Florida Senate - 2022                                    SB 1222
       By Senator Bean
       4-01088-22                                            20221222__
    1                        A bill to be entitled                      
    2         An act relating to nonemergent patient care; amending
    3         s. 401.23, F.S.; defining the term “community
    4         paramedicine”; amending s. 401.265, F.S.; providing
    5         that a physician who supervises the provision of
    6         certain services by a paramedic or an emergency
    7         medical technician is liable for any act or omission
    8         during the provision of such services; amending s.
    9         401.272, F.S.; revising a legislative purpose
   10         regarding emergency medical services community health
   11         care; authorizing paramedics and emergency medical
   12         technicians to perform community paramedicine under
   13         certain circumstances; amending s. 465.019, F.S.;
   14         specifying that Class III institutional pharmacies may
   15         dispense, distribute, compound, and fill prescriptions
   16         for medicinal drugs for inpatient and outpatient
   17         treatment; authorizing hospitals to dispense medicinal
   18         drugs to patients without first securing a community
   19         pharmacy permit under certain circumstances; amending
   20         ss. 14.33, 252.515, 395.1027, and 401.245, F.S.;
   21         conforming cross-references; providing an effective
   22         date.
   24  Be It Enacted by the Legislature of the State of Florida:
   26         Section 1. Present subsections (10) through (22) of section
   27  401.23, Florida Statutes, are redesignated as subsections (11)
   28  through (23), respectively, a new subsection (10) is added to
   29  that section, and present subsection (19) of that section is
   30  amended, to read:
   31         401.23 Definitions.—As used in this part, the term:
   32         (10) “Community paramedicine” means any nonemergent basic
   33  or advanced life support services provided in a community
   34  setting by a paramedic or an emergency medical technician, as
   35  applicable, under the medical supervision of a physician
   36  pursuant to a formal supervisory relationship or standing order,
   37  as described in s. 401.265, s. 458.348, or s. 459.025.
   38         (20)(19) “Physician” means a practitioner who is licensed
   39  under the provisions of chapter 458 or chapter 459. For the
   40  purpose of providing “medical direction” as defined in this
   41  section subsection (14) for the treatment of patients
   42  immediately before prior to or during transportation to a United
   43  States Department of Veterans Affairs medical facility,
   44  “physician” also means a practitioner employed by the United
   45  States Department of Veterans Affairs.
   46         Section 2. Subsection (4) of section 401.265, Florida
   47  Statutes, is amended to read:
   48         401.265 Medical directors.—
   49         (4) Each physician who supervises or provides medical
   50  direction to medical director who uses a paramedic or an
   51  emergency medical technician to perform community paramedicine;
   52  to perform blood pressure screening, health promotion, and
   53  wellness activities;, or to administer immunization for on any
   54  patient under a protocol as specified in s. 401.272, which is
   55  not in the provision of emergency care, is liable for any act or
   56  omission of any paramedic or emergency medical technician acting
   57  under his or her supervision and control when performing such
   58  services.
   59         Section 3. Subsections (1) and paragraph (a) of subsection
   60  (2) of section 401.272, Florida Statutes, are amended to read:
   61         401.272 Emergency medical services community health care.—
   62         (1) The purpose of this section is to encourage more
   63  effective use utilization of the skills of emergency medical
   64  technicians and paramedics by enabling them to perform community
   65  paramedicine, in partnership with local county health
   66  departments and health care facilities as defined in s. 408.07,
   67  specific additional health care tasks that are consistent with
   68  the public health and welfare.
   69         (2) Notwithstanding any other provision of law to the
   70  contrary:
   71         (a) Paramedics or emergency medical technicians may perform
   72  community paramedicine, health promotion and wellness
   73  activities, and blood pressure screenings in a nonemergency
   74  environment, within the scope of their training, and under the
   75  direction of a physician medical director. As used in this
   76  paragraph, the term “health promotion and wellness” means the
   77  provision of public health programs pertaining to the prevention
   78  of illness and injury.
   79         Section 4. Paragraph (d) of subsection (2) and paragraph
   80  (a) of subsection (4) of section 465.019, Florida Statutes, are
   81  amended to read:
   82         465.019 Institutional pharmacies; permits.—
   83         (2) The following classes of institutional pharmacies are
   84  established:
   85         (d)1. “Class III institutional pharmacies” are those
   86  institutional pharmacies, including central distribution
   87  facilities, affiliated with a hospital which that provide the
   88  same services that are authorized by a Class II institutional
   89  pharmacy permit. Class III institutional pharmacies may also:
   90         a. Dispense, distribute, compound, and fill prescriptions
   91  for medicinal drugs for inpatient or outpatient treatment.
   92         b. Prepare prepackaged drug products.
   93         c. Conduct other pharmaceutical services for the affiliated
   94  hospital and for entities under common control that are each
   95  permitted under this chapter to possess medicinal drugs.
   96         d. Provide the services in sub-subparagraphs a.-c. to an
   97  entity under common control which holds an active health care
   98  clinic establishment permit as required under s. 499.01(2)(r).
   99         2. A Class III institutional pharmacy shall maintain
  100  policies and procedures addressing:
  101         a. The consultant pharmacist responsible for pharmaceutical
  102  services.
  103         b. Safe practices for the preparation, dispensing,
  104  prepackaging, distribution, and transportation of medicinal
  105  drugs and prepackaged drug products.
  106         c. Recordkeeping to monitor the movement, distribution, and
  107  transportation of medicinal drugs and prepackaged drug products.
  108         d. Recordkeeping of pharmacy staff responsible for each
  109  step in the preparation, dispensing, prepackaging,
  110  transportation, and distribution of medicinal drugs and
  111  prepackaged drug products.
  112         e. Medicinal drugs and prepackaged drug products that may
  113  not be safely distributed among Class III institutional
  114  pharmacies.
  115         (4)(a) Medicinal drugs shall be dispensed by in an
  116  institutional pharmacy to outpatients only when that institution
  117  has secured a community pharmacy permit from the department.
  118  However, medicinal drugs may be dispensed by a hospital that has
  119  not secured a community pharmacy permit but operates a Class II
  120  or Class III institutional pharmacy may dispense medicinal drugs
  121  to a patient of the hospital’s emergency department or a
  122  hospital inpatient upon discharge if a prescriber, as defined in
  123  s. 465.025(1), treating the patient in such hospital determines
  124  that the medicinal drug is warranted and that community pharmacy
  125  services are not readily accessible, geographically or
  126  otherwise, to the patient. Such prescribing and dispensing must
  127  be for a supply of the drug that will last for the greater of
  128  the following:
  129         1. Up to 48 hours; or
  130         2. Through the end of the next business day.
  131         Section 5. Subsection (1) of section 14.33, Florida
  132  Statutes, is amended to read:
  133         14.33 Medal of Heroism.—
  134         (1) The Governor may award a Medal of Heroism of
  135  appropriate design, with ribbons and appurtenances, to a law
  136  enforcement, correctional, or correctional probation officer, as
  137  defined in s. 943.10(14); a firefighter, as defined in s.
  138  112.191(1)(b); an emergency medical technician, as defined in s.
  139  401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
  140  401.23(17). A recipient must have distinguished himself or
  141  herself conspicuously by gallantry and intrepidity, must have
  142  risked his or her life deliberately above and beyond the call of
  143  duty while performing duty in his or her respective position,
  144  and must have engaged in hazardous or perilous activities to
  145  preserve lives with the knowledge that such activities might
  146  result in great personal harm.
  147         Section 6. Paragraph (a) of subsection (3) of section
  148  252.515, Florida Statutes, is amended to read:
  149         252.515 Postdisaster Relief Assistance Act; immunity from
  150  civil liability.—
  151         (3) As used in this section, the term:
  152         (a) “Emergency first responder” means:
  153         1. A physician licensed under chapter 458.
  154         2. An osteopathic physician licensed under chapter 459.
  155         3. A chiropractic physician licensed under chapter 460.
  156         4. A podiatric physician licensed under chapter 461.
  157         5. A dentist licensed under chapter 466.
  158         6. An advanced practice registered nurse licensed under s.
  159  464.012.
  160         7. A physician assistant licensed under s. 458.347 or s.
  161  459.022.
  162         8. A worker employed by a public or private hospital in the
  163  state.
  164         9. A paramedic as defined in s. 401.23 s. 401.23(17).
  165         10. An emergency medical technician as defined in s. 401.23
  166  s. 401.23(11).
  167         11. A firefighter as defined in s. 633.102.
  168         12. A law enforcement officer as defined in s. 943.10.
  169         13. A member of the Florida National Guard.
  170         14. Any other personnel designated as emergency personnel
  171  by the Governor pursuant to a declared emergency.
  172         Section 7. Subsection (5) of section 395.1027, Florida
  173  Statutes, is amended to read:
  174         395.1027 Regional poison control centers.—
  175         (5) By October 1, 1999, each regional poison control center
  176  shall develop a prehospital emergency dispatch protocol with
  177  each licensee as defined in s. 401.23 by s. 401.23(13) in the
  178  geographic area covered by the regional poison control center.
  179  The prehospital emergency dispatch protocol shall be developed
  180  by each licensee’s medical director in conjunction with the
  181  designated regional poison control center responsible for the
  182  geographic area in which the licensee operates. The protocol
  183  shall define toxic substances and describe the procedure by
  184  which the designated regional poison control center may be
  185  consulted by the licensee. If a call is transferred to the
  186  designated regional poison control center in accordance with the
  187  protocol established under this section and s. 401.268, the
  188  designated regional poison control center shall assume
  189  responsibility and liability for the call.
  190         Section 8. Paragraph (b) of subsection (2) of section
  191  401.245, Florida Statutes, is amended to read:
  192         401.245 Emergency Medical Services Advisory Council.—
  193         (2)
  194         (b) Representation on the Emergency Medical Services
  195  Advisory Council shall include: two licensed physicians who are
  196  medical directors as defined in s. 401.23 s. 401.23(15) or
  197  whose medical practice is closely related to emergency medical
  198  services; two emergency medical service administrators, one of
  199  whom is employed by a fire service; two certified paramedics,
  200  one of whom is employed by a fire service; two certified
  201  emergency medical technicians, one of whom is employed by a fire
  202  service; one emergency medical services educator; one emergency
  203  nurse; one hospital administrator; one representative of air
  204  ambulance services; one representative of a commercial ambulance
  205  operator; and two laypersons who are in no way connected with
  206  emergency medical services, one of whom is a representative of
  207  the elderly. Ex officio members of the advisory council from
  208  state agencies shall include, but are shall not be limited to,
  209  representatives from the Department of Education, the Department
  210  of Management Services, the State Fire Marshal, the Department
  211  of Highway Safety and Motor Vehicles, the Department of
  212  Transportation, and the Division of Emergency Management.
  213         Section 9. This act shall take effect July 1, 2022.