Florida Senate - 2022                                     SB 768
       
       
        
       By Senator Rodriguez
       
       
       
       
       
       39-00626C-22                                           2022768__
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; amending
    3         s. 381.0045, F.S.; revising the purpose of the
    4         department’s targeted outreach program for certain
    5         pregnant women; requiring the department to encourage
    6         high-risk pregnant women of unknown status to be
    7         tested for sexually transmissible diseases; requiring
    8         the department to provide specified information to
    9         pregnant women who have human immunodeficiency virus
   10         (HIV); requiring the department to link women with
   11         mental health services when available; requiring the
   12         department to educate pregnant women who have HIV on
   13         certain information; requiring the department to
   14         provide, for a specified purpose, continued oversight
   15         of newborns exposed to HIV; amending s. 381.0303,
   16         F.S.; removing the Children’s Medical Services office
   17         from parties required to coordinate in the development
   18         of local emergency management plans for special needs
   19         shelters; amending s. 381.986, F.S.; authorizing the
   20         department to select samples of marijuana from medical
   21         marijuana treatment center facilities for certain
   22         testing; authorizing the department to select samples
   23         of marijuana delivery devices from medical marijuana
   24         treatment centers to determine whether the device is
   25         safe for use; requiring medical marijuana treatment
   26         centers to recall marijuana and marijuana delivery
   27         devices, instead of just edibles, under certain
   28         circumstances; exempting the department and its
   29         employees from criminal provisions if they acquire,
   30         possess, test, transport, or lawfully dispose of
   31         marijuana and marijuana delivery devices under certain
   32         circumstances; amending s. 401.23, F.S.; revising
   33         definitions; amending s. 401.25, F.S.; conforming a
   34         provision to changes made by the act; amending s.
   35         401.27, F.S.; revising certification and
   36         recertification requirements for emergency medical
   37         technicians and paramedics; amending s. 401.2701,
   38         F.S.; revising requirements for emergency medical
   39         services training programs; authorizing certain site
   40         visits to be conducted either in person or through
   41         electronic means; authorizing programs to substitute
   42         certain simulated, remote videoconferencing options
   43         for in-person training and related requirements;
   44         specifying requirements for requests for department
   45         approval of such options; providing for the renewal of
   46         program certification; providing for initial and
   47         ongoing department site visits of programs; revising
   48         program application procedures; amending s. 401.272,
   49         F.S.; revising functions paramedics and emergency
   50         medical technicians may perform in nonemergency
   51         environments; authorizing paramedics to administer
   52         public health countermeasures in nonemergency
   53         environments under certain circumstances; conforming
   54         provisions to changes made by the act; amending s.
   55         401.30, F.S.; revising recordkeeping requirements for
   56         emergency medical services providers; authorizing
   57         records to be in either written or electronic formats;
   58         revising the list of individuals and entities that may
   59         receive limited disclosure of certain otherwise
   60         confidential and exempt records; requiring the release
   61         of such records to be in compliance with specified
   62         provisions; amending s. 401.34, F.S.; deleting
   63         provisions and fees related to an obsolete
   64         examination; amending s. 401.425, F.S.; authorizing
   65         emergency medical review committees to review the
   66         performances of emergency medical technicians,
   67         paramedics, and emergency medical services providers
   68         to make recommendations for improvement; amending s.
   69         401.435, F.S.; relabeling “first responder agencies”
   70         as “emergency medical responder agencies”; revising
   71         minimum standards for emergency medical first
   72         responder training; amending s. 460.406, F.S.;
   73         revising provisions related to chiropractic physician
   74         licensing; amending s. 464.008, F.S.; deleting a
   75         requirement that certain nursing program graduates
   76         complete a specified preparatory course; amending s.
   77         464.018, F.S.; revising grounds for disciplinary
   78         action against licensed nurses; amending s. 467.003,
   79         F.S.; revising and defining terms; amending s.
   80         467.009, F.S.; revising provisions related to approved
   81         midwifery programs; amending s. 467.011, F.S.;
   82         revising requirements for licensure of midwives;
   83         amending s. 467.0125, F.S.; revising requirements for
   84         licensure by endorsement of midwives; revising
   85         requirements for temporary certificates to practice
   86         midwifery in this state; amending s. 467.205, F.S.;
   87         revising provisions relating to approval, continued
   88         monitoring, probationary status, provisional approval,
   89         and approval rescission of midwifery programs;
   90         amending s. 468.803, F.S.; revising provisions related
   91         to orthotist and prosthetist registration,
   92         examination, and licensing; amending s. 483.824, F.S.;
   93         revising educational requirements for clinical
   94         laboratory directors; amending s. 490.003, F.S.;
   95         defining the terms “doctoral degree from an American
   96         Psychological Association accredited program” and
   97         “doctoral degree in psychology”; amending ss. 490.005
   98         and 490.0051, F.S.; revising education requirements
   99         for psychologist licensure and provisional licensure,
  100         respectively; amending s. 491.005, F.S.; revising
  101         requirements for licensure of clinical social workers,
  102         marriage and family therapists, and mental health
  103         counselors; requiring that a licensed mental health
  104         professional be accessible through certain means when
  105         a registered intern provides clinical services through
  106         telehealth; amending s. 766.314, F.S.; deleting
  107         obsolete language and updating provisions to conform
  108         to current law; revising the frequency with which the
  109         department must submit certain reports to the Florida
  110         Birth-Related Neurological Injury Compensation
  111         Association; revising the content of such reports;
  112         providing an effective date.
  113          
  114  Be It Enacted by the Legislature of the State of Florida:
  115  
  116         Section 1. Subsections (2) and (3) of section 381.0045,
  117  Florida Statutes, are amended to read:
  118         381.0045 Targeted outreach for pregnant women.—
  119         (2) It is the purpose of this section to establish a
  120  targeted outreach program for high-risk pregnant women who may
  121  not seek proper prenatal care, who suffer from substance abuse
  122  or mental health problems, or who have acquired are infected
  123  with human immunodeficiency virus (HIV), and to provide these
  124  women with links to much-needed much needed services and
  125  information.
  126         (3) The department shall:
  127         (a) Conduct outreach programs through contracts with,
  128  grants to, or other working relationships with persons or
  129  entities where the target population is likely to be found.
  130         (b) Provide outreach that is peer-based, culturally
  131  sensitive, and performed in a nonjudgmental manner.
  132         (c) Encourage high-risk pregnant women of unknown status to
  133  be tested for HIV and other sexually transmissible diseases as
  134  specified by department rule.
  135         (d) Educate women not receiving prenatal care as to the
  136  benefits of such care.
  137         (e) Provide HIV-infected pregnant women who have HIV with
  138  information on the need for antiretroviral medication for their
  139  newborn, their medication options, and how they can access the
  140  medication after their discharge from the hospital so they can
  141  make an informed decision about the use of Zidovudine (AZT).
  142         (f) Link women with substance abuse treatment and mental
  143  health services, when available, and act as a liaison with
  144  Healthy Start coalitions, children’s medical services, Ryan
  145  White-funded providers, and other services of the Department of
  146  Health.
  147         (g) Educate pregnant women who have HIV on the importance
  148  of engaging in and continuing HIV care.
  149         (h) Provide continued oversight of any newborn exposed to
  150  HIV to determine the newborn’s final HIV status and ensure
  151  continued linkage to care if the newborn is diagnosed with HIV
  152  to HIV-exposed newborns.
  153         Section 2. Paragraphs (a) and (c) of subsection (2) of
  154  section 381.0303, Florida Statutes, are amended to read:
  155         381.0303 Special needs shelters.—
  156         (2) SPECIAL NEEDS SHELTER PLAN; STAFFING; STATE AGENCY
  157  ASSISTANCE.—If funds have been appropriated to support disaster
  158  coordinator positions in county health departments:
  159         (a) The department shall assume lead responsibility for the
  160  coordination of local medical and health care providers, the
  161  American Red Cross, and other interested parties in developing a
  162  plan for the staffing and medical management of special needs
  163  shelters and. The local Children’s Medical Services offices
  164  shall assume lead responsibility for the coordination of local
  165  medical and health care providers, the American Red Cross, and
  166  other interested parties in developing a plan for the staffing
  167  and medical management of pediatric special needs shelters.
  168  Plans must conform to the local comprehensive emergency
  169  management plan.
  170         (c) The appropriate county health department, Children’s
  171  Medical Services office, and local emergency management agency
  172  shall jointly decide who has responsibility for medical
  173  supervision in each special needs shelter.
  174         Section 3. Present paragraphs (e) through (h) of subsection
  175  (14) of section 381.986, Florida Statutes, are redesignated as
  176  paragraphs (f) through (i), respectively, a new paragraph (e) is
  177  added to that subsection, and paragraph (e) of subsection (8) of
  178  that section is amended, to read:
  179         381.986 Medical use of marijuana.—
  180         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
  181         (e) A licensed medical marijuana treatment center shall
  182  cultivate, process, transport, and dispense marijuana for
  183  medical use. A licensed medical marijuana treatment center may
  184  not contract for services directly related to the cultivation,
  185  processing, and dispensing of marijuana or marijuana delivery
  186  devices, except that a medical marijuana treatment center
  187  licensed pursuant to subparagraph (a)1. may contract with a
  188  single entity for the cultivation, processing, transporting, and
  189  dispensing of marijuana and marijuana delivery devices. A
  190  licensed medical marijuana treatment center must, at all times,
  191  maintain compliance with the criteria demonstrated and
  192  representations made in the initial application and the criteria
  193  established in this subsection. Upon request, the department may
  194  grant a medical marijuana treatment center a variance from the
  195  representations made in the initial application. Consideration
  196  of such a request shall be based upon the individual facts and
  197  circumstances surrounding the request. A variance may not be
  198  granted unless the requesting medical marijuana treatment center
  199  can demonstrate to the department that it has a proposed
  200  alternative to the specific representation made in its
  201  application which fulfills the same or a similar purpose as the
  202  specific representation in a way that the department can
  203  reasonably determine will not be a lower standard than the
  204  specific representation in the application. A variance may not
  205  be granted from the requirements in subparagraph 2. and
  206  subparagraphs (b)1. and 2.
  207         1. A licensed medical marijuana treatment center may
  208  transfer ownership to an individual or entity who meets the
  209  requirements of this section. A publicly traded corporation or
  210  publicly traded company that meets the requirements of this
  211  section is not precluded from ownership of a medical marijuana
  212  treatment center. To accommodate a change in ownership:
  213         a. The licensed medical marijuana treatment center shall
  214  notify the department in writing at least 60 days before the
  215  anticipated date of the change of ownership.
  216         b. The individual or entity applying for initial licensure
  217  due to a change of ownership must submit an application that
  218  must be received by the department at least 60 days before the
  219  date of change of ownership.
  220         c. Upon receipt of an application for a license, the
  221  department shall examine the application and, within 30 days
  222  after receipt, notify the applicant in writing of any apparent
  223  errors or omissions and request any additional information
  224  required.
  225         d. Requested information omitted from an application for
  226  licensure must be filed with the department within 21 days after
  227  the department’s request for omitted information or the
  228  application shall be deemed incomplete and shall be withdrawn
  229  from further consideration and the fees shall be forfeited.
  230         e. Within 30 days after the receipt of a complete
  231  application, the department shall approve or deny the
  232  application.
  233         2. A medical marijuana treatment center, and any individual
  234  or entity who directly or indirectly owns, controls, or holds
  235  with power to vote 5 percent or more of the voting shares of a
  236  medical marijuana treatment center, may not acquire direct or
  237  indirect ownership or control of any voting shares or other form
  238  of ownership of any other medical marijuana treatment center.
  239         3. A medical marijuana treatment center may not enter into
  240  any form of profit-sharing arrangement with the property owner
  241  or lessor of any of its facilities where cultivation,
  242  processing, storing, or dispensing of marijuana and marijuana
  243  delivery devices occurs.
  244         4. All employees of a medical marijuana treatment center
  245  must be 21 years of age or older and have passed a background
  246  screening pursuant to subsection (9).
  247         5. Each medical marijuana treatment center must adopt and
  248  enforce policies and procedures to ensure employees and
  249  volunteers receive training on the legal requirements to
  250  dispense marijuana to qualified patients.
  251         6. When growing marijuana, a medical marijuana treatment
  252  center:
  253         a. May use pesticides determined by the department, after
  254  consultation with the Department of Agriculture and Consumer
  255  Services, to be safely applied to plants intended for human
  256  consumption, but may not use pesticides designated as
  257  restricted-use pesticides pursuant to s. 487.042.
  258         b. Must grow marijuana within an enclosed structure and in
  259  a room separate from any other plant.
  260         c. Must inspect seeds and growing plants for plant pests
  261  that endanger or threaten the horticultural and agricultural
  262  interests of the state in accordance with chapter 581 and any
  263  rules adopted thereunder.
  264         d. Must perform fumigation or treatment of plants, or
  265  remove and destroy infested or infected plants, in accordance
  266  with chapter 581 and any rules adopted thereunder.
  267         7. Each medical marijuana treatment center must produce and
  268  make available for purchase at least one low-THC cannabis
  269  product.
  270         8. A medical marijuana treatment center that produces
  271  edibles must hold a permit to operate as a food establishment
  272  pursuant to chapter 500, the Florida Food Safety Act, and must
  273  comply with all the requirements for food establishments
  274  pursuant to chapter 500 and any rules adopted thereunder.
  275  Edibles may not contain more than 200 milligrams of
  276  tetrahydrocannabinol, and a single serving portion of an edible
  277  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  278  may have a potency variance of no greater than 15 percent.
  279  Edibles may not be attractive to children; be manufactured in
  280  the shape of humans, cartoons, or animals; be manufactured in a
  281  form that bears any reasonable resemblance to products available
  282  for consumption as commercially available candy; or contain any
  283  color additives. To discourage consumption of edibles by
  284  children, the department shall determine by rule any shapes,
  285  forms, and ingredients allowed and prohibited for edibles.
  286  Medical marijuana treatment centers may not begin processing or
  287  dispensing edibles until after the effective date of the rule.
  288  The department shall also adopt sanitation rules providing the
  289  standards and requirements for the storage, display, or
  290  dispensing of edibles.
  291         9. Within 12 months after licensure, a medical marijuana
  292  treatment center must demonstrate to the department that all of
  293  its processing facilities have passed a Food Safety Good
  294  Manufacturing Practices, such as Global Food Safety Initiative
  295  or equivalent, inspection by a nationally accredited certifying
  296  body. A medical marijuana treatment center must immediately stop
  297  processing at any facility which fails to pass this inspection
  298  until it demonstrates to the department that such facility has
  299  met this requirement.
  300         10. A medical marijuana treatment center that produces
  301  prerolled marijuana cigarettes may not use wrapping paper made
  302  with tobacco or hemp.
  303         11. When processing marijuana, a medical marijuana
  304  treatment center must:
  305         a. Process the marijuana within an enclosed structure and
  306  in a room separate from other plants or products.
  307         b. Comply with department rules when processing marijuana
  308  with hydrocarbon solvents or other solvents or gases exhibiting
  309  potential toxicity to humans. The department shall determine by
  310  rule the requirements for medical marijuana treatment centers to
  311  use such solvents or gases exhibiting potential toxicity to
  312  humans.
  313         c. Comply with federal and state laws and regulations and
  314  department rules for solid and liquid wastes. The department
  315  shall determine by rule procedures for the storage, handling,
  316  transportation, management, and disposal of solid and liquid
  317  waste generated during marijuana production and processing. The
  318  Department of Environmental Protection shall assist the
  319  department in developing such rules.
  320         d. Test the processed marijuana using a medical marijuana
  321  testing laboratory before it is dispensed. Results must be
  322  verified and signed by two medical marijuana treatment center
  323  employees. Before dispensing, the medical marijuana treatment
  324  center must determine that the test results indicate that low
  325  THC cannabis meets the definition of low-THC cannabis, the
  326  concentration of tetrahydrocannabinol meets the potency
  327  requirements of this section, the labeling of the concentration
  328  of tetrahydrocannabinol and cannabidiol is accurate, and all
  329  marijuana is safe for human consumption and free from
  330  contaminants that are unsafe for human consumption. The
  331  department shall determine by rule which contaminants must be
  332  tested for and the maximum levels of each contaminant which are
  333  safe for human consumption. The Department of Agriculture and
  334  Consumer Services shall assist the department in developing the
  335  testing requirements for contaminants that are unsafe for human
  336  consumption in edibles. The department shall also determine by
  337  rule the procedures for the treatment of marijuana that fails to
  338  meet the testing requirements of this section, s. 381.988, or
  339  department rule. The department may select samples of marijuana
  340  a random sample from edibles available for purchase in a medical
  341  marijuana treatment center dispensing facility which shall be
  342  tested by the department to determine whether that the marijuana
  343  edible meets the potency requirements of this section, is safe
  344  for human consumption, and is accurately labeled with the
  345  labeling of the tetrahydrocannabinol and cannabidiol
  346  concentration or to verify the result of marijuana testing
  347  conducted by a marijuana testing laboratory. The department may
  348  also select samples of marijuana delivery devices from a medical
  349  marijuana treatment center to determine whether the marijuana
  350  delivery device is safe for use by qualified patients is
  351  accurate. A medical marijuana treatment center may not require
  352  payment from the department for the sample. A medical marijuana
  353  treatment center must recall marijuana edibles, including all
  354  marijuana and marijuana products edibles made from the same
  355  batch of marijuana, that fails which fail to meet the potency
  356  requirements of this section, that is which are unsafe for human
  357  consumption, or for which the labeling of the
  358  tetrahydrocannabinol and cannabidiol concentration is
  359  inaccurate. A medical marijuana treatment center must also
  360  recall all marijuana delivery devices determined to be unsafe
  361  for use by qualified patients. The medical marijuana treatment
  362  center must retain records of all testing and samples of each
  363  homogenous batch of marijuana for at least 9 months. The medical
  364  marijuana treatment center must contract with a marijuana
  365  testing laboratory to perform audits on the medical marijuana
  366  treatment center’s standard operating procedures, testing
  367  records, and samples and provide the results to the department
  368  to confirm that the marijuana or low-THC cannabis meets the
  369  requirements of this section and that the marijuana or low-THC
  370  cannabis is safe for human consumption. A medical marijuana
  371  treatment center shall reserve two processed samples from each
  372  batch and retain such samples for at least 9 months for the
  373  purpose of such audits. A medical marijuana treatment center may
  374  use a laboratory that has not been certified by the department
  375  under s. 381.988 until such time as at least one laboratory
  376  holds the required certification, but in no event later than
  377  July 1, 2018.
  378         e. Package the marijuana in compliance with the United
  379  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  380  1471 et seq.
  381         f. Package the marijuana in a receptacle that has a firmly
  382  affixed and legible label stating the following information:
  383         (I) The marijuana or low-THC cannabis meets the
  384  requirements of sub-subparagraph d.
  385         (II) The name of the medical marijuana treatment center
  386  from which the marijuana originates.
  387         (III) The batch number and harvest number from which the
  388  marijuana originates and the date dispensed.
  389         (IV) The name of the physician who issued the physician
  390  certification.
  391         (V) The name of the patient.
  392         (VI) The product name, if applicable, and dosage form,
  393  including concentration of tetrahydrocannabinol and cannabidiol.
  394  The product name may not contain wording commonly associated
  395  with products marketed by or to children.
  396         (VII) The recommended dose.
  397         (VIII) A warning that it is illegal to transfer medical
  398  marijuana to another person.
  399         (IX) A marijuana universal symbol developed by the
  400  department.
  401         12. The medical marijuana treatment center shall include in
  402  each package a patient package insert with information on the
  403  specific product dispensed related to:
  404         a. Clinical pharmacology.
  405         b. Indications and use.
  406         c. Dosage and administration.
  407         d. Dosage forms and strengths.
  408         e. Contraindications.
  409         f. Warnings and precautions.
  410         g. Adverse reactions.
  411         13. In addition to the packaging and labeling requirements
  412  specified in subparagraphs 11. and 12., marijuana in a form for
  413  smoking must be packaged in a sealed receptacle with a legible
  414  and prominent warning to keep away from children and a warning
  415  that states marijuana smoke contains carcinogens and may
  416  negatively affect health. Such receptacles for marijuana in a
  417  form for smoking must be plain, opaque, and white without
  418  depictions of the product or images other than the medical
  419  marijuana treatment center’s department-approved logo and the
  420  marijuana universal symbol.
  421         14. The department shall adopt rules to regulate the types,
  422  appearance, and labeling of marijuana delivery devices dispensed
  423  from a medical marijuana treatment center. The rules must
  424  require marijuana delivery devices to have an appearance
  425  consistent with medical use.
  426         15. Each edible shall be individually sealed in plain,
  427  opaque wrapping marked only with the marijuana universal symbol.
  428  Where practical, each edible shall be marked with the marijuana
  429  universal symbol. In addition to the packaging and labeling
  430  requirements in subparagraphs 11. and 12., edible receptacles
  431  must be plain, opaque, and white without depictions of the
  432  product or images other than the medical marijuana treatment
  433  center’s department-approved logo and the marijuana universal
  434  symbol. The receptacle must also include a list of all the
  435  edible’s ingredients, storage instructions, an expiration date,
  436  a legible and prominent warning to keep away from children and
  437  pets, and a warning that the edible has not been produced or
  438  inspected pursuant to federal food safety laws.
  439         16. When dispensing marijuana or a marijuana delivery
  440  device, a medical marijuana treatment center:
  441         a. May dispense any active, valid order for low-THC
  442  cannabis, medical cannabis and cannabis delivery devices issued
  443  pursuant to former s. 381.986, Florida Statutes 2016, which was
  444  entered into the medical marijuana use registry before July 1,
  445  2017.
  446         b. May not dispense more than a 70-day supply of marijuana
  447  within any 70-day period to a qualified patient or caregiver.
  448  May not dispense more than one 35-day supply of marijuana in a
  449  form for smoking within any 35-day period to a qualified patient
  450  or caregiver. A 35-day supply of marijuana in a form for smoking
  451  may not exceed 2.5 ounces unless an exception to this amount is
  452  approved by the department pursuant to paragraph (4)(f).
  453         c. Must have the medical marijuana treatment center’s
  454  employee who dispenses the marijuana or a marijuana delivery
  455  device enter into the medical marijuana use registry his or her
  456  name or unique employee identifier.
  457         d. Must verify that the qualified patient and the
  458  caregiver, if applicable, each have an active registration in
  459  the medical marijuana use registry and an active and valid
  460  medical marijuana use registry identification card, the amount
  461  and type of marijuana dispensed matches the physician
  462  certification in the medical marijuana use registry for that
  463  qualified patient, and the physician certification has not
  464  already been filled.
  465         e. May not dispense marijuana to a qualified patient who is
  466  younger than 18 years of age. If the qualified patient is
  467  younger than 18 years of age, marijuana may only be dispensed to
  468  the qualified patient’s caregiver.
  469         f. May not dispense or sell any other type of cannabis,
  470  alcohol, or illicit drug-related product, including pipes or
  471  wrapping papers made with tobacco or hemp, other than a
  472  marijuana delivery device required for the medical use of
  473  marijuana and which is specified in a physician certification.
  474         g. Must, upon dispensing the marijuana or marijuana
  475  delivery device, record in the registry the date, time,
  476  quantity, and form of marijuana dispensed; the type of marijuana
  477  delivery device dispensed; and the name and medical marijuana
  478  use registry identification number of the qualified patient or
  479  caregiver to whom the marijuana delivery device was dispensed.
  480         h. Must ensure that patient records are not visible to
  481  anyone other than the qualified patient, his or her caregiver,
  482  and authorized medical marijuana treatment center employees.
  483         (14) EXCEPTIONS TO OTHER LAWS.—
  484         (e) Notwithstanding s. 893.13, s. 893.135, s. 893.147, or
  485  any other law, but subject to the requirements of this section,
  486  the department, including an employee of the department acting
  487  within the scope of his or her employment, may acquire, possess,
  488  test, transport, and lawfully dispose of marijuana and marijuana
  489  delivery devices as provided in this section, in s. 381.988, and
  490  by department rule.
  491         Section 4. Section 401.23, Florida Statutes, is amended to
  492  read:
  493         401.23 Definitions.—As used in this part, the term:
  494         (1) “Advanced life support” means assessment or treatment
  495  by a person certified qualified under this part to perform
  496  through the use of techniques such as endotracheal intubation,
  497  the administration of drugs or intravenous fluids, telemetry,
  498  cardiac monitoring, cardiac defibrillation, and other techniques
  499  described for the paramedic level in the EMT-Paramedic National
  500  Standard Curriculum or the United States Department of
  501  Transportation’s National EMS Education Standards and approved
  502  by, pursuant to rules of the department rule.
  503         (2) “Advanced life support service” means any emergency
  504  medical services provider that offers or provides transport or
  505  nontransport service which uses advanced life support
  506  techniques.
  507         (3) “Air ambulance” means any fixed-wing or rotary-wing
  508  aircraft used for, or intended to be used by an emergency
  509  medical services provider to provide, advanced life support
  510  services and transportation of individuals receiving such
  511  services for, air transportation of sick or injured persons
  512  requiring or likely to require medical attention during
  513  transport.
  514         (4) “Air ambulance service” means any emergency medical
  515  services provider that offers or provides advanced life support
  516  from or onboard an air ambulance publicly or privately owned
  517  service, licensed in accordance with the provisions of this
  518  part, which operates air ambulances to transport persons
  519  requiring or likely to require medical attention during
  520  transport.
  521         (5) “Ambulance” or “emergency medical services vehicle”
  522  means any privately or publicly owned land or water vehicle or
  523  air ambulance that is designed, constructed, reconstructed,
  524  maintained, equipped, or operated for, and is used by for, or
  525  intended to be used by an emergency medical services provider to
  526  provide basic or advanced life support services for, land or
  527  water transportation of sick or injured persons requiring or
  528  likely to require medical attention during transport.
  529         (6) “Ambulance driver” means any person who meets the
  530  requirements of s. 401.281.
  531         (7) “Basic life support” means the assessment or treatment
  532  by a person certified qualified under this part to perform
  533  through the use of techniques described in the United States
  534  Department of Transportation’s EMT-Basic National Standard
  535  Curriculum or the National EMS Education Standards of the United
  536  States Department of Transportation and approved by the
  537  department rule. The term includes the administration of oxygen
  538  and other techniques that have been approved and are performed
  539  under conditions specified by rules of the department.
  540         (8) “Basic life support service” means any emergency
  541  medical services provider that offers or provides service which
  542  uses only basic life support techniques.
  543         (9) “Certification” means any authorization issued under
  544  pursuant to this part to a person to provide basic life support
  545  act as an emergency medical technician or to provide basic and
  546  advanced life support as a paramedic.
  547         (10) “Department” means the Department of Health.
  548         (11) “Emergency medical technician” means a person who is
  549  certified by the department under this part to provide perform
  550  basic life support under medical direction in any of the
  551  following settings: pursuant to this part
  552         (a)Local communities.
  553         (b)Hospitals as defined in s. 395.002.
  554         (c)Urgent care centers as defined in s. 395.002.
  555         (d)Any other location specified by department rule.
  556         (12) “Interfacility transfer” means the transportation by
  557  ambulance of a patient between two facilities licensed under
  558  chapter 393, chapter 395, chapter 400, or chapter 429 or other
  559  facilities as specified by department rule, pursuant to this
  560  part.
  561         (13) “Licensee” means any basic life support service,
  562  advanced life support service, or air ambulance service licensed
  563  under pursuant to this part.
  564         (14) “Medical direction” means oral instruction direct
  565  supervision by a physician in person or through two-way voice
  566  communication or, when such voice communication is unavailable,
  567  through established standing orders, pursuant to rules of the
  568  department.
  569         (15) “Medical director” means a physician who is employed
  570  or contracted by a licensee and who provides medical direction
  571  supervision, including appropriate quality assurance but not
  572  including administrative and managerial functions, for daily
  573  operations and training under pursuant to this part.
  574         (16) “Mutual aid agreement” means a written agreement
  575  between two or more entities whereby the signing parties agree
  576  to lend aid to one another under conditions specified in the
  577  agreement and as authorized sanctioned by the governing body of
  578  each affected county.
  579         (17) “Paramedic” means a person who is certified by the
  580  department under this part to provide perform basic and advanced
  581  life support under medical direction in any of the following
  582  settings:
  583         (a)Local communities.
  584         (b)Hospitals as defined in s. 395.002.
  585         (c)Urgent care centers as defined in s. 395.002.
  586         (d)Any other location specified by department rule
  587  pursuant to this part.
  588         (18) “Permit” means any authorization issued under pursuant
  589  to this part for a vehicle to be operated as a basic life
  590  support or advanced life support transport vehicle or an
  591  advanced life support nontransport vehicle providing basic or
  592  advanced life support.
  593         (19) “Physician” means a person practitioner who is
  594  licensed to practice medicine under the provisions of chapter
  595  458 or osteopathic medicine under chapter 459. For the purpose
  596  of providing “medical direction” as defined in subsection (14)
  597  for the treatment of patients immediately before prior to or
  598  during transportation to a United States Department of Veterans
  599  Affairs medical facility, “physician” also means a person
  600  appointed to a physician position practitioner employed by the
  601  Secretary of the United States Department of Veterans Affairs.
  602         (20) “Registered nurse” means a person practitioner who is
  603  licensed to practice professional nursing under pursuant to part
  604  I of chapter 464.
  605         (21) “Service location” means any permanent location in or
  606  from which a licensee solicits, accepts, or conducts business
  607  under this part.
  608         (22) “Volunteer ambulance service” means a faith-based,
  609  not-for-profit charitable corporation registered under chapter
  610  617 which is licensed under this part as a basic life support
  611  service or an advanced life support service; which is not a
  612  parent, subsidiary, or affiliate of, or related to, any for
  613  profit entity; and which uses only unpaid volunteers to provide
  614  basic life support services or advanced life support services
  615  free of charge, is not operating for pecuniary profit or
  616  financial gain, and does not distribute to or inure to the
  617  benefit of its directors, volunteers, members, or officers any
  618  part of its assets or income.
  619         Section 5. Paragraph (d) of subsection (2) of section
  620  401.25, Florida Statutes, is amended to read:
  621         401.25 Licensure as a basic life support or an advanced
  622  life support service.—
  623         (2) The department shall issue a license for operation to
  624  any applicant who complies with the following requirements:
  625         (d) The applicant has obtained a certificate of public
  626  convenience and necessity from each county in which the
  627  applicant will operate. In issuing the certificate of public
  628  convenience and necessity, the governing body of each county
  629  shall consider the recommendations of municipalities within its
  630  jurisdiction. An applicant that is an active emergency medical
  631  first responder agency is exempt from this requirement if it:
  632         1. Is a faith-based, not-for-profit charitable corporation
  633  registered under chapter 617 which has been responding to
  634  medical emergencies in this state for at least 10 consecutive
  635  years.
  636         2. Is not a parent, subsidiary, or affiliate of, or related
  637  to, any for-profit entity.
  638         3. Provides basic life support services or advanced life
  639  support services solely through at least 50 unpaid licensed
  640  emergency medical technician or paramedic volunteers.
  641         4. Is not operating for pecuniary profit or financial gain.
  642         5. Does not distribute to or inure to the benefit of its
  643  directors, members, or officers any part of its assets or
  644  income.
  645         6. Does not receive any government funding. However, the
  646  volunteer ambulance service may receive funding from specialty
  647  license plate proceeds.
  648         7. Has never had a license denied, revoked, or suspended.
  649         8. Provides services free of charge.
  650         9. As part of its application for licensure, provides to
  651  the department a management plan that includes a training
  652  program, dispatch protocols, a complaint management system, an
  653  accident or injury handling system, a quality assurance program,
  654  and proof of adequate insurance coverage to meet state or county
  655  insurance requirements, whichever requirements are greater.
  656         10. Provides a disclaimer on all written materials that the
  657  volunteer ambulance service is not associated with the state’s
  658  911 system.
  659  
  660  The exemption under this paragraph may be granted to no more
  661  than four counties. This exemption notwithstanding, an applicant
  662  is not exempted from and must comply with all other requirements
  663  for licensure. An applicant must also take all reasonable
  664  efforts to enter into a memorandum of understanding with the
  665  emergency medical services licensee within whose jurisdiction
  666  the applicant will provide services in order to facilitate
  667  communications and coordinate emergency services for situations
  668  beyond the scope of the applicant’s capacity and for situations
  669  of advanced life support that are deemed priority 1 or priority
  670  2 emergencies.
  671         Section 6. Subsections (3), (4), and (5) of section 401.27,
  672  Florida Statutes, are amended to read:
  673         401.27 Personnel; standards and certification.—
  674         (3) Any person who desires to be certified or recertified
  675  as an emergency medical technician or paramedic must apply to
  676  the department under oath on forms provided by the department
  677  which shall contain such information as the department
  678  reasonably requires, which may include affirmative evidence of
  679  ability to comply with applicable laws and rules. The department
  680  shall determine whether the applicant meets the requirements
  681  specified in this section and in rules of the department and
  682  shall issue a certificate to any person who meets such
  683  requirements.
  684         (4) An applicant for certification or recertification as an
  685  emergency medical technician or paramedic must:
  686         (a) Have completed an appropriate training program as
  687  follows:
  688         1. For an emergency medical technician, an emergency
  689  medical technician training program approved by the department
  690  as equivalent to the most recent EMT-Basic National Standard
  691  Curriculum or the National EMS Education Standards of the United
  692  States Department of Transportation;
  693         2. For a paramedic, a paramedic training program approved
  694  by the department as equivalent to the most recent EMT-Paramedic
  695  National Standard Curriculum or the National EMS Education
  696  Standards of the United States Department of Transportation;
  697         (b) Confirm Certify under oath that he or she is not
  698  addicted to alcohol or any controlled substance;
  699         (c) Confirm Certify under oath that he or she is free from
  700  any physical or mental defect or disease that might impair the
  701  applicant’s ability to perform his or her duties;
  702         (d) Within 2 years after program completion have passed an
  703  examination developed or required by the department;
  704         (e)1. For an emergency medical technician, hold a current
  705  American Heart Association cardiopulmonary resuscitation course
  706  card or an American Red Cross cardiopulmonary resuscitation
  707  course card or its equivalent as defined by department rule;
  708         2. For a paramedic, hold a certificate of successful course
  709  completion in advanced cardiac life support from the American
  710  Heart Association or its equivalent as defined by department
  711  rule;
  712         (f) Submit to the department the application the
  713  certification fee and the nonrefundable examination fee
  714  prescribed in s. 401.34, and submit to the examination provider
  715  the nonrefundable which examination fee will be required for
  716  each examination administered to an applicant; and
  717         (g) Submit a completed application to the department, which
  718  application documents compliance with paragraphs (a), (b), (c),
  719  (e), (f), and this paragraph, and, if applicable, paragraph (d).
  720  The application must be submitted so as to be received by the
  721  department at least 30 calendar days before the next regularly
  722  scheduled examination for which the applicant desires to be
  723  scheduled.
  724         (5) The certification examination must be offered monthly.
  725  The department shall issue an examination admission notice to
  726  the applicant advising him or her of the time and place of the
  727  examination for which he or she is scheduled. Individuals
  728  achieving a passing score on the certification examination may
  729  be issued a temporary certificate with their examination grade
  730  report. The department must issue an original certification
  731  within 45 days after the examination. Examination questions and
  732  answers are not subject to discovery but may be introduced into
  733  evidence and considered only in camera in any administrative
  734  proceeding under chapter 120. If an administrative hearing is
  735  held, the department shall provide challenged examination
  736  questions and answers to the administrative law judge. The
  737  department shall establish by rule the procedure by which an
  738  applicant, and the applicant’s attorney, may review examination
  739  questions and answers in accordance with s. 119.071(1)(a).
  740         Section 7. Section 401.2701, Florida Statutes, is amended
  741  to read:
  742         401.2701 Emergency medical services training programs.—
  743         (1) Any private or public institution in Florida desiring
  744  to conduct an approved program for the education of emergency
  745  medical technicians and paramedics must shall:
  746         (a) Submit a completed application on a form adopted
  747  provided by the department rule, which must include:
  748         1. Evidence that the institution is in compliance with all
  749  applicable requirements of the Department of Education.
  750         2. Evidence of an affiliation agreement with a hospital
  751  that has an emergency department staffed by at least one
  752  physician and one registered nurse.
  753         3. Evidence of an affiliation agreement with a current
  754  emergency medical services provider that is licensed in this
  755  state. Such agreement shall include, at a minimum, a commitment
  756  by the provider to conduct the field experience portion of the
  757  education program. Evidence of an affiliation agreement is not
  758  required if the applicant is licensed by the department as an
  759  advanced life support service.
  760         4. Documentation verifying faculty, including:
  761         a. A medical director who is a licensed physician meeting
  762  the applicable requirements for emergency medical services
  763  medical directors as outlined in this chapter and rules of the
  764  department. The medical director shall have the duty and
  765  responsibility of certifying that graduates have successfully
  766  completed all phases of the education program and are proficient
  767  in basic or advanced life support techniques, as applicable.
  768         b. A program director responsible for the operation,
  769  organization, periodic review, administration, development, and
  770  approval of the program.
  771         5. Documentation verifying that the curriculum:
  772         a. Meets the most recent Emergency Medical Technician-Basic
  773  National Standard Curriculum or the National EMS Education
  774  Standards approved by the department for emergency medical
  775  technician programs and Emergency Medical Technician-Paramedic
  776  National Standard Curriculum or the National EMS Education
  777  Standards approved by the department for paramedic programs.
  778         b. Includes 2 hours of instruction on the trauma scorecard
  779  methodologies for assessment of adult trauma patients and
  780  pediatric trauma patients as specified by the department by
  781  rule.
  782         6. Evidence of sufficient medical and educational equipment
  783  to meet emergency medical services training program needs.
  784         (b) Receive a scheduled in-person or department-approved
  785  remote audio-visual site visit from the department to the
  786  applicant’s institution. Such site visit shall be conducted
  787  within 30 days after the department’s notification to the
  788  institution that the application was accepted for onsite review.
  789  During the site visit, the department must determine the
  790  applicant’s compliance with the following criteria:
  791         1. Emergency medical technician programs must be a minimum
  792  of 300 110 hours, with at least 20 hours of supervised clinical
  793  supervision, including 10 hours in a hospital emergency
  794  department.
  795         2. Paramedic programs must be available only to Florida
  796  certified emergency medical technicians or an emergency medical
  797  technicians, active duty and reserve military-trained emergency
  798  medical technicians, and emergency medical technician applicants
  799  applicant who will obtain Florida certification before prior to
  800  completion of phase one of the paramedic program. Paramedic
  801  programs must be a minimum of 1,100 700 hours of didactic and
  802  skills practice components, with the skills laboratory student
  803  to-instructor ratio not exceeding six to one. Paramedic programs
  804  must provide a field internship experience aboard an advanced
  805  life support permitted ambulance. However, a portion of the
  806  field internship experience may be satisfied aboard an advanced
  807  life support permitted vehicle other than an ambulance or by
  808  supervised, remote live videoconferencing together with
  809  simulated direct patient contact in a simulated advanced life
  810  support ambulance as provided determined by rule of the
  811  department rule.
  812         (2) A program may request department approval to substitute
  813  simulation and remote, live videoconferencing for supervised in
  814  person clinical instruction and direct patient-contact skills
  815  laboratory requirements. Requests must be made in writing and
  816  include the following:
  817         (a)The written approval of the training program medical
  818  director.
  819         (b)Documentation that all hospitals or emergency medical
  820  services providers with whom the program has an existing
  821  affiliation agreement have suspended in-person access for
  822  purposes of supervised clinical instruction and direct patient
  823  contact field internships.
  824         (c)The time period during which in-person access has been
  825  suspended.
  826         (d)Documentation of the design, development, and
  827  implementation of simulation and videoconferencing training.
  828         (e)Documentation of the inclusion of simulation and
  829  videoconferencing within the curriculum, the efficacy of
  830  simulation and videoconferencing, and student evaluations of
  831  simulation, debriefing, and videoconferencing.
  832         (3) After completion of the site visit, the department
  833  shall prepare a report that must which shall be provided to the
  834  institution. Upon completion of the report, an the application
  835  from a program that meets the criteria in paragraph (1)(b) is
  836  shall be deemed complete, and the provisions of s. 120.60
  837  applies. An application from a program that does not meet the
  838  criteria in paragraph (1)(b) is deemed incomplete, and
  839  subsection (5) applies shall apply.
  840         (4)(3) If the program is approved, the department must
  841  issue the institution a 2-year certificate of approval as an
  842  emergency medical technician training program or a paramedic
  843  training program. The department shall renew the certificate of
  844  approval upon receipt of a written statement from the program
  845  attesting that the training program continues to meet the
  846  requirements of the Department of Education and remains
  847  accredited by a national organization recognized by the
  848  department. The department shall perform a site visit for all
  849  initial nonaccredited programs. The department may periodically
  850  and randomly perform in-person and remote telecommunication
  851  inspection site visits to ensure compliance with this part and
  852  department rules.
  853         (5) If an the application is deemed incomplete denied, the
  854  department must notify the applicant of any errors, omissions,
  855  and areas of strength, areas needing improvement, and any
  856  suggested means of improving improvement of the program. The
  857  applicant must respond within 5 days after receiving the
  858  department’s notice either with a notice of intent to provide a
  859  plan of correction or a request for the department to proceed
  860  with a final determination on the application without a plan of
  861  correction. A denial notification shall be provided to the
  862  applicant so as to allow the applicant 5 days prior to the
  863  expiration of the application processing time in s. 120.60 to
  864  advise the department in writing of its intent to submit a plan
  865  of correction. Such intent notification shall provide the time
  866  for application processing in s. 120.60. The plan of correction
  867  must be received by submitted to the department within 30 days
  868  after the date of the applicant’s notice of intent and must
  869  specify the date by which the applicant intends to complete the
  870  application of the notice. The department shall notify advise
  871  the applicant of its approval or denial of the plan of
  872  correction within 30 days after of receipt. The denial of the
  873  plan of correction or denial of the application may be reviewed
  874  as provided in chapter 120.
  875         (6)(4) Approved emergency medical services training
  876  programs must maintain records and reports that must be made
  877  available to the department, upon written request. Such records
  878  must include student applications, records of attendance,
  879  records of participation in hospital clinic and field training,
  880  medical records, course objectives and outlines, class
  881  schedules, learning objectives, lesson plans, number of
  882  applicants, number of students accepted, admission requirements,
  883  description of qualifications, duties and responsibilities of
  884  faculty, and correspondence.
  885         (7)(5) Each approved program must notify the department
  886  within 30 days after any change in the professional or
  887  employment status of faculty. Each approved program must require
  888  its students to pass a comprehensive final written and practical
  889  examination evaluating the skills described in the current
  890  United States Department of Transportation EMT-Basic or EMT
  891  Paramedic National Standard Curriculum or the National EMS
  892  Education Standards and approved by the department. Each
  893  approved program must issue a certificate of completion to
  894  program graduates within 14 days after completion.
  895         Section 8. Section 401.272, Florida Statutes, is amended to
  896  read:
  897         401.272 Emergency medical services community health care.—
  898         (1) The purpose of this section is to encourage more
  899  effective use utilization of the skills of emergency medical
  900  technicians and paramedics by enabling them to perform, in
  901  partnership with local county health departments, specific
  902  additional health care tasks that are consistent with the public
  903  health and welfare.
  904         (2) Notwithstanding any other provision of law to the
  905  contrary:
  906         (a) Paramedics or emergency medical technicians may perform
  907  health promotion and wellness activities and blood pressure
  908  screenings in a nonemergency environment, within the scope of
  909  their training, and under medical direction the direction of a
  910  medical director. As used in this paragraph, the term “health
  911  promotion and wellness” means the provision of public health
  912  programs pertaining to the prevention of illness and injury.
  913         (b) Paramedics may administer immunizations and other
  914  public health countermeasures in a nonemergency environment,
  915  within the scope of their training, and under medical the
  916  direction of a medical director. There must be a written
  917  agreement between the paramedic’s medical director and the
  918  department or the county health department located in each
  919  county in which the paramedic administers immunizations or other
  920  public health countermeasures. This agreement must establish the
  921  protocols, policies, and procedures under which the paramedic
  922  must operate.
  923         (3) Each medical director under whose direction a paramedic
  924  administers immunizations or other public health countermeasures
  925  must verify and document that the paramedic has received
  926  sufficient training and experience to administer the
  927  immunizations or other public health countermeasures, as
  928  applicable. The verification must be documented on forms
  929  developed by the department, and the completed forms must be
  930  maintained at the service location of the licensee and made
  931  available to the department upon request.
  932         (4) The department may adopt and enforce all rules
  933  necessary to enforce the provisions relating to a paramedic’s
  934  administration of immunizations and other public health
  935  countermeasures and the performance of health promotion and
  936  wellness activities and blood pressure screenings by a paramedic
  937  or emergency medical technician in a nonemergency environment.
  938         Section 9. Subsections (1), (2), and (4) of section 401.30,
  939  Florida Statutes, are amended to read:
  940         401.30 Records.—
  941         (1) Each licensee must maintain accurate records of
  942  emergency calls on written or electronic forms that contain such
  943  information as is required by the department. The written or
  944  electronic These records must be available for inspection by the
  945  department at any reasonable time, and paper or electronic
  946  copies thereof must be furnished to the department upon request.
  947  The department shall prescribe by rule the give each licensee
  948  notice of what information such forms must contain.
  949         (2) Each licensee must provide the receiving facility
  950  hospital with a copy of an individual patient care record for
  951  each patient who is transported to the receiving facility
  952  hospital. The information contained in the patient care record
  953  and the method and timeframe for providing the record shall be
  954  prescribed by department rule of the department.
  955         (4) Records of emergency calls which contain patient
  956  examination or treatment information are confidential and exempt
  957  from the provisions of s. 119.07(1) and may not be disclosed
  958  without the consent of the person to whom they pertain, but
  959  appropriate limited disclosure may be made without such consent:
  960         (a) To the person’s guardian as defined in s. 744.102, to
  961  the person’s designated surrogate as defined in s. 765.101, to
  962  the person’s personal representative or trustee as those terms
  963  are defined in s. 731.201 to the next of kin if the person is
  964  deceased, or to a minor’s principal as defined in s. 765.101
  965  parent if the person is a minor;
  966         (b) To facility hospital personnel for use in conjunction
  967  with the treatment of the patient;
  968         (c) To the department;
  969         (d) To the emergency medical services provider service
  970  medical director;
  971         (e) For use in a critical incident stress debriefing. Any
  972  such discussions during a critical incident stress debriefing
  973  shall be considered privileged communication under s. 90.503;
  974         (f) In any civil or criminal action, unless otherwise
  975  prohibited by law, upon the issuance of a subpoena from a court
  976  of competent jurisdiction and proper notice by the party seeking
  977  such records, to the patient or his or her legal representative;
  978  or
  979         (g) To a local trauma agency or a regional trauma agency,
  980  or a panel or committee assembled by such an agency to assist
  981  the agency in performing quality assurance activities in
  982  accordance with a plan approved under s. 395.401. Records
  983  obtained under this paragraph are confidential and exempt from
  984  s. 119.07(1) and s. 24(a), Art. I of the State Constitution.
  985  
  986  Notwithstanding any other law to the contrary, the release of
  987  patient care records or data from patient care records must be
  988  in accordance with s. 401.425 and chapter 405. This subsection
  989  does not prohibit the department or a licensee from providing
  990  information to any law enforcement agency or any other
  991  regulatory agency responsible for the regulation or supervision
  992  of emergency medical services and personnel.
  993         Section 10. Subsections (4) through (7) of section 401.34,
  994  Florida Statutes, are amended to read:
  995         401.34 Fees.—
  996         (4)(a) If a certificate, license, or permit issued under
  997  this part is lost or destroyed, the person or entity to whom the
  998  certificate, license, or permit was issued may, upon payment of
  999  a fee to be set by the department not to exceed $10, obtain a
 1000  duplicate, or substitute thereof.
 1001         (b) Upon surrender of the original emergency medical
 1002  technician or paramedic certificate and receipt of a replacement
 1003  fee to be set by the department not to exceed $10, the
 1004  department shall issue a replacement certificate to make a
 1005  change in name.
 1006         (5) The department may provide same-day grading of the
 1007  examination for an applicant for emergency medical technician or
 1008  paramedic certification.
 1009         (6) The department may offer walk-in eligibility
 1010  determination and examination to applicants for emergency
 1011  medical technician or paramedic certification who pay to the
 1012  department a nonrefundable fee to be set by the department not
 1013  to exceed $65. The fee is in addition to the certification fee
 1014  and examination fee. The department must establish locations and
 1015  times for eligibility determination and examination.
 1016         (7) The cost of emergency medical technician or paramedic
 1017  certification examination review may not exceed $50.
 1018         Section 11. Subsection (5) of section 401.425, Florida
 1019  Statutes, is amended, and subsection (8) is added to that
 1020  section, to read:
 1021         401.425 Emergency medical services quality assurance;
 1022  immunity from liability.—
 1023         (5) The records or reports obtained or produced by a
 1024  committee providing quality assurance or quality improvement
 1025  activities as described in subsections (1)-(4) are exempt from
 1026  the provisions of s. 119.07(1) and s. 24(a), Art. I of the State
 1027  Constitution, and committee proceedings and meetings regarding
 1028  quality assurance or quality improvement activities are exempt
 1029  from the provisions of s. 286.011 and s. 24(b), Art. I of the
 1030  State Constitution. The investigations, proceedings, and records
 1031  of a committee providing quality assurance activities as
 1032  described in subsections (1)-(4) are shall not be subject to
 1033  discovery or introduction into evidence in any civil action or
 1034  disciplinary proceeding by the department or employing agency
 1035  arising out of matters that which are the subject of evaluation
 1036  and review by the committee, and a no person who was in
 1037  attendance at a meeting of such committee may not shall be
 1038  permitted or required to testify in any such civil action or
 1039  disciplinary proceeding as to any evidence or other matters
 1040  produced or presented during the proceedings of such committee
 1041  or as to any findings, recommendations, evaluations, opinions,
 1042  or other actions of such committee or any members thereof.
 1043  However, information, documents, or records provided to the
 1044  committee from sources external to the committee are not immune
 1045  from discovery or use in any such civil action or disciplinary
 1046  proceeding merely because they were presented during proceedings
 1047  of such committee, nor may should any person who testifies
 1048  before a committee or who is a member of such committee be
 1049  prevented from testifying as to matters within the person’s
 1050  knowledge, but, such witness may shall not be asked about his or
 1051  her testimony before a committee or information obtained from or
 1052  opinions formed by him or her as a result of participating in
 1053  activities conducted by a committee.
 1054         (8) An emergency medical review committee may review the
 1055  performance of an emergency medical technician, a paramedic, or
 1056  an emergency medical services provider and make recommendations
 1057  for performance improvement.
 1058         Section 12. Section 401.435, Florida Statutes, is amended
 1059  to read:
 1060         401.435 Emergency medical First responder agencies and
 1061  training.—
 1062         (1) The department must adopt by rule the United States
 1063  Department of Transportation National EMS Education Standards
 1064  for the Emergency Medical Responder level Services: First
 1065  Responder Training Course as the minimum standard for emergency
 1066  medical first responder training. In addition, the department
 1067  must adopt rules establishing minimum emergency medical first
 1068  responder instructor qualifications. For purposes of this
 1069  section, an emergency medical a first responder includes any
 1070  individual who receives training to render initial care to an
 1071  ill or injured person, other than an individual trained and
 1072  certified pursuant to s. 943.1395(1), but who does not have the
 1073  primary responsibility of treating and transporting ill or
 1074  injured persons.
 1075         (2) Each emergency medical first responder agency must take
 1076  all reasonable efforts to enter into a memorandum of
 1077  understanding with the emergency medical services licensee
 1078  within whose territory the agency operates in order to
 1079  coordinate emergency services at an emergency scene. The
 1080  department must provide a model memorandum of understanding for
 1081  this purpose. The memorandum of understanding must should
 1082  include dispatch protocols, the roles and responsibilities of
 1083  emergency medical first responder personnel at an emergency
 1084  scene, and the documentation required for patient care rendered.
 1085  For purposes of this section, the term “emergency medical first
 1086  responder agency” includes a law enforcement agency, a fire
 1087  service agency not licensed under this part, a lifeguard agency,
 1088  and a volunteer organization that renders, as part of its
 1089  routine functions, on-scene patient care before emergency
 1090  medical technicians or paramedics arrive.
 1091         Section 13. Subsection (1) of section 460.406, Florida
 1092  Statutes, is amended to read:
 1093         460.406 Licensure by examination.—
 1094         (1) Any person desiring to be licensed as a chiropractic
 1095  physician must apply to the department to take the licensure
 1096  examination. There shall be an application fee set by the board
 1097  not to exceed $100 which shall be nonrefundable. There shall
 1098  also be an examination fee not to exceed $500 plus the actual
 1099  per applicant cost to the department for purchase of portions of
 1100  the examination from the National Board of Chiropractic
 1101  Examiners or a similar national organization, which may be
 1102  refundable if the applicant is found ineligible to take the
 1103  examination. The department shall examine each applicant whom
 1104  who the board certifies has met all of the following criteria:
 1105         (a) Completed the application form and remitted the
 1106  appropriate fee.
 1107         (b) Submitted proof satisfactory to the department that he
 1108  or she is not less than 18 years of age.
 1109         (c) Submitted proof satisfactory to the department that he
 1110  or she is a graduate of a chiropractic college which is
 1111  accredited by or has status with the Council on Chiropractic
 1112  Education or its predecessor agency. However, any applicant who
 1113  is a graduate of a chiropractic college that was initially
 1114  accredited by the Council on Chiropractic Education in 1995, who
 1115  graduated from such college within the 4 years immediately
 1116  preceding such accreditation, and who is otherwise qualified is
 1117  shall be eligible to take the examination. An No application for
 1118  a license to practice chiropractic medicine may not shall be
 1119  denied solely because the applicant is a graduate of a
 1120  chiropractic college that subscribes to one philosophy of
 1121  chiropractic medicine as distinguished from another.
 1122         (d)1. For an applicant who has matriculated in a
 1123  chiropractic college before prior to July 2, 1990, completed at
 1124  least 2 years of residence college work, consisting of a minimum
 1125  of one-half the work acceptable for a bachelor’s degree granted
 1126  on the basis of a 4-year period of study, in a college or
 1127  university accredited by an institutional accrediting agency
 1128  recognized and approved by the United States Department of
 1129  Education. However, before prior to being certified by the board
 1130  to sit for the examination, each applicant who has matriculated
 1131  in a chiropractic college after July 1, 1990, must shall have
 1132  been granted a bachelor’s degree, based upon 4 academic years of
 1133  study, by a college or university accredited by an institutional
 1134  a regional accrediting agency that which is a member of the
 1135  Commission on Recognition of Postsecondary Accreditation.
 1136         2. Effective July 1, 2000, completed, before prior to
 1137  matriculation in a chiropractic college, at least 3 years of
 1138  residence college work, consisting of a minimum of 90 semester
 1139  hours leading to a bachelor’s degree in a liberal arts college
 1140  or university accredited by an institutional accrediting agency
 1141  recognized and approved by the United States Department of
 1142  Education. However, before prior to being certified by the board
 1143  to sit for the examination, each applicant who has matriculated
 1144  in a chiropractic college after July 1, 2000, must shall have
 1145  been granted a bachelor’s degree from an institution holding
 1146  accreditation for that degree from an institutional a regional
 1147  accrediting agency that which is recognized by the United States
 1148  Department of Education. The applicant’s chiropractic degree
 1149  must consist of credits earned in the chiropractic program and
 1150  may not include academic credit for courses from the bachelor’s
 1151  degree.
 1152         (e) Successfully completed the National Board of
 1153  Chiropractic Examiners certification examination in parts I, II,
 1154  III, and IV, and the physiotherapy examination of the National
 1155  Board of Chiropractic Examiners, with a score approved by the
 1156  board.
 1157         (f) Submitted to the department a set of fingerprints on a
 1158  form and under procedures specified by the department, along
 1159  with payment in an amount equal to the costs incurred by the
 1160  Department of Health for the criminal background check of the
 1161  applicant.
 1162  
 1163  The board may require an applicant who graduated from an
 1164  institution accredited by the Council on Chiropractic Education
 1165  more than 10 years before the date of application to the board
 1166  to take the National Board of Chiropractic Examiners Special
 1167  Purposes Examination for Chiropractic, or its equivalent, as
 1168  determined by the board. The board shall establish by rule a
 1169  passing score.
 1170         Section 14. Subsection (4) of section 464.008, Florida
 1171  Statutes, is amended to read:
 1172         464.008 Licensure by examination.—
 1173         (4) If an applicant who graduates from an approved program
 1174  does not take the licensure examination within 6 months after
 1175  graduation, he or she must enroll in and successfully complete a
 1176  board-approved licensure examination preparatory course. The
 1177  applicant is responsible for all costs associated with the
 1178  course and may not use state or federal financial aid for such
 1179  costs. The board shall by rule establish guidelines for
 1180  licensure examination preparatory courses.
 1181         Section 15. Paragraph (e) of subsection (1) of section
 1182  464.018, Florida Statutes, is amended to read:
 1183         464.018 Disciplinary actions.—
 1184         (1) The following acts constitute grounds for denial of a
 1185  license or disciplinary action, as specified in ss. 456.072(2)
 1186  and 464.0095:
 1187         (e) Having been found guilty of, regardless of
 1188  adjudication, or entered a plea of nolo contendere or guilty to,
 1189  regardless of adjudication, any offense prohibited under s.
 1190  435.04 or similar statute of another jurisdiction; or having
 1191  committed an act which constitutes domestic violence as defined
 1192  in s. 741.28.
 1193         Section 16. Present subsections (13) and (14) of section
 1194  467.003, Florida Statutes, are redesignated as subsections (14)
 1195  and (15), respectively, a new subsection (13) is added to that
 1196  section, and subsections (1) and (12) of that section are
 1197  amended, to read:
 1198         467.003 Definitions.—As used in this chapter, unless the
 1199  context otherwise requires:
 1200         (1) “Approved midwifery program” means a midwifery school
 1201  or a midwifery training program which is approved by the
 1202  department pursuant to s. 467.205.
 1203         (12) “Preceptor” means a physician licensed under chapter
 1204  458 or chapter 459, a licensed midwife licensed under this
 1205  chapter, or a certified nurse midwife licensed under chapter
 1206  464, who has a minimum of 3 years’ professional experience, and
 1207  who directs, teaches, supervises, and evaluates the learning
 1208  experiences of a the student midwife as part of an approved
 1209  midwifery program.
 1210         (13)“Prelicensure course” means a course of study, offered
 1211  by an approved midwifery program and approved by the department,
 1212  which an applicant for licensure must complete before a license
 1213  may be issued and which provides instruction in the laws and
 1214  rules of this state and demonstrates the student’s competency to
 1215  practice midwifery under this chapter.
 1216         Section 17. Section 467.009, Florida Statutes, is amended
 1217  to read:
 1218         467.009 Approved midwifery programs; education and training
 1219  requirements.—
 1220         (1) The department shall adopt standards for approved
 1221  midwifery programs which must include, but need not be limited
 1222  to, standards for all of the following:
 1223         (a). The standards shall encompass Clinical and classroom
 1224  instruction in all aspects of prenatal, intrapartal, and
 1225  postpartal care, including all of the following:
 1226         1. Obstetrics.;
 1227         2. Neonatal pediatrics.;
 1228         3. Basic sciences.;
 1229         4. Female reproductive anatomy and physiology.;
 1230         5. Behavioral sciences.;
 1231         6. Childbirth education.;
 1232         7. Community care.;
 1233         8. Epidemiology.;
 1234         9. Genetics.;
 1235         10. Embryology.;
 1236         11. Neonatology.;
 1237         12. Applied pharmacology.;
 1238         13. The medical and legal aspects of midwifery.;
 1239         14. Gynecology and women’s health.;
 1240         15. Family planning.;
 1241         16. Nutrition during pregnancy and lactation.;
 1242         17. Breastfeeding.; and
 1243         18. Basic nursing skills; and any other instruction
 1244  determined by the department and council to be necessary.
 1245         (b)The standards shall incorporate the Core competencies,
 1246  incorporating those established by the American College of Nurse
 1247  Midwives and the Midwives Alliance of North America, including
 1248  knowledge, skills, and professional behavior in all of the
 1249  following areas:
 1250         1. Primary management, collaborative management, referral,
 1251  and medical consultation.;
 1252         2. Antepartal, intrapartal, postpartal, and neonatal care.;
 1253         3. Family planning and gynecological care.;
 1254         4. Common complications.; and
 1255         5. Professional responsibilities.
 1256         (c)Noncurricular The standards shall include noncurriculum
 1257  matters under this section, including, but not limited to,
 1258  staffing and teacher qualifications.
 1259         (2) An approved midwifery program must offer shall include
 1260  a course of study and clinical training for a minimum of 3 years
 1261  which incorporates all of the standards, curriculum guidelines,
 1262  and educational objectives provided in this section and the
 1263  rules adopted hereunder.
 1264         (3)An approved midwifery program may reduce If the
 1265  applicant is a registered nurse or a licensed practical nurse or
 1266  has previous nursing or midwifery education, the required period
 1267  of training may be reduced to the extent of the student’s
 1268  applicant’s qualifications as a registered nurse or licensed
 1269  practical nurse or based on prior completion of equivalent
 1270  nursing or midwifery education, as determined under rules
 1271  adopted by the department rule. In no case shall the training be
 1272  reduced to a period of less than 2 years.
 1273         (4)(3)An approved midwifery program may accept students
 1274  who To be accepted into an approved midwifery program, an
 1275  applicant shall have both:
 1276         (a) A high school diploma or its equivalent.
 1277         (b) Taken three college-level credits each of math and
 1278  English or demonstrated competencies in communication and
 1279  computation.
 1280         (5)(4)As part of its course of study, an approved
 1281  midwifery program must require clinical training that includes
 1282  all of the following:
 1283         (a)A student midwife, during training, shall undertake,
 1284  under the supervision of a preceptor, The care of 50 women in
 1285  each of the prenatal, intrapartal, and postpartal periods under
 1286  the supervision of a preceptor., but The same women need not be
 1287  seen through all three periods.
 1288         (b)(5)Observation of The student midwife shall observe an
 1289  additional 25 women in the intrapartal period before qualifying
 1290  for a license.
 1291         (6) Clinical The training required under this section must
 1292  include all of the following:
 1293         (a)shall include Training in either hospitals or
 1294  alternative birth settings, or both.
 1295         (b)A requirement that students demonstrate competency in
 1296  the assessment of and differentiation, with particular emphasis
 1297  on learning the ability to differentiate between low-risk
 1298  pregnancies and high-risk pregnancies.
 1299         (7) A hospital or birthing center receiving public funds
 1300  shall be required to provide student midwives access to observe
 1301  labor, delivery, and postpartal procedures, provided the woman
 1302  in labor has given informed consent. The Department of Health
 1303  shall assist in facilitating access to hospital training for
 1304  approved midwifery programs.
 1305         (8)(7) The Department of Education shall adopt curricular
 1306  frameworks for midwifery programs offered by conducted within
 1307  public educational institutions under pursuant to this section.
 1308         (8) Nonpublic educational institutions that conduct
 1309  approved midwifery programs shall be accredited by a member of
 1310  the Commission on Recognition of Postsecondary Accreditation and
 1311  shall be licensed by the Commission for Independent Education.
 1312         Section 18. Section 467.011, Florida Statutes, is amended
 1313  to read:
 1314         467.011 Licensed midwives; qualifications; examination
 1315  Licensure by examination.—
 1316         (1) The department shall administer an examination to test
 1317  the proficiency of applicants in the core competencies required
 1318  to practice midwifery as specified in s. 467.009.
 1319         (2) The department shall develop, publish, and make
 1320  available to interested parties at a reasonable cost a
 1321  bibliography and guide for the examination.
 1322         (3) The department shall issue a license to practice
 1323  midwifery to an applicant who meets all of the following
 1324  criteria:
 1325         (1)Demonstrates that he or she has graduated from one of
 1326  the following:
 1327         (a) An approved midwifery program.
 1328         (b)A medical or midwifery program offered in another
 1329  state, jurisdiction, territory, or country whose graduation
 1330  requirements were equivalent to or exceeded those required by s.
 1331  467.009 and the rules adopted thereunder at the time of
 1332  graduation.
 1333         (2)Demonstrates that he or she has and successfully
 1334  completed a prelicensure course offered by an approved midwifery
 1335  program. Students graduating from an approved midwifery program
 1336  may meet this requirement by showing that the content
 1337  requirements for the prelicensure course were covered as part of
 1338  their course of study.
 1339         (3)Submits an application for licensure on a form approved
 1340  by the department and pays the appropriate fee.
 1341         (4)Demonstrates that he or she has received a passing
 1342  score on an the examination specified by the department, upon
 1343  payment of the required licensure fee.
 1344         Section 19. Section 467.0125, Florida Statutes, is amended
 1345  to read:
 1346         467.0125 Licensed midwives; qualifications; Licensure by
 1347  endorsement; temporary certificates.—
 1348         (1) The department shall issue a license by endorsement to
 1349  practice midwifery to an applicant who, upon applying to the
 1350  department, demonstrates to the department that she or he meets
 1351  all of the following criteria:
 1352         (a)1. Holds a valid certificate or diploma from a foreign
 1353  institution of medicine or midwifery or from a midwifery program
 1354  offered in another state, bearing the seal of the institution or
 1355  otherwise authenticated, which renders the individual eligible
 1356  to practice midwifery in the country or state in which it was
 1357  issued, provided the requirements therefor are deemed by the
 1358  department to be substantially equivalent to, or to exceed,
 1359  those established under this chapter and rules adopted under
 1360  this chapter, and submits therewith a certified translation of
 1361  the foreign certificate or diploma; or
 1362         2. Holds an active, unencumbered a valid certificate or
 1363  license to practice midwifery in another state, jurisdiction, or
 1364  territory issued by that state, provided the licensing
 1365  requirements of that state, jurisdiction, or territory at the
 1366  time the license was issued were therefor are deemed by the
 1367  department to be substantially equivalent to, or exceeded to
 1368  exceed, those established under this chapter and the rules
 1369  adopted hereunder under this chapter.
 1370         (b) Has successfully completed a 4-month prelicensure
 1371  course conducted by an approved midwifery program and has
 1372  submitted documentation to the department of successful
 1373  completion.
 1374         (c) Submits an application for licensure on a form approved
 1375  by the department and pays the appropriate fee Has successfully
 1376  passed the licensed midwifery examination.
 1377         (2) The department may issue a temporary certificate to
 1378  practice in areas of critical need to an applicant any midwife
 1379  who is qualifying for a midwifery license licensure by
 1380  endorsement under subsection (1) and who meets all of the
 1381  following criteria, with the following restrictions:
 1382         (a) Submits an application for a temporary certificate on a
 1383  form approved by the department and pays the appropriate fee,
 1384  which may not exceed $50 and is in addition to the fee required
 1385  for licensure by endorsement under subsection (1).
 1386         (b)Specifies on the application that he or she will The
 1387  Department of Health shall determine the areas of critical need,
 1388  and the midwife so certified shall practice only in one or more
 1389  of the following locations:
 1390         1.A county health department.
 1391         2.A correctional facility.
 1392         3.A United States Department of Veterans Affairs clinic.
 1393         4.A community health center funded by s. 329, s. 330, or
 1394  s. 340 of the Public Health Service Act.
 1395         5.Any other agency or institution that is approved by the
 1396  State Surgeon General and provides health care to meet the needs
 1397  of an underserved population in this state.
 1398         (c)Will practice only those specific areas, under the
 1399  supervision auspices of a physician licensed under pursuant to
 1400  chapter 458 or chapter 459, a certified nurse midwife licensed
 1401  under pursuant to part I of chapter 464, or a midwife licensed
 1402  under this chapter, who has a minimum of 3 years’ professional
 1403  experience.
 1404         (3)The department may issue a temporary certificate under
 1405  this section with the following restrictions:
 1406         (a)A requirement that a temporary certificateholder
 1407  practice only in areas of critical need. The State Surgeon
 1408  General shall determine the areas of critical need, which Such
 1409  areas shall include, but are not be limited to, health
 1410  professional shortage areas designated by the United States
 1411  Department of Health and Human Services.
 1412         (b) A requirement that if a temporary certificateholder’s
 1413  practice area ceases to be an area of critical need, within 30
 1414  days after such change the certificateholder must either:
 1415         1.Report a new practice area of critical need to the
 1416  department; or
 1417         2.Voluntarily relinquish the temporary certificate.
 1418         (4)The department shall review a temporary
 1419  certificateholder’s practice at least annually to determine
 1420  whether the certificateholder is meeting the requirements of
 1421  subsections (2) and (3) and the rules adopted thereunder. If the
 1422  department determines that a certificateholder is not meeting
 1423  these requirements, the department must revoke the temporary
 1424  certificate.
 1425         (5) A temporary certificate issued under this section is
 1426  shall be valid only as long as an area for which it is issued
 1427  remains an area of critical need, but no longer than 2 years,
 1428  and is shall not be renewable.
 1429         (c) The department may administer an abbreviated oral
 1430  examination to determine the midwife’s competency, but no
 1431  written regular examination shall be necessary.
 1432         (d) The department shall not issue a temporary certificate
 1433  to any midwife who is under investigation in another state for
 1434  an act which would constitute a violation of this chapter until
 1435  such time as the investigation is complete, at which time the
 1436  provisions of this section shall apply.
 1437         (e) The department shall review the practice under a
 1438  temporary certificate at least annually to ascertain that the
 1439  minimum requirements of the midwifery rules promulgated under
 1440  this chapter are being met. If it is determined that the minimum
 1441  requirements are not being met, the department shall immediately
 1442  revoke the temporary certificate.
 1443         (f) The fee for a temporary certificate shall not exceed
 1444  $50 and shall be in addition to the fee required for licensure.
 1445         Section 20. Section 467.205, Florida Statutes, is amended
 1446  to read:
 1447         467.205 Approval of midwifery programs.—
 1448         (1) The department must approve an accredited or state
 1449  licensed public or private institution seeking to provide
 1450  midwifery education and training as an approved midwifery
 1451  program in this state if the institution meets all of the
 1452  following criteria:
 1453         (a)Submits an application for approval on a form approved
 1454  by the department.
 1455         (b)Demonstrates to the department’s satisfaction that the
 1456  proposed midwifery program complies with s. 467.009 and the
 1457  rules adopted thereunder.
 1458         (c)For a private institution, demonstrates its
 1459  accreditation by a member of the Council for Higher Education
 1460  Accreditation or an accrediting agency approved by the United
 1461  States Department of Education and its licensing or provisional
 1462  licensing by the Commission for Independent Education An
 1463  organization desiring to conduct an approved program for the
 1464  education of midwives shall apply to the department and submit
 1465  such evidence as may be required to show that it complies with
 1466  s. 467.009 and with the rules of the department. Any accredited
 1467  or state-licensed institution of higher learning, public or
 1468  private, may provide midwifery education and training.
 1469         (2) The department shall adopt rules regarding educational
 1470  objectives, faculty qualifications, curriculum guidelines,
 1471  administrative procedures, and other training requirements as
 1472  are necessary to ensure that approved programs graduate midwives
 1473  competent to practice under this chapter.
 1474         (3) The department shall survey each organization applying
 1475  for approval. If the department is satisfied that the program
 1476  meets the requirements of s. 467.009 and rules adopted pursuant
 1477  to that section, it shall approve the program.
 1478         (2)(4) The department shall, at least once every 3 years,
 1479  certify whether each approved midwifery program is currently
 1480  compliant, and has maintained compliance, complies with the
 1481  requirements of standards developed under s. 467.009 and the
 1482  rules adopted thereunder.
 1483         (3)(5) If the department finds that an approved midwifery
 1484  program is not in compliance with the requirements of s. 467.009
 1485  or the rules adopted thereunder, or has lost its accreditation
 1486  status, the department must provide its finding to the program
 1487  in writing and no longer meets the required standards, it may
 1488  place the program on probationary status for a specified period
 1489  of time, which may not exceed 3 years until such time as the
 1490  standards are restored.
 1491         (4) If a program on probationary status does not come into
 1492  compliance with the requirements of s. 467.009 or the rules
 1493  adopted thereunder, or regain its accreditation status, as
 1494  applicable, within the period specified by the department fails
 1495  to correct these conditions within a specified period of time,
 1496  the department may rescind the program’s approval.
 1497         (5)A Any program that has having its approval rescinded
 1498  has shall have the right to reapply for approval.
 1499         (6) The department may grant provisional approval of a new
 1500  program seeking accreditation status, for a period not to exceed
 1501  5 years, provided that all other requirements of this section
 1502  are met.
 1503         (7)The department may rescind provisional approval of a
 1504  program that fails to meet the requirements of s. 467.009, this
 1505  section, or the rules adopted thereunder, in accordance with
 1506  procedures provided in subsections (3) and (4) may be granted
 1507  pending the licensure results of the first graduating class.
 1508         Section 21. Subsections (2), (3), and (4) and paragraphs
 1509  (a) and (b) of subsection (5) of section 468.803, Florida
 1510  Statutes, are amended to read:
 1511         468.803 License, registration, and examination
 1512  requirements.—
 1513         (2) An applicant for registration, examination, or
 1514  licensure must apply to the department on a form prescribed by
 1515  the board for consideration of board approval. Each initial
 1516  applicant shall submit a set of fingerprints to the department
 1517  in accordance with on a form and under procedures specified by
 1518  the department, along with payment in an amount equal to the
 1519  costs incurred by the department for state and national criminal
 1520  history checks of the applicant. The department shall submit the
 1521  fingerprints provided by an applicant to the Department of Law
 1522  Enforcement for a statewide criminal history check, and the
 1523  Department of Law Enforcement shall forward the fingerprints to
 1524  the Federal Bureau of Investigation for a national criminal
 1525  history check of the applicant. The board shall screen the
 1526  results to determine if an applicant meets licensure
 1527  requirements. The board shall consider for examination,
 1528  registration, or licensure each applicant whom who the board
 1529  verifies:
 1530         (a) Has submitted the completed application and completed
 1531  the fingerprinting requirements fingerprint forms and has paid
 1532  the applicable application fee, not to exceed $500, and the cost
 1533  of the state and national criminal history checks. The
 1534  application fee is and cost of the criminal history checks shall
 1535  be nonrefundable;
 1536         (b) Is of good moral character;
 1537         (c) Is 18 years of age or older; and
 1538         (d) Has completed the appropriate educational preparation.
 1539         (3) A person seeking to attain the orthotics or prosthetics
 1540  experience required for licensure in this state must be approved
 1541  by the board and registered as a resident by the department.
 1542  Although a registration may be held in both disciplines, for
 1543  independent registrations the board may not approve a second
 1544  registration until at least 1 year after the issuance of the
 1545  first registration. Notwithstanding subsection (2), a person who
 1546  has been approved by the board and registered by the department
 1547  in one discipline may apply for registration in the second
 1548  discipline without an additional state or national criminal
 1549  history check during the period in which the first registration
 1550  is valid. Each independent registration or dual registration is
 1551  valid for 2 years after the date of issuance unless otherwise
 1552  revoked by the department upon recommendation of the board. The
 1553  board shall set a registration fee not to exceed $500 to be paid
 1554  by the applicant. A registration may be renewed once by the
 1555  department upon recommendation of the board for a period no
 1556  longer than 1 year, as such renewal is defined by the board by
 1557  rule. The renewal fee may not exceed one-half the current
 1558  registration fee. To be considered by the board for approval of
 1559  registration as a resident, the applicant must have one of the
 1560  following:
 1561         (a) A Bachelor of Science or higher-level postgraduate
 1562  degree in orthotics and prosthetics from an a regionally
 1563  accredited college or university recognized by the Commission on
 1564  Accreditation of Allied Health Education Programs.
 1565         (b) A minimum of a bachelor’s degree from an
 1566  institutionally a regionally accredited college or university
 1567  and a certificate in orthotics or prosthetics from a program
 1568  recognized by the Commission on Accreditation of Allied Health
 1569  Education Programs, or its equivalent, as determined by the
 1570  board.
 1571         (c) A minimum of a bachelor’s degree from an
 1572  institutionally a regionally accredited college or university
 1573  and a dual certificate in both orthotics and prosthetics from
 1574  programs recognized by the Commission on Accreditation of Allied
 1575  Health Education Programs, or its equivalent, as determined by
 1576  the board.
 1577         (4) The department may develop and administer a state
 1578  examination for an orthotist or a prosthetist license, or the
 1579  board may approve the existing examination of a national
 1580  standards organization. The examination must be predicated on a
 1581  minimum of a baccalaureate-level education and formalized
 1582  specialized training in the appropriate field. Each examination
 1583  must demonstrate a minimum level of competence in basic
 1584  scientific knowledge, written problem solving, and practical
 1585  clinical patient management. The board shall require an
 1586  examination fee not to exceed the actual cost to the board in
 1587  developing, administering, and approving the examination, which
 1588  fee must be paid by the applicant. To be considered by the board
 1589  for examination, the applicant must have:
 1590         (a) For an examination in orthotics:
 1591         1. A Bachelor of Science or higher-level postgraduate
 1592  degree in orthotics and prosthetics from an institutionally a
 1593  regionally accredited college or university recognized by the
 1594  Commission on Accreditation of Allied Health Education Programs
 1595  or, at a minimum, a bachelor’s degree from an institutionally a
 1596  regionally accredited college or university and a certificate in
 1597  orthotics from a program recognized by the Commission on
 1598  Accreditation of Allied Health Education Programs, or its
 1599  equivalent, as determined by the board; and
 1600         2. An approved orthotics internship of 1 year of qualified
 1601  experience, as determined by the board, or an orthotic residency
 1602  or dual residency program recognized by the board.
 1603         (b) For an examination in prosthetics:
 1604         1. A Bachelor of Science or higher-level postgraduate
 1605  degree in orthotics and prosthetics from an institutionally a
 1606  regionally accredited college or university recognized by the
 1607  Commission on Accreditation of Allied Health Education Programs
 1608  or, at a minimum, a bachelor’s degree from an institutionally a
 1609  regionally accredited college or university and a certificate in
 1610  prosthetics from a program recognized by the Commission on
 1611  Accreditation of Allied Health Education Programs, or its
 1612  equivalent, as determined by the board; and
 1613         2. An approved prosthetics internship of 1 year of
 1614  qualified experience, as determined by the board, or a
 1615  prosthetic residency or dual residency program recognized by the
 1616  board.
 1617         (5) In addition to the requirements in subsection (2), to
 1618  be licensed as:
 1619         (a) An orthotist, the applicant must pay a license fee not
 1620  to exceed $500 and must have:
 1621         1. A Bachelor of Science or higher-level postgraduate
 1622  degree in orthotics and prosthetics from an institutionally a
 1623  regionally accredited college or university recognized by the
 1624  Commission on Accreditation of Allied Health Education Programs,
 1625  or a bachelor’s degree from an institutionally accredited
 1626  college or university and with a certificate in orthotics from a
 1627  program recognized by the Commission on Accreditation of Allied
 1628  Health Education Programs, or its equivalent, as determined by
 1629  the board;
 1630         2. An approved appropriate internship of 1 year of
 1631  qualified experience, as determined by the board, or a residency
 1632  program recognized by the board;
 1633         3. Completed the mandatory courses; and
 1634         4. Passed the state orthotics examination or the board
 1635  approved orthotics examination.
 1636         (b) A prosthetist, the applicant must pay a license fee not
 1637  to exceed $500 and must have:
 1638         1. A Bachelor of Science or higher-level postgraduate
 1639  degree in orthotics and prosthetics from an institutionally a
 1640  regionally accredited college or university recognized by the
 1641  Commission on Accreditation of Allied Health Education Programs,
 1642  or a bachelor’s degree from an institutionally accredited
 1643  college or university and with a certificate in prosthetics from
 1644  a program recognized by the Commission on Accreditation of
 1645  Allied Health Education Programs, or its equivalent, as
 1646  determined by the board;
 1647         2. An internship of 1 year of qualified experience, as
 1648  determined by the board, or a residency program recognized by
 1649  the board;
 1650         3. Completed the mandatory courses; and
 1651         4. Passed the state prosthetics examination or the board
 1652  approved prosthetics examination.
 1653         Section 22. Section 483.824, Florida Statutes, is amended
 1654  to read:
 1655         483.824 Qualifications of clinical laboratory director.—A
 1656  clinical laboratory director must have 4 years of clinical
 1657  laboratory experience with 2 years of experience in the
 1658  specialty to be directed or be nationally board certified in the
 1659  specialty to be directed, and must meet one of the following
 1660  requirements:
 1661         (1) Be a physician licensed under chapter 458 or chapter
 1662  459;
 1663         (2) Hold an earned doctoral degree in a chemical, physical,
 1664  or biological science from an a regionally accredited
 1665  institution and maintain national certification requirements
 1666  equal to those required by the federal Health Care Financing
 1667  Administration; or
 1668         (3) For the subspecialty of oral pathology, be a physician
 1669  licensed under chapter 458 or chapter 459 or a dentist licensed
 1670  under chapter 466.
 1671         Section 23. Subsection (3) of section 490.003, Florida
 1672  Statutes, is amended to read:
 1673         490.003 Definitions.—As used in this chapter:
 1674         (3)(a)“Doctoral degree from an American Psychological
 1675  Association accredited program” means Effective July 1, 1999,
 1676  “doctoral-level psychological education” and “doctoral degree in
 1677  psychology” mean a Psy.D., an Ed.D. in psychology, or a Ph.D. in
 1678  psychology from a psychology program at an educational
 1679  institution that, at the time the applicant was enrolled and
 1680  graduated:
 1681         1.(a) Had institutional accreditation from an agency
 1682  recognized and approved by the United States Department of
 1683  Education or was recognized as a member in good standing with
 1684  the Association of Universities and Colleges of Canada; and
 1685         2.(b) Had programmatic accreditation from the American
 1686  Psychological Association.
 1687         (b)“Doctoral degree in psychology” means a Psy.D., an
 1688  Ed.D. in psychology, or a Ph.D. in psychology from a psychology
 1689  program at an educational institution that, at the time the
 1690  applicant was enrolled and graduated, had institutional
 1691  accreditation from an agency recognized and approved by the
 1692  United States Department of Education or was recognized as a
 1693  member in good standing with the Association of Universities and
 1694  Colleges of Canada.
 1695         Section 24. Subsection (1) of section 490.005, Florida
 1696  Statutes, is amended to read:
 1697         490.005 Licensure by examination.—
 1698         (1) Any person desiring to be licensed as a psychologist
 1699  shall apply to the department to take the licensure examination.
 1700  The department shall license each applicant whom who the board
 1701  certifies has met all of the following requirements:
 1702         (a) Completed the application form and remitted a
 1703  nonrefundable application fee not to exceed $500 and an
 1704  examination fee set by the board sufficient to cover the actual
 1705  per applicant cost to the department for development, purchase,
 1706  and administration of the examination, but not to exceed $500.
 1707         (b) Submitted proof satisfactory to the board that the
 1708  applicant has received:
 1709         1. A doctoral degree from an American Psychological
 1710  Association accredited program Doctoral-level psychological
 1711  education; or
 1712         2. The equivalent of a doctoral degree from an American
 1713  Psychological Association accredited program doctoral-level
 1714  psychological education, as defined in s. 490.003(3), from a
 1715  program at a school or university located outside the United
 1716  States of America which was officially recognized by the
 1717  government of the country in which it is located as an
 1718  institution or program to train students to practice
 1719  professional psychology. The applicant has the burden of
 1720  establishing that this requirement has been met.
 1721         (c) Had at least 2 years or 4,000 hours of experience in
 1722  the field of psychology in association with or under the
 1723  supervision of a licensed psychologist meeting the academic and
 1724  experience requirements of this chapter or the equivalent as
 1725  determined by the board. The experience requirement may be met
 1726  by work performed on or off the premises of the supervising
 1727  psychologist if the off-premises work is not the independent,
 1728  private practice rendering of psychological services that does
 1729  not have a psychologist as a member of the group actually
 1730  rendering psychological services on the premises.
 1731         (d) Passed the examination. However, an applicant who has
 1732  obtained a passing score, as established by the board by rule,
 1733  on the psychology licensure examination designated by the board
 1734  as the national licensure examination need only pass the Florida
 1735  law and rules portion of the examination.
 1736         Section 25. Subsection (1) of section 490.0051, Florida
 1737  Statutes, is amended to read:
 1738         490.0051 Provisional licensure; requirements.—
 1739         (1) The department shall issue a provisional psychology
 1740  license to each applicant who the board certifies has:
 1741         (a) Completed the application form and remitted a
 1742  nonrefundable application fee not to exceed $250, as set by
 1743  board rule.
 1744         (b) Earned a doctoral degree from an American Psychological
 1745  Association accredited program in psychology as defined in s.
 1746  490.003(3).
 1747         (c) Met any additional requirements established by board
 1748  rule.
 1749         Section 26. Subsections (1), (3), and (4) of section
 1750  491.005, Florida Statutes, are amended to read:
 1751         491.005 Licensure by examination.—
 1752         (1) CLINICAL SOCIAL WORK.—Upon verification of
 1753  documentation and payment of a fee not to exceed $200, as set by
 1754  board rule, plus the actual per applicant cost to the department
 1755  for purchase of the examination from the American Association of
 1756  State Social Worker’s Boards or a similar national organization,
 1757  the department shall issue a license as a clinical social worker
 1758  to an applicant whom who the board certifies has met all of the
 1759  following criteria:
 1760         (a) Has Submitted an application and paid the appropriate
 1761  fee.
 1762         (b)1. Has Received a doctoral degree in social work from a
 1763  graduate school of social work which at the time the applicant
 1764  graduated was accredited by an accrediting agency recognized by
 1765  the United States Department of Education or has received a
 1766  master’s degree in social work from a graduate school of social
 1767  work which at the time the applicant graduated:
 1768         a. Was accredited by the Council on Social Work Education;
 1769         b. Was accredited by the Canadian Association of Schools of
 1770  Social Work; or
 1771         c. Has been determined to have been a program equivalent to
 1772  programs approved by the Council on Social Work Education by the
 1773  Foreign Equivalency Determination Service of the Council on
 1774  Social Work Education. An applicant who graduated from a program
 1775  at a university or college outside of the United States or
 1776  Canada must present documentation of the equivalency
 1777  determination from the council in order to qualify.
 1778         2. The applicant’s graduate program must have emphasized
 1779  direct clinical patient or client health care services,
 1780  including, but not limited to, coursework in clinical social
 1781  work, psychiatric social work, medical social work, social
 1782  casework, psychotherapy, or group therapy. The applicant’s
 1783  graduate program must have included all of the following
 1784  coursework:
 1785         a. A supervised field placement which was part of the
 1786  applicant’s advanced concentration in direct practice, during
 1787  which the applicant provided clinical services directly to
 1788  clients.
 1789         b. Completion of 24 semester hours or 32 quarter hours in
 1790  theory of human behavior and practice methods as courses in
 1791  clinically oriented services, including a minimum of one course
 1792  in psychopathology, and no more than one course in research,
 1793  taken in a school of social work accredited or approved pursuant
 1794  to subparagraph 1.
 1795         3. If the course title which appears on the applicant’s
 1796  transcript does not clearly identify the content of the
 1797  coursework, the applicant shall be required to provide
 1798  additional documentation, including, but not limited to, a
 1799  syllabus or catalog description published for the course.
 1800         (c) Has Had at least 2 years of clinical social work
 1801  experience, which took place subsequent to completion of a
 1802  graduate degree in social work at an institution meeting the
 1803  accreditation requirements of this section, under the
 1804  supervision of a licensed clinical social worker or the
 1805  equivalent who is a qualified supervisor as determined by the
 1806  board. An individual who intends to practice in Florida to
 1807  satisfy clinical experience requirements must register pursuant
 1808  to s. 491.0045 before commencing practice. If the applicant’s
 1809  graduate program was not a program which emphasized direct
 1810  clinical patient or client health care services as described in
 1811  subparagraph (b)2., the supervised experience requirement must
 1812  take place after the applicant has completed a minimum of 15
 1813  semester hours or 22 quarter hours of the coursework required. A
 1814  doctoral internship may be applied toward the clinical social
 1815  work experience requirement. A licensed mental health
 1816  professional must be on the premises when clinical services are
 1817  provided by a registered intern in a private practice setting.
 1818  When a registered intern provides clinical services through
 1819  telehealth, a licensed mental health professional must be
 1820  accessible by telephone or electronic means.
 1821         (d) Has Passed a theory and practice examination designated
 1822  by board rule provided by the department for this purpose.
 1823         (e) Has Demonstrated, in a manner designated by rule of the
 1824  board, knowledge of the laws and rules governing the practice of
 1825  clinical social work, marriage and family therapy, and mental
 1826  health counseling.
 1827         (3) MARRIAGE AND FAMILY THERAPY.—Upon verification of
 1828  documentation and payment of a fee not to exceed $200, as set by
 1829  board rule, plus the actual cost of the purchase of the
 1830  examination from the Association of Marital and Family Therapy
 1831  Regulatory Board, or similar national organization, the
 1832  department shall issue a license as a marriage and family
 1833  therapist to an applicant whom who the board certifies has met
 1834  all of the following criteria:
 1835         (a) Has Submitted an application and paid the appropriate
 1836  fee.
 1837         (b)1.Obtained one of the following:
 1838         a.Has A minimum of a master’s degree with major emphasis
 1839  in marriage and family therapy or a closely related field from a
 1840  program accredited by the Commission on Accreditation for
 1841  Marriage and Family Therapy Education or from a Florida
 1842  university program accredited by the Council for Accreditation
 1843  of Counseling and Related Educational Programs.
 1844         b.A minimum of a master’s degree with an emphasis in
 1845  marriage and family therapy with a degree conferred date before
 1846  July 1, 2027, from an institutionally accredited college or
 1847  university that is not yet accredited by the Commission on
 1848  Accreditation for Marriage and Family Therapy Education or the
 1849  Council for Accreditation of Counseling and Related Educational
 1850  Programs.
 1851         2.Completed and graduate courses approved by the Board of
 1852  Clinical Social Work, Marriage and Family Therapy, and Mental
 1853  Health Counseling.
 1854  
 1855  If the course title that appears on the applicant’s transcript
 1856  does not clearly identify the content of the coursework, the
 1857  applicant shall provide additional documentation, including, but
 1858  not limited to, a syllabus or catalog description published for
 1859  the course. The required master’s degree must have been received
 1860  in an institution of higher education that, at the time the
 1861  applicant graduated, was fully accredited by an institutional a
 1862  regional accrediting body recognized by the Commission on
 1863  Recognition of Postsecondary Accreditation or publicly
 1864  recognized as a member in good standing with the Association of
 1865  Universities and Colleges of Canada, or an institution of higher
 1866  education located outside the United States and Canada which, at
 1867  the time the applicant was enrolled and at the time the
 1868  applicant graduated, maintained a standard of training
 1869  substantially equivalent to the standards of training of those
 1870  institutions in the United States which are accredited by an
 1871  institutional a regional accrediting body recognized by the
 1872  Commission on Recognition of Postsecondary Accreditation. Such
 1873  foreign education and training must have been received in an
 1874  institution or program of higher education officially recognized
 1875  by the government of the country in which it is located as an
 1876  institution or program to train students to practice as
 1877  professional marriage and family therapists or psychotherapists.
 1878  The applicant has the burden of establishing that the
 1879  requirements of this provision have been met, and the board
 1880  shall require documentation, such as an evaluation by a foreign
 1881  equivalency determination service, as evidence that the
 1882  applicant’s graduate degree program and education were
 1883  equivalent to an accredited program in this country. An
 1884  applicant with a master’s degree from a program that did not
 1885  emphasize marriage and family therapy may complete the
 1886  coursework requirement in a training institution fully
 1887  accredited by the Commission on Accreditation for Marriage and
 1888  Family Therapy Education recognized by the United States
 1889  Department of Education.
 1890         (c) Has Had at least 2 years of clinical experience during
 1891  which 50 percent of the applicant’s clients were receiving
 1892  marriage and family therapy services, which must have been be at
 1893  the post-master’s level under the supervision of a licensed
 1894  marriage and family therapist with at least 5 years of
 1895  experience, or the equivalent, who is a qualified supervisor as
 1896  determined by the board. An individual who intends to practice
 1897  in Florida to satisfy the clinical experience requirements must
 1898  register pursuant to s. 491.0045 before commencing practice. If
 1899  a graduate has a master’s degree with a major emphasis in
 1900  marriage and family therapy or a closely related field which did
 1901  not include all of the coursework required by paragraph (b),
 1902  credit for the post-master’s level clinical experience may not
 1903  commence until the applicant has completed a minimum of 10 of
 1904  the courses required by paragraph (b), as determined by the
 1905  board, and at least 6 semester hours or 9 quarter hours of the
 1906  course credits must have been completed in the area of marriage
 1907  and family systems, theories, or techniques. Within the 2 years
 1908  of required experience, the applicant must shall provide direct
 1909  individual, group, or family therapy and counseling to cases
 1910  including those involving unmarried dyads, married couples,
 1911  separating and divorcing couples, and family groups that include
 1912  children. A doctoral internship may be applied toward the
 1913  clinical experience requirement. A licensed mental health
 1914  professional must be on the premises when clinical services are
 1915  provided by a registered intern in a private practice setting.
 1916  When a registered intern provides clinical services through
 1917  telehealth, a licensed mental health professional must be
 1918  accessible by telephone or other electronic means.
 1919         (d) Has Passed a theory and practice examination designated
 1920  by board rule provided by the department.
 1921         (e) Has Demonstrated, in a manner designated by board rule,
 1922  knowledge of the laws and rules governing the practice of
 1923  clinical social work, marriage and family therapy, and mental
 1924  health counseling.
 1925  
 1926  For the purposes of dual licensure, the department shall license
 1927  as a marriage and family therapist any person who meets the
 1928  requirements of s. 491.0057. Fees for dual licensure may not
 1929  exceed those stated in this subsection.
 1930         (4) MENTAL HEALTH COUNSELING.—Upon verification of
 1931  documentation and payment of a fee not to exceed $200, as set by
 1932  board rule, plus the actual per applicant cost of purchase of
 1933  the examination from the National Board for Certified Counselors
 1934  or its successor organization, the department shall issue a
 1935  license as a mental health counselor to an applicant whom who
 1936  the board certifies has met all of the following criteria:
 1937         (a) Has Submitted an application and paid the appropriate
 1938  fee.
 1939         (b)1. Obtained Has a minimum of an earned master’s degree
 1940  from a mental health counseling program accredited by the
 1941  Council for the Accreditation of Counseling and Related
 1942  Educational Programs which consists of at least 60 semester
 1943  hours or 80 quarter hours of clinical and didactic instruction,
 1944  including a course in human sexuality and a course in substance
 1945  abuse. If the master’s degree is earned from a program related
 1946  to the practice of mental health counseling which is not
 1947  accredited by the Council for the Accreditation of Counseling
 1948  and Related Educational Programs, then the coursework and
 1949  practicum, internship, or fieldwork must consist of at least 60
 1950  semester hours or 80 quarter hours and meet all of the following
 1951  requirements:
 1952         a. Thirty-three semester hours or 44 quarter hours of
 1953  graduate coursework, which must include a minimum of 3 semester
 1954  hours or 4 quarter hours of graduate-level coursework in each of
 1955  the following 11 content areas: counseling theories and
 1956  practice; human growth and development; diagnosis and treatment
 1957  of psychopathology; human sexuality; group theories and
 1958  practice; individual evaluation and assessment; career and
 1959  lifestyle assessment; research and program evaluation; social
 1960  and cultural foundations; substance abuse; and legal, ethical,
 1961  and professional standards issues in the practice of mental
 1962  health counseling. Courses in research, thesis or dissertation
 1963  work, practicums, internships, or fieldwork may not be applied
 1964  toward this requirement.
 1965         b. A minimum of 3 semester hours or 4 quarter hours of
 1966  graduate-level coursework addressing diagnostic processes,
 1967  including differential diagnosis and the use of the current
 1968  diagnostic tools, such as the current edition of the American
 1969  Psychiatric Association’s Diagnostic and Statistical Manual of
 1970  Mental Disorders. The graduate program must have emphasized the
 1971  common core curricular experience.
 1972         c. The equivalent, as determined by the board, of at least
 1973  700 hours of university-sponsored supervised clinical practicum,
 1974  internship, or field experience that includes at least 280 hours
 1975  of direct client services, as required in the accrediting
 1976  standards of the Council for Accreditation of Counseling and
 1977  Related Educational Programs for mental health counseling
 1978  programs. This experience may not be used to satisfy the post
 1979  master’s clinical experience requirement.
 1980         2. Has Provided additional documentation if a course title
 1981  that appears on the applicant’s transcript does not clearly
 1982  identify the content of the coursework. The documentation must
 1983  include, but is not limited to, a syllabus or catalog
 1984  description published for the course.
 1985  
 1986  Education and training in mental health counseling must have
 1987  been received in an institution of higher education that, at the
 1988  time the applicant graduated, was fully accredited by an
 1989  institutional a regional accrediting body recognized by the
 1990  Council for Higher Education Accreditation or its successor
 1991  organization or publicly recognized as a member in good standing
 1992  with the Association of Universities and Colleges of Canada, or
 1993  an institution of higher education located outside the United
 1994  States and Canada which, at the time the applicant was enrolled
 1995  and at the time the applicant graduated, maintained a standard
 1996  of training substantially equivalent to the standards of
 1997  training of those institutions in the United States which are
 1998  accredited by an institutional a regional accrediting body
 1999  recognized by the Council for Higher Education Accreditation or
 2000  its successor organization. Such foreign education and training
 2001  must have been received in an institution or program of higher
 2002  education officially recognized by the government of the country
 2003  in which it is located as an institution or program to train
 2004  students to practice as mental health counselors. The applicant
 2005  has the burden of establishing that the requirements of this
 2006  provision have been met, and the board shall require
 2007  documentation, such as an evaluation by a foreign equivalency
 2008  determination service, as evidence that the applicant’s graduate
 2009  degree program and education were equivalent to an accredited
 2010  program in this country. Beginning July 1, 2025, an applicant
 2011  must have a master’s degree from a program that is accredited by
 2012  the Council for Accreditation of Counseling and Related
 2013  Educational Programs which consists of at least 60 semester
 2014  hours or 80 quarter hours to apply for licensure under this
 2015  paragraph.
 2016         (c) Has Had at least 2 years of clinical experience in
 2017  mental health counseling, which must be at the post-master’s
 2018  level under the supervision of a licensed mental health
 2019  counselor or the equivalent who is a qualified supervisor as
 2020  determined by the board. An individual who intends to practice
 2021  in Florida to satisfy the clinical experience requirements must
 2022  register pursuant to s. 491.0045 before commencing practice. If
 2023  a graduate has a master’s degree with a major related to the
 2024  practice of mental health counseling which did not include all
 2025  the coursework required under sub-subparagraphs (b)1.a. and b.,
 2026  credit for the post-master’s level clinical experience may not
 2027  commence until the applicant has completed a minimum of seven of
 2028  the courses required under sub-subparagraphs (b)1.a. and b., as
 2029  determined by the board, one of which must be a course in
 2030  psychopathology or abnormal psychology. A doctoral internship
 2031  may be applied toward the clinical experience requirement. A
 2032  licensed mental health professional must be on the premises when
 2033  clinical services are provided by a registered intern in a
 2034  private practice setting. When a registered intern provides
 2035  clinical services through telehealth, a licensed mental health
 2036  professional must be accessible by telephone or other electronic
 2037  means.
 2038         (d) Has Passed a theory and practice examination designated
 2039  by department rule provided by the department for this purpose.
 2040         (e) Has Demonstrated, in a manner designated by board rule,
 2041  knowledge of the laws and rules governing the practice of
 2042  clinical social work, marriage and family therapy, and mental
 2043  health counseling.
 2044         Section 27. Subsection (6) and paragraph (c) of subsection
 2045  (9) of section 766.314, Florida Statutes, are amended to read:
 2046         766.314 Assessments; plan of operation.—
 2047         (6)(a) The association shall make all assessments required
 2048  by this section, except initial assessments of physicians
 2049  licensed on or after October 1, 1988, which assessments will be
 2050  made by the Department of Health Business and Professional
 2051  Regulation, and except assessments of casualty insurers pursuant
 2052  to subparagraph (5)(c)1., which assessments will be made by the
 2053  Office of Insurance Regulation. Beginning October 1, 1989, for
 2054  any physician licensed between October 1 and December 31 of any
 2055  year, the Department of Business and Professional Regulation
 2056  shall make the initial assessment plus the assessment for the
 2057  following calendar year. The Department of Health Business and
 2058  Professional Regulation shall provide the association, in an
 2059  electronic format, with a monthly report such frequency as
 2060  determined to be necessary, a listing, in a computer-readable
 2061  form, of the names and license numbers addresses of all
 2062  physicians licensed under chapter 458 or chapter 459.
 2063         (b)1. The association may enforce collection of assessments
 2064  required to be paid pursuant to ss. 766.301-766.316 by suit
 2065  filed in county court. The association is shall be entitled to
 2066  an award of attorney’s fees, costs, and interest upon the entry
 2067  of a judgment against a physician for failure to pay such
 2068  assessment, with such interest accruing until paid.
 2069  Notwithstanding the provisions of chapters 47 and 48, the
 2070  association may file such suit in either Leon County or the
 2071  county of the residence of the defendant.
 2072         2. The Department of Health Business and Professional
 2073  Regulation, upon notification by the association that an
 2074  assessment has not been paid and that there is an unsatisfied
 2075  judgment against a physician, shall refuse to not renew any
 2076  license issued to practice for such physician under issued
 2077  pursuant to chapter 458 or chapter 459 until the association
 2078  notifies the Department of Health that such time as the judgment
 2079  is satisfied in full.
 2080         (c) The Agency for Health Care Administration shall, upon
 2081  notification by the association that an assessment has not been
 2082  timely paid, enforce collection of such assessments required to
 2083  be paid by hospitals pursuant to ss. 766.301-766.316. Failure of
 2084  a hospital to pay such assessment is grounds for disciplinary
 2085  action pursuant to s. 395.1065 notwithstanding any provision of
 2086  law to the contrary.
 2087         (9)
 2088         (c) If In the event the total of all current estimates
 2089  equals 80 percent of the funds on hand and the funds that will
 2090  become available to the association within the next 12 months
 2091  from all sources described in subsections (4) and (5) and
 2092  paragraph (7)(a), the association may shall not accept any new
 2093  claims without express authority from the Legislature. Nothing
 2094  in this section precludes herein shall preclude the association
 2095  from accepting any claim if the injury occurred 18 months or
 2096  more before prior to the effective date of this suspension.
 2097  Within 30 days after of the effective date of this suspension,
 2098  the association shall notify the Governor, the Speaker of the
 2099  House of Representatives, the President of the Senate, the
 2100  Office of Insurance Regulation, the Agency for Health Care
 2101  Administration, and the Department of Health, and the Department
 2102  of Business and Professional Regulation of this suspension.
 2103         Section 28. This act shall take effect July 1, 2022.