Florida Senate - 2025                          SENATOR AMENDMENT
       Bill No. CS for CS for HB 1299
       
       
       
       
       
       
                                Ì340380{Î340380                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 2/AD/2R         .                                
             04/30/2025 05:39 PM       .                                
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       Senator Trumbull moved the following:
       
    1         Senate Substitute for Amendment (869614) (with title
    2  amendment)
    3  
    4         Delete everything after the enacting clause
    5  and insert:
    6         Section 1. Effective upon becoming a law, or, if this act
    7  fails to become a law until after June 1, 2025, operating
    8  retroactively to June 1, 2025, section 9 of chapter 2023-43,
    9  Laws of Florida, is amended to read:
   10         Section 9. Sections 381.00316(2)(g) and 381.00319(1)(e),
   11  Florida Statutes, as created by this act, are repealed June 1,
   12  2027 2025.
   13         Section 2. Effective upon becoming a law, or, if this act
   14  fails to become a law until after June 1, 2025, operating
   15  retroactively to June 1, 2025, paragraph (g) of subsection (2)
   16  of section 381.00316, Florida Statutes, is reenacted to read:
   17         381.00316 Discrimination by governmental and business
   18  entities based on health care choices; prohibition.—
   19         (2) As used in this section, the term:
   20         (g) “Messenger ribonucleic acid vaccine” means any vaccine
   21  that uses laboratory-produced messenger ribonucleic acid to
   22  trigger the human body’s immune system to generate an immune
   23  response.
   24         Section 3. Effective upon becoming a law, or, if this act
   25  fails to become a law until after June 1, 2025, operating
   26  retroactively to June 1, 2025, paragraph (e) of subsection (1)
   27  of section 381.00319, Florida Statutes, is reenacted to read:
   28         381.00319 Prohibition on mask mandates and vaccination and
   29  testing mandates for educational institutions.—
   30         (1) For purposes of this section, the term:
   31         (e) “Messenger ribonucleic acid vaccine” has the same
   32  meaning as in s. 381.00316.
   33         Section 4. Paragraphs (b), (e), and (f) of subsection (8)
   34  of section 381.986, Florida Statutes, are amended to read:
   35         381.986 Medical use of marijuana.—
   36         (8) MEDICAL MARIJUANA TREATMENT CENTERS.—
   37         (b) An applicant for licensure as a medical marijuana
   38  treatment center must shall apply to the department on a form
   39  prescribed by the department and adopted in rule. The department
   40  shall adopt rules pursuant to ss. 120.536(1) and 120.54
   41  establishing a procedure for the issuance and biennial renewal
   42  of licenses, including initial application and biennial renewal
   43  fees sufficient to cover the costs of implementing and
   44  administering this section, and establishing supplemental
   45  licensure fees for payment beginning May 1, 2018, sufficient to
   46  cover the costs of administering ss. 381.989 and 1004.4351. The
   47  department shall identify applicants with strong diversity plans
   48  reflecting this state’s commitment to diversity and implement
   49  training programs and other educational programs to enable
   50  minority persons and minority business enterprises, as defined
   51  in s. 288.703, and veteran business enterprises, as defined in
   52  s. 295.187, to compete for medical marijuana treatment center
   53  licensure and contracts. Subject to the requirements in
   54  subparagraphs (a)2.-4., the department shall issue a license to
   55  an applicant if the applicant meets the requirements of this
   56  section and pays the initial application fee. The department
   57  shall renew the licensure of a medical marijuana treatment
   58  center biennially if the licensee meets the requirements of this
   59  section and pays the biennial renewal fee. However, the
   60  department may not renew the license of a medical marijuana
   61  treatment center that has not begun to cultivate, process, and
   62  dispense marijuana by the date that the medical marijuana
   63  treatment center is required to renew its license. An individual
   64  may not be an applicant, owner, officer, board member, or
   65  manager on more than one application for licensure as a medical
   66  marijuana treatment center. An individual or entity may not be
   67  awarded more than one license as a medical marijuana treatment
   68  center. An applicant for licensure as a medical marijuana
   69  treatment center must demonstrate:
   70         1. That, for the 5 consecutive years before submitting the
   71  application, the applicant has been registered to do business in
   72  this the state.
   73         2. Possession of a valid certificate of registration issued
   74  by the Department of Agriculture and Consumer Services pursuant
   75  to s. 581.131.
   76         3. The technical and technological ability to cultivate and
   77  produce marijuana, including, but not limited to, low-THC
   78  cannabis.
   79         4. The ability to secure the premises, resources, and
   80  personnel necessary to operate as a medical marijuana treatment
   81  center.
   82         5. The ability to maintain accountability of all raw
   83  materials, finished products, and any byproducts to prevent
   84  diversion or unlawful access to or possession of these
   85  substances.
   86         6. An infrastructure reasonably located to dispense
   87  marijuana to registered qualified patients statewide or
   88  regionally as determined by the department.
   89         7. The financial ability to maintain operations for the
   90  duration of the 2-year approval cycle, including the provision
   91  of certified financial statements to the department.
   92         a. Upon approval, the applicant must post a $5 million
   93  performance bond issued by an authorized surety insurance
   94  company rated in one of the three highest rating categories by a
   95  nationally recognized rating service. However, a medical
   96  marijuana treatment center serving at least 1,000 qualified
   97  patients is only required to maintain a $2 million performance
   98  bond.
   99         b. In lieu of the performance bond required under sub
  100  subparagraph a., the applicant may provide an irrevocable letter
  101  of credit payable to the department or provide cash to the
  102  department. If provided with cash under this sub-subparagraph,
  103  the department must shall deposit the cash in the Grants and
  104  Donations Trust Fund within the Department of Health, subject to
  105  the same conditions as the bond regarding requirements for the
  106  applicant to forfeit ownership of the funds. If the funds
  107  deposited under this sub-subparagraph generate interest, the
  108  amount of that interest must shall be used by the department for
  109  the administration of this section.
  110         8. That all owners, officers, board members, and managers
  111  have passed a background screening pursuant to subsection (9).
  112  As used in this subparagraph, the term:
  113         a.“Manager” means any person with the authority to
  114  exercise or contribute to the operational control, direction, or
  115  management of an applicant or a medical marijuana treatment
  116  center or who has authority to supervise any employee of an
  117  applicant or a medical marijuana treatment center. The term
  118  includes an individual with the power or authority to direct or
  119  influence the direction or operation of an applicant or a
  120  medical marijuana treatment center through board membership, an
  121  agreement, or a contract.
  122         b.“Owner” means any person who owns or controls a 5
  123  percent or greater share of interests of the applicant or a
  124  medical marijuana treatment center which include beneficial or
  125  voting rights to interests. In the event that one person owns a
  126  beneficial right to interests and another person holds the
  127  voting rights with respect to such interests, then in such case,
  128  both are considered the owner of such interests.
  129         9. The employment of a medical director to supervise the
  130  activities of the medical marijuana treatment center.
  131         10. A diversity plan that promotes and ensures the
  132  involvement of minority persons and minority business
  133  enterprises, as defined in s. 288.703, or veteran business
  134  enterprises, as defined in s. 295.187, in ownership, management,
  135  and employment. An applicant for licensure renewal must show the
  136  effectiveness of the diversity plan by including the following
  137  with his or her application for renewal:
  138         a. Representation of minority persons and veterans in the
  139  medical marijuana treatment center’s workforce;
  140         b. Efforts to recruit minority persons and veterans for
  141  employment; and
  142         c. A record of contracts for services with minority
  143  business enterprises and veteran business enterprises.
  144         (e) A licensed medical marijuana treatment center shall
  145  cultivate, process, transport, and dispense marijuana for
  146  medical use. A licensed medical marijuana treatment center may
  147  not contract for services directly related to the cultivation,
  148  processing, and dispensing of marijuana or marijuana delivery
  149  devices, except that a medical marijuana treatment center
  150  licensed pursuant to subparagraph (a)1. may contract with a
  151  single entity for the cultivation, processing, transporting, and
  152  dispensing of marijuana and marijuana delivery devices. A
  153  licensed medical marijuana treatment center shall must, at all
  154  times, maintain compliance with the criteria demonstrated and
  155  representations made in the initial application and the criteria
  156  established in this subsection. Upon request, the department may
  157  grant a medical marijuana treatment center a variance from the
  158  representations made in the initial application. Consideration
  159  of such a request must shall be based upon the individual facts
  160  and circumstances surrounding the request. A variance may not be
  161  granted unless the requesting medical marijuana treatment center
  162  can demonstrate to the department that it has a proposed
  163  alternative to the specific representation made in its
  164  application which fulfills the same or a similar purpose as the
  165  specific representation in a way that the department can
  166  reasonably determine will not be a lower standard than the
  167  specific representation in the application. A variance may not
  168  be granted from the requirements in subparagraph 2. and
  169  subparagraphs (b)1. and 2.
  170         1. A licensed medical marijuana treatment center may
  171  transfer ownership to an individual or entity who meets the
  172  requirements of this section. A publicly traded corporation or
  173  publicly traded company that meets the requirements of this
  174  section is not precluded from ownership of a medical marijuana
  175  treatment center. To accommodate a change in ownership:
  176         a. The licensed medical marijuana treatment center shall
  177  notify the department in writing at least 60 days before the
  178  anticipated date of the change of ownership.
  179         b. The individual or entity applying for initial licensure
  180  due to a change of ownership must submit an application that
  181  must be received by the department at least 60 days before the
  182  date of change of ownership.
  183         c. Upon receipt of an application for a license, the
  184  department shall examine the application and, within 30 days
  185  after receipt, notify the applicant in writing of any apparent
  186  errors or omissions and request any additional information
  187  required.
  188         d. Requested information omitted from an application for
  189  licensure must be filed with the department within 21 days after
  190  the department’s request for omitted information or the
  191  application will shall be deemed incomplete and shall be
  192  withdrawn from further consideration and the fees shall be
  193  forfeited.
  194         e. Within 30 days after the receipt of a complete
  195  application, the department shall approve or deny the
  196  application.
  197         2. A medical marijuana treatment center, and any individual
  198  or entity who directly or indirectly owns, controls, or holds
  199  with power to vote 5 percent or more of the voting shares of a
  200  medical marijuana treatment center, may not acquire direct or
  201  indirect ownership or control of any voting shares or other form
  202  of ownership of any other medical marijuana treatment center.
  203         3. A medical marijuana treatment center may not enter into
  204  any form of profit-sharing arrangement with the property owner
  205  or lessor of any of its facilities where cultivation,
  206  processing, storing, or dispensing of marijuana and marijuana
  207  delivery devices occurs.
  208         4. All employees of a medical marijuana treatment center
  209  must be 21 years of age or older and have passed a background
  210  screening pursuant to subsection (9). As used in this
  211  subparagraph, the term “employee” means any person employed by a
  212  medical marijuana treatment center licensee in any capacity,
  213  including those whose duties involve any aspect of the
  214  cultivation, processing, transportation, or dispensing of
  215  marijuana. This requirement applies to all employees, regardless
  216  of the compensation received.
  217         5. Each medical marijuana treatment center must adopt and
  218  enforce policies and procedures to ensure employees and
  219  volunteers receive training on the legal requirements to
  220  dispense marijuana to qualified patients.
  221         6. When growing marijuana, a medical marijuana treatment
  222  center:
  223         a. May use pesticides determined by the department, after
  224  consultation with the Department of Agriculture and Consumer
  225  Services, to be safely applied to plants intended for human
  226  consumption, but may not use pesticides designated as
  227  restricted-use pesticides pursuant to s. 487.042.
  228         b. Must grow marijuana within an enclosed structure and in
  229  a room separate from any other plant.
  230         c. Must inspect seeds and growing plants for plant pests
  231  that endanger or threaten the horticultural and agricultural
  232  interests of the state in accordance with chapter 581 and any
  233  rules adopted thereunder.
  234         d. Must perform fumigation or treatment of plants, or
  235  remove and destroy infested or infected plants, in accordance
  236  with chapter 581 and any rules adopted thereunder.
  237         7. Each medical marijuana treatment center must produce and
  238  make available for purchase at least one low-THC cannabis
  239  product.
  240         8. A medical marijuana treatment center that produces
  241  edibles must hold a permit to operate as a food establishment
  242  pursuant to chapter 500, the Florida Food Safety Act, and must
  243  comply with all the requirements for food establishments
  244  pursuant to chapter 500 and any rules adopted thereunder.
  245  Edibles may not contain more than 200 milligrams of
  246  tetrahydrocannabinol, and a single serving portion of an edible
  247  may not exceed 10 milligrams of tetrahydrocannabinol. Edibles
  248  may not have a potency variance of no greater than 15 percent.
  249  Marijuana products, including edibles, may not be attractive to
  250  children; be manufactured in the shape of humans, cartoons, or
  251  animals; be manufactured in a form that bears any reasonable
  252  resemblance to products available for consumption as
  253  commercially available candy; or contain any color additives. To
  254  discourage consumption of edibles by children, the department
  255  shall determine by rule any shapes, forms, and ingredients
  256  allowed and prohibited for edibles. Medical marijuana treatment
  257  centers may not begin processing or dispensing edibles until
  258  after the effective date of the rule. The department shall also
  259  adopt sanitation rules providing the standards and requirements
  260  for the storage, display, or dispensing of edibles.
  261         9. Within 12 months after licensure, a medical marijuana
  262  treatment center must demonstrate to the department that all of
  263  its processing facilities have passed a Food Safety Good
  264  Manufacturing Practices, such as Global Food Safety Initiative
  265  or equivalent, inspection by a nationally accredited certifying
  266  body. A medical marijuana treatment center must immediately stop
  267  processing at any facility which fails to pass this inspection
  268  until it demonstrates to the department that such facility has
  269  met this requirement.
  270         10. A medical marijuana treatment center that produces
  271  prerolled marijuana cigarettes may not use wrapping paper made
  272  with tobacco or hemp.
  273         11. When processing marijuana, a medical marijuana
  274  treatment center must:
  275         a. Process the marijuana within an enclosed structure and
  276  in a room separate from other plants or products.
  277         b. Comply with department rules when processing marijuana
  278  with hydrocarbon solvents or other solvents or gases exhibiting
  279  potential toxicity to humans. The department shall determine by
  280  rule the requirements for medical marijuana treatment centers to
  281  use such solvents or gases exhibiting potential toxicity to
  282  humans.
  283         c. Comply with federal and state laws and regulations and
  284  department rules for solid and liquid wastes. The department
  285  shall determine by rule procedures for the storage, handling,
  286  transportation, management, and disposal of solid and liquid
  287  waste generated during marijuana production and processing. The
  288  Department of Environmental Protection shall assist the
  289  department in developing such rules.
  290         d. Test the processed marijuana using a medical marijuana
  291  testing laboratory before it is dispensed. Results must be
  292  verified and signed by two medical marijuana treatment center
  293  employees. Before dispensing, the medical marijuana treatment
  294  center must determine that the test results indicate that low
  295  THC cannabis meets the definition of low-THC cannabis, the
  296  concentration of tetrahydrocannabinol meets the potency
  297  requirements of this section, the labeling of the concentration
  298  of tetrahydrocannabinol and cannabidiol is accurate, and all
  299  marijuana is safe for human consumption and free from
  300  contaminants that are unsafe for human consumption. The
  301  department shall determine by rule which contaminants must be
  302  tested for and the maximum levels of each contaminant which are
  303  safe for human consumption. The Department of Agriculture and
  304  Consumer Services shall assist the department in developing the
  305  testing requirements for contaminants that are unsafe for human
  306  consumption in edibles. The department shall also determine by
  307  rule the procedures for the treatment of marijuana that fails to
  308  meet the testing requirements of this section, s. 381.988, or
  309  department rule. The department may select samples of marijuana
  310  from a medical marijuana treatment center facility which shall
  311  be tested by the department to determine whether the marijuana
  312  meets the potency requirements of this section, is safe for
  313  human consumption, and is accurately labeled with the
  314  tetrahydrocannabinol and cannabidiol concentration or to verify
  315  the result of marijuana testing conducted by a marijuana testing
  316  laboratory. The department may also select samples of marijuana
  317  delivery devices from a medical marijuana treatment center to
  318  determine whether the marijuana delivery device is safe for use
  319  by qualified patients. A medical marijuana treatment center may
  320  not require payment from the department for the sample. A
  321  medical marijuana treatment center must recall marijuana,
  322  including all marijuana and marijuana products made from the
  323  same batch of marijuana, that fails to meet the potency
  324  requirements of this section, that is unsafe for human
  325  consumption, or for which the labeling of the
  326  tetrahydrocannabinol and cannabidiol concentration is
  327  inaccurate. The department shall adopt rules to establish
  328  marijuana potency variations of no greater than 15 percent using
  329  negotiated rulemaking pursuant to s. 120.54(2)(d) which accounts
  330  for, but is not limited to, time lapses between testing, testing
  331  methods, testing instruments, and types of marijuana sampled for
  332  testing. The department may not issue any recalls for product
  333  potency as it relates to product labeling before issuing a rule
  334  relating to potency variation standards. A medical marijuana
  335  treatment center must also recall all marijuana delivery devices
  336  determined to be unsafe for use by qualified patients. The
  337  medical marijuana treatment center must retain records of all
  338  testing and samples of each homogeneous batch of marijuana for
  339  at least 9 months. The medical marijuana treatment center must
  340  contract with a marijuana testing laboratory to perform audits
  341  on the medical marijuana treatment center’s standard operating
  342  procedures, testing records, and samples and provide the results
  343  to the department to confirm that the marijuana or low-THC
  344  cannabis meets the requirements of this section and that the
  345  marijuana or low-THC cannabis is safe for human consumption. A
  346  medical marijuana treatment center shall reserve two processed
  347  samples from each batch and retain such samples for at least 9
  348  months for the purpose of such audits. A medical marijuana
  349  treatment center may use a laboratory that has not been
  350  certified by the department under s. 381.988 until such time as
  351  at least one laboratory holds the required certification, but in
  352  no event later than July 1, 2018.
  353         e. Package the marijuana in compliance with the United
  354  States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss.
  355  1471 et seq.
  356         f. Package the marijuana in a receptacle that has a firmly
  357  affixed and legible label stating the following information:
  358         (I) The marijuana or low-THC cannabis meets the
  359  requirements of sub-subparagraph d.
  360         (II) The name of the medical marijuana treatment center
  361  from which the marijuana originates.
  362         (III) The batch number and harvest number from which the
  363  marijuana originates and the date dispensed.
  364         (IV) The name of the physician who issued the physician
  365  certification.
  366         (V) The name of the patient.
  367         (VI) The product name, if applicable, and dosage form,
  368  including concentration of tetrahydrocannabinol and cannabidiol.
  369  The product name may not contain wording commonly associated
  370  with products that are attractive to children or which promote
  371  the recreational use of marijuana.
  372         (VII) The recommended dose.
  373         (VIII) A warning that it is illegal to transfer medical
  374  marijuana to another person.
  375         (IX) A marijuana universal symbol developed by the
  376  department.
  377         12. The medical marijuana treatment center shall include in
  378  each package a patient package insert with information on the
  379  specific product dispensed related to:
  380         a. Clinical pharmacology.
  381         b. Indications and use.
  382         c. Dosage and administration.
  383         d. Dosage forms and strengths.
  384         e. Contraindications.
  385         f. Warnings and precautions.
  386         g. Adverse reactions.
  387         13. In addition to the packaging and labeling requirements
  388  specified in subparagraphs 11. and 12., marijuana in a form for
  389  smoking must be packaged in a sealed receptacle with a legible
  390  and prominent warning to keep away from children and a warning
  391  that states marijuana smoke contains carcinogens and may
  392  negatively affect health. Such receptacles for marijuana in a
  393  form for smoking must be plain, opaque, and white without
  394  depictions of the product or images other than the medical
  395  marijuana treatment center’s department-approved logo and the
  396  marijuana universal symbol.
  397         14. The department shall adopt rules to regulate the types,
  398  appearance, and labeling of marijuana delivery devices dispensed
  399  from a medical marijuana treatment center. The rules must
  400  require marijuana delivery devices to have an appearance
  401  consistent with medical use.
  402         15. Each edible must be individually sealed in plain,
  403  opaque wrapping marked only with the marijuana universal symbol.
  404  Where practical, each edible must be marked with the marijuana
  405  universal symbol. In addition to the packaging and labeling
  406  requirements in subparagraphs 11. and 12., edible receptacles
  407  must be plain, opaque, and white without depictions of the
  408  product or images other than the medical marijuana treatment
  409  center’s department-approved logo and the marijuana universal
  410  symbol. The receptacle must also include a list of all the
  411  edible’s ingredients, storage instructions, an expiration date,
  412  a legible and prominent warning to keep away from children and
  413  pets, and a warning that the edible has not been produced or
  414  inspected pursuant to federal food safety laws.
  415         16. When dispensing marijuana or a marijuana delivery
  416  device, a medical marijuana treatment center:
  417         a. May dispense any active, valid order for low-THC
  418  cannabis, medical cannabis and cannabis delivery devices issued
  419  pursuant to former s. 381.986, Florida Statutes 2016, which was
  420  entered into the medical marijuana use registry before July 1,
  421  2017.
  422         b. May not dispense more than a 70-day supply of marijuana
  423  within any 70-day period to a qualified patient or caregiver.
  424  May not dispense more than one 35-day supply of marijuana in a
  425  form for smoking within any 35-day period to a qualified patient
  426  or caregiver. A 35-day supply of marijuana in a form for smoking
  427  may not exceed 2.5 ounces unless an exception to this amount is
  428  approved by the department pursuant to paragraph (4)(f).
  429         c. Must have the medical marijuana treatment center’s
  430  employee who dispenses the marijuana or a marijuana delivery
  431  device enter into the medical marijuana use registry his or her
  432  name or unique employee identifier.
  433         d. Must verify that the qualified patient and the
  434  caregiver, if applicable, each have an active registration in
  435  the medical marijuana use registry and an active and valid
  436  medical marijuana use registry identification card, the amount
  437  and type of marijuana dispensed matches the physician
  438  certification in the medical marijuana use registry for that
  439  qualified patient, and the physician certification has not
  440  already been filled.
  441         e. May not dispense marijuana to a qualified patient who is
  442  younger than 18 years of age. If the qualified patient is
  443  younger than 18 years of age, marijuana may only be dispensed to
  444  the qualified patient’s caregiver.
  445         f. May not dispense or sell any other type of cannabis,
  446  alcohol, or illicit drug-related product, including pipes or
  447  wrapping papers made with tobacco or hemp, other than a
  448  marijuana delivery device required for the medical use of
  449  marijuana and which is specified in a physician certification.
  450         g. Must, upon dispensing the marijuana or marijuana
  451  delivery device, record in the registry the date, time,
  452  quantity, and form of marijuana dispensed; the type of marijuana
  453  delivery device dispensed; and the name and medical marijuana
  454  use registry identification number of the qualified patient or
  455  caregiver to whom the marijuana delivery device was dispensed.
  456         h. Must ensure that patient records are not visible to
  457  anyone other than the qualified patient, his or her caregiver,
  458  and authorized medical marijuana treatment center employees.
  459         (f) To ensure the safety and security of premises where the
  460  cultivation, processing, storing, or dispensing of marijuana
  461  occurs, and to maintain adequate controls against the diversion,
  462  theft, and loss of marijuana or marijuana delivery devices, a
  463  medical marijuana treatment center shall:
  464         1.a. Maintain a fully operational security alarm system
  465  that secures all entry points and perimeter windows and is
  466  equipped with motion detectors; pressure switches; and duress,
  467  panic, and hold-up alarms; and
  468         b. Maintain a video surveillance system that records
  469  continuously 24 hours a day and meets the following criteria:
  470         (I) Cameras are fixed in a place that allows for the clear
  471  identification of persons and activities in controlled areas of
  472  the premises. Controlled areas include grow rooms, processing
  473  rooms, storage rooms, disposal rooms or areas, and point-of-sale
  474  rooms.
  475         (II) Cameras are fixed in entrances and exits to the
  476  premises, which must shall record from both indoor and outdoor,
  477  or ingress and egress, vantage points.
  478         (III) Recorded images must clearly and accurately display
  479  the time and date.
  480         (IV) Retain video surveillance recordings for at least 45
  481  days or longer upon the request of a law enforcement agency.
  482         2. Ensure that the medical marijuana treatment center’s
  483  outdoor premises have sufficient lighting from dusk until dawn.
  484         3. Ensure that the indoor premises where dispensing occurs
  485  includes a waiting area with sufficient space and seating to
  486  accommodate qualified patients and caregivers and at least one
  487  private consultation area that is isolated from the waiting area
  488  and area where dispensing occurs. A medical marijuana treatment
  489  center may not display products or dispense marijuana or
  490  marijuana delivery devices in the waiting area.
  491         4. Not dispense from its premises marijuana or a marijuana
  492  delivery device between the hours of 9 p.m. and 7 a.m., but may
  493  perform all other operations and deliver marijuana to qualified
  494  patients 24 hours a day.
  495         5. Store marijuana in a secured, locked room or a vault.
  496         6. Require at least two of its employees, or two employees
  497  of a security agency with whom it contracts, to be on the
  498  premises at all times where cultivation, processing, or storing
  499  of marijuana occurs.
  500         7. Require each employee or contractor to wear a photo
  501  identification badge at all times while on the premises.
  502         8. Require each visitor to wear a visitor pass at all times
  503  while on the premises.
  504         9. Implement an alcohol and drug-free workplace policy.
  505         10. Report to local law enforcement and notify the
  506  department through e-mail within 24 hours after the medical
  507  marijuana treatment center is notified or becomes aware of any
  508  actual or attempted the theft, diversion, or loss of marijuana.
  509         Section 5. Paragraph (d) of subsection (1) of section
  510  381.988, Florida Statutes, is amended to read:
  511         381.988 Medical marijuana testing laboratories; marijuana
  512  tests conducted by a certified laboratory.—
  513         (1) A person or entity seeking to be a certified marijuana
  514  testing laboratory must:
  515         (d) Require all employees, owners, and managers to submit
  516  to and pass a level 2 background screening pursuant to chapter
  517  435. The department shall deny certification if the person or
  518  entity seeking certification has a disqualifying offense as
  519  provided in s. 435.04 or has an arrest awaiting final
  520  disposition for, has been found guilty of, or has entered a plea
  521  of guilty or nolo contendere to, regardless of adjudication, any
  522  offense listed in chapter 837, chapter 895, or chapter 896 or
  523  similar law of another jurisdiction. Exemptions from
  524  disqualification as provided under s. 435.07 do not apply to
  525  this paragraph.
  526         1. As used in this paragraph, the term:
  527         a.“Employee” means any person whose duties or activities
  528  involve any aspect of regulatory compliance testing or research
  529  and development testing of marijuana for a certified marijuana
  530  testing laboratory, regardless of whether such person is
  531  compensated for his or her work.
  532         b.“Manager” means any person with authority to exercise or
  533  contribute to the operational control, direction, or management
  534  of an applicant or certified marijuana testing laboratory or who
  535  has authority to supervise any employee of an applicant or a
  536  certified marijuana testing laboratory. The term includes an
  537  individual with the power or authority to direct or influence
  538  the direction or operation of an applicant or a certified
  539  marijuana testing laboratory through board membership, an
  540  agreement, or a contract.
  541         c.“Owner” means any person who owns or controls a 5
  542  percent or greater share of interests of the applicant or a
  543  certified marijuana testing laboratory which include beneficial
  544  or voting rights to interests. In the event that one person owns
  545  a beneficial right to interests and another person holds the
  546  voting rights with respect to such interests, then in such case,
  547  both are considered the owner of such interests.
  548         2. Such employees, owners, and managers must submit a full
  549  set of fingerprints to the department or to a vendor, entity, or
  550  agency authorized by s. 943.053(13). The department, vendor,
  551  entity, or agency shall forward the fingerprints to the
  552  Department of Law Enforcement for state processing, and the
  553  Department of Law Enforcement shall forward the fingerprints to
  554  the Federal Bureau of Investigation for national processing.
  555         3.2. Fees for state and federal fingerprint processing and
  556  retention must shall be borne by the certified marijuana testing
  557  laboratory. The state cost for fingerprint processing is shall
  558  be as provided in s. 943.053(3)(e) for records provided to
  559  persons or entities other than those specified as exceptions
  560  therein.
  561         4.3. Fingerprints submitted to the Department of Law
  562  Enforcement pursuant to this paragraph must shall be retained by
  563  the Department of Law Enforcement as provided in s. 943.05(2)(g)
  564  and (h) and, when the Department of Law Enforcement begins
  565  participation in the program, enrolled in the Federal Bureau of
  566  Investigation’s national retained print arrest notification
  567  program. Any arrest record identified must shall be reported to
  568  the department.
  569         Section 6. Paragraphs (a) and (c) of subsection (2) of
  570  section 456.0145, Florida Statutes, are amended to read:
  571         456.0145 Mobile Opportunity by Interstate Licensure
  572  Endorsement (MOBILE) Act.—
  573         (2) LICENSURE BY ENDORSEMENT.—
  574         (a) An applicable board, or the department if there is no
  575  board, shall issue a license to practice in this state to an
  576  applicant who meets all of the following criteria:
  577         1. Submits a complete application.
  578         2. Holds an active, unencumbered license issued by another
  579  state, the District of Columbia, or a territory of the United
  580  States in a profession with a similar scope of practice, as
  581  determined by the board or department, as applicable. The term
  582  “scope of practice” means the full spectrum of functions,
  583  procedures, actions, and services that a health care
  584  practitioner is deemed competent and authorized to perform under
  585  a license issued in this state.
  586         3.a. Has obtained a passing score on a national licensure
  587  examination or holds a national certification recognized by the
  588  board, or the department if there is no board, as applicable to
  589  the profession for which the applicant is seeking licensure in
  590  this state; or
  591         b. Meets the requirements of paragraph (b).
  592         4. Has actively practiced the profession for which the
  593  applicant is applying for at least 2 3 years during the 4-year
  594  period immediately preceding the date of submission of the
  595  application.
  596         5. Attests that he or she is not, at the time of submission
  597  of the application, the subject of a disciplinary proceeding in
  598  a jurisdiction in which he or she holds a license or by the
  599  United States Department of Defense for reasons related to the
  600  practice of the profession for which he or she is applying.
  601         6. Has not had disciplinary action taken against him or her
  602  in the 5 years immediately preceding the date of submission of
  603  the application.
  604         7. Meets the financial responsibility requirements of s.
  605  456.048 or the applicable practice act, if required for the
  606  profession for which the applicant is seeking licensure.
  607         8. Submits a set of fingerprints for a background screening
  608  pursuant to s. 456.0135, if required for the profession for
  609  which he or she is applying.
  610  
  611  The department shall verify information submitted by the
  612  applicant under this subsection using the National Practitioner
  613  Data Bank, as applicable.
  614         (c) A person is ineligible for a license under this section
  615  if he or she:
  616         1. Has a complaint, an allegation, or an investigation
  617  pending before a licensing entity in another state, the District
  618  of Columbia, or a possession or territory of the United States;
  619         2. Has been convicted of or pled nolo contendere to,
  620  regardless of adjudication, any felony or misdemeanor related to
  621  the practice of a health care profession;
  622         3. Has had a health care provider license revoked or
  623  suspended by another state, the District of Columbia, or a
  624  territory of the United States, or has voluntarily surrendered
  625  any such license in lieu of having disciplinary action taken
  626  against the license; or
  627         4. Has been reported to the National Practitioner Data
  628  Bank, unless the applicant has successfully appealed to have his
  629  or her name removed from the data bank. If the reported adverse
  630  action was a result of conduct that would not constitute a
  631  violation of any law or rule in this state, the board, or the
  632  department if there is no board, may:
  633         a.Approve the application;
  634         b.Approve the application with restrictions on the scope
  635  of practice of the licensee;
  636         c.Approve the application with placement of the licensee
  637  on probation for a period of time and subject to such conditions
  638  as the board, or the department if there is no board, may
  639  specify, including, but not limited to, requiring the applicant
  640  to submit to treatment, attend continuing education courses, or
  641  submit to reexamination; or
  642         d.Deny the application.
  643         Section 7. Paragraph (d) of subsection (1) and subsection
  644  (3) of section 456.44, Florida Statutes, are amended to read:
  645         456.44 Controlled substance prescribing.—
  646         (1) DEFINITIONS.—As used in this section, the term:
  647         (d) “Board-certified pain management physician” means a
  648  physician who possesses board certification in pain medicine by
  649  the American Board of Pain Medicine, board certification by the
  650  American Board of Interventional Pain Physicians, or board
  651  certification or subcertification in pain management or pain
  652  medicine by a specialty board recognized by the American Board
  653  of Physician Specialties American Association of Physician
  654  Specialists or the American Board of Medical Specialties or an
  655  osteopathic physician who holds a certificate in Pain Management
  656  by the American Osteopathic Association.
  657         (3) STANDARDS OF PRACTICE FOR TREATMENT OF CHRONIC
  658  NONMALIGNANT PAIN.—The standards of practice in this section do
  659  not supersede the level of care, skill, and treatment recognized
  660  in general law related to health care licensure.
  661         (a) A complete medical history and a physical examination
  662  must be conducted before beginning any treatment and must be
  663  documented in the medical record. The exact components of the
  664  physical examination shall be left to the judgment of the
  665  registrant who is expected to perform a physical examination
  666  proportionate to the diagnosis that justifies a treatment. The
  667  medical record must, at a minimum, document the nature and
  668  intensity of the pain, current and past treatments for pain,
  669  underlying or coexisting diseases or conditions, the effect of
  670  the pain on physical and psychological function, a review of
  671  previous medical records, previous diagnostic studies, and
  672  history of alcohol and substance abuse. The medical record shall
  673  also document the presence of one or more recognized medical
  674  indications for the use of a controlled substance. Each
  675  registrant must develop a written plan for assessing each
  676  patient’s risk of aberrant drug-related behavior, which may
  677  include patient drug testing. Registrants must assess each
  678  patient’s risk for aberrant drug-related behavior and monitor
  679  that risk on an ongoing basis in accordance with the plan.
  680         (b) Each registrant must develop a written individualized
  681  treatment plan for each patient. The treatment plan shall state
  682  objectives that will be used to determine treatment success,
  683  such as pain relief and improved physical and psychosocial
  684  function, and shall indicate if any further diagnostic
  685  evaluations or other treatments are planned. After treatment
  686  begins, the registrant shall adjust drug therapy to the
  687  individual medical needs of each patient. Other treatment
  688  modalities, including a rehabilitation program, shall be
  689  considered depending on the etiology of the pain and the extent
  690  to which the pain is associated with physical and psychosocial
  691  impairment. The interdisciplinary nature of the treatment plan
  692  shall be documented.
  693         (c) The registrant shall discuss the risks and benefits of
  694  the use of controlled substances, including the risks of abuse
  695  and addiction, as well as physical dependence and its
  696  consequences, with the patient, persons designated by the
  697  patient, or the patient’s surrogate or guardian if the patient
  698  is incompetent. The registrant shall use a written controlled
  699  substance agreement between the registrant and the patient
  700  outlining the patient’s responsibilities, including, but not
  701  limited to:
  702         1. Number and frequency of controlled substance
  703  prescriptions and refills.
  704         2. Patient compliance and reasons for which drug therapy
  705  may be discontinued, such as a violation of the agreement.
  706         3. An agreement that controlled substances for the
  707  treatment of chronic nonmalignant pain shall be prescribed by a
  708  single treating registrant unless otherwise authorized by the
  709  treating registrant and documented in the medical record.
  710         (d) The patient shall be seen by the registrant at regular
  711  intervals, not to exceed 3 months, to assess the efficacy of
  712  treatment, ensure that controlled substance therapy remains
  713  indicated, evaluate the patient’s progress toward treatment
  714  objectives, consider adverse drug effects, and review the
  715  etiology of the pain. Continuation or modification of therapy
  716  shall depend on the registrant’s evaluation of the patient’s
  717  progress. If treatment goals are not being achieved, despite
  718  medication adjustments, the registrant shall reevaluate the
  719  appropriateness of continued treatment. The registrant shall
  720  monitor patient compliance in medication usage, related
  721  treatment plans, controlled substance agreements, and
  722  indications of substance abuse or diversion at a minimum of 3
  723  month intervals.
  724         (e) The registrant shall refer the patient as necessary for
  725  additional evaluation and treatment in order to achieve
  726  treatment objectives. Special attention shall be given to those
  727  patients who are at risk for misusing their medications and
  728  those whose living arrangements pose a risk for medication
  729  misuse or diversion. The management of pain in patients with a
  730  history of substance abuse or with a comorbid psychiatric
  731  disorder requires extra care, monitoring, and documentation and
  732  requires consultation with or referral to an addiction medicine
  733  specialist or a psychiatrist.
  734         (f) A registrant must maintain accurate, current, and
  735  complete records that are accessible and readily available for
  736  review and comply with the requirements of this section, the
  737  applicable practice act, and applicable board rules. The medical
  738  records must include, but are not limited to:
  739         1. The complete medical history and a physical examination,
  740  including history of drug abuse or dependence.
  741         2. Diagnostic, therapeutic, and laboratory results.
  742         3. Evaluations and consultations.
  743         4. Treatment objectives.
  744         5. Discussion of risks and benefits.
  745         6. Treatments.
  746         7. Medications, including date, type, dosage, and quantity
  747  prescribed.
  748         8. Instructions and agreements.
  749         9. Periodic reviews.
  750         10. Results of any drug testing.
  751         11. A photocopy of the patient’s government-issued photo
  752  identification.
  753         12. If a written prescription for a controlled substance is
  754  given to the patient, a duplicate of the prescription.
  755         13. The registrant’s full name presented in a legible
  756  manner.
  757         (g) A registrant shall immediately refer patients with
  758  signs or symptoms of substance abuse to a board-certified pain
  759  management physician, an addiction medicine specialist, or a
  760  mental health addiction facility as it pertains to drug abuse or
  761  addiction unless the registrant is a physician who is board
  762  certified or board-eligible in pain management. Throughout the
  763  period of time before receiving the consultant’s report, a
  764  prescribing registrant shall clearly and completely document
  765  medical justification for continued treatment with controlled
  766  substances and those steps taken to ensure medically appropriate
  767  use of controlled substances by the patient. Upon receipt of the
  768  consultant’s written report, the prescribing registrant shall
  769  incorporate the consultant’s recommendations for continuing,
  770  modifying, or discontinuing controlled substance therapy. The
  771  resulting changes in treatment shall be specifically documented
  772  in the patient’s medical record. Evidence or behavioral
  773  indications of diversion shall be followed by discontinuation of
  774  controlled substance therapy, and the patient shall be
  775  discharged, and all results of testing and actions taken by the
  776  registrant shall be documented in the patient’s medical record.
  777  
  778  This subsection does not apply to a board-eligible or board
  779  certified anesthesiologist, physiatrist, rheumatologist, or
  780  neurologist, or to a board-certified physician who has surgical
  781  privileges at a hospital or ambulatory surgery center and
  782  primarily provides surgical services. This subsection does not
  783  apply to a board-eligible or board-certified medical specialist
  784  who has also completed a fellowship in pain medicine approved by
  785  the Accreditation Council for Graduate Medical Education or the
  786  American Osteopathic Association, or who is board eligible or
  787  board certified in pain medicine by the American Board of Pain
  788  Medicine, the American Board of Interventional Pain Physicians,
  789  the American Board of Physician Specialties American Association
  790  of Physician Specialists, or a board approved by the American
  791  Board of Medical Specialties or the American Osteopathic
  792  Association and performs interventional pain procedures of the
  793  type routinely billed using surgical codes. This subsection does
  794  not apply to a registrant who prescribes medically necessary
  795  controlled substances for a patient during an inpatient stay in
  796  a hospital licensed under chapter 395.
  797         Section 8. Section 458.313, Florida Statutes, is amended to
  798  read:
  799         458.313 Licensure by endorsement; requirements; fees.—The
  800  department shall issue a license by endorsement to any applicant
  801  who, upon applying to the department on forms furnished by the
  802  department and remitting a fee set by the board in an amount not
  803  to exceed $500, the board certifies has:
  804         (1) Met the requirements for licensure by endorsement under
  805  s. 456.0145; or
  806         (2)Met the requirements for licensure by endorsement under
  807  s. 456.0145 except for s. 456.0145(2)(a)4. but has submitted
  808  evidence to the board’s satisfaction of the successful
  809  completion of either a board-approved postgraduate training
  810  program within 2 years preceding the filing of an application or
  811  a board-approved clinical competency examination within the year
  812  preceding the filing of an application.
  813         Section 9. Paragraph (i) of subsection (1) of section
  814  458.3145, Florida Statutes, is amended to read:
  815         458.3145 Medical faculty certificate.—
  816         (1) A medical faculty certificate may be issued without
  817  examination to an individual who meets all of the following
  818  criteria:
  819         (i) Has been offered and has accepted a full-time faculty
  820  appointment to teach in a program of medicine at any of the
  821  following institutions:
  822         1. The University of Florida.
  823         2. The University of Miami.
  824         3. The University of South Florida.
  825         4. The Florida State University.
  826         5. The Florida International University.
  827         6. The University of Central Florida.
  828         7. The Mayo Clinic College of Medicine and Science in
  829  Jacksonville, Florida.
  830         8. The Florida Atlantic University.
  831         9. The Johns Hopkins All Children’s Hospital in St.
  832  Petersburg, Florida.
  833         10. Nova Southeastern University.
  834         11. Lake Erie College of Osteopathic Medicine in Bradenton,
  835  Florida.
  836         12. Burrell College of Osteopathic Medicine in Melbourne,
  837  Florida.
  838         13.The Orlando College of Osteopathic Medicine.
  839         14.Lincoln Memorial University-DeBusk College of
  840  Osteopathic Medicine in Orange Park, Florida.
  841         15.Loma Linda University School of Medicine – AdventHealth
  842  regional campuses in Orlando, Florida.
  843         Section 10. Subsection (1) of section 458.315, Florida
  844  Statutes, is amended to read:
  845         458.315 Temporary certificate for practice in areas of
  846  critical need.—
  847         (1) A physician or physician assistant who is licensed to
  848  practice in any jurisdiction of the United States and whose
  849  license is currently valid may be issued a temporary certificate
  850  for practice in areas of critical need. A physician seeking such
  851  certificate must pay an application fee of $300. A physician
  852  assistant licensed to practice in any state of the United States
  853  or the District of Columbia whose license is currently valid may
  854  be issued a temporary certificate for practice in areas of
  855  critical need.
  856         Section 11. Subsection (1) of section 459.0076, Florida
  857  Statutes, is amended to read:
  858         459.0076 Temporary certificate for practice in areas of
  859  critical need.—
  860         (1) A physician or physician assistant who holds a valid
  861  license to practice in any jurisdiction of the United States may
  862  be issued a temporary certificate for practice in areas of
  863  critical need. A physician seeking such certificate must pay an
  864  application fee of $300. A physician assistant licensed to
  865  practice in any state of the United States or the District of
  866  Columbia whose license is currently valid may be issued a
  867  temporary certificate for practice in areas of critical need.
  868         Section 12. Paragraph (a) of subsection (1) of section
  869  458.3265, Florida Statutes, is amended to read:
  870         458.3265 Pain-management clinics.—
  871         (1) REGISTRATION.—
  872         (a)1. As used in this section, the term:
  873         a. “Board eligible” means successful completion of an
  874  anesthesia, physical medicine and rehabilitation, rheumatology,
  875  or neurology residency program approved by the Accreditation
  876  Council for Graduate Medical Education or the American
  877  Osteopathic Association for a period of 6 years from successful
  878  completion of such residency program.
  879         b. “Chronic nonmalignant pain” means pain unrelated to
  880  cancer which persists beyond the usual course of disease or the
  881  injury that is the cause of the pain or more than 90 days after
  882  surgery.
  883         c. “Pain-management clinic” or “clinic” means any publicly
  884  or privately owned facility:
  885         (I) That advertises in any medium for any type of pain
  886  management services; or
  887         (II) Where in any month a majority of patients are
  888  prescribed opioids, benzodiazepines, barbiturates, or
  889  carisoprodol for the treatment of chronic nonmalignant pain.
  890         2. Each pain-management clinic must register with the
  891  department or hold a valid certificate of exemption pursuant to
  892  subsection (2).
  893         3. The following clinics are exempt from the registration
  894  requirement of paragraphs (c)-(m) and must apply to the
  895  department for a certificate of exemption:
  896         a. A clinic licensed as a facility pursuant to chapter 395;
  897         b. A clinic in which the majority of the physicians who
  898  provide services in the clinic primarily provide surgical
  899  services;
  900         c. A clinic owned by a publicly held corporation whose
  901  shares are traded on a national exchange or on the over-the
  902  counter market and whose total assets at the end of the
  903  corporation’s most recent fiscal quarter exceeded $50 million;
  904         d. A clinic affiliated with an accredited medical school at
  905  which training is provided for medical students, residents, or
  906  fellows;
  907         e. A clinic that does not prescribe controlled substances
  908  for the treatment of pain;
  909         f. A clinic owned by a corporate entity exempt from federal
  910  taxation under 26 U.S.C. s. 501(c)(3);
  911         g. A clinic wholly owned and operated by one or more board
  912  eligible or board-certified anesthesiologists, physiatrists,
  913  rheumatologists, or neurologists; or
  914         h. A clinic wholly owned and operated by a physician
  915  multispecialty practice where one or more board-eligible or
  916  board-certified medical specialists, who have also completed
  917  fellowships in pain medicine approved by the Accreditation
  918  Council for Graduate Medical Education or who are also board
  919  certified in pain medicine by the American Board of Pain
  920  Medicine or a board approved by the American Board of Medical
  921  Specialties, the American Board of Physician Specialties
  922  American Association of Physician Specialists, or the American
  923  Osteopathic Association, perform interventional pain procedures
  924  of the type routinely billed using surgical codes.
  925         Section 13. Paragraph (a) of subsection (1) of section
  926  458.3475, Florida Statutes, is amended to read:
  927         458.3475 Anesthesiologist assistants.—
  928         (1) DEFINITIONS.—As used in this section, the term:
  929         (a) “Anesthesiologist” means an allopathic physician who
  930  holds an active, unrestricted license; who has successfully
  931  completed an anesthesiology training program approved by the
  932  Accreditation Council on Graduate Medical Education or its
  933  equivalent; and who is certified by the American Board of
  934  Anesthesiology, is eligible to take that board’s examination, or
  935  is certified by the Board of Certification in Anesthesiology
  936  affiliated with the American Board of Physician Specialties
  937  American Association of Physician Specialists.
  938         Section 14. Paragraph (a) of subsection (1) of section
  939  459.0137, Florida Statutes, is amended to read:
  940         459.0137 Pain-management clinics.—
  941         (1) REGISTRATION.—
  942         (a)1. As used in this section, the term:
  943         a. “Board eligible” means successful completion of an
  944  anesthesia, physical medicine and rehabilitation, rheumatology,
  945  or neurology residency program approved by the Accreditation
  946  Council for Graduate Medical Education or the American
  947  Osteopathic Association for a period of 6 years from successful
  948  completion of such residency program.
  949         b. “Chronic nonmalignant pain” means pain unrelated to
  950  cancer which persists beyond the usual course of disease or the
  951  injury that is the cause of the pain or more than 90 days after
  952  surgery.
  953         c. “Pain-management clinic” or “clinic” means any publicly
  954  or privately owned facility:
  955         (I) That advertises in any medium for any type of pain
  956  management services; or
  957         (II) Where in any month a majority of patients are
  958  prescribed opioids, benzodiazepines, barbiturates, or
  959  carisoprodol for the treatment of chronic nonmalignant pain.
  960         2. Each pain-management clinic must register with the
  961  department or hold a valid certificate of exemption pursuant to
  962  subsection (2).
  963         3. The following clinics are exempt from the registration
  964  requirement of paragraphs (c)-(m) and must apply to the
  965  department for a certificate of exemption:
  966         a. A clinic licensed as a facility pursuant to chapter 395;
  967         b. A clinic in which the majority of the physicians who
  968  provide services in the clinic primarily provide surgical
  969  services;
  970         c. A clinic owned by a publicly held corporation whose
  971  shares are traded on a national exchange or on the over-the
  972  counter market and whose total assets at the end of the
  973  corporation’s most recent fiscal quarter exceeded $50 million;
  974         d. A clinic affiliated with an accredited medical school at
  975  which training is provided for medical students, residents, or
  976  fellows;
  977         e. A clinic that does not prescribe controlled substances
  978  for the treatment of pain;
  979         f. A clinic owned by a corporate entity exempt from federal
  980  taxation under 26 U.S.C. s. 501(c)(3);
  981         g. A clinic wholly owned and operated by one or more board
  982  eligible or board-certified anesthesiologists, physiatrists,
  983  rheumatologists, or neurologists; or
  984         h. A clinic wholly owned and operated by a physician
  985  multispecialty practice where one or more board-eligible or
  986  board-certified medical specialists, who have also completed
  987  fellowships in pain medicine approved by the Accreditation
  988  Council for Graduate Medical Education or the American
  989  Osteopathic Association or who are also board-certified in pain
  990  medicine by the American Board of Pain Medicine or a board
  991  approved by the American Board of Medical Specialties, the
  992  American Board of Physician Specialties American Association of
  993  Physician Specialists, or the American Osteopathic Association,
  994  perform interventional pain procedures of the type routinely
  995  billed using surgical codes.
  996         Section 15. Paragraph (a) of subsection (1) of section
  997  459.023, Florida Statutes, is amended to read:
  998         459.023 Anesthesiologist assistants.—
  999         (1) DEFINITIONS.—As used in this section, the term:
 1000         (a) “Anesthesiologist” means an osteopathic physician who
 1001  holds an active, unrestricted license; who has successfully
 1002  completed an anesthesiology training program approved by the
 1003  Accreditation Council on Graduate Medical Education, or its
 1004  equivalent, or the American Osteopathic Association; and who is
 1005  certified by the American Osteopathic Board of Anesthesiology or
 1006  is eligible to take that board’s examination, is certified by
 1007  the American Board of Anesthesiology or is eligible to take that
 1008  board’s examination, or is certified by the Board of
 1009  Certification in Anesthesiology affiliated with the American
 1010  Board of Physician Specialties American Association of Physician
 1011  Specialists.
 1012         Section 16. Section 486.112, Florida Statutes, is amended
 1013  to read:
 1014         486.112 Physical Therapy Licensure Compact.—The Physical
 1015  Therapy Licensure Compact is hereby enacted into law and entered
 1016  into by this state with all other jurisdictions legally joining
 1017  therein in the form substantially as follows:
 1018  
 1019                              ARTICLE I                            
 1020                       PURPOSE AND OBJECTIVES                      
 1021  
 1022         (1) The purpose of the compact is to facilitate interstate
 1023  practice of physical therapy with the goal of improving public
 1024  access to physical therapy services. The compact preserves the
 1025  regulatory authority of member states to protect public health
 1026  and safety through their current systems of state licensure. For
 1027  purposes of state regulation under the compact, the practice of
 1028  physical therapy is deemed to have occurred in the state where
 1029  the patient is located at the time physical therapy is provided
 1030  to the patient.
 1031         (2) The compact is designed to achieve all of the following
 1032  objectives:
 1033         (a) Increase public access to physical therapy services by
 1034  providing for the mutual recognition of other member state
 1035  licenses.
 1036         (b) Enhance the states’ ability to protect the public’s
 1037  health and safety.
 1038         (c) Encourage the cooperation of member states in
 1039  regulating multistate physical therapy practice.
 1040         (d) Support spouses of relocating military members.
 1041         (e) Enhance the exchange of licensure, investigative, and
 1042  disciplinary information between member states.
 1043         (f) Allow a remote state to hold a provider of services
 1044  with a compact privilege in that state accountable to that
 1045  state’s practice standards.
 1046  
 1047                             ARTICLE II                            
 1048                             DEFINITIONS                           
 1049  
 1050         As used in the compact, and except as otherwise provided,
 1051  the term:
 1052         (1) “Active duty military” means full-time duty status in
 1053  the active uniformed service of the United States, including
 1054  members of the National Guard and Reserve on active duty orders
 1055  pursuant to 10 U.S.C. chapter 1209 or chapter 1211.
 1056         (2) “Adverse action” means disciplinary action taken by a
 1057  physical therapy licensing board based upon misconduct,
 1058  unacceptable performance, or a combination of both.
 1059         (3) “Alternative program” means a nondisciplinary
 1060  monitoring or practice remediation process approved by a state’s
 1061  physical therapy licensing board. The term includes, but is not
 1062  limited to, programs that address substance abuse issues.
 1063         (4) “Compact privilege” means the authorization granted by
 1064  a remote state to allow a licensee from another member state to
 1065  practice as a physical therapist or physical therapist assistant
 1066  in the remote state under its laws and rules.
 1067         (5) “Continuing competence” means a requirement, as a
 1068  condition of license renewal, to provide evidence of
 1069  participation in, and completion of, educational and
 1070  professional activities relevant to the practice of physical
 1071  therapy.
 1072         (6) “Data system” means the coordinated database and
 1073  reporting system created by the Physical Therapy Compact
 1074  Commission for the exchange of information between member states
 1075  relating to licensees or applicants under the compact, including
 1076  identifying information, licensure data, investigative
 1077  information, adverse actions, nonconfidential information
 1078  related to alternative program participation, any denials of
 1079  applications for licensure, and other information as specified
 1080  by commission rule.
 1081         (7) “Encumbered license” means a license that a physical
 1082  therapy licensing board has limited in any way.
 1083         (8) “Executive board” means a group of directors elected or
 1084  appointed to act on behalf of, and within the powers granted to
 1085  them by, the commission.
 1086         (9) “Home state” means the member state that is the
 1087  licensee’s primary state of residence.
 1088         (10) “Investigative information” means information,
 1089  records, and documents received or generated by a physical
 1090  therapy licensing board pursuant to an investigation.
 1091         (11) “Jurisprudence requirement” means the assessment of an
 1092  individual’s knowledge of the laws and rules governing the
 1093  practice of physical therapy in a specific state.
 1094         (12) “Licensee” means an individual who currently holds an
 1095  authorization from a state to practice as a physical therapist
 1096  or physical therapist assistant.
 1097         (13) “Member state” means a state that has enacted the
 1098  compact.
 1099         (14) “Party state” means any member state in which a
 1100  licensee holds a current license or compact privilege or is
 1101  applying for a license or compact privilege.
 1102         (15) “Physical therapist” means an individual licensed by a
 1103  state to practice physical therapy.
 1104         (16)(15) “Physical therapist assistant” means an individual
 1105  licensed by a state to assist a physical therapist in specified
 1106  areas of physical therapy.
 1107         (17)(16) “Physical therapy” or “the practice of physical
 1108  therapy” means the care and services provided by or under the
 1109  direction and supervision of a licensed physical therapist.
 1110         (18)(17) “Physical Therapy Compact Commission” or
 1111  “commission” means the national administrative body whose
 1112  membership consists of all states that have enacted the compact.
 1113         (19)(18) “Physical therapy licensing board” means the
 1114  agency of a state which is responsible for the licensing and
 1115  regulation of physical therapists and physical therapist
 1116  assistants.
 1117         (20)(19) “Remote state” means a member state other than the
 1118  home state where a licensee is exercising or seeking to exercise
 1119  the compact privilege.
 1120         (21)(20) “Rule” means a regulation, principle, or directive
 1121  adopted by the commission which has the force of law.
 1122         (22)(21) “State” means any state, commonwealth, district,
 1123  or territory of the United States of America which regulates the
 1124  practice of physical therapy.
 1125  
 1126                             ARTICLE III                           
 1127                 STATE PARTICIPATION IN THE COMPACT                
 1128  
 1129         (1) To participate in the compact, a state must do all of
 1130  the following:
 1131         (a) Participate fully in the commission’s data system,
 1132  including using the commission’s unique identifier, as defined
 1133  by commission rule.
 1134         (b) Have a mechanism in place for receiving and
 1135  investigating complaints about licensees.
 1136         (c) Notify the commission, in accordance with the terms of
 1137  the compact and rules, of any adverse action or the availability
 1138  of investigative information regarding a licensee.
 1139         (d) Fully implement a criminal background check
 1140  requirement, within a timeframe established by commission rule,
 1141  which uses results from the Federal Bureau of Investigation
 1142  record search on criminal background checks to make licensure
 1143  decisions in accordance with subsection (2).
 1144         (e) Comply with the commission’s rules.
 1145         (f) Use a recognized national examination as a requirement
 1146  for licensure pursuant to the commission’s rules.
 1147         (g) Have continuing competence requirements as a condition
 1148  for license renewal.
 1149         (2) Upon adoption of the compact, a member state has the
 1150  authority to obtain biometric-based information from each
 1151  licensee applying for a compact privilege and submit this
 1152  information to the Federal Bureau of Investigation for a
 1153  criminal background check in accordance with 28 U.S.C. s. 534
 1154  and 34 U.S.C. s. 40316.
 1155         (3) A member state must grant the compact privilege to a
 1156  licensee holding a valid unencumbered license in another member
 1157  state in accordance with the terms of the compact and rules.
 1158  
 1159                             ARTICLE IV                            
 1160                          COMPACT PRIVILEGE                        
 1161  
 1162         (1) To exercise the compact privilege under the compact, a
 1163  licensee must satisfy all of the following conditions:
 1164         (a) Hold a license in the home state.
 1165         (b) Not have an encumbrance on any state license.
 1166         (c) Be eligible for a compact privilege in all member
 1167  states in accordance with subsections (4), (7), and (8).
 1168         (d) Not have had an adverse action against any license or
 1169  compact privilege within the preceding 2 years.
 1170         (e) Notify the commission that the licensee is seeking the
 1171  compact privilege within a remote state.
 1172         (f) Meet any jurisprudence requirements established by the
 1173  remote state in which the licensee is seeking a compact
 1174  privilege.
 1175         (g) Report to the commission adverse action taken by any
 1176  nonmember state within 30 days after the date the adverse action
 1177  is taken.
 1178         (2) The compact privilege is valid until the expiration
 1179  date of the home license. The licensee must continue to meet the
 1180  requirements of subsection (1) to maintain the compact privilege
 1181  in a remote state.
 1182         (3) A licensee providing physical therapy in a remote state
 1183  under the compact privilege must comply with the laws and rules
 1184  of the remote state.
 1185         (4) A licensee providing physical therapy in a remote state
 1186  is subject to that state’s regulatory authority. A remote state
 1187  may, in accordance with due process and that state’s laws,
 1188  remove a licensee’s compact privilege in the remote state for a
 1189  specific period of time, impose fines, and take any other
 1190  necessary actions to protect the health and safety of its
 1191  citizens. The licensee is not eligible for a compact privilege
 1192  in any member state until the specific period of time for
 1193  removal has ended and all fines are paid.
 1194         (5) If a home state license is encumbered, the licensee
 1195  loses the compact privilege in any remote state until the
 1196  following conditions are met:
 1197         (a) The home state license is no longer encumbered.
 1198         (b) Two years have elapsed from the date of the adverse
 1199  action.
 1200         (6) Once an encumbered license in the home state is
 1201  restored to good standing, the licensee must meet the
 1202  requirements of subsection (1) to obtain a compact privilege in
 1203  any remote state.
 1204         (7) If a licensee’s compact privilege in any remote state
 1205  is removed, the licensee loses the compact privilege in all
 1206  remote states until all of the following conditions are met:
 1207         (a) The specific period of time for which the compact
 1208  privilege was removed has ended.
 1209         (b) All fines have been paid.
 1210         (c) Two years have elapsed from the date of the adverse
 1211  action.
 1212         (8) Once the requirements of subsection (7) have been met,
 1213  the licensee must meet the requirements of subsection (1) to
 1214  obtain a compact privilege in a remote state.
 1215  
 1216                              ARTICLE V                            
 1217                   ACTIVE DUTY MILITARY PERSONNEL                  
 1218                          AND THEIR SPOUSES                        
 1219  
 1220         A licensee who is active duty military or is the spouse of
 1221  an individual who is active duty military may choose any of the
 1222  following locations to designate his or her home state:
 1223         (1) Home of record.
 1224         (2) Permanent change of station location.
 1225         (3) State of current residence, if it is different from the
 1226  home of record or permanent change of station location.
 1227  
 1228                             ARTICLE VI                            
 1229                           ADVERSE ACTIONS                         
 1230  
 1231         (1) A home state has exclusive power to impose adverse
 1232  action against a license issued by the home state.
 1233         (2) A home state may take adverse action based on the
 1234  investigative information of a remote state, so long as the home
 1235  state follows its own procedures for imposing adverse action.
 1236         (3) The compact does not override a member state’s decision
 1237  that participation in an alternative program may be used in lieu
 1238  of adverse action and that such participation remain nonpublic
 1239  if required by the member state’s laws. Member states must
 1240  require licensees who enter any alternative programs in lieu of
 1241  discipline to agree not to practice in any other member state
 1242  during the term of the alternative program without prior
 1243  authorization from such other member state.
 1244         (4) A member state may investigate actual or alleged
 1245  violations of the laws and rules for the practice of physical
 1246  therapy committed in any other member state by a physical
 1247  therapist or physical therapist assistant practicing under the
 1248  compact who holds a license or compact privilege in such other
 1249  member state.
 1250         (5) A remote state may do any of the following:
 1251         (a) Take adverse actions as set forth in subsection (4) of
 1252  Article IV against a licensee’s compact privilege in the state.
 1253         (b) Issue subpoenas for both hearings and investigations
 1254  which require the attendance and testimony of witnesses and the
 1255  production of evidence. Subpoenas issued by a physical therapy
 1256  licensing board in a party member state for the attendance and
 1257  testimony of witnesses or for the production of evidence from
 1258  another party member state must be enforced in the latter state
 1259  by any court of competent jurisdiction, according to the
 1260  practice and procedure of that court applicable to subpoenas
 1261  issued in proceedings pending before it. The issuing authority
 1262  shall pay any witness fees, travel expenses, mileage, and other
 1263  fees required by the service laws of the state where the
 1264  witnesses or evidence is located.
 1265         (c) If otherwise permitted by state law, recover from the
 1266  licensee the costs of investigations and disposition of cases
 1267  resulting from any adverse action taken against that licensee.
 1268         (6)(a) In addition to the authority granted to a member
 1269  state by its respective physical therapy practice act or other
 1270  applicable state law, a member state may participate with other
 1271  member states in joint investigations of licensees.
 1272         (b) Member states shall share any investigative,
 1273  litigation, or compliance materials in furtherance of any joint
 1274  or individual investigation initiated under the compact.
 1275  
 1276                             ARTICLE VII                           
 1277                        ESTABLISHMENT OF THE                       
 1278                 PHYSICAL THERAPY COMPACT COMMISSION               
 1279  
 1280         (1) COMMISSION CREATED.—The member states hereby create and
 1281  establish a joint public agency known as the Physical Therapy
 1282  Compact Commission:
 1283         (a) The commission is an instrumentality of the member
 1284  states.
 1285         (b) Venue is proper, and judicial proceedings by or against
 1286  the commission must be brought solely and exclusively, in a
 1287  court of competent jurisdiction where the principal office of
 1288  the commission is located. The commission may waive venue and
 1289  jurisdictional defenses to the extent it adopts or consents to
 1290  participate in alternative dispute resolution proceedings.
 1291         (c) The compact may not be construed to be a waiver of
 1292  sovereign immunity.
 1293         (2) MEMBERSHIP, VOTING, AND MEETINGS.—
 1294         (a) Each member state has and is limited to one delegate
 1295  selected by that member state’s physical therapy licensing board
 1296  to serve on the commission. The delegate must be a current
 1297  member of the physical therapy licensing board who is a physical
 1298  therapist, a physical therapist assistant, a public member, or
 1299  the board administrator.
 1300         (b) A delegate may be removed or suspended from office as
 1301  provided by the law of the state from which the delegate is
 1302  appointed. Any vacancy occurring on the commission must be
 1303  filled by the physical therapy licensing board of the member
 1304  state for which the vacancy exists.
 1305         (c) Each delegate is entitled to one vote with regard to
 1306  the adoption of rules and bylaws and shall otherwise have an
 1307  opportunity to participate in the business and affairs of the
 1308  commission.
 1309         (d) A delegate shall vote in person or by such other means
 1310  as provided in the bylaws. The bylaws may provide for delegates’
 1311  participation in meetings by telephone or other means of
 1312  communication.
 1313         (e) The commission shall meet at least once during each
 1314  calendar year. Additional meetings may be held as set forth in
 1315  the bylaws.
 1316         (f) All meetings must be open to the public, and public
 1317  notice of meetings must be given in the same manner as required
 1318  under the rulemaking provisions in Article IX.
 1319         (g) The commission or the executive board or other
 1320  committees of the commission may convene in a closed, nonpublic
 1321  meeting if the commission or executive board or other committees
 1322  of the commission must discuss any of the following:
 1323         1. Noncompliance of a member state with its obligations
 1324  under the compact.
 1325         2. The employment, compensation, or discipline of, or other
 1326  matters, practices, or procedures related to, specific employees
 1327  or other matters related to the commission’s internal personnel
 1328  practices and procedures.
 1329         3. Current, threatened, or reasonably anticipated
 1330  litigation against the commission, executive board, or other
 1331  committees of the commission.
 1332         4. Negotiation of contracts for the purchase, lease, or
 1333  sale of goods, services, or real estate.
 1334         5. An accusation of any person of a crime or a formal
 1335  censure of any person.
 1336         6. Information disclosing trade secrets or commercial or
 1337  financial information that is privileged or confidential.
 1338         7. Information of a personal nature where disclosure would
 1339  constitute a clearly unwarranted invasion of personal privacy.
 1340         8. Investigatory records compiled for law enforcement
 1341  purposes.
 1342         9. Information related to any investigative reports
 1343  prepared by or on behalf of or for use of the commission or
 1344  other committee charged with responsibility for investigation or
 1345  determination of compliance issues pursuant to the compact.
 1346         10. Matters specifically exempted from disclosure by
 1347  federal or member state statute.
 1348         (h) If a meeting, or portion of a meeting, is closed
 1349  pursuant to this subsection, the commission’s legal counsel or
 1350  designee must certify that the meeting may be closed and must
 1351  reference each relevant exempting provision.
 1352         (i) The commission shall keep minutes that fully and
 1353  clearly describe all matters discussed in a meeting and shall
 1354  provide a full and accurate summary of actions taken and the
 1355  reasons therefor, including a description of the views
 1356  expressed. All documents considered in connection with an action
 1357  must be identified in the minutes. All minutes and documents of
 1358  a closed meeting must remain under seal, subject to release only
 1359  by a majority vote of the commission or order of a court of
 1360  competent jurisdiction.
 1361         (3) DUTIES.—The commission shall do all of the following:
 1362         (a) Establish the fiscal year of the commission.
 1363         (b) Establish bylaws.
 1364         (c) Maintain its financial records in accordance with the
 1365  bylaws.
 1366         (d) Meet and take such actions as are consistent with the
 1367  provisions of the compact and the bylaws.
 1368         (4) POWERS.—The commission may do any of the following:
 1369         (a) Adopt uniform rules to facilitate and coordinate
 1370  implementation and administration of the compact. The rules have
 1371  the force and effect of law and are binding in all member
 1372  states.
 1373         (b) Bring and prosecute legal proceedings or actions in the
 1374  name of the commission, provided that the standing of any state
 1375  physical therapy licensing board to sue or be sued under
 1376  applicable law is not affected.
 1377         (c) Purchase and maintain insurance and bonds.
 1378         (d) Borrow, accept, or contract for services of personnel,
 1379  including, but not limited to, employees of a member state.
 1380         (e) Hire employees and elect or appoint officers; fix the
 1381  compensation of, define the duties of, and grant appropriate
 1382  authority to such individuals to carry out the purposes of the
 1383  compact; and establish the commission’s personnel policies and
 1384  programs relating to conflicts of interest, qualifications of
 1385  personnel, and other related personnel matters.
 1386         (f) Accept any appropriate donations and grants of money,
 1387  equipment, supplies, materials, and services and receive, use,
 1388  and dispose of the same, provided that at all times the
 1389  commission avoids any appearance of impropriety or conflict of
 1390  interest.
 1391         (g) Lease, purchase, accept appropriate gifts or donations
 1392  of, or otherwise own, hold, improve, or use any property, real,
 1393  personal, or mixed, provided that at all times the commission
 1394  avoids any appearance of impropriety or conflict of interest.
 1395         (h) Sell, convey, mortgage, pledge, lease, exchange,
 1396  abandon, or otherwise dispose of any property, real, personal,
 1397  or mixed.
 1398         (i) Establish a budget and make expenditures.
 1399         (j) Borrow money.
 1400         (k) Appoint committees, including standing committees
 1401  composed of members, state regulators, state legislators or
 1402  their representatives, and consumer representatives, and such
 1403  other interested persons as may be designated in the compact and
 1404  the bylaws.
 1405         (l) Provide information to, receive information from, and
 1406  cooperate with law enforcement agencies.
 1407         (m) Establish and elect an executive board.
 1408         (n) Perform such other functions as may be necessary or
 1409  appropriate to achieve the purposes of the compact consistent
 1410  with the state regulation of physical therapy licensure and
 1411  practice.
 1412         (5) THE EXECUTIVE BOARD.—
 1413         (a) The executive board may act on behalf of the commission
 1414  according to the terms of the compact.
 1415         (b) The executive board shall be composed of the following
 1416  nine members:
 1417         1. Seven voting members who are elected by the commission
 1418  from the current membership of the commission.
 1419         2. One ex officio, nonvoting member from the recognized
 1420  national physical therapy professional association.
 1421         3. One ex officio, nonvoting member from the recognized
 1422  membership organization of the physical therapy licensing
 1423  boards.
 1424         (c) The ex officio members shall be selected by their
 1425  respective organizations.
 1426         (d) The commission may remove any member of the executive
 1427  board as provided in its bylaws.
 1428         (e) The executive board shall meet at least annually.
 1429         (f) The executive board shall do all of the following:
 1430         1. Recommend to the entire commission changes to the rules
 1431  or bylaws, compact legislation, fees paid by compact member
 1432  states, such as annual dues, and any commission compact fee
 1433  charged to licensees for the compact privilege.
 1434         2. Ensure compact administration services are appropriately
 1435  provided, contractually or otherwise.
 1436         3. Prepare and recommend the budget.
 1437         4. Maintain financial records on behalf of the commission.
 1438         5. Monitor compact compliance of member states and provide
 1439  compliance reports to the commission.
 1440         6. Establish additional committees as necessary.
 1441         7. Perform other duties as provided in the rules or bylaws.
 1442         (6) FINANCING OF THE COMMISSION.—
 1443         (a) The commission shall pay, or provide for the payment
 1444  of, the reasonable expenses of its establishment, organization,
 1445  and ongoing activities.
 1446         (b) The commission may accept any appropriate revenue
 1447  sources, donations, and grants of money, equipment, supplies,
 1448  materials, and services.
 1449         (c) The commission may levy and collect an annual
 1450  assessment from each member state or impose fees on other
 1451  parties to cover the cost of the operations and activities of
 1452  the commission and its staff. Such assessments and fees must
 1453  total to an amount sufficient to cover the commission’s annual
 1454  budget as approved each year for which revenue is not provided
 1455  by other sources. The aggregate annual assessment amount must be
 1456  allocated based upon a formula to be determined by the
 1457  commission, which shall adopt a rule binding upon all member
 1458  states.
 1459         (d) The commission may not incur obligations of any kind
 1460  before securing the funds adequate to meet such obligations; nor
 1461  may the commission pledge the credit of any of the member
 1462  states, except by and with the authority of the member state.
 1463         (e) The commission shall keep accurate accounts of all
 1464  receipts and disbursements. The receipts and disbursements of
 1465  the commission are subject to the audit and accounting
 1466  procedures established under its bylaws. However, all receipts
 1467  and disbursements of funds handled by the commission must be
 1468  audited yearly by a certified or licensed public accountant, and
 1469  the report of the audit must be included in and become part of
 1470  the annual report of the commission.
 1471         (7) QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION.—
 1472         (a) The members, officers, executive director, employees,
 1473  and representatives of the commission are immune from suit and
 1474  liability, whether personally or in their official capacity, for
 1475  any claim for damage to or loss of property or personal injury
 1476  or other civil liability caused by or arising out of any actual
 1477  or alleged act, error, or omission that occurred, or that the
 1478  person against whom the claim is made had a reasonable basis for
 1479  believing occurred, within the scope of commission employment,
 1480  duties, or responsibilities. However, this paragraph may not be
 1481  construed to protect any such person from suit or liability for
 1482  any damage, loss, injury, or liability caused by the
 1483  intentional, willful, or wanton misconduct of that person.
 1484         (b) The commission shall defend any member, officer,
 1485  executive director, employee, or representative of the
 1486  commission in any civil action seeking to impose liability
 1487  arising out of any actual or alleged act, error, or omission
 1488  that occurred within the scope of commission employment, duties,
 1489  or responsibilities, or that the person against whom the claim
 1490  is made had a reasonable basis for believing occurred within the
 1491  scope of commission employment, duties, or responsibilities.
 1492  However, this subsection may not be construed to prohibit any
 1493  member, officer, executive director, employee, or representative
 1494  of the commission from retaining his or her own counsel or to
 1495  require the commission to defend such person if the actual or
 1496  alleged act, error, or omission resulted from that person’s
 1497  intentional, willful, or wanton misconduct.
 1498         (c) The commission shall indemnify and hold harmless any
 1499  member, officer, executive director, employee, or representative
 1500  of the commission for the amount of any settlement or judgment
 1501  obtained against that person arising out of any actual or
 1502  alleged act, error, or omission that occurred within the scope
 1503  of commission employment, duties, or responsibilities, or that
 1504  such person had a reasonable basis for believing occurred within
 1505  the scope of commission employment, duties, or responsibilities,
 1506  provided that the actual or alleged act, error, or omission did
 1507  not result from the intentional, willful, or wanton misconduct
 1508  of that person.
 1509  
 1510                            ARTICLE VIII                           
 1511                             DATA SYSTEM                           
 1512  
 1513         (1) The commission shall provide for the development,
 1514  maintenance, and use of a coordinated database and reporting
 1515  system containing licensure, adverse action, and investigative
 1516  information on all licensees in member states.
 1517         (2) Notwithstanding any other provision of state law to the
 1518  contrary, a member state shall submit a uniform data set to the
 1519  data system on all individuals to whom the compact is applicable
 1520  as required by the rules of the commission, which data set must
 1521  include all of the following:
 1522         (a) Identifying information.
 1523         (b) Licensure data.
 1524         (c) Investigative information.
 1525         (d) Adverse actions against a license or compact privilege.
 1526         (e) Nonconfidential information related to alternative
 1527  program participation.
 1528         (f) Any denial of application for licensure, and the reason
 1529  for such denial.
 1530         (g) Other information that may facilitate the
 1531  administration of the compact, as determined by the rules of the
 1532  commission.
 1533         (3) Investigative information in the system pertaining to a
 1534  licensee in any member state must be available only to other
 1535  party member states.
 1536         (4) The commission shall promptly notify all member states
 1537  of any adverse action taken against a licensee or an individual
 1538  applying for a license in a member state. Adverse action
 1539  information pertaining to a licensee in any member state must be
 1540  available to all other member states.
 1541         (5) Member states contributing information to the data
 1542  system may designate information that may not be shared with the
 1543  public without the express permission of the contributing state.
 1544         (6) Any information submitted to the data system which is
 1545  subsequently required to be expunged by the laws of the member
 1546  state contributing the information must be removed from the data
 1547  system.
 1548  
 1549                             ARTICLE IX                            
 1550                             RULEMAKING                            
 1551  
 1552         (1) The commission shall exercise its rulemaking powers
 1553  pursuant to the criteria set forth in this article and the rules
 1554  adopted thereunder. Rules and amendments become binding as of
 1555  the date specified in each rule or amendment.
 1556         (2) If a majority of the legislatures of the member states
 1557  rejects a rule by enactment of a statute or resolution in the
 1558  same manner used to adopt the compact within 4 years after the
 1559  date of adoption of the rule, such rule does not have further
 1560  force and effect in any member state.
 1561         (3) Rules or amendments to the rules must be adopted at a
 1562  regular or special meeting of the commission.
 1563         (4) Before adoption of a final rule by the commission, and
 1564  at least 30 days before the meeting at which the rule will be
 1565  considered and voted upon, the commission must file a notice of
 1566  proposed rulemaking on all of the following:
 1567         (a) The website of the commission or another publicly
 1568  accessible platform.
 1569         (b) The website of each member state physical therapy
 1570  licensing board or another publicly accessible platform or the
 1571  publication in which each state would otherwise publish proposed
 1572  rules.
 1573         (5) The notice of proposed rulemaking must include all of
 1574  the following:
 1575         (a) The proposed date, time, and location of the meeting in
 1576  which the rule or amendment will be considered and voted upon.
 1577         (b) The text of the proposed rule or amendment and the
 1578  reason for the proposed rule.
 1579         (c) A request for comments on the proposed rule or
 1580  amendment from any interested person.
 1581         (d) The manner in which interested persons may submit
 1582  notice to the commission of their intention to attend the public
 1583  hearing and any written comments.
 1584         (6) Before adoption of a proposed rule or amendment, the
 1585  commission must allow persons to submit written data, facts,
 1586  opinions, and arguments, which must be made available to the
 1587  public.
 1588         (7) The commission must grant an opportunity for a public
 1589  hearing before it adopts a rule or an amendment if a hearing is
 1590  requested by any of the following:
 1591         (a) At least 25 persons.
 1592         (b) A state or federal governmental subdivision or agency.
 1593         (c) An association having at least 25 members.
 1594         (8) If a scheduled public hearing is held on the proposed
 1595  rule or amendment, the commission must publish the date, time,
 1596  and location of the hearing. If the hearing is held through
 1597  electronic means, the commission must publish the mechanism for
 1598  access to the electronic hearing.
 1599         (a) All persons wishing to be heard at the hearing must
 1600  notify the executive director of the commission or another
 1601  designated member in writing of their desire to appear and
 1602  testify at the hearing at least 5 business days before the
 1603  scheduled date of the hearing.
 1604         (b) Hearings must be conducted in a manner providing each
 1605  person who wishes to comment a fair and reasonable opportunity
 1606  to comment orally or in writing.
 1607         (c) All hearings must be recorded. A copy of the recording
 1608  must be made available on request.
 1609         (d) This article may not be construed to require a separate
 1610  hearing on each rule. Rules may be grouped for the convenience
 1611  of the commission at hearings required by this article.
 1612         (9) Following the scheduled hearing date, or by the close
 1613  of business on the scheduled hearing date if the hearing was not
 1614  held, the commission shall consider all written and oral
 1615  comments received.
 1616         (10) If no written notice of intent to attend the public
 1617  hearing by interested parties is received, the commission may
 1618  proceed with adoption of the proposed rule without a public
 1619  hearing.
 1620         (11) The commission shall, by majority vote of all members,
 1621  take final action on the proposed rule and shall determine the
 1622  effective date of the rule, if any, based on the rulemaking
 1623  record and the full text of the rule.
 1624         (12) Upon determination that an emergency exists, the
 1625  commission may consider and adopt an emergency rule without
 1626  prior notice, opportunity for comment, or hearing, provided that
 1627  the usual rulemaking procedures provided in the compact and in
 1628  this article are retroactively applied to the rule as soon as
 1629  reasonably possible, in no event later than 90 days after the
 1630  effective date of the rule. For the purposes of this subsection,
 1631  an emergency rule is one that must be adopted immediately in
 1632  order to do any of the following:
 1633         (a) Meet an imminent threat to public health, safety, or
 1634  welfare.
 1635         (b) Prevent a loss of commission or member state funds.
 1636         (c) Meet a deadline for the adoption of an administrative
 1637  rule established by federal law or rule.
 1638         (d) Protect public health and safety.
 1639         (13) The commission or an authorized committee of the
 1640  commission may direct revisions to a previously adopted rule or
 1641  amendment for purposes of correcting typographical errors,
 1642  errors in format, errors in consistency, or grammatical errors.
 1643  Public notice of any revisions must be posted on the website of
 1644  the commission. The revision is subject to challenge by any
 1645  person for a period of 30 days after posting. The revision may
 1646  be challenged only on grounds that the revision results in a
 1647  material change to a rule. A challenge must be made in writing
 1648  and delivered to the chair of the commission before the end of
 1649  the notice period. If a challenge is not made, the revision
 1650  takes effect without further action. If the revision is
 1651  challenged, the revision may not take effect without the
 1652  approval of the commission.
 1653  
 1654                              ARTICLE X                            
 1655                   OVERSIGHT, DISPUTE RESOLUTION,                  
 1656                           AND ENFORCEMENT                         
 1657  
 1658         (1) OVERSIGHT.—
 1659         (a) The executive, legislative, and judicial branches of
 1660  state government in each member state shall enforce the compact
 1661  and take all actions necessary and appropriate to carry out the
 1662  compact’s purposes and intent. The provisions of the compact and
 1663  the rules adopted pursuant thereto shall have standing as
 1664  statutory law.
 1665         (b) All courts shall take judicial notice of the compact
 1666  and the rules in any judicial or administrative proceeding in a
 1667  member state pertaining to the subject matter of the compact
 1668  which may affect the powers, responsibilities, or actions of the
 1669  commission.
 1670         (c) The commission is entitled to receive service of
 1671  process in any such proceeding and has standing to intervene in
 1672  such a proceeding for all purposes. Failure to provide service
 1673  of process to the commission renders a judgment or an order void
 1674  as to the commission, the compact, or the adopted rules.
 1675         (2) DEFAULT, TECHNICAL ASSISTANCE, AND TERMINATION.—
 1676         (a) If the commission determines that a member state has
 1677  defaulted in the performance of its obligations or
 1678  responsibilities under the compact or the adopted rules, the
 1679  commission must do all of the following:
 1680         1. Provide written notice to the defaulting state and other
 1681  member states of the nature of the default, the proposed means
 1682  of curing the default, and any other action to be taken by the
 1683  commission.
 1684         2. Provide remedial training and specific technical
 1685  assistance regarding the default.
 1686         (b) If a state in default fails to cure the default, the
 1687  defaulting state may be terminated from the compact upon an
 1688  affirmative vote of a majority of the member states, and all
 1689  rights, privileges, and benefits conferred by the compact may be
 1690  terminated on the effective date of termination. A cure of the
 1691  default does not relieve the offending state of obligations or
 1692  liabilities incurred during the period of default.
 1693         (c) Termination of membership in the compact may be imposed
 1694  only after all other means of securing compliance have been
 1695  exhausted. The commission shall give notice of intent to suspend
 1696  or terminate a defaulting member state to the governor and
 1697  majority and minority leaders of the defaulting state’s
 1698  legislature and to each of the member states.
 1699         (d) A state that has been terminated from the compact is
 1700  responsible for all assessments, obligations, and liabilities
 1701  incurred through the effective date of termination, including
 1702  obligations that extend beyond the effective date of
 1703  termination.
 1704         (e) The commission does not bear any costs related to a
 1705  state that is found to be in default or that has been terminated
 1706  from the compact, unless agreed upon in writing between the
 1707  commission and the defaulting state.
 1708         (f) The defaulting state may appeal the action of the
 1709  commission by petitioning the United States District Court for
 1710  the District of Columbia or the federal district where the
 1711  commission has its principal offices. The prevailing member
 1712  shall be awarded all costs of such litigation, including
 1713  reasonable attorney fees.
 1714         (3) DISPUTE RESOLUTION.—
 1715         (a) Upon request by a member state, the commission must
 1716  attempt to resolve disputes related to the compact which arise
 1717  among member states and between member and nonmember states.
 1718         (b) The commission shall adopt a rule providing for both
 1719  mediation and binding dispute resolution for disputes as
 1720  appropriate.
 1721         (4) ENFORCEMENT.—
 1722         (a) The commission, in the reasonable exercise of its
 1723  discretion, shall enforce the compact and the commission’s
 1724  rules.
 1725         (b) By majority vote, the commission may initiate legal
 1726  action in the United States District Court for the District of
 1727  Columbia or the federal district where the commission has its
 1728  principal offices against a member state in default to enforce
 1729  compliance with the provisions of the compact and its adopted
 1730  rules and bylaws. The relief sought may include both injunctive
 1731  relief and damages. In the event judicial enforcement is
 1732  necessary, the prevailing member shall be awarded all costs of
 1733  such litigation, including reasonable attorney fees.
 1734         (c) The remedies under this article are not the exclusive
 1735  remedies of the commission. The commission may pursue any other
 1736  remedies available under federal or state law.
 1737  
 1738                             ARTICLE XI                            
 1739                    DATE OF IMPLEMENTATION OF THE                  
 1740                      PHYSICAL THERAPY COMPACT                     
 1741                        AND ASSOCIATED RULES;                      
 1742                     WITHDRAWAL; AND AMENDMENTS                    
 1743  
 1744         (1) The compact becomes effective on the date that the
 1745  compact statute is enacted into law in the tenth member state.
 1746  The provisions that become effective at that time are limited to
 1747  the powers granted to the commission relating to assembly and
 1748  the adoption of rules. Thereafter, the commission shall meet and
 1749  exercise rulemaking powers necessary for the implementation and
 1750  administration of the compact.
 1751         (2) Any state that joins the compact subsequent to the
 1752  commission’s initial adoption of the rules is subject to the
 1753  rules as they exist on the date that the compact becomes law in
 1754  that state. Any rule that has been previously adopted by the
 1755  commission has the full force and effect of law on the day the
 1756  compact becomes law in that state.
 1757         (3) Any member state may withdraw from the compact by
 1758  enacting a statute repealing the same.
 1759         (a) A member state’s withdrawal does not take effect until
 1760  6 months after enactment of the repealing statute.
 1761         (b) Withdrawal does not affect the continuing requirement
 1762  of the withdrawing state’s physical therapy licensing board to
 1763  comply with the investigative and adverse action reporting
 1764  requirements of this act before the effective date of
 1765  withdrawal.
 1766         (4) The compact may not be construed to invalidate or
 1767  prevent any physical therapy licensure agreement or other
 1768  cooperative arrangement between a member state and a nonmember
 1769  state which does not conflict with the provisions of the
 1770  compact.
 1771         (5) The compact may be amended by the member states. An
 1772  amendment to the compact does not become effective and binding
 1773  upon any member state until it is enacted into the laws of all
 1774  member states.
 1775  
 1776                             ARTICLE XII                           
 1777                    CONSTRUCTION AND SEVERABILITY                  
 1778  
 1779         The compact must be liberally construed so as to carry out
 1780  the purposes thereof. The provisions of the compact are
 1781  severable, and if any phrase, clause, sentence, or provision of
 1782  the compact is declared to be contrary to the constitution of
 1783  any party member state or of the United States or the
 1784  applicability thereof to any government, agency, person, or
 1785  circumstance is held invalid, the validity of the remainder of
 1786  the compact and the applicability thereof to any government,
 1787  agency, person, or circumstance is not affected thereby. If the
 1788  compact is held contrary to the constitution of any party member
 1789  state, the compact remains in full force and effect as to the
 1790  remaining party member states and in full force and effect as to
 1791  the party member state affected as to all severable matters.
 1792         Section 17. Except as otherwise expressly provided in this
 1793  act and except for this section, which shall take effect upon
 1794  this act becoming a law, or, if this act fails to become a law
 1795  until after June 1, 2025, it shall take effect upon becoming a
 1796  law and shall operate retroactively to June 1, 2025, this act
 1797  shall take effect July 1, 2025.
 1798  
 1799  ================= T I T L E  A M E N D M E N T ================
 1800  And the title is amended as follows:
 1801         Delete everything before the enacting clause
 1802  and insert:
 1803                        A bill to be entitled                      
 1804         An act relating to the Department of Health; amending
 1805         chapter 2023-43, Laws of Florida; revising the repeal
 1806         date of the definition of the term “messenger
 1807         ribonucleic acid vaccine”; providing for contingent
 1808         retroactive operation; reenacting ss. 381.00316(2)(g)
 1809         and 381.00319(1)(e), F.S., relating to the prohibition
 1810         on discrimination by governmental and business
 1811         entities based on health care choices and the
 1812         prohibition on mask mandates and vaccination and
 1813         testing mandates for educational institutions,
 1814         respectively, for purposes of preserving the
 1815         definition of the term “messenger ribonucleic acid
 1816         vaccine,” notwithstanding its scheduled repeal;
 1817         amending s. 381.986, F.S.; defining terms for purposes
 1818         of background screening requirements for persons
 1819         affiliated with medical marijuana treatment centers;
 1820         requiring medical marijuana treatment centers to
 1821         notify the Department of Health through e-mail within
 1822         a specified timeframe after an actual or attempted
 1823         theft, diversion, or loss of marijuana; requiring
 1824         medical marijuana treatment centers to report
 1825         attempted thefts, in addition to actual thefts, to law
 1826         enforcement within a specified timeframe; amending s.
 1827         381.988, F.S.; defining terms for purposes of
 1828         background screening requirements for persons
 1829         affiliated with medical marijuana testing
 1830         laboratories; amending s. 456.0145, F.S.; revising
 1831         eligibility criteria for licensure by endorsement
 1832         under the MOBILE Act; amending s. 456.44, F.S.;
 1833         revising the definition of the term “board-certified
 1834         pain management physician” to replace the term
 1835         “American Association of Physician Specialists” with
 1836         “American Board of Physician Specialties”; making a
 1837         technical change; amending s. 458.313, F.S.; revising
 1838         the qualifications required for a person seeking
 1839         licensure by endorsement as an allopathic physician;
 1840         amending s. 458.3145, F.S.; revising the list of
 1841         institutions at which the department is authorized to
 1842         issue a medical faculty certificate to an individual
 1843         who has been offered and has accepted a full-time
 1844         faculty appointment; amending ss. 458.315 and
 1845         459.0076, F.S.; revising criteria authorizing
 1846         physician assistants to be issued temporary
 1847         certificates for practice in areas of critical need;
 1848         amending ss. 458.3265, 458.3475, 459.0137, and
 1849         459.023, F.S.; revising definitions to replace the
 1850         term “American Association of Physician Specialists”
 1851         with “American Board of Physician Specialties”;
 1852         amending s. 486.112, F.S.; defining the term “party
 1853         state”; authorizing a remote state to issue subpoenas
 1854         to individuals to testify or for the production of
 1855         evidence from a party located in a party state;
 1856         providing that such subpoenas are enforceable in the
 1857         party state; requiring that investigative information
 1858         pertaining to certain licensees in a certain system be
 1859         available only to other party states; revising
 1860         construction and severability of the compact to
 1861         conform to changes made by the act; providing
 1862         effective dates.