Florida Senate - 2010 CS for CS for SB 1256
By the Committees on Health and Human Services Appropriations;
and Health Regulation; and Senator Peaden
603-04264-10 20101256c2
1 A bill to be entitled
2 An act relating to the physician workforce; repealing
3 s. 381.0403(4) and (9), F.S., relating to the program
4 for graduate medical education innovations and the
5 graduate medical education committee and report;
6 amending s. 381.4018, F.S.; providing definitions;
7 requiring the Department of Health to coordinate and
8 enhance activities regarding the reentry of retired
9 military and other physicians into the physician
10 workforce; revising the list of governmental
11 stakeholders that the Department of Health is required
12 to work with regarding the state strategic plan and in
13 assessing the state’s physician workforce; creating
14 the Physician Workforce Advisory Council; providing
15 membership of the council; providing for appointments
16 to the council; providing terms of membership;
17 providing for removal of a council member; providing
18 for the chair and vice chair of the council; providing
19 that council members are not entitled to receive
20 compensation or reimbursement for per diem or travel
21 expenses; providing the duties of the council;
22 establishing the physician workforce graduate medical
23 education innovation pilot projects under the
24 department; providing the purposes of the pilot
25 projects; providing for the appropriation of state
26 funds for the pilot projects; requiring the pilot
27 projects to meet certain policy needs of the physician
28 workforce in this state; providing criteria for
29 prioritizing proposals for pilot projects; requiring
30 the department to adopt by rule appropriate
31 performance measures; requiring participating pilot
32 projects to submit an annual report to the department;
33 requiring state funds to be used to supplement funds
34 from other sources; requiring the department to adopt
35 rules; amending ss. 458.3192 and 459.0082, F.S.;
36 requiring the department to determine by geographic
37 area and specialty the number of physicians and
38 osteopathic physicians who plan to relocate outside
39 the state, practice medicine in this state, and reduce
40 or modify the scope of their practice; authorizing the
41 department to report additional information in its
42 findings to the Governor and the Legislature; amending
43 s. 458.315, F.S.; revising the standards for the Board
44 of Medicine to issue a temporary certificate to a
45 certain physicians to practice medicine in areas of
46 critical need; authorizing the State Surgeon General
47 to designate areas of critical need; creating s.
48 459.0076, F.S.; authorizing the Board of Osteopathic
49 Medicine to issue temporary certificates to
50 osteopathic physicians who meet certain requirements
51 to practice osteopathic medicine in areas of critical
52 need; providing restrictions for issuance of a
53 temporary certificate; authorizing the State Surgeon
54 General to designate areas of critical need;
55 authorizing the Board of Osteopathic Medicine to waive
56 the application fee and licensure fees for obtaining
57 temporary certificates for certain purposes; providing
58 an effective date.
59
60 Be It Enacted by the Legislature of the State of Florida:
61
62 Section 1. Subsections (4) and (9) of section 381.0403,
63 Florida Statutes, are repealed.
64 Section 2. Section 381.4018, Florida Statutes, is amended
65 to read:
66 381.4018 Physician workforce assessment and development.—
67 (1) DEFINITIONS.—As used in this section, the term:
68 (a) “Consortium” or “consortia” means a combination of
69 statutory teaching hospitals, statutory rural hospitals, other
70 hospitals, accredited medical schools, clinics operated by the
71 Department of Health, clinics operated by the Department of
72 Veterans’ Affairs, area health education centers, community
73 health centers, federally qualified health centers, prison
74 clinics, local community clinics, or other programs. At least
75 one member of the consortium shall be a sponsoring institution
76 accredited or currently seeking accreditation by the
77 Accreditation Council for Graduate Medical Education or the
78 American Osteopathic Association.
79 (b) “Council” means the Physician Workforce Advisory
80 Council.
81 (c) “Department” means the Department of Health.
82 (d) “Graduate medical education program” means a program
83 accredited by the Accreditation Council for Graduate Medical
84 Education or the American Osteopathic Association.
85 (e) “Primary care specialty” means emergency medicine,
86 family practice, internal medicine, pediatrics, psychiatry,
87 geriatrics, general surgery, obstetrics and gynecology, and
88 combined pediatrics and internal medicine and other specialties
89 as determined by the Physician Workforce Advisory Council or the
90 Department of Health.
91 (2)(1) LEGISLATIVE INTENT.—The Legislature recognizes that
92 physician workforce planning is an essential component of
93 ensuring that there is an adequate and appropriate supply of
94 well-trained physicians to meet this state’s future health care
95 service needs as the general population and elderly population
96 of the state increase. The Legislature finds that items to
97 consider relative to assessing the physician workforce may
98 include physician practice status; specialty mix; geographic
99 distribution; demographic information, including, but not
100 limited to, age, gender, race, and cultural considerations; and
101 needs of current or projected medically underserved areas in the
102 state. Long-term strategic planning is essential as the period
103 from the time a medical student enters medical school to
104 completion of graduate medical education may range from 7 to 10
105 years or longer. The Legislature recognizes that strategies to
106 provide for a well-trained supply of physicians must include
107 ensuring the availability and capacity of quality graduate
108 medical schools and graduate medical education programs in this
109 state, as well as using new or existing state and federal
110 programs providing incentives for physicians to practice in
111 needed specialties and in underserved areas in a manner that
112 addresses projected needs for physician manpower.
113 (3)(2) PURPOSE.—The department of Health shall serve as a
114 coordinating and strategic planning body to actively assess the
115 state’s current and future physician workforce needs and work
116 with multiple stakeholders to develop strategies and
117 alternatives to address current and projected physician
118 workforce needs.
119 (4)(3) GENERAL FUNCTIONS.—The department shall maximize the
120 use of existing programs under the jurisdiction of the
121 department and other state agencies and coordinate governmental
122 and nongovernmental stakeholders and resources in order to
123 develop a state strategic plan and assess the implementation of
124 such strategic plan. In developing the state strategic plan, the
125 department shall:
126 (a) Monitor, evaluate, and report on the supply and
127 distribution of physicians licensed under chapter 458 or chapter
128 459. The department shall maintain a database to serve as a
129 statewide source of data concerning the physician workforce.
130 (b) Develop a model and quantify, on an ongoing basis, the
131 adequacy of the state’s current and future physician workforce
132 as reliable data becomes available. Such model must take into
133 account demographics, physician practice status, place of
134 education and training, generational changes, population growth,
135 economic indicators, and issues concerning the “pipeline” into
136 medical education.
137 (c) Develop and recommend strategies to determine whether
138 the number of qualified medical school applicants who might
139 become competent, practicing physicians in this state will be
140 sufficient to meet the capacity of the state’s medical schools.
141 If appropriate, the department shall, working with
142 representatives of appropriate governmental and nongovernmental
143 entities, develop strategies and recommendations and identify
144 best practice programs that introduce health care as a
145 profession and strengthen skills needed for medical school
146 admission for elementary, middle, and high school students, and
147 improve premedical education at the precollege and college level
148 in order to increase this state’s potential pool of medical
149 students.
150 (d) Develop strategies to ensure that the number of
151 graduates from the state’s public and private allopathic and
152 osteopathic medical schools is are adequate to meet physician
153 workforce needs, based on the analysis of the physician
154 workforce data, so as to provide a high-quality medical
155 education to students in a manner that recognizes the uniqueness
156 of each new and existing medical school in this state.
157 (e) Pursue strategies and policies to create, expand, and
158 maintain graduate medical education positions in the state based
159 on the analysis of the physician workforce data. Such strategies
160 and policies must take into account the effect of federal
161 funding limitations on the expansion and creation of positions
162 in graduate medical education. The department shall develop
163 options to address such federal funding limitations. The
164 department shall consider options to provide direct state
165 funding for graduate medical education positions in a manner
166 that addresses requirements and needs relative to accreditation
167 of graduate medical education programs. The department shall
168 consider funding residency positions as a means of addressing
169 needed physician specialty areas, rural areas having a shortage
170 of physicians, and areas of ongoing critical need, and as a
171 means of addressing the state’s physician workforce needs based
172 on an ongoing analysis of physician workforce data.
173 (f) Develop strategies to maximize federal and state
174 programs that provide for the use of incentives to attract
175 physicians to this state or retain physicians within the state.
176 Such strategies should explore and maximize federal-state
177 partnerships that provide incentives for physicians to practice
178 in federally designated shortage areas. Strategies shall also
179 consider the use of state programs, such as the Florida Health
180 Service Corps established pursuant to s. 381.0302 and the
181 Medical Education Reimbursement and Loan Repayment Program
182 pursuant to s. 1009.65, which provide for education loan
183 repayment or loan forgiveness and provide monetary incentives
184 for physicians to relocate to underserved areas of the state.
185 (g) Coordinate and enhance activities relative to physician
186 workforce needs, undergraduate medical education, and graduate
187 medical education, and reentry of retired military and other
188 physicians into the physician workforce provided by the Division
189 of Medical Quality Assurance, the Community Hospital Education
190 Program and the Graduate Medical Education Committee established
191 pursuant to s. 381.0403, area health education center networks
192 established pursuant to s. 381.0402, and other offices and
193 programs within the department of Health as designated by the
194 State Surgeon General.
195 (h) Work in conjunction with and act as a coordinating body
196 for governmental and nongovernmental stakeholders to address
197 matters relating to the state’s physician workforce assessment
198 and development for the purpose of ensuring an adequate supply
199 of well-trained physicians to meet the state’s future needs.
200 Such governmental stakeholders shall include, but need not be
201 limited to, the State Surgeon General or his or her designee,
202 the Commissioner of Education or his or her designee, the
203 Secretary of Health Care Administration or his or her designee,
204 and the Chancellor of the State University System or his or her
205 designee from the Board of Governors of the State University
206 System, and, at the discretion of the department, other
207 representatives of state and local agencies that are involved in
208 assessing, educating, or training the state’s current or future
209 physicians. Other stakeholders shall include, but need not be
210 limited to, organizations representing the state’s public and
211 private allopathic and osteopathic medical schools;
212 organizations representing hospitals and other institutions
213 providing health care, particularly those that currently provide
214 or have an interest in providing accredited medical education
215 and graduate medical education to medical students and medical
216 residents; organizations representing allopathic and osteopathic
217 practicing physicians; and, at the discretion of the department,
218 representatives of other organizations or entities involved in
219 assessing, educating, or training the state’s current or future
220 physicians.
221 (i) Serve as a liaison with other states and federal
222 agencies and programs in order to enhance resources available to
223 the state’s physician workforce and medical education continuum.
224 (j) Act as a clearinghouse for collecting and disseminating
225 information concerning the physician workforce and medical
226 education continuum in this state.
227 (5) PHYSICIAN WORKFORCE ADVISORY COUNCIL.—There is created
228 in the department the Physician Workforce Advisory Council, an
229 advisory council as defined in s. 20.03. The council shall
230 comply with the requirements of s. 20.052, except as otherwise
231 provided in this section.
232 (a) The council shall consist of 19 members. Members
233 appointed by the State Surgeon General shall include:
234 1. A designee from the department who is a physician
235 licensed under chapter 458 or chapter 459 and recommended by the
236 State Surgeon General.
237 2. An individual who is affiliated with the Science
238 Students Together Reaching Instructional Diversity and
239 Excellence program and recommended by the area health education
240 center network.
241 3. Two individuals recommended by the Council of Florida
242 Medical School Deans, one representing a college of allopathic
243 medicine and one representing a college of osteopathic medicine.
244 4. One individual recommended by the Florida Hospital
245 Association, representing a hospital that is licensed under
246 chapter 395, has an accredited graduate medical education
247 program, and is not a statutory teaching hospital.
248 5. One individual representing a statutory teaching
249 hospital as defined in s. 408.07 and recommended by the Safety
250 Net Hospital Alliance.
251 6. One individual representing a family practice teaching
252 hospital as defined in s. 395.805 and recommended by the Council
253 of Family Medicine and Community Teaching Hospitals.
254 7. Two individuals recommended by the Florida Medical
255 Association, one representing a primary care specialty and one
256 representing a nonprimary care specialty.
257 8. Two individuals recommended by the Florida Osteopathic
258 Medical Association, one representing a primary care specialty
259 and one representing a nonprimary care specialty.
260 9. Two individuals who are program directors of accredited
261 graduate medical education programs, one representing a program
262 that is accredited by the Accreditation Council for Graduate
263 Medical Education and one representing a program that is
264 accredited by the American Osteopathic Association.
265 10. An individual recommended by the Florida Association of
266 Community Health Centers representing a federally qualified
267 health center located in a rural area as defined in s.
268 381.0406(2)(a).
269 11. An individual recommended by the Florida Academy of
270 Family Physicians.
271 12. An individual recommended by the Florida Alliance for
272 Health Professions Diversity.
273 13. The Chancellor of the State University System or his or
274 her designee.
275 14. A layperson member as determined by the State Surgeon
276 General.
277
278 Appointments to the council shall be made by the State Surgeon
279 General. Each entity authorized to make recommendations under
280 this subsection shall make at least two recommendations to the
281 State Surgeon General for each appointment to the council. The
282 State Surgeon General shall name one appointee for each position
283 from the recommendations made by each authorized entity.
284 (b) Each council member shall be appointed to a 4-year
285 term. An individual may not serve more than two terms. Any
286 council member may be removed from office for malfeasance;
287 misfeasance; neglect of duty; incompetence; permanent inability
288 to perform official duties; or pleading guilty or nolo
289 contendere to, or being found guilty of, a felony. Any council
290 member who meets the criteria for removal, or who is otherwise
291 unwilling or unable to properly fulfill the duties of the
292 office, shall be succeeded by an individual chosen by the State
293 Surgeon General to serve out the remainder of the council
294 member’s term. If the remainder of the replaced council member’s
295 term is less than 18 months, notwithstanding the provisions of
296 this paragraph, the succeeding council member may be reappointed
297 twice by the State Surgeon General.
298 (c) The chair of the council is the State Surgeon General,
299 who shall designate a vice chair from the membership of the
300 council to serve in the absence of the State Surgeon General. A
301 vacancy shall be filled for the remainder of the unexpired term
302 in the same manner as the original appointment.
303 (d) Council members are not entitled to receive
304 compensation or reimbursement for per diem or travel expenses.
305 (e) The council shall meet at least twice a year in person
306 or by teleconference.
307 (f) The council shall:
308 1. Advise the State Surgeon General and the department on
309 matters concerning current and future physician workforce needs
310 in this state;
311 2. Review survey materials and the compilation of survey
312 information;
313 3. Annually review the number, location, cost, and
314 reimbursement of graduate medical education programs and
315 positions;
316 4. Provide recommendations to the department regarding the
317 survey completed by physicians licensed under chapter 458 or
318 chapter 459;
319 5. Assist the department in preparing the annual report to
320 the Legislature pursuant to ss. 458.3192 and 459.0082;
321 6. Assist the department in preparing an initial strategic
322 plan, conduct ongoing strategic planning in accordance with this
323 section, and provide ongoing advice on implementing the
324 recommendations;
325 7. Monitor and provide recommendations regarding the need
326 for an increased number of primary care or other physician
327 specialties to provide the necessary current and projected
328 health and medical services for the state; and
329 8. Monitor and make recommendations regarding the status of
330 the needs relating to graduate medical education in this state.
331 (6) PHYSICIAN WORKFORCE GRADUATE MEDICAL EDUCATION
332 INNOVATION PILOT PROJECTS.—
333 (a) The Legislature finds that:
334 1. In order to ensure a physician workforce that is
335 adequate to meet the needs of this state’s residents and its
336 health care system, policymakers must consider the education and
337 training of future generations of well-trained health care
338 providers.
339 2. Physicians are likely to practice in the state where
340 they complete their graduate medical education.
341 3. It can directly affect the makeup of the physician
342 workforce by selectively funding graduate medical education
343 programs to provide needed specialists in geographic areas of
344 the state which have a deficient number of such specialists.
345 4. Developing additional positions in graduate medical
346 education programs is essential to the future of this state’s
347 health care system.
348 5. It was necessary in 2007 to pass legislation that
349 provided for an assessment of the status of this state’s current
350 and future physician workforce. The department is collecting and
351 analyzing information on an ongoing basis to assess this state’s
352 physician workforce needs, and such assessment may facilitate
353 the determination of graduate medical education needs and
354 strategies for the state.
355 (b) There is established under the department a program to
356 foster innovative graduate medical education pilot projects that
357 are designed to promote the expansion of graduate medical
358 education programs or positions to prepare physicians to
359 practice in needed specialties and underserved areas or settings
360 and to provide demographic and cultural representation in a
361 manner that addresses current and projected needs for this
362 state’s physician workforce. Funds appropriated annually by the
363 Legislature for this purpose shall be distributed to
364 participating hospitals, medical schools, other sponsors of
365 graduate medical education programs, consortia engaged in
366 developing new graduate medical education programs or positions
367 in those programs, or pilot projects providing innovative
368 graduate medical education in community-based clinical settings.
369 Pilot projects shall be selected on a competitive grant basis,
370 subject to available funds.
371 (c) Pilot projects shall be designed to meet one or more of
372 this state’s physician workforce needs, as determined pursuant
373 to this section, including, but not limited to:
374 1. Increasing the number of residencies or fellowships in
375 primary care or other needed specialties.
376 2. Enhancing the retention of primary care physicians or
377 other needed specialties in this state.
378 3. Promoting practice in rural or medically underserved
379 areas of the state.
380 4. Encouraging racial and ethnic diversity within the
381 state’s physician workforce.
382 5. Encouraging practice in community health care or other
383 ambulatory care settings.
384 6. Encouraging practice in clinics operated by the
385 department, including, but not limited to, county health
386 departments, clinics operated by the Department of Veterans’
387 Affairs, prison clinics, or similar settings of need.
388 7. Encouraging the increased production of geriatricians.
389 (d) Priority shall be given to a proposal for a pilot
390 project that:
391 1. Demonstrates a collaboration of federal, state, and
392 local entities that are public or private.
393 2. Obtains funding from multiple sources.
394 3. Focuses on enhancing graduate medical education in rural
395 or underserved areas.
396 4. Focuses on enhancing graduate medical education in
397 ambulatory or community-based settings other than a hospital
398 environment.
399 5. Includes the use of technology, such as electronic
400 medical records, distance consultation, and telemedicine, to
401 ensure that residents are better prepared to care for patients
402 in this state, regardless of the community in which the
403 residents practice.
404 6. Is designed to meet multiple policy needs as enumerated
405 in subsection (3).
406 7. Uses a consortium to provide for graduate medical
407 education experiences.
408 (e) The department shall adopt by rule appropriate
409 performance measures to use in order to consistently evaluate
410 the effectiveness, safety, and quality of the programs, as well
411 as the impact of each program on meeting this state’s physician
412 workforce needs.
413 (f) Participating pilot projects shall submit to the
414 department an annual report on the project in a manner required
415 by the department.
416 (g) Funding provided to a pilot project may be used only
417 for the direct costs of providing graduate medical education.
418 Accounting of such costs and expenditures shall be documented in
419 the annual report.
420 (h) State funds shall be used to supplement funds from any
421 local government, community, or private source. The state may
422 provide up to 50 percent of the funds, and local governmental
423 grants or community or private sources shall provide the
424 remainder of the funds.
425 (7) RULEMAKING.—The department shall adopt rules as
426 necessary to administer this section.
427 Section 3. Section 458.3192, Florida Statutes, is amended
428 to read:
429 458.3192 Analysis of survey results; report.—
430 (1) Each year, the Department of Health shall analyze the
431 results of the physician survey required by s. 458.3191 and
432 determine by geographic area and specialty the number of
433 physicians who:
434 (a) Perform deliveries of children in this state Florida.
435 (b) Read mammograms and perform breast-imaging-guided
436 procedures in this state Florida.
437 (c) Perform emergency care on an on-call basis for a
438 hospital emergency department.
439 (d) Plan to reduce or increase emergency on-call hours in a
440 hospital emergency department.
441 (e) Plan to relocate their allopathic or osteopathic
442 practice outside the state.
443 (f) Practice medicine in this state.
444 (g) Plan to reduce or modify the scope of their practice.
445 (2) The Department of Health must report its findings to
446 the Governor, the President of the Senate, and the Speaker of
447 the House of Representatives by November 1 each year. The
448 department shall also include in its report findings,
449 recommendations, and strategic planning activities as provided
450 in s. 381.4018. The department may also include other
451 information requested by the Physician Workforce Advisory
452 Council.
453 Section 4. Section 459.0082, Florida Statutes, is amended
454 to read:
455 459.0082 Analysis of survey results; report.—
456 (1) Each year, the Department of Health shall analyze the
457 results of the physician survey required by s. 459.0081 and
458 determine by geographic area and specialty the number of
459 physicians who:
460 (a) Perform deliveries of children in this state Florida.
461 (b) Read mammograms and perform breast-imaging-guided
462 procedures in this state Florida.
463 (c) Perform emergency care on an on-call basis for a
464 hospital emergency department.
465 (d) Plan to reduce or increase emergency on-call hours in a
466 hospital emergency department.
467 (e) Plan to relocate their allopathic or osteopathic
468 practice outside the state.
469 (f) Practice medicine in this state.
470 (g) Plan to reduce or modify the scope of their practice.
471 (2) The Department of Health must report its findings to
472 the Governor, the President of the Senate, and the Speaker of
473 the House of Representatives by November 1 each year. The
474 department shall also include in its report findings,
475 recommendations, and strategic planning activities as provided
476 in s. 381.4018. The department may also include other
477 information requested by the Physician Workforce Advisory
478 Council.
479 Section 5. Section 458.315, Florida Statutes, is amended to
480 read:
481 458.315 Temporary certificate for practice in areas of
482 critical need.—
483 (1) Any physician who:
484 (a) Is licensed to practice in any jurisdiction in the
485 United States and other state, whose license is currently valid;
486 or,
487 (b) Has served as a physician in the United States Armed
488 Forces for at least 10 years and received an honorable discharge
489 from the military;
490
491 and who pays an application fee of $300 may be issued a
492 temporary certificate for to practice in areas of communities of
493 Florida where there is a critical need for physicians.
494 (2) A certificate may be issued to a physician who:
495 (a) Practices in an area of critical need;
496 (b) Will be employed by or practice in a county health
497 department, correctional facility, Department of Veterans’
498 Affairs clinic, community health center funded by s. 329, s.
499 330, or s. 340 of the United States Public Health Services Act,
500 or other agency or institution that is approved by the State
501 Surgeon General and provides health care to meet the needs of
502 underserved populations in this state; or
503 (c) Will practice for a limited time to address critical
504 physician-specialty, demographic, or geographic needs for this
505 state’s physician workforce as determined by the State Surgeon
506 General entity that provides health care to indigents and that
507 is approved by the State Health Officer.
508 (3) The Board of Medicine may issue this temporary
509 certificate with the following restrictions:
510 (a)(1) The State Surgeon General board shall determine the
511 areas of critical need, and the physician so certified may
512 practice in any of those areas for a time to be determined by
513 the board. Such areas shall include, but are not be limited to,
514 health professional shortage areas designated by the United
515 States Department of Health and Human Services.
516 1.(a) A recipient of a temporary certificate for practice
517 in areas of critical need may use the certificate license to
518 work for any approved entity employer in any area of critical
519 need or as authorized by the State Surgeon General approved by
520 the board.
521 2.(b) The recipient of a temporary certificate for practice
522 in areas of critical need shall, within 30 days after accepting
523 employment, notify the board of all approved institutions in
524 which the licensee practices and of all approved institutions
525 where practice privileges have been denied.
526 (b)(2) The board may administer an abbreviated oral
527 examination to determine the physician’s competency, but a no
528 written regular examination is not required necessary. Within 60
529 days after receipt of an application for a temporary
530 certificate, the board shall review the application and issue
531 the temporary certificate, or notify the applicant of denial, or
532 notify the applicant that the board recommends additional
533 assessment, training, education, or other requirements as a
534 condition of certification. If the applicant has not actively
535 practiced during the prior 3 years and the board determines that
536 the applicant may lack clinical competency, possess diminished
537 or inadequate skills, lack necessary medical knowledge, or
538 exhibit patterns of deficits in clinical decisionmaking, the
539 board may:
540 1. Deny the application;
541 2. Issue a temporary certificate having reasonable
542 restrictions that may include, but are not limited to, a
543 requirement for the applicant to practice under the supervision
544 of a physician approved by the board; or
545 3. Issue a temporary certificate upon receipt of
546 documentation confirming that the applicant has met any
547 reasonable conditions of the board which may include, but are
548 not limited to, completing continuing education or undergoing an
549 assessment of skills and training.
550 (c)(3) Any certificate issued under this section is shall
551 be valid only so long as the State Surgeon General determines
552 that the reason area for which it was is issued remains a an
553 area of critical need to the state. The Board of Medicine shall
554 review each temporary certificateholder not the service within
555 said area not less than annually to ascertain that the minimum
556 requirements of the Medical Practice Act and its adopted the
557 rules and regulations promulgated thereunder are being complied
558 with. If it is determined that such minimum requirements are not
559 being met, the board shall forthwith revoke such certificate or
560 shall impose restrictions or conditions, or both, as a condition
561 of continued practice under the certificate.
562 (d)(4) The board may shall not issue a temporary
563 certificate for practice in an area of critical need to any
564 physician who is under investigation in any jurisdiction in the
565 United States another state for an act that which would
566 constitute a violation of this chapter until such time as the
567 investigation is complete, at which time the provisions of s.
568 458.331 shall apply.
569 (4)(5) The application fee and all licensure fees,
570 including neurological injury compensation assessments, shall be
571 waived for those persons obtaining a temporary certificate to
572 practice in areas of critical need for the purpose of providing
573 volunteer, uncompensated care for low-income residents
574 Floridians. The applicant must submit an affidavit from the
575 employing agency or institution stating that the physician will
576 not receive any compensation for any service involving the
577 practice of medicine.
578 Section 6. Section 459.0076, Florida Statutes, is created
579 to read:
580 459.0076 Temporary certificate for practice in areas of
581 critical need.—
582 (1) Any physician who:
583 (a) Is licensed to practice in any jurisdiction in the
584 United States and whose license is currently valid; or
585 (b) Has served as a physician in the United States Armed
586 Forces for at least 10 years and received an honorable discharge
587 from the military;
588
589 and who pays an application fee of $300 may be issued a
590 temporary certificate for practice in areas of critical need.
591 (2) A certificate may be issued to a physician who:
592 (a) Will practice in an area of critical need;
593 (b) Will be employed by or practice in a county health
594 department, correctional facility, Department of Veterans’
595 Affairs clinic, community health center funded by s. 329, s.
596 330, or s. 340 of the United States Public Health Services Act,
597 or other agency or institution that is approved by the State
598 Surgeon General and provides health care to meet the needs of
599 underserved populations in this state; or
600 (c) Will practice for a limited time to address critical
601 physician-specialty, demographic, or geographic needs for this
602 state’s physician workforce as determined by the State Surgeon
603 General.
604 (3) The Board of Osteopathic Medicine may issue this
605 temporary certificate with the following restrictions:
606 (a) The State Surgeon General shall determine the areas of
607 critical need. Such areas include, but are not limited to,
608 health professional shortage areas designated by the United
609 States Department of Health and Human Services.
610 1. A recipient of a temporary certificate for practice in
611 areas of critical need may use the certificate to work for any
612 approved entity in any area of critical need or as authorized by
613 the State Surgeon General.
614 2. The recipient of a temporary certificate for practice in
615 areas of critical need shall, within 30 days after accepting
616 employment, notify the board of all approved institutions in
617 which the licensee practices and of all approved institutions
618 where practice privileges have been denied.
619 (b) The board may administer an abbreviated oral
620 examination to determine the physician’s competency, but a
621 written regular examination is not required. Within 60 days
622 after receipt of an application for a temporary certificate, the
623 board shall review the application and issue the temporary
624 certificate, notify the applicant of denial, or notify the
625 applicant that the board recommends additional assessment,
626 training, education, or other requirements as a condition of
627 certification. If the applicant has not actively practiced
628 during the prior 3 years and the board determines that the
629 applicant may lack clinical competency, possess diminished or
630 inadequate skills, lack necessary medical knowledge, or exhibit
631 patterns of deficits in clinical decisionmaking, the board may:
632 1. Deny the application;
633 2. Issue a temporary certificate having reasonable
634 restrictions that may include, but are not limited to, a
635 requirement for the applicant to practice under the supervision
636 of a physician approved by the board; or
637 3. Issue a temporary certificate upon receipt of
638 documentation confirming that the applicant has met any
639 reasonable conditions of the board which may include, but are
640 not limited to, completing continuing education or undergoing an
641 assessment of skills and training.
642 (c) Any certificate issued under this section is valid only
643 so long as the State Surgeon General determines that the reason
644 for which it was issued remains a critical need to the state.
645 The Board of Osteopathic Medicine shall review each temporary
646 certificateholder not less than annually to ascertain that the
647 minimum requirements of the Osteopathic Medical Practice Act and
648 its adopted rules are being complied with. If it is determined
649 that such minimum requirements are not being met, the board
650 shall revoke such certificate or shall impose restrictions or
651 conditions, or both, as a condition of continued practice under
652 the certificate.
653 (d) The board may not issue a temporary certificate for
654 practice in an area of critical need to any physician who is
655 under investigation in any jurisdiction in the United States for
656 an act that would constitute a violation of this chapter until
657 such time as the investigation is complete, at which time the
658 provisions of s. 459.015 apply.
659 (4) The application fee and all licensure fees, including
660 neurological injury compensation assessments, shall be waived
661 for those persons obtaining a temporary certificate to practice
662 in areas of critical need for the purpose of providing
663 volunteer, uncompensated care for low-income residents. The
664 applicant must submit an affidavit from the employing agency or
665 institution stating that the physician will not receive any
666 compensation for any service involving the practice of medicine.
667 Section 7. This act shall take effect July 1, 2010.