HB 881

1	A bill to be entitled
2	An act relating to physician licensure requirements;
3	amending s. 458.311, F.S.; providing a definition;
4	providing an option for certain applicants for physician
5	licensure to complete an internship; authorizing the
6	Department of Health to develop procedures relating to
7	completion of the internship; requiring board approval of
8	internships; authorizing the board to adopt rules to
9	implement internship requirements, including fees to cover
10	costs; revising the requirement of the department to
11	impose conditions, limitations, or restrictions on a
12	license; amending ss. 458.313, 458.316, 458.3165, 458.317,
13	and 458.347, F.S.; correcting cross-references; providing
14	an effective date.
15
16	Be It Enacted by the Legislature of the State of Florida:
17
18	Section 1.  Subsections (2) through (8) of section 458.311,
19	Florida Statutes, are renumbered as subsections (3) through (9),
20	respectively, present subsections (5) and (7) are amended, and a
21	new subsection (2) is added to that section, to read:
22	458.311  Licensure by examination; requirements; fees.--
23	(2)(a)  As used in this section, the term "community-based
24	internship" means a program approved by the board in which a
25	graduate from a foreign medical school obtains required
26	postgraduate clinical experience at a hospital licensed in this
27	state.
28	(b)  Notwithstanding sub-subparagraphs(1)(f)1.c., 2.c., and
29	3.c. and paragraph (4)(d), except for passing part II of the
30	National Board of Medical Examiners examination or the
31	Educational Commission for Foreign Medical Graduates examination
32	equivalent as referred to in paragraph (4)(d), the department
33	may develop procedures for an applicant for licensure to meet
34	postgraduate training requirements by completion of a 2-year
35	community-based internship at a hospital licensed in this state.
36	The training provided in the community-based internship shall be
37	substantially similar, as defined by board rule, to the training
38	provided in an approved residency as provided in sub-
39	subparagraph (1)(f)1.c., sub-subparagraph (1)(f)2.c., or sub-
40	subparagraph (1)(f)3.c. In order for the community-based
41	internship to meet the requirements of this subsection, the
42	community-based internship must be approved by the board prior
43	to the applicant's entering into the community-based internship.
44	The applicant shall not be licensed under this subsection unless
45	the board finds that the applicant has successfully completed
46	the community-based internship. The board may adopt rules to
47	implement this subsection, including rules setting fees, which
48	may not exceed the actual costs of administering this
49	subsection.
50	(6)(5)  The board may not certify to the department for
51	licensure any applicant who is under investigation in another
52	jurisdiction for an offense which would constitute a violation
53	of this chapter until such investigation is completed. Upon
54	completion of the investigation, the provisions of s. 458.331
55	shall apply. Furthermore, the department may not issue an
56	unrestricted license to any individual who has committed any act
57	or offense in any jurisdiction which would constitute the basis
58	for disciplining a physician pursuant to s. 458.331. When the
59	board finds that an individual has committed an act or offense
60	in any jurisdiction which would constitute the basis for
61	disciplining a physician pursuant to s. 458.331, then the board
62	may enter an order imposing one or more of the terms set forth
63	in subsection (9) (8).
64	(8)(7)  Upon certification by the board, the department
65	shall impose conditions, limitations, or restrictions on a
66	license if the applicant is on probation in another jurisdiction
67	for an act which would constitute a violation of this chapter or
68	if the community-based internship requirement provided in
69	subsection (2) was complied with at a hospital that is not
70	licensed in this state.
71	Section 2.  Paragraph (a) of subsection (1) of section
72	458.313, Florida Statutes, is amended to read:
73	458.313  Licensure by endorsement; requirements; fees.--
74	(1)  The department shall issue a license by endorsement to
75	any applicant who, upon applying to the department on forms
76	furnished by the department and remitting a fee set by the board
77	not to exceed $500, the board certifies:
78	(a)  Has met the qualifications for licensure in s.
79	458.311(1)(b)-(g) or in s. 458.311(1)(b)-(e) and (g) and (4)
80	(3);
81	Section 3.  Subsection (1) of section 458.316, Florida
82	Statutes, is amended to read:
83	458.316  Public health certificate.--
84	(1)  Any person desiring to obtain a public health
85	certificate shall submit an application fee not to exceed $300
86	and shall demonstrate to the board that he or she is a graduate
87	of an accredited medical school and holds a master of public
88	health degree or is board eligible or certified in public health
89	or preventive medicine, or is licensed to practice medicine
90	without restriction in another jurisdiction in the United States
91	and holds a master of public health degree or is board eligible
92	or certified in public health or preventive medicine, and shall
93	meet the requirements in s. 458.311(1)(a)-(g) and (6) (5).
94	Section 4.  Section 458.3165, Florida Statutes, is amended
95	to read:
96	458.3165  Public psychiatry certificate.--The board shall
97	issue a public psychiatry certificate to an individual who
98	remits an application fee not to exceed $300, as set by the
99	board, who is a board-certified psychiatrist, who is licensed to
100	practice medicine without restriction in another state, and who
101	meets the requirements in s. 458.311(1)(a)-(g) and (6) (5). A
102	recipient of a public psychiatry certificate may use the
103	certificate to work at any public mental health facility or
104	program funded in part or entirely by state funds.
105	(1)  Such certificate shall:
106	(a)  Authorize the holder to practice only in a public
107	mental health facility or program funded in part or entirely by
108	state funds.
109	(b)  Be issued and renewable biennially if the secretary of
110	the Department of Health and the chair of the department of
111	psychiatry at one of the public medical schools or the chair of
112	the department of psychiatry at the accredited medical school at
113	the University of Miami recommend in writing that the
114	certificate be issued or renewed.
115	(c)  Automatically expire if the holder's relationship with
116	a public mental health facility or program expires.
117	(d)  Not be issued to a person who has been adjudged
118	unqualified or guilty of any of the prohibited acts in this
119	chapter.
120	(2)  The board may take disciplinary action against a
121	certificateholder for noncompliance with any part of this
122	section or for any reason for which a regular licensee may be
123	subject to discipline.
124	Section 5.  Paragraph (a) of subsection (1) of section
125	458.317, Florida Statutes, is amended to read:
126	458.317  Limited licenses.--
127	(1)(a)  Any person desiring to obtain a limited license
128	shall:
129	1.  Submit to the board, with an application and fee not to
130	exceed $300, an affidavit stating that he or she has been
131	licensed to practice medicine in any jurisdiction in the United
132	States for at least 10 years and intends to practice only
133	pursuant to the restrictions of a limited license granted
134	pursuant to this section. However, a physician who is not fully
135	retired in all jurisdictions may use a limited license only for
136	noncompensated practice. If the person applying for a limited
137	license submits a notarized statement from the employing agency
138	or institution stating that he or she will not receive
139	compensation for any service involving the practice of medicine,
140	the application fee and all licensure fees shall be waived.
141	However, any person who receives a waiver of fees for a limited
142	license shall pay such fees if the person receives compensation
143	for the practice of medicine.
144	2.  Meet the requirements in s. 458.311(1)(b)-(g) and (6)
145	(5). If the applicant graduated from medical school prior to
146	1946, the board or its appropriate committee may accept military
147	medical training or medical experience as a substitute for the
148	approved 1-year residency requirement in s. 458.311(1)(f).
149
150	Nothing herein limits in any way any policy by the board,
151	otherwise authorized by law, to grant licenses to physicians
152	duly licensed in other states under conditions less restrictive
153	than the requirements of this section. Notwithstanding the other
154	provisions of this section, the board may refuse to authorize a
155	physician otherwise qualified to practice in the employ of any
156	agency or institution otherwise qualified if the agency or
157	institution has caused or permitted violations of the provisions
158	of this chapter which it knew or should have known were
159	occurring.
160	Section 6.  Paragraph (b) of subsection (7) of section
161	458.347, Florida Statutes, is amended to read:
162	458.347  Physician assistants.--
163	(7)  PHYSICIAN ASSISTANT LICENSURE.--
164	(b)1.  Notwithstanding subparagraph (a)2. and
165	sub-subparagraph (a)3.a., the department shall examine each
166	applicant who the Board of Medicine certifies:
167	a.  Has completed the application form and remitted a
168	nonrefundable application fee not to exceed $500 and an
169	examination fee not to exceed $300, plus the actual cost to the
170	department to provide the examination. The examination fee is
171	refundable if the applicant is found to be ineligible to take
172	the examination. The department shall not require the applicant
173	to pass a separate practical component of the examination. For
174	examinations given after July 1, 1998, competencies measured
175	through practical examinations shall be incorporated into the
176	written examination through a multiple-choice format. The
177	department shall translate the examination into the native
178	language of any applicant who requests and agrees to pay all
179	costs of such translation, provided that the translation request
180	is filed with the board office no later than 9 months before the
181	scheduled examination and the applicant remits translation fees
182	as specified by the department no later than 6 months before the
183	scheduled examination, and provided that the applicant
184	demonstrates to the department the ability to communicate orally
185	in basic English. If the applicant is unable to pay translation
186	costs, the applicant may take the next available examination in
187	English if the applicant submits a request in writing by the
188	application deadline and if the applicant is otherwise eligible
189	under this section. To demonstrate the ability to communicate
190	orally in basic English, a passing score or grade is required,
191	as determined by the department or organization that developed
192	it, on the test for spoken English (TSE) by the Educational
193	Testing Service (ETS), the test of English as a foreign language
194	(TOEFL) by ETS, a high school or college level English course,
195	or the English examination for citizenship, Bureau of
196	Citizenship and Immigration Services. A notarized copy of an
197	Educational Commission for Foreign Medical Graduates (ECFMG)
198	certificate may also be used to demonstrate the ability to
199	communicate in basic English; and
200	b.(I)  Is an unlicensed physician who graduated from a
201	foreign medical school listed with the World Health Organization
202	who has not previously taken and failed the examination of the
203	National Commission on Certification of Physician Assistants and
204	who has been certified by the Board of Medicine as having met
205	the requirements for licensure as a medical doctor by
206	examination as set forth in s. 458.311(1), (4) (3), (5) (4), and
207	(6) (5), with the exception that the applicant is not required
208	to have completed an approved residency of at least 1 year and
209	the applicant is not required to have passed the licensing
210	examination specified under s. 458.311 or hold a valid, active
211	certificate issued by the Educational Commission for Foreign
212	Medical Graduates; was eligible and made initial application for
213	certification as a physician assistant in this state between
214	July 1, 1990, and June 30, 1991; and was a resident of this
215	state on July 1, 1990, or was licensed or certified in any state
216	in the United States as a physician assistant on July 1, 1990;
217	or
218	(II)  Completed all coursework requirements of the Master
219	of Medical Science Physician Assistant Program offered through
220	the Florida College of Physician's Assistants prior to its
221	closure in August of 1996. Prior to taking the examination, such
222	applicant must successfully complete any clinical rotations that
223	were not completed under such program prior to its termination
224	and any additional clinical rotations with an appropriate
225	physician assistant preceptor, not to exceed 6 months, that are
226	determined necessary by the council. The boards shall determine,
227	based on recommendations from the council, the facilities under
228	which such incomplete or additional clinical rotations may be
229	completed and shall also determine what constitutes successful
230	completion thereof, provided such requirements are comparable to
231	those established by accredited physician assistant programs.
232	This sub-sub-subparagraph is repealed July 1, 2001.
233	2.  The department may grant temporary licensure to an
234	applicant who meets the requirements of subparagraph 1. Between
235	meetings of the council, the department may grant temporary
236	licensure to practice based on the completion of all temporary
237	licensure requirements. All such administratively issued
238	licenses shall be reviewed and acted on at the next regular
239	meeting of the council. A temporary license expires 30 days
240	after receipt and notice of scores to the licenseholder from the
241	first available examination specified in subparagraph 1.
242	following licensure by the department. An applicant who fails
243	the proficiency examination is no longer temporarily licensed,
244	but may apply for a one-time extension of temporary licensure
245	after reapplying for the next available examination. Extended
246	licensure shall expire upon failure of the licenseholder to sit
247	for the next available examination or upon receipt and notice of
248	scores to the licenseholder from such examination.
249	3.  Notwithstanding any other provision of law, the
250	examination specified pursuant to subparagraph 1. shall be
251	administered by the department only five times. Applicants
252	certified by the board for examination shall receive at least 6
253	months' notice of eligibility prior to the administration of the
254	initial examination. Subsequent examinations shall be
255	administered at 1-year intervals following the reporting of the
256	scores of the first and subsequent examinations. For the
257	purposes of this paragraph, the department may develop, contract
258	for the development of, purchase, or approve an examination that
259	adequately measures an applicant's ability to practice with
260	reasonable skill and safety. The minimum passing score on the
261	examination shall be established by the department, with the
262	advice of the board. Those applicants failing to pass that
263	examination or any subsequent examination shall receive notice
264	of the administration of the next examination with the notice of
265	scores following such examination. Any applicant who passes the
266	examination and meets the requirements of this section shall be
267	licensed as a physician assistant with all rights defined
268	thereby.
269	Section 7.  This act shall take effect July 1, 2006.

CODING: Words stricken are deletions; words underlined are additions.