| 1 | A bill to be entitled | 
| 2 | An act relating to blood establishments; amending s. | 
| 3 | 381.06014, F.S.; redefining the term "blood establishment" | 
| 4 | and defining the term "volunteer donor"; prohibiting local | 
| 5 | governments from restricting access to public facilities | 
| 6 | or infrastructure for certain activities based on whether | 
| 7 | a blood establishment is operating as a for-profit | 
| 8 | organization or not-for-profit organization; prohibiting a | 
| 9 | blood establishment from considering whether certain | 
| 10 | customers are operating as for-profit organizations or | 
| 11 | not-for-profit organizations when determining service fees | 
| 12 | for selling blood or blood components; requiring that | 
| 13 | certain blood establishments disclose specified | 
| 14 | information on the Internet; authorizing the Department of | 
| 15 | Legal Affairs to assess a civil penalty against a blood | 
| 16 | establishment that fails to disclose specified information | 
| 17 | on the Internet; providing that the civil penalty accrues | 
| 18 | to the state and requiring that it be deposited as | 
| 19 | received into the General Revenue Fund; amending s. | 
| 20 | 499.003, F.S.; redefining the term "health care entity" to | 
| 21 | clarify that a blood establishment is a health care entity | 
| 22 | that may engage in certain activities; amending s. | 
| 23 | 499.005, F.S.; clarifying provisions that prohibit the | 
| 24 | unauthorized wholesale distribution of a prescription drug | 
| 25 | that was purchased by a hospital or other health care | 
| 26 | entity or donated or supplied at a reduced price to a | 
| 27 | charitable organization, to conform to changes made by the | 
| 28 | act; amending s. 499.01, F.S.; exempting certain blood | 
| 29 | establishments from the requirements to be permitted as a | 
| 30 | prescription drug manufacturer and register products; | 
| 31 | requiring that certain blood establishments obtain a | 
| 32 | restricted prescription drug distributor permit under | 
| 33 | specified conditions; limiting the prescription drugs that | 
| 34 | a blood establishment may distribute under a restricted | 
| 35 | prescription drug distributor permit; authorizing the | 
| 36 | Department of Health to adopt rules regarding the | 
| 37 | distribution of prescription drugs by blood | 
| 38 | establishments; providing an effective date. | 
| 39 | 
 | 
| 40 | Be It Enacted by the Legislature of the State of Florida: | 
| 41 | 
 | 
| 42 | Section 1.  Section 381.06014, Florida Statutes, is amended | 
| 43 | to read: | 
| 44 | 381.06014  Blood establishments.- | 
| 45 | (1)  As used in this section, the term: | 
| 46 | (a)  "Blood establishment" means any person, entity, or | 
| 47 | organization, operating within the state, which examines an | 
| 48 | individual for the purpose of blood donation or which collects, | 
| 49 | processes, stores, tests, or distributes blood or blood | 
| 50 | components collected from the human body for the purpose of | 
| 51 | transfusion, for any other medical purpose, or for the | 
| 52 | production of any biological product. A person, entity, or | 
| 53 | organization that uses a mobile unit to conduct such activities | 
| 54 | within the state is also a blood establishment. | 
| 55 | (b)  "Volunteer donor" means a person who does not receive | 
| 56 | remuneration, other than an incentive, for a blood donation | 
| 57 | intended for transfusion, and the product container of the | 
| 58 | donation from the person qualifies for labeling with the | 
| 59 | statement "volunteer donor" under 21 C.F.R. s. 606.121. | 
| 60 | (2)  Any blood establishment operating in the state may not | 
| 61 | conduct any activity defined in paragraph (1)(a) subsection (1)  | 
| 62 | unless that blood establishment is operated in a manner | 
| 63 | consistent with the provisions of Title 21 C.F.R. parts 211 and | 
| 64 | 600-640 , Code of Federal Regulations. | 
| 65 | (3)  Any blood establishment determined to be operating in | 
| 66 | the state in a manner not consistent with the provisions of | 
| 67 | Title 21 C.F.R. parts 211 and 600-640 , Code of Federal  | 
| 68 | Regulations,and in a manner that constitutes a danger to the | 
| 69 | health or well-being of donors or recipients as evidenced by the | 
| 70 | federal Food and Drug Administration's inspection reports and | 
| 71 | the revocation of the blood establishment's license or | 
| 72 | registration is shall bein violation of this chapter and must | 
| 73 | shallimmediately cease all operations in the state. | 
| 74 | (4)  The operation of a blood establishment in a manner not | 
| 75 | consistent with the provisions of Title 21 C.F.R. parts 211 and | 
| 76 | 600-640 , Code of Federal Regulations,and in a manner that | 
| 77 | constitutes a danger to the health or well-being of blood donors | 
| 78 | or recipients as evidenced by the federal Food and Drug | 
| 79 | Administration's inspection process is declared a nuisance and | 
| 80 | inimical to the public health, welfare, and safety. The Agency | 
| 81 | for Health Care Administration or any state attorney may bring | 
| 82 | an action for an injunction to restrain such operations or | 
| 83 | enjoin the future operation of the blood establishment. | 
| 84 | (5)  A local government may not restrict the access to or | 
| 85 | use of any public facility or infrastructure for the collection | 
| 86 | of blood or blood components from volunteer donors based on | 
| 87 | whether the blood establishment is operating as a for-profit | 
| 88 | organization or not-for-profit organization. | 
| 89 | (6)  In determining the service fee of blood or blood | 
| 90 | components received from volunteer donors and sold to hospitals | 
| 91 | or other health care providers, a blood establishment may not | 
| 92 | base the service fee of the blood or blood component solely on | 
| 93 | whether the purchasing entity is a for-profit organization or | 
| 94 | not-for-profit organization. | 
| 95 | (7)  A blood establishment that collects blood or blood | 
| 96 | components from volunteer donors must disclose on the Internet | 
| 97 | the information required under this subsection to educate and | 
| 98 | inform donors and the public about the blood establishment's | 
| 99 | activities. A hospital that collects blood or blood components | 
| 100 | to be used only by that hospital's licensed facilities or by a | 
| 101 | health care provider that is a part of the hospital's business | 
| 102 | entity is exempt from the disclosure requirements in this | 
| 103 | subsection. The information required to be disclosed under this | 
| 104 | subsection may be cumulative for all blood establishments within | 
| 105 | a business entity. A blood establishment must disclose on its | 
| 106 | website all of the following information: | 
| 107 | (a)  A description of the steps involved in collecting, | 
| 108 | processing, and distributing volunteer donations. | 
| 109 | (b)  By March 1 of each year, the number of units of blood | 
| 110 | components which were: | 
| 111 | 1.  Produced by the blood establishment during the | 
| 112 | preceding calendar year; | 
| 113 | 2.  Obtained from other sources during the preceding | 
| 114 | calendar year; | 
| 115 | 3.  Distributed during the preceding calendar year to | 
| 116 | health care providers located outside this state. However, if | 
| 117 | the blood establishment collects donations in a county outside | 
| 118 | this state, distributions to health care providers in that | 
| 119 | county shall be excluded. Such information shall be reported in | 
| 120 | the aggregate for health care providers located within the | 
| 121 | United States and its territories or outside the United States | 
| 122 | and its territories; and | 
| 123 | 4.  Distributed during the preceding calendar year to | 
| 124 | entities that are not health care providers. Such information | 
| 125 | shall be reported in the aggregate for purchasers located within | 
| 126 | the United States and its territories or outside the United | 
| 127 | States and its territories. | 
| 128 | (c)  The blood establishment's conflict-of-interest policy, | 
| 129 | policy concerning related-party transactions, whistleblower | 
| 130 | policy, and policy for determining executive compensation. If a | 
| 131 | change occurs to any of these documents, the revised document | 
| 132 | must be available on the blood establishment's website by the | 
| 133 | following March 1. | 
| 134 | (d)  Except for a hospital that collects blood or blood | 
| 135 | components from volunteer donors: | 
| 136 | 1.  The most recent 3 years of the Return of Organization | 
| 137 | Exempt from Income Tax, Internal Revenue Service Form 990, if | 
| 138 | the business entity for the blood establishment is eligible to | 
| 139 | file such return. The Form 990 must be available on the blood | 
| 140 | establishment's website within 60 calendar days after it is | 
| 141 | filed with the Internal Revenue Service; or | 
| 142 | 2.  If the business entity for the blood establishment is | 
| 143 | not eligible to file the Form 990 return, a balance sheet, | 
| 144 | income statement, and statement of changes in cash flow, along | 
| 145 | with the expression of an opinion thereon by an independent | 
| 146 | certified public accountant who audited or reviewed such | 
| 147 | financial statements. Such documents must be available on the | 
| 148 | blood establishment's website within 120 days after the end of | 
| 149 | the blood establishment's fiscal year and must remain on the | 
| 150 | blood establishment's website for at least 36 months. | 
| 151 | (8)  A blood establishment is liable for a civil penalty | 
| 152 | for failing to make the disclosures required under subsection | 
| 153 | (7). The Department of Legal Affairs may assess the civil | 
| 154 | penalty against the blood establishment for each day that it | 
| 155 | fails to make such required disclosures, but the penalty may not | 
| 156 | exceed $10,000 per year. If multiple blood establishments | 
| 157 | operated by a single business entity fail to meet such | 
| 158 | disclosure requirements, the civil penalty may be assessed | 
| 159 | against only one of the business entity's blood establishments. | 
| 160 | The Department of Legal Affairs may terminate an action if the | 
| 161 | blood establishment agrees to pay a stipulated civil penalty. A | 
| 162 | civil penalty so collected accrues to the state and shall be | 
| 163 | deposited as received into the General Revenue Fund unallocated. | 
| 164 | The Department of Legal Affairs may terminate the action and | 
| 165 | waive the civil penalty upon a showing of good cause by the | 
| 166 | blood establishment as to why the required disclosures were not | 
| 167 | made. | 
| 168 | Section 2.  Subsection (23) of section 499.003, Florida | 
| 169 | Statutes, is amended to read: | 
| 170 | 499.003  Definitions of terms used in this part.-As used in | 
| 171 | this part, the term: | 
| 172 | (23)  "Health care entity" means a closed pharmacy or any | 
| 173 | person, organization, or business entity that provides | 
| 174 | diagnostic, medical, surgical, or dental treatment or care, or | 
| 175 | chronic or rehabilitative care, but does not include any | 
| 176 | wholesale distributor or retail pharmacy licensed under state | 
| 177 | law to deal in prescription drugs. However, a blood | 
| 178 | establishment is a health care entity that may engage in the | 
| 179 | wholesale distribution of prescription drugs under s. | 
| 180 | 499.01(2)(g)1.c. | 
| 181 | Section 3.  Subsection (21) of section 499.005, Florida | 
| 182 | Statutes, is amended to read: | 
| 183 | 499.005  Prohibited acts.-It is unlawful for a person to | 
| 184 | perform or cause the performance of any of the following acts in | 
| 185 | this state: | 
| 186 | (21)  The wholesale distribution of any prescription drug | 
| 187 | that was: | 
| 188 | (a)  Purchased by a public or private hospital or other | 
| 189 | health care entity; or | 
| 190 | (b)  Donated or supplied at a reduced price to a charitable | 
| 191 | organization, | 
| 192 | 
 | 
| 193 | unless the wholesale distribution of the prescription drug is | 
| 194 | authorized in s. 499.01(2)(g)1.c. | 
| 195 | Section 4.  Paragraphs (a) and (g) of subsection (2) of | 
| 196 | section 499.01, Florida Statutes, are amended to read: | 
| 197 | 499.01  Permits.- | 
| 198 | (2)  The following permits are established: | 
| 199 | (a)  Prescription drug manufacturer permit.-A prescription | 
| 200 | drug manufacturer permit is required for any person that is a | 
| 201 | manufacturer of a prescription drug and that manufactures or | 
| 202 | distributes such prescription drugs in this state. | 
| 203 | 1.  A person that operates an establishment permitted as a | 
| 204 | prescription drug manufacturer may engage in wholesale | 
| 205 | distribution of prescription drugs manufactured at that | 
| 206 | establishment and must comply with all of the provisions of this | 
| 207 | part, except s. 499.01212, and the rules adopted under this | 
| 208 | part, except s. 499.01212, which thatapply to a wholesale | 
| 209 | distributor. | 
| 210 | 2.  A prescription drug manufacturer must comply with all | 
| 211 | appropriate state and federal good manufacturing practices. | 
| 212 | 3.  A blood establishment, as defined in s. 381.06014, | 
| 213 | operating in a manner consistent with the provisions of Title 21 | 
| 214 | C.F.R. parts 211 and 600-640, and manufacturing only the | 
| 215 | prescription drugs described in s. 499.003(54)(d) is not | 
| 216 | required to be permitted as a prescription drug manufacturer | 
| 217 | under this paragraph or to register products under s. 499.015. | 
| 218 | (g)  Restricted prescription drug distributor permit.- | 
| 219 | 1.  A restricted prescription drug distributor permit is | 
| 220 | required for: | 
| 221 | a.  Any person located in this state that engages in the | 
| 222 | distribution of a prescription drug, which distribution is not | 
| 223 | considered "wholesale distribution" under s. 499.003(54)(a). | 
| 224 | b. 1.AnyAperson located in this state who engages in the | 
| 225 | receipt or distribution of a prescription drug in this state for | 
| 226 | the purpose of processing its return or its destruction must  | 
| 227 | obtain a permit as a restricted prescription drug distributorif | 
| 228 | such person is not the person initiating the return, the | 
| 229 | prescription drug wholesale supplier of the person initiating | 
| 230 | the return, or the manufacturer of the drug. | 
| 231 | c.  A blood establishment located in this state which | 
| 232 | collects blood and blood components only from volunteer donors | 
| 233 | as defined in s. 381.06014 or pursuant to an authorized | 
| 234 | practitioner's order for medical treatment or therapy and | 
| 235 | engages in the wholesale distribution of a prescription drug not | 
| 236 | described in s. 499.003(54)(d) to a health care entity. The | 
| 237 | health care entity receiving a prescription drug distributed | 
| 238 | under this sub-subparagraph must be licensed as a closed | 
| 239 | pharmacy or provide health care services at that establishment. | 
| 240 | The blood establishment must operate in accordance with s. | 
| 241 | 381.06014 and may distribute only: | 
| 242 | (I)  Prescription drugs indicated for a bleeding or | 
| 243 | clotting disorder or anemia; | 
| 244 | (II)  Blood-collection containers approved under s. 505 of | 
| 245 | the federal act; | 
| 246 | (III)  Drugs that are blood derivatives, or a recombinant | 
| 247 | or synthetic form of a blood derivative; | 
| 248 | (IV)  Prescription drugs that are identified in rules | 
| 249 | adopted by the department and that are essential to services | 
| 250 | performed or provided by blood establishments and authorized for | 
| 251 | distribution by blood establishments under federal law; or | 
| 252 | (V)  To the extent authorized by federal law, drugs | 
| 253 | necessary to collect blood or blood components from volunteer | 
| 254 | blood donors; for blood establishment personnel to perform | 
| 255 | therapeutic procedures under the direction and supervision of a | 
| 256 | licensed physician; and to diagnose, treat, manage, and prevent | 
| 257 | any reaction of either a volunteer blood donor or a patient | 
| 258 | undergoing a therapeutic procedure performed under the direction | 
| 259 | and supervision of a licensed physician, | 
| 260 | 
 | 
| 261 | as long as all of the health care services provided by the blood | 
| 262 | establishment are related to its activities as a registered | 
| 263 | blood establishment or the health care services consist of | 
| 264 | collecting, processing, storing, or administering human | 
| 265 | hematopoietic stem cells or progenitor cells or performing | 
| 266 | diagnostic testing of specimens if such specimens are tested | 
| 267 | together with specimens undergoing routine donor testing. | 
| 268 | 2.  Storage, handling, and recordkeeping of these | 
| 269 | distributions by a person required to be permitted as a | 
| 270 | restricted prescription drug distributor must comply with the | 
| 271 | requirements for wholesale distributors under s. 499.0121, but | 
| 272 | not those set forth in s. 499.01212 if the distribution occurs | 
| 273 | pursuant to sub-subparagraph 1.a. or sub-subparagraph 1.b. | 
| 274 | 3.  A person who applies for a permit as a restricted | 
| 275 | prescription drug distributor, or for the renewal of such a | 
| 276 | permit, must provide to the department the information required | 
| 277 | under s. 499.012. | 
| 278 | 4.  The department may adopt rules regarding the | 
| 279 | distribution of prescription drugs by hospitals, health care | 
| 280 | entities, charitable organizations, orother persons not | 
| 281 | involved in wholesale distribution, and blood establishments, | 
| 282 | which rules are necessary for the protection of the public | 
| 283 | health, safety, and welfare. | 
| 284 | Section 5.  This act shall take effect July 1, 2011. |