This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives. STORAGE NAME: h0559a.RRS DATE: 1/14/2022 HOUSE OF REPRESENTATIVES STAFF ANALYSIS BILL #: CS/HB 559 Occupational Licensure of Military Spouses SPONSOR(S): Regulatory Reform Subcommittee, Hunschofsky and others TIED BILLS: IDEN./SIM. BILLS: SB 562 REFERENCE ACTION ANALYST STAFF DIRECTOR or BUDGET/POLICY CHIEF 1) Regulatory Reform Subcommittee 17 Y, 0 N, As CS Thompson Anstead 2) Professions & Public Health Subcommittee 3) Appropriations Committee 4) Commerce Committee SUMMARY ANALYSIS To help military families ease their transition into Florida, many licensing agencies in Florida have a special licensing process for spouses and surviving spouses of United States military members. The Department of Health (DOH) offers expedited licensure to applicants who are a spouse or surviving spouse of a person serving on active duty with the U.S. Armed Forces. DOH provides these services through the Florida Veterans Application for Licensure Online Response system. Such spouses are authorized to receive a temporary license to practice certain health care professions in Florida. In addition, the application fee, licensure fee, and unlicensed activity fee are waived for such applicants. The bill requires DOH or the applicable board or program to: Expedite applications submitted by a spouse of an active duty member of the U.S. Armed Forces; and Issue a temporary professional license valid for the duration of the application review process. The bill revises the DOH temporary professional licensure requirements for military spouses who hold a license to practice in another state as follows: Requires the immediate issuance of a full professional license, instead of a temporary license, to such applicants that submit certain information with their application. Requires DOH to waive the $65 application fee for such licenses. Removes the 12-month timeframe for such licenses. Specifies that such applicants are still required to follow license renewal requirements. The bill appears to have an insignificant fiscal impact on state government and no fiscal impact on local governments. The bill provides an effective date of July 1, 2022. STORAGE NAME: h0559a.RRS PAGE: 2 DATE: 1/14/2022 FULL ANALYSIS I. SUBSTANTIVE ANALYSIS A. EFFECT OF PROPOSED CHANGES: Background Licensure of Health Care Practitioners The Division of Medical Quality Assurance (MQA), within the Department of Health (DOH), has general regulatory authority over health care practitioners in Florida. 1 The MQA works in conjunction with 22 boards and four councils to license and regulate ten types of health care facilities and more than 200 licenses in over 40 health care professions. 2 Each profession is regulated by an individual practice act and by ch. 456, F.S., which provides general regulatory and licensure authority for the MQA. Military Spouse Licensure Florida offers expedited licensing and fee waivers to the spouse of a person serving on active duty 3 with the U.S. Armed Forces 4 who holds an active license to practice a health care profession in another state or jurisdiction. 5 To qualify for the expedited licensure and fee waivers, the spouse must: 6 Submit a complete application; Submit evidence of training or experience substantially equivalent to the requirements for licensure in this state for that health care profession and evidence that he or she has obtained a passing score on the appropriate examination of a national or regional standards organization if required for licensure in this state; Attest that he or she is not, at the time of submission of the application, the subject of a disciplinary proceeding in a jurisdiction in which he or she holds a license or by the U.S. Department of Defense for reasons related to the practice of the profession for which he or she is applying; Have actively practiced the profession for which he or she is applying for the 3 years preceding the date of submitting the application; and Submit a set of fingerprints for a background screening, if required for the profession for which he or she is applying, and does not have any disqualifying offenses. DOH is required to develop an application form, 7 and each board, or the department if there is no board, is required to waive the application fee, licensure fee, and unlicensed activity fee for such applicants. 8 Military Spouse Temporary Licensure Each board, or the department if there is no board, is also authorized to issue temporary licenses to the spouse of a member of the U.S. Armed Forces to practice his or her health care profession in Florida. 9 1 Pursuant to s. 456.001(4), F.S., health care practitioners are defined to include acupuncturists, physicians, physician assistants, chiropractors, podiatrists, naturopaths, dentists, dental hygienists, optometrists, nurses, nursing assistants, pharmacists, midwives, speech language pathologists, nursing home administrators, occupational therapists, respiratory therapists, dieticians, athletic trainers, orthotists, prosthetists, electrologists, massage therapists, clinical laboratory personnel, medical physicists, dispensers of optical devices or hearing aids, physical therapists, psychologists, social workers, counselors, and psychotherapists, among others. 2 Florida Department of Health, Division of Medical Quality Assurance, Annual Report and Long-Range Plan, Fiscal Year 2020- 2021, http://www.floridahealth.gov/licensing-and-regulation/reports-and-publications/_documents/annual-report-1617.pdf (last visited Jan. 3, 2022). 3 Full-time duty in the active military service of the United States. 10 U.S.C. § 101(d)(1). 4 Includes the United States Army, Navy, Air Force, Marine Corps, and Coast Guard. 10 U.S.C. § 101(a)(4). 5 S. 456.024(3), F.S. The application fee, licensure fee, and unlicensed activity fee is waived for such applicants. 6 S. 456.024(3)(b), F.S. 7 R. 64B-9.003, F.A.C. 8 S. 456.024(3)(a), F.S. 9 S. 456.024(4), F.S. STORAGE NAME: h0559a.RRS PAGE: 3 DATE: 1/14/2022 A temporary license is valid for one year and is not renewable. 10 To be eligible for a temporary license, a military spouse must: 11 Submit a completed application and application fee of $65; 12 Provide proof that he or she is married to a member of the U.S. Armed Forces serving on active duty in this state pursuant to official military orders; Provide proof of a valid license from another state or jurisdiction to practice the health profession for which he or she is applying and that such license is not subject to any disciplinary proceeding; Provide proof that he or she would otherwise be entitled to full licensure and is eligible to take the respective licensure examination as required in this state; and Pass a criminal background screening. DOH offers the Florida Veterans Application for Licensure Online Response System (VALOR), which provides expedited licensing for honorably discharged veterans and their spouses seeking licensure in all health care professions. 13 Veterans and spouses who apply through the VALOR process receive a waiver of most licensing fees. 14 Since its inception in 2016, there have been approximately 1,669 health care licensure applications submitted by and approved for active duty service members, military veterans, and their spouses through the VALOR expedited licensing process. There were 352 applications approved for health care licensure of military spouses and honorably discharged veterans from July 1, 2020 through June 30, 2021, approximately 1.38% of all licenses issued by the Department during the last fiscal year. 15 Effect of Proposed Changes The bill revises the DOH temporary license requirements for spouses of active duty members of the U.S. Armed Forces as follows: Requires the issuance of a full professional license, instead of allowing the issuance of a temporary license, to such applicants who fulfill the proper submission requirements. Requires DOH to waive the $65 application fee for such licensure. Removes the 12-month timeframe for such licensure. Requires such applicants to complete conditions for renewal required of all other licenseholders, including, without limitation, continuing education requirements. Requires the board, or the department if there is no board, to: o Expedite all applications submitted by a spouse of an active duty member of the U.S. Armed Forces; and o Issue a temporary professional license that is valid for the duration of the application review process to such spouse once the board or department verifies that the information provided by the spouse is accurate. B. SECTION DIRECTORY: Section 1: amends s. 456.024, F.S., requiring DOH or the applicable board to issue a professional license to spouses of active duty members of the U.S. Armed Forces if certain requirements are met; requiring DOH to waive the application fee for such license applications; authorizing applicants issued such licenses to renew their licenses if certain requirements are met; providing construction; requiring DOH or the applicable board to expedite applications for such licenses; requiring DOH or the applicable board to issue a 10 S. 456.024(4)(f), F.S. 11 S. 456.024(4)(a)-(d), F.S. 12 R. 64B-4.007, F.A.C. 13 DOH operates the Veterans Application for Licensure Online Response System (VALOR) to provide expedited licensing for active duty military members, honorably discharged veterans, and spouses of active duty military members with an active license in another state. See http://www.flhealthsource.gov/valor (last visited Jan. 4, 2021). 14 Florida Department of Health, Agency Analysis of 2022 HB 559, p. 2 (12/14/2021). 15 Id. STORAGE NAME: h0559a.RRS PAGE: 4 DATE: 1/14/2022 temporary professional license under certain circumstances; conforming provisions to changes made by the act. Section 2: provides an effective date of July 1, 2022. II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT A. FISCAL IMPACT ON STATE GOVERNMENT: 1. Revenues: Insignificant. According to DOH: 16 The Division of Medical Quality Assurance will experience a recurring loss of revenue due to the provisions of this bill. From July 1, 2020 through June 30, 2021, 352 applications were approved for health care licensure of military spouses, this includes approximately 1.38% of all licenses issued by the Department during the last fiscal year. It is anticipated that the bill will have an insignificant impact on the Division of Medical Quality Assurance trust fund related to the reduction in licensing fees. 2. Expenditures: None. According to DOH: 17 The Division of Medical Quality Assurance will experience a non-recurring increase in workload and costs associated with updating the Licensing and Enforcement Information Database System, Online Service Portal, Cognitive Virtual Agent, and armed services website to reflect changes to the licensing fees and requirements for a spouse of an active duty member of the Armed Forces of the United States. Current resources and budget authority are adequate to absorb. B. FISCAL IMPACT ON LOCAL GOVERNMENTS: 1. Revenues: None. 2. Expenditures: None. C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR: The bill removes the $65 DOH licensure fee for a spouse of a member of the U.S. Armed Forces who is on active duty. 18 D. FISCAL COMMENTS: The bill will have an indeterminate, negative fiscal impact on DOH. The bill will reduce licensing revenues to DOH but the exact amount is indeterminate. The bill will also create a cost to DOH to implement the provisions requiring expedited processing of licensure applications. The fiscal impacts to the state will depend on the number of people who take advantage of these provisions, although the agency has provided preliminary fiscal analysis indicating indeterminate yet insignificant impacts. 16 Florida Department of Health, Agency Analysis of 2022 HB 559, p. 4 (12/14/2021). 17 Florida Department of Health, Agency Analysis of 2022 HB 559, p. 5 (12/14/2021). 18 Id. STORAGE NAME: h0559a.RRS PAGE: 5 DATE: 1/14/2022 III. COMMENTS A. CONSTITUTIONAL ISSUES: 1. Applicability of Municipality/County Mandates Provision: Not applicable. This bill does not appear to affect county or municipal governments. 2. Other: None. B. RULE-MAKING AUTHORITY: The bill removes the requirement for military spouse applicants for licensure by DOH to submit the required application fee. To implement, DOH provides that it “would be required to update the Military Spouse Temporary License application and associated rule to make nomenclature updates and remove the $65 temporary licensure fee.” 19 Current law appears to provide sufficient rulemaking authority. C. DRAFTING ISSUES OR OTHER COMMENTS: Other Comments According to DOH: To implement, the Military Spouse Temporary License application… would be transitioned from a temporary license application to a full licensure application. It is the practice of DOH to expedite licensure for military spouses, as such, this component of the bill would not impact current operations. 20 The bill is unclear regarding incomplete applications and situations where supplemental documentation (e.g. transcripts, criminal history, prior license verification) is not yet received by the Department. It is the Department's practice to prioritize the processing of veterans and their spouses, and if the completed application and all supplemental information is received by the department, applications are processed in one day or less. As a result, the issuance of a temporary license would only occur if the applicant's application is deemed incomplete. IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES On January 12, 2021, the Regulatory Reform Subcommittee adopted one amendment and reported the bill favorably as a committee substitute. The committee substitute removed provisions related to the Department of Business and Professional Regulation from the bill. 19 Florida Department of Health, Agency Analysis of 2022 HB 559, p. 3 (12/14/2021). 20 Id.