Florida Senate - 2022 SB 1222 By Senator Bean 4-01088-22 20221222__ 1 A bill to be entitled 2 An act relating to nonemergent patient care; amending 3 s. 401.23, F.S.; defining the term community 4 paramedicine; amending s. 401.265, F.S.; providing 5 that a physician who supervises the provision of 6 certain services by a paramedic or an emergency 7 medical technician is liable for any act or omission 8 during the provision of such services; amending s. 9 401.272, F.S.; revising a legislative purpose 10 regarding emergency medical services community health 11 care; authorizing paramedics and emergency medical 12 technicians to perform community paramedicine under 13 certain circumstances; amending s. 465.019, F.S.; 14 specifying that Class III institutional pharmacies may 15 dispense, distribute, compound, and fill prescriptions 16 for medicinal drugs for inpatient and outpatient 17 treatment; authorizing hospitals to dispense medicinal 18 drugs to patients without first securing a community 19 pharmacy permit under certain circumstances; amending 20 ss. 14.33, 252.515, 395.1027, and 401.245, F.S.; 21 conforming cross-references; providing an effective 22 date. 23 24 Be It Enacted by the Legislature of the State of Florida: 25 26 Section 1.Present subsections (10) through (22) of section 27 401.23, Florida Statutes, are redesignated as subsections (11) 28 through (23), respectively, a new subsection (10) is added to 29 that section, and present subsection (19) of that section is 30 amended, to read: 31 401.23Definitions.As used in this part, the term: 32 (10)Community paramedicine means any nonemergent basic 33 or advanced life support services provided in a community 34 setting by a paramedic or an emergency medical technician, as 35 applicable, under the medical supervision of a physician 36 pursuant to a formal supervisory relationship or standing order, 37 as described in s. 401.265, s. 458.348, or s. 459.025. 38 (20)(19)Physician means a practitioner who is licensed 39 under the provisions of chapter 458 or chapter 459. For the 40 purpose of providing medical direction as defined in this 41 section subsection (14) for the treatment of patients 42 immediately before prior to or during transportation to a United 43 States Department of Veterans Affairs medical facility, 44 physician also means a practitioner employed by the United 45 States Department of Veterans Affairs. 46 Section 2.Subsection (4) of section 401.265, Florida 47 Statutes, is amended to read: 48 401.265Medical directors. 49 (4)Each physician who supervises or provides medical 50 direction to medical director who uses a paramedic or an 51 emergency medical technician to perform community paramedicine; 52 to perform blood pressure screening, health promotion, and 53 wellness activities;, or to administer immunization for on any 54 patient under a protocol as specified in s. 401.272, which is 55 not in the provision of emergency care, is liable for any act or 56 omission of any paramedic or emergency medical technician acting 57 under his or her supervision and control when performing such 58 services. 59 Section 3.Subsections (1) and paragraph (a) of subsection 60 (2) of section 401.272, Florida Statutes, are amended to read: 61 401.272Emergency medical services community health care. 62 (1)The purpose of this section is to encourage more 63 effective use utilization of the skills of emergency medical 64 technicians and paramedics by enabling them to perform community 65 paramedicine, in partnership with local county health 66 departments and health care facilities as defined in s. 408.07, 67 specific additional health care tasks that are consistent with 68 the public health and welfare. 69 (2)Notwithstanding any other provision of law to the 70 contrary: 71 (a)Paramedics or emergency medical technicians may perform 72 community paramedicine, health promotion and wellness 73 activities, and blood pressure screenings in a nonemergency 74 environment, within the scope of their training, and under the 75 direction of a physician medical director. As used in this 76 paragraph, the term health promotion and wellness means the 77 provision of public health programs pertaining to the prevention 78 of illness and injury. 79 Section 4.Paragraph (d) of subsection (2) and paragraph 80 (a) of subsection (4) of section 465.019, Florida Statutes, are 81 amended to read: 82 465.019Institutional pharmacies; permits. 83 (2)The following classes of institutional pharmacies are 84 established: 85 (d)1.Class III institutional pharmacies are those 86 institutional pharmacies, including central distribution 87 facilities, affiliated with a hospital which that provide the 88 same services that are authorized by a Class II institutional 89 pharmacy permit. Class III institutional pharmacies may also: 90 a.Dispense, distribute, compound, and fill prescriptions 91 for medicinal drugs for inpatient or outpatient treatment. 92 b.Prepare prepackaged drug products. 93 c.Conduct other pharmaceutical services for the affiliated 94 hospital and for entities under common control that are each 95 permitted under this chapter to possess medicinal drugs. 96 d.Provide the services in sub-subparagraphs a.-c. to an 97 entity under common control which holds an active health care 98 clinic establishment permit as required under s. 499.01(2)(r). 99 2.A Class III institutional pharmacy shall maintain 100 policies and procedures addressing: 101 a.The consultant pharmacist responsible for pharmaceutical 102 services. 103 b.Safe practices for the preparation, dispensing, 104 prepackaging, distribution, and transportation of medicinal 105 drugs and prepackaged drug products. 106 c.Recordkeeping to monitor the movement, distribution, and 107 transportation of medicinal drugs and prepackaged drug products. 108 d.Recordkeeping of pharmacy staff responsible for each 109 step in the preparation, dispensing, prepackaging, 110 transportation, and distribution of medicinal drugs and 111 prepackaged drug products. 112 e.Medicinal drugs and prepackaged drug products that may 113 not be safely distributed among Class III institutional 114 pharmacies. 115 (4)(a)Medicinal drugs shall be dispensed by in an 116 institutional pharmacy to outpatients only when that institution 117 has secured a community pharmacy permit from the department. 118 However, medicinal drugs may be dispensed by a hospital that has 119 not secured a community pharmacy permit but operates a Class II 120 or Class III institutional pharmacy may dispense medicinal drugs 121 to a patient of the hospitals emergency department or a 122 hospital inpatient upon discharge if a prescriber, as defined in 123 s. 465.025(1), treating the patient in such hospital determines 124 that the medicinal drug is warranted and that community pharmacy 125 services are not readily accessible, geographically or 126 otherwise, to the patient. Such prescribing and dispensing must 127 be for a supply of the drug that will last for the greater of 128 the following: 129 1.Up to 48 hours; or 130 2.Through the end of the next business day. 131 Section 5.Subsection (1) of section 14.33, Florida 132 Statutes, is amended to read: 133 14.33Medal of Heroism. 134 (1)The Governor may award a Medal of Heroism of 135 appropriate design, with ribbons and appurtenances, to a law 136 enforcement, correctional, or correctional probation officer, as 137 defined in s. 943.10(14); a firefighter, as defined in s. 138 112.191(1)(b); an emergency medical technician, as defined in s. 139 401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s. 140 401.23(17). A recipient must have distinguished himself or 141 herself conspicuously by gallantry and intrepidity, must have 142 risked his or her life deliberately above and beyond the call of 143 duty while performing duty in his or her respective position, 144 and must have engaged in hazardous or perilous activities to 145 preserve lives with the knowledge that such activities might 146 result in great personal harm. 147 Section 6.Paragraph (a) of subsection (3) of section 148 252.515, Florida Statutes, is amended to read: 149 252.515Postdisaster Relief Assistance Act; immunity from 150 civil liability. 151 (3)As used in this section, the term: 152 (a)Emergency first responder means: 153 1.A physician licensed under chapter 458. 154 2.An osteopathic physician licensed under chapter 459. 155 3.A chiropractic physician licensed under chapter 460. 156 4.A podiatric physician licensed under chapter 461. 157 5.A dentist licensed under chapter 466. 158 6.An advanced practice registered nurse licensed under s. 159 464.012. 160 7.A physician assistant licensed under s. 458.347 or s. 161 459.022. 162 8.A worker employed by a public or private hospital in the 163 state. 164 9.A paramedic as defined in s. 401.23 s. 401.23(17). 165 10.An emergency medical technician as defined in s. 401.23 166 s. 401.23(11). 167 11.A firefighter as defined in s. 633.102. 168 12.A law enforcement officer as defined in s. 943.10. 169 13.A member of the Florida National Guard. 170 14.Any other personnel designated as emergency personnel 171 by the Governor pursuant to a declared emergency. 172 Section 7.Subsection (5) of section 395.1027, Florida 173 Statutes, is amended to read: 174 395.1027Regional poison control centers. 175 (5)By October 1, 1999, each regional poison control center 176 shall develop a prehospital emergency dispatch protocol with 177 each licensee as defined in s. 401.23 by s. 401.23(13) in the 178 geographic area covered by the regional poison control center. 179 The prehospital emergency dispatch protocol shall be developed 180 by each licensees medical director in conjunction with the 181 designated regional poison control center responsible for the 182 geographic area in which the licensee operates. The protocol 183 shall define toxic substances and describe the procedure by 184 which the designated regional poison control center may be 185 consulted by the licensee. If a call is transferred to the 186 designated regional poison control center in accordance with the 187 protocol established under this section and s. 401.268, the 188 designated regional poison control center shall assume 189 responsibility and liability for the call. 190 Section 8.Paragraph (b) of subsection (2) of section 191 401.245, Florida Statutes, is amended to read: 192 401.245Emergency Medical Services Advisory Council. 193 (2) 194 (b)Representation on the Emergency Medical Services 195 Advisory Council shall include: two licensed physicians who are 196 s. 401.23(15) or 197 whose medical practice is closely related to emergency medical 198 services; two emergency medical service administrators, one of 199 whom is employed by a fire service; two certified paramedics, 200 one of whom is employed by a fire service; two certified 201 emergency medical technicians, one of whom is employed by a fire 202 service; one emergency medical services educator; one emergency 203 nurse; one hospital administrator; one representative of air 204 ambulance services; one representative of a commercial ambulance 205 operator; and two laypersons who are in no way connected with 206 emergency medical services, one of whom is a representative of 207 the elderly. Ex officio members of the advisory council from 208 state agencies shall include, but are shall not be limited to, 209 representatives from the Department of Education, the Department 210 of Management Services, the State Fire Marshal, the Department 211 of Highway Safety and Motor Vehicles, the Department of 212 Transportation, and the Division of Emergency Management. 213 Section 9.This act shall take effect July 1, 2022.