Bill Text: FL S0152 | 2016 | Regular Session | Comm Sub


Bill Title: Ordering of Medication

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2016-03-03 - Laid on Table, companion bill(s) passed, see HB 1241 (Ch. 2016-145) [S0152 Detail]

Download: Florida-2016-S0152-Comm_Sub.html
       Florida Senate - 2016                              CS for SB 152
       
       
        
       By the Committee on Appropriations; and Senator Grimsley
       
       576-04225A-16                                          2016152c1
    1                        A bill to be entitled                      
    2         An act relating to the ordering of medication;
    3         amending ss. 458.347 and 459.022, F.S.; revising the
    4         authority of a licensed physician assistant to order
    5         medication under the direction of a supervisory
    6         physician for a specified patient; authorizing a
    7         supervisory physician to delegate to a licensed
    8         physician assistant the authority to order medications
    9         for a patient at a licensed nursing home facility;
   10         amending s. 464.012, F.S.; authorizing an advanced
   11         registered nurse practitioner to order medication for
   12         administration to patients in specialized facilities;
   13         amending s. 465.003, F.S.; revising the term
   14         “prescription” to exclude an order for drugs or
   15         medicinal supplies dispensed for administration;
   16         amending s. 893.02, F.S.; revising the term
   17         “administer” to include the term “administration”;
   18         revising the term “prescription” to exclude an order
   19         for drugs or medicinal supplies dispensed for
   20         administration; amending s. 893.04, F.S.; conforming
   21         provisions to changes made by act; amending s. 893.05,
   22         F.S.; authorizing a licensed practitioner to authorize
   23         a licensed physician assistant or advanced registered
   24         nurse practitioner to order controlled substances for
   25         administration to patients in specified facilities
   26         under certain circumstances; reenacting ss.
   27         400.462(26), 401.445(1), 409.906(18), and 766.103(3),
   28         F.S., to incorporate the amendments made to ss.
   29         458.347 and 459.022, F.S., in references thereto;
   30         reenacting ss. 401.445(1) and 766.103(3), F.S., to
   31         incorporate the amendment made to s. 464.012, F.S., in
   32         references thereto; reenacting ss. 409.9201(1)(a),
   33         458.331(1)(pp), 459.015(1)(rr), 465.014(1),
   34         465.015(2)(c), 465.016(1)(s), 465.022(5)(j),
   35         465.023(1)(h), 465.1901, 499.003(43), and 831.30(1),
   36         F.S., to incorporate the amendment made to s. 465.003,
   37         F.S., in references thereto; reenacting ss.
   38         112.0455(5)(i), 381.986(7)(b), 440.102(1)(l),
   39         458.331(1)(pp), 459.015(1)(rr), 465.015(3),
   40         465.016(1)(s), 465.022(5)(j), 465.023(1)(h),
   41         499.0121(14), 768.36(1)(b), 810.02(3)(f),
   42         812.014(2)(c), 856.015(1)(c), 944.47(1)(a), 951.22(1),
   43         985.711(1)(a), 1003.57(1)(i), and 1006.09(8), F.S., to
   44         incorporate the amendment made to s. 893.02, F.S., in
   45         references thereto; reenacting s. 893.0551(3)(e),
   46         F.S., to incorporate the amendment made to s. 893.04,
   47         F.S., in a reference thereto; reenacting s.
   48         893.0551(3)(d), F.S., to incorporate the amendment
   49         made to s. 893.05, F.S., in a reference thereto;
   50         providing an effective date.
   51          
   52  Be It Enacted by the Legislature of the State of Florida:
   53  
   54         Section 1. Paragraph (g) of subsection (4) of section
   55  458.347, Florida Statutes, is amended to read:
   56         458.347 Physician assistants.—
   57         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   58         (g) A supervisory physician may delegate to a licensed
   59  physician assistant the authority to, and the licensed physician
   60  assistant acting under the direction of the supervisory
   61  physician may, order any medication medications for
   62  administration to the supervisory physician’s patient during his
   63  or her care in a facility licensed under chapter 395 or part II
   64  of chapter 400, notwithstanding any provisions in chapter 465 or
   65  chapter 893 which may prohibit this delegation. For the purpose
   66  of this paragraph, an order is not considered a prescription. A
   67  licensed physician assistant working in a facility that is
   68  licensed under chapter 395 or part II of chapter 400 may order
   69  any medication under the direction of the supervisory physician.
   70         Section 2. Paragraph (f) of subsection (4) of section
   71  459.022, Florida Statutes, is amended to read:
   72         459.022 Physician assistants.—
   73         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   74         (f) A supervisory physician may delegate to a licensed
   75  physician assistant the authority to, and the licensed physician
   76  assistant acting under the direction of the supervisory
   77  physician may, order any medication medications for
   78  administration to the supervisory physician’s patient during his
   79  or her care in a facility licensed under chapter 395 or part II
   80  of chapter 400, notwithstanding any provisions in chapter 465 or
   81  chapter 893 which may prohibit this delegation. For the purpose
   82  of this paragraph, an order is not considered a prescription. A
   83  licensed physician assistant working in a facility that is
   84  licensed under chapter 395 or part II of chapter 400 may order
   85  any medication under the direction of the supervisory physician.
   86         Section 3. Paragraph (a) of subsection (3) of section
   87  464.012, Florida Statutes, is amended to read:
   88         464.012 Certification of advanced registered nurse
   89  practitioners; fees.—
   90         (3) An advanced registered nurse practitioner shall perform
   91  those functions authorized in this section within the framework
   92  of an established protocol that is filed with the board upon
   93  biennial license renewal and within 30 days after entering into
   94  a supervisory relationship with a physician or changes to the
   95  protocol. The board shall review the protocol to ensure
   96  compliance with applicable regulatory standards for protocols.
   97  The board shall refer to the department licensees submitting
   98  protocols that are not compliant with the regulatory standards
   99  for protocols. A practitioner currently licensed under chapter
  100  458, chapter 459, or chapter 466 shall maintain supervision for
  101  directing the specific course of medical treatment. Within the
  102  established framework, an advanced registered nurse practitioner
  103  may:
  104         (a) Monitor and alter drug therapies and order any
  105  medication for administration to a patient in a facility
  106  licensed under chapter 395 or part II of chapter 400.
  107         Section 4. Subsection (14) of section 465.003, Florida
  108  Statutes, is amended to read:
  109         465.003 Definitions.—As used in this chapter, the term:
  110         (14) “Prescription” includes any order for drugs or
  111  medicinal supplies written or transmitted by any means of
  112  communication by a duly licensed practitioner authorized by the
  113  laws of this the state to prescribe such drugs or medicinal
  114  supplies and intended to be dispensed by a pharmacist, except
  115  for an order that is dispensed for administration. The term also
  116  includes an orally transmitted order by the lawfully designated
  117  agent of such practitioner;. The term also includes an order
  118  written or transmitted by a practitioner licensed to practice in
  119  a jurisdiction other than this state, but only if the pharmacist
  120  called upon to dispense such order determines, in the exercise
  121  of her or his professional judgment, that the order is valid and
  122  necessary for the treatment of a chronic or recurrent illness;
  123  and. The term “prescription” also includes a pharmacist’s order
  124  for a product selected from the formulary created pursuant to s.
  125  465.186. Prescriptions may be retained in written form or the
  126  pharmacist may cause them to be recorded in a data processing
  127  system, provided that such order can be produced in printed form
  128  upon lawful request.
  129         Section 5. Subsections (1) and (22) of section 893.02,
  130  Florida Statutes, are amended to read:
  131         893.02 Definitions.—The following words and phrases as used
  132  in this chapter shall have the following meanings, unless the
  133  context otherwise requires:
  134         (1) “Administer” or “administration” means the direct
  135  application of a controlled substance, whether by injection,
  136  inhalation, ingestion, or any other means, to the body of a
  137  person or animal.
  138         (22) “Prescription” means and includes any an order for
  139  drugs or medicinal supplies which is written, signed, or
  140  transmitted by any word of mouth, telephone, telegram, or other
  141  means of communication by a duly licensed practitioner
  142  authorized licensed by the laws of this the state to prescribe
  143  such drugs or medicinal supplies, is issued in good faith and in
  144  the course of professional practice, is intended to be filled,
  145  compounded, or dispensed by a another person authorized licensed
  146  by the laws of this the state to do so, and meets meeting the
  147  requirements of s. 893.04.
  148         (a) The term also includes an order for drugs or medicinal
  149  supplies so transmitted or written by a physician, dentist,
  150  veterinarian, or other practitioner licensed to practice in a
  151  state other than Florida, but only if the pharmacist called upon
  152  to fill such an order determines, in the exercise of his or her
  153  professional judgment, that the order was issued pursuant to a
  154  valid patient-physician relationship, that it is authentic, and
  155  that the drugs or medicinal supplies so ordered are considered
  156  necessary for the continuation of treatment of a chronic or
  157  recurrent illness.
  158         (b) The term does not include an order that is dispensed
  159  for administration by a licensed practitioner authorized by the
  160  laws of this state to administer such drugs or medicinal
  161  supplies.
  162         (c)However, If the physician writing the prescription is
  163  not known to the pharmacist, the pharmacist shall obtain proof
  164  to a reasonable certainty of the validity of the said
  165  prescription.
  166         (d) A prescription order for a controlled substance may
  167  shall not be issued on the same prescription blank with another
  168  prescription order for a controlled substance that which is
  169  named or described in a different schedule or with another, nor
  170  shall any prescription order for a controlled substance be
  171  issued on the same prescription blank as a prescription order
  172  for a medicinal drug, as defined in s. 465.003(8), that is which
  173  does not fall within the definition of a controlled substance as
  174  defined in this act.
  175         Section 6. Paragraphs (a), (d), and (f) of subsection (2)
  176  of section 893.04, Florida Statutes, are amended to read:
  177         893.04 Pharmacist and practitioner.—
  178         (2)(a) A pharmacist may not dispense a controlled substance
  179  listed in Schedule II, Schedule III, or Schedule IV to any
  180  patient or patient’s agent without first determining, in the
  181  exercise of her or his professional judgment, that the
  182  prescription order is valid. The pharmacist may dispense the
  183  controlled substance, in the exercise of her or his professional
  184  judgment, when the pharmacist or pharmacist’s agent has obtained
  185  satisfactory patient information from the patient or the
  186  patient’s agent.
  187         (d) Each written prescription written prescribed by a
  188  practitioner in this state for a controlled substance listed in
  189  Schedule II, Schedule III, or Schedule IV must include both a
  190  written and a numerical notation of the quantity of the
  191  controlled substance prescribed and a notation of the date in
  192  numerical, month/day/year format, or with the abbreviated month
  193  written out, or the month written out in whole. A pharmacist
  194  may, upon verification by the prescriber, document any
  195  information required by this paragraph. If the prescriber is not
  196  available to verify a prescription, the pharmacist may dispense
  197  the controlled substance, but may insist that the person to whom
  198  the controlled substance is dispensed provide valid photographic
  199  identification. If a prescription includes a numerical notation
  200  of the quantity of the controlled substance or date, but does
  201  not include the quantity or date written out in textual format,
  202  the pharmacist may dispense the controlled substance without
  203  verification by the prescriber of the quantity or date if the
  204  pharmacy previously dispensed another prescription for the
  205  person to whom the prescription was written.
  206         (f) A pharmacist may not knowingly dispense fill a
  207  prescription that has been forged for a controlled substance
  208  listed in Schedule II, Schedule III, or Schedule IV.
  209         Section 7. Subsection (1) of section 893.05, Florida
  210  Statutes, is amended to read:
  211         893.05 Practitioners and persons administering controlled
  212  substances in their absence.—
  213         (1)(a) A practitioner, in good faith and in the course of
  214  his or her professional practice only, may prescribe,
  215  administer, dispense, mix, or otherwise prepare a controlled
  216  substance, or the practitioner may cause the controlled
  217  substance same to be administered by a licensed nurse or an
  218  intern practitioner under his or her direction and supervision
  219  only.
  220         (b)Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
  221  464.012(3), as applicable, a practitioner who supervises a
  222  licensed physician assistant or advanced registered nurse
  223  practitioner may authorize the licensed physician assistant or
  224  advanced registered nurse practitioner to order controlled
  225  substances for administration to a patient in a facility
  226  licensed under chapter 395 or part II of chapter 400.
  227         (c) A veterinarian may so prescribe, administer, dispense,
  228  mix, or prepare a controlled substance for use on animals only,
  229  and may cause the controlled substance it to be administered by
  230  an assistant or orderly only under the veterinarian’s direction
  231  and supervision only.
  232         (d) A certified optometrist licensed under chapter 463 may
  233  not administer or prescribe a controlled substance listed in
  234  Schedule I or Schedule II of s. 893.03.
  235         Section 8. Subsection (26) of s. 400.462, subsection (1) of
  236  s. 401.445, subsection (18) of s. 409.906, and subsection (3) of
  237  s. 766.103, Florida Statutes, are reenacted for the purpose of
  238  incorporating the amendments made by this act to ss. 458.347 and
  239  459.022, Florida Statutes, in references thereto.
  240         Section 9. Subsection (1) of s. 401.445 and subsection (3)
  241  of s. 766.103, Florida Statutes, are reenacted for the purpose
  242  of incorporating the amendment made by this act to s. 464.012,
  243  Florida Statutes, in references thereto.
  244         Section 10. Paragraph (a) of subsection (1) of s. 409.9201,
  245  paragraph (pp) of subsection (1) of s. 458.331, paragraph (rr)
  246  of subsection (1) of s. 459.015, subsection (1) of s. 465.014,
  247  paragraph (c) of subsection (2) of s. 465.015, paragraph (s) of
  248  subsection (1) of s. 465.016, paragraph (j) of subsection (5) of
  249  s. 465.022, paragraph (h) of subsection (1) of s. 465.023, s.
  250  465.1901, subsection (43) of s. 499.003, and subsection (1) of
  251  s. 831.30, Florida Statutes, are reenacted for the purpose of
  252  incorporating the amendments made by this act to s. 465.003,
  253  Florida Statutes, in references thereto.
  254         Section 11. Paragraph (i) of subsection (5) of s. 112.0455,
  255  paragraph (b) of subsection (7) of s. 381.986, paragraph (l) of
  256  subsection (1) of s. 440.102, paragraph (pp) of subsection (1)
  257  of s. 458.331, paragraph (rr) of subsection (1) of s. 459.015,
  258  subsection (3) of s. 465.015, paragraph (s) of subsection (1) of
  259  s. 465.016, paragraph (j) of subsection (5) of s. 465.022,
  260  paragraph (h) of subsection (1) of s. 465.023, subsection (14)
  261  of s. 499.0121, paragraph (b) of subsection (1) of s. 768.36,
  262  paragraph (f) of subsection (3) of s. 810.02, paragraph (c) of
  263  subsection (2) of s. 812.014, paragraph (c) of subsection (1) of
  264  s. 856.015, paragraph (a) of subsection (1) of s. 944.47,
  265  subsection (1) of s. 951.22, paragraph (a) of subsection (1) of
  266  s. 985.711, paragraph (i) of subsection (1) of s. 1003.57, and
  267  subsection (8) of s. 1006.09, Florida Statutes, are reenacted
  268  for the purpose of incorporating the amendments made by this act
  269  to s. 893.02, Florida Statutes, in references thereto.
  270         Section 12. Paragraph (e) of subsection (3) of s. 893.0551,
  271  Florida Statutes, is reenacted for the purpose of incorporating
  272  the amendments made by this act to s. 893.04, Florida Statutes,
  273  in a reference thereto.
  274         Section 13. Paragraph (d) of subsection (3) of s. 893.0551,
  275  Florida Statutes, is reenacted for the purpose of incorporating
  276  the amendments made by this act to s. 893.05, Florida Statutes,
  277  in a reference thereto.
  278         Section 14. This act shall take effect July 1, 2016.

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