Florida Senate Bill S0768 Comm Sub / Bill

 Florida Senate - 2022 CS for SB 768  By the Committee on Health Policy; and Senator Rodriguez 588-02346-22 2022768c1 1 A bill to be entitled 2 An act relating to the Department of Health; amending 3 s. 381.0045, F.S.; revising the purpose of the 4 departments targeted outreach program for certain 5 pregnant women; requiring the department to encourage 6 high-risk pregnant women of unknown status to be 7 tested for sexually transmissible diseases; requiring 8 the department to provide specified information to 9 pregnant women who have human immunodeficiency virus 10 (HIV); requiring the department to link women with 11 mental health services when available; requiring the 12 department to educate pregnant women who have HIV on 13 certain information; requiring the department to 14 provide, for a specified purpose, continued oversight 15 of newborns exposed to HIV; amending s. 381.0303, 16 F.S.; removing the Childrens Medical Services office 17 from parties required to coordinate in the development 18 of local emergency management plans for special needs 19 shelters; amending s. 381.986, F.S.; authorizing the 20 department to select samples of marijuana from medical 21 marijuana treatment center facilities for certain 22 testing; authorizing the department to select samples 23 of marijuana delivery devices from medical marijuana 24 treatment centers to determine whether such devices 25 are safe for use; requiring medical marijuana 26 treatment centers to recall marijuana and marijuana 27 delivery devices, instead of just edibles, under 28 certain circumstances; exempting the department and 29 its employees from criminal provisions if they 30 acquire, possess, test, transport, or lawfully dispose 31 of marijuana and marijuana delivery devices under 32 certain circumstances; amending s. 456.039, F.S.; 33 requiring certain applicants for licensure as 34 physicians to provide specified documentation to the 35 department at the time of application; amending s. 36 460.406, F.S.; revising provisions related to 37 chiropractic physician licensing; amending s. 464.008, 38 F.S.; deleting a requirement that certain nursing 39 program graduates complete a specified preparatory 40 course; amending s. 464.018, F.S.; revising grounds 41 for disciplinary action against licensed nurses; 42 amending s. 467.003, F.S.; revising and defining 43 terms; amending s. 467.009, F.S.; revising provisions 44 related to accredited and approved midwifery programs; 45 amending s. 467.011, F.S.; revising requirements for 46 licensure of midwives; amending s. 467.0125, F.S.; 47 revising requirements for licensure by endorsement of 48 midwives; revising requirements for temporary 49 certificates to practice midwifery in this state; 50 amending s. 467.205, F.S.; revising provisions 51 relating to approval, continued monitoring, 52 probationary status, provisional approval, and 53 approval rescission of midwifery programs; amending s. 54 468.803, F.S.; revising provisions related to 55 orthotist and prosthetist registration, examination, 56 and licensing; amending s. 483.824, F.S.; revising 57 educational requirements for clinical laboratory 58 directors; amending s. 490.003, F.S.; defining the 59 terms doctoral degree from an American Psychological 60 Association accredited program and doctoral degree 61 in psychology; amending ss. 490.005 and 490.0051, 62 F.S.; revising education requirements for psychologist 63 licensure and provisional licensure, respectively; 64 amending s. 491.005, F.S.; revising requirements for 65 licensure of clinical social workers, marriage and 66 family therapists, and mental health counselors; 67 amending s. 766.314, F.S.; deleting obsolete language 68 and updating provisions to conform to current law; 69 revising the frequency with which the department must 70 submit certain reports to the Florida Birth-Related 71 Neurological Injury Compensation Association; revising 72 the content of such reports; authorizing the 73 association to enforce the collection of certain 74 assessments in circuit court under certain 75 circumstances; requiring the association to notify the 76 department and the applicable regulatory board of any 77 unpaid final judgment against a physician within a 78 specified timeframe; providing effective dates. 79 80 Be It Enacted by the Legislature of the State of Florida: 81 82 Section 1.Subsections (2) and (3) of section 381.0045, 83 Florida Statutes, are amended to read: 84 381.0045Targeted outreach for pregnant women. 85 (2)It is the purpose of this section to establish a 86 targeted outreach program for high-risk pregnant women who may 87 not seek proper prenatal care, who suffer from substance abuse 88 or mental health problems, or who have acquired are infected 89 with human immunodeficiency virus (HIV), and to provide these 90 women with links to much-needed much needed services and 91 information. 92 (3)The department shall: 93 (a)Conduct outreach programs through contracts with, 94 grants to, or other working relationships with persons or 95 entities where the target population is likely to be found. 96 (b)Provide outreach that is peer-based, culturally 97 sensitive, and performed in a nonjudgmental manner. 98 (c)Encourage high-risk pregnant women of unknown status to 99 be tested for HIV and other sexually transmissible diseases as 100 specified by department rule. 101 (d)Educate women not receiving prenatal care as to the 102 benefits of such care. 103 (e)Provide HIV-infected pregnant women who have HIV with 104 information on the need for antiretroviral medication for their 105 newborn, their medication options, and how they can access the 106 medication after their discharge from the hospital so they can 107 make an informed decision about the use of Zidovudine (AZT). 108 (f)Link women with substance abuse treatment and mental 109 health services, when available, and act as a liaison with 110 Healthy Start coalitions, childrens medical services, Ryan 111 White-funded providers, and other services of the Department of 112 Health. 113 (g)Educate pregnant women who have HIV on the importance 114 of engaging in and continuing HIV care. 115 (h)Provide continued oversight of any newborn exposed to 116 HIV to determine the newborns final HIV status and ensure 117 continued linkage to care if the newborn is diagnosed with HIV 118 to HIV-exposed newborns. 119 Section 2.Paragraphs (a) and (c) of subsection (2) of 120 section 381.0303, Florida Statutes, are amended to read: 121 381.0303Special needs shelters. 122 (2)SPECIAL NEEDS SHELTER PLAN; STAFFING; STATE AGENCY 123 ASSISTANCE.If funds have been appropriated to support disaster 124 coordinator positions in county health departments: 125 (a)The department shall assume lead responsibility for the 126 coordination of local medical and health care providers, the 127 American Red Cross, and other interested parties in developing a 128 plan for the staffing and medical management of special needs 129 shelters and. The local Childrens Medical Services offices 130 shall assume lead responsibility for the coordination of local 131 medical and health care providers, the American Red Cross, and 132 other interested parties in developing a plan for the staffing 133 and medical management of pediatric special needs shelters. 134 Plans must conform to the local comprehensive emergency 135 management plan. 136 (c)The appropriate county health department, Childrens 137 Medical Services office, and local emergency management agency 138 shall jointly decide who has responsibility for medical 139 supervision in each special needs shelter. 140 Section 3.Present paragraphs (e) through (h) of subsection 141 (14) of section 381.986, Florida Statutes, are redesignated as 142 paragraphs (f) through (i), respectively, a new paragraph (e) is 143 added to that subsection, and paragraph (e) of subsection (8) of 144 that section is amended, to read: 145 381.986Medical use of marijuana. 146 (8)MEDICAL MARIJUANA TREATMENT CENTERS. 147 (e)A licensed medical marijuana treatment center shall 148 cultivate, process, transport, and dispense marijuana for 149 medical use. A licensed medical marijuana treatment center may 150 not contract for services directly related to the cultivation, 151 processing, and dispensing of marijuana or marijuana delivery 152 devices, except that a medical marijuana treatment center 153 licensed pursuant to subparagraph (a)1. may contract with a 154 single entity for the cultivation, processing, transporting, and 155 dispensing of marijuana and marijuana delivery devices. A 156 licensed medical marijuana treatment center must, at all times, 157 maintain compliance with the criteria demonstrated and 158 representations made in the initial application and the criteria 159 established in this subsection. Upon request, the department may 160 grant a medical marijuana treatment center a variance from the 161 representations made in the initial application. Consideration 162 of such a request shall be based upon the individual facts and 163 circumstances surrounding the request. A variance may not be 164 granted unless the requesting medical marijuana treatment center 165 can demonstrate to the department that it has a proposed 166 alternative to the specific representation made in its 167 application which fulfills the same or a similar purpose as the 168 specific representation in a way that the department can 169 reasonably determine will not be a lower standard than the 170 specific representation in the application. A variance may not 171 be granted from the requirements in subparagraph 2. and 172 subparagraphs (b)1. and 2. 173 1.A licensed medical marijuana treatment center may 174 transfer ownership to an individual or entity who meets the 175 requirements of this section. A publicly traded corporation or 176 publicly traded company that meets the requirements of this 177 section is not precluded from ownership of a medical marijuana 178 treatment center. To accommodate a change in ownership: 179 a.The licensed medical marijuana treatment center shall 180 notify the department in writing at least 60 days before the 181 anticipated date of the change of ownership. 182 b.The individual or entity applying for initial licensure 183 due to a change of ownership must submit an application that 184 must be received by the department at least 60 days before the 185 date of change of ownership. 186 c.Upon receipt of an application for a license, the 187 department shall examine the application and, within 30 days 188 after receipt, notify the applicant in writing of any apparent 189 errors or omissions and request any additional information 190 required. 191 d.Requested information omitted from an application for 192 licensure must be filed with the department within 21 days after 193 the departments request for omitted information or the 194 application shall be deemed incomplete and shall be withdrawn 195 from further consideration and the fees shall be forfeited. 196 e.Within 30 days after the receipt of a complete 197 application, the department shall approve or deny the 198 application. 199 2.A medical marijuana treatment center, and any individual 200 or entity who directly or indirectly owns, controls, or holds 201 with power to vote 5 percent or more of the voting shares of a 202 medical marijuana treatment center, may not acquire direct or 203 indirect ownership or control of any voting shares or other form 204 of ownership of any other medical marijuana treatment center. 205 3.A medical marijuana treatment center may not enter into 206 any form of profit-sharing arrangement with the property owner 207 or lessor of any of its facilities where cultivation, 208 processing, storing, or dispensing of marijuana and marijuana 209 delivery devices occurs. 210 4.All employees of a medical marijuana treatment center 211 must be 21 years of age or older and have passed a background 212 screening pursuant to subsection (9). 213 5.Each medical marijuana treatment center must adopt and 214 enforce policies and procedures to ensure employees and 215 volunteers receive training on the legal requirements to 216 dispense marijuana to qualified patients. 217 6.When growing marijuana, a medical marijuana treatment 218 center: 219 a.May use pesticides determined by the department, after 220 consultation with the Department of Agriculture and Consumer 221 Services, to be safely applied to plants intended for human 222 consumption, but may not use pesticides designated as 223 restricted-use pesticides pursuant to s. 487.042. 224 b.Must grow marijuana within an enclosed structure and in 225 a room separate from any other plant. 226 c.Must inspect seeds and growing plants for plant pests 227 that endanger or threaten the horticultural and agricultural 228 interests of the state in accordance with chapter 581 and any 229 rules adopted thereunder. 230 d.Must perform fumigation or treatment of plants, or 231 remove and destroy infested or infected plants, in accordance 232 with chapter 581 and any rules adopted thereunder. 233 7.Each medical marijuana treatment center must produce and 234 make available for purchase at least one low-THC cannabis 235 product. 236 8.A medical marijuana treatment center that produces 237 edibles must hold a permit to operate as a food establishment 238 pursuant to chapter 500, the Florida Food Safety Act, and must 239 comply with all the requirements for food establishments 240 pursuant to chapter 500 and any rules adopted thereunder. 241 Edibles may not contain more than 200 milligrams of 242 tetrahydrocannabinol, and a single serving portion of an edible 243 may not exceed 10 milligrams of tetrahydrocannabinol. Edibles 244 may have a potency variance of no greater than 15 percent. 245 Edibles may not be attractive to children; be manufactured in 246 the shape of humans, cartoons, or animals; be manufactured in a 247 form that bears any reasonable resemblance to products available 248 for consumption as commercially available candy; or contain any 249 color additives. To discourage consumption of edibles by 250 children, the department shall determine by rule any shapes, 251 forms, and ingredients allowed and prohibited for edibles. 252 Medical marijuana treatment centers may not begin processing or 253 dispensing edibles until after the effective date of the rule. 254 The department shall also adopt sanitation rules providing the 255 standards and requirements for the storage, display, or 256 dispensing of edibles. 257 9.Within 12 months after licensure, a medical marijuana 258 treatment center must demonstrate to the department that all of 259 its processing facilities have passed a Food Safety Good 260 Manufacturing Practices, such as Global Food Safety Initiative 261 or equivalent, inspection by a nationally accredited certifying 262 body. A medical marijuana treatment center must immediately stop 263 processing at any facility which fails to pass this inspection 264 until it demonstrates to the department that such facility has 265 met this requirement. 266 10.A medical marijuana treatment center that produces 267 prerolled marijuana cigarettes may not use wrapping paper made 268 with tobacco or hemp. 269 11.When processing marijuana, a medical marijuana 270 treatment center must: 271 a.Process the marijuana within an enclosed structure and 272 in a room separate from other plants or products. 273 b.Comply with department rules when processing marijuana 274 with hydrocarbon solvents or other solvents or gases exhibiting 275 potential toxicity to humans. The department shall determine by 276 rule the requirements for medical marijuana treatment centers to 277 use such solvents or gases exhibiting potential toxicity to 278 humans. 279 c.Comply with federal and state laws and regulations and 280 department rules for solid and liquid wastes. The department 281 shall determine by rule procedures for the storage, handling, 282 transportation, management, and disposal of solid and liquid 283 waste generated during marijuana production and processing. The 284 Department of Environmental Protection shall assist the 285 department in developing such rules. 286 d.Test the processed marijuana using a medical marijuana 287 testing laboratory before it is dispensed. Results must be 288 verified and signed by two medical marijuana treatment center 289 employees. Before dispensing, the medical marijuana treatment 290 center must determine that the test results indicate that low 291 THC cannabis meets the definition of low-THC cannabis, the 292 concentration of tetrahydrocannabinol meets the potency 293 requirements of this section, the labeling of the concentration 294 of tetrahydrocannabinol and cannabidiol is accurate, and all 295 marijuana is safe for human consumption and free from 296 contaminants that are unsafe for human consumption. The 297 department shall determine by rule which contaminants must be 298 tested for and the maximum levels of each contaminant which are 299 safe for human consumption. The Department of Agriculture and 300 Consumer Services shall assist the department in developing the 301 testing requirements for contaminants that are unsafe for human 302 consumption in edibles. The department shall also determine by 303 rule the procedures for the treatment of marijuana that fails to 304 meet the testing requirements of this section, s. 381.988, or 305 department rule. The department may select samples of marijuana 306 a random sample from edibles available for purchase in a medical 307 marijuana treatment center dispensing facility which shall be 308 tested by the department to determine whether that the marijuana 309 edible meets the potency requirements of this section, is safe 310 for human consumption, and is accurately labeled with the 311 labeling of the tetrahydrocannabinol and cannabidiol 312 concentration or to verify the result of marijuana testing 313 conducted by a marijuana testing laboratory. The department may 314 also select samples of marijuana delivery devices from a medical 315 marijuana treatment center to determine whether the marijuana 316 delivery device is safe for use by qualified patients is 317 accurate. A medical marijuana treatment center may not require 318 payment from the department for the sample. A medical marijuana 319 treatment center must recall marijuana edibles, including all 320 marijuana and marijuana products edibles made from the same 321 batch of marijuana, that fails which fail to meet the potency 322 requirements of this section, that is which are unsafe for human 323 consumption, or for which the labeling of the 324 tetrahydrocannabinol and cannabidiol concentration is 325 inaccurate. A medical marijuana treatment center must also 326 recall all marijuana delivery devices determined to be unsafe 327 for use by qualified patients. The medical marijuana treatment 328 center must retain records of all testing and samples of each 329 homogenous batch of marijuana for at least 9 months. The medical 330 marijuana treatment center must contract with a marijuana 331 testing laboratory to perform audits on the medical marijuana 332 treatment centers standard operating procedures, testing 333 records, and samples and provide the results to the department 334 to confirm that the marijuana or low-THC cannabis meets the 335 requirements of this section and that the marijuana or low-THC 336 cannabis is safe for human consumption. A medical marijuana 337 treatment center shall reserve two processed samples from each 338 batch and retain such samples for at least 9 months for the 339 purpose of such audits. A medical marijuana treatment center may 340 use a laboratory that has not been certified by the department 341 under s. 381.988 until such time as at least one laboratory 342 holds the required certification, but in no event later than 343 July 1, 2018. 344 e.Package the marijuana in compliance with the United 345 States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss. 346 1471 et seq. 347 f.Package the marijuana in a receptacle that has a firmly 348 affixed and legible label stating the following information: 349 (I)The marijuana or low-THC cannabis meets the 350 requirements of sub-subparagraph d. 351 (II)The name of the medical marijuana treatment center 352 from which the marijuana originates. 353 (III)The batch number and harvest number from which the 354 marijuana originates and the date dispensed. 355 (IV)The name of the physician who issued the physician 356 certification. 357 (V)The name of the patient. 358 (VI)The product name, if applicable, and dosage form, 359 including concentration of tetrahydrocannabinol and cannabidiol. 360 The product name may not contain wording commonly associated 361 with products marketed by or to children. 362 (VII)The recommended dose. 363 (VIII)A warning that it is illegal to transfer medical 364 marijuana to another person. 365 (IX)A marijuana universal symbol developed by the 366 department. 367 12.The medical marijuana treatment center shall include in 368 each package a patient package insert with information on the 369 specific product dispensed related to: 370 a.Clinical pharmacology. 371 b.Indications and use. 372 c.Dosage and administration. 373 d.Dosage forms and strengths. 374 e.Contraindications. 375 f.Warnings and precautions. 376 g.Adverse reactions. 377 13.In addition to the packaging and labeling requirements 378 specified in subparagraphs 11. and 12., marijuana in a form for 379 smoking must be packaged in a sealed receptacle with a legible 380 and prominent warning to keep away from children and a warning 381 that states marijuana smoke contains carcinogens and may 382 negatively affect health. Such receptacles for marijuana in a 383 form for smoking must be plain, opaque, and white without 384 depictions of the product or images other than the medical 385 marijuana treatment centers department-approved logo and the 386 marijuana universal symbol. 387 14.The department shall adopt rules to regulate the types, 388 appearance, and labeling of marijuana delivery devices dispensed 389 from a medical marijuana treatment center. The rules must 390 require marijuana delivery devices to have an appearance 391 consistent with medical use. 392 15.Each edible shall be individually sealed in plain, 393 opaque wrapping marked only with the marijuana universal symbol. 394 Where practical, each edible shall be marked with the marijuana 395 universal symbol. In addition to the packaging and labeling 396 requirements in subparagraphs 11. and 12., edible receptacles 397 must be plain, opaque, and white without depictions of the 398 product or images other than the medical marijuana treatment 399 centers department-approved logo and the marijuana universal 400 symbol. The receptacle must also include a list of all the 401 edibles ingredients, storage instructions, an expiration date, 402 a legible and prominent warning to keep away from children and 403 pets, and a warning that the edible has not been produced or 404 inspected pursuant to federal food safety laws. 405 16.When dispensing marijuana or a marijuana delivery 406 device, a medical marijuana treatment center: 407 a.May dispense any active, valid order for low-THC 408 cannabis, medical cannabis and cannabis delivery devices issued 409 pursuant to former s. 381.986, Florida Statutes 2016, which was 410 entered into the medical marijuana use registry before July 1, 411 2017. 412 b.May not dispense more than a 70-day supply of marijuana 413 within any 70-day period to a qualified patient or caregiver. 414 May not dispense more than one 35-day supply of marijuana in a 415 form for smoking within any 35-day period to a qualified patient 416 or caregiver. A 35-day supply of marijuana in a form for smoking 417 may not exceed 2.5 ounces unless an exception to this amount is 418 approved by the department pursuant to paragraph (4)(f). 419 c.Must have the medical marijuana treatment centers 420 employee who dispenses the marijuana or a marijuana delivery 421 device enter into the medical marijuana use registry his or her 422 name or unique employee identifier. 423 d.Must verify that the qualified patient and the 424 caregiver, if applicable, each have an active registration in 425 the medical marijuana use registry and an active and valid 426 medical marijuana use registry identification card, the amount 427 and type of marijuana dispensed matches the physician 428 certification in the medical marijuana use registry for that 429 qualified patient, and the physician certification has not 430 already been filled. 431 e.May not dispense marijuana to a qualified patient who is 432 younger than 18 years of age. If the qualified patient is 433 younger than 18 years of age, marijuana may only be dispensed to 434 the qualified patients caregiver. 435 f.May not dispense or sell any other type of cannabis, 436 alcohol, or illicit drug-related product, including pipes or 437 wrapping papers made with tobacco or hemp, other than a 438 marijuana delivery device required for the medical use of 439 marijuana and which is specified in a physician certification. 440 g.Must, upon dispensing the marijuana or marijuana 441 delivery device, record in the registry the date, time, 442 quantity, and form of marijuana dispensed; the type of marijuana 443 delivery device dispensed; and the name and medical marijuana 444 use registry identification number of the qualified patient or 445 caregiver to whom the marijuana delivery device was dispensed. 446 h.Must ensure that patient records are not visible to 447 anyone other than the qualified patient, his or her caregiver, 448 and authorized medical marijuana treatment center employees. 449 (14)EXCEPTIONS TO OTHER LAWS. 450 (e)Notwithstanding s. 893.13, s. 893.135, s. 893.147, or 451 any other law, but subject to the requirements of this section, 452 the department, including an employee of the department acting 453 within the scope of his or her employment, may acquire, possess, 454 test, transport, and lawfully dispose of marijuana and marijuana 455 delivery devices as provided in this section, in s. 381.988, and 456 by department rule. 457 Section 4.Subsection (1) of section 456.039, Florida 458 Statutes, is amended to read: 459 456.039Designated health care professionals; information 460 required for licensure. 461 (1)Each person who applies for initial licensure or 462 license renewal as a physician under chapter 458, chapter 459, 463 chapter 460, or chapter 461, except a person applying for 464 registration pursuant to ss. 458.345 and 459.021, must furnish 465 the following information to the department, at the time of 466 application or, and each physician who applies for license 467 renewal under chapter 458, chapter 459, chapter 460, or chapter 468 461, except a person registered pursuant to ss. 458.345 and 469 459.021, must, in conjunction with the renewal of such license 470 and under procedures adopted by the department of Health, and in 471 addition to any other information that may be required from the 472 applicant, furnish the following information to the Department 473 of Health: 474 (a)1.The name of each medical school that the applicant 475 has attended, with the dates of attendance and the date of 476 graduation, and a description of all graduate medical education 477 completed by the applicant, excluding any coursework taken to 478 satisfy medical licensure continuing education requirements. 479 2.The name of each hospital at which the applicant has 480 privileges. 481 3.The address at which the applicant will primarily 482 conduct his or her practice. 483 4.Any certification that the applicant has received from a 484 specialty board that is recognized by the board to which the 485 applicant is applying. 486 5.The year that the applicant began practicing medicine. 487 6.Any appointment to the faculty of a medical school which 488 the applicant currently holds and an indication as to whether 489 the applicant has had the responsibility for graduate medical 490 education within the most recent 10 years. 491 7.A description of any criminal offense of which the 492 applicant has been found guilty, regardless of whether 493 adjudication of guilt was withheld, or to which the applicant 494 has pled guilty or nolo contendere. A criminal offense committed 495 in another jurisdiction which would have been a felony or 496 misdemeanor if committed in this state must be reported. If the 497 applicant indicates that a criminal offense is under appeal and 498 submits a copy of the notice for appeal of that criminal 499 offense, the department must state that the criminal offense is 500 under appeal if the criminal offense is reported in the 501 applicants profile. If the applicant indicates to the 502 department that a criminal offense is under appeal, the 503 applicant must, upon disposition of the appeal, submit to the 504 department a copy of the final written order of disposition. 505 8.A description of any final disciplinary action taken 506 within the previous 10 years against the applicant by the agency 507 regulating the profession that the applicant is or has been 508 licensed to practice, whether in this state or in any other 509 jurisdiction, by a specialty board that is recognized by the 510 American Board of Medical Specialties, the American Osteopathic 511 Association, or a similar national organization, or by a 512 licensed hospital, health maintenance organization, prepaid 513 health clinic, ambulatory surgical center, or nursing home. 514 Disciplinary action includes resignation from or nonrenewal of 515 medical staff membership or the restriction of privileges at a 516 licensed hospital, health maintenance organization, prepaid 517 health clinic, ambulatory surgical center, or nursing home taken 518 in lieu of or in settlement of a pending disciplinary case 519 related to competence or character. If the applicant indicates 520 that the disciplinary action is under appeal and submits a copy 521 of the document initiating an appeal of the disciplinary action, 522 the department must state that the disciplinary action is under 523 appeal if the disciplinary action is reported in the applicants 524 profile. 525 9.Relevant professional qualifications as defined by the 526 applicable board. 527 (b)In addition to the information required under paragraph 528 (a), for each applicant seeking who seeks licensure under 529 chapter 458, chapter 459, or chapter 461, and who has practiced 530 previously in this state or in another jurisdiction or a foreign 531 country, must provide the information required of licensees 532 under those chapters pursuant to s. 456.049. An applicant for 533 licensure under chapter 460 who has practiced previously in this 534 state or in another jurisdiction or a foreign country must 535 provide the same information as is required of licensees under 536 chapter 458, pursuant to s. 456.049. 537 (c)For each applicant seeking licensure under chapter 458 538 or chapter 459, proof of payment of the assessment required 539 under s. 766.314, if applicable. 540 Section 5.Subsection (1) of section 460.406, Florida 541 Statutes, is amended to read: 542 460.406Licensure by examination. 543 (1)Any person desiring to be licensed as a chiropractic 544 physician must apply to the department to take the licensure 545 examination. There shall be an application fee set by the board 546 not to exceed $100 which shall be nonrefundable. There shall 547 also be an examination fee not to exceed $500 plus the actual 548 per applicant cost to the department for purchase of portions of 549 the examination from the National Board of Chiropractic 550 Examiners or a similar national organization, which may be 551 refundable if the applicant is found ineligible to take the 552 examination. The department shall examine each applicant whom 553 who the board certifies has met all of the following criteria: 554 (a)Completed the application form and remitted the 555 appropriate fee. 556 (b)Submitted proof satisfactory to the department that he 557 or she is not less than 18 years of age. 558 (c)Submitted proof satisfactory to the department that he 559 or she is a graduate of a chiropractic college which is 560 accredited by or has status with the Council on Chiropractic 561 Education or its predecessor agency. However, any applicant who 562 is a graduate of a chiropractic college that was initially 563 accredited by the Council on Chiropractic Education in 1995, who 564 graduated from such college within the 4 years immediately 565 preceding such accreditation, and who is otherwise qualified is 566 shall be eligible to take the examination. An No application for 567 a license to practice chiropractic medicine may not shall be 568 denied solely because the applicant is a graduate of a 569 chiropractic college that subscribes to one philosophy of 570 chiropractic medicine as distinguished from another. 571 (d)1.For an applicant who has matriculated in a 572 chiropractic college before prior to July 2, 1990, completed at 573 least 2 years of residence college work, consisting of a minimum 574 of one-half the work acceptable for a bachelors degree granted 575 on the basis of a 4-year period of study, in a college or 576 university accredited by an institutional accrediting agency 577 recognized and approved by the United States Department of 578 Education. However, before prior to being certified by the board 579 to sit for the examination, each applicant who has matriculated 580 in a chiropractic college after July 1, 1990, must shall have 581 been granted a bachelors degree, based upon 4 academic years of 582 study, by a college or university accredited by an institutional 583 a regional accrediting agency that which is a member of the 584 Commission on Recognition of Postsecondary Accreditation. 585 2.Effective July 1, 2000, completed, before prior to 586 matriculation in a chiropractic college, at least 3 years of 587 residence college work, consisting of a minimum of 90 semester 588 hours leading to a bachelors degree in a liberal arts college 589 or university accredited by an institutional accrediting agency 590 recognized and approved by the United States Department of 591 Education. However, before prior to being certified by the board 592 to sit for the examination, each applicant who has matriculated 593 in a chiropractic college after July 1, 2000, must shall have 594 been granted a bachelors degree from an institution holding 595 accreditation for that degree from an institutional a regional 596 accrediting agency that which is recognized by the United States 597 Department of Education. The applicants chiropractic degree 598 must consist of credits earned in the chiropractic program and 599 may not include academic credit for courses from the bachelors 600 degree. 601 (e)Successfully completed the National Board of 602 Chiropractic Examiners certification examination in parts I, II, 603 III, and IV, and the physiotherapy examination of the National 604 Board of Chiropractic Examiners, with a score approved by the 605 board. 606 (f)Submitted to the department a set of fingerprints on a 607 form and under procedures specified by the department, along 608 with payment in an amount equal to the costs incurred by the 609 Department of Health for the criminal background check of the 610 applicant. 611 612 The board may require an applicant who graduated from an 613 institution accredited by the Council on Chiropractic Education 614 more than 10 years before the date of application to the board 615 to take the National Board of Chiropractic Examiners Special 616 Purposes Examination for Chiropractic, or its equivalent, as 617 determined by the board. The board shall establish by rule a 618 passing score. 619 Section 6.Subsection (4) of section 464.008, Florida 620 Statutes, is amended to read: 621 464.008Licensure by examination. 622 (4)If an applicant who graduates from an approved program 623 does not take the licensure examination within 6 months after 624 graduation, he or she must enroll in and successfully complete a 625 board-approved licensure examination preparatory course. The 626 applicant is responsible for all costs associated with the 627 course and may not use state or federal financial aid for such 628 costs. The board shall by rule establish guidelines for 629 licensure examination preparatory courses. 630 Section 7.Paragraph (e) of subsection (1) of section 631 464.018, Florida Statutes, is amended to read: 632 464.018Disciplinary actions. 633 (1)The following acts constitute grounds for denial of a 634 license or disciplinary action, as specified in ss. 456.072(2) 635 and 464.0095: 636 (e)Having been found guilty of, regardless of 637 adjudication, or entered a plea of nolo contendere or guilty to, 638 regardless of adjudication, any offense prohibited under s. 639 435.04 or similar statute of another jurisdiction; or having 640 committed an act which constitutes domestic violence as defined 641 in s. 741.28. 642 Section 8.Present subsections (13) and (14) of section 643 467.003, Florida Statutes, are redesignated as subsections (14) 644 and (15), respectively, a new subsection (13) is added to that 645 section, and subsections (1) and (12) of that section are 646 amended, to read: 647 467.003Definitions.As used in this chapter, unless the 648 context otherwise requires: 649 (1)Approved midwifery program means a midwifery school 650 or a midwifery training program which is approved by the 651 department pursuant to s. 467.205. 652 (12)Preceptor means a physician licensed under chapter 653 458 or chapter 459, a licensed midwife licensed under this 654 chapter, or a certified nurse midwife licensed under chapter 655 464, who has a minimum of 3 years professional experience, and 656 who directs, teaches, supervises, and evaluates the learning 657 experiences of a the student midwife as part of an approved 658 midwifery program. 659 (13)Prelicensure course means a course of study, offered 660 by an accredited midwifery program and approved by the 661 department, which an applicant for licensure must complete 662 before a license may be issued and which provides instruction in 663 the laws and rules of this state and demonstrates the students 664 competency to practice midwifery under this chapter. 665 Section 9.Section 467.009, Florida Statutes, is amended to 666 read: 667 467.009Accredited and approved midwifery programs; 668 education and training requirements. 669 (1)The department shall adopt standards for accredited and 670 approved midwifery programs which must include, but need not be 671 limited to, standards for all of the following: 672 (a). The standards shall encompass Clinical and classroom 673 instruction in all aspects of prenatal, intrapartal, and 674 postpartal care, including all of the following: 675 1.Obstetrics.; 676 2.Neonatal pediatrics.; 677 3.Basic sciences.; 678 4.Female reproductive anatomy and physiology.; 679 5.Behavioral sciences.; 680 6.Childbirth education.; 681 7.Community care.; 682 8.Epidemiology.; 683 9.Genetics.; 684 10.Embryology.; 685 11.Neonatology.; 686 12.Applied pharmacology.; 687 13.The medical and legal aspects of midwifery.; 688 14.Gynecology and womens health.; 689 15.Family planning.; 690 16.Nutrition during pregnancy and lactation.; 691 17.Breastfeeding.; and 692 18.Basic nursing skills; and any other instruction 693 determined by the department and council to be necessary. 694 (b)The standards shall incorporate the Core competencies, 695 incorporating those established by the American College of Nurse 696 Midwives and the Midwives Alliance of North America, including 697 knowledge, skills, and professional behavior in all of the 698 following areas: 699 1.Primary management, collaborative management, referral, 700 and medical consultation.; 701 2.Antepartal, intrapartal, postpartal, and neonatal care.; 702 3.Family planning and gynecological care.; 703 4.Common complications.; and 704 5.Professional responsibilities. 705 (c)Noncurricular The standards shall include noncurriculum 706 matters under this section, including, but not limited to, 707 staffing and teacher qualifications. 708 (2)An accredited and approved midwifery program must offer 709 shall include a course of study and clinical training for a 710 minimum of 3 years which incorporates all of the standards, 711 curriculum guidelines, and educational objectives provided in 712 this section and the rules adopted hereunder. 713 (3)An accredited and approved midwifery program may reduce 714 If the applicant is a registered nurse or a licensed practical 715 nurse or has previous nursing or midwifery education, the 716 required period of training may be reduced to the extent of the 717 students applicants qualifications as a registered nurse or 718 licensed practical nurse or based on prior completion of 719 equivalent nursing or midwifery education, as determined under 720 rules adopted by the department rule. In no case shall the 721 training be reduced to a period of less than 2 years. 722 (4)(3)An accredited and approved midwifery program may 723 accept students who To be accepted into an approved midwifery 724 program, an applicant shall have both: 725 (a)A high school diploma or its equivalent. 726 (b)Taken three college-level credits each of math and 727 English or demonstrated competencies in communication and 728 computation. 729 (5)(4)As part of its course of study, an accredited and 730 approved midwifery program must require clinical training that 731 includes all of the following: 732 (a)A student midwife, during training, shall undertake, 733 under the supervision of a preceptor, The care of 50 women in 734 each of the prenatal, intrapartal, and postpartal periods under 735 the supervision of a preceptor., but The same women need not be 736 seen through all three periods. 737 (b)(5)Observation of The student midwife shall observe an 738 additional 25 women in the intrapartal period before qualifying 739 for a license. 740 (6)Clinical The training required under this section must 741 include all of the following: 742 (a)shall include Training in either hospitals or 743 alternative birth settings, or both. 744 (b)A requirement that students demonstrate competency in 745 the assessment of and differentiation, with particular emphasis 746 on learning the ability to differentiate between low-risk 747 pregnancies and high-risk pregnancies. 748 (7)A hospital or birthing center receiving public funds 749 shall be required to provide student midwives access to observe 750 labor, delivery, and postpartal procedures, provided the woman 751 in labor has given informed consent. The Department of Health 752 shall assist in facilitating access to hospital training for 753 accredited and approved midwifery programs. 754 (8)(7)The Department of Education shall adopt curricular 755 frameworks for midwifery programs offered by conducted within 756 public educational institutions under pursuant to this section. 757 (8)Nonpublic educational institutions that conduct 758 approved midwifery programs shall be accredited by a member of 759 the Commission on Recognition of Postsecondary Accreditation and 760 shall be licensed by the Commission for Independent Education. 761 Section 10.Section 467.011, Florida Statutes, is amended 762 to read: 763 467.011Licensed midwives; qualifications; examination 764 Licensure by examination. 765 (1)The department shall administer an examination to test 766 the proficiency of applicants in the core competencies required 767 to practice midwifery as specified in s. 467.009. 768 (2)The department shall develop, publish, and make 769 available to interested parties at a reasonable cost a 770 bibliography and guide for the examination. 771 (3)The department shall issue a license to practice 772 midwifery to an applicant who meets all of the following 773 criteria: 774 (1)Demonstrates that he or she has graduated from one of 775 the following: 776 (a)An accredited and approved midwifery program. 777 (b)A medical or midwifery program offered in another 778 state, jurisdiction, territory, or country whose graduation 779 requirements were equivalent to or exceeded those required by s. 780 467.009 and the rules adopted thereunder at the time of 781 graduation. 782 (2)Demonstrates that he or she has and successfully 783 completed a prelicensure course offered by an accredited and 784 approved midwifery program. Students graduating from an 785 accredited and approved midwifery program may meet this 786 requirement by showing that the content requirements for the 787 prelicensure course were covered as part of their course of 788 study. 789 (3)Submits an application for licensure on a form approved 790 by the department and pays the appropriate fee. 791 (4)Demonstrates that he or she has received a passing 792 score on an the examination specified by the department, upon 793 payment of the required licensure fee. 794 Section 11.Section 467.0125, Florida Statutes, is amended 795 to read: 796 467.0125Licensed midwives; qualifications; Licensure by 797 endorsement; temporary certificates. 798 (1)The department shall issue a license by endorsement to 799 practice midwifery to an applicant who, upon applying to the 800 department, demonstrates to the department that she or he meets 801 all of the following criteria: 802 (a)1.Holds a valid certificate or diploma from a foreign 803 institution of medicine or midwifery or from a midwifery program 804 offered in another state, bearing the seal of the institution or 805 otherwise authenticated, which renders the individual eligible 806 to practice midwifery in the country or state in which it was 807 issued, provided the requirements therefor are deemed by the 808 department to be substantially equivalent to, or to exceed, 809 those established under this chapter and rules adopted under 810 this chapter, and submits therewith a certified translation of 811 the foreign certificate or diploma; or 812 2.Holds an active, unencumbered a valid certificate or 813 license to practice midwifery in another state, jurisdiction, or 814 territory issued by that state, provided the licensing 815 requirements of that state, jurisdiction, or territory at the 816 time the license was issued were therefor are deemed by the 817 department to be substantially equivalent to, or exceeded to 818 exceed, those established under this chapter and the rules 819 adopted hereunder under this chapter. 820 (b)Has successfully completed a 4-month prelicensure 821 course conducted by an accredited and approved midwifery program 822 and has submitted documentation to the department of successful 823 completion. 824 (c)Submits an application for licensure on a form approved 825 by the department and pays the appropriate fee Has successfully 826 passed the licensed midwifery examination. 827 (2)The department may issue a temporary certificate to 828 practice in areas of critical need to an applicant any midwife 829 who is qualifying for a midwifery license licensure by 830 endorsement under subsection (1) who meets all of the following 831 criteria, with the following restrictions: 832 (a)Submits an application for a temporary certificate on a 833 form approved by the department and pays the appropriate fee, 834 which may not exceed $50 and is in addition to the fee required 835 for licensure by endorsement under subsection (1). 836 (b)Specifies on the application that he or she will The 837 Department of Health shall determine the areas of critical need, 838 and the midwife so certified shall practice only in one or more 839 of the following locations: 840 1.A county health department. 841 2.A correctional facility. 842 3.A United States Department of Veterans Affairs clinic. 843 4.A community health center funded by s. 329, s. 330, or 844 s. 340 of the Public Health Service Act. 845 5.Any other agency or institution that is approved by the 846 State Surgeon General and provides health care to meet the needs 847 of an underserved population in this state. 848 (c)Will practice only those specific areas, under the 849 supervision auspices of a physician licensed under pursuant to 850 chapter 458 or chapter 459, a certified nurse midwife licensed 851 under pursuant to part I of chapter 464, or a midwife licensed 852 under this chapter, who has a minimum of 3 years professional 853 experience. 854 (3)The department may issue a temporary certificate under 855 this section with the following restrictions: 856 (a)A requirement that a temporary certificateholder 857 practice only in areas of critical need. The State Surgeon 858 General shall determine the areas of critical need, which Such 859 areas shall include, but are not be limited to, health 860 professional shortage areas designated by the United States 861 Department of Health and Human Services. 862 (b)A requirement that if a temporary certificateholders 863 practice area ceases to be an area of critical need, within 30 864 days after such change the certificateholder must either: 865 1.Report a new practice area of critical need to the 866 department; or 867 2.Voluntarily relinquish the temporary certificate. 868 (4)The department shall review a temporary 869 certificateholders practice at least annually to determine 870 whether the certificateholder is meeting the requirements of 871 subsections (2) and (3) and the rules adopted thereunder. If the 872 department determines that a certificateholder is not meeting 873 these requirements, the department must revoke the temporary 874 certificate. 875 (5)A temporary certificate issued under this section is 876 shall be valid only as long as an area for which it is issued 877 remains an area of critical need, but no longer than 2 years, 878 and is shall not be renewable. 879 (c)The department may administer an abbreviated oral 880 examination to determine the midwifes competency, but no 881 written regular examination shall be necessary. 882 (d)The department shall not issue a temporary certificate 883 to any midwife who is under investigation in another state for 884 an act which would constitute a violation of this chapter until 885 such time as the investigation is complete, at which time the 886 provisions of this section shall apply. 887 (e)The department shall review the practice under a 888 temporary certificate at least annually to ascertain that the 889 minimum requirements of the midwifery rules promulgated under 890 this chapter are being met. If it is determined that the minimum 891 requirements are not being met, the department shall immediately 892 revoke the temporary certificate. 893 (f)The fee for a temporary certificate shall not exceed 894 $50 and shall be in addition to the fee required for licensure. 895 Section 12.Section 467.205, Florida Statutes, is amended 896 to read: 897 467.205Approval of midwifery programs. 898 (1)The department must approve an accredited or state 899 licensed public or private institution seeking to provide 900 midwifery education and training as an approved midwifery 901 program in this state if the institution meets all of the 902 following criteria: 903 (a)Submits an application for approval on a form approved 904 by the department. 905 (b)Demonstrates to the departments satisfaction that the 906 proposed midwifery program complies with s. 467.009 and the 907 rules adopted thereunder. 908 (c)For a private institution, demonstrates its 909 accreditation by a member of the Council for Higher Education 910 Accreditation or an accrediting agency approved by the United 911 States Department of Education as an institutional accrediting 912 agency for direct-entry midwifery education programs and its 913 licensing or provisional licensing by the Commission for 914 Independent Education An organization desiring to conduct an 915 approved program for the education of midwives shall apply to 916 the department and submit such evidence as may be required to 917 show that it complies with s. 467.009 and with the rules of the 918 department. Any accredited or state-licensed institution of 919 higher learning, public or private, may provide midwifery 920 education and training. 921 (2)The department shall adopt rules regarding educational 922 objectives, faculty qualifications, curriculum guidelines, 923 administrative procedures, and other training requirements as 924 are necessary to ensure that approved programs graduate midwives 925 competent to practice under this chapter. 926 (3)The department shall survey each organization applying 927 for approval. If the department is satisfied that the program 928 meets the requirements of s. 467.009 and rules adopted pursuant 929 to that section, it shall approve the program. 930 (2)(4)The department shall, at least once every 3 years, 931 certify whether each approved midwifery program is currently 932 compliant, and has maintained compliance, complies with the 933 requirements of standards developed under s. 467.009 and the 934 rules adopted thereunder. 935 (3)(5)If the department finds that an approved midwifery 936 program is not in compliance with the requirements of s. 467.009 937 or the rules adopted thereunder, or has lost its accreditation 938 status, the department must provide its finding to the program 939 in writing and no longer meets the required standards, it may 940 place the program on probationary status for a specified period 941 of time, which may not exceed 3 years until such time as the 942 standards are restored. 943 (4)If a program on probationary status does not come into 944 compliance with the requirements of s. 467.009 or the rules 945 adopted thereunder, or regain its accreditation status, as 946 applicable, within the period specified by the department fails 947 to correct these conditions within a specified period of time, 948 the department may rescind the programs approval. 949 (5)A Any program that has having its approval rescinded 950 has shall have the right to reapply for approval. 951 (6)The department may grant provisional approval of a new 952 program seeking accreditation status, for a period not to exceed 953 5 years, provided that all other requirements of this section 954 are met. 955 (7)The department may rescind provisional approval of a 956 program that fails to meet the requirements of s. 467.009, this 957 section, or the rules adopted thereunder, in accordance with 958 procedures provided in subsections (3) and (4) may be granted 959 pending the licensure results of the first graduating class. 960 Section 13.Subsections (2), (3), and (4) and paragraphs 961 (a) and (b) of subsection (5) of section 468.803, Florida 962 Statutes, are amended to read: 963 468.803License, registration, and examination 964 requirements. 965 (2)An applicant for registration, examination, or 966 licensure must apply to the department on a form prescribed by 967 the board for consideration of board approval. Each initial 968 applicant shall submit a set of fingerprints to the department 969 in accordance with on a form and under procedures specified by 970 the department, along with payment in an amount equal to the 971 costs incurred by the department for state and national criminal 972 history checks of the applicant. The department shall submit the 973 fingerprints provided by an applicant to the Department of Law 974 Enforcement for a statewide criminal history check, and the 975 Department of Law Enforcement shall forward the fingerprints to 976 the Federal Bureau of Investigation for a national criminal 977 history check of the applicant. The board shall screen the 978 results to determine if an applicant meets licensure 979 requirements. The board shall consider for examination, 980 registration, or licensure each applicant whom who the board 981 verifies: 982 (a)Has submitted the completed application and completed 983 the fingerprinting requirements fingerprint forms and has paid 984 the applicable application fee, not to exceed $500, and the cost 985 of the state and national criminal history checks. The 986 application fee is and cost of the criminal history checks shall 987 be nonrefundable; 988 (b)Is of good moral character; 989 (c)Is 18 years of age or older; and 990 (d)Has completed the appropriate educational preparation. 991 (3)A person seeking to attain the orthotics or prosthetics 992 experience required for licensure in this state must be approved 993 by the board and registered as a resident by the department. 994 Although a registration may be held in both disciplines, for 995 independent registrations the board may not approve a second 996 registration until at least 1 year after the issuance of the 997 first registration. Notwithstanding subsection (2), a person who 998 has been approved by the board and registered by the department 999 in one discipline may apply for registration in the second 1000 discipline without an additional state or national criminal 1001 history check during the period in which the first registration 1002 is valid. Each independent registration or dual registration is 1003 valid for 2 years after the date of issuance unless otherwise 1004 revoked by the department upon recommendation of the board. The 1005 board shall set a registration fee not to exceed $500 to be paid 1006 by the applicant. A registration may be renewed once by the 1007 department upon recommendation of the board for a period no 1008 longer than 1 year, as such renewal is defined by the board by 1009 rule. The renewal fee may not exceed one-half the current 1010 registration fee. To be considered by the board for approval of 1011 registration as a resident, the applicant must have one of the 1012 following: 1013 (a)A Bachelor of Science or higher-level postgraduate 1014 degree in orthotics and prosthetics from an institutionally a 1015 regionally accredited college or university recognized by the 1016 Commission on Accreditation of Allied Health Education Programs. 1017 (b)A minimum of a bachelors degree from an 1018 institutionally a regionally accredited college or university 1019 and a certificate in orthotics or prosthetics from a program 1020 recognized by the Commission on Accreditation of Allied Health 1021 Education Programs, or its equivalent, as determined by the 1022 board. 1023 (c)A minimum of a bachelors degree from an 1024 institutionally a regionally accredited college or university 1025 and a dual certificate in both orthotics and prosthetics from 1026 programs recognized by the Commission on Accreditation of Allied 1027 Health Education Programs, or its equivalent, as determined by 1028 the board. 1029 (4)The department may develop and administer a state 1030 examination for an orthotist or a prosthetist license, or the 1031 board may approve the existing examination of a national 1032 standards organization. The examination must be predicated on a 1033 minimum of a baccalaureate-level education and formalized 1034 specialized training in the appropriate field. Each examination 1035 must demonstrate a minimum level of competence in basic 1036 scientific knowledge, written problem solving, and practical 1037 clinical patient management. The board shall require an 1038 examination fee not to exceed the actual cost to the board in 1039 developing, administering, and approving the examination, which 1040 fee must be paid by the applicant. To be considered by the board 1041 for examination, the applicant must have: 1042 (a)For an examination in orthotics: 1043 1.A Bachelor of Science or higher-level postgraduate 1044 degree in orthotics and prosthetics from an institutionally a 1045 regionally accredited college or university recognized by the 1046 Commission on Accreditation of Allied Health Education Programs 1047 or, at a minimum, a bachelors degree from an institutionally a 1048 regionally accredited college or university and a certificate in 1049 orthotics from a program recognized by the Commission on 1050 Accreditation of Allied Health Education Programs, or its 1051 equivalent, as determined by the board; and 1052 2.An approved orthotics internship of 1 year of qualified 1053 experience, as determined by the board, or an orthotic residency 1054 or dual residency program recognized by the board. 1055 (b)For an examination in prosthetics: 1056 1.A Bachelor of Science or higher-level postgraduate 1057 degree in orthotics and prosthetics from an institutionally a 1058 regionally accredited college or university recognized by the 1059 Commission on Accreditation of Allied Health Education Programs 1060 or, at a minimum, a bachelors degree from an institutionally a 1061 regionally accredited college or university and a certificate in 1062 prosthetics from a program recognized by the Commission on 1063 Accreditation of Allied Health Education Programs, or its 1064 equivalent, as determined by the board; and 1065 2.An approved prosthetics internship of 1 year of 1066 qualified experience, as determined by the board, or a 1067 prosthetic residency or dual residency program recognized by the 1068 board. 1069 (5)In addition to the requirements in subsection (2), to 1070 be licensed as: 1071 (a)An orthotist, the applicant must pay a license fee not 1072 to exceed $500 and must have: 1073 1.A Bachelor of Science or higher-level postgraduate 1074 degree in orthotics and prosthetics from an institutionally a 1075 regionally accredited college or university recognized by the 1076 Commission on Accreditation of Allied Health Education Programs, 1077 or a bachelors degree from an institutionally accredited 1078 college or university and with a certificate in orthotics from a 1079 program recognized by the Commission on Accreditation of Allied 1080 Health Education Programs, or its equivalent, as determined by 1081 the board; 1082 2.An approved appropriate internship of 1 year of 1083 qualified experience, as determined by the board, or a residency 1084 program recognized by the board; 1085 3.Completed the mandatory courses; and 1086 4.Passed the state orthotics examination or the board 1087 approved orthotics examination. 1088 (b)A prosthetist, the applicant must pay a license fee not 1089 to exceed $500 and must have: 1090 1.A Bachelor of Science or higher-level postgraduate 1091 degree in orthotics and prosthetics from an institutionally a 1092 regionally accredited college or university recognized by the 1093 Commission on Accreditation of Allied Health Education Programs, 1094 or a bachelors degree from an institutionally accredited 1095 college or university and with a certificate in prosthetics from 1096 a program recognized by the Commission on Accreditation of 1097 Allied Health Education Programs, or its equivalent, as 1098 determined by the board; 1099 2.An internship of 1 year of qualified experience, as 1100 determined by the board, or a residency program recognized by 1101 the board; 1102 3.Completed the mandatory courses; and 1103 4.Passed the state prosthetics examination or the board 1104 approved prosthetics examination. 1105 Section 14.Section 483.824, Florida Statutes, is amended 1106 to read: 1107 483.824Qualifications of clinical laboratory director.A 1108 clinical laboratory director must have 4 years of clinical 1109 laboratory experience with 2 years of experience in the 1110 specialty to be directed or be nationally board certified in the 1111 specialty to be directed, and must meet one of the following 1112 requirements: 1113 (1)Be a physician licensed under chapter 458 or chapter 1114 459; 1115 (2)Hold an earned doctoral degree in a chemical, physical, 1116 or biological science from an institutionally a regionally 1117 accredited institution and maintain national certification 1118 requirements equal to those required by the federal Health Care 1119 Financing Administration; or 1120 (3)For the subspecialty of oral pathology, be a physician 1121 licensed under chapter 458 or chapter 459 or a dentist licensed 1122 under chapter 466. 1123 Section 15.Subsection (3) of section 490.003, Florida 1124 Statutes, is amended to read: 1125 490.003Definitions.As used in this chapter: 1126 (3)(a)Doctoral degree from an American Psychological 1127 Association accredited program means Effective July 1, 1999, 1128 doctoral-level psychological education and doctoral degree in 1129 psychology mean a Psy.D., an Ed.D. in psychology, or a Ph.D. in 1130 psychology from a psychology program at an educational 1131 institution that, at the time the applicant was enrolled and 1132 graduated: 1133 1.(a)Had institutional accreditation from an agency 1134 recognized and approved by the United States Department of 1135 Education or was recognized as a member in good standing with 1136 Universities Canada the Association of Universities and Colleges 1137 of Canada; and 1138 2.(b)Had programmatic accreditation from the American 1139 Psychological Association. 1140 (b)Doctoral degree in psychology means a Psy.D., an 1141 Ed.D. in psychology, or a Ph.D. in psychology from a psychology 1142 program at an educational institution that, at the time the 1143 applicant was enrolled and graduated, had institutional 1144 accreditation from an agency recognized and approved by the 1145 United States Department of Education or was recognized as a 1146 member in good standing with Universities Canada. 1147 Section 16.Subsection (1) of section 490.005, Florida 1148 Statutes, is amended to read: 1149 490.005Licensure by examination. 1150 (1)Any person desiring to be licensed as a psychologist 1151 shall apply to the department to take the licensure examination. 1152 The department shall license each applicant whom who the board 1153 certifies has met all of the following requirements: 1154 (a)Completed the application form and remitted a 1155 nonrefundable application fee not to exceed $500 and an 1156 examination fee set by the board sufficient to cover the actual 1157 per applicant cost to the department for development, purchase, 1158 and administration of the examination, but not to exceed $500. 1159 (b)Submitted proof satisfactory to the board that the 1160 applicant has received: 1161 1.A doctoral degree from an American Psychological 1162 Association accredited program Doctoral-level psychological 1163 education; or 1164 2.The equivalent of a doctoral degree from an American 1165 Psychological Association accredited program doctoral-level 1166 psychological education, as defined in s. 490.003(3), from a 1167 program at a school or university located outside the United 1168 States of America which was officially recognized by the 1169 government of the country in which it is located as an 1170 institution or program to train students to practice 1171 professional psychology. The applicant has the burden of 1172 establishing that this requirement has been met. 1173 (c)Had at least 2 years or 4,000 hours of experience in 1174 the field of psychology in association with or under the 1175 supervision of a licensed psychologist meeting the academic and 1176 experience requirements of this chapter or the equivalent as 1177 determined by the board. The experience requirement may be met 1178 by work performed on or off the premises of the supervising 1179 psychologist if the off-premises work is not the independent, 1180 private practice rendering of psychological services that does 1181 not have a psychologist as a member of the group actually 1182 rendering psychological services on the premises. 1183 (d)Passed the examination. However, an applicant who has 1184 obtained a passing score, as established by the board by rule, 1185 on the psychology licensure examination designated by the board 1186 as the national licensure examination need only pass the Florida 1187 law and rules portion of the examination. 1188 Section 17.Subsection (1) of section 490.0051, Florida 1189 Statutes, is amended to read: 1190 490.0051Provisional licensure; requirements. 1191 (1)The department shall issue a provisional psychology 1192 license to each applicant whom who the board certifies has met 1193 all of the following criteria: 1194 (a)Completed the application form and remitted a 1195 nonrefundable application fee not to exceed $250, as set by 1196 board rule. 1197 (b)Earned a doctoral degree from an American Psychological 1198 Association accredited program in psychology as defined in s. 1199 490.003(3). 1200 (c)Met any additional requirements established by board 1201 rule. 1202 Section 18.Effective upon this act becoming a law, 1203 subsections (1), (3), and (4) of section 491.005, Florida 1204 Statutes, are amended to read: 1205 491.005Licensure by examination. 1206 (1)CLINICAL SOCIAL WORK.Upon verification of 1207 documentation and payment of a fee not to exceed $200, as set by 1208 board rule, plus the actual per applicant cost to the department 1209 for purchase of the examination from the American Association of 1210 State Social Workers Boards or a similar national organization, 1211 the department shall issue a license as a clinical social worker 1212 to an applicant whom who the board certifies has met all of the 1213 following criteria: 1214 (a)Has Submitted an application and paid the appropriate 1215 fee. 1216 (b)1.Has Received a doctoral degree in social work from a 1217 graduate school of social work which at the time the applicant 1218 graduated was accredited by an accrediting agency recognized by 1219 the United States Department of Education or has received a 1220 masters degree in social work from a graduate school of social 1221 work which at the time the applicant graduated: 1222 a.Was accredited by the Council on Social Work Education; 1223 b.Was accredited by the Canadian Association for of 1224 Schools of Social Work Education; or 1225 c.Has been determined to have been a program equivalent to 1226 programs approved by the Council on Social Work Education by the 1227 Foreign Equivalency Determination Service of the Council on 1228 Social Work Education. An applicant who graduated from a program 1229 at a university or college outside of the United States or 1230 Canada must present documentation of the equivalency 1231 determination from the council in order to qualify. 1232 2.The applicants graduate program must have emphasized 1233 direct clinical patient or client health care services, 1234 including, but not limited to, coursework in clinical social 1235 work, psychiatric social work, medical social work, social 1236 casework, psychotherapy, or group therapy. The applicants 1237 graduate program must have included all of the following 1238 coursework: 1239 a.A supervised field placement which was part of the 1240 applicants advanced concentration in direct practice, during 1241 which the applicant provided clinical services directly to 1242 clients. 1243 b.Completion of 24 semester hours or 32 quarter hours in 1244 theory of human behavior and practice methods as courses in 1245 clinically oriented services, including a minimum of one course 1246 in psychopathology, and no more than one course in research, 1247 taken in a school of social work accredited or approved pursuant 1248 to subparagraph 1. 1249 3.If the course title which appears on the applicants 1250 transcript does not clearly identify the content of the 1251 coursework, the applicant provided shall be required to provide 1252 additional documentation, including, but not limited to, a 1253 syllabus or catalog description published for the course. 1254 (c)Completed Has had at least 2 years of clinical social 1255 work experience, which took place subsequent to completion of a 1256 graduate degree in social work at an institution meeting the 1257 accreditation requirements of this section, under the 1258 supervision of a licensed clinical social worker or the 1259 equivalent who is a qualified supervisor as determined by the 1260 board. An individual who intends to practice in Florida to 1261 satisfy clinical experience requirements must register pursuant 1262 to s. 491.0045 before commencing practice. If the applicants 1263 graduate program was not a program which emphasized direct 1264 clinical patient or client health care services as described in 1265 subparagraph (b)2., the supervised experience requirement must 1266 take place after the applicant has completed a minimum of 15 1267 semester hours or 22 quarter hours of the coursework required. A 1268 doctoral internship may be applied toward the clinical social 1269 work experience requirement. A licensed mental health 1270 professional must be on the premises when clinical services are 1271 provided by a registered intern in a private practice setting. 1272 (d)Has Passed a theory and practice examination designated 1273 by board rule provided by the department for this purpose. 1274 (e)Has Demonstrated, in a manner designated by board rule 1275 of the board, knowledge of the laws and rules governing the 1276 practice of clinical social work, marriage and family therapy, 1277 and mental health counseling. 1278 (3)MARRIAGE AND FAMILY THERAPY.Upon verification of 1279 documentation and payment of a fee not to exceed $200, as set by 1280 board rule, plus the actual cost of the purchase of the 1281 examination from the Association of Marital and Family Therapy 1282 Regulatory Board, or similar national organization, the 1283 department shall issue a license as a marriage and family 1284 therapist to an applicant whom who the board certifies has met 1285 all of the following criteria: 1286 (a)Has Submitted an application and paid the appropriate 1287 fee. 1288 (b)1.Attained one of the following: 1289 a.A minimum of a masters degree in marriage and family 1290 therapy from a program accredited by the Commission on 1291 Accreditation for Marriage and Family Therapy Education. 1292 b.A minimum of a masters degree with a major emphasis in 1293 marriage and family therapy or a closely related field from a 1294 university program accredited by the Council on Accreditation of 1295 Counseling and Related Educational Programs and graduate courses 1296 approved by the board. 1297 c.Has A minimum of a masters degree with an major 1298 emphasis in marriage and family therapy or a closely related 1299 field, with a degree conferred before September 1, 2027, from an 1300 institutionally accredited college or university from a program 1301 accredited by the Commission on Accreditation for Marriage and 1302 Family Therapy Education or from a Florida university program 1303 accredited by the Council for Accreditation of Counseling and 1304 Related Educational Programs and graduate courses approved by 1305 the board of Clinical Social Work, Marriage and Family Therapy, 1306 and Mental Health Counseling. 1307 2.If the course title that appears on the applicants 1308 transcript does not clearly identify the content of the 1309 coursework, the applicant provided shall provide additional 1310 documentation, including, but not limited to, a syllabus or 1311 catalog description published for the course. The required 1312 masters degree must have been received in an institution of 1313 higher education that, at the time the applicant graduated, was 1314 fully accredited by an institutional a regional accrediting body 1315 recognized by the Council for Higher Education Accreditation or 1316 its successor organization Commission on Recognition of 1317 Postsecondary Accreditation or was publicly recognized as a 1318 member in good standing with Universities Canada the Association 1319 of Universities and Colleges of Canada, or an institution of 1320 higher education located outside the United States and Canada 1321 which, at the time the applicant was enrolled and at the time 1322 the applicant graduated, maintained a standard of training 1323 substantially equivalent to the standards of training of those 1324 institutions in the United States which are accredited by an 1325 institutional a regional accrediting body recognized by the 1326 Council for Higher Education Accreditation or its successor 1327 organization Commission on Recognition of Postsecondary 1328 Accreditation. Such foreign education and training must have 1329 been received in an institution or program of higher education 1330 officially recognized by the government of the country in which 1331 it is located as an institution or program to train students to 1332 practice as professional marriage and family therapists or 1333 psychotherapists. The applicant has the burden of establishing 1334 that the requirements of this provision have been met, and the 1335 board shall require documentation, such as an evaluation by a 1336 foreign equivalency determination service, as evidence that the 1337 applicants graduate degree program and education were 1338 equivalent to an accredited program in this country. An 1339 applicant with a masters degree from a program that did not 1340 emphasize marriage and family therapy may complete the 1341 coursework requirement in a training institution fully 1342 accredited by the Commission on Accreditation for Marriage and 1343 Family Therapy Education recognized by the United States 1344 Department of Education. 1345 (c)Completed Has had at least 2 years of clinical 1346 experience during which 50 percent of the applicants clients 1347 were receiving marriage and family therapy services, which must 1348 be at the post-masters level under the supervision of a 1349 licensed marriage and family therapist with at least 5 years of 1350 experience, or the equivalent, who is a qualified supervisor as 1351 determined by the board. An individual who intends to practice 1352 in Florida to satisfy the clinical experience requirements must 1353 register pursuant to s. 491.0045 before commencing practice. If 1354 a graduate has a masters degree with a major emphasis in 1355 marriage and family therapy or a closely related field which did 1356 not include all of the coursework required by paragraph (b), 1357 credit for the post-masters level clinical experience may not 1358 commence until the applicant has completed a minimum of 10 of 1359 the courses required by paragraph (b), as determined by the 1360 board, and at least 6 semester hours or 9 quarter hours of the 1361 course credits must have been completed in the area of marriage 1362 and family systems, theories, or techniques. Within the 2 years 1363 of required experience, the applicant shall provide direct 1364 individual, group, or family therapy and counseling to cases 1365 including those involving unmarried dyads, married couples, 1366 separating and divorcing couples, and family groups that include 1367 children. A doctoral internship may be applied toward the 1368 clinical experience requirement. A licensed mental health 1369 professional must be on the premises when clinical services are 1370 provided by a registered intern in a private practice setting. 1371 (d)Has Passed a theory and practice examination designated 1372 by board rule provided by the department. 1373 (e)Has Demonstrated, in a manner designated by board rule, 1374 knowledge of the laws and rules governing the practice of 1375 clinical social work, marriage and family therapy, and mental 1376 health counseling. 1377 1378 For the purposes of dual licensure, the department shall license 1379 as a marriage and family therapist any person who meets the 1380 requirements of s. 491.0057. Fees for dual licensure may not 1381 exceed those stated in this subsection. 1382 (4)MENTAL HEALTH COUNSELING.Upon verification of 1383 documentation and payment of a fee not to exceed $200, as set by 1384 board rule, plus the actual per applicant cost of purchase of 1385 the examination from the National Board for Certified Counselors 1386 or its successor organization, the department shall issue a 1387 license as a mental health counselor to an applicant whom who 1388 the board certifies has met all of the following criteria: 1389 (a)Has Submitted an application and paid the appropriate 1390 fee. 1391 (b)1.Attained Has a minimum of an earned masters degree 1392 from a mental health counseling program accredited by the 1393 Council for the Accreditation of Counseling and Related 1394 Educational Programs which consists of at least 60 semester 1395 hours or 80 quarter hours of clinical and didactic instruction, 1396 including a course in human sexuality and a course in substance 1397 abuse. If the masters degree is earned from a program related 1398 to the practice of mental health counseling which is not 1399 accredited by the Council for the Accreditation of Counseling 1400 and Related Educational Programs, then the coursework and 1401 practicum, internship, or fieldwork must consist of at least 60 1402 semester hours or 80 quarter hours and meet all of the following 1403 requirements: 1404 a.Thirty-three semester hours or 44 quarter hours of 1405 graduate coursework, which must include a minimum of 3 semester 1406 hours or 4 quarter hours of graduate-level coursework in each of 1407 the following 11 content areas: counseling theories and 1408 practice; human growth and development; diagnosis and treatment 1409 of psychopathology; human sexuality; group theories and 1410 practice; individual evaluation and assessment; career and 1411 lifestyle assessment; research and program evaluation; social 1412 and cultural foundations; substance abuse; and legal, ethical, 1413 and professional standards issues in the practice of mental 1414 health counseling. Courses in research, thesis or dissertation 1415 work, practicums, internships, or fieldwork may not be applied 1416 toward this requirement. 1417 b.A minimum of 3 semester hours or 4 quarter hours of 1418 graduate-level coursework addressing diagnostic processes, 1419 including differential diagnosis and the use of the current 1420 diagnostic tools, such as the current edition of the American 1421 Psychiatric Associations Diagnostic and Statistical Manual of 1422 Mental Disorders. The graduate program must have emphasized the 1423 common core curricular experience. 1424 c.The equivalent, as determined by the board, of at least 1425 700 hours of university-sponsored supervised clinical practicum, 1426 internship, or field experience that includes at least 280 hours 1427 of direct client services, as required in the accrediting 1428 standards of the Council for Accreditation of Counseling and 1429 Related Educational Programs for mental health counseling 1430 programs. This experience may not be used to satisfy the post 1431 masters clinical experience requirement. 1432 2.Has Provided additional documentation if a course title 1433 that appears on the applicants transcript does not clearly 1434 identify the content of the coursework. The documentation must 1435 include, but is not limited to, a syllabus or catalog 1436 description published for the course. 1437 1438 Education and training in mental health counseling must have 1439 been received in an institution of higher education that, at the 1440 time the applicant graduated, was fully accredited by an 1441 institutional a regional accrediting body recognized by the 1442 Council for Higher Education Accreditation or its successor 1443 organization or was publicly recognized as a member in good 1444 standing with Universities Canada the Association of 1445 Universities and Colleges of Canada, or an institution of higher 1446 education located outside the United States and Canada which, at 1447 the time the applicant was enrolled and at the time the 1448 applicant graduated, maintained a standard of training 1449 substantially equivalent to the standards of training of those 1450 institutions in the United States which are accredited by an 1451 institutional a regional accrediting body recognized by the 1452 Council for Higher Education Accreditation or its successor 1453 organization. Such foreign education and training must have been 1454 received in an institution or program of higher education 1455 officially recognized by the government of the country in which 1456 it is located as an institution or program to train students to 1457 practice as mental health counselors. The applicant has the 1458 burden of establishing that the requirements of this provision 1459 have been met, and the board shall require documentation, such 1460 as an evaluation by a foreign equivalency determination service, 1461 as evidence that the applicants graduate degree program and 1462 education were equivalent to an accredited program in this 1463 country. Beginning July 1, 2025, an applicant must have a 1464 masters degree from a program that is accredited by the Council 1465 for Accreditation of Counseling and Related Educational 1466 Programs, the Masters in Psychology and Counseling Accreditation 1467 Council, or an equivalent accrediting body which consists of at 1468 least 60 semester hours or 80 quarter hours to apply for 1469 licensure under this paragraph. 1470 (c)Completed Has had at least 2 years of clinical 1471 experience in mental health counseling, which must be at the 1472 post-masters level under the supervision of a licensed mental 1473 health counselor or the equivalent who is a qualified supervisor 1474 as determined by the board. An individual who intends to 1475 practice in Florida to satisfy the clinical experience 1476 requirements must register pursuant to s. 491.0045 before 1477 commencing practice. If a graduate has a masters degree with a 1478 major related to the practice of mental health counseling which 1479 did not include all the coursework required under sub 1480 subparagraphs (b)1.a. and b., credit for the post-masters level 1481 clinical experience may not commence until the applicant has 1482 completed a minimum of seven of the courses required under sub 1483 subparagraphs (b)1.a. and b., as determined by the board, one of 1484 which must be a course in psychopathology or abnormal 1485 psychology. A doctoral internship may be applied toward the 1486 clinical experience requirement. A licensed mental health 1487 professional must be on the premises when clinical services are 1488 provided by a registered intern in a private practice setting. 1489 (d)Has Passed a theory and practice examination designated 1490 by board rule provided by the department for this purpose. 1491 (e)Has Demonstrated, in a manner designated by board rule, 1492 knowledge of the laws and rules governing the practice of 1493 clinical social work, marriage and family therapy, and mental 1494 health counseling. 1495 Section 19.Subsection (6) and paragraph (c) of subsection 1496 (9) of section 766.314, Florida Statutes, are amended to read: 1497 766.314Assessments; plan of operation. 1498 (6)(a)The association shall make all assessments required 1499 by this section, except initial assessments of physicians 1500 licensed on or after October 1, 1988, which assessments will be 1501 made by the Department of Health Business and Professional 1502 Regulation, and except assessments of casualty insurers pursuant 1503 to subparagraph (5)(c)1., which assessments will be made by the 1504 Office of Insurance Regulation. Beginning October 1, 1989, for 1505 any physician licensed between October 1 and December 31 of any 1506 year, the Department of Business and Professional Regulation 1507 shall make the initial assessment plus the assessment for the 1508 following calendar year. The Department of Health Business and 1509 Professional Regulation shall provide the association, in an 1510 electronic format, with a monthly report such frequency as 1511 determined to be necessary, a listing, in a computer-readable 1512 form, of the names and license numbers addresses of all 1513 physicians licensed under chapter 458 or chapter 459. 1514 (b)1.The association may enforce collection of assessments 1515 required to be paid pursuant to ss. 766.301-766.316 by suit 1516 filed in county court, or in circuit court if the amount due 1517 could exceed the jurisdictional limits of county court. The 1518 association is shall be entitled to an award of attorney 1519 attorneys fees, costs, and interest upon the entry of a 1520 judgment against a physician for failure to pay such assessment, 1521 with such interest accruing until paid. Notwithstanding the 1522 provisions of chapters 47 and 48, the association may file such 1523 suit in either Leon County or the county of the residence of the 1524 defendant. The association shall notify the Department of Health 1525 and the applicable board of any unpaid final judgment against a 1526 physician within 7 days after the entry of final judgment. 1527 2.The Department of Health Business and Professional 1528 Regulation, upon notification by the association that an 1529 assessment has not been paid and that there is an unsatisfied 1530 judgment against a physician, shall refuse to not renew any 1531 license issued to practice for such physician under issued 1532 pursuant to chapter 458 or chapter 459 until the association 1533 notifies the Department of Health that such time as the judgment 1534 is satisfied in full. 1535 (c)The Agency for Health Care Administration shall, upon 1536 notification by the association that an assessment has not been 1537 timely paid, enforce collection of such assessments required to 1538 be paid by hospitals pursuant to ss. 766.301-766.316. Failure of 1539 a hospital to pay such assessment is grounds for disciplinary 1540 action pursuant to s. 395.1065 notwithstanding any provision of 1541 law to the contrary. 1542 (9) 1543 (c)If In the event the total of all current estimates 1544 equals 80 percent of the funds on hand and the funds that will 1545 become available to the association within the next 12 months 1546 from all sources described in subsections (4) and (5) and 1547 paragraph (7)(a), the association may shall not accept any new 1548 claims without express authority from the Legislature. Nothing 1549 in this section precludes herein shall preclude the association 1550 from accepting any claim if the injury occurred 18 months or 1551 more before prior to the effective date of this suspension. 1552 Within 30 days after of the effective date of this suspension, 1553 the association shall notify the Governor, the Speaker of the 1554 House of Representatives, the President of the Senate, the 1555 Office of Insurance Regulation, the Agency for Health Care 1556 Administration, and the Department of Health, and the Department 1557 of Business and Professional Regulation of this suspension. 1558 Section 20.Except as otherwise expressly provided in this 1559 act and except for this section, which shall take effect upon 1560 this act becoming a law, this act shall take effect July 1, 1561 2022.