Florida Senate - 2024 CS for SB 7016
By the Committees on Fiscal Policy; and Health Policy
594-02041-24 20247016c1
1 A bill to be entitled
2 An act relating to health care; amending s. 381.4019,
3 F.S.; revising the purpose of the Dental Student Loan
4 Repayment Program; defining the term “free clinic”;
5 including dental hygienists in the program; revising
6 eligibility requirements for the program; specifying
7 limits on award amounts for and participation of
8 dental hygienists under the program; revising
9 requirements for the distribution of awards under the
10 program; deleting the maximum number of new
11 practitioners who may participate in the program each
12 fiscal year; specifying that dentists and dental
13 hygienists are not eligible to receive funds under the
14 program unless they provide specified documentation;
15 requiring practitioners who receive payments under the
16 program to furnish certain information requested by
17 the Department of Health; requiring the Agency for
18 Health Care Administration to seek federal authority
19 to use specified matching funds for the program;
20 providing for future repeal of the program;
21 transferring, renumbering, and amending s. 1009.65,
22 F.S.; renaming the Medical Education Reimbursement and
23 Loan Repayment Program as the Florida Reimbursement
24 Assistance for Medical Education Program; revising the
25 types of practitioners who are eligible to participate
26 in the program; revising requirements for the
27 distribution of funds under the program; making
28 conforming and technical changes; requiring
29 practitioners who receive payments under the program
30 to furnish certain information requested by the
31 department; requiring the agency to seek federal
32 authority to use specified matching funds for the
33 program; providing for future repeal of the program;
34 creating s. 381.4021, F.S.; requiring the department
35 to provide annual reports to the Governor and the
36 Legislature on specified student loan repayment
37 programs; providing requirements for the report;
38 requiring the department to contract with an
39 independent third party to develop and conduct a
40 design study for evaluating the effectiveness of
41 specified student loan repayment programs; specifying
42 requirements for the design study; requiring the
43 department to begin collecting data for the study and
44 submit the study results to the Governor and the
45 Legislature by specified dates; requiring the
46 department to participate in a certain multistate
47 collaborative for a specified purpose; providing for
48 future repeal of the requirement; creating s.
49 381.9855, F.S.; requiring the department to implement
50 a Health Care Screening and Services Grant Program for
51 a specified purpose; specifying duties of the
52 department; authorizing nonprofit entities to apply
53 for grant funds to implement new health care screening
54 or services programs or mobile clinics or units to
55 expand the program’s delivery capabilities; specifying
56 requirements for grant recipients; authorizing the
57 department to adopt rules; requiring the department to
58 create and maintain an Internet-based portal to
59 provide specified information relating to available
60 health care screenings and services and volunteer
61 opportunities; authorizing the department to contract
62 with a third-party vendor to create and maintain the
63 portal; specifying requirements for the portal;
64 requiring the department to coordinate with county
65 health departments for a specified purpose; requiring
66 the department to include a clear and conspicuous link
67 to the portal on the homepage of its website;
68 requiring the department to publicize and encourage
69 the use of the portal and enlist the aid of county
70 health departments for such outreach; amending s.
71 383.2163, F.S.; expanding the telehealth minority
72 maternity care program from a pilot program to a
73 statewide program; authorizing the department to
74 enlist, rather than requiring the department to
75 direct, county health departments to assist in program
76 implementation; authorizing the department to receive
77 certain referrals from the Healthy Start program;
78 requiring the department to submit annual reports to
79 the Governor and the Legislature; providing
80 requirements for the reports; amending s. 383.302,
81 F.S.; defining the terms “advanced birth center” and
82 “medical director”; revising the definition of the
83 term “consultant”; creating s. 383.3081, F.S.;
84 providing requirements for birth centers designated as
85 advanced birth centers with respect to operating
86 procedures, staffing, and equipment; requiring
87 advanced birth centers to enter into a written
88 agreement with a blood bank for emergency blood bank
89 services; requiring that a patient who receives an
90 emergency blood transfusion at an advanced birth
91 center be immediately transferred to a hospital for
92 further care; requiring the agency to establish by
93 rule a process for birth centers to be designated as
94 advanced birth centers; authorizing the agency to
95 develop certain additional requirements or standards
96 for advanced birth centers; amending s. 383.309, F.S.;
97 providing minimum standards for advanced birth
98 centers; amending s. 383.313, F.S.; making technical
99 and conforming changes; creating s. 383.3131, F.S.;
100 providing requirements for laboratory and surgical
101 services at advanced birth centers; providing
102 conditions for administration of anesthesia;
103 authorizing the intrapartal use of chemical agents;
104 amending s. 383.315, F.S.; requiring advanced birth
105 centers to employ or maintain an agreement with an
106 obstetrician for specified purposes; amending s.
107 383.316, F.S.; requiring advanced birth centers to
108 provide for the transport of emergency patients to a
109 hospital; requiring each advanced birth center to
110 enter into a written transfer agreement with a local
111 hospital or an obstetrician for such transfers;
112 requiring birth centers and advanced birth centers to
113 assess and document transportation services and
114 transfer protocols annually; amending s. 383.318,
115 F.S.; providing protocols for postpartum care of
116 clients and infants at advanced birth centers;
117 amending s. 394.455, F.S.; revising definitions;
118 amending s. 394.457, F.S.; requiring the Department of
119 Children and Families to adopt certain minimum
120 standards for mobile crisis response services;
121 amending s. 394.4598, F.S.; authorizing certain
122 psychiatric nurses to provide opinions to the court
123 for the appointment of guardian advocates; authorizing
124 certain psychiatric nurses to consult with guardian
125 advocates for purposes of obtaining consent for
126 treatment; amending s. 394.4615, F.S.; authorizing
127 psychiatric nurses to make certain determinations
128 related to the release of clinical records; amending
129 s. 394.4625, F.S.; requiring certain treating
130 psychiatric nurses to document specified information
131 in a patient’s clinical record within a specified
132 timeframe of his or her voluntary admission for mental
133 health treatment; requiring clinical psychologists who
134 make determinations of involuntary placement at
135 certain mental health facilities to have specified
136 clinical experience; authorizing certain psychiatric
137 nurses to order emergency treatment for certain
138 patients; amending s. 394.463, F.S.; authorizing
139 certain psychiatric nurses to order emergency
140 treatment of certain patients; requiring a clinical
141 psychologist to have specified clinical experience to
142 approve the release of an involuntary patient at
143 certain mental health facilities; amending s.
144 394.4655, F.S.; requiring clinical psychologists to
145 have specified clinical experience in order to
146 recommend involuntary outpatient services for mental
147 health treatment; authorizing certain psychiatric
148 nurses to recommend involuntary outpatient services
149 for mental health treatment; providing an exception;
150 authorizing psychiatric nurses to make certain
151 clinical determinations that warrant bringing a
152 patient to a receiving facility for an involuntary
153 examination; making a conforming change; amending s.
154 394.467, F.S.; requiring clinical psychologists to
155 have specified clinical experience in order to
156 recommend involuntary inpatient services for mental
157 health treatment; authorizing certain psychiatric
158 nurses to recommend involuntary inpatient services for
159 mental health treatment; providing an exception;
160 amending s. 394.4781, F.S.; revising the definition of
161 the term “psychotic or severely emotionally disturbed
162 child”; amending s. 394.4785, F.S.; authorizing
163 psychiatric nurses to admit individuals over a certain
164 age into certain mental health units of a hospital
165 under certain conditions; requiring the agency to seek
166 federal approval for Medicaid coverage and
167 reimbursement authority for mobile crisis response
168 services; requiring the Department of Children and
169 Families to coordinate with the agency to provide
170 specified education to contracted mobile response team
171 services providers; amending s. 394.875, F.S.;
172 authorizing certain psychiatric nurses to prescribe
173 medication to clients of crisis stabilization units;
174 amending s. 395.1055, F.S.; requiring the agency to
175 adopt rules ensuring that hospitals that accept
176 certain payments give enrollment priority to certain
177 medical students, regardless of such payments, and
178 requiring certain hospitals to submit a nonemergent
179 care access plan (NCAP) to the agency for approval
180 before initial licensure or licensure renewal;
181 requiring that, beginning on a specified date, such
182 NCAPs be approved before a license may be issued or
183 renewed; requiring such hospitals to submit specified
184 data to the agency as part of the licensure renewal
185 process and update their NCAPs as needed, or as
186 directed by the agency, before each licensure renewal;
187 specifying requirements for NCAPs; requiring the
188 agency to establish a process for hospitals to share
189 certain information with certain patients’ managed
190 care plans; providing construction; amending s.
191 408.051, F.S.; requiring certain hospitals to make
192 available certain data to the agency’s Florida Health
193 Information Exchange program for a specified purpose;
194 authorizing the agency to adopt rules; amending s.
195 409.909, F.S.; authorizing the agency to allocate
196 specified funds under the Slots for Doctors Program
197 for existing resident positions at hospitals and
198 qualifying institutions if certain conditions are met;
199 requiring hospitals and qualifying institutions that
200 receive certain state funds to report specified data
201 to the agency annually; defining the term “sponsoring
202 institution”; requiring such hospitals and qualifying
203 institutions, beginning on a specified date, to
204 produce certain financial records or submit to certain
205 financial audits; providing applicability; providing
206 that hospitals and qualifying institutions that fail
207 to produce such financial records to the agency are no
208 longer eligible to participate in the Statewide
209 Medicaid Residency Program until a certain
210 determination is made by the agency; requiring
211 hospitals and qualifying institutions to request exit
212 surveys of residents upon completion of their
213 residency; providing requirements for the exit
214 surveys; creating the Graduate Medical Education
215 Committee within the agency; providing for membership
216 and meetings of the committee; requiring the
217 committee, beginning on a specified date, to submit an
218 annual report to the Governor and the Legislature
219 detailing specified information; requiring the agency
220 to provide administrative support to assist the
221 committee in the performance of its duties and to
222 provide certain information to the committee; creating
223 s. 409.91256, F.S.; creating the Training, Education,
224 and Clinicals in Health (TEACH) Funding Program for a
225 specified purpose; providing legislative intent;
226 defining terms; requiring the agency to develop an
227 application process and enter into certain agreements
228 to implement the program; specifying requirements to
229 qualify to receive reimbursements under the program;
230 requiring the agency, in consultation with the
231 Department of Health, to develop, or contract for the
232 development of, specified training for, and to provide
233 technical support to, preceptors; providing for
234 reimbursement under the program; requiring the agency
235 to submit an annual report to the Governor and the
236 Legislature; providing requirements for the report;
237 requiring the agency to contract with an independent
238 third party to develop and conduct a design study for
239 evaluating the impact of the program; specifying
240 requirements for the design study; requiring the
241 agency to begin collecting data for the study and
242 submit the study results to the Governor and the
243 Legislature by specified dates; authorizing the agency
244 to adopt rules; requiring the agency to seek federal
245 approval to use specified matching funds for the
246 program; providing for future repeal of the program;
247 amending s. 409.967, F.S.; requiring the agency to
248 produce a specified annual report on patient encounter
249 data under the statewide managed care program;
250 providing requirements for the report; requiring the
251 agency to submit the report to the Governor and the
252 Legislature by a specified date; authorizing the
253 agency to contract with a third-party vendor to
254 produce the report; amending s. 409.973, F.S.;
255 requiring Medicaid managed care plans to continue
256 assisting certain enrollees in scheduling an initial
257 appointment with a primary care provider and report
258 certain information to the agency; requiring plans to
259 seek to ensure that such enrollees have at least one
260 primary care appointment annually; requiring such
261 plans to coordinate with hospitals that contact them
262 for a specified purpose; requiring the plans to
263 coordinate with their members and members’ primary
264 care providers for such purpose; requiring the agency
265 to seek federal approval necessary to implement an
266 acute hospital care at home program meeting specified
267 criteria; amending s. 458.311, F.S.; revising an
268 education and training requirement for physician
269 licensure; exempting foreign-trained applicants for
270 physician licensure from the residency requirement if
271 they meet specified criteria; providing that
272 applicants who do not meet the specified criteria may
273 be certified for restricted licensure under certain
274 circumstances; providing certain employment
275 requirements for such applicants; requiring such
276 applicants to notify the Board of Medicine of any
277 changes in employment within a specified timeframe;
278 repealing s. 458.3124, F.S., relating to restricted
279 licenses of certain experienced foreign-trained
280 physicians; amending s. 458.314, F.S.; authorizing the
281 board to exclude certain foreign medical schools from
282 consideration as an institution that provides medical
283 education that is reasonably comparable to similar
284 accredited institutions in the United States;
285 providing construction; deleting obsolete language;
286 amending s. 458.3145, F.S.; revising criteria for
287 medical faculty certificates; deleting a cap on the
288 maximum number of extended medical faculty
289 certificates that may be issued at specified
290 institutions; amending ss. 458.315 and 459.0076, F.S.;
291 authorizing that temporary certificates for practice
292 in areas of critical need be issued to physician
293 assistants, rather than only to physicians, who meet
294 specified criteria; making conforming and technical
295 changes; amending ss. 458.317 and 459.0075, F.S.;
296 specifying who may be considered a graduate assistant
297 physician; creating limited licenses for graduate
298 assistant physicians; specifying criteria a person
299 must meet to obtain such licensure; requiring the
300 Board of Medicine and the Board of Osteopathic
301 Medicine, respectively, to establish certain
302 requirements by rule; providing for a one-time renewal
303 of such licenses; providing that limited licensed
304 graduate assistant physicians are not eligible to
305 apply for another limited license; authorizing limited
306 licensed graduate assistant physicians to provide
307 health care services only under the direct supervision
308 of a physician and pursuant to a written protocol;
309 providing requirements for, and limitations on, such
310 supervision and practice; providing requirements for
311 the supervisory protocols; providing that supervising
312 physicians are liable for any acts or omissions of
313 such graduate assistant physicians acting under their
314 supervision and control; authorizing third-party
315 payors to provide reimbursement for covered services
316 rendered by graduate assistant physicians; authorizing
317 the Board of Medicine and the Board of Osteopathic
318 Medicine, respectively, to adopt rules; creating s.
319 464.0121, F.S.; providing that temporary certificates
320 for practice in areas of critical need may be issued
321 to advanced practice registered nurses who meet
322 specified criteria; providing restrictions on the
323 issuance of temporary certificates; waiving licensure
324 fees for such applicants under certain circumstances;
325 amending s. 464.0123, F.S.; requiring certain
326 certified nurse midwives, as a condition precedent to
327 providing out-of-hospital intrapartum care, to
328 maintain a written policy for the transfer of patients
329 needing a higher acuity of care or emergency services;
330 requiring that such policy prescribe and require the
331 use of an emergency plan-of-care form; providing
332 requirements for the form; requiring such certified
333 nurse midwives to document specified information on
334 the form if a transfer of care is determined to be
335 necessary; requiring certified nurse midwives to
336 verbally provide the receiving provider with specified
337 information and make himself or herself immediately
338 available for consultation; requiring certified nurse
339 midwives to provide the patient’s emergency plan-of
340 care form, as well as certain patient records, to the
341 receiving provider upon the patient’s transfer;
342 requiring the Board of Nursing to adopt certain rules;
343 amending s. 464.019, F.S.; deleting the sunset date of
344 a certain annual report required of the Florida Center
345 for Nursing; amending s. 766.1115, F.S.; revising the
346 definition of the term “low-income” for purposes of
347 certain government contracts for health care services;
348 amending s. 1002.32, F.S.; requiring developmental
349 research (laboratory) schools (lab schools) to develop
350 programs for a specified purpose; requiring lab
351 schools to offer technical assistance to any school
352 district seeking to replicate the lab school’s
353 programs; requiring lab schools, beginning on a
354 specified date, to annually report to the Legislature
355 on the development of such programs and their results;
356 amending s. 1009.8962, F.S.; revising the definition
357 of the term “institution” for purposes of the Linking
358 Industry to Nursing Education (LINE) Fund; amending
359 ss. 381.4018 and 395.602, F.S.; conforming provisions
360 to changes made by the act; creating s. 456.4501,
361 F.S.; enacting the Interstate Medical Licensure
362 Compact in this state; providing the purpose of the
363 compact; providing that state medical boards of member
364 states retain jurisdiction to impose adverse action
365 against licenses issued under the compact; defining
366 terms; specifying eligibility requirements for
367 physicians seeking an expedited license under the
368 compact; providing requirements for designation of a
369 state of principal license for purposes of the
370 compact; authorizing the Interstate Medical Licensure
371 Compact Commission to develop certain rules; providing
372 an application and verification process for expedited
373 licensure under the compact; providing for expiration
374 and termination of expedited licenses; authorizing the
375 Interstate Commission to develop certain rules;
376 providing requirements for renewal of expedited
377 licenses; authorizing the Interstate Commission to
378 develop certain rules; providing for the establishment
379 of a database for coordinating licensure data amongst
380 member states; requiring and authorizing member boards
381 to report specified information to the database;
382 providing for confidentiality of such information;
383 providing construction; authorizing the Interstate
384 Commission to develop certain rules; authorizing
385 member states to conduct joint investigations and
386 share certain materials; providing for disciplinary
387 action of physicians licensed under the compact;
388 creating the Interstate Medical Licensure Compact
389 Commission; providing purpose and authority of the
390 commission; providing for membership and meetings of
391 the commission; providing public meeting and notice
392 requirements; authorizing closed meetings under
393 certain circumstances; providing public record
394 requirements; requiring the commission to establish an
395 executive committee; providing for membership, powers,
396 and duties of the committee; authorizing the
397 commission to establish other committees; specifying
398 powers and duties of the commission; providing for
399 financing of the commission; providing for
400 organization and operation of the commission;
401 providing limited immunity from liability for
402 commissioners and other agents or employees of the
403 commission; authorizing the commission to adopt rules;
404 providing for rulemaking procedures, including public
405 notice and meeting requirements; providing for
406 judicial review of adopted rules; providing for
407 oversight and enforcement of the compact in member
408 states; requiring courts in member states to take
409 judicial notice of the compact and the commission
410 rules for purposes of certain proceedings; providing
411 that the commission is entitled to receive service of
412 process and has standing in certain proceedings;
413 rendering judgments or orders void as to the
414 commission, the compact, or commission rules under
415 certain circumstances; providing for enforcement of
416 the compact; specifying venue and civil remedies in
417 such proceedings; providing for attorney fees;
418 providing construction; specifying default procedures
419 for member states; providing for dispute resolution
420 between member states; providing for eligibility and
421 procedures for enactment of the compact; requiring
422 that governors of nonmember states be invited to
423 participate in the activities of the commission on a
424 nonvoting basis before the compact is adopted in that
425 state; providing for amendment to the compact;
426 specifying procedures for withdrawal from and
427 subsequent reinstatement of the compact; authorizing
428 the Interstate Commission to develop certain rules;
429 providing for dissolution of the compact; providing
430 severability and construction; creating s. 456.4502,
431 F.S.; providing that a formal hearing before the
432 Division of Administrative Hearings must be held if
433 there are any disputed issues of material fact when
434 the licenses of certain physicians and osteopathic
435 physicians are suspended or revoked by this state
436 under the compact; requiring the Department of Health
437 to notify the Division of Administrative Hearings of a
438 petition for a formal hearing within a specified
439 timeframe; requiring the administrative law judge to
440 issue a recommended order; requiring the Board of
441 Medicine or the Board of Osteopathic Medicine, as
442 applicable, to determine and issue final orders in
443 certain cases; providing the department with standing
444 to seek judicial review of any final order of the
445 boards; creating s. 456.4504, F.S.; authorizing the
446 department to adopt rules to implement the compact;
447 creating ss. 458.3129 and 459.074, F.S.; providing
448 that an allopathic physician or an osteopathic
449 physician, respectively, licensed under the compact is
450 deemed to be licensed under ch. 458, F.S., or ch. 459,
451 F.S., as applicable; amending s. 768.28, F.S.;
452 designating the state commissioners of the Interstate
453 Medical Licensure Compact Commission and other members
454 or employees of the commission as state agents for the
455 purpose of applying sovereign immunity and waivers of
456 sovereign immunity; requiring the commission to pay
457 certain claims or judgments; authorizing the
458 commission to maintain insurance coverage to pay such
459 claims or judgments; creating s. 468.1335, F.S.;
460 creating the Audiology and Speech-Language Pathology
461 Interstate Compact; providing the purpose and
462 objectives of the compact; defining terms; specifying
463 requirements for state participation in the compact
464 and duties of member states; specifying that the
465 compact does not affect an individual’s ability to
466 apply for, and a member state’s ability to grant, a
467 single-state license pursuant to the laws of that
468 state; providing for recognition of compact privilege
469 in member states; specifying criteria a licensee must
470 meet for a compact privilege; providing for the
471 expiration and renewal of the compact privilege;
472 specifying that a licensee with a compact privilege in
473 a remote state must adhere to the laws and rules of
474 that state; authorizing member states to act on a
475 licensee’s compact privilege under certain
476 circumstances; specifying the consequences and
477 parameters of practice for a licensee whose compact
478 privilege has been acted on or whose home state
479 license is encumbered; specifying that a licensee may
480 hold a home state license in only one member state at
481 a time; specifying requirements and procedures for
482 changing a home state license designation; providing
483 for the recognition of the practice of audiology and
484 speech-language pathology through telehealth in member
485 states; specifying that licensees must adhere to the
486 laws and rules of the remote state where they provide
487 audiology or speech-language pathology through
488 telehealth; authorizing active duty military personnel
489 and their spouses to keep their home state designation
490 during active duty; specifying how such individuals
491 may subsequently change their home state license
492 designation; authorizing member states to take adverse
493 actions against licensees and issue subpoenas for
494 hearings and investigations under certain
495 circumstances; providing requirements and procedures
496 for such adverse action; authorizing member states to
497 engage in joint investigations under certain
498 circumstances; providing that a licensee’s compact
499 privilege must be deactivated in all member states for
500 the duration of an encumbrance imposed by the
501 licensee’s home state; providing for notice to the
502 data system and the licensee’s home state of any
503 adverse action taken against a licensee; establishing
504 the Audiology and Speech-Language Pathology Interstate
505 Compact Commission; providing for jurisdiction and
506 venue for court proceedings; providing for membership
507 and powers of the commission; specifying powers and
508 duties of the commission’s executive committee;
509 providing for the financing of the commission;
510 providing specified individuals immunity from civil
511 liability under certain circumstances; providing
512 exceptions; requiring the commission to defend the
513 specified individuals in civil actions under certain
514 circumstances; requiring the commission to indemnify
515 and hold harmless specified individuals for any
516 settlement or judgment obtained in such actions under
517 certain circumstances; providing for the development
518 of the data system, reporting procedures, and the
519 exchange of specified information between member
520 states; requiring the commission to notify member
521 states of any adverse action taken against a licensee
522 or applicant for licensure; authorizing member states
523 to designate as confidential information provided to
524 the data system; requiring the commission to remove
525 information from the data system under certain
526 circumstances; providing rulemaking procedures for the
527 commission; providing procedures for the resolution of
528 certain disputes; providing for commission enforcement
529 of the compact; providing for remedies; providing for
530 implementation of, withdrawal from, and amendment to
531 the compact; providing construction and for
532 severability; specifying that the compact, commission
533 rules, and commission actions are binding on member
534 states; amending s. 456.073, F.S.; requiring the
535 Department of Health to report certain investigative
536 information to the commission’s data system; amending
537 s. 456.076, F.S.; requiring that monitoring contracts
538 for certain impaired practitioners participating in
539 treatment programs contain specified terms; amending
540 s. 468.1135, F.S.; requiring the Board of Speech
541 Language Pathology and Audiology to appoint two of its
542 board members to serve as the state’s delegates on the
543 compact commission; amending s. 468.1185, F.S.;
544 exempting audiologists and speech-language
545 pathologists from licensure requirements if they are
546 practicing in this state pursuant to a compact
547 privilege under the compact; amending s. 468.1295,
548 F.S.; authorizing the board to take adverse action
549 against the compact privilege of audiologists and
550 speech-language pathologists for specified prohibited
551 acts; amending s. 768.28, F.S.; designating the state
552 delegates and other members or employees of the
553 compact commission as state agents for the purpose of
554 applying sovereign immunity and waivers of sovereign
555 immunity; requiring the commission to pay certain
556 claims or judgments; authorizing the compact
557 commission to maintain insurance coverage to pay such
558 claims or judgments; creating s. 486.112, F.S.;
559 creating the Physical Therapy Licensure Compact;
560 providing a purpose and objectives of the compact;
561 defining terms; specifying requirements for state
562 participation in the compact; authorizing member
563 states to obtain biometric-based information from and
564 conduct criminal background checks on licensees
565 applying for a compact privilege; requiring member
566 states to grant the compact privilege to licensees if
567 they meet specified criteria; specifying criteria
568 licensees must meet to exercise the compact privilege
569 under the compact; providing for the expiration of the
570 compact privilege; requiring licensees practicing in a
571 remote state under the compact privilege to comply
572 with the laws and rules of that state; subjecting
573 licensees to the regulatory authority of remote states
574 where they practice under the compact privilege;
575 providing for disciplinary action; specifying
576 circumstances under which licensees are ineligible for
577 a compact privilege; specifying conditions that a
578 licensee must meet to regain his or her compact
579 privilege after an adverse action; specifying
580 locations active duty military personnel and their
581 spouses may use to designate their home state for
582 purposes of the compact; providing that only a home
583 state may impose adverse action against a license
584 issued by that state; authorizing home states to take
585 adverse action based on investigative information of a
586 remote state, subject to certain requirements;
587 directing member states that use alternative programs
588 in lieu of discipline to require the licensee to agree
589 not to practice in other member states while
590 participating in the program, unless authorized by the
591 member state; authorizing member states to investigate
592 violations by licensees in other member states;
593 authorizing member states to take adverse action
594 against compact privileges issued in their respective
595 states; providing for joint investigations of
596 licensees under the compact; establishing the Physical
597 Therapy Compact Commission; providing for the venue
598 and jurisdiction for court proceedings by or against
599 the commission; providing construction; providing for
600 commission membership, voting, and meetings;
601 authorizing the commission to convene closed,
602 nonpublic meetings under certain circumstances;
603 specifying duties and powers of the commission;
604 providing for membership and duties of the executive
605 board of the commission; providing for financing of
606 the commission; providing for qualified immunity,
607 defense, and indemnification of the commission;
608 requiring the commission to develop and maintain a
609 coordinated database and reporting system for certain
610 information about licensees under the compact;
611 requiring member states to submit specified
612 information to the system; requiring that information
613 contained in the system be available only to member
614 states; requiring the commission to promptly notify
615 all member states of reported adverse action taken
616 against licensees or applicants for licensure;
617 authorizing member states to designate reported
618 information as exempt from public disclosure;
619 providing for the removal of submitted information
620 from the system under certain circumstances; providing
621 for commission rulemaking; providing construction;
622 providing for state enforcement of the compact;
623 providing for the default and termination of compact
624 membership; providing for appeals and costs; providing
625 procedures for the resolution of certain disputes;
626 providing for enforcement against a defaulting state;
627 providing construction; providing for implementation
628 and administration of the compact and associated
629 rules; providing that compact states that join after
630 initial adoption of the commission’s rules are subject
631 to such rules; specifying procedures for compact
632 states to withdraw from the compact; providing
633 construction; providing for amendment of the compact;
634 providing construction and severability; amending s.
635 456.073, F.S.; requiring the Department of Health to
636 report certain investigative information to the data
637 system; amending s. 456.076, F.S.; requiring
638 monitoring contracts for certain impaired
639 practitioners participating in treatment programs to
640 contain specified terms; amending s. 486.023, F.S.;
641 requiring the Board of Physical Therapy Practice to
642 appoint an individual to serve as the state’s delegate
643 on the Physical Therapy Compact Commission; amending
644 ss. 486.028, 486.031, 486.081, 486.102, and 486.107,
645 F.S.; exempting physical therapists and physical
646 therapist assistants from licensure requirements if
647 they are practicing in this state pursuant to a
648 compact privilege under the compact; amending s.
649 486.125, F.S.; authorizing the board to take adverse
650 action against the compact privilege of physical
651 therapists and physical therapist assistants for
652 specified prohibited acts; amending s. 768.28, F.S.;
653 designating the state delegate and other members or
654 employees of the commission as state agents for the
655 purpose of applying sovereign immunity and waivers of
656 sovereign immunity; requiring the commission to pay
657 certain claims or judgments; authorizing the
658 commission to maintain insurance coverage to pay such
659 claims or judgments; amending ss. 486.025, 486.0715,
660 and 486.1065, F.S.; conforming cross-references;
661 providing appropriations; providing effective dates.
662
663 Be It Enacted by the Legislature of the State of Florida:
664
665 Section 1. Section 381.4019, Florida Statutes, is amended
666 to read:
667 381.4019 Dental Student Loan Repayment Program.—The Dental
668 Student Loan Repayment Program is established to support the
669 state Medicaid program and promote access to dental care by
670 supporting qualified dentists and dental hygienists who treat
671 medically underserved populations in dental health professional
672 shortage areas or medically underserved areas.
673 (1) As used in this section, the term:
674 (a) “Dental health professional shortage area” means a
675 geographic area designated as such by the Health Resources and
676 Services Administration of the United States Department of
677 Health and Human Services.
678 (b) “Department” means the Department of Health.
679 (c) “Free clinic” means a provider that meets the
680 description of a clinic specified in s. 766.1115(3)(d)14.
681 (d) “Loan program” means the Dental Student Loan Repayment
682 Program.
683 (e)(d) “Medically underserved area” means a geographic
684 area, an area having a special population, or a facility which
685 is designated by department rule as a health professional
686 shortage area as defined by federal regulation and which has a
687 shortage of dental health professionals who serve Medicaid
688 recipients and other low-income patients.
689 (f)(e) “Public health program” means a county health
690 department, the Children’s Medical Services program, a federally
691 funded community health center, a federally funded migrant
692 health center, or other publicly funded or nonprofit health care
693 program designated by the department.
694 (2) The department shall establish a dental student loan
695 repayment program to benefit Florida-licensed dentists and
696 dental hygienists who:
697 (a) Demonstrate, as required by department rule, active
698 employment in a public health program or private practice that
699 serves Medicaid recipients and other low-income patients and is
700 located in a dental health professional shortage area or a
701 medically underserved area; and
702 (b) Volunteer 25 hours per year providing dental services
703 in a free clinic that is located in a dental health professional
704 shortage area or a medically underserved area, through another
705 volunteer program operated by the state pursuant to part IV of
706 chapter 110, or through a pro bono program approved by the Board
707 of Dentistry. In order to meet the requirements of this
708 paragraph, the volunteer hours must be verifiable in a manner
709 determined by the department.
710 (3) The department shall award funds from the loan program
711 to repay the student loans of a dentist or dental hygienist who
712 meets the requirements of subsection (2).
713 (a) An award shall be 20 percent of a dentist’s or dental
714 hygienist’s principal loan amount at the time he or she applied
715 for the program but may not exceed $50,000 per year per eligible
716 dentist or $7,500 per year per eligible dental hygienist.
717 (b) Only loans to pay the costs of tuition, books, dental
718 equipment and supplies, uniforms, and living expenses may be
719 covered.
720 (c) All repayments are contingent upon continued proof of
721 eligibility and must be made directly to the holder of the loan.
722 The state bears no responsibility for the collection of any
723 interest charges or other remaining balances.
724 (d) A dentist or dental hygienist may receive funds under
725 the loan program for at least 1 year, up to a maximum of 5
726 awards pursuant to paragraph (a), one award for each year he or
727 she maintains eligibility for the program for the entire year.
728 Such awards are not required to be awarded in consecutive years,
729 and, if a dentist or dental hygienist loses eligibility pursuant
730 to subsection (4) for the current year, he or she may reapply
731 for the program in a future year once he or she has regained
732 eligibility.
733 (e) The department shall limit the number of new dentists
734 participating in the loan program to not more than 10 per fiscal
735 year.
736 (4) A dentist or dental hygienist is not no longer eligible
737 to receive funds under the loan program if the dentist or dental
738 hygienist:
739 (a) Is no longer employed by a public health program or
740 private practice that meets the requirements of subsection (2)
741 or does not verify, in a manner determined by the department,
742 that he or she has volunteered his or her dental services for
743 the required number of hours.
744 (b) Ceases to participate in the Florida Medicaid program.
745 (c) Has disciplinary action taken against his or her
746 license by the Board of Dentistry for a violation of s. 466.028.
747 (5) A dentist or dental hygienist who receives payment
748 under the program shall furnish information requested by the
749 department for the purpose of the department’s duties under s.
750 381.4021.
751 (6) The department shall adopt rules to administer the loan
752 program.
753 (7)(6) Implementation of the loan program is subject to
754 legislative appropriation.
755 (8) The Agency for Health Care Administration shall seek
756 federal authority to use Title XIX matching funds for this
757 program.
758 (9) This section is repealed on July 1, 2034.
759 Section 2. Section 1009.65, Florida Statutes, is
760 transferred, renumbered as section 381.402, Florida Statutes,
761 and amended to read:
762 381.402 1009.65 Florida Reimbursement Assistance for
763 Medical Education Reimbursement and Loan Repayment Program.—
764 (1) To support the state Medicaid program and to encourage
765 qualified medical professionals to practice in underserved
766 locations where there are shortages of such personnel, there is
767 established the Florida Reimbursement Assistance for Medical
768 Education Reimbursement and Loan Repayment Program. The function
769 of the program is to make payments that offset loans and
770 educational expenses incurred by students for studies leading to
771 a medical or nursing degree, medical or nursing licensure, or
772 advanced practice registered nurse licensure or physician
773 assistant licensure.
774 (2) The following licensed or certified health care
775 practitioners professionals are eligible to participate in the
776 this program:
777 (a) Medical doctors with primary care specialties.,
778 (b) Doctors of osteopathic medicine with primary care
779 specialties.
780 (c) Advanced practice registered nurses registered to
781 engage in autonomous practice under s. 464.0123., physician
782 assistants, licensed practical nurses and registered nurses, and
783 (d) Advanced practice registered nurses with primary care
784 specialties such as certified nurse midwives.
785 (e) Physician assistants.
786 (f) Mental health professionals, including licensed
787 clinical social workers, licensed marriage and family
788 therapists, licensed mental health counselors, and licensed
789 psychologists.
790 (g) Licensed practical nurses and registered nurses.
791
792 Primary care medical specialties for physicians include
793 obstetrics, gynecology, general and family practice, geriatrics,
794 internal medicine, pediatrics, psychiatry, and other specialties
795 which may be identified by the Department of Health.
796 (3) From the funds available, the Department of Health
797 shall make payments as follows:
798 (a)1. For a 4-year period of continued proof of practice in
799 an area specified in paragraph (b), up to $150,000 for
800 physicians, up to $90,000 for advanced practice registered
801 nurses registered to engage in autonomous practice under s.
802 464.0123 and practicing autonomously, up to $75,000 for advanced
803 practice registered nurses and physician assistants, up to
804 $75,000 for mental health professionals, and up to $45,000
805 $4,000 per year for licensed practical nurses and registered
806 nurses. Each practitioner is eligible to receive an award for
807 only one 4-year period of continued proof of practice; however,
808 the 4 years of practice are not required to be consecutive. At
809 the end of each year that a practitioner participates in the
810 program, the department shall award 25 percent of a
811 practitioner’s principal loan amount at the time he or she
812 applied for the program, up to $10,000 per year for advanced
813 practice registered nurses and physician assistants, and up to
814 $20,000 per year for physicians. Penalties for noncompliance are
815 shall be the same as those in the National Health Services Corps
816 Loan Repayment Program. Educational expenses include costs for
817 tuition, matriculation, registration, books, laboratory and
818 other fees, other educational costs, and reasonable living
819 expenses as determined by the Department of Health.
820 (b)2. All payments are contingent on continued proof of:
821 1.a. Primary care practice in a rural hospital as an area
822 defined in s. 395.602(2)(b), or an underserved area designated
823 by the Department of Health, provided the practitioner accepts
824 Medicaid reimbursement if eligible for such reimbursement; or
825 b. For practitioners other than physicians, practice in
826 other settings, including, but not limited to, a nursing home
827 facility as defined in s. 400.021, a home health agency as
828 defined in s. 400.462, or an intermediate care facility for the
829 developmentally disabled as defined in s. 400.960. Any such
830 setting must be located in, or serve residents or patients in,
831 an underserved area designated by the Department of Health and
832 must provide services to Medicaid patients.
833 2. Providing 25 hours annually of volunteer primary care
834 services in a free clinic as specified in s. 766.1115(3)(d)14.
835 or through another volunteer program operated by the state
836 pursuant to part IV of chapter 110. In order to meet the
837 requirements of this subparagraph, the volunteer hours must be
838 verifiable in a manner determined by the department.
839 (c) Correctional facilities, state hospitals, and other
840 state institutions that employ medical personnel must shall be
841 designated by the Department of Health as underserved locations.
842 Locations with high incidences of infant mortality, high
843 morbidity, or low Medicaid participation by health care
844 professionals may be designated as underserved.
845 (b) Advanced practice registered nurses registered to
846 engage in autonomous practice under s. 464.0123 and practicing
847 in the primary care specialties of family medicine, general
848 pediatrics, general internal medicine, or midwifery. From the
849 funds available, the Department of Health shall make payments of
850 up to $15,000 per year to advanced practice registered nurses
851 registered under s. 464.0123 who demonstrate, as required by
852 department rule, active employment providing primary care
853 services in a public health program, an independent practice, or
854 a group practice that serves Medicaid recipients and other low
855 income patients and that is located in a primary care health
856 professional shortage area. Only loans to pay the costs of
857 tuition, books, medical equipment and supplies, uniforms, and
858 living expenses may be covered. For the purposes of this
859 paragraph:
860 1. “Primary care health professional shortage area” means a
861 geographic area, an area having a special population, or a
862 facility with a score of at least 18, as designated and
863 calculated by the Federal Health Resources and Services
864 Administration or a rural area as defined by the Federal Office
865 of Rural Health Policy.
866 2. “Public health program” means a county health
867 department, the Children’s Medical Services program, a federally
868 funded community health center, a federally funded migrant
869 health center, or any other publicly funded or nonprofit health
870 care program designated by the department.
871 (4)(2) The Department of Health may use funds appropriated
872 for the Medical Education Reimbursement and Loan Repayment
873 program as matching funds for federal loan repayment programs
874 such as the National Health Service Corps State Loan Repayment
875 Program.
876 (5) A health care practitioner who receives payment under
877 the program shall furnish information requested by the
878 department for the purpose of the department’s duties under s.
879 381.4021.
880 (6)(3) The Department of Health may adopt any rules
881 necessary for the administration of the Medical Education
882 Reimbursement and Loan Repayment program. The department may
883 also solicit technical advice regarding conduct of the program
884 from the Department of Education and Florida universities and
885 Florida College System institutions. The Department of Health
886 shall submit a budget request for an amount sufficient to fund
887 medical education reimbursement, loan repayments, and program
888 administration.
889 (7) The Agency for Health Care Administration shall seek
890 federal authority to use Title XIX matching funds for this
891 program.
892 (8) This section is repealed on July 1, 2034.
893 Section 3. Section 381.4021, Florida Statutes, is created
894 to read:
895 381.4021 Student loan repayment programs reporting.—
896 (1) For the student loan repayment programs established in
897 ss. 381.4019 and 381.402, the department shall annually provide
898 a report, beginning July 1, 2024, to the Governor, the President
899 of the Senate, and the Speaker of the House of Representatives
900 which, at a minimum, details all of the following:
901 (a) The number of applicants for loan repayment.
902 (b) The number of loan payments made under each program.
903 (c) The amounts for each loan payment made.
904 (d) The type of practitioner to whom each loan payment was
905 made.
906 (e) The number of loan payments each practitioner has
907 received under either program.
908 (f) The practice setting in which each practitioner who
909 received a loan payment practices.
910 (2)(a) The department shall contract with an independent
911 third party to develop and conduct a design study to evaluate
912 the impact of the student loan repayment programs established in
913 ss. 381.4019 and 381.402, including, but not limited to, the
914 effectiveness of the programs in recruiting and retaining health
915 care professionals in geographic and practice areas experiencing
916 shortages. The department shall begin collecting data for the
917 study by January 1, 2025, and shall submit the results of the
918 study to the Governor, the President of the Senate, and the
919 Speaker of the House of Representatives by January 1, 2030.
920 (b) The department shall participate in a provider
921 retention and information system management multistate
922 collaborative that collects data to measure outcomes of
923 education debt support-for-service programs.
924 (3) This section is repealed on July 1, 2034.
925 Section 4. Section 381.9855, Florida Statutes, is created
926 to read:
927 381.9855 Health Care Screening and Services Grant Program;
928 portal.—
929 (1)(a) The Department of Health shall implement a Health
930 Care Screening and Services Grant Program. The purpose of the
931 program is to expand access to no-cost health care screenings or
932 services for the general public facilitated by nonprofit
933 entities. The department shall do all of the following:
934 1. Publicize the availability of funds and enlist the aid
935 of county health departments for outreach to potential
936 applicants at the local level.
937 2. Establish an application process for submitting a grant
938 proposal and criteria an applicant must meet to be eligible.
939 3. Develop guidelines a grant recipient must follow for the
940 expenditure of grant funds and uniform data reporting
941 requirements for the purpose of evaluating the performance of
942 grant recipients.
943 (b) A nonprofit entity may apply for grant funds in order
944 to implement new health care screening or services programs that
945 the entity has not previously implemented.
946 (c) A nonprofit entity that has previously implemented a
947 specific health care screening or services program at one or
948 more specific locations may apply for grant funds in order to
949 provide the same or similar screenings or services at new
950 locations or through a mobile health clinic or mobile unit in
951 order to expand the program’s delivery capabilities.
952 (d) An entity that receives a grant under this section
953 must:
954 1. Follow Department of Health guidelines for reporting on
955 expenditure of grant funds and measures to evaluate the
956 effectiveness of the entity’s health care screening or services
957 program.
958 2. Publicize to the general public and encourage the use of
959 the health care screening portal created under subsection (2).
960 (e) The Department of Health may adopt rules for the
961 implementation of this subsection.
962 (2)(a) The Department of Health shall create and maintain
963 an Internet-based portal to direct the general public to events,
964 organizations, and venues in this state from which health
965 screenings or services may be obtained at no cost or at a
966 reduced cost and for the purpose of directing licensed health
967 care practitioners to opportunities for volunteering their
968 services to conduct, administer, or facilitate such health
969 screenings or services. The department may contract with a
970 third-party vendor for the creation or maintenance of the
971 portal.
972 (b) The portal must be easily accessible by the public, not
973 require a sign-up or login, and include the ability for a member
974 of the public to enter his or her address and obtain localized
975 and current data on opportunities for screenings and services
976 and volunteer opportunities for health care practitioners. The
977 portal must include, but need not be limited to, all statutorily
978 created screening programs, other than newborn screenings
979 established under chapter 383, which are funded and operational
980 under the department’s authority. The department shall
981 coordinate with county health departments so that the portal
982 includes information on such health screenings and services
983 provided by county health departments or by nonprofit entities
984 in partnership with county health departments.
985 (c) The department shall include a clear and conspicuous
986 link to the portal on the homepage of its website. The
987 department shall publicize the portal to, and encourage the use
988 of the portal by, the general public and shall enlist the aid of
989 county health departments for such outreach.
990 Section 5. Section 383.2163, Florida Statutes, is amended
991 to read:
992 383.2163 Telehealth minority maternity care program pilot
993 programs.—By July 1, 2022, The department shall establish a
994 statewide telehealth minority maternity care pilot program that
995 in Duval County and Orange County which uses telehealth to
996 expand the capacity for positive maternal health outcomes in
997 racial and ethnic minority populations. The department may
998 enlist shall direct and assist the county health departments in
999 Duval County and Orange County to assist with program
1000 implementation implement the programs.
1001 (1) DEFINITIONS.—As used in this section, the term:
1002 (a) “Department” means the Department of Health.
1003 (b) “Eligible pregnant woman” means a pregnant woman who is
1004 receiving, or is eligible to receive, maternal or infant care
1005 services from the department under chapter 381 or this chapter.
1006 (c) “Health care practitioner” has the same meaning as in
1007 s. 456.001.
1008 (d) “Health professional shortage area” means a geographic
1009 area designated as such by the Health Resources and Services
1010 Administration of the United States Department of Health and
1011 Human Services.
1012 (e) “Indigenous population” means any Indian tribe, band,
1013 or nation or other organized group or community of Indians
1014 recognized as eligible for services provided to Indians by the
1015 United States Secretary of the Interior because of their status
1016 as Indians, including any Alaskan native village as defined in
1017 43 U.S.C. s. 1602(c), the Alaska Native Claims Settlement Act,
1018 as that definition existed on the effective date of this act.
1019 (f) “Maternal mortality” means a death occurring during
1020 pregnancy or the postpartum period which is caused by pregnancy
1021 or childbirth complications.
1022 (g) “Medically underserved population” means the population
1023 of an urban or rural area designated by the United States
1024 Secretary of Health and Human Services as an area with a
1025 shortage of personal health care services or a population group
1026 designated by the United States Secretary of Health and Human
1027 Services as having a shortage of such services.
1028 (h) “Perinatal professionals” means doulas, personnel from
1029 Healthy Start and home visiting programs, childbirth educators,
1030 community health workers, peer supporters, certified lactation
1031 consultants, nutritionists and dietitians, social workers, and
1032 other licensed and nonlicensed professionals who assist women
1033 through their prenatal or postpartum periods.
1034 (i) “Postpartum” means the 1-year period beginning on the
1035 last day of a woman’s pregnancy.
1036 (j) “Severe maternal morbidity” means an unexpected outcome
1037 caused by a woman’s labor and delivery which results in
1038 significant short-term or long-term consequences to the woman’s
1039 health.
1040 (k) “Technology-enabled collaborative learning and capacity
1041 building model” means a distance health care education model
1042 that connects health care professionals, particularly
1043 specialists, with other health care professionals through
1044 simultaneous interactive videoconferencing for the purpose of
1045 facilitating case-based learning, disseminating best practices,
1046 and evaluating outcomes in the context of maternal health care.
1047 (2) PURPOSE.—The purpose of the program pilot programs is
1048 to:
1049 (a) Expand the use of technology-enabled collaborative
1050 learning and capacity building models to improve maternal health
1051 outcomes for the following populations and demographics:
1052 1. Ethnic and minority populations.
1053 2. Health professional shortage areas.
1054 3. Areas with significant racial and ethnic disparities in
1055 maternal health outcomes and high rates of adverse maternal
1056 health outcomes, including, but not limited to, maternal
1057 mortality and severe maternal morbidity.
1058 4. Medically underserved populations.
1059 5. Indigenous populations.
1060 (b) Provide for the adoption of and use of telehealth
1061 services that allow for screening and treatment of common
1062 pregnancy-related complications, including, but not limited to,
1063 anxiety, depression, substance use disorder, hemorrhage,
1064 infection, amniotic fluid embolism, thrombotic pulmonary or
1065 other embolism, hypertensive disorders relating to pregnancy,
1066 diabetes, cerebrovascular accidents, cardiomyopathy, and other
1067 cardiovascular conditions.
1068 (3) TELEHEALTH SERVICES AND EDUCATION.—The program pilot
1069 programs shall adopt the use of telehealth or coordinate with
1070 prenatal home visiting programs, or both, to provide all of the
1071 following services and education to eligible pregnant women up
1072 to the last day of their postpartum periods, as applicable:
1073 (a) Referrals to Healthy Start’s coordinated intake and
1074 referral program to offer families prenatal home visiting
1075 services. The program may also accept referrals from the Healthy
1076 Start program of eligible pregnant women seeking services
1077 offered under the program.
1078 (b) Services and education addressing social determinants
1079 of health, including, but not limited to, all of the following:
1080 1. Housing placement options.
1081 2. Transportation services or information on how to access
1082 such services.
1083 3. Nutrition counseling.
1084 4. Access to healthy foods.
1085 5. Lactation support.
1086 6. Lead abatement and other efforts to improve air and
1087 water quality.
1088 7. Child care options.
1089 8. Car seat installation and training.
1090 9. Wellness and stress management programs.
1091 10. Coordination across safety net and social support
1092 services and programs.
1093 (c) Evidence-based health literacy and pregnancy,
1094 childbirth, and parenting education for women in the prenatal
1095 and postpartum periods.
1096 (d) For women during their pregnancies through the
1097 postpartum periods, connection to support from doulas and other
1098 perinatal health workers.
1099 (e) Tools for prenatal women to conduct key components of
1100 maternal wellness checks, including, but not limited to, all of
1101 the following:
1102 1. A device to measure body weight, such as a scale.
1103 2. A device to measure blood pressure which has a verbal
1104 reader to assist the pregnant woman in reading the device and to
1105 ensure that the health care practitioner performing the wellness
1106 check through telehealth is able to hear the reading.
1107 3. A device to measure blood sugar levels with a verbal
1108 reader to assist the pregnant woman in reading the device and to
1109 ensure that the health care practitioner performing the wellness
1110 check through telehealth is able to hear the reading.
1111 4. Any other device that the health care practitioner
1112 performing wellness checks through telehealth deems necessary.
1113 (4) TRAINING.—The program pilot programs shall provide
1114 training to participating health care practitioners and other
1115 perinatal professionals on all of the following:
1116 (a) Implicit and explicit biases, racism, and
1117 discrimination in the provision of maternity care and how to
1118 eliminate these barriers to accessing adequate and competent
1119 maternity care.
1120 (b) The use of remote patient monitoring tools for
1121 pregnancy-related complications.
1122 (c) How to screen for social determinants of health risks
1123 in the prenatal and postpartum periods, such as inadequate
1124 housing, lack of access to nutritional foods, environmental
1125 risks, transportation barriers, and lack of continuity of care.
1126 (d) Best practices in screening for and, as needed,
1127 evaluating and treating maternal mental health conditions and
1128 substance use disorders.
1129 (e) Information collection, recording, and evaluation
1130 activities to:
1131 1. Study the impact of the pilot program;
1132 2. Ensure access to and the quality of care;
1133 3. Evaluate patient outcomes as a result of the pilot
1134 program;
1135 4. Measure patient experience; and
1136 5. Identify best practices for the future expansion of the
1137 pilot program.
1138 (5) REPORTS.—By October 31, 2025, and each October 31
1139 thereafter, the department shall submit a program report to the
1140 Governor, the President of the Senate, and the Speaker of the
1141 House of Representatives which includes, at a minimum, all of
1142 the following for the previous fiscal year:
1143 (a) The total number of clients served and the demographic
1144 information for the population served, including ethnicity and
1145 race, age, education levels, and geographic location.
1146 (b) The total number of screenings performed, by type.
1147 (c) The number of participants identified as having
1148 experienced pregnancy-related complications, the number of
1149 participants who received treatments for such complications, and
1150 the final outcome of the pregnancy for such participants.
1151 (d) The number of referrals made to the Healthy Start
1152 program or other prenatal home visiting programs and the number
1153 of participants who subsequently received services from such
1154 programs.
1155 (e) The number of referrals made to doulas and other
1156 perinatal professionals and the number of participants who
1157 subsequently received services from doulas and other perinatal
1158 professionals.
1159 (f) The number and types of devices given to participants
1160 to conduct maternal wellness checks.
1161 (g) The average length of participation by program
1162 participants.
1163 (h) Composite results of a participant survey that measures
1164 the participants’ experience with the program.
1165 (i) The total number of health care practitioners trained,
1166 by provider type and specialty.
1167 (j) The results of a survey of the health care
1168 practitioners trained under the program. The survey must address
1169 the quality and impact of the training provided, the health care
1170 practitioners’ experiences using remote patient monitoring
1171 tools, the best practices provided in the training, and any
1172 suggestions for improvements.
1173 (k) Aggregate data on the maternal and infant health
1174 outcomes of program participants.
1175 (l) For the initial report, all available quantifiable data
1176 related to the telehealth minority maternity care pilot
1177 programs.
1178 (6) FUNDING.—The pilot programs shall be funded using funds
1179 appropriated by the Legislature for the Closing the Gap grant
1180 program. The department’s Division of Community Health Promotion
1181 and Office of Minority Health and Health Equity shall also work
1182 in partnership to apply for federal funds that are available to
1183 assist the department in accomplishing the program’s purpose and
1184 successfully implementing the program pilot programs.
1185 (7)(6) RULES.—The department may adopt rules to implement
1186 this section.
1187 Section 6. Present subsections (1) through (8), (9), and
1188 (10) of section 383.302, Florida Statutes, are redesignated as
1189 subsections (2) through (9), (11), and (12), respectively, new
1190 subsections (1) and (10) are added to that section, and present
1191 subsection (4) of that section is amended, to read:
1192 383.302 Definitions of terms used in ss. 383.30-383.332.—As
1193 used in ss. 383.30-383.332, the term:
1194 (1) “Advanced birth center” means a licensed birth center
1195 designated as an advanced birth center which may perform trial
1196 of labor after cesarean deliveries for screened patients who
1197 qualify; planned low-risk cesarean deliveries; and anticipated
1198 vaginal deliveries for laboring patients from the beginning of
1199 the 37th week of gestation through the end of the 41st week of
1200 gestation.
1201 (5)(4) “Consultant” means a physician licensed pursuant to
1202 chapter 458 or chapter 459 who agrees to provide advice and
1203 services to a birth center and who either:
1204 (a) Is certified or eligible for certification by the
1205 American Board of Obstetrics and Gynecology or the American
1206 Osteopathic Board of Obstetrics and Gynecology;, or
1207 (b) Has hospital obstetrical privileges.
1208 (10) “Medical director” means a person who holds an active
1209 unrestricted license as a physician under chapter 458 or chapter
1210 459.
1211 Section 7. Section 383.3081, Florida Statutes, is created
1212 to read:
1213 383.3081 Advanced birth center designation.—
1214 (1) To be designated as an advanced birth center, a birth
1215 center must, in addition to maintaining compliance with all of
1216 the requirements under ss. 383.30-383.332 applicable to birth
1217 centers and advanced birth centers, meet all of the following
1218 criteria:
1219 (a) Be operated and staffed 24 hours per day, 7 days per
1220 week.
1221 (b) Employ two medical directors to oversee the activities
1222 of the center, one of whom must be a board-certified
1223 obstetrician and one of whom must be a board-certified
1224 anesthesiologist.
1225 (c) Have at least one properly equipped, dedicated surgical
1226 suite for the performance of cesarean deliveries.
1227 (d) Employ at least one registered nurse and ensure that at
1228 least one registered nurse is present in the center at all times
1229 and has the ability to stabilize and facilitate the transfer of
1230 patients and newborn infants when appropriate.
1231 (e) Enter into a written agreement with a blood bank for
1232 emergency blood bank services and have written protocols for the
1233 management of obstetrical hemorrhage which include provisions
1234 for emergency blood transfusions. If a patient admitted to an
1235 advanced birth center receives an emergency blood transfusion at
1236 the center, the patient must immediately thereafter be
1237 transferred to a hospital for further care.
1238 (f) Meet all standards adopted by rule for birth centers,
1239 unless specified otherwise, and advanced birth centers pursuant
1240 to s. 383.309.
1241 (g) Comply with the Florida Building Code and Florida Fire
1242 Prevention Code standards for ambulatory surgical centers.
1243 (h) Qualify for, enter into, and maintain a Medicaid
1244 provider agreement with the agency pursuant to s. 409.907 and
1245 provide services to Medicaid recipients according to the terms
1246 of the provider agreement.
1247 (2) The agency shall establish by rule a process for
1248 designating a birth center that meets the requirements of this
1249 section as an advanced birth center. The agency may develop any
1250 requirements or standards it deems necessary for patient safety
1251 which advanced birth centers must meet as a condition of the
1252 designation.
1253 Section 8. Section 383.309, Florida Statutes, is amended to
1254 read:
1255 383.309 Minimum standards for birth centers and advanced
1256 birth centers; rules and enforcement.—
1257 (1) The agency shall adopt and enforce rules to administer
1258 ss. 383.30-383.332 and part II of chapter 408, which rules shall
1259 include, but are not limited to, reasonable and fair minimum
1260 standards for ensuring that:
1261 (a) Sufficient numbers and qualified types of personnel and
1262 occupational disciplines are available at all times to provide
1263 necessary and adequate patient care and safety.
1264 (b) Infection control, housekeeping, sanitary conditions,
1265 disaster plan, and medical record procedures that will
1266 adequately protect patient care and provide safety are
1267 established and implemented.
1268 (c) Licensed facilities are established, organized, and
1269 operated consistent with established programmatic standards.
1270 (2) The standards adopted by rule for designating a birth
1271 center as an advanced birth center must, at a minimum, be
1272 equivalent to the minimum standards adopted for ambulatory
1273 surgical centers pursuant to s. 395.1055 and must include
1274 standards for quality of care, blood transfusions, and sanitary
1275 conditions for food handling and food service.
1276 (3) The agency may not establish any rule governing the
1277 design, construction, erection, alteration, modification,
1278 repair, or demolition of birth centers. It is the intent of the
1279 Legislature to preempt that function to the Florida Building
1280 Commission and the State Fire Marshal through adoption and
1281 maintenance of the Florida Building Code and the Florida Fire
1282 Prevention Code. However, the agency shall provide technical
1283 assistance to the commission and the State Fire Marshal in
1284 updating the construction standards of the Florida Building Code
1285 and the Florida Fire Prevention Code which govern birth centers.
1286 In addition, the agency may enforce the special-occupancy
1287 provisions of the Florida Building Code and the Florida Fire
1288 Prevention Code which apply to birth centers in conducting any
1289 inspection authorized under this chapter or part II of chapter
1290 408.
1291 Section 9. Section 383.313, Florida Statutes, is amended to
1292 read:
1293 383.313 Birth center performance of laboratory and surgical
1294 services; use of anesthetic and chemical agents.—
1295 (1) LABORATORY SERVICES.—A birth center may collect
1296 specimens for those tests that are requested under protocol. A
1297 birth center must obtain and continuously maintain certification
1298 by the Centers for Medicare and Medicaid Services under the
1299 federal Clinical Laboratory Improvement Amendments and the
1300 federal rules adopted thereunder in order to perform laboratory
1301 tests specified by rule of the agency, and which are appropriate
1302 to meet the needs of the patient.
1303 (2) SURGICAL SERVICES.—Except for advanced birth centers
1304 authorized to provide surgical services under s. 383.3131, only
1305 those surgical procedures that are shall be limited to those
1306 normally performed during uncomplicated childbirths, such as
1307 episiotomies and repairs, may be performed at a birth center.
1308 and shall not include Operative obstetrics or cesarean caesarean
1309 sections may not be performed at a birth center.
1310 (3) ADMINISTRATION OF ANALGESIA AND ANESTHESIA.—General and
1311 conduction anesthesia may not be administered at a birth center.
1312 Systemic analgesia may be administered, and local anesthesia for
1313 pudendal block and episiotomy repair may be performed if
1314 procedures are outlined by the clinical staff and performed by
1315 personnel who have the with statutory authority to do so.
1316 (4) INTRAPARTAL USE OF CHEMICAL AGENTS.—Labor may not be
1317 inhibited, stimulated, or augmented with chemical agents during
1318 the first or second stage of labor unless prescribed by
1319 personnel who have the with statutory authority to do so and
1320 unless in connection with and before prior to emergency
1321 transport.
1322 Section 10. Section 383.3131, Florida Statutes, is created
1323 to read:
1324 383.3131 Advanced birth center performance of laboratory
1325 and surgical services; use of anesthetic and chemical agents.—
1326 (1) LABORATORY SERVICES.—An advanced birth center shall
1327 have a clinical laboratory on site. The clinical laboratory
1328 must, at a minimum, be capable of providing laboratory testing
1329 for hematology, metabolic screening, liver function, and
1330 coagulation studies. An advanced birth center may collect
1331 specimens for those tests that are requested under protocol. An
1332 advanced birth center may perform laboratory tests as defined by
1333 rule of the agency. Laboratories located in advanced birth
1334 centers must be appropriately certified by the Centers for
1335 Medicare and Medicaid Services under the federal Clinical
1336 Laboratory Improvement Amendments and the federal rules adopted
1337 thereunder.
1338 (2) SURGICAL SERVICES.—In addition to surgical procedures
1339 authorized under s. 383.313(2), surgical procedures for low-risk
1340 cesarean deliveries and surgical management of immediate
1341 complications may also be performed at an advanced birth center.
1342 Postpartum sterilization may be performed before discharge of
1343 the patient who has given birth during that admission.
1344 Circumcisions may be performed before discharge of the newborn
1345 infant.
1346 (3) ADMINISTRATION OF ANALGESIA AND ANESTHESIA.—General,
1347 conduction, and local anesthesia may be administered at an
1348 advanced birth center if administered by personnel who have the
1349 statutory authority to do so. All general anesthesia must be
1350 administered by an anesthesiologist or a certified registered
1351 nurse anesthetist in accordance with s. 464.012. When general
1352 anesthesia is administered, a physician or a certified
1353 registered nurse anesthetist must be present in the advanced
1354 birth center during the anesthesia and postanesthesia recovery
1355 period until the patient is fully alert. Each advanced birth
1356 center shall comply with s. 395.0191(2)(b).
1357 (4) INTRAPARTAL USE OF CHEMICAL AGENTS.—Labor may be
1358 inhibited, stimulated, or augmented with chemical agents during
1359 the first or second stage of labor at an advanced birth center
1360 if prescribed by personnel who have the statutory authority to
1361 do so. Labor may be electively induced beginning at the 39th
1362 week of gestation for a patient with a documented Bishop score
1363 of 8 or greater.
1364 Section 11. Subsection (3) is added to section 383.315,
1365 Florida Statutes, to read:
1366 383.315 Agreements with consultants for advice or services;
1367 maintenance.—
1368 (3) An advanced birth center shall employ or maintain an
1369 agreement with an obstetrician who must be on call at all times
1370 during which a patient is in active labor in the center to
1371 attend deliveries, available to respond to emergencies, and,
1372 when necessary, available to perform cesarean deliveries.
1373 Section 12. Section 383.316, Florida Statutes, is amended
1374 to read:
1375 383.316 Transfer and transport of clients to hospitals.—
1376 (1) If unforeseen complications arise during labor,
1377 delivery, or postpartum recovery, the client must shall be
1378 transferred to a hospital.
1379 (2) Each birth center licensed facility shall make
1380 arrangements with a local ambulance service licensed under
1381 chapter 401 for the transport of emergency patients to a
1382 hospital. Such arrangements must shall be documented in the
1383 center’s policy and procedures manual of the facility if the
1384 birth center does not own or operate a licensed ambulance. The
1385 policy and procedures manual shall also must contain specific
1386 protocols for the transfer of any patient to a licensed
1387 hospital.
1388 (3) Each advanced birth center shall enter into a written
1389 transfer agreement with a local hospital licensed under chapter
1390 395 for the transfer and admission of emergency patients to the
1391 hospital or a written agreement with an obstetrician who has
1392 hospital privileges to provide coverage at all times and who has
1393 agreed to accept the transfer of the advanced birth center’s
1394 patients.
1395 (4) A birth center licensed facility shall identify
1396 neonatal-specific transportation services, including ground and
1397 air ambulances; list their particular qualifications; and have
1398 the telephone numbers for access to these services clearly
1399 listed and immediately available.
1400 (5)(4) The birth center shall assess and document Annual
1401 assessments of the transportation services and transfer
1402 protocols annually shall be made and documented.
1403 Section 13. Present subsections (2) and (3) of section
1404 383.318, Florida Statutes, are redesignated as subsections (3)
1405 and (4), respectively, a new subsection (2) is added to that
1406 section, and subsection (1) of that section is amended, to read:
1407 383.318 Postpartum care for birth center clients and
1408 infants.—
1409 (1) Except at advanced birth centers that must adhere to
1410 the requirements of subsection (2), a mother and her infant must
1411 shall be dismissed from a the birth center within 24 hours after
1412 the birth of the infant, except in unusual circumstances as
1413 defined by rule of the agency. If a mother or her infant is
1414 retained at the birth center for more than 24 hours after the
1415 birth, a report must shall be filed with the agency within 48
1416 hours after of the birth and must describe describing the
1417 circumstances and the reasons for the decision.
1418 (2)(a) A mother and her infant must be dismissed from an
1419 advanced birth center within 48 hours after a vaginal delivery
1420 of the infant or within 72 hours after a delivery by cesarean
1421 section, except in unusual circumstances as defined by rule of
1422 the agency.
1423 (b) If a mother or her infant is retained at the advanced
1424 birth center for more than the timeframes set forth in paragraph
1425 (a), a report must be filed with the agency within 48 hours
1426 after the scheduled discharge time and must describe the
1427 circumstances and the reasons for the decision.
1428 Section 14. Subsections (5), (31), and (36) of section
1429 394.455, Florida Statutes, are amended to read:
1430 394.455 Definitions.—As used in this part, the term:
1431 (5) “Clinical psychologist” means a person licensed to
1432 practice psychology under chapter 490 a psychologist as defined
1433 in s. 490.003(7) with 3 years of postdoctoral experience in the
1434 practice of clinical psychology, inclusive of the experience
1435 required for licensure, or a psychologist employed by a facility
1436 operated by the United States Department of Veterans Affairs
1437 that qualifies as a receiving or treatment facility under this
1438 part.
1439 (31) “Mobile crisis response service” or “mobile response
1440 team” means a nonresidential behavioral health crisis service
1441 available 24 hours per day, 7 days per week which provides
1442 immediate intensive assessments and interventions, including
1443 screening for admission into a mental health receiving facility,
1444 an addictions receiving facility, or a detoxification facility,
1445 for the purpose of identifying appropriate treatment services.
1446 (36) “Psychiatric nurse” means an advanced practice
1447 registered nurse licensed under s. 464.012 who has a master’s or
1448 doctoral degree in psychiatric nursing and, holds a national
1449 advanced practice certification as a psychiatric mental health
1450 advanced practice nurse, and has 1 year 2 years of post-master’s
1451 clinical experience under the supervision of a physician.
1452 Section 15. Paragraph (c) of subsection (5) of section
1453 394.457, Florida Statutes, is amended to read:
1454 394.457 Operation and administration.—
1455 (5) RULES.—
1456 (c) The department shall adopt rules establishing minimum
1457 standards for services provided by a mental health overlay
1458 program or a mobile crisis response service. Minimum standards
1459 for a mobile crisis response service must:
1460 1. Include the requirements of the child, adolescent, and
1461 young adult mobile response teams established under s.
1462 394.495(7) and ensure coverage of all counties by these
1463 specified teams; and
1464 2. Create a structure for general mobile response teams
1465 which focuses on crisis diversion and the reduction of
1466 involuntary commitment under this chapter. The structure must
1467 require, but need not be limited to, the following:
1468 a. Triage and rapid crisis intervention within 60 minutes;
1469 b. Provision of and referral to evidence-based services
1470 that are responsive to the needs of the individual and the
1471 individual’s family;
1472 c. Screening, assessment, early identification, and care
1473 coordination; and
1474 d. Confirmation that the individual who received the mobile
1475 crisis response was connected to a service provider and
1476 prescribed medications, if needed.
1477 Section 16. Subsections (1) and (3) of section 394.4598,
1478 Florida Statutes, are amended to read:
1479 394.4598 Guardian advocate.—
1480 (1) The administrator may petition the court for the
1481 appointment of a guardian advocate based upon the opinion of a
1482 psychiatrist or psychiatric nurse practicing within the
1483 framework of an established protocol with a psychiatrist that
1484 the patient is incompetent to consent to treatment. If the court
1485 finds that a patient is incompetent to consent to treatment and
1486 has not been adjudicated incapacitated and had a guardian with
1487 the authority to consent to mental health treatment appointed,
1488 the court must it shall appoint a guardian advocate. The patient
1489 has the right to have an attorney represent him or her at the
1490 hearing. If the person is indigent, the court must shall appoint
1491 the office of the public defender to represent him or her at the
1492 hearing. The patient has the right to testify, cross-examine
1493 witnesses, and present witnesses. The proceeding must shall be
1494 recorded, either electronically or stenographically, and
1495 testimony must shall be provided under oath. One of the
1496 professionals authorized to give an opinion in support of a
1497 petition for involuntary placement, as described in s. 394.4655
1498 or s. 394.467, must testify. A guardian advocate must meet the
1499 qualifications of a guardian contained in part IV of chapter
1500 744, except that a professional referred to in this part, an
1501 employee of the facility providing direct services to the
1502 patient under this part, a departmental employee, a facility
1503 administrator, or member of the Florida local advocacy council
1504 may shall not be appointed. A person who is appointed as a
1505 guardian advocate must agree to the appointment.
1506 (3) A facility requesting appointment of a guardian
1507 advocate must, before prior to the appointment, provide the
1508 prospective guardian advocate with information about the duties
1509 and responsibilities of guardian advocates, including the
1510 information about the ethics of medical decisionmaking. Before
1511 asking a guardian advocate to give consent to treatment for a
1512 patient, the facility shall provide to the guardian advocate
1513 sufficient information so that the guardian advocate can decide
1514 whether to give express and informed consent to the treatment,
1515 including information that the treatment is essential to the
1516 care of the patient, and that the treatment does not present an
1517 unreasonable risk of serious, hazardous, or irreversible side
1518 effects. Before giving consent to treatment, the guardian
1519 advocate must meet and talk with the patient and the patient’s
1520 physician or psychiatric nurse practicing within the framework
1521 of an established protocol with a psychiatrist in person, if at
1522 all possible, and by telephone, if not. The decision of the
1523 guardian advocate may be reviewed by the court, upon petition of
1524 the patient’s attorney, the patient’s family, or the facility
1525 administrator.
1526 Section 17. Subsection (11) of section 394.4615, Florida
1527 Statutes, is amended to read:
1528 394.4615 Clinical records; confidentiality.—
1529 (11) Patients must shall have reasonable access to their
1530 clinical records, unless such access is determined by the
1531 patient’s physician or the patient’s psychiatric nurse to be
1532 harmful to the patient. If the patient’s right to inspect his or
1533 her clinical record is restricted by the facility, written
1534 notice of such restriction must shall be given to the patient
1535 and the patient’s guardian, guardian advocate, attorney, and
1536 representative. In addition, the restriction must shall be
1537 recorded in the clinical record, together with the reasons for
1538 it. The restriction of a patient’s right to inspect his or her
1539 clinical record expires shall expire after 7 days but may be
1540 renewed, after review, for subsequent 7-day periods.
1541 Section 18. Paragraph (f) of subsection (1) and subsection
1542 (5) of section 394.4625, Florida Statutes, are amended to read:
1543 394.4625 Voluntary admissions.—
1544 (1) AUTHORITY TO RECEIVE PATIENTS.—
1545 (f) Within 24 hours after admission of a voluntary patient,
1546 the treating admitting physician or psychiatric nurse practicing
1547 within the framework of an established protocol with a
1548 psychiatrist shall document in the patient’s clinical record
1549 that the patient is able to give express and informed consent
1550 for admission. If the patient is not able to give express and
1551 informed consent for admission, the facility must shall either
1552 discharge the patient or transfer the patient to involuntary
1553 status pursuant to subsection (5).
1554 (5) TRANSFER TO INVOLUNTARY STATUS.—When a voluntary
1555 patient, or an authorized person on the patient’s behalf, makes
1556 a request for discharge, the request for discharge, unless
1557 freely and voluntarily rescinded, must be communicated to a
1558 physician, a clinical psychologist with at least 3 years of
1559 clinical experience, or a psychiatrist as quickly as possible,
1560 but not later than 12 hours after the request is made. If the
1561 patient meets the criteria for involuntary placement, the
1562 administrator of the facility must file with the court a
1563 petition for involuntary placement, within 2 court working days
1564 after the request for discharge is made. If the petition is not
1565 filed within 2 court working days, the patient must shall be
1566 discharged. Pending the filing of the petition, the patient may
1567 be held and emergency treatment rendered in the least
1568 restrictive manner, upon the written order of a physician or a
1569 psychiatric nurse practicing within the framework of an
1570 established protocol with a psychiatrist, if it is determined
1571 that such treatment is necessary for the safety of the patient
1572 or others.
1573 Section 19. Paragraph (f) of subsection (2) of section
1574 394.463, Florida Statutes, is amended to read:
1575 394.463 Involuntary examination.—
1576 (2) INVOLUNTARY EXAMINATION.—
1577 (f) A patient must shall be examined by a physician or a
1578 clinical psychologist, or by a psychiatric nurse performing
1579 within the framework of an established protocol with a
1580 psychiatrist at a facility without unnecessary delay to
1581 determine if the criteria for involuntary services are met.
1582 Emergency treatment may be provided upon the order of a
1583 physician or a psychiatric nurse practicing within the framework
1584 of an established protocol with a psychiatrist if the physician
1585 or psychiatric nurse determines that such treatment is necessary
1586 for the safety of the patient or others. The patient may not be
1587 released by the receiving facility or its contractor without the
1588 documented approval of a psychiatrist or a clinical psychologist
1589 with at least 3 years of clinical experience or, if the
1590 receiving facility is owned or operated by a hospital, health
1591 system, or nationally accredited community mental health center,
1592 the release may also be approved by a psychiatric nurse
1593 performing within the framework of an established protocol with
1594 a psychiatrist, or an attending emergency department physician
1595 with experience in the diagnosis and treatment of mental illness
1596 after completion of an involuntary examination pursuant to this
1597 subsection. A psychiatric nurse may not approve the release of a
1598 patient if the involuntary examination was initiated by a
1599 psychiatrist unless the release is approved by the initiating
1600 psychiatrist. The release may be approved through telehealth.
1601 Section 20. Paragraphs (a) and (b) of subsection (3),
1602 paragraph (b) of subsection (7), and paragraph (a) of subsection
1603 (8) of section 394.4655, Florida Statutes, are amended to read:
1604 394.4655 Involuntary outpatient services.—
1605 (3) INVOLUNTARY OUTPATIENT SERVICES.—
1606 (a)1. A patient who is being recommended for involuntary
1607 outpatient services by the administrator of the facility where
1608 the patient has been examined may be retained by the facility
1609 after adherence to the notice procedures provided in s.
1610 394.4599. The recommendation must be supported by the opinion of
1611 a psychiatrist and the second opinion of a clinical psychologist
1612 with at least 3 years of clinical experience, or another
1613 psychiatrist, or a psychiatric nurse practicing within the
1614 framework of an established protocol with a psychiatrist, both
1615 of whom have personally examined the patient within the
1616 preceding 72 hours, that the criteria for involuntary outpatient
1617 services are met. However, if the administrator certifies that a
1618 psychiatrist or a clinical psychologist with at least 3 years of
1619 clinical experience is not available to provide the second
1620 opinion, the second opinion may be provided by a licensed
1621 physician who has postgraduate training and experience in
1622 diagnosis and treatment of mental illness, a physician assistant
1623 who has at least 3 years’ experience and is supervised by such
1624 licensed physician or a psychiatrist, a clinical social worker,
1625 a clinical psychologist with less than 3 years of clinical
1626 experience, or by a psychiatric nurse. Any second opinion
1627 authorized in this subparagraph may be conducted through a face
1628 to-face examination, in person or by electronic means. Such
1629 recommendation must be entered on an involuntary outpatient
1630 services certificate that authorizes the facility to retain the
1631 patient pending completion of a hearing. The certificate must be
1632 made a part of the patient’s clinical record.
1633 2. If the patient has been stabilized and no longer meets
1634 the criteria for involuntary examination pursuant to s.
1635 394.463(1), the patient must be released from the facility while
1636 awaiting the hearing for involuntary outpatient services. Before
1637 filing a petition for involuntary outpatient services, the
1638 administrator of the facility or a designated department
1639 representative must identify the service provider that will have
1640 primary responsibility for service provision under an order for
1641 involuntary outpatient services, unless the person is otherwise
1642 participating in outpatient psychiatric treatment and is not in
1643 need of public financing for that treatment, in which case the
1644 individual, if eligible, may be ordered to involuntary treatment
1645 pursuant to the existing psychiatric treatment relationship.
1646 3. The service provider shall prepare a written proposed
1647 treatment plan in consultation with the patient or the patient’s
1648 guardian advocate, if appointed, for the court’s consideration
1649 for inclusion in the involuntary outpatient services order that
1650 addresses the nature and extent of the mental illness and any
1651 co-occurring substance use disorder that necessitate involuntary
1652 outpatient services. The treatment plan must specify the likely
1653 level of care, including the use of medication, and anticipated
1654 discharge criteria for terminating involuntary outpatient
1655 services. Service providers may select and supervise other
1656 individuals to implement specific aspects of the treatment plan.
1657 The services in the plan must be deemed clinically appropriate
1658 by a physician, clinical psychologist, psychiatric nurse, mental
1659 health counselor, marriage and family therapist, or clinical
1660 social worker who consults with, or is employed or contracted
1661 by, the service provider. The service provider must certify to
1662 the court in the proposed plan whether sufficient services for
1663 improvement and stabilization are currently available and
1664 whether the service provider agrees to provide those services.
1665 If the service provider certifies that the services in the
1666 proposed treatment plan are not available, the petitioner may
1667 not file the petition. The service provider must notify the
1668 managing entity if the requested services are not available. The
1669 managing entity must document such efforts to obtain the
1670 requested services.
1671 (b) If a patient in involuntary inpatient placement meets
1672 the criteria for involuntary outpatient services, the
1673 administrator of the facility may, before the expiration of the
1674 period during which the facility is authorized to retain the
1675 patient, recommend involuntary outpatient services. The
1676 recommendation must be supported by the opinion of a
1677 psychiatrist and the second opinion of a clinical psychologist
1678 with at least 3 years of clinical experience, or another
1679 psychiatrist, or a psychiatric nurse practicing within the
1680 framework of an established protocol with a psychiatrist, both
1681 of whom have personally examined the patient within the
1682 preceding 72 hours, that the criteria for involuntary outpatient
1683 services are met. However, if the administrator certifies that a
1684 psychiatrist or a clinical psychologist with at least 3 years of
1685 clinical experience is not available to provide the second
1686 opinion, the second opinion may be provided by a licensed
1687 physician who has postgraduate training and experience in
1688 diagnosis and treatment of mental illness, a physician assistant
1689 who has at least 3 years’ experience and is supervised by such
1690 licensed physician or a psychiatrist, a clinical social worker,
1691 a clinical psychologist with less than 3 years of clinical
1692 experience, or by a psychiatric nurse. Any second opinion
1693 authorized in this subparagraph may be conducted through a face
1694 to-face examination, in person or by electronic means. Such
1695 recommendation must be entered on an involuntary outpatient
1696 services certificate, and the certificate must be made a part of
1697 the patient’s clinical record.
1698 (7) HEARING ON INVOLUNTARY OUTPATIENT SERVICES.—
1699 (b)1. If the court concludes that the patient meets the
1700 criteria for involuntary outpatient services pursuant to
1701 subsection (2), the court must shall issue an order for
1702 involuntary outpatient services. The court order must shall be
1703 for a period of up to 90 days. The order must specify the nature
1704 and extent of the patient’s mental illness. The order of the
1705 court and the treatment plan must be made part of the patient’s
1706 clinical record. The service provider shall discharge a patient
1707 from involuntary outpatient services when the order expires or
1708 any time the patient no longer meets the criteria for
1709 involuntary placement. Upon discharge, the service provider
1710 shall send a certificate of discharge to the court.
1711 2. The court may not order the department or the service
1712 provider to provide services if the program or service is not
1713 available in the patient’s local community, if there is no space
1714 available in the program or service for the patient, or if
1715 funding is not available for the program or service. The service
1716 provider must notify the managing entity if the requested
1717 services are not available. The managing entity must document
1718 such efforts to obtain the requested services. A copy of the
1719 order must be sent to the managing entity by the service
1720 provider within 1 working day after it is received from the
1721 court. The order may be submitted electronically through
1722 existing data systems. After the order for involuntary services
1723 is issued, the service provider and the patient may modify the
1724 treatment plan. For any material modification of the treatment
1725 plan to which the patient or, if one is appointed, the patient’s
1726 guardian advocate agrees, the service provider shall send notice
1727 of the modification to the court. Any material modifications of
1728 the treatment plan which are contested by the patient or the
1729 patient’s guardian advocate, if applicable, must be approved or
1730 disapproved by the court consistent with subsection (3).
1731 3. If, in the clinical judgment of a physician or a
1732 psychiatric nurse practicing within the framework of an
1733 established protocol with a psychiatrist, the patient has failed
1734 or has refused to comply with the treatment ordered by the
1735 court, and, in the clinical judgment of the physician or
1736 psychiatric nurse, efforts were made to solicit compliance and
1737 the patient may meet the criteria for involuntary examination, a
1738 person may be brought to a receiving facility pursuant to s.
1739 394.463. If, after examination, the patient does not meet the
1740 criteria for involuntary inpatient placement pursuant to s.
1741 394.467, the patient must be discharged from the facility. The
1742 involuntary outpatient services order must shall remain in
1743 effect unless the service provider determines that the patient
1744 no longer meets the criteria for involuntary outpatient services
1745 or until the order expires. The service provider must determine
1746 whether modifications should be made to the existing treatment
1747 plan and must attempt to continue to engage the patient in
1748 treatment. For any material modification of the treatment plan
1749 to which the patient or the patient’s guardian advocate, if
1750 applicable, agrees, the service provider shall send notice of
1751 the modification to the court. Any material modifications of the
1752 treatment plan which are contested by the patient or the
1753 patient’s guardian advocate, if applicable, must be approved or
1754 disapproved by the court consistent with subsection (3).
1755 (8) PROCEDURE FOR CONTINUED INVOLUNTARY OUTPATIENT
1756 SERVICES.—
1757 (a)1. If the person continues to meet the criteria for
1758 involuntary outpatient services, the service provider must
1759 shall, at least 10 days before the expiration of the period
1760 during which the treatment is ordered for the person, file in
1761 the court that issued the order for involuntary outpatient
1762 services a petition for continued involuntary outpatient
1763 services. The court shall immediately schedule a hearing on the
1764 petition to be held within 15 days after the petition is filed.
1765 2. The existing involuntary outpatient services order
1766 remains in effect until disposition on the petition for
1767 continued involuntary outpatient services.
1768 3. A certificate must shall be attached to the petition
1769 which includes a statement from the person’s physician or a
1770 clinical psychologist with at least 3 years of clinical
1771 experience justifying the request, a brief description of the
1772 patient’s treatment during the time he or she was receiving
1773 involuntary services, and an individualized plan of continued
1774 treatment.
1775 4. The service provider shall develop the individualized
1776 plan of continued treatment in consultation with the patient or
1777 the patient’s guardian advocate, if applicable. When the
1778 petition has been filed, the clerk of the court shall provide
1779 copies of the certificate and the individualized plan of
1780 continued services to the department, the patient, the patient’s
1781 guardian advocate, the state attorney, and the patient’s private
1782 counsel or the public defender.
1783 Section 21. Subsection (2) of section 394.467, Florida
1784 Statutes, is amended to read:
1785 394.467 Involuntary inpatient placement.—
1786 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be
1787 retained by a facility or involuntarily placed in a treatment
1788 facility upon the recommendation of the administrator of the
1789 facility where the patient has been examined and after adherence
1790 to the notice and hearing procedures provided in s. 394.4599.
1791 The recommendation must be supported by the opinion of a
1792 psychiatrist and the second opinion of a clinical psychologist
1793 with at least 3 years of clinical experience, or another
1794 psychiatrist, or a psychiatric nurse practicing within the
1795 framework of an established protocol with a psychiatrist, both
1796 of whom have personally examined the patient within the
1797 preceding 72 hours, that the criteria for involuntary inpatient
1798 placement are met. However, if the administrator certifies that
1799 a psychiatrist or a clinical psychologist with at least 3 years
1800 of clinical experience is not available to provide the second
1801 opinion, the second opinion may be provided by a licensed
1802 physician who has postgraduate training and experience in
1803 diagnosis and treatment of mental illness, a clinical
1804 psychologist with less than 3 years of clinical experience, or
1805 by a psychiatric nurse. Any opinion authorized in this
1806 subsection may be conducted through a face-to-face examination,
1807 in person, or by electronic means. Such recommendation must
1808 shall be entered on a petition for involuntary inpatient
1809 placement certificate that authorizes the facility to retain the
1810 patient pending transfer to a treatment facility or completion
1811 of a hearing.
1812 Section 22. Subsection (1) of section 394.4781, Florida
1813 Statutes, is amended to read:
1814 394.4781 Residential care for psychotic and emotionally
1815 disturbed children.—
1816 (1) DEFINITIONS.—As used in this section, the term:
1817 (b)(a) “Psychotic or severely emotionally disturbed child”
1818 means a child so diagnosed by a psychiatrist or a clinical
1819 psychologist with at least 3 years of clinical experience, each
1820 of whom must have who has specialty training and experience with
1821 children. Such a severely emotionally disturbed child or
1822 psychotic child shall be considered by this diagnosis to benefit
1823 by and require residential care as contemplated by this section.
1824 (a)(b) “Department” means the Department of Children and
1825 Families.
1826 Section 23. Subsection (2) of section 394.4785, Florida
1827 Statutes, is amended to read:
1828 394.4785 Children and adolescents; admission and placement
1829 in mental facilities.—
1830 (2) A person under the age of 14 who is admitted to any
1831 hospital licensed pursuant to chapter 395 may not be admitted to
1832 a bed in a room or ward with an adult patient in a mental health
1833 unit or share common areas with an adult patient in a mental
1834 health unit. However, a person 14 years of age or older may be
1835 admitted to a bed in a room or ward in the mental health unit
1836 with an adult if the admitting physician or psychiatric nurse
1837 documents in the case record that such placement is medically
1838 indicated or for reasons of safety. Such placement must shall be
1839 reviewed by the attending physician or a designee or on-call
1840 physician each day and documented in the case record.
1841 Section 24. Effective upon this act becoming a law, the
1842 Agency for Health Care Administration shall seek federal
1843 approval for coverage and reimbursement authority for mobile
1844 crisis response services pursuant to 42 U.S.C. s. 1396w-6. The
1845 Department of Children and Families must coordinate with the
1846 Agency for Health Care Administration to educate contracted
1847 providers of child, adolescent, and young adult mobile response
1848 team services on the process to enroll as a Medicaid provider;
1849 encourage and incentivize enrollment as a Medicaid provider; and
1850 reduce barriers to maximizing federal reimbursement for
1851 community-based mobile crisis response services.
1852 Section 25. Paragraph (a) of subsection (1) of section
1853 394.875, Florida Statutes, is amended to read:
1854 394.875 Crisis stabilization units, residential treatment
1855 facilities, and residential treatment centers for children and
1856 adolescents; authorized services; license required.—
1857 (1)(a) The purpose of a crisis stabilization unit is to
1858 stabilize and redirect a client to the most appropriate and
1859 least restrictive community setting available, consistent with
1860 the client’s needs. Crisis stabilization units may screen,
1861 assess, and admit for stabilization persons who present
1862 themselves to the unit and persons who are brought to the unit
1863 under s. 394.463. Clients may be provided 24-hour observation,
1864 medication prescribed by a physician, or psychiatrist, or
1865 psychiatric nurse performing within the framework of an
1866 established protocol with a psychiatrist, and other appropriate
1867 services. Crisis stabilization units shall provide services
1868 regardless of the client’s ability to pay and shall be limited
1869 in size to a maximum of 30 beds.
1870 Section 26. Paragraphs (i) and (j) are added to subsection
1871 (1) of section 395.1055, Florida Statutes, to read:
1872 395.1055 Rules and enforcement.—
1873 (1) The agency shall adopt rules pursuant to ss. 120.536(1)
1874 and 120.54 to implement the provisions of this part, which shall
1875 include reasonable and fair minimum standards for ensuring that:
1876 (i) A hospital that accepts payment from any medical school
1877 in exchange for, or directly or indirectly related to, allowing
1878 students from the medical school to obtain clinical hours or
1879 instruction at that hospital gives priority to medical students
1880 enrolled in a medical school listed in s. 458.3145(1)(i),
1881 regardless of such payments.
1882 (j) All hospitals with an emergency department, including
1883 hospital-based off-campus emergency departments, submit to the
1884 agency for approval a nonemergent care access plan (NCAP) for
1885 assisting patients to gain access to appropriate care settings
1886 when they either present at the emergency department with
1887 nonemergent health care needs or indicate, when receiving a
1888 medical screening examination, triage, or treatment at the
1889 hospital, that they lack regular access to primary care.
1890 Effective July 1, 2025, such NCAP must be approved by the agency
1891 before the hospital may receive initial licensure or licensure
1892 renewal occurring after that date. A hospital with an approved
1893 NCAP must submit data to the agency demonstrating the
1894 effectiveness of its plan as part of the licensure renewal
1895 process and must update the plan as necessary, or as directed by
1896 the agency, before each licensure renewal. An NCAP must include:
1897 1. Procedures that ensure the plan does not conflict or
1898 interfere with the hospital’s duties and responsibilities under
1899 s. 395.1041 or 42 U.S.C. s. 1395dd;
1900 2. Procedures to educate patients about care that would be
1901 best provided in a primary care setting and the importance of
1902 receiving regular primary care; and
1903 3. At least one of the following:
1904 a. A partnership agreement with one or more nearby
1905 federally qualified health centers or other primary care
1906 settings. The goals of such partnership agreement must include,
1907 but need not be limited to, identifying patients who have
1908 presented at the emergency department for nonemergent care, care
1909 that would best be provided in a primary care setting, or
1910 emergency care that could potentially have been avoided through
1911 the regular provision of primary care, and, if such a patient
1912 indicates that he or she lacks regular access to primary care,
1913 proactively establishing a relationship between the patient and
1914 the federally qualified health center or other primary care
1915 setting so that the patient develops a medical home at such
1916 setting for nonemergent and preventive health care services.
1917 b. The establishment, construction, and operation of a
1918 hospital-owned urgent care center colocated within or adjacent
1919 to the hospital emergency department location. After the
1920 hospital conducts a medical screening examination, and if
1921 appropriate for the patient’s needs, the hospital may seek to
1922 divert to the urgent care center a patient who presents at the
1923 emergency department needing nonemergent health care services.
1924 An NCAP with procedures for diverting a patient from the
1925 emergency department in this manner must include procedures for
1926 assisting such patients in identifying appropriate primary care
1927 settings, providing a current list, with contact information, of
1928 such settings within 20 miles of the hospital location, and
1929 subsequently assisting the patient in arranging for a follow-up
1930 examination in a primary care setting, as appropriate for the
1931 patient.
1932
1933 For such patients who are enrolled in the Medicaid program and
1934 are members of a Medicaid managed care plan, the hospital’s NCAP
1935 must include outreach to the patient’s Medicaid managed care
1936 plan and coordination with the managed care plan for
1937 establishing a relationship between the patient and a primary
1938 care setting as appropriate for the patient, which may include a
1939 federally qualified health center or other primary care setting
1940 with which the hospital has a partnership agreement. For such a
1941 Medicaid enrollee, the agency shall establish a process for the
1942 hospital to share updated contact information for the patient,
1943 if such information is in the hospital’s possession, with the
1944 patient’s managed care plan. This paragraph may not be construed
1945 to preclude a hospital from complying with s. 395.1041 or 42
1946 U.S.C. s. 1395dd.
1947 Section 27. Present subsections (5) and (6) of section
1948 408.051, Florida Statutes, are redesignated as subsections (6)
1949 and (7), respectively, and a new subsection (5) is added to that
1950 section, to read:
1951 408.051 Florida Electronic Health Records Exchange Act.—
1952 (5) HOSPITAL DATA.—A hospital as defined in s. 395.002(12)
1953 which maintains certified electronic health record technology
1954 must make available admit, transfer, and discharge data to the
1955 agency’s Florida Health Information Exchange program for the
1956 purpose of supporting public health data registries and patient
1957 care coordination. The agency may adopt rules to implement this
1958 subsection.
1959 Section 28. Present subsection (8) of section 409.909,
1960 Florida Statutes, is redesignated as subsection (10), a new
1961 subsection (8) and subsection (9) are added to that section, and
1962 paragraph (a) of subsection (6) of that section is amended, to
1963 read:
1964 409.909 Statewide Medicaid Residency Program.—
1965 (6) The Slots for Doctors Program is established to address
1966 the physician workforce shortage by increasing the supply of
1967 highly trained physicians through the creation of new resident
1968 positions, which will increase access to care and improve health
1969 outcomes for Medicaid recipients.
1970 (a)1. Notwithstanding subsection (4), the agency shall
1971 annually allocate $100,000 to hospitals and qualifying
1972 institutions for each newly created resident position that is
1973 first filled on or after June 1, 2023, and filled thereafter,
1974 and that is accredited by the Accreditation Council for Graduate
1975 Medical Education or the Osteopathic Postdoctoral Training
1976 Institution in an initial or established accredited training
1977 program which is in a physician specialty or subspecialty in a
1978 statewide supply-and-demand deficit.
1979 2. Notwithstanding the requirement that a new resident
1980 position be created to receive funding under this subsection,
1981 the agency may allocate $100,000 to hospitals and qualifying
1982 institutions, pursuant to subparagraph 1., for up to 200
1983 resident positions that existed before July 1, 2023, if such
1984 resident position:
1985 a. Is in a physician specialty or subspecialty experiencing
1986 a statewide supply-and-demand deficit;
1987 b. Has been unfilled for a period of 3 or more years;
1988 c. Is subsequently filled on or after June 1, 2024, and
1989 remains filled thereafter; and
1990 d. Is accredited by the Accreditation Council for Graduate
1991 Medical Education or the Osteopathic Postdoctoral Training
1992 Institution in an initial or established accredited training
1993 program.
1994 3. If applications for resident positions under this
1995 paragraph exceed the number of authorized resident positions or
1996 the available funding allocated, the agency shall prioritize
1997 applications for resident positions that are in a primary care
1998 specialty as specified in paragraph (2)(a).
1999 (8) If a hospital or qualifying institution receives state
2000 funds, including, but not limited to, intergovernmental
2001 transfers, under any of the programs established under this
2002 chapter, that hospital or qualifying institution must annually
2003 report to the agency data on each resident position funded.
2004 (a) Specific to funds allocated under this section, other
2005 than funds allocated pursuant to subsection (5), the data
2006 required to be reported under this subsection must include, but
2007 is not limited to, all of the following:
2008 1. The sponsoring institution for the resident position. As
2009 used in this section, the term “sponsoring institution” means an
2010 organization that oversees, supports, and administers one or
2011 more resident positions.
2012 2. The year the position was created and the current
2013 program year of the resident who is filling the position.
2014 3. Whether the position is currently filled and whether
2015 there has been any period of time when it was not filled.
2016 4. The specialty or subspecialty for which the position is
2017 accredited and whether the position is a fellowship position.
2018 5. Each state funding source that was used to create the
2019 position or is being used to maintain the position, and the
2020 general purpose for which the funds were used.
2021 (b) Specific to funds allocated pursuant to subsection (5)
2022 on or after July 1, 2021, the data must include, but is not
2023 limited to, all of the following:
2024 1. The date on which the hospital or qualifying institution
2025 applied for funds under the program.
2026 2. The date on which the position funded by the program
2027 became accredited.
2028 3. The date on which the position was first filled and
2029 whether it has remained filled.
2030 4. The specialty of the position created.
2031 (c) Beginning on July 1, 2025, each hospital or qualifying
2032 institution shall annually produce detailed financial records no
2033 later than 30 days after the end of its fiscal year, detailing
2034 the manner in which state funds allocated under this section
2035 were expended. This requirement does not apply to funds
2036 allocated before July 1, 2025. The agency may also require that
2037 any hospital or qualifying institution submit to an audit of its
2038 financial records related to funds allocated under this section
2039 after July 1, 2025.
2040 (d) If a hospital or qualifying institution fails to
2041 produce records as required by this section, such hospital or
2042 qualifying institution is no longer eligible to participate in
2043 any program established under this section until the hospital or
2044 qualifying institution has met the agency’s requirements for
2045 producing the required records.
2046 (e) Upon completion of a residency, each hospital or
2047 qualifying institution must request that the resident fill out
2048 an exit survey on a form developed by the agency. The completed
2049 exit surveys must be provided to the agency annually. The exit
2050 survey must include, but need not be limited to, questions on
2051 all of the following:
2052 1. Whether the exiting resident has procured employment.
2053 2. Whether the exiting resident plans to leave the state
2054 and, if so, for which reasons.
2055 3. Where and in which specialty the exiting resident
2056 intends to practice.
2057 4. Whether the exiting resident envisions himself or
2058 herself working in the medical field as a long-term career.
2059 (9) The Graduate Medical Education Committee is created
2060 within the agency.
2061 (a) The committee shall be composed of the following
2062 members:
2063 1. Three deans, or their designees, from medical schools in
2064 this state, appointed by the chair of the Council of Florida
2065 Medical School Deans.
2066 2. Four members appointed by the Governor, one of whom is a
2067 representative of the Florida Medical Association or the Florida
2068 Osteopathic Medical Association who has supervised or is
2069 currently supervising residents, one of whom is a member of the
2070 Florida Hospital Association, one of whom is a member of the
2071 Safety Net Hospital Alliance, and one of whom is a physician
2072 licensed under chapter 458 or chapter 459 practicing at a
2073 qualifying institution.
2074 3. Two members appointed by the Secretary of Health Care
2075 Administration, one of whom represents a statutory teaching
2076 hospital as defined in s. 408.07(46) and one of whom is a
2077 physician who has supervised or is currently supervising
2078 residents.
2079 4. Two members appointed by the State Surgeon General, one
2080 of whom must represent a teaching hospital as defined in s.
2081 408.07 and one of whom is a physician who has supervised or is
2082 currently supervising residents or interns.
2083 5. Two members, one appointed by the President of the
2084 Senate and one appointed by the Speaker of the House of the
2085 Representatives.
2086 (b)1. The members of the committee appointed under
2087 subparagraph (a)1. shall serve 4-year terms. When such members’
2088 terms expire, the chair of the Council of Florida Medical School
2089 Deans shall appoint new members as detailed in paragraph (a)1.
2090 from different medical schools on a rotating basis and may not
2091 reappoint a dean from a medical school that has been represented
2092 on the committee until all medical schools in the state have had
2093 an opportunity to be represented on the committee.
2094 2. The members of the committee appointed under
2095 subparagraphs (a)2., 3., and 4. shall serve 4-year terms, with
2096 the initial term being 3 years for members appointed under
2097 subparagraph (a)4. and 2 years for members appointed under
2098 subparagraph (a)3. The committee shall elect a chair to serve
2099 for a 1-year term.
2100 (c) Members shall serve without compensation but are
2101 entitled to reimbursement for per diem and travel expenses
2102 pursuant to s. 112.061.
2103 (d) The committee shall convene its first meeting by July
2104 1, 2024, and shall meet as often as necessary to conduct its
2105 business, but at least twice annually, at the call of the chair.
2106 The committee may conduct its meetings though teleconference or
2107 other electronic means. A majority of the members of the
2108 committee constitutes a quorum, and a meeting may not be held
2109 with less than a quorum present. The affirmative vote of a
2110 majority of the members of the committee present is necessary
2111 for any official action by the committee.
2112 (e) Beginning on July 1, 2025, the committee shall submit
2113 an annual report to the Governor, the President of the Senate,
2114 and the Speaker of the House of Representatives which must, at a
2115 minimum, detail all of the following:
2116 1. The role of residents and medical faculty in the
2117 provision of health care.
2118 2. The relationship of graduate medical education to the
2119 state’s physician workforce.
2120 3. The typical workload for residents and the role such
2121 workload plays in retaining physicians in the long-term
2122 workforce.
2123 4. The costs of training medical residents for hospitals
2124 and qualifying institutions.
2125 5. The availability and adequacy of all sources of revenue
2126 available to support graduate medical education.
2127 6. The use of state funds, including, but not limited to,
2128 intergovernmental transfers, for graduate medical education for
2129 each hospital or qualifying institution receiving such funds.
2130 (f) The agency shall provide reasonable and necessary
2131 support staff and materials to assist the committee in the
2132 performance of its duties. The agency shall also provide the
2133 information obtained pursuant to subsection (8) to the committee
2134 and assist the committee, as requested, in obtaining any other
2135 information deemed necessary by the committee to produce its
2136 report.
2137 Section 29. Section 409.91256, Florida Statutes, is created
2138 to read:
2139 409.91256 Training, Education, and Clinicals in Health
2140 (TEACH) Funding Program.—
2141 (1) PURPOSE AND INTENT.—The Training, Education, and
2142 Clinicals in Health (TEACH) Funding Program is created to
2143 provide a high-quality educational experience while supporting
2144 participating federally qualified health centers, community
2145 mental health centers, rural health clinics, and certified
2146 community behavioral health clinics by offsetting administrative
2147 costs and loss of revenue associated with training residents and
2148 students to become licensed health care practitioners. Further,
2149 it is the intent of the Legislature to use the program to
2150 support the state Medicaid program and underserved populations
2151 by expanding the available health care workforce.
2152 (2) DEFINITIONS.—As used in this section, the term:
2153 (a) “Agency” means the Agency for Health Care
2154 Administration.
2155 (b) “Preceptor” means a Florida-licensed health care
2156 practitioner who directs, teaches, supervises, and evaluates the
2157 learning experience of a resident or student during a clinical
2158 rotation.
2159 (c) “Primary care specialty” means general internal
2160 medicine, family medicine, obstetrics and gynecology, general
2161 pediatrics, psychiatry, geriatric medicine, or any other
2162 specialty the agency identifies as primary care.
2163 (d) “Qualified facility” means a federally qualified health
2164 center, a community mental health center, rural health clinic,
2165 or a certified community behavioral health clinic.
2166 (3) APPLICATION FOR REIMBURSEMENT; AGREEMENTS;
2167 PARTICIPATION REQUIREMENTS.—The agency shall develop an
2168 application process for qualified facilities to apply for funds
2169 to offset the administrative costs and loss of revenue
2170 associated with establishing, maintaining, or expanding a
2171 clinical training program. Upon approving an application, the
2172 agency shall enter into an agreement with the qualified facility
2173 which, at minimum, must require the qualified facility to do all
2174 of the following:
2175 (a) Agree to provide appropriate supervision or precepting
2176 for one or more of the following categories of residents or
2177 students:
2178 1. Allopathic or osteopathic residents pursuing a primary
2179 care specialty.
2180 2. Dental residents.
2181 3. Advanced practice registered nursing students pursuing a
2182 primary care specialty.
2183 4. Nursing students.
2184 5. Allopathic or osteopathic medical students.
2185 6. Dental students.
2186 7. Dental hygiene students.
2187 8. Physician assistant students.
2188 9. Behavioral health students, including students studying
2189 psychology, clinical social work, marriage and family therapy,
2190 or mental health counseling.
2191 (b) Meet and maintain all requirements to operate an
2192 accredited residency program if the qualified facility operates
2193 a residency program.
2194 (c) Obtain and maintain accreditation from an accreditation
2195 body approved by the agency if the qualified facility provides
2196 clinical rotations.
2197 (d) Ensure that clinical preceptors meet agency standards
2198 for precepting students, including the completion of any
2199 training required by the agency.
2200 (e) Submit quarterly reports to the agency by the first day
2201 of the second month following the end of a quarter to obtain
2202 reimbursement. At a minimum, the report must include all of the
2203 following:
2204 1. The type of residency or clinical rotation offered by
2205 the qualified facility, the number of residents or students
2206 participating in each type of clinical rotation or residency,
2207 and the number of hours worked by each resident or student each
2208 month.
2209 2. Evaluations by the residents and student participants of
2210 the clinical experience on an evaluation form developed by the
2211 agency.
2212 3. An itemized list of administrative costs associated with
2213 the operation of the clinical training program, including
2214 accreditation costs and other costs relating to the creation,
2215 implementation, and maintenance of the program.
2216 4. A calculation of lost revenue associated with operating
2217 the clinical training program.
2218 (4) TRAINING.—The agency, in consultation with the
2219 Department of Health, shall develop, or contract for the
2220 development of, training for preceptors and make such training
2221 available in either a live or electronic format. The agency
2222 shall also provide technical support for preceptors.
2223 (5) REIMBURSEMENT.—Qualified facilities may be reimbursed
2224 under this section only to offset the administrative costs or
2225 lost revenue associated with training students, allopathic
2226 residents, osteopathic residents, or dental residents who are
2227 enrolled in an accredited educational or residency program based
2228 in this state.
2229 (a) Subject to an appropriation, the agency may reimburse a
2230 qualified facility based on the number of clinical training
2231 hours reported under subparagraph (3)(e)1. The allowed
2232 reimbursement per student is as follows:
2233 1. A medical or dental resident at a rate of $50 per hour.
2234 2. A first-year medical student at a rate of $27 per hour.
2235 3. A second-year medical student at a rate of $27 per hour.
2236 4. A third-year medical student at a rate of $29 per hour.
2237 5. A fourth-year medical student at a rate of $29 per hour.
2238 6. A dental student at a rate of $22 per hour.
2239 7. An advanced practice registered nursing student at a
2240 rate of $22 per hour.
2241 8. A physician assistant student at a rate of $22 per hour.
2242 9. A behavioral health student at a rate of $15 per hour.
2243 10. A dental hygiene student at a rate of $15 per hour.
2244 (b) A qualified facility may not be reimbursed more than
2245 $75,000 per fiscal year; however, if it operates a residency
2246 program, it may be reimbursed up to $100,000 each fiscal year.
2247 (6) DATA.—A qualified facility that receives payment under
2248 the program shall furnish information requested by the agency
2249 for the purpose of the agency’s duties under subsections (7) and
2250 (8).
2251 (7) REPORTS.—By December 1, 2025, and each December 1
2252 thereafter, the agency shall submit to the Governor, the
2253 President of the Senate, and the Speaker of the House of
2254 Representatives a report detailing the effects of the program
2255 for the prior fiscal year, including, but not limited to, all of
2256 the following:
2257 (a) The number of students trained in the program, by
2258 school, area of study, and clinical hours earned.
2259 (b) The number of students trained and the amount of
2260 program funds received by each participating qualified facility.
2261 (c) The number of program participants found to be employed
2262 by a participating qualified facility or in a federally
2263 designated health professional shortage area upon completion of
2264 their education and training.
2265 (d) Any other data the agency deems useful for determining
2266 the effectiveness of the program.
2267 (8) EVALUATION.—The agency shall contract with an
2268 independent third party to develop and conduct a design study to
2269 evaluate the impact of the TEACH funding program, including, but
2270 not limited to, the program’s effectiveness in both of the
2271 following areas:
2272 (a) Enabling qualified facilities to provide clinical
2273 rotations and residency opportunities to students and medical
2274 school graduates, as applicable.
2275 (b) Enabling the recruitment and retention of health care
2276 professionals in geographic and practice areas experiencing
2277 shortages.
2278
2279 The agency shall begin collecting data for the study by January
2280 1, 2025, and shall submit the results of the study to the
2281 Governor, the President of the Senate, and the Speaker of the
2282 House of Representatives by January 1, 2030.
2283 (9) RULES.—The agency may adopt rules to implement this
2284 section.
2285 (10) FEDERAL FUNDING.—The agency shall seek federal
2286 approval to use Title XIX matching funds for the program.
2287 (11) SUNSET.—This section is repealed on July 1, 2034.
2288 Section 30. Paragraph (e) of subsection (2) of section
2289 409.967, Florida Statutes, is amended to read:
2290 409.967 Managed care plan accountability.—
2291 (2) The agency shall establish such contract requirements
2292 as are necessary for the operation of the statewide managed care
2293 program. In addition to any other provisions the agency may deem
2294 necessary, the contract must require:
2295 (e) Encounter data.—The agency shall maintain and operate a
2296 Medicaid Encounter Data System to collect, process, store, and
2297 report on covered services provided to all Medicaid recipients
2298 enrolled in prepaid plans.
2299 1. Each prepaid plan must comply with the agency’s
2300 reporting requirements for the Medicaid Encounter Data System.
2301 Prepaid plans must submit encounter data electronically in a
2302 format that complies with the Health Insurance Portability and
2303 Accountability Act provisions for electronic claims and in
2304 accordance with deadlines established by the agency. Prepaid
2305 plans must certify that the data reported is accurate and
2306 complete.
2307 2. The agency is responsible for validating the data
2308 submitted by the plans. The agency shall develop methods and
2309 protocols for ongoing analysis of the encounter data that
2310 adjusts for differences in characteristics of prepaid plan
2311 enrollees to allow comparison of service utilization among plans
2312 and against expected levels of use. The analysis shall be used
2313 to identify possible cases of systemic underutilization or
2314 denials of claims and inappropriate service utilization such as
2315 higher-than-expected emergency department encounters. The
2316 analysis shall provide periodic feedback to the plans and enable
2317 the agency to establish corrective action plans when necessary.
2318 One of the focus areas for the analysis shall be the use of
2319 prescription drugs.
2320 3. The agency shall make encounter data available to those
2321 plans accepting enrollees who are assigned to them from other
2322 plans leaving a region.
2323 4. The agency shall annually produce a report entitled
2324 “Analysis of Potentially Preventable Health Care Events of
2325 Florida Medicaid Enrollees.” The report must include, but need
2326 not be limited to, an analysis of the potentially preventable
2327 hospital emergency department visits, hospital admissions, and
2328 hospital readmissions that occurred during the previous state
2329 fiscal year which may have been prevented with better access to
2330 primary care, improved medication management, or better
2331 coordination of care, reported by age, eligibility group,
2332 managed care plan, and region, including conditions contributing
2333 to each potentially preventable event or category of potentially
2334 preventable events. The agency may include any other data or
2335 analysis parameters to augment the report which it deems
2336 pertinent to the analysis. The report must demonstrate trends
2337 using applicable historical data. The agency shall submit the
2338 report to the Governor, the President of the Senate, and the
2339 Speaker of the House of Representatives by October 1, 2024, and
2340 each October 1 thereafter. The agency may contract with a third
2341 party vendor to produce the report required under this
2342 subparagraph.
2343 Section 31. Subsection (4) of section 409.973, Florida
2344 Statutes, is amended to read:
2345 409.973 Benefits.—
2346 (4) PRIMARY CARE INITIATIVE.—Each plan operating in the
2347 managed medical assistance program shall establish a program to
2348 encourage enrollees to establish a relationship with their
2349 primary care provider. Each plan shall:
2350 (a) Provide information to each enrollee on the importance
2351 of and procedure for selecting a primary care provider, and
2352 thereafter automatically assign to a primary care provider any
2353 enrollee who fails to choose a primary care provider.
2354 (b) If the enrollee was not a Medicaid recipient before
2355 enrollment in the plan, assist the enrollee in scheduling an
2356 initial appointment with the primary care provider. If possible,
2357 such enrollee’s initial the appointment should be made within 30
2358 days after enrollment in the plan. If an initial appointment is
2359 not made within such 30-day period, the plan must continue
2360 assisting the enrollee to schedule an initial appointment and
2361 must report the delay and the reason for the delay to the
2362 agency. The plan shall seek to ensure that such an enrollee has
2363 at least one appointment annually with his or her primary care
2364 provider.
2365 (c) Report to the agency the number of enrollees assigned
2366 to each primary care provider within the plan’s network.
2367 (d) Report to the agency the number of enrollees who have
2368 not had an appointment with their primary care provider within
2369 their first year of enrollment.
2370 (e) Report to the agency the number of emergency room
2371 visits by enrollees who have not had at least one appointment
2372 with their primary care provider.
2373 (f) Coordinate with a hospital that contacts the plan under
2374 the requirements of s. 395.1055(1)(j) for the purpose of
2375 establishing the appropriate delivery of primary care services
2376 for the plan’s members who present at the hospital’s emergency
2377 department for nonemergent care or emergency care that could
2378 potentially have been avoided through the regular provision of
2379 primary care. The plan shall coordinate with such member and the
2380 member’s primary care provider for such purpose.
2381 Section 32. The Agency for Health Care Administration shall
2382 seek federal approval necessary to implement an acute hospital
2383 care at home program in the state Medicaid program which is
2384 substantially consistent with the parameters specified in 42
2385 U.S.C. s. 1395cc–7(a)(2) and (3).
2386 Section 33. Paragraph (f) of subsection (1) and subsections
2387 (3) and (8) of section 458.311, Florida Statutes, are amended to
2388 read:
2389 458.311 Licensure by examination; requirements; fees.—
2390 (1) Any person desiring to be licensed as a physician, who
2391 does not hold a valid license in any state, shall apply to the
2392 department on forms furnished by the department. The department
2393 shall license each applicant who the board certifies:
2394 (f) Meets one of the following medical education and
2395 postgraduate training requirements:
2396 1.a. Is a graduate of an allopathic medical school or
2397 allopathic college recognized and approved by an accrediting
2398 agency recognized by the United States Office of Education or is
2399 a graduate of an allopathic medical school or allopathic college
2400 within a territorial jurisdiction of the United States
2401 recognized by the accrediting agency of the governmental body of
2402 that jurisdiction;
2403 b. If the language of instruction of the medical school is
2404 other than English, has demonstrated competency in English
2405 through presentation of a satisfactory grade on the Test of
2406 Spoken English of the Educational Testing Service or a similar
2407 test approved by rule of the board; and
2408 c. Has completed an approved residency of at least 1 year.
2409 2.a. Is a graduate of an allopathic foreign medical school
2410 registered with the World Health Organization and certified
2411 pursuant to s. 458.314 as having met the standards required to
2412 accredit medical schools in the United States or reasonably
2413 comparable standards;
2414 b. If the language of instruction of the foreign medical
2415 school is other than English, has demonstrated competency in
2416 English through presentation of the Educational Commission for
2417 Foreign Medical Graduates English proficiency certificate or by
2418 a satisfactory grade on the Test of Spoken English of the
2419 Educational Testing Service or a similar test approved by rule
2420 of the board; and
2421 c. Has completed an approved residency of at least 1 year.
2422 3.a. Is a graduate of an allopathic foreign medical school
2423 which has not been certified pursuant to s. 458.314 and has not
2424 been excluded from consideration under s. 458.314(8);
2425 b. Has had his or her medical credentials evaluated by the
2426 Educational Commission for Foreign Medical Graduates, holds an
2427 active, valid certificate issued by that commission, and has
2428 passed the examination utilized by that commission; and
2429 c. Has completed an approved residency of at least 1 year;
2430 however, after October 1, 1992, the applicant shall have
2431 completed an approved residency or fellowship of at least 2
2432 years in one specialty area. However, to be acceptable, the
2433 fellowship experience and training must be counted toward
2434 regular or subspecialty certification by a board recognized and
2435 certified by the American Board of Medical Specialties.
2436 (3) Notwithstanding the provisions of subparagraph
2437 (1)(f)3., a graduate of a foreign medical school that has not
2438 been excluded from consideration under s. 458.314(8) need not
2439 present the certificate issued by the Educational Commission for
2440 Foreign Medical Graduates or pass the examination utilized by
2441 that commission if the graduate:
2442 (a) Has received a bachelor’s degree from an accredited
2443 United States college or university.
2444 (b) Has studied at a medical school which is recognized by
2445 the World Health Organization.
2446 (c) Has completed all of the formal requirements of the
2447 foreign medical school, except the internship or social service
2448 requirements, and has passed part I of the National Board of
2449 Medical Examiners examination or the Educational Commission for
2450 Foreign Medical Graduates examination equivalent.
2451 (d) Has completed an academic year of supervised clinical
2452 training in a hospital affiliated with a medical school approved
2453 by the Council on Medical Education of the American Medical
2454 Association and upon completion has passed part II of the
2455 National Board of Medical Examiners examination or the
2456 Educational Commission for Foreign Medical Graduates examination
2457 equivalent.
2458 (8) When the board determines that any applicant for
2459 licensure has failed to meet, to the board’s satisfaction, each
2460 of the appropriate requirements set forth in this section, it
2461 may enter an order requiring one or more of the following terms:
2462 (a) Refusal to certify to the department an application for
2463 licensure, certification, or registration;
2464 (b) Certification to the department of an application for
2465 licensure, certification, or registration with restrictions on
2466 the scope of practice of the licensee; or
2467 (c) Certification to the department of an application for
2468 licensure, certification, or registration with placement of the
2469 physician on probation for a period of time and subject to such
2470 conditions as the board may specify, including, but not limited
2471 to, requiring the physician to submit to treatment, attend
2472 continuing education courses, submit to reexamination, or work
2473 under the supervision of another physician;
2474 (d) Certification to the department of a person desiring to
2475 be licensed as a physician under this section who has held an
2476 active medical faculty certificate under s. 458.3145 for at
2477 least 3 years and has held a full-time faculty appointment for
2478 at least 3 consecutive years to teach in a program of medicine
2479 listed under s. 458.3145(1)(i); or
2480 (e) Certification to the department of an application for
2481 licensure submitted by a graduate of a foreign medical school
2482 that has not been excluded from consideration under s.
2483 458.314(8) if the graduate has not completed an approved
2484 residency under sub-subparagraphs (1)(f)2.c. or 3.c. but meets
2485 the following criteria:
2486 1. Has an active, unencumbered license to practice medicine
2487 in a foreign country;
2488 2. Has actively practiced medicine during the entire 4-year
2489 period preceding the date of the submission of a licensure
2490 application;
2491 3. Has completed a residency or substantially similar
2492 postgraduate medical training in a country recognized by his or
2493 her licensing jurisdiction which is substantially similar to a
2494 residency program accredited by the Accreditation Council for
2495 Graduate Medical Education, as determined by the board;
2496 4. Has had his or her medical credentials evaluated by the
2497 Educational Commission for Foreign Medical Graduates, holds an
2498 active, valid certificate issued by that commission, and has
2499 passed the examination used by that commission; and
2500 5. Has an offer for full-time employment as a physician
2501 from a health care provider that operates in this state. For the
2502 purposes of this paragraph, the term “health care provider”
2503 means a health care professional, health care facility, or
2504 entity licensed or certified to provide health services in this
2505 state as recognized by the board.
2506
2507 An applicant who is not certified for unrestricted licensure
2508 under this paragraph may be certified by the board under
2509 paragraph (b) or paragraph (c), as applicable. A physician
2510 licensed after receiving certification under this paragraph must
2511 maintain his or her employment with the original employer or
2512 with another health care provider that operates in this state,
2513 at a location within this state, for at least 2 consecutive
2514 years after licensure, in accordance with rules adopted by the
2515 board. Such physician must notify the board within 5 business
2516 days after any change of employer.
2517 Section 34. Section 458.3124, Florida Statutes, is
2518 repealed.
2519 Section 35. Subsection (8) of section 458.314, Florida
2520 Statutes, is amended to read:
2521 458.314 Certification of foreign educational institutions.—
2522 (8) If a foreign medical school does not seek certification
2523 under this section, the board may, at its discretion, exclude
2524 the foreign medical school from consideration as an institution
2525 that provides medical education that is reasonably comparable to
2526 that of similar accredited institutions in the United States and
2527 that adequately prepares its students for the practice of
2528 medicine in this state. However, a license or medical faculty
2529 certificate issued to a physician under this chapter before July
2530 1, 2024, is not affected by this subsection Each institution
2531 which has been surveyed before October 1, 1986, by the
2532 Commission to Evaluate Foreign Medical Schools or the Commission
2533 on Foreign Medical Education of the Federation of State Medical
2534 Boards, Inc., and whose survey and supporting documentation
2535 demonstrates that it provides an educational program, including
2536 curriculum, reasonably comparable to that of similar accredited
2537 institutions in the United States shall be considered fully
2538 certified, for purposes of chapter 86-245, Laws of Florida.
2539 Section 36. Subsections (1) and (4) of section 458.3145,
2540 Florida Statutes, are amended to read:
2541 458.3145 Medical faculty certificate.—
2542 (1) A medical faculty certificate may be issued without
2543 examination to an individual who meets all of the following
2544 criteria:
2545 (a) Is a graduate of an accredited medical school or its
2546 equivalent, or is a graduate of a foreign medical school listed
2547 with the World Health Organization which has not been excluded
2548 from consideration under s. 458.314(8).;
2549 (b) Holds a valid, current license to practice medicine in
2550 another jurisdiction.;
2551 (c) Has completed the application form and remitted a
2552 nonrefundable application fee not to exceed $500.;
2553 (d) Has completed an approved residency or fellowship of at
2554 least 1 year or has received training that which has been
2555 determined by the board to be equivalent to the 1-year residency
2556 requirement.;
2557 (e) Is at least 21 years of age.;
2558 (f) Is of good moral character.;
2559 (g) Has not committed any act in this or any other
2560 jurisdiction which would constitute the basis for disciplining a
2561 physician under s. 458.331.;
2562 (h) For any applicant who has graduated from medical school
2563 after October 1, 1992, has completed, before entering medical
2564 school, the equivalent of 2 academic years of preprofessional,
2565 postsecondary education, as determined by rule of the board,
2566 which must include, at a minimum, courses in such fields as
2567 anatomy, biology, and chemistry.; and
2568 (i) Has been offered and has accepted a full-time faculty
2569 appointment to teach in a program of medicine at any of the
2570 following institutions:
2571 1. The University of Florida.;
2572 2. The University of Miami.;
2573 3. The University of South Florida.;
2574 4. The Florida State University.;
2575 5. The Florida International University.;
2576 6. The University of Central Florida.;
2577 7. The Mayo Clinic College of Medicine and Science in
2578 Jacksonville, Florida.;
2579 8. The Florida Atlantic University.;
2580 9. The Johns Hopkins All Children’s Hospital in St.
2581 Petersburg, Florida.;
2582 10. Nova Southeastern University.; or
2583 11. Lake Erie College of Osteopathic Medicine.
2584 (4) In any year, the maximum number of extended medical
2585 faculty certificateholders as provided in subsection (2) may not
2586 exceed 30 persons at each institution named in subparagraphs
2587 (1)(i)1.-6., 8., and 9. and at the facility named in s. 1004.43
2588 and may not exceed 10 persons at the institution named in
2589 subparagraph (1)(i)7.
2590 Section 37. Section 458.315, Florida Statutes, is amended
2591 to read:
2592 458.315 Temporary certificate for practice in areas of
2593 critical need.—
2594 (1) A physician or physician assistant who is licensed to
2595 practice in any jurisdiction of the United States and, whose
2596 license is currently valid, and who pays an application fee of
2597 $300 may be issued a temporary certificate for practice in areas
2598 of critical need. A physician seeking such certificate must pay
2599 an application fee of $300.
2600 (2) A temporary certificate may be issued under this
2601 section to a physician or physician assistant who will:
2602 (a) Will Practice in an area of critical need;
2603 (b) Will Be employed by or practice in a county health
2604 department; correctional facility; Department of Veterans’
2605 Affairs clinic; community health center funded by s. 329, s.
2606 330, or s. 340 of the United States Public Health Services Act;
2607 or other agency or institution that is approved by the State
2608 Surgeon General and provides health care services to meet the
2609 needs of underserved populations in this state; or
2610 (c) Will Practice for a limited time to address critical
2611 physician-specialty, demographic, or geographic needs for this
2612 state’s physician workforce as determined by the State Surgeon
2613 General.
2614 (3) The board of Medicine may issue a this temporary
2615 certificate under this section subject to with the following
2616 restrictions:
2617 (a) The State Surgeon General shall determine the areas of
2618 critical need. Such areas include, but are not limited to,
2619 health professional shortage areas designated by the United
2620 States Department of Health and Human Services.
2621 1. A recipient of a temporary certificate for practice in
2622 areas of critical need may use the certificate to work for any
2623 approved entity in any area of critical need or as authorized by
2624 the State Surgeon General.
2625 2. The recipient of a temporary certificate for practice in
2626 areas of critical need shall, within 30 days after accepting
2627 employment, notify the board of all approved institutions in
2628 which the licensee practices and of all approved institutions
2629 where practice privileges have been denied, as applicable.
2630 (b) The board may administer an abbreviated oral
2631 examination to determine the physician’s or physician
2632 assistant’s competency, but a written regular examination is not
2633 required. Within 60 days after receipt of an application for a
2634 temporary certificate, the board shall review the application
2635 and issue the temporary certificate, notify the applicant of
2636 denial, or notify the applicant that the board recommends
2637 additional assessment, training, education, or other
2638 requirements as a condition of certification. If the applicant
2639 has not actively practiced during the 3-year period immediately
2640 preceding the application prior 3 years and the board determines
2641 that the applicant may lack clinical competency, possess
2642 diminished or inadequate skills, lack necessary medical
2643 knowledge, or exhibit patterns of deficits in clinical
2644 decisionmaking, the board may:
2645 1. Deny the application;
2646 2. Issue a temporary certificate having reasonable
2647 restrictions that may include, but are not limited to, a
2648 requirement for the applicant to practice under the supervision
2649 of a physician approved by the board; or
2650 3. Issue a temporary certificate upon receipt of
2651 documentation confirming that the applicant has met any
2652 reasonable conditions of the board which may include, but are
2653 not limited to, completing continuing education or undergoing an
2654 assessment of skills and training.
2655 (c) Any certificate issued under this section is valid only
2656 so long as the State Surgeon General determines that the reason
2657 for which it was issued remains a critical need to the state.
2658 The board of Medicine shall review each temporary
2659 certificateholder at least not less than annually to ascertain
2660 that the certificateholder is complying with the minimum
2661 requirements of the Medical Practice Act and its adopted rules,
2662 as applicable to the certificateholder are being complied with.
2663 If it is determined that the certificateholder is not meeting
2664 such minimum requirements are not being met, the board must
2665 shall revoke such certificate or shall impose restrictions or
2666 conditions, or both, as a condition of continued practice under
2667 the certificate.
2668 (d) The board may not issue a temporary certificate for
2669 practice in an area of critical need to any physician or
2670 physician assistant who is under investigation in any
2671 jurisdiction in the United States for an act that would
2672 constitute a violation of this chapter until such time as the
2673 investigation is complete, at which time the provisions of s.
2674 458.331 applies apply.
2675 (4) The application fee and all licensure fees, including
2676 neurological injury compensation assessments, are shall be
2677 waived for those persons obtaining a temporary certificate to
2678 practice in areas of critical need for the purpose of providing
2679 volunteer, uncompensated care for low-income residents. The
2680 applicant must submit an affidavit from the employing agency or
2681 institution stating that the physician or physician assistant
2682 will not receive any compensation for any health care services
2683 provided by the applicant service involving the practice of
2684 medicine.
2685 Section 38. Section 458.317, Florida Statutes, is amended
2686 to read:
2687 458.317 Limited licenses.—
2688 (1) PHYSICIANS LICENSED IN UNITED STATES JURISDICTIONS.—
2689 (a) Any person desiring to obtain a limited license under
2690 this subsection shall submit to the board an application and fee
2691 not to exceed $300 and demonstrate that he or she has been
2692 licensed to practice medicine in any jurisdiction in the United
2693 States for at least 10 years and intends to practice only
2694 pursuant to the restrictions of a limited license granted
2695 pursuant to this subsection section. However, a physician who is
2696 not fully retired in all jurisdictions may use a limited license
2697 only for noncompensated practice. If the person applying for a
2698 limited license submits a statement from the employing agency or
2699 institution stating that he or she will not receive compensation
2700 for any service involving the practice of medicine, the
2701 application fee and all licensure fees shall be waived. However,
2702 any person who receives a waiver of fees for a limited license
2703 shall pay such fees if the person receives compensation for the
2704 practice of medicine.
2705 (b) If it has been more than 3 years since active practice
2706 was conducted by the applicant, the full-time director of the
2707 county health department or a licensed physician, approved by
2708 the board, must shall supervise the applicant for a period of 6
2709 months after he or she is granted a limited license under this
2710 subsection for practice, unless the board determines that a
2711 shorter period of supervision will be sufficient to ensure that
2712 the applicant is qualified for licensure. Procedures for such
2713 supervision must shall be established by the board.
2714 (c) The recipient of a limited license under this
2715 subsection may practice only in the employ of public agencies or
2716 institutions or nonprofit agencies or institutions meeting the
2717 requirements of s. 501(c)(3) of the Internal Revenue Code, which
2718 agencies or institutions are located in the areas of critical
2719 medical need as determined by the board. Determination of
2720 medically underserved areas shall be made by the board after
2721 consultation with the department of Health and statewide medical
2722 organizations; however, such determination shall include, but
2723 not be limited to, health professional shortage areas designated
2724 by the United States Department of Health and Human Services. A
2725 recipient of a limited license under this subsection may use the
2726 license to work for any approved employer in any area of
2727 critical need approved by the board.
2728 (d) The recipient of a limited license shall, within 30
2729 days after accepting employment, notify the board of all
2730 approved institutions in which the licensee practices and of all
2731 approved institutions where practice privileges have been
2732 denied.
2733 (e) This subsection does not limit Nothing herein limits in
2734 any way any policy by the board, otherwise authorized by law, to
2735 grant licenses to physicians duly licensed in other states under
2736 conditions less restrictive than the requirements of this
2737 subsection section. Notwithstanding the other provisions of this
2738 subsection section, the board may refuse to authorize a
2739 physician otherwise qualified to practice in the employ of any
2740 agency or institution otherwise qualified if the agency or
2741 institution has caused or permitted violations of the provisions
2742 of this chapter which it knew or should have known were
2743 occurring.
2744 (f)(2) The board shall notify the director of the full-time
2745 local county health department of any county in which a licensee
2746 intends to practice under the provisions of this subsection act.
2747 The director of the full-time county health department shall
2748 assist in the supervision of any licensee within the county and
2749 shall notify the board which issued the licensee his or her
2750 license if he or she becomes aware of any actions by the
2751 licensee which would be grounds for revocation of the limited
2752 license. The board shall establish procedures for such
2753 supervision.
2754 (g)(3) The board shall review the practice of each licensee
2755 biennially to verify compliance with the restrictions prescribed
2756 in this subsection section and other applicable provisions of
2757 this chapter.
2758 (h)(4) Any person holding an active license to practice
2759 medicine in this the state may convert that license to a limited
2760 license under this subsection for the purpose of providing
2761 volunteer, uncompensated care for low-income Floridians. The
2762 applicant must submit a statement from the employing agency or
2763 institution stating that he or she will not receive compensation
2764 for any service involving the practice of medicine. The
2765 application fee and all licensure fees, including neurological
2766 injury compensation assessments, are shall be waived for such
2767 applicant.
2768 (2) GRADUATE ASSISTANT PHYSICIANS.—A graduate assistant
2769 physician is a medical school graduate who meets the
2770 requirements of this subsection and has obtained a limited
2771 license from the board for the purpose of practicing temporarily
2772 under the direct supervision of a physician who has a full,
2773 active, and unencumbered license issued under this chapter,
2774 pending the graduate’s entrance into a residency under the
2775 National Resident Match Program.
2776 (a) Any person desiring to obtain a limited license as a
2777 graduate assistant physician must submit to the board an
2778 application and demonstrate that he or she meets all of the
2779 following criteria:
2780 1. Is a graduate of an allopathic medical school or
2781 allopathic college approved by an accrediting agency recognized
2782 by the United States Department of Education.
2783 2. Has successfully passed all parts of the United States
2784 Medical Licensing Examination.
2785 3. Has not received and accepted a residency match from the
2786 National Resident Match Program within the first year following
2787 graduation from medical school.
2788 (b) The board shall issue a graduate assistant physician
2789 limited license for a duration of 2 years to an applicant who
2790 meets the requirements of paragraph (a) and all of the following
2791 criteria:
2792 1. Is at least 21 years of age.
2793 2. Is of good moral character.
2794 3. Submits documentation that the applicant has agreed to
2795 enter into a written protocol drafted by a physician with a
2796 full, active, and unencumbered license issued under this chapter
2797 upon the board’s issuance of a limited license to the applicant
2798 and submits a copy of the protocol. The board shall establish by
2799 rule specific provisions that must be included in a physician
2800 drafted protocol.
2801 4. Has not committed any act or offense in this or any
2802 other jurisdiction which would constitute the basis for
2803 disciplining a physician under s. 458.331.
2804 5. Has submitted to the department a set of fingerprints on
2805 a form and under procedures specified by the department.
2806 6. The board may not certify to the department for limited
2807 licensure under this subsection any applicant who is under
2808 investigation in another jurisdiction for an offense which would
2809 constitute a violation of this chapter or chapter 456 until such
2810 investigation is completed. Upon completion of the
2811 investigation, s. 458.331 applies. Furthermore, the department
2812 may not issue a limited license to any individual who has
2813 committed any act or offense in any jurisdiction which would
2814 constitute the basis for disciplining a physician under s.
2815 458.331. If the board finds that an individual has committed an
2816 act or offense in any jurisdiction which would constitute the
2817 basis for disciplining a physician under s. 458.331, the board
2818 may enter an order imposing one of the following terms:
2819 a. Refusal to certify to the department an application for
2820 a graduate assistant physician limited license; or
2821 b. Certification to the department of an application for a
2822 graduate assistant physician limited license with restrictions
2823 on the scope of practice of the licensee.
2824 (c) A graduate assistant physician limited licensee may
2825 apply for a one-time renewal of his or her limited license by
2826 submitting a board-approved application, documentation of actual
2827 practice under the required protocol during the initial limited
2828 licensure period, and documentation of applications he or she
2829 has submitted for accredited graduate medical education training
2830 programs. The one-time renewal terminates after 1 year. A
2831 graduate assistant physician who has received a limited license
2832 under this subsection is not eligible to apply for another
2833 limited license, regardless of whether he or she received a one
2834 time renewal under this paragraph.
2835 (d) A limited licensed graduate assistant physician may
2836 provide health care services only under the direct supervision
2837 of a physician with a full, active, and unencumbered license
2838 issued under this chapter.
2839 (e) A physician must be approved by the board to supervise
2840 a limited licensed graduate assistant physician.
2841 (f) A physician may supervise no more than two graduate
2842 assistant physicians with limited licenses.
2843 (g) Supervision of limited licensed graduate assistant
2844 physicians requires the physical presence of the supervising
2845 physician at the location where the services are rendered.
2846 (h) A physician-drafted protocol must specify the duties
2847 and responsibilities of the limited licensed graduate assistant
2848 physician according to criteria adopted by board rule.
2849 (i) Each protocol that applies to a limited licensed
2850 graduate assistant physician and his or her supervising
2851 physician must ensure that:
2852 1. There is a process for the evaluation of the limited
2853 licensed graduate assistant physicians’ performance; and
2854 2. The delegation of any medical task or procedure is
2855 within the supervising physician’s scope of practice and
2856 appropriate for the graduate assistant physician’s level of
2857 competency.
2858 (j) A limited licensed graduate assistant physician’s
2859 prescriptive authority is governed by the physician-drafted
2860 protocol and criteria adopted by the board and may not exceed
2861 that of his or her supervising physician. Any prescriptions and
2862 orders issued by the graduate assistant physician must identify
2863 both the graduate assistant physician and the supervising
2864 physician.
2865 (k) A physician who supervises a graduate assistant
2866 physician is liable for any acts or omissions of the graduate
2867 assistant physician acting under the physician’s supervision and
2868 control. Third-party payors may reimburse employers of graduate
2869 assistant physicians for covered services rendered by graduate
2870 assistant physicians.
2871 (3) RULES.—The board may adopt rules to implement this
2872 section.
2873 Section 39. Section 459.0075, Florida Statutes, is amended
2874 to read:
2875 459.0075 Limited licenses.—
2876 (1) PHYSICIANS LICENSED IN UNITED STATES JURISDICTIONS.—
2877 (a) Any person desiring to obtain a limited license under
2878 this subsection must shall:
2879 1.(a) Submit to the board a licensure application and fee
2880 required by this chapter. However, an osteopathic physician who
2881 is not fully retired in all jurisdictions may use a limited
2882 license only for noncompensated practice. If the person applying
2883 for a limited license submits a statement from the employing
2884 agency or institution stating that she or he will not receive
2885 monetary compensation for any service involving the practice of
2886 osteopathic medicine, the application fee and all licensure fees
2887 shall be waived. However, any person who receives a waiver of
2888 fees for a limited license must shall pay such fees if the
2889 person receives compensation for the practice of osteopathic
2890 medicine.
2891 2.(b) Submit proof that such osteopathic physician has been
2892 licensed to practice osteopathic medicine in any jurisdiction in
2893 the United States in good standing and pursuant to law for at
2894 least 10 years.
2895 3.(c) Complete an amount of continuing education
2896 established by the board.
2897 (b)(2) If it has been more than 3 years since active
2898 practice was conducted by the applicant, the full-time director
2899 of the local county health department must shall supervise the
2900 applicant for a period of 6 months after the applicant is
2901 granted a limited license under this subsection to practice,
2902 unless the board determines that a shorter period of supervision
2903 will be sufficient to ensure that the applicant is qualified for
2904 licensure under this subsection pursuant to this section.
2905 Procedures for such supervision must shall be established by the
2906 board.
2907 (c)(3) The recipient of a limited license under this
2908 subsection may practice only in the employ of public agencies or
2909 institutions or nonprofit agencies or institutions meeting the
2910 requirements of s. 501(c)(3) of the Internal Revenue Code, which
2911 agencies or institutions are located in areas of critical
2912 medical need or in medically underserved areas as determined
2913 pursuant to 42 U.S.C. s. 300e-1(7).
2914 (d)(4) The board shall notify the director of the full-time
2915 local county health department of any county in which a licensee
2916 intends to practice under the provisions of this subsection
2917 section. The director of the full-time county health department
2918 shall assist in the supervision of any licensee within the her
2919 or his county and shall notify the board if she or he becomes
2920 aware of any action by the licensee which would be a ground for
2921 revocation of the limited license. The board shall establish
2922 procedures for such supervision.
2923 (e)(5) The State board of Osteopathic Medicine shall review
2924 the practice of each licensee under this subsection section
2925 biennially to verify compliance with the restrictions prescribed
2926 in this subsection section and other provisions of this chapter.
2927 (f)(6) Any person holding an active license to practice
2928 osteopathic medicine in this the state may convert that license
2929 to a limited license under this subsection for the purpose of
2930 providing volunteer, uncompensated care for low-income
2931 Floridians. The applicant must submit a statement from the
2932 employing agency or institution stating that she or he or she
2933 will not receive compensation for any service involving the
2934 practice of osteopathic medicine. The application fee and all
2935 licensure fees, including neurological injury compensation
2936 assessments, are shall be waived for such applicant.
2937 (2) GRADUATE ASSISTANT PHYSICIANS.—A graduate assistant
2938 physician is a medical school graduate who meets the
2939 requirements of this subsection and has obtained a limited
2940 license from the board for the purpose of practicing temporarily
2941 under the direct supervision of a physician who has a full,
2942 active, and unencumbered license issued under this chapter,
2943 pending the graduate’s entrance into a residency under the
2944 National Resident Match Program.
2945 (a) Any person desiring to obtain a limited license as a
2946 graduate assistant physician must submit to the board an
2947 application and demonstrate that she or he meets all of the
2948 following criteria:
2949 1. Is a graduate of a school or college of osteopathic
2950 medicine approved by an accrediting agency recognized by the
2951 United States Department of Education.
2952 2. Has successfully passed all parts of the examination
2953 conducted by the National Board of Osteopathic Medical Examiners
2954 or other examination approved by the board.
2955 3. Has not received and accepted a residency match from the
2956 National Residency Match Program within the first year following
2957 graduation from medical school.
2958 (b) The board shall issue a graduate assistant physician
2959 limited license for a duration of 2 years to an applicant who
2960 meets the requirements of paragraph (a) and all of the following
2961 criteria:
2962 1. Is at least 21 years of age.
2963 2. Is of good moral character.
2964 3. Submits documentation that the applicant has agreed to
2965 enter into a written protocol drafted by a physician with a
2966 full, active, and unencumbered license issued under this chapter
2967 upon the board’s issuance of a limited license to the applicant,
2968 and submits a copy of the protocol. The board shall establish by
2969 rule specific provisions that must be included in a physician
2970 drafted protocol.
2971 4. Has not committed any act or offense in this or any
2972 other jurisdiction which would constitute the basis for
2973 disciplining a physician under s. 459.015.
2974 5. Has submitted to the department a set of fingerprints on
2975 a form and under procedures specified by the department.
2976 6. The board may not certify to the department for limited
2977 licensure under this subsection any applicant who is under
2978 investigation in another jurisdiction for an offense which would
2979 constitute a violation of this chapter or chapter 456 until such
2980 investigation is completed. Upon completion of the
2981 investigation, s. 459.015 applies. Furthermore, the department
2982 may not issue a limited license to any individual who has
2983 committed any act or offense in any jurisdiction which would
2984 constitute the basis for disciplining a physician under s.
2985 459.015. If the board finds that an individual has committed an
2986 act or offense in any jurisdiction which would constitute the
2987 basis for disciplining a physician under s. 459.015, the board
2988 may enter an order imposing one of the following terms:
2989 a. Refusal to certify to the department an application for
2990 a graduate assistant physician limited license; or
2991 b. Certification to the department of an application for a
2992 graduate assistant physician limited license with restrictions
2993 on the scope of practice of the licensee.
2994 (c) A graduate assistant physician limited licensee may
2995 apply for a one-time renewal of his or her limited licensed by
2996 submitting a board-approved application, documentation of actual
2997 practice under the required protocol during the initial limited
2998 licensure period, and documentation of applications he or she
2999 has submitted for accredited graduate medical education training
3000 programs. The one-time renewal terminates after 1 year. A
3001 graduate assistant physician who has received a limited license
3002 under this subsection is not eligible to apply for another
3003 limited license, regardless of whether he or she received a one
3004 time renewal under this paragraph.
3005 (d) A limited licensed graduate assistant physician may
3006 provide health care services only under the direct supervision
3007 of a physician with a full, active, and unencumbered license
3008 issued under this chapter.
3009 (e) A physician must be approved by the board to supervise
3010 a limited licensed graduate assistant physician.
3011 (f) A physician may supervise no more than two graduate
3012 assistant physicians with limited licenses.
3013 (g) Supervision of limited licensed graduate assistant
3014 physicians requires the physical presence of the supervising
3015 physician at the location where the services are rendered.
3016 (h) A physician-drafted protocol must specify the duties
3017 and responsibilities of the limited licensed graduate assistant
3018 physician according to criteria adopted by board rule.
3019 (i) Each protocol that applies to a limited licensed
3020 graduate assistant physician and his or her supervising
3021 physician must ensure that:
3022 1. There is a process for the evaluation of the limited
3023 licensed graduate assistant physicians’ performance; and
3024 2. The delegation of any medical task or procedure is
3025 within the supervising physician’s scope of practice and
3026 appropriate for the graduate assistant physician’s level of
3027 competency.
3028 (j) A limited licensed graduate assistant physician’s
3029 prescriptive authority is governed by the physician-drafted
3030 protocol and criteria adopted by the board and may not exceed
3031 that of his or her supervising physician. Any prescriptions and
3032 orders issued by the graduate assistant physician must identify
3033 both the graduate assistant physician and the supervising
3034 physician.
3035 (k) A physician who supervises a graduate assistant
3036 physician is liable for any acts or omissions of the graduate
3037 assistant physician acting under the physician’s supervision and
3038 control. Third-party payors may reimburse employers of graduate
3039 assistant physicians for covered services rendered by graduate
3040 assistant physicians.
3041 (3) RULES.—The board may adopt rules to implement this
3042 section.
3043 Section 40. Section 459.0076, Florida Statutes, is amended
3044 to read:
3045 459.0076 Temporary certificate for practice in areas of
3046 critical need.—
3047 (1) A physician or physician assistant who holds a valid
3048 license is licensed to practice in any jurisdiction of the
3049 United States, whose license is currently valid, and who pays an
3050 application fee of $300 may be issued a temporary certificate
3051 for practice in areas of critical need. A physician seeking such
3052 certificate must pay an application fee of $300.
3053 (2) A temporary certificate may be issued under this
3054 section to a physician or physician assistant who will:
3055 (a) Will Practice in an area of critical need;
3056 (b) Will Be employed by or practice in a county health
3057 department; correctional facility; Department of Veterans’
3058 Affairs clinic; community health center funded by s. 329, s.
3059 330, or s. 340 of the United States Public Health Services Act;
3060 or other agency or institution that is approved by the State
3061 Surgeon General and provides health care to meet the needs of
3062 underserved populations in this state; or
3063 (c) Will Practice for a limited time to address critical
3064 physician-specialty, demographic, or geographic needs for this
3065 state’s physician workforce as determined by the State Surgeon
3066 General.
3067 (3) The board of Osteopathic Medicine may issue this
3068 temporary certificate subject to with the following
3069 restrictions:
3070 (a) The State Surgeon General shall determine the areas of
3071 critical need. Such areas include, but are not limited to,
3072 health professional shortage areas designated by the United
3073 States Department of Health and Human Services.
3074 1. A recipient of a temporary certificate for practice in
3075 areas of critical need may use the certificate to work for any
3076 approved entity in any area of critical need or as authorized by
3077 the State Surgeon General.
3078 2. The recipient of a temporary certificate for practice in
3079 areas of critical need shall, within 30 days after accepting
3080 employment, notify the board of all approved institutions in
3081 which the licensee practices and of all approved institutions
3082 where practice privileges have been denied, as applicable.
3083 (b) The board may administer an abbreviated oral
3084 examination to determine the physician’s or physician
3085 assistant’s competency, but a written regular examination is not
3086 required. Within 60 days after receipt of an application for a
3087 temporary certificate, the board shall review the application
3088 and issue the temporary certificate, notify the applicant of
3089 denial, or notify the applicant that the board recommends
3090 additional assessment, training, education, or other
3091 requirements as a condition of certification. If the applicant
3092 has not actively practiced during the 3-year period immediately
3093 preceding the application prior 3 years and the board determines
3094 that the applicant may lack clinical competency, possess
3095 diminished or inadequate skills, lack necessary medical
3096 knowledge, or exhibit patterns of deficits in clinical
3097 decisionmaking, the board may:
3098 1. Deny the application;
3099 2. Issue a temporary certificate having reasonable
3100 restrictions that may include, but are not limited to, a
3101 requirement for the applicant to practice under the supervision
3102 of a physician approved by the board; or
3103 3. Issue a temporary certificate upon receipt of
3104 documentation confirming that the applicant has met any
3105 reasonable conditions of the board which may include, but are
3106 not limited to, completing continuing education or undergoing an
3107 assessment of skills and training.
3108 (c) Any certificate issued under this section is valid only
3109 so long as the State Surgeon General determines that the reason
3110 for which it was issued remains a critical need to the state.
3111 The board of Osteopathic Medicine shall review each temporary
3112 certificateholder at least not less than annually to ascertain
3113 that the certificateholder is complying with the minimum
3114 requirements of the Osteopathic Medical Practice Act and its
3115 adopted rules, as applicable to the certificateholder are being
3116 complied with. If it is determined that the certificateholder is
3117 not meeting such minimum requirements are not being met, the
3118 board must shall revoke such certificate or shall impose
3119 restrictions or conditions, or both, as a condition of continued
3120 practice under the certificate.
3121 (d) The board may not issue a temporary certificate for
3122 practice in an area of critical need to any physician or
3123 physician assistant who is under investigation in any
3124 jurisdiction in the United States for an act that would
3125 constitute a violation of this chapter until such time as the
3126 investigation is complete, at which time the provisions of s.
3127 459.015 applies apply.
3128 (4) The application fee and all licensure fees, including
3129 neurological injury compensation assessments, are shall be
3130 waived for those persons obtaining a temporary certificate to
3131 practice in areas of critical need for the purpose of providing
3132 volunteer, uncompensated care for low-income residents. The
3133 applicant must submit an affidavit from the employing agency or
3134 institution stating that the physician or physician assistant
3135 will not receive any compensation for any health care services
3136 that he or she provides service involving the practice of
3137 medicine.
3138 Section 41. Section 464.0121, Florida Statutes, is created
3139 to read:
3140 464.0121 Temporary certificate for practice in areas of
3141 critical need.—
3142 (1) An advanced practice registered nurse who is licensed
3143 to practice in any jurisdiction of the United States, whose
3144 license is currently valid, and who meets educational and
3145 training requirements established by the board may be issued a
3146 temporary certificate for practice in areas of critical need.
3147 (2) A temporary certificate may be issued under this
3148 section to an advanced practice registered nurse who will:
3149 (a) Practice in an area of critical need;
3150 (b) Be employed by or practice in a county health
3151 department; correctional facility; Department of Veterans’
3152 Affairs clinic; community health center funded by s. 329, s.
3153 330, or s. 340 of the United States Public Health Services Act;
3154 or another agency or institution that is approved by the State
3155 Surgeon General and that provides health care services to meet
3156 the needs of underserved populations in this state; or
3157 (c) Practice for a limited time to address critical health
3158 care specialty, demographic, or geographic needs relating to
3159 this state’s accessibility of health care services as determined
3160 by the State Surgeon General.
3161 (3) The board may issue a temporary certificate under this
3162 section subject to the following restrictions:
3163 (a) The State Surgeon General shall determine the areas of
3164 critical need. Such areas include, but are not limited to,
3165 health professional shortage areas designated by the United
3166 States Department of Health and Human Services.
3167 1. A recipient of a temporary certificate for practice in
3168 areas of critical need may use the certificate to work for any
3169 approved entity in any area of critical need or as authorized by
3170 the State Surgeon General.
3171 2. The recipient of a temporary certificate for practice in
3172 areas of critical need shall, within 30 days after accepting
3173 employment, notify the board of all approved institutions in
3174 which the licensee practices as part of his or her employment.
3175 (b) The board may administer an abbreviated oral
3176 examination to determine the advanced practice registered
3177 nurse’s competency, but may not require a written regular
3178 examination. Within 60 days after receipt of an application for
3179 a temporary certificate, the board shall review the application
3180 and issue the temporary certificate, notify the applicant of
3181 denial, or notify the applicant that the board recommends
3182 additional assessment, training, education, or other
3183 requirements as a condition of certification. If the applicant
3184 has not actively practiced during the 3-year period immediately
3185 preceding the application and the board determines that the
3186 applicant may lack clinical competency, possess diminished or
3187 inadequate skills, lack necessary medical knowledge, or exhibit
3188 patterns of deficits in clinical decisionmaking, the board may:
3189 1. Deny the application;
3190 2. Issue a temporary certificate imposing reasonable
3191 restrictions that may include, but are not limited to, a
3192 requirement that the applicant practice under the supervision of
3193 a physician approved by the board; or
3194 3. Issue a temporary certificate upon receipt of
3195 documentation confirming that the applicant has met any
3196 reasonable conditions of the board, which may include, but are
3197 not limited to, completing continuing education or undergoing an
3198 assessment of skills and training.
3199 (c) Any certificate issued under this section is valid only
3200 so long as the State Surgeon General maintains the determination
3201 that the critical need that supported the issuance of the
3202 temporary certificate remains a critical need to the state. The
3203 board shall review each temporary certificateholder at least
3204 annually to ascertain that the certificateholder is complying
3205 with the minimum requirements of the Nurse Practice Act and its
3206 adopted rules, as applicable to the certificateholder. If it is
3207 determined that the certificateholder is not meeting such
3208 minimum requirements, the board must revoke such certificate or
3209 impose restrictions or conditions, or both, as a condition of
3210 continued practice under the certificate.
3211 (d) The board may not issue a temporary certificate for
3212 practice in an area of critical need to any advanced practice
3213 registered nurse who is under investigation in any jurisdiction
3214 in the United States for an act that would constitute a
3215 violation of this part until such time as the investigation is
3216 complete, at which time s. 464.018 applies.
3217 (4) All licensure fees, including neurological injury
3218 compensation assessments, are waived for those persons obtaining
3219 a temporary certificate to practice in areas of critical need
3220 for the purpose of providing volunteer, uncompensated care for
3221 low-income residents. The applicant must submit an affidavit
3222 from the employing agency or institution stating that the
3223 advanced practice registered nurse will not receive any
3224 compensation for any health care services that he or she
3225 provides.
3226 Section 42. Paragraph (b) of subsection (3) of section
3227 464.0123, Florida Statutes, is amended to read:
3228 464.0123 Autonomous practice by an advanced practice
3229 registered nurse.—
3230 (3) PRACTICE REQUIREMENTS.—
3231 (b)1. In order to provide out-of-hospital intrapartum care,
3232 a certified nurse midwife engaged in the autonomous practice of
3233 nurse midwifery must maintain a written policy for the transfer
3234 of patients needing a higher acuity of care or emergency
3235 services. The policy must prescribe and require the use of an
3236 emergency plan-of-care form, which must be signed by the patient
3237 before admission to intrapartum care. At a minimum, the form
3238 must include all of the following:
3239 a. The name and address of the closest hospital that
3240 provides maternity and newborn services.
3241 b. Reasons for which transfer of care would be necessary,
3242 including the transfer-of-care conditions prescribed by board
3243 rule.
3244 c. Ambulances or other emergency medical services that
3245 would be used to transport the patient in the event of an
3246 emergency.
3247 2. If transfer of care is determined necessary by the
3248 certified nurse midwife or under the terms of the written
3249 policy, the certified nurse midwife must document all of the
3250 following information on the patient’s emergency plan-of-care
3251 form:
3252 a. The name, date of birth, and condition of the patient.
3253 b. The gravidity and parity of the patient and the
3254 gestational age and condition of the fetus or newborn infant.
3255 c. The reasons that necessitated the transfer of care.
3256 d. A description of the situation, relevant clinical
3257 background, assessment, and recommendations.
3258 e. The planned mode of transporting the patient to the
3259 receiving facility.
3260 f. The expected time of arrival at the receiving facility.
3261 3. Before transferring the patient, or as soon as possible
3262 during or after an emergency transfer, the certified nurse
3263 midwife shall provide the receiving provider with a verbal
3264 summary of the information specified in subparagraph 2. and make
3265 himself or herself immediately available for consultation. Upon
3266 transfer of the patient to the receiving facility, the certified
3267 nurse midwife must provide the receiving provider with the
3268 patient’s emergency plan-of-care form as soon as practicable.
3269 4. The certified nurse midwife shall provide the receiving
3270 provider, as soon as practicable, with the patient’s prenatal
3271 records, including patient history, prenatal laboratory results,
3272 sonograms, prenatal care flow sheets, maternal fetal medical
3273 reports, and labor flow charting and current notations.
3274 5. The board shall adopt rules to prescribe transfer-of
3275 care conditions, monitor for excessive transfers, conduct
3276 reviews of adverse maternal and neonatal outcomes, and monitor
3277 the licensure of certified nurse midwives engaged in autonomous
3278 practice must have a written patient transfer agreement with a
3279 hospital and a written referral agreement with a physician
3280 licensed under chapter 458 or chapter 459 to engage in nurse
3281 midwifery.
3282 Section 43. Subsection (10) of section 464.019, Florida
3283 Statutes, is amended to read:
3284 464.019 Approval of nursing education programs.—
3285 (10) IMPLEMENTATION STUDY.—The Florida Center for Nursing
3286 shall study the administration of this section and submit
3287 reports to the Governor, the President of the Senate, and the
3288 Speaker of the House of Representatives annually by January 30,
3289 through January 30, 2025. The annual reports shall address the
3290 previous academic year; provide data on the measures specified
3291 in paragraphs (a) and (b), as such data becomes available; and
3292 include an evaluation of such data for purposes of determining
3293 whether this section is increasing the availability of nursing
3294 education programs and the production of quality nurses. The
3295 department and each approved program or accredited program shall
3296 comply with requests for data from the Florida Center for
3297 Nursing.
3298 (a) The Florida Center for Nursing shall evaluate program
3299 specific data for each approved program and accredited program
3300 conducted in the state, including, but not limited to:
3301 1. The number of programs and student slots available.
3302 2. The number of student applications submitted, the number
3303 of qualified applicants, and the number of students accepted.
3304 3. The number of program graduates.
3305 4. Program retention rates of students tracked from program
3306 entry to graduation.
3307 5. Graduate passage rates on the National Council of State
3308 Boards of Nursing Licensing Examination.
3309 6. The number of graduates who become employed as practical
3310 or professional nurses in the state.
3311 (b) The Florida Center for Nursing shall evaluate the
3312 board’s implementation of the:
3313 1. Program application approval process, including, but not
3314 limited to, the number of program applications submitted under
3315 subsection (1), the number of program applications approved and
3316 denied by the board under subsection (2), the number of denials
3317 of program applications reviewed under chapter 120, and a
3318 description of the outcomes of those reviews.
3319 2. Accountability processes, including, but not limited to,
3320 the number of programs on probationary status, the number of
3321 approved programs for which the program director is required to
3322 appear before the board under subsection (5), the number of
3323 approved programs terminated by the board, the number of
3324 terminations reviewed under chapter 120, and a description of
3325 the outcomes of those reviews.
3326 (c) The Florida Center for Nursing shall complete an annual
3327 assessment of compliance by programs with the accreditation
3328 requirements of subsection (11), include in the assessment a
3329 determination of the accreditation process status for each
3330 program, and submit the assessment as part of the reports
3331 required by this subsection.
3332 Section 44. Paragraph (e) of subsection (3) of section
3333 766.1115, Florida Statutes, is amended to read:
3334 766.1115 Health care providers; creation of agency
3335 relationship with governmental contractors.—
3336 (3) DEFINITIONS.—As used in this section, the term:
3337 (e) “Low-income” means:
3338 1. A person who is Medicaid-eligible under Florida law;
3339 2. A person who is without health insurance and whose
3340 family income does not exceed 300 200 percent of the federal
3341 poverty level as defined annually by the federal Office of
3342 Management and Budget; or
3343 3. Any client of the department who voluntarily chooses to
3344 participate in a program offered or approved by the department
3345 and meets the program eligibility guidelines of the department.
3346 Section 45. Paragraph (f) is added to subsection (3) of
3347 section 1002.32, Florida Statutes, to read:
3348 1002.32 Developmental research (laboratory) schools.—
3349 (3) MISSION.—The mission of a lab school shall be the
3350 provision of a vehicle for the conduct of research,
3351 demonstration, and evaluation regarding management, teaching,
3352 and learning. Programs to achieve the mission of a lab school
3353 shall embody the goals and standards established pursuant to ss.
3354 1000.03(5) and 1001.23(1) and shall ensure an appropriate
3355 education for its students.
3356 (f) Each lab school shall develop programs that accelerate
3357 the entry of enrolled lab school students into articulated
3358 health care programs at its affiliated university or at any
3359 public or private postsecondary institution, with the approval
3360 of the university president. Each lab school shall offer
3361 technical assistance to any Florida school district seeking to
3362 replicate the lab school′s programs and must annually, beginning
3363 December 1, 2025, report to the President of the Senate and the
3364 Speaker of the House of Representatives on the development of
3365 such programs and their results.
3366 Section 46. Paragraph (b) of subsection (3) of section
3367 1009.8962, Florida Statutes, is amended to read:
3368 1009.8962 Linking Industry to Nursing Education (LINE)
3369 Fund.—
3370 (3) As used in this section, the term:
3371 (b) “Institution” means a school district career center
3372 under s. 1001.44;, a charter technical career center under s.
3373 1002.34;, a Florida College System institution;, a state
3374 university;, or an independent nonprofit college or university
3375 located and chartered in this state and accredited by an agency
3376 or association that is recognized by the database created and
3377 maintained by the United States Department of Education to grant
3378 baccalaureate degrees;, or an independent school, college, or
3379 university with an accredited program as defined in s. 464.003
3380 which is located in this state and licensed by the Commission
3381 for Independent Education pursuant to s. 1005.31, which has a
3382 nursing education program that meets or exceeds the following:
3383 1. For a certified nursing assistant program, a completion
3384 rate of at least 70 percent for the prior year.
3385 2. For a licensed practical nurse, associate of science in
3386 nursing, and bachelor of science in nursing program, a first
3387 time passage rate on the National Council of State Boards of
3388 Nursing Licensing Examination of at least 75 70 percent for the
3389 prior year based on a minimum of 10 testing participants.
3390 Section 47. Paragraph (f) of subsection (3) of section
3391 381.4018, Florida Statutes, is amended to read:
3392 381.4018 Physician workforce assessment and development.—
3393 (3) GENERAL FUNCTIONS.—The department shall maximize the
3394 use of existing programs under the jurisdiction of the
3395 department and other state agencies and coordinate governmental
3396 and nongovernmental stakeholders and resources in order to
3397 develop a state strategic plan and assess the implementation of
3398 such strategic plan. In developing the state strategic plan, the
3399 department shall:
3400 (f) Develop strategies to maximize federal and state
3401 programs that provide for the use of incentives to attract
3402 physicians to this state or retain physicians within the state.
3403 Such strategies should explore and maximize federal-state
3404 partnerships that provide incentives for physicians to practice
3405 in federally designated shortage areas, in otherwise medically
3406 underserved areas, or in rural areas. Strategies shall also
3407 consider the use of state programs, such as the Medical
3408 Education Reimbursement and Loan Repayment Program pursuant to
3409 s. 381.402 s. 1009.65, which provide for education loan
3410 repayment or loan forgiveness and provide monetary incentives
3411 for physicians to relocate to underserved areas of the state.
3412
3413 The department may adopt rules to implement this subsection,
3414 including rules that establish guidelines to implement the
3415 federal Conrad 30 Waiver Program created under s. 214(l) of the
3416 Immigration and Nationality Act.
3417 Section 48. Subsection (3) of section 395.602, Florida
3418 Statutes, is amended to read:
3419 395.602 Rural hospitals.—
3420 (3) USE OF FUNDS.—It is the intent of the Legislature that
3421 funds as appropriated shall be utilized by the department for
3422 the purpose of increasing the number of primary care physicians,
3423 physician assistants, certified nurse midwives, nurse
3424 practitioners, and nurses in rural areas, either through the
3425 Medical Education Reimbursement and Loan Repayment Program as
3426 defined by s. 381.402 s. 1009.65 or through a federal loan
3427 repayment program which requires state matching funds. The
3428 department may use funds appropriated for the Medical Education
3429 Reimbursement and Loan Repayment Program as matching funds for
3430 federal loan repayment programs for health care personnel, such
3431 as that authorized in Pub. L. No. 100-177, s. 203. If the
3432 department receives federal matching funds, the department shall
3433 only implement the federal program. Reimbursement through either
3434 program shall be limited to:
3435 (a) Primary care physicians, physician assistants,
3436 certified nurse midwives, nurse practitioners, and nurses
3437 employed by or affiliated with rural hospitals, as defined in
3438 this act; and
3439 (b) Primary care physicians, physician assistants,
3440 certified nurse midwives, nurse practitioners, and nurses
3441 employed by or affiliated with rural area health education
3442 centers, as defined in this section. These personnel shall
3443 practice:
3444 1. In a county with a population density of no greater than
3445 100 persons per square mile; or
3446 2. Within the boundaries of a hospital tax district which
3447 encompasses a population of no greater than 100 persons per
3448 square mile.
3449
3450 If the department administers a federal loan repayment program,
3451 priority shall be given to obligating state and federal matching
3452 funds pursuant to paragraphs (a) and (b). The department may use
3453 federal matching funds in other health workforce shortage areas
3454 and medically underserved areas in the state for loan repayment
3455 programs for primary care physicians, physician assistants,
3456 certified nurse midwives, nurse practitioners, and nurses who
3457 are employed by publicly financed health care programs that
3458 serve medically indigent persons.
3459 Section 49. Section 456.4501, Florida Statutes, is created
3460 to read:
3461 456.4501 Interstate Medical Licensure Compact.—The
3462 Interstate Medical Licensure Compact is hereby enacted into law
3463 and entered into by this state with all other jurisdictions
3464 legally joining therein in the form substantially as follows:
3465
3466 SECTION 1
3467 PURPOSE
3468 In order to strengthen access to health care, and in
3469 recognition of the advances in the delivery of health care, the
3470 member states of the Interstate Medical Licensure Compact have
3471 allied in common purpose to develop a comprehensive process that
3472 complements the existing licensing and regulatory authority of
3473 state medical boards and provides a streamlined process that
3474 allows physicians to become licensed in multiple states, thereby
3475 enhancing the portability of a medical license and ensuring the
3476 safety of patients. The compact creates another pathway for
3477 licensure and does not otherwise change a state’s existing
3478 medical practice act. The compact also adopts the prevailing
3479 standard for licensure and affirms that the practice of medicine
3480 occurs where the patient is located at the time of the
3481 physician-patient encounter and, therefore, requires the
3482 physician to be under the jurisdiction of the state medical
3483 board where the patient is located. State medical boards that
3484 participate in the compact retain the jurisdiction to impose an
3485 adverse action against a license to practice medicine in that
3486 state issued to a physician through the procedures in the
3487 compact.
3488
3489 SECTION 2
3490 DEFINITIONS
3491 As used in the compact, the term:
3492 (1) “Bylaws” means those bylaws established by the
3493 Interstate Commission pursuant to Section 11 for its governance
3494 or for directing and controlling its actions and conduct.
3495 (2) “Commissioner” means the voting representative
3496 appointed by each member board pursuant to Section 11.
3497 (3) “Conviction” means a finding by a court that an
3498 individual is guilty of a criminal offense, through adjudication
3499 or entry of a plea of guilt or no contest to the charge by the
3500 offender. Evidence of an entry of a conviction of a criminal
3501 offense by the court shall be considered final for purposes of
3502 disciplinary action by a member board.
3503 (4) “Expedited license” means a full and unrestricted
3504 medical license granted by a member state to an eligible
3505 physician through the process set forth in the compact.
3506 (5) “Interstate Commission” means the Interstate Medical
3507 Licensure Compact Commission created pursuant to Section 11.
3508 (6) “License” means authorization by a state for a
3509 physician to engage in the practice of medicine, which would be
3510 unlawful without the authorization.
3511 (7) “Medical practice act” means laws and regulations
3512 governing the practice of allopathic and osteopathic medicine
3513 within a member state.
3514 (8) “Member board” means a state agency in a member state
3515 which acts in the sovereign interests of the state by protecting
3516 the public through licensure, regulation, and education of
3517 physicians as directed by the state government.
3518 (9) “Member state” means a state that has enacted the
3519 compact.
3520 (10) “Offense” means a felony, high court misdemeanor, or
3521 crime of moral turpitude.
3522 (11) “Physician” means any person who:
3523 (a) Is a graduate of a medical school accredited by the
3524 Liaison Committee on Medical Education, the Commission on
3525 Osteopathic College Accreditation, or a medical school listed in
3526 the International Medical Education Directory or its equivalent;
3527 (b) Passed each component of the United States Medical
3528 Licensing Examination (USMLE) or the Comprehensive Osteopathic
3529 Medical Licensing Examination (COMLEX-USA) within three
3530 attempts, or any of its predecessor examinations accepted by a
3531 state medical board as an equivalent examination for licensure
3532 purposes;
3533 (c) Successfully completed graduate medical education
3534 approved by the Accreditation Council for Graduate Medical
3535 Education or the American Osteopathic Association;
3536 (d) Holds specialty certification or a time-unlimited
3537 specialty certificate recognized by the American Board of
3538 Medical Specialties or the American Osteopathic Association’s
3539 Bureau of Osteopathic Specialists; however, the specialty
3540 certification or a time-unlimited specialty certificate does not
3541 have to be maintained once a physician is initially determined
3542 to be eligible for expedited licensure through the compact;
3543 (e) Possesses a full and unrestricted license to engage in
3544 the practice of medicine issued by a member board;
3545 (f) Has never been convicted or received adjudication,
3546 deferred adjudication, community supervision, or deferred
3547 disposition for any offense by a court of appropriate
3548 jurisdiction;
3549 (g) Has never held a license authorizing the practice of
3550 medicine subjected to discipline by a licensing agency in any
3551 state, federal, or foreign jurisdiction, excluding any action
3552 related to nonpayment of fees related to a license;
3553 (h) Has never had a controlled substance license or permit
3554 suspended or revoked by a state or the United States Drug
3555 Enforcement Administration; and
3556 (i) Is not under active investigation by a licensing agency
3557 or law enforcement authority in any state, federal, or foreign
3558 jurisdiction.
3559 (12) “Practice of medicine” means the diagnosis, treatment,
3560 prevention, cure, or relieving of a human disease, ailment,
3561 defect, complaint, or other physical or mental condition by
3562 attendance, advice, device, diagnostic test, or other means, or
3563 offering, undertaking, attempting to do, or holding oneself out
3564 as able to do any of these acts.
3565 (13) “Rule” means a written statement by the Interstate
3566 Commission adopted pursuant to Section 12 of the compact which
3567 is of general applicability; implements, interprets, or
3568 prescribes a policy or provision of the compact or an
3569 organizational, procedural, or practice requirement of the
3570 Interstate Commission; and has the force and effect of statutory
3571 law in a member state, if the rule is not inconsistent with the
3572 laws of the member state. The term includes the amendment,
3573 repeal, or suspension of an existing rule.
3574 (14) “State” means any state, commonwealth, district, or
3575 territory of the United States.
3576 (15) “State of principal license” means a member state
3577 where a physician holds a license to practice medicine and which
3578 has been designated as such by the physician for purposes of
3579 registration and participation in the compact.
3580
3581 SECTION 3
3582 ELIGIBILITY
3583 (1) A physician must meet the eligibility requirements as
3584 provided in subsection (11) of Section 2 to receive an expedited
3585 license under the terms of the compact.
3586 (2) A physician who does not meet the requirements
3587 specified in subsection (11) of Section 2 may obtain a license
3588 to practice medicine in a member state if the individual
3589 complies with all laws and requirements, other than the compact,
3590 relating to the issuance of a license to practice medicine in
3591 that state.
3592
3593 SECTION 4
3594 DESIGNATION OF STATE OF PRINCIPAL LICENSE
3595 (1) A physician shall designate a member state as the state
3596 of principal license for purposes of registration for expedited
3597 licensure through the compact if the physician possesses a full
3598 and unrestricted license to practice medicine in that state and
3599 the state is:
3600 (a) The state of primary residence for the physician;
3601 (b) The state where at least 25 percent of the physician’s
3602 practice of medicine occurs;
3603 (c) The location of the physician’s employer; or
3604 (d) If no state qualifies under paragraph (a), paragraph
3605 (b), or paragraph (c), the state designated as the physician’s
3606 state of residence for purpose of federal income tax.
3607 (2) A physician may redesignate a member state as state of
3608 principal license at any time, as long as the state meets one of
3609 the descriptions under subsection (1).
3610 (3) The Interstate Commission may develop rules to
3611 facilitate redesignation of another member state as the state of
3612 principal license.
3613
3614 SECTION 5
3615 APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
3616 (1) A physician seeking licensure through the compact must
3617 file an application for an expedited license with the member
3618 board of the state selected by the physician as the state of
3619 principal license.
3620 (2) Upon receipt of an application for an expedited
3621 license, the member board within the state selected as the state
3622 of principal license shall evaluate whether the physician is
3623 eligible for expedited licensure and issue a letter of
3624 qualification, verifying or denying the physician’s eligibility,
3625 to the Interstate Commission.
3626 (a) Static qualifications, which include verification of
3627 medical education, graduate medical education, results of any
3628 medical or licensing examination, and other qualifications as
3629 determined by the Interstate Commission through rule, are not
3630 subject to additional primary source verification if already
3631 primary source-verified by the state of principal license.
3632 (b) The member board within the state selected as the state
3633 of principal license shall, in the course of verifying
3634 eligibility, perform a criminal background check of an
3635 applicant, including the use of the results of fingerprint or
3636 other biometric data checks compliant with the requirements of
3637 the Federal Bureau of Investigation, with the exception of
3638 federal employees who have a suitability determination in
3639 accordance with 5 C.F.R. s. 731.202.
3640 (c) Appeal on the determination of eligibility must be made
3641 to the member state where the application was filed and is
3642 subject to the law of that state.
3643 (3) Upon verification in subsection (2), physicians
3644 eligible for an expedited license must complete the registration
3645 process established by the Interstate Commission to receive a
3646 license in a member state selected pursuant to subsection (1).
3647 (4) After receiving verification of eligibility under
3648 subsection (2) and upon an applicant’s completion of any
3649 registration process required under subsection (3), a member
3650 board shall issue an expedited license to the physician. This
3651 license authorizes the physician to practice medicine in the
3652 issuing state consistent with the medical practice act and all
3653 applicable laws and regulations of the issuing member board and
3654 member state.
3655 (5) An expedited license is valid for a period consistent
3656 with the licensure period in the member state and in the same
3657 manner as required for other physicians holding a full and
3658 unrestricted license within the member state.
3659 (6) An expedited license obtained through the compact must
3660 be terminated if a physician fails to maintain a license in the
3661 state of principal license for a nondisciplinary reason, without
3662 redesignation of a new state of principal license.
3663 (7) The Interstate Commission may develop rules regarding
3664 the application process and the issuance of an expedited
3665 license.
3666
3667 SECTION 6
3668 RENEWAL AND CONTINUED PARTICIPATION
3669 (1) A physician seeking to renew an expedited license
3670 granted in a member state shall complete a renewal process with
3671 the Interstate Commission if the physician:
3672 (a) Maintains a full and unrestricted license in a state of
3673 principal license;
3674 (b) Has not been convicted or received adjudication,
3675 deferred adjudication, community supervision, or deferred
3676 disposition for any offense by a court of appropriate
3677 jurisdiction;
3678 (c) Has not had a license authorizing the practice of
3679 medicine subject to discipline by a licensing agency in any
3680 state, federal, or foreign jurisdiction, excluding any action
3681 related to nonpayment of fees related to a license; and
3682 (d) Has not had a controlled substance license or permit
3683 suspended or revoked by a state or the United States Drug
3684 Enforcement Administration.
3685 (2) Physicians shall comply with all continuing
3686 professional development or continuing medical education
3687 requirements for renewal of a license issued by a member state.
3688 (3) Physician information collected by the Interstate
3689 Commission during the renewal process must be distributed to all
3690 member boards.
3691 (4) The Interstate Commission may develop rules to address
3692 renewal of licenses obtained through the compact.
3693
3694 SECTION 7
3695 COORDINATED INFORMATION SYSTEM
3696 (1) The Interstate Commission shall establish a database of
3697 all physicians licensed, or who have applied for licensure,
3698 under Section 5.
3699 (2) Notwithstanding any other provision of law, member
3700 boards shall report to the Interstate Commission any public
3701 action or complaints against a licensed physician who has
3702 applied or received an expedited license through the compact.
3703 (3) Member boards shall report to the Interstate Commission
3704 disciplinary or investigatory information determined as
3705 necessary and proper by rule of the Interstate Commission.
3706 (4) Member boards may report to the Interstate Commission
3707 any nonpublic complaint, disciplinary, or investigatory
3708 information not required by subsection (3).
3709 (5) Member boards shall share complaint or disciplinary
3710 information about a physician upon request of another member
3711 board.
3712 (6) All information provided to the Interstate Commission
3713 or distributed by member boards shall be confidential, filed
3714 under seal, and used only for investigatory or disciplinary
3715 matters.
3716 (7) The Interstate Commission may develop rules for
3717 mandated or discretionary sharing of information by member
3718 boards.
3719
3720 SECTION 8
3721 JOINT INVESTIGATIONS
3722 (1) Licensure and disciplinary records of physicians are
3723 deemed investigative.
3724 (2) In addition to the authority granted to a member board
3725 by its respective medical practice act or other applicable state
3726 law, a member board may participate with other member boards in
3727 joint investigations of physicians licensed by the member
3728 boards.
3729 (3) A subpoena issued by a member state is enforceable in
3730 other member states.
3731 (4) Member boards may share any investigative, litigation,
3732 or compliance materials in furtherance of any joint or
3733 individual investigation initiated under the compact.
3734 (5) Any member state may investigate actual or alleged
3735 violations of the statutes authorizing the practice of medicine
3736 in any other member state in which a physician holds a license
3737 to practice medicine.
3738
3739 SECTION 9
3740 DISCIPLINARY ACTIONS
3741 (1) Any disciplinary action taken by any member board
3742 against a physician licensed through the compact is deemed
3743 unprofessional conduct that may be subject to discipline by
3744 other member boards, in addition to any violation of the medical
3745 practice act or regulations in that state.
3746 (2) If a license granted to a physician by the member board
3747 in the state of principal license is revoked, surrendered or
3748 relinquished in lieu of discipline, or suspended, then all
3749 licenses issued to the physician by member boards shall
3750 automatically be placed, without further action necessary by any
3751 member board, on the same status. If the member board in the
3752 state of principal license subsequently reinstates the
3753 physician’s license, a license issued to the physician by any
3754 other member board must remain encumbered until that respective
3755 member board takes action to reinstate the license in a manner
3756 consistent with the medical practice act of that state.
3757 (3) If disciplinary action is taken against a physician by
3758 a member board not in the state of principal license, any other
3759 member board may deem the action conclusive as to matter of law
3760 and fact decided, and:
3761 (a) Impose the same or lesser sanctions against the
3762 physician so long as such sanctions are consistent with the
3763 medical practice act of that state; or
3764 (b) Pursue separate disciplinary action against the
3765 physician under its respective medical practice act, regardless
3766 of the action taken in other member states.
3767 (4) If a license granted to a physician by a member board
3768 is revoked, surrendered or relinquished in lieu of discipline,
3769 or suspended, any license issued to the physician by any other
3770 member board must be suspended, automatically and immediately
3771 without further action necessary by the other member boards, for
3772 90 days after entry of the order by the disciplining board, to
3773 permit the member boards to investigate the basis for the action
3774 under the medical practice act of that state. A member board may
3775 terminate the automatic suspension of the license it issued
3776 before the completion of the 90-day suspension period in a
3777 manner consistent with the medical practice act of that state.
3778
3779 SECTION 10
3780 INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION
3781 (1) The member states hereby create the Interstate Medical
3782 Licensure Compact Commission.
3783 (2) The purpose of the Interstate Commission is the
3784 administration of the compact, which is a discretionary state
3785 function.
3786 (3) The Interstate Commission is a body corporate and joint
3787 agency of the member states and has all the responsibilities,
3788 powers, and duties set forth in the compact, and such additional
3789 powers as may be conferred upon it by a subsequent concurrent
3790 action of the respective legislatures of the member states in
3791 accordance with the terms of the compact.
3792 (4) The Interstate Commission shall consist of two voting
3793 representatives appointed by each member state, who shall serve
3794 as commissioners. In states where allopathic and osteopathic
3795 physicians are regulated by separate member boards, or if the
3796 licensing and disciplinary authority is split between multiple
3797 member boards within a member state, the member state shall
3798 appoint one representative from each member board. Each
3799 commissioner must be one of the following:
3800 (a) An allopathic or osteopathic physician appointed to a
3801 member board.
3802 (b) An executive director, an executive secretary, or a
3803 similar executive of a member board.
3804 (c) A member of the public appointed to a member board.
3805 (5) The Interstate Commission shall meet at least once each
3806 calendar year. A portion of this meeting must be a business
3807 meeting to address such matters as may properly come before the
3808 commission, including the election of officers. The chairperson
3809 may call additional meetings and shall call for a meeting upon
3810 the request of a majority of the member states.
3811 (6) The bylaws may provide for meetings of the Interstate
3812 Commission to be conducted by telecommunication or other
3813 electronic means.
3814 (7) Each commissioner participating at a meeting of the
3815 Interstate Commission is entitled to one vote. A majority of
3816 commissioners constitutes a quorum for the transaction of
3817 business, unless a larger quorum is required by the bylaws of
3818 the Interstate Commission. A commissioner may not delegate a
3819 vote to another commissioner. In the absence of its
3820 commissioner, a member state may delegate voting authority for a
3821 specified meeting to another person from that state who must
3822 meet the qualification requirements specified in subsection (4).
3823 (8) The Interstate Commission shall provide public notice
3824 of all meetings, and all meetings must be open to the public.
3825 The Interstate Commission may close a meeting, in full or in
3826 portion, where it determines by a two-thirds vote of the
3827 commissioners present that an open meeting would be likely to:
3828 (a) Relate solely to the internal personnel practices and
3829 procedures of the Interstate Commission;
3830 (b) Discuss matters specifically exempted from disclosure
3831 by federal statute;
3832 (c) Discuss trade secrets or commercial or financial
3833 information that is privileged or confidential;
3834 (d) Involve accusing a person of a crime, or formally
3835 censuring a person;
3836 (e) Discuss information of a personal nature, the
3837 disclosure of which would constitute a clearly unwarranted
3838 invasion of personal privacy;
3839 (f) Discuss investigative records compiled for law
3840 enforcement purposes; or
3841 (g) Specifically relate to participation in a civil action
3842 or other legal proceeding.
3843 (9) The Interstate Commission shall keep minutes that fully
3844 describe all matters discussed in a meeting and provide a full
3845 and accurate summary of actions taken, including a record of any
3846 roll call votes.
3847 (10) The Interstate Commission shall make its information
3848 and official records, to the extent not otherwise designated in
3849 the compact or by its rules, available to the public for
3850 inspection.
3851 (11) The Interstate Commission shall establish an executive
3852 committee, which shall include officers, members, and others as
3853 determined by the bylaws. The executive committee has the power
3854 to act on behalf of the Interstate Commission, with the
3855 exception of rulemaking, during periods when the Interstate
3856 Commission is not in session. When acting on behalf of the
3857 Interstate Commission, the executive committee shall oversee the
3858 administration of the compact, including enforcement and
3859 compliance with the compact and its bylaws and rules, and other
3860 duties as necessary.
3861 (12) The Interstate Commission may establish other
3862 committees for governance and administration of the compact.
3863
3864 SECTION 11
3865 POWERS AND DUTIES OF THE INTERSTATE COMMISSION
3866 The Interstate Commission has all of the following powers
3867 and duties:
3868 (1) Overseeing and maintaining the administration of the
3869 compact.
3870 (2) Adopting rules, which shall be binding to the extent
3871 and in the manner provided for in the compact.
3872 (3) Issuing, upon the request of a member state or member
3873 board, advisory opinions concerning the meaning or
3874 interpretation of the compact and its bylaws, rules, and
3875 actions.
3876 (4) Enforcing compliance with the compact, the rules
3877 adopted by the Interstate Commission, and the bylaws, using all
3878 necessary and proper means, including, but not limited to, the
3879 use of judicial process.
3880 (5) Establishing and appointing committees, including, but
3881 not limited to, an executive committee as required by Section
3882 11, which shall have the power to act on behalf of the
3883 Interstate Commission in carrying out its powers and duties.
3884 (6) Paying for or providing for the payment of the expenses
3885 related to the establishment, organization, and ongoing
3886 activities of the Interstate Commission.
3887 (7) Establishing and maintaining one or more offices.
3888 (8) Borrowing, accepting, hiring, or contracting for
3889 services of personnel.
3890 (9) Purchasing and maintaining insurance and bonds.
3891 (10) Employing an executive director, who shall have the
3892 power to employ, select, or appoint employees, agents, or
3893 consultants and to determine their qualifications, define their
3894 duties, and fix their compensation.
3895 (11) Establishing personnel policies and programs relating
3896 to conflicts of interest, rates of compensation, and
3897 qualifications of personnel.
3898 (12) Accepting donations and grants of money, equipment,
3899 supplies, materials, and services and receiving, using, and
3900 disposing of them in a manner consistent with the conflict-of
3901 interest policies established by the Interstate Commission.
3902 (13) Leasing, purchasing, accepting contributions or
3903 donations of, or otherwise owning, holding, improving, or using
3904 any property, real, personal, or mixed.
3905 (14) Selling conveying, mortgaging, pledging, leasing,
3906 exchanging, abandoning, or otherwise disposing of any property,
3907 real, personal, or mixed.
3908 (15) Establishing a budget and making expenditures.
3909 (16) Adopting a seal and bylaws governing the management
3910 and operation of the Interstate Commission.
3911 (17) Reporting annually to the legislatures and governors
3912 of the member states concerning the activities of the Interstate
3913 Commission during the preceding year. Such reports must also
3914 include reports of financial audits and any recommendations that
3915 may have been adopted by the Interstate Commission.
3916 (18) Coordinating education, training, and public awareness
3917 regarding the compact and its implementation and operation.
3918 (19) Maintaining records in accordance with the bylaws.
3919 (20) Seeking and obtaining trademarks, copyrights, and
3920 patents.
3921 (21) Performing any other functions necessary or
3922 appropriate to achieve the purposes of the compact.
3923
3924 SECTION 12
3925 FINANCE POWERS
3926 (1) The Interstate Commission may levy on and collect an
3927 annual assessment from each member state to cover the cost of
3928 the operations and activities of the Interstate Commission and
3929 its staff. The total assessment, subject to appropriation, must
3930 be sufficient to cover the annual budget approved each year for
3931 which revenue is not provided by other sources. The aggregate
3932 annual assessment amount must be allocated upon a formula to be
3933 determined by the Interstate Commission, which shall adopt a
3934 rule binding upon all member states.
3935 (2) The Interstate Commission may not incur obligations of
3936 any kind before securing the funds adequate to meet the same.
3937 (3) The Interstate Commission may not pledge the credit of
3938 any of the member states, except by, and with the authority of,
3939 the member state.
3940 (4) The Interstate Commission is subject to an annual
3941 financial audit conducted by a certified or licensed public
3942 accountant, and the report of the audit must be included in the
3943 annual report of the Interstate Commission.
3944
3945 SECTION 13
3946 ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION
3947 (1) The Interstate Commission shall, by a majority of
3948 commissioners present and voting, adopt bylaws to govern its
3949 conduct as may be necessary or appropriate to carry out the
3950 purposes of the compact within 12 months after the first
3951 Interstate Commission meeting.
3952 (2) The Interstate Commission shall elect or appoint
3953 annually from among its commissioners a chairperson, a vice
3954 chairperson, and a treasurer, each of whom shall have such
3955 authority and duties as may be specified in the bylaws. The
3956 chairperson, or in the chairperson’s absence or disability, the
3957 vice chairperson, shall preside over all meetings of the
3958 Interstate Commission.
3959 (3) Officers selected pursuant to subsection (2) shall
3960 serve without remuneration from the Interstate Commission.
3961 (4) The officers and employees of the Interstate Commission
3962 are immune from suit and liability, either personally or in
3963 their official capacity, for a claim for damage to or loss of
3964 property or personal injury or other civil liability caused or
3965 arising out of, or relating to, an actual or alleged act, error,
3966 or omission that occurred, or that such person had a reasonable
3967 basis for believing occurred, within the scope of Interstate
3968 Commission employment, duties, or responsibilities; provided
3969 that such person is not protected from suit or liability for
3970 damage, loss, injury, or liability caused by the intentional or
3971 willful and wanton misconduct of such person.
3972 (a) The liability of the executive director and employees
3973 of the Interstate Commission or representatives of the
3974 Interstate Commission, acting within the scope of such person’s
3975 employment or duties for acts, errors, or omissions occurring
3976 within such person’s state, may not exceed the limits of
3977 liability set forth under the constitution and laws of that
3978 state for state officials, employees, and agents. The Interstate
3979 Commission is considered to be an instrumentality of the states
3980 for the purposes of any such action. Nothing in this subsection
3981 may be construed to protect such person from suit or liability
3982 for damage, loss, injury, or liability caused by the intentional
3983 or willful and wanton misconduct of such person.
3984 (b) The Interstate Commission shall defend the executive
3985 director and its employees and, subject to the approval of the
3986 attorney general or other appropriate legal counsel of the
3987 member state represented by an Interstate Commission
3988 representative, shall defend such persons in any civil action
3989 seeking to impose liability arising out of an actual or alleged
3990 act, error, or omission that occurred within the scope of
3991 Interstate Commission employment, duties, or responsibilities,
3992 or that the defendant had a reasonable basis for believing
3993 occurred within the scope of Interstate Commission employment,
3994 duties, or responsibilities, provided that the actual or alleged
3995 act, error, or omission did not result from intentional or
3996 willful and wanton misconduct on the part of such person.
3997 (c) To the extent not covered by the state involved, the
3998 member state, or the Interstate Commission, the representatives
3999 or employees of the Interstate Commission must be held harmless
4000 in the amount of a settlement or judgment, including attorney
4001 fees and costs, obtained against such persons arising out of an
4002 actual or alleged act, error, or omission that occurred within
4003 the scope of Interstate Commission employment, duties, or
4004 responsibilities, or that such persons had a reasonable basis
4005 for believing occurred within the scope of Interstate Commission
4006 employment, duties, or responsibilities, provided that the
4007 actual or alleged act, error, or omission did not result from
4008 intentional or willful and wanton misconduct on the part of such
4009 persons.
4010
4011 SECTION 14
4012 RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION
4013 (1) The Interstate Commission shall adopt reasonable rules
4014 in order to effectively and efficiently achieve the purposes of
4015 the compact. However, in the event the Interstate Commission
4016 exercises its rulemaking authority in a manner that is beyond
4017 the scope of the purposes of the compact, or the powers granted
4018 hereunder, then such an action by the Interstate Commission is
4019 invalid and has no force or effect.
4020 (2) Rules deemed appropriate for the operations of the
4021 Interstate Commission must be made pursuant to a rulemaking
4022 process that substantially conforms to the “Model State
4023 Administrative Procedure Act” of 2010, and subsequent amendments
4024 thereto.
4025 (3) Not later than 30 days after a rule is adopted, any
4026 person may file a petition for judicial review of the rule in
4027 the United States District Court for the District of Columbia or
4028 the federal district where the Interstate Commission has its
4029 principal offices, provided that the filing of such a petition
4030 does not stay or otherwise prevent the rule from becoming
4031 effective unless the court finds that the petitioner has a
4032 substantial likelihood of success. The court must give deference
4033 to the actions of the Interstate Commission consistent with
4034 applicable law and may not find the rule to be unlawful if the
4035 rule represents a reasonable exercise of the authority granted
4036 to the Interstate Commission.
4037
4038 SECTION 15
4039 OVERSIGHT OF INTERSTATE COMPACT
4040 (1) The executive, legislative, and judicial branches of
4041 state government in each member state shall enforce the compact
4042 and shall take all actions necessary and appropriate to
4043 effectuate the compact’s purposes and intent. The compact and
4044 the rules adopted hereunder shall have standing as statutory law
4045 but do not override existing state authority to regulate the
4046 practice of medicine.
4047 (2) All courts shall take judicial notice of the compact
4048 and the rules in any judicial or administrative proceeding in a
4049 member state pertaining to the subject matter of the compact
4050 which may affect the powers, responsibilities, or actions of the
4051 Interstate Commission.
4052 (3) The Interstate Commission is entitled to receive all
4053 service of process in any such proceeding and shall have
4054 standing to intervene in the proceeding for all purposes.
4055 Failure to provide service of process to the Interstate
4056 Commission shall render a judgment or order void as to the
4057 Interstate Commission, the compact, or adopted rules, as
4058 applicable.
4059
4060 SECTION 16
4061 ENFORCEMENT OF INTERSTATE COMPACT
4062 (1) The Interstate Commission, in the reasonable exercise
4063 of its discretion, shall enforce the provisions and rules of the
4064 compact.
4065 (2) The Interstate Commission may, by majority vote of the
4066 commissioners, initiate legal action in the United States
4067 District Court for the District of Columbia, or, at the
4068 discretion of the Interstate Commission, in the federal district
4069 where the Interstate Commission has its principal offices, to
4070 enforce compliance with the compact and its adopted rules and
4071 bylaws against a member state in default. The relief sought may
4072 include both injunctive relief and damages. In the event
4073 judicial enforcement is necessary, the prevailing party must be
4074 awarded all costs of such litigation, including reasonable
4075 attorney fees.
4076 (3) The remedies herein are not the exclusive remedies of
4077 the Interstate Commission. The Interstate Commission may avail
4078 itself of any other remedies available under state law or the
4079 regulation of a profession.
4080
4081 SECTION 17
4082 DEFAULT PROCEDURES
4083 (1) The grounds for default include, but are not limited
4084 to, failure of a member state to perform such obligations or
4085 responsibilities imposed upon it by the compact, or the rules
4086 and bylaws of the Interstate Commission adopted under the
4087 compact.
4088 (2) If the Interstate Commission determines that a member
4089 state has defaulted in the performance of its obligations or
4090 responsibilities under the compact, or the bylaws or adopted
4091 rules, the Interstate Commission shall:
4092 (a) Provide written notice to the defaulting state and
4093 other member states of the nature of the default, the means of
4094 curing the default, and any action taken by the Interstate
4095 Commission. The Interstate Commission shall specify the
4096 conditions by which the defaulting state must cure its default;
4097 and
4098 (b) Provide remedial training and specific technical
4099 assistance regarding the default.
4100 (3) If the defaulting state fails to cure the default, the
4101 defaulting state may be terminated from the compact upon an
4102 affirmative vote of a majority of the commissioners and all
4103 rights, privileges, and benefits conferred by the compact
4104 terminate on the effective date of the termination. A cure of
4105 the default does not relieve the offending state of obligations
4106 or liabilities incurred during the period of the default.
4107 (4) Termination of membership in the compact must be
4108 imposed only after all other means of securing compliance have
4109 been exhausted. Notice of intent to terminate must be given by
4110 the Interstate Commission to the governor, the majority and
4111 minority leaders of the defaulting state’s legislature, and each
4112 of the member states.
4113 (5) The Interstate Commission shall establish rules and
4114 procedures to address licenses and physicians that are
4115 materially impacted by the termination of a member state, or the
4116 withdrawal of a member state.
4117 (6) The member state which has been terminated is
4118 responsible for all dues, obligations, and liabilities incurred
4119 through the effective date of termination, including
4120 obligations, the performance of which extends beyond the
4121 effective date of termination.
4122 (7) The Interstate Commission shall not bear any costs
4123 relating to any state that has been found to be in default or
4124 which has been terminated from the compact, unless otherwise
4125 mutually agreed upon in writing between the Interstate
4126 Commission and the defaulting state.
4127 (8) The defaulting state may appeal the action of the
4128 Interstate Commission by petitioning the United States District
4129 Court for the District of Columbia or the federal district where
4130 the Interstate Commission has its principal offices. The
4131 prevailing party must be awarded all costs of such litigation
4132 including reasonable attorney fees.
4133
4134 SECTION 18
4135 DISPUTE RESOLUTION
4136 (1) The Interstate Commission shall attempt, upon the
4137 request of a member state, to resolve disputes that are subject
4138 to the compact and that may arise among member states or member
4139 boards.
4140 (2) The Interstate Commission shall adopt rules providing
4141 for both mediation and binding dispute resolution as
4142 appropriate.
4143
4144 SECTION 19
4145 MEMBER STATES, EFFECTIVE DATE, AND AMENDMENT
4146 (1) Any state is eligible to become a member state of the
4147 compact.
4148 (2) The compact becomes effective and binding upon
4149 legislative enactment of the compact into law by no less than
4150 seven states. Thereafter, it becomes effective and binding on a
4151 state upon enactment of the compact into law by that state.
4152 (3) The governors of nonmember states, or their designees,
4153 must be invited to participate in the activities of the
4154 Interstate Commission on a nonvoting basis before adoption of
4155 the compact by all states.
4156 (4) The Interstate Commission may propose amendments to the
4157 compact for enactment by the member states. No amendment becomes
4158 effective and binding upon the Interstate Commission and the
4159 member states unless and until it is enacted into law by
4160 unanimous consent of the member states.
4161
4162 SECTION 20
4163 WITHDRAWAL
4164 (1) Once effective, the compact shall continue in force and
4165 remain binding upon each member state. However, a member state
4166 may withdraw from the compact by specifically repealing the
4167 statute which enacted the compact into law.
4168 (2) Withdrawal from the compact must be made by the
4169 enactment of a statute repealing the same, but the withdrawal
4170 shall not take effect until 1 year after the effective date of
4171 such statute and until written notice of the withdrawal has been
4172 given by the withdrawing state to the governor of each other
4173 member state.
4174 (3) The withdrawing state shall immediately notify the
4175 chairperson of the Interstate Commission in writing upon the
4176 introduction of legislation repealing the compact in the
4177 withdrawing state.
4178 (4) The Interstate Commission shall notify the other member
4179 states of the withdrawing state’s intent to withdraw within 60
4180 days after receipt of notice provided under subsection (3).
4181 (5) The withdrawing state is responsible for all dues,
4182 obligations, and liabilities incurred through the effective date
4183 of withdrawal, including obligations, the performance of which
4184 extend beyond the effective date of withdrawal.
4185 (6) Reinstatement following withdrawal of a member state
4186 shall occur upon the withdrawing state reenacting the compact or
4187 upon such later date as determined by the Interstate Commission.
4188 (7) The Interstate Commission may develop rules to address
4189 the impact of the withdrawal of a member state on licenses
4190 granted in other member states to physicians who designated the
4191 withdrawing member state as the state of principal license.
4192
4193 SECTION 21
4194 DISSOLUTION
4195 (1) The compact shall dissolve effective upon the date of
4196 the withdrawal or default of the member state which reduces the
4197 membership in the compact to one member state.
4198 (2) Upon the dissolution of the compact, the compact
4199 becomes null and void and shall be of no further force or
4200 effect, the business and affairs of the Interstate Commission
4201 must be concluded, and surplus funds of the Interstate
4202 Commission must be distributed in accordance with the bylaws.
4203
4204 SECTION 22
4205 SEVERABILITY AND CONSTRUCTION
4206 (1) The provisions of the compact are severable, and if any
4207 phrase, clause, sentence, or provision is deemed unenforceable,
4208 the remaining provisions of the compact remain enforceable.
4209 (2) The provisions of the compact must be liberally
4210 construed to effectuate its purposes.
4211 (3) The compact may be construed to prohibit the
4212 applicability of other interstate compacts to which the states
4213 are members.
4214
4215 SECTION 23
4216 BINDING EFFECT OF COMPACT AND OTHER LAWS
4217 (1) Nothing herein prevents the enforcement of any other
4218 law of a member state which is not inconsistent with the
4219 compact.
4220 (2) All laws in a member state in conflict with the compact
4221 are superseded to the extent of the conflict.
4222 (3) All lawful actions of the Interstate Commission,
4223 including all rules and bylaws adopted by the commission, are
4224 binding upon the member states.
4225 (4) All agreements between the Interstate Commission and
4226 the member states are binding in accordance with their terms.
4227 (5) In the event any provision of the compact exceeds the
4228 constitutional limits imposed on the legislature of any member
4229 state, such provision is ineffective to the extent of the
4230 conflict with the constitutional provision in question in that
4231 member state.
4232 Section 50. Section 456.4502, Florida Statutes, is created
4233 to read:
4234 456.4502 Interstate Medical Licensure Compact; disciplinary
4235 proceedings.—A physician licensed pursuant to chapter 458,
4236 chapter 459, or s. 456.4501 whose license is suspended or
4237 revoked by this state pursuant to the Interstate Medical
4238 Licensure Compact as a result of disciplinary action taken
4239 against the physician’s license in another state must be granted
4240 a formal hearing before an administrative law judge from the
4241 Division of Administrative Hearings held pursuant to chapter 120
4242 if there are any disputed issues of material fact. In such
4243 proceedings:
4244 (1) Notwithstanding s. 120.569(2), the department shall
4245 notify the division within 45 days after receipt of a petition
4246 or request for a formal hearing.
4247 (2) The determination of whether the physician has violated
4248 the laws and rules regulating the practice of medicine or
4249 osteopathic medicine, as applicable, including a determination
4250 of the reasonable standard of care, is a conclusion of law that
4251 is to be determined by appropriate board and is not a finding of
4252 fact to be determined by an administrative law judge.
4253 (3) The administrative law judge shall issue a recommended
4254 order pursuant to chapter 120.
4255 (4) The Board of Medicine or the Board of Osteopathic
4256 Medicine, as applicable, shall determine and issue the final
4257 order in each disciplinary case. Such order shall constitute
4258 final agency action.
4259 (5) Any consent order or agreed-upon settlement is subject
4260 to the approval of the department.
4261 (6) The department shall have standing to seek judicial
4262 review of any final order of the board, pursuant to s. 120.68.
4263 Section 51. Section 456.4504, Florida Statutes, is created
4264 to read:
4265 456.4504 Interstate Medical Licensure Compact Rules.—The
4266 department may adopt rules to implement the Interstate Medical
4267 Licensure Compact.
4268 Section 52. Section 458.3129, Florida Statutes, is created
4269 to read:
4270 458.3129 Interstate Medical Licensure Compact.—A physician
4271 licensed to practice allopathic medicine under s. 456.4501 is
4272 deemed to also be licensed under this chapter.
4273 Section 53. Section 459.074, Florida Statutes, is created
4274 to read:
4275 459.074 Interstate Medical Licensure Compact.—A physician
4276 licensed to practice osteopathic medicine under s. 456.4501 is
4277 deemed to also be licensed under this chapter.
4278 Section 54. Paragraph (j) is added to subsection (10) of
4279 section 768.28, Florida Statutes, to read:
4280 768.28 Waiver of sovereign immunity in tort actions;
4281 recovery limits; civil liability for damages caused during a
4282 riot; limitation on attorney fees; statute of limitations;
4283 exclusions; indemnification; risk management programs.—
4284 (10)
4285 (j) For purposes of this section, the representative
4286 appointed from the Board of Medicine and the representative
4287 appointed from the Board of Osteopathic Medicine, when serving
4288 as commissioners of the Interstate Medical Licensure Compact
4289 Commission pursuant to s. 456.4501, and any administrator,
4290 officer, executive director, employee, or representative of the
4291 Interstate Medical Licensure Compact Commission, when acting
4292 within the scope of their employment, duties, or
4293 responsibilities in this state, are considered agents of the
4294 state. The commission shall pay any claims or judgments pursuant
4295 to this section and may maintain insurance coverage to pay any
4296 such claims or judgments.
4297 Section 55. Section 468.1335, Florida Statutes, is created
4298 to read:
4299 468.1335 Audiology and Speech-Language Pathology Interstate
4300 Compact.—The Audiology and Speech-Language Pathology Interstate
4301 Compact is hereby enacted into law and entered into by this
4302 state with all other states legally joining therein in the form
4303 substantially as follows:
4304
4305 ARTICLE I
4306 PURPOSE
4307 (1) The purpose of the compact is to facilitate the
4308 interstate practice of audiology and speech-language pathology
4309 with the goal of improving public access to audiology and
4310 speech-language pathology services.
4311 (2) The practice of audiology and speech-language pathology
4312 occurs in the state where the patient, client, or student is
4313 located at the time the services are provided.
4314 (3) The compact preserves the regulatory authority of
4315 states to protect the public health and safety through the
4316 current system of state licensure.
4317 (4) The compact is designed to achieve all of the following
4318 objectives:
4319 (a) Increase public access to audiology and speech-language
4320 pathology services by providing for the mutual recognition of
4321 other member state licenses.
4322 (b) Enhance the states’ abilities to protect public health
4323 and safety.
4324 (c) Encourage the cooperation of member states in
4325 regulating multistate audiology and speech-language pathology
4326 practices.
4327 (d) Support spouses of relocating active duty military
4328 personnel.
4329 (e) Enhance the exchange of licensure, investigative, and
4330 disciplinary information between member states.
4331 (f) Allow a remote state to hold a licensee with compact
4332 privilege in that state accountable to that state’s practice
4333 standards.
4334 (g) Allow for the use of telehealth technology to
4335 facilitate increased access to audiology and speech-language
4336 pathology services.
4337
4338 ARTICLE II
4339 DEFINITIONS
4340 As used in the compact, the term:
4341 (1) “Active duty military” means full-time duty status in
4342 the active uniformed service of the United States, including
4343 members of the National Guard and Reserve on active duty orders
4344 pursuant to 10 U.S.C. chapters 1209 and 1211.
4345 (2) “Adverse action” means any administrative, civil,
4346 equitable, or criminal action permitted by a state’s laws which
4347 is imposed by a licensing board against a licensee, including
4348 actions against an individual’s license or privilege to
4349 practice, such as revocation, suspension, probation, monitoring
4350 of the licensee, or restriction on the licensee’s practice.
4351 (3) “Alternative program” means a nondisciplinary
4352 monitoring process approved by an audiology licensing board or a
4353 speech-language pathology licensing board to address impaired
4354 licensees.
4355 (4) “Audiologist” means an individual who is licensed by a
4356 state to practice audiology.
4357 (5) “Audiology” means the care and services provided by a
4358 licensed audiologist as provided in the member state’s rules and
4359 regulations.
4360 (6) “Audiology and Speech-Language Pathology Interstate
4361 Compact Commission” or “commission” means the national
4362 administrative body whose membership consists of all states that
4363 have enacted the compact.
4364 (7) “Audiology licensing board” means the agency of a state
4365 which is responsible for the licensing and regulation of
4366 audiologists.
4367 (8) “Compact privilege” means the authorization granted by
4368 a remote state to allow a licensee from another member state to
4369 practice as an audiologist or speech-language pathologist in the
4370 remote state under its rules and regulations. The practice of
4371 audiology or speech-language pathology occurs in the member
4372 state where the patient, client, or student is located at the
4373 time the services are provided.
4374 (9) “Current significant investigative information,”
4375 “investigative materials,” “investigative records,” or
4376 “investigative reports” means information that a licensing
4377 board, after an inquiry or investigation that includes
4378 notification and an opportunity for the audiologist or speech
4379 language pathologist to respond, if required by state law, has
4380 reason to believe is not groundless and, if proved true, would
4381 indicate more than a minor infraction.
4382 (10) “Data system” means a repository of information
4383 relating to licensees, including, but not limited to, continuing
4384 education, examination, licensure, investigative, compact
4385 privilege, and adverse action information.
4386 (11) “Encumbered license” means a license in which an
4387 adverse action restricts the practice of audiology or speech
4388 language pathology by the licensee and the adverse action has
4389 been reported to the National Practitioner Data Bank.
4390 (12) “Executive committee” means a group of directors
4391 elected or appointed to act on behalf of, and within the powers
4392 granted to them by, the commission.
4393 (13) “Home state” means the member state that is the
4394 licensee’s primary state of residence.
4395 (14) “Impaired licensee” means a licensee whose
4396 professional practice is adversely affected by substance abuse,
4397 addiction, or other health-related conditions.
4398 (15) “Licensee” means a person who is licensed by his or
4399 her home state to practice as an audiologist or speech-language
4400 pathologist.
4401 (16) “Licensing board” means the agency of a state which is
4402 responsible for the licensing and regulation of audiologists or
4403 speech-language pathologists.
4404 (17) “Member state” means a state that has enacted the
4405 compact.
4406 (18) “Privilege to practice” means the legal authorization
4407 to practice audiology or speech-language pathology in a remote
4408 state.
4409 (19) “Remote state” means a member state, other than the
4410 home state, where a licensee is exercising or seeking to
4411 exercise his or her compact privilege.
4412 (20) “Rule” means a regulation, principle, or directive
4413 adopted by the commission which has the force of law.
4414 (21) “Single-state license” means an audiology or speech
4415 language pathology license issued by a member state which
4416 authorizes practice only within the issuing state and does not
4417 include a privilege to practice in any other member state.
4418 (22) “Speech-language pathologist” means an individual who
4419 is licensed to practice speech-language pathology.
4420 (23) “Speech-language pathology” means the care and
4421 services provided by a licensed speech-language pathologist as
4422 provided in the member state’s rules and regulations.
4423 (24) “Speech-language pathology licensing board” means the
4424 agency of a state which is responsible for the licensing and
4425 regulation of speech-language pathologists.
4426 (25) “State” means any state, commonwealth, district, or
4427 territory of the United States of America which regulates the
4428 practice of audiology and speech-language pathology.
4429 (26) “State practice laws” means a member state’s laws,
4430 rules, and regulations that govern the practice of audiology or
4431 speech-language pathology, define the scope of audiology or
4432 speech-language pathology practice, and create the methods and
4433 grounds for imposing discipline.
4434 (27) “Telehealth” means the application of
4435 telecommunication technology to deliver audiology or speech
4436 language pathology services at a distance for assessment,
4437 intervention, or consultation.
4438
4439 ARTICLE III
4440 STATE PARTICIPATION
4441 (1) A license issued to an audiologist or speech-language
4442 pathologist by a home state to a resident in that state must be
4443 recognized by each member state as authorizing an audiologist or
4444 speech-language pathologist to practice audiology or speech
4445 language pathology, under a privilege to practice, in each
4446 member state.
4447 (2) A state must implement procedures for considering the
4448 criminal history records of applicants for initial privilege to
4449 practice. These procedures must include the submission of
4450 fingerprints or other biometric-based information by applicants
4451 for the purpose of obtaining an applicant’s criminal history
4452 records from the Federal Bureau of Investigation and the agency
4453 responsible for retaining that state’s criminal history records.
4454 (a) A member state must fully implement a criminal history
4455 records check procedure, within a timeframe established by rule,
4456 which requires the member state to receive an applicant’s
4457 criminal history records from the Federal Bureau of
4458 Investigation and the agency responsible for retaining the
4459 member state’s criminal history records and use such records in
4460 making licensure decisions.
4461 (b) Communication between a member state, the commission,
4462 and other member states regarding the verification of
4463 eligibility for licensure through the compact may not include
4464 any information received from the Federal Bureau of
4465 Investigation relating to a criminal history records check
4466 performed by a member state under Pub. L. No. 92-544.
4467 (3) Upon application for a privilege to practice, the
4468 licensing board in the issuing remote state must determine,
4469 through the data system, whether the applicant has ever held, or
4470 is the holder of, a license issued by any other state, whether
4471 there are any encumbrances on any license or privilege to
4472 practice held by the applicant, and whether any adverse action
4473 has been taken against any license or privilege to practice held
4474 by the applicant.
4475 (4) Each member state must require an applicant to obtain
4476 or retain a license in his or her home state and meet the home
4477 state’s qualifications for licensure or renewal of licensure and
4478 all other applicable state laws.
4479 (5) Each member state must require that an applicant meet
4480 all of the following criteria to receive the privilege to
4481 practice as an audiologist in the member state:
4482 (a) One of the following educational requirements:
4483 1. On or before December 31, 2007, has graduated with a
4484 master’s degree or doctoral degree in audiology, or an
4485 equivalent degree, regardless of the name of such degree, from a
4486 program that is accredited by an accrediting agency recognized
4487 by the Council for Higher Education Accreditation, or its
4488 successor, or by the United States Department of Education and
4489 operated by a college or university accredited by a regional or
4490 national accrediting organization recognized by the board;
4491 2. On or after January 1, 2008, has graduated with a
4492 doctoral degree in audiology, or an equivalent degree,
4493 regardless of the name of such degree, from a program that is
4494 accredited by an accrediting agency recognized by the Council
4495 for Higher Education Accreditation, or its successor, or by the
4496 United States Department of Education and operated by a college
4497 or university accredited by a regional or national accrediting
4498 organization recognized by the board; or
4499 3. Has graduated from an audiology program that is housed
4500 in an institution of higher education outside of the United
4501 States for which the degree program and institution have been
4502 approved by the authorized accrediting body in the applicable
4503 country and the degree program has been verified by an
4504 independent credentials review agency to be comparable to a
4505 state licensing board-approved program.
4506 (b) Has completed a supervised clinical practicum
4507 experience from an accredited educational institution or its
4508 cooperating programs as required by the commission.
4509 (c) Has successfully passed a national examination approved
4510 by the commission.
4511 (d) Holds an active, unencumbered license.
4512 (e) Has not been convicted or found guilty of, or entered a
4513 plea of guilty or nolo contendere to, regardless of
4514 adjudication, a felony in any jurisdiction which directly
4515 relates to the practice of his or her profession or the ability
4516 to practice his or her profession.
4517 (f) Has a valid United States social security number or a
4518 national provider identifier.
4519 (6) Each member state must require that an applicant meet
4520 all of the following criteria to receive the privilege to
4521 practice as a speech-language pathologist in the member state:
4522 (a) One of the following educational requirements:
4523 1. Has graduated with a master’s degree from a speech
4524 language pathology program that is accredited by an organization
4525 recognized by the United States Department of Education and
4526 operated by a college or university accredited by a regional or
4527 national accrediting organization recognized by the board; or
4528 2. Has graduated from a speech-language pathology program
4529 that is housed in an institution of higher education outside of
4530 the United States for which the degree program and institution
4531 have been approved by the authorized accrediting body in the
4532 applicable country and the degree program has been verified by
4533 an independent credentials review agency to be comparable to a
4534 state licensing board-approved program.
4535 (b) Has completed a supervised clinical practicum
4536 experience from an educational institution or its cooperating
4537 programs as required by the commission.
4538 (c) Has completed a supervised postgraduate professional
4539 experience as required by the commission.
4540 (d) Has successfully passed a national examination approved
4541 by the commission.
4542 (e) Holds an active, unencumbered license.
4543 (f) Has not been convicted or found guilty of, or entered a
4544 plea of guilty or nolo contendere to, regardless of
4545 adjudication, a felony in any jurisdiction which directly
4546 relates to the practice of his or her profession or the ability
4547 to practice his or her profession.
4548 (g) Has a valid United States social security number or
4549 national provider identifier.
4550 (7) The privilege to practice is derived from the home
4551 state license.
4552 (8) An audiologist or speech-language pathologist
4553 practicing in a member state must comply with the state practice
4554 laws of the member state where the client is located at the time
4555 service is provided. The practice of audiology and speech
4556 language pathology includes all audiology and speech-language
4557 pathology practices as defined by the state practice laws of the
4558 member state where the client is located. The practice of
4559 audiology and speech-language pathology in a member state under
4560 a privilege to practice subjects an audiologist or speech
4561 language pathologist to the jurisdiction of the licensing
4562 boards, courts, and laws of the member state where the client is
4563 located at the time service is provided.
4564 (9) Individuals not residing in a member state shall
4565 continue to be able to apply for a member state’s single-state
4566 license as provided under the laws of each member state.
4567 However, the single-state license granted to these individuals
4568 may not be recognized as granting the privilege to practice
4569 audiology or speech-language pathology in any other member
4570 state. The compact does not affect the requirements established
4571 by a member state for the issuance of a single-state license.
4572 (10) Member states must comply with the bylaws and rules of
4573 the commission.
4574
4575 ARTICLE IV
4576 COMPACT PRIVILEGE
4577 (1) To exercise compact privilege under the compact, the
4578 audiologist or speech-language pathologist must meet all of the
4579 following criteria:
4580 (a) Hold an active license in the home state.
4581 (b) Have no encumbrance on any state license.
4582 (c) Be eligible for compact privilege in any member state
4583 in accordance with Article III.
4584 (d) Not have any adverse action against any license or
4585 compact privilege within the 2 years preceding the date of
4586 application.
4587 (e) Notify the commission that he or she is seeking compact
4588 privilege within a remote state or states.
4589 (f) Report to the commission any adverse action taken by
4590 any nonmember state within 30 days after the date the adverse
4591 action is taken.
4592 (2) For the purposes of compact privilege, an audiologist
4593 or speech-language pathologist may hold only one home state
4594 license at a time.
4595 (3) Except as provided in Article VI, if an audiologist or
4596 speech-language pathologist changes his or her primary state of
4597 residence by moving between two member states, the audiologist
4598 or speech-language pathologist must apply for licensure in the
4599 new home state, and the license issued by the prior home state
4600 shall be deactivated in accordance with applicable rules adopted
4601 by the commission.
4602 (4) The audiologist or speech-language pathologist may
4603 apply for licensure in advance of a change in his or her primary
4604 state of residence.
4605 (5) A license may not be issued by the new home state until
4606 the audiologist or speech-language pathologist provides
4607 satisfactory evidence of a change in his or her primary state of
4608 residence to the new home state and satisfies all applicable
4609 requirements to obtain a license from the new home state.
4610 (6) If an audiologist or speech-language pathologist
4611 changes his or her primary state of residence by moving from a
4612 member state to a nonmember state, the license issued by the
4613 prior home state shall convert to a single-state license, valid
4614 only in the former home state.
4615 (7) Compact privilege is valid until the expiration date of
4616 the home state license. The licensee must comply with the
4617 requirements of subsection (1) to maintain compact privilege in
4618 the remote state.
4619 (8) A licensee providing audiology or speech-language
4620 pathology services in a remote state under compact privilege
4621 shall function within the laws and regulations of the remote
4622 state.
4623 (9) A remote state may, in accordance with due process and
4624 state law, remove a licensee’s compact privilege in the remote
4625 state for a specific period of time, impose fines, or take any
4626 other necessary actions to protect the health and safety of its
4627 residents.
4628 (10) If a home state license is encumbered, the licensee
4629 shall lose compact privilege in all remote states until both of
4630 the following occur:
4631 (a) The home state license is no longer encumbered.
4632 (b) Two years have lapsed from the date of the adverse
4633 action.
4634 (11) Once an encumbered license in the home state is
4635 restored to good standing, the licensee must meet the
4636 requirements of subsection (1) to obtain compact privilege in
4637 any remote state.
4638 (12) Once the requirements of subsection (10) have been
4639 met, the licensee must meet the requirements in subsection (1)
4640 to obtain compact privilege in a remote state.
4641
4642 ARTICLE V
4643 COMPACT PRIVILEGE TO PRACTICE TELEHEALTH
4644 Member states shall recognize the right of an audiologist
4645 or speech-language pathologist, licensed by a home state in
4646 accordance with Article III and under rules adopted by the
4647 commission, to practice audiology or speech-language pathology
4648 in any member state through the use of telehealth under
4649 privilege to practice as provided in the compact and rules
4650 adopted by the commission.
4651
4652 ARTICLE VI
4653 ACTIVE DUTY MILITARY PERSONNEL AND THEIR SPOUSES
4654 Active duty military personnel, or their spouses, as
4655 applicable, shall designate a home state where the individual
4656 has a current license in good standing. The individual may
4657 retain the home state designation during the period the
4658 servicemember is on active duty. Subsequent to designating a
4659 home state, the individual shall change his or her home state
4660 only through application for licensure in the new state.
4661
4662 ARTICLE VII
4663 ADVERSE ACTIONS
4664 (1) In addition to the other powers conferred by state law,
4665 a remote state may:
4666 (a) Take adverse action against an audiologist’s or speech
4667 language pathologist’s privilege to practice within that member
4668 state.
4669 1. Only the home state has the power to take adverse action
4670 against an audiologist’s or a speech-language pathologist’s
4671 license issued by the home state.
4672 2. For purposes of taking adverse action, the home state
4673 shall give the same priority and effect to reported conduct
4674 received from a member state as it would if the conduct had
4675 occurred within the home state. In so doing, the home state
4676 shall apply its own state laws to determine appropriate action.
4677 (b) Issue subpoenas for both hearings and investigations
4678 that require the attendance and testimony of witnesses as well
4679 as the production of evidence. Subpoenas issued by a licensing
4680 board in a member state for the attendance and testimony of
4681 witnesses or the production of evidence from another member
4682 state must be enforced in the latter state by any court of
4683 competent jurisdiction according to the practice and procedure
4684 of that court applicable to subpoenas issued in proceedings
4685 pending before it. The issuing authority shall pay any witness
4686 fees, travel expenses, mileage, and other fees required by the
4687 service statutes of the state in which the witnesses or evidence
4688 is located.
4689 (c) Complete any pending investigations of an audiologist
4690 or speech-language pathologist who changes his or her primary
4691 state of residence during the course of the investigations. The
4692 home state also has the authority to take appropriate actions
4693 and shall promptly report the conclusions of the investigations
4694 to the administrator of the data system. The administrator of
4695 the data system shall promptly notify the new home state of any
4696 adverse actions.
4697 (d) If otherwise allowed by state law, recover from the
4698 affected audiologist or speech-language pathologist the costs of
4699 investigations and disposition of cases resulting from any
4700 adverse action taken against that audiologist or speech-language
4701 pathologist.
4702 (e) Take adverse action based on the factual findings of
4703 the remote state, provided that the member state follows the
4704 member state’s own procedures for taking the adverse action.
4705 (2)(a) In addition to the authority granted to a member
4706 state by its respective audiology or speech-language pathology
4707 practice act or other applicable state law, any member state may
4708 participate with other member states in joint investigations of
4709 licensees.
4710 (b) Member states shall share any investigative,
4711 litigation, or compliance materials in furtherance of any joint
4712 or individual investigation initiated under the compact.
4713 (3) If adverse action is taken by the home state against an
4714 audiologist’s or a speech language pathologist’s license, the
4715 audiologist’s or speech-language pathologist’s privilege to
4716 practice in all other member states shall be deactivated until
4717 all encumbrances have been removed from the home state license.
4718 All home state disciplinary orders that impose adverse action
4719 against an audiologist’s or a speech language pathologist’s
4720 license must include a statement that the audiologist’s or
4721 speech-language pathologist’s privilege to practice is
4722 deactivated in all member states during the pendency of the
4723 order.
4724 (4) If a member state takes adverse action, it must
4725 promptly notify the administrator of the data system. The
4726 administrator of the data system shall promptly notify the home
4727 state of any adverse actions by remote states.
4728 (5) The compact does not override a member state’s decision
4729 that participation in an alternative program may be used in lieu
4730 of adverse action.
4731
4732 ARTICLE VIII
4733 ESTABLISHMENT OF THE AUDIOLOGY
4734 AND SPEECH-LANGUAGE PATHOLOGY INTERSTATE COMPACT COMMISSION
4735 (1) The member states hereby create and establish a joint
4736 public agency known as the Audiology and Speech-Language
4737 Pathology Interstate Compact Commission.
4738 (a) The commission is an instrumentality of the compact
4739 states.
4740 (b) Venue is proper, and judicial proceedings by or against
4741 the commission must be brought solely and exclusively, in a
4742 court of competent jurisdiction where the principal office of
4743 the commission is located. The commission may waive venue and
4744 jurisdictional defenses to the extent it adopts or consents to
4745 participate in alternative dispute resolution proceedings.
4746 (c) The compact does not waive sovereign immunity except to
4747 the extent sovereign immunity is waived in the member states.
4748 (2)(a) Each member state must have two delegates selected
4749 by that member state’s licensing boards. The delegates must be
4750 current members of the licensing boards. One delegate must be an
4751 audiologist and one delegate must be a speech-language
4752 pathologist.
4753 (b) An additional five delegates, who are either public
4754 members or board administrators from licensing boards, must be
4755 chosen by the executive committee from a pool of nominees
4756 provided by the commission at large.
4757 (c) A delegate may be removed or suspended from office as
4758 provided by the state law from which the delegate is appointed.
4759 (d) The member state board shall fill any vacancy occurring
4760 on the commission within 90 days after the vacancy occurs.
4761 (e) Each delegate is entitled to one vote with regard to
4762 the adoption of rules and creation of bylaws and shall otherwise
4763 have an opportunity to participate in the business and affairs
4764 of the commission.
4765 (f) A delegate shall vote in person or by other means as
4766 provided in the bylaws. The bylaws may provide for delegates’
4767 participation in meetings by telephone or other means of
4768 communication.
4769 (g) The commission shall meet at least once during each
4770 calendar year. Additional meetings must be held as provided in
4771 the bylaws and rules.
4772 (3) The commission has the following powers and duties:
4773 (a) Establish the commission’s fiscal year.
4774 (b) Establish bylaws.
4775 (c) Establish a code of ethics.
4776 (d) Maintain its financial records in accordance with the
4777 bylaws.
4778 (e) Meet and take actions as are consistent with the
4779 compact and the bylaws.
4780 (f) Adopt uniform rules to facilitate and coordinate
4781 implementation and administration of the compact. The rules have
4782 the force and effect of law and are binding on all member
4783 states.
4784 (g) Bring and prosecute legal proceedings or actions in the
4785 name of the commission, provided that the standing of an
4786 audiology licensing board or a speech-language pathology
4787 licensing board to sue or be sued under applicable law is not
4788 affected.
4789 (h) Purchase and maintain insurance and bonds.
4790 (i) Borrow, accept, or contract for services of personnel,
4791 including, but not limited to, employees of a member state.
4792 (j) Hire employees, elect or appoint officers, fix
4793 compensation, define duties, grant individuals appropriate
4794 authority to carry out the purposes of the compact, and
4795 establish the commission’s personnel policies and programs
4796 relating to conflicts of interest, qualifications of personnel,
4797 and other related personnel matters.
4798 (k) Accept any appropriate donations and grants of money,
4799 equipment, supplies, and materials and services, and receive,
4800 use, and dispose of the same, provided that at all times the
4801 commission must avoid any appearance of impropriety or conflict
4802 of interest.
4803 (l) Lease, purchase, accept appropriate gifts or donations
4804 of, or otherwise own, hold, improve, or use any property, real,
4805 personal, or mixed, provided that at all times the commission
4806 shall avoid any appearance of impropriety.
4807 (m) Sell, convey, mortgage, pledge, lease, exchange,
4808 abandon, or otherwise dispose of any property real, personal, or
4809 mixed.
4810 (n) Establish a budget and make expenditures.
4811 (o) Borrow money.
4812 (p) Appoint committees, including standing committees,
4813 composed of members and other interested persons as may be
4814 designated in the compact and the bylaws.
4815 (q) Provide and receive information from, and cooperate
4816 with, law enforcement agencies.
4817 (r) Establish and elect an executive committee.
4818 (s) Perform other functions as may be necessary or
4819 appropriate to achieve the purposes of the compact consistent
4820 with the state regulation of audiology and speech-language
4821 pathology licensure and practice.
4822 (4) The executive committee shall have the power to act on
4823 behalf of the commission according to the terms of the compact.
4824 (a) The executive committee must be composed of 10 members
4825 as follows:
4826 1. Seven voting members who are elected by the commission
4827 from the current membership of the commission.
4828 2. Two ex officio members, consisting of one nonvoting
4829 member from a recognized national audiology professional
4830 association and one nonvoting member from a recognized national
4831 speech-language pathology association.
4832 3. One ex officio, nonvoting member from the recognized
4833 membership organization of the audiology and speech-language
4834 pathology licensing boards.
4835 (b) The ex officio members must be selected by their
4836 respective organizations.
4837 (c) The commission may remove any member of the executive
4838 committee as provided in the bylaws.
4839 (d) The executive committee shall meet at least annually.
4840 (e) The executive committee has the following duties and
4841 responsibilities:
4842 1. Recommend to the entire commission changes to the rules
4843 or bylaws and changes to this compact legislation.
4844 2. Ensure compact administration services are appropriately
4845 provided, contractual or otherwise.
4846 3. Prepare and recommend the budget.
4847 4. Maintain financial records on behalf of the commission.
4848 5. Monitor compact compliance of member states and provide
4849 compliance reports to the commission.
4850 6. Establish additional committees as necessary.
4851 7. Other duties as provided by rule or bylaw.
4852 (f) All meetings must be open to the public, and public
4853 notice of meetings must be given in the same manner as required
4854 under the rulemaking provisions in Article X.
4855 (g) If a meeting or any portion of a meeting is closed
4856 under this subsection, the commission’s legal counsel or
4857 designee must certify that the meeting may be closed and must
4858 reference each relevant exempting provision.
4859 (h) The commission shall keep minutes that fully and
4860 clearly describe all matters discussed in a meeting and shall
4861 provide a full and accurate summary of actions taken, and the
4862 reasons therefore, including a description of the views
4863 expressed. All documents considered in connection with an action
4864 must be identified in minutes. All minutes and documents of a
4865 closed meeting must remain under seal, subject to release by a
4866 majority vote of the commission or order of a court of competent
4867 jurisdiction.
4868 (5) Relating to the financing of the commission, the
4869 commission:
4870 (a) Shall pay, or provide for the payment of, the
4871 reasonable expenses of its establishment, organization, and
4872 ongoing activities.
4873 (b) May accept any and all appropriate revenue sources,
4874 donations, and grants of money, equipment, supplies, materials,
4875 and services.
4876 (c) May not incur obligations of any kind before securing
4877 the funds adequate to meet the same and may not pledge the
4878 credit of any of the member states, except by and with the
4879 authority of the member state.
4880 (d) Shall keep accurate accounts of all receipts and
4881 disbursements of funds. The receipts and disbursements of funds
4882 of the commission are subject to the audit and accounting
4883 procedures established under its bylaws. However, all receipts
4884 and disbursements of funds handled by the commission must be
4885 audited yearly by a certified or licensed public accountant, and
4886 the report of the audit must be included in and become part of
4887 the annual report of the commission.
4888 (6) Relating to qualified immunity, defense, and
4889 indemnification:
4890 (a) The members, officers, executive director, employees,
4891 and representatives of the commission are immune from suit and
4892 liability, either personally or in their official capacity, for
4893 any claim for damage to or loss of property or personal injury
4894 or other civil liability caused by or arising out of any actual
4895 or alleged act, error, or omission that occurred, or that the
4896 person against whom the claim is made had a reasonable basis for
4897 believing occurred, within the scope of commission employment,
4898 duties, or responsibilities; provided that this paragraph may
4899 not be construed to protect any person from suit or liability
4900 for any damage, loss, injury, or liability caused by the
4901 intentional or willful or wanton misconduct of that person.
4902 (b) The commission shall defend any member, officer,
4903 executive director, employee, or representative of the
4904 commission in any civil action seeking to impose liability
4905 arising out of any actual or alleged act, error, or omission
4906 that occurred within the scope of commission employment, duties,
4907 or responsibilities, or that the person against whom the claim
4908 is made had a reasonable basis for believing occurred within the
4909 scope of commission employment, duties, or responsibilities;
4910 provided that this paragraph may not be construed to prohibit
4911 that person from retaining his or her own counsel; and provided
4912 further that the actual or alleged act, error, or omission did
4913 not result from that person’s intentional or willful or wanton
4914 misconduct.
4915 (c) The commission shall indemnify and hold harmless any
4916 member, officer, executive director, employee, or representative
4917 of the commission for the amount of any settlement or judgment
4918 obtained against that person arising out of any actual or
4919 alleged act, error, or omission that occurred within the scope
4920 of commission employment, duties, or responsibilities, or that
4921 the person had a reasonable basis for believing occurred within
4922 the scope of commission employment, duties, or responsibilities,
4923 provided that the actual or alleged act, error, or omission did
4924 not result from the intentional or willful or wanton misconduct
4925 of that person.
4926
4927 ARTICLE IX
4928 DATA SYSTEM
4929 (1) The commission shall provide for the development,
4930 maintenance, and use of a coordinated database and reporting
4931 system containing licensure, adverse action, and current
4932 significant investigative information on all licensed
4933 individuals in member states.
4934 (2) Notwithstanding any other law to the contrary, a member
4935 state shall submit a uniform data set to the data system on all
4936 individuals to whom the compact is applicable as required by the
4937 rules of the commission, including all of the following
4938 information:
4939 (a) Identifying information.
4940 (b) Licensure data.
4941 (c) Adverse actions against a license or compact privilege.
4942 (d) Nonconfidential information related to alternative
4943 program participation.
4944 (e) Any denial of application for licensure, and the reason
4945 for such denial.
4946 (f) Other information that may facilitate the
4947 administration of the compact, as determined by the rules of the
4948 commission.
4949 (3) Current significant investigative information
4950 pertaining to a licensee in a member state must be available
4951 only to other member states.
4952 (4) The commission shall promptly notify all member states
4953 of any adverse action taken against a licensee or an individual
4954 applying for a license. Adverse action information pertaining to
4955 a licensee or an individual applying for a license in any member
4956 state must be available to any other member state.
4957 (5) Member states contributing information to the data
4958 system may designate information that may not be shared with the
4959 public without the express permission of the contributing state.
4960 (6) Any information submitted to the data system that is
4961 subsequently required to be expunged by the laws of the member
4962 state contributing the information must be removed from the data
4963 system.
4964
4965 ARTICLE X
4966 RULEMAKING
4967 (1) The commission shall exercise its rulemaking powers
4968 pursuant to the criteria provided in this article and the rules
4969 adopted thereunder. Rules and amendments become binding as of
4970 the date specified in each rule or amendment.
4971 (2) If a majority of the legislatures of the member states
4972 rejects a rule by enactment of a statute or resolution in the
4973 same manner used to adopt the compact within 4 years after the
4974 date of adoption of the rule, the rule has no further force and
4975 effect in any member state.
4976 (3) Rules or amendments to the rules must be adopted at a
4977 regular or special meeting of the commission.
4978 (4) Before adoption of a final rule or rules by the
4979 commission, and at least 30 days before the meeting at which the
4980 rule shall be considered and voted upon, the commission shall
4981 file a notice of proposed rulemaking:
4982 (a) On the website of the commission or other publicly
4983 accessible platform; and
4984 (b) On the website of each member state audiology licensing
4985 board and speech-language pathology licensing board or other
4986 publicly accessible platform or the publication where each state
4987 would otherwise publish proposed rules.
4988 (5) The notice of proposed rulemaking must include all of
4989 the following:
4990 (a) The proposed time, date, and location of the meeting in
4991 which the rule will be considered and voted upon.
4992 (b) The text of and reason for the proposed rule or
4993 amendment.
4994 (c) A request for comments on the proposed rule from any
4995 interested person.
4996 (d) The manner in which interested persons may submit
4997 notice to the commission of their intention to attend the public
4998 hearing and any written comments.
4999 (6) Before the adoption of a proposed rule, the commission
5000 shall allow persons to submit written data, facts, opinions, and
5001 arguments, which shall be made available to the public.
5002 (a) The commission shall grant an opportunity for a public
5003 hearing before it adopts a rule or amendment if a hearing is
5004 requested by:
5005 1. At least 25 persons;
5006 2. A state or federal governmental subdivision or agency;
5007 or
5008 3. An association having at least 25 members.
5009 (b) If a hearing is held on the proposed rule or amendment,
5010 the commission must publish the place, time, and date of the
5011 scheduled public hearing. If the hearing is held via electronic
5012 means, the commission must publish the mechanism for access to
5013 the electronic hearing.
5014 (c) All persons wishing to be heard at the hearing shall
5015 notify the executive director of the commission or other
5016 designated member in writing of their desire to appear and
5017 testify at the hearing not less than 5 business days before the
5018 scheduled date of the hearing.
5019 (d) Hearings must be conducted in a manner providing each
5020 person who wishes to comment a fair and reasonable opportunity
5021 to comment orally or in writing.
5022 (e) All hearings must be recorded. A copy of the recording
5023 must be made available on request.
5024 (7) This article does not require a separate hearing on
5025 each rule. Rules may be grouped for the convenience of the
5026 commission at hearings required by this article.
5027 (8) Following the scheduled hearing date, or by the close
5028 of business on the scheduled hearing date if the hearing was not
5029 held, the commission shall consider all written and oral
5030 comments received.
5031 (9) If no written notice of intent to attend the public
5032 hearing by interested parties is received, the commission may
5033 proceed with adoption of the proposed rule without a public
5034 hearing.
5035 (10) The commission shall, by majority vote of all members,
5036 take final action on the proposed rule and shall determine the
5037 effective date of the rule, if any, based on the rulemaking
5038 record and the full text of the rule.
5039 (11) Upon determination that an emergency exists, the
5040 commission may consider and adopt an emergency rule without
5041 prior notice, opportunity for comment, or hearing, provided that
5042 the usual rulemaking procedures provided in the compact and in
5043 this article retroactively apply to the rule as soon as
5044 reasonably possible, but in no event later than 90 days after
5045 the effective date of the rule. For purposes of this subsection,
5046 an emergency rule is one that must be adopted immediately in
5047 order to:
5048 (a) Meet an imminent threat to public health, safety, or
5049 welfare;
5050 (b) Prevent a loss of commission or member state funds; or
5051 (c) Meet a deadline for the promulgation of an
5052 administrative rule that is established by federal law or rule.
5053 (12) The commission or an authorized committee of the
5054 commission may direct revisions to a previously adopted rule or
5055 amendment for purposes of correcting typographical errors,
5056 errors in format, errors in consistency, or grammatical errors.
5057 Public notice of any revisions must be posted on the website of
5058 the commission. The revisions are subject to challenge by any
5059 person for a period of 30 days after posting. A revision may be
5060 challenged only on grounds that it results in a material change
5061 to a rule. A challenge must be made in writing and delivered to
5062 the chair of the commission before the end of the notice period.
5063 If no challenge is made, the revision takes effect without
5064 further action. If the revision is challenged, the revision may
5065 not take effect without the approval of the commission.
5066
5067 ARTICLE XI
5068 DISPUTE RESOLUTION
5069 AND ENFORCEMENT
5070 (1)(a) Upon request by a member state, the commission shall
5071 attempt to resolve disputes related to the compact which arise
5072 among member states and between member and nonmember states.
5073 (b) The commission shall adopt a rule providing for both
5074 mediation and binding dispute resolution for disputes as
5075 appropriate.
5076 (2)(a) The commission, in the reasonable exercise of its
5077 discretion, shall enforce the compact.
5078 (b) By majority vote, the commission may initiate legal
5079 action in the United States District Court for the District of
5080 Columbia or the federal district where the commission has its
5081 principal offices against a member state in default to enforce
5082 compliance with the compact and its adopted rules and bylaws.
5083 The relief sought may include both injunctive relief and
5084 damages. In the event judicial enforcement is necessary, the
5085 prevailing member must be awarded all costs of litigation,
5086 including reasonable attorney fees.
5087 (c) The remedies provided in this subsection are not the
5088 exclusive remedies of the commission. The commission may pursue
5089 any other remedies available under federal or state law.
5090
5091 ARTICLE XII
5092 EFFECTIVE DATE, WITHDRAWAL, AND AMENDMENT
5093 (1) The compact becomes effective and binding on the date
5094 of legislative enactment of the compact by no fewer than 10
5095 member states. The provisions, which become effective at that
5096 time, shall be limited to the powers granted to the commission
5097 relating to assembly and the adoption of rules. Thereafter, the
5098 commission shall meet and exercise rulemaking powers as
5099 necessary to implement and administer the compact.
5100 (2) Any state that joins the compact subsequent to the
5101 commission’s initial adoption of the rules is subject to the
5102 rules as they exist on the date on which the compact becomes law
5103 in that state. Any rule that has been previously adopted by the
5104 commission has the full force and effect of law on the day the
5105 compact becomes law in that state.
5106 (3) A member state may withdraw from the compact by
5107 enacting a statute repealing the compact.
5108 (a) A member state’s withdrawal does not take effect until
5109 6 months after enactment of the repealing statute.
5110 (b) Withdrawal does not affect the continuing requirement
5111 of the withdrawing state’s audiology licensing board or speech
5112 language pathology licensing board to comply with the
5113 investigative and adverse action reporting requirements of the
5114 compact before the effective date of withdrawal.
5115 (4) The compact does not invalidate or prevent any
5116 audiology or speech-language pathology licensure agreement or
5117 other cooperative arrangement between a member state and a
5118 nonmember state which does not conflict with the compact.
5119 (5) The compact may be amended by the member states. An
5120 amendment to the compact does not become effective and binding
5121 upon any member state until it is enacted into the laws of all
5122 member states.
5123
5124 ARTICLE XIII
5125 CONSTRUCTION AND SEVERABILITY
5126 The compact must be liberally construed so as to effectuate
5127 its purposes. The provisions of the compact are severable and if
5128 any phrase, clause, sentence, or provision of the compact is
5129 declared to be contrary to the constitution of any member state
5130 or of the United States or the applicability thereof to any
5131 government, agency, person, or circumstance is held invalid, the
5132 validity of the remainder of the compact and the applicability
5133 thereof to any government, agency, person, or circumstance is
5134 not affected. If the compact is held contrary to the
5135 constitution of any member state, it shall remain in full force
5136 and effect as to the remaining member states and in full force
5137 and effect as to the member state affected as to all severable
5138 matters.
5139
5140 ARTICLE XIV
5141 BINDING EFFECT OF COMPACT AND OTHER LAWS
5142 (1) This compact does not prevent the enforcement of any
5143 other law of a member state which is not inconsistent with the
5144 compact.
5145 (2) All laws of a member state in conflict with the compact
5146 are superseded to the extent of the conflict.
5147 (3) All lawful actions of the commission, including all
5148 rules and bylaws adopted by the commission, are binding upon the
5149 member states.
5150 (4) All agreements between the commission and the member
5151 states are binding in accordance with their terms.
5152 (5) In the event any provision of the compact exceeds the
5153 constitutional limits imposed on the legislature of any member
5154 state, the provision is ineffective to the extent of the
5155 conflict with the constitutional provision in question in that
5156 member state.
5157 Section 56. Subsection (10) of section 456.073, Florida
5158 Statutes, is amended to read:
5159 456.073 Disciplinary proceedings.—Disciplinary proceedings
5160 for each board shall be within the jurisdiction of the
5161 department.
5162 (10)(a) The complaint and all information obtained pursuant
5163 to the investigation by the department are confidential and
5164 exempt from s. 119.07(1) until 10 days after probable cause has
5165 been found to exist by the probable cause panel or by the
5166 department, or until the regulated professional or subject of
5167 the investigation waives his or her privilege of
5168 confidentiality, whichever occurs first.
5169 (b) The department shall report any significant
5170 investigation information relating to a nurse holding a
5171 multistate license to the coordinated licensure information
5172 system pursuant to s. 464.0095; any investigative information
5173 relating to an audiologist or a speech-language pathologist
5174 holding a compact privilege under the Audiology and Speech
5175 Language Pathology Interstate Compact to the data system
5176 pursuant to s. 468.1335; any significant investigatory
5177 information relating to a psychologist practicing under the
5178 Psychology Interjurisdictional Compact to the coordinated
5179 licensure information system pursuant to s. 490.0075;, and any
5180 significant investigatory information relating to a health care
5181 practitioner practicing under the Professional Counselors
5182 Licensure Compact to the data system pursuant to s. 491.017, and
5183 any significant investigatory information relating to a
5184 psychologist practicing under the Psychology Interjurisdictional
5185 Compact to the coordinated licensure information system pursuant
5186 to s. 490.0075.
5187 (c) Upon completion of the investigation and a
5188 recommendation by the department to find probable cause, and
5189 pursuant to a written request by the subject or the subject’s
5190 attorney, the department shall provide the subject an
5191 opportunity to inspect the investigative file or, at the
5192 subject’s expense, forward to the subject a copy of the
5193 investigative file. Notwithstanding s. 456.057, the subject may
5194 inspect or receive a copy of any expert witness report or
5195 patient record connected with the investigation if the subject
5196 agrees in writing to maintain the confidentiality of any
5197 information received under this subsection until 10 days after
5198 probable cause is found and to maintain the confidentiality of
5199 patient records pursuant to s. 456.057. The subject may file a
5200 written response to the information contained in the
5201 investigative file. Such response must be filed within 20 days
5202 of mailing by the department, unless an extension of time has
5203 been granted by the department.
5204 (d) This subsection does not prohibit the department from
5205 providing the complaint and any information obtained pursuant to
5206 the department’s investigation such information to any law
5207 enforcement agency or to any other regulatory agency.
5208 Section 57. Subsection (5) of section 456.076, Florida
5209 Statutes, is amended to read:
5210 456.076 Impaired practitioner programs.—
5211 (5) A consultant shall enter into a participant contract
5212 with an impaired practitioner and shall establish the terms of
5213 monitoring and shall include the terms in a participant
5214 contract. In establishing the terms of monitoring, the
5215 consultant may consider the recommendations of one or more
5216 approved evaluators, treatment programs, or treatment providers.
5217 A consultant may modify the terms of monitoring if the
5218 consultant concludes, through the course of monitoring, that
5219 extended, additional, or amended terms of monitoring are
5220 required for the protection of the health, safety, and welfare
5221 of the public. If the impaired practitioner is an audiologist or
5222 a speech-language pathologist practicing under the Audiology and
5223 Speech-Language Pathology Interstate Compact pursuant to s.
5224 468.1335, a psychologist practicing under the Psychology
5225 Interjurisdictional Compact pursuant to s. 490.0075, or a health
5226 care practitioner practicing under the Professional Counselors
5227 Licensure Compact pursuant to s. 491.017, the terms of the
5228 monitoring contract must include the impaired practitioner’s
5229 withdrawal from all practice under the compact unless authorized
5230 by a member state. If the impaired practitioner is a
5231 psychologist practicing under the Psychology Interjurisdictional
5232 Compact pursuant to s. 490.0075, the terms of the monitoring
5233 contract must include the impaired practitioner’s withdrawal
5234 from all practice under the compact.
5235 Section 58. Present subsections (4), (5), and (6) of
5236 section 468.1135, Florida Statutes, are redesignated as
5237 subsections (5), (6), and (7), respectively, and a new
5238 subsection (4) is added to that section, to read:
5239 468.1135 Board of Speech-Language Pathology and Audiology.—
5240 (4) The board shall appoint two of its members to serve as
5241 the state’s delegates on the Audiology and Speech-Language
5242 Pathology Interstate Compact Commission, as required under s.
5243 468.1335, one of whom must be an audiologist and one of whom
5244 must be a speech-language pathologist.
5245 Section 59. Subsection (6) is added to section 468.1185,
5246 Florida Statutes, to read:
5247 468.1185 Licensure.—
5248 (6) A person licensed as an audiologist or a speech
5249 language pathologist in another state who is practicing under
5250 the Audiology and Speech-Language Pathology Interstate Compact
5251 pursuant to s. 468.1335, and only within the scope provided
5252 therein, is exempt from the licensure requirements of this
5253 section.
5254 Section 60. Subsections (1) and (2) of section 468.1295,
5255 Florida Statutes, are amended to read:
5256 468.1295 Disciplinary proceedings.—
5257 (1) The following acts constitute grounds for denial of a
5258 license or disciplinary action, as specified in s. 456.072(2) or
5259 s. 468.1335:
5260 (a) Procuring, or attempting to procure, a license by
5261 bribery, by fraudulent misrepresentation, or through an error of
5262 the department or the board.
5263 (b) Having a license revoked, suspended, or otherwise acted
5264 against, including denial of licensure, by the licensing
5265 authority of another state, territory, or country.
5266 (c) Being convicted or found guilty of, or entering a plea
5267 of nolo contendere to, regardless of adjudication, a crime in
5268 any jurisdiction which directly relates to the practice of
5269 speech-language pathology or audiology.
5270 (d) Making or filing a report or record which the licensee
5271 knows to be false, intentionally or negligently failing to file
5272 a report or records required by state or federal law, willfully
5273 impeding or obstructing such filing, or inducing another person
5274 to impede or obstruct such filing. Such report or record shall
5275 include only those reports or records which are signed in one’s
5276 capacity as a licensed speech-language pathologist or
5277 audiologist.
5278 (e) Advertising goods or services in a manner which is
5279 fraudulent, false, deceptive, or misleading in form or content.
5280 (f) Being proven guilty of fraud or deceit or of
5281 negligence, incompetency, or misconduct in the practice of
5282 speech-language pathology or audiology.
5283 (g) Violating a lawful order of the board or department
5284 previously entered in a disciplinary hearing, or failing to
5285 comply with a lawfully issued subpoena of the board or
5286 department.
5287 (h) Practicing with a revoked, suspended, inactive, or
5288 delinquent license.
5289 (i) Using, or causing or promoting the use of, any
5290 advertising matter, promotional literature, testimonial,
5291 guarantee, warranty, label, brand, insignia, or other
5292 representation, however disseminated or published, which is
5293 misleading, deceiving, or untruthful.
5294 (j) Showing or demonstrating or, in the event of sale,
5295 delivery of a product unusable or impractical for the purpose
5296 represented or implied by such action.
5297 (k) Failing to submit to the board on an annual basis, or
5298 such other basis as may be provided by rule, certification of
5299 testing and calibration of such equipment as designated by the
5300 board and on the form approved by the board.
5301 (l) Aiding, assisting, procuring, employing, or advising
5302 any licensee or business entity to practice speech-language
5303 pathology or audiology contrary to this part, chapter 456, or
5304 any rule adopted pursuant thereto.
5305 (m) Misrepresenting the professional services available in
5306 the fitting, sale, adjustment, service, or repair of a hearing
5307 aid, or using any other term or title which might connote the
5308 availability of professional services when such use is not
5309 accurate.
5310 (n) Representing, advertising, or implying that a hearing
5311 aid or its repair is guaranteed without providing full
5312 disclosure of the identity of the guarantor; the nature, extent,
5313 and duration of the guarantee; and the existence of conditions
5314 or limitations imposed upon the guarantee.
5315 (o) Representing, directly or by implication, that a
5316 hearing aid utilizing bone conduction has certain specified
5317 features, such as the absence of anything in the ear or leading
5318 to the ear, or the like, without disclosing clearly and
5319 conspicuously that the instrument operates on the bone
5320 conduction principle and that in many cases of hearing loss this
5321 type of instrument may not be suitable.
5322 (p) Stating or implying that the use of any hearing aid
5323 will improve or preserve hearing or prevent or retard the
5324 progression of a hearing impairment or that it will have any
5325 similar or opposite effect.
5326 (q) Making any statement regarding the cure of the cause of
5327 a hearing impairment by the use of a hearing aid.
5328 (r) Representing or implying that a hearing aid is or will
5329 be “custom-made,” “made to order,” or “prescription-made,” or in
5330 any other sense specially fabricated for an individual, when
5331 such is not the case.
5332 (s) Canvassing from house to house or by telephone, either
5333 in person or by an agent, for the purpose of selling a hearing
5334 aid, except that contacting persons who have evidenced an
5335 interest in hearing aids, or have been referred as in need of
5336 hearing aids, shall not be considered canvassing.
5337 (t) Failing to notify the department in writing of a change
5338 in current mailing and place-of-practice address within 30 days
5339 after such change.
5340 (u) Failing to provide all information as described in ss.
5341 468.1225(5)(b), 468.1245(1), and 468.1246.
5342 (v) Exercising influence on a client in such a manner as to
5343 exploit the client for financial gain of the licensee or of a
5344 third party.
5345 (w) Practicing or offering to practice beyond the scope
5346 permitted by law or accepting and performing professional
5347 responsibilities the licensee or certificateholder knows, or has
5348 reason to know, the licensee or certificateholder is not
5349 competent to perform.
5350 (x) Aiding, assisting, procuring, or employing any
5351 unlicensed person to practice speech-language pathology or
5352 audiology.
5353 (y) Delegating or contracting for the performance of
5354 professional responsibilities by a person when the licensee
5355 delegating or contracting for performance of such
5356 responsibilities knows, or has reason to know, such person is
5357 not qualified by training, experience, and authorization to
5358 perform them.
5359 (z) Committing any act upon a patient or client which would
5360 constitute sexual battery or which would constitute sexual
5361 misconduct as defined pursuant to s. 468.1296.
5362 (aa) Being unable to practice the profession for which he
5363 or she is licensed or certified under this chapter with
5364 reasonable skill or competence as a result of any mental or
5365 physical condition or by reason of illness, drunkenness, or use
5366 of drugs, narcotics, chemicals, or any other substance. In
5367 enforcing this paragraph, upon a finding by the State Surgeon
5368 General, his or her designee, or the board that probable cause
5369 exists to believe that the licensee or certificateholder is
5370 unable to practice the profession because of the reasons stated
5371 in this paragraph, the department shall have the authority to
5372 compel a licensee or certificateholder to submit to a mental or
5373 physical examination by a physician, psychologist, clinical
5374 social worker, marriage and family therapist, or mental health
5375 counselor designated by the department or board. If the licensee
5376 or certificateholder refuses to comply with the department’s
5377 order directing the examination, such order may be enforced by
5378 filing a petition for enforcement in the circuit court in the
5379 circuit in which the licensee or certificateholder resides or
5380 does business. The department shall be entitled to the summary
5381 procedure provided in s. 51.011. A licensee or certificateholder
5382 affected under this paragraph shall at reasonable intervals be
5383 afforded an opportunity to demonstrate that he or she can resume
5384 the competent practice for which he or she is licensed or
5385 certified with reasonable skill and safety to patients.
5386 (bb) Violating any provision of this chapter or chapter
5387 456, or any rules adopted pursuant thereto.
5388 (2)(a) The board may enter an order denying licensure or
5389 imposing any of the penalties in s. 456.072(2) against any
5390 applicant for licensure or licensee who is found guilty of
5391 violating any provision of subsection (1) of this section or who
5392 is found guilty of violating any provision of s. 456.072(1).
5393 (b) The board may take adverse action against an
5394 audiologist’s or a speech-language pathologist’s compact
5395 privilege under the Audiology and Speech-Language Pathology
5396 Interstate Compact pursuant to s. 468.1335 and may impose any of
5397 the penalties in s. 456.072(2) if an audiologist or a speech
5398 language pathologist commits an act specified in subsection (1)
5399 or s. 456.072(1).
5400 Section 61. Paragraph (j) is added to subsection (10) of
5401 section 768.28, Florida Statutes, to read:
5402 768.28 Waiver of sovereign immunity in tort actions;
5403 recovery limits; civil liability for damages caused during a
5404 riot; limitation on attorney fees; statute of limitations;
5405 exclusions; indemnification; risk management programs.—
5406 (10)
5407 (j) For purposes of this section, the individuals appointed
5408 under s. 468.1135(4) as the state’s delegates on the Audiology
5409 and Speech-Language Pathology Interstate Compact Commission,
5410 when serving in that capacity pursuant to s. 468.1335, and any
5411 administrator, officer, executive director, employee, or
5412 representative of the commission, when acting within the scope
5413 of his or her employment, duties, or responsibilities in this
5414 state, is considered an agent of the state. The commission shall
5415 pay any claims or judgments pursuant to this section and may
5416 maintain insurance coverage to pay any such claims or judgments.
5417 Section 62. Section 486.112, Florida Statutes, is created
5418 to read:
5419 486.112 Physical Therapy Licensure Compact.—The Physical
5420 Therapy Licensure Compact is hereby enacted into law and entered
5421 into by this state with all other jurisdictions legally joining
5422 therein in the form substantially as follows:
5423
5424 ARTICLE I
5425 PURPOSE AND OBJECTIVES
5426 (1) The purpose of the compact is to facilitate interstate
5427 practice of physical therapy with the goal of improving public
5428 access to physical therapy services. The compact preserves the
5429 regulatory authority of member states to protect public health
5430 and safety through their current systems of state licensure. For
5431 purposes of state regulation under the compact, the practice of
5432 physical therapy is deemed to have occurred in the state where
5433 the patient is located at the time physical therapy is provided
5434 to the patient.
5435 (2) The compact is designed to achieve all of the following
5436 objectives:
5437 (a) Increase public access to physical therapy services by
5438 providing for the mutual recognition of other member state
5439 licenses.
5440 (b) Enhance the states’ ability to protect the public’s
5441 health and safety.
5442 (c) Encourage the cooperation of member states in
5443 regulating multistate physical therapy practice.
5444 (d) Support spouses of relocating military members.
5445 (e) Enhance the exchange of licensure, investigative, and
5446 disciplinary information between member states.
5447 (f) Allow a remote state to hold a provider of services
5448 with a compact privilege in that state accountable to that
5449 state’s practice standards.
5450
5451 ARTICLE II
5452 DEFINITIONS
5453 As used in the compact, and except as otherwise provided,
5454 the term:
5455 (1)“Active duty military” means full-time duty status in
5456 the active uniformed service of the United States, including
5457 members of the National Guard and Reserve on active duty orders
5458 pursuant to 10 U.S.C. chapter 1209 or chapter 1211.
5459 (2) “Adverse action” means disciplinary action taken by a
5460 physical therapy licensing board based upon misconduct,
5461 unacceptable performance, or a combination of both.
5462 (3) “Alternative program” means a nondisciplinary
5463 monitoring or practice remediation process approved by a state’s
5464 physical therapy licensing board. The term includes, but is not
5465 limited to, programs that address substance abuse issues.
5466 (4) “Compact privilege” means the authorization granted by
5467 a remote state to allow a licensee from another member state to
5468 practice as a physical therapist or physical therapist assistant
5469 in the remote state under its laws and rules.
5470 (5) “Continuing competence” means a requirement, as a
5471 condition of license renewal, to provide evidence of
5472 participation in, and completion of, educational and
5473 professional activities relevant to the practice of physical
5474 therapy.
5475 (6) “Data system” means the coordinated database and
5476 reporting system created by the Physical Therapy Compact
5477 Commission for the exchange of information between member states
5478 relating to licensees or applicants under the compact, including
5479 identifying information, licensure data, investigative
5480 information, adverse actions, nonconfidential information
5481 related to alternative program participation, any denials of
5482 applications for licensure, and other information as specified
5483 by commission rule.
5484 (7) “Encumbered license” means a license that a physical
5485 therapy licensing board has limited in any way.
5486 (8) “Executive board” means a group of directors elected or
5487 appointed to act on behalf of, and within the powers granted to
5488 them by, the commission.
5489 (9) “Home state” means the member state that is the
5490 licensee’s primary state of residence.
5491 (10) “Investigative information” means information,
5492 records, and documents received or generated by a physical
5493 therapy licensing board pursuant to an investigation.
5494 (11) “Jurisprudence requirement” means the assessment of an
5495 individual’s knowledge of the laws and rules governing the
5496 practice of physical therapy in a specific state.
5497 (12) “Licensee” means an individual who currently holds an
5498 authorization from a state to practice as a physical therapist
5499 or physical therapist assistant.
5500 (13) “Member state” means a state that has enacted the
5501 compact.
5502 (14) “Physical therapist” means an individual licensed by a
5503 state to practice physical therapy.
5504 (15) “Physical therapist assistant” means an individual
5505 licensed by a state to assist a physical therapist in specified
5506 areas of physical therapy.
5507 (16) “Physical therapy” or “the practice of physical
5508 therapy” means the care and services provided by or under the
5509 direction and supervision of a licensed physical therapist.
5510 (17) “Physical Therapy Compact Commission” or “commission”
5511 means the national administrative body whose membership consists
5512 of all states that have enacted the compact.
5513 (18) “Physical therapy licensing board” means the agency of
5514 a state which is responsible for the licensing and regulation of
5515 physical therapists and physical therapist assistants.
5516 (19) “Remote state” means a member state other than the
5517 home state where a licensee is exercising or seeking to exercise
5518 the compact privilege.
5519 (20) “Rule” means a regulation, principle, or directive
5520 adopted by the commission which has the force of law.
5521 (21) “State” means any state, commonwealth, district, or
5522 territory of the United States of America which regulates the
5523 practice of physical therapy.
5524
5525 ARTICLE III
5526 STATE PARTICIPATION IN THE COMPACT
5527 (1) To participate in the compact, a state must do all of
5528 the following:
5529 (a) Participate fully in the commission’s data system,
5530 including using the commission’s unique identifier, as defined
5531 by commission rule.
5532 (b) Have a mechanism in place for receiving and
5533 investigating complaints about licensees.
5534 (c) Notify the commission, in accordance with the terms of
5535 the compact and rules, of any adverse action or the availability
5536 of investigative information regarding a licensee.
5537 (d) Fully implement a criminal background check
5538 requirement, within a timeframe established by commission rule,
5539 which uses results from the Federal Bureau of Investigation
5540 record search on criminal background checks to make licensure
5541 decisions in accordance with subsection (2).
5542 (e) Comply with the commission’s rules.
5543 (f) Use a recognized national examination as a requirement
5544 for licensure pursuant to the commission’s rules.
5545 (g) Have continuing competence requirements as a condition
5546 for license renewal.
5547 (2) Upon adoption of the compact, a member state has the
5548 authority to obtain biometric-based information from each
5549 licensee applying for a compact privilege and submit this
5550 information to the Federal Bureau of Investigation for a
5551 criminal background check in accordance with 28 U.S.C. s. 534
5552 and 34 U.S.C. s. 40316.
5553 (3) A member state must grant the compact privilege to a
5554 licensee holding a valid unencumbered license in another member
5555 state in accordance with the terms of the compact and rules.
5556
5557 ARTICLE IV
5558 COMPACT PRIVILEGE
5559 (1) To exercise the compact privilege under the compact, a
5560 licensee must satisfy all of the following conditions:
5561 (a) Hold a license in the home state.
5562 (b) Not have an encumbrance on any state license.
5563 (c) Be eligible for a compact privilege in all member
5564 states in accordance with subsections (4), (7), and (8).
5565 (d) Not have had an adverse action against any license or
5566 compact privilege within the preceding 2 years.
5567 (e) Notify the commission that the licensee is seeking the
5568 compact privilege within a remote state.
5569 (f) Meet any jurisprudence requirements established by the
5570 remote state in which the licensee is seeking a compact
5571 privilege.
5572 (g) Report to the commission adverse action taken by any
5573 nonmember state within 30 days after the date the adverse action
5574 is taken.
5575 (2) The compact privilege is valid until the expiration
5576 date of the home license. The licensee must continue to meet the
5577 requirements of subsection (1) to maintain the compact privilege
5578 in a remote state.
5579 (3) A licensee providing physical therapy in a remote state
5580 under the compact privilege must comply with the laws and rules
5581 of the remote state.
5582 (4) A licensee providing physical therapy in a remote state
5583 is subject to that state’s regulatory authority. A remote state
5584 may, in accordance with due process and that state’s laws,
5585 remove a licensee’s compact privilege in the remote state for a
5586 specific period of time, impose fines, and take any other
5587 necessary actions to protect the health and safety of its
5588 citizens. The licensee is not eligible for a compact privilege
5589 in any member state until the specific period of time for
5590 removal has ended and all fines are paid.
5591 (5) If a home state license is encumbered, the licensee
5592 loses the compact privilege in any remote state until the
5593 following conditions are met:
5594 (a) The home state license is no longer encumbered.
5595 (b) Two years have elapsed from the date of the adverse
5596 action.
5597 (6) Once an encumbered license in the home state is
5598 restored to good standing, the licensee must meet the
5599 requirements of subsection (1) to obtain a compact privilege in
5600 any remote state.
5601 (7) If a licensee’s compact privilege in any remote state
5602 is removed, the licensee loses the compact privilege in all
5603 remote states until all of the following conditions are met:
5604 (a) The specific period of time for which the compact
5605 privilege was removed has ended.
5606 (b) All fines have been paid.
5607 (c) Two years have elapsed from the date of the adverse
5608 action.
5609 (8) Once the requirements of subsection (7) have been met,
5610 the licensee must meet the requirements of subsection (1) to
5611 obtain a compact privilege in a remote state.
5612
5613 ARTICLE V
5614 ACTIVE DUTY MILITARY PERSONNEL AND THEIR SPOUSES
5615 A licensee who is active duty military or is the spouse of
5616 an individual who is active duty military may choose any of the
5617 following locations to designate his or her home state:
5618 (1) Home of record.
5619 (2) Permanent change of station location.
5620 (3) State of current residence, if it is different from the
5621 home of record or permanent change of station location.
5622
5623 ARTICLE VI
5624 ADVERSE ACTIONS
5625 (1) A home state has exclusive power to impose adverse
5626 action against a license issued by the home state.
5627 (2) A home state may take adverse action based on the
5628 investigative information of a remote state, so long as the home
5629 state follows its own procedures for imposing adverse action.
5630 (3) The compact does not override a member state’s decision
5631 that participation in an alternative program may be used in lieu
5632 of adverse action and that such participation remain nonpublic
5633 if required by the member state’s laws. Member states must
5634 require licensees who enter any alternative programs in lieu of
5635 discipline to agree not to practice in any other member state
5636 during the term of the alternative program without prior
5637 authorization from such other member state.
5638 (4) A member state may investigate actual or alleged
5639 violations of the laws and rules for the practice of physical
5640 therapy committed in any other member state by a physical
5641 therapist or physical therapist assistant practicing under the
5642 compact who holds a license or compact privilege in such other
5643 member state.
5644 (5) A remote state may do any of the following:
5645 (a) Take adverse actions as set forth in subsection (4) of
5646 article IV against a licensee’s compact privilege in the state.
5647 (b) Issue subpoenas for both hearings and investigations
5648 which require the attendance and testimony of witnesses and the
5649 production of evidence. Subpoenas issued by a physical therapy
5650 licensing board in a member state for the attendance and
5651 testimony of witnesses or for the production of evidence from
5652 another member state must be enforced in the latter state by any
5653 court of competent jurisdiction, according to the practice and
5654 procedure of that court applicable to subpoenas issued in
5655 proceedings pending before it. The issuing authority shall pay
5656 any witness fees, travel expenses, mileage, and other fees
5657 required by the service laws of the state where the witnesses or
5658 evidence is located.
5659 (c) If otherwise permitted by state law, recover from the
5660 licensee the costs of investigations and disposition of cases
5661 resulting from any adverse action taken against that licensee.
5662 (6)(a) In addition to the authority granted to a member
5663 state by its respective physical therapy practice act or other
5664 applicable state law, a member state may participate with other
5665 member states in joint investigations of licensees.
5666 (b) Member states shall share any investigative,
5667 litigation, or compliance materials in furtherance of any joint
5668 or individual investigation initiated under the compact.
5669
5670 ARTICLE VII
5671 ESTABLISHMENT OF THE PHYSICAL THERAPY COMPACT COMMISSION
5672 (1) COMMISSION CREATED.—The member states hereby create and
5673 establish a joint public agency known as the Physical Therapy
5674 Compact Commission:
5675 (a) The commission is an instrumentality of the member
5676 states.
5677 (b) Venue is proper, and judicial proceedings by or against
5678 the commission must be brought solely and exclusively, in a
5679 court of competent jurisdiction where the principal office of
5680 the commission is located. The commission may waive venue and
5681 jurisdictional defenses to the extent it adopts or consents to
5682 participate in alternative dispute resolution proceedings.
5683 (c) The compact may not be construed to be a waiver of
5684 sovereign immunity.
5685 (2) MEMBERSHIP, VOTING, AND MEETINGS.—
5686 (a) Each member state has and is limited to one delegate
5687 selected by that member state’s physical therapy licensing board
5688 to serve on the commission. The delegate must be a current
5689 member of the physical therapy licensing board who is a physical
5690 therapist, a physical therapist assistant, a public member, or
5691 the board administrator.
5692 (b) A delegate may be removed or suspended from office as
5693 provided by the law of the state from which the delegate is
5694 appointed. Any vacancy occurring on the commission must be
5695 filled by the physical therapy licensing board of the member
5696 state for which the vacancy exists.
5697 (c) Each delegate is entitled to one vote with regard to
5698 the adoption of rules and bylaws and shall otherwise have an
5699 opportunity to participate in the business and affairs of the
5700 commission.
5701 (d) A delegate shall vote in person or by such other means
5702 as provided in the bylaws. The bylaws may provide for delegates’
5703 participation in meetings by telephone or other means of
5704 communication.
5705 (e) The commission shall meet at least once during each
5706 calendar year. Additional meetings may be held as set forth in
5707 the bylaws.
5708 (f) All meetings must be open to the public, and public
5709 notice of meetings must be given in the same manner as required
5710 under the rulemaking provisions in article IX.
5711 (g) The commission or the executive board or other
5712 committees of the commission may convene in a closed, nonpublic
5713 meeting if the commission or executive board or other committees
5714 of the commission must discuss any of the following:
5715 1. Noncompliance of a member state with its obligations
5716 under the compact.
5717 2. The employment, compensation, or discipline of, or other
5718 matters, practices, or procedures related to, specific employees
5719 or other matters related to the commission’s internal personnel
5720 practices and procedures.
5721 3. Current, threatened, or reasonably anticipated
5722 litigation against the commission, executive board, or other
5723 committees of the commission.
5724 4. Negotiation of contracts for the purchase, lease, or
5725 sale of goods, services, or real estate.
5726 5. An accusation of any person of a crime or a formal
5727 censure of any person.
5728 6. Information disclosing trade secrets or commercial or
5729 financial information that is privileged or confidential.
5730 7. Information of a personal nature where disclosure would
5731 constitute a clearly unwarranted invasion of personal privacy.
5732 8. Investigatory records compiled for law enforcement
5733 purposes.
5734 9. Information related to any investigative reports
5735 prepared by or on behalf of or for use of the commission or
5736 other committee charged with responsibility for investigation or
5737 determination of compliance issues pursuant to the compact.
5738 10. Matters specifically exempted from disclosure by
5739 federal or member state statute.
5740 (h) If a meeting, or portion of a meeting, is closed
5741 pursuant to this subsection, the commission’s legal counsel or
5742 designee must certify that the meeting may be closed and must
5743 reference each relevant exempting provision.
5744 (i) The commission shall keep minutes that fully and
5745 clearly describe all matters discussed in a meeting and shall
5746 provide a full and accurate summary of actions taken and the
5747 reasons therefor, including a description of the views
5748 expressed. All documents considered in connection with an action
5749 must be identified in the minutes. All minutes and documents of
5750 a closed meeting must remain under seal, subject to release only
5751 by a majority vote of the commission or order of a court of
5752 competent jurisdiction.
5753 (3) DUTIES.—The commission shall do all of the following:
5754 (a) Establish the fiscal year of the commission.
5755 (b) Establish bylaws.
5756 (c) Maintain its financial records in accordance with the
5757 bylaws.
5758 (d) Meet and take such actions as are consistent with the
5759 provisions of the compact and the bylaws.
5760 (4) POWERS.—The commission may do any of the following:
5761 (a) Adopt uniform rules to facilitate and coordinate
5762 implementation and administration of the compact. The rules have
5763 the force and effect of law and are binding in all member
5764 states.
5765 (b) Bring and prosecute legal proceedings or actions in the
5766 name of the commission, provided that the standing of any state
5767 physical therapy licensing board to sue or be sued under
5768 applicable law is not affected.
5769 (c) Purchase and maintain insurance and bonds.
5770 (d) Borrow, accept, or contract for services of personnel,
5771 including, but not limited to, employees of a member state.
5772 (e) Hire employees and elect or appoint officers; fix the
5773 compensation of, define the duties of, and grant appropriate
5774 authority to such individuals to carry out the purposes of the
5775 compact; and establish the commission’s personnel policies and
5776 programs relating to conflicts of interest, qualifications of
5777 personnel, and other related personnel matters.
5778 (f) Accept any appropriate donations and grants of money,
5779 equipment, supplies, materials, and services and receive, use,
5780 and dispose of the same, provided that at all times the
5781 commission avoids any appearance of impropriety or conflict of
5782 interest.
5783 (g) Lease, purchase, accept appropriate gifts or donations
5784 of, or otherwise own, hold, improve, or use any property, real,
5785 personal, or mixed, provided that at all times the commission
5786 avoids any appearance of impropriety or conflict of interest.
5787 (h) Sell, convey, mortgage, pledge, lease, exchange,
5788 abandon, or otherwise dispose of any property, real, personal,
5789 or mixed.
5790 (i) Establish a budget and make expenditures.
5791 (j) Borrow money.
5792 (k) Appoint committees, including standing committees
5793 composed of members, state regulators, state legislators or
5794 their representatives, and consumer representatives, and such
5795 other interested persons as may be designated in the compact and
5796 the bylaws.
5797 (l) Provide information to, receive information from, and
5798 cooperate with law enforcement agencies.
5799 (m) Establish and elect an executive board.
5800 (n) Perform such other functions as may be necessary or
5801 appropriate to achieve the purposes of the compact consistent
5802 with the state regulation of physical therapy licensure and
5803 practice.
5804 (5) THE EXECUTIVE BOARD.—
5805 (a) The executive board may act on behalf of the commission
5806 according to the terms of the compact.
5807 (b) The executive board shall be composed of the following
5808 nine members:
5809 1. Seven voting members who are elected by the commission
5810 from the current membership of the commission.
5811 2. One ex officio, nonvoting member from the recognized
5812 national physical therapy professional association.
5813 3. One ex officio, nonvoting member from the recognized
5814 membership organization of the physical therapy licensing
5815 boards.
5816 (c) The ex officio members shall be selected by their
5817 respective organizations.
5818 (d) The commission may remove any member of the executive
5819 board as provided in its bylaws.
5820 (e) The executive board shall meet at least annually.
5821 (f) The executive board shall do all of the following:
5822 1. Recommend to the entire commission changes to the rules
5823 or bylaws, compact legislation, fees paid by compact member
5824 states, such as annual dues, and any commission compact fee
5825 charged to licensees for the compact privilege.
5826 2. Ensure compact administration services are appropriately
5827 provided, contractually or otherwise.
5828 3. Prepare and recommend the budget.
5829 4. Maintain financial records on behalf of the commission.
5830 5. Monitor compact compliance of member states and provide
5831 compliance reports to the commission.
5832 6. Establish additional committees as necessary.
5833 7. Perform other duties as provided in the rules or bylaws.
5834 (6) FINANCING OF THE COMMISSION.—
5835 (a) The commission shall pay, or provide for the payment
5836 of, the reasonable expenses of its establishment, organization,
5837 and ongoing activities.
5838 (b) The commission may accept any appropriate revenue
5839 sources, donations, and grants of money, equipment, supplies,
5840 materials, and services.
5841 (c) The commission may levy and collect an annual
5842 assessment from each member state or impose fees on other
5843 parties to cover the cost of the operations and activities of
5844 the commission and its staff. Such assessments and fees must
5845 total to an amount sufficient to cover the commission’s annual
5846 budget as approved each year for which revenue is not provided
5847 by other sources. The aggregate annual assessment amount must be
5848 allocated based upon a formula to be determined by the
5849 commission, which shall adopt a rule binding upon all member
5850 states.
5851 (d) The commission may not incur obligations of any kind
5852 before securing the funds adequate to meet such obligations; nor
5853 may the commission pledge the credit of any of the member
5854 states, except by and with the authority of the member state.
5855 (e) The commission shall keep accurate accounts of all
5856 receipts and disbursements. The receipts and disbursements of
5857 the commission are subject to the audit and accounting
5858 procedures established under its bylaws. However, all receipts
5859 and disbursements of funds handled by the commission must be
5860 audited yearly by a certified or licensed public accountant, and
5861 the report of the audit must be included in and become part of
5862 the annual report of the commission.
5863 (7) QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION.—
5864 (a) The members, officers, executive director, employees,
5865 and representatives of the commission are immune from suit and
5866 liability, whether personally or in their official capacity, for
5867 any claim for damage to or loss of property or personal injury
5868 or other civil liability caused by or arising out of any actual
5869 or alleged act, error, or omission that occurred, or that the
5870 person against whom the claim is made had a reasonable basis for
5871 believing occurred, within the scope of commission employment,
5872 duties, or responsibilities. However, this paragraph may not be
5873 construed to protect any such person from suit or liability for
5874 any damage, loss, injury, or liability caused by the
5875 intentional, willful, or wanton misconduct of that person.
5876 (b) The commission shall defend any member, officer,
5877 executive director, employee, or representative of the
5878 commission in any civil action seeking to impose liability
5879 arising out of any actual or alleged act, error, or omission
5880 that occurred within the scope of commission employment, duties,
5881 or responsibilities, or that the person against whom the claim
5882 is made had a reasonable basis for believing occurred within the
5883 scope of commission employment, duties, or responsibilities.
5884 However, this subsection may not be construed to prohibit any
5885 member, officer, executive director, employee, or representative
5886 of the commission from retaining his or her own counsel or to
5887 require the commission to defend such person if the actual or
5888 alleged act, error, or omission resulted from that person’s
5889 intentional, willful, or wanton misconduct.
5890 (c) The commission shall indemnify and hold harmless any
5891 member, officer, executive director, employee, or representative
5892 of the commission for the amount of any settlement or judgment
5893 obtained against that person arising out of any actual or
5894 alleged act, error, or omission that occurred within the scope
5895 of commission employment, duties, or responsibilities, or that
5896 such person had a reasonable basis for believing occurred within
5897 the scope of commission employment, duties, or responsibilities,
5898 provided that the actual or alleged act, error, or omission did
5899 not result from the intentional, willful, or wanton misconduct
5900 of that person.
5901
5902 ARTICLE VIII
5903 DATA SYSTEM
5904 (1) The commission shall provide for the development,
5905 maintenance, and use of a coordinated database and reporting
5906 system containing licensure, adverse action, and investigative
5907 information on all licensees in member states.
5908 (2) Notwithstanding any other provision of state law to the
5909 contrary, a member state shall submit a uniform data set to the
5910 data system on all individuals to whom the compact is applicable
5911 as required by the rules of the commission, which data set must
5912 include all of the following:
5913 (a) Identifying information.
5914 (b) Licensure data.
5915 (c) Investigative information.
5916 (d) Adverse actions against a license or compact privilege.
5917 (e) Nonconfidential information related to alternative
5918 program participation.
5919 (f) Any denial of application for licensure and the reason
5920 for such denial.
5921 (g) Other information that may facilitate the
5922 administration of the compact, as determined by the rules of the
5923 commission.
5924 (3) Investigative information in the system pertaining to a
5925 licensee in any member state must be available only to other
5926 member states.
5927 (4) The commission shall promptly notify all member states
5928 of any adverse action taken against a licensee or an individual
5929 applying for a license in a member state. Adverse action
5930 information pertaining to a licensee in any member state must be
5931 available to all other member states.
5932 (5) Member states contributing information to the data
5933 system may designate information that may not be shared with the
5934 public without the express permission of the contributing state.
5935 (6) Any information submitted to the data system which is
5936 subsequently required to be expunged by the laws of the member
5937 state contributing the information must be removed from the data
5938 system.
5939
5940 ARTICLE IX
5941 RULEMAKING
5942 (1) The commission shall exercise its rulemaking powers
5943 pursuant to the criteria set forth in this article and the rules
5944 adopted thereunder. Rules and amendments become binding as of
5945 the date specified in each rule or amendment.
5946 (2) If a majority of the legislatures of the member states
5947 rejects a rule by enactment of a statute or resolution in the
5948 same manner used to adopt the compact within 4 years after the
5949 date of adoption of the rule, such rule does not have further
5950 force and effect in any member state.
5951 (3) Rules or amendments to the rules must be adopted at a
5952 regular or special meeting of the commission.
5953 (4) Before adoption of a final rule by the commission, and
5954 at least 30 days before the meeting at which the rule will be
5955 considered and voted upon, the commission must file a notice of
5956 proposed rulemaking on all of the following:
5957 (a) The website of the commission or another publicly
5958 accessible platform.
5959 (b) The website of each member state physical therapy
5960 licensing board or another publicly accessible platform or the
5961 publication in which each state would otherwise publish proposed
5962 rules.
5963 (5) The notice of proposed rulemaking must include all of
5964 the following:
5965 (a) The proposed date, time, and location of the meeting in
5966 which the rule or amendment will be considered and voted upon.
5967 (b) The text of the proposed rule or amendment and the
5968 reason for the proposed rule.
5969 (c) A request for comments on the proposed rule or
5970 amendment from any interested person.
5971 (d) The manner in which interested persons may submit
5972 notice to the commission of their intention to attend the public
5973 hearing and any written comments.
5974 (6) Before adoption of a proposed rule or amendment, the
5975 commission must allow persons to submit written data, facts,
5976 opinions, and arguments, which must be made available to the
5977 public.
5978 (7) The commission must grant an opportunity for a public
5979 hearing before it adopts a rule or an amendment if a hearing is
5980 requested by any of the following:
5981 (a) At least 25 persons.
5982 (b) A state or federal governmental subdivision or agency.
5983 (c) An association having at least 25 members.
5984 (8) If a scheduled public hearing is held on the proposed
5985 rule or amendment, the commission must publish the date, time,
5986 and location of the hearing. If the hearing is held through
5987 electronic means, the commission must publish the mechanism for
5988 access to the electronic hearing.
5989 (a) All persons wishing to be heard at the hearing must
5990 notify the executive director of the commission or another
5991 designated member in writing of their desire to appear and
5992 testify at the hearing at least 5 business days before the
5993 scheduled date of the hearing.
5994 (b) Hearings must be conducted in a manner providing each
5995 person who wishes to comment a fair and reasonable opportunity
5996 to comment orally or in writing.
5997 (c) All hearings must be recorded. A copy of the recording
5998 must be made available on request.
5999 (d) This article may not be construed to require a separate
6000 hearing on each rule. Rules may be grouped for the convenience
6001 of the commission at hearings required by this article.
6002 (9) Following the scheduled hearing date, or by the close
6003 of business on the scheduled hearing date if the hearing was not
6004 held, the commission shall consider all written and oral
6005 comments received.
6006 (10) If no written notice of intent to attend the public
6007 hearing by interested parties is received, the commission may
6008 proceed with adoption of the proposed rule without a public
6009 hearing.
6010 (11) The commission shall, by majority vote of all members,
6011 take final action on the proposed rule and shall determine the
6012 effective date of the rule, if any, based on the rulemaking
6013 record and the full text of the rule.
6014 (12) Upon determination that an emergency exists, the
6015 commission may consider and adopt an emergency rule without
6016 prior notice, opportunity for comment, or hearing, provided that
6017 the usual rulemaking procedures provided in the compact and in
6018 this article are retroactively applied to the rule as soon as
6019 reasonably possible, in no event later than 90 days after the
6020 effective date of the rule. For the purposes of this subsection,
6021 an emergency rule is one that must be adopted immediately in
6022 order to do any of the following:
6023 (a) Meet an imminent threat to public health, safety, or
6024 welfare.
6025 (b) Prevent a loss of commission or member state funds.
6026 (c) Meet a deadline for the adoption of an administrative
6027 rule established by federal law or rule.
6028 (d) Protect public health and safety.
6029 (13) The commission or an authorized committee of the
6030 commission may direct revisions to a previously adopted rule or
6031 amendment for purposes of correcting typographical errors,
6032 errors in format, errors in consistency, or grammatical errors.
6033 Public notice of any revisions must be posted on the website of
6034 the commission. The revision is subject to challenge by any
6035 person for a period of 30 days after posting. The revision may
6036 be challenged only on grounds that the revision results in a
6037 material change to a rule. A challenge must be made in writing
6038 and delivered to the chair of the commission before the end of
6039 the notice period. If a challenge is not made, the revision
6040 takes effect without further action. If the revision is
6041 challenged, the revision may not take effect without the
6042 approval of the commission.
6043
6044 ARTICLE X
6045 OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
6046 (1) OVERSIGHT.—
6047 (a) The executive, legislative, and judicial branches of
6048 state government in each member state shall enforce the compact
6049 and take all actions necessary and appropriate to carry out the
6050 compact’s purposes and intent. The provisions of the compact and
6051 the rules adopted pursuant thereto shall have standing as
6052 statutory law.
6053 (b) All courts shall take judicial notice of the compact
6054 and the rules in any judicial or administrative proceeding in a
6055 member state pertaining to the subject matter of the compact
6056 which may affect the powers, responsibilities, or actions of the
6057 commission.
6058 (c) The commission is entitled to receive service of
6059 process in any such proceeding and has standing to intervene in
6060 such a proceeding for all purposes. Failure to provide service
6061 of process to the commission renders a judgment or an order void
6062 as to the commission, the compact, or the adopted rules.
6063 (2) DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION.—
6064 (a) If the commission determines that a member state has
6065 defaulted in the performance of its obligations or
6066 responsibilities under the compact or the adopted rules, the
6067 commission must do all of the following:
6068 1. Provide written notice to the defaulting state and other
6069 member states of the nature of the default, the proposed means
6070 of curing the default, and any other action to be taken by the
6071 commission.
6072 2. Provide remedial training and specific technical
6073 assistance regarding the default.
6074 (b) If a state in default fails to cure the default, the
6075 defaulting state may be terminated from the compact upon an
6076 affirmative vote of a majority of the member states, and all
6077 rights, privileges, and benefits conferred by the compact may be
6078 terminated on the effective date of termination. A cure of the
6079 default does not relieve the offending state of obligations or
6080 liabilities incurred during the period of default.
6081 (c) Termination of membership in the compact may be imposed
6082 only after all other means of securing compliance have been
6083 exhausted. The commission shall give notice of intent to suspend
6084 or terminate a defaulting member state to the governor and
6085 majority and minority leaders of the defaulting state’s
6086 legislature and to each of the member states.
6087 (d) A state that has been terminated from the compact is
6088 responsible for all assessments, obligations, and liabilities
6089 incurred through the effective date of termination, including
6090 obligations that extend beyond the effective date of
6091 termination.
6092 (e) The commission does not bear any costs related to a
6093 state that is found to be in default or that has been terminated
6094 from the compact, unless agreed upon in writing between the
6095 commission and the defaulting state.
6096 (f) The defaulting state may appeal the action of the
6097 commission by petitioning the U.S. District Court for the
6098 District of Columbia or the federal district where the
6099 commission has its principal offices. The prevailing member
6100 shall be awarded all costs of such litigation, including
6101 reasonable attorney fees.
6102 (3) DISPUTE RESOLUTION.—
6103 (a) Upon request by a member state, the commission must
6104 attempt to resolve disputes related to the compact which arise
6105 among member states and between member and nonmember states.
6106 (b) The commission shall adopt a rule providing for both
6107 mediation and binding dispute resolution for disputes as
6108 appropriate.
6109 (4) ENFORCEMENT.—
6110 (a) The commission, in the reasonable exercise of its
6111 discretion, shall enforce the compact and the commission’s
6112 rules.
6113 (b) By majority vote, the commission may initiate legal
6114 action in the United States District Court for the District of
6115 Columbia or the federal district where the commission has its
6116 principal offices against a member state in default to enforce
6117 compliance with the provisions of the compact and its adopted
6118 rules and bylaws. The relief sought may include both injunctive
6119 relief and damages. In the event judicial enforcement is
6120 necessary, the prevailing member shall be awarded all costs of
6121 such litigation, including reasonable attorney fees.
6122 (c) The remedies under this article are not the exclusive
6123 remedies of the commission. The commission may pursue any other
6124 remedies available under federal or state law.
6125
6126 ARTICLE XI
6127 DATE OF IMPLEMENTATION OF THE PHYSICAL THERAPY COMPACT AND
6128 ASSOCIATED RULES; WITHDRAWAL; AND AMENDMENTS
6129 (1) The compact becomes effective on the date that the
6130 compact statute is enacted into law in the tenth member state.
6131 The provisions that become effective at that time are limited to
6132 the powers granted to the commission relating to assembly and
6133 the adoption of rules. Thereafter, the commission shall meet and
6134 exercise rulemaking powers necessary for the implementation and
6135 administration of the compact.
6136 (2) Any state that joins the compact subsequent to the
6137 commission’s initial adoption of the rules is subject to the
6138 rules as they exist on the date that the compact becomes law in
6139 that state. Any rule that has been previously adopted by the
6140 commission has the full force and effect of law on the day the
6141 compact becomes law in that state.
6142 (3) Any member state may withdraw from the compact by
6143 enacting a statute repealing the same.
6144 (a) A member state’s withdrawal does not take effect until
6145 6 months after enactment of the repealing statute.
6146 (b) Withdrawal does not affect the continuing requirement
6147 of the withdrawing state’s physical therapy licensing board to
6148 comply with the investigative and adverse action reporting
6149 requirements of this act before the effective date of
6150 withdrawal.
6151 (4) The compact may not be construed to invalidate or
6152 prevent any physical therapy licensure agreement or other
6153 cooperative arrangement between a member state and a nonmember
6154 state which does not conflict with the provisions of the
6155 compact.
6156 (5) The compact may be amended by the member states. An
6157 amendment to the compact does not become effective and binding
6158 upon any member state until it is enacted into the laws of all
6159 member states.
6160
6161 ARTICLE XII
6162 CONSTRUCTION AND SEVERABILITY
6163 The compact must be liberally construed so as to carry out
6164 the purposes thereof. The provisions of the compact are
6165 severable, and if any phrase, clause, sentence, or provision of
6166 the compact is declared to be contrary to the constitution of
6167 any member state or of the United States or the applicability
6168 thereof to any government, agency, person, or circumstance is
6169 held invalid, the validity of the remainder of the compact and
6170 the applicability thereof to any government, agency, person, or
6171 circumstance is not affected thereby. If the compact is held
6172 contrary to the constitution of any member state, the compact
6173 remains in full force and effect as to the remaining member
6174 states and in full force and effect as to the member state
6175 affected as to all severable matters.
6176 Section 63. Subsection (10) of section 456.073, Florida
6177 Statutes, is amended to read:
6178 456.073 Disciplinary proceedings.—Disciplinary proceedings
6179 for each board shall be within the jurisdiction of the
6180 department.
6181 (10)(a) The complaint and all information obtained pursuant
6182 to the investigation by the department are confidential and
6183 exempt from s. 119.07(1) until 10 days after probable cause has
6184 been found to exist by the probable cause panel or by the
6185 department, or until the regulated professional or subject of
6186 the investigation waives his or her privilege of
6187 confidentiality, whichever occurs first.
6188 (b) The department shall report any significant
6189 investigation information relating to a nurse holding a
6190 multistate license to the coordinated licensure information
6191 system pursuant to s. 464.0095; any investigative information
6192 relating to a physical therapist or physical therapist assistant
6193 holding a compact privilege under the Physical Therapy Licensure
6194 Compact to the data system pursuant to s. 486.112; any
6195 significant investigatory information relating to a psychologist
6196 practicing under the Psychology Interjurisdictional Compact to
6197 the coordinated licensure information system pursuant to s.
6198 490.0075;, and any significant investigatory information
6199 relating to a health care practitioner practicing under the
6200 Professional Counselors Licensure Compact to the data system
6201 pursuant to s. 491.017, and any significant investigatory
6202 information relating to a psychologist practicing under the
6203 Psychology Interjurisdictional Compact to the coordinated
6204 licensure information system pursuant to s. 490.0075.
6205 (c) Upon completion of the investigation and a
6206 recommendation by the department to find probable cause, and
6207 pursuant to a written request by the subject or the subject’s
6208 attorney, the department shall provide the subject an
6209 opportunity to inspect the investigative file or, at the
6210 subject’s expense, forward to the subject a copy of the
6211 investigative file. Notwithstanding s. 456.057, the subject may
6212 inspect or receive a copy of any expert witness report or
6213 patient record connected with the investigation if the subject
6214 agrees in writing to maintain the confidentiality of any
6215 information received under this subsection until 10 days after
6216 probable cause is found and to maintain the confidentiality of
6217 patient records pursuant to s. 456.057. The subject may file a
6218 written response to the information contained in the
6219 investigative file. Such response must be filed within 20 days
6220 of mailing by the department, unless an extension of time has
6221 been granted by the department.
6222 (d) This subsection does not prohibit the department from
6223 providing the complaint and any information obtained pursuant to
6224 the department’s investigation such information to any law
6225 enforcement agency or to any other regulatory agency.
6226 Section 64. Subsection (5) of section 456.076, Florida
6227 Statutes, is amended to read:
6228 456.076 Impaired practitioner programs.—
6229 (5) A consultant shall enter into a participant contract
6230 with an impaired practitioner and shall establish the terms of
6231 monitoring and shall include the terms in a participant
6232 contract. In establishing the terms of monitoring, the
6233 consultant may consider the recommendations of one or more
6234 approved evaluators, treatment programs, or treatment providers.
6235 A consultant may modify the terms of monitoring if the
6236 consultant concludes, through the course of monitoring, that
6237 extended, additional, or amended terms of monitoring are
6238 required for the protection of the health, safety, and welfare
6239 of the public. If the impaired practitioner is a physical
6240 therapist or physical therapist assistant practicing under the
6241 Physical Therapy Licensure Compact pursuant to s. 486.112, a
6242 psychologist practicing under the Psychology Interjurisdictional
6243 Compact pursuant to s. 490.0075, or a health care practitioner
6244 practicing under the Professional Counselors Licensure Compact
6245 pursuant to s. 491.017, the terms of the monitoring contract
6246 must include the impaired practitioner’s withdrawal from all
6247 practice under the compact unless authorized by a member state.
6248 If the impaired practitioner is a psychologist practicing under
6249 the Psychology Interjurisdictional Compact pursuant to s.
6250 490.0075, the terms of the monitoring contract must include the
6251 impaired practitioner’s withdrawal from all practice under the
6252 compact.
6253 Section 65. Subsection (5) is added to section 486.023,
6254 Florida Statutes, to read:
6255 486.023 Board of Physical Therapy Practice.—
6256 (5) The board shall appoint an individual to serve as the
6257 state’s delegate on the Physical Therapy Compact Commission, as
6258 required under s. 486.112.
6259 Section 66. Section 486.028, Florida Statutes, is amended
6260 to read:
6261 486.028 License to practice physical therapy required.—A No
6262 person may not shall practice, or hold herself or himself out as
6263 being able to practice, physical therapy in this state unless
6264 she or he is licensed under in accordance with the provisions of
6265 this chapter or holds a compact privilege in this state under
6266 the Physical Therapy Licensure Compact as specified in s.
6267 486.112.; however, Nothing in This chapter does not shall
6268 prohibit any person licensed in this state under any other law
6269 from engaging in the practice for which she or he is licensed.
6270 Section 67. Section 486.031, Florida Statutes, is amended
6271 to read:
6272 486.031 Physical therapist; licensing requirements;
6273 exemption.—
6274 (1) To be eligible for licensing as a physical therapist,
6275 an applicant must:
6276 (a)(1) Be at least 18 years old;
6277 (b)(2) Be of good moral character; and
6278 (c)1.(3)(a) Have been graduated from a school of physical
6279 therapy which has been approved for the educational preparation
6280 of physical therapists by the appropriate accrediting agency
6281 recognized by the Council for Higher Education Accreditation or
6282 its successor Commission on Recognition of Postsecondary
6283 Accreditation or the United States Department of Education at
6284 the time of her or his graduation and have passed, to the
6285 satisfaction of the board, the American Registry Examination
6286 before prior to 1971 or a national examination approved by the
6287 board to determine her or his fitness for practice as a physical
6288 therapist under this chapter as hereinafter provided;
6289 2.(b) Have received a diploma from a program in physical
6290 therapy in a foreign country and have educational credentials
6291 deemed equivalent to those required for the educational
6292 preparation of physical therapists in this country, as
6293 recognized by the appropriate agency as identified by the board,
6294 and have passed to the satisfaction of the board an examination
6295 to determine her or his fitness for practice as a physical
6296 therapist under this chapter as hereinafter provided; or
6297 3.(c) Be entitled to licensure without examination as
6298 provided in s. 486.081.
6299 (2) A person licensed as a physical therapist in another
6300 state who is practicing under the Physical Therapy Licensure
6301 Compact pursuant to s. 486.112, and only within the scope
6302 provided therein, is exempt from the licensure requirements of
6303 this section.
6304 Section 68. Section 486.081, Florida Statutes, is amended
6305 to read:
6306 486.081 Physical therapist; issuance of license without
6307 examination to person passing examination of another authorized
6308 examining board; fee; exemption.—
6309 (1) The board may grant cause a license without
6310 examination, to be issued by through the department, without
6311 examination to any applicant who presents evidence satisfactory
6312 to the board of having passed the American Registry Examination
6313 before prior to 1971 or an examination in physical therapy
6314 before a similar lawfully authorized examining board of another
6315 state, the District of Columbia, a territory, or a foreign
6316 country, if the standards for licensure in physical therapy in
6317 such other state, district, territory, or foreign country are
6318 determined by the board to be as high as those of this state, as
6319 established by rules adopted under pursuant to this chapter. Any
6320 person who holds a license pursuant to this section may use the
6321 words “physical therapist” or “physiotherapist” or the letters
6322 “P.T.” in connection with her or his name or place of business
6323 to denote her or his licensure hereunder. A person who holds a
6324 license pursuant to this section and obtains a doctoral degree
6325 in physical therapy may use the letters “D.P.T.” and “P.T.” A
6326 physical therapist who holds a degree of Doctor of Physical
6327 Therapy may not use the title “doctor” without also clearly
6328 informing the public of his or her profession as a physical
6329 therapist.
6330 (2) At the time of filing an making application for
6331 licensure without examination under pursuant to the terms of
6332 this section, the applicant shall pay to the department a
6333 nonrefundable fee not to exceed $175, as determined fixed by the
6334 board, no part of which will be returned.
6335 (3) A person licensed as a physical therapist in another
6336 state who is practicing under the Physical Therapy Licensure
6337 Compact pursuant to s. 486.112, and only within the scope
6338 provided therein, is exempt from the licensure requirements of
6339 this section.
6340 Section 69. Section 486.102, Florida Statutes, is amended
6341 to read:
6342 486.102 Physical therapist assistant; licensing
6343 requirements; exemption.—
6344 (1) To be eligible for licensing by the board as a physical
6345 therapist assistant, an applicant must:
6346 (a)(1) Be at least 18 years old;
6347 (b)(2) Be of good moral character; and
6348 (c)1.(3)(a) Have been graduated from a school providing
6349 giving a course of at least not less than 2 years for physical
6350 therapist assistants, which has been approved for the
6351 educational preparation of physical therapist assistants by the
6352 appropriate accrediting agency recognized by the Council for
6353 Higher Education Accreditation or its successor Commission on
6354 Recognition of Postsecondary Accreditation or the United States
6355 Department of Education, at the time of her or his graduation
6356 and have passed to the satisfaction of the board an examination
6357 to determine her or his fitness for practice as a physical
6358 therapist assistant under this chapter as hereinafter provided;
6359 2.(b) Have been graduated from a school providing giving a
6360 course for physical therapist assistants in a foreign country
6361 and have educational credentials deemed equivalent to those
6362 required for the educational preparation of physical therapist
6363 assistants in this country, as recognized by the appropriate
6364 agency as identified by the board, and passed to the
6365 satisfaction of the board an examination to determine her or his
6366 fitness for practice as a physical therapist assistant under
6367 this chapter as hereinafter provided;
6368 3.(c) Be entitled to licensure without examination as
6369 provided in s. 486.107; or
6370 4.(d) Have been enrolled between July 1, 2014, and July 1,
6371 2016, in a physical therapist assistant school in this state
6372 which was accredited at the time of enrollment; and
6373 a.1. Have been graduated or be eligible to graduate from
6374 such school no later than July 1, 2018; and
6375 b.2. Have passed to the satisfaction of the board an
6376 examination to determine his or her fitness for practice as a
6377 physical therapist assistant as provided in s. 486.104.
6378 (2) A person licensed as a physical therapist assistant in
6379 another state who is practicing under the Physical Therapy
6380 Licensure Compact pursuant to s. 486.112, and only within the
6381 scope provided therein, is exempt from the licensure
6382 requirements of this section.
6383 Section 70. Section 486.107, Florida Statutes, is amended
6384 to read:
6385 486.107 Physical therapist assistant; issuance of license
6386 without examination to person licensed in another jurisdiction;
6387 fee; exemption.—
6388 (1) The board may grant cause a license without
6389 examination, to be issued by through the department, without
6390 examination to any applicant who presents evidence to the board,
6391 under oath, of licensure in another state, the District of
6392 Columbia, or a territory, if the standards for registering as a
6393 physical therapist assistant or licensing of a physical
6394 therapist assistant, as applicable the case may be, in such
6395 other state are determined by the board to be as high as those
6396 of this state, as established by rules adopted under pursuant to
6397 this chapter. Any person who holds a license pursuant to this
6398 section may use the words “physical therapist assistant,” or the
6399 letters “P.T.A.,” in connection with her or his name to denote
6400 licensure hereunder.
6401 (2) At the time of filing an making application for
6402 licensing without examination under pursuant to the terms of
6403 this section, the applicant shall pay to the department a
6404 nonrefundable fee not to exceed $175, as determined fixed by the
6405 board, no part of which will be returned.
6406 (3) A person licensed as a physical therapist assistant in
6407 another state who is practicing under the Physical Therapy
6408 Licensure Compact pursuant to s. 486.112, and only within the
6409 scope provided therein, is exempt from the licensure
6410 requirements of this section.
6411 Section 71. Section 486.125, Florida Statutes, is amended
6412 to read:
6413 486.125 Refusal, revocation, or suspension of license;
6414 administrative fines and other disciplinary measures.—
6415 (1) The following acts constitute grounds for denial of a
6416 license or disciplinary action, as specified in s. 456.072(2) or
6417 s. 486.112:
6418 (a) Being unable to practice physical therapy with
6419 reasonable skill and safety to patients by reason of illness or
6420 use of alcohol, drugs, narcotics, chemicals, or any other type
6421 of material or as a result of any mental or physical condition.
6422 1. In enforcing this paragraph, upon a finding of the State
6423 Surgeon General or the State Surgeon General’s designee that
6424 probable cause exists to believe that the licensee is unable to
6425 practice physical therapy due to the reasons stated in this
6426 paragraph, the department shall have the authority to compel a
6427 physical therapist or physical therapist assistant to submit to
6428 a mental or physical examination by a physician designated by
6429 the department. If the licensee refuses to comply with such
6430 order, the department’s order directing such examination may be
6431 enforced by filing a petition for enforcement in the circuit
6432 court where the licensee resides or serves as a physical therapy
6433 practitioner. The licensee against whom the petition is filed
6434 may shall not be named or identified by initials in any public
6435 court records or documents, and the proceedings must shall be
6436 closed to the public. The department shall be entitled to the
6437 summary procedure provided in s. 51.011.
6438 2. A physical therapist or physical therapist assistant
6439 whose license is suspended or revoked pursuant to this
6440 subsection shall, at reasonable intervals, be given an
6441 opportunity to demonstrate that she or he can resume the
6442 competent practice of physical therapy with reasonable skill and
6443 safety to patients.
6444 3. Neither the record of proceeding nor the orders entered
6445 by the board in any proceeding under this subsection may be used
6446 against a physical therapist or physical therapist assistant in
6447 any other proceeding.
6448 (b) Having committed fraud in the practice of physical
6449 therapy or deceit in obtaining a license as a physical therapist
6450 or as a physical therapist assistant.
6451 (c) Being convicted or found guilty regardless of
6452 adjudication, of a crime in any jurisdiction which directly
6453 relates to the practice of physical therapy or to the ability to
6454 practice physical therapy. The entry of any plea of nolo
6455 contendere is shall be considered a conviction for purpose of
6456 this chapter.
6457 (d) Having treated or undertaken to treat human ailments by
6458 means other than by physical therapy, as defined in this
6459 chapter.
6460 (e) Failing to maintain acceptable standards of physical
6461 therapy practice as set forth by the board in rules adopted
6462 pursuant to this chapter.
6463 (f) Engaging directly or indirectly in the dividing,
6464 transferring, assigning, rebating, or refunding of fees received
6465 for professional services, or having been found to profit by
6466 means of a credit or other valuable consideration, such as an
6467 unearned commission, discount, or gratuity, with any person
6468 referring a patient or with any relative or business associate
6469 of the referring person. Nothing in This chapter may not shall
6470 be construed to prohibit the members of any regularly and
6471 properly organized business entity which is comprised of
6472 physical therapists and which is recognized under the laws of
6473 this state from making any division of their total fees among
6474 themselves as they determine necessary.
6475 (g) Having a license revoked or suspended; having had other
6476 disciplinary action taken against her or him; or having had her
6477 or his application for a license refused, revoked, or suspended
6478 by the licensing authority of another state, territory, or
6479 country.
6480 (h) Violating a lawful order of the board or department
6481 previously entered in a disciplinary hearing.
6482 (i) Making or filing a report or record which the licensee
6483 knows to be false. Such reports or records shall include only
6484 those which are signed in the capacity of a physical therapist.
6485 (j) Practicing or offering to practice beyond the scope
6486 permitted by law or accepting and performing professional
6487 responsibilities which the licensee knows or has reason to know
6488 that she or he is not competent to perform, including, but not
6489 limited to, specific spinal manipulation.
6490 (k) Violating any provision of this chapter or chapter 456,
6491 or any rules adopted pursuant thereto.
6492 (2)(a) The board may enter an order denying licensure or
6493 imposing any of the penalties in s. 456.072(2) against any
6494 applicant for licensure or licensee who is found guilty of
6495 violating any provision of subsection (1) of this section or who
6496 is found guilty of violating any provision of s. 456.072(1).
6497 (b) The board may take adverse action against a physical
6498 therapist’s or a physical therapist assistant’s compact
6499 privilege under the Physical Therapy Licensure Compact pursuant
6500 to s. 486.112 and may impose any of the penalties in s.
6501 456.072(2), if a physical therapist or physical therapist
6502 assistant commits an act specified in subsection (1) or s.
6503 456.072(1).
6504 (3) The board may shall not reinstate the license of a
6505 physical therapist or physical therapist assistant or approve
6506 cause a license to be issued to a person it has deemed
6507 unqualified until such time as it is satisfied that she or he
6508 has complied with all the terms and conditions set forth in the
6509 final order and that such person is capable of safely engaging
6510 in the practice of physical therapy.
6511 Section 72. Paragraph (j) is added to subsection (10) of
6512 section 768.28, Florida Statutes, to read:
6513 768.28 Waiver of sovereign immunity in tort actions;
6514 recovery limits; civil liability for damages caused during a
6515 riot; limitation on attorney fees; statute of limitations;
6516 exclusions; indemnification; risk management programs.—
6517 (10)
6518 (j) For purposes of this section, the individual appointed
6519 under s. 486.023(5) as the state’s delegate on the Physical
6520 Therapy Compact Commission, when serving in that capacity
6521 pursuant to s. 486.112, and any administrator, officer,
6522 executive director, employee, or representative of the Physical
6523 Therapy Compact Commission, when acting within the scope of his
6524 or her employment, duties, or responsibilities in this state, is
6525 considered an agent of the state. The commission shall pay any
6526 claims or judgments pursuant to this section and may maintain
6527 insurance coverage to pay any such claims or judgments.
6528 Section 73. Section 486.025, Florida Statutes, is amended
6529 to read:
6530 486.025 Powers and duties of the Board of Physical Therapy
6531 Practice.—The board may administer oaths, summon witnesses, take
6532 testimony in all matters relating to its duties under this
6533 chapter, establish or modify minimum standards of practice of
6534 physical therapy as defined in s. 486.021, including, but not
6535 limited to, standards of practice for the performance of dry
6536 needling by physical therapists, and adopt rules pursuant to ss.
6537 120.536(1) and 120.54 to implement this chapter. The board may
6538 also review the standing and reputability of any school or
6539 college offering courses in physical therapy and whether the
6540 courses of such school or college in physical therapy meet the
6541 standards established by the appropriate accrediting agency
6542 referred to in s. 486.031(1)(c) s. 486.031(3)(a). In determining
6543 the standing and reputability of any such school and whether the
6544 school and courses meet such standards, the board may
6545 investigate and personally inspect the school and courses.
6546 Section 74. Paragraph (b) of subsection (1) of section
6547 486.0715, Florida Statutes, is amended to read:
6548 486.0715 Physical therapist; issuance of temporary permit.—
6549 (1) The board shall issue a temporary physical therapist
6550 permit to an applicant who meets the following requirements:
6551 (b) Is a graduate of an approved United States physical
6552 therapy educational program and meets all the eligibility
6553 requirements for licensure under ch. 456, s. 486.031(1)(a), (b),
6554 and (c)1. s. 486.031(1)-(3)(a), and related rules, except
6555 passage of a national examination approved by the board is not
6556 required.
6557 Section 75. Paragraph (b) of subsection (1) of section
6558 486.1065, Florida Statutes, is amended to read:
6559 486.1065 Physical therapist assistant; issuance of
6560 temporary permit.—
6561 (1) The board shall issue a temporary physical therapist
6562 assistant permit to an applicant who meets the following
6563 requirements:
6564 (b) Is a graduate of an approved United States physical
6565 therapy assistant educational program and meets all the
6566 eligibility requirements for licensure under ch. 456, s.
6567 486.102(1)(a), (b), and (c)1. s. 486.102(1)-(3)(a), and related
6568 rules, except passage of a national examination approved by the
6569 board is not required.
6570 Section 76. Effective July 1, 2024, for the 2024-2025
6571 fiscal year, the sum of $50 million in recurring funds from the
6572 General Revenue Fund is appropriated in the Grants and Aids –
6573 Health Care Education Reimbursement and Loan Repayment Program
6574 category to the Department of Health for the Florida
6575 Reimbursement Assistance for Medical Education Program
6576 established in s. 381.402, Florida Statutes.
6577 Section 77. Effective July 1, 2024, for the 2024-2025
6578 fiscal year, the sum of $13.2 million in recurring funds from
6579 the General Revenue Fund is appropriated in the Dental Student
6580 Loan Repayment Program category to the Department of Health for
6581 the Dental Student Loan Repayment Program established in s.
6582 381.4019, Florida Statutes.
6583 Section 78. Effective July 1, 2024, for the 2024-2025
6584 fiscal year, the sum of $23,357,876 in recurring funds from the
6585 General Revenue Fund is appropriated in the Grants and Aids –
6586 Minority Health Initiatives category to the Department of Health
6587 to expand statewide the telehealth minority maternity care
6588 program established in s. 383.2163, Florida Statutes. The
6589 department shall establish 15 regions in which to implement the
6590 program statewide based on the location of hospitals providing
6591 obstetrics and maternity care and pertinent data from nearby
6592 counties for severe maternal morbidity and maternal mortality.
6593 The department shall identify the criteria for selecting
6594 providers for regional implementation and, at a minimum,
6595 consider the maternal level of care designations for hospitals
6596 within the region, the neonatal intensive care unit levels of
6597 hospitals within the region, and the experience of community
6598 based organizations to screen for and treat common pregnancy
6599 related complications.
6600 Section 79. Effective July 1, 2024, for the 2024-2025
6601 fiscal year, the sum of $40 million in recurring funds from the
6602 General Revenue Fund is appropriated to the Agency for Health
6603 Care Administration to implement the Training, Education, and
6604 Clinicals in Health (TEACH) Funding Program established in s.
6605 409.91256, Florida Statutes, as created by this act.
6606 Section 80. Effective July 1, 2024, for the 2024-2025
6607 fiscal year, the sum of $2 million in recurring funds from the
6608 General Revenue Fund is appropriated to the University of
6609 Florida, Florida State University, Florida Atlantic University,
6610 and Florida Agricultural and Mechanical University for the
6611 purpose of implementing lab school articulated health care
6612 programs required by s. 1002.32, Florida Statutes. Each of these
6613 state universities shall receive $500,000 from this
6614 appropriation.
6615 Section 81. Effective July 1, 2024, for the 2024-2025
6616 fiscal year, the sum of $5 million in recurring funds from the
6617 General Revenue Fund is appropriated in the Aid to Local
6618 Governments Grants and Aids – Nursing Education category to the
6619 Department of Education for the purpose of implementing the
6620 Linking Industry to Nursing Education (LINE) Fund established in
6621 s. 1009.8962, Florida Statutes.
6622 Section 82. Effective July 1, 2024, for the 2024-2025
6623 fiscal year, the sums of $29,841,000 in recurring funds from the
6624 General Revenue Fund and $40,159,000 in recurring funds from the
6625 Medical Care Trust Fund are appropriated in the Graduate Medical
6626 Education category to the Agency for Health Care Administration
6627 for the Slots for Doctors Program established in s. 409.909,
6628 Florida Statutes.
6629 Section 83. Effective July 1, 2024, for the 2024-2025
6630 fiscal year, the sums of $42,630,000 in recurring funds from the
6631 Grants and Donations Trust Fund and $57,370,000 in recurring
6632 funds from the Medical Care Trust Fund are appropriated in the
6633 Graduate Medical Education category to the Agency for Health
6634 Care Administration to provide to statutory teaching hospitals
6635 as defined in s. 408.07(46), Florida Statutes, which provide
6636 highly specialized tertiary care, including comprehensive stroke
6637 and Level 2 adult cardiovascular services; NICU II and III; and
6638 adult open heart; and which have more than 30 full-time
6639 equivalent (FTE) residents over the Medicare cap in accordance
6640 with the CMS-2552 provider 2021 fiscal year-end federal Centers
6641 for Medicare and Medicaid Services Healthcare Cost Report, HCRIS
6642 data extract on December 1, 2022, worksheet E-4, line 6 minus
6643 worksheet E-4, line 5, shall be designated as a High Tertiary
6644 Statutory Teaching Hospital and be eligible for funding
6645 calculated on a per Graduate Medical Education resident-FTE
6646 proportional allocation that shall be in addition to any other
6647 Graduate Medical Education funding. Of these funds, $44,562,400
6648 shall be first distributed to hospitals with greater than 500
6649 unweighted fiscal year 2022-2023 FTEs. The remaining funds shall
6650 be distributed proportionally based on the total unweighted
6651 fiscal year 2022-2023 FTEs. Payments to providers under this
6652 section are contingent upon the nonfederal share being provided
6653 through intergovernmental transfers in the Grants and Donations
6654 Trust Fund. In the event the funds are not available in the
6655 Grants and Donations Trust Fund, the State of Florida is not
6656 obligated to make payments under this section.
6657 Section 84. Effective July 1, 2024, for the 2024-2025
6658 fiscal year, the sums of $64,928,943 in recurring funds from the
6659 General Revenue Fund and $87,379,156 in recurring funds from the
6660 Medical Care Trust Fund are appropriated to the Agency for
6661 Health Care Administration to establish a Pediatric Normal
6662 Newborn, Pediatric Obstetrics, and Adult Obstetrics Diagnosis
6663 Related Grouping (DRG) reimbursement methodology and increase
6664 the existing marginal cost percentages for transplant
6665 pediatrics, pediatrics, and neonates. The fiscal year 2024-2025
6666 General Appropriations Act shall establish the DRG reimbursement
6667 methodology for hospital inpatient services as directed in s.
6668 409.905(5)(c), Florida Statutes.
6669 Section 85. Effective October 1, 2024, for the 2024-2025
6670 fiscal year, the sums of $14,888,903 in recurring funds from the
6671 General Revenue Fund and $20,036,979 in recurring funds from the
6672 Medical Care Trust Fund are appropriated to the Agency for
6673 Health Care Administration to provide a Medicaid reimbursement
6674 rate increase for dental care services. Health plans that
6675 participate in the Statewide Medicaid Managed Care program shall
6676 pass through the fee increase to providers in this
6677 appropriation.
6678 Section 86. Effective July 1, 2024, for the 2024-2025
6679 fiscal year, the sums of $83,456,275 in recurring funds from the
6680 General Revenue Fund and $112,312,609 in recurring funds from
6681 the Operations and Maintenance Trust Fund are appropriated in
6682 the Home and Community-Based Services Waiver category to the
6683 Agency for Persons with Disabilities to provide a uniform
6684 iBudget Waiver provider rate increase. The sum of $195,768,884
6685 in recurring funds from the Medical Care Trust Fund is
6686 appropriated in the Home and Community-Based Services Waiver
6687 category to the Agency for Health Care Administration to
6688 establish budget authority for Medicaid services.
6689 Section 87. Effective July 1, 2024, for the 2024-2025
6690 fiscal year, the sum of $11,525,152 in recurring funds from the
6691 General Revenue Fund is appropriated in the Grants and Aids –
6692 Community Mental Health Services category to the Department of
6693 Children and Families to enhance crisis diversion through mobile
6694 response teams established under s. 394.495, Florida Statutes,
6695 by adding an additional 16 mobile response teams to ensure
6696 coverage in every county.
6697 Section 88. Effective July 1, 2024, for the 2024-2025
6698 fiscal year, the sum of $10 million in recurring funds from the
6699 General Revenue Fund is appropriated to the Department of Health
6700 to implement the Health Care Screening and Services Grant
6701 Program established in s. 381.9855, Florida Statutes, as created
6702 by this act.
6703 Section 89. Effective July 1, 2024, for the 2024-2025
6704 fiscal year, the sum of $150,000 in nonrecurring funds from the
6705 General Revenue Fund and $150,000 in nonrecurring funds from the
6706 Medical Care Trust Fund are appropriated to the Agency for
6707 Health Care Administration to contract with a vendor to develop
6708 a reimbursement methodology for covered services at advanced
6709 birth centers. The agency shall submit the reimbursement
6710 methodology and estimated fiscal impact to the Executive Office
6711 of the Governor’s Office of Policy and Budget, the chair of the
6712 Senate Appropriations Committee, and the chair of the House
6713 Appropriations Committee no later than December 31, 2024.
6714 Section 90. Effective July 1, 2024, for the 2024-2025
6715 fiscal year, the sum of $2.4 million in recurring funds from the
6716 General Revenue Fund is appropriated to the Agency for Health
6717 Care Administration for the purpose of providing behavioral
6718 health family navigators in state-licensed specialty hospitals
6719 providing comprehensive acute care services to children pursuant
6720 to s. 395.002(28), Florida Statutes, to help facilitate early
6721 access to mental health treatment. Each licensed specialty
6722 hospital shall receive $600,000 from this appropriation.
6723 Section 91. Effective October 1, 2024, for the 2024-2025
6724 fiscal year, the sums of $12,238,469 in recurring funds from the
6725 General Revenue Fund, $127,300 in recurring funds from the
6726 Refugee Assistance Trust Fund, and $16,641,433 in recurring
6727 funds from the Medical Care Trust Fund are appropriated to the
6728 Agency for Health Care Administration to provide a Medicaid
6729 reimbursement rate increase for private duty nursing services
6730 provided by licensed practical nurses and registered nurses.
6731 Health plans that participate in the Statewide Medicaid Managed
6732 Care program shall pass through the fee increase to providers in
6733 this appropriation.
6734 Section 92. Effective October 1, 2024, for the 2024-2025
6735 fiscal year, the sums of $14,580,660 in recurring funds from the
6736 General Revenue Fund and $19,622,154 in recurring funds from the
6737 Medical Care Trust Fund are appropriated to the Agency for
6738 Health Care Administration to provide a Medicaid reimbursement
6739 rate increase for occupational therapy, physical therapy, and
6740 speech therapy providers. Health plans that participate in the
6741 Statewide Medicaid Managed Care program shall pass through the
6742 fee increase to providers in this appropriation.
6743 Section 93. Effective October 1, 2024, for the 2024-2025
6744 fiscal year, the sums of $9,666,352 in recurring funds from the
6745 General Revenue Fund and $13,008,646 in recurring funds from the
6746 Medical Care Trust Fund are appropriated to the Agency for
6747 Health Care Administration to provide a Medicaid reimbursement
6748 rate increase for Current Procedural Terminology codes 97153 and
6749 97155 related to behavioral analysis services. Health plans that
6750 participate in the Statewide Medicaid Managed Care program shall
6751 pass through the fee increase to providers in this
6752 appropriation.
6753 Section 94. Effective July 1, 2024, for the 2024-2025
6754 fiscal year, the sums of $585,758 in recurring funds and
6755 $1,673,421 in nonrecurring funds from the General Revenue Fund,
6756 $928,001 in recurring funds and $54,513 in nonrecurring funds
6757 from the Health Care Trust Fund, $100,000 in nonrecurring funds
6758 from the Administrative Trust Fund, and $585,758 in recurring
6759 funds and $1,573,421 in nonrecurring funds from the Medical Care
6760 Trust Fund are appropriated to the Agency for Health Care
6761 Administration, and 20 full-time equivalent positions with the
6762 associated salary rate of 1,247,140 are authorized for the
6763 purpose of implementing this act.
6764 Section 95. Effective July 1, 2024, for the 2024-2025
6765 fiscal year, the sums of $2,389,146 in recurring funds and
6766 $1,190,611 in nonrecurring funds from the General Revenue Fund
6767 and $1,041,578 in recurring funds and $287,633 in nonrecurring
6768 funds from the Medical Quality Assurance Trust Fund are
6769 appropriated to the Department of Health, and 25 full-time
6770 equivalent positions with the associated salary rate of
6771 1,739,740, are authorized for the purpose of implementing this
6772 act.
6773 Section 96. Except as otherwise expressly provided in this
6774 act, this act shall take effect upon becoming a law.