
17  prescription and the date filled.
18         (d)  The prescription shall be retained on file by the
19  proprietor of the pharmacy in which it is filled for a period
20  of 2 years.
21         (e)  Affixed to the original container in which a
22  controlled substance is delivered upon a prescription or
23  authorized refill thereof, as hereinafter provided, there
24  shall be a label bearing the following information:
25         1.  The name and address of the pharmacy from which
26  such controlled substance was dispensed.
27         2.  The date on which the prescription for such
28  controlled substance was filled.
29         3.  The number of such prescription, as recorded in the
30  prescription files of the pharmacy in which it is filled.
31         4.  The name of the prescribing practitioner.
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    CS for CS for SB 2390                          First Engrossed
 1         5.  The name of the patient for whom, or of the owner
 2  and species of the animal for which, the controlled substance
 3  is prescribed.
 4         6.  The directions for the use of the controlled
 5  substance prescribed in the prescription.
 6         7.  A clear, concise warning that it is a crime to
 7  transfer the controlled substance to any person other than the
 8  patient for whom prescribed.
 9         (f)  A prescription for a controlled substance listed
10  in Schedule II may be dispensed only upon a written
11  prescription of a practitioner, except that in an emergency
12  situation, as defined by regulation of the Department of
13  Health, such controlled substance may be dispensed upon oral
14  prescription but is limited to a 72-hour supply. No
15  prescription for a controlled substance listed in Schedule II
16  may be refilled.
17         (g)  No prescription for a controlled substance listed
18  in Schedule Schedules III, Schedule IV, or Schedule V may be
19  filled or refilled more than five times within a period of 6
20  months after the date on which the prescription was written
21  unless the prescription is renewed by a practitioner.
22         (2)(a)  A pharmacist may not dispense a controlled
23  substance listed in Schedule II, Schedule III, or Schedule IV
24  to any patient or patient's agent without first determining,
25  in the exercise of her or his professional judgment, that the
26  order is valid.  The pharmacist or pharmacist's agent shall
27  also obtain the patient or patient's agent identification
28  information, in writing, electronic format or other approved
29  manner prior to dispensing any controlled substance. If the
30  patient or patient's agent does not have appropriate
31  identification, the pharmacist may dispense the controlled
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    CS for CS for SB 2390                          First Engrossed
 1  substance only when the pharmacist determines, in the exercise
 2  of her or his professional judgment, that the order is valid
 3  and includes such information in the patient's record. The
 4  Board of Pharmacy may adopt, by rule, required patient
 5  identification information for controlled substances and
 6  procedures for a pharmacist to verify the validity of a
 7  prescription for controlled substances for circumstances in
 8  which the pharmacist was not provided required identification
 9  information.
10         (b)  Any pharmacist that dispenses by mail a controlled
11  substance listed in Schedule II, Schedule III, or Schedule IV
12  shall be exempt from the requirement to obtain suitable
13  identification for the prescription dispensed by mail.
14         (c)  Any controlled substance listed in Schedule III or
15  Schedule IV may be dispensed by a pharmacist upon an oral
16  prescription if, before filling the prescription, the
17  pharmacist reduces it to writing or records the prescription
18  electronically if permitted by federal law. Such prescriptions
19  must contain the date of the oral authorization.
20         (d)  All written prescriptions prescribed by a
21  practitioner in this state for a controlled substance listed
22  in Schedule II, Schedule III, or Schedule IV must include both
23  a written and a numerical notation of the quantity on the face
24  of the prescription and a notation of the date with the
25  abbreviated month written out on the face of the prescription.
26  A pharmacist shall be permitted, upon verification by the
27  prescriber, to document any information required by this
28  paragraph.
29         (e)  A pharmacist may not dispense more than a 30-day
30  supply of a controlled substance listed in Schedule III upon
31  an oral prescription issued in this state.
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    CS for CS for SB 2390                          First Engrossed
 1         (f)  A pharmacist may not knowingly fill a prescription
 2  that has been forged for a controlled substance listed in
 3  Schedule II, Schedule III, or Schedule IV.
 4         (3)(2)  Notwithstanding the provisions of subsection
 5  (1), a pharmacist may dispense a one-time emergency refill of
 6  up to a 72-hour supply of the prescribed medication for any
 7  medicinal drug other than a medicinal drug listed in Schedule
 8  II, in compliance with the provisions of s. 465.0275.
 9         (4)(3)  The legal owner of any stock of controlled
10  substances in a pharmacy, upon discontinuance of dealing in
11  controlled substances, may sell said stock to a manufacturer,
12  wholesaler, or pharmacy.  Such controlled substances may be
13  sold only upon an order form, when such an order form is
14  required for sale by the drug abuse laws of the United States
15  or this state, or regulations pursuant thereto.
16         Section 35.  Section 893.055, Florida Statutes, is
17  created to read:
18         893.055  Electronic monitoring system for prescription
19  of controlled substances listed in Schedules II, III, and
20  IV.--
21         (1)  By June 30, 2004, the Department of Health shall
22  design and establish an electronic system consistent with the
23  American Society for Automation in Pharmacy (ASAP) standards
24  to monitor the prescribing and dispensing of controlled
25  substances listed in Schedules II, III, and IV by health care
26  practitioners within the state and the dispensing of such
27  controlled substances to an individual at a specific address
28  within the state by a pharmacy permitted or registered by the
29  Board of Pharmacy.
30         (2)  Any controlled substance listed in Schedule II,
31  Schedule III, or Schedule IV which is dispensed to an
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    CS for CS for SB 2390                          First Engrossed
 1  individual in this state must be reported to the Department of
 2  Health through the system, as soon thereafter as possible but
 3  not more than 35 days after the date the controlled substance
 4  is dispensed, each time the controlled substance is dispensed.
 5  A pharmacy may meet the reporting requirements of this section
 6  by providing the Department of Health an exchangeable
 7  electronic disc or tape of each controlled substance listed in
 8  Schedules II, III, and IV which it dispenses.
 9         (3)  This section does not apply to controlled
10  substances:
11         (a)  Administered by a health care practitioner
12  directly to a patient.
13         (b)  Dispensed by a health care practitioner authorized
14  to prescribe controlled substances directly to a patient and
15  limited to an amount adequate to treat the patient for a
16  period of no more than 72 hours.
17         (c)  Dispensed by a health care practitioner or a
18  pharmacist to an in-patient of a facility with an
19  institutional pharmacy permit.
20         (d)  Dispensed by a health care practitioner or a
21  pharmacist to a patient under a prescription written within 10
22  days of a surgical procedure for the patient, which notes that
23  such drugs are prescribed for treatment of a postoperative
24  condition and the date of the surgery.
25         (e)  Ordered from an institutional pharmacy permitted
26  under s. 465.019 in accordance with the institutional policy
27  for such controlled substances or drugs.
28         (f)  Either dispensed by a pharmacist or administered
29  by a health care practitioner to a patient or resident
30  receiving care from a hospital, nursing home, assisted living
31  facility, home health agency, hospice, or intermediate care
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    CS for CS for SB 2390                          First Engrossed
 1  facility for the developmentally disabled which is licensed in
 2  this state.
 3         (g)  Prescribed by a health care practitioner for a
 4  patient less than 16 years of age.
 5         (4)  The data required to be reported under this
 6  section shall be determined by the Department of Health by
 7  rule but may include any data required under s. 893.04.
 8         (5)  A practitioner or pharmacist who dispenses a
 9  controlled substance under this section must submit the
10  information required by this section in an electronic or other
11  format approved by rule of the Department of Health. The cost
12  to the dispenser in submitting the information required by
13  this subsection shall not be material or extraordinary. Costs
14  not considered to be material or extraordinary include, but
15  are not limited to, regular postage, compact disks, zip drive
16  storage, regular electronic mail, magnetic tapes, diskettes,
17  and facsimile charges. The information submitted to the
18  Department of Health under this section may be transmitted to
19  any person or agency authorized to receive it pursuant to
20  section 2 of Senate Bill 1784 or similar legislation, and that
21  person or agency may maintain the information received for up
22  to 24 months before purging it from its records. All
23  transmissions required by this paragraph shall comply with
24  relevant federal and state privacy and security laws.
25  Notwithstanding the foregoing, any authorized agency receiving
26  such information may maintain it longer than 24 months if the
27  information is pertinent to an ongoing investigation or
28  prosecution.
29         (6)  Any person who knowingly fails to report the
30  dispensing of a controlled substance listed in Schedule II,
31  Schedule III, or Schedule IV as required by this section
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 1  commits a misdemeanor of the first degree, punishable as
 2  provided in s. 775.082 or s. 775.083.
 3         (7)  The Department of Health and the regulatory boards
 4  for the health care practitioners subject to this section
 5  shall adopt rules pursuant to ss. 120.536(1) and 120.54
 6  necessary to implement and administer this section.
 7         (8)  All costs incurred by the Department of Health in
 8  implementing the prescription monitoring system shall be borne
 9  by the department, and there is appropriated annually, subject
10  to the availability of funds, from the Grants and Donations
11  Trust Fund an amount necessary to cover such costs. The
12  Medical Quality Assurance Trust Fund may not be used to
13  implement or otherwise fund this program.
14         Section 36.  Section 893.065, Florida Statutes, is
15  created to read:
16         893.065  Counterfeit-resistant prescription blanks for
17  controlled substances listed in Schedules II, III, and
18  IV.--The Department of Health shall develop and adopt by rule
19  the form and content for a counterfeit-resistant prescription
20  blank which may be used by practitioners to prescribe a
21  controlled substance listed in Schedule II, Schedule III, or
22  Schedule IV. The Department of Health may require the
23  prescription blanks to be printed on distinctive, watermarked
24  paper and to bear the preprinted name, address, and category
25  of professional licensure of the practitioner and that
26  practitioner's federal registry number for controlled
27  substances. The prescription blanks may not be transferred.
28         Section 37.  There is appropriated $2,196,352 from the
29  Grants and Donations Trust Fund to the Department of Health,
30  and three full-time equivalent positions are authorized, for
31  
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    CS for CS for SB 2390                          First Engrossed
 1  fiscal year 2003-2004 to implement the provisions of sections
 2  893.055 and 893.065, Florida Statutes, as created by this act.
 3         Section 38.  The penalties created in sections
 4  831.311(2) and 893.055(6), Florida Statutes, by this act shall
 5  be effective only upon the adoption by the Department of
 6  Health and each applicable professional regulatory board of
 7  the rules required pursuant to sections 893.055(7) and
 8  893.065, Florida Statutes, as created by this act.
 9         Section 39.  Effective May 1, 2003, subsection (2) of
10  section 409.904, Florida Statutes, is amended to read:
11         409.904  Optional payments for eligible persons.--The
12  agency may make payments for medical assistance and related
13  services on behalf of the following persons who are determined
14  to be eligible subject to the income, assets, and categorical
15  eligibility tests set forth in federal and state law.  Payment
16  on behalf of these Medicaid eligible persons is subject to the
17  availability of moneys and any limitations established by the
18  General Appropriations Act or chapter 216.
19         (2)  A caretaker relative or parent, a pregnant woman,
20  a child under age 19 who would otherwise qualify for Florida
21  Kidcare Medicaid, a child up to age 21 who would otherwise
22  qualify under s. 409.903(1), a person age 65 or over, or a
23  blind or disabled person, who would otherwise be eligible for
24  Florida Medicaid, except that the income or assets of such
25  family or person exceed established limitations. For a family
26  or person in one of these coverage groups, medical expenses
27  are deductible from income in accordance with federal
28  requirements in order to make a determination of eligibility.
29  Expenses used to meet spend-down liability are not
30  reimbursable by Medicaid. Effective July May 1, 2003, when
31  determining the eligibility of a pregnant woman, a child, or
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    CS for CS for SB 2390                          First Engrossed
 1  an aged, blind, or disabled individual, $270 shall be deducted
 2  from the countable income of the filing unit. When determining
 3  the eligibility of the parent or caretaker relative as defined
 4  by Title XIX of the Social Security Act, the additional income
 5  disregard of $270 does not apply. A family or person eligible
 6  under the coverage known as the "medically needy," is eligible
 7  to receive the same services as other Medicaid recipients,
 8  with the exception of services in skilled nursing facilities
 9  and intermediate care facilities for the developmentally
10  disabled.
11         Section 40.  The non-recurring sums of $8,265,777 from
12  the General Revenue Fund, $2,505,224 from the Grants and
13  Donations Trust Fund, and $11,727,287 from the Medical Care
14  Trust Fund are appropriated to the Agency for Health Care
15  Administration to implement section 39 of this act during the
16  2002-2003 fiscal year. This section takes effect May 1, 2003.
17         Section 41.  Except as otherwise expressly provided,
18  sections 39-41 shall take effect July 1, 2003, but if this act
19  becomes a law after May 1, 2003, sections 39 and 40 of this
20  act shall operate retroactively to that date.
21         Section 42.  Except as otherwise expressly provided in
22  this act, this act shall take effect July 1, 2004, if Senate
23  Bill 1784 or similar legislation is adopted in the same
24  legislative session or an extension thereof and becomes law.
25  
26  
27  
28  
29  
30  
31  
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