Bill Text: FL S1066 | 2014 | Regular Session | Comm Sub


Bill Title: Department of Health

Spectrum: Slight Partisan Bill (? 2-1)

Status: (Failed) 2014-05-02 - Died in Appropriations, companion bill(s) passed, see HB 97 (Ch. 2014-108) [S1066 Detail]

Download: Florida-2014-S1066-Comm_Sub.html
       Florida Senate - 2014                      CS for CS for SB 1066
       
       
        
       By the Committees on Transportation; and Health Policy; and
       Senator Grimsley
       
       
       
       
       596-04195-14                                          20141066c2
    1                        A bill to be entitled                      
    2         An act relating to the Department of Health; amending
    3         s. 322.142, F.S.; authorizing the Department of
    4         Highway Safety and Motor Vehicles to provide
    5         reproductions of specified records to the Department
    6         of Health under certain circumstances; amending s.
    7         381.004, F.S.; revising and providing definitions;
    8         specifying the notification and consent procedures for
    9         performing an HIV test in a health care setting and a
   10         nonhealth care setting; amending s. 381.7355, F.S.;
   11         adding a requirement for project proposals under the
   12         grant program to address racial and ethnic disparities
   13         in morbidity and mortality rates relating to sickle
   14         cell disease; amending s. 395.3025, F.S.; clarifying
   15         duties of the Department of Health to maintain the
   16         confidentiality of patient records that it obtains
   17         under subpoena pursuant to an investigation;
   18         authorizing licensees under investigation to inspect
   19         or receive copies of patient records connected with
   20         the investigation, subject to certain conditions;
   21         amending s. 456.013, F.S.; deleting requirements for
   22         the physical size of licenses issued for various
   23         health professions; amending s. 456.025, F.S.;
   24         deleting a fee provision for the issuance of wall
   25         certificates for various health profession licenses;
   26         authorizing the boards or the department to adopt
   27         rules waiving certain fees for a specified period in
   28         certain circumstances; amending s. 458.319, F.S.;
   29         providing continuing medical education requirements
   30         for Board of Medicine licensees; authorizing the board
   31         to adopt rules; amending s. 458.3485, F.S.; deleting
   32         language relating to the certification and
   33         registration of medical assistants; amending s.
   34         464.203, F.S.; revising certified nursing assistant
   35         inservice training requirements; repealing s.
   36         464.2085, F.S., relating to the creation, membership,
   37         and duties of the Council on Certified Nursing
   38         Assistants; amending s. 466.032, F.S.; deleting a
   39         requirement that the department provide certain notice
   40         to a dental laboratory operator who fails to renew her
   41         or his registration; amending s. 467.009, F.S.;
   42         updating the name of the organization that accredits
   43         certain midwifery programs; amending s. 468.1665,
   44         F.S.; increasing the number of members of the Board of
   45         Nursing Home Administrators who must be licensed
   46         nursing home administrators and decreasing the number
   47         of members who must be health care practitioners;
   48         amending s. 468.1695, F.S.; revising the
   49         qualifications of applicants who may sit for the
   50         licensed nursing home administrator examination to
   51         include an applicant with a master’s degree in certain
   52         subjects; repealing s. 468.1735, F.S., relating to
   53         provisional licenses for nursing home administrators;
   54         amending ss. 468.503 and 468.505, F.S.; revising the
   55         organization with whom an individual must be
   56         registered to be a registered dietitian; revising a
   57         definition; amending ss. 480.033 and 480.041, F.S.;
   58         deleting provisions relating to massage therapy
   59         apprentices and apprenticeship programs; deleting a
   60         definition and revising licensure requirements for
   61         massage therapists, to conform; amending s. 480.042,
   62         F.S.; revising requirements for conducting massage
   63         therapist licensing examinations and maintaining
   64         examination records; amending s. 480.044, F.S.;
   65         deleting a fee for massage therapy apprentices;
   66         amending s. 486.031, F.S.; revising provisions
   67         relating to the recognition of physical therapy
   68         programs and educational credentials from foreign
   69         countries to meet requirements for licensing as a
   70         physical therapist; amending s. 766.1115, F.S.;
   71         extending the period a health care provider remains an
   72         agent of the state after an individual is deemed
   73         ineligible; amending ss. 456.032 and 823.05, F.S.;
   74         conforming cross-references; providing an effective
   75         date.
   76          
   77  Be It Enacted by the Legislature of the State of Florida:
   78  
   79         Section 1. Subsection (4) of section 322.142, Florida
   80  Statutes, is amended to read:
   81         322.142 Color photographic or digital imaged licenses.—
   82         (4) The department may maintain a film negative or print
   83  file. The department shall maintain a record of the digital
   84  image and signature of the licensees, together with other data
   85  required by the department for identification and retrieval.
   86  Reproductions from the file or digital record are exempt from
   87  the provisions of s. 119.07(1) and shall be made and issued
   88  only:
   89         (a) For departmental administrative purposes;
   90         (b) For the issuance of duplicate licenses;
   91         (c) In response to law enforcement agency requests;
   92         (d) To the Department of Business and Professional
   93  Regulation pursuant to an interagency agreement for the purpose
   94  of accessing digital images for reproduction of licenses issued
   95  by the Department of Business and Professional Regulation;
   96         (e) To the Department of State pursuant to an interagency
   97  agreement to facilitate determinations of eligibility of voter
   98  registration applicants and registered voters in accordance with
   99  ss. 98.045 and 98.075;
  100         (f) To the Department of Revenue pursuant to an interagency
  101  agreement for use in establishing paternity and establishing,
  102  modifying, or enforcing support obligations in Title IV-D cases;
  103         (g) To the Department of Children and Families pursuant to
  104  an interagency agreement to conduct protective investigations
  105  under part III of chapter 39 and chapter 415;
  106         (h) To the Department of Children and Families pursuant to
  107  an interagency agreement specifying the number of employees in
  108  each of that department’s regions to be granted access to the
  109  records for use as verification of identity to expedite the
  110  determination of eligibility for public assistance and for use
  111  in public assistance fraud investigations;
  112         (i) To the Department of Financial Services pursuant to an
  113  interagency agreement to facilitate the location of owners of
  114  unclaimed property, the validation of unclaimed property claims,
  115  and the identification of fraudulent or false claims;
  116         (j) To district medical examiners pursuant to an
  117  interagency agreement for the purpose of identifying a deceased
  118  individual, determining cause of death, and notifying next of
  119  kin of any investigations, including autopsies and other
  120  laboratory examinations, authorized in s. 406.11; or
  121         (k) To the following persons for the purpose of identifying
  122  a person as part of the official work of a court:
  123         1. A justice or judge of this state;
  124         2. An employee of the state courts system who works in a
  125  position that is designated in writing for access by the Chief
  126  Justice of the Supreme Court or a chief judge of a district or
  127  circuit court, or by his or her designee; or
  128         3. A government employee who performs functions on behalf
  129  of the state courts system in a position that is designated in
  130  writing for access by the Chief Justice or a chief judge, or by
  131  his or her designee; or
  132         (l) To the Department of Health, pursuant to an interagency
  133  agreement to access digital images to verify the identity of an
  134  individual during an investigation under chapter 456, and for
  135  the reproduction of licenses issued by the Department of Health.
  136         Section 2. Subsection (1), paragraphs (a), (b), (g), and
  137  (h) of subsection (2), and paragraph (d) of subsection (4) of
  138  section 381.004, Florida Statutes, are amended, and subsection
  139  (1) of that section is reordered, to read:
  140         381.004 HIV testing.—
  141         (1) DEFINITIONS.—As used in this section, the term:
  142         (a) “Health care setting” means a setting devoted to both
  143  the diagnosis and care of persons, such as county health
  144  department clinics, hospital emergency departments, urgent care
  145  clinics, substance abuse treatment clinics, primary care
  146  settings, community clinics, mobile medical clinics, and
  147  correctional health care facilities.
  148         (b)(a) “HIV test” means a test ordered after July 6, 1988,
  149  to determine the presence of the antibody or antigen to human
  150  immunodeficiency virus or the presence of human immunodeficiency
  151  virus infection.
  152         (c)(b) “HIV test result” means a laboratory report of a
  153  human immunodeficiency virus test result entered into a medical
  154  record on or after July 6, 1988, or any report or notation in a
  155  medical record of a laboratory report of a human
  156  immunodeficiency virus test. As used in this section, The term
  157  “HIV test result” does not include test results reported to a
  158  health care provider by a patient.
  159         (d) “Nonhealth care setting” means a site that conducts HIV
  160  testing for the sole purpose of identifying HIV infection. Such
  161  setting does not provide medical treatment but may include
  162  community-based organizations, outreach settings, county health
  163  department HIV testing programs, and mobile vans.
  164         (f)(c) “Significant exposure” means:
  165         1. Exposure to blood or body fluids through needlestick,
  166  instruments, or sharps;
  167         2. Exposure of mucous membranes to visible blood or body
  168  fluids, to which universal precautions apply according to the
  169  National Centers for Disease Control and Prevention, including,
  170  without limitations, the following body fluids:
  171         a. Blood.
  172         b. Semen.
  173         c. Vaginal secretions.
  174         d. Cerebrospinal Cerebro-spinal fluid (CSF).
  175         e. Synovial fluid.
  176         f. Pleural fluid.
  177         g. Peritoneal fluid.
  178         h. Pericardial fluid.
  179         i. Amniotic fluid.
  180         j. Laboratory specimens that contain HIV (e.g., suspensions
  181  of concentrated virus); or
  182         3. Exposure of skin to visible blood or body fluids,
  183  especially when the exposed skin is chapped, abraded, or
  184  afflicted with dermatitis or the contact is prolonged or
  185  involving an extensive area.
  186         (e)(d) “Preliminary HIV test” means an antibody or
  187  antibody-antigen screening test, such as the enzyme-linked
  188  immunosorbent assays (IA), or a rapid test approved by the
  189  federal Food and Drug Administration (ELISAs) or the Single-Use
  190  Diagnostic System (SUDS).
  191         (g)(e) “Test subject” or “subject of the test” means the
  192  person upon whom an HIV test is performed, or the person who has
  193  legal authority to make health care decisions for the test
  194  subject.
  195         (2) HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED CONSENT;
  196  RESULTS; COUNSELING; CONFIDENTIALITY.—
  197         (a) Before performing an HIV test:
  198         1. In a health care setting, the person to be tested shall
  199  be provided information about the test, and notified that the
  200  test is planned, that he or she has the right to decline the
  201  test, and that he or she has the right to confidential treatment
  202  of information identifying the subject of the test and the
  203  results of the test as provided by law. If the person to be
  204  tested declines the test, such decision shall be documented in
  205  the medical record. No person in this state shall order a test
  206  designed to identify the human immunodeficiency virus, or its
  207  antigen or antibody, without first obtaining the informed
  208  consent of the person upon whom the test is being performed,
  209  except as specified in paragraph (h). Informed consent shall be
  210  preceded by an explanation of the right to confidential
  211  treatment of information identifying the subject of the test and
  212  the results of the test to the extent provided by law.
  213  Information shall also be provided on the fact that a positive
  214  HIV test result will be reported to the county health department
  215  with sufficient information to identify the test subject and on
  216  the availability and location of sites at which anonymous
  217  testing is performed. As required in paragraph (3)(c), each
  218  county health department shall maintain a list of sites at which
  219  anonymous testing is performed, including the locations, phone
  220  numbers, and hours of operation of the sites. Consent need not
  221  be in writing provided there is documentation in the medical
  222  record that the test has been explained and the consent has been
  223  obtained.
  224         2.In a nonhealth care setting, a provider shall obtain the
  225  informed consent of the person upon whom the test is being
  226  performed. Informed consent shall be preceded by an explanation
  227  of the right to confidential treatment of information
  228  identifying the subject of the test and the results of the test
  229  as provided by law.
  230  
  231  The test subject shall also be informed that a positive HIV test
  232  result will be reported to the county health department with
  233  sufficient information to identify the test subject and on the
  234  availability and location of sites at which anonymous testing is
  235  performed. As required in paragraph (3)(c), each county health
  236  department shall maintain a list of sites at which anonymous
  237  testing is performed, including the locations, telephone
  238  numbers, and hours of operation of the sites.
  239         (b) Except as provided in paragraph (h), informed consent
  240  must be obtained from a legal guardian or other person
  241  authorized by law if when the person:
  242         1. Is not competent, is incapacitated, or is otherwise
  243  unable to make an informed judgment; or
  244         2. Has not reached the age of majority, except as provided
  245  in s. 384.30.
  246         (g) Human immunodeficiency virus test results contained in
  247  the medical records of a hospital licensed under chapter 395 may
  248  be released in accordance with s. 395.3025 without being subject
  249  to the requirements of subparagraph (e)2., subparagraph (e)9.,
  250  or paragraph (f) if; provided the hospital has notified the
  251  patient of the limited confidentiality protections afforded HIV
  252  test results contained in hospital medical records obtained
  253  written informed consent for the HIV test in accordance with
  254  provisions of this section.
  255         (h) Notwithstanding the provisions of paragraph (a),
  256  informed consent is not required:
  257         1. When testing for sexually transmissible diseases is
  258  required by state or federal law, or by rule including the
  259  following situations:
  260         a. HIV testing pursuant to s. 796.08 of persons convicted
  261  of prostitution or of procuring another to commit prostitution.
  262         b. HIV testing of inmates pursuant to s. 945.355 before
  263  prior to their release from prison by reason of parole,
  264  accumulation of gain-time credits, or expiration of sentence.
  265         c. Testing for HIV by a medical examiner in accordance with
  266  s. 406.11.
  267         d. HIV testing of pregnant women pursuant to s. 384.31.
  268         2. Those exceptions provided for blood, plasma, organs,
  269  skin, semen, or other human tissue pursuant to s. 381.0041.
  270         3. For the performance of an HIV-related test by licensed
  271  medical personnel in bona fide medical emergencies if when the
  272  test results are necessary for medical diagnostic purposes to
  273  provide appropriate emergency care or treatment to the person
  274  being tested and the patient is unable to consent, as supported
  275  by documentation in the medical record. Notification of test
  276  results in accordance with paragraph (c) is required.
  277         4. For the performance of an HIV-related test by licensed
  278  medical personnel for medical diagnosis of acute illness where,
  279  in the opinion of the attending physician, providing
  280  notification obtaining informed consent would be detrimental to
  281  the patient, as supported by documentation in the medical
  282  record, and the test results are necessary for medical
  283  diagnostic purposes to provide appropriate care or treatment to
  284  the person being tested. Notification of test results in
  285  accordance with paragraph (c) is required if it would not be
  286  detrimental to the patient. This subparagraph does not authorize
  287  the routine testing of patients for HIV infection without
  288  notification informed consent.
  289         5. If When HIV testing is performed as part of an autopsy
  290  for which consent was obtained pursuant to s. 872.04.
  291         6. For the performance of an HIV test upon a defendant
  292  pursuant to the victim’s request in a prosecution for any type
  293  of sexual battery where a blood sample is taken from the
  294  defendant voluntarily, pursuant to court order for any purpose,
  295  or pursuant to the provisions of s. 775.0877, s. 951.27, or s.
  296  960.003; however, the results of an any HIV test performed shall
  297  be disclosed solely to the victim and the defendant, except as
  298  provided in ss. 775.0877, 951.27, and 960.003.
  299         7. If When an HIV test is mandated by court order.
  300         8. For epidemiological research pursuant to s. 381.0031,
  301  for research consistent with institutional review boards created
  302  by 45 C.F.R. part 46, or for the performance of an HIV-related
  303  test for the purpose of research, if the testing is performed in
  304  a manner by which the identity of the test subject is not known
  305  and may not be retrieved by the researcher.
  306         9. If When human tissue is collected lawfully without the
  307  consent of the donor for corneal removal as authorized by s.
  308  765.5185 or enucleation of the eyes as authorized by s. 765.519.
  309         10. For the performance of an HIV test upon an individual
  310  who comes into contact with medical personnel in such a way that
  311  a significant exposure has occurred during the course of
  312  employment or within the scope of practice and where a blood
  313  sample is available which that was taken from that individual
  314  voluntarily by medical personnel for other purposes. The term
  315  “medical personnel” includes a licensed or certified health care
  316  professional; an employee of a health care professional or
  317  health care facility; employees of a laboratory licensed under
  318  chapter 483; personnel of a blood bank or plasma center; a
  319  medical student or other student who is receiving training as a
  320  health care professional at a health care facility; and a
  321  paramedic or emergency medical technician certified by the
  322  department to perform life-support procedures under s. 401.23.
  323         a. Before performing Prior to performance of an HIV test on
  324  a voluntarily obtained blood sample, the individual from whom
  325  the blood was obtained shall be requested to consent to the
  326  performance of the test and to the release of the results. If
  327  consent cannot be obtained within the time necessary to perform
  328  the HIV test and begin prophylactic treatment of the exposed
  329  medical personnel, all information concerning the performance of
  330  an HIV test and any HIV test result shall be documented only in
  331  the medical personnel’s record unless the individual gives
  332  written consent to entering this information on the individual’s
  333  medical record.
  334         b. Reasonable attempts to locate the individual and to
  335  obtain consent shall be made, and all attempts must be
  336  documented. If the individual cannot be found or is incapable of
  337  providing consent, an HIV test may be conducted on the available
  338  blood sample. If the individual does not voluntarily consent to
  339  the performance of an HIV test, the individual shall be informed
  340  that an HIV test will be performed, and counseling shall be
  341  furnished as provided in this section. However, HIV testing
  342  shall be conducted only after appropriate medical personnel
  343  under the supervision of a licensed physician documents, in the
  344  medical record of the medical personnel, that there has been a
  345  significant exposure and that, in accordance with the written
  346  protocols based on the National Centers for Disease Control and
  347  Prevention guidelines on HIV postexposure prophylaxis and in the
  348  physician’s medical judgment, the information is medically
  349  necessary to determine the course of treatment for the medical
  350  personnel.
  351         c. Costs of an any HIV test of a blood sample performed
  352  with or without the consent of the individual, as provided in
  353  this subparagraph, shall be borne by the medical personnel or
  354  the employer of the medical personnel. However, costs of testing
  355  or treatment not directly related to the initial HIV tests or
  356  costs of subsequent testing or treatment may not be borne by the
  357  medical personnel or the employer of the medical personnel.
  358         d. In order to use utilize the provisions of this
  359  subparagraph, the medical personnel must either be tested for
  360  HIV pursuant to this section or provide the results of an HIV
  361  test taken within 6 months before prior to the significant
  362  exposure if such test results are negative.
  363         e. A person who receives the results of an HIV test
  364  pursuant to this subparagraph shall maintain the confidentiality
  365  of the information received and of the persons tested. Such
  366  confidential information is exempt from s. 119.07(1).
  367         f. If the source of the exposure will not voluntarily
  368  submit to HIV testing and a blood sample is not available, the
  369  medical personnel or the employer of such person acting on
  370  behalf of the employee may seek a court order directing the
  371  source of the exposure to submit to HIV testing. A sworn
  372  statement by a physician licensed under chapter 458 or chapter
  373  459 that a significant exposure has occurred and that, in the
  374  physician’s medical judgment, testing is medically necessary to
  375  determine the course of treatment constitutes probable cause for
  376  the issuance of an order by the court. The results of the test
  377  shall be released to the source of the exposure and to the
  378  person who experienced the exposure.
  379         11. For the performance of an HIV test upon an individual
  380  who comes into contact with medical personnel in such a way that
  381  a significant exposure has occurred during the course of
  382  employment or within the scope of practice of the medical
  383  personnel while the medical personnel provides emergency medical
  384  treatment to the individual; or notwithstanding s. 384.287, an
  385  individual who comes into contact with nonmedical personnel in
  386  such a way that a significant exposure has occurred while the
  387  nonmedical personnel provides emergency medical assistance
  388  during a medical emergency. For the purposes of this
  389  subparagraph, a medical emergency means an emergency medical
  390  condition outside of a hospital or health care facility that
  391  provides physician care. The test may be performed only during
  392  the course of treatment for the medical emergency.
  393         a. An individual who is capable of providing consent shall
  394  be requested to consent to an HIV test before prior to the
  395  testing. If consent cannot be obtained within the time necessary
  396  to perform the HIV test and begin prophylactic treatment of the
  397  exposed medical personnel and nonmedical personnel, all
  398  information concerning the performance of an HIV test and its
  399  result, shall be documented only in the medical personnel’s or
  400  nonmedical personnel’s record unless the individual gives
  401  written consent to entering this information in on the
  402  individual’s medical record.
  403         b. HIV testing shall be conducted only after appropriate
  404  medical personnel under the supervision of a licensed physician
  405  documents, in the medical record of the medical personnel or
  406  nonmedical personnel, that there has been a significant exposure
  407  and that, in accordance with the written protocols based on the
  408  National Centers for Disease Control and Prevention guidelines
  409  on HIV postexposure prophylaxis and in the physician’s medical
  410  judgment, the information is medically necessary to determine
  411  the course of treatment for the medical personnel or nonmedical
  412  personnel.
  413         c. Costs of any HIV test performed with or without the
  414  consent of the individual, as provided in this subparagraph,
  415  shall be borne by the medical personnel or the employer of the
  416  medical personnel or nonmedical personnel. However, costs of
  417  testing or treatment not directly related to the initial HIV
  418  tests or costs of subsequent testing or treatment may not be
  419  borne by the medical personnel or the employer of the medical
  420  personnel or nonmedical personnel.
  421         d. In order to use utilize the provisions of this
  422  subparagraph, the medical personnel or nonmedical personnel
  423  shall be tested for HIV pursuant to this section or shall
  424  provide the results of an HIV test taken within 6 months before
  425  prior to the significant exposure if such test results are
  426  negative.
  427         e. A person who receives the results of an HIV test
  428  pursuant to this subparagraph shall maintain the confidentiality
  429  of the information received and of the persons tested. Such
  430  confidential information is exempt from s. 119.07(1).
  431         f. If the source of the exposure will not voluntarily
  432  submit to HIV testing and a blood sample was not obtained during
  433  treatment for the medical emergency, the medical personnel, the
  434  employer of the medical personnel acting on behalf of the
  435  employee, or the nonmedical personnel may seek a court order
  436  directing the source of the exposure to submit to HIV testing. A
  437  sworn statement by a physician licensed under chapter 458 or
  438  chapter 459 that a significant exposure has occurred and that,
  439  in the physician’s medical judgment, testing is medically
  440  necessary to determine the course of treatment constitutes
  441  probable cause for the issuance of an order by the court. The
  442  results of the test shall be released to the source of the
  443  exposure and to the person who experienced the exposure.
  444         12. For the performance of an HIV test by the medical
  445  examiner or attending physician upon an individual who expired
  446  or could not be resuscitated while receiving emergency medical
  447  assistance or care and who was the source of a significant
  448  exposure to medical or nonmedical personnel providing such
  449  assistance or care.
  450         a. HIV testing may be conducted only after appropriate
  451  medical personnel under the supervision of a licensed physician
  452  documents in the medical record of the medical personnel or
  453  nonmedical personnel that there has been a significant exposure
  454  and that, in accordance with the written protocols based on the
  455  National Centers for Disease Control and Prevention guidelines
  456  on HIV postexposure prophylaxis and in the physician’s medical
  457  judgment, the information is medically necessary to determine
  458  the course of treatment for the medical personnel or nonmedical
  459  personnel.
  460         b. Costs of an any HIV test performed under this
  461  subparagraph may not be charged to the deceased or to the family
  462  of the deceased person.
  463         c. For the provisions of this subparagraph to be
  464  applicable, the medical personnel or nonmedical personnel must
  465  be tested for HIV under this section or must provide the results
  466  of an HIV test taken within 6 months before the significant
  467  exposure if such test results are negative.
  468         d. A person who receives the results of an HIV test
  469  pursuant to this subparagraph shall comply with paragraph (e).
  470         13. For the performance of an HIV-related test medically
  471  indicated by licensed medical personnel for medical diagnosis of
  472  a hospitalized infant as necessary to provide appropriate care
  473  and treatment of the infant if when, after a reasonable attempt,
  474  a parent cannot be contacted to provide consent. The medical
  475  records of the infant must shall reflect the reason consent of
  476  the parent was not initially obtained. Test results shall be
  477  provided to the parent when the parent is located.
  478         14. For the performance of HIV testing conducted to monitor
  479  the clinical progress of a patient previously diagnosed to be
  480  HIV positive.
  481         15. For the performance of repeated HIV testing conducted
  482  to monitor possible conversion from a significant exposure.
  483         (4) HUMAN IMMUNODEFICIENCY VIRUS TESTING REQUIREMENTS;
  484  REGISTRATION WITH THE DEPARTMENT OF HEALTH; EXEMPTIONS FROM
  485  REGISTRATION.—No county health department and no other person in
  486  this state shall conduct or hold themselves out to the public as
  487  conducting a testing program for acquired immune deficiency
  488  syndrome or human immunodeficiency virus status without first
  489  registering with the Department of Health, reregistering each
  490  year, complying with all other applicable provisions of state
  491  law, and meeting the following requirements:
  492         (d) A program in a health care setting shall meet the
  493  notification criteria contained in subparagraph (2)(a)1. A
  494  program in a nonhealth care setting shall meet all informed
  495  consent criteria contained in subparagraph (2)(a)2. The program
  496  must meet all the informed consent criteria contained in
  497  subsection (2).
  498         Section 3. Paragraph (a) of subsection (2) of section
  499  381.7355, Florida Statutes, is amended to read:
  500         381.7355 Project requirements; review criteria.—
  501         (2) A proposal must include each of the following elements:
  502         (a) The purpose and objectives of the proposal, including
  503  identification of the particular racial or ethnic disparity the
  504  project will address. The proposal must address one or more of
  505  the following priority areas:
  506         1. Decreasing racial and ethnic disparities in maternal and
  507  infant mortality rates.
  508         2. Decreasing racial and ethnic disparities in morbidity
  509  and mortality rates relating to cancer.
  510         3. Decreasing racial and ethnic disparities in morbidity
  511  and mortality rates relating to HIV/AIDS.
  512         4. Decreasing racial and ethnic disparities in morbidity
  513  and mortality rates relating to cardiovascular disease.
  514         5. Decreasing racial and ethnic disparities in morbidity
  515  and mortality rates relating to diabetes.
  516         6. Increasing adult and child immunization rates in certain
  517  racial and ethnic populations.
  518         7. Decreasing racial and ethnic disparities in oral health
  519  care.
  520         8. Decreasing racial and ethnic disparities in morbidity
  521  and mortality rates relating to sickle cell disease.
  522         Section 4. Paragraph (e) of subsection (4) of section
  523  395.3025, Florida Statutes, is amended to read:
  524         395.3025 Patient and personnel records; copies;
  525  examination.—
  526         (4) Patient records are confidential and may must not be
  527  disclosed without the consent of the patient or his or her legal
  528  representative, but appropriate disclosure may be made without
  529  such consent to:
  530         (e) The department agency upon subpoena issued pursuant to
  531  s. 456.071., but The records obtained thereby must be used
  532  solely for the purpose of the department agency and the
  533  appropriate professional board in its investigation,
  534  prosecution, and appeal of disciplinary proceedings. If the
  535  department agency requests copies of the records, the facility
  536  shall charge a fee pursuant to this section no more than its
  537  actual copying costs, including reasonable staff time. The
  538  department and the appropriate professional board must maintain
  539  the confidentiality of patient records obtained under this
  540  paragraph pursuant to s. 456.057. A licensee who is the subject
  541  of a department investigation may inspect or receive a copy of a
  542  patient record connected with the investigation if the licensee
  543  agrees in writing to maintain the confidentiality of the patient
  544  record pursuant to s. 456.057 must be sealed and must not be
  545  available to the public pursuant to s. 119.07(1) or any other
  546  statute providing access to records, nor may they be available
  547  to the public as part of the record of investigation for and
  548  prosecution in disciplinary proceedings made available to the
  549  public by the agency or the appropriate regulatory board.
  550  However, the agency must make available, upon written request by
  551  a practitioner against whom probable cause has been found, any
  552  such records that form the basis of the determination of
  553  probable cause.
  554         Section 5. Subsection (2) of section 456.013, Florida
  555  Statutes, is amended to read:
  556         456.013 Department; general licensing provisions.—
  557         (2) Before the issuance of a any license, the department
  558  shall charge an initial license fee as determined by the
  559  applicable board or, if there is no board, by rule of the
  560  department. Upon receipt of the appropriate license fee, the
  561  department shall issue a license to a any person certified by
  562  the appropriate board, or its designee, as having met the
  563  licensure requirements imposed by law or rule. The license shall
  564  consist of a wallet-size identification card and a wall card
  565  measuring 6 1/2 inches by 5 inches. The licensee shall surrender
  566  the license to the department the wallet-size identification
  567  card and the wall card if the licensee’s license was is issued
  568  in error or is revoked.
  569         Section 6. Present subsections (5) through (11) of section
  570  456.025, Florida Statutes, are redesignated as subsections (4)
  571  through (10), respectively, and present subsections (4) and (6)
  572  are amended to read:
  573         456.025 Fees; receipts; disposition.—
  574         (4) Each board, or the department if there is no board, may
  575  charge a fee not to exceed $25, as determined by rule, for the
  576  issuance of a wall certificate pursuant to s. 456.013(2)
  577  requested by a licensee who was licensed prior to July 1, 1998,
  578  or for the issuance of a duplicate wall certificate requested by
  579  any licensee.
  580         (5)(6) If the cash balance of the trust fund at the end of
  581  any fiscal year exceeds the total appropriation provided for the
  582  regulation of the health care professions in the prior fiscal
  583  year, the boards, in consultation with the department, may lower
  584  the license renewal fees. When the department determines, based
  585  on long-range estimates of revenue, that a profession’s trust
  586  fund balance exceeds the amount required to cover necessary
  587  functions, each board, or the department when there is no board,
  588  may adopt rules to implement the waiver of initial application
  589  fees, initial licensure fees, unlicensed activity fees, or
  590  renewal fees for that profession. The waiver of renewal fees may
  591  not exceed 2 years.
  592         Section 7. Subsections (2) through (4) of section 458.319,
  593  Florida Statutes, are redesignated as subsections (3) through
  594  (5), respectively, and a new subsection (2) is added to that
  595  section, to read:
  596         458.319 Renewal of license.—
  597         (2) Each licensee shall demonstrate his or her professional
  598  competency by completing at least 40 hours of continuing medical
  599  education every 2 years. The board, by rule, may:
  600         (a) Provide that continuing medical education approved by
  601  the American Medical Association satisfies some or all of the
  602  continuing medical education requirements.
  603         (b) Mandate specific continuing medical education
  604  requirements.
  605         (c) Approve alternative methods for obtaining continuing
  606  medical education credits, including, but not limited to:
  607         1. Attendance at a board meeting at which another licensee
  608  is disciplined;
  609         2. Service as a volunteer expert witness for the department
  610  in a disciplinary proceeding; or
  611         3. Service as a member of a probable cause panel following
  612  expiration of a board member’s term.
  613         (d) Provide that up to 25 percent of the required
  614  continuing medical education hours may be fulfilled through pro
  615  bono services to the indigent, underserved populations, or
  616  patients in critical need areas in the state where the licensee
  617  practices.
  618         1. The board shall require that any pro bono service be
  619  approved in advance to receive credit for continuing medical
  620  education under this paragraph.
  621         2. The standard for determining indigency is that
  622  recognized by the federal poverty guidelines and must be less
  623  than 150 percent of the federal poverty level.
  624         (e) Provide that a portion of the continuing medical
  625  education hours may be fulfilled by performing research in
  626  critical need areas or by training for advanced professional
  627  certification.
  628         (f) Adopt rules to define underserved and critical need
  629  areas.
  630         Section 8. Subsection (3) of section 458.3485, Florida
  631  Statutes, is amended to read:
  632         458.3485 Medical assistant.—
  633         (3) CERTIFICATION.—Medical assistants may be certified by
  634  the American Association of Medical Assistants or as a
  635  Registered Medical Assistant by the American Medical
  636  Technologists.
  637         Section 9. Subsection (7) of section 464.203, Florida
  638  Statutes, is amended to read:
  639         464.203 Certified nursing assistants; certification
  640  requirement.—
  641         (7) A certified nursing assistant shall complete 24 12
  642  hours of inservice training during each biennium calendar year.
  643  The certified nursing assistant shall maintain be responsible
  644  for maintaining documentation demonstrating compliance with
  645  these provisions. The Council on Certified Nursing Assistants,
  646  in accordance with s. 464.2085(2)(b), shall propose rules to
  647  implement this subsection.
  648         Section 10. Section 464.2085, Florida Statutes, is
  649  repealed.
  650         Section 11. Subsection (2) of section 466.032, Florida
  651  Statutes, is amended to read:
  652         466.032 Registration.—
  653         (2) Upon the failure of any dental laboratory operator to
  654  comply with subsection (1), the department shall notify her or
  655  him by registered mail, within 1 month after the registration
  656  renewal date, return receipt requested, at her or his last known
  657  address, of such failure and inform her or him of the provisions
  658  of subsections (3) and (4).
  659         Section 12. Subsection (8) of section 467.009, Florida
  660  Statutes, is amended to read:
  661         467.009 Midwifery programs; education and training
  662  requirements.—
  663         (8) Nonpublic educational institutions that conduct
  664  approved midwifery programs shall be accredited by a member of
  665  the Council for Higher Education Commission on Recognition of
  666  Postsecondary Accreditation and shall be licensed by the
  667  Commission for Independent Education.
  668         Section 13. Subsection (2) of section 468.1665, Florida
  669  Statutes, is amended to read:
  670         468.1665 Board of Nursing Home Administrators; membership;
  671  appointment; terms.—
  672         (2) Four Three members of the board must be licensed
  673  nursing home administrators. One member Two members of the board
  674  must be a health care practitioner practitioners. The remaining
  675  two members of the board must be laypersons who are not, and
  676  have never been, nursing home administrators or members of any
  677  health care profession or occupation. At least one member of the
  678  board must be 60 years of age or older.
  679         Section 14. Subsection (2) of section 468.1695, Florida
  680  Statutes, is amended to read:
  681         468.1695 Licensure by examination.—
  682         (2) The department shall examine each applicant who the
  683  board certifies has completed the application form and remitted
  684  an examination fee set by the board not to exceed $250 and who:
  685         (a)1. Holds a baccalaureate or master’s degree from an
  686  accredited college or university and majored in health care
  687  administration, health services administration, or an equivalent
  688  major, or has credit for at least 60 semester hours in subjects,
  689  as prescribed by rule of the board, which prepare the applicant
  690  for total management of a nursing home; and
  691         2. Has fulfilled the requirements of a college-affiliated
  692  or university-affiliated internship in nursing home
  693  administration or of a 1,000-hour nursing home administrator-in
  694  training program prescribed by the board; or
  695         (b)1. Holds a baccalaureate degree from an accredited
  696  college or university; and
  697         2.a. Has fulfilled the requirements of a 2,000-hour nursing
  698  home administrator-in-training program prescribed by the board;
  699  or
  700         b. Has 1 year of management experience allowing for the
  701  application of executive duties and skills, including the
  702  staffing, budgeting, and directing of resident care, dietary,
  703  and bookkeeping departments within a skilled nursing facility,
  704  hospital, hospice, assisted living facility with a minimum of 60
  705  licensed beds, or geriatric residential treatment program and,
  706  if such experience is not in a skilled nursing facility, has
  707  fulfilled the requirements of a 1,000-hour nursing home
  708  administrator-in-training program prescribed by the board.
  709         Section 15. Section 468.1735, Florida Statutes, is
  710  repealed.
  711         Section 16. Subsection (11) of section 468.503, Florida
  712  Statutes, is amended to read:
  713         468.503 Definitions.—As used in this part:
  714         (11) “Registered dietitian” means an individual registered
  715  with the accrediting body of the Academy of Nutrition and
  716  Dietetics Commission on Dietetic Registration, the accrediting
  717  body of the American Dietetic Association.
  718         Section 17. Subsection (4) of section 468.505, Florida
  719  Statutes, is amended to read:
  720         468.505 Exemptions; exceptions.—
  721         (4) Notwithstanding any other provision of this part, an
  722  individual registered by the accrediting body of the Academy of
  723  Nutrition and Dietetics Commission on Dietetic Registration of
  724  the American Dietetic Association has the right to use the title
  725  “Registered Dietitian” and the designation “R.D.”
  726         Section 18. Subsection (5) of section 480.033, Florida
  727  Statutes, is amended to read:
  728         480.033 Definitions.—As used in this act:
  729         (5) “Apprentice” means a person approved by the board to
  730  study massage under the instruction of a licensed massage
  731  therapist.
  732         Section 19. Subsections (1) and (4) of section 480.041,
  733  Florida Statutes, are amended to read:
  734         480.041 Massage therapists; qualifications; licensure;
  735  endorsement.—
  736         (1) A Any person is qualified for licensure as a massage
  737  therapist under this act who:
  738         (a) Is at least 18 years of age or has received a high
  739  school diploma or graduate equivalency diploma;
  740         (b) Has completed a course of study at a board-approved
  741  massage school or has completed an apprenticeship program that
  742  meets standards adopted by the board; and
  743         (c) Has received a passing grade on an examination
  744  administered by the department.
  745         (4) The board shall adopt rules:
  746         (a) Establishing a minimum training program for
  747  apprentices.
  748         (b) Providing for educational standards, examination, and
  749  certification for the practice of colonic irrigation, as defined
  750  in s.480.033 s. 480.033(6), by massage therapists.
  751         (b)(c) Specifying licensing procedures for practitioners
  752  desiring to be licensed in this state who hold an active license
  753  and have practiced in any other state, territory, or
  754  jurisdiction of the United States or any foreign national
  755  jurisdiction which has licensing standards substantially similar
  756  to, equivalent to, or more stringent than the standards of this
  757  state.
  758         Section 20. Subsection (5) of section 480.042, Florida
  759  Statutes, is amended to read:
  760         480.042 Examinations.—
  761         (5) All licensing examinations shall be conducted in such
  762  manner that the applicant shall be known to the department by
  763  number until her or his examination is completed and the proper
  764  grade determined. An accurate record of each examination shall
  765  be maintained, made; and that record, together with all
  766  examination papers, shall be filed with the State Surgeon
  767  General and shall be kept by the testing entities for reference
  768  and inspection for a period of not less than 2 years immediately
  769  following the examination.
  770         Section 21. Paragraph (h) of subsection (1) of section
  771  480.044, Florida Statutes, is amended to read:
  772         480.044 Fees; disposition.—
  773         (1) The board shall set fees according to the following
  774  schedule:
  775         (h) Fee for apprentice: not to exceed $100.
  776         Section 22. Subsection (3) of section 486.031, Florida
  777  Statutes, is amended to read:
  778         486.031 Physical therapist; licensing requirements.—To be
  779  eligible for licensing as a physical therapist, an applicant
  780  must:
  781         (3)(a) Have been graduated from a school of physical
  782  therapy which has been approved for the educational preparation
  783  of physical therapists by the appropriate accrediting agency
  784  recognized by the Commission on Recognition of Postsecondary
  785  Accreditation or the United States Department of Education at
  786  the time of her or his graduation and have passed, to the
  787  satisfaction of the board, the American Registry Examination
  788  before prior to 1971 or a national examination approved by the
  789  board to determine her or his fitness for practice as a physical
  790  therapist as hereinafter provided;
  791         (b) Have received a diploma from a program in physical
  792  therapy in a foreign country and have educational credentials
  793  deemed equivalent to those required for the educational
  794  preparation of physical therapists in this country, as
  795  recognized by the board or by an appropriate agency as
  796  identified by the board, and have passed to the satisfaction of
  797  the board an examination to determine her or his fitness for
  798  practice as a physical therapist as hereinafter provided; or
  799         (c) Be entitled to licensure without examination as
  800  provided in s. 486.081.
  801         Section 23. Subsection (4) of section 766.1115, Florida
  802  Statutes, is amended to read:
  803         766.1115 Health care providers; creation of agency
  804  relationship with governmental contractors.—
  805         (4) CONTRACT REQUIREMENTS.—A health care provider that
  806  executes a contract with a governmental contractor to deliver
  807  health care services on or after April 17, 1992, as an agent of
  808  the governmental contractor is an agent for purposes of s.
  809  768.28(9), while acting within the scope of duties under the
  810  contract, if the contract complies with the requirements of this
  811  section and regardless of whether the individual treated is
  812  later found to be ineligible. A health care provider shall
  813  continue to be an agent for purposes of s. 768.28(9) for 30 days
  814  after a determination of ineligibility to allow for treatment
  815  until the individual transitions to treatment by another health
  816  care provider. A health care provider under contract with the
  817  state may not be named as a defendant in any action arising out
  818  of medical care or treatment provided on or after April 17,
  819  1992, under contracts entered into under this section. The
  820  contract must provide that:
  821         (a) The right of dismissal or termination of any health
  822  care provider delivering services under the contract is retained
  823  by the governmental contractor.
  824         (b) The governmental contractor has access to the patient
  825  records of any health care provider delivering services under
  826  the contract.
  827         (c) Adverse incidents and information on treatment outcomes
  828  must be reported by any health care provider to the governmental
  829  contractor if the incidents and information pertain to a patient
  830  treated under the contract. The health care provider shall
  831  submit the reports required by s. 395.0197. If an incident
  832  involves a professional licensed by the Department of Health or
  833  a facility licensed by the Agency for Health Care
  834  Administration, the governmental contractor shall submit such
  835  incident reports to the appropriate department or agency, which
  836  shall review each incident and determine whether it involves
  837  conduct by the licensee that is subject to disciplinary action.
  838  All patient medical records and any identifying information
  839  contained in adverse incident reports and treatment outcomes
  840  which are obtained by governmental entities under this paragraph
  841  are confidential and exempt from the provisions of s. 119.07(1)
  842  and s. 24(a), Art. I of the State Constitution.
  843         (d) Patient selection and initial referral must be made by
  844  the governmental contractor or the provider. Patients may not be
  845  transferred to the provider based on a violation of the
  846  antidumping provisions of the Omnibus Budget Reconciliation Act
  847  of 1989, the Omnibus Budget Reconciliation Act of 1990, or
  848  chapter 395.
  849         (e) If emergency care is required, the patient need not be
  850  referred before receiving treatment, but must be referred within
  851  48 hours after treatment is commenced or within 48 hours after
  852  the patient has the mental capacity to consent to treatment,
  853  whichever occurs later.
  854         (f) The provider is subject to supervision and regular
  855  inspection by the governmental contractor.
  856  
  857  A governmental contractor that is also a health care provider is
  858  not required to enter into a contract under this section with
  859  respect to the health care services delivered by its employees.
  860         Section 24. Subsection (2) of section 456.032, Florida
  861  Statutes, is amended to read:
  862         456.032 Hepatitis B or HIV carriers.—
  863         (2) Any person licensed by the department and any other
  864  person employed by a health care facility who contracts a blood
  865  borne infection shall have a rebuttable presumption that the
  866  illness was contracted in the course and scope of his or her
  867  employment, provided that the person, as soon as practicable,
  868  reports to the person’s supervisor or the facility’s risk
  869  manager any significant exposure, as that term is defined in s.
  870  381.004(1) s. 381.004(1)(c), to blood or body fluids. The
  871  employer may test the blood or body fluid to determine if it is
  872  infected with the same disease contracted by the employee. The
  873  employer may rebut the presumption by the preponderance of the
  874  evidence. Except as expressly provided in this subsection, there
  875  shall be no presumption that a blood-borne infection is a job
  876  related injury or illness.
  877         Section 25. Subsection (3) of section 823.05, Florida
  878  Statutes, is amended to read:
  879         823.05 Places and groups engaged in criminal gang-related
  880  activity declared a nuisance; massage establishments engaged in
  881  prohibited activity; may be abated and enjoined.—
  882         (3) A massage establishment as defined in s. 480.033(7)
  883  that operates in violation of s. 480.0475 or s. 480.0535(2) is
  884  declared a nuisance and may be abated or enjoined as provided in
  885  ss. 60.05 and 60.06.
  886         Section 26. This act shall take effect July 1, 2014.
  887  

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