Bill Text: FL S1250 | 2016 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Health Care Workforce
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2016-03-09 - Laid on Table, companion bill(s) passed, see HB 423 (Ch. 2016-224), CS/HB 977 (Ch. 2016-231) [S1250 Detail]
Download: Florida-2016-S1250-Comm_Sub.html
Bill Title: Health Care Workforce
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2016-03-09 - Laid on Table, companion bill(s) passed, see HB 423 (Ch. 2016-224), CS/HB 977 (Ch. 2016-231) [S1250 Detail]
Download: Florida-2016-S1250-Comm_Sub.html
Florida Senate - 2016 CS for SB 1250 By the Committee on Children, Families, and Elder Affairs; and Senator Latvala 586-03330-16 20161250c1 1 A bill to be entitled 2 An act relating to behavioral health workforce; 3 amending s. 110.12315, F.S.; expanding the categories 4 of persons who may prescribe brand name drugs under 5 the prescription drug program when medically 6 necessary; amending ss. 310.071, 310.073, and 310.081, 7 F.S.; exempting controlled substances prescribed by an 8 advanced registered nurse practitioner or a physician 9 assistant from the disqualifications for certification 10 or licensure, and for continued certification or 11 licensure, as a deputy pilot or state pilot; amending 12 s. 394.453, F.S.; revising legislative intent; 13 amending s. 394.467, F.S.; authorizing procedures for 14 recommending admission of a patient to a treatment 15 facility; amending s. 395.1051, F.S.; requiring a 16 hospital to provide specified advance notice to 17 certain obstetrical physicians before it closes its 18 obstetrical department or ceases to provide 19 obstetrical services; amending s. 397.451, F.S.; 20 revising provisions relating to exemptions from 21 disqualification for certain service provider 22 personnel; amending s. 456.072, F.S.; providing 23 mandatory administrative penalties for certain 24 violations relating to prescribing or dispensing a 25 controlled substance; amending s. 456.44, F.S.; 26 providing a definition; deleting an obsolete date; 27 requiring advanced registered nurse practitioners and 28 physician assistants who prescribe controlled 29 substances for certain pain to make a certain 30 designation, comply with registration requirements, 31 and follow specified standards of practice; providing 32 applicability; amending ss. 458.3265 and 459.0137, 33 F.S.; limiting the authority to prescribe a controlled 34 substance in a pain-management clinic only to a 35 physician licensed under chapter 458 or chapter 459, 36 F.S.; amending s. 458.347, F.S.; revising the required 37 continuing education requirements for a physician 38 assistant; requiring that a specified formulary limit 39 the prescription of certain controlled substances by 40 physician assistants as of a specified date; amending 41 s. 464.003, F.S.; redefining the term “advanced or 42 specialized nursing practice”; deleting the joint 43 committee established in the definition; amending s. 44 464.012, F.S.; requiring the Board of Nursing to 45 establish a committee to recommend a formulary of 46 controlled substances that may not be prescribed, or 47 may be prescribed only on a limited basis, by an 48 advanced registered nurse practitioner; specifying the 49 membership of the committee; providing parameters for 50 the formulary; requiring that the formulary be adopted 51 by board rule; specifying the process for amending the 52 formulary and imposing a burden of proof; limiting the 53 formulary’s application in certain instances; 54 requiring the board to adopt the committee’s initial 55 recommendations by a specified date; authorizing an 56 advanced registered nurse practitioner to prescribe, 57 dispense, administer, or order drugs, including 58 certain controlled substances under certain 59 circumstances, as of a specified date; amending s. 60 464.013, F.S.; revising continuing education 61 requirements for renewal of a license or certificate; 62 amending s. 464.018, F.S.; specifying acts that 63 constitute grounds for denial of a license or for 64 disciplinary action against an advanced registered 65 nurse practitioner; amending s. 893.02, F.S.; 66 redefining the term “practitioner” to include advanced 67 registered nurse practitioners and physician 68 assistants under the Florida Comprehensive Drug Abuse 69 Prevention and Control Act for the purpose of 70 prescribing controlled substances if a certain 71 requirement is met; amending s. 948.03, F.S.; 72 providing that possession of drugs or narcotics 73 prescribed by an advanced registered nurse 74 practitioner or a physician assistant does not violate 75 a prohibition relating to the possession of drugs or 76 narcotics during probation; amending ss. 458.348 and 77 459.025, F.S.; conforming provisions to changes made 78 by the act; reenacting ss. 458.331(10), 458.347(7)(g), 79 459.015(10), 459.022(7)(f), and 465.0158(5)(b), F.S., 80 relating to grounds for disciplinary action against 81 certain licensed health care practitioners or 82 applicants, physician assistant licensure, the 83 imposition of penalties upon physician assistants by 84 the Board of Osteopathic Medicine, and nonresident 85 sterile compounding permits, respectively, to 86 incorporate the amendment made by the act to s. 87 456.072, F.S., in references thereto; reenacting ss. 88 456.072(1)(mm) and 466.02751, F.S., relating to 89 grounds for discipline of certain licensed health care 90 practitioners or applicants and dentist practitioner 91 profiles, respectively, to incorporate the amendment 92 made by the act to s. 456.44, F.S., in references 93 thereto; reenacting ss. 458.303, 458.3475(7)(b), 94 459.022(4)(e) and (9)(c), and 459.023(7)(b), F.S., 95 relating to the nonapplicability of certain provisions 96 to specified health care practitioners, and the duties 97 of the Board of Medicine and the Board of Osteopathic 98 Medicine with respect to anesthesiologist assistants, 99 respectively, to incorporate the amendment made by the 100 act to s. 458.347, F.S., in references thereto; 101 reenacting ss. 456.041(1)(a) and 458.348(1) and (2), 102 F.S., relating to practitioner profiles and notice and 103 standards for formal supervisory relationships, 104 respectively, to incorporate the amendment made by the 105 act to s. 464.012, F.S., in references thereto; 106 reenacting s. 464.0205(7), F.S., relating to 107 certification as a retired volunteer nurse to 108 incorporate the amendment made by the act to s. 109 464.013, F.S., in a reference thereto; reenacting ss. 110 320.0848(11), 464.008(2), 464.009(5), and 111 464.0205(1)(b), (3), and (4)(b), F.S., relating to 112 violations of provisions for disability parking, 113 licensure by examination of registered nurses and 114 licensed practical nurses, licensure by endorsement to 115 practice professional or practical nursing, 116 disciplinary actions against nursing applicants or 117 licensees, and retired volunteer nurse certifications, 118 respectively, to incorporate the amendment made by the 119 act to s. 464.018, F.S., in references thereto; 120 reenacting s. 775.051, F.S., relating to exclusion as 121 a defense and nonadmissibility as evidence of 122 voluntary intoxication to incorporate the amendment 123 made by the act to s. 893.02, F.S., in a reference 124 thereto; reenacting ss. 944.17(3)(a), 948.001(8), and 125 948.101(1)(e), F.S., relating to receipt by the state 126 correctional system of certain persons sentenced to 127 incarceration, the definition of the term “probation,” 128 and the terms and conditions of community control, 129 respectively, to incorporate the amendment made by the 130 act to s. 948.03, F.S., in references thereto; 131 providing effective dates. 132 133 Be It Enacted by the Legislature of the State of Florida: 134 135 Section 1. Subsection (7) of section 110.12315, Florida 136 Statutes, is amended to read: 137 110.12315 Prescription drug program.—The state employees’ 138 prescription drug program is established. This program shall be 139 administered by the Department of Management Services, according 140 to the terms and conditions of the plan as established by the 141 relevant provisions of the annual General Appropriations Act and 142 implementing legislation, subject to the following conditions: 143 (7) The department shall establish the reimbursement 144 schedule for prescription pharmaceuticals dispensed under the 145 program. Reimbursement rates for a prescription pharmaceutical 146 must be based on the cost of the generic equivalent drug if a 147 generic equivalent exists, unless the physician, advanced 148 registered nurse practitioner, or physician assistant 149 prescribing the pharmaceutical clearly states on the 150 prescription that the brand name drug is medically necessary or 151 that the drug product is included on the formulary of drug 152 products that may not be interchanged as provided in chapter 153 465, in which case reimbursement must be based on the cost of 154 the brand name drug as specified in the reimbursement schedule 155 adopted by the department. 156 Section 2. Paragraph (c) of subsection (1) of section 157 310.071, Florida Statutes, is amended, and subsection (3) of 158 that section is republished, to read: 159 310.071 Deputy pilot certification.— 160 (1) In addition to meeting other requirements specified in 161 this chapter, each applicant for certification as a deputy pilot 162 must: 163 (c) Be in good physical and mental health, as evidenced by 164 documentary proof of having satisfactorily passed a complete 165 physical examination administered by a licensed physician within 166 the preceding 6 months. The board shall adopt rules to establish 167 requirements for passing the physical examination, which rules 168 shall establish minimum standards for the physical or mental 169 capabilities necessary to carry out the professional duties of a 170 certificated deputy pilot. Such standards shall include zero 171 tolerance for any controlled substance regulated under chapter 172 893 unless that individual is under the care of a physician, 173 advanced registered nurse practitioner, or physician assistant 174 and that controlled substance was prescribed by that physician, 175 advanced registered nurse practitioner, or physician assistant. 176 To maintain eligibility as a certificated deputy pilot, each 177 certificated deputy pilot must annually provide documentary 178 proof of having satisfactorily passed a complete physical 179 examination administered by a licensed physician. The physician 180 must know the minimum standards and certify that the 181 certificateholder satisfactorily meets the standards. The 182 standards for certificateholders shall include a drug test. 183 (3) The initial certificate issued to a deputy pilot shall 184 be valid for a period of 12 months, and at the end of this 185 period, the certificate shall automatically expire and shall not 186 be renewed. During this period, the board shall thoroughly 187 evaluate the deputy pilot’s performance for suitability to 188 continue training and shall make appropriate recommendations to 189 the department. Upon receipt of a favorable recommendation by 190 the board, the department shall issue a certificate to the 191 deputy pilot, which shall be valid for a period of 2 years. The 192 certificate may be renewed only two times, except in the case of 193 a fully licensed pilot who is cross-licensed as a deputy pilot 194 in another port, and provided the deputy pilot meets the 195 requirements specified for pilots in paragraph (1)(c). 196 Section 3. Subsection (3) of section 310.073, Florida 197 Statutes, is amended to read: 198 310.073 State pilot licensing.—In addition to meeting other 199 requirements specified in this chapter, each applicant for 200 license as a state pilot must: 201 (3) Be in good physical and mental health, as evidenced by 202 documentary proof of having satisfactorily passed a complete 203 physical examination administered by a licensed physician within 204 the preceding 6 months. The board shall adopt rules to establish 205 requirements for passing the physical examination, which rules 206 shall establish minimum standards for the physical or mental 207 capabilities necessary to carry out the professional duties of a 208 licensed state pilot. Such standards shall include zero 209 tolerance for any controlled substance regulated under chapter 210 893 unless that individual is under the care of a physician, 211 advanced registered nurse practitioner, or physician assistant 212 and that controlled substance was prescribed by that physician, 213 advanced registered nurse practitioner, or physician assistant. 214 To maintain eligibility as a licensed state pilot, each licensed 215 state pilot must annually provide documentary proof of having 216 satisfactorily passed a complete physical examination 217 administered by a licensed physician. The physician must know 218 the minimum standards and certify that the licensee 219 satisfactorily meets the standards. The standards for licensees 220 shall include a drug test. 221 Section 4. Paragraph (b) of subsection (3) of section 222 310.081, Florida Statutes, is amended to read: 223 310.081 Department to examine and license state pilots and 224 certificate deputy pilots; vacancies.— 225 (3) Pilots shall hold their licenses or certificates 226 pursuant to the requirements of this chapter so long as they: 227 (b) Are in good physical and mental health as evidenced by 228 documentary proof of having satisfactorily passed a physical 229 examination administered by a licensed physician or physician 230 assistant within each calendar year. The board shall adopt rules 231 to establish requirements for passing the physical examination, 232 which rules shall establish minimum standards for the physical 233 or mental capabilities necessary to carry out the professional 234 duties of a licensed state pilot or a certificated deputy pilot. 235 Such standards shall include zero tolerance for any controlled 236 substance regulated under chapter 893 unless that individual is 237 under the care of a physician, advanced registered nurse 238 practitioner, or physician assistant and that controlled 239 substance was prescribed by that physician, advanced registered 240 nurse practitioner, or physician assistant. To maintain 241 eligibility as a certificated deputy pilot or licensed state 242 pilot, each certificated deputy pilot or licensed state pilot 243 must annually provide documentary proof of having satisfactorily 244 passed a complete physical examination administered by a 245 licensed physician. The physician must know the minimum 246 standards and certify that the certificateholder or licensee 247 satisfactorily meets the standards. The standards for 248 certificateholders and for licensees shall include a drug test. 249 250 Upon resignation or in the case of disability permanently 251 affecting a pilot’s ability to serve, the state license or 252 certificate issued under this chapter shall be revoked by the 253 department. 254 Section 5. Section 394.453, Florida Statutes, is amended to 255 read: 256 394.453 Legislative intent.—It is the intent of the 257 Legislature to authorize and direct the Department of Children 258 and Families to evaluate, research, plan, and recommend to the 259 Governor and the Legislature programs designed to reduce the 260 occurrence, severity, duration, and disabling aspects of mental, 261 emotional, and behavioral disorders. It is the intent of the 262 Legislature that treatment programs for such disorders shall 263 include, but not be limited to, comprehensive health, social, 264 educational, and rehabilitative services to persons requiring 265 intensive short-term and continued treatment in order to 266 encourage them to assume responsibility for their treatment and 267 recovery. It is intended that such persons be provided with 268 emergency service and temporary detention for evaluation when 269 required; that they be admitted to treatment facilities on a 270 voluntary basis when extended or continuing care is needed and 271 unavailable in the community; that involuntary placement be 272 provided only when expert evaluation determines that it is 273 necessary; that any involuntary treatment or examination be 274 accomplished in a setting which is clinically appropriate and 275 most likely to facilitate the person’s return to the community 276 as soon as possible; and that individual dignity and human 277 rights be guaranteed to all persons who are admitted to mental 278 health facilities or who are being held under s. 394.463. It is 279 the further intent of the Legislature that the least restrictive 280 means of intervention be employed based on the individual needs 281 of each person, within the scope of available services. It is 282 the policy of this state that the use of restraint and seclusion 283 on clients is justified only as an emergency safety measure to 284 be used in response to imminent danger to the client or others. 285 It is, therefore, the intent of the Legislature to achieve an 286 ongoing reduction in the use of restraint and seclusion in 287 programs and facilities serving persons with mental illness. The 288 Legislature further finds the need for additional psychiatrists 289 to be of critical state concern and recommends the establishment 290 of an additional psychiatry program to be offered by one of 291 Florida’s schools of medicine currently not offering psychiatry. 292 The program shall seek to integrate primary care and psychiatry 293 and other evolving models of care for persons with mental health 294 and substance use disorders. Additionally, the Legislature finds 295 that the use of telemedicine for patient evaluation, case 296 management, and ongoing care will improve management of patient 297 care and reduce costs of transportation. 298 Section 6. Subsection (2) of section 394.467, Florida 299 Statutes, is amended to read: 300 394.467 Involuntary inpatient placement.— 301 (2) ADMISSION TO A TREATMENT FACILITY.—A patient may be 302 retained by a receiving facility or involuntarily placed in a 303 treatment facility upon the recommendation of the administrator 304 of the receiving facility where the patient has been examined 305 and after adherence to the notice and hearing procedures 306 provided in s. 394.4599. The recommendation must be supported by 307 the opinion of a psychiatrist and the second opinion of a 308 clinical psychologist or another psychiatrist, both of whom have 309 personally examined the patient within the preceding 72 hours, 310 that the criteria for involuntary inpatient placement are met. 311 However, in a county that has a population of fewer than 50,000, 312 if the administrator certifies that a psychiatrist or clinical 313 psychologist is not available to provide the second opinion, the 314 second opinion may be provided by a licensed physician who has 315 postgraduate training and experience in diagnosis and treatment 316 of mental and nervous disorders or by a psychiatric nurse. Any 317secondopinion authorized in this subsection may be conducted 318 through a face-to-face examination, in person or by electronic 319 means. Such recommendation shall be entered on an involuntary 320 inpatient placement certificate that authorizes the receiving 321 facility to retain the patient pending transfer to a treatment 322 facility or completion of a hearing. 323 Section 7. Section 395.1051, Florida Statutes, is amended 324 to read: 325 395.1051 Duty to notify patients and physicians.— 326 (1) An appropriately trained person designated by each 327 licensed facility shall inform each patient, or an individual 328 identified pursuant to s. 765.401(1), in person about adverse 329 incidents that result in serious harm to the patient. 330 Notification of outcomes of care whichthatresult in harm to 331 the patient under this section doesshallnot constitute an 332 acknowledgment or admission of liability and may not, nor can it333 be introduced as evidence. 334 (2) A hospital shall notify each obstetrical physician who 335 has privileges at the hospital at least 90 days before the 336 hospital closes its obstetrical department or ceases to provide 337 obstetrical services. 338 Section 8. Paragraphs (e) and (f) of subsection (1) and 339 paragraph (b) of subsection (4) of section 397.451, Florida 340 Statutes, are amended to read: 341 397.451 Background checks of service provider personnel.— 342 (1) PERSONNEL BACKGROUND CHECKS; REQUIREMENTS AND 343 EXCEPTIONS.— 344 (e) Personnel employed directly or under contract with the 345 Department of Corrections in an inmate substance abuse program 346who have direct contact with unmarried inmates under the age of34718 or with inmates who are developmentally disabledare exempt 348 from the fingerprinting and background check requirements of 349 this section unless they have direct contact with unmarried 350 inmates under the age of 18 or with inmates who are 351 developmentally disabled. 352 (f) Service provider personnel who request an exemption 353 from disqualification must submit the request within 30 days 354 after being notified of the disqualification. If 5 years or more 355 have elapsed since the most recent disqualifying offense, 356 service provider personnel may work with adults with substance 357 use disorders under the supervision of a qualified professional 358 licensed under chapter 490 or chapter 491 or a master’s level 359 certified addiction professional until the agency makes a final 360 determination regarding the request for an exemption from 361 disqualificationUpon notification of the disqualification, the362service provider shall comply with requirements regarding363exclusion from employment in s. 435.06. 364 (4) EXEMPTIONS FROM DISQUALIFICATION.— 365 (b) Since rehabilitated substance abuse impaired persons 366 are effective in the successful treatment and rehabilitation of 367 individuals with substance use disorderssubstance abuse368impaired adolescents, for service providers which treat 369 adolescents 13 years of age and older, service provider 370 personnel whose background checks indicate crimes under s. 371 817.563, s. 893.13, or s. 893.147 may be exempted from 372 disqualification from employment pursuant to this paragraph. 373 Section 9. Subsection (7) of section 456.072, Florida 374 Statutes, is amended to read: 375 456.072 Grounds for discipline; penalties; enforcement.— 376 (7) Notwithstanding subsection (2), upon a finding that a 377 physician has prescribed or dispensed a controlled substance, or 378 caused a controlled substance to be prescribed or dispensed, in 379 a manner that violates the standard of practice set forth in s. 380 458.331(1)(q) or (t), s. 459.015(1)(t) or (x), s. 461.013(1)(o) 381 or (s), or s. 466.028(1)(p) or (x), or that an advanced 382 registered nurse practitioner has prescribed or dispensed a 383 controlled substance, or caused a controlled substance to be 384 prescribed or dispensed in a manner that violates the standard 385 of practice set forth in s. 464.018(1)(n) or s. 464.018(1)(p)6., 386 the physician or advanced registered nurse practitioner shall be 387 suspended for a period of not less than 6 months and pay a fine 388 of not less than $10,000 per count. Repeated violations shall 389 result in increased penalties. 390 Section 10. Section 456.44, Florida Statutes, is amended to 391 read: 392 456.44 Controlled substance prescribing.— 393 (1) DEFINITIONS.— As used in this section, the term: 394 (a) “Addiction medicine specialist” means a board-certified 395 psychiatrist with a subspecialty certification in addiction 396 medicine or who is eligible for such subspecialty certification 397 in addiction medicine, an addiction medicine physician certified 398 or eligible for certification by the American Society of 399 Addiction Medicine, or an osteopathic physician who holds a 400 certificate of added qualification in Addiction Medicine through 401 the American Osteopathic Association. 402 (b) “Adverse incident” means any incident set forth in s. 403 458.351(4)(a)-(e) or s. 459.026(4)(a)-(e). 404 (c) “Board-certified pain management physician” means a 405 physician who possesses board certification in pain medicine by 406 the American Board of Pain Medicine, board certification by the 407 American Board of Interventional Pain Physicians, or board 408 certification or subcertification in pain management or pain 409 medicine by a specialty board recognized by the American 410 Association of Physician Specialists or the American Board of 411 Medical Specialties or an osteopathic physician who holds a 412 certificate in Pain Management by the American Osteopathic 413 Association. 414 (d) “Board eligible” means successful completion of an 415 anesthesia, physical medicine and rehabilitation, rheumatology, 416 or neurology residency program approved by the Accreditation 417 Council for Graduate Medical Education or the American 418 Osteopathic Association for a period of 6 years from successful 419 completion of such residency program. 420 (e) “Chronic nonmalignant pain” means pain unrelated to 421 cancer which persists beyond the usual course of disease or the 422 injury that is the cause of the pain or more than 90 days after 423 surgery. 424 (f) “Mental health addiction facility” means a facility 425 licensed under chapter 394 or chapter 397. 426 (g) “Registrant” means a physician, physician assistant, or 427 advanced registered nurse practitioner who meets the 428 requirements of subsection (2). 429 (2) REGISTRATION.—Effective January 1, 2012,A physician 430 licensed under chapter 458, chapter 459, chapter 461, or chapter 431 466, a physician assistant licensed under chapter 458 or chapter 432 459, or an advanced registered nurse practitioner certified 433 under part I of chapter 464 who prescribes any controlled 434 substance, listed in Schedule II, Schedule III, or Schedule IV 435 as defined in s. 893.03, for the treatment of chronic 436 nonmalignant pain, must: 437 (a) Designate himself or herself as a controlled substance 438 prescribing practitioner on his or herthe physician’s439 practitioner profile. 440 (b) Comply with the requirements of this section and 441 applicable board rules. 442 (3) STANDARDS OF PRACTICE.—The standards of practice in 443 this section do not supersede the level of care, skill, and 444 treatment recognized in general law related to health care 445 licensure. 446 (a) A complete medical history and a physical examination 447 must be conducted before beginning any treatment and must be 448 documented in the medical record. The exact components of the 449 physical examination shall be left to the judgment of the 450 registrantclinicianwho is expected to perform a physical 451 examination proportionate to the diagnosis that justifies a 452 treatment. The medical record must, at a minimum, document the 453 nature and intensity of the pain, current and past treatments 454 for pain, underlying or coexisting diseases or conditions, the 455 effect of the pain on physical and psychological function, a 456 review of previous medical records, previous diagnostic studies, 457 and history of alcohol and substance abuse. The medical record 458 shall also document the presence of one or more recognized 459 medical indications for the use of a controlled substance. Each 460 registrant must develop a written plan for assessing each 461 patient’s risk of aberrant drug-related behavior, which may 462 include patient drug testing. Registrants must assess each 463 patient’s risk for aberrant drug-related behavior and monitor 464 that risk on an ongoing basis in accordance with the plan. 465 (b) Each registrant must develop a written individualized 466 treatment plan for each patient. The treatment plan shall state 467 objectives that will be used to determine treatment success, 468 such as pain relief and improved physical and psychosocial 469 function, and shall indicate if any further diagnostic 470 evaluations or other treatments are planned. After treatment 471 begins, the registrantphysician shall adjust drug therapy to 472 the individual medical needs of each patient. Other treatment 473 modalities, including a rehabilitation program, shall be 474 considered depending on the etiology of the pain and the extent 475 to which the pain is associated with physical and psychosocial 476 impairment. The interdisciplinary nature of the treatment plan 477 shall be documented. 478 (c) The registrantphysicianshall discuss the risks and 479 benefits of the use of controlled substances, including the 480 risks of abuse and addiction, as well as physical dependence and 481 its consequences, with the patient, persons designated by the 482 patient, or the patient’s surrogate or guardian if the patient 483 is incompetent. The registrantphysicianshall use a written 484 controlled substance agreement between the registrantphysician485 and the patient outlining the patient’s responsibilities, 486 including, but not limited to: 487 1. Number and frequency of controlled substance 488 prescriptions and refills. 489 2. Patient compliance and reasons for which drug therapy 490 may be discontinued, such as a violation of the agreement. 491 3. An agreement that controlled substances for the 492 treatment of chronic nonmalignant pain shall be prescribed by a 493 single treating registrantphysicianunless otherwise authorized 494 by the treating registrantphysicianand documented in the 495 medical record. 496 (d) The patient shall be seen by the registrantphysician497 at regular intervals, not to exceed 3 months, to assess the 498 efficacy of treatment, ensure that controlled substance therapy 499 remains indicated, evaluate the patient’s progress toward 500 treatment objectives, consider adverse drug effects, and review 501 the etiology of the pain. Continuation or modification of 502 therapy shall depend on the registrant’sphysician’sevaluation 503 of the patient’s progress. If treatment goals are not being 504 achieved, despite medication adjustments, the registrant 505physicianshall reevaluate the appropriateness of continued 506 treatment. The registrantphysicianshall monitor patient 507 compliance in medication usage, related treatment plans, 508 controlled substance agreements, and indications of substance 509 abuse or diversion at a minimum of 3-month intervals. 510 (e) The registrantphysicianshall refer the patient as 511 necessary for additional evaluation and treatment in order to 512 achieve treatment objectives. Special attention shall be given 513 to those patients who are at risk for misusing their medications 514 and those whose living arrangements pose a risk for medication 515 misuse or diversion. The management of pain in patients with a 516 history of substance abuse or with a comorbid psychiatric 517 disorder requires extra care, monitoring, and documentation and 518 requires consultation with or referral to an addiction medicine 519 specialist or psychiatrist. 520 (f) A registrantphysician registered under this section521 must maintain accurate, current, and complete records that are 522 accessible and readily available for review and comply with the 523 requirements of this section, the applicable practice act, and 524 applicable board rules. The medical records must include, but 525 are not limited to: 526 1. The complete medical history and a physical examination, 527 including history of drug abuse or dependence. 528 2. Diagnostic, therapeutic, and laboratory results. 529 3. Evaluations and consultations. 530 4. Treatment objectives. 531 5. Discussion of risks and benefits. 532 6. Treatments. 533 7. Medications, including date, type, dosage, and quantity 534 prescribed. 535 8. Instructions and agreements. 536 9. Periodic reviews. 537 10. Results of any drug testing. 538 11. A photocopy of the patient’s government-issued photo 539 identification. 540 12. If a written prescription for a controlled substance is 541 given to the patient, a duplicate of the prescription. 542 13. The registrant’sphysician’sfull name presented in a 543 legible manner. 544 (g) A registrant shall immediately refer patients with 545 signs or symptoms of substanceabuse shall be immediately546referredto a board-certified pain management physician, an 547 addiction medicine specialist, or a mental health addiction 548 facility as it pertains to drug abuse or addiction unless the 549 registrant is a physician who is board-certified or board 550 eligible in pain management. Throughout the period of time 551 before receiving the consultant’s report, a prescribing 552 registrantphysicianshall clearly and completely document 553 medical justification for continued treatment with controlled 554 substances and those steps taken to ensure medically appropriate 555 use of controlled substances by the patient. Upon receipt of the 556 consultant’s written report, the prescribing registrant 557physicianshall incorporate the consultant’s recommendations for 558 continuing, modifying, or discontinuing controlled substance 559 therapy. The resulting changes in treatment shall be 560 specifically documented in the patient’s medical record. 561 Evidence or behavioral indications of diversion shall be 562 followed by discontinuation of controlled substance therapy, and 563 the patient shall be discharged, and all results of testing and 564 actions taken by the registrantphysicianshall be documented in 565 the patient’s medical record. 566 567 This subsection does not apply to a board-eligible or board 568 certified anesthesiologist, physiatrist, rheumatologist, or 569 neurologist, or to a board-certified physician who has surgical 570 privileges at a hospital or ambulatory surgery center and 571 primarily provides surgical services. This subsection does not 572 apply to a board-eligible or board-certified medical specialist 573 who has also completed a fellowship in pain medicine approved by 574 the Accreditation Council for Graduate Medical Education or the 575 American Osteopathic Association, or who is board eligible or 576 board certified in pain medicine by the American Board of Pain 577 Medicine or a board approved by the American Board of Medical 578 Specialties or the American Osteopathic Association and performs 579 interventional pain procedures of the type routinely billed 580 using surgical codes. This subsection does not apply to a 581 registrant, physician, advanced registered nurse practitioner, 582 or physician assistant who prescribes medically necessary 583 controlled substances for a patient during an inpatient stay in 584 a hospital licensed under chapter 395. 585 Section 11. Paragraph (b) of subsection (2) of section 586 458.3265, Florida Statutes, is amended to read: 587 458.3265 Pain-management clinics.— 588 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities 589 apply to any physician who provides professional services in a 590 pain-management clinic that is required to be registered in 591 subsection (1). 592 (b) Onlya person may not dispense any medication on the593premises of a registered pain-management clinic unless he or she594isa physician licensed under this chapter or chapter 459 may 595 dispense medication or prescribe a controlled substance 596 regulated under chapter 893 on the premises of a registered 597 pain-management clinic. 598 Section 12. Paragraph (b) of subsection (2) of section 599 459.0137, Florida Statutes, is amended to read: 600 459.0137 Pain-management clinics.— 601 (2) PHYSICIAN RESPONSIBILITIES.—These responsibilities 602 apply to any osteopathic physician who provides professional 603 services in a pain-management clinic that is required to be 604 registered in subsection (1). 605 (b) Onlya person may not dispense any medication on the606premises of a registered pain-management clinic unless he or she607isa physician licensed under this chapter or chapter 458 may 608 dispense medication or prescribe a controlled substance 609 regulated under chapter 893 on the premises of a registered 610 pain-management clinic. 611 Section 13. Paragraph (e) of subsection (4) of section 612 458.347, Florida Statutes, is amended, and paragraph (c) of 613 subsection (9) of that section is republished, to read: 614 458.347 Physician assistants.— 615 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 616 (e) A supervisory physician may delegate to a fully 617 licensed physician assistant the authority to prescribe or 618 dispense any medication used in the supervisory physician’s 619 practice unless such medication is listed on the formulary 620 created pursuant to paragraph (f). A fully licensed physician 621 assistant may only prescribe or dispense such medication under 622 the following circumstances: 623 1. A physician assistant must clearly identify to the 624 patient that he or she is a physician assistant. Furthermore, 625 the physician assistant must inform the patient that the patient 626 has the right to see the physician prior to any prescription 627 being prescribed or dispensed by the physician assistant. 628 2. The supervisory physician must notify the department of 629 his or her intent to delegate, on a department-approved form, 630 before delegating such authority and notify the department of 631 any change in prescriptive privileges of the physician 632 assistant. Authority to dispense may be delegated only by a 633 supervising physician who is registered as a dispensing 634 practitioner in compliance with s. 465.0276. 635 3. The physician assistant must file with the department a 636 signed affidavit that he or she has completed a minimum of 10 637 continuing medical education hours in the specialty practice in 638 which the physician assistant has prescriptive privileges with 639 each licensure renewal application. Three of the 10 hours must 640 consist of a continuing education course on the safe and 641 effective prescribing of controlled substance medications 642 offered by a statewide professional association of physicians in 643 this state accredited to provide educational activities 644 designated for the American Medical Association Physician’s 645 Recognition Award Category I Credit or designated by the 646 American Academy of Physician Assistants as a Category 1 Credit. 647 4. The department may issue a prescriber number to the 648 physician assistant granting authority for the prescribing of 649 medicinal drugs authorized within this paragraph upon completion 650 of the foregoing requirements. The physician assistant shall not 651 be required to independently register pursuant to s. 465.0276. 652 5. The prescription must be written in a form that complies 653 with chapter 499 and must contain, in addition to the 654 supervisory physician’s name, address, and telephone number, the 655 physician assistant’s prescriber number. Unless it is a drug or 656 drug sample dispensed by the physician assistant, the 657 prescription must be filled in a pharmacy permitted under 658 chapter 465 and must be dispensed in that pharmacy by a 659 pharmacist licensed under chapter 465. The appearance of the 660 prescriber number creates a presumption that the physician 661 assistant is authorized to prescribe the medicinal drug and the 662 prescription is valid. 663 6. The physician assistant must note the prescription or 664 dispensing of medication in the appropriate medical record. 665 (9) COUNCIL ON PHYSICIAN ASSISTANTS.—The Council on 666 Physician Assistants is created within the department. 667 (c) The council shall: 668 1. Recommend to the department the licensure of physician 669 assistants. 670 2. Develop all rules regulating the use of physician 671 assistants by physicians under this chapter and chapter 459, 672 except for rules relating to the formulary developed under 673 paragraph (4)(f). The council shall also develop rules to ensure 674 that the continuity of supervision is maintained in each 675 practice setting. The boards shall consider adopting a proposed 676 rule developed by the council at the regularly scheduled meeting 677 immediately following the submission of the proposed rule by the 678 council. A proposed rule submitted by the council may not be 679 adopted by either board unless both boards have accepted and 680 approved the identical language contained in the proposed rule. 681 The language of all proposed rules submitted by the council must 682 be approved by both boards pursuant to each respective board’s 683 guidelines and standards regarding the adoption of proposed 684 rules. If either board rejects the council’s proposed rule, that 685 board must specify its objection to the council with 686 particularity and include any recommendations it may have for 687 the modification of the proposed rule. 688 3. Make recommendations to the boards regarding all matters 689 relating to physician assistants. 690 4. Address concerns and problems of practicing physician 691 assistants in order to improve safety in the clinical practices 692 of licensed physician assistants. 693 Section 14. Effective January 1, 2017, paragraph (f) of 694 subsection (4) of section 458.347, Florida Statutes, is amended 695 to read: 696 458.347 Physician assistants.— 697 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 698 (f)1. The council shall establish a formulary of medicinal 699 drugs that a fully licensed physician assistant having 700 prescribing authority under this section or s. 459.022 may not 701 prescribe. The formulary must includecontrolled substances as702defined in chapter 893,general anesthetics,and radiographic 703 contrast materials, and must limit the prescription of Schedule 704 II controlled substances as defined in s. 893.03 to a 7-day 705 supply. The formulary must also restrict the prescribing of 706 psychiatric mental health controlled substances for children 707 under 18 years of age. 708 2. In establishing the formulary, the council shall consult 709 with a pharmacist licensed under chapter 465, but not licensed 710 under this chapter or chapter 459, who shall be selected by the 711 State Surgeon General. 712 3. Only the council shall add to, delete from, or modify 713 the formulary. Any person who requests an addition, deletion, or 714 modification of a medicinal drug listed on such formulary has 715 the burden of proof to show cause why such addition, deletion, 716 or modification should be made. 717 4. The boards shall adopt the formulary required by this 718 paragraph, and each addition, deletion, or modification to the 719 formulary, by rule. Notwithstanding any provision of chapter 120 720 to the contrary, the formulary rule shall be effective 60 days 721 after the date it is filed with the Secretary of State. Upon 722 adoption of the formulary, the department shall mail a copy of 723 such formulary to each fully licensed physician assistant having 724 prescribing authority under this section or s. 459.022, and to 725 each pharmacy licensed by the state. The boards shall establish, 726 by rule, a fee not to exceed $200 to fund the provisions of this 727 paragraph and paragraph (e). 728 Section 15. Subsection (2) of section 464.003, Florida 729 Statutes, is amended to read: 730 464.003 Definitions.—As used in this part, the term: 731 (2) “Advanced or specialized nursing practice” means, in 732 addition to the practice of professional nursing, the 733 performance of advanced-level nursing acts approved by the board 734 which, by virtue of postbasic specialized education, training, 735 and experience, are appropriately performed by an advanced 736 registered nurse practitioner. Within the context of advanced or 737 specialized nursing practice, the advanced registered nurse 738 practitioner may perform acts of nursing diagnosis and nursing 739 treatment of alterations of the health status. The advanced 740 registered nurse practitioner may also perform acts of medical 741 diagnosis and treatment, prescription, and operation as 742 authorized within the framework of an established supervisory 743 protocolwhich are identified and approved by a joint committee744composed of three members appointed by the Board of Nursing, two745of whom must be advanced registered nurse practitioners; three746members appointed by the Board of Medicine, two of whom must747have had work experience with advanced registered nurse748practitioners; and the State Surgeon General or the State749Surgeon General’s designee.Each committee member appointed by a750board shall be appointed to a term of 4 years unless a shorter751term is required to establish or maintain staggered terms. The752Board of Nursing shall adopt rules authorizing the performance753of any such acts approved by the joint committee. Unless754otherwise specified by the joint committee, such acts must be755performed under the general supervision of a practitioner756licensed under chapter 458, chapter 459, or chapter 466 within757the framework of standing protocols which identify the medical758acts to be performed and the conditions for their performance.759 The department may, by rule, require that a copy of the protocol 760 be filed with the department along with the notice required by 761 s. 458.348. 762 Section 16. Section 464.012, Florida Statutes, is amended 763 to read: 764 464.012 Certification of advanced registered nurse 765 practitioners; fees; controlled substance prescribing.— 766 (1) Any nurse desiring to be certified as an advanced 767 registered nurse practitioner shall apply to the department and 768 submit proof that he or she holds a current license to practice 769 professional nursing and that he or she meets one or more of the 770 following requirements as determined by the board: 771 (a) Satisfactory completion of a formal postbasic 772 educational program of at least one academic year, the primary 773 purpose of which is to prepare nurses for advanced or 774 specialized practice. 775 (b) Certification by an appropriate specialty board. Such 776 certification shall be required for initial state certification 777 and any recertification as a registered nurse anesthetist or 778 nurse midwife. The board may by rule provide for provisional 779 state certification of graduate nurse anesthetists and nurse 780 midwives for a period of time determined to be appropriate for 781 preparing for and passing the national certification 782 examination. 783 (c) Graduation from a program leading to a master’s degree 784 in a nursing clinical specialty area with preparation in 785 specialized practitioner skills. For applicants graduating on or 786 after October 1, 1998, graduation from a master’s degree program 787 shall be required for initial certification as a nurse 788 practitioner under paragraph (4)(c). For applicants graduating 789 on or after October 1, 2001, graduation from a master’s degree 790 program shall be required for initial certification as a 791 registered nurse anesthetist under paragraph (4)(a). 792 (2) The board shall provide by rule the appropriate 793 requirements for advanced registered nurse practitioners in the 794 categories of certified registered nurse anesthetist, certified 795 nurse midwife, and nurse practitioner. 796 (3) An advanced registered nurse practitioner shall perform 797 those functions authorized in this section within the framework 798 of an established protocol that is filed with the board upon 799 biennial license renewal and within 30 days after entering into 800 a supervisory relationship with a physician or changes to the 801 protocol. The board shall review the protocol to ensure 802 compliance with applicable regulatory standards for protocols. 803 The board shall refer to the department licensees submitting 804 protocols that are not compliant with the regulatory standards 805 for protocols. A practitioner currently licensed under chapter 806 458, chapter 459, or chapter 466 shall maintain supervision for 807 directing the specific course of medical treatment. Within the 808 established framework, an advanced registered nurse practitioner 809 may: 810 (a) Monitor and alter drug therapies. 811 (b) Initiate appropriate therapies for certain conditions. 812 (c) Perform additional functions as may be determined by 813 rule in accordance with s. 464.003(2). 814 (d) Order diagnostic tests and physical and occupational 815 therapy. 816 (4) In addition to the general functions specified in 817 subsection (3), an advanced registered nurse practitioner may 818 perform the following acts within his or her specialty: 819 (a) The certified registered nurse anesthetist may, to the 820 extent authorized by established protocol approved by the 821 medical staff of the facility in which the anesthetic service is 822 performed, perform any or all of the following: 823 1. Determine the health status of the patient as it relates 824 to the risk factors and to the anesthetic management of the 825 patient through the performance of the general functions. 826 2. Based on history, physical assessment, and supplemental 827 laboratory results, determine, with the consent of the 828 responsible physician, the appropriate type of anesthesia within 829 the framework of the protocol. 830 3. Order under the protocol preanesthetic medication. 831 4. Perform under the protocol procedures commonly used to 832 render the patient insensible to pain during the performance of 833 surgical, obstetrical, therapeutic, or diagnostic clinical 834 procedures. These procedures include ordering and administering 835 regional, spinal, and general anesthesia; inhalation agents and 836 techniques; intravenous agents and techniques; and techniques of 837 hypnosis. 838 5. Order or perform monitoring procedures indicated as 839 pertinent to the anesthetic health care management of the 840 patient. 841 6. Support life functions during anesthesia health care, 842 including induction and intubation procedures, the use of 843 appropriate mechanical supportive devices, and the management of 844 fluid, electrolyte, and blood component balances. 845 7. Recognize and take appropriate corrective action for 846 abnormal patient responses to anesthesia, adjunctive medication, 847 or other forms of therapy. 848 8. Recognize and treat a cardiac arrhythmia while the 849 patient is under anesthetic care. 850 9. Participate in management of the patient while in the 851 postanesthesia recovery area, including ordering the 852 administration of fluids and drugs. 853 10. Place special peripheral and central venous and 854 arterial lines for blood sampling and monitoring as appropriate. 855 (b) The certified nurse midwife may, to the extent 856 authorized by an established protocol which has been approved by 857 the medical staff of the health care facility in which the 858 midwifery services are performed, or approved by the nurse 859 midwife’s physician backup when the delivery is performed in a 860 patient’s home, perform any or all of the following: 861 1. Perform superficial minor surgical procedures. 862 2. Manage the patient during labor and delivery to include 863 amniotomy, episiotomy, and repair. 864 3. Order, initiate, and perform appropriate anesthetic 865 procedures. 866 4. Perform postpartum examination. 867 5. Order appropriate medications. 868 6. Provide family-planning services and well-woman care. 869 7. Manage the medical care of the normal obstetrical 870 patient and the initial care of a newborn patient. 871 (c) The nurse practitioner may perform any or all of the 872 following acts within the framework of established protocol: 873 1. Manage selected medical problems. 874 2. Order physical and occupational therapy. 875 3. Initiate, monitor, or alter therapies for certain 876 uncomplicated acute illnesses. 877 4. Monitor and manage patients with stable chronic 878 diseases. 879 5. Establish behavioral problems and diagnosis and make 880 treatment recommendations. 881 (5) The board shall certify, and the department shall issue 882 a certificate to, any nurse meeting the qualifications in this 883 section. The board shall establish an application fee not to 884 exceed $100 and a biennial renewal fee not to exceed $50. The 885 board is authorized to adopt such other rules as are necessary 886 to implement the provisions of this section. 887 (6)(a) The board shall establish a committee to recommend a 888 formulary of controlled substances that an advanced registered 889 nurse practitioner may not prescribe or may prescribe only for 890 specific uses or in limited quantities. The committee must 891 consist of three advanced registered nurse practitioners 892 licensed under this section, recommended by the Board of 893 Nursing; three physicians licensed under chapter 458 or chapter 894 459 who have work experience with advanced registered nurse 895 practitioners, recommended by the Board of Medicine; and a 896 pharmacist licensed under chapter 465 who holds a Doctor of 897 Pharmacy degree, recommended by the Board of Pharmacy. The 898 committee may recommend an evidence-based formulary applicable 899 to all advanced registered nurse practitioners which is limited 900 by specialty certification, is limited to approved uses of 901 controlled substances, or is subject to other similar 902 restrictions the committee finds are necessary to protect the 903 health, safety, and welfare of the public. The formulary must 904 restrict the prescribing of psychiatric mental health controlled 905 substances for children under 18 years of age to advanced 906 registered nurse practitioners who also are psychiatric nurses 907 as defined in s. 394.455. The formulary must also limit the 908 prescribing of Schedule II controlled substances as defined in 909 s. 893.03 to a 7-day supply, except that such restriction does 910 not apply to controlled substances that are psychiatric 911 medications prescribed by psychiatric nurses as defined in s. 912 394.455. 913 (b) The board shall adopt by rule the recommended formulary 914 and any revisions to the formulary which it finds are supported 915 by evidence-based clinical findings presented by the Board of 916 Medicine, the Board of Osteopathic Medicine, or the Board of 917 Dentistry. 918 (c) The formulary required under this subsection does not 919 apply to a controlled substance that is dispensed for 920 administration pursuant to an order, including an order for 921 medication authorized by subparagraph (4)(a)3., subparagraph 922 (4)(a)4., or subparagraph (4)(a)9. 923 (d) The board shall adopt the committee’s initial 924 recommendation no later October 31, 2016. 925 Section 17. Effective January 1, 2017, subsection (3) of 926 section 464.012, Florida Statutes, as amended by this act, is 927 amended to read: 928 464.012 Certification of advanced registered nurse 929 practitioners; fees; controlled substance prescribing.— 930 (3) An advanced registered nurse practitioner shall perform 931 those functions authorized in this section within the framework 932 of an established protocol that is filed with the board upon 933 biennial license renewal and within 30 days after entering into 934 a supervisory relationship with a physician or changes to the 935 protocol. The board shall review the protocol to ensure 936 compliance with applicable regulatory standards for protocols. 937 The board shall refer to the department licensees submitting 938 protocols that are not compliant with the regulatory standards 939 for protocols. A practitioner currently licensed under chapter 940 458, chapter 459, or chapter 466 shall maintain supervision for 941 directing the specific course of medical treatment. Within the 942 established framework, an advanced registered nurse practitioner 943 may: 944 (a) Prescribe, dispense, administer, or order any drug; 945 however, an advanced registered nurse practitioner may only 946 prescribe or dispense a controlled substance as defined in s. 947 893.03 if the advanced registered nurse practitioner has 948 graduated from a program leading to a master’s or doctoral 949 degree in a clinical nursing specialty area with training in 950 specialized practitioner skills.Monitor and alter drug951therapies.952 (b) Initiate appropriate therapies for certain conditions. 953 (c) Perform additional functions as may be determined by 954 rule in accordance with s. 464.003(2). 955 (d) Order diagnostic tests and physical and occupational 956 therapy. 957 Section 18. Subsection (3) of section 464.013, Florida 958 Statutes, is amended to read: 959 464.013 Renewal of license or certificate.— 960 (3) The board shall by rule prescribe up to 30 hours of 961 continuing education biennially as a condition for renewal of a 962 license or certificate. 963 (a) A nurse who is certified by a health care specialty 964 program accredited by the National Commission for Certifying 965 Agencies or the Accreditation Board for Specialty Nursing 966 Certification is exempt from continuing education requirements. 967 The criteria for programs mustshallbe approved by the board. 968 (b) Notwithstanding the exemption in paragraph (a), as part 969 of the maximum 30 hours of continuing education hours required 970 under this subsection, advanced registered nurse practitioners 971 certified under s. 464.012 must complete at least 3 hours of 972 continuing education on the safe and effective prescription of 973 controlled substances. Such continuing education courses must be 974 offered by a statewide professional association of physicians in 975 this state accredited to provide educational activities 976 designated for the American Medical Association Physician’s 977 Recognition Award Category 1 Credit, the American Nurses 978 Credentialing Center, the American Association of Nurse 979 Anesthetists, or the American Association of Nurse Practitioners 980 and may be offered in a distance-learning format. 981 Section 19. Paragraph (p) is added to subsection (1) of 982 section 464.018, Florida Statutes, and subsection (2) of that 983 section is republished, to read: 984 464.018 Disciplinary actions.— 985 (1) The following acts constitute grounds for denial of a 986 license or disciplinary action, as specified in s. 456.072(2): 987 (p) For an advanced registered nurse practitioner: 988 1. Presigning blank prescription forms. 989 2. Prescribing for office use any medicinal drug appearing 990 on Schedule II in chapter 893. 991 3. Prescribing, ordering, dispensing, administering, 992 supplying, selling, or giving a drug that is an amphetamine or a 993 sympathomimetic amine drug, or a compound designated in s. 994 893.03(2) as a Schedule II controlled substance, to or for any 995 person except for: 996 a. The treatment of narcolepsy; hyperkinesis; behavioral 997 syndrome in children characterized by the developmentally 998 inappropriate symptoms of moderate to severe distractibility, 999 short attention span, hyperactivity, emotional lability, and 1000 impulsivity; or drug-induced brain dysfunction. 1001 b. The differential diagnostic psychiatric evaluation of 1002 depression or the treatment of depression shown to be refractory 1003 to other therapeutic modalities. 1004 c. The clinical investigation of the effects of such drugs 1005 or compounds when an investigative protocol is submitted to, 1006 reviewed by, and approved by the department before such 1007 investigation is begun. 1008 4. Prescribing, ordering, dispensing, administering, 1009 supplying, selling, or giving growth hormones, testosterone or 1010 its analogs, human chorionic gonadotropin (HCG), or other 1011 hormones for the purpose of muscle building or to enhance 1012 athletic performance. As used in this subparagraph, the term 1013 “muscle building” does not include the treatment of injured 1014 muscle. A prescription written for the drug products identified 1015 in this subparagraph may be dispensed by a pharmacist with the 1016 presumption that the prescription is for legitimate medical use. 1017 5. Promoting or advertising on any prescription form a 1018 community pharmacy unless the form also states: “This 1019 prescription may be filled at any pharmacy of your choice.” 1020 6. Prescribing, dispensing, administering, mixing, or 1021 otherwise preparing a legend drug, including a controlled 1022 substance, other than in the course of his or her professional 1023 practice. For the purposes of this subparagraph, it is legally 1024 presumed that prescribing, dispensing, administering, mixing, or 1025 otherwise preparing legend drugs, including all controlled 1026 substances, inappropriately or in excessive or inappropriate 1027 quantities is not in the best interest of the patient and is not 1028 in the course of the advanced registered nurse practitioner’s 1029 professional practice, without regard to his or her intent. 1030 7. Prescribing, dispensing, or administering a medicinal 1031 drug appearing on any schedule set forth in chapter 893 to 1032 himself or herself, except a drug prescribed, dispensed, or 1033 administered to the advanced registered nurse practitioner by 1034 another practitioner authorized to prescribe, dispense, or 1035 administer medicinal drugs. 1036 8. Prescribing, ordering, dispensing, administering, 1037 supplying, selling, or giving amygdalin (laetrile) to any 1038 person. 1039 9. Dispensing a substance designated in s. 893.03(2) or (3) 1040 as a substance controlled in Schedule II or Schedule III, 1041 respectively, in violation of s. 465.0276. 1042 10. Promoting or advertising through any communication 1043 medium the use, sale, or dispensing of a substance designated in 1044 s. 893.03 as a controlled substance. 1045 (2) The board may enter an order denying licensure or 1046 imposing any of the penalties in s. 456.072(2) against any 1047 applicant for licensure or licensee who is found guilty of 1048 violating any provision of subsection (1) of this section or who 1049 is found guilty of violating any provision of s. 456.072(1). 1050 Section 20. Subsection (21) of section 893.02, Florida 1051 Statutes, is amended to read: 1052 893.02 Definitions.—The following words and phrases as used 1053 in this chapter shall have the following meanings, unless the 1054 context otherwise requires: 1055 (21) “Practitioner” means a physician licensed under 1056pursuant tochapter 458, a dentist licensed underpursuant to1057 chapter 466, a veterinarian licensed underpursuant tochapter 1058 474, an osteopathic physician licensed underpursuant tochapter 1059 459, an advanced registered nurse practitioner certified under 1060 chapter 464, a naturopath licensed underpursuant tochapter 1061 462, a certified optometrist licensed underpursuant tochapter 1062 463, or a podiatric physician licensed underpursuant tochapter 1063 461, or a physician assistant licensed under chapter 458 or 1064 chapter 459, provided such practitioner holds a valid federal 1065 controlled substance registry number. 1066 Section 21. Paragraph (n) of subsection (1) of section 1067 948.03, Florida Statutes, is amended to read: 1068 948.03 Terms and conditions of probation.— 1069 (1) The court shall determine the terms and conditions of 1070 probation. Conditions specified in this section do not require 1071 oral pronouncement at the time of sentencing and may be 1072 considered standard conditions of probation. These conditions 1073 may include among them the following, that the probationer or 1074 offender in community control shall: 1075 (n) Be prohibited from using intoxicants to excess or 1076 possessing any drugs or narcotics unless prescribed by a 1077 physician, advanced registered nurse practitioner, or physician 1078 assistant. The probationer or community controllee mayshallnot 1079 knowingly visit places where intoxicants, drugs, or other 1080 dangerous substances are unlawfully sold, dispensed, or used. 1081 Section 22. Paragraph (a) of subsection (1) and subsection 1082 (2) of section 458.348, Florida Statutes, are amended to read: 1083 458.348 Formal supervisory relationships, standing orders, 1084 and established protocols; notice; standards.— 1085 (1) NOTICE.— 1086 (a) When a physician enters into a formal supervisory 1087 relationship or standing orders with an emergency medical 1088 technician or paramedic licensed pursuant to s. 401.27, which 1089 relationship or orders contemplate the performance of medical 1090 acts, or when a physician enters into an established protocol 1091 with an advanced registered nurse practitioner, which protocol 1092 contemplates the performance of medicalacts identified and1093approved by the joint committee pursuant to s. 464.003(2) or1094 acts set forth in s. 464.012(3) and (4), the physician shall 1095 submit notice to the board. The notice shall contain a statement 1096 in substantially the following form: 1097 1098 I, ...(name and professional license number of 1099 physician)..., of ...(address of physician)... have hereby 1100 entered into a formal supervisory relationship, standing orders, 1101 or an established protocol with ...(number of persons)... 1102 emergency medical technician(s), ...(number of persons)... 1103 paramedic(s), or ...(number of persons)... advanced registered 1104 nurse practitioner(s). 1105 1106 (2) ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.—The 1107 joint committeecreated under s. 464.003(2)shall determine 1108 minimum standards for the content of established protocols 1109 pursuant to which an advanced registered nurse practitioner may 1110 perform medical actsidentified and approved by the joint1111committee pursuant to s. 464.003(2)or acts set forth in s. 1112 464.012(3) and (4) and shall determine minimum standards for 1113 supervision of such acts by the physician, unless the joint 1114 committee determines that any act set forth in s. 464.012(3) or 1115 (4) is not a medical act. Such standards shall be based on risk 1116 to the patient and acceptable standards of medical care and 1117 shall take into account the special problems of medically 1118 underserved areas. The standards developed by the joint 1119 committee shall be adopted as rules by the Board of Nursing and 1120 the Board of Medicine for purposes of carrying out their 1121 responsibilities pursuant to part I of chapter 464 and this 1122 chapter, respectively, but neither board shall have disciplinary 1123 powers over the licensees of the other board. 1124 Section 23. Paragraph (a) of subsection (1) of section 1125 459.025, Florida Statutes, is amended to read: 1126 459.025 Formal supervisory relationships, standing orders, 1127 and established protocols; notice; standards.— 1128 (1) NOTICE.— 1129 (a) When an osteopathic physician enters into a formal 1130 supervisory relationship or standing orders with an emergency 1131 medical technician or paramedic licensed pursuant to s. 401.27, 1132 which relationship or orders contemplate the performance of 1133 medical acts, or when an osteopathic physician enters into an 1134 established protocol with an advanced registered nurse 1135 practitioner, which protocol contemplates the performance of 1136 medical actsidentified and approved by the joint committee1137pursuant to s. 464.003(2)or acts set forth in s. 464.012(3) and 1138 (4), the osteopathic physician shall submit notice to the board. 1139 The notice must contain a statement in substantially the 1140 following form: 1141 1142 I, ...(name and professional license number of osteopathic 1143 physician)..., of ...(address of osteopathic physician)... have 1144 hereby entered into a formal supervisory relationship, standing 1145 orders, or an established protocol with ...(number of 1146 persons)... emergency medical technician(s), ...(number of 1147 persons)... paramedic(s), or ...(number of persons)... advanced 1148 registered nurse practitioner(s). 1149 Section 24. For the purpose of incorporating the amendment 1150 made by this act to section 456.072, Florida Statutes, in a 1151 reference thereto, subsection (10) of section 458.331, Florida 1152 Statutes, is reenacted to read: 1153 458.331 Grounds for disciplinary action; action by the 1154 board and department.— 1155 (10) A probable cause panel convened to consider 1156 disciplinary action against a physician assistant alleged to 1157 have violated s. 456.072 or this section must include one 1158 physician assistant. The physician assistant must hold a valid 1159 license to practice as a physician assistant in this state and 1160 be appointed to the panel by the Council of Physician 1161 Assistants. The physician assistant may hear only cases 1162 involving disciplinary actions against a physician assistant. If 1163 the appointed physician assistant is not present at the 1164 disciplinary hearing, the panel may consider the matter and vote 1165 on the case in the absence of the physician assistant. The 1166 training requirements set forth in s. 458.307(4) do not apply to 1167 the appointed physician assistant. Rules need not be adopted to 1168 implement this subsection. 1169 Section 25. For the purpose of incorporating the amendment 1170 made by this act to section 456.072, Florida Statutes, in a 1171 reference thereto, paragraph (g) of subsection (7) of section 1172 458.347, Florida Statutes, is reenacted to read: 1173 458.347 Physician assistants.— 1174 (7) PHYSICIAN ASSISTANT LICENSURE.— 1175 (g) The Board of Medicine may impose any of the penalties 1176 authorized under ss. 456.072 and 458.331(2) upon a physician 1177 assistant if the physician assistant or the supervising 1178 physician has been found guilty of or is being investigated for 1179 any act that constitutes a violation of this chapter or chapter 1180 456. 1181 Section 26. For the purpose of incorporating the amendment 1182 made by this act to section 456.072, Florida Statutes, in a 1183 reference thereto, subsection (10) of section 459.015, Florida 1184 Statutes, is reenacted to read: 1185 459.015 Grounds for disciplinary action; action by the 1186 board and department.— 1187 (10) A probable cause panel convened to consider 1188 disciplinary action against a physician assistant alleged to 1189 have violated s. 456.072 or this section must include one 1190 physician assistant. The physician assistant must hold a valid 1191 license to practice as a physician assistant in this state and 1192 be appointed to the panel by the Council of Physician 1193 Assistants. The physician assistant may hear only cases 1194 involving disciplinary actions against a physician assistant. If 1195 the appointed physician assistant is not present at the 1196 disciplinary hearing, the panel may consider the matter and vote 1197 on the case in the absence of the physician assistant. The 1198 training requirements set forth in s. 458.307(4) do not apply to 1199 the appointed physician assistant. Rules need not be adopted to 1200 implement this subsection. 1201 Section 27. For the purpose of incorporating the amendment 1202 made by this act to section 456.072, Florida Statutes, in a 1203 reference thereto, paragraph (f) of subsection (7) of section 1204 459.022, Florida Statutes, is reenacted to read: 1205 459.022 Physician assistants.— 1206 (7) PHYSICIAN ASSISTANT LICENSURE.— 1207 (f) The Board of Osteopathic Medicine may impose any of the 1208 penalties authorized under ss. 456.072 and 459.015(2) upon a 1209 physician assistant if the physician assistant or the 1210 supervising physician has been found guilty of or is being 1211 investigated for any act that constitutes a violation of this 1212 chapter or chapter 456. 1213 Section 28. For the purpose of incorporating the amendment 1214 made by this act to section 456.072, Florida Statutes, in a 1215 reference thereto, subsection (5) of section 465.0158, Florida 1216 Statutes, is reenacted to read: 1217 465.0158 Nonresident sterile compounding permit.— 1218 (5) In accordance with this chapter, the board may deny, 1219 revoke, or suspend the permit of; fine; or reprimand a permittee 1220 for: 1221 (a) Failure to comply with this section; 1222 (b) A violation listed under s. 456.0635, s. 456.065, or s. 1223 456.072, except s. 456.072(1)(s) or (1)(u); 1224 (c) A violation under s. 465.0156(5); or 1225 (d) A violation listed under s. 465.016. 1226 Section 29. For the purpose of incorporating the amendment 1227 made by this act to section 456.44, Florida Statutes, in a 1228 reference thereto, paragraph (mm) of subsection (1) of section 1229 456.072, Florida Statutes, is reenacted to read: 1230 456.072 Grounds for discipline; penalties; enforcement.— 1231 (1) The following acts shall constitute grounds for which 1232 the disciplinary actions specified in subsection (2) may be 1233 taken: 1234 (mm) Failure to comply with controlled substance 1235 prescribing requirements of s. 456.44. 1236 Section 30. For the purpose of incorporating the amendment 1237 made by this act to section 456.44, Florida Statutes, in a 1238 reference thereto, section 466.02751, Florida Statutes, is 1239 reenacted to read: 1240 466.02751 Establishment of practitioner profile for 1241 designation as a controlled substance prescribing practitioner. 1242 The Department of Health shall establish a practitioner profile 1243 for dentists licensed under this chapter for a practitioner’s 1244 designation as a controlled substance prescribing practitioner 1245 as provided in s. 456.44. 1246 Section 31. For the purpose of incorporating the amendment 1247 made by this act to section 458.347, Florida Statutes, in a 1248 reference thereto, section 458.303, Florida Statutes, is 1249 reenacted to read: 1250 458.303 Provisions not applicable to other practitioners; 1251 exceptions, etc.— 1252 (1) The provisions of ss. 458.301, 458.305, 458.307, 1253 458.309, 458.311, 458.313, 458.315, 458.317, 458.319, 458.321, 1254 458.327, 458.329, 458.331, 458.337, 458.339, 458.341, 458.343, 1255 458.345, 458.347, and this section shall have no application to: 1256 (a) Other duly licensed health care practitioners acting 1257 within their scope of practice authorized by statute. 1258 (b) Any physician lawfully licensed in another state or 1259 territory or foreign country, when meeting duly licensed 1260 physicians of this state in consultation. 1261 (c) Commissioned medical officers of the Armed Forces of 1262 the United States and of the Public Health Service of the United 1263 States while on active duty and while acting within the scope of 1264 their military or public health responsibilities. 1265 (d) Any person while actually serving without salary or 1266 professional fees on the resident medical staff of a hospital in 1267 this state, subject to the provisions of s. 458.321. 1268 (e) Any person furnishing medical assistance in case of an 1269 emergency. 1270 (f) The domestic administration of recognized family 1271 remedies. 1272 (g) The practice of the religious tenets of any church in 1273 this state. 1274 (h) Any person or manufacturer who, without the use of 1275 drugs or medicine, mechanically fits or sells lenses, artificial 1276 eyes or limbs, or other apparatus or appliances or is engaged in 1277 the mechanical examination of eyes for the purpose of 1278 constructing or adjusting spectacles, eyeglasses, or lenses. 1279 (2) Nothing in s. 458.301, s. 458.305, s. 458.307, s. 1280 458.309, s. 458.311, s. 458.313, s. 458.319, s. 458.321, s. 1281 458.327, s. 458.329, s. 458.331, s. 458.337, s. 458.339, s. 1282 458.341, s. 458.343, s. 458.345, s. 458.347, or this section 1283 shall be construed to prohibit any service rendered by a 1284 registered nurse or a licensed practical nurse, if such service 1285 is rendered under the direct supervision and control of a 1286 licensed physician who provides specific direction for any 1287 service to be performed and gives final approval to all services 1288 performed. Further, nothing in this or any other chapter shall 1289 be construed to prohibit any service rendered by a medical 1290 assistant in accordance with the provisions of s. 458.3485. 1291 Section 32. For the purpose of incorporating the amendment 1292 made by this act to section 458.347, Florida Statutes, in a 1293 reference thereto, paragraph (b) of subsection (7) of section 1294 458.3475, Florida Statutes, is reenacted to read: 1295 458.3475 Anesthesiologist assistants.— 1296 (7) ANESTHESIOLOGIST AND ANESTHESIOLOGIST ASSISTANT TO 1297 ADVISE THE BOARD.— 1298 (b) In addition to its other duties and responsibilities as 1299 prescribed by law, the board shall: 1300 1. Recommend to the department the licensure of 1301 anesthesiologist assistants. 1302 2. Develop all rules regulating the use of anesthesiologist 1303 assistants by qualified anesthesiologists under this chapter and 1304 chapter 459, except for rules relating to the formulary 1305 developed under s. 458.347(4)(f). The board shall also develop 1306 rules to ensure that the continuity of supervision is maintained 1307 in each practice setting. The boards shall consider adopting a 1308 proposed rule at the regularly scheduled meeting immediately 1309 following the submission of the proposed rule. A proposed rule 1310 may not be adopted by either board unless both boards have 1311 accepted and approved the identical language contained in the 1312 proposed rule. The language of all proposed rules must be 1313 approved by both boards pursuant to each respective board’s 1314 guidelines and standards regarding the adoption of proposed 1315 rules. 1316 3. Address concerns and problems of practicing 1317 anesthesiologist assistants to improve safety in the clinical 1318 practices of licensed anesthesiologist assistants. 1319 Section 33. For the purpose of incorporating the amendment 1320 made by this act to section 458.347, Florida Statutes, in 1321 references thereto, paragraph (e) of subsection (4) and 1322 paragraph (c) of subsection (9) of section 459.022, Florida 1323 Statutes, are reenacted to read: 1324 459.022 Physician assistants.— 1325 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 1326 (e) A supervisory physician may delegate to a fully 1327 licensed physician assistant the authority to prescribe or 1328 dispense any medication used in the supervisory physician’s 1329 practice unless such medication is listed on the formulary 1330 created pursuant to s. 458.347. A fully licensed physician 1331 assistant may only prescribe or dispense such medication under 1332 the following circumstances: 1333 1. A physician assistant must clearly identify to the 1334 patient that she or he is a physician assistant. Furthermore, 1335 the physician assistant must inform the patient that the patient 1336 has the right to see the physician prior to any prescription 1337 being prescribed or dispensed by the physician assistant. 1338 2. The supervisory physician must notify the department of 1339 her or his intent to delegate, on a department-approved form, 1340 before delegating such authority and notify the department of 1341 any change in prescriptive privileges of the physician 1342 assistant. Authority to dispense may be delegated only by a 1343 supervisory physician who is registered as a dispensing 1344 practitioner in compliance with s. 465.0276. 1345 3. The physician assistant must file with the department a 1346 signed affidavit that she or he has completed a minimum of 10 1347 continuing medical education hours in the specialty practice in 1348 which the physician assistant has prescriptive privileges with 1349 each licensure renewal application. 1350 4. The department may issue a prescriber number to the 1351 physician assistant granting authority for the prescribing of 1352 medicinal drugs authorized within this paragraph upon completion 1353 of the foregoing requirements. The physician assistant shall not 1354 be required to independently register pursuant to s. 465.0276. 1355 5. The prescription must be written in a form that complies 1356 with chapter 499 and must contain, in addition to the 1357 supervisory physician’s name, address, and telephone number, the 1358 physician assistant’s prescriber number. Unless it is a drug or 1359 drug sample dispensed by the physician assistant, the 1360 prescription must be filled in a pharmacy permitted under 1361 chapter 465, and must be dispensed in that pharmacy by a 1362 pharmacist licensed under chapter 465. The appearance of the 1363 prescriber number creates a presumption that the physician 1364 assistant is authorized to prescribe the medicinal drug and the 1365 prescription is valid. 1366 6. The physician assistant must note the prescription or 1367 dispensing of medication in the appropriate medical record. 1368 (9) COUNCIL ON PHYSICIAN ASSISTANTS.—The Council on 1369 Physician Assistants is created within the department. 1370 (c) The council shall: 1371 1. Recommend to the department the licensure of physician 1372 assistants. 1373 2. Develop all rules regulating the use of physician 1374 assistants by physicians under chapter 458 and this chapter, 1375 except for rules relating to the formulary developed under s. 1376 458.347. The council shall also develop rules to ensure that the 1377 continuity of supervision is maintained in each practice 1378 setting. The boards shall consider adopting a proposed rule 1379 developed by the council at the regularly scheduled meeting 1380 immediately following the submission of the proposed rule by the 1381 council. A proposed rule submitted by the council may not be 1382 adopted by either board unless both boards have accepted and 1383 approved the identical language contained in the proposed rule. 1384 The language of all proposed rules submitted by the council must 1385 be approved by both boards pursuant to each respective board’s 1386 guidelines and standards regarding the adoption of proposed 1387 rules. If either board rejects the council’s proposed rule, that 1388 board must specify its objection to the council with 1389 particularity and include any recommendations it may have for 1390 the modification of the proposed rule. 1391 3. Make recommendations to the boards regarding all matters 1392 relating to physician assistants. 1393 4. Address concerns and problems of practicing physician 1394 assistants in order to improve safety in the clinical practices 1395 of licensed physician assistants. 1396 Section 34. For the purpose of incorporating the amendment 1397 made by this act to section 458.347, Florida Statutes, in a 1398 reference thereto, paragraph (b) of subsection (7) of section 1399 459.023, Florida Statutes, is reenacted to read: 1400 459.023 Anesthesiologist assistants.— 1401 (7) ANESTHESIOLOGIST AND ANESTHESIOLOGIST ASSISTANT TO 1402 ADVISE THE BOARD.— 1403 (b) In addition to its other duties and responsibilities as 1404 prescribed by law, the board shall: 1405 1. Recommend to the department the licensure of 1406 anesthesiologist assistants. 1407 2. Develop all rules regulating the use of anesthesiologist 1408 assistants by qualified anesthesiologists under this chapter and 1409 chapter 458, except for rules relating to the formulary 1410 developed under s. 458.347(4)(f). The board shall also develop 1411 rules to ensure that the continuity of supervision is maintained 1412 in each practice setting. The boards shall consider adopting a 1413 proposed rule at the regularly scheduled meeting immediately 1414 following the submission of the proposed rule. A proposed rule 1415 may not be adopted by either board unless both boards have 1416 accepted and approved the identical language contained in the 1417 proposed rule. The language of all proposed rules must be 1418 approved by both boards pursuant to each respective board’s 1419 guidelines and standards regarding the adoption of proposed 1420 rules. 1421 3. Address concerns and problems of practicing 1422 anesthesiologist assistants to improve safety in the clinical 1423 practices of licensed anesthesiologist assistants. 1424 Section 35. For the purpose of incorporating the amendment 1425 made by this act to section 464.012, Florida Statutes, in a 1426 reference thereto, paragraph (a) of subsection (1) of section 1427 456.041, Florida Statutes, is reenacted to read: 1428 456.041 Practitioner profile; creation.— 1429 (1)(a) The Department of Health shall compile the 1430 information submitted pursuant to s. 456.039 into a practitioner 1431 profile of the applicant submitting the information, except that 1432 the Department of Health shall develop a format to compile 1433 uniformly any information submitted under s. 456.039(4)(b). 1434 Beginning July 1, 2001, the Department of Health may compile the 1435 information submitted pursuant to s. 456.0391 into a 1436 practitioner profile of the applicant submitting the 1437 information. The protocol submitted pursuant to s. 464.012(3) 1438 must be included in the practitioner profile of the advanced 1439 registered nurse practitioner. 1440 Section 36. For the purpose of incorporating the amendment 1441 made by this act to section 464.012, Florida Statutes, in 1442 references thereto, subsections (1) and (2) of section 458.348, 1443 Florida Statutes, are reenacted to read: 1444 458.348 Formal supervisory relationships, standing orders, 1445 and established protocols; notice; standards.— 1446 (1) NOTICE.— 1447 (a) When a physician enters into a formal supervisory 1448 relationship or standing orders with an emergency medical 1449 technician or paramedic licensed pursuant to s. 401.27, which 1450 relationship or orders contemplate the performance of medical 1451 acts, or when a physician enters into an established protocol 1452 with an advanced registered nurse practitioner, which protocol 1453 contemplates the performance of medical acts identified and 1454 approved by the joint committee pursuant to s. 464.003(2) or 1455 acts set forth in s. 464.012(3) and (4), the physician shall 1456 submit notice to the board. The notice shall contain a statement 1457 in substantially the following form: 1458 I, ...(name and professional license number of 1459 physician)..., of ...(address of physician)... have hereby 1460 entered into a formal supervisory relationship, standing orders, 1461 or an established protocol with ...(number of persons)... 1462 emergency medical technician(s), ...(number of persons)... 1463 paramedic(s), or ...(number of persons)... advanced registered 1464 nurse practitioner(s). 1465 (b) Notice shall be filed within 30 days of entering into 1466 the relationship, orders, or protocol. Notice also shall be 1467 provided within 30 days after the physician has terminated any 1468 such relationship, orders, or protocol. 1469 (2) ESTABLISHMENT OF STANDARDS BY JOINT COMMITTEE.—The 1470 joint committee created under s. 464.003(2) shall determine 1471 minimum standards for the content of established protocols 1472 pursuant to which an advanced registered nurse practitioner may 1473 perform medical acts identified and approved by the joint 1474 committee pursuant to s. 464.003(2) or acts set forth in s. 1475 464.012(3) and (4) and shall determine minimum standards for 1476 supervision of such acts by the physician, unless the joint 1477 committee determines that any act set forth in s. 464.012(3) or 1478 (4) is not a medical act. Such standards shall be based on risk 1479 to the patient and acceptable standards of medical care and 1480 shall take into account the special problems of medically 1481 underserved areas. The standards developed by the joint 1482 committee shall be adopted as rules by the Board of Nursing and 1483 the Board of Medicine for purposes of carrying out their 1484 responsibilities pursuant to part I of chapter 464 and this 1485 chapter, respectively, but neither board shall have disciplinary 1486 powers over the licensees of the other board. 1487 Section 37. For the purpose of incorporating the amendment 1488 made by this act to section 464.013, Florida Statutes, in a 1489 reference thereto, subsection (7) of section 464.0205, Florida 1490 Statutes, is reenacted to read: 1491 464.0205 Retired volunteer nurse certificate.— 1492 (7) The retired volunteer nurse certificate shall be valid 1493 for 2 years, and a certificateholder may reapply for a 1494 certificate so long as the certificateholder continues to meet 1495 the eligibility requirements of this section. Any legislatively 1496 mandated continuing education on specific topics must be 1497 completed by the certificateholder prior to renewal; otherwise, 1498 the provisions of s. 464.013 do not apply. 1499 Section 38. For the purpose of incorporating the amendment 1500 made by this act to section 464.018, Florida Statutes, in a 1501 reference thereto, subsection (11) of section 320.0848, Florida 1502 Statutes, is reenacted to read: 1503 320.0848 Persons who have disabilities; issuance of 1504 disabled parking permits; temporary permits; permits for certain 1505 providers of transportation services to persons who have 1506 disabilities.— 1507 (11) A violation of this section is grounds for 1508 disciplinary action under s. 458.331, s. 459.015, s. 460.413, s. 1509 461.013, s. 463.016, or s. 464.018, as applicable. 1510 Section 39. For the purpose of incorporating the amendment 1511 made by this act to section 464.018, Florida Statutes, in a 1512 reference thereto, subsection (2) of section 464.008, Florida 1513 Statutes, is reenacted to read: 1514 464.008 Licensure by examination.— 1515 (2) Each applicant who passes the examination and provides 1516 proof of meeting the educational requirements specified in 1517 subsection (1) shall, unless denied pursuant to s. 464.018, be 1518 entitled to licensure as a registered professional nurse or a 1519 licensed practical nurse, whichever is applicable. 1520 Section 40. For the purpose of incorporating the amendment 1521 made by this act to section 464.018, Florida Statutes, in a 1522 reference thereto, subsection (5) of section 464.009, Florida 1523 Statutes, is reenacted to read: 1524 464.009 Licensure by endorsement.— 1525 (5) The department shall not issue a license by endorsement 1526 to any applicant who is under investigation in another state, 1527 jurisdiction, or territory of the United States for an act which 1528 would constitute a violation of this part or chapter 456 until 1529 such time as the investigation is complete, at which time the 1530 provisions of s. 464.018 shall apply. 1531 Section 41. For the purpose of incorporating the amendment 1532 made by this act to section 464.018, Florida Statutes, in 1533 references thereto, paragraph (b) of subsection (1), subsection 1534 (3), and paragraph (b) of subsection (4) of section 464.0205, 1535 Florida Statutes, are reenacted to read: 1536 464.0205 Retired volunteer nurse certificate.— 1537 (1) Any retired practical or registered nurse desiring to 1538 serve indigent, underserved, or critical need populations in 1539 this state may apply to the department for a retired volunteer 1540 nurse certificate by providing: 1541 (b) Verification that the applicant had been licensed to 1542 practice nursing in any jurisdiction in the United States for at 1543 least 10 years, had retired or plans to retire, intends to 1544 practice nursing only pursuant to the limitations provided by 1545 the retired volunteer nurse certificate, and has not committed 1546 any act that would constitute a violation under s. 464.018(1). 1547 (3) The board may deny a retired volunteer nurse 1548 certificate to any applicant who has committed, or who is under 1549 investigation or prosecution for, any act that would constitute 1550 a ground for disciplinary action under s. 464.018. 1551 (4) A retired volunteer nurse receiving certification from 1552 the board shall: 1553 (b) Comply with the minimum standards of practice for 1554 nurses and be subject to disciplinary action for violations of 1555 s. 464.018, except that the scope of practice for certified 1556 volunteers shall be limited to primary and preventive health 1557 care, or as further defined by board rule. 1558 Section 42. For the purpose of incorporating the amendment 1559 made by this act to section 893.02, Florida Statutes, in a 1560 reference thereto, section 775.051, Florida Statutes, is 1561 reenacted to read: 1562 775.051 Voluntary intoxication; not a defense; evidence not 1563 admissible for certain purposes; exception.—Voluntary 1564 intoxication resulting from the consumption, injection, or other 1565 use of alcohol or other controlled substance as described in 1566 chapter 893 is not a defense to any offense proscribed by law. 1567 Evidence of a defendant’s voluntary intoxication is not 1568 admissible to show that the defendant lacked the specific intent 1569 to commit an offense and is not admissible to show that the 1570 defendant was insane at the time of the offense, except when the 1571 consumption, injection, or use of a controlled substance under 1572 chapter 893 was pursuant to a lawful prescription issued to the 1573 defendant by a practitioner as defined in s. 893.02. 1574 Section 43. For the purpose of incorporating the amendment 1575 made by this act to section 948.03, Florida Statutes, in a 1576 reference thereto, paragraph (a) of subsection (3) of section 1577 944.17, Florida Statutes, is reenacted to read: 1578 944.17 Commitments and classification; transfers.— 1579 (3)(a) Notwithstanding the provisions of s. 948.03, only 1580 those persons who are convicted and sentenced in circuit court 1581 to a cumulative sentence of incarceration for 1 year or more, 1582 whether sentence is imposed in the same or separate circuits, 1583 may be received by the department into the state correctional 1584 system. Such persons shall be delivered to the custody of the 1585 department at such reception and classification centers as shall 1586 be provided for this purpose. 1587 Section 44. For the purpose of incorporating the amendment 1588 made by this act to section 948.03, Florida Statutes, in a 1589 reference thereto, subsection (8) of section 948.001, Florida 1590 Statutes, is reenacted to read: 1591 948.001 Definitions.—As used in this chapter, the term: 1592 (8) “Probation” means a form of community supervision 1593 requiring specified contacts with parole and probation officers 1594 and other terms and conditions as provided in s. 948.03. 1595 Section 45. For the purpose of incorporating the amendment 1596 made by this act to section 948.03, Florida Statutes, in a 1597 reference thereto, paragraph (e) of subsection (1) of section 1598 948.101, Florida Statutes, is reenacted to read: 1599 948.101 Terms and conditions of community control.— 1600 (1) The court shall determine the terms and conditions of 1601 community control. Conditions specified in this subsection do 1602 not require oral pronouncement at the time of sentencing and may 1603 be considered standard conditions of community control. The 1604 court shall require intensive supervision and surveillance for 1605 an offender placed into community control, which may include, 1606 but is not limited to: 1607 (e) The standard conditions of probation set forth in s. 1608 948.03. 1609 Section 46. Except as otherwise expressly provided in this 1610 act, this act shall take effect upon becoming a law.