Senate Bill sb2170

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    Florida Senate - 2004                                  SB 2170

    By Senator Peaden





    2-1033-04

  1                      A bill to be entitled

  2         An act relating to the Department of Health;

  3         amending s. 395.0193, F.S., relating to

  4         disciplinary powers; correcting references to

  5         the Division of Medical Quality Assurance and

  6         the department; amending s. 395.0197, F.S.;

  7         requiring the Agency for Health Care

  8         Administration to forward reports of adverse

  9         incidents to the division; amending s.

10         395.3025, F.S.; providing requirements for a

11         facility administrator or records custodian

12         with respect to the certification of patient

13         records; specifying the charges for reproducing

14         records; revising purposes for which patient

15         records may be used; amending s. 395.7015,

16         F.S., relating to annual assessments;

17         correcting cross-references; amending s.

18         400.141, F.S.; providing requirements for the

19         production of records by nursing home

20         facilities; amending s. 400.145, F.S.;

21         providing requirements for a facility

22         administrator or records custodian with respect

23         to the certification of patient records;

24         amending s. 400.147, F.S.; requiring the Agency

25         for Health Care Administration to provide

26         certain reports to the division; amending s.

27         400.211, F.S.; revising inservice training

28         requirements for nursing assistants; amending

29         s. 400.423, F.S.; requiring the Agency for

30         Health Care Administration to forward reports

31         of adverse incidents to the division; creating

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 1         s. 400.455, F.S.; providing requirements for

 2         the production of records by assisted living

 3         facilities; amending s. 456.005, F.S.;

 4         requiring the department to obtain input from

 5         licensees in developing long-range plans;

 6         amending s. 456.011, F.S.; providing procedures

 7         for resolving a conflict between two or more

 8         boards; authorizing the Secretary of Health to

 9         resolve certain conflicts through rulemaking or

10         a declaratory statement; amending s. 456.012,

11         F.S.; limiting challenges by a board to a

12         declaratory statement; amending s. 456.013,

13         F.S.; increasing the period of validity of a

14         temporary license; authorizing a rule allowing

15         coursework to be completed by certain teaching

16         activities; revising requirements for wall

17         certificates; revising requirements for

18         continuing education; amending s. 381.00593,

19         F.S., relating to the public school volunteer

20         program; correcting a cross-reference; amending

21         s. 456.017, F.S.; revising requirements for

22         examinations; authorizing the department to

23         post scores on the Internet; creating s.

24         456.0195, F.S.; requiring continuing education

25         concerning domestic violence, HIV and AIDS, and

26         the prevention of medical errors; specifying

27         course content; providing for disciplinary

28         action for failure to comply with the

29         requirements; amending s. 456.025, F.S.;

30         revising reporting requirements for the

31         department concerning management of the boards;

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 1         amending s. 456.031, F.S.; revising

 2         requirements for continuing education

 3         concerning domestic violence; deleting a

 4         reporting requirement; amending ss. 456.036 and

 5         456.037, F.S.; authorizing the board or

 6         department to require the display of a license;

 7         amending s. 456.039, F.S., relating to

 8         designated health care professionals;

 9         correcting a cross-reference; amending s.

10         456.057, F.S.; specifying the charges for

11         reproducing records; amending s. 456.063, F.S.;

12         authorizing the board or the department to

13         adopt rules to determine the sufficiency of an

14         allegation of sexual misconduct; amending s.

15         456.072, F.S.; revising certain grounds for

16         disciplinary action; prohibiting the provision

17         of a drug if the patient does not have a valid

18         professional relationship with the prescribing

19         practitioner; authorizing the department to

20         impose a fee to defray the costs of monitoring

21         a licensee's compliance with an order; amending

22         s. 456.073, F.S.; revising certain procedures

23         for investigations concerning a disciplinary

24         proceeding; amending s. 457.105, F.S.; revising

25         requirements for licensure to practice

26         acupuncture; authorizing the department to

27         require certain additional information and to

28         require the evaluation of an applicant;

29         amending s. 457.109, F.S.; clarifying

30         circumstances under which the department may

31         take disciplinary action; amending s. 458.303,

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 1         F.S., relating to certain exceptions to the

 2         practice acts; correcting cross-references;

 3         amending s. 458.311, F.S.; revising licensure

 4         requirements for physicians; amending s.

 5         458.3124, F.S., relating to restricted

 6         licenses; correcting a cross-reference;

 7         amending s. 458.315, F.S.; revising

 8         requirements for issuing a limited license to

 9         practice as a physician; providing for waiver

10         of fees and assessments; amending s. 458.319,

11         F.S., relating to continuing education;

12         conforming provisions; amending s. 458.320,

13         F.S., relating to financial responsibility;

14         correcting a cross-reference; amending s.

15         458.331, F.S.; revising requirements for a

16         physician in responding to a complaint or other

17         document; amending s. 458.345, F.S., relating

18         to the registration of residents, interns, and

19         fellows; correcting a cross-reference; amending

20         s. 458.347, F.S.; revising requirements for

21         licensure as a physician assistant; revising

22         requirements for temporary licensure;

23         authorizing the board to mandate requirements

24         for continuing medical education, including

25         alternative methods for obtaining credits;

26         amending s. 459.008, F.S.; authorizing the

27         board to require by rule continuing medical

28         education and approve alternative methods of

29         obtaining credits; amending s. 459.015, F.S.;

30         revising requirements for an osteopathic

31         physician in responding to a complaint or other

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 1         document; amending s. 459.021, F.S.; revising

 2         certain requirements for registration as a

 3         resident, intern, or fellow; amending s.

 4         460.406, F.S., relating to the licensure of

 5         chiropractic physicians; correcting a

 6         reference; amending ss. 460.413 and 461.013,

 7         F.S.; revising requirements for a chiropractic

 8         physician and podiatric physician in responding

 9         to a complaint or other document; amending s.

10         463.006, F.S., relating to optometry;

11         correcting a reference; amending s. 464.0205,

12         F.S., relating to volunteer nurses; correcting

13         a cross-reference; amending s. 464.201, F.S.;

14         defining the term "practice of a certified

15         nursing assistant"; amending s. 464.202, F.S.;

16         requiring rules for practice as a certified

17         nursing assistant which specify the scope of

18         authorized practice and level of supervision

19         required; amending s. 464.203, F.S.; revising

20         screening requirements for certified nursing

21         assistants; amending s. 464.204, F.S., relating

22         to disciplinary actions; clarifying a

23         cross-reference; amending s. 465.003, F.S.;

24         redefining the term "pharmacy" to include an

25         Internet pharmacy; amending s. 465.0075, F.S.;

26         clarifying requirements for certain continuing

27         education for pharmacists; amending s. 465.016,

28         F.S.; providing that the dispensing of drugs

29         when there is not a valid practitioner-patient

30         relationship constitutes grounds for denying

31         licensure or imposing disciplinary action;

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 1         amending s. 465.0161, F.S.; providing that the

 2         distribution of medicinal drugs without a

 3         license is a second-degree felony; amending s.

 4         465.018, F.S.; revising licensing requirements

 5         for community pharmacies; requiring background

 6         checks of licensees and certain officers of a

 7         corporation; amending s. 465.025, F.S.;

 8         revising requirements for the substitution of

 9         drugs; deleting requirements that a pharmacy

10         establish a formulary of generic and brand name

11         drugs; amending s. 465.0265, F.S.; providing

12         requirements for central fill pharmacies that

13         prepare prescriptions on behalf of pharmacies;

14         amending s. 466.007, F.S.; revising

15         requirements for dental hygienists in

16         qualifying for examination; amending s.

17         466.021, F.S.; revising records requirements

18         concerning unlicensed persons employed by a

19         dentist; amending s. 467.009, F.S., relating to

20         midwifery programs; correcting references;

21         amending s. 467.013, F.S.; providing for

22         placing a midwife license on inactive status

23         pursuant to rule of the department; deleting

24         requirements for reactivating an inactive

25         license; amending s. 467.0135, F.S.; revising

26         requirements for fees, to conform; amending s.

27         467.017, F.S.; revising requirements for the

28         emergency care plan; amending s. 468.1155,

29         F.S., relating to the practice of

30         speech-language pathology and audiology;

31         correcting references; amending s. 468.509,

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 1         F.S., relating to dietitian/nutritionists;

 2         correcting references; amending s. 468.707,

 3         F.S., relating to licensure as an athletic

 4         trainer; conforming provisions to changes made

 5         by the act; amending s. 480.033, F.S., relating

 6         to the regulation of massage therapists;

 7         providing definitions and deleting obsolete

 8         provisions; amending s. 480.034, F.S.;

 9         specifying certain exemptions with respect to

10         the application of ch. 480, F.S.; amending s.

11         480.041, F.S.; revising requirements for

12         licensure as a massage therapist; authorizing

13         the department to require certain additional

14         information and to require the evaluation of an

15         applicant; amending s. 480.043, F.S.; providing

16         requirements for the licensure of a massage

17         establishment; requiring background checks of

18         an applicant; providing requirements for the

19         transfer of a license or the transfer of an

20         interest in a license or business; requiring

21         background checks; amending s. 480.046, F.S.;

22         providing additional grounds for disciplinary

23         action; amending s. 486.021, F.S., relating to

24         the practice of physical therapy; redefining

25         the term "direct supervision"; amending s.

26         486.031, F.S., relating to licensure

27         requirements; correcting references; amending

28         s. 486.051, F.S.; revising examination

29         requirements; amending s. 486.081, F.S.;

30         providing for licensure by endorsement for

31         physical therapists licensed in another

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 1         jurisdiction; amending s. 486.102, F.S.;

 2         revising requirements for licensure; correcting

 3         reference; amending s. 486.104, F.S.; revising

 4         examination requirements for a physical

 5         therapist assistant; amending s. 486.107, F.S.;

 6         providing for licensure by endorsement for

 7         physical therapist assistants licensed in

 8         another jurisdiction; amending s. 486.109,

 9         F.S.; revising requirements for continuing

10         education; amending s. 486.161, F.S.; providing

11         an exemption from licensure for certain

12         physical therapists affiliated with a team or

13         organization temporarily located in the state;

14         amending s. 486.172, F.S.; clarifying

15         provisions governing the qualifications of

16         immigrants for examination; amending s.

17         490.005, F.S., relating to psychological

18         services; correcting references; amending s.

19         491.005, F.S., relating to clinical,

20         counseling, and psychotherapy services;

21         revising licensure requirements; correcting

22         references; amending s. 491.006, F.S.;

23         providing requirements for licensure by

24         endorsement as a mental health counselor;

25         amending ss. 491.009 and 491.0145, F.S.;

26         clarifying provisions governing the discipline

27         of a certified master social worker; creating

28         s. 491.0146, F.S.; providing for the validity

29         of certain licenses to practice as a certified

30         master social worker; amending s. 817.505,

31         F.S.; clarifying provisions prohibiting actions

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 1         that constitute patient brokering; amending s.

 2         817.567, F.S., relating to making false claims

 3         of a degree or title; correcting a reference;

 4         amending s. 895.02, F.S.; including Medicaid

 5         provider fraud and the distribution of drugs as

 6         an Internet pharmacy without a license within

 7         the definition of the term "racketeering

 8         activity" for purposes of the Florida RICO Act;

 9         amending s. 1009.992, F.S., relating to the

10         Florida Higher Education Loan Authority Act;

11         correcting a reference; repealing ss. 456.033,

12         456.034, 458.313, 458.3147, 458.316, 458.3165,

13         458.317, 468.711(3), and 480.044(1)(h), F.S.,

14         relating to instruction concerning HIV and

15         AIDS, licensure by endorsement of physicians,

16         medical school eligibility, public health and

17         public psychiatry certificates, limited

18         licenses, and examination fees; providing an

19         effective date.

20  

21  Be It Enacted by the Legislature of the State of Florida:

22  

23         Section 1.  Subsection (4) of section 395.0193, Florida

24  Statutes, is amended to read:

25         395.0193  Licensed facilities; peer review;

26  disciplinary powers; agency or partnership with physicians.--

27         (4)  Pursuant to ss. 458.337 and 459.016, any

28  disciplinary actions taken under subsection (3) shall be

29  reported in writing to the Division of Medical Health Quality

30  Assurance of the Department of Health agency within 30 working

31  days after its initial occurrence, regardless of the pendency

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 1  of appeals to the governing board of the hospital. The

 2  notification shall identify the disciplined practitioner, the

 3  action taken, and the reason for such action. All final

 4  disciplinary actions taken under subsection (3), if different

 5  from those which were reported to the division agency within

 6  30 days after the initial occurrence, shall be reported within

 7  10 working days to the Division of Medical Health Quality

 8  Assurance of the department agency in writing and shall

 9  specify the disciplinary action taken and the specific grounds

10  therefor. The division shall review each report and determine

11  whether it potentially involved conduct by the licensee that

12  is subject to disciplinary action, in which case s. 456.073

13  shall apply. The reports are not subject to inspection under

14  s. 119.07(1) even if the division's investigation results in a

15  finding of probable cause.

16         Section 2.  Subsection (7) of section 395.0197, Florida

17  Statutes, is amended to read:

18         395.0197  Internal risk management.--

19         (7)  Any of the following adverse incidents, whether

20  occurring in the licensed facility or arising from health care

21  prior to admission in the licensed facility, shall be reported

22  by the facility to the agency within 15 calendar days after

23  its occurrence:

24         (a)  The death of a patient;

25         (b)  Brain or spinal damage to a patient;

26         (c)  The performance of a surgical procedure on the

27  wrong patient;

28         (d)  The performance of a wrong-site surgical

29  procedure;

30         (e)  The performance of a wrong surgical procedure;

31  

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 1         (f)  The performance of a surgical procedure that is

 2  medically unnecessary or otherwise unrelated to the patient's

 3  diagnosis or medical condition;

 4         (g)  The surgical repair of damage resulting to a

 5  patient from a planned surgical procedure, where the damage is

 6  not a recognized specific risk, as disclosed to the patient

 7  and documented through the informed-consent process; or

 8         (h)  The performance of procedures to remove unplanned

 9  foreign objects remaining from a surgical procedure.

10  

11  The agency may grant extensions to this reporting requirement

12  for more than 15 days upon justification submitted in writing

13  by the facility administrator to the agency. The agency may

14  require an additional, final report. These reports shall not

15  be available to the public pursuant to s. 119.07(1) or any

16  other law providing access to public records, nor be

17  discoverable or admissible in any civil or administrative

18  action, except in disciplinary proceedings by the agency or

19  the appropriate regulatory board, nor shall they be available

20  to the public as part of the record of investigation for and

21  prosecution in disciplinary proceedings made available to the

22  public by the agency or the appropriate regulatory board.

23  However, the agency or the appropriate regulatory board shall

24  make available, upon written request by a health care

25  professional against whom probable cause has been found, any

26  such records which form the basis of the determination of

27  probable cause. The agency may investigate, as it deems

28  appropriate, any such incident and prescribe measures that

29  must or may be taken in response to the incident. The agency

30  shall forward a copy of the report of review each incident to

31  the Division of Medical Quality Assurance in the Department of

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 1  Health to and determine whether it potentially involved

 2  conduct by the health care professional who is subject to

 3  disciplinary action, in which case the provisions of s.

 4  456.073 shall apply.

 5         Section 3.  Paragraphs (a) and (e) of subsection (4)

 6  and paragraph (b) of subsection (7) of section 395.3025,

 7  Florida Statutes, are amended to read:

 8         395.3025  Patient and personnel records; copies;

 9  examination.--

10         (4)  Patient records are confidential and must not be

11  disclosed without the consent of the person to whom they

12  pertain, but appropriate disclosure may be made without such

13  consent to:

14         (a)  Licensed Facility personnel and all other licensed

15  health care practitioners attending physicians for use in

16  connection with the treatment of the patient.

17         (e)  The Department of Health agency upon subpoena

18  issued pursuant to s. 456.071, but the records obtained

19  thereby must be used solely for the purpose of the department

20  agency and the appropriate professional board in its

21  investigation, prosecution, and appeal of disciplinary

22  proceedings. The administrator or records custodian in a

23  facility licensed under this chapter shall certify that a true

24  and complete copy of the records requested pursuant to a

25  subpoena or the release of a patient have been provided to the

26  department or otherwise identify those documents that have not

27  been provided. If the department agency requests copies of the

28  records, the facility may charge the department the reasonable

29  costs of reproducing the records shall charge no more than its

30  actual copying costs, including reasonable staff time. The

31  records must be sealed and must not be available to the public

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 1  pursuant to s. 119.07(1) or any other statute providing access

 2  to records, nor may they be available to the public as part of

 3  the record of investigation for and prosecution in

 4  disciplinary proceedings made available to the public by the

 5  department agency or the appropriate regulatory board.

 6  However, the department agency must make available, upon

 7  written request by a practitioner against whom probable cause

 8  has been found, any such records that form the basis of the

 9  determination of probable cause.

10         1.  Reasonable costs of reproducing copies of written

11  or typed documents or reports may not be more than:

12         a.  For the first 25 pages, $1 per page.

13         b.  For each page in excess of 25 pages, 25 cents.

14         2.  Reasonable costs of reproducing X rays and other

15  special kinds of records are the actual costs. The term

16  "actual costs" means the cost of the material and supplies

17  used to duplicate the record, as well as the labor costs

18  associated with the duplication.

19         (7)

20         (b)  Absent a specific written release or authorization

21  permitting utilization of patient information for solicitation

22  or marketing the sale of goods or services, any use of such

23  that information for that purpose those purposes is

24  prohibited. As used in this paragraph, the term "marketing"

25  has the same meaning as set forth in 45 C.F.R. s. 164.501.

26         Section 4.  Paragraph (b) of subsection (2) of section

27  395.7015, Florida Statutes, is amended to read:

28         395.7015  Annual assessment on health care entities.--

29         (2)  There is imposed an annual assessment against

30  certain health care entities as described in this section:

31  

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 1         (b)  For the purpose of this section, "health care

 2  entities" include the following:

 3         1.  Ambulatory surgical centers and mobile surgical

 4  facilities licensed under s. 395.003. This subsection shall

 5  only apply to mobile surgical facilities operating under

 6  contracts entered into on or after July 1, 1998.

 7         2.  Clinical laboratories licensed under s. 483.091,

 8  excluding any hospital laboratory defined under s. 483.041(6),

 9  any clinical laboratory operated by the state or a political

10  subdivision of the state, any clinical laboratory which

11  qualifies as an exempt organization under s. 501(c)(3) of the

12  Internal Revenue Code of 1986, as amended, and which receives

13  70 percent or more of its gross revenues from services to

14  charity patients or Medicaid patients, and any blood, plasma,

15  or tissue bank procuring, storing, or distributing blood,

16  plasma, or tissue either for future manufacture or research or

17  distributed on a nonprofit basis, and further excluding any

18  clinical laboratory which is wholly owned and operated by 6 or

19  fewer physicians who are licensed pursuant to chapter 458 or

20  chapter 459 and who practice in the same group practice, and

21  at which no clinical laboratory work is performed for patients

22  referred by any health care provider who is not a member of

23  the same group.

24         3.  Diagnostic-imaging centers that are freestanding

25  outpatient facilities that provide specialized services for

26  the identification or determination of a disease through

27  examination and also provide sophisticated radiological

28  services, and in which services are rendered by a physician

29  licensed by the Board of Medicine under s. 458.311, s.

30  458.313, or s. 458.315 s. 458.317, or by an osteopathic

31  physician licensed by the Board of Osteopathic Medicine under

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 1  s. 459.006, s. 459.007, or s. 459.0075.  For purposes of this

 2  paragraph, "sophisticated radiological services" means the

 3  following:  magnetic resonance imaging; nuclear medicine;

 4  angiography; arteriography; computed tomography; positron

 5  emission tomography; digital vascular imaging; bronchography;

 6  lymphangiography; splenography; ultrasound, excluding

 7  ultrasound providers that are part of a private physician's

 8  office practice or when ultrasound is provided by two or more

 9  physicians licensed under chapter 458 or chapter 459 who are

10  members of the same professional association and who practice

11  in the same medical specialties; and such other sophisticated

12  radiological services, excluding mammography, as adopted in

13  rule by the board.

14         Section 5.  Subsection (10) of section 400.141, Florida

15  Statutes, is amended to read:

16         400.141  Administration and management of nursing home

17  facilities.--Every licensed facility shall comply with all

18  applicable standards and rules of the agency and shall:

19         (10)  Keep full records of resident admissions and

20  discharges; medical and general health status, including

21  medical records, personal and social history, and identity and

22  address of next of kin or other persons who may have

23  responsibility for the affairs of the residents; and

24  individual resident care plans including, but not limited to,

25  prescribed services, service frequency and duration, and

26  service goals.  The records shall be open to inspection by the

27  agency. A certified true and complete copy of the records

28  shall be provided to the Department of Health upon subpoena

29  issued pursuant to s. 456.057 or s. 456.071. The provisions of

30  chapter 456 apply to the records obtained pursuant to this

31  section.

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 1  

 2  Facilities that have been awarded a Gold Seal under the

 3  program established in s. 400.235 may develop a plan to

 4  provide certified nursing assistant training as prescribed by

 5  federal regulations and state rules and may apply to the

 6  agency for approval of their program.

 7         Section 6.  Subsection (3) is added to section 400.145,

 8  Florida Statutes, to read:

 9         400.145  Records of care and treatment of resident;

10  copies to be furnished.--

11         (3)  The administrator or records custodian in a

12  facility licensed under this chapter shall certify that a true

13  and complete copy of the records requested pursuant to a

14  subpoena or patient release have been provided to the

15  department or otherwise identify those documents that have not

16  been provided.

17         Section 7.  Subsections (7) and (8) of section 400.147,

18  Florida Statutes, are amended to read:

19         400.147  Internal risk management and quality assurance

20  program.--

21         (7)  The facility shall initiate an investigation and

22  shall notify the agency within 1 business day after the risk

23  manager or his or her designee has received a report pursuant

24  to paragraph (1)(d). The notification must be made in writing

25  and be provided electronically, by facsimile device or

26  overnight mail delivery. The notification must include

27  information regarding the identity of the affected resident,

28  the type of adverse incident, the initiation of an

29  investigation by the facility, and whether the events causing

30  or resulting in the adverse incident represent a potential

31  risk to any other resident. The notification is confidential

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 1  as provided by law and is not discoverable or admissible in

 2  any civil or administrative action, except in disciplinary

 3  proceedings by the Department of Health agency or the

 4  appropriate regulatory board. The agency may investigate, as

 5  it deems appropriate, any such incident and prescribe measures

 6  that must or may be taken in response to the incident. The

 7  department agency shall review each incident and determine

 8  whether it potentially involved conduct by the health care

 9  professional who is subject to disciplinary action, in which

10  case the provisions of s. 456.073 shall apply.

11         (8)(a)  Each facility shall complete the investigation

12  and submit an adverse incident report to the agency for each

13  adverse incident within 15 calendar days after its occurrence.

14  If, after a complete investigation, the risk manager

15  determines that the incident was not an adverse incident as

16  defined in subsection (5), the facility shall include this

17  information in the report. The agency shall develop a form for

18  reporting this information.

19         (b)  A copy of the report submitted The information

20  reported to the agency pursuant to paragraph (a) which relates

21  to health care practitioners as defined in s. 456.001(4) shall

22  be forwarded to the Division of Medical Quality Assurance of

23  the Department of Health for review persons licensed under

24  chapter 458, chapter 459, chapter 461, or chapter 466 shall be

25  reviewed by the agency. The division agency shall determine

26  whether any of the incidents potentially involved conduct by a

27  health care professional who is subject to disciplinary

28  action, in which case the provisions of s. 456.073 shall

29  apply.

30         (c)  The report submitted to the agency must also

31  contain the name of the risk manager of the facility.

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 1         (d)  The adverse incident report is confidential as

 2  provided by law and is not discoverable or admissible in any

 3  civil or administrative action, except in disciplinary

 4  proceedings by the agency or the appropriate regulatory board.

 5         Section 8.  Subsection (4) of section 400.211, Florida

 6  Statutes, is amended to read:

 7         400.211  Persons employed as nursing assistants;

 8  certification requirement.--

 9         (4)  When employed by a nursing home facility for a

10  12-month period or longer, a nursing assistant, to maintain

11  certification, shall submit to a performance review every 12

12  months and must receive regular inservice education based on

13  the outcome of such reviews. The inservice training must:

14         (a)  Be sufficient to ensure the continuing competence

15  of nursing assistants, must be at least 12 18 hours per year,

16  and may include hours accrued under s. 464.203(8);

17         (b)  Include, at a minimum:

18         1.  Techniques for assisting with eating and proper

19  feeding;

20         2.  Principles of adequate nutrition and hydration;

21         3.  Techniques for assisting and responding to the

22  cognitively impaired resident or the resident with difficult

23  behaviors;

24         4.  Techniques for caring for the resident at the

25  end-of-life; and

26         5.  Recognizing changes that place a resident at risk

27  for pressure ulcers and falls; and

28         (c)  Address areas of weakness as determined in nursing

29  assistant performance reviews and may address the special

30  needs of residents as determined by the nursing home facility

31  staff.

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 1  

 2  Costs associated with this training may not be reimbursed from

 3  additional Medicaid funding through interim rate adjustments.

 4         Section 9.  Subsection (7) of section 400.423, Florida

 5  Statutes, is amended to read:

 6         400.423  Internal risk management and quality assurance

 7  program; adverse incidents and reporting requirements.--

 8         (7)  A copy of the report submitted The information

 9  reported to the agency pursuant to subsection (3) which

10  relates to health care practitioners as defined in s.

11  456.001(4) shall be forwarded to the Division of Medical

12  Quality Assurance of the Department of Health for review

13  persons licensed under chapter 458, chapter 459, chapter 461,

14  chapter 464, or chapter 465 shall be reviewed by the agency.

15  The agency shall determine whether any of the incidents

16  potentially involved conduct by a health care professional who

17  is subject to disciplinary action, in which case the

18  provisions of s. 456.073 apply. The agency may investigate, as

19  it deems appropriate, any such incident and prescribe measures

20  that must or may be taken in response to the incident. The

21  division agency shall review each incident and determine

22  whether it potentially involved conduct by a health care

23  professional who is subject to disciplinary action, in which

24  case the provisions of s. 456.073 apply.

25         Section 10.  Section 400.455, Florida Statutes, is

26  created to read:

27         400.455  Certified copy of subpoenaed records.--Upon a

28  subpoena issued by the Department of Health pursuant to s.

29  456.057 or s. 456.071, a certified true and complete copy of

30  the requested records shall be provided. The provisions of

31  

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 1  chapter 456 apply to the records obtained pursuant to this

 2  section.

 3         Section 11.  Section 456.005, Florida Statutes, is

 4  amended to read:

 5         456.005  Long-range policy planning; plans, reports,

 6  and recommendations.--To facilitate efficient and

 7  cost-effective regulation, the department and the board, where

 8  appropriate, shall develop and implement a long-range policy

 9  planning and monitoring process to include recommendations

10  specific to each profession. Such process shall include

11  estimates of revenues, expenditures, cash balances, and

12  performance statistics for each profession. The period covered

13  shall not be less than 5 years. The department, with input

14  from the boards and licensees, shall develop the long-range

15  plan and must obtain the approval of the secretary. The

16  department shall monitor compliance with the approved

17  long-range plan and, with input from the boards, shall

18  annually update the plans for approval by the secretary. The

19  department shall provide concise management reports to the

20  boards quarterly.  As part of the review process, the

21  department shall evaluate:

22         (1)  Whether the department, including the boards and

23  the various functions performed by the department, is

24  operating efficiently and effectively and if there is a need

25  for a board or council to assist in cost-effective regulation.

26         (2)  How and why the various professions are regulated.

27         (3)  Whether there is a need to continue regulation,

28  and to what degree.

29         (4)  Whether or not consumer protection is adequate,

30  and how it can be improved.

31  

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 1         (5)  Whether there is consistency between the various

 2  practice acts.

 3         (6)  Whether unlicensed activity is adequately

 4  enforced.

 5  

 6  Such plans should include conclusions and recommendations on

 7  these and other issues as appropriate.  Such plans shall be

 8  provided to the Governor and the Legislature by November 1 of

 9  each year.

10         Section 12.  Subsection (5) of section 456.011, Florida

11  Statutes, is amended to read:

12         (Substantial rewording of subsection. See

13         s. 456.011(5), F.S., for present text.)

14         456.011  Boards; organization; meetings; compensation

15  and travel expenses.--

16         (5)  Notwithstanding the provisions of chapter 120,

17  when two or more boards have identified a conflict in the

18  interpretation or application of the respective practice acts

19  of the boards, the following administrative remedies shall be

20  employed:

21         (a)  One board or the secretary shall request that the

22  boards establish a special committee to resolve the conflict.

23  The special committee shall consist of two members designated

24  by each board, who may be members of the designating board or

25  other experts designated by the board, and three additional

26  persons appointed by the secretary who are not members of

27  either profession and who do not have an interest in either

28  profession. The committee shall, by majority vote, make any

29  recommendations that the committee finds necessary, including,

30  but not limited to, recommended rules to resolve the

31  differences.

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 1         (b)  Matters that cannot be resolved through the

 2  special committee may be resolved by the department through

 3  informal mediation by the department or agent of the

 4  department. If the committee agrees to a mediated resolution,

 5  the mediator shall notify the department of the terms of the

 6  resolution. The committee shall be provided the opportunity to

 7  record with the department an acknowledgement of satisfaction

 8  of the terms of mediation within 60 days after the mediator's

 9  notification to the department. A mediated settlement reached

10  by the special committee shall be binding on the applicable

11  boards.

12         (c)  If the boards elect not to resolve a conflict

13  through the means established in paragraph (a) or paragraph

14  (b), the secretary may resolve the differences through

15  rulemaking or, in the case of a declaratory statement,

16  notwithstanding the provisions of chapter 120, the boards

17  shall have standing to petition the department to issue an

18  order.

19         (d)  For any administrative remedy specified in this

20  subsection, the department shall provide legal representation.

21         Section 13.  Subsection (3) of section 456.012 is

22  amended to read:

23         456.012  Board rules; final agency action;

24  challenges.--

25         (3)  No board created within the department shall have

26  standing to challenge a rule, or proposed rule, or declaratory

27  statement of another board. However, if there is a dispute

28  between boards concerning a rule, or proposed rule, or

29  declaratory statement, the boards may avail themselves of the

30  provisions of s. 456.011(5).

31  

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 1         Section 14.  Section 456.013, Florida Statutes, is

 2  amended to read:

 3         456.013  Department; general licensing provisions.--

 4         (1)(a)  Any person desiring to be licensed in a

 5  profession within the jurisdiction of the department shall

 6  apply to the department in writing to take the licensure

 7  examination.  The application shall be made on a form prepared

 8  and furnished by the department. The application form must be

 9  available on the World Wide Web and the department may accept

10  electronically submitted applications beginning July 1, 2001.

11  The application shall require the social security number of

12  the applicant, except as provided in paragraph (b). The form

13  shall be supplemented as needed to reflect any material change

14  in any circumstance or condition stated in the application

15  which takes place between the initial filing of the

16  application and the final grant or denial of the license and

17  which might affect the decision of the department. If an

18  application is submitted electronically, the department may

19  require supplemental materials, including an original

20  signature of the applicant and verification of credentials, to

21  be submitted in a nonelectronic format. An incomplete

22  application shall expire 1 year after initial filing. In order

23  to further the economic development goals of the state, and

24  notwithstanding any law to the contrary, the department may

25  enter into an agreement with the county tax collector for the

26  purpose of appointing the county tax collector as the

27  department's agent to accept applications for licenses and

28  applications for renewals of licenses. The agreement must

29  specify the time within which the tax collector must forward

30  any applications and accompanying application fees to the

31  department.

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 1         (b)  If an applicant has not been issued a social

 2  security number by the Federal Government at the time of

 3  application because the applicant is not a citizen or resident

 4  of this country, the department may process the application

 5  using a unique personal identification number. If such an

 6  applicant is otherwise eligible for licensure, the board, or

 7  the department when there is no board, may issue a temporary

 8  license, as established by rule of the board, or the

 9  department if there is no board, to the applicant, which shall

10  expire 90 30 days after issuance unless a social security

11  number is obtained and submitted in writing to the department.

12  Upon receipt of the applicant's social security number, the

13  department shall issue a new license, which shall expire at

14  the end of the current biennium.

15         (2)  The board, or the department if there is no board,

16  may adopt a rule allowing an applicant for licensure to

17  complete the coursework requirements for licensure by

18  successfully completing the required courses as a student or

19  by teaching the required graduate course as an instructor or

20  professor in an accredited institution.

21         (3)(2)  Before the issuance of any license, the

22  department shall charge an initial license fee as determined

23  by the applicable board or, if no such board exists, by rule

24  of the department. Upon receipt of the appropriate license

25  fee, the department shall issue a license to any person

26  certified by the appropriate board, or its designee, as having

27  met the licensure requirements imposed by law or rule. The

28  license shall consist of a wallet-size identification card and

29  a wall card measuring 6 1/2  inches by 5 inches. In addition

30  to the two-part license, the department, at the time of

31  initial licensure if specified by the board or, if there is no

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 1  board, by department rule, and if the board has a positive

 2  cash balance, shall issue a wall certificate suitable for

 3  conspicuous display, which shall be no smaller than 8 1/2

 4  inches by 14 inches. The licensee shall surrender to the

 5  department the wallet-size identification card, the wall card,

 6  and the wall certificate, if one has been issued by the

 7  department, if the licensee's license was issued in error and

 8  is revoked.

 9         (4)(3)(a)  The board, or the department when there is

10  no board, may refuse to issue an initial license to any

11  applicant who is under investigation or prosecution in any

12  jurisdiction for an action that would constitute a violation

13  of this chapter or the professional practice acts administered

14  by the department and the boards, until such time as the

15  investigation or prosecution is complete, and the time period

16  in which the licensure application must be granted or denied

17  shall be tolled until 15 days after the receipt of the final

18  results of the investigation or prosecution.

19         (b)  If an applicant has been convicted of a felony

20  related to the practice or ability to practice any health care

21  profession, the board, or the department when there is no

22  board, may require the applicant to prove that his or her

23  civil rights have been restored.

24         (c)  In considering applications for licensure, the

25  board, or the department when there is no board, may require a

26  personal appearance of the applicant. If the applicant is

27  required to appear, the time period in which a licensure

28  application must be granted or denied shall be tolled until

29  such time as the applicant appears. However, if the applicant

30  fails to appear before the board at either of the next two

31  regularly scheduled board meetings, or fails to appear before

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 1  the department within 30 days if there is no board, the

 2  application for licensure shall be denied.

 3         (5)(4)  When any administrative law judge conducts a

 4  hearing pursuant to the provisions of chapter 120 with respect

 5  to the issuance of a license by the department, the

 6  administrative law judge shall submit his or her recommended

 7  order to the appropriate board, which shall thereupon issue a

 8  final order.  The applicant for licensure may appeal the final

 9  order of the board in accordance with the provisions of

10  chapter 120.

11         (6)(5)  A privilege against civil liability is hereby

12  granted to any witness for any information furnished by the

13  witness in any proceeding pursuant to this section, unless the

14  witness acted in bad faith or with malice in providing such

15  information.

16         (6)  As a condition of renewal of a license, the Board

17  of Medicine, the Board of Osteopathic Medicine, the Board of

18  Chiropractic Medicine, and the Board of Podiatric Medicine

19  shall each require licensees which they respectively regulate

20  to periodically demonstrate their professional competency by

21  completing at least 40 hours of continuing education every 2

22  years.  The boards may require by rule that up to 1 hour of

23  the required 40 or more hours be in the area of risk

24  management or cost containment. This provision shall not be

25  construed to limit the number of hours that a licensee may

26  obtain in risk management or cost containment to be credited

27  toward satisfying the 40 or more required hours. This

28  provision shall not be construed to require the boards to

29  impose any requirement on licensees except for the completion

30  of at least 40 hours of continuing education every 2 years.

31  Each of such boards shall determine whether any specific

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 1  continuing education requirements not otherwise mandated by

 2  law shall be mandated and shall approve criteria for, and the

 3  content of, any continuing education mandated by such board.

 4  Notwithstanding any other provision of law, the board, or the

 5  department when there is no board, may approve by rule

 6  alternative methods of obtaining continuing education credits

 7  in risk management. The alternative methods may include

 8  attending a board meeting at which another licensee is

 9  disciplined, serving as a volunteer expert witness for the

10  department in a disciplinary case, or serving as a member of a

11  probable cause panel following the expiration of a board

12  member's term. Other boards within the Division of Medical

13  Quality Assurance, or the department if there is no board, may

14  adopt rules granting continuing education hours in risk

15  management for attending a board meeting at which another

16  licensee is disciplined, for serving as a volunteer expert

17  witness for the department in a disciplinary case, or for

18  serving as a member of a probable cause panel following the

19  expiration of a board member's term.

20         (7)  The boards, or the department when there is no

21  board, shall require the completion of a 2-hour course

22  relating to prevention of medical errors as part of the

23  licensure and renewal process. The 2-hour course shall count

24  towards the total number of continuing education hours

25  required for the profession. The course shall be approved by

26  the board or department, as appropriate, and shall include a

27  study of root-cause analysis, error reduction and prevention,

28  and patient safety. In addition, the course approved by the

29  Board of Medicine and the Board of Osteopathic Medicine shall

30  include information relating to the five most misdiagnosed

31  conditions during the previous biennium, as determined by the

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 1  board. If the course is being offered by a facility licensed

 2  pursuant to chapter 395 for its employees, the board may

 3  approve up to 1 hour of the 2-hour course to be specifically

 4  related to error reduction and prevention methods used in that

 5  facility.

 6         (8)  The respective boards within the jurisdiction of

 7  the department, or the department when there is no board, may

 8  adopt rules to provide for the use of approved videocassette

 9  courses, not to exceed 5 hours per subject, to fulfill the

10  continuing education requirements of the professions they

11  regulate. Such rules shall provide for prior approval of the

12  board, or the department when there is no board, of the

13  criteria for and content of such courses and shall provide for

14  a videocassette course validation form to be signed by the

15  vendor and the licensee and submitted to the department, along

16  with the license renewal application, for continuing education

17  credit.

18         (7)(9)  Any board that currently requires continuing

19  education for renewal of a license, or the department if there

20  is no board, shall adopt rules to establish the criteria for

21  continuing education courses.  The rules may provide that up

22  to a maximum of 25 percent of the required continuing

23  education hours can be fulfilled by the performance of pro

24  bono services to the indigent or to underserved populations or

25  in areas of critical need within the state where the licensee

26  practices. The board, or the department if there is no board,

27  must require that any pro bono services be approved in advance

28  in order to receive credit for continuing education under this

29  subsection. The standard for determining indigency shall be

30  that recognized by the Federal Poverty Income Guidelines

31  produced by the United States Department of Health and Human

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 1  Services.  The rules may provide for approval by the board, or

 2  the department if there is no board, that a part of the

 3  continuing education hours can be fulfilled by performing

 4  research in critical need areas or for training leading to

 5  advanced professional certification.  The board, or the

 6  department if there is no board, may make rules to define

 7  underserved and critical need areas.  The department shall

 8  adopt rules for administering continuing education

 9  requirements adopted by the boards or the department if there

10  is no board.

11         (8)(10)  Notwithstanding any law to the contrary, an

12  elected official who is licensed under a practice act

13  administered by the Division of Medical Quality Assurance may

14  hold employment for compensation with any public agency

15  concurrent with such public service.  Such dual service must

16  be disclosed according to any disclosure required by

17  applicable law.

18         (9)(11)  In any instance in which a licensee or

19  applicant to the department is required to be in compliance

20  with a particular provision by, on, or before a certain date,

21  and if that date occurs on a Saturday, Sunday, or a legal

22  holiday, then the licensee or applicant is deemed to be in

23  compliance with the specific date requirement if the required

24  action occurs on the first succeeding day which is not a

25  Saturday, Sunday, or legal holiday.

26         (10)(12)  Pursuant to the federal Personal

27  Responsibility and Work Opportunity Reconciliation Act of

28  1996, each party is required to provide his or her social

29  security number in accordance with this section.  Disclosure

30  of social security numbers obtained through this requirement

31  

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 1  shall be limited to the purpose of administration of the Title

 2  IV-D program for child support enforcement.

 3         Section 15.  Paragraph (a) of subsection (4) of section

 4  381.00593, Florida Statutes, is amended to read:

 5         381.00593  Public school volunteer health care

 6  practitioner program.--

 7         (4)(a)  Notwithstanding any provision of chapter 458,

 8  chapter 459, chapter 460, chapter 461, chapter 463, part I of

 9  chapter 464, chapter 465, chapter 466, chapter 467, part I of

10  chapter 468, or chapter 486 to the contrary, any health care

11  practitioner who participates in the program established in

12  this section and thereby agrees to provide his or her

13  services, without compensation, in a public school for at

14  least 80 hours a year for each school year during the biennial

15  licensure period, or, if the health care practitioner is

16  retired, for at least 400 hours a year for each school year

17  during the licensure period, upon providing sufficient proof

18  from the applicable school district that the health care

19  practitioner has completed such hours at the time of license

20  renewal under procedures specified by the Department of

21  Health, shall be eligible for the following:

22         1.  Waiver of the biennial license renewal fee for an

23  active license; and

24         2.  Fulfillment of a maximum of 25 percent of the

25  continuing education hours required for license renewal,

26  pursuant to s. 456.013(7) s. 456.013(9).

27  

28  The school district may establish a schedule for health care

29  practitioners who participate in the program.

30  

31  

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 1         Section 16.  Paragraph (c) of subsection (1) and

 2  subsection (2) of section 456.017, Florida Statutes, are

 3  amended, and subsection (7) is added to that section, to read:

 4         456.017  Examinations.--

 5         (1)

 6         (c)1.  The board, or the department when there is no

 7  board, shall approve by rule the use of one or more national

 8  examinations which the department has certified as meeting

 9  requirements of national examinations and generally accepted

10  testing standards pursuant to department rules. Providers of

11  examinations seeking certification by the department shall pay

12  the actual costs incurred by the department in making a

13  determination regarding the certification.  The name and

14  number of a candidate may be provided to a national contractor

15  for the limited purpose of preparing the grade tape and

16  information to be returned to the board or department; or, to

17  the extent otherwise specified by rule, the candidate may

18  apply directly to the vendor of the national examination and

19  supply test score information to the department. The

20  department may delegate to the board the duty to provide and

21  administer the examination.  Any national examination approved

22  by a board, or the department when there is no board, prior to

23  October 1, 1997, is deemed certified under this paragraph.

24         2.  The board, or the department when there is no

25  board, shall approve and begin administering a national

26  examination no later than December 31, 2001. Neither the board

27  nor the department may administer a state-developed written

28  examination after December 31, 2001, notwithstanding any other

29  provision of law, if a national examination has been certified

30  by the department. The examination may be administered

31  

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 1  electronically if adequate security measures are used, as

 2  determined by rule of the department.

 3         3.  The board, or the department when there is no

 4  board, may administer a state-developed practical or clinical

 5  examination, as required by the applicable practice act, if

 6  all costs of development, purchase, validation,

 7  administration, review, and defense are paid by the

 8  examination candidate prior to the administration of the

 9  examination. If a national practical or clinical examination

10  is available and certified by the department pursuant to this

11  section, the board, or the department when there is no board,

12  may administer the national examination.

13         4.  It is the intent of the Legislature to reduce the

14  costs associated with state examinations and to encourage the

15  use of national examinations whenever possible.

16         (2)  For each examination developed by the department

17  or a contracted vendor, the board, or the department when

18  there is no board, shall adopt rules providing for

19  reexamination of any applicants who failed an examination

20  developed by the department or a contracted vendor. If both a

21  written and a practical examination are given, an applicant

22  shall be required to retake only the portion of the

23  examination on which the applicant failed to achieve a passing

24  grade, if the applicant successfully passes that portion

25  within a reasonable time, as determined by rule of the board,

26  or the department when there is no board, of passing the other

27  portion. Except for national examinations approved and

28  administered pursuant to this section, the department shall

29  provide procedures for applicants who fail an examination

30  developed by the department or a contracted vendor to review

31  their examination questions, answers, papers, grades, and

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 1  grading key for the questions the candidate answered

 2  incorrectly or, if not feasible, the parts of the examination

 3  failed. Applicants shall bear the actual cost for the

 4  department to provide examination review pursuant to this

 5  subsection. An applicant may waive in writing the

 6  confidentiality of the applicant's examination grades.

 7  Notwithstanding any other provisions, only candidates who fail

 8  an examination with a score that is by less than 10 percent

 9  below the minimum score required to pass the examination shall

10  be entitled to challenge the validity of the examination at

11  hearing.

12         (7)  The department may post examination scores

13  electronically on the Internet in lieu of mailing the scores

14  to each applicant. Such electronic posting of the examination

15  scores meets the requirements of chapter 120 if the department

16  also posts with the examination scores a notification of

17  rights as set forth in chapter 120. The date of receipt for

18  purposes of chapter 120 is the date the examination scores are

19  posted electronically. The department shall also notify the

20  examinee when scores are posted electronically of the

21  availability of a post-examination review, if applicable.

22         Section 17.  Section 456.0195, Florida Statutes, is

23  created to read:

24         456.0195  Continuing education; instruction on domestic

25  violence; instruction on HIV and AIDS; instruction on

26  prevention of medical errors.--

27         (1)  The purpose of this section is to encourage health

28  care practitioners, as defined in s. 456.001, to complete

29  continuing education courses in specified subject areas as a

30  condition of license renewal, as applicable to the area of

31  practice. The boards, or the department when there is no

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 1  board, may require the completion of courses, including, but

 2  not limited to, the following subject areas, as defined by

 3  board or department rule:

 4         (a)  Domestic violence as defined in s. 741.28. The

 5  course shall include information on the number of patients in

 6  that professional's practice who are likely to be victims of

 7  domestic violence and the number who are likely to be

 8  perpetrators of domestic violence; screening procedures for

 9  determining whether a patient has any history of being a

10  victim or perpetrator of domestic violence; and instruction on

11  how to provide such patients with information on, or how to

12  refer such patients to, resources in the local community, such

13  as domestic violence centers and other advocacy groups that

14  provide legal aid, shelter, victim counseling, batterer

15  counseling, or child protection services.

16         (b)  Human immunodeficiency virus and acquired immune

17  deficiency syndrome. The course shall consist of education on

18  the modes of transmission, infection-control procedures,

19  clinical management, and prevention of human immunodeficiency

20  virus and acquired immune deficiency syndrome. The course

21  shall include information on current state law concerning

22  acquired immune deficiency syndrome and its impact on testing;

23  confidentiality of test results; treatment of patients; any

24  protocols and procedures applicable to human immunodeficiency

25  virus counseling, testing, and reporting; the offering of HIV

26  testing to pregnant women; and partner-notification issues

27  pursuant to ss. 381.004 and 384.25.

28         (c)  Prevention of medical errors. The course shall

29  include a study of root-cause analysis, error reduction and

30  prevention, and patient safety. If the course is being offered

31  by a facility licensed under chapter 395 for its employees,

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 1  the board may approve up to 1 hour of the 2-hour course to be

 2  specifically related to error reduction and prevention methods

 3  used in that facility.

 4         (2)  Proof of completion of continuing education

 5  courses as defined in subsection (1) shall be defined by board

 6  rule, or by department rule if there is no board.

 7         (3)  Courses completed in the subject areas specified

 8  in subsection (1) shall count towards the total number of

 9  continuing education hours required for license renewal for

10  the profession.

11         (4)  Any person holding two or more licenses subject to

12  this section shall be required to complete only the

13  requirement for one license.

14         (5)  Failure to comply with courses required by the

15  boards, or the department if there is no board, constitutes

16  grounds for disciplinary action under each respective practice

17  act and under s. 456.072(1)(k).

18         Section 18.  Subsections (4) and (9) of section

19  456.025, Florida Statutes, are amended to read:

20         456.025  Fees; receipts; disposition.--

21         (4)  Each board, or the department if there is no

22  board, may charge a fee not to exceed $25, as determined by

23  rule, for the issuance of a wall certificate pursuant to s.

24  456.013(3) s. 456.013(2) requested by a licensee who was

25  licensed prior to July 1, 1998, or for the issuance of a

26  duplicate wall certificate requested by any licensee.

27         (9)  The department shall provide a condensed

28  management report of revenues and expenditures, performance

29  measures, and recommendations, if needed, to each board at

30  least once each quarter budgets, finances, performance

31  statistics, and recommendations to each board at least once a

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 1  quarter. The department shall identify and include in such

 2  presentations any changes, or projected changes, made to the

 3  board's budget since the last presentation.

 4         Section 19.  Section 456.031, Florida Statutes, is

 5  amended to read:

 6         456.031  Requirement for instruction on domestic

 7  violence.--

 8         (1)(a)  The appropriate board shall require each person

 9  licensed or certified under chapter 458, chapter 459, part I

10  of chapter 464, chapter 466, chapter 467, chapter 490, or

11  chapter 491 to complete a 1-hour continuing education course,

12  approved by the board, on domestic violence, as defined in s.

13  741.28, as part of initial licensure, biennial relicensure, or

14  recertification. The course shall consist of a skills-based

15  curriculum that includes practice protocols for identifying

16  and treating a victim of domestic violence, consistent with

17  the profession and instructions on practical applications. As

18  used in this section, the term "skills-based curriculum" means

19  a curriculum that details methods of practical applications to

20  improve responses to domestic violence victims through

21  culturally competent methods of routine screening, assessment,

22  intervention, and health-records documentation. Each licensee

23  must complete 2 hours of continuing education on domestic

24  violence every 4 years, as prescribed by board rule. Initial

25  applicants for licensure shall be allowed 1 year following the

26  date of licensure to complete the required course. information

27  on the number of patients in that professional's practice who

28  are likely to be victims of domestic violence and the number

29  who are likely to be perpetrators of domestic violence,

30  screening procedures for determining whether a patient has any

31  history of being either a victim or a perpetrator of domestic

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 1  violence, and instruction on how to provide such patients with

 2  information on, or how to refer such patients to, resources in

 3  the local community, such as domestic violence centers and

 4  other advocacy groups, that provide legal aid, shelter, victim

 5  counseling, batterer counseling, or child protection services.

 6         (b)  Each such licensee or certificateholder shall

 7  submit confirmation of having completed such course, on a form

 8  provided by the board, when submitting fees for each biennial

 9  renewal.

10         (c)  The board may approve additional equivalent

11  courses that may be used to satisfy the requirements of

12  paragraph (a).  Each licensing board that requires a licensee

13  to complete an educational course pursuant to this subsection

14  may include the hour required for completion of the course in

15  the total hours of continuing education required by law for

16  such profession unless the continuing education requirements

17  for such profession consist of fewer than 30 hours biennially.

18         (b)(d)  Any person holding two or more licenses subject

19  to the provisions of this subsection shall be permitted to

20  show proof of having taken one board-approved course on

21  domestic violence, for purposes of initial licensure,

22  relicensure, or recertification for additional licenses.

23         (e)  Failure to comply with the requirements of this

24  subsection shall constitute grounds for disciplinary action

25  under each respective practice act and under s. 456.072(1)(k).

26  In addition to discipline by the board, the licensee shall be

27  required to complete such course.

28         (2)  The board shall also require, as a condition of

29  granting a license under any chapter specified in paragraph

30  (1)(a), that each applicant for initial licensure under the

31  appropriate chapter complete an educational course acceptable

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 1  to the board on domestic violence which is substantially

 2  equivalent to the course required in subsection (1).  An

 3  applicant who has not taken such course at the time of

 4  licensure shall, upon submission of an affidavit showing good

 5  cause, be allowed 6 months to complete such requirement.

 6         (3)(a)  In lieu of completing a course as required in

 7  subsection (1), a licensee or certificateholder may complete a

 8  course in end-of-life care and palliative health care, if the

 9  licensee or certificateholder has completed an approved

10  domestic violence course in the immediately preceding

11  biennium.

12         (b)  In lieu of completing a course as required by

13  subsection (1), a person licensed under chapter 466 who has

14  completed an approved domestic-violence education course in

15  the immediately preceding 2 years may complete a course

16  approved by the Board of Dentistry.

17         (2)(4)  Each board may adopt rules to carry out the

18  provisions of this section.

19         (5)  Each board shall report to the President of the

20  Senate, the Speaker of the House of Representatives, and the

21  chairs of the appropriate substantive committees of the

22  Legislature by March 1 of each year as to the implementation

23  of and compliance with the requirements of this section.

24         Section 20.  Subsection (13) of section 456.036,

25  Florida Statutes, is amended to read:

26         456.036  Licenses; active and inactive status;

27  delinquency.--

28         (13)  The board, or the department when there is no

29  board, may adopt rules pursuant to ss. 120.536(1) and 120.54

30  as necessary to implement this section. The rules may require

31  the display of a license.

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 1         Section 21.  Section 456.037, Florida Statutes, is

 2  amended to read:

 3         456.037  Business establishments; requirements for

 4  active status licenses; delinquency; discipline;

 5  applicability; display of license.--

 6         (1)  A business establishment regulated by the Division

 7  of Medical Quality Assurance pursuant to this chapter may

 8  provide regulated services only if the business establishment

 9  has an active status license. A business establishment that

10  provides regulated services without an active status license

11  is in violation of this section and s. 456.072, and the board,

12  or the department if there is no board, may impose discipline

13  on the business establishment.

14         (2)  A business establishment must apply with a

15  complete application, as defined by rule of the board, or the

16  department if there is no board, to renew an active status

17  license before the license expires. If a business

18  establishment fails to renew before the license expires, the

19  license becomes delinquent, except as otherwise provided in

20  statute, in the license cycle following expiration.

21         (3)  A delinquent business establishment must apply

22  with a complete application, as defined by rule of the board,

23  or the department if there is no board, for active status

24  within 6 months after becoming delinquent. Failure of a

25  delinquent business establishment to renew the license within

26  the 6 months after the expiration date of the license renders

27  the license null without any further action by the board or

28  the department. Any subsequent licensure shall be as a result

29  of applying for and meeting all requirements imposed on a

30  business establishment for new licensure.

31  

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 1         (4)  The status or a change in status of a business

 2  establishment license does not alter in any way the right of

 3  the board, or of the department if there is no board, to

 4  impose discipline or to enforce discipline previously imposed

 5  on a business establishment for acts or omissions committed by

 6  the business establishment while holding a license, whether

 7  active or null.

 8         (5)  This section applies to any business establishment

 9  registered, permitted, or licensed by the department to do

10  business. Business establishments include, but are not limited

11  to, dental laboratories, electrology facilities, massage

12  establishments, and pharmacies.

13         (6)  The board, or the department if there is no board,

14  may require the display of a license by rule.

15         Section 22.  Paragraph (a) of subsection (4) of section

16  456.039, Florida Statutes, is amended to read:

17         456.039  Designated health care professionals;

18  information required for licensure.--

19         (4)(a)  An applicant for initial licensure must submit

20  a set of fingerprints to the Department of Health in

21  accordance with s. 458.311, s. 458.3115, s. 458.3124, s.

22  458.313, s. 459.0055, s. 460.406, or s. 461.006.

23         Section 23.  Subsection (16) of section 456.057,

24  Florida Statutes, is amended to read:

25         456.057  Ownership and control of patient records;

26  report or copies of records to be furnished.--

27         (16)  A health care practitioner or records owner

28  furnishing copies of reports or records or making the reports

29  or records available for digital scanning pursuant to this

30  section may shall charge the department the reasonable costs

31  of reproducing the records no more than the actual cost of

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 1  copying, including reasonable staff time, or the amount

 2  specified in administrative rule by the appropriate board, or

 3  the department when there is no board.

 4         (a)  Reasonable costs of reproducing copies of written

 5  or typed documents or reports may not be more than:

 6         1.  For the first 25 pages, $1 per page.

 7         2.  For each page in excess of 25 pages, 25 cents.

 8         (b)  Reasonable costs of reproducing X rays and other

 9  special kinds of records are the actual costs. The term

10  "actual costs" means the cost of the material and supplies

11  used to duplicate the record, as well as the labor costs

12  associated with the duplication.

13         Section 24.  Subsection (3) of section 456.063, Florida

14  Statutes, is amended to read:

15         456.063  Sexual misconduct; disqualification for

16  license, certificate, or registration.--

17         (3)  Licensed health care practitioners shall report

18  allegations of sexual misconduct to the department, regardless

19  of the practice setting in which the alleged sexual misconduct

20  occurred. Each board, or the department if there is no board,

21  may adopt rules to administer the requirements for reporting

22  allegations of sexual misconduct, including rules to determine

23  the sufficiency of allegations.

24         Section 25.  Paragraphs (aa) and (bb) of subsection (1)

25  of section 456.072, Florida Statutes, are amended, paragraph

26  (ff) is added to that subsection, and subsection (7) is added

27  to that section, to read:

28         456.072  Grounds for discipline; penalties;

29  enforcement.--

30  

31  

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 1         (1)  The following acts shall constitute grounds for

 2  which the disciplinary actions specified in subsection (2) may

 3  be taken:

 4         (aa)  Performing or attempting to perform health care

 5  services on the wrong patient, a wrong-site procedure, a wrong

 6  procedure, or an unauthorized procedure or a procedure that is

 7  medically unnecessary or otherwise unrelated to the patient's

 8  diagnosis or medical condition. For the purposes of this

 9  paragraph, performing or attempting to perform health care

10  services includes invasive actions taken in furtherance of the

11  preparation of the patient, but does not include those

12  preparations that are noninvasive.

13         (bb)  Leaving a foreign body in a patient, such as a

14  sponge, clamp, forceps, surgical needle, or other

15  paraphernalia commonly used in surgical, examination, or other

16  diagnostic procedures, unless leaving the foreign body is

17  medically indicated and documented in the patient record. For

18  the purposes of this paragraph, it shall be legally presumed

19  that retention of a foreign body is not in the best interest

20  of the patient and is not within the standard of care of the

21  profession, unless medically indicated and documented in the

22  patient record regardless of the intent of the professional.

23         (ff)  Prescribing, administering, dispensing, or

24  distributing a legend drug, including a controlled substance,

25  when the practitioner knows or reasonably should know that the

26  receiving patient has not established a valid professional

27  relationship with the prescribing practitioner. A medical

28  questionnaire completed by Internet, telephone, electronic

29  transfer, or mail does not establish a valid professional

30  relationship.

31  

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 1         (7)  In addition to any other discipline imposed by

 2  final order and entered on or after July 1, 2004, pursuant to

 3  this section, or discipline imposed through final order and

 4  entered on or after July 1, 2004, for violation of any

 5  practice act, the board, or the department when there is no

 6  board, shall assess a nonrefundable fee to defray the costs of

 7  monitoring the licensee's compliance with the order in the

 8  amount of $25 per month for each month or portion of a month

 9  set forth in the final order to complete the length of term of

10  the probation, suspension, or practice restrictions imposed by

11  the final order. The assessment shall be included in the terms

12  of the final order. The board, or the department if there is

13  no board, may elect to assess the same fee to offset other

14  costs of monitoring compliance with the terms imposed by a

15  final order that does not include probation, suspension, or

16  practice restrictions.

17         Section 26.  Subsection (1) of section 456.073, Florida

18  Statutes, is amended to read:

19         456.073  Disciplinary proceedings.--Disciplinary

20  proceedings for each board shall be within the jurisdiction of

21  the department.

22         (1)  The department, for the boards under its

23  jurisdiction, shall cause to be investigated any complaint

24  that is filed before it if the complaint is in writing, signed

25  by the complainant, and legally sufficient. A complaint filed

26  by a state prisoner against a health care practitioner

27  employed by or otherwise providing health care services within

28  a facility of the Department of Corrections is not legally

29  sufficient unless there is a showing that the prisoner

30  complainant has exhausted all available administrative

31  remedies within the state correctional system before filing

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 1  the complaint. However, if the Department of Health determines

 2  after a preliminary inquiry of a state prisoner's complaint

 3  that the practitioner may present a serious threat to the

 4  health and safety of any individual who is not a state

 5  prisoner, the Department of Health may determine legal

 6  sufficiency and proceed with discipline. The Department of

 7  Health shall be notified within 15 days after the Department

 8  of Corrections disciplines or allows a health care

 9  practitioner to resign for an offense related to the practice

10  of his or her profession. A complaint is legally sufficient if

11  it contains ultimate facts that show that a violation of this

12  chapter, of any of the practice acts relating to the

13  professions regulated by the department, or of any rule

14  adopted by the department or a regulatory board in the

15  department has occurred. In order to determine legal

16  sufficiency, the department may require supporting information

17  or documentation. The department may investigate, and the

18  department or the appropriate board may take appropriate final

19  action on, a complaint even though the original complainant

20  withdraws it or otherwise indicates a desire not to cause the

21  complaint to be investigated or prosecuted to completion. The

22  department may investigate an anonymous complaint if the

23  complaint is in writing and is legally sufficient, if the

24  alleged violation of law or rules is substantial, and if the

25  department has reason to believe, after preliminary inquiry,

26  that the violations alleged in the complaint are true. The

27  department may investigate a complaint made by a confidential

28  informant if the complaint is legally sufficient, if the

29  alleged violation of law or rule is substantial, and if the

30  department has reason to believe, after preliminary inquiry,

31  that the allegations of the complainant are true. The

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 1  department may initiate an investigation if it has reasonable

 2  cause to believe that a licensee or a group of licensees has

 3  violated a Florida statute, a rule of the department, or a

 4  rule of a board. Notwithstanding subsection (13), the

 5  department may investigate information filed pursuant to s.

 6  456.041(4) relating to liability actions with respect to

 7  practitioners licensed under chapter 458 or chapter 459 which

 8  have been reported under s. 456.049 or s. 627.912 within the

 9  previous 6 years for any paid claim that exceeds $50,000.

10  Except as provided in ss. 458.331(9), 459.015(9), 460.413(5),

11  and 461.013(6), When an investigation of any subject is

12  undertaken, the department shall promptly furnish to the

13  subject or the subject's attorney a copy of the complaint or

14  document that resulted in the initiation of the investigation.

15  The subject may submit a written response to the information

16  contained in such complaint or document within 30 20 days

17  after service to the subject of the complaint or document. The

18  subject's written response shall be considered by the probable

19  cause panel. The right to respond does not prohibit the

20  issuance of a summary emergency order if necessary to protect

21  the public. However, if the secretary, or the secretary's

22  designee, and the chair of the respective board or the chair

23  of its probable cause panel agree in writing that such

24  notification would be detrimental to the investigation, the

25  department may withhold notification. The department may

26  conduct an investigation without notification to any subject

27  if the act under investigation is a criminal offense.

28         Section 27.  Subsection (2) of section 457.105, Florida

29  Statutes, is amended, and subsection (3) is added to that

30  section, to read:

31         457.105  Licensure qualifications and fees.--

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 1         (2)  A person may become licensed to practice

 2  acupuncture if the person applies to the department and:

 3         (a)  Is 21 years of age or older, has good moral

 4  character, and has the ability to communicate in English,

 5  which is demonstrated by having passed the national written

 6  examination in English or, if such examination was passed in a

 7  foreign language, by also having passed a nationally

 8  recognized English proficiency examination;

 9         (b)  Effective July 31, 2001, has completed 60 college

10  credits from an accredited postsecondary institution as a

11  prerequisite to enrollment in and completion of an authorized

12  3-year course of study in acupuncture and oriental medicine,

13  and has completed a 3-year course of study in acupuncture and

14  oriental medicine, and effective July 31, 2001, a 4-year

15  course of study in acupuncture and oriental medicine, which

16  meets standards established by the board by rule, which

17  standards include, but are not limited to, successful

18  completion of academic courses in western anatomy, western

19  physiology, western pathology, western biomedical terminology,

20  first aid, and cardiopulmonary resuscitation (CPR). However,

21  any person who enrolled in an authorized course of study in

22  acupuncture before August 1, 1997, must have completed only a

23  2-year course of study which meets standards established by

24  the board by rule, which standards must include, but are not

25  limited to, successful completion of academic courses in

26  western anatomy, western physiology, and western pathology. In

27  addition, any person who enrolled in an authorized 3-year

28  course of study in acupuncture and oriental medicine prior to

29  July 31, 2001, must have completed 60 college credits from an

30  accredited postsecondary institution as a prerequisite to

31  enrollment in an authorized 3-year course of study in

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 1  acupuncture and oriental medicine and must have completed a

 2  3-year course of study in acupuncture and oriental medicine

 3  which meets standards established by the board by rule;

 4         (c)  Has successfully completed a board-approved

 5  national certification process, is actively licensed in a

 6  state that has examination requirements that are substantially

 7  equivalent to or more stringent than those of this state, or

 8  passes the national an examination approved administered by

 9  the board department, which examination tests the applicant's

10  competency and knowledge of the practice of acupuncture and

11  oriental medicine. At the request of any applicant, oriental

12  nomenclature for the points shall be used in the examination.

13  The examination shall include a practical examination of the

14  knowledge and skills required to practice modern and

15  traditional acupuncture and oriental medicine, covering

16  diagnostic and treatment techniques and procedures; and

17         (d)  Pays the required fees set by the board by rule

18  not to exceed the following amounts:

19         1.  Examination fee: $500 plus the actual per applicant

20  cost to the department for purchase of the written and

21  practical portions of the examination from a national

22  organization approved by the board.

23         2.  Application fee: $300.

24         3.  Reexamination fee: $500 plus the actual per

25  applicant cost to the department for purchase of the written

26  and practical portions of the examination from a national

27  organization approved by the board.

28         4.  Initial biennial licensure fee: $400, if licensed

29  in the first half of the biennium, and $200, if licensed in

30  the second half of the biennium.

31  

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 1         (3)  Notwithstanding s. 120.60(1), upon receipt of an

 2  application for a license, the board shall examine the

 3  application and, within 30 days after receipt, notify the

 4  applicant of any apparent errors or omissions and request any

 5  additional information the board is permitted by law to

 6  require. Within 30 days after receipt of such additional

 7  information, the board shall review it and may request

 8  additional information needed to clarify such information or

 9  to answer new questions raised by or directly related to such

10  additional information. Where appropriate, the board may

11  require the results of an evaluation through the Professionals

12  Resource Network as additional information, clarifying

13  information, or as the answer to new questions raised by or

14  directly related to information submitted by an applicant. The

15  department may not deny a license for failure to correct an

16  error or omission or to supply additional information, provide

17  clarifying information, or answer new questions raised by or

18  directly related to additional information unless the board

19  timely notified the applicant within the appropriate 30-day

20  period. An application shall be considered complete upon

21  receipt of all requested information and correction of any

22  error or omission for which the applicant was timely notified

23  or when the time for such notification has expired. Each

24  application for a license shall be approved or denied within

25  90 days after receipt of a completed application unless a

26  shorter period of time for board action is provided by law.

27  The 90-day time period shall be tolled by the initiation of a

28  proceeding under ss. 120.569 and 120.57. An application for a

29  license must be approved or denied within the 90-day or

30  shorter time period, within 15 days after the conclusion of a

31  public hearing held on the application, or within 45 days

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 1  after a recommended order is submitted to the board and the

 2  parties, whichever is later. The board must approve any

 3  application for a license or for an examination required for

 4  licensure if the board has not approved or denied the

 5  application within the time periods prescribed by this

 6  subsection.

 7         Section 28.  Paragraph (c) of subsection (1) of section

 8  457.109, Florida Statutes, is amended to read:

 9         457.109  Disciplinary actions; grounds; action by the

10  board.--

11         (1)  The following acts constitute grounds for denial

12  of a license or disciplinary action, as specified in s.

13  456.072(2):

14         (c)  Being convicted or found guilty, or entering a

15  plea of nolo contendere to, regardless of adjudication, in a

16  court of this state or other any jurisdiction of a crime that

17  which directly relates to the practice of acupuncture or to

18  the ability to practice acupuncture.  Any plea of nolo

19  contendere shall be considered a conviction for purposes of

20  this chapter.

21         Section 29.  Section 458.303, Florida Statutes, is

22  amended to read:

23         458.303  Provisions not applicable to other

24  practitioners; exceptions, etc.--

25         (1)  The provisions of ss. 458.301, 458.303, 458.305,

26  458.307, 458.309, 458.311, 458.313, 458.315, 458.317, 458.319,

27  458.321, 458.327, 458.329, 458.331, 458.337, 458.339, 458.341,

28  458.343, 458.345, and 458.347 shall have no application to:

29         (a)  Other duly licensed health care practitioners

30  acting within their scope of practice authorized by statute.

31  

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 1         (b)  Any physician lawfully licensed in another state

 2  or territory or foreign country, when meeting duly licensed

 3  physicians of this state in consultation.

 4         (c)  Commissioned medical officers of the Armed Forces

 5  of the United States and of the Public Health Service of the

 6  United States while on active duty and while acting within the

 7  scope of their military or public health responsibilities.

 8         (d)  Any person while actually serving without salary

 9  or professional fees on the resident medical staff of a

10  hospital in this state, subject to the provisions of s.

11  458.321.

12         (e)  Any person furnishing medical assistance in case

13  of an emergency.

14         (f)  The domestic administration of recognized family

15  remedies.

16         (g)  The practice of the religious tenets of any church

17  in this state.

18         (h)  Any person or manufacturer who, without the use of

19  drugs or medicine, mechanically fits or sells lenses,

20  artificial eyes or limbs, or other apparatus or appliances or

21  is engaged in the mechanical examination of eyes for the

22  purpose of constructing or adjusting spectacles, eyeglasses,

23  or lenses.

24         (2)  Nothing in s. 458.301, s. 458.303, s. 458.305, s.

25  458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.

26  458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.

27  458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347

28  shall be construed to prohibit any service rendered by a

29  registered nurse or a licensed practical nurse, if such

30  service is rendered under the direct supervision and control

31  of a licensed physician who provides specific direction for

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 1  any service to be performed and gives final approval to all

 2  services performed.  Further, nothing in this or any other

 3  chapter shall be construed to prohibit any service rendered by

 4  a medical assistant in accordance with the provisions of s.

 5  458.3485.

 6         Section 30.  Section 458.311, Florida Statutes, is

 7  amended to read:

 8         (Substantial rewording of section. See

 9         s. 458.311, F.S., for present text.)

10         458.311  Licensure; requirements; fees.--

11         (1)  Any person desiring to be licensed as a physician

12  shall apply to the department on forms furnished by the

13  department. The department shall license each applicant who

14  the board certifies has met the provisions of this section.

15         (2)  Each applicant must demonstrate compliance with

16  the following:

17         (a)  Has completed the application form and remitted a

18  nonrefundable application fee not to exceed $500.

19         (b)  Is at least 21 years of age.

20         (c)  Is of good moral character.

21         (d)  Has not committed any act or offense in this or

22  any other jurisdiction which would constitute the basis for

23  disciplining a physician pursuant to s. 458.331.

24         (e)  Has submitted to the department a set of

25  fingerprints on a form and under procedures specified by the

26  department, along with a payment in an amount equal to the

27  costs incurred by the department for the criminal history

28  check of the applicant.

29         (f)  Has caused to be submitted to the department core

30  credentials verified by the Federation Credentials

31  

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 1  Verification Service of the Federation of State Medical

 2  Boards.

 3         (g)  For an applicant holding a valid active license in

 4  another state, has submitted evidence of the active licensed

 5  practice of medicine in another jurisdiction for at least 2 of

 6  the immediately preceding 4 years or evidence of successful

 7  completion of either a board-approved postgraduate training

 8  program within 2 years preceding the filing of an application

 9  or a board-approved clinical competency examination within the

10  year preceding the filing of an application for licensure. For

11  purposes of this paragraph, the term "active licensed practice

12  of medicine" means that practice of medicine by physicians,

13  including those employed by any governmental entity in

14  community or public health, as defined by this chapter, those

15  designated as medical directors under s. 641.495(11) who are

16  practicing medicine, and those on the active teaching faculty

17  of an accredited medical school. If the applicant fails to

18  meet the requirements of this paragraph, the board may impose

19  conditions on the license, including, but not limited to,

20  supervision of practice.

21         (3)  Each applicant must demonstrate that he or she has

22  complied with one of the following:

23         (a)  Is a graduate of an allopathic medical school or

24  allopathic college recognized and approved by an accrediting

25  agency recognized by the United States Department of Education

26  or is a graduate of an allopathic medical school or allopathic

27  college within a territorial jurisdiction of the United States

28  recognized by the accrediting agency of the governmental body

29  of that jurisdiction; or

30         (b)  Is a graduate of an allopathic international

31  medical school registered with the World Health Organization

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 1  and has had his or her medical credentials evaluated by the

 2  Educational Commission for Foreign Medical Graduates, holds an

 3  active, valid certificate issued by that commission, and has

 4  passed the examination used by that commission. However, a

 5  graduate of an international medical school need not present

 6  the certificate issued by the Educational Commission for

 7  Foreign Medical Graduates or pass the examination used by that

 8  commission if the graduate has:

 9         1.  Received a bachelor's degree from an accredited

10  United States college or university.

11         2.  Studied at a medical school which is recognized by

12  the World Health Organization.

13         3.  Completed all of the formal requirements of the

14  international medical school, except the internship or social

15  service requirements, and passed part I of the National Board

16  of Medical Examiners examination or the Educational Commission

17  for Foreign Medical Graduates examination equivalent.

18         4.  Completed an academic year of supervised clinical

19  training in a hospital affiliated with a medical school

20  approved by the Council on Medical Education of the American

21  Medical Association and, upon completion, passed part II of

22  the National Board of Medical Examiners examination or the

23  Educational Commission for Foreign Medical Graduates

24  examination equivalent.

25         (4)  Each applicant must demonstrate that he or she has

26  completed a residency approved by the Accreditation Council

27  for Graduate Medical Education (ACGME), as defined by board

28  rule, of at least 2 years, or a fellowship of at least 2 years

29  in one specialty area that is counted toward regular or

30  subspecialty certification by a board recognized and certified

31  by the American Board of Medical Specialties. However, each

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 1  applicant who meets the requirements of paragraph (3)(a) and

 2  who completed his or her training prior to October 1, 2003,

 3  must demonstrate completion of at least 1 year of an approved

 4  residency.

 5         (5)(a)  Each applicant must demonstrate that he or she

 6  has complied with one of the following examination

 7  requirements:

 8         1.  Prior to January 1, 2000, has obtained a passing

 9  score, as established by rule of the board, on the licensure

10  examination of the National Board of Medical Examiners (NBME),

11  the licensure examination of the Federation of State Medical

12  Boards of the United States, Inc. (FLEX), the United States

13  Medical Licensing Examination (USMLE), or a combination

14  thereof;

15         2.  On or after January 1, 2000, has obtained a passing

16  score on all three steps of the United States Medical

17  Licensing Examination (USMLE); or

18         3.  Has obtained a passing score on a state board

19  examination or the Canadian licensing examination (LLMCC) if

20  the applicant has a current active license in at least one

21  other jurisdiction of the United States or Canada and has

22  practiced pursuant to such licensure continuously for the

23  immediately preceding 10 years without encumbrance on the

24  license.

25         (b)  As prescribed by board rule, the board may require

26  an applicant who does not pass any step of the national

27  licensing examination after five attempts to complete

28  additional remedial education or training.

29         (c)  As prescribed by board rule, the board may require

30  an applicant who does not pass all steps of the United States

31  Medical Licensing Examination (USMLE) within 7 years to

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 1  complete additional remedial education or training or to

 2  retake the step of the examination which the applicant passed

 3  first.

 4         (6)  The department and the board shall ensure that

 5  applicants for licensure meet the criteria of this section

 6  through an investigative process.

 7         (7)  The board may not certify to the department for

 8  licensure any applicant who is under investigation in another

 9  jurisdiction for an offense that would constitute a violation

10  of this chapter until such investigation is completed. Upon

11  completion of the investigation, the provisions of s. 458.331

12  shall apply. Furthermore, the department may not issue an

13  unrestricted license to any individual who has committed any

14  act or offense in any jurisdiction which would constitute the

15  basis for disciplining a physician pursuant to s. 458.331.

16  When the board finds that an individual has committed an act

17  or offense in any jurisdiction which would constitute the

18  basis for disciplining a physician pursuant to s. 458.331, the

19  board may enter an order imposing one or more of the terms set

20  forth in s. 456.072(2).

21         (8)  The board may adopt rules pursuant to ss.

22  120.536(1) and 120.54 necessary to carry out the provisions of

23  this section, which shall be applied on a uniform and

24  consistent basis.

25         (9)  When the board determines that any applicant for

26  licensure has failed to meet, to the board's satisfaction,

27  each of the appropriate requirements set forth in this

28  section, it may enter an order requiring one or more of the

29  following terms:

30         (a)  Refusal to certify to the department an

31  application for licensure, certification, or registration;

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 1         (b)  Certification to the department of an application

 2  for licensure, certification, or registration with

 3  restrictions on the scope of practice of the licensee; or

 4         (c)  Certification to the department of an application

 5  for licensure, certification, or registration with placement

 6  of the physician on probation for a period of time and subject

 7  to conditions specified by the board, including, but not

 8  limited to, requiring the physician to submit to treatment,

 9  attend continuing education courses, submit to reexamination,

10  or work under the supervision of another physician.

11         Section 31.  Subsection (5) of section 458.3124,

12  Florida Statutes, is amended to read:

13         458.3124  Restricted license; certain experienced

14  foreign-trained physicians.--

15         (5)  Notwithstanding s. 458.311(3) and (4) s.

16  458.311(1)(f), a person who successfully meets the

17  requirements of this section and who successfully passes Step

18  III of the United States Medical Licensing Examination is

19  eligible for full licensure as a physician.

20         Section 32.  Section 458.315, Florida Statutes, is

21  amended to read:

22         (Substantial rewording of section. See

23         s. 458.315, F.S., for present text.)

24         458.315  Limited licenses.--

25         (1)  Any person desiring to obtain a limited license

26  shall apply to the department on forms furnished by the

27  department. The department shall license each applicant who

28  the board certifies:

29         (a)  Has submitted to the department, with an

30  application and fee not to exceed $300, a statement stating

31  that he or she has been licensed to practice medicine in any

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 1  jurisdiction or territory of the United States or Canada for

 2  at least 2 years and intends to practice only pursuant to the

 3  restrictions of a limited license granted pursuant to this

 4  section. However, if the physician will use the limited

 5  license only for noncompensated practice and submits a

 6  statement from the employing agency or institution stating

 7  that he or she will not receive compensation for any service

 8  involving the practice of medicine, the application fee and

 9  all licensure fees shall be waived.

10         (b)  Has submitted evidence of the active licensed

11  practice of medicine in any jurisdiction or territory of the

12  United States or Canada for at least 2 of the immediately

13  preceding 4 years. For purposes of this paragraph, the term

14  "active licensed practice of medicine" means that practice of

15  medicine by physicians, including those employed by any

16  government entity in community or public health, as defined by

17  this chapter, those designated as medical directors under s.

18  641.495(11) who are practicing medicine, and those on the

19  active teaching faculty of an accredited medical school. If it

20  has been more than 3 years since active practice was conducted

21  by the applicant, a licensed physician approved by the board

22  shall supervise the applicant for a period of 6 months after

23  he or she is granted a limited license for practice, unless

24  the board determines that a shorter period of supervision will

25  be sufficient to ensure that the applicant is qualified for

26  licensure. Procedures for such supervision shall be

27  established by the board.

28         (c)  Has submitted to the department a set of

29  fingerprints on a form and following procedures established by

30  the department for the criminal history check of the

31  applicant.

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 1         (d)  Has not committed any act or offense in this or

 2  any other jurisdiction which would constitute the basis for

 3  disciplining a physician pursuant to s. 458.331.

 4         (2)  After approval of an application under this

 5  section, a limited license may not be issued until the

 6  applicant provides to the board an affidavit stating that

 7  there have been no substantial changes in his or her status

 8  since initial application.

 9         (3)  The recipient of a limited license used for

10  noncompensated practice shall practice only in the employ of

11  programs or facilities that provide uncompensated health care

12  services by volunteer licensed health care professionals to

13  low-income persons whose family income does not exceed 120

14  percent of the federal poverty level or to uninsured persons.

15  These facilities include, but are not limited to, the

16  department, community and migrant health centers funded under

17  s. 330 of the Public Health Service Act, and volunteer health

18  care provider programs contracted with the department to

19  provide uncompensated care under the provisions of s.

20  766.1115.

21         (4)  The recipient of a limited license used for

22  compensated practice shall practice only in the employ of

23  certain programs and facilities that provide health care

24  services and that are located within federally designated

25  primary care health professional shortage areas, unless

26  otherwise approved by the Secretary of Health. These programs

27  and facilities include, but are not limited to, the

28  department, the Department of Corrections, county or municipal

29  correctional facilities, the Department of Juvenile Justice,

30  the Department of Children and Family Services, and those

31  

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 1  programs and facilities funded under s. 330 of the Public

 2  Health Service Act.

 3         (5)  The recipient of a limited license shall, within

 4  30 days after accepting employment, notify the board of all

 5  approved institutions in which the licensee practices and all

 6  approved institutions in which the licensee's practice

 7  privileges have been denied. Evidence of noncompensated

 8  employment shall be required for the fee waiver under

 9  paragraph (1)(a).

10         (6)  Upon renewal, a limited licenseholder shall, in

11  addition to complying with other applicable provisions of this

12  chapter, document compliance with the restrictions prescribed

13  in this section.

14         (7)  Any person holding an active or inactive license

15  to practice medicine in the state may convert that license to

16  a limited license for the purpose of providing volunteer,

17  uncompensated care for low-income residents of this state. The

18  licensee must submit a statement from the employing agency or

19  institution stating that he or she will not receive

20  compensation for any service involving the practice of

21  medicine. All licensure fees, including neurological injury

22  compensation assessments, shall be waived.

23         (8)  This section does not limit in any way any policy

24  by the board, otherwise authorized by law, to grant licenses

25  to physicians duly licensed in other states under conditions

26  less restrictive than the requirements of this section.

27  Notwithstanding any other provision of this section, the board

28  may refuse to authorize a physician otherwise qualified to

29  practice in the employ of any agency or institution if the

30  agency or institution has caused or permitted violations of

31  

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 1  the provisions of this chapter which it knew or should have

 2  known were occurring.

 3         Section 33.  Subsection (4) of section 458.319, Florida

 4  Statutes, is amended to read:

 5         458.319  Renewal of license.--

 6         (4)  Notwithstanding the provisions of s. 456.033, A

 7  physician may complete continuing education on end-of-life

 8  care and palliative care in lieu of continuing education in

 9  AIDS/HIV, if that physician has completed the AIDS/HIV

10  continuing education in the immediately preceding biennium.

11         Section 34.  Paragraph (c) of subsection (5) of section

12  458.320, Florida Statutes, is amended to read:

13         458.320  Financial responsibility.--

14         (5)  The requirements of subsections (1), (2), and (3)

15  do not apply to:

16         (c)  Any person holding a limited license pursuant to

17  s. 458.315 s. 458.317 and practicing under the scope of such

18  limited license.

19         Section 35.  Subsection (9) of section 458.331, Florida

20  Statutes, is amended to read:

21         458.331  Grounds for disciplinary action; action by the

22  board and department.--

23         (9)  When an investigation of a physician is

24  undertaken, the department shall promptly furnish to the

25  physician or the physician's attorney a copy of the complaint

26  or document which resulted in the initiation of the

27  investigation. For purposes of this subsection, such documents

28  include, but are not limited to: the pertinent portions of an

29  annual report submitted to the department pursuant to s.

30  395.0197(6); a report of an adverse incident which is provided

31  to the department pursuant to s. 395.0197; a report of peer

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 1  review disciplinary action submitted to the department

 2  pursuant to s. 395.0193(4) or s. 458.337, providing that the

 3  investigations, proceedings, and records relating to such peer

 4  review disciplinary action shall continue to retain their

 5  privileged status even as to the licensee who is the subject

 6  of the investigation, as provided by ss. 395.0193(8) and

 7  458.337(3); a report of a closed claim submitted pursuant to

 8  s. 627.912; a presuit notice submitted pursuant to s.

 9  766.106(2); and a petition brought under the Florida

10  Birth-Related Neurological Injury Compensation Plan, pursuant

11  to s. 766.305(2). The physician may submit a written response

12  to the information contained in the complaint or document

13  which resulted in the initiation of the investigation within

14  30 45 days after service to the physician of the complaint or

15  document. The physician's written response shall be considered

16  by the probable cause panel.

17         Section 36.  Paragraph (c) of subsection (1) of section

18  458.345, Florida Statutes, is amended to read:

19         458.345  Registration of resident physicians, interns,

20  and fellows; list of hospital employees; prescribing of

21  medicinal drugs; penalty.--

22         (1)  Any person desiring to practice as a resident

23  physician, assistant resident physician, house physician,

24  intern, or fellow in fellowship training which leads to

25  subspecialty board certification in this state, or any person

26  desiring to practice as a resident physician, assistant

27  resident physician, house physician, intern, or fellow in

28  fellowship training in a teaching hospital in this state as

29  defined in s. 408.07(44) or s. 395.805(2), who does not hold a

30  valid, active license issued under this chapter shall apply to

31  the department to be registered and shall remit a fee not to

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 1  exceed $300 as set by the board.  The department shall

 2  register any applicant the board certifies has met the

 3  following requirements:

 4         (c)  Is a graduate of a medical school or college as

 5  specified in s. 458.311(3) s. 458.311(1)(f).

 6         Section 37.  Subsection (7) of section 458.347, Florida

 7  Statutes, is amended to read:

 8         458.347  Physician assistants.--

 9         (7)  PHYSICIAN ASSISTANT LICENSURE.--

10         (a)  Any person desiring to be licensed as a physician

11  assistant must apply to the department. The department shall

12  issue a license to any person certified by the council as

13  having met the following requirements:

14         1.  Is at least 18 years of age.

15         2.  Has satisfactorily passed a proficiency examination

16  by an acceptable score established by the National Commission

17  on Certification of Physician Assistants.  If an applicant

18  does not hold a current certificate issued by the National

19  Commission on Certification of Physician Assistants and has

20  not actively practiced as a physician assistant within the

21  immediately preceding 4 years, the applicant must retake and

22  successfully complete the entry-level examination of the

23  National Commission on Certification of Physician Assistants

24  to be eligible for licensure.

25         3.  Has completed the application form and remitted an

26  application fee not to exceed $300 as set by the boards. An

27  application for licensure made by a physician assistant must

28  include:

29         a.  A certificate of completion of a physician

30  assistant training program specified in subsection (6).

31         b.  A sworn statement of any prior felony convictions.

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 1         c.  A sworn statement of any previous revocation or

 2  denial of licensure or certification in any state.

 3         d.  Two letters of recommendation.

 4         (b)1.  Notwithstanding subparagraph (a)2. and

 5  sub-subparagraph (a)3.a., the department shall examine each

 6  applicant who the Board of Medicine certifies:

 7         a.  Has completed the application form and remitted a

 8  nonrefundable application fee not to exceed $500 and an

 9  examination fee not to exceed $300, plus the actual cost to

10  the department to provide the examination. The examination fee

11  is refundable if the applicant is found to be ineligible to

12  take the examination. The department shall not require the

13  applicant to pass a separate practical component of the

14  examination. For examinations given after July 1, 1998,

15  competencies measured through practical examinations shall be

16  incorporated into the written examination through a

17  multiple-choice format. The department shall translate the

18  examination into the native language of any applicant who

19  requests and agrees to pay all costs of such translation,

20  provided that the translation request is filed with the board

21  office no later than 9 months before the scheduled examination

22  and the applicant remits translation fees as specified by the

23  department no later than 6 months before the scheduled

24  examination, and provided that the applicant demonstrates to

25  the department the ability to communicate orally in basic

26  English. If the applicant is unable to pay translation costs,

27  the applicant may take the next available examination in

28  English if the applicant submits a request in writing by the

29  application deadline and if the applicant is otherwise

30  eligible under this section. To demonstrate the ability to

31  communicate orally in basic English, a passing score or grade

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 1  is required, as determined by the department or organization

 2  that developed it, on the test for spoken English (TSE) by the

 3  Educational Testing Service (ETS), the test of English as a

 4  foreign language (TOEFL) by ETS, a high school or college

 5  level English course, or the English examination for

 6  citizenship, Immigration and Naturalization Service. A

 7  notarized copy of an Educational Commission for Foreign

 8  Medical Graduates (ECFMG) certificate may also be used to

 9  demonstrate the ability to communicate in basic English; and

10         b.(I)  Is an unlicensed physician who graduated from a

11  foreign medical school listed with the World Health

12  Organization who has not previously taken and failed the

13  examination of the National Commission on Certification of

14  Physician Assistants and who has been certified by the Board

15  of Medicine as having met the requirements for licensure as a

16  medical doctor by examination as set forth in s. 458.311(1),

17  (3), (4), and (5), with the exception that the applicant is

18  not required to have completed an approved residency of at

19  least 1 year and the applicant is not required to have passed

20  the licensing examination specified under s. 458.311 or hold a

21  valid, active certificate issued by the Educational Commission

22  for Foreign Medical Graduates; was eligible and made initial

23  application for certification as a physician assistant in this

24  state between July 1, 1990, and June 30, 1991; and was a

25  resident of this state on July 1, 1990, or was licensed or

26  certified in any state in the United States as a physician

27  assistant on July 1, 1990; or

28         (II)  Completed all coursework requirements of the

29  Master of Medical Science Physician Assistant Program offered

30  through the Florida College of Physician's Assistants prior to

31  its closure in August of 1996. Prior to taking the

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 1  examination, such applicant must successfully complete any

 2  clinical rotations that were not completed under such program

 3  prior to its termination and any additional clinical rotations

 4  with an appropriate physician assistant preceptor, not to

 5  exceed 6 months, that are determined necessary by the council.

 6  The boards shall determine, based on recommendations from the

 7  council, the facilities under which such incomplete or

 8  additional clinical rotations may be completed and shall also

 9  determine what constitutes successful completion thereof,

10  provided such requirements are comparable to those established

11  by accredited physician assistant programs. This

12  sub-sub-subparagraph is repealed July 1, 2001.

13         1.2.  The department may grant temporary licensure to

14  an applicant who meets the requirements of s. 458.311

15  subparagraph 1. Between meetings of the council, the

16  department may grant temporary licensure to practice based on

17  the completion of all temporary licensure requirements. All

18  such administratively issued licenses shall be reviewed and

19  acted on at the next regular meeting of the council. A

20  temporary license expires 30 days after receipt and notice of

21  scores to the licenseholder from the first available

22  examination specified in s. 458.311 subparagraph 1. following

23  licensure by the department. An applicant who fails the

24  proficiency examination is no longer temporarily licensed, but

25  may apply for a one-time extension of temporary licensure

26  after reapplying for the next available examination. Extended

27  licensure shall expire upon failure of the licenseholder to

28  sit for the next available examination or upon receipt and

29  notice of scores to the licenseholder from such examination.

30         2.3.  Notwithstanding any other provision of law, the

31  examination specified pursuant to s. 458.311 subparagraph 1.

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 1  shall be administered by the department only five times.

 2  Applicants certified by the board for examination shall

 3  receive at least 6 months' notice of eligibility prior to the

 4  administration of the initial examination. Subsequent

 5  examinations shall be administered at 1-year intervals

 6  following the reporting of the scores of the first and

 7  subsequent examinations. For the purposes of this paragraph,

 8  the department may develop, contract for the development of,

 9  purchase, or approve an examination that adequately measures

10  an applicant's ability to practice with reasonable skill and

11  safety. The minimum passing score on the examination shall be

12  established by the department, with the advice of the board.

13  Those applicants failing to pass that examination or any

14  subsequent examination shall receive notice of the

15  administration of the next examination with the notice of

16  scores following such examination. Any applicant who passes

17  the examination and meets the requirements of this section

18  shall be licensed as a physician assistant with all rights

19  defined thereby.

20         (c)  The license must be renewed biennially.  Each

21  renewal must include:

22         1.  A renewal fee not to exceed $500 as set by the

23  boards.

24         2.  A sworn statement of no felony convictions in the

25  previous 2 years.

26         (d)  Each licensed physician assistant shall biennially

27  complete 100 hours of continuing medical education or shall

28  hold a current certificate issued by the National Commission

29  on Certification of Physician Assistants.

30         (e)  Upon employment as a physician assistant, a

31  licensed physician assistant must notify the department in

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 1  writing within 30 days after such employment or after any

 2  subsequent changes in the supervising physician. The

 3  notification must include the full name, Florida medical

 4  license number, specialty, and address of the supervising

 5  physician.

 6         (f)  Notwithstanding subparagraph (a)2., the department

 7  may grant a temporary license to a recent graduate of an

 8  approved program, as specified in subsection (6), who expects

 9  to take the first examination administered by the National

10  Commission on Certification of Physician Assistants available

11  for registration after the applicant's graduation, a temporary

12  license. The temporary license shall expire 1 year after the

13  date of graduation 30 days after receipt of scores of the

14  proficiency examination administered by the National

15  Commission on Certification of Physician Assistants.  Between

16  meetings of the council, the department may grant a temporary

17  license to practice pursuant to this subsection based on the

18  completion of all temporary licensure requirements.  All such

19  administratively issued licenses shall be reviewed and acted

20  on at the next regular meeting of the council. The recent

21  graduate may be licensed prior to employment, but must comply

22  with paragraph (e). An applicant who has passed the

23  proficiency examination may be granted permanent licensure. An

24  applicant failing the proficiency examination is no longer

25  temporarily licensed, but may reapply for a 1-year extension

26  of temporary licensure.  An applicant may not be granted more

27  than two temporary licenses and may not be licensed as a

28  physician assistant until he or she passes the examination

29  administered by the National Commission on Certification of

30  Physician Assistants. As prescribed by board rule, the council

31  may require an applicant who does not pass the licensing

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 1  examination after five or more attempts to complete additional

 2  remedial education or training. The council shall prescribe

 3  the additional requirements in a manner that permits the

 4  applicant to complete the requirements and be reexamined

 5  within 2 years after the date the applicant petitions the

 6  council to retake the examination a sixth or subsequent time.

 7         (g)  The Board of Medicine may impose any of the

 8  penalties authorized under ss. 456.072 and 458.331(2) upon a

 9  physician assistant if the physician assistant or the

10  supervising physician has been found guilty of or is being

11  investigated for any act that constitutes a violation of this

12  chapter or chapter 456.

13         Section 38.  Subsections (4) and (5) of section

14  459.008, Florida Statutes, are amended to read:

15         459.008  Renewal of licenses and certificates.--

16         (4)  The board shall, by rule, prescribe continuing

17  education programs and courses, not to exceed 40 hours

18  biennially, as a condition for renewal of a license. Such

19  programs and courses must build on the basic educational

20  requirements for licensure as an osteopathic physician and

21  must be approved by the board. Notwithstanding any other

22  provision of law, the board may mandate by rule specific

23  continuing medical education requirements and may approve by

24  rule alternative methods of obtaining continuing education

25  credits, including, but not limited to, attending a board

26  meeting at which another licensee is disciplined, serving as a

27  volunteer expert witness for the department in a disciplinary

28  case, or serving as a member of a probable cause panel

29  following the expiration of a board member's term.

30         (5)  Notwithstanding the provisions of s. 456.033, An

31  osteopathic physician may complete continuing education on

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 1  end-of-life and palliative care in lieu of continuing

 2  education in AIDS/HIV, if that physician has completed the

 3  AIDS/HIV continuing education in the immediately preceding

 4  biennium.

 5         Section 39.  Subsection (9) of section 459.015, Florida

 6  Statutes, is amended to read:

 7         459.015  Grounds for disciplinary action; action by the

 8  board and department.--

 9         (9)  When an investigation of an osteopathic physician

10  is undertaken, the department shall promptly furnish to the

11  osteopathic physician or his or her attorney a copy of the

12  complaint or document which resulted in the initiation of the

13  investigation. For purposes of this subsection, such documents

14  include, but are not limited to:  the pertinent portions of an

15  annual report submitted to the department pursuant to s.

16  395.0197(6); a report of an adverse incident which is provided

17  to the department pursuant to s. 395.0197; a report of peer

18  review disciplinary action submitted to the department

19  pursuant to s. 395.0193(4) or s. 459.016, provided that the

20  investigations, proceedings, and records relating to such peer

21  review disciplinary action shall continue to retain their

22  privileged status even as to the licensee who is the subject

23  of the investigation, as provided by ss. 395.0193(8) and

24  459.016(3); a report of a closed claim submitted pursuant to

25  s. 627.912; a presuit notice submitted pursuant to s.

26  766.106(2); and a petition brought under the Florida

27  Birth-Related Neurological Injury Compensation Plan, pursuant

28  to s. 766.305(2).  The osteopathic physician may submit a

29  written response to the information contained in the complaint

30  or document which resulted in the initiation of the

31  investigation within 30 45 days after service to the

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 1  osteopathic physician of the complaint or document. The

 2  osteopathic physician's written response shall be considered

 3  by the probable cause panel.

 4         Section 40.  Subsections (1), (2), and (5) of section

 5  459.021, Florida Statutes, are amended to read:

 6         459.021  Registration of resident physicians, interns,

 7  and fellows; list of hospital employees; penalty.--

 8         (1)  Any person who holds a degree of Doctor of

 9  Osteopathic Medicine from a college of osteopathic medicine

10  recognized and approved by the American Osteopathic

11  Association who desires to practice as a resident physician,

12  assistant resident physician, house physician, intern, or

13  fellow in fellowship training which leads to subspecialty

14  board certification in this state, or any person desiring to

15  practice as a resident physician, assistant resident

16  physician, house physician, intern, or fellow in fellowship

17  training in a teaching hospital in this state as defined in s.

18  408.07(44) or s. 395.805(2), who does not hold an active

19  license issued under this chapter shall apply to the

20  department to be registered, on an application provided by the

21  department, no later than within 30 days prior to of

22  commencing such a training program and shall remit a fee not

23  to exceed $300 as set by the board.

24         (2)  Any person required to be registered under this

25  section shall renew such registration annually and shall remit

26  a renewal fee not to exceed $300 as set by the board.  Such

27  registration shall be terminated upon the registrant's receipt

28  of an active license issued under this chapter.  No person

29  shall be registered under this section for an aggregate of

30  more than 5 years, unless additional years are approved by the

31  board.

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 1         (5)  It is a misdemeanor of the second degree,

 2  punishable as provided in s. 775.082 or s. 775.083, for any

 3  hospital or teaching hospital, and also for the

 4  superintendent, administrator, and other person or persons

 5  having administrative authority in such hospital to willfully:

 6         (a)  To Employ the services in such hospital of any

 7  person listed in subsection (3), unless such person is

 8  registered with the department under the law or the holder of

 9  a license to practice osteopathic medicine under this chapter.

10         (b)  To Fail to furnish to the department the list and

11  information required by subsection (3).

12         Section 41.  Paragraphs (d) of subsection (1) of

13  section 460.406, Florida Statutes, is amended to read:

14         460.406  Licensure by examination.--

15         (1)  Any person desiring to be licensed as a

16  chiropractic physician shall apply to the department to take

17  the licensure examination. There shall be an application fee

18  set by the board not to exceed $100 which shall be

19  nonrefundable.  There shall also be an examination fee not to

20  exceed $500 plus the actual per applicant cost to the

21  department for purchase of portions of the examination from

22  the National Board of Chiropractic Examiners or a similar

23  national organization, which may be refundable if the

24  applicant is found ineligible to take the examination.  The

25  department shall examine each applicant who the board

26  certifies has:

27         (d)1.  For an applicant who has matriculated in a

28  chiropractic college prior to July 2, 1990, completed at least

29  2 years of residence college work, consisting of a minimum of

30  one-half the work acceptable for a bachelor's degree granted

31  on the basis of a 4-year period of study, in a college or

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 1  university accredited by an accrediting agency recognized and

 2  approved by the United States Department of Education.

 3  However, prior to being certified by the board to sit for the

 4  examination, each applicant who has matriculated in a

 5  chiropractic college after July 1, 1990, shall have been

 6  granted a bachelor's degree, based upon 4 academic years of

 7  study, by a college or university accredited by a regional

 8  accrediting agency which is a member of the Council for Higher

 9  Education Accreditation or the United States Department of

10  Education Commission on Recognition of Postsecondary

11  Accreditation.

12         2.  Effective July 1, 2000, completed, prior to

13  matriculation in a chiropractic college, at least 3 years of

14  residence college work, consisting of a minimum of 90 semester

15  hours leading to a bachelor's degree in a liberal arts college

16  or university accredited by an accrediting agency recognized

17  and approved by the United States Department of Education.

18  However, prior to being certified by the board to sit for the

19  examination, each applicant who has matriculated in a

20  chiropractic college after July 1, 2000, shall have been

21  granted a bachelor's degree from an institution holding

22  accreditation for that degree from a regional accrediting

23  agency which is recognized by the United States Department of

24  Education.  The applicant's chiropractic degree must consist

25  of credits earned in the chiropractic program and may not

26  include academic credit for courses from the bachelor's

27  degree.

28         Section 42.  Subsection (5) of section 460.413, Florida

29  Statutes, is amended to read:

30         460.413  Grounds for disciplinary action; action by

31  board or department.--

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 1         (5)  When an investigation of a chiropractic physician

 2  is undertaken, the department shall promptly furnish to the

 3  chiropractic physician or her or his attorney a copy of the

 4  complaint or document which resulted in the initiation of the

 5  investigation. The chiropractic physician may submit a written

 6  response to the information contained in such complaint or

 7  document within 30 45 days after service to the chiropractic

 8  physician of the complaint or document.  The chiropractic

 9  physician's written response shall be considered by the

10  probable cause panel.

11         Section 43.  Subsection (6) of section 461.013, Florida

12  Statutes, is amended to read:

13         461.013  Grounds for disciplinary action; action by the

14  board; investigations by department.--

15         (6)  When an investigation of a podiatric physician is

16  undertaken, the department shall promptly furnish to the

17  podiatric physician or her or his attorney a copy of the

18  complaint or document which resulted in the initiation of the

19  investigation.  The podiatric physician may submit a written

20  response to the information contained in such complaint or

21  document within 30 45 days after service to the podiatric

22  physician of the complaint or document.  The podiatric

23  physician's written response shall be considered by the

24  probable cause panel.

25         Section 44.  Paragraph (b) of subsection (1) of section

26  463.006, Florida Statutes, is amended to read:

27         463.006  Licensure and certification by examination.--

28         (1)  Any person desiring to be a licensed practitioner

29  pursuant to this chapter shall apply to the department to take

30  the licensure and certification examinations. The department

31  shall examine each applicant who the board determines has:

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 1         (b)  Submitted proof satisfactory to the department

 2  that she or he:

 3         1.  Is at least 18 years of age.

 4         2.  Has graduated from an accredited school or college

 5  of optometry approved by rule of the board.

 6         3.  Is of good moral character.

 7         4.  Has successfully completed at least 110 hours of

 8  transcript-quality coursework and clinical training in general

 9  and ocular pharmacology as determined by the board, at an

10  institution that:

11         a.  Has facilities for both didactic and clinical

12  instructions in pharmacology.; and

13         b.  Is accredited by a regional or professional

14  accrediting organization that is recognized and approved by

15  the Council for Higher Education Commission on Recognition of

16  Postsecondary Accreditation or the United States Department of

17  Education.

18         5.  Has completed at least 1 year of supervised

19  experience in differential diagnosis of eye disease or

20  disorders as part of the optometric training or in a clinical

21  setting as part of the optometric experience.

22         Section 45.  Paragraph (a) of subsection (4) of section

23  464.0205, Florida Statutes, is amended to read:

24         464.0205  Retired volunteer nurse certificate.--

25         (4)  A retired volunteer nurse receiving certification

26  from the board shall:

27         (a)  Work under the direct supervision of the director

28  of a county health department, a physician working under a

29  limited license issued pursuant to s. 458.315 s. 458.317 or s.

30  459.0075, a physician licensed under chapter 458 or chapter

31  459, an advanced registered nurse practitioner certified under

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 1  s. 464.012, or a registered nurse licensed under s. 464.008 or

 2  s. 464.009.

 3         Section 46.  Subsection (6) is added to section

 4  464.201, Florida Statutes, to read:

 5         464.201  Definitions.--As used in this part, the term:

 6         (6)  "Practice of a certified nursing assistant" means

 7  providing care and assisting persons with tasks relating to

 8  the activities of daily living. Such tasks are those

 9  associated with personal care, maintaining mobility, nutrition

10  and hydration, toileting and elimination, assistive devices,

11  safety and cleanliness, data gathering, reporting abnormal

12  signs and symptoms, postmortem care, patient socialization and

13  reality orientation, end-of-life care, CPR and emergency care,

14  notification of residents' or patients' rights, documentation

15  of nursing assistant services, and other tasks that a

16  certified nurse assistant may perform after training beyond

17  that required for initial certification and upon validation of

18  competence in that skill by a registered nurse. This

19  subsection does not restrict the ability of any person who is

20  otherwise trained and educated from performing such tasks.

21         Section 47.  Section 464.202, Florida Statutes, is

22  amended to read:

23         464.202  Duties and powers of the board.--The board

24  shall maintain, or contract with or approve another entity to

25  maintain, a state registry of certified nursing assistants.

26  The registry must consist of the name of each certified

27  nursing assistant in this state; other identifying information

28  defined by board rule; certification status; the effective

29  date of certification; other information required by state or

30  federal law; information regarding any crime or any abuse,

31  neglect, or exploitation as provided under chapter 435; and

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 1  any disciplinary action taken against the certified nursing

 2  assistant. The registry shall be accessible to the public, the

 3  certificateholder, employers, and other state agencies. The

 4  board shall adopt by rule testing procedures for use in

 5  certifying nursing assistants and shall adopt rules regulating

 6  the practice of certified nursing assistants which specify the

 7  scope of practice authorized and level of supervision required

 8  for the practice of certified nursing assistants to enforce

 9  this part. The board may contract with or approve another

10  entity or organization to provide the examination services,

11  including the development and administration of examinations.

12  The board shall require that the contract provider offer

13  certified nursing assistant applications via the Internet, and

14  may require the contract provider to accept certified nursing

15  assistant applications for processing via the Internet.  The

16  board shall require the contract provider to provide the

17  preliminary results of the certified nursing examination on

18  the date the test is administered. The provider shall pay all

19  reasonable costs and expenses incurred by the board in

20  evaluating the provider's application and performance during

21  the delivery of services, including examination services and

22  procedures for maintaining the certified nursing assistant

23  registry.

24         Section 48.  Subsections (1) and (5) of section

25  464.203, Florida Statutes, are amended, and subsections (8)

26  and (9) are added to that section, to read:

27         464.203  Certified nursing assistants; certification

28  requirement.--

29         (1)  The board shall issue a certificate to practice as

30  a certified nursing assistant to any person who demonstrates a

31  minimum competency to read and write and successfully passes

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 1  the required statewide criminal screening through the

 2  Department of Law Enforcement, including Level I screening

 3  pursuant to chapter 435, or, if the applicant has not

 4  maintained continuous residency within the state for 5 years

 5  immediately preceding the date of application, Level II

 6  screening that includes a fingerprint check through the

 7  Department of Law Enforcement and the Federal Bureau of

 8  Investigation pursuant to chapter 435, Level I or Level II

 9  screening pursuant to s. 400.215 and meets one of the

10  following requirements:

11         (a)  Has successfully completed an approved training

12  program and achieved a minimum score, established by rule of

13  the board, on the nursing assistant competency examination,

14  which consists of a written portion and skills-demonstration

15  portion approved by the board and administered at a site and

16  by personnel approved by the department.

17         (b)  Has achieved a minimum score, established by rule

18  of the board, on the nursing assistant competency examination,

19  which consists of a written portion and skills-demonstration

20  portion, approved by the board and administered at a site and

21  by personnel approved by the department and:

22         1.  Has a high school diploma, or its equivalent; or

23         2.  Is at least 18 years of age.

24         (c)  Is currently certified in another state; is listed

25  on that state's certified nursing assistant registry; and has

26  not been found to have committed abuse, neglect, or

27  exploitation in that state.

28         (d)  Has completed the curriculum developed under the

29  Enterprise Florida Jobs and Education Partnership Grant and

30  achieved a minimum score, established by rule of the board, on

31  the nursing assistant competency examination, which consists

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 1  of a written portion and skills-demonstration portion,

 2  approved by the board and administered at a site and by

 3  personnel approved by the department.

 4         (5)  Certification as a nursing assistant, in

 5  accordance with this part, may be renewed continues in effect

 6  until such time as the nursing assistant allows a period of 24

 7  consecutive months to pass during which period the nursing

 8  assistant fails to perform any nursing-related services for

 9  monetary compensation. When a nursing assistant fails to

10  perform any nursing-related services for monetary compensation

11  for a period of 24 consecutive months, the nursing assistant

12  must complete a new training and competency evaluation program

13  or a new competency evaluation program.

14         (8)  The department shall renew a certificate upon

15  receipt of the renewal application and imposition of a fee of

16  not less than $20 and not more than $50 biennially. The

17  department shall adopt rules establishing a procedure for the

18  biennial renewal of certificates. Any certificate not renewed

19  by July 1, 2006, shall be void.

20         (9)  Notwithstanding any provision of law to the

21  contrary, any entity required to conduct a Level I or Level II

22  screening, pursuant to chapter 435, is exempt from rescreening

23  any certified nursing assistant upon employment if the

24  screening date on the certificate issued by the board is

25  within the last 12 months, the certified nursing assistant has

26  not been unemployed for more than 180 days, and the nursing

27  assistant attests under penalty of perjury to not having been

28  convicted of a disqualifying offense since the completion of

29  such screening.

30         Section 49.  Paragraph (b) of subsection (1) of section

31  464.204, Florida Statutes, is amended to read:

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 1         464.204  Denial, suspension, or revocation of

 2  certification; disciplinary actions.--

 3         (1)  The following acts constitute grounds for which

 4  the board may impose disciplinary sanctions as specified in

 5  subsection (2):

 6         (b)  Intentionally Violating any provision of part I or

 7  part II of this chapter, chapter 456, or the rules adopted by

 8  the board.

 9         Section 50.  Paragraph (a) of subsection (11) of

10  section 465.003, Florida Statutes, is amended to read:

11         465.003  Definitions.--As used in this chapter, the

12  term:

13         (11)(a)  "Pharmacy" includes a community pharmacy, an

14  institutional pharmacy, a nuclear pharmacy, and a special

15  pharmacy, and an Internet pharmacy.

16         1.  The term "community pharmacy" includes every

17  location where medicinal drugs are compounded, dispensed,

18  stored, or sold or where prescriptions are filled or dispensed

19  on an outpatient basis.

20         2.  The term "institutional pharmacy" includes every

21  location in a hospital, clinic, nursing home, dispensary,

22  sanitarium, extended care facility, or other facility,

23  hereinafter referred to as "health care institutions," where

24  medicinal drugs are compounded, dispensed, stored, or sold.

25         3.  The term "nuclear pharmacy" includes every location

26  where radioactive drugs and chemicals within the

27  classification of medicinal drugs are compounded, dispensed,

28  stored, or sold.  The term "nuclear pharmacy" does not include

29  hospitals licensed under chapter 395 or the nuclear medicine

30  facilities of such hospitals.

31  

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 1         4.  The term "special pharmacy" includes every location

 2  where medicinal drugs are compounded, dispensed, stored, or

 3  sold if such locations are not otherwise defined in this

 4  subsection.

 5         5.  The term "Internet pharmacy" includes locations

 6  that are not otherwise defined in this subsection where

 7  medicinal drugs are compounded, dispensed, or stored and

 8  subsequently sold primarily or exclusively to consumers over

 9  the Internet. An Internet pharmacy must be licensed as a

10  pharmacy under this chapter to sell medicinal drugs to persons

11  in this state.

12         Section 51.  Subsection (2) of section 465.0075,

13  Florida Statutes, is amended to read:

14         465.0075  Licensure by endorsement; requirements;

15  fee.--

16         (2)  An applicant licensed in another state for a

17  period in excess of 2 years from the date of application for

18  licensure in this state shall submit a total of at least 30

19  hours of board-approved continuing education for the 24 months

20  2 calendar years immediately preceding application.

21         Section 52.  Paragraph (i) of subsection (1) of section

22  465.016, Florida Statutes, is amended, and paragraph (s) is

23  added to that subsection, to read:

24         465.016  Disciplinary actions.--

25         (1)  The following acts constitute grounds for denial

26  of a license or disciplinary action, as specified in s.

27  456.072(2):

28         (i)  Compounding, dispensing, or distributing a legend

29  drug, including any controlled substance, other than in the

30  course of the professional practice of pharmacy.  For purposes

31  of this paragraph, it shall be legally presumed that the

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 1  compounding, dispensing, or distributing of legend drugs in

 2  excessive or inappropriate quantities is not in the best

 3  interests of the patient and is not in the course of the

 4  professional practice of pharmacy. A quantity of legend drug

 5  which the licensee knows or reasonably should know was not

 6  prescribed in the course of a valid professional relationship

 7  is presumed to be an excessive or inappropriate quantity. A

 8  medical questionnaire completed by Internet, telephone,

 9  electronic transfer, or mail does not establish a valid

10  professional relationship.

11         (s)  Dispensing any medicinal drug based upon a

12  communication that purports to be a prescription as defined by

13  s. 465.003(14) or s. 893.02(2) when the pharmacist knows or

14  has reason to believe that the purported prescription is not

15  based upon a valid practitioner-patient relationship,

16  including appropriate patient history and a face-to-face or

17  visual encounter by the practitioner.

18         Section 53.  Section 465.0161, Florida Statutes, is

19  created to read:

20         465.0161  Distribution of medicinal drugs without a

21  license.--An Internet pharmacy that distributes medicinal

22  drugs to persons in this state without being licensed as a

23  pharmacy under this chapter commits a felony of the second

24  degree, punishable as provided in s. 775.082 or s. 775.083.

25         Section 54.  Section 465.018, Florida Statutes, is

26  amended to read:

27         465.018  Community pharmacies; permits.--

28         (1)  Any person desiring a permit to operate a

29  community pharmacy shall apply to the department. A permit

30  shall be issued only to a person of good moral character who

31  is at least 21 years of age. A permit shall be issued only to

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 1  a corporation whose officers are of good moral character and

 2  are at least 21 years of age. A permit may not be issued to

 3  any person who has been convicted within the past 15 years of

 4  any felony relating to the practice of pharmacy in this state

 5  or any other state of the United States, and a permit may not

 6  be issued to a corporation if any of its officers have been so

 7  convicted. The term "conviction" includes entering a plea of

 8  guilty or nolo contendere, regardless of adjudication.

 9         (2)  If the board office certifies that the application

10  complies with the laws of the state and the rules of the board

11  governing pharmacies, the department shall issue the permit.

12  No permit shall be issued unless a licensed pharmacist is

13  designated as the prescription department manager responsible

14  for maintaining all drug records, providing for the security

15  of the prescription department, and following such other rules

16  as relate to the practice of the profession of pharmacy.  The

17  permittee and the newly designated prescription department

18  manager shall notify the department within 10 days of any

19  change in prescription department manager.

20         (3)  The department may suspend or revoke the permit

21  of, or may refuse to issue a permit to:

22         (a)  Any person, firm, or corporation the permit of

23  which has been disciplined, been abandoned, or become null and

24  void after written notice that disciplinary proceedings had

25  been or would be brought against the permit;

26         (b)  Any corporation if an officer, director, or person

27  interested directly or indirectly in the corporation has had

28  her or his permit disciplined, abandoned, or become null and

29  void after written notice that disciplinary proceedings had

30  been or would be brought against her or his permit; or

31  

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 1         (c)  Any person who is or has been an officer of a

 2  corporation, or who was interested directly or indirectly in a

 3  corporation, the permit of which has been disciplined, been

 4  abandoned, or become null and void after written notice that

 5  disciplinary proceedings had been or would be brought against

 6  the permit.

 7         (4)(a)  An applicant for initial licensure must submit

 8  a set of fingerprints to the Department of Health for each

 9  person owning more than 5 percent of the proposed permit or,

10  in the case of a corporation, each officer of the corporation.

11         (b)  The Department of Health shall submit the

12  fingerprints provided by an applicant for initial licensure to

13  the Department of Law Enforcement for a statewide criminal

14  history check, and the Department of Law Enforcement shall

15  forward the fingerprints to the Federal Bureau of

16  Investigation for a national criminal history check of the

17  applicant.

18         Section 55.  Subsections (2) and (5) of section

19  465.025, Florida Statutes, are amended to read:

20         465.025  Substitution of drugs.--

21         (2)  A pharmacist who receives a prescription for a

22  brand name drug shall, unless requested otherwise by the

23  purchaser, substitute a less expensive, generically equivalent

24  drug product that is:

25         (a)  distributed by a business entity doing business,

26  and subject to suit and service of legal process, in the

27  United States; and

28         (b)  Listed in the formulary of generic and brand name

29  drug products as provided in subsection (5) for the brand name

30  drug prescribed,

31  

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 1  unless the prescriber writes the words "MEDICALLY NECESSARY,"

 2  in her or his own handwriting, on the face of a written

 3  prescription; or unless, in the case of an electronically

 4  transmitted prescription, the prescriber indicates in the

 5  transmitted prescription that the brand name drug is medically

 6  necessary; or unless, in the case of an oral prescription, the

 7  prescriber expressly indicates to the pharmacist that the

 8  brand name drug prescribed is medically necessary.

 9         (5)  Each community pharmacy shall establish a

10  formulary of generic and brand name drug products which, if

11  selected as the drug product of choice, would not pose a

12  threat to the health and safety of patients receiving

13  prescription medication.  In compiling the list of generic and

14  brand name drug products for inclusion in the formulary, the

15  pharmacist shall rely on drug product research, testing,

16  information, and formularies compiled by other pharmacies, by

17  states, by the United States Department of Health, Education,

18  and Welfare, by the United States Department of Health and

19  Human Services, or by any other source which the pharmacist

20  deems reliable.  Each community pharmacy shall make such

21  formulary available to the public, the Board of Pharmacy, or

22  any physician requesting same.  This formulary shall be

23  revised following each addition, deletion, or modification of

24  said formulary.

25         Section 56.  Present subsection (4) of section

26  465.0265, Florida Statutes, is redesignated as subsection (8),

27  and a new subsection (4) and subsections (5), (6), and (7) are

28  added to that section, to read:

29         465.0265  Centralized prescription filling.--

30         (4)  A central fill pharmacy may not prepare

31  prescriptions provided directly by a patient or individual

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 1  practitioner and may not mail or otherwise deliver a filled

 2  prescription directly to a patient or individual practitioner.

 3  A filled prescription must be transported to the originating

 4  pharmacy to which the prescription was delivered for delivery

 5  to the patient.

 6         (5)  A central fill pharmacy may prepare prescriptions

 7  only on behalf of pharmacies with which it has a contractual

 8  agreement to provide such services or with which it shares a

 9  common owner. Each central fill pharmacy shall keep a list of

10  pharmacies for which it has agreed to provide such services

11  and must verify the Drug Enforcement Administration

12  registration of any pharmacy it is doing business with prior

13  to sending or receiving a prescription for a controlled

14  substance.

15         (6)  Each pharmacy shall keep a list of those central

16  fill pharmacies permitted to prepare prescriptions on its

17  behalf and verify that those pharmacies are registered with

18  the Drug Enforcement Administration.

19         (7)  A central fill pharmacy must comply with the same

20  security requirements applicable to pharmacies, including the

21  general requirement to maintain effective controls and

22  procedures to guard against theft and diversion of controlled

23  substances.

24         Section 57.  Paragraph (a) of subsection (3) of section

25  466.007, Florida Statutes, is amended to read:

26         466.007  Examination of dental hygienists.--

27         (3)  A graduate of a dental college or school shall be

28  entitled to take the examinations required in this section to

29  practice dental hygiene in this state if, in addition to the

30  requirements specified in subsection (2), the graduate meets

31  the following requirements:

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 1         (a)  Submits the following credentials for review by

 2  the board:

 3         1.  Transcripts totaling of predental education and

 4  dental education totaling 5 academic years of postsecondary

 5  education, including 4 academic years of postsecondary dental

 6  education; and

 7         2.  A dental school diploma which is comparable to a

 8  D.D.S. or D.M.D.

 9  

10  Such credentials shall be submitted in a manner provided by

11  rule of the board.  The board shall approve those credentials

12  which comply with this paragraph and with rules of the board

13  adopted pursuant to this paragraph.  The provisions of this

14  paragraph notwithstanding, an applicant of a foreign dental

15  college or school not accredited in accordance with s.

16  466.006(2)(b) who cannot produce the credentials required by

17  this paragraph, as a result of political or other conditions

18  in the country in which the applicant received his or her

19  education, may seek the board's approval of his or her

20  educational background by submitting, in lieu of the

21  credentials required in this paragraph, such other reasonable

22  and reliable evidence as may be set forth by board rule.  The

23  board shall not accept such other evidence until it has made a

24  reasonable attempt to obtain the credentials required by this

25  paragraph from the educational institutions the applicant is

26  alleged to have attended, unless the board is otherwise

27  satisfied that such credentials cannot be obtained.

28         Section 58.  Section 466.021, Florida Statutes, is

29  amended to read:

30         466.021  Employment of unlicensed persons by dentist;

31  penalty.--Every duly licensed dentist who uses the services of

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 1  any unlicensed person for the purpose of constructing,

 2  altering, repairing, or duplicating any denture, partial

 3  denture, bridge splint, or orthodontic or prosthetic appliance

 4  shall be required to furnish such unlicensed person with a

 5  written work order in such form as prescribed by rule of the

 6  board. This form shall be dated and signed by such dentist and

 7  shall include the patient's name or number with sufficient

 8  descriptive information to clearly identify the case for each

 9  separate and individual piece of work. A copy of such work

10  order shall be retained in a permanent file in the dentist's

11  office for a period of 4 2 years, and the original work order

12  shall be retained in a permanent file for a period of 4 2

13  years by such unlicensed person in her or his place of

14  business. Such permanent file of work orders to be kept by

15  such dentist or by such unlicensed person shall be open to

16  inspection at any reasonable time by the department or its

17  duly constituted agent. Failure of the dentist to keep such

18  permanent records of such work orders shall subject the

19  dentist to suspension or revocation of her or his license to

20  practice dentistry. Failure of such unlicensed person to have

21  in her or his possession a work order as required by this

22  section shall be admissible evidence of a violation of this

23  chapter and shall constitute a misdemeanor of the second

24  degree, punishable as provided in s. 775.082 or s. 775.083.

25  Nothing in this section shall preclude a registered dental

26  laboratory from working for another registered dental

27  laboratory, provided that such work is performed pursuant to

28  written authorization, in a form to be prescribed by rule of

29  the board, which evidences that the originating laboratory has

30  obtained a valid work order and which sets forth the work to

31  be performed. Furthermore, nothing in this section shall

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 1  preclude a registered laboratory from providing its services

 2  to dentists licensed and practicing in another state, provided

 3  that such work is requested or otherwise authorized in written

 4  form which clearly identifies the name and address of the

 5  requesting dentist and which sets forth the work to be

 6  performed.

 7         Section 59.  Subsection (8) of section 467.009, Florida

 8  Statutes, is amended to read:

 9         467.009  Midwifery programs; education and training

10  requirements.--

11         (8)  Nonpublic educational institutions that conduct

12  approved midwifery programs shall be accredited by an

13  accrediting agency recognized and approved by the Council for

14  Higher Education Accreditation or the United States Department

15  of Education a member of the Commission on Recognition of

16  Postsecondary Accreditation and shall be licensed by the

17  Commission for Independent State Board of Nonpublic Career

18  Education.

19         Section 60.  Section 467.013, Florida Statutes, is

20  amended to read:

21         467.013  Inactive status.--A licensee may request that

22  his or her license be placed in an inactive status by making

23  application to the department prior to department rule and

24  paying a fee.

25         (1)  An inactive license may be renewed for one

26  additional biennium upon application to the department and

27  payment of the applicable biennium renewal fee. The department

28  shall establish by rule procedures and fees for applying to

29  place a license on inactive status, renewing an inactive

30  license, and reactivating an inactive license. The fee for any

31  

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 1  of these procedures may not exceed the biennial renewal fee

 2  established by the department.

 3         (2)  Any license that is not renewed by the end of the

 4  biennium established by the department automatically reverts

 5  to involuntary inactive status unless the licensee has applied

 6  for voluntary inactive status. Such license may be reactivated

 7  only if the licensee meets the requirements for reactivating

 8  the license established by department rule.

 9         (3)  A midwife who desires to reactivate an inactive

10  license shall apply to the department, complete the

11  reactivation application, remit the applicable fees, and

12  submit proof of compliance with the requirements for

13  continuing education established by department rule.

14         (4)  Each licensed midwife whose license has been

15  placed on inactive status for more than 1 year must complete

16  continuing education hours as a condition of reactivating the

17  inactive license.

18         (5)  The licensee shall submit to the department

19  evidence of participation in 10 hours of continuing education,

20  approved by the department and clinically related to the

21  practice of midwifery, for each year of the biennium in which

22  the license was inactive. This requirement is in addition to

23  submitting evidence of completing the continuing education

24  required for the most recent biennium in which the licensee

25  held an active license.

26         Section 61.  Section 467.0135, Florida Statutes, is

27  amended to read:

28         467.0135  Fees.--The department shall establish fees

29  for application, examination, initial licensure, renewal of

30  active status licensure, licensure by endorsement, inactive

31  status, delinquent status, and reactivation of an inactive

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 1  status license. The appropriate fee must be paid at the time

 2  of application and is payable to the Department of Health, in

 3  accordance with rules adopted by the department. A fee is

 4  nonrefundable, unless otherwise provided by rule. A fee may

 5  not exceed:

 6         (1)  Five hundred dollars for examination.

 7         (1)(2)  Five hundred dollars for initial licensure.

 8         (2)(3)  Five hundred dollars for renewal of an active

 9  status license licensure.

10         (3)(4)  Two hundred dollars for application, which fee

11  is nonrefundable.

12         (4)(5)  Five hundred dollars for renewal reactivation

13  of an inactive status license.

14         (5)(6)  Five hundred dollars for licensure by

15  endorsement.

16  

17  A fee for inactive status, reactivation of an inactive status

18  license, or delinquency may not exceed the fee established by

19  the department for biennial renewal of an active license. All

20  fees collected under this section shall be deposited in the

21  Medical Quality Assurance Trust Fund.

22         Section 62.  Subsection (1) of section 467.017, Florida

23  Statutes, is amended to read:

24         467.017  Emergency care plan; immunity.--

25         (1)  Every licensed midwife shall develop a written

26  plan for the appropriate delivery of emergency care.  A copy

27  of the plan shall accompany any application for license

28  issuance and must be made available upon request of the

29  department or renewal.  The plan shall address the following:

30         (a)  Consultation with other health care providers.

31         (b)  Emergency transfer.

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 1         (c)  Access to neonatal intensive care units and

 2  obstetrical units or other patient care areas.

 3         Section 63.  Paragraph (b) of subsection (2) and

 4  paragraph (b) of subsection (3) of section 468.1155, Florida

 5  Statutes, are amended to read:

 6         468.1155  Provisional license; requirements.--

 7         (2)  The department shall issue a provisional license

 8  to practice speech-language pathology to each applicant who

 9  the board certifies has:

10         (b)  Received a master's degree or is currently

11  enrolled in a doctoral degree program with a major emphasis in

12  speech-language pathology from an institution of higher

13  learning which is, or at the time the applicant was enrolled

14  and graduated was, accredited by an accrediting agency

15  recognized by the Council for Higher Education Accreditation,

16  the United States Department of Education, or a successor

17  organization, or from an institution which is a member in good

18  standing with the Association of Universities and Colleges of

19  Canada.  An applicant who graduated from or is currently

20  enrolled in a program at a university or college outside the

21  United States or Canada must present documentation of the

22  determination of equivalency to standards established by the

23  Council for Higher Education Accreditation in order to

24  qualify.  The applicant must have completed 60 semester hours

25  that include:

26         1.  Fundamental information applicable to the normal

27  development and use of speech, hearing, and language;

28  information about training in management of speech, hearing,

29  and language disorders; and information supplementary to these

30  fields.

31         2.  Six semester hours in audiology.

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 1         3.  Thirty of the required 60 semester hours in courses

 2  acceptable toward a graduate degree by the college or

 3  university in which these courses were taken, of which 24

 4  semester hours must be in speech-language pathology.

 5         (3)  The department shall issue a provisional license

 6  to practice audiology to each applicant who the board

 7  certifies has:

 8         (b)  Received a master's degree or is currently

 9  enrolled in a doctoral degree program with a major emphasis in

10  audiology from an institution of higher learning which is, or

11  at the time the applicant was enrolled and graduated was,

12  accredited by an accrediting agency recognized by the Council

13  for Higher Education Accreditation, the United States

14  Department of Education, or a successor organization, or from

15  an institution which is a member in good standing with the

16  Association of Universities and Colleges of Canada. An

17  applicant who graduated from or is currently enrolled in a

18  program at a university or college outside the United States

19  or Canada must present documentation of the determination of

20  equivalency to standards established by the Council for Higher

21  Education Accreditation in order to qualify.  The applicant

22  must have completed 60 semester hours that include:

23         1.  Fundamental information applicable to the normal

24  development and use of speech, hearing, and language;

25  information about training in management of speech, hearing,

26  and language disorders; and information supplementary to these

27  fields.

28         2.  Six semester hours in speech-language pathology.

29         3.  Thirty of the required 60 semester hours in courses

30  acceptable toward a graduate degree by the college or

31  

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 1  university in which these courses were taken, of which 24

 2  semester hours must be in audiology.

 3         Section 64.  Subsection (2) of section 468.509, Florida

 4  Statutes, is amended to read:

 5         468.509  Dietitian/nutritionist; requirements for

 6  licensure.--

 7         (2)  The agency shall examine any applicant who the

 8  board certifies has completed the application form and

 9  remitted the application and examination fees specified in s.

10  468.508 and who:

11         (a)1.  Possesses a baccalaureate or postbaccalaureate

12  degree with a major course of study in human nutrition, food

13  and nutrition, dietetics, or food management, or an equivalent

14  major course of study, from a school or program accredited, at

15  the time of the applicant's graduation, by the appropriate

16  accrediting agency recognized by the Council for Higher

17  Education Commission on Recognition of Postsecondary

18  Accreditation or and the United States Department of

19  Education; and

20         2.  Has completed a preprofessional experience

21  component of not less than 900 hours or has education or

22  experience determined to be equivalent by the board; or

23         (b)1.  Has an academic degree, from a foreign country,

24  that has been validated by an accrediting agency approved by

25  the United States Department of Education as equivalent to the

26  baccalaureate or postbaccalaureate degree conferred by a

27  regionally accredited college or university in the United

28  States;

29         2.  Has completed a major course of study in human

30  nutrition, food and nutrition, dietetics, or food management;

31  and

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 1         3.  Has completed a preprofessional experience

 2  component of not less than 900 hours or has education or

 3  experience determined to be equivalent by the board.

 4         Section 65.  Section 468.707, Florida Statutes, is

 5  amended to read:

 6         468.707  Licensure by examination; requirements.--

 7         (1)  Any person desiring to be licensed as an athletic

 8  trainer shall apply to the department on a form approved by

 9  the department.

10         (1)(a)  The department shall license each applicant

11  who:

12         (a)1.  Has completed the application form and remitted

13  the required fees.

14         (b)2.  Is at least 21 years of age.

15         (c)3.  Has obtained a baccalaureate degree from a

16  college or university accredited by an accrediting agency

17  recognized and approved by the United States Department of

18  Education or the Council for Higher Education Commission on

19  Recognition of Postsecondary Accreditation, or approved by the

20  board.

21         (d)4.  Has completed coursework from a college or

22  university accredited by an accrediting agency recognized and

23  approved by the United States Department of Education or the

24  Council for Higher Education Commission on Recognition of

25  Postsecondary Accreditation, or approved by the board, in each

26  of the following areas, as provided by rule: health, human

27  anatomy, kinesiology/biomechanics, human physiology,

28  physiology of exercise, basic athletic training, and advanced

29  athletic training.

30         (e)5.  Has current certification in standard first aid

31  and cardiovascular pulmonary resuscitation from the American

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 1  Red Cross or an equivalent certification as determined by the

 2  board.

 3         (f)6.  Has, within 2 of the preceding 5 years, attained

 4  a minimum of 800 hours of athletic training experience under

 5  the direct supervision of a licensed athletic trainer or an

 6  athletic trainer certified by the National Athletic Trainers'

 7  Association or a comparable national athletic standards

 8  organization.

 9         (g)7.  Has passed an examination administered or

10  approved by the board.

11         (2)(b)  The department shall also license each

12  applicant who:

13         (a)1.  Has completed the application form and remitted

14  the required fees no later than October 1, 1996.

15         (b)2.  Is at least 21 years of age.

16         (c)3.  Has current certification in standard first aid

17  and cardiovascular pulmonary resuscitation from the American

18  Red Cross or an equivalent certification as determined by the

19  board.

20         (d)1.4.a.  Has practiced athletic training for at least

21  3 of the 5 years preceding application; or

22         2.b.  Is currently certified by the National Athletic

23  Trainers' Association or a comparable national athletic

24  standards organization.

25         (2)  Pursuant to the requirements of s. 456.034, each

26  applicant shall complete a continuing education course on

27  human immunodeficiency virus and acquired immune deficiency

28  syndrome as part of initial licensure.

29         Section 66.  Section 480.033, Florida Statutes, is

30  amended to read:

31         480.033  Definitions.--As used in this act:

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 1         (1)  "Board" means the Board of Massage Therapy.

 2         (2)  "Department" means the Department of Health.

 3         (3)  "Massage" means the manipulation of the soft

 4  tissues of the human body with the hand, foot, arm, or elbow,

 5  whether or not such manipulation is aided by hydrotherapy,

 6  including colonic irrigation, or thermal therapy; any

 7  electrical or mechanical device; or the application to the

 8  human body of a chemical or herbal preparation.

 9         (4)  "Massage therapist" means a person licensed as

10  required by this act, who administers massage for

11  compensation.

12         (5)  "Apprentice" means a person approved by the board

13  to study massage under the instruction of a licensed massage

14  therapist.

15         (5)(6)  "Colonic irrigation" means a method of

16  hydrotherapy used to cleanse the colon with the aid of a

17  mechanical device and water.

18         (6)(7)  "Establishment" means a site or premises, or

19  portion thereof, wherein a massage therapist practices

20  massage.

21         (7)(8)  "Licensure" means the procedure by which a

22  person, hereinafter referred to as a "practitioner," applies

23  to the board for approval to practice massage or to operate an

24  establishment.

25         (8)(9)  "Board-approved massage school" means a

26  facility which meets minimum standards for training and

27  curriculum as determined by rule of the board and which is

28  licensed by the Department of Education pursuant to chapter

29  1005 or the equivalent licensing authority of another state or

30  is within the public school system of this state.

31  

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 1         (9)  "Massage establishment licensed premises" means

 2  not only rooms where massage therapy is being practiced by an

 3  active licensed massage therapist, but also all other rooms in

 4  the building which are so closely connected therewith as to

 5  admit the free passage from one room to other rooms over which

 6  the massage establishment licensee has some dominion or

 7  control, and includes all of the area embraced in the sketch

 8  appearing on or attached to the application for the massage

 9  establishment license involved and designated as such on the

10  sketch, in addition to that area included or designated by

11  general law. The Board of Massage Therapy may approve an

12  application for expansion of the licensed premises upon

13  submission of a sketch outlining the expanded premises, an

14  application for expansion of the premises, and the appropriate

15  fee if the licensed premises is expanded to meet the

16  requirements for licensure of a massage establishment.

17         (10)  "Licensed premises" means an establishment,

18  operated by a legal or business entity, person, or persons,

19  which holds a massage establishment license issued by the

20  Board of Massage Therapy and which meets the qualifications

21  set forth in this chapter.

22         (11)  "Relative" means an individual who is related to

23  the licensee or the executive officer, director, or person

24  holding an interest in the licensee as the father, mother,

25  son, daughter, brother, sister, uncle, aunt, first cousin,

26  nephew, niece, husband, wife, father-in-law, mother-in-law,

27  son-in-law, daughter-in-law, brother-in-law, sister-in-law,

28  stepfather, stepmother, stepson, stepdaughter, stepsister,

29  stepbrother, half brother, or half sister.

30         Section 67.  Subsection (5) is added to section

31  480.034, Florida Statutes, to read:

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 1         480.034  Exemptions.--

 2         (5)  The requirements of this chapter for the licensure

 3  of an establishment do not apply to the office of a health

 4  care practitioner licensed under chapter 457, chapter 458,

 5  chapter 459, chapter 460, chapter 461, chapter 466, or chapter

 6  486.

 7         Section 68.  Section 480.041, Florida Statutes, is

 8  amended to read:

 9         480.041  Massage therapists; qualifications; licensure;

10  endorsement.--

11         (1)  Any person is qualified for licensure as a massage

12  therapist under this act who:

13         (a)  Has completed an application form and submitted

14  the appropriate fee to the department, is at least 18 years of

15  age, or has received a high school diploma or graduate

16  equivalency diploma, and demonstrates good moral character;

17         (b)  Has completed a course of study at a

18  board-approved massage school or has completed an

19  apprenticeship program that meets standards adopted by the

20  board; and

21         (c)  Has received a passing grade on a board-approved

22  national an examination certified administered by the

23  department.

24         (2)  Every person desiring to be examined for licensure

25  as a massage therapist shall apply to the department in

26  writing upon forms prepared and furnished by the department.

27  Such Applicants for licensure shall be subject to the

28  provisions of s. 480.046(1). Applicants may take an

29  examination administered by the department only upon meeting

30  the requirements of this section as determined by the board.

31  

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 1         (3)  Upon an applicant's passing the examination and

 2  paying the initial licensure fee, the department shall issue

 3  to the applicant a license, valid until the next scheduled

 4  renewal date, to practice massage.

 5         (3)(4)  The board shall adopt rules:

 6         (a)  Establishing a minimum training program for

 7  apprentices.

 8         (a)(b)  Providing for educational standards,

 9  examination, and certification for the practice of colonic

10  irrigation, as defined in s. 480.033(6), by massage

11  therapists.

12         (b)(c)  Specifying licensing procedures for

13  practitioners desiring to be licensed in this state who hold

14  an active license and have practiced in any other state,

15  territory, or jurisdiction of the United States or any foreign

16  national jurisdiction which has licensing standards

17  substantially similar to, equivalent to, or more stringent

18  than the standards of this state.

19         (4)  Notwithstanding the provisions of s. 120.60(1),

20  upon receipt of an application for a license, the board shall

21  examine the application and, within 30 days after such

22  receipt, notify the applicant of any apparent errors or

23  omissions and request any additional information the board is

24  permitted by law to require. Within 30 days after receipt of

25  the additional information, the board shall review it and may

26  request additional information needed to clarify such

27  additional information or to answer new questions raised by or

28  directly related to such additional information. Where

29  appropriate, the board may require the results of an

30  evaluation through the Professionals Resource Network as

31  additional information or clarifying information, or as the

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 1  answer to new questions raised by or directly related to

 2  information submitted by an applicant. The department may not

 3  deny a license for failure to correct an error or omission or

 4  to supply additional information, provide clarifying

 5  information, or answer new questions raised by or directly

 6  related to additional information unless the board has timely

 7  notified the applicant within the appropriate 30-day period.

 8  An application is complete upon receipt of all requested

 9  information and correction of any error or omission for which

10  the applicant was timely notified or when the time for such

11  notification has expired. Each application for a license shall

12  be approved or denied within 90 days after receipt of a

13  completed application unless a shorter period of time for

14  department action is provided by law. The 90-day time period

15  shall be tolled by the initiation of a proceeding under ss.

16  120.569 and 120.57. An application for a license must be

17  approved or denied within the 90-day or shorter time period,

18  within 15 days after the conclusion of a public hearing held

19  on the application, or within 45 days after a recommended

20  order is submitted to the department and the parties,

21  whichever is later. The department must approve any

22  application for a license or for an examination required for

23  licensure if the department has not approved or denied the

24  application within the time periods prescribed by this

25  subsection.

26         Section 69.  Subsections (3), (4), (7), and (8) of

27  section 480.043, Florida Statutes, are amended to read:

28         480.043  Massage establishments; requisites; licensure;

29  inspection.--

30         (3)  Any person, firm, or corporation desiring to

31  operate a massage establishment in the state shall submit to

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 1  the department an application, upon forms provided by the

 2  department, accompanied by any information requested by the

 3  department and an application fee.

 4         (a)  To hold a massage establishment license, a person

 5  must be at least 18 years of age. If the applicant for a

 6  massage establishment license is a corporation or other

 7  business entity, the license shall be issued only to a

 8  corporation or other business entity whose officers are at

 9  least 18 years of age. The applicant must be a legal or

10  business entity, person, or persons and must include all

11  persons, officers, shareholders, and directors of such legal

12  or business entity who have a direct or indirect interest in

13  the business seeking to be licensed under this chapter as a

14  massage establishment.

15         (b)  A massage establishment license may not be issued

16  to any person who has been convicted within the last 5 years

17  in this state, any other state, or in the United States of

18  soliciting for prostitution, pandering, letting premises for

19  prostitution, keeping a disorderly place, or any crime that is

20  a violation of chapter 893 or the controlled substance act of

21  any other state or the Federal Government; or who has been

22  convicted in the last 15 years of any felony in this state,

23  any other state, or the United States; and may not be issued

24  to a corporation or other business entity any of the officers

25  of which have been so convicted. The term "convicted" or

26  "conviction" includes adjudication of guilt on a plea of

27  guilty or nolo contendere or the forfeiture of a bond when

28  charged with a crime.

29         (c)  An application for a massage establishment license

30  must include the names of the owners, including all persons,

31  corporations, or other business entities with direct or

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 1  indirect ownership interest, and the name of the officers,

 2  directors, stockholders, or partners of the establishment.

 3         (d)  Prior to any application for a massage

 4  establishment license being approved, the Board of Massage

 5  Therapy may require the applicant to file a set of

 6  fingerprints on a form and following procedures specified by

 7  the department, along with payment in an amount equal to the

 8  costs incurred by the Department of Health for the criminal

 9  background check of the applicant. The Department of Health

10  shall submit the fingerprints provided by the applicant to the

11  Department of Law Enforcement for a statewide criminal history

12  check, and the Department of Law Enforcement shall forward the

13  fingerprints to the Federal Bureau of Investigation for a

14  national criminal history check of the applicant. The

15  Department of Health shall review the results of the criminal

16  history check, issue a license to an applicant who has met all

17  of the other requirements for licensure and who has no

18  criminal history, and shall refer any applicant having a

19  criminal history to the board for a determination as to

20  whether a license should be issued and under what conditions.

21  The department may not issue a license to any applicant who is

22  under investigation in another state for any act that would

23  constitute a violation of this chapter or chapter 456 until

24  that investigation is complete, at which time the provisions

25  of this chapter shall apply.

26         (4)  Upon receiving the application, the board shall

27  department may cause an investigation to be made of the

28  proposed massage establishment, both as to qualifications of

29  the applicant and the premises and location sought to be

30  licensed.

31  

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 1         (7)(a)  Once issued, a licensee may not transfer or

 2  attempt to transfer any license or interest in a license or

 3  business or change executive officers or directors contrary to

 4  the provisions of this section. A no license for operation of

 5  a massage establishment may not be transferred from one owner

 6  to another except as provided in this paragraph. When the

 7  holder of a massage establishment license has made a bona fide

 8  sale of the business that he or she is licensed to conduct, he

 9  or she may obtain a transfer of the license to the purchaser

10  of the business if the application of the purchaser is

11  approved by the Board of Massage Therapy in accordance with

12  the procedures for an initial application for a massage

13  establishment. If the request to transfer the license is

14  denied, the holder of the massage establishment license shall

15  immediately return the original license to the Board of

16  Massage Therapy. A licensee is not entitled as a matter of

17  right to the transfer of a massage establishment license, or

18  of an interest in a massage establishment license, to a

19  relative or any other person, and is not entitled as a matter

20  of right to a change of executive officers or directors.

21         (b)  A license may be transferred from one location to

22  another only after inspection and approval by the board and

23  receipt of an application and inspection fee set by rule of

24  the board, not to exceed $125.

25         (c)  A license may be transferred from one business

26  name to another after approval by the board and receipt of an

27  application fee set by rule of the board, not to exceed $25.

28         (8)  Renewal of license registration for massage

29  establishments shall be accomplished pursuant to rules adopted

30  by the board.  The board is further authorized to adopt rules

31  governing delinquent renewal of licenses and may impose

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 1  penalty fees for delinquent renewal. An applicant for renewal

 2  who has not previously submitted a set of fingerprints for

 3  purposes of certification must submit a set of fingerprints to

 4  the department as a condition of initial renewal after July 1,

 5  2004. The applicant must submit the fingerprints on a form and

 6  following procedures specified by the department, along with

 7  payment in an amount equal to the costs incurred by the

 8  department for a national criminal history check. For

 9  subsequent renewals, the applicant for renewed certification

10  must submit information necessary to conduct a statewide

11  criminal history check, along with payment in an amount equal

12  to the costs incurred by the department for a statewide

13  criminal history check.

14         (a)  The department shall submit the fingerprints

15  provided by an applicant for initial certification to the

16  Department of Law Enforcement for a statewide criminal history

17  check, and the Department of Law Enforcement shall forward the

18  fingerprints to the Federal Bureau of Investigation for a

19  national criminal history check of the applicant after July 1,

20  2004.

21         (b)  For any subsequent renewal of the applicant's

22  certificate, the department shall submit the required

23  information for a statewide criminal history check of the

24  applicant to the Department of Law Enforcement.

25         (c)  Any applicant for initial certification or renewal

26  of certification who submits to the department a set of

27  fingerprints and information required for the criminal history

28  check required under this section is not required to provide a

29  subsequent set of fingerprints or other duplicate information

30  required for a criminal history check.

31  

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 1         Section 70.  Subsection (3) of section 480.046, Florida

 2  Statutes, is amended to read:

 3         480.046  Grounds for disciplinary action by the

 4  board.--

 5         (3)  The board shall have the power to revoke or

 6  suspend the license of a massage establishment licensed under

 7  this act, or to deny subsequent licensure of such an

 8  establishment, in either of the following cases:

 9         (a)  Upon proof that a license has been obtained by

10  fraud or misrepresentation.

11         (b)  Upon proof that the holder of a license is guilty

12  of fraud or deceit or of gross negligence, incompetency, or

13  misconduct in the operation of the establishment so licensed.

14         (c)  Upon proof that the holder of the massage

15  establishment license, or the licensee's agent, officer,

16  servant, or employee, on the licensed premises, or elsewhere

17  while in the scope of employment, engaged in or permitted

18  disorderly conduct on the premises, prostitution, solicitation

19  of prostitution, pandering, the letting of premises for

20  prostitution, a violation of chapter 893, or a violation of

21  the controlled substance act of any other state or the Federal

22  Government, including permitting another on the licensed

23  premises to violate any of the laws of this state or the

24  United States.

25         (d)  Upon proof that the holder of the massage

26  establishment license, or the licensee's agent, officer,

27  servant, or employee, or, if a corporation, any officer or

28  stockholder thereof, committed a violation of this chapter or

29  any rule adopted by the board.

30         (e)  Upon proof that the name of the massage

31  establishment or address of the massage establishment was

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 1  changed prior to receiving written authorization from the

 2  board, or upon proof that the owner of the massage

 3  establishment transferred or attempted to transfer the

 4  ownership from one owner to another without prior written

 5  approval of the board.

 6         Section 71.  Subsection (9) of section 486.021, Florida

 7  Statutes, is amended to read:

 8         486.021  Definitions.--In this chapter, unless the

 9  context otherwise requires, the term:

10         (9)  "Direct supervision" means supervision by a

11  physical therapist who is licensed pursuant to this chapter.

12  Except in a case of emergency, direct supervision requires the

13  physical presence of the licensed physical therapist for

14  consultation and direction of the actions of a physical

15  therapist or physical therapist assistant who is practicing

16  under a temporary permit and who is a candidate for licensure

17  by examination.

18         Section 72.  Section 486.031, Florida Statutes, is

19  amended to read:

20         486.031  Physical therapist; licensing

21  requirements.--To be eligible for licensing as a physical

22  therapist, an applicant must:

23         (1)  Be at least 18 years old.;

24         (2)  Be of good moral character.; and

25         (3)(a)  Have been graduated from a school of physical

26  therapy which has been approved for the educational

27  preparation of physical therapists by an the appropriate

28  accrediting agency recognized by the Council for Higher

29  Education Commission on Recognition of Postsecondary

30  Accreditation or the United States Department of Education, or

31  a successor organization, at the time of her or his graduation

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 1  and have passed, to the satisfaction of the board, the

 2  American Registry Examination prior to 1971 or a national

 3  examination approved by the board to determine her or his

 4  fitness for practice as a physical therapist as hereinafter

 5  provided;

 6         (b)  Have received a diploma from a program in physical

 7  therapy in a foreign country and have educational credentials

 8  deemed equivalent to those required for the educational

 9  preparation of physical therapists in this country, as

10  recognized by the appropriate agency as identified by the

11  board, and have passed to the satisfaction of the board an

12  examination to determine her or his fitness for practice as a

13  physical therapist as hereinafter provided; or

14         (c)  Be entitled to licensure without examination as

15  provided in s. 486.081.

16         Section 73.  Section 486.051, Florida Statutes, is

17  amended to read:

18         486.051  Physical therapist; examination of

19  applicant.--The examinations of an applicant for licensing as

20  a physical therapist shall be in accordance with rules adopted

21  by the board, to test the applicant's qualifications and shall

22  include the taking of tests a test by the applicant.  If an

23  applicant fails to pass the examination in three attempts, the

24  applicant shall not be eligible for reexamination unless she

25  or he completes additional educational or training

26  requirements prescribed by the board.  An applicant who has

27  completed the additional educational or training requirements

28  prescribed by the board may take the examination on two more

29  occasions.  If the applicant has failed to pass the

30  examination after five attempts, she or he is no longer

31  eligible to take the examination.

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 1         Section 74.  Section 486.081, Florida Statutes, is

 2  amended to read:

 3         486.081  Physical therapist; issuance of license by

 4  endorsement without examination to a person licensed in

 5  another jurisdiction passing examination of another authorized

 6  examining board; fee.--

 7         (1)  The board may cause a license to be issued through

 8  the department by endorsement without examination to any

 9  applicant who presents evidence satisfactory to the board,

10  under oath, of having passed the American Registry Examination

11  prior to 1971 or of licensure in another jurisdiction an

12  examination in physical therapy before a similar lawfully

13  authorized examining board of another state, the District of

14  Columbia, a territory, or a foreign country, if the standards

15  for licensure in physical therapy in such other jurisdiction

16  state, district, territory, or foreign country are determined

17  by the board to be as high as those of this state, as

18  established by rules adopted pursuant to this chapter. Any

19  person who holds a license pursuant to this section may use

20  the words "physical therapist" or "physiotherapist," or the

21  letters "P.T.," in connection with her or his name or place of

22  business to denote her or his licensure hereunder.

23         (2)  At the time of making application for licensure by

24  endorsement without examination pursuant to the terms of this

25  section, the applicant shall pay to the department a fee not

26  to exceed $175 as fixed by the board, no part of which will be

27  returned.

28         (3)  If an applicant seeking reentry into the

29  profession has not been in active practice within the last 3

30  years, the applicant shall, prior to applying for licensure,

31  

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 1  submit to the board documentation of competence to practice as

 2  required by rule of the board.

 3         Section 75.  Section 486.102, Florida Statutes, is

 4  amended to read:

 5         486.102  Physical therapist assistant; licensing

 6  requirements.--To be eligible for licensing by the board as a

 7  physical therapist assistant, an applicant must:

 8         (1)  Be at least 18 years old.;

 9         (2)  Be of good moral character.; and

10         (3)(a)  Have been graduated from a school giving a

11  course of not less than 2 years for physical therapist

12  assistants, which has been approved for the educational

13  preparation of physical therapist assistants by the

14  appropriate accrediting agency recognized by the Council for

15  Higher Education Commission on Recognition of Postsecondary

16  Accreditation or the United States Department of Education, or

17  a successor organization, or which is approved by the board,

18  at the time of the applicant's her or his graduation. An

19  applicant must and have passed to the satisfaction of the

20  board an examination to determine the applicant's eligibility

21  for licensure to her or his fitness for practice as a physical

22  therapist assistant as hereinafter provided;

23         (b)  Be a graduate of a physical therapy assistant

24  program Have been graduated from a school giving a course for

25  physical therapist assistants in a foreign country and have

26  educational credentials deemed equivalent to those required

27  for the educational preparation of physical therapist

28  assistants in this country, as recognized by the appropriate

29  agency as identified by the board, and passed to the

30  satisfaction of the board an examination to determine the

31  applicant's eligibility for licensure to her or his fitness

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 1  for practice as a physical therapist assistant as hereinafter

 2  provided; or

 3         (c)  Be entitled to licensure by endorsement without

 4  examination as provided in s. 486.107.

 5         Section 76.  Section 486.104, Florida Statutes, is

 6  amended to read:

 7         486.104  Physical therapist assistant; examination of

 8  applicant.--The examination of an applicant for licensing as a

 9  physical therapist assistant shall be in accordance with rules

10  adopted by the board, to test the applicant's qualifications

11  and shall include the taking of tests a test by the applicant.

12  If an applicant fails to pass the examination in three

13  attempts, the applicant shall not be eligible for

14  reexamination unless she or he completes additional

15  educational or training requirements prescribed by the board.

16  An applicant who has completed the additional educational or

17  training requirements prescribed by the board may take the

18  examination on two more occasions.  If the applicant has

19  failed to pass the examination after five attempts, she or he

20  is no longer eligible to take the examination.

21         Section 77.  Section 486.107, Florida Statutes, is

22  amended to read:

23         486.107  Physical therapist assistant; issuance of

24  license by endorsement without examination to person licensed

25  in another jurisdiction; fee.--

26         (1)  The board may cause a license to be issued through

27  the department by endorsement without examination to any

28  applicant who presents evidence to the board, under oath, of

29  licensure in another jurisdiction state, the District of

30  Columbia, or a territory, if the standards for registering as

31  a physical therapist assistant or licensing of a physical

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 1  therapist assistant, as the case may be, in such other

 2  jurisdiction state are determined by the board to be as high

 3  as those of this state, as established by rules adopted

 4  pursuant to this chapter. Any person who holds a license

 5  pursuant to this section may use the words "physical therapist

 6  assistant," or the letters "P.T.A.," in connection with her or

 7  his name to denote licensure hereunder.

 8         (2)  At the time of making application for licensing by

 9  endorsement without examination pursuant to the terms of this

10  section, the applicant shall pay to the department a fee not

11  to exceed $175 as fixed by the board, no part of which will be

12  returned.

13         (3)  An applicant seeking reentry into the profession

14  who has not been in active practice within the last 3 years

15  shall, prior to applying for licensure, submit to the board

16  documentation of competence to practice as required by rule of

17  the board.

18         Section 78.  Subsection (2) of section 486.109, Florida

19  Statutes, is amended to read:

20         486.109  Continuing education.--

21         (2)  The board shall accept approve only those courses

22  sponsored by a college or university which provides a

23  curriculum for professional education of training physical

24  therapists or physical therapist assistants which is

25  accredited by, or has status with an accrediting agency

26  approved by, the United States Department of Education as

27  determined by board rule, or courses sponsored or approved by

28  the Florida Physical Therapy Association or the American

29  Physical Therapy Association.

30         Section 79.  Subsection (2) of section 486.161, Florida

31  Statutes, is amended to read:

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 1         486.161  Exemptions.--

 2         (2)  No provision of this chapter shall be construed to

 3  prohibit:

 4         (a)  Any student who is enrolled in a school or course

 5  of physical therapy approved by the board from performing such

 6  acts of physical therapy as are incidental to her or his

 7  course of study.; or

 8         (b)  Any physical therapist from another state from

 9  performing physical therapy incidental to a course of study

10  when taking or giving a postgraduate course or other course of

11  study in this state, provided such physical therapist is

12  licensed in another jurisdiction or holds an appointment on

13  the faculty of a school approved for training physical

14  therapists or physical therapist assistants.

15         (c)  Any physical therapist who is licensed in another

16  jurisdiction of the United States or credentialed in another

17  country from performing physical therapy if that person, by

18  contract or employment, is providing physical therapy to

19  individuals affiliated with or employed by an established

20  athletic team, athletic organization, or performing arts

21  company temporarily practicing, competing, or performing in

22  this state for not more than 60 days in a calendar year.

23         Section 80.  Section 486.172, Florida Statutes, is

24  amended to read:

25         486.172  Application of s. 456.021.--The provisions of

26  s. 456.021, relating to the qualification of immigrants for

27  examination to practice a licensed profession or occupation,

28  shall also be applicable to the provisions of this chapter.

29         Section 81.  Paragraph (b) of subsection (2) of section

30  490.005, Florida Statutes, is amended to read:

31         490.005  Licensure by examination.--

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 1         (2)  Any person desiring to be licensed as a school

 2  psychologist shall apply to the department to take the

 3  licensure examination.  The department shall license each

 4  applicant who the department certifies has:

 5         (b)  Submitted satisfactory proof to the department

 6  that the applicant:

 7         1.  Has received a doctorate, specialist, or equivalent

 8  degree from a program primarily psychological in nature and

 9  has completed 60 semester hours or 90 quarter hours of

10  graduate study, in areas related to school psychology as

11  defined by rule of the department, from a college or

12  university which at the time the applicant was enrolled and

13  graduated was accredited by an accrediting agency recognized

14  and approved by the Council for Higher Education Accreditation

15  or the United States Department of Education Commission on

16  Recognition of Postsecondary Accreditation or from an

17  institution that which is publicly recognized as a member in

18  good standing with the Association of Universities and

19  Colleges of Canada.

20         2.  Has had a minimum of 3 years of experience in

21  school psychology, 2 years of which must be supervised by an

22  individual who is a licensed school psychologist or who has

23  otherwise qualified as a school psychologist supervisor, by

24  education and experience, as set forth by rule of the

25  department.  A doctoral internship may be applied toward the

26  supervision requirement.

27         3.  Has passed an examination provided by the

28  department.

29         Section 82.  Subsections (1), (3), and (4) of section

30  491.005, Florida Statutes, are amended to read:

31         491.005  Licensure by examination.--

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 1         (1)  CLINICAL SOCIAL WORK.--Upon verification of

 2  documentation and payment of a fee not to exceed $200, as set

 3  by board rule, plus the actual per applicant cost to the

 4  department for purchase of the examination from the American

 5  Association of State Social Worker's Boards or a similar

 6  national organization, the department shall issue a license as

 7  a clinical social worker to an applicant who the board

 8  certifies:

 9         (a)  Has made application therefor and paid the

10  appropriate fee.

11         (b)1.  Has received a doctoral degree in social work

12  from a graduate school of social work which at the time the

13  applicant graduated was accredited by an accrediting agency

14  recognized by the United States Department of Education or has

15  received a master's degree in social work from a graduate

16  school of social work which at the time the applicant

17  graduated:

18         a.  Was accredited by the Council on Social Work

19  Education;

20         b.  Was accredited by the Canadian Association of

21  Schools of Social Work; or

22         c.  Has been determined to have been a program

23  equivalent to programs approved by the Council on Social Work

24  Education by the Foreign Equivalency Determination Service of

25  the Council on Social Work Education.  An applicant who

26  graduated from a program at a university or college outside of

27  the United States or Canada must present documentation of the

28  equivalency determination from the council in order to

29  qualify.

30         2.  The applicant's graduate program must have

31  emphasized direct clinical patient or client health care

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 1  services, including, but not limited to, coursework in

 2  clinical social work, psychiatric social work, medical social

 3  work, social casework, psychotherapy, or group therapy.  The

 4  applicant's graduate program must have included all of the

 5  following coursework:

 6         a.  A supervised field placement which was part of the

 7  applicant's advanced concentration in direct practice, during

 8  which the applicant provided clinical services directly to

 9  clients.

10         b.  Completion of 24 semester hours or 32 quarter hours

11  in theory of human behavior and practice methods as courses in

12  clinically oriented services, including a minimum of one

13  course in psychopathology, and no more than one course in

14  research, taken in a school of social work accredited or

15  approved pursuant to subparagraph 1.

16         3.  If the course title which appears on the

17  applicant's transcript does not clearly identify the content

18  of the coursework, the applicant shall be required to provide

19  additional documentation, including, but not limited to, a

20  syllabus or catalog description published for the course.

21         (c)  Has had not less than 2 years of clinical social

22  work experience, which took place subsequent to completion of

23  a graduate degree in social work at an institution meeting the

24  accreditation requirements of this section, under the

25  supervision of a licensed clinical social worker or the

26  equivalent who is a qualified supervisor as determined by the

27  board. An individual who intends to practice in Florida to

28  satisfy clinical experience requirements must register

29  pursuant to s. 491.0045 prior to commencing practice.  If the

30  applicant's graduate program was not a program which

31  emphasized direct clinical patient or client health care

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 1  services as described in subparagraph (b)2., the supervised

 2  experience requirement must take place after the applicant has

 3  completed a minimum of 15 semester hours or 22 quarter hours

 4  of the coursework required.  A doctoral internship may be

 5  applied toward the clinical social work experience

 6  requirement. The clinical experience requirement may be met by

 7  work performed on or off the premises of the supervising

 8  clinical social worker, or the equivalent, if all work is

 9  performed under the direct supervision of provided the

10  off-premises work is not the independent private practice

11  rendering of clinical social work that does not have a

12  licensed mental health professional, as determined by the

13  board, on the premises at the same time the intern is

14  providing services.

15         (d)  Has passed a theory and practice examination

16  approved provided by the board department for this purpose,

17  which may be taken only following completion of the

18  requirement for clinical experience.

19         (e)  Has demonstrated, in a manner designated by rule

20  of the board, knowledge of the laws and rules governing the

21  practice of clinical social work, marriage and family therapy,

22  and mental health counseling.

23         (f)  Has satisfied all requirements for coursework in

24  this section by successfully completing the required course as

25  a student or by teaching the required graduate course as an

26  instructor or professor in an accredited institution.

27         (3)  MARRIAGE AND FAMILY THERAPY.--Upon verification of

28  documentation and payment of a fee not to exceed $200, as set

29  by board rule, plus the actual cost to the department for the

30  purchase of the examination from the Association of Marital

31  and Family Therapy Regulatory Board, or similar national

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 1  organization, the department shall issue a license as a

 2  marriage and family therapist to an applicant who the board

 3  certifies:

 4         (a)  Has made application therefor and paid the

 5  appropriate fee.

 6         (b)1.  Has a minimum of a master's degree with major

 7  emphasis in marriage and family therapy, or a closely related

 8  field, and has completed all of the following requirements:

 9         a.  Thirty-six semester hours or 48 quarter hours of

10  graduate coursework, which must include a minimum of 3

11  semester hours or 4 quarter hours of graduate-level course

12  credits in each of the following nine areas: dynamics of

13  marriage and family systems; marriage therapy and counseling

14  theory and techniques; family therapy and counseling theory

15  and techniques; individual human development theories

16  throughout the life cycle; personality theory or general

17  counseling theory and techniques; psychopathology; human

18  sexuality theory and counseling techniques; psychosocial

19  theory; and substance abuse theory and counseling techniques.

20  Courses in research, evaluation, appraisal, assessment, or

21  testing theories and procedures; thesis or dissertation work;

22  or practicums, internships, or fieldwork may not be applied

23  toward this requirement.

24         b.  A minimum of one graduate-level course of 3

25  semester hours or 4 quarter hours in legal, ethical, and

26  professional standards issues in the practice of marriage and

27  family therapy or a course determined by the board to be

28  equivalent.

29         c.  A minimum of one graduate-level course of 3

30  semester hours or 4 quarter hours in diagnosis, appraisal,

31  assessment, and testing for individual or interpersonal

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 1  disorder or dysfunction; and a minimum of one 3-semester-hour

 2  or 4-quarter-hour graduate-level course in behavioral research

 3  which focuses on the interpretation and application of

 4  research data as it applies to clinical practice.  Credit for

 5  thesis or dissertation work, practicums, internships, or

 6  fieldwork may not be applied toward this requirement.

 7         d.  A minimum of one supervised clinical practicum,

 8  internship, or field experience in a marriage and family

 9  counseling setting, during which the student provided 180

10  direct client contact hours of marriage and family therapy

11  services under the supervision of an individual who met the

12  requirements for supervision under paragraph (c). This

13  requirement may be met by a supervised practice experience

14  which took place outside the academic arena, but which is

15  certified as equivalent to a graduate-level practicum or

16  internship program which required a minimum of 180 direct

17  client contact hours of marriage and family therapy services

18  currently offered within an academic program of a college or

19  university accredited by an accrediting agency approved by the

20  United States Department of Education, or an institution which

21  is publicly recognized as a member in good standing with the

22  Association of Universities and Colleges of Canada or a

23  training institution accredited by the Commission on

24  Accreditation for Marriage and Family Therapy Education

25  recognized by the United States Department of Education.

26  Certification shall be required from an official of such

27  college, university, or training institution.

28         2.  If the course title which appears on the

29  applicant's transcript does not clearly identify the content

30  of the coursework, the applicant shall be required to provide

31  

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 1  additional documentation, including, but not limited to, a

 2  syllabus or catalog description published for the course.

 3  

 4  The required master's degree must have been received in an

 5  institution of higher education which at the time the

 6  applicant graduated was:  fully accredited by a regional

 7  accrediting body recognized by the Council for Higher

 8  Education Accreditation or the United States Department of

 9  Education Commission on Recognition of Postsecondary

10  Accreditation; publicly recognized as a member in good

11  standing with the Association of Universities and Colleges of

12  Canada; or an institution of higher education located outside

13  the United States and Canada, which at the time the applicant

14  was enrolled and at the time the applicant graduated

15  maintained a standard of training substantially equivalent to

16  the standards of training of those institutions in the United

17  States which are accredited by a regional accrediting body

18  recognized by the Council for Higher Education Accreditation

19  or the United States Department of Education Commission on

20  Recognition of Postsecondary Accreditation.  Such foreign

21  education and training must have been received in an

22  institution or program of higher education officially

23  recognized by the government of the country in which it is

24  located as an institution or program to train students to

25  practice as professional marriage and family therapists or

26  psychotherapists.  The burden of establishing that the

27  requirements of this provision have been met shall be upon the

28  applicant, and the board shall require documentation, such as,

29  but not limited to, an evaluation by a foreign equivalency

30  determination service, as evidence that the applicant's

31  graduate degree program and education were equivalent to an

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 1  accredited program in this country.  An applicant with a

 2  master's degree from a program which did not emphasize

 3  marriage and family therapy may complete the coursework

 4  requirement in a training institution fully accredited by the

 5  Commission on Accreditation for Marriage and Family Therapy

 6  Education recognized by the United States Department of

 7  Education.

 8         (c)  Has had not less than 2 years of clinical

 9  experience during which 50 percent of the applicant's clients

10  were receiving marriage and family therapy services, which

11  must be at the post-master's level under the supervision of a

12  licensed marriage and family therapist with at least 5 years

13  of experience, or the equivalent, who is a qualified

14  supervisor as determined by the board.  An individual who

15  intends to practice in Florida to satisfy the clinical

16  experience requirements must register pursuant to s. 491.0045

17  prior to commencing practice.  If a graduate has a master's

18  degree with a major emphasis in marriage and family therapy or

19  a closely related field that did not include all the

20  coursework required under sub-subparagraphs (b)1.a.-c., credit

21  for the post-master's level clinical experience shall not

22  commence until the applicant has completed a minimum of 10 of

23  the courses required under sub-subparagraphs (b)1.a.-c., as

24  determined by the board, and at least 6 semester hours or 9

25  quarter hours of the course credits must have been completed

26  in the area of marriage and family systems, theories, or

27  techniques. Within the 3 years of required experience, the

28  applicant shall provide direct individual, group, or family

29  therapy and counseling, to include the following categories of

30  cases:  unmarried dyads, married couples, separating and

31  divorcing couples, and family groups including children.  A

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 1  doctoral internship may be applied toward the clinical

 2  experience requirement.  The clinical experience requirement

 3  may be met by work performed on or off the premises of the

 4  supervising marriage and family therapist, or the equivalent,

 5  if all work is performed under the direct supervision of

 6  provided the off-premises work is not the independent private

 7  practice rendering of marriage and family therapy services

 8  that does not have a licensed mental health professional, as

 9  determined by the board, on the premises at the same time the

10  intern is providing services.

11         (d)  Has passed a theory and practice examination

12  approved provided by the board department for this purpose,

13  which may be taken only following completion of the

14  requirement for clinical experience.

15         (e)  Has demonstrated, in a manner designated by rule

16  of the board, knowledge of the laws and rules governing the

17  practice of clinical social work, marriage and family therapy,

18  and mental health counseling.

19         (f)  For the purposes of dual licensure, the department

20  shall license as a marriage and family therapist any person

21  who meets the requirements of s. 491.0057. Fees for dual

22  licensure shall not exceed those stated in this subsection.

23         (g)  Has satisfied all requirements for coursework in

24  this section by successfully completing the required course as

25  a student or by teaching the required graduate course as an

26  instructor or professor in an accredited institution.

27         (4)  MENTAL HEALTH COUNSELING.--Upon verification of

28  documentation and payment of a fee not to exceed $200, as set

29  by board rule, plus the actual per applicant cost to the

30  department for purchase of the examination from the

31  Professional Examination Service for the National Academy of

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 1  Certified Clinical Mental Health Counselors or a similar

 2  national organization, the department shall issue a license as

 3  a mental health counselor to an applicant who the board

 4  certifies:

 5         (a)  Has made application therefor and paid the

 6  appropriate fee.

 7         (b)1.  Has a minimum of an earned master's degree from

 8  a mental health counseling program accredited by the Council

 9  for the Accreditation of Counseling and Related Educational

10  Programs that consists of at least 60 semester hours or 80

11  quarter hours of clinical and didactic instruction, including

12  a course in human sexuality and a course in substance abuse.

13  If the master's degree is earned from a program related to the

14  practice of mental health counseling that is not accredited by

15  the Council for the Accreditation of Counseling and Related

16  Educational Programs, then the coursework and practicum,

17  internship, or fieldwork must consist of at least 60 semester

18  hours or 80 quarter hours and meet the following requirements:

19         a.  Thirty-three semester hours or 44 quarter hours of

20  graduate coursework, which must include a minimum of 3

21  semester hours or 4 quarter hours of graduate-level coursework

22  in each of the following 11 content areas: counseling theories

23  and practice; human growth and development; diagnosis and

24  treatment of psychopathology; human sexuality; group theories

25  and practice; individual evaluation and assessment; career and

26  lifestyle assessment; research and program evaluation; social

27  and cultural foundations; counseling in community settings;

28  and substance abuse. Courses in research, thesis or

29  dissertation work, practicums, internships, or fieldwork may

30  not be applied toward this requirement.

31  

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 1         b.  A minimum of 3 semester hours or 4 quarter hours of

 2  graduate-level coursework in legal, ethical, and professional

 3  standards issues in the practice of mental health counseling,

 4  which includes goals, objectives, and practices of

 5  professional counseling organizations, codes of ethics, legal

 6  considerations, standards of preparation, certifications and

 7  licensing, and the role identity and professional obligations

 8  of mental health counselors. Courses in research, thesis or

 9  dissertation work, practicums, internships, or fieldwork may

10  not be applied toward this requirement.

11         c.  The equivalent, as determined by the board, of at

12  least 1,000 hours of university-sponsored supervised clinical

13  practicum, internship, or field experience as required in the

14  accrediting standards of the Council for Accreditation of

15  Counseling and Related Educational Programs for mental health

16  counseling programs. This experience may not be used to

17  satisfy the post-master's clinical experience requirement.

18         2.  If the course title which appears on the

19  applicant's transcript does not clearly identify the content

20  of the coursework, the applicant shall be required to provide

21  additional documentation, including, but not limited to, a

22  syllabus or catalog description published for the course.

23  

24  Education and training in mental health counseling must have

25  been received in an institution of higher education which at

26  the time the applicant graduated was: fully accredited by a

27  regional accrediting body recognized by the Council for Higher

28  Education Accreditation or the United States Department of

29  Education Commission on Recognition of Postsecondary

30  Accreditation; publicly recognized as a member in good

31  standing with the Association of Universities and Colleges of

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 1  Canada; or an institution of higher education located outside

 2  the United States and Canada, which at the time the applicant

 3  was enrolled and at the time the applicant graduated

 4  maintained a standard of training substantially equivalent to

 5  the standards of training of those institutions in the United

 6  States which are accredited by a regional accrediting body

 7  recognized by the Council for Higher Education Accreditation

 8  or the United States Department of Education Commission on

 9  Recognition of Postsecondary Accreditation. Such foreign

10  education and training must have been received in an

11  institution or program of higher education officially

12  recognized by the government of the country in which it is

13  located as an institution or program to train students to

14  practice as mental health counselors. The burden of

15  establishing that the requirements of this provision have been

16  met shall be upon the applicant, and the board shall require

17  documentation, such as, but not limited to, an evaluation by a

18  foreign equivalency determination service, as evidence that

19  the applicant's graduate degree program and education were

20  equivalent to an accredited program in this country.

21         (c)  Has had not less than 2 years of clinical

22  experience in mental health counseling, which must be at the

23  post-master's level under the supervision of a licensed mental

24  health counselor or the equivalent who is a qualified

25  supervisor as determined by the board. An individual who

26  intends to practice in Florida to satisfy the clinical

27  experience requirements must register pursuant to s. 491.0045

28  prior to commencing practice. If a graduate has a master's

29  degree with a major related to the practice of mental health

30  counseling that did not include all the coursework required

31  under sub-subparagraphs (b)1.a.-b., credit for the

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 1  post-master's level clinical experience shall not commence

 2  until the applicant has completed a minimum of seven of the

 3  courses required under sub-subparagraphs (b)1.a.-b., as

 4  determined by the board, one of which must be a course in

 5  psychopathology or abnormal psychology. A doctoral internship

 6  may be applied toward the clinical experience requirement. The

 7  clinical experience requirement may be met by work performed

 8  on or off the premises of the supervising mental health

 9  counselor, or the equivalent, if all work is performed under

10  the direct supervision of provided the off-premises work is

11  not the independent private practice rendering of services

12  that does not have a licensed mental health professional, as

13  determined by the board, on the premises at the same time the

14  intern is providing services.

15         (d)  Has passed a theory and practice examination

16  approved provided by the board department for this purpose,

17  which may be taken only following completion of the

18  requirement for clinical experience.

19         (e)  Has demonstrated, in a manner designated by rule

20  of the board, knowledge of the laws and rules governing the

21  practice of clinical social work, marriage and family therapy,

22  and mental health counseling.

23         (f)  Has satisfied all requirements for coursework in

24  this section by successfully completing the required course as

25  a student or by teaching the required graduate course as an

26  instructor or professor in an accredited institution.

27         Section 83.  Paragraph (b) of subsection (1) of section

28  491.006, Florida Statutes, is amended to read:

29         491.006  Licensure or certification by endorsement.--

30         (1)  The department shall license or grant a

31  certificate to a person in a profession regulated by this

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 1  chapter who, upon applying to the department and remitting the

 2  appropriate fee, demonstrates to the board that he or she:

 3         (b)1.  Holds an active valid license to practice and

 4  has actively practiced the profession for which licensure is

 5  applied in another state for 3 of the last 5 years immediately

 6  preceding licensure.

 7         2.  Meets the education requirements of this chapter

 8  for the profession for which licensure is applied.

 9         3.  Has passed a substantially equivalent licensing

10  examination in another state or has passed the licensure

11  examination in this state in the profession for which the

12  applicant seeks licensure.

13         4.  Holds a license in good standing, is not under

14  investigation for an act that would constitute a violation of

15  this chapter, and has not been found to have committed any act

16  that would constitute a violation of this chapter. The fees

17  paid by any applicant for certification as a master social

18  worker under this section are nonrefundable.

19  

20  An applicant for licensure by endorsement as a mental health

21  counselor who has not completed a psychopathology or abnormal

22  psychology course may be accepted for licensure by the board

23  if the applicant has completed 2 years of post-master's level

24  supervised clinical experience and has actively practiced as a

25  mental health counselor in another state or territory for 5 of

26  the last 6 years without being subject to disciplinary action.

27         Section 84.  Subsection (2) of section 491.009, Florida

28  Statutes, is amended to read:

29         491.009  Discipline.--

30         (2)  The department, in the case of a certified master

31  social worker, or, in the case of psychologists, the board,

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 1  may enter an order denying licensure or imposing any of the

 2  penalties in s. 456.072(2) against any applicant for licensure

 3  or licensee who is found guilty of violating any provision of

 4  subsection (1) of this section or who is found guilty of

 5  violating any provision of s. 456.072(1).

 6         Section 85.  Section 491.0145, Florida Statutes, is

 7  amended to read:

 8         491.0145  Certified master social worker.--The

 9  department may not adopt any rules that would cause any person

10  who was not licensed as a certified master social worker in

11  accordance with this chapter on January 1, 1990, to become

12  licensed. The department may certify an applicant for a

13  designation as a certified master social worker upon the

14  following conditions:

15         (1)  The applicant completes an application to be

16  provided by the department and pays a nonrefundable fee not to

17  exceed $250 to be established by rule of the department. The

18  completed application must be received by the department at

19  least 60 days before the date of the examination in order for

20  the applicant to qualify to take the scheduled exam.

21         (2)  The applicant submits proof satisfactory to the

22  department that the applicant has received a doctoral degree

23  in social work, or a master's degree with a major emphasis or

24  specialty in clinical practice or administration, including,

25  but not limited to, agency administration and supervision,

26  program planning and evaluation, staff development, research,

27  community organization, community services, social planning,

28  and human service advocacy.  Doctoral degrees must have been

29  received from a graduate school of social work which at the

30  time the applicant was enrolled and graduated was accredited

31  by an accrediting agency approved by the United States

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 1  Department of Education.  Master's degrees must have been

 2  received from a graduate school of social work which at the

 3  time the applicant was enrolled and graduated was accredited

 4  by the Council on Social Work Education or the Canadian

 5  Association of Schools of Social Work or by one that meets

 6  comparable standards.

 7         (3)  The applicant has had at least 3 years'

 8  experience, as defined by rule, including, but not limited to,

 9  clinical services or administrative activities as defined in

10  subsection (2), 2 years of which must be at the post-master's

11  level under the supervision of a person who meets the

12  education and experience requirements for certification as a

13  certified master social worker, as defined by rule, or

14  licensure as a clinical social worker under this chapter.  A

15  doctoral internship may be applied toward the supervision

16  requirement.

17         (4)  Any person who holds a master's degree in social

18  work from institutions outside the United States may apply to

19  the department for certification if the academic training in

20  social work has been evaluated as equivalent to a degree from

21  a school accredited by the Council on Social Work Education.

22  Any such person shall submit a copy of the academic training

23  from the Foreign Equivalency Determination Service of the

24  Council on Social Work Education.

25         (5)  The applicant has passed an examination required

26  by the department for this purpose. The nonrefundable fee for

27  such examination may not exceed $250 as set by department

28  rule.

29         (6)  Nothing in this chapter shall be construed to

30  authorize a certified master social worker to provide clinical

31  social work services.

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 1         Section 86.  Section 491.0146, Florida Statutes, is

 2  created to read:

 3         491.0146  Saving clause.--All licenses to practice as a

 4  certified master social worker issued pursuant to this chapter

 5  and valid on October 1, 2002, shall remain in full force and

 6  effect.

 7         Section 87.  Paragraph (a) of subsection (2) of section

 8  817.505, Florida Statutes, is amended to read:

 9         817.505  Patient brokering prohibited; exceptions;

10  penalties.--

11         (2)  For the purposes of this section, the term:

12         (a)  "Health care provider or health care facility"

13  means any person or entity licensed, certified, or registered

14  with the Department of Health or the Agency for Health Care

15  Administration; any person or entity that has contracted with

16  the Agency for Health Care Administration to provide goods or

17  services to Medicaid recipients as provided under s. 409.907;

18  a county health department established under part I of chapter

19  154; any community service provider contracting with the

20  Department of Children and Family Services to furnish alcohol,

21  drug abuse, or mental health services under part IV of chapter

22  394; any substance abuse service provider licensed under

23  chapter 397; or any federally supported primary care program

24  such as a migrant or community health center authorized under

25  ss. 329 and 330 of the United States Public Health Services

26  Act.

27         Section 88.  Subsection (1) of section 817.567, Florida

28  Statutes, is amended to read:

29         817.567  Making false claims of academic degree or

30  title.--

31  

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 1         (1)  No person in the state may claim, either orally or

 2  in writing, to possess an academic degree, as defined in s.

 3  1005.02, or the title associated with said degree, unless the

 4  person has, in fact, been awarded said degree from an

 5  institution that is:

 6         (a)  Accredited by a regional or professional

 7  accrediting agency recognized by the United States Department

 8  of Education or the Council for Higher Education Commission on

 9  Recognition of Postsecondary Accreditation;

10         (b)  Provided, operated, and supported by a state

11  government or any of its political subdivisions or by the

12  Federal Government;

13         (c)  A school, institute, college, or university

14  chartered outside the United States, the academic degree from

15  which has been validated by an accrediting agency approved by

16  the United States Department of Education as equivalent to the

17  baccalaureate or postbaccalaureate degree conferred by a

18  regionally accredited college or university in the United

19  States;

20         (d)  Licensed by the State Board of Independent

21  Colleges and Universities pursuant to ss. 1005.01-1005.38 or

22  exempt from licensure pursuant to s. 246.085; or

23         (e)  A religious seminary, institute, college, or

24  university which offers only educational programs that prepare

25  students for a religious vocation, career, occupation,

26  profession, or lifework, and the nomenclature of whose

27  certificates, diplomas, or degrees clearly identifies the

28  religious character of the educational program.

29         Section 89.  Paragraph (a) of subsection (1) of section

30  895.02, Florida Statutes, is amended to read:

31  

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 1         895.02  Definitions.--As used in ss. 895.01-895.08, the

 2  term:

 3         (1)  "Racketeering activity" means to commit, to

 4  attempt to commit, to conspire to commit, or to solicit,

 5  coerce, or intimidate another person to commit:

 6         (a)  Any crime which is chargeable by indictment or

 7  information under the following provisions of the Florida

 8  Statutes:

 9         1.  Section 210.18, relating to evasion of payment of

10  cigarette taxes.

11         2.  Section 403.727(3)(b), relating to environmental

12  control.

13         3.  Section 409.920, relating to Medicaid provider

14  fraud.

15         4.3.  Section 414.39, relating to public assistance

16  fraud.

17         5.4.  Section 409.920, relating to Medicaid provider

18  fraud.

19         6.5.  Section 440.105 or s. 440.106, relating to

20  workers' compensation.

21         7.  Section 465.0161, relating to distribution of

22  medicinal drugs without a license as an Internet pharmacy.

23         8.6.  Sections 499.0051, 499.0052, 499.0053, 499.0054,

24  and 499.0691, relating to crimes involving contraband and

25  adulterated drugs.

26         9.7.  Part IV of chapter 501, relating to

27  telemarketing.

28         10.8.  Chapter 517, relating to sale of securities and

29  investor protection.

30         11.9.  Section 550.235, s. 550.3551, or s. 550.3605,

31  relating to dogracing and horseracing.

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 1         12.10.  Chapter 550, relating to jai alai frontons.

 2         13.11.  Chapter 552, relating to the manufacture,

 3  distribution, and use of explosives.

 4         14.12.  Chapter 560, relating to money transmitters, if

 5  the violation is punishable as a felony.

 6         15.13.  Chapter 562, relating to beverage law

 7  enforcement.

 8         16.14.  Section 624.401, relating to transacting

 9  insurance without a certificate of authority, s.

10  624.437(4)(c)1., relating to operating an unauthorized

11  multiple-employer welfare arrangement, or s. 626.902(1)(b),

12  relating to representing or aiding an unauthorized insurer.

13         17.15.  Section 655.50, relating to reports of currency

14  transactions, when such violation is punishable as a felony.

15         18.16.  Chapter 687, relating to interest and usurious

16  practices.

17         19.17.  Section 721.08, s. 721.09, or s. 721.13,

18  relating to real estate timeshare plans.

19         20.18.  Chapter 782, relating to homicide.

20         21.19.  Chapter 784, relating to assault and battery.

21         22.20.  Chapter 787, relating to kidnapping.

22         23.21.  Chapter 790, relating to weapons and firearms.

23         24.22.  Section 796.03, s. 796.04, s.  796.05, or s.

24  796.07, relating to prostitution.

25         25.23.  Chapter 806, relating to arson.

26         26.24.  Section 810.02(2)(c), relating to specified

27  burglary of a dwelling or structure.

28         27.25.  Chapter 812, relating to theft, robbery, and

29  related crimes.

30         28.26.  Chapter 815, relating to computer-related

31  crimes.

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 1         29.27.  Chapter 817, relating to fraudulent practices,

 2  false pretenses, fraud generally, and credit card crimes.

 3         30.28.  Chapter 825, relating to abuse, neglect, or

 4  exploitation of an elderly person or disabled adult.

 5         31.29.  Section 827.071, relating to commercial sexual

 6  exploitation of children.

 7         32.30.  Chapter 831, relating to forgery and

 8  counterfeiting.

 9         33.31.  Chapter 832, relating to issuance of worthless

10  checks and drafts.

11         34.32.  Section 836.05, relating to extortion.

12         35.33.  Chapter 837, relating to perjury.

13         36.34.  Chapter 838, relating to bribery and misuse of

14  public office.

15         37.35.  Chapter 843, relating to obstruction of

16  justice.

17         38.36.  Section 847.011, s. 847.012, s. 847.013, s.

18  847.06, or s. 847.07, relating to obscene literature and

19  profanity.

20         39.37.  Section 849.09, s. 849.14, s. 849.15, s.

21  849.23, or s. 849.25, relating to gambling.

22         40.38.  Chapter 874, relating to criminal street gangs.

23         41.39.  Chapter 893, relating to drug abuse prevention

24  and control.

25         42.40.  Chapter 896, relating to offenses related to

26  financial transactions.

27         43.41.  Sections 914.22 and 914.23, relating to

28  tampering with a witness, victim, or informant, and

29  retaliation against a witness, victim, or informant.

30         44.42.  Sections 918.12 and 918.13, relating to

31  tampering with jurors and evidence.

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 1         Section 90.  Subsection (13) of section 1009.992,

 2  Florida Statutes, is amended to read:

 3         1009.992  Definitions.--As used in this act:

 4         (13)  "Institution" means any college or university

 5  which, by virtue of law or charter, is accredited by and holds

 6  membership in the Council for Higher Education Commission on

 7  Recognition of Postsecondary Accreditation; which grants

 8  baccalaureate or associate degrees; which is not a pervasively

 9  sectarian institution; and which does not discriminate in the

10  admission of students on the basis of race, color, religion,

11  sex, or creed.

12         Section 91.  Sections 456.033, 456.034, 458.313,

13  458.3147, 458.316, 458.3165, 458.317, subsection (3) of

14  section 468.711, and paragraph (h) of subsection (1) of

15  section 480.044, Florida Statutes, are repealed.

16         Section 92.  This act shall take effect July 1, 2004.

17  

18            *****************************************

19                          SENATE SUMMARY

20    Revises various provisions of law concerning the
      regulation of health care practitioners by the Department
21    of Health. Corrects terminology and cross-references.
      Provides procedures for resolving conflicts between two
22    or more boards. Revises requirements for continuing
      education concerning HIV and AIDS. Prohibits dispensing a
23    drug if the patient does not have a valid professional
      relationship with the prescribing practitioner. Requires
24    the licensure of Internet pharmacies. Provides that the
      distribution of medicinal drugs without a license is a
25    second-degree felony. Revises the requirements for
      background checks for certain professionals and officers
26    of a corporation. Includes Medicaid provider fraud and
      the distribution of drugs without a license within those
27    offenses covered by the Florida RICO Act. (See bill for
      details.)
28  

29  

30  

31  

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