HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 1 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S A bill to be entitled 1 An act relating to nonemergent patient care; amending 2 s. 401.23, F.S.; defining the term "community 3 paramedicine"; amending s. 401.265, F.S.; providing 4 that a physician who supervises the provision of 5 certain services by a paramedic or an emergency 6 medical technician is liable for any act or omission 7 during the provision of such services; amending s. 8 401.272, F.S.; revising a legislative purpose 9 regarding emergency medical services community health 10 care; authorizing paramedics and emergency medical 11 technicians to perform community paramedicine under 12 certain circumstances; amending s. 465.019, F.S.; 13 specifying that Class III institutional pharmacies may 14 dispense, distribute, compound, and fill prescriptions 15 for medicinal drugs for inpatient and outpatient 16 treatment; authorizing hospitals to dispense medicinal 17 drugs to patients without first securing a community 18 pharmacy permit under certain circumstances; amending 19 ss. 14.33, 252.515, 395.1027, and 401.245, F.S.; 20 conforming cross-references; providing an effective 21 date. 22 23 Be It Enacted by the Legislature of the State of Florida: 24 25 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 2 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S Section 1. Present subsections (10 ) through (22) of 26 section 401.23, Florida Statutes, are redesignated as 27 subsections (11) through (23), respectively, a new subsection 28 (10) is added to that section, and present subsection (19) of 29 that section is amended, to read: 30 401.23 Definitions. —As used in this part, the term: 31 (10) "Community paramedicine" means any nonemergent basic 32 or advanced life support services provided in a community 33 setting by a paramedic or an emergency medical technician, as 34 applicable, under the medical supervision of a p hysician 35 pursuant to a formal supervisory relationship or standing order, 36 as described in s. 401.265, s. 458.348, or s. 459.025. 37 (20)(19) "Physician" means a practitioner who is licensed 38 under the provisions of chapter 458 or chapter 459. For the 39 purpose of providing "medical direction" as defined in this 40 section subsection (14) for the treatment of patients 41 immediately before prior to or during transportation to a United 42 States Department of Veterans Affairs medical facility, 43 "physician" also means a pra ctitioner employed by the United 44 States Department of Veterans Affairs. 45 Section 2. Subsection (4) of section 401.265, Florida 46 Statutes, is amended to read: 47 401.265 Medical directors. — 48 (4) Each physician who supervises or provides medical 49 direction to medical director who uses a paramedic or an 50 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 3 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S emergency medical technician to perform community paramedicine; 51 to perform blood pressure screening, health promotion, and 52 wellness activities;, or to administer immunization for on any 53 patient under a protoco l as specified in s. 401.272, which is 54 not in the provision of emergency care, is liable for any act or 55 omission of any paramedic or emergency medical technician acting 56 under his or her supervision and control when performing such 57 services. 58 Section 3. Subsections (1) and paragraph (a) of subsection 59 (2) of section 401.272, Florida Statutes, are amended to read: 60 401.272 Emergency medical services community health care. — 61 (1) The purpose of this section is to encourage more 62 effective use utilization of the skills of emergency medical 63 technicians and paramedics by enabling them to perform community 64 paramedicine, in partnership with local county health 65 departments and health care facilities as defined in s. 408.07 , 66 specific additional health care tasks tha t are consistent with 67 the public health and welfare . 68 (2) Notwithstanding any other provision of law to the 69 contrary: 70 (a) Paramedics or emergency medical technicians may 71 perform community paramedicine, health promotion and wellness 72 activities, and blood pressure screenings in a nonemergency 73 environment, within the scope of their training, and under the 74 direction of a physician medical director. As used in this 75 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 4 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S paragraph, the term "health promotion and wellness" means the 76 provision of public hea lth programs pertaining to the prevention 77 of illness and injury. 78 Section 4. Paragraph (d) of subsection (2) and paragraph 79 (a) of subsection (4) of section 465.019, Florida Statutes, are 80 amended to read: 81 465.019 Institutional pharmacies; permits. — 82 (2) The following classes of institutional pharmacies are 83 established: 84 (d)1. "Class III institutional pharmacies" are those 85 institutional pharmacies, including central distribution 86 facilities, affiliated with a hospital which that provide the 87 same services that are authorized by a Class II institutional 88 pharmacy permit. Class III institutional pharmacies may also: 89 a. Dispense, distribute, compound, and fill prescriptions 90 for medicinal drugs for inpatient or outpatient treatment . 91 b. Prepare prepackaged drug products. 92 c. Conduct other pharmaceutical services for the 93 affiliated hospital and for entities under common control that 94 are each permitted under this chapter to possess medicinal 95 drugs. 96 d. Provide the services in sub -subparagraphs a.-c. to an 97 entity under common control which holds an active health care 98 clinic establishment permit as required under s. 499.01(2)(r). 99 2. A Class III institutional pharmacy shall maintain 100 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 5 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S policies and procedures addressing: 101 a. The consultant pharmacist responsible for 102 pharmaceutical services. 103 b. Safe practices for the preparation, dispensing, 104 prepackaging, distribution, and transportation of medicinal 105 drugs and prepackaged drug products. 106 c. Recordkeeping to monitor the movement, distribution, 107 and transportation of medicinal drugs and prepackaged drug 108 products. 109 d. Recordkeeping of pharmacy staff responsible for each 110 step in the preparation, dispensing, prepackaging, 111 transportation, and distribution of medicinal drugs and 112 prepackaged drug products. 113 e. Medicinal drugs and prepackaged drug products that may 114 not be safely distributed among Class III institutional 115 pharmacies. 116 (4)(a) Medicinal drugs shall be dispensed by in an 117 institutional pharmacy to outpatients only when that institution 118 has secured a community pharmacy permit from the department. 119 However, medicinal drugs may be dispensed by a hospital that has 120 not secured a community pharmacy permit but operates a Class II 121 or Class III institutional pharmacy may dispense medicinal drugs 122 to a patient of the hosp ital's emergency department or a 123 hospital inpatient upon discharge if a prescriber, as defined in 124 s. 465.025(1), treating the patient in such hospital determines 125 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 6 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S that the medicinal drug is warranted and that community pharmacy 126 services are not readily acce ssible, geographically or 127 otherwise, to the patient. Such prescribing and dispensing must 128 be for a supply of the drug that will last for the greater of 129 the following: 130 1. Up to 48 hours; or 131 2. Through the end of the next business day. 132 Section 5. Subsection (1) of section 14.33, Florida 133 Statutes, is amended to read: 134 14.33 Medal of Heroism. — 135 (1) The Governor may award a Medal of Heroism of 136 appropriate design, with ribbons and appurtenances, to a law 137 enforcement, correctional, or correctional probat ion officer, as 138 defined in s. 943.10(14); a firefighter, as defined in s. 139 112.191(1)(b); an emergency medical technician, as defined in s. 140 401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s. 141 401.23(17). A recipient must have distinguished hims elf or 142 herself conspicuously by gallantry and intrepidity, must have 143 risked his or her life deliberately above and beyond the call of 144 duty while performing duty in his or her respective position, 145 and must have engaged in hazardous or perilous activities to 146 preserve lives with the knowledge that such activities might 147 result in great personal harm. 148 Section 6. Paragraph (a) of subsection (3) of section 149 252.515, Florida Statutes, is amended to read: 150 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 7 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 252.515 Postdisaster Relief Assistance Act; immunity fro m 151 civil liability.— 152 (3) As used in this section, the term: 153 (a) "Emergency first responder" means: 154 1. A physician licensed under chapter 458. 155 2. An osteopathic physician licensed under chapter 459. 156 3. A chiropractic physician licensed under chapter 460. 157 4. A podiatric physician licensed under chapter 461. 158 5. A dentist licensed under chapter 466. 159 6. An advanced practice registered nurse licensed under s. 160 464.012. 161 7. A physician assistant licensed under s. 458.347 or s. 162 459.022. 163 8. A worker employed by a public or private hospital in 164 the state. 165 9. A paramedic as defined in s. 401.23 s. 401.23(17). 166 10. An emergency medical technician as defined in s. 167 401.23 s. 401.23(11). 168 11. A firefighter as defined in s. 633.102. 169 12. A law enforcement officer as defined in s. 943.10. 170 13. A member of the Florida National Guard. 171 14. Any other personnel designated as emergency personnel 172 by the Governor pursuant to a declared emergency. 173 Section 7. Subsection (5) of section 395.1027, Florida 174 Statutes, is amended to read: 175 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 8 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S 395.1027 Regional poison control centers. — 176 (5) By October 1, 1999, each regional poison control 177 center shall develop a prehospital emergency dispatch protocol 178 with each licensee as defined in s. 401.23 by s. 401.23(13) in 179 the geographic area covered by the regional poison control 180 center. The prehospital emergency dispatch protocol shall be 181 developed by each licensee's medical director in conjunction 182 with the designated regional poison control center responsible 183 for the geographic area in which the licensee operates. The 184 protocol shall define toxic substances and describe the 185 procedure by which the designated regional poison control center 186 may be consulted by the licensee. If a call is transferred to 187 the designated regional poison control center in accordance with 188 the protocol established under this section and s. 401.268, the 189 designated regional poison control center shall assume 190 responsibility and liability for the call. 191 Section 8. Paragraph (b) of subsection (2) of sec tion 192 401.245, Florida Statutes, is amended to read: 193 401.245 Emergency Medical Services Advisory Council. — 194 (2) 195 (b) Representation on the Emergency Medical Services 196 Advisory Council shall include : two licensed physicians who are 197 "medical directors" as defined in s. 401.23 s. 401.23(15) or 198 whose medical practice is closely related to emergency medical 199 services; two emergency medical service administrators, one of 200 HB 937 2022 CODING: Words stricken are deletions; words underlined are additions. hb0937-00 Page 9 of 9 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S whom is employed by a fire service; two certified paramedics, 201 one of whom is employed by a fi re service; two certified 202 emergency medical technicians, one of whom is employed by a fire 203 service; one emergency medical services educator; one emergency 204 nurse; one hospital administrator; one representative of air 205 ambulance services; one representative o f a commercial ambulance 206 operator; and two laypersons who are in no way connected with 207 emergency medical services, one of whom is a representative of 208 the elderly. Ex officio members of the advisory council from 209 state agencies shall include, but are shall not be limited to, 210 representatives from the Department of Education, the Department 211 of Management Services, the State Fire Marshal, the Department 212 of Highway Safety and Motor Vehicles, the Department of 213 Transportation, and the Division of Emergency Manageme nt. 214 Section 9. This act shall take effect July 1, 2022. 215