Bill Text: FL S0622 | 2018 | Regular Session | Enrolled


Bill Title: Health Care Facility Regulation

Spectrum:

Status: (Passed) 2018-03-21 - Chapter No. 2018-24 [S0622 Detail]

Download: Florida-2018-S0622-Enrolled.html
       ENROLLED
       2018 Legislature             CS for CS for SB 622, 2nd Engrossed
       
       
       
       
       
       
                                                              2018622er
    1  
    2         An act relating to health care facility regulation;
    3         creating s. 154.13, F.S.; providing that a designated
    4         facility owned or operated by a public health trust
    5         and located within the boundaries of a municipality is
    6         under the exclusive jurisdiction of the county
    7         creating the public health trust; amending ss.
    8         381.0031, 381.004, 384.31, 395.009, 400.0625, and
    9         409.905, F.S.; eliminating state licensure
   10         requirements for clinical laboratories; requiring
   11         clinical laboratories to be federally certified;
   12         amending s. 381.915, F.S.; increasing the number of
   13         years that a cancer center may participate in Tier 3
   14         of the Florida Consortium of National Cancer Institute
   15         Centers Program; increasing the number of years after
   16         qualification that a certain Tier 3 cancer center may
   17         pursue specified NCI designations; amending s.
   18         383.313, F.S.; requiring a birth center to be
   19         federally certified and meet specified requirements to
   20         perform certain laboratory tests; repealing s.
   21         383.335, F.S., relating to partial exemptions from
   22         licensure requirements for certain facilities that
   23         provide obstetrical and gynecological surgical
   24         services; amending s. 395.002, F.S.; revising and
   25         deleting definitions to remove the term “mobile
   26         surgical facility”; conforming a cross-reference;
   27         amending s. 395.003, F.S.; conforming provisions to
   28         changes made by the act; authorizing certain
   29         specialty-licensed children’s hospitals to provide
   30         obstetrical services under certain circumstances;
   31         creating s. 395.0091, F.S.; requiring the Agency for
   32         Health Care Administration, in consultation with the
   33         Board of Clinical Laboratory Personnel, to adopt rules
   34         establishing criteria for alternate-site laboratory
   35         testing; requiring specifications to be included in
   36         the criteria; defining the term “alternate-site
   37         testing”; amending ss. 395.0161 and 395.0163, F.S.;
   38         deleting licensure and inspection requirements for
   39         mobile surgical facilities to conform to changes made
   40         by the act; amending s. 395.0197, F.S.; requiring the
   41         manager of a hospital or ambulatory surgical center
   42         internal risk management program to demonstrate
   43         competence in specified administrative and health care
   44         service areas; conforming provisions to changes made
   45         by the act; repealing s. 395.1046, F.S., relating to
   46         hospital complaint investigation procedures; amending
   47         s. 395.1055, F.S.; requiring hospitals that provide
   48         specified services to meet agency licensure
   49         requirements; providing standards to be included in
   50         licensure requirements; conforming a provision to
   51         changes made by the act; requiring a level 2
   52         background screening for personnel of distinct part
   53         nursing units; requiring the agency to adopt rules
   54         establishing standards for pediatric cardiac
   55         catheterization and pediatric cardiovascular surgery
   56         programs; providing requirements for such programs;
   57         requiring pediatric cardiac programs to participate in
   58         the clinical outcome reporting systems; revising
   59         duties and membership of the pediatric cardiac
   60         technical advisory panel; repealing ss. 395.10971 and
   61         395.10972, F.S., relating to the purpose and the
   62         establishment of the Health Care Risk Manager Advisory
   63         Council, respectively; amending s. 395.10973, F.S.;
   64         removing requirements relating to agency standards for
   65         health care risk managers to conform provisions to
   66         changes made by the act; repealing s. 395.10974, F.S.,
   67         relating to licensure of health care risk managers,
   68         qualifications, licensure, and fees; repealing s.
   69         395.10975, F.S., relating to grounds for denial,
   70         suspension, or revocation of a health care risk
   71         manager’s license and an administrative fine; amending
   72         s. 395.602, F.S.; deleting definitions for the terms
   73         “emergency care hospital,” “essential access community
   74         hospital,” “inactive rural hospital bed,” and “rural
   75         primary care hospital”; amending s. 395.603, F.S.;
   76         deleting provisions relating to deactivation of
   77         general hospital beds by certain rural and emergency
   78         care hospitals; repealing s. 395.604, F.S., relating
   79         to other rural hospital programs; repealing s.
   80         395.605, F.S., relating to emergency care hospitals;
   81         amending s. 395.701, F.S.; revising the definition of
   82         the term “hospital” to exclude hospitals operated by a
   83         state agency; amending s. 400.191, F.S.; removing the
   84         30-month reporting timeframe for the Nursing Home
   85         Guide; amending s. 400.464, F.S.; requiring that a
   86         license issued to a home health agency on or after a
   87         specified date specify the services the organization
   88         is authorized to perform and whether the services
   89         constitute skilled care; providing that the provision
   90         or advertising of certain services constitutes
   91         unlicensed activity under certain circumstances;
   92         authorizing certain persons, entities or organizations
   93         providing home health services to voluntarily apply
   94         for a certificate of exemption from licensure by
   95         providing certain information to the agency; providing
   96         that the certificate is valid for a specified time and
   97         is nontransferable; authorizing the agency to charge a
   98         fee for the certificate; amending s. 400.471, F.S.;
   99         revising home health agency licensure requirements;
  100         providing requirements for proof of accreditation for
  101         home health agencies applying for change of ownership
  102         or the addition of skilled care services; removing a
  103         provision prohibiting the agency from issuing a
  104         license to a home health agency that fails to satisfy
  105         the requirements of a Medicare certification survey
  106         from the agency; amending s. 400.474, F.S.; revising
  107         conditions for the imposition of a fine against a home
  108         health agency; amending s. 400.476, F.S.; requiring a
  109         home health agency providing skilled nursing care to
  110         have a director of nursing; amending s. 400.484, F.S.;
  111         imposing administrative fines on home health agencies
  112         for specified classes of violations; amending s.
  113         400.497, F.S.; requiring the agency to adopt, publish,
  114         and enforce rules establishing standards for
  115         certificates of exemption; amending s. 400.506, F.S.;
  116         specifying a criminal penalty for any person who owns,
  117         operates, or maintains an unlicensed nurse registry
  118         that fails to cease operation immediately and apply
  119         for a license after notification from the agency;
  120         revising provisions authorizing the agency to impose a
  121         fine on a nurse registry that fails to cease operation
  122         after agency notification; revising circumstances
  123         under which the agency is authorized to deny, suspend,
  124         or revoke a license or impose a fine on a nurse
  125         registry; prohibiting a nurse registry from
  126         monitoring, supervising, managing, or training a
  127         certain caregiver who is an independent contractor;
  128         amending s. 400.606, F.S.; removing a requirement that
  129         an existing licensed health care provider’s hospice
  130         licensure application be accompanied by a copy of the
  131         most recent profit-loss statement and licensure
  132         inspection report; amending s. 400.925, F.S.; revising
  133         the definition of the term “home medical equipment”;
  134         amending s. 400.931, F.S.; requiring a home medical
  135         equipment provider to notify the agency of certain
  136         personnel changes within a specified timeframe;
  137         amending s. 400.933, F.S.; requiring the agency to
  138         accept the submission of a valid medical oxygen retail
  139         establishment permit issued by the Department of
  140         Business and Professional Regulation in lieu of an
  141         agency inspection for licensure; amending s. 400.980,
  142         F.S.; revising the timeframe within which a health
  143         care services pool registrant must provide the agency
  144         with certain changes of information; amending s.
  145         400.9935, F.S.; specifying that a voluntary
  146         certificate of exemption may be valid for up to 2
  147         years; amending s. 408.036, F.S.; conforming
  148         provisions to changes made by the act; deleting
  149         obsolete provisions relating to certificate of need
  150         requirements for specified services; amending s.
  151         408.0361, F.S.; providing an exception for a hospital
  152         to become a Level I Adult Cardiovascular provider if
  153         certain requirements are met; amending s. 408.05,
  154         F.S.; requiring the agency to contract with the
  155         Society of Thoracic Surgeons and the American College
  156         of Cardiology for the collection of certain data for
  157         publication on the agency’s website for certain
  158         purposes; amending s. 408.061, F.S.; excluding
  159         hospitals operated by state agencies from certain
  160         financial reporting requirements; conforming a cross
  161         reference; amending s. 408.07, F.S.; deleting the
  162         definition for the term “clinical laboratory”;
  163         amending s. 408.20, F.S.; exempting hospitals operated
  164         by any state agency from assessments against the
  165         Health Care Trust Fund to fund certain agency
  166         activities; repealing s. 408.7056, F.S., relating to
  167         the Subscriber Assistance Program; amending s.
  168         408.803, F.S.; defining the term “relative” for
  169         purposes of the Health Care Licensing Procedures Act;
  170         amending s. 408.806, F.S.; authorizing licensees who
  171         hold licenses for multiple providers to request that
  172         the agency align related license expiration dates;
  173         authorizing the agency to issue licenses for an
  174         abbreviated licensure period and to charge a prorated
  175         licensure fee; amending s. 408.809, F.S.; expanding
  176         the scope of persons subject to a level 2 background
  177         screening to include any employee of a licensee who is
  178         a controlling interest and certain part-time
  179         contractors; amending s. 408.810, F.S.; providing that
  180         an applicant for change of ownership licensure is
  181         exempt from furnishing proof of financial ability to
  182         operate if certain conditions are met; authorizing the
  183         agency to adopt rules governing circumstances under
  184         which a controlling interest may act in certain legal
  185         capacities on behalf of a patient or client; requiring
  186         a licensee to ensure that certain persons do not hold
  187         an ownership interest if the licensee is not organized
  188         as or owned by a publicly traded corporation; defining
  189         the term “publicly traded corporation”; amending s.
  190         408.812, F.S.; providing that certain unlicensed
  191         activity by a provider constitutes abuse and neglect;
  192         clarifying that the agency may impose a fine or
  193         penalty, as prescribed in an authorizing statute, if
  194         an unlicensed provider who has received notification
  195         fails to cease operation; authorizing the agency to
  196         revoke all licenses and impose a fine or penalties
  197         upon a controlling interest or licensee who has an
  198         interest in more than one provider and who fails to
  199         license a provider rendering services that require
  200         licensure in certain circumstances; amending s.
  201         408.820, F.S.; deleting certain exemptions from part
  202         II of ch. 408, F.S., for specified providers to
  203         conform provisions to changes made by the act;
  204         amending s. 409.907, F.S.; removing the agency’s
  205         authority to consider certain factors in determining
  206         whether to enter into, and in maintaining, a Medicaid
  207         provider agreement; amending s. 429.02, F.S.; revising
  208         definitions of the terms “assisted living facility”
  209         and “personal services”; amending s. 429.04, F.S.;
  210         providing additional exemptions from licensure as an
  211         assisted living facility; requiring a person or entity
  212         asserting the exemption to provide documentation that
  213         substantiates the claim upon agency investigation of
  214         unlicensed activity; amending s. 429.08, F.S.;
  215         providing criminal penalties and fines for a person
  216         who rents or otherwise maintains a building or
  217         property used as an unlicensed assisted living
  218         facility; providing criminal penalties and fines for a
  219         person who owns, operates, or maintains an unlicensed
  220         assisted living facility after receiving notice from
  221         the agency; amending s. 429.176, F.S.; prohibiting an
  222         assisted living facility from operating for more than
  223         a specified time without an administrator who has
  224         completed certain educational requirements; amending
  225         s. 429.24, F.S.; providing that 30-day written notice
  226         of rate increase for residency in an assisted living
  227         facility is not required in certain situations;
  228         amending s. 429.28, F.S.; revising the assisted living
  229         facility resident bill of rights to include assistance
  230         with obtaining access to adequate and appropriate
  231         health care; defining the term “adequate and
  232         appropriate health care”; deleting a requirement that
  233         the agency conduct at least one monitoring visit under
  234         certain circumstances; deleting provisions authorizing
  235         the agency to conduct periodic followup inspections
  236         and complaint investigations under certain
  237         circumstances; amending s. 429.294, F.S.; deleting the
  238         specified timeframe within which an assisted living
  239         facility must provide complete copies of a resident’s
  240         records in an investigation of resident’s rights;
  241         amending s. 429.34, F.S.; authorizing the agency to
  242         inspect and investigate assisted living facilities as
  243         necessary to determine compliance with certain laws;
  244         removing a provision requiring the agency to inspect
  245         each licensed assisted living facility at least
  246         biennially; authorizing the agency to conduct
  247         monitoring visits of each facility cited for prior
  248         violations under certain circumstances; amending s.
  249         429.52, F.S.; requiring an assisted living facility
  250         administrator to complete required training and
  251         education within a specified timeframe; amending s.
  252         435.04, F.S.; providing that security background
  253         investigations must ensure that a person has not been
  254         arrested for, and is not awaiting final disposition
  255         of, certain offenses; requiring that security
  256         background investigations for purposes of
  257         participation in the Medicaid program screen for
  258         violations of federal or state law, rule, or
  259         regulation governing any state Medicaid program, the
  260         Medicare program, or any other publicly funded federal
  261         or state health care or health insurance program;
  262         specifying offenses under federal law or any state law
  263         that the security background investigations must
  264         screen for; amending s. 456.054, F.S.; prohibiting any
  265         person or entity from paying or receiving a kickback
  266         for referring patients to a clinical laboratory;
  267         prohibiting a clinical laboratory from providing
  268         personnel to perform certain functions or duties in a
  269         health care practitioner’s office or dialysis
  270         facility; providing an exception; prohibiting a
  271         clinical laboratory from leasing space in any part of
  272         a health care practitioner’s office or dialysis
  273         facility; repealing part I of ch. 483, F.S., relating
  274         to clinical laboratories; amending s. 483.294, F.S.;
  275         removing a requirement that the agency inspect
  276         multiphasic health testing centers at least once
  277         annually; amending s. 483.801, F.S.; providing an
  278         exemption from regulation for certain persons employed
  279         by certain laboratories; amending s. 483.803, F.S.;
  280         revising definitions of the terms “clinical
  281         laboratory” and “clinical laboratory examination”;
  282         removing a cross-reference; amending s. 641.511, F.S.;
  283         revising health maintenance organization subscriber
  284         grievance reporting requirements; repealing s. 641.60,
  285         F.S., relating to the Statewide Managed Care Ombudsman
  286         Committee; repealing s. 641.65, F.S., relating to
  287         district managed care ombudsman committees; repealing
  288         s. 641.67, F.S., relating to a district managed care
  289         ombudsman committee, exemption from public records
  290         requirements, and exceptions; repealing s. 641.68,
  291         F.S., relating to a district managed care ombudsman
  292         committee and exemption from public meeting
  293         requirements; repealing s. 641.70, F.S., relating to
  294         agency duties relating to the Statewide Managed Care
  295         Ombudsman Committee and the district managed care
  296         ombudsman committees; repealing s. 641.75, F.S.,
  297         relating to immunity from liability and limitation on
  298         testimony; amending s. 945.36, F.S.; authorizing law
  299         enforcement personnel to conduct drug tests on certain
  300         inmates and releasees; amending ss. 20.43, 220.1845,
  301         376.30781, 376.86, 381.0034, 381.0405, 383.14, 383.30,
  302         383.301, 383.302, 383.305, 383.309, 383.33, 385.211,
  303         394.4787, 395.001, 395.7015, 400.9905, 408.033,
  304         408.802, 409.9116, 409.975, 429.19, 456.001, 456.057,
  305         456.076, 458.307, 458.345, 459.021, 483.813, 483.823,
  306         491.003, 627.351, 627.602, 627.6406, 627.64194,
  307         627.6513, 627.6574, 641.185, 641.31, 641.312,
  308         641.3154, 641.51, 641.515, 641.55, 766.118, 766.202,
  309         1009.65, and 1011.52, F.S.; conforming provisions to
  310         changes made by the act; providing an effective date.
  311          
  312  Be It Enacted by the Legislature of the State of Florida:
  313  
  314         Section 1. Paragraph (g) of subsection (3) of section
  315  20.43, Florida Statutes, is amended to read:
  316         20.43 Department of Health.—There is created a Department
  317  of Health.
  318         (3) The following divisions of the Department of Health are
  319  established:
  320         (g) Division of Medical Quality Assurance, which is
  321  responsible for the following boards and professions established
  322  within the division:
  323         1. The Board of Acupuncture, created under chapter 457.
  324         2. The Board of Medicine, created under chapter 458.
  325         3. The Board of Osteopathic Medicine, created under chapter
  326  459.
  327         4. The Board of Chiropractic Medicine, created under
  328  chapter 460.
  329         5. The Board of Podiatric Medicine, created under chapter
  330  461.
  331         6. Naturopathy, as provided under chapter 462.
  332         7. The Board of Optometry, created under chapter 463.
  333         8. The Board of Nursing, created under part I of chapter
  334  464.
  335         9. Nursing assistants, as provided under part II of chapter
  336  464.
  337         10. The Board of Pharmacy, created under chapter 465.
  338         11. The Board of Dentistry, created under chapter 466.
  339         12. Midwifery, as provided under chapter 467.
  340         13. The Board of Speech-Language Pathology and Audiology,
  341  created under part I of chapter 468.
  342         14. The Board of Nursing Home Administrators, created under
  343  part II of chapter 468.
  344         15. The Board of Occupational Therapy, created under part
  345  III of chapter 468.
  346         16. Respiratory therapy, as provided under part V of
  347  chapter 468.
  348         17. Dietetics and nutrition practice, as provided under
  349  part X of chapter 468.
  350         18. The Board of Athletic Training, created under part XIII
  351  of chapter 468.
  352         19. The Board of Orthotists and Prosthetists, created under
  353  part XIV of chapter 468.
  354         20. Electrolysis, as provided under chapter 478.
  355         21. The Board of Massage Therapy, created under chapter
  356  480.
  357         22. The Board of Clinical Laboratory Personnel, created
  358  under part II III of chapter 483.
  359         23. Medical physicists, as provided under part IV of
  360  chapter 483.
  361         24. The Board of Opticianry, created under part I of
  362  chapter 484.
  363         25. The Board of Hearing Aid Specialists, created under
  364  part II of chapter 484.
  365         26. The Board of Physical Therapy Practice, created under
  366  chapter 486.
  367         27. The Board of Psychology, created under chapter 490.
  368         28. School psychologists, as provided under chapter 490.
  369         29. The Board of Clinical Social Work, Marriage and Family
  370  Therapy, and Mental Health Counseling, created under chapter
  371  491.
  372         30. Emergency medical technicians and paramedics, as
  373  provided under part III of chapter 401.
  374         Section 2. Section 154.13, Florida Statutes, is created to
  375  read:
  376         154.13Designated facilities; jurisdiction.—Any designated
  377  facility owned or operated by a public health trust and located
  378  within the boundaries of a municipality is under the exclusive
  379  jurisdiction of the county creating the public health trust and
  380  is not within the jurisdiction of the municipality.
  381         Section 3. Paragraph (k) of subsection (2) of section
  382  220.1845, Florida Statutes, is amended to read:
  383         220.1845 Contaminated site rehabilitation tax credit.—
  384         (2) AUTHORIZATION FOR TAX CREDIT; LIMITATIONS.—
  385         (k) In order to encourage the construction and operation of
  386  a new health care facility as defined in s. 408.032 or s.
  387  408.07, or a health care provider as defined in s. 408.07 or s.
  388  408.7056, on a brownfield site, an applicant for a tax credit
  389  may claim an additional 25 percent of the total site
  390  rehabilitation costs, not to exceed $500,000, if the applicant
  391  meets the requirements of this paragraph. In order to receive
  392  this additional tax credit, the applicant must provide
  393  documentation indicating that the construction of the health
  394  care facility or health care provider by the applicant on the
  395  brownfield site has received a certificate of occupancy or a
  396  license or certificate has been issued for the operation of the
  397  health care facility or health care provider.
  398         Section 4. Paragraph (f) of subsection (3) of section
  399  376.30781, Florida Statutes, is amended to read:
  400         376.30781 Tax credits for rehabilitation of drycleaning
  401  solvent-contaminated sites and brownfield sites in designated
  402  brownfield areas; application process; rulemaking authority;
  403  revocation authority.—
  404         (3)
  405         (f) In order to encourage the construction and operation of
  406  a new health care facility or a health care provider, as defined
  407  in s. 408.032 or, s. 408.07, or s. 408.7056, on a brownfield
  408  site, an applicant for a tax credit may claim an additional 25
  409  percent of the total site rehabilitation costs, not to exceed
  410  $500,000, if the applicant meets the requirements of this
  411  paragraph. In order to receive this additional tax credit, the
  412  applicant must provide documentation indicating that the
  413  construction of the health care facility or health care provider
  414  by the applicant on the brownfield site has received a
  415  certificate of occupancy or a license or certificate has been
  416  issued for the operation of the health care facility or health
  417  care provider.
  418         Section 5. Subsection (1) of section 376.86, Florida
  419  Statutes, is amended to read:
  420         376.86 Brownfield Areas Loan Guarantee Program.—
  421         (1) The Brownfield Areas Loan Guarantee Council is created
  422  to review and approve or deny, by a majority vote of its
  423  membership, the situations and circumstances for participation
  424  in partnerships by agreements with local governments, financial
  425  institutions, and others associated with the redevelopment of
  426  brownfield areas pursuant to the Brownfields Redevelopment Act
  427  for a limited state guaranty of up to 5 years of loan guarantees
  428  or loan loss reserves issued pursuant to law. The limited state
  429  loan guaranty applies only to 50 percent of the primary lenders
  430  loans for redevelopment projects in brownfield areas. If the
  431  redevelopment project is for affordable housing, as defined in
  432  s. 420.0004, in a brownfield area, the limited state loan
  433  guaranty applies to 75 percent of the primary lender’s loan. If
  434  the redevelopment project includes the construction and
  435  operation of a new health care facility or a health care
  436  provider, as defined in s. 408.032 or, s. 408.07, or s.
  437  408.7056, on a brownfield site and the applicant has obtained
  438  documentation in accordance with s. 376.30781 indicating that
  439  the construction of the health care facility or health care
  440  provider by the applicant on the brownfield site has received a
  441  certificate of occupancy or a license or certificate has been
  442  issued for the operation of the health care facility or health
  443  care provider, the limited state loan guaranty applies to 75
  444  percent of the primary lender’s loan. A limited state guaranty
  445  of private loans or a loan loss reserve is authorized for
  446  lenders licensed to operate in the state upon a determination by
  447  the council that such an arrangement would be in the public
  448  interest and the likelihood of the success of the loan is great.
  449         Section 6. Subsection (2) of section 381.0031, Florida
  450  Statutes, is amended to read:
  451         381.0031 Epidemiological research; report of diseases of
  452  public health significance to department.—
  453         (2) Any practitioner licensed in this state to practice
  454  medicine, osteopathic medicine, chiropractic medicine,
  455  naturopathy, or veterinary medicine; any hospital licensed under
  456  part I of chapter 395; or any laboratory appropriately certified
  457  by the Centers for Medicare and Medicaid Services under the
  458  federal Clinical Laboratory Improvement Amendments and the
  459  federal rules adopted thereunder which licensed under chapter
  460  483 that diagnoses or suspects the existence of a disease of
  461  public health significance shall immediately report the fact to
  462  the Department of Health.
  463         Section 7. Subsection (3) of section 381.0034, Florida
  464  Statutes, is amended to read:
  465         381.0034 Requirement for instruction on HIV and AIDS.—
  466         (3) The department shall require, as a condition of
  467  granting a license under chapter 467 or part II III of chapter
  468  483, that an applicant making initial application for licensure
  469  complete an educational course acceptable to the department on
  470  human immunodeficiency virus and acquired immune deficiency
  471  syndrome. Upon submission of an affidavit showing good cause, an
  472  applicant who has not taken a course at the time of licensure
  473  shall be allowed 6 months to complete this requirement.
  474         Section 8. Paragraph (c) of subsection (4) of section
  475  381.004, Florida Statutes, is amended to read:
  476         381.004 HIV testing.—
  477         (4) HUMAN IMMUNODEFICIENCY VIRUS TESTING REQUIREMENTS;
  478  REGISTRATION WITH THE DEPARTMENT OF HEALTH; EXEMPTIONS FROM
  479  REGISTRATION.—No county health department and no other person in
  480  this state shall conduct or hold themselves out to the public as
  481  conducting a testing program for acquired immune deficiency
  482  syndrome or human immunodeficiency virus status without first
  483  registering with the Department of Health, reregistering each
  484  year, complying with all other applicable provisions of state
  485  law, and meeting the following requirements:
  486         (c) The program shall have all laboratory procedures
  487  performed in a laboratory appropriately certified by the Centers
  488  for Medicare and Medicaid Services under the federal Clinical
  489  Laboratory Improvement Amendments and the federal rules adopted
  490  thereunder licensed under the provisions of chapter 483.
  491         Section 9. Paragraph (f) of subsection (4) of section
  492  381.0405, Florida Statutes, is amended to read:
  493         381.0405 Office of Rural Health.—
  494         (4) COORDINATION.—The office shall:
  495         (f) Assume responsibility for state coordination of the
  496  Rural Hospital Transition Grant Program, the Essential Access
  497  Community Hospital Program, and other federal rural health care
  498  programs.
  499         Section 10. Paragraph (c) of subsection (4) of section
  500  381.915, Florida Statutes, is amended to read:
  501         381.915 Florida Consortium of National Cancer Institute
  502  Centers Program.—
  503         (4) Tier designations and corresponding weights within the
  504  Florida Consortium of National Cancer Institute Centers Program
  505  are as follows:
  506         (c) Tier 3: Florida-based cancer centers seeking
  507  designation as either a NCI-designated cancer center or NCI
  508  designated comprehensive cancer center, which shall be weighted
  509  at 1.0.
  510         1. A cancer center shall meet the following minimum
  511  criteria to be considered eligible for Tier 3 designation in any
  512  given fiscal year:
  513         a. Conducting cancer-related basic scientific research and
  514  cancer-related population scientific research;
  515         b. Offering and providing the full range of diagnostic and
  516  treatment services on site, as determined by the Commission on
  517  Cancer of the American College of Surgeons;
  518         c. Hosting or conducting cancer-related interventional
  519  clinical trials that are registered with the NCI’s Clinical
  520  Trials Reporting Program;
  521         d. Offering degree-granting programs or affiliating with
  522  universities through degree-granting programs accredited or
  523  approved by a nationally recognized agency and offered through
  524  the center or through the center in conjunction with another
  525  institution accredited by the Commission on Colleges of the
  526  Southern Association of Colleges and Schools;
  527         e. Providing training to clinical trainees, medical
  528  trainees accredited by the Accreditation Council for Graduate
  529  Medical Education or the American Osteopathic Association, and
  530  postdoctoral fellows recently awarded a doctorate degree; and
  531         f. Having more than $5 million in annual direct costs
  532  associated with their total NCI peer-reviewed grant funding.
  533         2. The General Appropriations Act or accompanying
  534  legislation may limit the number of cancer centers which shall
  535  receive Tier 3 designations or provide additional criteria for
  536  such designation.
  537         3. A cancer center’s participation in Tier 3 shall be
  538  limited to 6 5 years.
  539         4. A cancer center that qualifies as a designated Tier 3
  540  center under the criteria provided in subparagraph 1. by July 1,
  541  2014, is authorized to pursue NCI designation as a cancer center
  542  or a comprehensive cancer center for 6 5 years after
  543  qualification.
  544         Section 11. Paragraph (a) of subsection (2) of section
  545  383.14, Florida Statutes, is amended to read:
  546         383.14 Screening for metabolic disorders, other hereditary
  547  and congenital disorders, and environmental risk factors.—
  548         (2) RULES.—
  549         (a) After consultation with the Genetics and Newborn
  550  Screening Advisory Council, the department shall adopt and
  551  enforce rules requiring that every newborn in this state shall:
  552         1. Before becoming 1 week of age, be subjected to a test
  553  for phenylketonuria;
  554         2. Be tested for any condition included on the federal
  555  Recommended Uniform Screening Panel which the council advises
  556  the department should be included under the state’s screening
  557  program. After the council recommends that a condition be
  558  included, the department shall submit a legislative budget
  559  request to seek an appropriation to add testing of the condition
  560  to the newborn screening program. The department shall expand
  561  statewide screening of newborns to include screening for such
  562  conditions within 18 months after the council renders such
  563  advice, if a test approved by the United States Food and Drug
  564  Administration or a test offered by an alternative vendor which
  565  is compatible with the clinical standards established under part
  566  I of chapter 483 is available. If such a test is not available
  567  within 18 months after the council makes its recommendation, the
  568  department shall implement such screening as soon as a test
  569  offered by the United States Food and Drug Administration or by
  570  an alternative vendor is available; and
  571         3. At the appropriate age, be tested for such other
  572  metabolic diseases and hereditary or congenital disorders as the
  573  department may deem necessary from time to time.
  574         Section 12. Section 383.30, Florida Statutes, is amended to
  575  read:
  576         383.30 Birth Center Licensure Act; short title.—Sections
  577  383.30-383.332 383.30-383.335 shall be known and may be cited as
  578  the “Birth Center Licensure Act.”
  579         Section 13. Section 383.301, Florida Statutes, is amended
  580  to read:
  581         383.301 Licensure and regulation of birth centers;
  582  legislative intent.—It is the intent of the Legislature to
  583  provide for the protection of public health and safety in the
  584  establishment, maintenance, and operation of birth centers by
  585  providing for licensure of birth centers and for the
  586  development, establishment, and enforcement of minimum standards
  587  with respect to birth centers. The requirements of part II of
  588  chapter 408 shall apply to the provision of services that
  589  require licensure pursuant to ss. 383.30-383.332 383.30-383.335
  590  and part II of chapter 408 and to entities licensed by or
  591  applying for such licensure from the Agency for Health Care
  592  Administration pursuant to ss. 383.30-383.332 383.30-383.335. A
  593  license issued by the agency is required in order to operate a
  594  birth center in this state.
  595         Section 14. Section 383.302, Florida Statutes, is amended
  596  to read:
  597         383.302 Definitions of terms used in ss. 383.30-383.332
  598  383.30-383.335.—As used in ss. 383.30-383.332 383.30-383.335,
  599  the term:
  600         (1) “Agency” means the Agency for Health Care
  601  Administration.
  602         (2) “Birth center” means any facility, institution, or
  603  place, which is not an ambulatory surgical center or a hospital
  604  or in a hospital, in which births are planned to occur away from
  605  the mother’s usual residence following a normal, uncomplicated,
  606  low-risk pregnancy.
  607         (3) “Clinical staff” means individuals employed full time
  608  or part time by a birth center who are licensed or certified to
  609  provide care at childbirth.
  610         (4) “Consultant” means a physician licensed pursuant to
  611  chapter 458 or chapter 459 who agrees to provide advice and
  612  services to a birth center and who either:
  613         (a) Is certified or eligible for certification by the
  614  American Board of Obstetrics and Gynecology, or
  615         (b) Has hospital obstetrical privileges.
  616         (5) “Governing body” means any individual, group,
  617  corporation, or institution which is responsible for the overall
  618  operation and maintenance of a birth center.
  619         (6) “Governmental unit” means the state or any county,
  620  municipality, or other political subdivision or any department,
  621  division, board, or other agency of any of the foregoing.
  622         (7) “Licensed facility” means a facility licensed in
  623  accordance with s. 383.305.
  624         (8) “Low-risk pregnancy” means a pregnancy which is
  625  expected to result in an uncomplicated birth, as determined
  626  through risk criteria developed by rule of the department, and
  627  which is accompanied by adequate prenatal care.
  628         (9) “Person” means any individual, firm, partnership,
  629  corporation, company, association, institution, or joint stock
  630  association and means any legal successor of any of the
  631  foregoing.
  632         (10) “Premises” means those buildings, beds, and facilities
  633  located at the main address of the licensee and all other
  634  buildings, beds, and facilities for the provision of maternity
  635  care located in such reasonable proximity to the main address of
  636  the licensee as to appear to the public to be under the dominion
  637  and control of the licensee.
  638         Section 15. Subsection (1) of section 383.305, Florida
  639  Statutes, is amended to read:
  640         383.305 Licensure; fees.—
  641         (1) In accordance with s. 408.805, an applicant or a
  642  licensee shall pay a fee for each license application submitted
  643  under ss. 383.30-383.332 383.30-383.335 and part II of chapter
  644  408. The amount of the fee shall be established by rule.
  645         Section 16. Subsection (1) of section 383.309, Florida
  646  Statutes, is amended to read:
  647         383.309 Minimum standards for birth centers; rules and
  648  enforcement.—
  649         (1) The agency shall adopt and enforce rules to administer
  650  ss. 383.30-383.332 383.30-383.335 and part II of chapter 408,
  651  which rules shall include, but are not limited to, reasonable
  652  and fair minimum standards for ensuring that:
  653         (a) Sufficient numbers and qualified types of personnel and
  654  occupational disciplines are available at all times to provide
  655  necessary and adequate patient care and safety.
  656         (b) Infection control, housekeeping, sanitary conditions,
  657  disaster plan, and medical record procedures that will
  658  adequately protect patient care and provide safety are
  659  established and implemented.
  660         (c) Licensed facilities are established, organized, and
  661  operated consistent with established programmatic standards.
  662         Section 17. Subsection (1) of section 383.313, Florida
  663  Statutes, is amended to read:
  664         383.313 Performance of laboratory and surgical services;
  665  use of anesthetic and chemical agents.—
  666         (1) LABORATORY SERVICES.—A birth center may collect
  667  specimens for those tests that are requested under protocol. A
  668  birth center must obtain and continuously maintain certification
  669  by the Centers for Medicare and Medicaid Services under the
  670  federal Clinical Laboratory Improvement Amendments and the
  671  federal rules adopted thereunder in order to may perform simple
  672  laboratory tests specified, as defined by rule of the agency,
  673  and which are appropriate to meet the needs of the patient is
  674  exempt from the requirements of chapter 483, provided no more
  675  than five physicians are employed by the birth center and
  676  testing is conducted exclusively in connection with the
  677  diagnosis and treatment of clients of the birth center.
  678         Section 18. Subsection (1) and paragraph (a) of subsection
  679  (2) of section 383.33, Florida Statutes, are amended to read:
  680         383.33 Administrative penalties; moratorium on admissions.—
  681         (1) In addition to the requirements of part II of chapter
  682  408, the agency may impose an administrative fine not to exceed
  683  $500 per violation per day for the violation of any provision of
  684  ss. 383.30-383.332 383.30-383.335, part II of chapter 408, or
  685  applicable rules.
  686         (2) In determining the amount of the fine to be levied for
  687  a violation, as provided in this section, the following factors
  688  shall be considered:
  689         (a) The severity of the violation, including the
  690  probability that death or serious harm to the health or safety
  691  of any person will result or has resulted; the severity of the
  692  actual or potential harm; and the extent to which the provisions
  693  of ss. 383.30-383.332 383.30-383.335, part II of chapter 408, or
  694  applicable rules were violated.
  695         Section 19. Section 383.335, Florida Statutes, is repealed.
  696         Section 20. Section 384.31, Florida Statutes, is amended to
  697  read:
  698         384.31 Testing of pregnant women; duty of the attendant.
  699  Every person, including every physician licensed under chapter
  700  458 or chapter 459 or midwife licensed under part I of chapter
  701  464 or chapter 467, attending a pregnant woman for conditions
  702  relating to pregnancy during the period of gestation and
  703  delivery shall cause the woman to be tested for sexually
  704  transmissible diseases, including HIV, as specified by
  705  department rule. Testing shall be performed by a laboratory
  706  appropriately certified by the Centers for Medicare and Medicaid
  707  Services under the federal Clinical Laboratory Improvement
  708  Amendments and the federal rules adopted thereunder approved for
  709  such purposes under part I of chapter 483. The woman shall be
  710  informed of the tests that will be conducted and of her right to
  711  refuse testing. If a woman objects to testing, a written
  712  statement of objection, signed by the woman, shall be placed in
  713  the woman’s medical record and no testing shall occur.
  714         Section 21. Subsection (2) of section 385.211, Florida
  715  Statutes, is amended to read:
  716         385.211 Refractory and intractable epilepsy treatment and
  717  research at recognized medical centers.—
  718         (2) Notwithstanding chapter 893, medical centers recognized
  719  pursuant to s. 381.925, or an academic medical research
  720  institution legally affiliated with a licensed children’s
  721  specialty hospital as defined in s. 395.002(27) s. 395.002(28)
  722  that contracts with the Department of Health, may conduct
  723  research on cannabidiol and low-THC cannabis. This research may
  724  include, but is not limited to, the agricultural development,
  725  production, clinical research, and use of liquid medical
  726  derivatives of cannabidiol and low-THC cannabis for the
  727  treatment for refractory or intractable epilepsy. The authority
  728  for recognized medical centers to conduct this research is
  729  derived from 21 C.F.R. parts 312 and 316. Current state or
  730  privately obtained research funds may be used to support the
  731  activities described in this section.
  732         Section 22. Subsection (7) of section 394.4787, Florida
  733  Statutes, is amended to read:
  734         394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, and
  735  394.4789.—As used in this section and ss. 394.4786, 394.4788,
  736  and 394.4789:
  737         (7) “Specialty psychiatric hospital” means a hospital
  738  licensed by the agency pursuant to s. 395.002(27) s. 395.002(28)
  739  and part II of chapter 408 as a specialty psychiatric hospital.
  740         Section 23. Section 395.001, Florida Statutes, is amended
  741  to read:
  742         395.001 Legislative intent.—It is the intent of the
  743  Legislature to provide for the protection of public health and
  744  safety in the establishment, construction, maintenance, and
  745  operation of hospitals and, ambulatory surgical centers, and
  746  mobile surgical facilities by providing for licensure of same
  747  and for the development, establishment, and enforcement of
  748  minimum standards with respect thereto.
  749         Section 24. Present subsections (22) through (33) of
  750  section 395.002, Florida Statutes, are redesignated as
  751  subsections (21) through (32), respectively, and subsections (3)
  752  and (16) of that section and present subsections (21) and (23)
  753  of that section are amended, to read:
  754         395.002 Definitions.—As used in this chapter:
  755         (3) “Ambulatory surgical center” or “mobile surgical
  756  facility” means a facility the primary purpose of which is to
  757  provide elective surgical care, in which the patient is admitted
  758  to and discharged from such facility within the same working day
  759  and is not permitted to stay overnight, and which is not part of
  760  a hospital. However, a facility existing for the primary purpose
  761  of performing terminations of pregnancy, an office maintained by
  762  a physician for the practice of medicine, or an office
  763  maintained for the practice of dentistry may shall not be
  764  construed to be an ambulatory surgical center, provided that any
  765  facility or office which is certified or seeks certification as
  766  a Medicare ambulatory surgical center shall be licensed as an
  767  ambulatory surgical center pursuant to s. 395.003. Any structure
  768  or vehicle in which a physician maintains an office and
  769  practices surgery, and which can appear to the public to be a
  770  mobile office because the structure or vehicle operates at more
  771  than one address, shall be construed to be a mobile surgical
  772  facility.
  773         (16) “Licensed facility” means a hospital or, ambulatory
  774  surgical center, or mobile surgical facility licensed in
  775  accordance with this chapter.
  776         (21)“Mobile surgical facility” is a mobile facility in
  777  which licensed health care professionals provide elective
  778  surgical care under contract with the Department of Corrections
  779  or a private correctional facility operating pursuant to chapter
  780  957 and in which inmate patients are admitted to and discharged
  781  from said facility within the same working day and are not
  782  permitted to stay overnight. However, mobile surgical facilities
  783  may only provide health care services to the inmate patients of
  784  the Department of Corrections, or inmate patients of a private
  785  correctional facility operating pursuant to chapter 957, and not
  786  to the general public.
  787         (22)(23) “Premises” means those buildings, beds, and
  788  equipment located at the address of the licensed facility and
  789  all other buildings, beds, and equipment for the provision of
  790  hospital or, ambulatory surgical, or mobile surgical care
  791  located in such reasonable proximity to the address of the
  792  licensed facility as to appear to the public to be under the
  793  dominion and control of the licensee. For any licensee that is a
  794  teaching hospital as defined in s. 408.07 s. 408.07(45),
  795  reasonable proximity includes any buildings, beds, services,
  796  programs, and equipment under the dominion and control of the
  797  licensee that are located at a site with a main address that is
  798  within 1 mile of the main address of the licensed facility; and
  799  all such buildings, beds, and equipment may, at the request of a
  800  licensee or applicant, be included on the facility license as a
  801  single premises.
  802         Section 25. Paragraphs (a) and (b) of subsection (1),
  803  paragraph (b) of subsection (2), and paragraph (b) of subsection
  804  (6) of section 395.003, Florida Statutes, are amended to read:
  805         395.003 Licensure; denial, suspension, and revocation.—
  806         (1)(a) The requirements of part II of chapter 408 apply to
  807  the provision of services that require licensure pursuant to ss.
  808  395.001-395.1065 and part II of chapter 408 and to entities
  809  licensed by or applying for such licensure from the Agency for
  810  Health Care Administration pursuant to ss. 395.001-395.1065. A
  811  license issued by the agency is required in order to operate a
  812  hospital or, ambulatory surgical center, or mobile surgical
  813  facility in this state.
  814         (b)1. It is unlawful for a person to use or advertise to
  815  the public, in any way or by any medium whatsoever, any facility
  816  as a “hospital,or “ambulatory surgical center,or “mobile
  817  surgical facility” unless such facility has first secured a
  818  license under the provisions of this part.
  819         2. This part does not apply to veterinary hospitals or to
  820  commercial business establishments using the word “hospital,or
  821  “ambulatory surgical center,or “mobile surgical facility” as a
  822  part of a trade name if no treatment of human beings is
  823  performed on the premises of such establishments.
  824         (2)
  825         (b) The agency shall, at the request of a licensee that is
  826  a teaching hospital as defined in s. 408.07 s. 408.07(45), issue
  827  a single license to a licensee for facilities that have been
  828  previously licensed as separate premises, provided such
  829  separately licensed facilities, taken together, constitute the
  830  same premises as defined in s. 395.002 s. 395.002(23). Such
  831  license for the single premises shall include all of the beds,
  832  services, and programs that were previously included on the
  833  licenses for the separate premises. The granting of a single
  834  license under this paragraph may shall not in any manner reduce
  835  the number of beds, services, or programs operated by the
  836  licensee.
  837         (6)
  838         (b) A specialty-licensed children’s hospital that has
  839  licensed neonatal intensive care unit beds and is located in
  840  District 5 or District 11, as defined in s. 408.032, as of
  841  January 1, 2018, a county with a population of 1,750,000 or more
  842  may provide obstetrical services, in accordance with the
  843  pertinent guidelines promulgated by the American College of
  844  Obstetricians and Gynecologists and with verification of
  845  guidelines and compliance with internal safety standards by the
  846  Voluntary Review for Quality of Care Program of the American
  847  College of Obstetricians and Gynecologists and in compliance
  848  with the agency’s rules pertaining to the obstetrical department
  849  in a hospital and offer healthy mothers all necessary critical
  850  care equipment, services, and the capability of providing up to
  851  10 beds for labor and delivery care, which services are
  852  restricted to the diagnosis, care, and treatment of pregnant
  853  women of any age who have documentation by an examining
  854  physician that includes information regarding:
  855         1. At least one fetal characteristic or condition diagnosed
  856  intra-utero that would characterize the pregnancy or delivery as
  857  high risk including structural abnormalities of the digestive,
  858  central nervous, and cardiovascular systems and disorders of
  859  genetic malformations and skeletal dysplasia, acute metabolic
  860  emergencies, and babies of mothers with rheumatologic disorders;
  861  or
  862         2. Medical advice or a diagnosis indicating that the fetus
  863  may require at least one perinatal intervention.
  864  
  865  This paragraph shall not preclude a specialty-licensed
  866  children’s hospital from complying with s. 395.1041 or the
  867  Emergency Medical Treatment and Active Labor Act, 42 U.S.C.
  868  1395dd.
  869         Section 26. Subsection (1) of section 395.009, Florida
  870  Statutes, is amended to read:
  871         395.009 Minimum standards for clinical laboratory test
  872  results and diagnostic X-ray results; prerequisite for issuance
  873  or renewal of license.—
  874         (1) As a requirement for issuance or renewal of its
  875  license, each licensed facility shall require that all clinical
  876  laboratory tests performed by or for the licensed facility be
  877  performed by a clinical laboratory appropriately certified by
  878  the Centers for Medicare and Medicaid Services under the federal
  879  Clinical Laboratory Improvement Amendments and the federal rules
  880  adopted thereunder licensed under the provisions of chapter 483.
  881         Section 27. Section 395.0091, Florida Statutes, is created
  882  to read:
  883         395.0091Alternate-site testing.—The agency, in
  884  consultation with the Board of Clinical Laboratory Personnel,
  885  shall adopt by rule the criteria for alternate-site testing to
  886  be performed under the supervision of a clinical laboratory
  887  director. At a minimum, the criteria must address hospital
  888  internal needs assessment; a protocol for implementation,
  889  including the identification of tests to be performed and who
  890  will perform them; selection of the method of testing to be used
  891  for alternate-site testing; minimum training and education
  892  requirements for those who will perform alternate-site testing,
  893  such as documented training, licensure, certification, or other
  894  medical professional background not limited to laboratory
  895  professionals; documented inservice training and initial and
  896  ongoing competency validation; an appropriate internal and
  897  external quality control protocol; an internal mechanism for the
  898  central laboratory to identify and track alternate-site testing;
  899  and recordkeeping requirements. Alternate-site testing locations
  900  must register when the hospital applies to renew its license.
  901  For purposes of this section, the term “alternate-site testing”
  902  includes any laboratory testing done under the administrative
  903  control of a hospital, but performed out of the physical or
  904  administrative confines of the central laboratory.
  905         Section 28. Paragraph (f) of subsection (1) of section
  906  395.0161, Florida Statutes, is amended to read:
  907         395.0161 Licensure inspection.—
  908         (1) In addition to the requirement of s. 408.811, the
  909  agency shall make or cause to be made such inspections and
  910  investigations as it deems necessary, including:
  911         (f)Inspections of mobile surgical facilities at each time
  912  a facility establishes a new location, prior to the admission of
  913  patients. However, such inspections shall not be required when a
  914  mobile surgical facility is moved temporarily to a location
  915  where medical treatment will not be provided.
  916         Section 29. Subsection (3) of section 395.0163, Florida
  917  Statutes, is amended to read:
  918         395.0163 Construction inspections; plan submission and
  919  approval; fees.—
  920         (3)In addition to the requirements of s. 408.811, the
  921  agency shall inspect a mobile surgical facility at initial
  922  licensure and at each time the facility establishes a new
  923  location, prior to admission of patients. However, such
  924  inspections shall not be required when a mobile surgical
  925  facility is moved temporarily to a location where medical
  926  treatment will not be provided.
  927         Section 30. Subsection (2), paragraph (c) of subsection
  928  (6), and subsections (16) and (17) of section 395.0197, Florida
  929  Statutes, are amended to read:
  930         395.0197 Internal risk management program.—
  931         (2) The internal risk management program is the
  932  responsibility of the governing board of the health care
  933  facility. Each licensed facility shall hire a risk manager,
  934  licensed under s. 395.10974, who is responsible for
  935  implementation and oversight of the such facility’s internal
  936  risk management program and who demonstrates competence, through
  937  education or experience, in all of the following areas:
  938         (a)Applicable standards of health care risk management.
  939         (b)Applicable federal, state, and local health and safety
  940  laws and rules.
  941         (c)General risk management administration.
  942         (d)Patient care.
  943         (e)Medical care.
  944         (f)Personal and social care.
  945         (g)Accident prevention.
  946         (h)Departmental organization and management.
  947         (i)Community interrelationships.
  948         (j)Medical terminology as required by this section. A risk
  949  manager must not be made responsible for more than four internal
  950  risk management programs in separate licensed facilities, unless
  951  the facilities are under one corporate ownership or the risk
  952  management programs are in rural hospitals.
  953         (6)
  954         (c) The report submitted to the agency must shall also
  955  contain the name and license number of the risk manager of the
  956  licensed facility, a copy of its policy and procedures which
  957  govern the measures taken by the facility and its risk manager
  958  to reduce the risk of injuries and adverse incidents, and the
  959  results of such measures. The annual report is confidential and
  960  is not available to the public pursuant to s. 119.07(1) or any
  961  other law providing access to public records. The annual report
  962  is not discoverable or admissible in any civil or administrative
  963  action, except in disciplinary proceedings by the agency or the
  964  appropriate regulatory board. The annual report is not available
  965  to the public as part of the record of investigation for and
  966  prosecution in disciplinary proceedings made available to the
  967  public by the agency or the appropriate regulatory board.
  968  However, the agency or the appropriate regulatory board shall
  969  make available, upon written request by a health care
  970  professional against whom probable cause has been found, any
  971  such records which form the basis of the determination of
  972  probable cause.
  973         (16) There shall be no monetary liability on the part of,
  974  and no cause of action for damages shall arise against, any risk
  975  manager, licensed under s. 395.10974, for the implementation and
  976  oversight of the internal risk management program in a facility
  977  licensed under this chapter or chapter 390 as required by this
  978  section, for any act or proceeding undertaken or performed
  979  within the scope of the functions of such internal risk
  980  management program if the risk manager acts without intentional
  981  fraud.
  982         (17) A privilege against civil liability is hereby granted
  983  to any licensed risk manager or licensed facility with regard to
  984  information furnished pursuant to this chapter, unless the
  985  licensed risk manager or facility acted in bad faith or with
  986  malice in providing such information.
  987         Section 31. Section 395.1046, Florida Statutes, is
  988  repealed.
  989         Section 32. Present subsection (10) of section 395.1055,
  990  Florida Statutes, is redesignated as subsection (12),
  991  subsections (2), (3), and (9) of that section are amended,
  992  paragraph (i) is added to subsection (1) of that section, and a
  993  new subsection (10) and subsection (11) are added to that
  994  section, to read:
  995         395.1055 Rules and enforcement.—
  996         (1) The agency shall adopt rules pursuant to ss. 120.536(1)
  997  and 120.54 to implement the provisions of this part, which shall
  998  include reasonable and fair minimum standards for ensuring that:
  999         (i)All hospitals providing organ transplantation, neonatal
 1000  intensive care services, inpatient psychiatric services,
 1001  inpatient substance abuse services, or comprehensive medical
 1002  rehabilitation meet the minimum licensure requirements adopted
 1003  by the agency. Such licensure requirements must include quality
 1004  of care, nurse staffing, physician staffing, physical plant,
 1005  equipment, emergency transportation, and data reporting
 1006  standards.
 1007         (2) Separate standards may be provided for general and
 1008  specialty hospitals, ambulatory surgical centers, mobile
 1009  surgical facilities, and statutory rural hospitals as defined in
 1010  s. 395.602.
 1011         (3) The agency shall adopt rules with respect to the care
 1012  and treatment of patients residing in distinct part nursing
 1013  units of hospitals which are certified for participation in
 1014  Title XVIII (Medicare) and Title XIX (Medicaid) of the Social
 1015  Security Act skilled nursing facility program. Such rules shall
 1016  take into account the types of patients treated in hospital
 1017  skilled nursing units, including typical patient acuity levels
 1018  and the average length of stay in such units, and shall be
 1019  limited to the appropriate portions of the Omnibus Budget
 1020  Reconciliation Act of 1987 (Pub. L. No. 100-203) (December 22,
 1021  1987), Title IV (Medicare, Medicaid, and Other Health-Related
 1022  Programs), Subtitle C (Nursing Home Reform), as amended. The
 1023  agency shall require level 2 background screening as specified
 1024  in s. 408.809(1)(e) pursuant to s. 408.809 and chapter 435 for
 1025  personnel of distinct part nursing units.
 1026         (9) The agency shall establish a technical advisory panel,
 1027  pursuant to s. 20.052, to develop procedures and standards for
 1028  measuring outcomes of pediatric cardiac catheterization programs
 1029  and pediatric cardiovascular open-heart surgery programs.
 1030         (a) Members of the panel must have technical expertise in
 1031  pediatric cardiac medicine, shall serve without compensation,
 1032  and may not be reimbursed for per diem and travel expenses. be
 1033  composed
 1034         (b) Voting members of the panel shall include: 3 at-large
 1035  members, including 1 cardiologist who is board certified in
 1036  caring for adults with congenital heart disease and 2 board
 1037  certified pediatric cardiologists, neither of whom may be
 1038  employed by any of the hospitals specified in subparagraphs 1.
 1039  10. or their affiliates, each of whom is appointed by the
 1040  Secretary of Health Care Administration, and 10 members, and an
 1041  alternate for each member, each of whom is a pediatric
 1042  cardiologist or a pediatric cardiovascular surgeon, each
 1043  appointed by the chief executive officer of one of the following
 1044  hospitals:
 1045         1. Johns Hopkins All Children’s Hospital in St. Petersburg.
 1046         2. Arnold Palmer Hospital for Children in Orlando.
 1047         3. Joe DiMaggio Children’s Hospital in Hollywood.
 1048         4. Nicklaus Children’s Hospital in Miami.
 1049         5. St. Joseph’s Children’s Hospital in Tampa.
 1050         6. University of Florida Health Shands Hospital in
 1051  Gainesville.
 1052         7. University of Miami Holtz Children’s Hospital in Miami.
 1053         8. Wolfson Children’s Hospital in Jacksonville.
 1054         9. Florida Hospital for Children in Orlando.
 1055         10. Nemours Children’s Hospital in Orlando.
 1056  
 1057  Appointments made under subparagraphs 1.-10. are contingent upon
 1058  the hospital’s maintenance of pediatric certificates of need and
 1059  the hospital’s compliance with this section and rules adopted
 1060  thereunder, as determined by the Secretary of Health Care
 1061  Administration. A member appointed under subparagraphs 1.-10.
 1062  whose hospital fails to maintain such certificates or comply
 1063  with standards may serve only as a nonvoting member until the
 1064  hospital restores such certificates or complies with such
 1065  standards.
 1066         (c) The Secretary of Health Care Administration may appoint
 1067  nonvoting members to the panel. Nonvoting members may include:
 1068         1. The Secretary of Health Care Administration.
 1069         2. The Surgeon General.
 1070         3. The Deputy Secretary of Children’s Medical Services.
 1071         4. Any current or past Division Director of Children’s
 1072  Medical Services.
 1073         5. A parent of a child with congenital heart disease.
 1074         6. An adult with congenital heart disease.
 1075         7. A representative from each of the following
 1076  organizations: the Florida Chapter of the American Academy of
 1077  Pediatrics, the Florida Chapter of the American College of
 1078  Cardiology, the Greater Southeast Affiliate of the American
 1079  Heart Association, the Adult Congenital Heart Association, the
 1080  March of Dimes, the Florida Association of Children’s Hospitals,
 1081  and the Florida Society of Thoracic and Cardiovascular Surgeons.
 1082         (d)The panel shall meet biannually, or more frequently
 1083  upon the call of the Secretary of Health Care Administration.
 1084  Such meetings may be conducted telephonically, or by other
 1085  electronic means.
 1086         (e) The duties of the panel include recommending to the
 1087  agency standards for quality of care, personnel, physical plant,
 1088  equipment, emergency transportation, and data reporting for
 1089  hospitals that provide pediatric cardiac services.
 1090         (f) Beginning on January 1, 2020, and annually thereafter,
 1091  the panel shall submit a report to the Governor, the President
 1092  of the Senate, the Speaker of the House of Representatives, the
 1093  Secretary of Health Care Administration, and the State Surgeon
 1094  General. The report must summarize the panel’s activities during
 1095  the preceding fiscal year and include data and performance
 1096  measures on surgical morbidity and mortality for all pediatric
 1097  cardiac programs.
 1098         (b) Based on the recommendations of the panel, the agency
 1099  shall develop and adopt rules for pediatric cardiac
 1100  catheterization programs and pediatric open-heart surgery
 1101  programs which include at least the following:
 1102         1. A risk adjustment procedure that accounts for the
 1103  variations in severity and case mix found in hospitals in this
 1104  state;
 1105         2. Outcome standards specifying expected levels of
 1106  performance in pediatric cardiac programs. Such standards may
 1107  include, but are not limited to, in-hospital mortality,
 1108  infection rates, nonfatal myocardial infarctions, length of
 1109  postoperative bleeds, and returns to surgery; and
 1110         3. Specific steps to be taken by the agency and licensed
 1111  facilities that do not meet the outcome standards within a
 1112  specified time, including time required for detailed case
 1113  reviews and development and implementation of corrective action
 1114  plans.
 1115         (c) This subsection is repealed on July 1, 2022.
 1116         (10) Based on the recommendations of the advisory panel in
 1117  subsection (9), the agency shall adopt rules for pediatric
 1118  cardiac programs which, at a minimum, include:
 1119         (a) Standards for pediatric cardiac catheterization
 1120  services and pediatric cardiovascular surgery including quality
 1121  of care, personnel, physical plant, equipment, emergency
 1122  transportation, data reporting, and appropriate operating hours
 1123  and timeframes for mobilization for emergency procedures.
 1124         (b) Outcome standards consistent with nationally
 1125  established levels of performance in pediatric cardiac programs.
 1126         (c) Specific steps to be taken by the agency and licensed
 1127  facilities when the facilities do not meet the outcome standards
 1128  within a specified time, including time required for detailed
 1129  case reviews and the development and implementation of
 1130  corrective action plans.
 1131         (11) A pediatric cardiac program shall:
 1132         (a) Have a pediatric cardiology clinic affiliated with a
 1133  hospital licensed under this chapter.
 1134         (b) Have a pediatric cardiac catheterization laboratory and
 1135  a pediatric cardiovascular surgical program located in the
 1136  hospital.
 1137         (c) Have a risk adjustment surgical procedure protocol
 1138  following the guidelines established by the Society of Thoracic
 1139  Surgeons.
 1140         (d) Have quality assurance and quality improvement
 1141  processes in place to enhance clinical operation and patient
 1142  satisfaction with services.
 1143         (e) Participate in the clinical outcome reporting systems
 1144  operated by the Society of Thoracic Surgeons and the American
 1145  College of Cardiology.
 1146         (12)(10) The agency may adopt rules to administer the
 1147  requirements of part II of chapter 408.
 1148         Section 33. Section 395.10971, Florida Statutes, is
 1149  repealed.
 1150         Section 34. Section 395.10972, Florida Statutes, is
 1151  repealed.
 1152         Section 35. Section 395.10973, Florida Statutes, is amended
 1153  to read:
 1154         395.10973 Powers and duties of the agency.—It is the
 1155  function of the agency to:
 1156         (1) Adopt rules pursuant to ss. 120.536(1) and 120.54 to
 1157  implement the provisions of this part and part II of chapter 408
 1158  conferring duties upon it.
 1159         (2)Develop, impose, and enforce specific standards within
 1160  the scope of the general qualifications established by this part
 1161  which must be met by individuals in order to receive licenses as
 1162  health care risk managers. These standards shall be designed to
 1163  ensure that health care risk managers are individuals of good
 1164  character and otherwise suitable and, by training or experience
 1165  in the field of health care risk management, qualified in
 1166  accordance with the provisions of this part to serve as health
 1167  care risk managers, within statutory requirements.
 1168         (3)Develop a method for determining whether an individual
 1169  meets the standards set forth in s. 395.10974.
 1170         (4)Issue licenses to qualified individuals meeting the
 1171  standards set forth in s. 395.10974.
 1172         (5)Receive, investigate, and take appropriate action with
 1173  respect to any charge or complaint filed with the agency to the
 1174  effect that a certified health care risk manager has failed to
 1175  comply with the requirements or standards adopted by rule by the
 1176  agency or to comply with the provisions of this part.
 1177         (6)Establish procedures for providing periodic reports on
 1178  persons certified or disciplined by the agency under this part.
 1179         (2)(7) Develop a model risk management program for health
 1180  care facilities which will satisfy the requirements of s.
 1181  395.0197.
 1182         (3)(8) Enforce the special-occupancy provisions of the
 1183  Florida Building Code which apply to hospitals, intermediate
 1184  residential treatment facilities, and ambulatory surgical
 1185  centers in conducting any inspection authorized by this chapter
 1186  and part II of chapter 408.
 1187         Section 36. Section 395.10974, Florida Statutes, is
 1188  repealed.
 1189         Section 37. Section 395.10975, Florida Statutes, is
 1190  repealed.
 1191         Section 38. Subsection (2) of section 395.602, Florida
 1192  Statutes, is amended to read:
 1193         395.602 Rural hospitals.—
 1194         (2) DEFINITIONS.—As used in this part, the term:
 1195         (a)“Emergency care hospital” means a medical facility
 1196  which provides:
 1197         1.Emergency medical treatment; and
 1198         2.Inpatient care to ill or injured persons prior to their
 1199  transportation to another hospital or provides inpatient medical
 1200  care to persons needing care for a period of up to 96 hours. The
 1201  96-hour limitation on inpatient care does not apply to respite,
 1202  skilled nursing, hospice, or other nonacute care patients.
 1203         (b)“Essential access community hospital” means any
 1204  facility which:
 1205         1.Has at least 100 beds;
 1206         2.Is located more than 35 miles from any other essential
 1207  access community hospital, rural referral center, or urban
 1208  hospital meeting criteria for classification as a regional
 1209  referral center;
 1210         3.Is part of a network that includes rural primary care
 1211  hospitals;
 1212         4.Provides emergency and medical backup services to rural
 1213  primary care hospitals in its rural health network;
 1214         5.Extends staff privileges to rural primary care hospital
 1215  physicians in its network; and
 1216         6.Accepts patients transferred from rural primary care
 1217  hospitals in its network.
 1218         (c)“Inactive rural hospital bed” means a licensed acute
 1219  care hospital bed, as defined in s. 395.002(13), that is
 1220  inactive in that it cannot be occupied by acute care inpatients.
 1221         (a)(d) “Rural area health education center” means an area
 1222  health education center (AHEC), as authorized by Pub. L. No. 94
 1223  484, which provides services in a county with a population
 1224  density of up to no greater than 100 persons per square mile.
 1225         (b)(e) “Rural hospital” means an acute care hospital
 1226  licensed under this chapter, having 100 or fewer licensed beds
 1227  and an emergency room, which is:
 1228         1. The sole provider within a county with a population
 1229  density of up to 100 persons per square mile;
 1230         2. An acute care hospital, in a county with a population
 1231  density of up to 100 persons per square mile, which is at least
 1232  30 minutes of travel time, on normally traveled roads under
 1233  normal traffic conditions, from any other acute care hospital
 1234  within the same county;
 1235         3. A hospital supported by a tax district or subdistrict
 1236  whose boundaries encompass a population of up to 100 persons per
 1237  square mile;
 1238         4. A hospital classified as a sole community hospital under
 1239  42 C.F.R. s. 412.92, regardless of the number of licensed beds;
 1240         5. A hospital with a service area that has a population of
 1241  up to 100 persons per square mile. As used in this subparagraph,
 1242  the term “service area” means the fewest number of zip codes
 1243  that account for 75 percent of the hospital’s discharges for the
 1244  most recent 5-year period, based on information available from
 1245  the hospital inpatient discharge database in the Florida Center
 1246  for Health Information and Transparency at the agency; or
 1247         6. A hospital designated as a critical access hospital, as
 1248  defined in s. 408.07.
 1249  
 1250  Population densities used in this paragraph must be based upon
 1251  the most recently completed United States census. A hospital
 1252  that received funds under s. 409.9116 for a quarter beginning no
 1253  later than July 1, 2002, is deemed to have been and shall
 1254  continue to be a rural hospital from that date through June 30,
 1255  2021, if the hospital continues to have up to 100 licensed beds
 1256  and an emergency room. An acute care hospital that has not
 1257  previously been designated as a rural hospital and that meets
 1258  the criteria of this paragraph shall be granted such designation
 1259  upon application, including supporting documentation, to the
 1260  agency. A hospital that was licensed as a rural hospital during
 1261  the 2010-2011 or 2011-2012 fiscal year shall continue to be a
 1262  rural hospital from the date of designation through June 30,
 1263  2021, if the hospital continues to have up to 100 licensed beds
 1264  and an emergency room.
 1265         (f)“Rural primary care hospital” means any facility
 1266  meeting the criteria in paragraph (e) or s. 395.605 which
 1267  provides:
 1268         1.Twenty-four-hour emergency medical care;
 1269         2.Temporary inpatient care for periods of 72 hours or less
 1270  to patients requiring stabilization before discharge or transfer
 1271  to another hospital. The 72-hour limitation does not apply to
 1272  respite, skilled nursing, hospice, or other nonacute care
 1273  patients; and
 1274         3.Has no more than six licensed acute care inpatient beds.
 1275         (c)(g) “Swing-bed” means a bed which can be used
 1276  interchangeably as either a hospital, skilled nursing facility
 1277  (SNF), or intermediate care facility (ICF) bed pursuant to 42
 1278  C.F.R. parts 405, 435, 440, 442, and 447.
 1279         Section 39. Section 395.603, Florida Statutes, is amended
 1280  to read:
 1281         395.603 Deactivation of general hospital beds; Rural
 1282  hospital impact statement.—
 1283         (1) The agency shall establish, by rule, a process by which
 1284  a rural hospital, as defined in s. 395.602, that seeks licensure
 1285  as a rural primary care hospital or as an emergency care
 1286  hospital, or becomes a certified rural health clinic as defined
 1287  in Pub. L. No. 95-210, or becomes a primary care program such as
 1288  a county health department, community health center, or other
 1289  similar outpatient program that provides preventive and curative
 1290  services, may deactivate general hospital beds. Rural primary
 1291  care hospitals and emergency care hospitals shall maintain the
 1292  number of actively licensed general hospital beds necessary for
 1293  the facility to be certified for Medicare reimbursement.
 1294  Hospitals that discontinue inpatient care to become rural health
 1295  care clinics or primary care programs shall deactivate all
 1296  licensed general hospital beds. All hospitals, clinics, and
 1297  programs with inactive beds shall provide 24-hour emergency
 1298  medical care by staffing an emergency room. Providers with
 1299  inactive beds shall be subject to the criteria in s. 395.1041.
 1300  The agency shall specify in rule requirements for making 24-hour
 1301  emergency care available. Inactive general hospital beds shall
 1302  be included in the acute care bed inventory, maintained by the
 1303  agency for certificate-of-need purposes, for 10 years from the
 1304  date of deactivation of the beds. After 10 years have elapsed,
 1305  inactive beds shall be excluded from the inventory. The agency
 1306  shall, at the request of the licensee, reactivate the inactive
 1307  general beds upon a showing by the licensee that licensure
 1308  requirements for the inactive general beds are met.
 1309         (2) In formulating and implementing policies and rules that
 1310  may have significant impact on the ability of rural hospitals to
 1311  continue to provide health care services in rural communities,
 1312  the agency, the department, or the respective regulatory board
 1313  adopting policies or rules regarding the licensure or
 1314  certification of health care professionals shall provide a rural
 1315  hospital impact statement. The rural hospital impact statement
 1316  shall assess the proposed action in light of the following
 1317  questions:
 1318         (1)(a) Do the health personnel affected by the proposed
 1319  action currently practice in rural hospitals or are they likely
 1320  to in the near future?
 1321         (2)(b) What are the current numbers of the affected health
 1322  personnel in this state, their geographic distribution, and the
 1323  number practicing in rural hospitals?
 1324         (3)(c) What are the functions presently performed by the
 1325  affected health personnel, and are such functions presently
 1326  performed in rural hospitals?
 1327         (4)(d) What impact will the proposed action have on the
 1328  ability of rural hospitals to recruit the affected personnel to
 1329  practice in their facilities?
 1330         (5)(e) What impact will the proposed action have on the
 1331  limited financial resources of rural hospitals through increased
 1332  salaries and benefits necessary to recruit or retain such health
 1333  personnel?
 1334         (6)(f) Is there a less stringent requirement which could
 1335  apply to practice in rural hospitals?
 1336         (7)(g) Will this action create staffing shortages, which
 1337  could result in a loss to the public of health care services in
 1338  rural hospitals or result in closure of any rural hospitals?
 1339         Section 40. Section 395.604, Florida Statutes, is repealed.
 1340         Section 41. Section 395.605, Florida Statutes, is repealed.
 1341         Section 42. Paragraph (c) of subsection (1) of section
 1342  395.701, Florida Statutes, is amended to read:
 1343         395.701 Annual assessments on net operating revenues for
 1344  inpatient and outpatient services to fund public medical
 1345  assistance; administrative fines for failure to pay assessments
 1346  when due; exemption.—
 1347         (1) For the purposes of this section, the term:
 1348         (c) “Hospital” means a health care institution as defined
 1349  in s. 395.002(12), but does not include any hospital operated by
 1350  a state the agency or the Department of Corrections.
 1351         Section 43. Paragraph (b) of subsection (2) of section
 1352  395.7015, Florida Statutes, is amended to read:
 1353         395.7015 Annual assessment on health care entities.—
 1354         (2) There is imposed an annual assessment against certain
 1355  health care entities as described in this section:
 1356         (b) For the purpose of this section, “health care entities”
 1357  include the following:
 1358         1. Ambulatory surgical centers and mobile surgical
 1359  facilities licensed under s. 395.003. This subsection shall only
 1360  apply to mobile surgical facilities operating under contracts
 1361  entered into on or after July 1, 1998.
 1362         2.Clinical laboratories licensed under s. 483.091,
 1363  excluding any hospital laboratory defined under s. 483.041(6),
 1364  any clinical laboratory operated by the state or a political
 1365  subdivision of the state, any clinical laboratory which
 1366  qualifies as an exempt organization under s. 501(c)(3) of the
 1367  Internal Revenue Code of 1986, as amended, and which receives 70
 1368  percent or more of its gross revenues from services to charity
 1369  patients or Medicaid patients, and any blood, plasma, or tissue
 1370  bank procuring, storing, or distributing blood, plasma, or
 1371  tissue either for future manufacture or research or distributed
 1372  on a nonprofit basis, and further excluding any clinical
 1373  laboratory which is wholly owned and operated by 6 or fewer
 1374  physicians who are licensed pursuant to chapter 458 or chapter
 1375  459 and who practice in the same group practice, and at which no
 1376  clinical laboratory work is performed for patients referred by
 1377  any health care provider who is not a member of the same group.
 1378         2.3. Diagnostic-imaging centers that are freestanding
 1379  outpatient facilities that provide specialized services for the
 1380  identification or determination of a disease through examination
 1381  and also provide sophisticated radiological services, and in
 1382  which services are rendered by a physician licensed by the Board
 1383  of Medicine under s. 458.311, s. 458.313, or s. 458.317, or by
 1384  an osteopathic physician licensed by the Board of Osteopathic
 1385  Medicine under s. 459.0055 or s. 459.0075. For purposes of this
 1386  paragraph, “sophisticated radiological services” means the
 1387  following: magnetic resonance imaging; nuclear medicine;
 1388  angiography; arteriography; computed tomography; positron
 1389  emission tomography; digital vascular imaging; bronchography;
 1390  lymphangiography; splenography; ultrasound, excluding ultrasound
 1391  providers that are part of a private physician’s office practice
 1392  or when ultrasound is provided by two or more physicians
 1393  licensed under chapter 458 or chapter 459 who are members of the
 1394  same professional association and who practice in the same
 1395  medical specialties; and such other sophisticated radiological
 1396  services, excluding mammography, as adopted in rule by the
 1397  board.
 1398         Section 44. Subsection (1) of section 400.0625, Florida
 1399  Statutes, is amended to read:
 1400         400.0625 Minimum standards for clinical laboratory test
 1401  results and diagnostic X-ray results.—
 1402         (1) Each nursing home, as a requirement for issuance or
 1403  renewal of its license, shall require that all clinical
 1404  laboratory tests performed for the nursing home be performed by
 1405  a clinical laboratory appropriately certified by the Centers for
 1406  Medicare and Medicaid Services under the federal Clinical
 1407  Laboratory Improvement Amendments and the federal rules adopted
 1408  thereunder licensed under the provisions of chapter 483, except
 1409  for such self-testing procedures as are approved by the agency
 1410  by rule. Results of clinical laboratory tests performed prior to
 1411  admission which meet the minimum standards provided in s.
 1412  483.181(3) shall be accepted in lieu of routine examinations
 1413  required upon admission and clinical laboratory tests which may
 1414  be ordered by a physician for residents of the nursing home.
 1415         Section 45. Paragraph (a) of subsection (2) of section
 1416  400.191, Florida Statutes, is amended to read:
 1417         400.191 Availability, distribution, and posting of reports
 1418  and records.—
 1419         (2) The agency shall publish the Nursing Home Guide
 1420  quarterly in electronic form to assist consumers and their
 1421  families in comparing and evaluating nursing home facilities.
 1422         (a) The agency shall provide an Internet site which shall
 1423  include at least the following information either directly or
 1424  indirectly through a link to another established site or sites
 1425  of the agency’s choosing:
 1426         1. A section entitled “Have you considered programs that
 1427  provide alternatives to nursing home care?” which shall be the
 1428  first section of the Nursing Home Guide and which shall
 1429  prominently display information about available alternatives to
 1430  nursing homes and how to obtain additional information regarding
 1431  these alternatives. The Nursing Home Guide shall explain that
 1432  this state offers alternative programs that permit qualified
 1433  elderly persons to stay in their homes instead of being placed
 1434  in nursing homes and shall encourage interested persons to call
 1435  the Comprehensive Assessment Review and Evaluation for Long-Term
 1436  Care Services (CARES) Program to inquire if they qualify. The
 1437  Nursing Home Guide shall list available home and community-based
 1438  programs which shall clearly state the services that are
 1439  provided and indicate whether nursing home services are included
 1440  if needed.
 1441         2. A list by name and address of all nursing home
 1442  facilities in this state, including any prior name by which a
 1443  facility was known during the previous 24-month period.
 1444         3. Whether such nursing home facilities are proprietary or
 1445  nonproprietary.
 1446         4. The current owner of the facility’s license and the year
 1447  that that entity became the owner of the license.
 1448         5. The name of the owner or owners of each facility and
 1449  whether the facility is affiliated with a company or other
 1450  organization owning or managing more than one nursing facility
 1451  in this state.
 1452         6. The total number of beds in each facility and the most
 1453  recently available occupancy levels.
 1454         7. The number of private and semiprivate rooms in each
 1455  facility.
 1456         8. The religious affiliation, if any, of each facility.
 1457         9. The languages spoken by the administrator and staff of
 1458  each facility.
 1459         10. Whether or not each facility accepts Medicare or
 1460  Medicaid recipients or insurance, health maintenance
 1461  organization, Veterans Administration, CHAMPUS program, or
 1462  workers’ compensation coverage.
 1463         11. Recreational and other programs available at each
 1464  facility.
 1465         12. Special care units or programs offered at each
 1466  facility.
 1467         13. Whether the facility is a part of a retirement
 1468  community that offers other services pursuant to part III of
 1469  this chapter or part I or part III of chapter 429.
 1470         14. Survey and deficiency information, including all
 1471  federal and state recertification, licensure, revisit, and
 1472  complaint survey information, for each facility for the past 30
 1473  months. For noncertified nursing homes, state survey and
 1474  deficiency information, including licensure, revisit, and
 1475  complaint survey information for the past 30 months shall be
 1476  provided.
 1477         Section 46. Subsection (1) and paragraphs (b), (e), and (f)
 1478  of subsection (4) of section 400.464, Florida Statutes, are
 1479  amended, and subsection (6) is added to that section, to read:
 1480         400.464 Home health agencies to be licensed; expiration of
 1481  license; exemptions; unlawful acts; penalties.—
 1482         (1) The requirements of part II of chapter 408 apply to the
 1483  provision of services that require licensure pursuant to this
 1484  part and part II of chapter 408 and entities licensed or
 1485  registered by or applying for such licensure or registration
 1486  from the Agency for Health Care Administration pursuant to this
 1487  part. A license issued by the agency is required in order to
 1488  operate a home health agency in this state. A license issued on
 1489  or after July 1, 2018, must specify the home health services the
 1490  organization is authorized to perform and indicate whether such
 1491  specified services are considered skilled care. The provision or
 1492  advertising of services that require licensure pursuant to this
 1493  part without such services being specified on the face of the
 1494  license issued on or after July 1, 2018, constitutes unlicensed
 1495  activity as prohibited under s. 408.812.
 1496         (4)
 1497         (b) The operation or maintenance of an unlicensed home
 1498  health agency or the performance of any home health services in
 1499  violation of this part is declared a nuisance, inimical to the
 1500  public health, welfare, and safety. The agency or any state
 1501  attorney may, in addition to other remedies provided in this
 1502  part, bring an action for an injunction to restrain such
 1503  violation, or to enjoin the future operation or maintenance of
 1504  the home health agency or the provision of home health services
 1505  in violation of this part or part II of chapter 408, until
 1506  compliance with this part or the rules adopted under this part
 1507  has been demonstrated to the satisfaction of the agency.
 1508         (e) Any person who owns, operates, or maintains an
 1509  unlicensed home health agency and who, within 10 working days
 1510  after receiving notification from the agency, fails to cease
 1511  operation and apply for a license under this part commits a
 1512  misdemeanor of the second degree, punishable as provided in s.
 1513  775.082 or s. 775.083. Each day of continued operation is a
 1514  separate offense.
 1515         (f) Any home health agency that fails to cease operation
 1516  after agency notification may be fined in accordance with s.
 1517  408.812 $500 for each day of noncompliance.
 1518         (6)Any person, entity, or organization providing home
 1519  health services which is exempt from licensure under subsection
 1520  (5) may voluntarily apply for a certificate of exemption from
 1521  licensure under its exempt status with the agency on a form that
 1522  specifies its name or names and addresses, a statement of the
 1523  reasons why it is exempt from licensure as a home health agency,
 1524  and other information deemed necessary by the agency. A
 1525  certificate of exemption is valid for a period of not more than
 1526  2 years and is not transferable. The agency may charge an
 1527  applicant $100 for a certificate of exemption or charge the
 1528  actual cost of processing the certificate.
 1529         Section 47. Subsections (6) through (9) of section 400.471,
 1530  Florida Statutes, are redesignated as subsections (5) through
 1531  (8), respectively, and present subsections (2),(6), and (9) of
 1532  that section are amended, to read:
 1533         400.471 Application for license; fee.—
 1534         (2) In addition to the requirements of part II of chapter
 1535  408, the initial applicant, the applicant for a change of
 1536  ownership, and the applicant for the addition of skilled care
 1537  services must file with the application satisfactory proof that
 1538  the home health agency is in compliance with this part and
 1539  applicable rules, including:
 1540         (a) A listing of services to be provided, either directly
 1541  by the applicant or through contractual arrangements with
 1542  existing providers.
 1543         (b) The number and discipline of professional staff to be
 1544  employed.
 1545         (c)Completion of questions concerning volume data on the
 1546  renewal application as determined by rule.
 1547         (c)(d) A business plan, signed by the applicant, which
 1548  details the home health agency’s methods to obtain patients and
 1549  its plan to recruit and maintain staff.
 1550         (d)(e) Evidence of contingency funding as required under s.
 1551  408.8065 equal to 1 month’s average operating expenses during
 1552  the first year of operation.
 1553         (e)(f) A balance sheet, income and expense statement, and
 1554  statement of cash flows for the first 2 years of operation which
 1555  provide evidence of having sufficient assets, credit, and
 1556  projected revenues to cover liabilities and expenses. The
 1557  applicant has demonstrated financial ability to operate if the
 1558  applicant’s assets, credit, and projected revenues meet or
 1559  exceed projected liabilities and expenses. An applicant may not
 1560  project an operating margin of 15 percent or greater for any
 1561  month in the first year of operation. All documents required
 1562  under this paragraph must be prepared in accordance with
 1563  generally accepted accounting principles and compiled and signed
 1564  by a certified public accountant.
 1565         (f)(g) All other ownership interests in health care
 1566  entities for each controlling interest, as defined in part II of
 1567  chapter 408.
 1568         (g)(h) In the case of an application for initial licensure,
 1569  an application for a change of ownership, or an application for
 1570  the addition of skilled care services, documentation of
 1571  accreditation, or an application for accreditation, from an
 1572  accrediting organization that is recognized by the agency as
 1573  having standards comparable to those required by this part and
 1574  part II of chapter 408. A home health agency that is not
 1575  Medicare or Medicaid certified and does not provide skilled care
 1576  is exempt from this paragraph. Notwithstanding s. 408.806, an
 1577  initial applicant that has applied for accreditation must
 1578  provide proof of accreditation that is not conditional or
 1579  provisional and a survey demonstrating compliance with the
 1580  requirements of this part, part II of chapter 408, and
 1581  applicable rules from an accrediting organization that is
 1582  recognized by the agency as having standards comparable to those
 1583  required by this part and part II of chapter 408 within 120 days
 1584  after the date of the agency’s receipt of the application for
 1585  licensure or the application shall be withdrawn from further
 1586  consideration. Such accreditation must be continuously
 1587  maintained by the home health agency to maintain licensure. The
 1588  agency shall accept, in lieu of its own periodic licensure
 1589  survey, the submission of the survey of an accrediting
 1590  organization that is recognized by the agency if the
 1591  accreditation of the licensed home health agency is not
 1592  provisional and if the licensed home health agency authorizes
 1593  releases of, and the agency receives the report of, the
 1594  accrediting organization.
 1595         (6)The agency may not issue a license designated as
 1596  certified to a home health agency that fails to satisfy the
 1597  requirements of a Medicare certification survey from the agency.
 1598         (8)(9) The agency may not issue a renewal license for a
 1599  home health agency in any county having at least one licensed
 1600  home health agency and that has more than one home health agency
 1601  per 5,000 persons, as indicated by the most recent population
 1602  estimates published by the Legislature’s Office of Economic and
 1603  Demographic Research, if the applicant or any controlling
 1604  interest has been administratively sanctioned by the agency
 1605  during the 2 years prior to the submission of the licensure
 1606  renewal application for one or more of the following acts:
 1607         (a) An intentional or negligent act that materially affects
 1608  the health or safety of a client of the provider;
 1609         (b) Knowingly providing home health services in an
 1610  unlicensed assisted living facility or unlicensed adult family
 1611  care home, unless the home health agency or employee reports the
 1612  unlicensed facility or home to the agency within 72 hours after
 1613  providing the services;
 1614         (c) Preparing or maintaining fraudulent patient records,
 1615  such as, but not limited to, charting ahead, recording vital
 1616  signs or symptoms which were not personally obtained or observed
 1617  by the home health agency’s staff at the time indicated,
 1618  borrowing patients or patient records from other home health
 1619  agencies to pass a survey or inspection, or falsifying
 1620  signatures;
 1621         (d) Failing to provide at least one service directly to a
 1622  patient for a period of 60 days;
 1623         (e) Demonstrating a pattern of falsifying documents
 1624  relating to the training of home health aides or certified
 1625  nursing assistants or demonstrating a pattern of falsifying
 1626  health statements for staff who provide direct care to patients.
 1627  A pattern may be demonstrated by a showing of at least three
 1628  fraudulent entries or documents;
 1629         (f) Demonstrating a pattern of billing any payor for
 1630  services not provided. A pattern may be demonstrated by a
 1631  showing of at least three billings for services not provided
 1632  within a 12-month period;
 1633         (g) Demonstrating a pattern of failing to provide a service
 1634  specified in the home health agency’s written agreement with a
 1635  patient or the patient’s legal representative, or the plan of
 1636  care for that patient, except unless a reduction in service is
 1637  mandated by Medicare, Medicaid, or a state program or as
 1638  provided in s. 400.492(3). A pattern may be demonstrated by a
 1639  showing of at least three incidents, regardless of the patient
 1640  or service, in which the home health agency did not provide a
 1641  service specified in a written agreement or plan of care during
 1642  a 3-month period;
 1643         (h) Giving remuneration to a case manager, discharge
 1644  planner, facility-based staff member, or third-party vendor who
 1645  is involved in the discharge planning process of a facility
 1646  licensed under chapter 395, chapter 429, or this chapter from
 1647  whom the home health agency receives referrals or gives
 1648  remuneration as prohibited in s. 400.474(6)(a);
 1649         (i) Giving cash, or its equivalent, to a Medicare or
 1650  Medicaid beneficiary;
 1651         (j) Demonstrating a pattern of billing the Medicaid program
 1652  for services to Medicaid recipients which are medically
 1653  unnecessary as determined by a final order. A pattern may be
 1654  demonstrated by a showing of at least two such medically
 1655  unnecessary services within one Medicaid program integrity audit
 1656  period;
 1657         (k) Providing services to residents in an assisted living
 1658  facility for which the home health agency does not receive fair
 1659  market value remuneration; or
 1660         (l) Providing staffing to an assisted living facility for
 1661  which the home health agency does not receive fair market value
 1662  remuneration.
 1663         Section 48. Subsection (5) of section 400.474, Florida
 1664  Statutes, is amended to read:
 1665         400.474 Administrative penalties.—
 1666         (5) The agency shall impose a fine of $5,000 against a home
 1667  health agency that demonstrates a pattern of failing to provide
 1668  a service specified in the home health agency’s written
 1669  agreement with a patient or the patient’s legal representative,
 1670  or the plan of care for that patient, except unless a reduction
 1671  in service is mandated by Medicare, Medicaid, or a state program
 1672  or as provided in s. 400.492(3). A pattern may be demonstrated
 1673  by a showing of at least three incidences, regardless of the
 1674  patient or service, where the home health agency did not provide
 1675  a service specified in a written agreement or plan of care
 1676  during a 3-month period. The agency shall impose the fine for
 1677  each occurrence. The agency may also impose additional
 1678  administrative fines under s. 400.484 for the direct or indirect
 1679  harm to a patient, or deny, revoke, or suspend the license of
 1680  the home health agency for a pattern of failing to provide a
 1681  service specified in the home health agency’s written agreement
 1682  with a patient or the plan of care for that patient.
 1683         Section 49. Paragraph (c) of subsection (2) of section
 1684  400.476, Florida Statutes, is amended to read:
 1685         400.476 Staffing requirements; notifications; limitations
 1686  on staffing services.—
 1687         (2) DIRECTOR OF NURSING.—
 1688         (c) A home health agency that provides skilled nursing care
 1689  must is not Medicare or Medicaid certified and does not provide
 1690  skilled care or provides only physical, occupational, or speech
 1691  therapy is not required to have a director of nursing and is
 1692  exempt from paragraph (b).
 1693         Section 50. Section 400.484, Florida Statutes, is amended
 1694  to read:
 1695         400.484 Right of inspection; violations deficiencies;
 1696  fines.—
 1697         (1) In addition to the requirements of s. 408.811, the
 1698  agency may make such inspections and investigations as are
 1699  necessary in order to determine the state of compliance with
 1700  this part, part II of chapter 408, and applicable rules.
 1701         (2) The agency shall impose fines for various classes of
 1702  violations deficiencies in accordance with the following
 1703  schedule:
 1704         (a) Class I violations are as provided in s. 408.813 A
 1705  class I deficiency is any act, omission, or practice that
 1706  results in a patient’s death, disablement, or permanent injury,
 1707  or places a patient at imminent risk of death, disablement, or
 1708  permanent injury. Upon finding a class I violation deficiency,
 1709  the agency shall impose an administrative fine in the amount of
 1710  $15,000 for each occurrence and each day that the violation
 1711  deficiency exists.
 1712         (b) Class II violations are as provided in s. 408.813 A
 1713  class II deficiency is any act, omission, or practice that has a
 1714  direct adverse effect on the health, safety, or security of a
 1715  patient. Upon finding a class II violation deficiency, the
 1716  agency shall impose an administrative fine in the amount of
 1717  $5,000 for each occurrence and each day that the violation
 1718  deficiency exists.
 1719         (c) Class III violations are as provided in s. 408.813 A
 1720  class III deficiency is any act, omission, or practice that has
 1721  an indirect, adverse effect on the health, safety, or security
 1722  of a patient. Upon finding an uncorrected or repeated class III
 1723  violation deficiency, the agency shall impose an administrative
 1724  fine not to exceed $1,000 for each occurrence and each day that
 1725  the uncorrected or repeated violation deficiency exists.
 1726         (d) Class IV violations are as provided in s. 408.813 A
 1727  class IV deficiency is any act, omission, or practice related to
 1728  required reports, forms, or documents which does not have the
 1729  potential of negatively affecting patients. These violations are
 1730  of a type that the agency determines do not threaten the health,
 1731  safety, or security of patients. Upon finding an uncorrected or
 1732  repeated class IV violation deficiency, the agency shall impose
 1733  an administrative fine not to exceed $500 for each occurrence
 1734  and each day that the uncorrected or repeated violation
 1735  deficiency exists.
 1736         (3) In addition to any other penalties imposed pursuant to
 1737  this section or part, the agency may assess costs related to an
 1738  investigation that results in a successful prosecution,
 1739  excluding costs associated with an attorney’s time.
 1740         Section 51. Subsection (4) of section 400.497, Florida
 1741  Statutes, is amended to read:
 1742         400.497 Rules establishing minimum standards.—The agency
 1743  shall adopt, publish, and enforce rules to implement part II of
 1744  chapter 408 and this part, including, as applicable, ss. 400.506
 1745  and 400.509, which must provide reasonable and fair minimum
 1746  standards relating to:
 1747         (4) Licensure application and renewal and certificates of
 1748  exemption.
 1749         Section 52. Subsection (5), paragraphs (d) and (e) of
 1750  subsection (6), paragraph (a) of subsection (15), and subsection
 1751  (19) of section 400.506, Florida Statutes, are amended to read:
 1752         400.506 Licensure of nurse registries; requirements;
 1753  penalties.—
 1754         (5)(a) In addition to the requirements of s. 408.812, any
 1755  person who owns, operates, or maintains an unlicensed nurse
 1756  registry and who, within 10 working days after receiving
 1757  notification from the agency, fails to cease operation and apply
 1758  for a license under this part commits a misdemeanor of the
 1759  second degree, punishable as provided in s. 775.082 or s.
 1760  775.083. Each day of continued operation is a separate offense.
 1761         (b) If a nurse registry fails to cease operation after
 1762  agency notification, the agency may impose a fine pursuant to s.
 1763  408.812 of $500 for each day of noncompliance.
 1764         (6)
 1765         (d) A registered nurse, licensed practical nurse, certified
 1766  nursing assistant, companion or homemaker, or home health aide
 1767  referred for contract under this chapter by a nurse registry is
 1768  deemed an independent contractor and not an employee of the
 1769  nurse registry under any chapter regardless of the obligations
 1770  imposed on a nurse registry under this chapter or chapter 408.
 1771         (e) Upon referral of a registered nurse, licensed practical
 1772  nurse, certified nursing assistant, companion or homemaker, or
 1773  home health aide for contract in a private residence or
 1774  facility, the nurse registry shall advise the patient, the
 1775  patient’s family, or any other person acting on behalf of the
 1776  patient, at the time of the contract for services, that the
 1777  caregiver referred by the nurse registry is an independent
 1778  contractor and that the it is not the obligation of a nurse
 1779  registry may not to monitor, supervise, manage, or train a
 1780  caregiver referred for contract under this chapter.
 1781         (15)(a) The agency may deny, suspend, or revoke the license
 1782  of a nurse registry and shall impose a fine of $5,000 against a
 1783  nurse registry that:
 1784         1. Provides services to residents in an assisted living
 1785  facility for which the nurse registry does not receive fair
 1786  market value remuneration.
 1787         2. Provides staffing to an assisted living facility for
 1788  which the nurse registry does not receive fair market value
 1789  remuneration.
 1790         3. Fails to provide the agency, upon request, with copies
 1791  of all contracts with assisted living facilities which were
 1792  executed within the last 5 years.
 1793         4.Gives remuneration to a case manager, discharge planner,
 1794  facility-based staff member, or third-party vendor who is
 1795  involved in the discharge planning process of a facility
 1796  licensed under chapter 395 or this chapter and from whom the
 1797  nurse registry receives referrals. A nurse registry is exempt
 1798  from this subparagraph if it does not bill the Florida Medicaid
 1799  program or the Medicare program or share a controlling interest
 1800  with any entity licensed, registered, or certified under part II
 1801  of chapter 408 that bills the Florida Medicaid program or the
 1802  Medicare program.
 1803         5.Gives remuneration to a physician, a member of the
 1804  physician’s office staff, or an immediate family member of the
 1805  physician, and the nurse registry received a patient referral in
 1806  the last 12 months from that physician or the physician’s office
 1807  staff. A nurse registry is exempt from this subparagraph if it
 1808  does not bill the Florida Medicaid program or the Medicare
 1809  program or share a controlling interest with any entity
 1810  licensed, registered, or certified under part II of chapter 408
 1811  that bills the Florida Medicaid program or the Medicare program.
 1812         (19) It is not the obligation of A nurse registry may not
 1813  to monitor, supervise, manage, or train a registered nurse,
 1814  licensed practical nurse, certified nursing assistant, companion
 1815  or homemaker, or home health aide referred for contract under
 1816  this chapter. In the event of a violation of this chapter or a
 1817  violation of any other law of this state by a referred
 1818  registered nurse, licensed practical nurse, certified nursing
 1819  assistant, companion or homemaker, or home health aide, or a
 1820  deficiency in credentials which comes to the attention of the
 1821  nurse registry, the nurse registry shall advise the patient to
 1822  terminate the referred person’s contract, providing the reason
 1823  for the suggested termination; cease referring the person to
 1824  other patients or facilities; and, if practice violations are
 1825  involved, notify the licensing board. This section does not
 1826  affect or negate any other obligations imposed on a nurse
 1827  registry under chapter 408.
 1828         Section 53. Subsection (1) of section 400.606, Florida
 1829  Statutes, is amended to read:
 1830         400.606 License; application; renewal; conditional license
 1831  or permit; certificate of need.—
 1832         (1) In addition to the requirements of part II of chapter
 1833  408, the initial application and change of ownership application
 1834  must be accompanied by a plan for the delivery of home,
 1835  residential, and homelike inpatient hospice services to
 1836  terminally ill persons and their families. Such plan must
 1837  contain, but need not be limited to:
 1838         (a) The estimated average number of terminally ill persons
 1839  to be served monthly.
 1840         (b) The geographic area in which hospice services will be
 1841  available.
 1842         (c) A listing of services which are or will be provided,
 1843  either directly by the applicant or through contractual
 1844  arrangements with existing providers.
 1845         (d) Provisions for the implementation of hospice home care
 1846  within 3 months after licensure.
 1847         (e) Provisions for the implementation of hospice homelike
 1848  inpatient care within 12 months after licensure.
 1849         (f) The number and disciplines of professional staff to be
 1850  employed.
 1851         (g) The name and qualifications of any existing or
 1852  potential contractee.
 1853         (h) A plan for attracting and training volunteers.
 1854  
 1855  If the applicant is an existing licensed health care provider,
 1856  the application must be accompanied by a copy of the most recent
 1857  profit-loss statement and, if applicable, the most recent
 1858  licensure inspection report.
 1859         Section 54. Subsection (6) of section 400.925, Florida
 1860  Statutes, is amended to read:
 1861         400.925 Definitions.—As used in this part, the term:
 1862         (6) “Home medical equipment” includes any product as
 1863  defined by the Food and Drug Administration’s Federal Food,
 1864  Drug, and Cosmetic Act, any products reimbursed under the
 1865  Medicare Part B Durable Medical Equipment benefits, or any
 1866  products reimbursed under the Florida Medicaid durable medical
 1867  equipment program. Home medical equipment includes:
 1868         (a) Oxygen and related respiratory equipment; manual,
 1869  motorized, or customized wheelchairs and related seating and
 1870  positioning, but does not include prosthetics or orthotics or
 1871  any splints, braces, or aids custom fabricated by a licensed
 1872  health care practitioner;
 1873         (b) Motorized scooters;
 1874         (c) Personal transfer systems; and
 1875         (d) Specialty beds, for use by a person with a medical
 1876  need; and
 1877         (e)Manual, motorized, or customized wheelchairs and
 1878  related seating and positioning, but does not include
 1879  prosthetics or orthotics or any splints, braces, or aids custom
 1880  fabricated by a licensed health care practitioner.
 1881         Section 55. Subsection (4) of section 400.931, Florida
 1882  Statutes, is amended to read:
 1883         400.931 Application for license; fee.—
 1884         (4) When a change of the general manager of a home medical
 1885  equipment provider occurs, the licensee must notify the agency
 1886  of the change within the timeframes established in part II of
 1887  chapter 408 and applicable rules 45 days.
 1888         Section 56. Subsection (2) of section 400.933, Florida
 1889  Statutes, is amended to read:
 1890         400.933 Licensure inspections and investigations.—
 1891         (2) The agency shall accept, in lieu of its own periodic
 1892  inspections for licensure, submission of the following:
 1893         (a) The survey or inspection of an accrediting
 1894  organization, provided the accreditation of the licensed home
 1895  medical equipment provider is not provisional and provided the
 1896  licensed home medical equipment provider authorizes release of,
 1897  and the agency receives the report of, the accrediting
 1898  organization; or
 1899         (b) A copy of a valid medical oxygen retail establishment
 1900  permit issued by the Department of Business and Professional
 1901  Regulation Health, pursuant to chapter 499.
 1902         Section 57. Subsection (2) of section 400.980, Florida
 1903  Statutes, is amended to read:
 1904         400.980 Health care services pools.—
 1905         (2) The requirements of part II of chapter 408 apply to the
 1906  provision of services that require licensure or registration
 1907  pursuant to this part and part II of chapter 408 and to entities
 1908  registered by or applying for such registration from the agency
 1909  pursuant to this part. Registration or a license issued by the
 1910  agency is required for the operation of a health care services
 1911  pool in this state. In accordance with s. 408.805, an applicant
 1912  or licensee shall pay a fee for each license application
 1913  submitted using this part, part II of chapter 408, and
 1914  applicable rules. The agency shall adopt rules and provide forms
 1915  required for such registration and shall impose a registration
 1916  fee in an amount sufficient to cover the cost of administering
 1917  this part and part II of chapter 408. In addition to the
 1918  requirements in part II of chapter 408, the registrant must
 1919  provide the agency with any change of information contained on
 1920  the original registration application within the timeframes
 1921  established in this part, part II of chapter 408, and applicable
 1922  rules 14 days prior to the change.
 1923         Section 58. Paragraphs (a) through (d) of subsection (4) of
 1924  section 400.9905, Florida Statutes, are amended to read:
 1925         400.9905 Definitions.—
 1926         (4) “Clinic” means an entity where health care services are
 1927  provided to individuals and which tenders charges for
 1928  reimbursement for such services, including a mobile clinic and a
 1929  portable equipment provider. As used in this part, the term does
 1930  not include and the licensure requirements of this part do not
 1931  apply to:
 1932         (a) Entities licensed or registered by the state under
 1933  chapter 395; entities licensed or registered by the state and
 1934  providing only health care services within the scope of services
 1935  authorized under their respective licenses under ss. 383.30
 1936  383.332 383.30-383.335, chapter 390, chapter 394, chapter 397,
 1937  this chapter except part X, chapter 429, chapter 463, chapter
 1938  465, chapter 466, chapter 478, part I of chapter 483, chapter
 1939  484, or chapter 651; end-stage renal disease providers
 1940  authorized under 42 C.F.R. part 405, subpart U; providers
 1941  certified under 42 C.F.R. part 485, subpart B or subpart H; or
 1942  any entity that provides neonatal or pediatric hospital-based
 1943  health care services or other health care services by licensed
 1944  practitioners solely within a hospital licensed under chapter
 1945  395.
 1946         (b) Entities that own, directly or indirectly, entities
 1947  licensed or registered by the state pursuant to chapter 395;
 1948  entities that own, directly or indirectly, entities licensed or
 1949  registered by the state and providing only health care services
 1950  within the scope of services authorized pursuant to their
 1951  respective licenses under ss. 383.30-383.332 383.30-383.335,
 1952  chapter 390, chapter 394, chapter 397, this chapter except part
 1953  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
 1954  478, part I of chapter 483, chapter 484, or chapter 651; end
 1955  stage renal disease providers authorized under 42 C.F.R. part
 1956  405, subpart U; providers certified under 42 C.F.R. part 485,
 1957  subpart B or subpart H; or any entity that provides neonatal or
 1958  pediatric hospital-based health care services by licensed
 1959  practitioners solely within a hospital licensed under chapter
 1960  395.
 1961         (c) Entities that are owned, directly or indirectly, by an
 1962  entity licensed or registered by the state pursuant to chapter
 1963  395; entities that are owned, directly or indirectly, by an
 1964  entity licensed or registered by the state and providing only
 1965  health care services within the scope of services authorized
 1966  pursuant to their respective licenses under ss. 383.30-383.332
 1967  383.30-383.335, chapter 390, chapter 394, chapter 397, this
 1968  chapter except part X, chapter 429, chapter 463, chapter 465,
 1969  chapter 466, chapter 478, part I of chapter 483, chapter 484, or
 1970  chapter 651; end-stage renal disease providers authorized under
 1971  42 C.F.R. part 405, subpart U; providers certified under 42
 1972  C.F.R. part 485, subpart B or subpart H; or any entity that
 1973  provides neonatal or pediatric hospital-based health care
 1974  services by licensed practitioners solely within a hospital
 1975  under chapter 395.
 1976         (d) Entities that are under common ownership, directly or
 1977  indirectly, with an entity licensed or registered by the state
 1978  pursuant to chapter 395; entities that are under common
 1979  ownership, directly or indirectly, with an entity licensed or
 1980  registered by the state and providing only health care services
 1981  within the scope of services authorized pursuant to their
 1982  respective licenses under ss. 383.30-383.332 383.30-383.335,
 1983  chapter 390, chapter 394, chapter 397, this chapter except part
 1984  X, chapter 429, chapter 463, chapter 465, chapter 466, chapter
 1985  478, part I of chapter 483, chapter 484, or chapter 651; end
 1986  stage renal disease providers authorized under 42 C.F.R. part
 1987  405, subpart U; providers certified under 42 C.F.R. part 485,
 1988  subpart B or subpart H; or any entity that provides neonatal or
 1989  pediatric hospital-based health care services by licensed
 1990  practitioners solely within a hospital licensed under chapter
 1991  395.
 1992  
 1993  Notwithstanding this subsection, an entity shall be deemed a
 1994  clinic and must be licensed under this part in order to receive
 1995  reimbursement under the Florida Motor Vehicle No-Fault Law, ss.
 1996  627.730-627.7405, unless exempted under s. 627.736(5)(h).
 1997         Section 59. Subsection (6) of section 400.9935, Florida
 1998  Statutes, is amended to read:
 1999         400.9935 Clinic responsibilities.—
 2000         (6) Any person or entity providing health care services
 2001  which is not a clinic, as defined under s. 400.9905, may
 2002  voluntarily apply for a certificate of exemption from licensure
 2003  under its exempt status with the agency on a form that sets
 2004  forth its name or names and addresses, a statement of the
 2005  reasons why it cannot be defined as a clinic, and other
 2006  information deemed necessary by the agency. An exemption may be
 2007  valid for up to 2 years and is not transferable. The agency may
 2008  charge an applicant for a certificate of exemption in an amount
 2009  equal to $100 or the actual cost of processing the certificate,
 2010  whichever is less. An entity seeking a certificate of exemption
 2011  must publish and maintain a schedule of charges for the medical
 2012  services offered to patients. The schedule must include the
 2013  prices charged to an uninsured person paying for such services
 2014  by cash, check, credit card, or debit card. The schedule must be
 2015  posted in a conspicuous place in the reception area of the
 2016  entity and must include, but is not limited to, the 50 services
 2017  most frequently provided by the entity. The schedule may group
 2018  services by three price levels, listing services in each price
 2019  level. The posting must be at least 15 square feet in size. As a
 2020  condition precedent to receiving a certificate of exemption, an
 2021  applicant must provide to the agency documentation of compliance
 2022  with these requirements.
 2023         Section 60. Paragraph (a) of subsection (2) of section
 2024  408.033, Florida Statutes, is amended to read:
 2025         408.033 Local and state health planning.—
 2026         (2) FUNDING.—
 2027         (a) The Legislature intends that the cost of local health
 2028  councils be borne by assessments on selected health care
 2029  facilities subject to facility licensure by the Agency for
 2030  Health Care Administration, including abortion clinics, assisted
 2031  living facilities, ambulatory surgical centers, birth birthing
 2032  centers, clinical laboratories except community nonprofit blood
 2033  banks and clinical laboratories operated by practitioners for
 2034  exclusive use regulated under s. 483.035, home health agencies,
 2035  hospices, hospitals, intermediate care facilities for the
 2036  developmentally disabled, nursing homes, health care clinics,
 2037  and multiphasic testing centers and by assessments on
 2038  organizations subject to certification by the agency pursuant to
 2039  chapter 641, part III, including health maintenance
 2040  organizations and prepaid health clinics. Fees assessed may be
 2041  collected prospectively at the time of licensure renewal and
 2042  prorated for the licensure period.
 2043         Section 61. Present paragraphs (f) through (l) of
 2044  subsection (3) of section 408.036, Florida Statutes, are
 2045  redesignated as paragraphs (e) through (k), respectively,
 2046  present paragraphs (o) through (t) of that subsection are
 2047  redesignated as paragraphs (l) through (q), respectively, and
 2048  present paragraphs (e), (m), (n), and (p) of that subsection are
 2049  amended, to read:
 2050         408.036 Projects subject to review; exemptions.—
 2051         (3) EXEMPTIONS.—Upon request, the following projects are
 2052  subject to exemption from the provisions of subsection (1):
 2053         (e)For mobile surgical facilities and related health care
 2054  services provided under contract with the Department of
 2055  Corrections or a private correctional facility operating
 2056  pursuant to chapter 957.
 2057         (m)1.For the provision of adult open-heart services in a
 2058  hospital located within the boundaries of a health service
 2059  planning district, as defined in s. 408.032(5), which has
 2060  experienced an annual net out-migration of at least 600 open
 2061  heart-surgery cases for 3 consecutive years according to the
 2062  most recent data reported to the agency, and the districts
 2063  population per licensed and operational open-heart programs
 2064  exceeds the state average of population per licensed and
 2065  operational open-heart programs by at least 25 percent. All
 2066  hospitals within a health service planning district which meet
 2067  the criteria reference in sub-subparagraphs 2.a.-h. shall be
 2068  eligible for this exemption on July 1, 2004, and shall receive
 2069  the exemption upon filing for it and subject to the following:
 2070         a.A hospital that has received a notice of intent to grant
 2071  a certificate of need or a final order of the agency granting a
 2072  certificate of need for the establishment of an open-heart
 2073  surgery program is entitled to receive a letter of exemption for
 2074  the establishment of an adult open-heart-surgery program upon
 2075  filing a request for exemption and complying with the criteria
 2076  enumerated in sub-subparagraphs 2.a.-h., and is entitled to
 2077  immediately commence operation of the program.
 2078         b. An otherwise eligible hospital that has not received a
 2079  notice of intent to grant a certificate of need or a final order
 2080  of the agency granting a certificate of need for the
 2081  establishment of an open-heart-surgery program is entitled to
 2082  immediately receive a letter of exemption for the establishment
 2083  of an adult open-heart-surgery program upon filing a request for
 2084  exemption and complying with the criteria enumerated in sub
 2085  subparagraphs 2.a.-h., but is not entitled to commence operation
 2086  of its program until December 31, 2006.
 2087         2. A hospital shall be exempt from the certificate-of-need
 2088  review for the establishment of an open-heart-surgery program
 2089  when the application for exemption submitted under this
 2090  paragraph complies with the following criteria:
 2091         a. The applicant must certify that it will meet and
 2092  continuously maintain the minimum licensure requirements adopted
 2093  by the agency governing adult open-heart programs, including the
 2094  most current guidelines of the American College of Cardiology
 2095  and American Heart Association Guidelines for Adult Open Heart
 2096  Programs.
 2097         b. The applicant must certify that it will maintain
 2098  sufficient appropriate equipment and health personnel to ensure
 2099  quality and safety.
 2100         c. The applicant must certify that it will maintain
 2101  appropriate times of operation and protocols to ensure
 2102  availability and appropriate referrals in the event of
 2103  emergencies.
 2104         d. The applicant can demonstrate that it has discharged at
 2105  least 300 inpatients with a principal diagnosis of ischemic
 2106  heart disease for the most recent 12-month period as reported to
 2107  the agency.
 2108         e. The applicant is a general acute care hospital that is
 2109  in operation for 3 years or more.
 2110         f. The applicant is performing more than 300 diagnostic
 2111  cardiac catheterization procedures per year, combined inpatient
 2112  and outpatient.
 2113         g. The applicant’s payor mix at a minimum reflects the
 2114  community average for Medicaid, charity care, and self-pay
 2115  patients or the applicant must certify that it will provide a
 2116  minimum of 5 percent of Medicaid, charity care, and self-pay to
 2117  open-heart-surgery patients.
 2118         h. If the applicant fails to meet the established criteria
 2119  for open-heart programs or fails to reach 300 surgeries per year
 2120  by the end of its third year of operation, it must show cause
 2121  why its exemption should not be revoked.
 2122         3. By December 31, 2004, and annually thereafter, the
 2123  agency shall submit a report to the Legislature providing
 2124  information concerning the number of requests for exemption it
 2125  has received under this paragraph during the calendar year and
 2126  the number of exemptions it has granted or denied during the
 2127  calendar year.
 2128         (n) For the provision of percutaneous coronary intervention
 2129  for patients presenting with emergency myocardial infarctions in
 2130  a hospital without an approved adult open-heart-surgery program.
 2131  In addition to any other documentation required by the agency, a
 2132  request for an exemption submitted under this paragraph must
 2133  comply with the following:
 2134         1. The applicant must certify that it will meet and
 2135  continuously maintain the requirements adopted by the agency for
 2136  the provision of these services. These licensure requirements
 2137  shall be adopted by rule and must be consistent with the
 2138  guidelines published by the American College of Cardiology and
 2139  the American Heart Association for the provision of percutaneous
 2140  coronary interventions in hospitals without adult open-heart
 2141  services. At a minimum, the rules must require the following:
 2142         a. Cardiologists must be experienced interventionalists who
 2143  have performed a minimum of 75 interventions within the previous
 2144  12 months.
 2145         b. The hospital must provide a minimum of 36 emergency
 2146  interventions annually in order to continue to provide the
 2147  service.
 2148         c. The hospital must offer sufficient physician, nursing,
 2149  and laboratory staff to provide the services 24 hours a day, 7
 2150  days a week.
 2151         d. Nursing and technical staff must have demonstrated
 2152  experience in handling acutely ill patients requiring
 2153  intervention based on previous experience in dedicated
 2154  interventional laboratories or surgical centers.
 2155         e. Cardiac care nursing staff must be adept in hemodynamic
 2156  monitoring and Intra-aortic Balloon Pump (IABP) management.
 2157         f. Formalized written transfer agreements must be developed
 2158  with a hospital with an adult open-heart-surgery program, and
 2159  written transport protocols must be in place to ensure safe and
 2160  efficient transfer of a patient within 60 minutes. Transfer and
 2161  transport agreements must be reviewed and tested, with
 2162  appropriate documentation maintained at least every 3 months.
 2163  However, a hospital located more than 100 road miles from the
 2164  closest Level II adult cardiovascular services program does not
 2165  need to meet the 60-minute transfer time protocol if the
 2166  hospital demonstrates that it has a formalized, written transfer
 2167  agreement with a hospital that has a Level II program. The
 2168  agreement must include written transport protocols that ensure
 2169  the safe and efficient transfer of a patient, taking into
 2170  consideration the patient’s clinical and physical
 2171  characteristics, road and weather conditions, and viability of
 2172  ground and air ambulance service to transfer the patient.
 2173         g. Hospitals implementing the service must first undertake
 2174  a training program of 3 to 6 months’ duration, which includes
 2175  establishing standards and testing logistics, creating quality
 2176  assessment and error management practices, and formalizing
 2177  patient-selection criteria.
 2178         2. The applicant must certify that it will use at all times
 2179  the patient-selection criteria for the performance of primary
 2180  angioplasty at hospitals without adult open-heart-surgery
 2181  programs issued by the American College of Cardiology and the
 2182  American Heart Association. At a minimum, these criteria would
 2183  provide for the following:
 2184         a. Avoidance of interventions in hemodynamically stable
 2185  patients who have identified symptoms or medical histories.
 2186         b. Transfer of patients who have a history of coronary
 2187  disease and clinical presentation of hemodynamic instability.
 2188         3. The applicant must agree to submit a quarterly report to
 2189  the agency detailing patient characteristics, treatment, and
 2190  outcomes for all patients receiving emergency percutaneous
 2191  coronary interventions pursuant to this paragraph. This report
 2192  must be submitted within 15 days after the close of each
 2193  calendar quarter.
 2194         4. The exemption provided by this paragraph does not apply
 2195  unless the agency determines that the hospital has taken all
 2196  necessary steps to be in compliance with all requirements of
 2197  this paragraph, including the training program required under
 2198  sub-subparagraph 1.g.
 2199         5. Failure of the hospital to continuously comply with the
 2200  requirements of sub-subparagraphs 1.c.-f. and subparagraphs 2.
 2201  and 3. will result in the immediate expiration of this
 2202  exemption.
 2203         6. Failure of the hospital to meet the volume requirements
 2204  of sub-subparagraphs 1.a. and b. within 18 months after the
 2205  program begins offering the service will result in the immediate
 2206  expiration of the exemption.
 2207  
 2208  If the exemption for this service expires under subparagraph 5.
 2209  or subparagraph 6., the agency may not grant another exemption
 2210  for this service to the same hospital for 2 years and then only
 2211  upon a showing that the hospital will remain in compliance with
 2212  the requirements of this paragraph through a demonstration of
 2213  corrections to the deficiencies that caused expiration of the
 2214  exemption. Compliance with the requirements of this paragraph
 2215  includes compliance with the rules adopted pursuant to this
 2216  paragraph.
 2217         (m)(p) For replacement of a licensed nursing home on the
 2218  same site, or within 5 miles of the same site if within the same
 2219  subdistrict, if the number of licensed beds does not increase
 2220  except as permitted under paragraph (e) (f).
 2221         Section 62. Paragraph (b) of subsection (3) of section
 2222  408.0361, Florida Statutes, is amended to read:
 2223         408.0361 Cardiovascular services and burn unit licensure.—
 2224         (3) In establishing rules for adult cardiovascular
 2225  services, the agency shall include provisions that allow for:
 2226         (b)1. For a hospital seeking a Level I program,
 2227  demonstration that, for the most recent 12-month period as
 2228  reported to the agency, it has provided a minimum of 300 adult
 2229  inpatient and outpatient diagnostic cardiac catheterizations or,
 2230  for the most recent 12-month period, has discharged or
 2231  transferred at least 300 patients inpatients with the principal
 2232  diagnosis of ischemic heart disease and that it has a
 2233  formalized, written transfer agreement with a hospital that has
 2234  a Level II program, including written transport protocols to
 2235  ensure safe and efficient transfer of a patient within 60
 2236  minutes.
 2237         2.a.A hospital located more than 100 road miles from the
 2238  closest Level II adult cardiovascular services program does not
 2239  need to meet the diagnostic cardiac catheterization volume and
 2240  ischemic heart disease diagnosis volume requirements in
 2241  subparagraph 1., if the hospital demonstrates that it has, for
 2242  the most recent 12-month period as reported to the agency,
 2243  provided a minimum of 100 adult inpatient and outpatient
 2244  diagnostic cardiac catheterizations or that, for the most recent
 2245  12-month period, it has discharged or transferred at least 300
 2246  patients with the principal diagnosis of ischemic heart disease.
 2247         b.However, A hospital located more than 100 road miles
 2248  from the closest Level II adult cardiovascular services program
 2249  does not need to meet the 60-minute transfer time protocol
 2250  requirement in subparagraph 1., if the hospital demonstrates
 2251  that it has a formalized, written transfer agreement with a
 2252  hospital that has a Level II program. The agreement must include
 2253  written transport protocols to ensure the safe and efficient
 2254  transfer of a patient, taking into consideration the patient’s
 2255  clinical and physical characteristics, road and weather
 2256  conditions, and viability of ground and air ambulance service to
 2257  transfer the patient.
 2258         3.At a minimum, the rules for adult cardiovascular
 2259  services must require nursing and technical staff to have
 2260  demonstrated experience in handling acutely ill patients
 2261  requiring intervention, based on the staff member’s previous
 2262  experience in dedicated cardiac interventional laboratories or
 2263  surgical centers. If a staff member’s previous experience is in
 2264  a dedicated cardiac interventional laboratory at a hospital that
 2265  does not have an approved adult open-heart-surgery program, the
 2266  staff member’s previous experience qualifies only if, at the
 2267  time the staff member acquired his or her experience, the
 2268  dedicated cardiac interventional laboratory:
 2269         a.Had an annual volume of 500 or more percutaneous cardiac
 2270  intervention procedures;
 2271         b.Achieved a demonstrated success rate of 95 percent or
 2272  greater for percutaneous cardiac intervention procedures;
 2273         c.Experienced a complication rate of less than 5 percent
 2274  for percutaneous cardiac intervention procedures; and
 2275         d. Performed diverse cardiac procedures, including, but not
 2276  limited to, balloon angioplasty and stenting, rotational
 2277  atherectomy, cutting balloon atheroma remodeling, and procedures
 2278  relating to left ventricular support capability.
 2279         Section 63. Paragraph (k) is added to subsection (3) of
 2280  section 408.05, Florida Statutes, to read:
 2281         408.05 Florida Center for Health Information and
 2282  Transparency.—
 2283         (3) HEALTH INFORMATION TRANSPARENCY.—In order to
 2284  disseminate and facilitate the availability of comparable and
 2285  uniform health information, the agency shall perform the
 2286  following functions:
 2287         (k)Contract with the Society of Thoracic Surgeons and the
 2288  American College of Cardiology to obtain data reported pursuant
 2289  to s. 395.1055 for publication on the agency’s website in a
 2290  manner that will allow consumers to be informed of aggregate
 2291  data and to compare pediatric cardiac programs.
 2292         Section 64. Subsection (4) of section 408.061, Florida
 2293  Statutes, is amended to read:
 2294         408.061 Data collection; uniform systems of financial
 2295  reporting; information relating to physician charges;
 2296  confidential information; immunity.—
 2297         (4) Within 120 days after the end of its fiscal year, each
 2298  health care facility, excluding continuing care facilities,
 2299  hospitals operated by state agencies, and nursing homes as those
 2300  terms are defined in s. 408.07 s. 408.07(14) and (37), shall
 2301  file with the agency, on forms adopted by the agency and based
 2302  on the uniform system of financial reporting, its actual
 2303  financial experience for that fiscal year, including
 2304  expenditures, revenues, and statistical measures. Such data may
 2305  be based on internal financial reports which are certified to be
 2306  complete and accurate by the provider. However, hospitals’
 2307  actual financial experience shall be their audited actual
 2308  experience. Every nursing home shall submit to the agency, in a
 2309  format designated by the agency, a statistical profile of the
 2310  nursing home residents. The agency, in conjunction with the
 2311  Department of Elderly Affairs and the Department of Health,
 2312  shall review these statistical profiles and develop
 2313  recommendations for the types of residents who might more
 2314  appropriately be placed in their homes or other noninstitutional
 2315  settings.
 2316         Section 65. Subsection (11) of section 408.07, Florida
 2317  Statutes, is amended to read:
 2318         408.07 Definitions.—As used in this chapter, with the
 2319  exception of ss. 408.031-408.045, the term:
 2320         (11)“Clinical laboratory” means a facility licensed under
 2321  s. 483.091, excluding: any hospital laboratory defined under s.
 2322  483.041(6); any clinical laboratory operated by the state or a
 2323  political subdivision of the state; any blood or tissue bank
 2324  where the majority of revenues are received from the sale of
 2325  blood or tissue and where blood, plasma, or tissue is procured
 2326  from volunteer donors and donated, processed, stored, or
 2327  distributed on a nonprofit basis; and any clinical laboratory
 2328  which is wholly owned and operated by physicians who are
 2329  licensed pursuant to chapter 458 or chapter 459 and who practice
 2330  in the same group practice, and at which no clinical laboratory
 2331  work is performed for patients referred by any health care
 2332  provider who is not a member of that same group practice.
 2333         Section 66. Subsection (4) of section 408.20, Florida
 2334  Statutes, is amended to read:
 2335         408.20 Assessments; Health Care Trust Fund.—
 2336         (4) Hospitals operated by a state agency the Department of
 2337  Children and Families, the Department of Health, or the
 2338  Department of Corrections are exempt from the assessments
 2339  required under this section.
 2340         Section 67. Section 408.7056, Florida Statutes, is
 2341  repealed.
 2342         Section 68. Subsections (10), (11), and (27) of section
 2343  408.802, Florida Statutes, are amended to read:
 2344         408.802 Applicability.—The provisions of this part apply to
 2345  the provision of services that require licensure as defined in
 2346  this part and to the following entities licensed, registered, or
 2347  certified by the agency, as described in chapters 112, 383, 390,
 2348  394, 395, 400, 429, 440, 483, and 765:
 2349         (10)Mobile surgical facilities, as provided under part I
 2350  of chapter 395.
 2351         (11)Health care risk managers, as provided under part I of
 2352  chapter 395.
 2353         (27)Clinical laboratories, as provided under part I of
 2354  chapter 483.
 2355         Section 69. Subsections (12) and (13) of section 408.803,
 2356  Florida Statutes, are redesignated as subsections (13) and (14),
 2357  respectively, and a new subsection (12) is added to that
 2358  section, to read:
 2359         408.803 Definitions.—As used in this part, the term:
 2360         (12)“Relative” means an individual who is the father,
 2361  mother, stepfather, stepmother, son, daughter, brother, sister,
 2362  grandmother, grandfather, great-grandmother, great-grandfather,
 2363  grandson, granddaughter, uncle, aunt, first cousin, nephew,
 2364  niece, husband, wife, father-in-law, mother-in-law, son-in-law,
 2365  daughter-in-law, brother-in-law, sister-in-law, stepson,
 2366  stepdaughter, stepbrother, stepsister, half-brother, or half
 2367  sister of a patient or client.
 2368         Section 70. Paragraph (c) of subsection (7) of section
 2369  408.806, Florida Statutes, is amended, and subsection (9) is
 2370  added to that section, to read:
 2371         408.806 License application process.—
 2372         (7)
 2373         (c) If an inspection is required by the authorizing statute
 2374  for a license application other than an initial application, the
 2375  inspection must be unannounced. This paragraph does not apply to
 2376  inspections required pursuant to ss. 383.324, 395.0161(4) and,
 2377  429.67(6), and 483.061(2).
 2378         (9)A licensee that holds a license for multiple providers
 2379  licensed by the agency may request that all related license
 2380  expiration dates be aligned. Upon such request, the agency may
 2381  issue a license for an abbreviated licensure period with a
 2382  prorated licensure fee.
 2383         Section 71. Paragraphs (d) and (e) of subsection (1) of
 2384  section 408.809, Florida Statutes, are amended to read:
 2385         408.809 Background screening; prohibited offenses.—
 2386         (1) Level 2 background screening pursuant to chapter 435
 2387  must be conducted through the agency on each of the following
 2388  persons, who are considered employees for the purposes of
 2389  conducting screening under chapter 435:
 2390         (d) Any person who is a controlling interest if the agency
 2391  has reason to believe that such person has been convicted of any
 2392  offense prohibited by s. 435.04. For each controlling interest
 2393  who has been convicted of any such offense, the licensee shall
 2394  submit to the agency a description and explanation of the
 2395  conviction at the time of license application.
 2396         (e) Any person, as required by authorizing statutes,
 2397  seeking employment with a licensee or provider who is expected
 2398  to, or whose responsibilities may require him or her to, provide
 2399  personal care or services directly to clients or have access to
 2400  client funds, personal property, or living areas; and any
 2401  person, as required by authorizing statutes, contracting with a
 2402  licensee or provider whose responsibilities require him or her
 2403  to provide personal care or personal services directly to
 2404  clients, or contracting with a licensee or provider to work 20
 2405  hours a week or more who will have access to client funds,
 2406  personal property, or living areas. Evidence of contractor
 2407  screening may be retained by the contractor’s employer or the
 2408  licensee.
 2409         Section 72. Subsection (8) of section 408.810, Florida
 2410  Statutes, is amended, and subsections (11), (12), and (13) are
 2411  added to that section, to read:
 2412         408.810 Minimum licensure requirements.—In addition to the
 2413  licensure requirements specified in this part, authorizing
 2414  statutes, and applicable rules, each applicant and licensee must
 2415  comply with the requirements of this section in order to obtain
 2416  and maintain a license.
 2417         (8) Upon application for initial licensure or change of
 2418  ownership licensure, the applicant shall furnish satisfactory
 2419  proof of the applicant’s financial ability to operate in
 2420  accordance with the requirements of this part, authorizing
 2421  statutes, and applicable rules. The agency shall establish
 2422  standards for this purpose, including information concerning the
 2423  applicant’s controlling interests. The agency shall also
 2424  establish documentation requirements, to be completed by each
 2425  applicant, that show anticipated provider revenues and
 2426  expenditures, the basis for financing the anticipated cash-flow
 2427  requirements of the provider, and an applicant’s access to
 2428  contingency financing. A current certificate of authority,
 2429  pursuant to chapter 651, may be provided as proof of financial
 2430  ability to operate. The agency may require a licensee to provide
 2431  proof of financial ability to operate at any time if there is
 2432  evidence of financial instability, including, but not limited
 2433  to, unpaid expenses necessary for the basic operations of the
 2434  provider. An applicant applying for change of ownership
 2435  licensure is exempt from furnishing proof of financial ability
 2436  to operate if the provider has been licensed for at least 5
 2437  years, and:
 2438         (a)The ownership change is a result of a corporate
 2439  reorganization under which the controlling interest is unchanged
 2440  and the applicant submits organizational charts that represent
 2441  the current and proposed structure of the reorganized
 2442  corporation; or
 2443         (b)The ownership change is due solely to the death of a
 2444  person holding a controlling interest, and the surviving
 2445  controlling interests continue to hold at least 51 percent of
 2446  ownership after the change of ownership.
 2447         (11)The agency may adopt rules that govern the
 2448  circumstances under which a controlling interest, an
 2449  administrator, an employee, or a contractor, or a representative
 2450  thereof, who is not a relative of the client may act as an agent
 2451  of the client in authorizing consent for medical treatment,
 2452  assignment of benefits, and release of information. Such rules
 2453  may include requirements related to disclosure, bonding,
 2454  restrictions, and client protections.
 2455         (12)The licensee shall ensure that no person holds any
 2456  ownership interest, either directly or indirectly, regardless of
 2457  ownership structure, who:
 2458         (a)Has a disqualifying offense pursuant to s. 408.809; or
 2459         (b)Holds or has held any ownership interest, either
 2460  directly or indirectly, regardless of ownership structure, in a
 2461  provider that had a license revoked or an application denied
 2462  pursuant to s. 408.815.
 2463         (13)If the licensee is a publicly traded corporation or is
 2464  wholly owned, directly or indirectly, by a publicly traded
 2465  corporation, subsection (12) does not apply to those persons
 2466  whose sole relationship with the corporation is as a shareholder
 2467  of publicly traded shares. As used in this subsection, a
 2468  “publicly traded corporation” is a corporation that issues
 2469  securities traded on an exchange registered with the United
 2470  States Securities and Exchange Commission as a national
 2471  securities exchange.
 2472         Section 73. Section 408.812, Florida Statutes, is amended
 2473  to read:
 2474         408.812 Unlicensed activity.—
 2475         (1) A person or entity may not offer or advertise services
 2476  that require licensure as defined by this part, authorizing
 2477  statutes, or applicable rules to the public without obtaining a
 2478  valid license from the agency. A licenseholder may not advertise
 2479  or hold out to the public that he or she holds a license for
 2480  other than that for which he or she actually holds the license.
 2481         (2) The operation or maintenance of an unlicensed provider
 2482  or the performance of any services that require licensure
 2483  without proper licensure is a violation of this part and
 2484  authorizing statutes. Unlicensed activity constitutes harm that
 2485  materially affects the health, safety, and welfare of clients,
 2486  and constitutes abuse and neglect, as defined in s. 415.102. The
 2487  agency or any state attorney may, in addition to other remedies
 2488  provided in this part, bring an action for an injunction to
 2489  restrain such violation, or to enjoin the future operation or
 2490  maintenance of the unlicensed provider or the performance of any
 2491  services in violation of this part and authorizing statutes,
 2492  until compliance with this part, authorizing statutes, and
 2493  agency rules has been demonstrated to the satisfaction of the
 2494  agency.
 2495         (3) It is unlawful for any person or entity to own,
 2496  operate, or maintain an unlicensed provider. If after receiving
 2497  notification from the agency, such person or entity fails to
 2498  cease operation and apply for a license under this part and
 2499  authorizing statutes, the person or entity is shall be subject
 2500  to penalties as prescribed by authorizing statutes and
 2501  applicable rules. Each day of continued operation is a separate
 2502  offense.
 2503         (4) Any person or entity that fails to cease operation
 2504  after agency notification may be fined $1,000 for each day of
 2505  noncompliance.
 2506         (5) When a controlling interest or licensee has an interest
 2507  in more than one provider and fails to license a provider
 2508  rendering services that require licensure, the agency may revoke
 2509  all licenses, and impose actions under s. 408.814, and
 2510  regardless of correction, impose a fine of $1,000 per day,
 2511  unless otherwise specified by authorizing statutes, against each
 2512  licensee until such time as the appropriate license is obtained
 2513  or the unlicensed activity ceases for the unlicensed operation.
 2514         (6) In addition to granting injunctive relief pursuant to
 2515  subsection (2), if the agency determines that a person or entity
 2516  is operating or maintaining a provider without obtaining a
 2517  license and determines that a condition exists that poses a
 2518  threat to the health, safety, or welfare of a client of the
 2519  provider, the person or entity is subject to the same actions
 2520  and fines imposed against a licensee as specified in this part,
 2521  authorizing statutes, and agency rules.
 2522         (7) Any person aware of the operation of an unlicensed
 2523  provider must report that provider to the agency.
 2524         Section 74. Subsections (10), (11) and (26) of section
 2525  408.820, Florida Statutes, are amended, and subsections (12)
 2526  through (25) and (27) and (28) are redesignated as subsections
 2527  (10) through (23) and (24) and (25), respectively, to read:
 2528         408.820 Exemptions.—Except as prescribed in authorizing
 2529  statutes, the following exemptions shall apply to specified
 2530  requirements of this part:
 2531         (10)Mobile surgical facilities, as provided under part I
 2532  of chapter 395, are exempt from s. 408.810(7)-(10).
 2533         (11)Health care risk managers, as provided under part I of
 2534  chapter 395, are exempt from ss. 408.806(7), 408.810(4)-(10),
 2535  and 408.811.
 2536         (26)Clinical laboratories, as provided under part I of
 2537  chapter 483, are exempt from s. 408.810(5)-(10).
 2538         Section 75. Subsection (7) of section 409.905, Florida
 2539  Statutes, is amended to read:
 2540         409.905 Mandatory Medicaid services.—The agency may make
 2541  payments for the following services, which are required of the
 2542  state by Title XIX of the Social Security Act, furnished by
 2543  Medicaid providers to recipients who are determined to be
 2544  eligible on the dates on which the services were provided. Any
 2545  service under this section shall be provided only when medically
 2546  necessary and in accordance with state and federal law.
 2547  Mandatory services rendered by providers in mobile units to
 2548  Medicaid recipients may be restricted by the agency. Nothing in
 2549  this section shall be construed to prevent or limit the agency
 2550  from adjusting fees, reimbursement rates, lengths of stay,
 2551  number of visits, number of services, or any other adjustments
 2552  necessary to comply with the availability of moneys and any
 2553  limitations or directions provided for in the General
 2554  Appropriations Act or chapter 216.
 2555         (7) INDEPENDENT LABORATORY SERVICES.—The agency shall pay
 2556  for medically necessary diagnostic laboratory procedures ordered
 2557  by a licensed physician or other licensed practitioner of the
 2558  healing arts which are provided for a recipient in a laboratory
 2559  that meets the requirements for Medicare participation and is
 2560  appropriately certified by the Centers for Medicare and Medicaid
 2561  Services under the federal Clinical Laboratory Improvement
 2562  Amendments and the federal rules adopted thereunder licensed
 2563  under chapter 483, if required.
 2564         Section 76. Subsection (10) of section 409.907, Florida
 2565  Statutes, is amended to read:
 2566         409.907 Medicaid provider agreements.—The agency may make
 2567  payments for medical assistance and related services rendered to
 2568  Medicaid recipients only to an individual or entity who has a
 2569  provider agreement in effect with the agency, who is performing
 2570  services or supplying goods in accordance with federal, state,
 2571  and local law, and who agrees that no person shall, on the
 2572  grounds of handicap, race, color, or national origin, or for any
 2573  other reason, be subjected to discrimination under any program
 2574  or activity for which the provider receives payment from the
 2575  agency.
 2576         (10) The agency may consider whether the provider, or any
 2577  officer, director, agent, managing employee, or affiliated
 2578  person, or any partner or shareholder having an ownership
 2579  interest equal to 5 percent or greater in the provider if the
 2580  provider is a corporation, partnership, or other business
 2581  entity, has:
 2582         (a) Made a false representation or omission of any material
 2583  fact in making the application, including the submission of an
 2584  application that conceals the controlling or ownership interest
 2585  of any officer, director, agent, managing employee, affiliated
 2586  person, or partner or shareholder who may not be eligible to
 2587  participate;
 2588         (b) Been or is currently excluded, suspended, terminated
 2589  from, or has involuntarily withdrawn from participation in,
 2590  Florida’s Medicaid program or any other state’s Medicaid
 2591  program, or from participation in any other governmental or
 2592  private health care or health insurance program;
 2593         (c)Been convicted of a criminal offense relating to the
 2594  delivery of any goods or services under Medicaid or Medicare or
 2595  any other public or private health care or health insurance
 2596  program including the performance of management or
 2597  administrative services relating to the delivery of goods or
 2598  services under any such program;
 2599         (d)Been convicted under federal or state law of a criminal
 2600  offense related to the neglect or abuse of a patient in
 2601  connection with the delivery of any health care goods or
 2602  services;
 2603         (e)Been convicted under federal or state law of a criminal
 2604  offense relating to the unlawful manufacture, distribution,
 2605  prescription, or dispensing of a controlled substance;
 2606         (f)Been convicted of any criminal offense relating to
 2607  fraud, theft, embezzlement, breach of fiduciary responsibility,
 2608  or other financial misconduct;
 2609         (g)Been convicted under federal or state law of a crime
 2610  punishable by imprisonment of a year or more which involves
 2611  moral turpitude;
 2612         (h)Been convicted in connection with the interference or
 2613  obstruction of any investigation into any criminal offense
 2614  listed in this subsection;
 2615         (i)Been found to have violated federal or state laws,
 2616  rules, or regulations governing Florida’s Medicaid program or
 2617  any other state’s Medicaid program, the Medicare program, or any
 2618  other publicly funded federal or state health care or health
 2619  insurance program, and been sanctioned accordingly;
 2620         (c)(j) Been previously found by a licensing, certifying, or
 2621  professional standards board or agency to have violated the
 2622  standards or conditions relating to licensure or certification
 2623  or the quality of services provided; or
 2624         (d)(k) Failed to pay any fine or overpayment properly
 2625  assessed under the Medicaid program in which no appeal is
 2626  pending or after resolution of the proceeding by stipulation or
 2627  agreement, unless the agency has issued a specific letter of
 2628  forgiveness or has approved a repayment schedule to which the
 2629  provider agrees to adhere.
 2630         Section 77. Subsection (6) of section 409.9116, Florida
 2631  Statutes, is amended to read:
 2632         409.9116 Disproportionate share/financial assistance
 2633  program for rural hospitals.—In addition to the payments made
 2634  under s. 409.911, the Agency for Health Care Administration
 2635  shall administer a federally matched disproportionate share
 2636  program and a state-funded financial assistance program for
 2637  statutory rural hospitals. The agency shall make
 2638  disproportionate share payments to statutory rural hospitals
 2639  that qualify for such payments and financial assistance payments
 2640  to statutory rural hospitals that do not qualify for
 2641  disproportionate share payments. The disproportionate share
 2642  program payments shall be limited by and conform with federal
 2643  requirements. Funds shall be distributed quarterly in each
 2644  fiscal year for which an appropriation is made. Notwithstanding
 2645  the provisions of s. 409.915, counties are exempt from
 2646  contributing toward the cost of this special reimbursement for
 2647  hospitals serving a disproportionate share of low-income
 2648  patients.
 2649         (6) This section applies only to hospitals that were
 2650  defined as statutory rural hospitals, or their successor-in
 2651  interest hospital, prior to January 1, 2001. Any additional
 2652  hospital that is defined as a statutory rural hospital, or its
 2653  successor-in-interest hospital, on or after January 1, 2001, is
 2654  not eligible for programs under this section unless additional
 2655  funds are appropriated each fiscal year specifically to the
 2656  rural hospital disproportionate share and financial assistance
 2657  programs in an amount necessary to prevent any hospital, or its
 2658  successor-in-interest hospital, eligible for the programs prior
 2659  to January 1, 2001, from incurring a reduction in payments
 2660  because of the eligibility of an additional hospital to
 2661  participate in the programs. A hospital, or its successor-in
 2662  interest hospital, which received funds pursuant to this section
 2663  before January 1, 2001, and which qualifies under s.
 2664  395.602(2)(b) s. 395.602(2)(e), shall be included in the
 2665  programs under this section and is not required to seek
 2666  additional appropriations under this subsection.
 2667         Section 78. Paragraphs (a) and (b) of subsection (1) of
 2668  section 409.975, Florida Statutes, are amended to read:
 2669         409.975 Managed care plan accountability.—In addition to
 2670  the requirements of s. 409.967, plans and providers
 2671  participating in the managed medical assistance program shall
 2672  comply with the requirements of this section.
 2673         (1) PROVIDER NETWORKS.—Managed care plans must develop and
 2674  maintain provider networks that meet the medical needs of their
 2675  enrollees in accordance with standards established pursuant to
 2676  s. 409.967(2)(c). Except as provided in this section, managed
 2677  care plans may limit the providers in their networks based on
 2678  credentials, quality indicators, and price.
 2679         (a) Plans must include all providers in the region that are
 2680  classified by the agency as essential Medicaid providers, unless
 2681  the agency approves, in writing, an alternative arrangement for
 2682  securing the types of services offered by the essential
 2683  providers. Providers are essential for serving Medicaid
 2684  enrollees if they offer services that are not available from any
 2685  other provider within a reasonable access standard, or if they
 2686  provided a substantial share of the total units of a particular
 2687  service used by Medicaid patients within the region during the
 2688  last 3 years and the combined capacity of other service
 2689  providers in the region is insufficient to meet the total needs
 2690  of the Medicaid patients. The agency may not classify physicians
 2691  and other practitioners as essential providers. The agency, at a
 2692  minimum, shall determine which providers in the following
 2693  categories are essential Medicaid providers:
 2694         1. Federally qualified health centers.
 2695         2. Statutory teaching hospitals as defined in s. 408.07(44)
 2696  s. 408.07(45).
 2697         3. Hospitals that are trauma centers as defined in s.
 2698  395.4001(14).
 2699         4. Hospitals located at least 25 miles from any other
 2700  hospital with similar services.
 2701  
 2702  Managed care plans that have not contracted with all essential
 2703  providers in the region as of the first date of recipient
 2704  enrollment, or with whom an essential provider has terminated
 2705  its contract, must negotiate in good faith with such essential
 2706  providers for 1 year or until an agreement is reached, whichever
 2707  is first. Payments for services rendered by a nonparticipating
 2708  essential provider shall be made at the applicable Medicaid rate
 2709  as of the first day of the contract between the agency and the
 2710  plan. A rate schedule for all essential providers shall be
 2711  attached to the contract between the agency and the plan. After
 2712  1 year, managed care plans that are unable to contract with
 2713  essential providers shall notify the agency and propose an
 2714  alternative arrangement for securing the essential services for
 2715  Medicaid enrollees. The arrangement must rely on contracts with
 2716  other participating providers, regardless of whether those
 2717  providers are located within the same region as the
 2718  nonparticipating essential service provider. If the alternative
 2719  arrangement is approved by the agency, payments to
 2720  nonparticipating essential providers after the date of the
 2721  agency’s approval shall equal 90 percent of the applicable
 2722  Medicaid rate. Except for payment for emergency services, if the
 2723  alternative arrangement is not approved by the agency, payment
 2724  to nonparticipating essential providers shall equal 110 percent
 2725  of the applicable Medicaid rate.
 2726         (b) Certain providers are statewide resources and essential
 2727  providers for all managed care plans in all regions. All managed
 2728  care plans must include these essential providers in their
 2729  networks. Statewide essential providers include:
 2730         1. Faculty plans of Florida medical schools.
 2731         2. Regional perinatal intensive care centers as defined in
 2732  s. 383.16(2).
 2733         3. Hospitals licensed as specialty children’s hospitals as
 2734  defined in s. 395.002(27) s. 395.002(28).
 2735         4. Accredited and integrated systems serving medically
 2736  complex children which comprise separately licensed, but
 2737  commonly owned, health care providers delivering at least the
 2738  following services: medical group home, in-home and outpatient
 2739  nursing care and therapies, pharmacy services, durable medical
 2740  equipment, and Prescribed Pediatric Extended Care.
 2741  
 2742  Managed care plans that have not contracted with all statewide
 2743  essential providers in all regions as of the first date of
 2744  recipient enrollment must continue to negotiate in good faith.
 2745  Payments to physicians on the faculty of nonparticipating
 2746  Florida medical schools shall be made at the applicable Medicaid
 2747  rate. Payments for services rendered by regional perinatal
 2748  intensive care centers shall be made at the applicable Medicaid
 2749  rate as of the first day of the contract between the agency and
 2750  the plan. Except for payments for emergency services, payments
 2751  to nonparticipating specialty children’s hospitals shall equal
 2752  the highest rate established by contract between that provider
 2753  and any other Medicaid managed care plan.
 2754         Section 79. Subsections (5) and (17) of section 429.02,
 2755  Florida Statutes, are amended to read:
 2756         429.02 Definitions.—When used in this part, the term:
 2757         (5) “Assisted living facility” means any building or
 2758  buildings, section or distinct part of a building, private home,
 2759  boarding home, home for the aged, or other residential facility,
 2760  regardless of whether operated for profit or not, which
 2761  undertakes through its ownership or management provides to
 2762  provide housing, meals, and one or more personal services for a
 2763  period exceeding 24 hours to one or more adults who are not
 2764  relatives of the owner or administrator.
 2765         (17) “Personal services” means direct physical assistance
 2766  with or supervision of the activities of daily living, and the
 2767  self-administration of medication, or and other similar services
 2768  which the department may define by rule. The term may “Personal
 2769  services” shall not be construed to mean the provision of
 2770  medical, nursing, dental, or mental health services.
 2771         Section 80. Paragraphs (b) and (d) of subsection (2) of
 2772  section 429.04, Florida Statutes, are amended, and subsection
 2773  (3) is added that section, to read:
 2774         429.04 Facilities to be licensed; exemptions.—
 2775         (2) The following are exempt from licensure under this
 2776  part:
 2777         (b) Any facility or part of a facility licensed by the
 2778  Agency for Persons with Disabilities under chapter 393, a mental
 2779  health facility licensed under or chapter 394, a hospital
 2780  licensed under chapter 395, a nursing home licensed under part
 2781  II of chapter 400, an inpatient hospice licensed under part IV
 2782  of chapter 400, a home for special services licensed under part
 2783  V of chapter 400, an intermediate care facility licensed under
 2784  part VIII of chapter 400, or a transitional living facility
 2785  licensed under part XI of chapter 400.
 2786         (d) Any person who provides housing, meals, and one or more
 2787  personal services on a 24-hour basis in the person’s own home to
 2788  not more than two adults who do not receive optional state
 2789  supplementation. The person who provides the housing, meals, and
 2790  personal services must own or rent the home and must have
 2791  established the home as his or her permanent residence. For
 2792  purposes of this paragraph, any person holding a homestead
 2793  exemption at an address other than that at which the person
 2794  asserts this exemption is presumed to not have established
 2795  permanent residence reside therein. This exemption does not
 2796  apply to a person or entity that previously held a license
 2797  issued by the agency which was revoked or for which renewal was
 2798  denied by final order of the agency, or when the person or
 2799  entity voluntarily relinquished the license during agency
 2800  enforcement proceedings.
 2801         (3)Upon agency investigation of unlicensed activity, any
 2802  person or entity that claims that it is exempt under this
 2803  section must provide documentation substantiating entitlement to
 2804  the exemption.
 2805         Section 81. Paragraphs (b) and (d) of subsection (1) of
 2806  section 429.08, Florida Statutes, are amended to read:
 2807         429.08 Unlicensed facilities; referral of person for
 2808  residency to unlicensed facility; penalties.—
 2809         (1)
 2810         (b) Except as provided under paragraph (d), Any person who
 2811  owns, rents, or otherwise maintains a building or property used
 2812  as operates, or maintains an unlicensed assisted living facility
 2813  commits a felony of the third degree, punishable as provided in
 2814  s. 775.082, s. 775.083, or s. 775.084. Each day of continued
 2815  operation is a separate offense.
 2816         (d) In addition to the requirements of s. 408.812, any
 2817  person who owns, operates, or maintains an unlicensed assisted
 2818  living facility after receiving notice from the agency due to a
 2819  change in this part or a modification in rule within 6 months
 2820  after the effective date of such change and who, within 10
 2821  working days after receiving notification from the agency, fails
 2822  to cease operation or apply for a license under this part
 2823  commits a felony of the third degree, punishable as provided in
 2824  s. 775.082, s. 775.083, or s. 775.084. Each day of continued
 2825  operation is a separate offense.
 2826         Section 82. Section 429.176, Florida Statutes, is amended
 2827  to read:
 2828         429.176 Notice of change of administrator.—If, during the
 2829  period for which a license is issued, the owner changes
 2830  administrators, the owner must notify the agency of the change
 2831  within 10 days and provide documentation within 90 days that the
 2832  new administrator has completed the applicable core educational
 2833  requirements under s. 429.52. A facility may not be operated for
 2834  more than 120 consecutive days without an administrator who has
 2835  completed the core educational requirements.
 2836         Section 83. Subsection (7) of section 429.19, Florida
 2837  Statutes, is amended to read:
 2838         429.19 Violations; imposition of administrative fines;
 2839  grounds.—
 2840         (7) In addition to any administrative fines imposed, the
 2841  agency may assess a survey fee, equal to the lesser of one half
 2842  of the facility’s biennial license and bed fee or $500, to cover
 2843  the cost of conducting initial complaint investigations that
 2844  result in the finding of a violation that was the subject of the
 2845  complaint or monitoring visits conducted under s. 429.28(3)(c)
 2846  to verify the correction of the violations.
 2847         Section 84. Subsection (2) of section 429.24, Florida
 2848  Statutes, is amended to read:
 2849         429.24 Contracts.—
 2850         (2) Each contract must contain express provisions
 2851  specifically setting forth the services and accommodations to be
 2852  provided by the facility; the rates or charges; provision for at
 2853  least 30 days’ written notice of a rate increase; the rights,
 2854  duties, and obligations of the residents, other than those
 2855  specified in s. 429.28; and other matters that the parties deem
 2856  appropriate. A new service or accommodation added to, or
 2857  implemented in, a resident’s contract for which the resident was
 2858  not previously charged does not require a 30-day written notice
 2859  of a rate increase. Whenever money is deposited or advanced by a
 2860  resident in a contract as security for performance of the
 2861  contract agreement or as advance rent for other than the next
 2862  immediate rental period:
 2863         (a) Such funds shall be deposited in a banking institution
 2864  in this state that is located, if possible, in the same
 2865  community in which the facility is located; shall be kept
 2866  separate from the funds and property of the facility; may not be
 2867  represented as part of the assets of the facility on financial
 2868  statements; and shall be used, or otherwise expended, only for
 2869  the account of the resident.
 2870         (b) The licensee shall, within 30 days of receipt of
 2871  advance rent or a security deposit, notify the resident or
 2872  residents in writing of the manner in which the licensee is
 2873  holding the advance rent or security deposit and state the name
 2874  and address of the depository where the moneys are being held.
 2875  The licensee shall notify residents of the facility’s policy on
 2876  advance deposits.
 2877         Section 85. Paragraphs (e) and (j) of subsection (1) and
 2878  paragraphs (c), (d), and (e) of subsection (3) of section
 2879  429.28, Florida Statutes, are amended to read:
 2880         429.28 Resident bill of rights.—
 2881         (1) No resident of a facility shall be deprived of any
 2882  civil or legal rights, benefits, or privileges guaranteed by
 2883  law, the Constitution of the State of Florida, or the
 2884  Constitution of the United States as a resident of a facility.
 2885  Every resident of a facility shall have the right to:
 2886         (e) Freedom to participate in and benefit from community
 2887  services and activities and to pursue achieve the highest
 2888  possible level of independence, autonomy, and interaction within
 2889  the community.
 2890         (j) Assistance with obtaining access to adequate and
 2891  appropriate health care. For purposes of this paragraph, the
 2892  term “adequate and appropriate health care” means the management
 2893  of medications, assistance in making appointments for health
 2894  care services, the provision of or arrangement of transportation
 2895  to health care appointments, and the performance of health care
 2896  services in accordance with s. 429.255 which are consistent with
 2897  established and recognized standards within the community.
 2898         (3)
 2899         (c)During any calendar year in which no survey is
 2900  conducted, the agency shall conduct at least one monitoring
 2901  visit of each facility cited in the previous year for a class I
 2902  or class II violation, or more than three uncorrected class III
 2903  violations.
 2904         (d)The agency may conduct periodic followup inspections as
 2905  necessary to monitor the compliance of facilities with a history
 2906  of any class I, class II, or class III violations that threaten
 2907  the health, safety, or security of residents.
 2908         (e)The agency may conduct complaint investigations as
 2909  warranted to investigate any allegations of noncompliance with
 2910  requirements required under this part or rules adopted under
 2911  this part.
 2912         Section 86. Subsection (1) of section 429.294, Florida
 2913  Statutes, is amended to read:
 2914         429.294 Availability of facility records for investigation
 2915  of resident’s rights violations and defenses; penalty.—
 2916         (1) Failure to provide complete copies of a resident’s
 2917  records, including, but not limited to, all medical records and
 2918  the resident’s chart, within the control or possession of the
 2919  facility within 10 days, in accordance with the provisions of s.
 2920  400.145, shall constitute evidence of failure of that party to
 2921  comply with good faith discovery requirements and shall waive
 2922  the good faith certificate and presuit notice requirements under
 2923  this part by the requesting party.
 2924         Section 87. Subsection (2) of section 429.34, Florida
 2925  Statutes, is amended to read:
 2926         429.34 Right of entry and inspection.—
 2927         (2)(a)In addition to the requirements of s. 408.811, the
 2928  agency may inspect and investigate facilities as necessary to
 2929  determine compliance with this part, part II of chapter 408, and
 2930  rules adopted thereunder. The agency shall inspect each licensed
 2931  assisted living facility at least once every 24 months to
 2932  determine compliance with this chapter and related rules. If an
 2933  assisted living facility is cited for a class I violation or
 2934  three or more class II violations arising from separate surveys
 2935  within a 60-day period or due to unrelated circumstances during
 2936  the same survey, the agency must conduct an additional licensure
 2937  inspection within 6 months.
 2938         (b)During any calendar year in which a survey is not
 2939  conducted, the agency may conduct monitoring visits of each
 2940  facility cited in the previous year for a class I or class II
 2941  violation or for more than three uncorrected class III
 2942  violations.
 2943         Section 88. Subsection (4) of section 429.52, Florida
 2944  Statutes, is amended to read:
 2945         429.52 Staff training and educational programs; core
 2946  educational requirement.—
 2947         (4) Effective January 1, 2004, a new facility administrator
 2948  must complete the required training and education, including the
 2949  competency test, within 90 days after date of employment a
 2950  reasonable time after being employed as an administrator, as
 2951  determined by the department. Failure to do so is a violation of
 2952  this part and subjects the violator to an administrative fine as
 2953  prescribed in s. 429.19. Administrators licensed in accordance
 2954  with part II of chapter 468 are exempt from this requirement.
 2955  Other licensed professionals may be exempted, as determined by
 2956  the department by rule.
 2957         Section 89. Subsection (3) of section 435.04, Florida
 2958  Statutes, is amended, and subsection (4) is added to that
 2959  section, to read:
 2960         435.04 Level 2 screening standards.—
 2961         (3) The security background investigations under this
 2962  section must ensure that no person subject to this section has
 2963  been arrested for and is awaiting final disposition of, been
 2964  found guilty of, regardless of adjudication, or entered a plea
 2965  of nolo contendere or guilty to, any offense that constitutes
 2966  domestic violence as defined in s. 741.28, whether such act was
 2967  committed in this state or in another jurisdiction.
 2968         (4)For the purpose of screening applicability to
 2969  participate in the Medicaid program, the security background
 2970  investigations under this section must ensure that a person
 2971  subject to screening under this section has not been arrested
 2972  for and is not awaiting final disposition of; has not been found
 2973  guilty of, regardless of adjudication, or entered a plea of nolo
 2974  contendere or guilty to; and has not been adjudicated delinquent
 2975  and the record sealed or expunged for, any of the following
 2976  offenses:
 2977         (a)Violation of a federal law or a law in any state which
 2978  creates a criminal offense relating to:
 2979         1.The delivery of any goods or services under Medicaid or
 2980  Medicare or any other public or private health care or health
 2981  insurance program, including the performance of management or
 2982  administrative services relating to the delivery of goods or
 2983  services under any such program;
 2984         2.Neglect or abuse of a patient in connection with the
 2985  delivery of any health care good or service;
 2986         3.Unlawful manufacture, distribution, prescription, or
 2987  dispensing of a controlled substance;
 2988         4.Fraud, theft, embezzlement, breach of fiduciary
 2989  responsibility, or other financial misconduct; or
 2990         5.Moral turpitude, if punishable by imprisonment of a year
 2991  or more.
 2992         6.Interference with or obstruction of an investigation
 2993  into any criminal offense identified in this subsection.
 2994         (b) Violation of the following state laws or laws of
 2995  another jurisdiction:
 2996         1.Section 817.569, criminal use of a public record or
 2997  information contained in a public record;
 2998         2.Section 838.016, unlawful compensation or reward for
 2999  official behavior;
 3000         3.Section 838.021, corruption by threat against a public
 3001  servant;
 3002         4.Section 838.022, official misconduct;
 3003         5.Section 838.22, bid tampering;
 3004         6.Section 839.13, falsifying records;
 3005         7.Section 839.26, misuse of confidential information; or
 3006         (c)Violation of a federal or state law, rule, or
 3007  regulation governing the Florida Medicaid program or any other
 3008  state Medicaid program, the Medicare program, or any other
 3009  publicly funded federal or state health care or health insurance
 3010  program.
 3011         Section 90. Subsection (4) of section 456.001, Florida
 3012  Statutes, is amended to read:
 3013         456.001 Definitions.—As used in this chapter, the term:
 3014         (4) “Health care practitioner” means any person licensed
 3015  under chapter 457; chapter 458; chapter 459; chapter 460;
 3016  chapter 461; chapter 462; chapter 463; chapter 464; chapter 465;
 3017  chapter 466; chapter 467; part I, part II, part III, part V,
 3018  part X, part XIII, or part XIV of chapter 468; chapter 478;
 3019  chapter 480; part II or part III or part IV of chapter 483;
 3020  chapter 484; chapter 486; chapter 490; or chapter 491.
 3021         Section 91. Subsection (3) of section 456.054, Florida
 3022  Statutes, is redesignated as subsection (4), and a new
 3023  subsection (3) is added to that section, to read:
 3024         456.054 Kickbacks prohibited.—
 3025         (3)(a)It is unlawful for any person or any entity to pay
 3026  or receive, directly or indirectly, a commission, bonus,
 3027  kickback, or rebate from, or to engage in any form of a split
 3028  fee arrangement with, a dialysis facility, health care
 3029  practitioner, surgeon, person, or entity for referring patients
 3030  to a clinical laboratory as defined in s. 483.803.
 3031         (b)It is unlawful for any clinical laboratory to:
 3032         1.Provide personnel to perform any functions or duties in
 3033  a health care practitioner’s office or dialysis facility for any
 3034  purpose, including for the collection or handling of specimens,
 3035  directly or indirectly through an employee, contractor,
 3036  independent staffing company, lease agreement, or otherwise,
 3037  unless the laboratory and the practitioner’s office, or dialysis
 3038  facility, are wholly owned and operated by the same entity.
 3039         2.Lease space within any part of a health care
 3040  practitioner’s office or dialysis facility for any purpose,
 3041  including for the purpose of establishing a collection station
 3042  where materials or specimens are collected or drawn from
 3043  patients.
 3044         Section 92. Paragraphs (h) and (i) of subsection (2) of
 3045  section 456.057, Florida Statutes, are amended to read:
 3046         456.057 Ownership and control of patient records; report or
 3047  copies of records to be furnished; disclosure of information.—
 3048         (2) As used in this section, the terms “records owner,”
 3049  “health care practitioner,” and “health care practitioner’s
 3050  employer” do not include any of the following persons or
 3051  entities; furthermore, the following persons or entities are not
 3052  authorized to acquire or own medical records, but are authorized
 3053  under the confidentiality and disclosure requirements of this
 3054  section to maintain those documents required by the part or
 3055  chapter under which they are licensed or regulated:
 3056         (h) Clinical laboratory personnel licensed under part II
 3057  III of chapter 483.
 3058         (i) Medical physicists licensed under part III IV of
 3059  chapter 483.
 3060         Section 93. Paragraph (j) of subsection (1) of section
 3061  456.076, Florida Statutes, is amended to read:
 3062         456.076 Impaired practitioner programs.—
 3063         (1) As used in this section, the term:
 3064         (j) “Practitioner” means a person licensed, registered,
 3065  certified, or regulated by the department under part III of
 3066  chapter 401; chapter 457; chapter 458; chapter 459; chapter 460;
 3067  chapter 461; chapter 462; chapter 463; chapter 464; chapter 465;
 3068  chapter 466; chapter 467; part I, part II, part III, part V,
 3069  part X, part XIII, or part XIV of chapter 468; chapter 478;
 3070  chapter 480; part II or part III or part IV of chapter 483;
 3071  chapter 484; chapter 486; chapter 490; or chapter 491; or an
 3072  applicant for a license, registration, or certification under
 3073  the same laws.
 3074         Section 94. Subsection (2) of section 458.307, Florida
 3075  Statutes, is amended to read:
 3076         458.307 Board of Medicine.—
 3077         (2) Twelve members of the board must be licensed physicians
 3078  in good standing in this state who are residents of the state
 3079  and who have been engaged in the active practice or teaching of
 3080  medicine for at least 4 years immediately preceding their
 3081  appointment. One of the physicians must be on the full-time
 3082  faculty of a medical school in this state, and one of the
 3083  physicians must be in private practice and on the full-time
 3084  staff of a statutory teaching hospital in this state as defined
 3085  in s. 408.07. At least one of the physicians must be a graduate
 3086  of a foreign medical school. The remaining three members must be
 3087  residents of the state who are not, and never have been,
 3088  licensed health care practitioners. One member must be a health
 3089  care risk manager licensed under s. 395.10974. At least one
 3090  member of the board must be 60 years of age or older.
 3091         Section 95. Subsection (1) of section 458.345, Florida
 3092  Statutes, is amended to read:
 3093         458.345 Registration of resident physicians, interns, and
 3094  fellows; list of hospital employees; prescribing of medicinal
 3095  drugs; penalty.—
 3096         (1) Any person desiring to practice as a resident
 3097  physician, assistant resident physician, house physician,
 3098  intern, or fellow in fellowship training which leads to
 3099  subspecialty board certification in this state, or any person
 3100  desiring to practice as a resident physician, assistant resident
 3101  physician, house physician, intern, or fellow in fellowship
 3102  training in a teaching hospital in this state as defined in s.
 3103  408.07 s. 408.07(45) or s. 395.805(2), who does not hold a
 3104  valid, active license issued under this chapter shall apply to
 3105  the department to be registered and shall remit a fee not to
 3106  exceed $300 as set by the board. The department shall register
 3107  any applicant the board certifies has met the following
 3108  requirements:
 3109         (a) Is at least 21 years of age.
 3110         (b) Has not committed any act or offense within or without
 3111  the state which would constitute the basis for refusal to
 3112  certify an application for licensure pursuant to s. 458.331.
 3113         (c) Is a graduate of a medical school or college as
 3114  specified in s. 458.311(1)(f).
 3115         Section 96. Subsection (1) of s. 459.021, Florida Statutes,
 3116  is amended to read:
 3117         459.021 Registration of resident physicians, interns, and
 3118  fellows; list of hospital employees; penalty.—
 3119         (1) Any person who holds a degree of Doctor of Osteopathic
 3120  Medicine from a college of osteopathic medicine recognized and
 3121  approved by the American Osteopathic Association who desires to
 3122  practice as a resident physician, intern, or fellow in
 3123  fellowship training which leads to subspecialty board
 3124  certification in this state, or any person desiring to practice
 3125  as a resident physician, intern, or fellow in fellowship
 3126  training in a teaching hospital in this state as defined in s.
 3127  408.07 s. 408.07(45) or s. 395.805(2), who does not hold an
 3128  active license issued under this chapter shall apply to the
 3129  department to be registered, on an application provided by the
 3130  department, before commencing such a training program and shall
 3131  remit a fee not to exceed $300 as set by the board.
 3132         Section 97. Part I of chapter 483, Florida Statutes,
 3133  consisting of sections 483.011, 483.021, 483.031, 483.035,
 3134  483.041, 483.051, 483.061, 483.091, 483.101, 483.111, 483.172,
 3135  483.181, 483.191, 483.201, 483.221, 483.23, 483.245, and 483.26,
 3136  is repealed.
 3137         Section 98. Section 483.294, Florida Statutes, is amended
 3138  to read:
 3139         483.294 Inspection of centers.—In accordance with s.
 3140  408.811, the agency shall, at least once annually, inspect the
 3141  premises and operations of all centers subject to licensure
 3142  under this part.
 3143         Section 99. Subsections (3) and (5) of section 483.801,
 3144  Florida Statutes, are amended, and subsection (6) is added to
 3145  that section, to read:
 3146         483.801 Exemptions.—This part applies to all clinical
 3147  laboratories and clinical laboratory personnel within this
 3148  state, except:
 3149         (3) Persons engaged in testing performed by laboratories
 3150  that are wholly owned and operated by one or more practitioners
 3151  licensed under chapter 458, chapter 459, chapter 460, chapter
 3152  461, chapter 462, chapter 463, or chapter 466 who practice in
 3153  the same group practice, and in which no clinical laboratory
 3154  work is performed for patients referred by any health care
 3155  provider who is not a member of that group practice regulated
 3156  under s. 483.035(1) or exempt from regulation under s.
 3157  483.031(2).
 3158         (5) Advanced registered nurse practitioners licensed under
 3159  part I of chapter 464 who perform provider-performed microscopy
 3160  procedures (PPMP) in a an exclusive-use laboratory setting
 3161  pursuant to subsection (3).
 3162         (6)Persons performing laboratory testing within a
 3163  physician office practice for patients referred by a health care
 3164  provider who is a member of the same physician office practice,
 3165  if the laboratory or entity operating the laboratory within a
 3166  physician office practice is under common ownership, directly or
 3167  indirectly, with an entity licensed pursuant to chapter 395.
 3168         Section 100. Subsections (2), (3), and (4) of section
 3169  483.803, Florida Statutes, are amended to read:
 3170         483.803 Definitions.—As used in this part, the term:
 3171         (2) “Clinical laboratory” means the physical location in
 3172  which one or more of the following services are performed to
 3173  provide information or materials for use in the diagnosis,
 3174  prevention, or treatment of a disease or the identification or
 3175  assessment of a medical or physical condition:
 3176         (a)Clinical laboratory services, which entail the
 3177  examination of fluids or other materials taken from the human
 3178  body.
 3179         (b)Anatomic laboratory services, which entail the
 3180  examination of tissue taken from the human body.
 3181         (c)Cytology laboratory services, which entail the
 3182  examination of cells from individual tissues or fluid taken from
 3183  the human body a clinical laboratory as defined in s. 483.041.
 3184         (3) “Clinical laboratory examination” means a procedure
 3185  performed to deliver the services identified in subsection (2),
 3186  including the oversight or interpretation of such services
 3187  clinical laboratory examination as defined in s. 483.041.
 3188         (4) “Clinical laboratory personnel” includes a clinical
 3189  laboratory director, supervisor, technologist, blood gas
 3190  analyst, or technician who performs or is responsible for
 3191  laboratory test procedures, but the term does not include
 3192  trainees, persons who perform screening for blood banks or
 3193  plasmapheresis centers, phlebotomists, or persons employed by a
 3194  clinical laboratory to perform manual pretesting duties or
 3195  clerical, personnel, or other administrative responsibilities,
 3196  or persons engaged in testing performed by laboratories
 3197  regulated under s. 483.035(1) or exempt from regulation under s.
 3198  483.031(2).
 3199         Section 101. Section 483.813, Florida Statutes, is amended
 3200  to read:
 3201         483.813 Clinical laboratory personnel license.—A person may
 3202  not conduct a clinical laboratory examination or report the
 3203  results of such examination unless such person is licensed under
 3204  this part to perform such procedures. However, this provision
 3205  does not apply to any practitioner of the healing arts
 3206  authorized to practice in this state or to persons engaged in
 3207  testing performed by laboratories regulated under s. 483.035(1)
 3208  or exempt from regulation under s. 483.031(2). The department
 3209  may grant a temporary license to any candidate it deems properly
 3210  qualified, for a period not to exceed 1 year.
 3211         Section 102. Subsection (2) of section 483.823, Florida
 3212  Statutes, is amended to read:
 3213         483.823 Qualifications of clinical laboratory personnel.—
 3214         (2) Personnel qualifications may require appropriate
 3215  education, training, or experience or the passing of an
 3216  examination in appropriate subjects or any combination of these,
 3217  but a no practitioner of the healing arts licensed to practice
 3218  in this state is not required to obtain any license under this
 3219  part or to pay any fee under this part hereunder except the fee
 3220  required for clinical laboratory licensure.
 3221         Section 103. Paragraph (c) of subsection (7), and
 3222  subsections (8) and (9) of section 491.003, Florida Statutes,
 3223  are amended to read:
 3224         491.003 Definitions.—As used in this chapter:
 3225         (7) The “practice of clinical social work” is defined as
 3226  the use of scientific and applied knowledge, theories, and
 3227  methods for the purpose of describing, preventing, evaluating,
 3228  and treating individual, couple, marital, family, or group
 3229  behavior, based on the person-in-situation perspective of
 3230  psychosocial development, normal and abnormal behavior,
 3231  psychopathology, unconscious motivation, interpersonal
 3232  relationships, environmental stress, differential assessment,
 3233  differential planning, and data gathering. The purpose of such
 3234  services is the prevention and treatment of undesired behavior
 3235  and enhancement of mental health. The practice of clinical
 3236  social work includes methods of a psychological nature used to
 3237  evaluate, assess, diagnose, treat, and prevent emotional and
 3238  mental disorders and dysfunctions (whether cognitive, affective,
 3239  or behavioral), sexual dysfunction, behavioral disorders,
 3240  alcoholism, and substance abuse. The practice of clinical social
 3241  work includes, but is not limited to, psychotherapy,
 3242  hypnotherapy, and sex therapy. The practice of clinical social
 3243  work also includes counseling, behavior modification,
 3244  consultation, client-centered advocacy, crisis intervention, and
 3245  the provision of needed information and education to clients,
 3246  when using methods of a psychological nature to evaluate,
 3247  assess, diagnose, treat, and prevent emotional and mental
 3248  disorders and dysfunctions (whether cognitive, affective, or
 3249  behavioral), sexual dysfunction, behavioral disorders,
 3250  alcoholism, or substance abuse. The practice of clinical social
 3251  work may also include clinical research into more effective
 3252  psychotherapeutic modalities for the treatment and prevention of
 3253  such conditions.
 3254         (c) The terms “diagnose” and “treat,” as used in this
 3255  chapter, when considered in isolation or in conjunction with any
 3256  provision of the rules of the board, may shall not be construed
 3257  to permit the performance of any act which clinical social
 3258  workers are not educated and trained to perform, including, but
 3259  not limited to, admitting persons to hospitals for treatment of
 3260  the foregoing conditions, treating persons in hospitals without
 3261  medical supervision, prescribing medicinal drugs as defined in
 3262  chapter 465, authorizing clinical laboratory procedures pursuant
 3263  to chapter 483, or radiological procedures, or use of
 3264  electroconvulsive therapy. In addition, this definition shall
 3265  may not be construed to permit any person licensed,
 3266  provisionally licensed, registered, or certified pursuant to
 3267  this chapter to describe or label any test, report, or procedure
 3268  as “psychological,” except to relate specifically to the
 3269  definition of practice authorized in this subsection.
 3270         (8) The term “practice of marriage and family therapy”
 3271  means is defined as the use of scientific and applied marriage
 3272  and family theories, methods, and procedures for the purpose of
 3273  describing, evaluating, and modifying marital, family, and
 3274  individual behavior, within the context of marital and family
 3275  systems, including the context of marital formation and
 3276  dissolution, and is based on marriage and family systems theory,
 3277  marriage and family development, human development, normal and
 3278  abnormal behavior, psychopathology, human sexuality,
 3279  psychotherapeutic and marriage and family therapy theories and
 3280  techniques. The practice of marriage and family therapy includes
 3281  methods of a psychological nature used to evaluate, assess,
 3282  diagnose, treat, and prevent emotional and mental disorders or
 3283  dysfunctions (whether cognitive, affective, or behavioral),
 3284  sexual dysfunction, behavioral disorders, alcoholism, and
 3285  substance abuse. The practice of marriage and family therapy
 3286  includes, but is not limited to, marriage and family therapy,
 3287  psychotherapy, including behavioral family therapy,
 3288  hypnotherapy, and sex therapy. The practice of marriage and
 3289  family therapy also includes counseling, behavior modification,
 3290  consultation, client-centered advocacy, crisis intervention, and
 3291  the provision of needed information and education to clients,
 3292  when using methods of a psychological nature to evaluate,
 3293  assess, diagnose, treat, and prevent emotional and mental
 3294  disorders and dysfunctions (whether cognitive, affective, or
 3295  behavioral), sexual dysfunction, behavioral disorders,
 3296  alcoholism, or substance abuse. The practice of marriage and
 3297  family therapy may also include clinical research into more
 3298  effective psychotherapeutic modalities for the treatment and
 3299  prevention of such conditions.
 3300         (a) Marriage and family therapy may be rendered to
 3301  individuals, including individuals affected by termination of
 3302  marriage, to couples, whether married or unmarried, to families,
 3303  or to groups.
 3304         (b) The use of specific methods, techniques, or modalities
 3305  within the practice of marriage and family therapy is restricted
 3306  to marriage and family therapists appropriately trained in the
 3307  use of such methods, techniques, or modalities.
 3308         (c) The terms “diagnose” and “treat,” as used in this
 3309  chapter, when considered in isolation or in conjunction with any
 3310  provision of the rules of the board, may shall not be construed
 3311  to permit the performance of any act that which marriage and
 3312  family therapists are not educated and trained to perform,
 3313  including, but not limited to, admitting persons to hospitals
 3314  for treatment of the foregoing conditions, treating persons in
 3315  hospitals without medical supervision, prescribing medicinal
 3316  drugs as defined in chapter 465, authorizing clinical laboratory
 3317  procedures pursuant to chapter 483, or radiological procedures,
 3318  or the use of electroconvulsive therapy. In addition, this
 3319  definition may shall not be construed to permit any person
 3320  licensed, provisionally licensed, registered, or certified
 3321  pursuant to this chapter to describe or label any test, report,
 3322  or procedure as “psychological,” except to relate specifically
 3323  to the definition of practice authorized in this subsection.
 3324         (d) The definition of “marriage and family therapy”
 3325  contained in this subsection includes all services offered
 3326  directly to the general public or through organizations, whether
 3327  public or private, and applies whether payment is requested or
 3328  received for services rendered.
 3329         (9) The term “practice of mental health counseling” means
 3330  is defined as the use of scientific and applied behavioral
 3331  science theories, methods, and techniques for the purpose of
 3332  describing, preventing, and treating undesired behavior and
 3333  enhancing mental health and human development and is based on
 3334  the person-in-situation perspectives derived from research and
 3335  theory in personality, family, group, and organizational
 3336  dynamics and development, career planning, cultural diversity,
 3337  human growth and development, human sexuality, normal and
 3338  abnormal behavior, psychopathology, psychotherapy, and
 3339  rehabilitation. The practice of mental health counseling
 3340  includes methods of a psychological nature used to evaluate,
 3341  assess, diagnose, and treat emotional and mental dysfunctions or
 3342  disorders, (whether cognitive, affective, or behavioral),
 3343  behavioral disorders, interpersonal relationships, sexual
 3344  dysfunction, alcoholism, and substance abuse. The practice of
 3345  mental health counseling includes, but is not limited to,
 3346  psychotherapy, hypnotherapy, and sex therapy. The practice of
 3347  mental health counseling also includes counseling, behavior
 3348  modification, consultation, client-centered advocacy, crisis
 3349  intervention, and the provision of needed information and
 3350  education to clients, when using methods of a psychological
 3351  nature to evaluate, assess, diagnose, treat, and prevent
 3352  emotional and mental disorders and dysfunctions (whether
 3353  cognitive, affective, or behavioral), behavioral disorders,
 3354  sexual dysfunction, alcoholism, or substance abuse. The practice
 3355  of mental health counseling may also include clinical research
 3356  into more effective psychotherapeutic modalities for the
 3357  treatment and prevention of such conditions.
 3358         (a) Mental health counseling may be rendered to
 3359  individuals, including individuals affected by the termination
 3360  of marriage, and to couples, families, groups, organizations,
 3361  and communities.
 3362         (b) The use of specific methods, techniques, or modalities
 3363  within the practice of mental health counseling is restricted to
 3364  mental health counselors appropriately trained in the use of
 3365  such methods, techniques, or modalities.
 3366         (c) The terms “diagnose” and “treat,” as used in this
 3367  chapter, when considered in isolation or in conjunction with any
 3368  provision of the rules of the board, may shall not be construed
 3369  to permit the performance of any act that which mental health
 3370  counselors are not educated and trained to perform, including,
 3371  but not limited to, admitting persons to hospitals for treatment
 3372  of the foregoing conditions, treating persons in hospitals
 3373  without medical supervision, prescribing medicinal drugs as
 3374  defined in chapter 465, authorizing clinical laboratory
 3375  procedures pursuant to chapter 483, or radiological procedures,
 3376  or the use of electroconvulsive therapy. In addition, this
 3377  definition may shall not be construed to permit any person
 3378  licensed, provisionally licensed, registered, or certified
 3379  pursuant to this chapter to describe or label any test, report,
 3380  or procedure as “psychological,” except to relate specifically
 3381  to the definition of practice authorized in this subsection.
 3382         (d) The definition of “mental health counseling” contained
 3383  in this subsection includes all services offered directly to the
 3384  general public or through organizations, whether public or
 3385  private, and applies whether payment is requested or received
 3386  for services rendered.
 3387         Section 104. Paragraph (h) of subsection (4) of section
 3388  627.351, Florida Statutes, is amended to read:
 3389         627.351 Insurance risk apportionment plans.—
 3390         (4) MEDICAL MALPRACTICE RISK APPORTIONMENT.—
 3391         (h) As used in this subsection:
 3392         1. “Health care provider” means hospitals licensed under
 3393  chapter 395; physicians licensed under chapter 458; osteopathic
 3394  physicians licensed under chapter 459; podiatric physicians
 3395  licensed under chapter 461; dentists licensed under chapter 466;
 3396  chiropractic physicians licensed under chapter 460; naturopaths
 3397  licensed under chapter 462; nurses licensed under part I of
 3398  chapter 464; midwives licensed under chapter 467; clinical
 3399  laboratories registered under chapter 483; physician assistants
 3400  licensed under chapter 458 or chapter 459; physical therapists
 3401  and physical therapist assistants licensed under chapter 486;
 3402  health maintenance organizations certificated under part I of
 3403  chapter 641; ambulatory surgical centers licensed under chapter
 3404  395; other medical facilities as defined in subparagraph 2.;
 3405  blood banks, plasma centers, industrial clinics, and renal
 3406  dialysis facilities; or professional associations, partnerships,
 3407  corporations, joint ventures, or other associations for
 3408  professional activity by health care providers.
 3409         2. “Other medical facility” means a facility the primary
 3410  purpose of which is to provide human medical diagnostic services
 3411  or a facility providing nonsurgical human medical treatment, to
 3412  which facility the patient is admitted and from which facility
 3413  the patient is discharged within the same working day, and which
 3414  facility is not part of a hospital. However, a facility existing
 3415  for the primary purpose of performing terminations of pregnancy
 3416  or an office maintained by a physician or dentist for the
 3417  practice of medicine may shall not be construed to be an “other
 3418  medical facility.”
 3419         3. “Health care facility” means any hospital licensed under
 3420  chapter 395, health maintenance organization certificated under
 3421  part I of chapter 641, ambulatory surgical center licensed under
 3422  chapter 395, or other medical facility as defined in
 3423  subparagraph 2.
 3424         Section 105. Paragraph (h) of subsection (1) of section
 3425  627.602, Florida Statutes, is amended to read:
 3426         627.602 Scope, format of policy.—
 3427         (1) Each health insurance policy delivered or issued for
 3428  delivery to any person in this state must comply with all
 3429  applicable provisions of this code and all of the following
 3430  requirements:
 3431         (h) Section 641.312 and the provisions of the Employee
 3432  Retirement Income Security Act of 1974, as implemented by 29
 3433  C.F.R. s. 2560.503-1, relating to internal grievances. This
 3434  paragraph does not apply to a health insurance policy that is
 3435  subject to the Subscriber Assistance Program under s. 408.7056
 3436  or to the types of benefits or coverages provided under s.
 3437  627.6513(1)-(14) issued in any market.
 3438         Section 106. Subsection (1) of section 627.6406, Florida
 3439  Statutes, is amended to read:
 3440         627.6406 Maternity care.—
 3441         (1) Any policy of health insurance which that provides
 3442  coverage for maternity care must also cover the services of
 3443  certified nurse-midwives and midwives licensed pursuant to
 3444  chapter 467, and the services of birth centers licensed under
 3445  ss. 383.30-383.332 383.30-383.335.
 3446         Section 107. Paragraphs (b) and (e) of subsection (1) of
 3447  section 627.64194, Florida Statutes, are amended to read:
 3448         627.64194 Coverage requirements for services provided by
 3449  nonparticipating providers; payment collection limitations.—
 3450         (1) As used in this section, the term:
 3451         (b) “Facility” means a licensed facility as defined in s.
 3452  395.002(16) and an urgent care center as defined in s. 395.002
 3453  s. 395.002(30).
 3454         (e) “Nonparticipating provider” means a provider who is not
 3455  a preferred provider as defined in s. 627.6471 or a provider who
 3456  is not an exclusive provider as defined in s. 627.6472. For
 3457  purposes of covered emergency services under this section, a
 3458  facility licensed under chapter 395 or an urgent care center
 3459  defined in s. 395.002 s. 395.002(30) is a nonparticipating
 3460  provider if the facility has not contracted with an insurer to
 3461  provide emergency services to its insureds at a specified rate.
 3462         Section 108. Section 627.6513, Florida Statutes, is amended
 3463  to read:
 3464         627.6513 Scope.—Section 641.312 and the provisions of the
 3465  Employee Retirement Income Security Act of 1974, as implemented
 3466  by 29 C.F.R. s. 2560.503-1, relating to internal grievances,
 3467  apply to all group health insurance policies issued under this
 3468  part. This section does not apply to a group health insurance
 3469  policy that is subject to the Subscriber Assistance Program in
 3470  s. 408.7056 or to:
 3471         (1) Coverage only for accident insurance, or disability
 3472  income insurance, or any combination thereof.
 3473         (2) Coverage issued as a supplement to liability insurance.
 3474         (3) Liability insurance, including general liability
 3475  insurance and automobile liability insurance.
 3476         (4) Workers’ compensation or similar insurance.
 3477         (5) Automobile medical payment insurance.
 3478         (6) Credit-only insurance.
 3479         (7) Coverage for onsite medical clinics, including prepaid
 3480  health clinics under part II of chapter 641.
 3481         (8) Other similar insurance coverage, specified in rules
 3482  adopted by the commission, under which benefits for medical care
 3483  are secondary or incidental to other insurance benefits. To the
 3484  extent possible, such rules must be consistent with regulations
 3485  adopted by the United States Department of Health and Human
 3486  Services.
 3487         (9) Limited scope dental or vision benefits, if offered
 3488  separately.
 3489         (10) Benefits for long-term care, nursing home care, home
 3490  health care, or community-based care, or any combination
 3491  thereof, if offered separately.
 3492         (11) Other similar, limited benefits, if offered
 3493  separately, as specified in rules adopted by the commission.
 3494         (12) Coverage only for a specified disease or illness, if
 3495  offered as independent, noncoordinated benefits.
 3496         (13) Hospital indemnity or other fixed indemnity insurance,
 3497  if offered as independent, noncoordinated benefits.
 3498         (14) Benefits provided through a Medicare supplemental
 3499  health insurance policy, as defined under s. 1882(g)(1) of the
 3500  Social Security Act, coverage supplemental to the coverage
 3501  provided under 10 U.S.C. chapter 55, and similar supplemental
 3502  coverage provided to coverage under a group health plan, which
 3503  are offered as a separate insurance policy and as independent,
 3504  noncoordinated benefits.
 3505         Section 109. Subsection (1) of section 627.6574, Florida
 3506  Statutes, is amended to read:
 3507         627.6574 Maternity care.—
 3508         (1) Any group, blanket, or franchise policy of health
 3509  insurance which that provides coverage for maternity care must
 3510  also cover the services of certified nurse-midwives and midwives
 3511  licensed pursuant to chapter 467, and the services of birth
 3512  centers licensed under ss. 383.30-383.332 383.30-383.335.
 3513         Section 110. Paragraph (j) of subsection (1) of section
 3514  641.185, Florida Statutes, is amended to read:
 3515         641.185 Health maintenance organization subscriber
 3516  protections.—
 3517         (1) With respect to the provisions of this part and part
 3518  III, the principles expressed in the following statements shall
 3519  serve as standards to be followed by the commission, the office,
 3520  the department, and the Agency for Health Care Administration in
 3521  exercising their powers and duties, in exercising administrative
 3522  discretion, in administrative interpretations of the law, in
 3523  enforcing its provisions, and in adopting rules:
 3524         (j)A health maintenance organization should receive timely
 3525  and, if necessary, urgent review by an independent state
 3526  external review organization for unresolved grievances and
 3527  appeals pursuant to s. 408.7056.
 3528         Section 111. Paragraph (a) of subsection (18) of section
 3529  641.31, Florida Statutes, is amended to read:
 3530         641.31 Health maintenance contracts.—
 3531         (18)(a) Health maintenance contracts that provide coverage,
 3532  benefits, or services for maternity care must provide, as an
 3533  option to the subscriber, the services of nurse-midwives and
 3534  midwives licensed pursuant to chapter 467, and the services of
 3535  birth centers licensed pursuant to ss. 383.30-383.332 383.30
 3536  383.335, if such services are available within the service area.
 3537         Section 112. Section 641.312, Florida Statutes, is amended
 3538  to read:
 3539         641.312 Scope.—The Office of Insurance Regulation may adopt
 3540  rules to administer the provisions of the National Association
 3541  of Insurance Commissioners’ Uniform Health Carrier External
 3542  Review Model Act, issued by the National Association of
 3543  Insurance Commissioners and dated April 2010. This section does
 3544  not apply to a health maintenance contract that is subject to
 3545  the Subscriber Assistance Program under s. 408.7056 or to the
 3546  types of benefits or coverages provided under s. 627.6513(1)
 3547  (14) issued in any market.
 3548         Section 113. Subsection (4) of section 641.3154, Florida
 3549  Statutes, is amended to read:
 3550         641.3154 Organization liability; provider billing
 3551  prohibited.—
 3552         (4) A provider or any representative of a provider,
 3553  regardless of whether the provider is under contract with the
 3554  health maintenance organization, may not collect or attempt to
 3555  collect money from, maintain any action at law against, or
 3556  report to a credit agency a subscriber of an organization for
 3557  payment of services for which the organization is liable, if the
 3558  provider in good faith knows or should know that the
 3559  organization is liable. This prohibition applies during the
 3560  pendency of any claim for payment made by the provider to the
 3561  organization for payment of the services and any legal
 3562  proceedings or dispute resolution process to determine whether
 3563  the organization is liable for the services if the provider is
 3564  informed that such proceedings are taking place. It is presumed
 3565  that a provider does not know and should not know that an
 3566  organization is liable unless:
 3567         (a) The provider is informed by the organization that it
 3568  accepts liability;
 3569         (b) A court of competent jurisdiction determines that the
 3570  organization is liable; or
 3571         (c)The office or agency makes a final determination that
 3572  the organization is required to pay for such services subsequent
 3573  to a recommendation made by the Subscriber Assistance Panel
 3574  pursuant to s. 408.7056; or
 3575         (c)(d) The agency issues a final order that the
 3576  organization is required to pay for such services subsequent to
 3577  a recommendation made by a resolution organization pursuant to
 3578  s. 408.7057.
 3579         Section 114. Paragraph (c) of subsection (5) of section
 3580  641.51, Florida Statutes, is amended to read:
 3581         641.51 Quality assurance program; second medical opinion
 3582  requirement.—
 3583         (5)(c) For second opinions provided by contract physicians
 3584  the organization is prohibited from charging a fee to the
 3585  subscriber in an amount in excess of the subscriber fees
 3586  established by contract for referral contract physicians. The
 3587  organization shall pay the amount of all charges, which are
 3588  usual, reasonable, and customary in the community, for second
 3589  opinion services performed by a physician not under contract
 3590  with the organization, but may require the subscriber to be
 3591  responsible for up to 40 percent of such amount. The
 3592  organization may require that any tests deemed necessary by a
 3593  noncontract physician shall be conducted by the organization.
 3594  The organization may deny reimbursement rights granted under
 3595  this section in the event the subscriber seeks in excess of
 3596  three such referrals per year if such subsequent referral costs
 3597  are deemed by the organization to be evidence that the
 3598  subscriber has unreasonably overutilized the second opinion
 3599  privilege. A subscriber thus denied reimbursement under this
 3600  section has shall have recourse to grievance procedures as
 3601  specified in ss. 408.7056, 641.495, and 641.511. The
 3602  organization’s physician’s professional judgment concerning the
 3603  treatment of a subscriber derived after review of a second
 3604  opinion is shall be controlling as to the treatment obligations
 3605  of the health maintenance organization. Treatment not authorized
 3606  by the health maintenance organization is shall be at the
 3607  subscriber’s expense.
 3608         Section 115. Subsection (1), paragraph (e) of subsection
 3609  (3), paragraph (d) of subsection (4), paragraphs (g) and (h) of
 3610  subsection (6), and subsections (7) through (12) of section
 3611  641.511, Florida Statutes, are amended to read:
 3612         641.511 Subscriber grievance reporting and resolution
 3613  requirements.—
 3614         (1) Every organization must have a grievance procedure
 3615  available to its subscribers for the purpose of addressing
 3616  complaints and grievances. Every organization must notify its
 3617  subscribers that a subscriber must submit a grievance within 1
 3618  year after the date of occurrence of the action that initiated
 3619  the grievance, and may submit the grievance for review to the
 3620  Subscriber Assistance Program panel as provided in s. 408.7056
 3621  after receiving a final disposition of the grievance through the
 3622  organization’s grievance process. An organization shall maintain
 3623  records of all grievances and shall report annually to the
 3624  agency the total number of grievances handled, a categorization
 3625  of the cases underlying the grievances, and the final
 3626  disposition of the grievances.
 3627         (3) Each organization’s grievance procedure, as required
 3628  under subsection (1), must include, at a minimum:
 3629         (e) A notice that a subscriber may voluntarily pursue
 3630  binding arbitration in accordance with the terms of the contract
 3631  if offered by the organization, after completing the
 3632  organization’s grievance procedure and as an alternative to the
 3633  Subscriber Assistance Program. Such notice shall include an
 3634  explanation that the subscriber may incur some costs if the
 3635  subscriber pursues binding arbitration, depending upon the terms
 3636  of the subscriber’s contract.
 3637         (4)
 3638         (d)In any case when the review process does not resolve a
 3639  difference of opinion between the organization and the
 3640  subscriber or the provider acting on behalf of the subscriber,
 3641  the subscriber or the provider acting on behalf of the
 3642  subscriber may submit a written grievance to the Subscriber
 3643  Assistance Program.
 3644         (6)
 3645         (g)In any case when the expedited review process does not
 3646  resolve a difference of opinion between the organization and the
 3647  subscriber or the provider acting on behalf of the subscriber,
 3648  the subscriber or the provider acting on behalf of the
 3649  subscriber may submit a written grievance to the Subscriber
 3650  Assistance Program.
 3651         (g)(h) An organization shall not provide an expedited
 3652  retrospective review of an adverse determination.
 3653         (7)Each organization shall send to the agency a copy of
 3654  its quarterly grievance reports submitted to the office pursuant
 3655  to s. 408.7056(12).
 3656         (7)(8) The agency shall investigate all reports of
 3657  unresolved quality of care grievances received from:
 3658         (a) annual and quarterly grievance reports submitted by the
 3659  organization to the office.
 3660         (b)Review requests of subscribers whose grievances remain
 3661  unresolved after the subscriber has followed the full grievance
 3662  procedure of the organization.
 3663         (9)(a)The agency shall advise subscribers with grievances
 3664  to follow their organization’s formal grievance process for
 3665  resolution prior to review by the Subscriber Assistance Program.
 3666  The subscriber may, however, submit a copy of the grievance to
 3667  the agency at any time during the process.
 3668         (b)Requiring completion of the organization’s grievance
 3669  process before the Subscriber Assistance Program panel’s review
 3670  does not preclude the agency from investigating any complaint or
 3671  grievance before the organization makes its final determination.
 3672         (10)Each organization must notify the subscriber in a
 3673  final decision letter that the subscriber may request review of
 3674  the organization’s decision concerning the grievance by the
 3675  Subscriber Assistance Program, as provided in s. 408.7056, if
 3676  the grievance is not resolved to the satisfaction of the
 3677  subscriber. The final decision letter must inform the subscriber
 3678  that the request for review must be made within 365 days after
 3679  receipt of the final decision letter, must explain how to
 3680  initiate such a review, and must include the addresses and toll
 3681  free telephone numbers of the agency and the Subscriber
 3682  Assistance Program.
 3683         (8)(11) Each organization, as part of its contract with any
 3684  provider, must require the provider to post a consumer
 3685  assistance notice prominently displayed in the reception area of
 3686  the provider and clearly noticeable by all patients. The
 3687  consumer assistance notice must state the addresses and toll
 3688  free telephone numbers of the Agency for Health Care
 3689  Administration, the Subscriber Assistance Program, and the
 3690  Department of Financial Services. The consumer assistance notice
 3691  must also clearly state that the address and toll-free telephone
 3692  number of the organization’s grievance department shall be
 3693  provided upon request. The agency may adopt rules to implement
 3694  this section.
 3695         (9)(12) The agency may impose administrative sanction, in
 3696  accordance with s. 641.52, against an organization for
 3697  noncompliance with this section.
 3698         Section 116. Subsection (1) of section 641.515, Florida
 3699  Statutes, is amended to read:
 3700         641.515 Investigation by the agency.—
 3701         (1) The agency shall investigate further any quality of
 3702  care issue contained in recommendations and reports submitted
 3703  pursuant to s. ss. 408.7056 and 641.511. The agency shall also
 3704  investigate further any information that indicates that the
 3705  organization does not meet accreditation standards or the
 3706  standards of the review organization performing the external
 3707  quality assurance assessment pursuant to reports submitted under
 3708  s. 641.512. Every organization shall submit its books and
 3709  records and take other appropriate action as may be necessary to
 3710  facilitate an examination. The agency shall have access to the
 3711  organization’s medical records of individuals and records of
 3712  employed and contracted physicians, with the consent of the
 3713  subscriber or by court order, as necessary to administer carry
 3714  out the provisions of this part.
 3715         Section 117. Subsection (2) of section 641.55, Florida
 3716  Statutes, is amended to read:
 3717         641.55 Internal risk management program.—
 3718         (2) The risk management program shall be the responsibility
 3719  of the governing authority or board of the organization. Every
 3720  organization which has an annual premium volume of $10 million
 3721  or more and which directly provides health care in a building
 3722  owned or leased by the organization shall hire a risk manager,
 3723  certified under ss. 395.10971-395.10975, who is shall be
 3724  responsible for implementation of the organization’s risk
 3725  management program required by this section. A part-time risk
 3726  manager may shall not be responsible for risk management
 3727  programs in more than four organizations or facilities. Every
 3728  organization that which does not directly provide health care in
 3729  a building owned or leased by the organization and every
 3730  organization with an annual premium volume of less than $10
 3731  million shall designate an officer or employee of the
 3732  organization to serve as the risk manager.
 3733  
 3734  The gross data compiled under this section or s. 395.0197 shall
 3735  be furnished by the agency upon request to organizations to be
 3736  utilized for risk management purposes. The agency shall adopt
 3737  rules necessary to administer carry out the provisions of this
 3738  section.
 3739         Section 118. Section 641.60, Florida Statutes, is repealed.
 3740         Section 119. Section 641.65, Florida Statutes, is repealed.
 3741         Section 120. Section 641.67, Florida Statutes, is repealed.
 3742         Section 121. Section 641.68, Florida Statutes, is repealed.
 3743         Section 122. Section 641.70, Florida Statutes, is repealed.
 3744         Section 123. Section 641.75, Florida Statutes, is repealed.
 3745         Section 124. Paragraph (b) of subsection (6) of section
 3746  766.118, Florida Statutes, is amended to read:
 3747         766.118 Determination of noneconomic damages.—
 3748         (6) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF A
 3749  PRACTITIONER PROVIDING SERVICES AND CARE TO A MEDICAID
 3750  RECIPIENT.—Notwithstanding subsections (2), (3), and (5), with
 3751  respect to a cause of action for personal injury or wrongful
 3752  death arising from medical negligence of a practitioner
 3753  committed in the course of providing medical services and
 3754  medical care to a Medicaid recipient, regardless of the number
 3755  of such practitioner defendants providing the services and care,
 3756  noneconomic damages may not exceed $300,000 per claimant, unless
 3757  the claimant pleads and proves, by clear and convincing
 3758  evidence, that the practitioner acted in a wrongful manner. A
 3759  practitioner providing medical services and medical care to a
 3760  Medicaid recipient is not liable for more than $200,000 in
 3761  noneconomic damages, regardless of the number of claimants,
 3762  unless the claimant pleads and proves, by clear and convincing
 3763  evidence, that the practitioner acted in a wrongful manner. The
 3764  fact that a claimant proves that a practitioner acted in a
 3765  wrongful manner does not preclude the application of the
 3766  limitation on noneconomic damages prescribed elsewhere in this
 3767  section. For purposes of this subsection:
 3768         (b) The term “practitioner,” in addition to the meaning
 3769  prescribed in subsection (1), includes any hospital or,
 3770  ambulatory surgical center, or mobile surgical facility as
 3771  defined and licensed under chapter 395.
 3772         Section 125. Subsection (4) of section 766.202, Florida
 3773  Statutes, is amended to read:
 3774         766.202 Definitions; ss. 766.201-766.212.—As used in ss.
 3775  766.201-766.212, the term:
 3776         (4) “Health care provider” means any hospital or,
 3777  ambulatory surgical center, or mobile surgical facility as
 3778  defined and licensed under chapter 395; a birth center licensed
 3779  under chapter 383; any person licensed under chapter 458,
 3780  chapter 459, chapter 460, chapter 461, chapter 462, chapter 463,
 3781  part I of chapter 464, chapter 466, chapter 467, part XIV of
 3782  chapter 468, or chapter 486; a clinical lab licensed under
 3783  chapter 483; a health maintenance organization certificated
 3784  under part I of chapter 641; a blood bank; a plasma center; an
 3785  industrial clinic; a renal dialysis facility; or a professional
 3786  association partnership, corporation, joint venture, or other
 3787  association for professional activity by health care providers.
 3788         Section 126. Section 945.36, Florida Statutes, is amended
 3789  to read:
 3790         945.36 Exemption from health testing regulations for Law
 3791  enforcement personnel authorized to conduct conducting drug
 3792  tests on inmates and releasees.—
 3793         (1) Any law enforcement officer, state or county probation
 3794  officer, employee of the Department of Corrections, or employee
 3795  of a contracted community correctional center who is certified
 3796  by the Department of Corrections pursuant to subsection (2) may
 3797  administer, is exempt from part I of chapter 483, for the
 3798  limited purpose of administering a urine screen drug test to:
 3799         (a) Persons during incarceration;
 3800         (b) Persons released as a condition of probation for either
 3801  a felony or misdemeanor;
 3802         (c) Persons released as a condition of community control;
 3803         (d) Persons released as a condition of conditional release;
 3804         (e) Persons released as a condition of parole;
 3805         (f) Persons released as a condition of provisional release;
 3806         (g) Persons released as a condition of pretrial release; or
 3807         (h) Persons released as a condition of control release.
 3808         (2) The Department of Corrections shall develop a procedure
 3809  for certification of any law enforcement officer, state or
 3810  county probation officer, employee of the Department of
 3811  Corrections, or employee of a contracted community correctional
 3812  center to perform a urine screen drug test on the persons
 3813  specified in subsection (1).
 3814         Section 127. Paragraph (b) of subsection (2) of section
 3815  1009.65, Florida Statutes, is amended to read:
 3816         1009.65 Medical Education Reimbursement and Loan Repayment
 3817  Program.—
 3818         (2) From the funds available, the Department of Health
 3819  shall make payments to selected medical professionals as
 3820  follows:
 3821         (b) All payments are shall be contingent on continued proof
 3822  of primary care practice in an area defined in s. 395.602(2)(b)
 3823  s. 395.602(2)(e), or an underserved area designated by the
 3824  Department of Health, provided the practitioner accepts Medicaid
 3825  reimbursement if eligible for such reimbursement. Correctional
 3826  facilities, state hospitals, and other state institutions that
 3827  employ medical personnel shall be designated by the Department
 3828  of Health as underserved locations. Locations with high
 3829  incidences of infant mortality, high morbidity, or low Medicaid
 3830  participation by health care professionals may be designated as
 3831  underserved.
 3832         Section 128. Subsection (2) of section 1011.52, Florida
 3833  Statutes, is amended to read:
 3834         1011.52 Appropriation to first accredited medical school.—
 3835         (2) In order for a medical school to qualify under the
 3836  provisions of this section and to be entitled to the benefits
 3837  herein, such medical school:
 3838         (a) Must be primarily operated and established to offer,
 3839  afford, and render a medical education to residents of the state
 3840  qualifying for admission to such institution;
 3841         (b) Must be operated by a municipality or county of this
 3842  state, or by a nonprofit organization heretofore or hereafter
 3843  established exclusively for educational purposes;
 3844         (c) Must, upon the formation and establishment of an
 3845  accredited medical school, transmit and file with the Department
 3846  of Education documentary proof evidencing the facts that such
 3847  institution has been certified and approved by the council on
 3848  medical education and hospitals of the American Medical
 3849  Association and has adequately met the requirements of that
 3850  council in regard to its administrative facilities,
 3851  administrative plant, clinical facilities, curriculum, and all
 3852  other such requirements as may be necessary to qualify with the
 3853  council as a recognized, approved, and accredited medical
 3854  school;
 3855         (d) Must certify to the Department of Education the name,
 3856  address, and educational history of each student approved and
 3857  accepted for enrollment in such institution for the ensuing
 3858  school year; and
 3859         (e) Must have in place an operating agreement with a
 3860  government-owned hospital that is located in the same county as
 3861  the medical school and that is a statutory teaching hospital as
 3862  defined in s. 408.07(44) s. 408.07(45). The operating agreement
 3863  must shall provide for the medical school to maintain the same
 3864  level of affiliation with the hospital, including the level of
 3865  services to indigent and charity care patients served by the
 3866  hospital, which was in place in the prior fiscal year. Each
 3867  year, documentation demonstrating that an operating agreement is
 3868  in effect shall be submitted jointly to the Department of
 3869  Education by the hospital and the medical school prior to the
 3870  payment of moneys from the annual appropriation.
 3871         Section 129. This act shall take effect July 1, 2018.

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