Bill Text: FL S1256 | 2010 | Regular Session | Comm Sub
Bill Title: Physician Workforce [SPSC]
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2010-04-30 - Died on Calendar, companion bill(s) passed, see HB 5311 (Ch. 2010-161) [S1256 Detail]
Download: Florida-2010-S1256-Comm_Sub.html
Florida Senate - 2010 CS for CS for SB 1256 By the Committees on Health and Human Services Appropriations; and Health Regulation; and Senator Peaden 603-04264-10 20101256c2 1 A bill to be entitled 2 An act relating to the physician workforce; repealing 3 s. 381.0403(4) and (9), F.S., relating to the program 4 for graduate medical education innovations and the 5 graduate medical education committee and report; 6 amending s. 381.4018, F.S.; providing definitions; 7 requiring the Department of Health to coordinate and 8 enhance activities regarding the reentry of retired 9 military and other physicians into the physician 10 workforce; revising the list of governmental 11 stakeholders that the Department of Health is required 12 to work with regarding the state strategic plan and in 13 assessing the state’s physician workforce; creating 14 the Physician Workforce Advisory Council; providing 15 membership of the council; providing for appointments 16 to the council; providing terms of membership; 17 providing for removal of a council member; providing 18 for the chair and vice chair of the council; providing 19 that council members are not entitled to receive 20 compensation or reimbursement for per diem or travel 21 expenses; providing the duties of the council; 22 establishing the physician workforce graduate medical 23 education innovation pilot projects under the 24 department; providing the purposes of the pilot 25 projects; providing for the appropriation of state 26 funds for the pilot projects; requiring the pilot 27 projects to meet certain policy needs of the physician 28 workforce in this state; providing criteria for 29 prioritizing proposals for pilot projects; requiring 30 the department to adopt by rule appropriate 31 performance measures; requiring participating pilot 32 projects to submit an annual report to the department; 33 requiring state funds to be used to supplement funds 34 from other sources; requiring the department to adopt 35 rules; amending ss. 458.3192 and 459.0082, F.S.; 36 requiring the department to determine by geographic 37 area and specialty the number of physicians and 38 osteopathic physicians who plan to relocate outside 39 the state, practice medicine in this state, and reduce 40 or modify the scope of their practice; authorizing the 41 department to report additional information in its 42 findings to the Governor and the Legislature; amending 43 s. 458.315, F.S.; revising the standards for the Board 44 of Medicine to issue a temporary certificate to a 45 certain physicians to practice medicine in areas of 46 critical need; authorizing the State Surgeon General 47 to designate areas of critical need; creating s. 48 459.0076, F.S.; authorizing the Board of Osteopathic 49 Medicine to issue temporary certificates to 50 osteopathic physicians who meet certain requirements 51 to practice osteopathic medicine in areas of critical 52 need; providing restrictions for issuance of a 53 temporary certificate; authorizing the State Surgeon 54 General to designate areas of critical need; 55 authorizing the Board of Osteopathic Medicine to waive 56 the application fee and licensure fees for obtaining 57 temporary certificates for certain purposes; providing 58 an effective date. 59 60 Be It Enacted by the Legislature of the State of Florida: 61 62 Section 1. Subsections (4) and (9) of section 381.0403, 63 Florida Statutes, are repealed. 64 Section 2. Section 381.4018, Florida Statutes, is amended 65 to read: 66 381.4018 Physician workforce assessment and development.— 67 (1) DEFINITIONS.—As used in this section, the term: 68 (a) “Consortium” or “consortia” means a combination of 69 statutory teaching hospitals, statutory rural hospitals, other 70 hospitals, accredited medical schools, clinics operated by the 71 Department of Health, clinics operated by the Department of 72 Veterans’ Affairs, area health education centers, community 73 health centers, federally qualified health centers, prison 74 clinics, local community clinics, or other programs. At least 75 one member of the consortium shall be a sponsoring institution 76 accredited or currently seeking accreditation by the 77 Accreditation Council for Graduate Medical Education or the 78 American Osteopathic Association. 79 (b) “Council” means the Physician Workforce Advisory 80 Council. 81 (c) “Department” means the Department of Health. 82 (d) “Graduate medical education program” means a program 83 accredited by the Accreditation Council for Graduate Medical 84 Education or the American Osteopathic Association. 85 (e) “Primary care specialty” means emergency medicine, 86 family practice, internal medicine, pediatrics, psychiatry, 87 geriatrics, general surgery, obstetrics and gynecology, and 88 combined pediatrics and internal medicine and other specialties 89 as determined by the Physician Workforce Advisory Council or the 90 Department of Health. 91 (2)(1)LEGISLATIVE INTENT.—The Legislature recognizes that 92 physician workforce planning is an essential component of 93 ensuring that there is an adequate and appropriate supply of 94 well-trained physicians to meet this state’s future health care 95 service needs as the general population and elderly population 96 of the state increase. The Legislature finds that items to 97 consider relative to assessing the physician workforce may 98 include physician practice status; specialty mix; geographic 99 distribution; demographic information, including, but not 100 limited to, age, gender, race, and cultural considerations; and 101 needs of current or projected medically underserved areas in the 102 state. Long-term strategic planning is essential as the period 103 from the time a medical student enters medical school to 104 completion of graduate medical education may range from 7 to 10 105 years or longer. The Legislature recognizes that strategies to 106 provide for a well-trained supply of physicians must include 107 ensuring the availability and capacity of qualitygraduate108 medical schools and graduate medical education programs in this 109 state, as well as using new or existing state and federal 110 programs providing incentives for physicians to practice in 111 needed specialties and in underserved areas in a manner that 112 addresses projected needs for physician manpower. 113 (3)(2)PURPOSE.—The departmentof Healthshall serve as a 114 coordinating and strategic planning body to actively assess the 115 state’s current and future physician workforce needs and work 116 with multiple stakeholders to develop strategies and 117 alternatives to address current and projected physician 118 workforce needs. 119 (4)(3)GENERAL FUNCTIONS.—The department shall maximize the 120 use of existing programs under the jurisdiction of the 121 department and other state agencies and coordinate governmental 122 and nongovernmental stakeholders and resources in order to 123 develop a state strategic plan and assess the implementation of 124 such strategic plan. In developing the state strategic plan, the 125 department shall: 126 (a) Monitor, evaluate, and report on the supply and 127 distribution of physicians licensed under chapter 458 or chapter 128 459. The department shall maintain a database to serve as a 129 statewide source of data concerning the physician workforce. 130 (b) Develop a model and quantify, on an ongoing basis, the 131 adequacy of the state’s current and future physician workforce 132 as reliable data becomes available. Such model must take into 133 account demographics, physician practice status, place of 134 education and training, generational changes, population growth, 135 economic indicators, and issues concerning the “pipeline” into 136 medical education. 137 (c) Develop and recommend strategies to determine whether 138 the number of qualified medical school applicants who might 139 become competent, practicing physicians in this state will be 140 sufficient to meet the capacity of the state’s medical schools. 141 If appropriate, the department shall, working with 142 representatives of appropriate governmental and nongovernmental 143 entities, develop strategies and recommendations and identify 144 best practice programs that introduce health care as a 145 profession and strengthen skills needed for medical school 146 admission for elementary, middle, and high school students, and 147 improve premedical education at the precollege and college level 148 in order to increase this state’s potential pool of medical 149 students. 150 (d) Develop strategies to ensure that the number of 151 graduates from the state’s public and private allopathic and 152 osteopathic medical schools isareadequate to meet physician 153 workforce needs, based on the analysis of the physician 154 workforce data, so as to provide a high-quality medical 155 education to students in a manner that recognizes the uniqueness 156 of each new and existing medical school in this state. 157 (e) Pursue strategies and policies to create, expand, and 158 maintain graduate medical education positions in the state based 159 on the analysis of the physician workforce data. Such strategies 160 and policies must take into account the effect of federal 161 funding limitations on the expansion and creation of positions 162 in graduate medical education. The department shall develop 163 options to address such federal funding limitations. The 164 department shall consider options to provide direct state 165 funding for graduate medical education positions in a manner 166 that addresses requirements and needs relative to accreditation 167 of graduate medical education programs. The department shall 168 consider funding residency positions as a means of addressing 169 needed physician specialty areas, rural areas having a shortage 170 of physicians, and areas of ongoing critical need, and as a 171 means of addressing the state’s physician workforce needs based 172 on an ongoing analysis of physician workforce data. 173 (f) Develop strategies to maximize federal and state 174 programs that provide for the use of incentives to attract 175 physicians to this state or retain physicians within the state. 176 Such strategies should explore and maximize federal-state 177 partnerships that provide incentives for physicians to practice 178 in federally designated shortage areas. Strategies shall also 179 consider the use of state programs, such as the Florida Health 180 Service Corps established pursuant to s. 381.0302 and the 181 Medical Education Reimbursement and Loan Repayment Program 182 pursuant to s. 1009.65, which provide for education loan 183 repayment or loan forgiveness and provide monetary incentives 184 for physicians to relocate to underserved areas of the state. 185 (g) Coordinate and enhance activities relative to physician 186 workforce needs, undergraduate medical education,andgraduate 187 medical education, and reentry of retired military and other 188 physicians into the physician workforce provided by the Division 189 of Medical Quality Assurance,the Community Hospital Education190Program and the Graduate Medical Education Committee established191pursuant to s.381.0403,area health education center networks 192 established pursuant to s. 381.0402, and other offices and 193 programs within the departmentof Healthas designated by the 194 State Surgeon General. 195 (h) Work in conjunction with and act as a coordinating body 196 for governmental and nongovernmental stakeholders to address 197 matters relating to the state’s physician workforce assessment 198 and development for the purpose of ensuring an adequate supply 199 of well-trained physicians to meet the state’s future needs. 200 Such governmental stakeholders shall include, but need not be 201 limited to, the State Surgeon General or his or her designee, 202 the Commissioner of Education or his or her designee, the 203 Secretary of Health Care Administration or his or her designee, 204 and the Chancellor of the State University System or his or her 205 designeefrom the Board of Governors of the State University206System, and, at the discretion of the department, other 207 representatives of state and local agencies that are involved in 208 assessing, educating, or training the state’s current or future 209 physicians. Other stakeholders shall include, but need not be 210 limited to, organizations representing the state’s public and 211 private allopathic and osteopathic medical schools; 212 organizations representing hospitals and other institutions 213 providing health care, particularly those that currently provide 214 or have an interest in providing accredited medical education 215 and graduate medical education to medical students and medical 216 residents; organizations representing allopathic and osteopathic 217 practicing physicians; and, at the discretion of the department, 218 representatives of other organizations or entities involved in 219 assessing, educating, or training the state’s current or future 220 physicians. 221 (i) Serve as a liaison with other states and federal 222 agencies and programs in order to enhance resources available to 223 the state’s physician workforce and medical education continuum. 224 (j) Act as a clearinghouse for collecting and disseminating 225 information concerning the physician workforce and medical 226 education continuum in this state. 227 (5) PHYSICIAN WORKFORCE ADVISORY COUNCIL.—There is created 228 in the department the Physician Workforce Advisory Council, an 229 advisory council as defined in s. 20.03. The council shall 230 comply with the requirements of s. 20.052, except as otherwise 231 provided in this section. 232 (a) The council shall consist of 19 members. Members 233 appointed by the State Surgeon General shall include: 234 1. A designee from the department who is a physician 235 licensed under chapter 458 or chapter 459 and recommended by the 236 State Surgeon General. 237 2. An individual who is affiliated with the Science 238 Students Together Reaching Instructional Diversity and 239 Excellence program and recommended by the area health education 240 center network. 241 3. Two individuals recommended by the Council of Florida 242 Medical School Deans, one representing a college of allopathic 243 medicine and one representing a college of osteopathic medicine. 244 4. One individual recommended by the Florida Hospital 245 Association, representing a hospital that is licensed under 246 chapter 395, has an accredited graduate medical education 247 program, and is not a statutory teaching hospital. 248 5. One individual representing a statutory teaching 249 hospital as defined in s. 408.07 and recommended by the Safety 250 Net Hospital Alliance. 251 6. One individual representing a family practice teaching 252 hospital as defined in s. 395.805 and recommended by the Council 253 of Family Medicine and Community Teaching Hospitals. 254 7. Two individuals recommended by the Florida Medical 255 Association, one representing a primary care specialty and one 256 representing a nonprimary care specialty. 257 8. Two individuals recommended by the Florida Osteopathic 258 Medical Association, one representing a primary care specialty 259 and one representing a nonprimary care specialty. 260 9. Two individuals who are program directors of accredited 261 graduate medical education programs, one representing a program 262 that is accredited by the Accreditation Council for Graduate 263 Medical Education and one representing a program that is 264 accredited by the American Osteopathic Association. 265 10. An individual recommended by the Florida Association of 266 Community Health Centers representing a federally qualified 267 health center located in a rural area as defined in s. 268 381.0406(2)(a). 269 11. An individual recommended by the Florida Academy of 270 Family Physicians. 271 12. An individual recommended by the Florida Alliance for 272 Health Professions Diversity. 273 13. The Chancellor of the State University System or his or 274 her designee. 275 14. A layperson member as determined by the State Surgeon 276 General. 277 278 Appointments to the council shall be made by the State Surgeon 279 General. Each entity authorized to make recommendations under 280 this subsection shall make at least two recommendations to the 281 State Surgeon General for each appointment to the council. The 282 State Surgeon General shall name one appointee for each position 283 from the recommendations made by each authorized entity. 284 (b) Each council member shall be appointed to a 4-year 285 term. An individual may not serve more than two terms. Any 286 council member may be removed from office for malfeasance; 287 misfeasance; neglect of duty; incompetence; permanent inability 288 to perform official duties; or pleading guilty or nolo 289 contendere to, or being found guilty of, a felony. Any council 290 member who meets the criteria for removal, or who is otherwise 291 unwilling or unable to properly fulfill the duties of the 292 office, shall be succeeded by an individual chosen by the State 293 Surgeon General to serve out the remainder of the council 294 member’s term. If the remainder of the replaced council member’s 295 term is less than 18 months, notwithstanding the provisions of 296 this paragraph, the succeeding council member may be reappointed 297 twice by the State Surgeon General. 298 (c) The chair of the council is the State Surgeon General, 299 who shall designate a vice chair from the membership of the 300 council to serve in the absence of the State Surgeon General. A 301 vacancy shall be filled for the remainder of the unexpired term 302 in the same manner as the original appointment. 303 (d) Council members are not entitled to receive 304 compensation or reimbursement for per diem or travel expenses. 305 (e) The council shall meet at least twice a year in person 306 or by teleconference. 307 (f) The council shall: 308 1. Advise the State Surgeon General and the department on 309 matters concerning current and future physician workforce needs 310 in this state; 311 2. Review survey materials and the compilation of survey 312 information; 313 3. Annually review the number, location, cost, and 314 reimbursement of graduate medical education programs and 315 positions; 316 4. Provide recommendations to the department regarding the 317 survey completed by physicians licensed under chapter 458 or 318 chapter 459; 319 5. Assist the department in preparing the annual report to 320 the Legislature pursuant to ss. 458.3192 and 459.0082; 321 6. Assist the department in preparing an initial strategic 322 plan, conduct ongoing strategic planning in accordance with this 323 section, and provide ongoing advice on implementing the 324 recommendations; 325 7. Monitor and provide recommendations regarding the need 326 for an increased number of primary care or other physician 327 specialties to provide the necessary current and projected 328 health and medical services for the state; and 329 8. Monitor and make recommendations regarding the status of 330 the needs relating to graduate medical education in this state. 331 (6) PHYSICIAN WORKFORCE GRADUATE MEDICAL EDUCATION 332 INNOVATION PILOT PROJECTS.— 333 (a) The Legislature finds that: 334 1. In order to ensure a physician workforce that is 335 adequate to meet the needs of this state’s residents and its 336 health care system, policymakers must consider the education and 337 training of future generations of well-trained health care 338 providers. 339 2. Physicians are likely to practice in the state where 340 they complete their graduate medical education. 341 3. It can directly affect the makeup of the physician 342 workforce by selectively funding graduate medical education 343 programs to provide needed specialists in geographic areas of 344 the state which have a deficient number of such specialists. 345 4. Developing additional positions in graduate medical 346 education programs is essential to the future of this state’s 347 health care system. 348 5. It was necessary in 2007 to pass legislation that 349 provided for an assessment of the status of this state’s current 350 and future physician workforce. The department is collecting and 351 analyzing information on an ongoing basis to assess this state’s 352 physician workforce needs, and such assessment may facilitate 353 the determination of graduate medical education needs and 354 strategies for the state. 355 (b) There is established under the department a program to 356 foster innovative graduate medical education pilot projects that 357 are designed to promote the expansion of graduate medical 358 education programs or positions to prepare physicians to 359 practice in needed specialties and underserved areas or settings 360 and to provide demographic and cultural representation in a 361 manner that addresses current and projected needs for this 362 state’s physician workforce. Funds appropriated annually by the 363 Legislature for this purpose shall be distributed to 364 participating hospitals, medical schools, other sponsors of 365 graduate medical education programs, consortia engaged in 366 developing new graduate medical education programs or positions 367 in those programs, or pilot projects providing innovative 368 graduate medical education in community-based clinical settings. 369 Pilot projects shall be selected on a competitive grant basis, 370 subject to available funds. 371 (c) Pilot projects shall be designed to meet one or more of 372 this state’s physician workforce needs, as determined pursuant 373 to this section, including, but not limited to: 374 1. Increasing the number of residencies or fellowships in 375 primary care or other needed specialties. 376 2. Enhancing the retention of primary care physicians or 377 other needed specialties in this state. 378 3. Promoting practice in rural or medically underserved 379 areas of the state. 380 4. Encouraging racial and ethnic diversity within the 381 state’s physician workforce. 382 5. Encouraging practice in community health care or other 383 ambulatory care settings. 384 6. Encouraging practice in clinics operated by the 385 department, including, but not limited to, county health 386 departments, clinics operated by the Department of Veterans’ 387 Affairs, prison clinics, or similar settings of need. 388 7. Encouraging the increased production of geriatricians. 389 (d) Priority shall be given to a proposal for a pilot 390 project that: 391 1. Demonstrates a collaboration of federal, state, and 392 local entities that are public or private. 393 2. Obtains funding from multiple sources. 394 3. Focuses on enhancing graduate medical education in rural 395 or underserved areas. 396 4. Focuses on enhancing graduate medical education in 397 ambulatory or community-based settings other than a hospital 398 environment. 399 5. Includes the use of technology, such as electronic 400 medical records, distance consultation, and telemedicine, to 401 ensure that residents are better prepared to care for patients 402 in this state, regardless of the community in which the 403 residents practice. 404 6. Is designed to meet multiple policy needs as enumerated 405 in subsection (3). 406 7. Uses a consortium to provide for graduate medical 407 education experiences. 408 (e) The department shall adopt by rule appropriate 409 performance measures to use in order to consistently evaluate 410 the effectiveness, safety, and quality of the programs, as well 411 as the impact of each program on meeting this state’s physician 412 workforce needs. 413 (f) Participating pilot projects shall submit to the 414 department an annual report on the project in a manner required 415 by the department. 416 (g) Funding provided to a pilot project may be used only 417 for the direct costs of providing graduate medical education. 418 Accounting of such costs and expenditures shall be documented in 419 the annual report. 420 (h) State funds shall be used to supplement funds from any 421 local government, community, or private source. The state may 422 provide up to 50 percent of the funds, and local governmental 423 grants or community or private sources shall provide the 424 remainder of the funds. 425 (7) RULEMAKING.—The department shall adopt rules as 426 necessary to administer this section. 427 Section 3. Section 458.3192, Florida Statutes, is amended 428 to read: 429 458.3192 Analysis of survey results; report.— 430 (1) Each year, the Department of Health shall analyze the 431 results of the physician survey required by s. 458.3191 and 432 determine by geographic area and specialty the number of 433 physicians who: 434 (a) Perform deliveries of children in this stateFlorida. 435 (b) Read mammograms and perform breast-imaging-guided 436 procedures in this stateFlorida. 437 (c) Perform emergency care on an on-call basis for a 438 hospital emergency department. 439 (d) Plan to reduce or increase emergency on-call hours in a 440 hospital emergency department. 441 (e) Plan to relocatetheir allopathic or osteopathic442practiceoutside the state. 443 (f) Practice medicine in this state. 444 (g) Plan to reduce or modify the scope of their practice. 445 (2) The Department of Health must report its findings to 446 the Governor, the President of the Senate, and the Speaker of 447 the House of Representatives by November 1 each year. The 448 department shall also include in its report findings, 449 recommendations, and strategic planning activities as provided 450 in s. 381.4018. The department may also include other 451 information requested by the Physician Workforce Advisory 452 Council. 453 Section 4. Section 459.0082, Florida Statutes, is amended 454 to read: 455 459.0082 Analysis of survey results; report.— 456 (1) Each year, the Department of Health shall analyze the 457 results of the physician survey required by s. 459.0081 and 458 determine by geographic area and specialty the number of 459 physicians who: 460 (a) Perform deliveries of children in this stateFlorida. 461 (b) Read mammograms and perform breast-imaging-guided 462 procedures in this stateFlorida. 463 (c) Perform emergency care on an on-call basis for a 464 hospital emergency department. 465 (d) Plan to reduce or increase emergency on-call hours in a 466 hospital emergency department. 467 (e) Plan to relocatetheir allopathic or osteopathic468practiceoutside the state. 469 (f) Practice medicine in this state. 470 (g) Plan to reduce or modify the scope of their practice. 471 (2) The Department of Health must report its findings to 472 the Governor, the President of the Senate, and the Speaker of 473 the House of Representatives by November 1 each year. The 474 department shall also include in its report findings, 475 recommendations, and strategic planning activities as provided 476 in s. 381.4018. The department may also include other 477 information requested by the Physician Workforce Advisory 478 Council. 479 Section 5. Section 458.315, Florida Statutes, is amended to 480 read: 481 458.315 Temporary certificate for practice in areas of 482 critical need.— 483 (1) Any physician who: 484 (a) Is licensed to practice in any jurisdiction in the 485 United States andother state,whose license is currently valid; 486 or,487 (b) Has served as a physician in the United States Armed 488 Forces for at least 10 years and received an honorable discharge 489 from the military; 490 491 and who pays an application fee of $300 may be issued a 492 temporary certificate fortopractice in areas ofcommunities of493Florida where there is acritical needfor physicians. 494 (2) A certificate may be issued to a physician who: 495 (a) Practices in an area of critical need; 496 (b) Will be employed by or practice in a county health 497 department, correctional facility, Department of Veterans’ 498 Affairs clinic, community health center funded by s. 329, s. 499 330, or s. 340 of the United States Public Health Services Act, 500 or other agency or institution that is approved by the State 501 Surgeon General and provides health care to meet the needs of 502 underserved populations in this state; or 503 (c) Will practice for a limited time to address critical 504 physician-specialty, demographic, or geographic needs for this 505 state’s physician workforce as determined by the State Surgeon 506 Generalentity that provides health care to indigents and that507is approved by the State Health Officer. 508 (3) The Board of Medicine may issue this temporary 509 certificate with the following restrictions: 510 (a)(1)The State Surgeon Generalboardshall determine the 511 areas of critical need, and the physician so certified may512practice in any of those areas for a time to be determined by513the board. Such areasshallinclude, but are notbelimited to, 514 health professional shortage areas designated by the United 515 States Department of Health and Human Services. 516 1.(a)A recipient of a temporary certificate for practice 517 in areas of critical need may use the certificatelicenseto 518 work for any approved entityemployerin any area of critical 519 need or as authorized by the State Surgeon Generalapproved by520the board. 521 2.(b)The recipient of a temporary certificate for practice 522 in areas of critical need shall, within 30 days after accepting 523 employment, notify the board of all approved institutions in 524 which the licensee practices and of all approved institutions 525 where practice privileges have been denied. 526 (b)(2)The board may administer an abbreviated oral 527 examination to determine the physician’s competency, but ano528 written regular examination is not requirednecessary. Within 60 529 days after receipt of an application for a temporary 530 certificate, the board shall review the application and issue 531 the temporary certificate,ornotify the applicant of denial, or 532 notify the applicant that the board recommends additional 533 assessment, training, education, or other requirements as a 534 condition of certification. If the applicant has not actively 535 practiced during the prior 3 years and the board determines that 536 the applicant may lack clinical competency, possess diminished 537 or inadequate skills, lack necessary medical knowledge, or 538 exhibit patterns of deficits in clinical decisionmaking, the 539 board may: 540 1. Deny the application; 541 2. Issue a temporary certificate having reasonable 542 restrictions that may include, but are not limited to, a 543 requirement for the applicant to practice under the supervision 544 of a physician approved by the board; or 545 3. Issue a temporary certificate upon receipt of 546 documentation confirming that the applicant has met any 547 reasonable conditions of the board which may include, but are 548 not limited to, completing continuing education or undergoing an 549 assessment of skills and training. 550 (c)(3)Any certificate issued under this section isshall551bevalid only so long as the State Surgeon General determines 552 that the reasonareafor which it wasisissued remains aan553area ofcritical need to the state. The Board of Medicine shall 554 review each temporary certificateholder notthe service within555said area notless than annually to ascertain that the minimum 556 requirements of the Medical Practice Act and its adoptedthe557 rulesand regulations promulgated thereunderare being complied 558 with. If it is determined that such minimum requirements are not 559 being met, the board shallforthwithrevoke such certificate or 560 shall impose restrictions or conditions, or both, as a condition 561 of continued practice under the certificate. 562 (d)(4)The board mayshallnot issue a temporary 563 certificate for practice in an area of critical need to any 564 physician who is under investigation in any jurisdiction in the 565 United Statesanother statefor an act thatwhichwould 566 constitute a violation of this chapter until such time as the 567 investigation is complete, at which time the provisions of s. 568 458.331shallapply. 569 (4)(5)The application fee and all licensure fees, 570 including neurological injury compensation assessments, shall be 571 waived for those persons obtaining a temporary certificate to 572 practice in areas of critical need for the purpose of providing 573 volunteer, uncompensated care for low-income residents 574Floridians. The applicant must submit an affidavit from the 575 employing agency or institution stating that the physician will 576 not receive any compensation for any service involving the 577 practice of medicine. 578 Section 6. Section 459.0076, Florida Statutes, is created 579 to read: 580 459.0076 Temporary certificate for practice in areas of 581 critical need.— 582 (1) Any physician who: 583 (a) Is licensed to practice in any jurisdiction in the 584 United States and whose license is currently valid; or 585 (b) Has served as a physician in the United States Armed 586 Forces for at least 10 years and received an honorable discharge 587 from the military; 588 589 and who pays an application fee of $300 may be issued a 590 temporary certificate for practice in areas of critical need. 591 (2) A certificate may be issued to a physician who: 592 (a) Will practice in an area of critical need; 593 (b) Will be employed by or practice in a county health 594 department, correctional facility, Department of Veterans’ 595 Affairs clinic, community health center funded by s. 329, s. 596 330, or s. 340 of the United States Public Health Services Act, 597 or other agency or institution that is approved by the State 598 Surgeon General and provides health care to meet the needs of 599 underserved populations in this state; or 600 (c) Will practice for a limited time to address critical 601 physician-specialty, demographic, or geographic needs for this 602 state’s physician workforce as determined by the State Surgeon 603 General. 604 (3) The Board of Osteopathic Medicine may issue this 605 temporary certificate with the following restrictions: 606 (a) The State Surgeon General shall determine the areas of 607 critical need. Such areas include, but are not limited to, 608 health professional shortage areas designated by the United 609 States Department of Health and Human Services. 610 1. A recipient of a temporary certificate for practice in 611 areas of critical need may use the certificate to work for any 612 approved entity in any area of critical need or as authorized by 613 the State Surgeon General. 614 2. The recipient of a temporary certificate for practice in 615 areas of critical need shall, within 30 days after accepting 616 employment, notify the board of all approved institutions in 617 which the licensee practices and of all approved institutions 618 where practice privileges have been denied. 619 (b) The board may administer an abbreviated oral 620 examination to determine the physician’s competency, but a 621 written regular examination is not required. Within 60 days 622 after receipt of an application for a temporary certificate, the 623 board shall review the application and issue the temporary 624 certificate, notify the applicant of denial, or notify the 625 applicant that the board recommends additional assessment, 626 training, education, or other requirements as a condition of 627 certification. If the applicant has not actively practiced 628 during the prior 3 years and the board determines that the 629 applicant may lack clinical competency, possess diminished or 630 inadequate skills, lack necessary medical knowledge, or exhibit 631 patterns of deficits in clinical decisionmaking, the board may: 632 1. Deny the application; 633 2. Issue a temporary certificate having reasonable 634 restrictions that may include, but are not limited to, a 635 requirement for the applicant to practice under the supervision 636 of a physician approved by the board; or 637 3. Issue a temporary certificate upon receipt of 638 documentation confirming that the applicant has met any 639 reasonable conditions of the board which may include, but are 640 not limited to, completing continuing education or undergoing an 641 assessment of skills and training. 642 (c) Any certificate issued under this section is valid only 643 so long as the State Surgeon General determines that the reason 644 for which it was issued remains a critical need to the state. 645 The Board of Osteopathic Medicine shall review each temporary 646 certificateholder not less than annually to ascertain that the 647 minimum requirements of the Osteopathic Medical Practice Act and 648 its adopted rules are being complied with. If it is determined 649 that such minimum requirements are not being met, the board 650 shall revoke such certificate or shall impose restrictions or 651 conditions, or both, as a condition of continued practice under 652 the certificate. 653 (d) The board may not issue a temporary certificate for 654 practice in an area of critical need to any physician who is 655 under investigation in any jurisdiction in the United States for 656 an act that would constitute a violation of this chapter until 657 such time as the investigation is complete, at which time the 658 provisions of s. 459.015 apply. 659 (4) The application fee and all licensure fees, including 660 neurological injury compensation assessments, shall be waived 661 for those persons obtaining a temporary certificate to practice 662 in areas of critical need for the purpose of providing 663 volunteer, uncompensated care for low-income residents. The 664 applicant must submit an affidavit from the employing agency or 665 institution stating that the physician will not receive any 666 compensation for any service involving the practice of medicine. 667 Section 7. This act shall take effect July 1, 2010.