Senate Bill sb2390e1

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  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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    CS for CS for SB 2390                          First Engrossed



 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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    CS for CS for SB 2390                          First Engrossed



 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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 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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 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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 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


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 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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 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


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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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 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."


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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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 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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 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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 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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 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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 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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 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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 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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 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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 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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 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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 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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 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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 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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    CS for CS for SB 2390                          First Engrossed



 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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