The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Health Policy
BILL: CS/SB 466
INTRODUCER: Senator Torres and others
SUBJECT: Military Medics and Corpsmen of Florida Program
DATE: January 17, 2022
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Rossitto-Van
Winkle
Brown
HP
Fav/CS
2. MS
3. AP
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 466 authorizes the Department of Health (DOH) to establish and administer the Military
Medics and Corpsmen of Florida (MMACOF) program, which is created under the bill, in
collaboration with Florida Is For Veterans, Inc. (FIFV). The program is designed to assist
veterans and their spouses in finding pathways toward clinical, leadership, and nonclinical
careers in health care or health care-related fields in Florida.
The MMACOF program requires the FIFV to recruit and review the military eligibility of
veterans and their spouses and to assist military-trained health care veterans (MTHCV) in
applying for the MMACOF Health Care Certification program for the purpose of assisting
MTHCVs obtain employment with participating health care providers, maintain medical skills,
address the shortage of health care professionals in this state, and work toward obtaining
appropriate health care registration, certification, or licensure.
Under the program the DOH is responsible for issuing MMACOF Health Care Certificates to
MTHCVs with specific clinical skills, as determined by the Board of Medicine (BOM) to
practice without a license under direct supervision of an appropriately licensed or certified health
care practitioner.
The MMACOF program also assists veterans and their spouses, who do not meet the definition
of a MTHCV, but who have served in health care-related fields, to receive assistance from the
REVISED: BILL: CS/SB 466 Page 2
program in résumé writing, mentorship, and obtaining employment with participating health care
providers. For veterans and their spouses who have gained management experience, or
completed an advanced degree, the MMACOF program is charged with helping them find
civilian health care leadership and management employment in a variety of health care
disciplines.
The bill provides an effective date of July 1, 2022.
II. Present Situation:
Florida Department of Veterans’ Affairs (FDVA)
The Legislature created the FDVA to assist all former, present, and future members of the U.S.
Armed Forces and their dependents in preparing claims for and securing compensation,
hospitalization, career training, and other benefits or privileges to which they are, or may
become, entitled to under federal or state law by reason of their service in the U.S. Armed
Forces. All services rendered under the FDVA must be without charge to the claimant.
1
More
than 1.5 million veterans currently live in Florida, making the state’s veteran population the third
largest nationally.
2
Florida Is For Veterans, Inc., (FIFV)
Section 295.21, F.S., created “Florida Is For Veterans, Inc.,” within the FDVA as a nonprofit
corporation that is registered, incorporated, organized, and operated under ch. 617, F.S.; and is
not part of state government. FIFV is a separate budget entity and is not subject to the control of
the FDVA.
The purpose of FIFV is to promote Florida as a veteran-friendly state that seeks to provide
veterans with employment opportunities and promotes the hiring of veterans by the business
community. FIFV encourages retired and recently separated military personnel to remain in the
state or to make Florida their permanent residence. FIFV’s mission is to promote the value of
military skill sets to businesses, assist in tailoring the training of veterans to match the needs of
the state employment marketplace, and enhance the entrepreneurial skills of veterans.
All agencies of the state are authorized and directed to provide technical assistance to FIFV as it
may require and to identify programs within each agency to provide assistance or benefits to
veterans who are located in Florida or are considering relocation to the state. The FDVA may
authorize the FIFV to use of the FDVA property, facilities, and personnel services and may
prescribe, by contract, any condition with which FIFV must comply in order to use the FDVA
property, facilities, or personnel services.
3
1
Section 292.05(1), F.S.
2
Florida Department of Veterans’ Affairs, Our Veterans, available at http://floridavets.org/our-veterans/ (last visited Dec. 8,
2021).
3
Section 295.21, F.S. BILL: CS/SB 466 Page 3
United States Armed Forced
The U.S. Armed Forces are made up of the six military branches: Air Force, Army, Coast
Guard,
4
Marine Corps, Navy and, most recently, the Space Force. There are three general
categories of military personnel: active duty (full-time soldiers and sailors); reserve & guard
forces (usually working in civilian jobs but can be called to full-time active duty); and veterans
and retirees (past members of the military). Additionally, there are the millions of family
members of military members, past and present. The President of the United States is the
commander in chief of the U.S. Armed Forces and is responsible for all final decisions. The
secretary of the U.S. Department of Defense (DOD) has control over the military and each
branch, except the Coast Guard, which is under the Department of Homeland Security (DHS).
With more than two million civilian and military employees, the U.S. DOD is the world's largest
employer.
5
Enlisted Members vs. Officers
Joining the U.S. Armed Forces as an enlisted member or an officer has a significant impact on
the type of experience and training a new recruit receives. All enlisted jobs require a high school
diploma, although, with certain exceptions, a passing General Education Development (GED)
test score is acceptable. While enlisted careers do include infantry roles, most jobs involve
hands-on training for mechanical, transportation, human service, or office fields that transfer
well to the civilian world.
Almost all officer positions require a four-year college degree or equivalent. Officers are the
managers of the military, acting in leadership roles that require planning, directing operations,
and making critical decisions. Officer positions also include careers that require advanced
degrees, such as law and medicine.
6
Enlisted Personnel
Each branch of the U.S. Armed Forces employs its own unique set of titles for its various
enlisted personnel, and all branches of the service utilize the same test to assign Advanced
Individualized Training (AIT) to new recruits, though different branches use different
classification systems. The U.S. Army and Marines use the MOS Job Line Categories,
7
the Navy
4
The Coast Guard was originally part of the U.S. Department of Transportation (DOT), but after the terrorist attacks of
September 11, 2001, President George W. Bush established the Department of Homeland Security (DHS), and the Coast
Guard was transferred from civilian leadership to military leadership as part of DHS in 2003. United States Coast Guard,
Historian's Office—Timeline 1900s-2000s, available at https://www.history.uscg.mil/Complete-Time-Line/Time-Line-1900-
2000/ (last visited Jan. 9, 2022).
5
Military.com, What Are the Branches of the US Military? available at https://www.military.com/join-armed-forces/us-
military-branches-overview.html (last visited Dec. 8, 2021).
6
Today’s Military, Enlisted and Officer Paths, available at https://www.todaysmilitary.com/ways-to-serve/enlisted-officer-
paths (last visited Dec. 8, 2021).
7
See Operation Military Kids, Army, Army Combat Medic Specialist (MOS 68W): Career Details, available at
https://www.operationmilitarykids.org/army-combat-medic-specialist-mos-68w/ (last visited Jan. 13, 2022); Operation
Military Kids, Marines, Marine Corps MOS List And ASVAB Scores, available at
https://www.operationmilitarykids.org/marine-corps-mos-list-asvab-scores/ (last visited Jan. 9, 2022). BILL: CS/SB 466 Page 4
and Coast Guard use job “Ratings” categories, though not the same ones,
8,9
and the Air Force
and Space Force both use MOS and Air Force Specialty Codes (AFSC).
For the sake of brevity, this analysis will use the U.S. Army, the country’s oldest military branch,
as the generic model for the basic discussion of the recruitment process in the U.S. Armed Forces
as it pertains to traditional health care jobs available to enlisted personnel, generally, recognizing
that each service branch has its own unique nuances and requirements for similar healthcare jobs.
To become an enlisted soldier in the U.S. Army, a person must:
Be U.S. citizen or permanent resident with a valid Green Card (Permanent Resident Card);
Be between 17-35 years old;
Achieve a minimum score on the Armed Services Vocational Aptitude Battery (ASVAB)
exam;
Meet medical, moral, and physical requirements; and
Be a high school graduate or equivalent, in most cases.
Officers
Becoming an Army officer is different from enlisting as a soldier. Officers are responsible for
leading soldiers and planning missions. Training and initial requirements for accepting a
commission as an officer vary, but generally, to qualify a person must:
Be a college graduate by the time he or she is commissioned as an officer;
Be between 18 and 32 years old;
Meet medical, moral, and physical requirements; and
Be eligible for a secret security clearance.
If a person is qualified, there are four main paths to becoming an Army officer:
The Army Reserve Officers’ Training Corps (ROTC);
Direct commission;
Officer Candidate School (OCS); or
Attending the U.S. Military Academy.
10
Basic Training
No matter which branch of the U.S. Armed Forces a recruit choses, he or she will go to basic
training. Basic training, often called boot camp, prepares recruits for all elements of service:
physical, mental, and emotional. It gives service members the basic tools necessary to perform
the roles that will be assigned for the duration of their tour. Each of the services has its own
training program, tailoring the curriculum to the specialized nature of its role in the Military. The
8
TheBalanceCareers.com, Careers, Navy Jobs, Navy Hospital Corpsman (HM) Enlisted Ratings available at
https://www.thebalancecareers.com/hospital-corpsman-3345823 (last visited Jan. 11, 2022).
9
TheBalanceCareers.com, U.S. Military Careers, Military Branches, Pros and Cons of Enlisting in the Coast Guard, available
at https://www.thebalancecareers.com/pros-cons-enlisting-in-coast-guard-4061204#toc-coast-guard-requirements (last visited
Jan. 11, 2022).
10
U.S. Army, Learn How to Join, Army Eligibility Requirements, available at https://www.goarmy.com/learn/understanding-
the-asvab.html (last visited Jan. 7, 2022). BILL: CS/SB 466 Page 5
length of basic training varies from eight to 13 weeks, depending on the branch of the service.
Basic training includes daily cardio, weight training, pushups and sit-ups.
11
Armed Services Vocational Aptitude Battery (ASVAB)
As previously noted, all potential U.S. Armed Force members, during the recruiting process,
must take the ASVAB exam, which is administered while the recruit is at the Military Entrance
Processing Station (MEPS). The ASVAB exam is a multiple-choice exam that helps determine
the military careers for which an individual is best suited. There are two versions of the test:
The enlistment version, which is given at a MEPS
12
and is used for recruiting purposes only;
The student version, also known Career Exploration Program (CEP), used for career
exploration, which is given in high schools and community colleges, at job corps centers, and
at correctional facilities.
13
The ASVAB exam is a series of subtests to help the Army and Marines determine what MOS job
classification, what Rating in the Navy,
14,15,16
or what Air Force Specialty Code (AFSC) in the
Air Force and Space Force, an individual might be best qualified for. It is an aptitude test, not an
intelligence test. The ASVAB exam has two different scores and is divided into different
sections:
Arithmetic Reasoning (AR): Measures ability to solve basic arithmetic word problems;
Assembling Objects (AO): Measures ability with spatial relationships;
Auto & Shop Information (AS): Measures knowledge of automotive maintenance and repair,
as well as wood and metal shop practices;
Electronics Information (EI): Measures knowledge of electrical current, circuits, devices, and
electronic systems;
11
Today’s Military, Boot Camp, available at https://www.todaysmilitary.com/joining-eligibility/boot-camp (last visited Dec.
8, 2021).
12
Today’s Military, Enlisting in the Military, available at https://www.todaysmilitary.com/joining-eligibility/enlisting-
military (last visited Dec. 8, 2021). The MEPS is a joint Service organization that determines an applicant's physical
qualifications, aptitude and moral standards as set by each branch of military service. There are MEPS locations all over the
country.
13
Operation Military Kids, Navy HM Hospital Corpsman: Everything You Wanted To Know (Dec. 19, 2019) available at
https://www.operationmilitarykids.org/navy-hospital-corpsman/#what-does-it-take-to-become-a-corpsman-in-the-navy (last
visited Dec. 8, 2021).
14
TheBalanceCareers.com, Military Branches, U.S. Navy, Navy Careers: What You Need to Know About Navy Enlisted
Ratings, (update Sept. 20, 2019) available at https://www.thebalancecareers.com/navy-enlisted-rating-job-descriptions-
3345844 (last visited Jan, 9, 2022). When it comes to Navy jobs, the sea service uses a different language than most
industries. You might hear references to Navy MOS, or Military Occupational Specialties, but the most common way to refer
to enlisted jobs is with the term "ratings."
15
The U. S. Marines do not have a dedicated medical corps, but use Navy corpsmen (HS) as their medical support personnel.
Corpsman train as soldiers as well as medical technicians, and serve alongside both Navy and Marine forces. They work in
medical settings in the field, in military hospitals and in medical clinics and ships. McQuerrey, Lisa, CHRON, What Is a
Corpsman in the Marines? (updated Jul. 1, 2018), available at https://work.chron.com/corpsman-marines-6677.html (last
visited Jan .9, 2022).
16
Unlike the Army, Navy and Air Force, the Coast Guard does not have a dedicated medical corps. However, a yeoman can
still pursue a career in health care with the Coast Guard, because the enlisted member’s AIT rating for the health services
technicians (HS), who is an enlisted Navy hospital corpsman (HM), who serve in a U. S. Coast Guard unit. Eliodoro Reinol,
Askinglot, updated Jan. 3, 2020, What is a corpsman in the Coast Guard? available at https://askinglot.com/what-is-a-
corpsman-in-the-coast-guard (last visited Jan. 9, 2022). BILL: CS/SB 466 Page 6
General Science (GS): Measures knowledge of life science, earth and space science, and
physical science;
Mathematics Knowledge (MK): Measures knowledge of mathematical concepts and
applications;
Mechanical Comprehension (MC): Measures knowledge of the principles of mechanical
devices, structural support, and properties of materials;
Paragraph Comprehension (PC): Measures ability to obtain information from written
material; and.
Word Knowledge (WK): Measures ability to understand the meaning of words through
synonyms.
The Armed Forces Qualification Test (AFQT) score includes arithmetic reasoning, mathematics
knowledge, word knowledge, and paragraph comprehensions, and determines if an individual is
qualified at all to serve in any branch of the military. A recruit’s score on the remaining aptitude
subtests are used for job placement. All nine ASVAB subtests are scored as a percentile in
relation to how well the recruit did in comparison with all other recruits who took the same
ASVAB test.
17,18
The Army currently has the longest list of available MOS job line categories.
19
The Army offers
over 150 MOS specialties and uses the aforementioned subtest categories to create MOS job line
categories relevant to the type of jobs a recruit is best qualified for, as follows:
MOS Job Line Categories ASVAB Subtests Most Relevant to MOS
Clerical (CL) AR, MK, VE
20
Combat (CO) AR, AS, CS, and MC
Electronics (EL) AR, EI, GS, and MK
Field Artillery (FA) AR, CS, MC, and MK
General Maintenance (GM) AS, EI, GS, and MK
General Technical (GT) AR and VE
Mechanical Maintenance (MM) AS, EI, and MC
Operators & Food (OF) AS, MC, and VE
Surveillance & Communications (SC) AR, AS, MC, and VE
Skilled Technical (ST) GS, MC, MK, and VE
The U.S. Army uses some of the following traditional health care job classifications as MOS job
lines. Listed below are the most relevant ASVAB subtests scores required for those jobs, which
combine to create the potential recruit’s required minimum scores for suitability for a specific
17
Operation Military Kids, General Military Questions, ASVAB Scores and the Military Jobs that Qualify, available at
https://www.operationmilitarykids.org/asvab-scores-and-the-military-jobs-that-qualify/#army-asvab-scores (last visited Jan.
6, 2022).
18
U.S. Army, Learn How to Join, Understanding the ASVAB Test, available at
https://www.goarmy.com/learn/understanding-the-asvab.100-0-99-0-0-110-0-99-0-101.results.html (last visited Jan. 13,
2022).
19
Operation Military Kids, General Military Questions, ASVAB Scores and the Military Jobs that Qualify, available at
https://www.operationmilitarykids.org/asvab-scores-and-the-military-jobs-that-qualify/#army-asvab-scores (last visited Jan.
6, 2022).
20
Id. VE, or Verbal Expression, is the sum of PC and WK. BILL: CS/SB 466 Page 7
MOS job line. Again, for brevity purposes, only U.S. Army traditional health care jobs available
to enlisted personnel are listed. Each footnote provides the specific qualifications and training to
achieve those jobs in the U.S. Army to provide more detail. The other branches of the U.S.
Armed Forces also have similar traditional health care jobs.
MOS Army Job Title Length of Time
of Training
21
Minimum ASVAB
Subtest Scores
68B Orthopedic Specialist
22
14 weeks ST: 101, GT: 107
68C Practical Nursing Specialist
23
52 weeks ST: 101, GT: 107
68E Dental Specialist
24
8 weeks ST: 91
68F Physical Therapy Specialist
25
28 weeks ST: 101, GT: 107
68H Optical Laboratory Specialist
26
18 weeks GM: 98
68K Medical Laboratory Specialist
27
52 weeks ST: 106
68L Occupational Therapy Specialist
28
34 weeks ST: 101, GT: 107
68N Cardiovascular Specialist
29
56 weeks ST: 101, GT: 107
21
Operation Military Kids, Army, What is Army AIT? available at https://www.operationmilitarykids.org/army-ait/ (last
visited Jan. 13, 2022).
22
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Orthopedic Specialist (68B), available at
https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/orthopedic-
specialist.html (last visited. Jan. 13, 2022).
23
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, General Care, Practical Nursing
Specialist (68C), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/general-care/68e-
dental-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Practical Nursing Specialist (MOS
68C), available at https://www.operationmilitarykids.org/army-practical-nursing-specialist-mos-68c/ (last visited Jan. 13,
2022).
24
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, General Care, Dental specialist
(68E), available at https://www.operationmilitarykids.org/army-dental-specialist-mos-68e/ (last visited Jan. 13, 2022).
25
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Physical
Therapy Specialist 68F , available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/physical-
mental-health/68f-physical-therapy-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army
Physical Therapy Specialist (MOS 68F): Career Details, available at https://www.operationmilitarykids.org/army-physical-
therapy-specialist-mos-68f/ (last visited Jan. 13, 2022).
26
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Optical
Laboratory Specialist (68H), available at https://www.goarmy.com/careers-and-jobs/career-match/science-
medicine/physical-mental-health/68h-optical-laboratory-specialist.html (last visited Jan. 13, 2022).
27
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Medical Laboratory Specialist (68K),
available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/research/68k-medical-laboratory-
specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Medical Laboratory Specialist (MOS 68K),
available at https://www.operationmilitarykids.org/army-medical-laboratory-specialist-mos-68k/ (last visited Jan. 13, 2022).
28
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Occupational Therapy Specialist
(68L),available at https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-
emergency/occupational-therapy-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army
Occupational Therapy Specialist (MOS 68L), available at https://www.operationmilitarykids.org/army-occupational-therapy-
specialist-mos-68l/ (last visited Jan. 13, 2022).
29
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, General Care, Cardiovascular
Specialist (68N), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/general-care/68n-
cardiovascular-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Cardiovascular Specialist
(MOS 68N), available at https://www.operationmilitarykids.org/army-cardiovascular-specialist-mos-68n/ (last visited Jan. 13,
2022). BILL: CS/SB 466 Page 8
68P Radiology Specialist
30
46 weeks ST: 106
68Q Pharmacy Specialist
31
19 weeks ST: 95
68S Preventive Medicine Specialist
32
15 weeks ST: 101
68U Ear, Nose, and Throat (ENT)
Specialist
33
14 weeks ST: 101, GT: 107
68V Respiratory Specialist
34
36 weeks ST: 102
68W Combat Medic Specialist
35
16 weeks ST: 101, GT: 107
68X Behavioral or Mental Health
Specialist
36
20 weeks ST: 101
68Y Eye Specialist
37
13 weeks ST: 101, GT: 107
The U.S. Army uses these additional health care related MOS job titles, and lists the following
most relevant ASVAB subtests scores required for those jobs, which combine to create the
potential recruit’s required minimum scores for suitability for a specific MOS job line.
30
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Radiology Specialist (68P), available at
https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/radiology-
specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Radiologist Specialist (MOS 68P), available
at https://www.operationmilitarykids.org/army-radiologist-specialist-mos-68p/ (last visited Jan. 13, 2022).
31
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Pharmacy
Specialist (68Q), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/physical-mental-
health/68q-pharmacy-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Pharmacy Specialist
(MOS 68Q): Career Details, available at https://www.operationmilitarykids.org/army-pharmacy-specialist-mos-68q/ (last
visited Jan. 13, 2022).
32
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health,
Preventative medical Specialist (68S), available at https://www.goarmy.com/careers-and-jobs/career-match/science-
medicine/physical-mental-health/68s-preventive-medicine-specialist.html (last visited Jan. 13, 2022).
33
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Ear, Nose And Throat (ENT) Specialist
(68U), available at https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/ear-
nose-throat-specialist.html (last visited Jan. 13, 2022).
34
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Respiratory Specialist (68V), available at
https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/respiratory-
specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Respiratory Specialist (MOS 68V): Career
Details, available at https://www.operationmilitarykids.org/army-respiratory-specialist-mos-68v-career-details/ (last visited
Jan. 13, 2022).
35
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Intensive Care, Combat Medic
Specialist (68W), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/intensive-care/68w-
combat-medic-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Combat Medic Specialist
(MOS 68W): Career Details, available at https://www.operationmilitarykids.org/army-combat-medic-specialist-mos-68w/
(last visited Jan. 13, 2022).
36
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Behavioral Health Specialist (68X),
available at https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-
emergency/behavioral-health-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Behavioral
Health Specialist (MOS 68X): Career Details, available at https://www.operationmilitarykids.org/army-behavioral-health-
specialist-mos-68x/ (last visited Jan. 13, 2022).
37
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Eye Specialist (68Y), available at
https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/eye-specialist.html
(last visited Jan. 13, 2022). BILL: CS/SB 466 Page 9
MOS Army Job Title Length of
Time
Training
38
Minimum ASVAB
Subtest Scores
68A Biomedical Equipment Specialist
39
41 weeks EL: 107
68G Patient Administration Specialist
40
7 weeks CL: 90
68J Medical Logistics Specialist
41
6 weeks CL: 90
68M Nutrition Care Specialist
42
7 weeks OF: 95
Military Health Care Education
After a recruit attends boot camp, Army AIT is mandatory. AIT teaches critical job skills needed
to serve the military in the recruit’s assigned MOS job line. This is where the technical training
begins at the Medical Education and Training Campus (METC) at Fort Sam Houston, Texas,
where medical personnel from all branches of the service learn and refine their skills. METC has
48 medical programs, 16,500 graduates a year, and is a state-of-the-art U.S. DOD health care
education campus that trains enlisted medical personnel. Training times vary depending upon a
recruit's progress and individual MOS, Rating, or AFSC career track.
43
Army Practical Nursing Specialist
An Army practical nursing specialist (MOS 68C) is responsible for performing nursing care
procedures. These specialists work with physicians, nurses, and non-commissioned officers
(NCO) to bring preventative, therapeutic, and emergency care to soldiers and their families. This
position requires skilled individuals who are comfortable working in all medical situations,
whether in a controlled or deployed environment.
38
Supra note 21.
39
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Research, Biomedical Equipment
specialist (68A), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/research/68a-
biomedical-equipment-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Biomedical
Equipment Specialist (MOS 68A): Career Details, available at https://www.operationmilitarykids.org/army-biomedical-
equipment-specialist-mos-68a/ (last visited Jan. 13, 2022).
40
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Patient
Administration Specialist (68G), available at https://www.goarmy.com/careers-and-jobs/career-match/science-
medicine/physical-mental-health/68g-patient-administration-specialist.html (last visited Jan. 13, 2022). Operation Military
Kids, Army, Patient Admonition Specialist (MOS 68G) available at https://www.operationmilitarykids.org/68-series-
mos/#Patientmos68G (last visited Jan. 13, 2022).
41
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Medical Logistics Specialist (68J), available
at https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/medical-logistics-
specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Medical Logistics Specialist (MOS 68J):
Career Details, available at https://www.operationmilitarykids.org/army-medical-logistics-specialist-mos-68j/ (last visited
Jan. 13, 2022).
42
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Nutrition
Care Specialist (68M), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/physical-
mental-health/68m-nutrition-care-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Nutrition Care
Specialist (MOS 68M), available at https://www.operationmilitarykids.org/68-series-mos/#Nutritionmos68M (last visited Jan.
13, 2022).
43
Medical Education and Training Campus, Welcome to the Medical Education & Training Campus (METC), available at
http://www.metc.mil/ (last visited Jan. 13, 2022). BILL: CS/SB 466 Page 10
Qualifications and Training
The Army practical nursing specialist (MOS 68C) is required to attend 10 weeks of boot camp
and is an entry-level position that requires recruits to pass all physical and medical evaluations.
To enter training for an Army practical nursing specialist, a recruit must receive a minimum
score of 101 on the Skilled Technical (ST) and 107 on the General Technical (GT) portions of
the ASVAB test. The recruit will then receive 52 weeks of AIT training at METC at Fort Sam
Houston in Texas.
Two phases of classroom training are required: field and clinical instruction. At the end of
training, the soldier must pass the Texas Board of Nursing National Clinical Licensure
Examination. After passing the examination, the soldier will be a Licensed Practical Nurse.
44
Army Combat Medic Specialist (CMS)
A CMS, MOS 68W job, trains as a soldier responsible for providing emergency medical
treatment at the point of a soldiers’ wounding on the battlefield. Soldiers in this MOS line also
assist with limited primary care and health protection. They provide evacuation of patients from
a point of injury.
45
A CMS administers emergency medical care in humanitarian situations,
serves as a first responder and triages illnesses and injuries to save lives in many situations. A
CMS is also trained to train other soldiers in lifesaving and first responder courses.
46
Qualifications and Training
A CMS is an entry-level position that requires basic physical and medical evaluations. A soldier
desiring a career as a CMS must receive a minimum score of 101 on the ST and 107 on the GT
portions of the ASVAB test. After entry-level testing, a CMS candidate will attend AIT for 16
weeks which will include practice in patient care. After AIT, the CMS candidate must obtain
certification from the National Registry of Emergency Medical Technicians (EMT) to begin his
or her career as a CMS soldier in the U.S. Army.
47
A CMS is trained to perform necessary medical care in battlefield situations and has been trained
in specific skills to perform under physician supervision or protocols, as follows:
Take vital signs;
Ambulance operations and patient transport;
Emergency situation assessment (triage);
Injury identification and temporary resolution protocols to stabilize a patient for transport;
44
U.S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, General Care, Practical Nursing
Specialist (68C), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/general-care/68c-
practical-nursing-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Practical Nursing
Specialist (MOS 68C), available at https://www.operationmilitarykids.org/army-practical-nursing-specialist-mos-68c/ (last
visited Jan. 13, 2022).
45
Operation Military Kids, Army, Army Combat Medic Specialist (MOS 68W): Career Details, available at
https://www.operationmilitarykids.org/army-combat-medic-specialist-mos-68w/ (last visited Jan. 13, 2022).
46
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Intensive Care, Combat Medic
Specialist (68W), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/intensive-care/68w-
combat-medic-specialist.html (last visited Jan. 13, 2022).
47
Operation Military Kids, Army, Army Combat Medic Specialist (MOS 68W): Career Details, available at
https://www.operationmilitarykids.org/army-combat-medic-specialist-mos-68w/ (last visited Jan. 13, 2022). BILL: CS/SB 466 Page 11
Insert IVs;
Apply a tourniquet;
Suture a wound;
Perform cardiopulmonary resuscitation (CPR);
Administer oxygen;
Take and prepare blood samples for laboratory analysis;
Administer injections, vaccines, and medications;
Manage a patient’s airway;
Stop hemorrhaging;
In a healthcare setting, a CMS is trained to:
o Assist a doctor or nurse;
o Prepare patients for surgery;
o Prepare equipment and supplies for surgery;
o Prepare and clean a room after a patient visit; and
o Keep health records and files up-to-date.
48
Army Radiologist Specialist (MOS 68P)
In the Army, radiology is a clinical field where specialists learn to use imaging technology in the
diagnosis and treatment of diseases and injuries. An Army radiologist specialist is very similar to
his or her civilian counterpart and performs medical imaging at military clinics or hospitals.
Education and Training
To become an Army radiologist specialist, a recruit must attend 10 weeks of boot camp, even
though it is a non-combat position, and score a 106 or higher on the Skilled Technical (ST)
portion of the ASVAB. In addition, the recruit must have normal color vision and have had at
least one year of high school algebra. Pregnant women cannot apply for a radiologist specialist
MOS position because of the powerful imaging equipment the Army radiologist specialist
handles and the radiation it emits.
Following boot camp, the recruit will attend AIT METC in Texas where he or she will learn to
operate X-ray imaging and other related equipment such as ultrasound, MRI, and CAT scan
equipment, in order to get images of human body for physicians to utilize in making diagnoses
and planning courses of treatment.
49
Pharmacy Specialist (MOS 68Q)
An Army pharmacy specialist prepares and dispenses prescription medication under the direction
of the pharmacist. A pharmacy specialist also maintains pharmacy supplies and records and
keeps track of inventory. These soldiers must be familiar with pharmacy laws and regulations,
drug types, uses, and how to mix medications.
48
Id.
49
U.S. Army, Careers & Jobs, Search Careers & Jobs, Medical and Emergency, Radiology Specialist (68P), available at
https://www.goarmy.com/careers-and-jobs/browse-career-and-job-categories/medical-and-emergency/radiology-
specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Radiologist Specialist (MOS 68P), available
at https://www.operationmilitarykids.org/army-radiologist-specialist-mos-68p/ (last visited Jan. 13, 2022). BILL: CS/SB 466 Page 12
Qualifications and Training
An Army recruit seeking assignment as an Army pharmacy specialist must receive at least a 95
on the Skilled Technical (ST) portion of the ASVAB test. After completing all entry level
testing, recruits will attend complete 10 weeks of boot camp and then attend AIT at METC in
Texas for 23 weeks, in a program accredited by the American Society of Health System
Pharmacists,
50
which includes practical experience with pharmaceutical tasks, including the use
of robotics and other highly technical equipment to fulfill prescriptions.
The recruit desiring assignment as an Army pharmacy specialist is required to have finger
dexterity in both hands. He or she will work under the direction of a pharmacist and learn to:
Assist in the preparation and dispensing of medications;
Measure, mix and compound medications;
Verify dosages based on patient age, weight and medical status; and
Verify dosage regimen and the quantity prior to releasing medication;
Fill outpatient or inpatient orders in a hospital setting;
Fill pain medication for a released patients, IV bags for inpatients, or syringes for a newborn
babies;
Order medical supplies such as syringes or sterile pads; and
Discuss medications with the patients.
51
Federal Tort Claims Act (FTCA)
The FTCA, dating back to 1946, allows private parties to recover restitution for certain torts
committed by employees or agents of the U.S. government, including military health care
providers. The FTCA gives people the ability to hold the U.S. government responsible for
wrongdoing committed by its employees or agents in the course of their employment. The statute
of limitation for FTCA cases is two years. To prove negligence, the injured party must file a
claim with the appropriate federal agency within two years of the injury or death. The Act also
provides authority for the federal government to defend against such claims.
FTCA cases can involve several areas of personal injury law. The Act applies when someone is
injured in one of the following ways:
Military Base Hospitals Medical Malpractice;
Veterans Affairs (VA) Malpractice;
Military Truck or Vehicular Wreck;
50
The American Society of Hospital Pharmacists (ASHP), About ASHP, Welcome to ASHP available at
https://www.ashp.org/about-ashp?loginreturnUrl=SSOCheckOnly (last visited Jan. 16, 2022). The ASHP was formed on
August 21, 1942. The ASHP is the collective voice of pharmacists who serve as patient care providers in hospitals, health
systems, ambulatory clinics, and other healthcare settings spanning the full spectrum of medication use. The organization’s
more than 60,000 members include pharmacists, student pharmacists, and pharmacy technicians. For 80 years, ASHP has
been at the forefront of efforts to improve medication use and enhance patient safety.
51
U. S. Army, Careers & Jobs, Search Careers & Jobs, Career Match, Science Medicine, Physical Mental Health, Pharmacy
Specialist (68Q), available at https://www.goarmy.com/careers-and-jobs/career-match/science-medicine/physical-mental-
health/68q-pharmacy-specialist.html (last visited Jan. 13, 2022); Operation Military Kids, Army, Army Pharmacy Specialist
(MOS 68Q): Career Details, available at https://www.operationmilitarykids.org/army-pharmacy-specialist-mos-68q/ (last
visited Jan. 13, 2022).
BILL: CS/SB 466 Page 13
Medical Malpractice at a Federally Funded Clinic;
Premises Liability on Federal Property;
Vehicle Accident Involving Federal Employee; and
Personal Injury by Federal Employee.
52
When someone is injured by a federal employee or by federal property, the claimant must bring
his or her lawsuit under the FTCA. Under the FTCA, the laws of the state where the accident
occurred control damages limitations. For example, in Florida, personal injury or medical
malpractice damages arising out of the same incident or occurrence are capped at $200,000 per
occurrence, or $300,000.00 in the aggregate. Punitive damages are prohibited. This is effectively
providing personal injury and, if applicable, medical malpractice insurance to all federal health
care practitioners.
53
Florida’s Department of Health (DOH)
The Legislature created the DOH to protect and promote the health, safety and welfare of all
residents and visitors in the state.
54
The DOH is charged with the regulation of health
practitioners for the preservation of the health, safety, and welfare of the public. The Division of
Medical Quality Assurance (MQA) is responsible for the boards
55
and professions within the
DOH.
56
Health Care Practitioner Regulation
The DOH, Division of MQA, provides health care practitioner regulation and support to health
care licensure boards and councils. Boards are responsible for approving or denying an
applicant’s license based upon:
The applicants qualifications specified in statute;
Reviewing and approving continuing education courses and practitioners;
Promulgating administrative rules authorized by statute;
Determining probable cause in cases resulting from complaints; and
Disciplining practitioners found to be in violation of applicable laws.
The Division of MQA licenses and regulates seven types of health care facilities and more than
200 license types in over 40 professions, while partnering with 22 boards and four councils.
57
52
28 U.S.C. ss. 2671-2680, 2021; The United States Department of Justice, Federal Tort Claims Act Litigation Section,
available at https://www.justice.gov/civil/federal-tort-claims-act-litigation-section (last visited Jan. 10, 2022).
53
Section 768.28, F.S.
54
Sections 20.43 and 456.003, F.S.
55
Under s. 456.001(1), F.S., “board” is defined as any board, commission, or other statutorily created entity, to the extent
such entity is authorized to exercise regulatory or rulemaking functions within the DOH or, in some cases, within the MQA.
56
Section 20.43, F.S.
57
The Department of Health, Senate Bill 466, 2022 Agency Legislative Bill Analysis (Dec. 8, 2021)(on file with the Senate
Committee on Health Policy). BILL: CS/SB 466 Page 14
Health Care Practitioner Scope of Practice
The scope of practice for a regulated health care profession includes those activities and
procedures that a person with a specified level of education, training, and competency is
authorized to perform under the laws and rules of the state in which the person practices. Scope
of practice can also incorporate conditions that may limit the exercise of authorized activities and
procedures.
58
Licensed health care practitioners in Florida may only perform that which is
authorized by the scope of practice for their profession. Individuals who perform functions
outside of their scope of practice are subject to discipline. Individuals who perform tasks that are
specific to a scope of practice identified in Florida Statutes without the required licensure may be
considered to be performing unlicensed activities in violation of law.
59
The Board of Medicine
The Florida Board of Medicine (BOM) functions within the DOH/MQA, and is composed of 15
members appointed by the Governor and confirmed by the Senate. Twelve members of the BOM
must be licensed physicians in good standing who are Florida residents and who have been
actively engaged in the practice or teaching medicine for at least four years immediately
preceding their appointment. Of the members, one must be a full-time faculty member of a
Florida medical school; one must be in private practice; one must be a full-time staff member of
a statutory teaching hospital; and at least one must be a graduate of a foreign medical school. The
remaining three members are consumer members who are residents of the state who have never
been licensed health care practitioners. One member must be a health care risk manager and at
least one member must be 60 years of age or older.
Practice of Medicine
A physician is a person who is licensed to practice medicine in Florida. Practicing medicine
includes the diagnosis, treatment, operation, or prescription for any human disease, pain, injury,
deformity, or other physical or mental condition.
60
58
Federation of State Medical Boards, Assessing Scope of Practice in Health Care Delivery, (Apr., 2005) available at
https://www.fsmb.org/search-results/?s=relevance&n=10&q=definition+of+scope+of+practice (last visited Dec. 8, 2021).
The Federation of State Medical Boards is a national non-profit association whose members include all medical licensing and
disciplinary boards in the United States, and the U.S. territories. The Federation acts as a collective voice for 70 member
medical boards in promoting high standards for medical licensure and practice. The Guidelines recommend that State
regulators and legislators review the following factors when considering scope of practice initiatives in the interest of public
health and patient safety: (1) The existence of a verifiable need for the proposed scope of practice change; (2) Existing scopes
of practice and the effect of requested changes on public health and safety; (3) Formal education and training purported to
support scope of practice changes and the existence of a formal process for accreditation; (4) Existing or proposed regulatory
mechanisms such as licensure, certification and registration; (5) The advisability of allowing independent practice or
requiring collaboration or supervision; (6) The advisability of interaction and cooperation between affected regulatory boards
in evaluating issues that involve multiple practitioners, in investigating complaints, and in recommending appropriate
discipline; (7) The requirements for full and accurate disclosure by all health care practitioners as to their qualifications to
provide health care services; (8) The accountability and liability issues relating to scope of practice changes; (9) The details,
rationale, and ethics of any proposals to bypass licensing or regulatory requirements in allowing scope of practice changes,
the implications for other practitioners, and the effect on patient safety; and (10) The financial impact and incentives related
to and affecting the scope of practice changes.
59
Section 456.072, F.S.
60
Section 458.305, F.S. BILL: CS/SB 466 Page 15
Allopathic standards of practice and standards of care for particular practice settings include, but
are not limited to, education and training, equipment and supplies, medications including
anesthetics, assistance of and delegation to other personnel, transfer agreements, sterilization,
records, performance of complex or multiple procedures, informed consent, and policy and
procedure manuals.
61
The Practice of Nursing
The scope of practice of nursing varies based on the type of education, training, and nursing
licensure held by the health care practitioner.
The Licensed Practical Nurse (LPN)
An LPN may perform selected acts, including:
The administration of treatments and medications, in the care of the ill, injured, or infirm;
The promotion of wellness, maintenance of health, and prevention of illness of others under
the direction of a registered nurse, a licensed physician, a licensed osteopathic physician, a
licensed podiatric physician, or a licensed dentist; and
The teaching of general principles of health and wellness to the public and to students other
than nursing students.
62
LPN Qualifications and Training for Licensure
Licensure for an LPN is in accordance with s. 464.003, F.S., and includes the following
minimum education qualifications and exam requirements, with noted alternative methods to
meet requirements:
Graduation from a Florida approved, or accredited LPN nursing education program as
defined in s. 464.003, F.S.;
Graduation form an Accreditation Commission for Education in Nursing (ACEN) or
Commission on Collegiate Nursing Education (CCNE) accredited LPN nursing program that
has been issued a National Council Licensure Examination (NCLEX) code by the National
Council of State Boards of Nursing (NCSBN);
Graduation from an LPN nursing education program that is approved or recognized by the
jurisdiction in which it is based and that has been issued an NCLEX code by the NCBSN;
Graduation from a military nursing education program that has been issued an NCLEX code
by NCSBN;
Graduation from a non-NCSBN jurisdiction (e.g. Puerto Rico), or international nursing
education program that the Board of Nursing (BON) determines to be equivalent to an
approved program; or
Successful completion of courses in a registered nursing education program that are
equivalent to a practical nursing education program – Practical Nurse Examination based on
practical nursing Equivalency (PNEQ).
61
Section 458.311(1)(c), F.S.
62
Section 464.003(18), F.S. BILL: CS/SB 466 Page 16
An LPN may also qualify for licensure in Florida by meeting endorsement qualifications
(holding a valid license in another state and meeting other minimum qualifications) or by Nurse
Licensure Compact.
All nursing programs requesting BON approval must conform to the Florida Department of
Education curriculum framework. In order to ensure the preparation of nurses capable of
competent practice, the curriculum must: reflect the stated philosophy and objectives of the
program; evidence an organized pattern of instruction consistent with principles of learning and
sound educational practices; provide systematic evaluation of students in both clinical experience
and theoretical instruction; and evidence ongoing program evaluation in relation to the currency
of content, competency of instruction, adequacy of clinical experiences and effectiveness of
graduate performance. The specific minimum requirements for a practical nursing programs are
the following: content must include medical, surgical, obstetrical, pediatric, geriatric, acute care
in long term care and community settings; personal, family, and community health concepts;
nutrition; human growth and development; body structure and function; interpersonal
relationship skills; mental health concepts; pharmacology and medication administration; legal
aspects of nursing; and the curriculum must consist of at least 50% clinical training.
63
The Certified Nursing Assistant (CNA)
A CNA may provide care and assistance to persons with tasks related to the activities of daily
living. These tasks includes personal care, maintaining mobility, nutrition and hydration,
toileting and elimination, assistive devices, safety and cleanliness, data gathering, reporting
abnormal signs and symptoms, postmortem care, patient socialization and reality orientation,
end-of-life care, cardiopulmonary resuscitation and emergency care, residents’ or patients’
rights, documentation of nursing-assistant services. Other tasks may be performed upon
completion of training beyond the minimum qualifications for initial certification and upon
validation of competence in that skill by an RN.
64
CNA Qualifications and Training for Licensure
Qualifications for a CNA are in accordance with s. 464.203, F.S., includes the following
minimum education qualifications and exam requirements, with noted alternative methods to
meet requirements:
Successful completion of an approved training program and achieved a minimum score on
the nursing assistant competency examination. The examination consists of a written portion
and skills-demonstration portion approved by the board and administered at a site and by
personnel approved by the DOH;
Achieve a minimum score, established by rule of the board, on the nursing assistant
competency examination, and has a high school diploma, or its equivalent; or is at least 18
years of age;
Completion of the curriculum developed under the Enterprise Florida Jobs and Education
Partnership Grant and achieved a minimum score on the nursing assistant competency
examination; or
63
Fla. Admin. Code. R. 64B9-2.021 (2021).
64
Section 464.201(5), F.S. BILL: CS/SB 466 Page 17
CNAs may qualify for licensure by endorsement if they are currently certified in another
state or territory of the United States or District of Columbia and successfully complete
criminal history and discipline history requirements.
The CNA Examination must consist of a written exam and a clinical skills test. Both must be
passed within a two-year period in order to achieve certification. Results on either the written or
clinical exams that are over two years old are invalid, and both tests must be repeated. The
general areas of competency of the written exam include: the role of the nursing assistant;
promotion of safety; promotion of function and health of patients; and basic and specific nursing
care for patients with changes in health. For the written exam, the BON accepts a minimum
passing score of 76 percent.
65
The CNA clinical skills exam includes four test areas: personal care, promotion of function,
health and safety; reporting and recording; and hand washing. In each area CNA candidates are
tested on five tasks. The tasks in the three areas, excluding hand washing, are as follows:
Personal Care:
o Perineal care – female;
o Catheter care;
o Dressing;
o Partial bed bath;
o Toileting – bedpan;
o Mouth care – brushing teeth;
o Mouth care – care of dentures;
o Grooming – hair and nail care;
o Feeding;
o Change an occupied bed; and
o Foot care.
Promotion of function, health, and safety:
o Change of position;
o Transfer;
o Range of motion for upper extremity;
o Range of motion for lower extremity; and,
o Ambulation.
Reporting and Recording:
o Measure and record pulse and respirations;
o Measure and record weight;
o Measure and record content of urinary drainage bag; and
o Measure and record blood pressure.
For the Clinical Skills Test, the recommended minimum passing level for each task is three
standard errors of measure below the mean; which will vary depending on the difficulty of the
items selected by the testing service. If an applicant fails to pass the CNA competency
examination in three attempts, the applicant is not eligible for reexamination unless the applicant
completes an approved training program.
66
65
Fla. Admin. Code R. 64B9-15.008 (2021).
66
Id. BILL: CS/SB 466 Page 18
Emergency Medical Services (EMS)
The Legislature created ch. 401, F.S., in 1973 with the intent to establish a statewide organized
and regulated system of regional EMS providers with two major objectives:
To develop a statewide system of emergency medical telecommunications to maximize the
use of existing radio channels to provide faster and more effective EMS to the general
population;
67
and
To protect and enhance the public health, safety, and welfare with the establishment a state
wide EMS plan to:
o Monitor the quality of patient care delivered by each licensed service;
o Certify EMS personnel;
o Create an EMS advisory council;
o Develop a comprehensive statewide injury-prevention program; and
o Development minimum standards for EMS providers, personnel, vehicles, services,
medical direction and inspections.
68
The Legislature further recognized that a major impediment to meeting its two legislative
objectives for s. 401, F.S., was the inability of governmental and private agencies to respond
cooperatively in order to finance a system of regional EMS. In response, the Legislature found it
in the public interest to foster the development of a statewide EMS provider system and created
the Florida Emergency Medical Services Grant Act.
69
This law authorizes the DOH to make
grants to local agencies, EMS organizations, and youth athletic organizations to provide EMS,
including emergency medical dispatch, and work with local EMS organizations to expand the
use of automated external defibrillator (AED) devices.
70
Emergency Medical Service Providers
Every person, firm, corporation, association, or governmental entity owning or acting as agent
for the owner of any business or service which furnishes, operates, conducts, maintains,
advertises, engages in, proposes to engage in, or professes to engage in the business or service of
providing prehospital or interfacility advanced life support (ALS) services or basic life support
(BLS) transportation services must be licensed as a BLS service or an ALS service, or both,
before offering such service to the public.
71
The Emergency Medical Technician (EMT)
An EMT is certified by the DOH to perform BLS techniques.
72
The BLS techniques includes the
treatment of medical emergencies by a certified EMT qualified in the use of techniques of patient
assessment, cardiopulmonary resuscitation (CPR), splinting, obstetrical assistance, bandaging,
administration of oxygen, application of medical anti-shock trousers, administration of a
subcutaneous injection using a premeasured auto-injector of epinephrine for an anaphylactic
67
Section 401.013, F.S.
68
Section 401.211, F.S.
69
See ss. 401.101 and 401.104, F.S.
70
Section 401.111, F.S.
71
Section 401.25(1), F.S.
72
Section 401.23(11), F.S. BILL: CS/SB 466 Page 19
reaction, and other techniques described in the U.S. DOT, EMT Basic Training Course
Curriculum (EMT-BTCC).
73
EMT Qualifications and Training
Qualifications for an EMT are in accordance with s. 401.27, F.S., and include the following
minimum requirements:
Out of state or military applicants trained in accordance with either the 1994 U.S. DOT
EMT-Basic National Standard Curriculum or the January 2009 U.S. DOT National EMS
Education Standards and currently hold a valid EMT certification from the National Registry
of Emergency Medical Technicians (NR-EMT);
Completion of an emergency medical technician training course equivalent to the most recent
emergency medical technician basic training course of the U.S. DOT, within one year after
course completion have passed an examination for an emergency medical technician, hold
either a current American Heart Association cardiopulmonary resuscitation course card or an
American Red Cross cardiopulmonary resuscitation course card or its equivalent.
To be eligible for an EMT certification in Florida, an applicant must:
Submit a completed application;
Submit proof to the Certification Unit of meeting the required professional education in one
of the following ways:
o Florida Trained – Successful completion of EMT course from a DOH approved program
within two years of passing the examination;
o Out-of-State Trained – Submit proof of current NR-EMT certification;
o Florida Paramedic Certification. A Florida certified paramedic may use his or her
paramedic certificate, provided that it is current and in good standing, to satisfy the
professional education requirements for certification as an EMT; or
o If the applicant was initially trained in Florida, received a Florida EMT certification, but
did not maintain the certification, the applicant may apply by Out of State Certification
and submit a copy of one of the following to the Certification Unit:
An American Red Cross CPR for Professional Rescuer card;
An American Heart Association BLS for the Healthcare Provider;
A CPR equivalent certification from an organization approved by the Bureau of EMS pursuant to
Florida Administrative Code Rule 64J-1.022.
74
The Paramedic
A certified paramedic may perform both BLS and ALS.
75
ALS includes the assessment or
treatment by a certified paramedic qualified in the use of techniques such as endotracheal
intubation, the administration of drugs or intravenous fluids, telemetry, cardiac monitoring,
73
Section 401.23(7), F.S.
74
Section 401.25, F.S.; Fla. Admin C. Rule 64J-1.008, (2021); Florida Department of Health, Licensing and Regulation,
EMT and Paramedics, Licensing, Emergency Medical Technicians, available at https://www.floridahealth.gov/licensing-and-
regulation/emt-paramedics/licensing/index.html (last visited Jan. 10. 2022).
75
Section 401.23(17), F.S. BILL: CS/SB 466 Page 20
cardiac defibrillation, and other techniques described in the EMT-Paramedic National Standard
Curriculum or the National EMS Education Standards, pursuant to DOH administrative rules.
76
Any member of the U.S. Armed Forces, on active duty, who at the time he or she became a
member, was in good standing with the DOH, and certified to practice as an EMT or paramedic
in Florida remains in good standing without registering, paying dues or fees, or performing any
other act, as long as he or she is an active duty member of the U.S. Armed Forces, and for a
period of six months after he or she is discharge from active duty.
77
Paramedic Qualifications and Training
Protection of the public is incumbent upon the accurate determination that a health care
professional is qualified to practice the health care profession for which they are seeking
licensure. Florida statutes delineate the minimum qualifications for each license based on the
profession and the associated scope of practice. However, all professions have the same general
categories of requirements for licensure, including:
Minimum educational requirements. This requirement may also encompass an internship
program or residency training.
Successful examination completion. Most health care professions require the successful
completion of a national examination to demonstrate competency.
Criminal history evaluation. All applicants are required to disclose prior criminal history,
professions identified in s. 456.0135, F.S., require electronic fingerprint submission. Certain
criminal activity reflected in the history may preclude licensure.
Disciplinary history evaluation. Disciplinary history evaluation includes all prior licensure in
any profession in any jurisdiction. Certain types of discipline may preclude licensure.
Health history evaluation. Applicants are required to disclose health history, including
evidence of impairment. Boards evaluate the disclosure to determine if the applicant is safe
to practice prior to making a final licensure determination.
To be eligible for a paramedic certification in Florida, an applicant must:
Submit a completed Application;
Possess a high school diploma or GED;
Submit proof to the Certification Unit of meeting the required professional education in one
of the following ways:
o Florida Trained - Successful completion of a paramedic course from an approved
program within two years of passing the examination. If the course was taken more than
two years before you passed the examination it will not be accepted;
o Out of State Certification – An applicant must submit proof of current NR-EMT
certification; or
o Health Professional Licensure – A Florida licensed physician, physician assistant,
dentist, or registered nurse may apply for certification as a paramedic and subsequently
challenge the paramedic exam, provided he or she holds a Florida EMT certificate which
76
Section 401.23(1), F,S.
77
Section 401.2715, F.S. BILL: CS/SB 466 Page 21
is current, in good standing, and has successfully completed an advance cardiac life
support course.
78
The bill provides an effective date of July 1, 2022.
III. Effect of Proposed Changes:
CS/SB 466 authorizes the DOH, in collaboration with FIFV, to establish and administer the
MMACOF program created under the bill. The program is designed to assist veterans and their
spouses in finding pathways toward clinical, leadership, and nonclinical careers in health care or
health care-related fields in Florida if they meet certain requirements.
The bill authorizes the FIFV, to recruit and review the military eligibility of veterans and their
spouses and to assist MTHCVs in applying for the MMACOF Health Care Certification
program, which is designed to assist MTHCVs obtain employment with participating health care
providers, maintain medical skills, address the shortage of health care professionals in the state,
and work toward obtaining appropriate health care registration, certification, or licensure.
The bill defines a “military-trained veteran” as a person who:
Has served within the preceding consecutive 12 months as a medic in the U.S. Army, a
medical technician in the U.S. Air Force, a hospital corpsman in the U.S. Navy, or a health
services technician in the U.S. Coast Guard;
Was discharged or separated from military service under conditions other than dishonorable;
Has received MMACOF Health Care Program Qualified Status from the DOH;
Is enrolled, on at least a half-time basis, in an approved and accredited Florida health care
education and training program specific to the health care field for which the DOH has issued
the MMACOF Health Care Program Qualified Status; and
Has applied for and received approval from the DOH for the MMACOF Health Care
Certification program.
The bill also defines a “participating health care provider” as:
A physician licensed under chs. 458, or 459, F.S.;
A professional corporation or partnership of a licensed physicians licensed under chs. 458 or
459, F.S.;
A hospital licensed under ch. 395, F.S.;
An office registered under ss. 458.328 or 459. 0138, F.S;
A commercial enterprise having medical facilities for its employees which are supervised by
one or more licensed physicians licensed under chs, 458 or 459, F.S.; or
A facility which is licensed under ch. 395, F.S., which offers medical services to the public
and is supervised by one or more licensed physicians licensed under chs. 458 or 459, F.S.
The bill defines “veteran” the same as in s. 1.01(14), F.S., or a former member of the Florida
National Guard.
78
Section 401.25, F.S.; Fla. Admin. C. Rule 64J-1.009, (2021); Florida Department of Health, Licensing and Regulation,
EMT and Paramedics, Licensing, Paramedic, available at https://www.floridahealth.gov/licensing-and-regulation/emt-
paramedics/licensing/index.html (last visited Jan. 10. 2022). BILL: CS/SB 466 Page 22
The bill requires the MMACOF program to consist of three components: the MMACOF Health
Care Certification program, the No Veteran Left Behind component, and the Health Care
Leadership component.
Under the MMACOF Health Care Certification program, the FIFV is authorized to recruit and
review the military eligibility of veterans according to the military requirements for acceptance
into the MMACOF Health Care Certification program and is required to assist each individual
veteran in completing a DOH MMACOF Health Care Certification program application form.
The bill authorizes the FIFV to recruit, establish, and maintain a statewide list of MMACOF
Health Care Certification program participating health care providers. The bill requires a
participating health care provider to agree to employ unlicensed MTHCVs who hold an
MMACOF Health Care Certificate in specific health care fields, who are qualified to perform
specific health care skills under the direct supervision of a licensed health care provider in such
specific field, and who are enrolled on at least a half-time basis in an approved and accredited
Florida health care education and training program for the health care field. The bill also requires
the FIFV to assist MTHCVs who hold an MMACOF Health Care Certificate in identifying
participating health care providers for potential employment, including providing assistance with
résumé writing, application completion, and interviewing skills.
The bill directs the DOH and each DOH board to develop the MMACOF application form, and
the DOH is required to waive the application fee, certificate fee, and unlicensed activity fee for
all such applicants. The bill requires the MMACOF Health Care Certification program
application to include, but not be limited to, the following information:
The individual’s civilian and military education; health care education and training; a list of
practice skills regularly performed in the military during service as a medic in the U.S. Army,
a medical technician in the U.S. Air Force, a hospital corpsman in the U.S. Navy, or a health
services technician in the U.S. Coast Guard; and any other health care-related education or
experience the individual has received as a civilian or active duty service member; and one of
the following:
o A disclosure by the MMACOF Health Care Certification program applicant stating
whether he or she is currently enrolled, on at least a half-time basis, in an approved and
accredited Florida health care education and training program for a specified health care
practice areas and the status of that enrollment; or
o If the MMACOF Health Care Certification program applicant is not currently enrolled in
an approved and accredited Florida health care education and training program, the
applicant’s preference for the health care practice area in which he or she seeks to pursue
future education and training and, if known, which approved and accredited Florida
health care education and training program he or she plans to enter under the MMACOF
Health Care Certification program.
The bill authorizes the BOM to review, in consultation with any other professional board the
BOM deems appropriate, each veteran’s individual MMACOF Health Care Certification
program application and, based on criteria set forth in BOM rule, to determine within 30 days
which of the following health care practice areas the individual veteran is eligible to practice in
under the direct supervision of a health care practitioner, as defined by the specific profession’s BILL: CS/SB 466 Page 23
practice act, while the veteran is enrolled on at least a half-time basis in an approved and
accredited Florida health care education and training program for such practice areas:
Certified nursing assistant;
Dental assistant;
Dental hygienist;
Emergency medical technologist;
Licensed practical nurse;
Laboratory technologist;
Medical assistant;
Optician;
Physician assistant;
Occupational therapy assistant;
Radiologic technologist;
Registered nurse;
Respiratory care or therapy technician;
Paramedic;
Pharmacy technician;
Physical therapist assistant; or
Physical therapist.
The bill requires the BOM to delineate the practice skills that the MTHCV is permitted to
perform under the direct supervision of a licensed health care practitioner in the field in which
the veteran is to practice and further requires that once the BOM has determined that an applicant
has sufficient civilian or military health care education and training in one or more health care
practice areas, the veteran’s application must be given “MMACOF Health Care Program
Qualified” status, and that the veteran must be notified of the status in writing within 14 days.
The bill requires the DOH to also provide the veteran with a list of practice skills the BOM has
determined the veteran has experience to perform under direct supervision when employed by a
participating health care provider after obtaining his or her MMACOF Health Care Certificate.
The notification must include instructions on how the veteran may obtain an MMACOF Health
Care Certificate.
The bill specifies that the BOM’s initial determination of the veteran’s “MMACOF Program
Health Care Qualified” status expires 18 months after its first issuance, unless the veteran applies
for an MMACOF Health Care Certificate before the expiration date.
The bill requires that, to obtain an MMACOF Health Care Certificate, a veteran whose
MMACOF Health Care Certification application is in “MMACOF Program Health Care
Qualified” status must provide to the DOH documentation of his or her enrollment, on at least a
half-time basis, signed by the registrar or similar representative of the approved and accredited
Florida health care education and training program, for his or her approved health care field on a
form or in the manner prescribed by DOH rule. Upon receipt by the DOH of the veteran’s proof
of at least half-time enrollment in an approved and accredited Florida health care education and
training program for the health care field for which the veteran is “MMACOF Program Health
Care Qualified,” the DOH may issue to the veteran an MMACOF Health Care Certificate that BILL: CS/SB 466 Page 24
qualifies the unlicensed veteran for employment with a participating health care provider in a
position matching the health care field listed above on the veteran’s MMACOF Health Care
Certificate.
The bill specifies that the veteran’s MMACOF Health Care Certificate is valid for the length of
time the veteran remains actively enrolled on at least a half-time basis in an approved and
accredited Florida health care education and training program, and he or she may continue to
practice the skills approved by the BOM in a participating civilian health care provider setting
while enrolled on at least a one-half time basis in an accredited and approved Florida health care
educational and training program or accredited nursing program.
The bill authorizes the DOH to provide by rule a method for annual renewal of MTHCVs’
MMACOF Program Health Care Certifications.
The bill requires a MMACOF Health Care Certificate holder to provide the DOH and FIFV the
following information within 10 days after civilian employment under his or her MMACOF
Health Care Certificate with a participating health care provider:
The name, address, and telephone number of the participating health care provider that
employs the MTHCV; and
The name and phone number of a contact health care provider who is responsible for
supervising the MTHCV and who has a copy of the list of practice skills for which the BOM
has determined the MTHCV has sufficient experience to perform under supervision with his
or her MMACOF Health Care Certificate.
The bill requires an MMACOF Health Care Certificate holder to notify the DOH and FIFV in
writing within 10 days of the MTHCV’s employment termination with his or her participating
health care provider, or if the MTHCV fails to remain in or maintain active enrollment, on at
least a half-time basis, in an approved and accredited Florida health care education and training
program.
The bill mandates that a participating health care provider that employs a MTHCV notify the
DOH and FIFV in writing within 10 days of the termination, including the reasons for the
termination.
The bill requires an approved and accredited Florida health care education and training program
that has enrolled a MTHCV who holds a MMACOF Health Care Certificate and who is
employed by a participating health care provider, to notify the DOH and FIFV in writing within
10 days after:
The termination of the MTHCV’s enrollment from the approved and accredited Florida
health care education and training program for any reason, and to include in the notice the
reason(s) for termination;
The MTHCV’s enrollment drops below a half-time basis; or
The MTHCV’s class absences are of sufficient number to cause the MTHCV to drop or fail
classes, dropping his or her enrollment to less than a half-time basis.
The bill specifies 19 separate grounds for the denial of an MMACOF Health Care Certificate or
disciplinary action against a MMACOF Health Care Certification program applicate or BILL: CS/SB 466 Page 25
Certificate holder and specifies that either the DOH or the BOM may enter an order denying
certification or imposing penalties under ch. 456, F.S., against any certificate applicant.
The bill does not authorize the DOH or the BOM to issue or reinstate a MTHCV’s MMACOF
Health Care Certificate to any MTHCV it has deemed unqualified until such time as the DOH or
the BOM is satisfied that the MTHCV has complied with the terms and conditions of the final
order and that the certificate holder can safely practice as a MTHCV.
The bill authorizes the BOM to establish by rule guidelines for the disposition of disciplinary
cases involving specific violations. The guidelines may include minimum and maximum fines,
periods of supervision on probation, or conditions upon probation or reissuance of a MTHCV’s
MMACOF Health Care Certificate.
The No Veteran Left Behind component requires the MMACOF program to provide assistance to
veterans who do not meet the definition of the “medically trained veteran” but who have served
in health care-related specialties, in résumé writing, mentorship, and obtaining employment with
participating health care providers.
The Health Care Leadership component requires the MMACOF program to assist veterans who,
in the course of their military service, have gained management experience or completed
advanced degrees, to find civilian health care leadership and management employment in a
variety of health care disciplines.
The bill authorizes the DOH and the BOM to adopt rules pursuant to ss. 120.536(1) and 120.54,
F.S., to implement s. 295.126, F.S.
The bill amends s. 295.21, F.S., to authorize the creation of a subprogram dedicated to health
care services employment under the Veterans Employment and Training Services Program. The
bill provides that the purpose of the health care service subprogram is to link veterans who have
armed service health care training and are seeking employment in health care fields to health
care organizations wishing to hire dedicated, well-trained workers. The program is to meet the
health care workforce demands of this state by facilitating access to training and education in
health fields for veterans and to promote the health care licensing programs provided by the
state.
The bill provides an effect date of July 1, 2022.
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None. BILL: CS/SB 466 Page 26
C. Trust Funds Restrictions:
None.
D. State Tax or Fee Increases:
None.
E. Other Constitutional Issues:
None.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
The bill, in part, is designed to address the shortage of health care professionals in this
state, but the impact is indeterminate at this time.
C. Government Sector Impact:
According to the DOH, the MQA may experience a recurring increase in workload and
cost associated with the collaboration with the FIFV for the MMACOF program. The bill
does not specify the roles that the MQA will contribute; therefore, the fiscal impact is
indeterminate.
79
VI. Technical Deficiencies:
None.
VII. Related Issues:
The bill defines eligible veterans to be “medically-trained” as a medic in the U.S. Army, a
medical technician in the U. S. Air Force, or a hospital corpsman in the U.S. Navy or the U.S.
Coast Guard. The actual military titles for those individuals are the Army Combat Medic
Specialist (CMS), Navy Hospital Corpsman (HM), Air Force Aerospace Medical Service
Technician (AMST), and Coast Guard Health Service Technician (HS).
The bill excludes from the program the U.S. Marine Corp, which uses Navy trained HMs who
are Marines, and the Space Force, which currently uses Aerospace Medical Service Technicians
(AMST) trained by the Air Force, even though they are in the Space Force.
79
Florida Department of Health, 2022 Legislative Analysis of SB 466, dated October 21, 2021 (on file with the Senate
Committee on Health Policy). BILL: CS/SB 466 Page 27
The bill also does not provide any legislative direction to the DOH to address the following
issues:
Adverse incident reporting; and
Professional liability insurance.
VIII. Statutes Affected:
This bill creates section 295.126 of the Florida Statutes.
The bill amends section 295.21 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
CS by Health Policy on January 13, 2022:
The CS:
Authorizes the DOH to establish and administer the MMACOF program, in
collaboration with the FIFV, instead of the FDVA establishing and administering the
program;
Applies to military veterans and their spouses, not just military veterans;
Requires the DOH to waive certain fees for MMACOF program applicants;
Provides application requirements;
Requires disclosure of specific information by an applicant;
Requires the participating health care providers to agree to specified terms;
Requires a specific application process;
Requires the BOM, and any other boards it deems appropriate, to determine the areas
in which a veteran is eligible to practice and to specify what skills the veterans may
perform under direct supervision;
Requires the certificate holder, DOH, FIFV, participating health care providers, and
certain education and training programs to provide specific information to each other
within specified time periods regarding employment status and the status of the
veteran’s enrollment on at least a half-time basis in an approved and accredited
Florida health care education and training program;
Authorizes grounds for denial of an MMACOF Health Care Certificate or
disciplinary action against a certificate holder;
Authorizes both the DOH or the BOM to issue disciplinary orders;
Authorizes the DOH to make rules for certificate renewal; the BOM to make rules to
establish guidelines for the disposition of disciplinary cases; and the DOH and the
BOM to make rules to implement s. 295.126, F.S.; and
Amends s. 295.21, F.S. to authorize the creation of a subprogram dedicated to health
care services employment,
B. Amendments:
None. BILL: CS/SB 466 Page 28
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.