Meeting Packet - Professions & Public Health Subcommittee, January 13, 2022
Summary
A meeting packet of the Professions & Public Health Subcommittee for Thursday, January 13, 2022, 9:00 AM, at Webster Hall, with a meeting notice listing HB 17, HB 343, HB 413, HB 7005, HB 7007 and a medical use of marijuana implementation update by Christopher Ferguson of the Florida Department of Health. The staff analysis of HB 17, Telehealth Practice Standards, says the bill allows practitioners to prescribe Schedule III, IV, and V controlled substances via telehealth, has no fiscal impact on state or local government, and provides an effective date of July 1, 2022. The closing presentation pages from the Office of Medical Marijuana Use include a table of product types with THC percentages and a note that a single-serving edible may not exceed 10 mg of THC.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
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Professions and Public Health
Subcommittee
Thursday, January 13, 2022
9:00 AM – 11:00 AM
Webster Hall (212 Knott)
Meeting Packet
Chris Sprowls Will Robinson
Speaker Chair
Committee Meeting Notice
HOUSE OF REPRESENTATIVES
Professions & Public Health Subcommittee
Start Date and Time: Thursday, January 13, 2022 09:00 am
End Date and Time: Thursday, January 13, 2022 11:00 am
Location: Webster Hall (212 Knott)
Duration: 2.00 hrs
Consideration of the following bill(s):
HB 17 Telehealth Practice Standards by Fabricio, Giallombardo
HB 343 Mental Health Professional Licensure by Koster
HB 413 Delegation of the Administration of Prescription Medications by Snyder
HB 7005 OGSR/Information Relating to the Medical Use of Marijuana/Department of Health by Government
Operations Subcommittee, Rizo
HB 7007 OGSR/Nonviable Birth Certificates/Department of Health by Government Operations Subcommittee,
Fetterhoff
Medical use of marijuana implementation update by Christopher Ferguson, Director, Office of Medical
Marijuana Use, Florida Department of Health
For information about attending or testifying at a committee meeting, please see the “Visiting the House”
tab at www.myfloridahouse.gov.
NOTICE FINALIZED on 01/11/2022 4:02PM by Osborne.Erin
01/11/2022 04:02:10PM Leagis ® Page 1 of 1
HB 17
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 17 Telehealth Practice Standards
SPONSOR(S): Fabricio
TIED BILLS: IDEN./SIM. BILLS:
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Rahming McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
Telehealth is the remote provision of health care services through the use of technology. Telehealth is not a
type of health care service but rather is a mechanism for delivery of health care services. Health care
professionals use telehealth as a platform to provide traditional health care services in a non-traditional
manner. These services include, among others, preventative medicine and the treatment of chronic conditions.
Practitioners have the ability to prescribe drugs via telehealth, but state and federal law limits the ability of
practitioners to dispense controlled substances using telehealth. Controlled substances are drugs with an
increased potential for patient abuse. The Florida Comprehensive Drug Abuse Prevention and Control Act
classifies controlled substances into five categories, called Schedules. Schedule I drugs have a high potential
for abuse and no accepted medical use. Drugs classified in schedules II through V still have the potential for
abuse, but also have well established medical uses.
At present, Florida law prohibits a telehealth provider from using telehealth services to prescribe a controlled
substance except when treating:
• A psychiatric disorder;
• An inpatient at a hospital;
• A patient receiving hospice services; and
• A resident of a nursing home facility.
Federal law requires a practitioner to conduct at least one in-person medical evaluation prior to dispensing a
controlled substance to a patient via telehealth.
HB 17 allows practitioners to prescribe Schedule III, IV, and V controlled substances via telehealth.
The bill has no fiscal impact on state or local government.
The bill provides an effective date of July 1, 2022.
FULL ANALYSIS
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
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I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Current Situation
Telehealth
Telehealth is not a type of health care service but rather is a mechanism for delivery of health care
services. Health care professionals use telehealth as a platform to provide traditional health care
services in a non-traditional manner. These services include, among others, preventative medicine and
the treatment of chronic conditions. 1
Telehealth, in its modern form, 2 started in the 1960s in large part driven by the military and space
technology sectors. 3 Specifically, telehealth was used to remotely monitor physiological measurements
of certain military and space program personnel. As this technology became more readily available to
the civilian market, telehealth began to be used for linking physicians with patients in remote, rural
areas. As advancements were made in telecommunication technology, the use of telehealth became
more widespread to include not only rural areas but also urban communities. Due to recent technology
advancements and general accessibility, the use of telehealth has spread rapidly and is now becoming
integrated into the ongoing operations of hospitals and healthcare systems around the country. 4 In fact,
there are currently an estimated 200 telehealth networks, with 3,000 service sites in the U.S. 5
Telehealth is used to address several problems in the current health care system. Inadequate access to
care is one of the primary obstacles to obtaining quality health care. 6 This occurs in both rural areas
and urban communities. 7 Telehealth reduces the impact of this issue by providing a mechanism to
deliver quality health care, irrespective of the location of a patient or a health care professional. Cost is
another barrier to obtaining quality health care. 8 This includes the cost of travel to and from the health
care facility, as well as related loss of wages from work absences. Costs are reduced through
telehealth by decreasing the time and distance required to travel to the health care professional. Two
more issues addressed through telehealth are the reutilization of health care services and hospital
readmission. These often occur due to a lack of proper follow-up care by the patient 9 or a chronic
condition. 10 These issues however can potentially be avoided through the use of telehealth and
telemonitoring. 11
Regulation of Telehealth in Florida
Service Providers
1 U.S. Department of Health and Human Services, Report to Congress: E-Health and Telemedicine (August 12, 2016), available at
https://aspe.hhs.gov/system/files/pdf/206751/TelemedicineE-HealthReport.pdf (last visited Nov. 1, 2021).
2 Historically, telehealth can be traced back to the mid to late 19th century with one of the first published accounts occurring in the early
20th century when electrocardiograph data were transmitted over telephone wires. See Field MJ, editor, Institute of Medicine
Committee on Evaluating Clinical Applications of Telemedicine, Telemedicine: A Guide to Assessing Telecommunications in Health
Care. 2, Evolution and Current Applications of Telemedicine, available at https://www.ncbi.nlm.nih.gov/books/NBK45445/ (last visited
Nov. 1, 2021).
3 Id.
4 American Telemedicine Association, Telehealth Basics, available at https://www.americantelemed.org/resource/why-telemedicine/
(last visited Nov. 1, 2021).
5 Id.
6 Id.
7 Id.
8 Id.
9 Post-surgical examination subsequent to a patient’s release from a hospital is a prime example. Specifically, infection can occur
without proper follow-up and ultimately leads to a readmission to the hospital.
10 For example, diabetes is a chronic condition which can benefit by treatment through telehealth.
11 Telemonitoring is the process of using audio, video, and other telecommunications and electronic information processing
technologies to monitor the health status of a patient from a distance.
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In 2019, the Legislature passed and the Governor signed CS/CS/HB 23, which established a
framework for telehealth services in Florida law. 12 The act broadly defines telehealth as the use of
synchronous or asynchronous telecommunications technology by a telehealth provider to provide
health care services, including, but not limited to:
• Assessment, diagnosis, consultation, treatment, and monitoring of a patient;
• Transfer of medical data;
• Patient and professional health-related education;
• Public health services; and
• Health administration.
Telehealth does not include audio-only telephone calls, e-mail messages, or facsimile transmission
under Florida law. 13 No express authority is needed to communicate using these methods.
Health care services may be provided via telehealth by a Florida-licensed health care practitioner, a
practitioner licensed under a multistate health care licensure compact of which Florida is a member, 14
or a registered out-of-state-health care provider. 15
Out-of-state telehealth providers must register biennially with the Department of Health (DOH) or the
applicable board to provide telehealth services, within the relevant scope of practice established by
Florida law and rule, to patients in this state. To register or renew registration as an out-of-state
telehealth provider, the health care professional must:
• Hold an active and unencumbered license, which is substantially similar to a license issued to a
Florida practitioner in the same profession, in a U.S. state or jurisdiction and
• Not have been subject to licensure disciplinary action during the five years before submission of
the registration application; 16
• Not be subject to a pending licensure disciplinary investigation or action;
• Not have had license revoked in any state or jurisdiction;
• Designate a registered agent in this state for the service of process;
• Maintain professional liability coverage or financial responsibility, which covers services
provided to patients not located in the provider’s home state, in the same amount as required for
Florida-licensed practitioners; 17 and
• Prominently display a link to the DOH website, described below, which provides public
information on registered telehealth providers. 18
Standards of Practice
Current law sets the standard of care for telehealth providers at the same level as the standard of care
for health care practitioners or health care providers providing in-person health care services to patients
in this state. This ensures that a patient receives the same standard of care irrespective of the modality
used by the health care professional to deliver the services. A patient receiving telehealth services may
12 Ch. 2019-137, L.O.F.
13 S. 456.47(1), F.S.
14 Florida is a member of the Nurse Licensure Compact. See s. 464.0095, F.S.
15 S. 456.47(4), F.S.
16 The bill requires DOH to consult the National Practitioner Data Bank to verify whether adverse information is available for the
registrant.
17 Florida law requires physicians, acupuncturists, chiropractic physicians, dentists, anesthesiologist assistants, advanced practice
registered nurses, and licensed midwives to demonstrate $100,000 per claim and an annual aggregate of $300,000 of professional
responsibility (see ss. 458.320 and 459.0085, F.S.; r. 64B1-12.001. F.A.C; r. 64B2-17.009, F.A.C.; 64B5-17.0105, F.A.C.; rr. 64B8-
31.006 and 64B15-7.006, F.A.C.; r. 64B9-4.002, F.A.C.; and r. 64B24-7.013, F.A.C.; respectively). Podiatric physicians must
demonstrate professional responsibility in the amount of $100,000 (see r. 64B18-14.0072, F.A.C.).
18 S. 456.47(4), F.S.
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be in any location at the time services are rendered and a telehealth provider may be in any location
when providing telehealth services to a patient. 19
Practitioners may perform a patient evaluation using telehealth. A practitioner using telehealth is not
required to research a patient’s medical history or conduct a physical examination of the patient before
providing telehealth services to the patient if the telehealth provider is capable of conducting a patient
evaluation in a manner consistent with the applicable standard of care sufficient to diagnose and treat
the patient when using telehealth.
Controlled Substances
Florida Law
Chapter 893, F.S., the Florida Comprehensive Drug Abuse Prevention and Control Act, classifies
controlled substances into five categories, called schedules. These schedules regulate the
manufacture, distribution, preparation, and dispensing of the substances listed therein. The
distinguishing factors between the different drug schedules are the “potential for abuse” 20 of the
substance and whether there is a currently accepted medical use for the substance. 21
The controlled substance schedules are as follows:
• Schedule I substances have a high potential for abuse and currently have no accepted medical
use in the United States, including substances such as cannabis and heroin. 22
• Schedule II substances have a high potential for abuse and have a currently accepted but
severely restricted medical use in the United States, including substances such as raw opium,
fentanyl, and codeine. 23
• Schedule III substances have a potential for abuse less than the substances contained in
Schedules I and II and have a currently accepted medical use in the United States, including
substances such as stimulants and anabolic steroids. 24
• Schedule IV substances have a low potential for abuse relative to substances in Schedule III
and have a currently accepted medical use in the United States, including substances such as
benzodiazepines and barbiturates. 25
• Schedule V substances have a low potential for abuse relative to the substances in Schedule IV
and have a currently accepted medical use in the United States, including substances such as
mixtures that contain small quantities of opiates, narcotics, or stimulants. 26
Federal Law
The Federal Controlled Substances Act 27 also classifies controlled substances into schedules based on
the potential for abuse and whether there is a currently accepted medical use for the substance. The
Drug Enforcement Administration (DEA) is required to consider the following when determining where
to schedule a substance: 28
19 S. 456.47(2), F.S.
20 S. 893.035(3)(a), F.S., defines “potential for abuse” to mean that a substance has properties as a central nervous system stimulant or
depressant or a hallucinogen that create a substantial likelihood of its being: 1) used in amounts that create a hazard to the user’s
health or safety of the community; 2) diverted from legal channels and distributed through illegal channels; or 3) taken on the user’s
own initiative rather than on the basis of professional medical advice.
21 See s. 893.03, F.S.
22 S. 893.03(1), F.S.
23 S. 893.03(2), F.S.
24 S. 893.03(3), F.S.
25 S. 893.03(4), F.S.
26 S. 893.03(5), F.S.
27 21 U.S.C. § 812.
28 21 U.S.C. § 811(c).
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• The substance’s actual or relative potential for abuse;
• Scientific evidence of the substance’s pharmacological effect, if known;
• The state of current scientific knowledge regarding the substance;
• The substance’s history and current pattern of abuse;
• The scope, duration, and significance of abuse;
• What, if any, risk there is to public health;
• The substance’s psychic or physiological dependence liability; and
• Whether the substance is an immediate precursor of a substance already controlled.
Telehealth Prescribing of Controlled Substances
Federal law specifically prohibits prescribing controlled substances via the Internet without an in-person
evaluation: 29
No controlled substance that is a prescription drug as determined under the Federal
Food, Drug, and Cosmetic Act may be delivered, distributed, or dispensed by means of
the Internet without a valid prescription. 30
The in-person medical evaluation requires that the patient be in the physical presence of the provider
without regard to the presence or conduct of other professionals. 31 However, the Ryan Haight Online
Pharmacy Consumer Protection Act, 32 signed into law in October 2008, created a pathway for
telehealth practitioners to dispense controlled substances via telehealth. The practitioner is still subject
to the requirement that all controlled substance prescriptions be issued for a legitimate purpose by a
practitioner acting in the usual course of professional practice. But, once an in-person evaluation of the
patient has occurred, the practitioner may provide future prescriptions for controlled substances for that
patient using telehealth services. 33
Florida law currently prohibits a telehealth provider from using telehealth services to prescribe a
controlled substance except when treating:
• A psychiatric disorder;
• An inpatient at a hospital licensed under ch. 395, F.S.;
• A patient receiving hospice services as defined under s. 400.601, F.S.;
• A resident of a nursing home facility as defined under s. 400.021(12), F.S.
Effect of Proposed Changes
HB 17 allows practitioners to prescribe Schedule III, IV, and V controlled substances using telehealth
services without limitation and retains current law restrictions on prescribing Schedule II controlled
substances through telehealth.
The bill provides an effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 456.47, F.S.; relating to use of telehealth to provide services.
Section 2: Provides an effective date of July 1, 2022.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
29 21 CFR §829
30 A valid prescription is defined as one issued by a practitioner who has conducted at least one in-person medical evaluation of the
patient.
31 21 CFR § 829(e)(2).
32 Ryan Haight Online Consumer Protection Act of 2008, Public Law 110-425 (H.R. 6353).
33 Id.
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A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
DOH has sufficient rule-making authority to implement the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 17 2022
1 A bill to be entitled
2 An act relating to telehealth practice standards;
3 amending s. 456.47, F.S.; revising the prohibition on
4 prescribing controlled substances through the use of
5 telehealth to include only specified controlled
6 substances; providing an effective date.
7
8 Be It Enacted by the Legislature of the State of Florida:
9
10 Section 1. Paragraph (c) of subsection (2) of section
11 456.47, Florida Statutes, is amended to read:
12 456.47 Use of telehealth to provide services.—
13 (2) PRACTICE STANDARDS.—
14 (c) A telehealth provider may not use telehealth to
15 prescribe a controlled substance listed in Schedule II of s.
16 893.03 unless the controlled substance is prescribed for the
17 following:
18 1. The treatment of a psychiatric disorder;
19 2. Inpatient treatment at a hospital licensed under
20 chapter 395;
21 3. The treatment of a patient receiving hospice services
22 as defined in s. 400.601; or
23 4. The treatment of a resident of a nursing home facility
24 as defined in s. 400.021.
25 Section 2. This act shall take effect July 1, 2022.
Page 1 of 1
CODING: Words stricken are deletions; words underlined are additions.
hb0017-00
HB 343
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 343 Mental Health Professional Licensure
SPONSOR(S): Koster and others
TIED BILLS: IDEN./SIM. BILLS: SB 566
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Morris McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
Marriage and family therapists are trained mental health professionals who diagnose and treat mental health
and emotional disorders within the context of marriage and family systems. A marriage and family therapist
may treat a wide range of clinical problems, including depression, marital problems, child-parent problems, as
well as individual problems. A mental health counselor is an individual who uses scientific and applied
behavioral science theories, methods, and techniques to describe, prevent, and treat undesired behavior and
enhance mental health and human development. The Board of Clinical Social Work, Marriage and Family
Therapy, and Mental Health Counseling within the Department of Health (DOH) regulates the practice of
marriage and family therapy and mental health counseling.
In 2020, the Legislature passed HB 713 which, among other things, revised the licensure requirements for
marriage and family therapists. Beginning on July 1, 2020, applicants for licensure must hold a master’s
degree from a program accredited by the Commission of Accreditation for Marriage and Family Therapy
Education or a Florida university accredited by the Council for Accreditation of Counseling and Related
Educational Programs (CACREP). However, the legislation did not provide a window of time for education
programs which did not have those specific accreditations at the time the law was enacted to become
accredited, meaning students who graduate on or after July 1, 2020, from such programs do not meet the
accreditation qualification for licensure in Florida. HB 343 revises educational requirements for marriage and
family therapy and mental health counselor licenses. The bill allows DOH to continue to issue licenses to
graduates of otherwise qualified Florida marriage and family therapy programs until July 1, 2027, while such
programs seek accreditation.
A mental health counselor is an individual who uses scientific and applied behavioral science theories,
methods, and techniques to describe, prevent, and treat undesired behavior and enhance mental health and
human development. The same 2020 legislation also revised the licensure requirements for mental health
counselors by requiring applicants for licensure who apply after July 1, 2025, to hold a master’s degree from a
program accredited by CACREP. There are currently sixteen university mental health counselor programs
accredited by CACREP in this state. The University of West Florida’s (UWF) mental health counselor program
is the only program accredited by the Masters in Psychology and Counseling Accreditation Council (MPCAC)
in this state. Thus, beginning in 2025, UWF graduates will not meet the requirements for licensure as a mental
health counselor. The bill adds the MPCAC, or an equivalent body, as an authorized accrediting body for
mental health counselor education programs beginning on July 1, 2025, allowing UWF to continue to graduate
students who will meet the accreditation requirements for licensure.
The bill has an insignificant, negative fiscal impact on DOH and no fiscal impact on local governments.
The bill takes effect upon becoming law.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Marriage and Family Therapists
Marriage and family therapy incorporates marriage and family therapy, psychotherapy, hypnotherapy,
sex therapy, counseling, behavior modification, consultation, client-centered advocacy, crisis
intervention, and the provision of needed information and education to clients. 1 An applicant seeking
licensure as a mental health counselor must: 2
• Possess a master’s degree from an a program accredited by the Commission on Accreditation
for Marriage and Family Therapy Education or from a Florida university program accredited by
the Council for Accreditation of Counseling and Related Educational Programs and board-
approved graduate courses; 3
• Complete two years of post-master’s supervised experience under the supervision of a licensed
marriage and family therapist with five years of experience or the equivalent who is a qualified
supervisor as determined by the board;
• Pass a board-approved examination; and
• Demonstrate knowledge of laws and rules governing the practice.
DOH must verify that an applicant’s education matches the specified courses and hours as outlined in
statute. However, there are organizations that accredit marriage and family therapy education
programs, including the Commission on Accreditation for Marriage and Family Therapy Education
(COAMFTE) and the Council for the Accreditation of Counseling and Related Educational Programs
(CACREP) that establish the minimum standards to meet the requirements to practice the profession. 4
In 2020, the Legislature passed HB 713, which, among other things, revised licensure requirements for
marriage and family therapists. Beginning on July 1, 2020, applicants for licensure must possess a
master’s degree from an a program accredited by COAMFTE or from a Florida university program
accredited by CACREP and board-approved graduate courses. 5 However, a window of time was not
granted for education programs which were unaccredited at the time to apply for and obtain such
accreditation, meaning students who graduate on or after July 1, 2020, from such programs do not
meet the accreditation qualifications for licensure in Florida. 6 Currently, six universities in Florida have a
marriage and family therapy program that is not accredited by either COAMFTE or CACREP. 7
1 Department of Health, Agency Analysis of House Bill 343 (Oct. 25, 2021).
2 Section 491.005(3), F.S. An individual may qualify for a dual license in marriage and family therapy if he or she passes an
examination in marriage and family therapy and has held an active license for at least three years as a psychologist, clinical social
worker, mental health counselor, or advanced registered nurse practitioner who is determined by the Board of Nursing to be a specialist
in psychiatric mental health (s. 491.0057, F.S.)
3 Ch. 2020-133, Laws of Fla, required applicants for licensure as a marriage and family therapist to graduate from an accredited
program or an accredited Florida university program.
4 See Commission on Accreditation for Marriage and Family Therapy Education, What Are the Benefits of COAMFTE Accreditation,
https://www.coamfte.org/COAMFTE/Accreditation/About_Accreditation.aspx (last visited March 16, 2021), and Council for the
Accreditation of Counseling and Related Educational Programs, About CACREP, https://www.cacrep.org/about-cacrep/ (last visited
March 16, 2021).
5 Section 491.005, F.S. (2020).
6 Supra, note 1.
7 Email from Andrew Love, Director of Legislative Planning, Department of Health, MFT Follow-up, (July 27, 2021). The universities are
Carlos Albizu, Jacksonville University, Palm Beach Atlantic University, St. Thomas University, University of Miami, and University of
Phenix.
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Mental Health Counselors
A mental health counselor is an individual who uses scientific and applied behavioral science theories,
methods, and techniques to describe, prevent, and treat undesired behavior and enhance mental
health and human development and is based on research and theory in personality, family, group, and
organizational dynamics and development, career planning, cultural diversity, human growth and
development, human sexuality, normal and abnormal behavior, psychopathology, psychotherapy, and
rehabilitation. 8 To qualify for licensure as a mental health counselor, an individual must: 9
• Have a master’s degree from a mental health counseling program accredited by CACREP, or a
program related to the practice of mental health counseling that includes coursework and a 700-
hour practicum, internship, or fieldwork of which at least 280 hours must be in direct client
services;
• Have at least two years of post-master’s supervised clinical experience in mental health
counseling;
• Pass an examination from the Professional Examination Service for the National Academy of
Certified Clinical Mental Health Counselors; and
• Pass an eight-hour course on Florida laws and rules approved by the Board of Clinical Social
Work, Marriage and Family Therapy, and Mental Health Counseling. 10
Ch. 2020-133, L.O.F, also revised licensure requirements for mental health counselors. Beginning July
1, 2025, applicants for licensure as a mental health counselor must hold a master’s degree from a
program accredited by CACREP. 11 The CACREP accreditation standards require 60 credits of
specified educational content and a 700-hour practicum requiring face-to-face psychotherapy. 12 There
are currently sixteen universities in this state accredited by CACREP. 13 The University of West Florida’s
(UWF) mental health counselor program is the only program accredited by the Masters in Psychology
and Counseling Accreditation Council in this state. 14 Thus, beginning in 2025, UWF’s current
accreditation for its mental health counselor program will not be sufficient for graduates to meet
licensure requirements in this state.
Effect of the Bill
Marriage and Family Therapists
The bill allows DOH to continue to issue licenses to graduates of otherwise qualified Florida marriage
and family therapy programs until July 1, 2027, while such programs seek accreditation.
Mental Health Counselors
The bill adds the Masters in Psychology and Counseling Accreditation Council, or an equivalent body,
as an authorized accrediting body for mental health counselor education programs beginning on July 1,
2025. This will allow UWF to continue to graduate students who are eligible for licensure in this state.
B. SECTION DIRECTORY:
Section 1: Amends s. 491.005, F.S., relating to licensure by examination.
Section 2: Provides the bill shall take effect upon becoming a law.
8 Sections 491.003(6) and (9), F.S.
9 Section 491.005(4), F.S.
10 Section 491.005(4), F.S., and r. 64B4-3.0035, F.A.C.
11 Section 491.005(4)(b), F.S.
12 Supra, note 1.
13 Council for Accreditation for Counseling and Related Educational Programs, Find a Program, https://www.cacrep.org/directory/ (last
visited Dec. 22, 2021).
14 Masters in Psychology and Counseling Accreditation Council, Accredited Programs, http://mpcacaccreditation.org/accredited-
programs/ (last visited Dec. 22, 2021).
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II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
DOH will experience a non-recurring increase in workload to update IT systems and websites, the
impact of which can be absorbed within current resources. 15
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. The bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
Rule-making authority is not needed to implement the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
15 Supra, note 1.
STORAGE NAME: h0343.PPH PAGE: 4
DATE: 1/11/2022
F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 343 2022
1 A bill to be entitled
2 An act relating to mental health professional
3 licensure; amending s. 491.005, F.S.; revising
4 educational requirements for marriage and family
5 therapist and mental health counselor licenses;
6 providing an effective date.
7
8 Be It Enacted by the Legislature of the State of Florida:
9
10 Section 1. Subsections (3) and (4) of section 491.005,
11 Florida Statutes, are amended to read:
12 491.005 Licensure by examination.—
13 (3) MARRIAGE AND FAMILY THERAPY.—Upon verification of
14 documentation and payment of a fee not to exceed $200, as set by
15 board rule, plus the actual cost of the purchase of the
16 examination from the Association of Marital and Family Therapy
17 Regulatory Board, or similar national organization, the
18 department shall issue a license as a marriage and family
19 therapist to an applicant who the board certifies has met all of
20 the following criteria:
21 (a) Has Submitted an application and paid the appropriate
22 fee.
23 (b)1. Attained one of the following:
24 a. A minimum of a master's degree in marriage and family
25 therapy from a program accredited by the Commission on
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HB 343 2022
26 Accreditation for Marriage and Family Therapy Education;
27 b. A minimum of a master's degree with a major emphasis in
28 marriage and family therapy or a closely related field from a
29 university program accredited by the Council on Accreditation of
30 Counseling and Related Educational Programs and graduate courses
31 approved by the board; or
32 c. Has A minimum of a master's degree with an major
33 emphasis in marriage and family therapy or a closely related
34 field, with a degree conferred before September 1, 2027, from an
35 institutionally accredited college or university from a program
36 accredited by the Commission on Accreditation for Marriage and
37 Family Therapy Education or from a Florida university program
38 accredited by the Council for Accreditation of Counseling and
39 Related Educational Programs and graduate courses approved by
40 the board of Clinical Social Work, Marriage and Family Therapy,
41 and Mental Health Counseling.
42 2. If the course title that appears on the applicant's
43 transcript does not clearly identify the content of the
44 coursework, the applicant must shall provide additional
45 documentation, including, but not limited to, a syllabus or
46 catalog description published for the course. The required
47 master's degree must have been received in an institution of
48 higher education that, at the time the applicant graduated, was
49 fully accredited by a regional accrediting body recognized by
50 the Commission on Recognition of Postsecondary Accreditation or
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HB 343 2022
51 publicly recognized as a member in good standing with the
52 Association of Universities and Colleges of Canada, or an
53 institution of higher education located outside the United
54 States and Canada which, at the time the applicant was enrolled
55 and at the time the applicant graduated, maintained a standard
56 of training substantially equivalent to the standards of
57 training of those institutions in the United States which are
58 accredited by a regional accrediting body recognized by the
59 Commission on Recognition of Postsecondary Accreditation. Such
60 foreign education and training must have been received in an
61 institution or program of higher education officially recognized
62 by the government of the country in which it is located as an
63 institution or program to train students to practice as
64 professional marriage and family therapists or psychotherapists.
65 The applicant has the burden of establishing that the
66 requirements of this provision have been met, and the board
67 shall require documentation, such as an evaluation by a foreign
68 equivalency determination service, as evidence that the
69 applicant's graduate degree program and education were
70 equivalent to an accredited program in this country. An
71 applicant with a master's degree from a program that did not
72 emphasize marriage and family therapy may complete the
73 coursework requirement in a training institution fully
74 accredited by the Commission on Accreditation for Marriage and
75 Family Therapy Education recognized by the United States
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HB 343 2022
76 Department of Education.
77 (c) Completed Has had at least 2 years of clinical
78 experience during which 50 percent of the applicant's clients
79 were receiving marriage and family therapy services, which must
80 be at the post-master's level under the supervision of a
81 licensed marriage and family therapist with at least 5 years of
82 experience, or the equivalent, who is a qualified supervisor as
83 determined by the board. An individual who intends to practice
84 in Florida to satisfy the clinical experience requirements must
85 register pursuant to s. 491.0045 before commencing practice. If
86 a graduate has a master's degree with a major emphasis in
87 marriage and family therapy or a closely related field which did
88 not include all of the coursework required by paragraph (b),
89 credit for the post-master's level clinical experience may not
90 commence until the applicant has completed a minimum of 10 of
91 the courses required by paragraph (b), as determined by the
92 board, and at least 6 semester hours or 9 quarter hours of the
93 course credits must have been completed in the area of marriage
94 and family systems, theories, or techniques. Within the 2 years
95 of required experience, the applicant shall provide direct
96 individual, group, or family therapy and counseling to cases
97 including those involving unmarried dyads, married couples,
98 separating and divorcing couples, and family groups that include
99 children. A doctoral internship may be applied toward the
100 clinical experience requirement. A licensed mental health
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HB 343 2022
101 professional must be on the premises when clinical services are
102 provided by a registered intern in a private practice setting.
103 (d) Has Passed a theory and practice examination provided
104 by the department.
105 (e) Has Demonstrated, in a manner designated by board
106 rule, knowledge of the laws and rules governing the practice of
107 clinical social work, marriage and family therapy, and mental
108 health counseling.
109
110 For the purposes of dual licensure, the department shall licens e
111 as a marriage and family therapist any person who meets the
112 requirements of s. 491.0057. Fees for dual licensure may not
113 exceed those stated in this subsection.
114 (4) MENTAL HEALTH COUNSELING.—Upon verification of
115 documentation and payment of a fee not to exceed $200, as set by
116 board rule, plus the actual per applicant cost of purchase of
117 the examination from the National Board for Certified Counselors
118 or its successor organization, the department shall issue a
119 license as a mental health counselor to an applicant who the
120 board certifies has met all of the following criteria:
121 (a) Has Submitted an application and paid the appropriate
122 fee.
123 (b)1. Attained Has a minimum of an earned master's degree
124 from a mental health counseling program accredited by the
125 Council for the Accreditation of Counseling and Related
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HB 343 2022
126 Educational Programs which consists of at least 60 semester
127 hours or 80 quarter hours of clinical and didactic instruction,
128 including a course in human sexuality and a course in substance
129 abuse. If the master's degree is earned from a program related
130 to the practice of mental health counseling which is not
131 accredited by the Council for the Accreditation of Counseling
132 and Related Educational Programs, then the coursework and
133 practicum, internship, or fieldwork must consist of at least 60
134 semester hours or 80 quarter hours and meet all of the following
135 requirements:
136 a. Thirty-three semester hours or 44 quarter hours of
137 graduate coursework, which must include a minimum of 3 semester
138 hours or 4 quarter hours of graduate-level coursework in each of
139 the following 11 content areas: counseling theories and
140 practice; human growth and development; diagnosis and trea tment
141 of psychopathology; human sexuality; group theories and
142 practice; individual evaluation and assessment; career and
143 lifestyle assessment; research and program evaluation; social
144 and cultural foundations; substance abuse; and legal, ethical,
145 and professional standards issues in the practice of mental
146 health counseling. Courses in research, thesis or dissertation
147 work, practicums, internships, or fieldwork may not be applied
148 toward this requirement.
149 b. A minimum of 3 semester hours or 4 quarter hours of
150 graduate-level coursework addressing diagnostic processes,
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HB 343 2022
151 including differential diagnosis and the use of the current
152 diagnostic tools, such as the current edition of the American
153 Psychiatric Association's Diagnostic and Statistical Manual of
154 Mental Disorders. The graduate program must have emphasized the
155 common core curricular experience.
156 c. The equivalent, as determined by the board, of at least
157 700 hours of university-sponsored supervised clinical practicum,
158 internship, or field experience that includes at least 280 hours
159 of direct client services, as required in the accrediting
160 standards of the Council for Accreditation of Counseling and
161 Related Educational Programs for mental health counseling
162 programs. This experience may not be used to satisfy th e post-
163 master's clinical experience requirement.
164 2. Has Provided additional documentation if a course title
165 that appears on the applicant's transcript does not clearly
166 identify the content of the coursework. The documentation must
167 include, but is not limited to, a syllabus or catalog
168 description published for the course.
169
170 Education and training in mental health counseling must have
171 been received in an institution of higher education that, at the
172 time the applicant graduated, was fully accredited by a regi onal
173 accrediting body recognized by the Council for Higher Education
174 Accreditation or its successor organization or publicly
175 recognized as a member in good standing with the Association of
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HB 343 2022
176 Universities and Colleges of Canada, or an institution of higher
177 education located outside the United States and Canada which, at
178 the time the applicant was enrolled and at the time the
179 applicant graduated, maintained a standard of training
180 substantially equivalent to the standards of training of those
181 institutions in the United States which are accredited by a
182 regional accrediting body recognized by the Council for Higher
183 Education Accreditation or its successor organization. Such
184 foreign education and training must have been received in an
185 institution or program of higher education officially recognized
186 by the government of the country in which it is located as an
187 institution or program to train students to practice as mental
188 health counselors. The applicant has the burden of establishing
189 that the requirements of this provision have been met, and the
190 board shall require documentation, such as an evaluation by a
191 foreign equivalency determination service, as evidence that the
192 applicant's graduate degree program and education were
193 equivalent to an accredited program in this country. Beginning
194 July 1, 2025, an applicant must have a master's degree from a
195 program that is accredited by the Council for Accreditation of
196 Counseling and Related Educational Programs, the Masters in
197 Psychology and Counseling Accreditation Council, or a n
198 equivalent accrediting body which consists of at least 60
199 semester hours or 80 quarter hours to apply for licensure under
200 this paragraph.
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201 (c) Completed Has had at least 2 years of clinical
202 experience in mental health counseling, which must be at the
203 post-master's level under the supervision of a licensed mental
204 health counselor or the equivalent who is a qualified supervisor
205 as determined by the board. An individual who intends to
206 practice in Florida to satisfy the clinical experience
207 requirements must register pursuant to s. 491.0045 before
208 commencing practice. If a graduate has a master's degree with a
209 major related to the practice of mental health counseling which
210 did not include all the coursework required under sub -
211 subparagraphs (b)1.a. and b., credit for the post-master's level
212 clinical experience may not commence until the applicant has
213 completed a minimum of seven of the courses required under sub-
214 subparagraphs (b)1.a. and b., as determined by the board, one of
215 which must be a course in psychopathology or abnormal
216 psychology. A doctoral internship may be applied toward the
217 clinical experience requirement. A licensed mental health
218 professional must be on the premises when clinical services are
219 provided by a registered intern in a private practice se tting.
220 (d) Has Passed a theory and practice examination provided
221 by the department for this purpose.
222 (e) Has Demonstrated, in a manner designated by board
223 rule, knowledge of the laws and rules governing the practice of
224 clinical social work, marriage and family therapy, and mental
225 health counseling.
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 343 2022
226 Section 2. This act shall take effect upon becoming a law.
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
COMMITTEE/SUBCOMMITTEE ACTION
ADOPTED (Y/N)
ADOPTED AS AMENDED (Y/N)
ADOPTED W/O OBJECTION (Y/N)
FAILED TO ADOPT (Y/N)
WITHDRAWN (Y/N)
OTHER
1 Committee/Subcommittee hearing bill: Professions & Public
2 Health Subcommittee
3 Representative Koster offered the following:
4
5 Amendment (with title amendment)
6 Remove everything after the enacting clause and insert:
7 Section 1. Subsections (3) and (4) of section 491.005,
8 Florida Statutes, are amended to read:
9 491.005 Licensure by examination.—
10 (3) MARRIAGE AND FAMILY THERAPY.— Upon verification of
11 documentation and payment of a fee not to exceed $200, as set by
12 board rule, plus the actual cost of the purchase of the
13 examination from the Association of Marital and Family Therapy
14 Regulatory Board, or similar national organization, the
15 department shall issue a license as a marriage and family
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
16 therapist to an applicant who the board certifies has met all of
17 the following criteria:
18 (a) Has Submitted an application and paid the appropriate
19 fee.
20 (b) 1. Attained one of the following:
21 a. A minimum of a master's degree in marriage and family
22 therapy from a program accredited by the Commission on
23 Accreditation for Marriage and Family Therapy Education;
24 b. A minimum of a master's degree with a major emphasis in
25 marriage and family therapy or a closely related field from a
26 university program accredited by the Council on Accreditation of
27 Counseling and Related Educational Programs and graduate courses
28 approved by the board; or
29 c. Has a minimum of a master's degree with an major
30 emphasis in marriage and family therapy or a closely related
31 field, with a degree conferred before September 1, 2027, from an
32 institutionally accredited college or university from a program
33 accredited by the Commission on Accreditation for Marriage and
34 Family Therapy Education or from a Florida university program
35 accredited by the Council for Accreditation of Counseling and
36 Related Educational Programs and graduate courses approved by
37 the board of Clinical Social Work, Marriage and Family Therapy,
38 and Mental Health Counseling.
39 2. If the course title that appears on the applicant's
40 transcript does not clearly identify the content of the
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
41 coursework, the applicant must shall provide additional
42 documentation, including, but not limited to, a syllabus or
43 catalog description published for the course. The required
44 master's degree must have been received in an institution of
45 higher education that, at the time the applicant graduated, was
46 fully accredited by an institutional a regional accrediting body
47 recognized by the Council for Higher Education Accreditation or
48 its successor organization Commission on Recognition of
49 Postsecondary Accreditation or publicly recognized as a member
50 in good standing with the Association of Universities and
51 Colleges of Canada, or an institution of higher education
52 located outside the United States and Canada which, at the time
53 the applicant was enrolled and at the time the applicant
54 graduated, maintained a standard of training substantially
55 equivalent to the standards of training of those institutions in
56 the United States which are accredited by an institutional a
57 regional accrediting body recognized by the Council for Higher
58 Education Accreditation or its successor organization Commission
59 on Recognition of Postsecondary Accreditation. Such foreign
60 education and training must have been received in an institution
61 or program of higher education officially recognized by the
62 government of the country in which it is located as an
63 institution or program to train students to practice as
64 professional marriage and family therapists or psychotherapists.
65 The applicant has the burden of establishing that the
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
66 requirements of this provision have been met, and the board
67 shall require documentation, such as an evaluation by a foreign
68 equivalency determination service, as evidence that the
69 applicant's graduate degree program and education were
70 equivalent to an accredited program in this country. An
71 applicant with a master's degree from a program that did not
72 emphasize marriage and family therapy may complete the
73 coursework requirement in a training institution fully
74 accredited by the Commission on Accreditation for Marriage and
75 Family Therapy Education recognized by the United States
76 Department of Education.
77 (c) Completed Has had at least 2 years of clinical
78 experience during which 50 percent of the applicant's clients
79 were receiving marriage and family therapy services, which must
80 be at the post-master's level under the supervision of a
81 licensed marriage and family therapist with at least 5 years of
82 experience, or the equivalent, who is a qualified supervisor as
83 determined by the board. An individual who intends to practice
84 in Florida to satisfy the clinical experience requirements must
85 register pursuant to s. 491.0045 before commencing practice. If
86 a graduate has a master's degree with a major emphasis in
87 marriage and family therapy or a closely related field which did
88 not include all of the coursework required by paragraph (b),
89 credit for the post-master's level clinical experience may not
90 commence until the applicant has completed a minimum of 10 of
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
91 the courses required by paragraph (b), as determined by the
92 board, and at least 6 semester hours or 9 quarter hours of the
93 course credits must have been completed in the area of marriage
94 and family systems, theories, or techniques. Within the 2 years
95 of required experience, the applicant shall provide direct
96 individual, group, or family therapy and counseling to cases
97 including those involving unmarried dyads, married couples,
98 separating and divorcing couples, and family groups that include
99 children. A doctoral internship may be applied toward the
100 clinical experience requirement. A licensed mental health
101 professional must be on the premises when clinical services are
102 provided by a registered intern in a private practice setting.
103 (d) Has Passed a theory and practice examination
104 designated by board rule provided by the department.
105 (e) Has Demonstrated, in a manner designated by board
106 rule, knowledge of the laws and rules governing the practice of
107 clinical social work, marriage and family therapy, and mental
108 health counseling.
109
110 For the purposes of dual licensure, the department shall license
111 as a marriage and family therapist any person who meets the
112 requirements of s. 491.0057. Fees for dual licensure may not
113 exceed those stated in this subsection.
114 (4) MENTAL HEALTH COUNSELING.—Upon verification of
115 documentation and payment of a fee not to exceed $200, as set by
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
116 board rule, plus the actual per applicant cost of purchase of
117 the examination from the National Board for Certified Counselors
118 or its successor organization, the department shall issue a
119 license as a mental health counselor to an applicant who the
120 board certifies has met all of the following criteria:
121 (a) Has submitted an application and paid the appropriate
122 fee.
123 (b)1. Attained Has a minimum of an earned master's degree
124 from a mental health counseling program accredited by the
125 Council for the Accreditation of Counseling and Related
126 Educational Programs which consists of at least 60 semester
127 hours or 80 quarter hours of clinical and didactic instruction,
128 including a course in human sexuality and a course in substance
129 abuse. If the master's degree is earned from a program related
130 to the practice of mental health counseling which is not
131 accredited by the Council for the Accreditation of Counseling
132 and Related Educational Programs, then the coursework and
133 practicum, internship, or fieldwork must consist of at least 60
134 semester hours or 80 quarter hours and meet all of the following
135 requirements:
136 a. Thirty-three semester hours or 44 quarter hours of
137 graduate coursework, which must include a minimum of 3 semester
138 hours or 4 quarter hours of graduate-level coursework in each of
139 the following 11 content areas: counseling theories and
140 practice; human growth and development; diagnosis and treatment
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Bill No. HB 343 (2022)
Amendment No. 1
141 of psychopathology; human sexuality; group theories and
142 practice; individual evaluation and assessment; career and
143 lifestyle assessment; research and program evaluation; social
144 and cultural foundations; substance abuse; and legal, ethical,
145 and professional standards issues in the practice of mental
146 health counseling. Courses in research, thesis or dissertation
147 work, practicums, internships, or fieldwork may not be applied
148 toward this requirement.
149 b. A minimum of 3 semester hours or 4 quarter hours of
150 graduate-level coursework addressing diagnostic processes,
151 including differential diagnosis and the use of the current
152 diagnostic tools, such as the current edition of the American
153 Psychiatric Association's Diagnostic and Statistical Manual of
154 Mental Disorders. The graduate program must have emphasized the
155 common core curricular experience.
156 c. The equivalent, as determined by the board, of at least
157 700 hours of university-sponsored supervised clinical practicum,
158 internship, or field experience that includes at least 280 hours
159 of direct client services, as required in the accrediting
160 standards of the Council for Accreditation of Counseling and
161 Related Educational Programs for mental health counseling
162 programs. This experience may not be used to satisfy the post-
163 master's clinical experience requirement.
164 2. Has Provided additional documentation if a course title
165 that appears on the applicant's transcript does not clearly
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Bill No. HB 343 (2022)
Amendment No. 1
166 identify the content of the coursework. The documentation must
167 include, but is not limited to, a syllabus or catalog
168 description published for the course.
169
170 Education and training in mental health counseling must have
171 been received in an institution of higher education that, at the
172 time the applicant graduated, was fully accredited by an
173 institutional a regional accrediting body recognized by the
174 Council for Higher Education Accreditation or its successor
175 organization or publicly recognized as a member in good standing
176 with the Association of Universities and Colleges of Canada, or
177 an institution of higher education located outside the United
178 States and Canada which, at the time the applicant was enrolled
179 and at the time the applicant graduated, maintained a standard
180 of training substantially equivalent to the standards of
181 training of those institutions in the United States which are
182 accredited by an institutional a regional accrediting body
183 recognized by the Council for Higher Education Accreditation or
184 its successor organization. Such foreign education and training
185 must have been received in an institution or program of higher
186 education officially recognized by the government of the country
187 in which it is located as an institution or program to train
188 students to practice as mental health counselors. The applicant
189 has the burden of establishing that the requirements of this
190 provision have been met, and the board shall require
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
191 documentation, such as an evaluation by a foreign equivalency
192 determination service, as evidence that the applicant's graduate
193 degree program and education were equivalent to an accredited
194 program in this country. Beginning July 1, 2025, an applicant
195 must have a master's degree from a program that is accredited by
196 the Council for Accreditation of Counseling and Related
197 Educational Programs, the Masters in Psychology and Counseling
198 Accreditation Council, or an equivalent accrediting body which
199 consists of at least 60 semester hours or 80 quarter hours to
200 apply for licensure under this paragraph.
201 (c) Completed Has had at least 2 years of clinical
202 experience in mental health counseling, which must be at the
203 post-master's level under the supervision of a licensed mental
204 health counselor or the equivalent who is a qualified supervisor
205 as determined by the board. An individual who intends to
206 practice in Florida to satisfy the clinical experience
207 requirements must register pursuant to s. 491.0045 before
208 commencing practice. If a graduate has a master's degree with a
209 major related to the practice of mental health counseling which
210 did not include all the coursework required under sub-
211 subparagraphs (b)1.a. and b., credit for the post-master's level
212 clinical experience may not commence until the applicant has
213 completed a minimum of seven of the courses required under sub-
214 subparagraphs (b)1.a. and b., as determined by the board, one of
215 which must be a course in psychopathology or abnormal
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COMMITTEE/SUBCOMMITTEE AMENDMENT
Bill No. HB 343 (2022)
Amendment No. 1
216 psychology. A doctoral internship may be applied toward the
217 clinical experience requirement. A licensed mental health
218 professional must be on the premises when clinical services are
219 provided by a registered intern in a private practice setting.
220 (d) Has passed a theory and practice examination
221 designated by department rule provided by the department for
222 this purpose.
223 (e) Has Demonstrated, in a manner designated by board
224 rule, knowledge of the laws and rules governing the practice of
225 clinical social work, marriage and family therapy, and mental
226 health counseling.
227 Section 2. This act shall take effect upon becoming a law.
228
229 -----------------------------------------------------
230 T I T L E A M E N D M E N T
231 Remove everything before the enacting clause and insert:
232 An act relating to mental health professional licensure;
233 amending s. 491.005, F.S.; revising licensing requirements for
234 marriage and family therapists and mental health counselors;
235 providing an effective date.
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HB 413
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 413 Delegation of the Administration of Prescription Medications
SPONSOR(S): Snyder
TIED BILLS: IDEN./SIM. BILLS: SB 700
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Professions & Public Health Subcommittee Rahming McElroy
2) Health & Human Services Committee
SUMMARY ANALYSIS
Certified nursing assistants (CNAs) and home-health aides (HHAs) assist older individuals and those with
disabilities with daily tasks, such as dressing, bathing, and eating. Under current law, a CNA or HHA may
administer oral, transdermal, ophthalmic, otic, rectal, inhaled, enteral, or topical prescription medications to a
patient of a home health agency if a registered nurse delegates such tasks and the CNA or HHA:
• Has completed a 6-hour training course approved by the Board of Nursing (Board); and
• Has been found competent to administer medication to a patient in a safe and sanitary manner.
A registered nurse or physician must conduct the training and determine whether the CNA or HHA can
competently administer medication, and annually validate such competency. Current law requires the Board
and the Agency for Health Care Administration (AHCA) to adopt rules, in consultation with each other, on the
standards and procedures that a CNA or HHA must follow for medication administration. Such rules must
address qualifications for trainers, medication label requirements, documentation and recordkeeping, storage
and disposal of medication, instructions for safe medication administration, informed consent, training
curriculum, and validation procedures.
A registered nurse is prohibited from delegating the administration of medications listed as Schedule II,
Schedule III, or Schedule IV controlled substances.
Under current law, a registered nurse is not authorized to delegate to a CNA or HHA medication administration
to a patient of a nurse registry.
A nurse registry is an agency licensed to secure employment for registered nurses, licensed practical nurses,
certified nursing assistants, home health aides, homemakers, and companions (caregivers) in a patient’s home
or with health care facilities or other entities. Caregivers referred for contract to a patient by a nurse registry are
independent contractors not employees of the nurse registry. Nurse registries must advise patients that
caregivers referred for contract are independent contractors and that the nurse registry is prohibited from
monitoring, supervising, managing, or training caregivers.
HB 413 authorizes a registered nurse to delegate to a CNA or HHA medication administration to a patient of a
nurse registry. The bill requires a nurse registry that authorizes a registered nurse to delegate tasks to a CNA
or HHA to ensure that such delegation meets specified requirements. The bill requires the Board, in
consultation with AHCA, to adopt rules on the standards and procedures that a CNA must follow for medication
administration to a patient of a nurse registry.
The bill has no fiscal impact on state or local governments.
The bill has an effective date of July 1, 2022.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h0413.PPH
DATE: 1/11/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Florida Direct Care Workers
Direct care workers assist older individuals and those with disabilities with daily tasks, such as
dressing, bathing, and eating. 1 They work in many different settings, such as private homes, group
homes, residential care facilities, assisted living facilities, skilled nursing facilities, and hospitals. 2 Direct
care workers account for 70 to 80 percent of all paid hands-on long-term care and personal assistance
for the elderly or disabled. 3
Nursing Assistants or Nursing Aides
Nursing assistants or nursing aides generally work in nursing homes, although some work in assisted
living facilities, other community-based settings, or hospitals. 4 The Florida Board of Nursing (Board),
within the Department of Health, certifies nursing assistants (CNAs) who must, among other things,
hold a high school diploma or equivalent, complete a 120-hour board-approved training program, and
pass a nursing assistant competency exam. 5 The Board establishes the general scope of practice for
CNAs, who perform services under the general supervision 6 of a registered nurse or licensed practical
nurse. 7 A CNA may not work independently and may not perform any tasks that require specialized
nursing knowledge, judgment, or skills. 8
Home Health Aides
Home health aides (HHA) provide essentially the same care and services as nursing assistants, but
they assist people in their homes or in community settings under the supervision of a nurse or a
physical, speech, occupational, or respiratory therapist. 9 In Florida, HHAs are not licensed or certified.
However, the Agency for Health Care Administration (AHCA) licenses home health agencies and
establishes training requirements for HHAs employed by home health agencies. HHAs who work for
state licensed only home health agencies or who work for a nurse registry must complete 40 hours of
training or pass an AHCA-developed competency examination. 10 However, HHAs who works for a
home health agency certified by Medicare or Medicaid must complete at least 75 hours of training and
successfully pass a competency evaluation to meet federal regulations. 11
Nurse Delegation of Duties
1 Paraprofessional Healthcare Institute, Understanding the Direct Care Workforce, available at https://phinational.org/policy-
research/key-facts-faq/ (last visited Nov. 22, 2021).
2 Paraprofessional Healthcare Institute, Direct Care Workforce 2018 Year in Review, https://phinational.org/resource/the-direct-care-
workforce-year-in-review-2018/ (last visited Nov. 22, 2021).
3 Paraprofessional Healthcare Institute, Who Are Direct-Care Workers? https://phinational.org/wp-
content/uploads/legacy/clearinghouse/NCDCW%20Fact%20Sheet-1.pdf (last visited Nov. 22, 2021).
4 Id.
5 S. 464.203, F.S., and r. 64B9-15.006, F.A.C. Eighty hours must be classroom instruction and 40 hours must be clinical instruction, 20
of which must be in long term care clinical instruction in a licensed nursing home. 42 C.F.R. § 483.152 requires 75 hours of training;
Florida training requirements exceed the federal minimum training requirements.
6 Under general supervision, the registered nurse or licensed practical nurse does not need to be present but must be available for
consultation and advice, either in person or by a communication device. R. 64B9-15.001(6), F.A.C
7 R. 64B9-15.002, F.A.C.
8 Id.
9 Supra note 3. If the only service the home health agency provides is physical, speech, or occupational therapy, in addition to home
health aide or CNA services, a licensed therapist may provide supervision. R. 59A-8.0095, F.A.C.
10 R. 59A-8.0095(5)(d).
11 42 C.F.R. § 484.80. See also, Agency for Health Care Administration, Home Health Aides, available at
https://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Lab_HomeServ/HHA/Home_health_aides.shtml (last visited Nov. 22,
2021).
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Under current law, a registered nurse is authorized to delegate any task, including medication
administration, to a CNA or HHA, 12 if the registered nurse determines that the CNA or HHA is
competent to perform the task, the task is delegable under federal law, and the task: 13
• Is within the nurse’s scope of practice;
• Frequently recurs in the routine care of a patient or group of patients;
• Is performed according to an established sequence of steps;
• Involves little or no modification from one patient to another;
• May be performed with a predictable outcome;
• Does not inherently involve ongoing assessment, interpretation, or clinical judgement; and
• Does not endanger a patient’s life or well-being.
Medication Administration
Medication administration is to obtain and provide a single dose of a medication to a patient for his or
her consumption. 14 Currently, a CNA or HHA may administer oral, transdermal, ophthalmic, otic, rectal,
inhaled, enteral, or topical prescription medications to a patient of a home health agency if a registered
nurse delegates such tasks to the CNA and the CNA: 15
• Has completed a 6-hour training course approved by the Board; and
• Has been found competent to administer medication to a patient in a safe and sanitary manner.
A registered nurse or physician must conduct the training and determine whether the CNA or HHA can
competently administer medication, and annually validate such competency. 16 Current law requires the
Board and AHCA to adopt rules, in consultation with each other, on the standards and procedures that
a CNA or HHA must follow for medication administration to a patient of a home health agency. 17 Such
rules must address qualifications for trainers, medication label requirements, documentation and
recordkeeping, storage and disposal of medication, instructions for safe medication administration,
informed consent, training curriculum, and validation procedures. 18
A registered nurse is prohibited from delegating the administration of medications listed as Schedule II,
Schedule III, or Schedule IV controlled substances. 19
Under current law, a registered nurse is not authorized to delegate to a CNA or HHA medication
administration to a patient of a nurse registry. Additionally, the Board and AHCA are not required to
adopt rules on the standards and procedures that a CNA must follow for medication administration to a
patient of a nurse registry.
Nurse Registries
A nurse registry is an agency licensed to secure employment for registered nurses, licensed practical
nurses, certified nursing assistants, home health aides, homemakers, and companions (caregivers) in a
patient’s home or with health care facilities or other entities. 20 Nurse registries are governed by part II of
chapter 408, F.S., 21 associated rules in Chapter 59A-35, F.A.C., and the nurse registry rules in Chapter
59A-18, F.A.C. A nurse registry must be licensed by AHCA to offer contracts in Florida. 22
12 Ss. 400.489 and 464.2035, F.S. Home health aide includes those CNAs who work in positions that work as home health aides or
equivalent positions.
13 Ss. 400.489 and 464.0156, F.S.
14 S. 465.003, F.S.
15 Ss. 400.489(1) and 464.2035(1), F.S.
16 Id.
17 Ss. 400.489(3) and 464.2035(3), F.S.
18 Id.
19 S. 464.0156(1), F.S
20 S. 400.462(21), F.S.
21 S. 400.506(2), F.S. A nurse registry is also governed by the provisions in s. 400.506, F.S.
22 S. 400.506(1), F.S.
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A caregiver referred by a nurse registry for contract in a private residences who is not a nurse licensed
under part I of chapter 464, such as a CNA or HHA, may only provide patient services or care for which
they have been certified or trained to perform under current law or rules of AHCA or the Department of
Business and Professional Regulation. 23 Providing services beyond their authorized scope constitutes
the unauthorized practice of medicine or a violation of the Nurse Practice Act and is subject to
punishment as provided under current law.
A caregiver referred for contract to a patient by a nurse registry is an independent contractor not an
employee of the nurse registry. 24 Nurse registries must advise patients that a caregiver referred for
contract is an independent contractor and that the nurse registry is prohibited from monitoring,
supervising, managing, or training the caregiver. 25
Effect of Proposed Bill
HB 413 authorizes a registered nurse to delegate to a CNA or HHA medication administration to a
patient of a nurse registry. The bill requires a nurse registry that authorizes a registered nurse to
delegate tasks to a CNA or HHA to ensure that such delegation meets the requirements of chapter 400,
chapter 464, and the rules adopted thereunder. The bill requires the Board, in consultation with AHCA,
to adopt rules on the standards and procedures that a CNA must follow for medication administration to
a patient of a nurse registry.
The bill has an effective date of July 1, 2022.
B. SECTION DIRECTORY:
Section 1: Amends s. 400.506, relating to the licensure of nurse registries.
Section 2: Amends s. 464.0156, relating to the delegation of duties.
Section 3: Amends s. 464.2035, relating to the administration of medication.
Section 4: Provides an effective date of July 1, 2022.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
23 S. 400.506(7).
24 S. 400.506(6)(d).
25 S. 400.506(6)(e).
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D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
The bill provides sufficient rulemaking authority to implement the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 413 2022
1 A bill to be entitled
2 An act relating to delegation of the administration of
3 prescription medications; amending s. 400.506, F.S.;
4 requiring a nurse registry that authorizes a
5 registered nurse to delegate tasks to a certified
6 nursing assistant or a home health aide to ensure that
7 certain requirements are met; amending s. 464.0156,
8 F.S.; authorizing a registered nurse to delegate the
9 administration of certain duties for the care of a
10 patient of a nurse registry; amending s. 464.2035,
11 F.S.; authorizing certified nursing assistants to
12 administer certain medication to patients of nurse
13 registries under certain circumstances; providing an
14 effective date.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1. Subsection (7) of section 400.506, Florida
19 Statutes, is amended to read:
20 400.506 Licensure of nurse registries; requirements;
21 penalties.—
22 (7) A person who is referred by a nurse registry for
23 contract in private residences and who is not a nurse licensed
24 under part I of chapter 464 may perform only those services or
25 care to clients that the person has been certified to perform or
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HB 413 2022
26 trained to perform as required by law or rules of the Agency for
27 Health Care Administration or the Department of Business and
28 Professional Regulation. Providing services beyond the scope
29 authorized under this subsection constitutes the unauthorized
30 practice of medicine or a violation of the Nurse Practice Act
31 and is punishable as provided under chapter 458, chapter 459, or
32 part I of chapter 464. If a nurse registry authorizes a
33 registered nurse to delegate tasks, including medication
34 administration, to a certified nursing assistant under chapter
35 464 or to a home health aide under s. 400.490, the nurse
36 registry must ensure that such delegation meets the requirements
37 of this chapter and chapter 464 and the rules adopted
38 thereunder.
39 Section 2. Subsection (2) of section 464.0156, Florida
40 Statutes, is amended to read:
41 464.0156 Delegation of duties.—
42 (2) A registered nurse may delegate to a certified nursing
43 assistant or a home health aide the administration of oral,
44 transdermal, ophthalmic, otic, rectal, inhaled, enteral, or
45 topical prescription medications to a patient of a home health
46 agency or nurse registry, if the certified nursing assistant or
47 home health aide meets the requirements of s. 464.2035 or s.
48 400.489, respectively. A registered nurse may not delegate the
49 administration of any controlled substance listed in Schedule
50 II, Schedule III, or Schedule IV of s. 893.03 or 21 U.S.C. s.
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HB 413 2022
51 812.
52 Section 3. Subsections (1) and (3) of section 464.2035,
53 Florida Statutes, are amended to read:
54 464.2035 Administration of medication.—
55 (1) A certified nursing assistant may administer oral,
56 transdermal, ophthalmic, otic, rectal, inhaled, enteral, or
57 topical prescription medication to a patient of a home health
58 agency or nurse registry if the certified nursing assistant has
59 been delegated such task by a registered nurse licensed under
60 part I of this chapter, has satisfactorily completed an initial
61 6-hour training course approved by the board, and has been found
62 competent to administer medication to a patient in a safe and
63 sanitary manner. The training, determination of competency, and
64 initial and annual validation required under this section must
65 be conducted by a registered nurse licensed under this chapter
66 or a physician licensed under chapter 458 or chapter 459.
67 (3) The board, in consultation with the Agency for Health
68 Care Administration, shall establish by rule standards and
69 procedures that a certified nursing assistant must follow when
70 administering medication to a patient of a home health agency or
71 nurse registry. Such rules must, at a minimum, address
72 qualification requirements for trainers, requirements for
73 labeling medication, documentation and recordkeeping, the
74 storage and disposal of medication, instructions concerning the
75 safe administration of medication, informed-consent requirements
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76 and records, and the training curriculum and validation
77 procedures.
78 Section 4. This act shall take effect July 1, 2022.
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hb0413-00
HB 7005
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 7005 PCB GOS-22-01 OGSR/Information Relating to the Medical Use of
Marijuana/Department of Health
SPONSOR(S): Government Operations Subcommittee, Rizo
TIED BILLS: IDEN./SIM. BILLS: SB 7002
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
Orig. Comm.: Government Operations 13 Y, 0 N Roth Toliver
Subcommittee
1) Professions & Public Health Subcommittee Rahming McElroy
2) State Affairs Committee
SUMMARY ANALYSIS
The Open Government Sunset Review Act requires the Legislature to review each public record and each
public meeting exemption five years after enactment. If the Legislature does not reenact the exemption, it
automatically repeals on October 2nd of the fifth year after enactment.
The Department of Health Office of Medical Marijuana (OMMU) has been tasked with creating and maintaining
a secure, electronic, and online medical marijuana use registry for physicians, patients, and caregivers.
Additionally, OMMU must issue medical marijuana use registry identification cards for qualified patients and
caregivers.
Current law provides a public record exemption for certain information relating to medical marijuana held by the
Florida Department of Health. The public record exemption protects the following information from disclosure:
• A patient’s or caregiver’s personal identifying information held in the medical marijuana use registry
including, but not limited to, the patient’s or caregiver’s name, address, date of birth, photograph, and
telephone number.
• Personal identifying information collected for the purpose of issuing a patient’s or caregiver’s medical
marijuana use registry identification card.
• Personal identifying information pertaining to the physician certification for marijuana and the
dispensing thereof, including but not limited to, information related to the patient’s diagnosis, exception
requests to the daily dose amount limit, and the qualified patient’s experience related to the medical
use of marijuana.
• Personal identifying information contained in a qualified physician’s Drug Enforcement Administration
number, residential address, and government-issued identification card.
The bill saves from repeal the public record exemption, which will repeal on October 2, 2022, if this bill does
not become law.
The bill does not appear to have a fiscal impact on state or local governments.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h7005.PPH
DATE: 1/11/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Open Government Sunset Review Act
The Open Government Sunset Review Act (Act) 1 sets forth a legislative review process for newly
created or substantially amended public record or public meeting exemptions. It requires an automatic
repeal of the exemption on October 2nd of the fifth year after creation or substantial amendment,
unless the Legislature reenacts the exemption. 2
The Act provides that a public record or public meeting exemption may be created or maintained only if
it serves an identifiable public purpose. In addition, it may be no broader than is necessary to meet one
of the following purposes:
• Allow the state or its political subdivisions to effectively and efficiently administer a
governmental program, which administration would be significantly impaired without the
exemption.
• Protect sensitive personal information that, if released, would be defamatory or would
jeopardize an individual’s safety; however, only the identity of an individual may be exempted
under this provision.
• Protect trade or business secrets. 3
If, and only if, in reenacting an exemption that will repeal, the exemption is expanded (essentially
creating a new exemption), then a public necessity statement and a two-thirds vote for passage are
required. 4 If the exemption is reenacted with grammatical or stylistic changes that do not expand the
exemption, if the exemption is narrowed, or if an exception to the exemption is created then a public
necessity statement and a two-thirds vote for passage are not required.
Department of Health (DOH)
The purpose of DOH is to protect and promote the health of all residents and visitors in Florida. 5 Under
current law, DOH must: 6
• Identify, diagnose, and conduct surveillance of diseases and health conditions in the state and
accumulate the health statistics necessary to establish trends.
• Implement interventions that prevent or limit the impact or spread of diseases and health
conditions.
• Collect, manage, and analyze vital statistics and other health data to inform the public and
formulate public health policy and planning.
• Maintain and coordinate preparedness for and responses to public health emergencies in the
state.
• Provide or ensure the provision of quality health care and related services to identified
populations in the state.
• Regulate environmental activities that have a direct impact on public health in the state.
• Regulate health practitioners for the preservation of the health, safety, and welfare of the public.
Office of Medical Marijuana Use
1 S. 119.15, F.S.
2 S. 119.15(3), F.S.
3 S. 119.15(6)(b), F.S.
4 Art. I, s. 24(c), Fla. Const.
5 S. 20.43(1), F.S.
6 S. 20.43(1)(a)-(g), F.S.
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The Department of Health Office of Medical Marijuana Use (OMMU) is responsible for the statewide
implementation and oversight of medical marijuana. This includes the development and implementation
of DOH’s rules for medical marijuana, oversight of the database of ordering physicians and qualified
patients (Medical Marijuana Use Registry), patient and caregiver identification cards and licensure of
businesses authorized to provide low-THC cannabis and medical marijuana to qualified patients.
Medical Marijuana Use Registry
OMMU has been tasked with creating and maintaining a secure, electronic, and online medical
marijuana use registry for physicians, patients, and caregivers. 7 The medical marijuana use registry
must be accessible to law enforcement agencies, qualified physicians, and medical marijuana
treatment centers (MMTC) to verify the authorization of a qualified patient 8 or a caregiver 9 to possess
marijuana or a marijuana delivery device and to record the marijuana or marijuana delivery device
dispensed. 10 The medical marijuana use registry must also be accessible to practitioners licensed to
prescribe prescription drugs to ensure proper care for patients before medications that may interact
with the medical use of marijuana are prescribed. 11 OMMU must determine whether an individual is a
resident of Florida for the purpose of registration of qualified patients and caregivers in the medical
marijuana use registry. 12
OMMU may suspend or revoke the registration of a qualified patient or caregiver if the qualified patient
or caregiver: 13
• Provides misleading, incorrect, false, or fraudulent information to OMMU;
• Obtains a supply of marijuana in an amount greater than the amount authorized by the
physician certification;
• Falsifies, alters, or otherwise modifies an identification card;
• Fails to timely notify OMMU of any changes to his or her qualified patient status; or
• Violates the requirements of Florida statute or rule regarding the use of medical marijuana.
Additionally, OMMU:
• Must immediately suspend the registration of a qualified patient or caregiver charged with a
violation of the Florida Comprehensive Drug Abuse Prevention and Control Act 14 until final
disposition of any alleged offense. 15
• May revoke the registration of a qualified patient or caregiver who cultivates marijuana or who
acquires, possesses, or delivers marijuana from any person or entity other than a MMTC. 16
• Must revoke the registration of a qualified patient, and the patient’s associated caregiver, upon
notification that the patient no longer meets the criteria of a qualified patient. 17
Use Registry Identification Cards
7 S. 381.986(5)(a), F.S.
8 The term “qualified patient” means a resident of this state who has been added to the medical marijuana use registry by
a qualified physician to receive marijuana or a marijuana delivery device for a medical use and who has a qualified patient
identification card. S. 381.986(1)(l), F.S.
9 The term “caregiver” means a resident of this state who has agreed to assist with a qualified patient’s medical use of
marijuana, has a caregiver identification card, and meets the requirements of s. 381.986(6), F.S. S. 381.986(1)(a), F.S.
10 S. 381.986(5)(a), F.S.
11 Id.
12 S. 381.986(5)(b), F.S.
13 S. 381.986(5)(c), F.S.
14 Ch. 893, F.S.
15 S. 381.986(5)(d)-(e), F.S.
16 S. 381.986(5)(f), F.S.
17 S. 381.986(5)(g), F.S.
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OMMU must issue medical marijuana use registry identification cards for qualified patients and
caregivers who are residents of Florida. Identification cards must be renewed annually and must
include, at a minimum: 18
• The name, address, and date of birth of the qualified patient or caregiver.
• A full-face, passport-type, color photograph of the qualified patient or caregiver.
• Identification as a qualified patient or a caregiver.
• The unique numeric identifier used for the qualified patient in the medical marijuana use
registry.
• For a caregiver, the name and unique numeric identifier of the caregiver and the qualified
patient or patients that the caregiver is assisting.
• The expiration date of the identification card.
Applications for identification cards must be submitted on a form prescribed by OMMU, and OMMU
may charge a reasonable fee associated with the issuance, replacement, and renewal of identification
cards. 19 A qualified patient or caregiver must return his or her identification card to OMMU within five
business days after revocation. 20
Physician Certification
A qualified physician 21 may issue a physician certification only if the qualified physician: 22
• Conducted a physical examination while physically present in the same room as the patient and
a full assessment of the medical history of the patient.
• Diagnosed the patient with at least one qualifying medical condition. 23
• Determined that the medical use of marijuana would likely outweigh the potential health risks for
the patient.
• Determined whether the patient is pregnant.
• Reviewed the patient’s controlled drug prescription history in the prescription drug monitoring
program database. 24
• Reviewed the medical marijuana use registry and confirmed that the patient does not have an
active physician certification from another qualified physician.
• Registered as the issuer of the physician certification for the named qualified patient on the
medical marijuana use registry in an electronic manner.
• Obtains the voluntary and informed written consent of the patient for medical use of marijuana
each time the qualified physician issues a physician certification for the patient.
Public Record Exemption under Review
In 2017, the Legislature expanded a public record exemption that protected certain personal identifying
information relating to medical marijuana held by DOH. The information is confidential and exempt 25
from public disclosure. The public record exemption protects the following information from disclosure:
18 S. 381.986(7)(a)1.-6., F.S.
19 S. 381.986(7)(d), F.S.
20 S. 381.986(7)(e), F.S.
21 The term “qualified physician” means a person who holds an active, unrestricted license as an allopathic physician
under chapter 458 or as an osteopathic physician under chapter 459 and is in compliance with the physician education
requirements of subsection s. 381.986(3), F.S. S. 381.986(1)(m), F.S.
22 S. 381.986(4)(a), F.S.
23 A list of qualifying medical conditions are found in s. 381.986(2), F.S.
24 The prescription drug monitoring program database was established pursuant to s. 893.055, F.S.
25 There is a difference between records the Legislature designates exempt from public record requirements and those
the Legislature deems confidential and exempt. A record classified as exempt from public disclosure may be disclosed
under certain circumstances. See WFTV, Inc. v. Sch. Bd. of Seminole, 874 So.2d 48, 53 (Fla. 5th DCA 2004), review
denied 892 So.2d 1015 (Fla. 2004); City of Riviera Beach v. Barfield, 642 So.2d 1135 (Fla. 4th DCA 1994); Williams v.
City of Minneola, 575 So.2d 683, 687 (Fla. 5th DCA 1991). If the Legislature designates a record as confidential and
exempt from public disclosure, such record may not be released, by the custodian of public records, to anyone other than
the persons or entities specifically designated in statute. See Attorney General Opinion 85-62 (Aug. 1, 1985).
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• A patient’s or caregiver’s personal identifying information held in the medical marijuana use
registry including, but not limited to, the patient’s or caregiver’s name, address, date of birth,
photograph, and telephone number.
• Personal identifying information collected for the purpose of issuing a patient’s or caregiver’s
medical marijuana use registry identification card.
• Personal identifying information pertaining to the physician certification for marijuana and the
dispensing thereof, including but not limited to, information related to the patient’s diagnosis,
exception requests to the daily dose amount limit, and the qualified patient’s experience related
to the medical use of marijuana.
• A qualified physician’s Drug Enforcement Administration number, residential address, and
government-issued identification card.
DOH must allow the following entities to access the confidential and exempt information in the medical
marijuana use registry: 26
• A law enforcement agency that is investigating a violation of law regarding marijuana in which
the subject of the investigation claims an exception. 27
• A MMTC approved by DOH, which is attempting to verify the authenticity of a physician
certification for marijuana, including whether the certification had been previously filled and
whether the certification was issued for the person attempting to have it filled. 28
• A physician who has issued a certification for marijuana for the purpose of monitoring the
patient’s use of such marijuana or for the purpose of determining, before issuing a certification
for marijuana, whether another physician has issued a certification for the patient’s use of
marijuana. 29
• A practitioner licensed to prescribe prescription medications to ensure proper care of a patient
before prescribing medication to that patient which may interact with marijuana.
• An employee of DOH for the purposes of maintaining the registry and periodic reporting or
disclosure of information that has been redacted to exclude personal identifying information.
• An employee of DOH for the purposes of reviewing physician registration and the issuance of
physician certifications to monitor practices that could facilitate unlawful diversion or the misuse
of marijuana or a marijuana delivery device.
• The DOH’s relevant health care regulatory boards responsible for the licensure, regulation, or
discipline of a physician if he or she is involved in a specific investigation of a violation of
medical use of marijuana. 30
• The Consortium for Medical Marijuana Clinical Outcomes Research. 31
• A person engaged in bona fide research. 32
DOH must also allow access to the confidential and exempt information pertaining to the physician
certification for marijuana and the dispensing thereof, whether in the registry or otherwise held by DOH,
to a DOH employee for the purpose of approving or disapproving a request for an exception to the daily
dose amount limit for a qualified patient, and to the Consortium for Medical Marijuana Clinical
Outcomes Research for the purpose of conducting research regarding the medical use of marijuana. 33
26 S. 381.987(2), F.S.
27 A law enforcement agency cannot access information related to a patient’s diagnosis.
28 A MMTC cannot access information related to a patient’s diagnosis.
29 The physician may access the confidential and exempt information only for the patient for whom he or she has issued a
certification or is determining whether to issue a certification for the use of marijuana.
30 See s. 381.986, F.S.
31 The Consortium for Medical Marijuana Clinical Outcomes Research is established in s. 1004.4351(4), F.S.
32 In order to engage in bona fide research, the person must agree:
• To submit a research plan to DOH which specifies the exact nature of the information requested and the intended
use of the information;
• To maintain the confidentiality of the records or information if personal identifying information is made available to
the researcher;
• To destroy any confidential and exempt records or information obtained after the research is concluded; and
• Not to contact, directly or indirectly, for any purpose, a patient or physician whose information is in the registry.
33 S. 381.987(3), F.S.
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All confidential and exempt information released by DOH remains confidential and exempt, and a
person who receives access to such information must maintain the confidential and exempt status of
the information received. 34 A person who willfully and knowingly violates the public records exemption
for personal identifying information relating to medical marijuana held by DOH commits a felony of the
third degree. 35
The 2017 public necessity statement 36 for the exemption states the following:
The choice made by a physician to certify, and by his or her patient to use,
marijuana to treat the patient's medical condition or symptoms and the choice
made by a caregiver to assist a qualifying patient with the medical use of marijuana
is a personal and private matter between such parties. The availability of such
information could make the public aware of both the patient's use of marijuana and
the patient's diseases or other medical conditions for which the patient is using
marijuana. The knowledge of the patient's use of marijuana, the knowledge that
the physician certified the use of marijuana, the knowledge of the patient's
diseases or other medical conditions, and the knowledge that a caregiver is
assisting a patient with the medical use of marijuana could be used to embarrass,
humiliate, harass, or discriminate against the patient, the caregiver, or the
physician. This information could be used as a discriminatory tool by an employer
who disapproves of the patient's use of marijuana, the caregiver's assistance in
the use of marijuana, or the physician certification of such use. 37
Pursuant to the Open Government Sunset Review Act, the exemption will repeal on October 2, 2022,
unless saved from repeal by the Legislature. 38
During the 2021 interim, subcommittee staff 39 met with staff from DOH. DOH staff stated they had not
had any issues interpreting or applying the exemption and that they were unaware of the existence of
any complaints concerning the exemption. Further, DOH staff stated that there have been no legal
challenges concerning the exemption. Between January 1, 2018, and August 31, 2021, the OMMU staff
has received approximately 644 requests for the confidential and exempt information contained in the
medical marijuana use registry. This total consists of approximately 71 subpoenas for patient medical
records and 573 requests for customized medical marijuana use registry data. As such, DOH staff
recommended that the exemption be reenacted as is.
Effect of the Bill
The bill removes the scheduled repeal date of the public record exemption for certain personal
identifying information relating to medical marijuana held by DOH, thereby reenacting the public record
exemption. The bill also makes non-substantive technical changes to the statute and removes
language permitting DOH to protect additional records at its discretion.
B. SECTION DIRECTORY:
Section 1: Amends s. 381.987, F.S., to save from repeal the public record exemption for personal
identifying information relating to medical marijuana held by the department.
Section 2: Provides an effective date of October 1, 2022.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
34 S. 381.987(4), F.S.
35 S. 381.987(5), F.S. A third degree felony is punishable by up to 5 years imprisonment or a fine up to $5,000.
36 Art. I, s. 24(c), Fla. Const., requires each public record exemption “state with specificity the public necessity justifying
the exemption.”
37 Ch. 2017-231, L.O.F.
38 S. 381.987(6), F.S.
39 Government Operations Subcommittee, Florida House of Representatives.
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DATE: 1/11/2022
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
None.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
None.
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 7005 2022
1 A bill to be entitled
2 An act relating to a review under the Open Government
3 Sunset Review Act; amending s. 381.987, F.S., which
4 provides an exemption from public records requirements
5 for certain information of patients, caregivers, and
6 qualified physicians held by the Department of Health
7 relating to the medical use of marijuana; removing the
8 scheduled repeal of the exemption; making technical
9 changes; providing an effective date.
10
11 Be It Enacted by the Legislature of the State of Florida:
12
13 Section 1. Subsections (1) and (6) of section 381.987,
14 Florida Statutes, are amended to read:
15 381.987 Public records exemption for personal identifying
16 information relating to medical marijuana held by the
17 department.—
18 (1) The following information held by the department is
19 confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
20 of the State Constitution:
21 (a) A patient's or caregiver's personal identifying
22 information held by the department in the medical marijuana use
23 registry established under s. 381.986, including, but not
24 limited to, the patient's or caregiver's name, address, date of
25 birth, photograph, and telephone number.
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 7005 2022
26 (b) All personal identifying information collected f or the
27 purpose of issuing a patient's or caregiver's medical marijuana
28 use registry identification card described in s. 381.986.
29 (c) All personal identifying information pertaining to the
30 physician certification for marijuana and the dispensing thereof
31 held by the department, including, but not limited to,
32 information related to the patient's diagnosis, exception
33 requests to the daily dose amount limit, and the qualified
34 patient's experience related to the medical use of marijuana .
35 (d) A qualified physician's Drug Enforcement
36 Administration number, residential address, and government -
37 issued identification card.
38 (6) This section is subject to the Open Government Sunset
39 Review Act in accordance with s. 119.15 and shall stand repealed
40 on October 2, 2022, unless reviewed and saved from repeal
41 through reenactment by the Legislature.
42 Section 2. This act shall take effect October 1, 2022.
Page 2 of 2
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hb7005-00
HB 7007
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 7007 PCB GOS 22-02 OGSR/Nonviable Birth Certificates/Department of Health
SPONSOR(S): Government Operations Subcommittee, Fetterhoff
TIED BILLS: IDEN./SIM. BILLS: SB 7000
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
Orig. Comm.: Government Operations 13 Y, 0 N Roth Toliver
Subcommittee
1) Professions & Public Health Subcommittee Rahming McElroy
2) State Affairs Committee
SUMMARY ANALYSIS
The Open Government Sunset Review Act requires the Legislature to review each public record and each
public meeting exemption five years after enactment. If the Legislature does not reenact the exemption, it
automatically repeals on October 2nd of the fifth year after enactment.
The Florida Vital Statistics Act directs the Department of Health (DOH), to establish the Bureau of Vital
Statistics under the direction of a state registrar for the uniform and efficient registration, compilation, storage,
and preservation of all vital records in Florida.
A nonviable birth is an “an unintentional, spontaneous fetal demise occurring after the completion of the 9th
week of gestation but prior to the 20th week of gestation of a pregnancy that has been verified by a health care
practitioner.” For any nonviable birth in Florida, DOH must issue a certificate of nonviable birth within 60 days
upon the request of a parent named on the registration of nonviable birth.
Current law provides a public record exemption for certain information that may be collected by DOH when
issuing a nonviable birth certificate. Specifically, the parentage of the fetus, marital status of the parents, the
cause of death, and any medical information included in nonviable birth records are confidential and exempt
from public disclosure. However, DOH may issue a certified copy of an original nonviable birth certificate which
includes the confidential and exempt information to the fetus’s parent, to any local, state, or federal agency for
official purposes upon approval by DOH, or upon the order of any court of competent jurisdiction. Additionally,
DOH may release the confidential and exempt information for health research purposes as approved by the
department.
The bill saves from repeal the public record exemption, which will repeal on October 2, 2022, if this bill does
not become law.
The bill does not appear to have a fiscal impact on state or local governments.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h7007.PPH
DATE: 1/11/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Open Government Sunset Review Act
The Open Government Sunset Review Act (Act) 1 sets forth a legislative review process for newly
created or substantially amended public record or public meeting exemptions. It requires an automatic
repeal of the exemption on October 2nd of the fifth year after creation or substantial amendment,
unless the Legislature reenacts the exemption. 2
The Act provides that a public record or public meeting exemption may be created or maintained only if
it serves an identifiable public purpose. In addition, it may be no broader than is necessary to meet one
of the following purposes:
• Allow the state or its political subdivisions to effectively and efficiently administer a
governmental program, which administration would be significantly impaired without the
exemption.
• Protect sensitive personal information that, if released, would be defamatory or would
jeopardize an individual’s safety; however, only the identity of an individual may be exempted
under this provision.
• Protect trade or business secrets. 3
If, and only if, in reenacting an exemption that will repeal, the exemption is expanded (essentially
creating a new exemption), then a public necessity statement and a two-thirds vote for passage are
required. 4 If the exemption is reenacted with grammatical or stylistic changes that do not expand the
exemption, if the exemption is narrowed, or if an exception to the exemption is created then a public
necessity statement and a two-thirds vote for passage are not required.
Department of Health (DOH)
The purpose of DOH is to protect and promote the health of all residents and visitors in Florida. 5 Under
current law, DOH must: 6
• Identify, diagnose, and conduct surveillance of diseases and health conditions in the state and
accumulate the health statistics necessary to establish trends.
• Implement interventions that prevent or limit the impact or spread of diseases and health
conditions.
• Collect, manage, and analyze vital statistics and other health data to inform the public and
formulate public health policy and planning.
• Maintain and coordinate preparedness for and responses to public health emergencies in the
state.
• Provide or ensure the provision of quality health care and related services to identified
populations in the state.
• Regulate environmental activities that have a direct impact on public health in the state.
• Regulate health practitioners for the preservation of the health, safety, and welfare of the public.
1 S. 119.15, F.S.
2 S. 119.15(3), F.S.
3 S. 119.15(6)(b), F.S.
4 S. 24(c), Art. I, Fla. Const.
5 S. 20.43(1), F.S.
6 S. 20.43(1)(a)-(g), F.S.
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Vital Statistics in Florida
The Florida Vital Statistics Act 7 directs DOH to establish the Bureau of Vital Statistics 8 under the
direction of a state registrar for the uniform and efficient registration, compilation, storage, and
preservation of all vital records 9 in this state. 10 DOH is also responsible for establishing registration
districts throughout the state and appointing a local registrar of vital statistics for each registration
district. 11
Registration of Live Births
Within five days of each live birth in Florida, a certificate of live birth must be filed with the local registrar
of the district in which the birth occurred. 12 The state registrar may receive the registration of the birth
certificate electronically through facsimile or other electronic transfer. 13
Registration of Deaths
A certificate for each death or fetal death 14 that occurs in Florida must be filed within five days after
such death and prior to the final disposition of the dead body or fetus. 15 Final disposition means the
burial, interment, entombment, cremation, removal from the state, anatomical donation, or other
authorized disposition of a dead body or fetus. 16 The registration of the death certificate may be
submitted via DOH’s electronic death registration system to the Bureau of Vital Statistics on a form
prescribed by DOH, or to the local registrar of the district in which the death occurred. 17
Stillbirth Registration
DOH must issue a certificate of birth resulting in stillbirth upon the request of any parent listed on a fetal
death certificate. 18 A stillbirth is an unintended, intrauterine fetal death after a gestational age of not
less than 20 completed weeks. 19 The certificate of birth resulting in stillbirth must be issued within 60
days of the request 20 and a parent may request the certificate of birth resulting in stillbirth regardless of
the date the fetal death certificate was issued. 21 The certificate of birth resulting in stillbirth may not be
used to pursue a civil cause of action against a person or an entity for bodily injury, personal injury, or
wrongful death. 22
A healthcare practitioner or health care facility required to register the fetal death, must advise the
parent of the stillborn child that they may request a certificate of birth resulting in stillbirth and how to
7 S. 382.001, F.S.
8 Although the statute refers to an Office of Vital Statistics, it has been established as the Bureau of Vital Statistics within
DOH. The Bureau has been established under DOH’s Division of Public Health Statistics and Performance Management.
9 A vital record is defined as certificates or reports of birth, death, fetal death, marriage, dissolution of marriage, certain
name change, and data related thereto. S. 382.002(18), F.S.
10 S. 382.003(1), F.S.
11 S. 382.003(2), F.S.
12 S. 382.013, F.S.
13 S. 382.013(1)(h), F.S.
14 S. 382.002(8), F.S., a “fetal death” is a death prior to the complete expulsion or extraction of a product of human
conception from its mother if the 20th week of gestation has been reached and the death is indicated by the fact that after
such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart,
pulsation of the umbilical cord, or definite movement of voluntary muscles.
15 S. 382.008(1), F.S.
16 S. 382.002(9), F.S.
17 S. 382.008(1), F.S.
18 S. 382.0085, F.S.
19 S. 382.002(17), F.S.
20 S. 382.0085(1), F.S.
21 S. 382.0085(6), F.S.
22 S. 382.0085(9), F.S.
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receive such certificate. The parent must also be advised that the certificate of birth resulting in stillbirth
is a public record if it is held by an agency. 23
The certificate of birth resulting in stillbirth contains:
• The date of the stillbirth;
• The county in which the stillbirth occurred;
• The name of the stillborn child;
• The state file number of the corresponding certificate of fetal death; and
• A statement that the certificate is not proof of live birth. 24
Certificate of Nonviable Birth
A nonviable birth is an “an unintentional, spontaneous fetal demise occurring after the completion of the
9th week of gestation but prior to the 20th week of gestation of a pregnancy that has been verified by a
health care practitioner.” 25 For any nonviable birth in Florida, DOH must issue a certificate of nonviable
birth within 60 days upon the request of a parent named on the registration of nonviable birth. 26
The person or entity authorized to register a nonviable birth must advise a parent of a nonviable birth of
the following: 27
• That the parent may request the preparation of a certificate of nonviable birth.
• That the parent may obtain a certificate of nonviable birth by contacting the Bureau of Vital
Statistics.
• How the parent may contact the Bureau of Vital Statistics to request a certificate of nonviable
birth.
• That a copy of the original certificate of nonviable birth is available as a public record.
• That a copy of the original certificate of nonviable birth will not include the parentage, the marital
status of the parent, the cause of death of the fetus, or any medical information.
Within 30 days of a receipt of a request from a parent, the health care practitioners and health care
facilities required to advise a parent of the availability of the certificate of nonviable birth must file a
registration of nonviable birth with DOH or a local registrar of the district in which the nonviable birth
occurred. 28 The registration may be filed in the state’s electronic death registration system or on a form
prescribed by DOH. 29
The certificate of nonviable birth must contain the date of the nonviable birth, the county in which the
nonviable birth occurred, and the name of the fetus provided on the registration of nonviable birth
submitted by the attending healthcare practitioner or the healthcare facility at which the nonviable birth
occurred. 30 If the fetus does not have a name, the Bureau of Vital Statistics is directed to indicate “baby
boy” or “baby girl” and the last name of the parent on the certificate of nonviable birth. If the sex of the
fetus is not known, the Bureau of Vital Statistics is directed to indicate the name “baby” and the last
name of the parent on the certificate of nonviable birth. 31 The certificate must state, “This certificate is
not proof of a live birth,” on its front. 32
The Bureau of Vital Statistics may not use a certificate of nonviable birth in the calculation of live birth
statistics, and a nonviable birth may not be used to establish, bring, or support a civil cause of action
23 S. 382.0085(2), F.S.
24 S. 382.0085(4), F.S.
25 S. 382.002(14), F.S.
26 S. 382.0086(1), F.S.
27 S. 382.0086(2), F.S.
28 S. 382.008(7), F.S.
29 Id.
30 S. 382.0086(4)(a)-(c), F.S.
31 S. 382.0086(4)(c), F.S.
32 S. 382.0086(4)(d), F.S.
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seeking damages against any person or entity for bodily injury, personal injury, or wrongful death for a
nonviable birth. 33
Public Record Exemption under Review
In 2017, the Legislature created a public record exemption in s. 382.008(8), F.S., for certain information
that may be collected by DOH when issuing a nonviable birth certificate. Specifically, the parentage of
the fetus, marital status of the parents, the cause of death, and any medical information included in
nonviable birth records are confidential and exempt 34 from public disclosure. However, DOH may issue
a certified copy of an original nonviable birth certificate which includes the confidential and exempt
information to the fetus’s parent, to any local, state, or federal agency for official purposes upon
approval by DOH, or upon the order of any court of competent jurisdiction. Additionally, DOH may
release the confidential and exempt information for health research purposes as approved by the
department.
The 2017 public necessity statement 35 for the exemption states the following:
Medical information, including the cause of death of a nonviable fetus, and any
medical information pertaining thereto, is sensitive and personal in nature and
disclosure of such information may lead to an invasion of privacy of a parent
experiencing a nonviable birth. Disclosure of information regarding the parentage
of a nonviable fetus and the marital status of such fetus' parent may discourage
an individual who would otherwise request a nonviable birth certificate from doing
so due to real or perceived stigma regarding the nonviability of the fetus, the fetus'
parentage, or the marital status of the fetus' parent. Currently, death and fetal
death records make such information confidential and exempt from public
disclosure. The Legislature finds that the same protections should be afforded to
a parent who wishes to memorialize a nonviable birth with a nonviable birth
certificate as part of his or her grieving process. 36
Pursuant to the Open Government Sunset Review Act, the exemption will repeal on October 2, 2022,
unless saved from repeal by the Legislature. 37
During the 2021 interim, subcommittee staff met with staff from DOH. DOH staff stated they had not
had any issues interpreting or applying the exemption and that they were unaware of the existence of
any litigation concerning the exemption. Further, DOH staff stated that they had not received any
complaints concerning the exemption. As such, DOH staff recommended that the exemption be
reenacted as is.
Effect of the Bill
The bill removes the scheduled repeal date of the public record exemption for certain information that
may be collected when issuing a nonviable birth certificate, thereby reenacting the public record
33 Ss. 382.0086(8)&(9), F.S.
34 There is a difference between records the Legislature designates exempt from public record requirements and those
the Legislature deems confidential and exempt. A record classified as exempt from public disclosure may be disclosed
under certain circumstances. See WFTV, Inc. v. Sch. Bd. of Seminole, 874 So.2d 48, 53 (Fla. 5th DCA 2004), review
denied 892 So.2d 1015 (Fla. 2004); City of Riviera Beach v. Barfield, 642 So.2d 1135 (Fla. 4th DCA 1994); Williams v.
City of Minneola, 575 So.2d 683, 687 (Fla. 5th DCA 1991). If the Legislature designates a record as confidential and
exempt from public disclosure, such record may not be released, by the custodian of public records, to anyone other than
the persons or entities specifically designated in statute. See Attorney General Opinion 85-62 (Aug. 1, 1985).
35 Art. I, s. 24(c), Fla. Const., requires each public record exemption “state with specificity the public necessity justifying
the exemption.”
36 Ch. 2017-39, L.O.F.
37 S. 382.008(8)(d), F.S.
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exemption. The bill also makes non-substantive technical changes to the statute to create uniformity
with similar statutes.
B. SECTION DIRECTORY:
Section 1: Amends s. 382.008, F.S., to save from repeal the public record exemption for nonviable
birth records.
Section 2: Provides an effective date of October 1, 2022.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
None.
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
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DATE: 1/11/2022
IV. AMENDMENTS/ COMMITTEE SUBSTITUTE CHANGES
None.
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
HB 7007 2022
1 A bill to be entitled
2 An act relating to a review under the Open Government
3 Sunset Review Act; amending s. 382.008, F.S., which
4 provides an exemption from public records requirements
5 for certain information included in nonviable birth
6 certificates issued by the Department of Health;
7 removing the scheduled repeal of the exemption; making
8 technical changes; providing an effective date.
9
10 Be It Enacted by the Legislature of the State of Florida:
11
12 Section 1. Subsection (8) of section 382.008, Florida
13 Statutes, is amended to read:
14 382.008 Death, fetal death, and nonviable birth
15 registration.—
16 (8)(a) The original nonviable birth certificate shall
17 contain all of the information required by the department for
18 legal, social, and health research purposes. The department may
19 issue a certified copy of an original nonviable birth
20 certificate which includes the confidential and exempt
21 information:
22 1. To the fetus' parent;
23 2. To any local, state, or federal agency for official
24 purposes upon approval by the department; or
25 3. Upon the order of any court of competent jurisdiction.
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26 (b) All information relating to the cause of death and
27 parentage of a nonviable fetus, the marital status of such
28 fetus' parent, and any medical information included in nonviable
29 birth records held by a state agency is confidential and exempt
30 from s. 119.07(1) and s. 24(a), Art. I of the State
31 Constitution, but may be released for health research purposes
32 as approved by the department.
33 (c)1. The department shall authorize the issuance of a
34 certified copy of all or part of an original nonviable birth
35 certificate, excluding any information that is confidential and
36 exempt from s. 119.07(1) and s. 24(a), Art. I of the State
37 Constitution, to any person requesting such copy, pursuant to
38 paragraph (b), upon receipt of a request and payment of the fee
39 prescribed in s. 382.0255.
40 2. The department may issue a certified copy of an
41 original nonviable birth certificate which includes the
42 confidential and exempt information:
43 a. To the fetus' parent;
44 b. To any local, state, or federal agency for official
45 purposes upon approval by the department; or
46 c. Upon the order of any court of competent jurisdiction.
47 (d) This subsection is subject to the Open Government
48 Review Act in accordance with s. 119.15, and shall stand
49 repealed on October 2, 2022, unless reviewed and saved from
50 repeal through reenactment by the Legislature.
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HB 7007 2022
51 Section 2. This act shall take effect October 1, 2022.
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OMMU Presentation
FLORIDA DEPARTMENT OF HEALTH
Office of Medical
Marijuana Use
Program Update
Florida House of Representatives
Professions & Public Health Subcommittee
January 13, 2022
Christopher Ferguson, Director
Office of Medical Marijuana Use
1
Program Overview
• The Office of Medical Marijuana Use (OMMU):
• Develops and implements the Department of Health’s rules for medical marijuana.
• Oversees the statewide Medical Marijuana Use Registry (MMUR).
• Licenses Florida businesses to cultivate, process and dispense medical marijuana to
qualified patients.
• Certifies marijuana testing laboratories to ensure the health and safety of the public as it
relates to marijuana.
• There are currently 22 licensed medical marijuana treatment centers (MMTCs), 21 of which
have received authorization at all three stages to dispense to qualified patients.
• Additionally, the OMMU has approved nine certified marijuana testing laboratories (CMTLs).
2
OMMU Organization
Director’s
Office
Compliance and
Operations Unit
Licensing Unit
3
Operations Unit:
Highlights
4
MMUR: Recent Enhancements
• Some recent enhancements to the MMUR include:
• Addition of the ability for MMTCs to select marijuana delivery devices as an option for
dispensation.
• Addition of marijuana in form for smoking and edibles as permissible routes of
administration.
• Application Programming Interface (API) integration to permit single-entry automation by
MMTCs.
• Creation of a physician certification documentation dashboard allowing physicians to
submit required documentation directly in the MMUR.
• Integration with the Department of Highway Safety and Motor Vehicles (DHSMV)
identification (ID) card photograph and demographic data.
5
MMUR: Next Steps
• Moving forward, the OMMU plans to implement:
• Continued integration of the MMUR with other OMMU systems to improve business
processes and increase efficiency.
• Continued upgrades to accommodate growth.
• Improved reporting infrastructure to allow for better reporting capabilities.
• Same-day approval of MMUR ID card applications when an ID card application is coupled
with DHSMV information.
6
MMUR ID Card Applications - Patients
700,000
657,196
629,495
600,000 558,711
500,000 470,562
400,000 373,592
301,336
300,000
200,000
100,000
0
2019 2020 2021 (as of 11/30/2021)
Patient Applications Received Patient Applications Approved
7
MMUR ID Card Application - Caregivers
10,000
8,846
9,000
8,369
8,100
8,000
7,000 6,826
6,434
6,000
4,933
5,000
4,000
3,000
2,000
1,000
0
2019 2020 2021 (as of 11/30/2021)
Caregiver Applications Received Caregiver Applications Approved
8
MMUR ID Card Application Processing Times
14
12
10
8
6
4
2
0
Initial Application Days to Initial Application Days to Renewal Application Days to Renewal Application Days to
Approval Print from Approval Approval Print from Approval
2019 11 9 12 9
2020 11 8 12 8
2021 (as of 12/01/2021) 6 4 7 3
9
Active Patients
700,000
645,687
600,000
500,000
455,425
400,000
288,709
300,000
200,000
100,000
0
2019 2020 2021 (as of 12/01/2021)
2019 2020 2021 (as of 12/01/2021)
10
Active Caregivers
10,000
9,000 8,605
8,000
7,000 6,510
6,000
5,000 4,688
4,000
3,000
2,000
1,000
0
2019 2020 2021 (as of 12/01/2021)
2019 2020 2021 (as of 12/01/2021)
11
Qualified Physicians and Physician Certifications
October 1, 2018 – October 1, 2019 – October 1, 2020 –
September 30, September 30, September 30,
2019 2020 2021
Certifications 460,469 664,779 975,267
Qualified Physicians
1,487 1,625 1,684
with Certifications
All Qualified
2,556 2,700 2,563
Physicians
Data source: Physician Certification Pattern Review Panel 2022 Annual Report, https://flboardofmedicine.gov/pdfs/012022-PCPR-PanelAR.pdf.
12
Call Center
Number of Calls Received
300,000
266,797
• The OMMU recently installed the Avaya
245,735
Phone System which: 250,000 Implementation of
DHSMV Integration
• Creates phone queues to facilitate
agent-caller communication. 200,000
• Enables OMMU call team to better track 168,429
and log incoming calls. 150,000
• Creates a more robust interactive voice
response (IVR) providing information 100,000
that reduces the dependency level of a
caller speaking to an agent.
50,000
0
2019 2020 2021 (as of
11/30/2021)
Number of Calls Received
13
Compliance Licensing Enforcement and Regulatory
(CLEAR) System
In June 2020, the OMMU implemented In August 2020, the OMMU began Phase 2 of
CLEAR. the CLEAR implementation.
14
Florida Administrative Code and Register Rules
Since January 2019, the OMMU has:
Adopted 36 Adopted 9 Filed 13 Notices of
Emergency Rules Nonemergency Rule Development
Rules for 28 Rules
Filed 4 Notices of Held 3 Rules
Proposed Rule for Workshops
7 Rules
15
MMTC Application Rules
• The OMMU recently adopted the following emergency rules:
• 64ER21-16, Application for Pigford/Black Farmers Litigation (BFL) MMTC Licensure,
effective October 13, 2021.
• 64ER21-19, Application Window for the Pigford/BFL Batching Cycle, effective
December 1, 2021.
• The OMMU is moving forward with administrative rulemaking to establish an application
process for non-Pigford/BFL applicants. The OMMU will publish any application rule and date
the OMMU will begin accepting applications in the Florida Administrative Register.
• Based on statutory requirements, the OMMU will award up to 19 MMTC licenses.
16
Compliance and
Licensing Unit:
Highlights
17
450
400
350
300
250
Facilities 200
150
100
50
0
Cultivation Dispensing Fulfillment and Processing
Facility Facility Storage Facility Facility
2019 21 200 9 13
2020 27 290 12 21
2021 (as of 12/01/2021) 38 384 13 30
18
Inspections
1,400
1,202
1,200
1,000
800
600
400 342
200
0
2020 2021 (as of 12/01/2021)
19
1000
900
800
700
600
Variance Cases
500
400
300
200
100
0
Number of Variance Average Processing Estimated Variances
Cases Time in Days Per Month
2019 606 47 51
2020 823 27 69
2021 (as of 12/01/2021) 905 21 82
20
MMTC Product Offerings
Range in Potency
Count of
Tetrahydrocannabinol (THC) Content as a Percent of
Product Types Processed Products to
Volume
Market
Lower Threshold Upper Threshold
Balm 6 0.4% 0.9%
Body Oil 18 0.7% 1.2%
Capsule 67 0.5% 3.0%
Concentrate 72 63.0% 90.0%
Flower Cup 17 15.0% 28.0%
Inhaled (Crumble) 13 80.0% 90.0%
Inhaled (Diamond) 1 67.0% 89.0%
Inhaled (Rosin) 10 80.0% 90.0%
Inhaled (RSO) 18 60.0% 90.0%
Inhaled (Sauce) 3 80.0% 90.0%
Inhaled (Shatter) 17 80.0% 90.0%
Inhaled (Wax) 4 80.0% 90.0%
Inhaler 3 60.0% 87.0%
Kief 9 70.0% 85.0%
Lotion 24 0.3% 0.8%
Oil (Tincture) 108 1.3% 4.0%
Powder 3 95.0% 100.0%
Pre-roll 30 15.0% 28.0%
Resin 5 80.0% 90.0%
Suppository 9 1.3% 3.0%
Transdermal Patch 18 11.1% 90.0%
Vaporizer Cartridge 216 60.0% 87.0%
Vaporizer Disposable 20 75.0% 87.0%
Whole Flower 210 10.0% 28.0%
A multi-serving edible may not contain more than 200 mg of THC, and a
single-serving edible, or a single serving portion of a multi-serving edible, 21
Edibles 145 may not exceed 10 mg of THC.
Thank you
Contact Information
Mailing Address: Phone: 850-245-4657
Office of Medical Marijuana Use FAX : 850-487-7046
4052 Bald Cypress Way, Bin M-01 Email: MedicalMarijuanaUse@flhealth.gov
Tallahassee, FL 32399 Website: www.knowthefactsmmj.com
22
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